Friday, October 25, 2013

October Patient of the Month- Baby!!!!

About five months ago, Baby’s mom noticed a painful swelling in her right front leg and brought her in for an exam. Dr. Murphy discovered a mass on Baby’s right forearm just below the elbow and obtained a sample. The mass was determined to be a Mast Cell Tumor (MCT); which can be a very aggressive form of cancer. They are best treated by removing the mass with very wide margins ( 3cm in all directions). Because of the location of Baby’s MCT the only way to get that type of clean margin was to amputate Baby’s entire right front leg.

Because Baby was a 12 year old dog (but a spry 12 year old), the decision to remove her whole leg did not come easily to her parents. The possibility of a good quality of life with only three legs was discussed. Finally, because of Baby’s clear and progressively worsening pain, they moved forward with the surgery and removed her front leg. Immediately after surgery, Baby felt better and her lighter load only encouraged her playful behavior

Her recovery was long due to complications with healing. She and her family became frequent visitors to HAH as she healed. Throughout her treatment she was a joyful pet and a wonderful patient to work with.

Mast cell tumors are graded from 1 to 3, with grade 3 being the most aggressive. Grade 3 mast cells grow very quickly and usually spread microscopically to other parts of the body by the time the initial tumor is diagnosed.  Unfortunately, the pathology done on the tissue submitted after her leg was amputated showed that Baby had a grade 3 MCT.  Earlier this month her aggressive cancer spread despite surgery, and Baby passed away at home with her family. Her family never regretted their decision to remover her leg as she was able to spend three more happy months with them. She also became a cherished visitor here at the HAH.   

This month we remember Baby Gillman as our October Patient of the Month! She holds a special place in the hearts of her family both at home and at the HAH.

She was a happy girl!!!

Thursday, October 24, 2013

Heartworm Diagnosis

Dogs and cats that do not receive monthly heartworm prevention are at increased risk. Dogs and cats may be heartworm infested and not show clinical signs. In dogs the most common clinical signs include coughing, exercise intolerance, acute respiratory distress and collapse. Cats are less likely to show clinical signs, but when they do, coughing, difficulty breathing, vomiting and lethargy are commonly observed.
Dr. Leo Londono D.V.M.- HAH
University of Florida

Anxiety and Your Pet

Cats and dogs are creatures of habit, much like their owners.  Anxiety can be brought on by the introduction of new members to a family (four legged or two legged), hectic and changing owner schedules, moving house, loud noises (e.g. thunderstorm/fireworks), lack of stimulation, separation anxiety, as well as illness, discomfort, or disease.  Before trying to modify your pets’ behavior, take them to the vet and ensure that they are healthy and not stressed due to pain or illness.  After ruling out a physiological reason for your pets’ anxiety, behavior modification techniques can be implemented.  These can be as simple as creating a more regimented everyday schedule for your pet or positive reinforcement with small healthy treats. Behavior modification techniques are the cornerstone in treating anxious pets however they can be used in conjunction with psychopharmacology or behavioral medication.  Talking with your veterinarian or an animal behavior specialist about the unwanted behavior your pet is exhibiting is the best first step in figuring out the reason for their anxiety and the correct way to manage it. 
Lauren Diamant D.V.M.- HAH
University College of Dublin Ireland

Canine Bloat

Gastric Dilation Volvulus (AKA:Bloat, gastric torsion, GDV). Large, deep-chested dogs are predisposed to this condition where the stomach rotates around itself. Risk factors associated with this condition include stress, once a day feeding, dogs that eat too fast and/or exercise after eating.

The signs of bloat include abdominal distention, abdominal pain, salivation, retching and/or vomiting. If your dog shows these clinical signs, immediate veterinary intervention is necessary and surgery to return the stomach to a normal position.

Dr. Leo Londono D.V.M.- HAH
University of Florida 

Potty training

There is nothing more exhilarating then to bring that wriggling little ball of fur home after making that life changing decision to become a pet owner.  The excitement of being a puppy/kitten parent may slowly wane as you begin to realize that you are now faced with the task of teaching it where and when it is acceptable to use the potty.  Kittens are usually much easier to train as they often instinctively know to eliminate in a clean well placed litter box once they are shown its location.  Puppies on the other hand are a whole different kettle of fish to stew.  Puppies do not make the association to eliminate in any specific place without repetitive consistent positive reinforcement and this requires a good deal of time and patience from an owner.  The following are a few simple tips to help you start training your puppy:

  1. Designate a potty place outside/in the grass that is isolated from other dogs and animals.
  2. Use a word or phrase to help your pet associate using the potty in the correct place at the correct time  e.g. “pee-pees” or “potty-potty”.
  3. ONLY use positive reinforcement to help train your animal to use the appropriate place to eliminate—always have a healthy treat to give your pet immediately after they eliminate.  Punishment is confusing to the puppy and can create many other problems including fear and aggression issues.
  4. Take your puppy out to use the potty frequently when you are home (i.e. 1-2 times an hour).  Puppies need to urinate and defecate more often then adults and are in the process of developing control over these eliminations.
  5. When not at home, leave some newspaper out for the puppy to eliminate on.  Also be aware that 6-8 hours is a very long time for a puppy to have to hold its bodily functions without a break and it is not a realistic expectation for you to have of them.
 Other then that, have patience and lots of fun with your furry new family members!

Dr. Lauren Diamant D.V.M.- HAH
University College of Dublin Ireland

Dr. Jodi Heim on Kennel Cough

Kennel cough is a bacterial infection in the respiratory tract.  It causes bronchitis, with a harsh, dry cough.  Rarely, it can lead to pneumonia.  It is called “kennel cough” due to the highly contagious nature in dogs housed in close quarters.  Often dogs are affected after being adopted from a shelter or being boarded at a kennel.  Uncomplicated cases of kennel cough respond very well to antibiotic treatment.  There is a high risk for the other dogs in the household to get the infection as well so they should be closely monitored and separated if possible.  Dogs in contact with other dogs (dog park, Petsmart, boarding, day care) should be vaccinated yearly to help prevent infection.

Dr. Jodi Heim, D.V.M. - HAH 
Tufts University, 2011

Blocked Cats- Urethral Obstruction

Cats with the inability to urinate (urethral obstruction) need to be seen by a doctor immediately as it is a life-threatening emergency.  Symptoms include straining to urinate with no urine production, crying, lethargy, anorexia, and hiding.  They may be dribbling urine and sometimes blood is seen in the urine.  Urethral obstruction is most often seen in middle aged male cats although any cat can develop this problem.  There are many causes of the obstruction including urinary stones, cancer, and infection although often no cause is found.  The obstruction causes life-threatening electrolyte abnormalities so seek medical attention immediately if you suspect your cat is unable to urinate.  Treatment involves passing a catheter to relieve the blockage, correcting electrolyte abnormalities and dehydration, and addressing any underlying problem.  Long-term management is crucial in preventing further episodes.

Dr. Jodi Heim, D.V.M.-HAH 
Tufts University, 2011

Hot Spots in Canines

A hot spot, or moist dermatitis, is a bacterial skin infection most often caused by licking, bathing, or swimming.  Long or dense fur breeds like golden retrievers and German Shepherds are often afflicted with this problem.  Other factors that are involved may be hot/humid weather, fleas, or allergies.  The spots are often on the neck, face and thigh.  The area is matted with fur, red, and is very moist.  Often the lesion is more extensive than originally anticipated until the fur can be shaved and the true extent can be visualized.   The condition is very itchy and painful and should be treated immediately.  Treatment involves shaving the fur, cleaning and drying the area, antibiotics and topical medications.  More severe cases may require steroids as well.  Dogs may require a collar to prevent them from licking the area while it heals.

Jodi Heim, D.V.M.-HAH 
Tufts University 2011

Bufo Toad Toxicity

Anyone who has lived in South Florida long enough has at some point come across the infamous Bufo Toad.  These short legged stocky critters have a pair of parotid glands behind each eye which secrete a toxic white substance.  Most intoxication occurs when curious dogs lick or bite into the toads distributing the toxin on to their gums. Almost immediately dogs will begin to produce a copious amount of saliva and foam at the mouth.  If pets are found at this point of the intoxication it is recommended that owners clean out their pets mouth with cool water and a wash cloth, making sure not to direct the water at the back of the mouth.  In many situations no further symptoms are seen and no further treatments are needed.  However in severe intoxications pets may begin to seizure and require immediate medical attention to prevent progression of disease.  This toxin is very fast acting and most clinical signs are seen within 20-40 minutes of exposure, if no signs are present after 1 hour of exposure it is less likely that pets will be affected.  If you have any questions or concerns about your pet being exposed to a Bufo Toad, contact your local veterinarian or the Hollywood Animal Hospital any time.    

Dr. Carlos Ameijeiras , D.V.M.- HAH 
Mississippi State, 2011

Fatty Liver Disease in Cats

Feline hepatic lipidosis, also known as "fatty liver" is a disease that affects cats. Most cats that suffer from this condition are middle-aged and overweight or obese but any cat can be affected. Other risk factors include stressful events such as surgery, a change in diet, or not eating/drinking (anorexia). The first signs owners might notice include inappetance or anorexia for a long period of time (sometimes up to several weeks), weight loss, vomiting and lethargy. Other signs that may occur include diarrhea, constipation and weakness. Any of these signs warrant examination by a veterinarian. Upon examination, physical findings include dehydration, icterus (yellow mucous membranes), an unkept appearance, muscle wasting and a large liver. Cats are predisposed to getting fatty liver because they have higher nutritional requirements for protein and other important acids in the body. Triglycerides, a form of fat found in the blood accumulates in the liver of cats with hepatic lipidosis. Your veterinarian will need to perform blood tests, an x-ray of the abdomen and possibly even an ultrasound if he/she suspects this disease is present. To make a definitive diagnosis a biopsy of the liver is needed. The main treatment for cats with fatty liver includes stabilization and nutritional support with a balanced, high protein diet. This usually requires a feeding tube. Other treatments include correction of dehydration with intravenous fluids, anti-vomiting medications, and vitamin supplementation. Without supportive care the prognosis for this condition is poor.

 Maggie Low, D.V.M- HAH
University of Florida, 2012

Personal interview with our Dr. Jon by

My father, Dr. C. E. Dee and My uncle, Dr. I. C. Frederickson formed the original Hollywood Animal Hospital (HAH) in 1947 as a small family-run hospital. Since 1950 the hospital has been a Certified Member Hospital of the AAHA. In 1978, the practice moved to the current hospital building, and the adjacent Outpatient Clinic was built in 1996. A 2010 expansion of the hospital brought the square footage up to 20,000. Today, HAH is a large state-of-the art, 24/7 major regional referral centre that is owned and managed by Jon, Larry & James Dee in conjunction with two equal partners, James Herrington and Tommy Sessa (all veterinarians).

My father was the ultimate role model: graduating at the top of his class from Iowa State’s College of Veterinary Medicine while playing guard and captain of the football team; served as veterinary consultant to the Surgeon General’s office with the rank of Brigadier General; served as state veterinarian for the Florida Racing Commission; served as gubernatorial appointee to Florida’s State Board on Veterinary Medicine for 24 years and as president of that group for many years. Lucille, my mother was every bit as influential (Dad died in 1996) to her sons and HAH. To this day, at the ripe young age of 95, she drives herself to work 5 days a week and is the unquestioned hospital matriarch and bookkeeper in conjunction with my sister Barbara (a retired human intensive care nurse). At the suggestion of brother David (an environmental law attorney) the siblings established a $100.000 scholarship in our parents’ names for University of Florida veterinary students.

Brother Larry has been very actively involved in organized veterinary medicine on the state, national and international level for more than 30 years, including president of FVMA, AAHA, WSAVA, ABVP and is currently a candidate for AVMA president-elect. He is a boarded by examination member of ABVP. Brother James is our Chief Financial Officer. In addition, he is one of the founding members of VMG1. Veterinary Management Group 1 was the first of the present 23 VMGs. These groups are under the auspices of VSG, Veterinary Study Groups, of which he has been secretary since its conception. Presently VSG provides management assistance to practices in small animal medicine, feline medicine, emergency medicine, specialty practice, mixed practice, equine practice and a group made up of University practitioners. VMG continues to grow and presently services over 600 practices.

The family has been very fortunate in that each of the veterinary brothers have focused on different opportunities within the profession. Those opportunities have led me to become a boarded surgeon, researcher, author and lecturer. Larry’s focus has been on internal medicine, surgery and organized veterinary medicine, while James has focused on practice management. These opportunities have allowed us to go across the country and around the globe. It would have been exceedingly difficult without the efforts of our boarded partners and associates. The practice currently consists of 22 doctors with a total staff of 129 members.

G.S-S. How, in your family practice did you ‘get the job’ or ‘assume the role’ of being the orthopaedic Surgeon?

Primarily by default I think. In orthopedics in general and especially orthopedics in the elite athlete it is very difficult for you and others to ignore your shortcomings. Hence, you need to seriously improve. In 1967 after having finished a general internship at Washington State I began working with Robert Knowles (a charter diplomate of ACVS) in Miami for two years. I needed an additional source of income to attend the many continuing education courses needed to fill the educational “gaps”. Working days, on call every other night and every other Sunday at the hospital, I was able to take a part time job at the local dog tracks on the off days/nights as either the state/track veterinarian. My father and uncle had raised greyhounds when I was a boy and I had worked as a trainer one summer in Colorado before entering veterinary school at Auburn. So I knew the life style and could ‘walk the walk and talk the talk”.

The following several years were spent in the family practice at HAH before leaving for Colorado State to obtain a masters’ in surgery in 1974. I’ve always had an interest in surgery in general and orthopedics in particular. However my combined 70+ graduate credits (from WSU & CSU) revolved around veterinary and human soft tissue surgery, ophthalmology and radiology. But, I had a strong surgical/scientific base and very little current information was documented/published about injuries in the elite canine athlete in this golden age of greyhound racing. My first relevant paper was in 1976 ACVS boards were achieved in 1977.

One day Bruce Hohn from Ohio State was visiting HAH and commented “Jon you have more of these cases than anyone in the world, could you present these at the AO course in Ohio”? Hence the snowball began to roll and 25+ years later as an AO lecturer, 40+ (publications, book chapters), lectures, a textbook on Canine Sports Medicine & Surgery and charter diplomate status in the American College of Sports Medicine and Rehabilitation, the rest is history.

G.S-S. I’m aware that you perform most orthopaedic operations and that you have become particularly well known for your work on the lower limbs of dogs and cats. Though you have operated upon a lot of Greyhounds, please describe the difficulties that you may have encountered when you carried that work into other breeds and other species.

No difficulties were encountered in the transition from Greyhounds to other breeds. You learned from the pristine anatomy of the Greyhound and your soft tissue techniques were refined in dealing with the thin skin and associated low fat index. Your physical exams were more precise because of the stellar anatomy and definition of structures in the Greyhound. As an elite athlete the definition of success was at a higher plateau. i.e. walking without a limb was not good enough. Success is defined by wins as second place is not good enough.

A lot of Greyhound surgery involves intra-articular repair of very small bones. These small bones are infrequently injured in the general population, but the same techniques apply to their “smaller bones”

G.S-S. In any of the above m├ętier, did any individuals become your mentors; individuals who have had a significant effects upon your career?

ABSOLUTELY! The two most influential individuals on my career were my father/mother and W.F. “Bill” Jackson. My father/mother were always “there for me” and Bill ignited my enthusiasm for continuous learning more than any other individual. Then there is a long list of significant others along the way: Ben Horelein, Bill Magrane, Wade Brinker, Don Piermattei, Glen Severin, Jacques Jenny, Jack Alexander, Howard Rosen, Dick Rudy, Bruce Hohn, Bill Whittick, Bill DeHoff and Barclay & Theresa Slocum. And because it is “still fun” one has the opportunity to be stimulated by some of the young lions such as: John Dyce, Noel Fitzpatrick, Antonio Pozzi, Massimo Petazzoni and of course my friend Aldo Vezzoni.
G.S-S. You were born into a family that has a long history in the profession. Please tell readers about that history and also how the family practice developed into an internationally known Animal Hospital?

October Team Member of the Month- Thomas!!!

Many of our clients are first introduced to the HAH by way of our emergency staff. Yet, during our busy daytime hours that team is rarely seen or recognized. However, the fact is, a huge part of our success is dependent on the quality, 24 hour care we offer and it is our night crew that makes this possible.

This month we would like to recognize as Team Member of the Month our Emergency Crew Supervisor, Thomas!! Thomas has been with the HAH for 13 years and has earned great respect from our staff and doctors over that time.  He has hired and trained the incredible team that we count on to care for our patients and assists our doctors with emergencies throughout the night.

He has been describes by staff as a big teddy bear that always tries to see the positive side of situations and manages to get his point across to the staff without offending anyone.

Thomas is the glue that holds our overnight crew together and we could not be more appreciative and grateful to have him on our team!!