Tag: Lincoln Road Veterinary Clinic

Visiting the Vet – Ruby’s Urine Culture

At last we have the details.

On September 1st, I published an update on Ruby’s condition with regard to her UTI. This was because Ruby had had a re-occurrence of blood in her urine. Dr. Jim took an xray and also wanted Ruby’s urine sent across to Three Rivers Hospital for a culture. As I explained in that post, using information found online:

A urine culture is a test to find germs (such as bacteria) in the urine that can cause an infection. Urine in the bladder is normally sterile. This means it does not contain any bacteria or other organisms (such as fungi). But bacteria can enter the urethra and cause a urinary tract infection (UTI).

A sample of urine is added to a substance that promotes the growth of germs. If no germs grow, the culture is negative. If germs grow, the culture is positive. The type of germ may be identified using a microscope or chemical tests. Sometimes other tests are done to find the right medicine for treating the infection. This is called sensitivity testing.

Late on Tuesday afternoon, the Clinic rang to say that the full results were in.

So yesterday morning, the air still heavy with the smoke from the forest fires, we called in to Lincoln Road.

The report from Rogue Regional Medical Center, as in Three Rivers Hospital, offered the following:

VET URINE CULTURE

SPECIMEN SOURCE: URINE

COMMENTS TO MICRO: URINE

CULTURE RESULTS: 20,000 CFU/ML PROTEUS MIRABILIS

REPORT STATUS: FINAL 09/02/2017

(My emphasis)

That translated into Ruby’s medicine being changed from her present course of Amoxicillin antibiotic to Enrofloxacin (Two 136 mg tablets by mouth every 24 hours for 10 days.)

A quick web search produced this (in part):

Enrofloxacin (ENR) is a fluoroquinolone antibiotic sold by the Bayer Corporation under the trade name Baytril. Enrofloxacin is currently approved by the FDA for the treatment of individual pets and domestic animals in the United States.

Jeannie reading the details on the label.

Onwards and upwards!

Visiting the Vet – More on Ruby

A need to re-check Ruby.

On Tuesday the Visiting the Vet post was about our Ruby. As was explained in the early part of that post:

Back on the 11th August Jean and I took Ruby into Lincoln Road Vet because there was blood in her urine. Ruby is one of our six dogs that we have at home. Ruby is the last of the Mexican ex-rescue dogs and is an eleven-year old Sharpei mix.

Dr Jim thought that Ruby had a straightforward Urinary Tract Infection (UTI) and that a course of antibiotic would fix that.

All of that was reported in my previous post and, indeed, it did look as though it was all resolved.

Then on Tuesday night we discovered a pee in the house that had blood in it. Repeated yesterday. Although we hadn’t caught Ruby in the act, so to speak, we were pretty sure that it was her with the blood in her urine (again).

So yesterday morning back we went to Lincoln Road Vet Clinic to be seen by Dr. Jim.

Jim and his assistant, Cianna, first took Ruby through to a lab at the back of the clinic to take an X-ray and draw some of Ruby’s urine directly from her bladder.

That urine was going to be cultured by Three Rivers Hospital in Grants Pass for that was the only reliable way of seeing what might be the cause of the infection. A quick web search found more information about a urine culture:

A urine culture is a test to find germs (such as bacteria) in the urine that can cause an infection. Urine in the bladder is normally sterile. This means it does not contain any bacteria or other organisms (such as fungi). But bacteria can enter the urethra and cause a urinary tract infection (UTI).

A sample of urine is added to a substance that promotes the growth of germs. If no germs grow, the culture is negative. If germs grow, the culture is positive. The type of germ may be identified using a microscope or chemical tests. Sometimes other tests are done to find the right medicine for treating the infection. This is called sensitivity testing.

In no time at all the images from the X-ray were available to be viewed.

Jim was delighted to report that there was no sign of stones or a tumor. Ruby is an eleven-year old dog and what Jim did see on the X-ray was ‘bridging’ along parts of Ruby’s spine. The technical term for this is spondylosis and, again, a quick web search found more:

Spondylosis in dogs, also called spondylosis deformans, is a degenerative condition that usually occurs most along the spine in older dogs. There, degenerative disks cause bone spurs to develop. These bone spurs can form bridges from one vertebrae to the next, limiting flexibility and range of motion.
Most cases of spondylosis require minor pain relief, and dogs can live out healthy, comfortable lives with this condition.

It’s not a very good image but here is an enlargement of that first X-ray picture (or rather my photograph of same) showing that bridging.

Jim offered some general information regarding idiopathic cystitis that is more commonly seen in female cats but can also be seen in dogs. In cats the cause is more likely to be stress but in dogs the more likely cause is an infection; as in a UTI. In both cats and dogs the signs are frequent peeing but cats are more likely to incur some pain when urinating compared to dogs.

Back to Ruby.

The second X-ray image (below) did nothing to change Jim’s mind that Ruby might have a UTI that requires a change of antibiotic to accurately combat the infection.

While waiting for the results of the urine culture, Jim recommended putting Ruby on a second course of Amoxicillin.

When we get those results I will add the details to this post.

Visiting the Vet – Ruby’s UTI

This one is closer to home!

Back on the 11th August Jean and I took Ruby into Lincoln Road Vet because there was blood in her urine. Ruby is one of our six dogs that we have at home. Ruby is the last of the Mexican ex-rescue dogs and is an eleven-year old Sharpei mix.

Here she is staring up at me to the right of Oliver in the picture below .

In clockwise order: Oliver; Sweeny; Ruby; Pedy.

Because of Ruby’s age and background and the fact that there was significant blood in her urine we were bracing ourselves for some bad news.

Once checked in it wasn’t too long a wait before we were shown in to Dr. Jim’s room.

There Jim took some urine for analysis and then started examining Ruby. Jim was worried that Ruby might have kidney stones.

However, and thankfully, the urine test revealed an infection, nothing worse! A urinary tract infection or UTI.

Therefore, the first move would be to start Ruby on a course of Amoxillin.

Jim explained that Amoxillin was an antibiotic that he thought would be good for Ruby and would quickly determine whether or not Ruby had a simple urinary tract infection (UTI) or if it was something more challenging (my words).

Wikipedia offers a good description of Amoxicillin, from which I offer the opening paragraph.

Amoxicillin, also spelled amoxycillin, is an antibiotic useful for the treatment of a number of bacterial infections.[2] It is the first line treatment for middle ear infections. It may also be used for strep throat, pneumonia, skin infections, and urinary tract infections among others.[2] It is taken by mouth, or less commonly by injection.[2][3]

Maybe my initial reluctance to publish this Visiting the Vet post was down to me not wanting to do that before the results of the antibiotic treatment were clear.

Ergo, Jean and I are overjoyed to report that the Amoxicillin course did sort everything out and that Ruby is over her UTI and back to being her normal, healthy, happy self.

When Jim called us at home a week later he was just as pleased to hear the good news!

Visiting the Vet – Jefferson’s heart!

Welcome to August!

July 13th. 11:00 The second case that I sat in on was Linda bringing in Jefferson.

Jefferson is an eight-year-old long-haired male Dachshund. Linda had decided to bring her dog into Lincoln Road because recently Jefferson had started coughing but only when he was pulling on his leash.

Linda added that Jefferson seemed to be chewing on a number of pine cones just now.

Jim examined Jefferson. First examining the dog’s lymph node and then listening to either side of the dog’s chest.

While everything sounded fine on Jefferson’s right side, Jim detected a very small heart murmur when listening to Jefferson’s left side.

Jim also noted that the lymph node was prominent but not enlarged. Dogs can get lymphoma.

Nothing arose to give cause for concern but in view of the chewing of pine cones, Jim thought that giving Jefferson an injection of ‘Lepto’ would be no bad thing.

11:20 All done!

I subsequently did a web search on ‘Lepto’ and came across this on the Vetstreet website: (in part)

It’s scary to think that a fun stroll through the woods or swim in a favorite watering hole can lead to a terrible illness, but it can –– for you as well as your dog. Leptospirosis is caused by a bacteria spread through soil, water, and the urine of infected animals, and if not caught early it can be deadly. There is a vaccine available for the most common subtypes of the bacteria that infect dogs, but it’s not always a recommended part of the routine vaccination protocol. Ask your veterinarian if the leptospirosis vaccine is right for your dog.

Overview

Leptospirosis is a potentially serious disease caused by the bacterium Leptospira interrogans. It affects dogs but can also infect a wide variety of domestic and wild animals as well as humans.

The organism is usually spread through infected urine, but contaminated water or soil, reproductive secretions, and even consumption of infected tissues can also transmit the infection. Introduction of the organism through skin wounds can also occur. Common carriers of the organism include raccoons, opossums, rodents, skunks, and dogs.

To be continued:

(Please note: These observations are mine alone and because of the busy environment it must be assumed that my interpretation of what was taking place might not be totally accurate. Nothing in this blog post should be used by a reader to make any medical judgment about an animal. If you have any concern about an animal do make an appointment to see a properly qualified veterinarian doctor.)

Visiting the Vet – Hyperthyroidism

Lady Jessica isn’t feeling too well.

09:50 July 13th, 2017.

Jessica Louise is a 14-year-old cat that normally lives happily outside. But in recent times ‘Jessie’ has become very thin despite constantly eating and has now preferred to be inside the home even accounting for the fact of there being dogs in the house.

Jim’s pretty certain that he is looking at a cat with a hyperthyroid thyroid gland. No question that a blood test is needed and the blood sample is taken without delay.

The results are soon back and confirm that Jessie’s T4 readings of >8.00 mg/dL are very high, indeed beyond the upper limit of their testing equipment. Jim explains that the normal range for T4 is between 0.80 – 4.70 mg/dL.

The puzzled look on my face is seen by Jim and he takes a few minutes out to explain what a blood test accomplishes.

There are three parts to the blood test:

  1. The Complete Blood Count (CBC), that is the cellular part of the test.
  2. The chemistry of the blood, measuring the condition of the kidneys, liver, electrolytes, diabetic status as in blood glucose level, and more.
  3. The optional Part, a test for T4 Total Thyroxine level.

A very quick web search found this from which one reads:

Your dog or cat’s T4 (Total T4) is a useful screening test to detect an under-active thyroid gland (hypothyroidism) in dogs or an over-active one (hyperthyroidism) in cats. But total T4 levels are a considerably more accurate way to diagnose an overly active thyroid gland in your cat than an under-active thyroid gland in your dog.

Jim prescribes Methimazole. Once again, back at my desk a quick web search for Methimazole For Cats finds:

What is Methimazole?

Methimazole is used to treat hyperthyroidism in cats. It has largely replaced propylthiouracil in this treatment process since it has a lower incidence of adverse side effects. Methimazole requires a prescription from your veterinarian, and is sold per tablet.

(This is only one of many products found online!)

Jim weighs Jessie and finds that she is 4lbs 12 oz. Her weight should be in excess of 8 lbs.

The clinic protocol is that Jessie should not be seen until at least 45 days has elapsed. But Dr. Jim underlines that Jessie should be brought back in to the clinic before then if there is no weight gain soon or, especially, if Jessie continues to lose weight.

10:05 All done.

To be continued:

(Please note: These observations are mine alone and because of the busy environment it must be assumed that my interpretation of what was taking place might not be totally accurate. Nothing in this blog post should be used by a reader to make any medical judgment about an animal. If you have any concern about an animal do make an appointment to see a properly qualified veterinarian doctor.)

ooooo

Good people, may I ask for your assistance.

Best explained by sharing part of a recent email sent to Yvonne D. who has offered her help with my book project. In past times, Yvonne was a Veterinary Technician.

Dear Yvonne,

My Visiting the Vet theme on Learning from Dogs has awakened within me the interest and passion to write my second book. Or, to put it more accurately, to switch away from the present theme that I have been struggling to get stuck into for months.

I spoke with Russel Codd at the clinic and he is really keen to support me.

The overall idea that is forming in my mind is to write a book that alternates, chapter by chapter, between observing the medical and clinical goings-on at a number of vet clinics in town, including specialist processes, surgery, cardiac, etc., and chapters that look deeply into the many different relationships that individuals have with their pets; primarily with dogs and cats.

I want to get into the ‘mindset’ of people who have pets in their lives across the whole range of feelings of those said people. From those who love their pets practically without any limit, to the homeless people (almost 100% men) whom one sees with a dog or two in tow alongside the highway. But also exploring those who seem so hateful. E.g. our pet sitter knows a man who threw his elderly dog away in some local woods. What causes someone to be like this? I want to find out!!

The book will be called: Of Pets, and Of People.

With very kind wishes,

Paul

Copyright (c) 2017 Paul Handover

Any feedback at all would be fabulous! What would you like to see in such a book? What would you most definitely not want to read?

Visiting the Vet – Updates

How this theme is taking shape!

But first, let me offer an update and a correction.

In my first report, published on June 28th, the very first patient for Dr. Jim was Ginger.Here’s an extract from that report:

It was immediately clear to Jim when he listened to Ginger’s heart that it was racing; Jim thought at something like 200 beats per minute. Jim continued to check Ginger over although, as he told me later, he had an idea that Ginger’s medical problem was a cardiac issue. Jim arranged for Ginger to be given an X-ray as well as blood work.

A number of you wanted me to check on Ginger’s status. Jim said that in a follow-up call made by the clinic they were told that Ginger was doing well.

The second item is a correction. In the report that described Lynn bringing in a stray kitten that had terrible puss oozing from one eye, I wrote: “Moments later Jim has not only cleaned out all the puss but found and removed the cause of the infection that was behind the kitten’s eyeball.”

When I queried with Jim what was the cause of the infection, he said that there was nothing physical behind the eye but that the kitten had contracted a severe eye infection probably a viral infection. The kitten was also doing well.

So last Thursday, the 13th July, I returned to Lincoln Road, arriving at 09:45. My plan was to spend the morning with Jim and then the afternoon with Dr. Russel  Codd the owner of the clinic.

It was another wonderfully interesting day and I have sufficient material for the next two to three weeks.

This is Cooper, a male Jack Russell, being checked out by Dr. Russ.

Dr. Russ started the afternoon at 14:30 so there was a bit of a wait after Jim had finished his morning at 12:05. That prompted me to see if future sessions watching Dr. Russ at work could be morning ones.

In other words, I would go across to Lincoln Road on two mornings a month; one to spend with Dr. Jim and one with Dr. Russ. I have yet to speak to Russ about that but can’t envisage an issue.

What Russel Codd did say to me that afternoon was that he really supported this theme and that he might arrange for me to ‘shadow’ one or two specialists who work locally in Grants Pass.  Plus, I did venture the idea that maybe there was book potential and Russ was very happy with that possible development as well.

So Sue, there’s the answer to you writing last week: “Lots of information here perhaps for a second book?” Great suggestion! (Indeed, good people, I am giving the idea of turning this series into a book very careful thought and will ask for feedback from you in a subsequent post once I am clearer about the purpose and objectives of such a book.)

So the first of my reports from my visit on the 13th will be published either later this week or early next week.

Thank you, everyone, for your interest, suggestions and support. You really are a great group of readers!

Visiting the Vet – Transformations.

This is why some choose to become veterinary doctors.

Today I write about the last animal that Dr. Jim attended to from my morning at Lincoln Road on June 22nd. I have been blown away by the interest in this theme from so many of you. Thank you!

Indeed, today I am back at the clinic spending both the morning and some of the afternoon watching and recording.

My plan from now on, subject to Dr. Codd supporting the idea, is to spend time at the clinic roughly one day a month. For in just the five or six hours of a day’s visit there is such a variety of events that it will provide more than enough material for me to present Visiting the Vet posts regularly each week during the following month.

OK! Now to the last patient that morning.

12:20

A woman carries in a stray kitten that had been found on the premises of a local scrap metal dealer.

The woman, Lynn, didn’t hesitate to bring the kitten to Lincoln Road because it had an infected right eye.

Jim takes some blood, in itself a bit of a challenge with such a young kitten, and looks more closely at the male kitten. He observes that the eye is most terribly infected with puss pouring out and Jim is of no doubt that the kitten had this eye infection since birth just a few weeks ago.

I come closer to take a photograph (the one above) and am in awe of the delicate way that Jim uses a tiny swab, Lynn holding the kitten for Jim, to clear the puss away from the eye. Moments later Jim has not only cleaned out all the puss but found and removed the cause of the infection that was behind the kitten’s eyeball.

12:40 The kitten sees with both eyes. What a transformation in just twenty minutes.

Jim looks up at Lynn: “Lynn, you do know you have saved his life!”

Lynn replies: “I didn’t really want another cat!”

Jim then gets some food for the kitten and gives it time to settle down.

Lynn and I chat and I am flattered to learn that Lynn has previously purchased a copy of my book. It can be such a small world at times!

12:30 All done. Lynn wraps the kitten back into the same towel that was used to bring it in to the clinic such a short time ago.

Thus ended my first experience of being behind the scenes of a busy vet practice.

The experience has profoundly affected me.

For as well as the astounding level of medical skill that I have observed it was also clear, as Jim put it, that he has to play counselor, psychotherapist, and even bartender. Why bartender? Because Jim quietly offers the observation that quite a few persons come in with their pets when they are the worse for drink! The owner that is not the animal!

Seriously though, let me offer what I concluded after just this one visit to Lincoln Road. That Jim and, I’m sure, Dr. Russ and many thousands of DVMs across the world, have many more demands on them than just being a good doctor.

They must display attention to detail and have an inquiring mind. They must be genuinely empathetic for the animal owner’s circumstances. But also good record keepers! Also they will have to endure a great deal of kneeling. Then, again, those knees have to be topped with a head that is jam-packed full of knowledge and experience to avoid jumping to incorrect conclusions. More subjectively, their emotions have to be kept under control for they frequently will see animals that have not been best cared for and, again all too frequently, they will have to end the life of a dear pet as gently and painlessly as is possible.

To be continued!

Visiting the Vet – Buffy & Chloe

Still it comes, one pet after another!

It’s 11:05

This is Buffy, a nine-year-old Dachshund crossed with a Terrier, who is drinking and peeing too much according to the lady who brought Buffy in to the clinic this morning. Adding that Buffy seems to be always hungry and quieter than normal.

Jim runs a blood test and not long after says that nothing has jumped out at him as a potential issue from Part One of the test results. (Apparently, the blood test comprised two parts – I will learn more in a subsequent visit to Lincoln Road.)

Buffy’s heart sounds good. Buffy has not lost weight.

Then Part Two of the blood test results reveal, thankfully, that Buffy is not diabetic, is not indicating Cushing’s Syndrome, and that Buffy’s kidneys are fine.

In other words, Buffy has the look of a healthy dog.

Has this all been a waste of time and money? Not at all, says Dr. Jim. This is the first time the clinic has seen Buffy and all the test results can now be logged providing a baseline of data for future reference purposes.

11:50 In comes Chloe.

Chloe has been vomiting up her food and, consequently, has stopped eating. Jim is concerned that Chloe is overweight and that in the very hot weather of recent days (high 90s F./mid 30s C.) he has been seeing a number of dogs with excessive heat problems.

One thing that could be done to Chloe was to clip her excessively long toe nails.

Jim does that.

12:15 All done.

To be continued:

(Please note: These observations are mine alone and because of the busy environment it must be assumed that my interpretation of what was taking place might not be totally accurate. Nothing in this blog post should be used by a reader to make any medical judgment about an animal. If you have any concern about an animal do make an appointment to see a properly qualified veterinarian doctor.)

Visiting the Vet – Kenya’s itch.

Practical ways of treating Kenya’s itchy skin.

10:45 Next along was Kenya and his ‘Mum’.

The story was that after a raw patch had appeared on Kenya’s back it had then become very itchy for the brave dog.

Jim shaved the area clear of fur and cleaned the skin to aid a closer examination.

Jim then explained that the challenge in these sorts of cases is that it is very easy to throw a lot of money at the problem without any guarantee of success.  Not only were there cost considerations but also the question of whether to go down the route of injections or administer pills.

As an observer I was struck, but not surprised knowing Jim as a friend, to see how an open and honest assessment of the problem came way before any commercial implications.

Jim’s view was to leave it for the time being but he did recommend using a hypoallergenic shampoo. There were a number to choose from but Jim supported the shampoo manufactured by Bayer and sold under the brand name of Hylyt Shampoo.

There are a number of online sources for this shampoo. I chose, more or less at random, the one at Allvet Supply.

That website describes the shampoo, thus:

HyLyt Shampoo is a hypoallergenic dog shampoo and is perfect for routine use in bathing dogs and cats. The shampoo is safe for normal, dry or sensitive skin types and may be used in conjunction with topical therapeutics.

HyLyt shampoo contains a light fragrance that will leave your pets smelling clean and fresh. The gentle shampoo formula is ideal for bathing both dogs and cats. The soap-free formula is pH balanced and will not dry out delicate skin or fur.

In addition to the gentle formula, HyLyt shampoo also contains special emollients for moisturizing and proteins for conditioning. The hypoallergenic dog shampoo also contains fatty acids to reduce scaling and flaking of the skin. If your pet suffers from seasonal or acute dryness, HyLyt shampoo will help restore their skin and coat to optimal health and beauty.

Then it was time for a quick checkup underneath Kenya, so to speak, and that was it!

11:00 All done!

I am having trouble getting my head around the fact that I have only been watching proceedings for two-and-a-half hours! So much knowledge on show. So much experience. So much compassion for our beloved pets!

To be continued:

(Please note: These observations are mine alone and because of the busy environment it must be assumed that my interpretation of what was taking place might not be totally accurate. Nothing in this blog post should be used by a reader to make any medical judgment about an animal. If you have any concern about an animal do make an appointment to see a properly qualified veterinarian doctor.)

Visiting the Vet – Hunt the Foxtail

Yet another interesting case for Dr. Jim.

As soon as it was time to say ‘goodbye’ to Ace the cat then in came an entirely different case.

1020 – Back to dogs!

This was Millie, a pit mix, who had been dropped off at the Clinic earlier on. Millie’s owner said that there appeared to be something troubling Millie’s ears. Millie was, indeed, shaking her head a great deal.

Jim established that it was Millie’s left ear that was the source of the irritation. This was immediately obvious since Millie cried as soon as Jim touched that left ear.

The first examination didn’t identify anything that might be the cause. But apparently the endoscope had such a narrow field of view that it was easy to miss an irritant. Time for another, more extensive examination using that same endoscope.

This time the problem was identified. A foxtail that had penetrated Millie’s ear so deeply that the seed-head had pierced Millie’s eardrum.

Carefully, oh so carefully, Jim pulled the foxtail out from Millie’s ear. I couldn’t believe just how large it was.

About an inch (2.5 cm) long.

I was unable to grab a photograph of Millie’s face once the foxtail had been removed. Trust me it was a face full of doggie smiles.

But I can’t move on to the next patient without remarking how Millie was so beautifully behaved. How maligned the Pitbull and Pitbull Mixes are!

10:45 All done with Millie!

To be continued:

(Please note: These observations are mine alone and because of the busy environment it must be assumed that my interpretation of what was taking place might not be totally accurate. Nothing in this blog post should be used by a reader to make any medical judgment about an animal. If you have any concern about an animal do make an appointment to see a properly qualified veterinarian doctor.)