Archive for the 'July 2011' Category

Happily ever after!

Friday, July 22nd, 2011

A week ago, I had a very busy weekend. On Saturday, Bunny came in for what was sup­posed to be an upper res­pi­ra­tory infec­tion.  How­ever, on phys­i­cal exam, the rab­bit had a very large urine filled blad­der that was dif­fi­cult to express. I was con­cerned the rab­bit could have a blad­der stone or sludge and accord­ing to the owner, Bunny had a his­tory of blad­der sludge that was pre­vi­ously treated. For those not famil­iar with blad­der sludge, this is a med­ical con­di­tion in which cal­cium salts build up in the uri­nary blad­der. Rab­bits are very effi­cient about absorb­ing cal­cium from the diet and the kid­neys fil­ter the excess out for excre­tion. Some rab­bits also have a genetic pre­dis­po­si­tion to this prob­lem as well (this is sus­pected in Bunny). The excret­ed­cal­cium will com­bine with other min­er­als and you end up with a clay like sub­stance that sits in the blad­der. This sed­i­ment, aka sludge, is so thick and irri­tat­ing that it can lead to blad­der inflam­ma­tion, dif­fi­culty to uri­nate, infec­tion, and cause the pet to not feel well. Radi­ographs (x-rays) con­firmed a diag­no­sis and I rec­om­mended med­ical man­age­ment to help with the symp­toms. Often, treat­ment includes fluid sup­port, mas­sag­ing and express­ing the blad­der, antibi­otics, and pain med­ica­tions. I also rec­om­mended a med­ica­tion to help improve blad­der tone and make it eas­ier for Bunny to uri­nate. We had planned on fol­low­ing up on Mon­day as well.  The fol­low­ing day, I received a call that Bunny needed to go to the ER in the evening because she stopped uri­nat­ing. They were able to give more flu­ids and express her blad­der but by Sun­day morn­ing, she was strug­gling again and the owner wanted to see if we can give more flu­ids in the morn­ing. So I came in on Sun­day and we talked about how Bunny was doing and that morn­ing she really wasn’t eat­ing well. After giv­ing flu­ids, I attempted to express her blad­der but at that time I was unable to express any urine except a few drops. Now it became a con­cern that she was obstructed. We dis­cussed attempt­ing to catheter­ize and see if I can empty her blad­der with a catheter and the owner con­sented. We were both con­cerned since Bunny was debil­li­tated and this will require gen­eral anes­the­sia. But I didn’t know what other choice we had. After prepar­ing every­thing, my assis­tant and I sedated Bunny and attempted catheter­i­za­tion but to no avail, it was just not suc­cess­ful. When I called Bunny’s owner/mom, I dis­cussed my con­cerns and dif­fi­cul­ties and we talked about the next step. Although risky, the next option is a cys­to­tomy which means open­ing up the abdomen, open­ing the blad­der and flush­ing out all of the mate­r­ial. There were anes­thetic risks, risks that she still would not be able uri­nate after surgery, and risks of infec­tion. Unfor­tu­nately, our only other option was to con­sider euthana­sia. Bunny’s mom opted to give surgery a try so we pro­ceeded. The surgery was tricky since I had to flush out sand as well as grit the size of small peb­bles. I had to lib­er­ally flush the abdomen of any of the sed­i­ment that had man­aged to migrate out of the blad­der and I had to make sure we tried to get every lit­tle piece out. It wasn’t easy and there was no guar­an­tee that I could get every thing. Finally, I reached a point that I felt I had done all that I could so I closed my inci­sions and we woke up Bunny. She was amaz­ing through surgery and after. Bunny’s mom was able to trans­fer her to the overnight emer­gency facil­ity for fur­ther inte­senive care. After I left,  I con­tin­ued to fret about this bunny for the next 24 hours–most vets can­not leave their job at the door. But the next day I received a call that Bunny was uri­nat­ing on her own and start­ing to eat. The plan was that she would be released from the hos­pi­tal the fol­low­ing day if she con­tin­ued to do well. By Tues­day, Bunny was able to go home! Now its a week later and Bunny came in for a recheck visit. Her owner has worked hard with her all week to assist her feed­ings and give injec­tions as well as oral med­ica­tions. All of the hard work has paid off. Bunny is doing really well, eat­ing, uri­nat­ing and active. She still has  to fin­ish her recov­ery and will need long term mon­i­tor­ing for recur­ring sludgy blad­der but she is a fighter and I am so glad to have been a part of her recov­ery. Not all emer­gen­cies end up the way you want, hope, wish–so I never take the good ones for granted. This happy end­ing will stay with me.

Sky Rats

Monday, July 11th, 2011

Since I have blogged about rats, I decided to put a blog together about their fly­ing compadres–the Pigeon. Truth be told, I also love pigeons. They are adapt­able, non-agressive, wildlife with an amaz­ing his­tory. We all think of these dirty birds that carry dis­ease and poop on you when you are walk­ing in a big city. But there is alot more to them. They have a mil­i­tary his­tory and have received com­men­da­tions for bravely fly­ing mes­sages out of enemy ter­ri­to­ries even when injured. The rac­ing pigeon can fly for hun­dreds of miles to make its way home (I can­not drive across town some­times with­out get­ting lost and hav­ing to call my hus­band for help or refer to my phone’s GPS) and the fancy breed of pigeons can rival any other species in beauty and quirky­ness. I have had some doves and pigeons as patients. The pigeons were rac­ing pigeons we diag­nosed with bac­te­r­ial infec­tions. Unfor­tu­nately, there can be alot of overuse of antibi­otics in the pigeon world and that leads to resis­tant bac­te­ria. I am lucky to have dealt with some clients that have appre­ci­ated this con­cern and we were able to actu­ally sub­mit cul­tures and treat infec­tions appro­pri­ately.  My own per­sonal expe­ri­ence with the pigeon’s close cousin –the morn­ing dove–was dur­ing one sum­mer liv­ing in an apart­ment in Fair­fax, VA. I had a lit­tle bal­cony that was set up with a table, chairs and I had some pots for flow­ers out there. I had left the soil filled pots out­side dur­ing the win­ter, and by spring it appar­ently made a great nest­ing site for a pair of doves. I kept hear­ing alot of coo­ing and noise out­side and when I looked out the win­dow, I found the pair build­ing the nest…then lay­ing eggs…then feed­ing the chicks. I was able to watch the pro­gres­sion through the spring and even­tu­ally there was a whole fam­ily liv­ing out there. I did not step out onto the bal­cony for months due to these squat­ting ten­nants, but I enjoyed watch­ing them inter­act. Once every­one flew the nest, I had a major cleanup project to deal with–not so fun.
One of my best expe­ri­ences with pigeons was feed­ing and hav­ing them perch on my in St. Mark’s Square, Venice Italy. This was one of the stops on my hon­ey­moon, and for me one of the most memorable.

I am not the only one that has an affin­ity for these birds. Mr. James Walker has an amaz­ing web­site that includes draw­ings and pho­tos of these birds–appreciating the dif­fer­ences of pigeons around the coun­try and also their beauty in flight: Check out the link to snap­shots and see the slide show.

Some won­der­ful books for the pigeon lovers out there include:

Pigeons: The Fascinating Saga of the World's Most Revered and Reviled Bird

This is an easy read and really puts an edu­ca­tional and humer­ous spin on the nat­ural his­tory of the pigeon.

Another fun book (table book) is:

So if your main expe­ri­ence with pigeons is when they poop on your car, or when they harangue you for food in the park, I can under­stand how you may not be a fan. But if you would like to learn more about them and see another side of them, there are plenty of great books out there to read.

Oh Rats!

Wednesday, July 6th, 2011

I thought I would blog a lit­tle bit about rats. I really like them and I have some clients that LOVE them. You wouldn’t think that they would be great pets but the are smart, social, and affec­tion­ate. Unfor­tu­nately, their life span tends to be about 2 years and by that time they may deal­ing with chronic dis­eases like can­cers, heart dis­ease or the dreaded res­pi­ra­tory infec­tions that are so com­mon. Now, although I would never touch a sewer rat, I find them fas­ci­nat­ing as well. I love going to Man­hat­tan and while wait­ing for the sub­way trains, look on the tracks to see if any rats are around. Usu­ally I can spot one or two and it makes my day–I don’t know why. I do know I am not the only one though. Robert Sul­li­van wrote a fas­ci­nat­ing book that I pur­chased dur­ing one of my last trips to NYC. It can also be pur­chased on Ama­zon. It is a great read if you are like me and curi­ous about the rats in our country:

Rats: Observations on the History and Habitat of the City's Most Unwanted Inhabitants (Alex Awards (Awards))

As I stated ear­lier, I have an affin­ity for pet rats, but I have clients that do take it to a bit of an extreme. When talk­ing to these rat afi­ciona­dos, there does tend to be a high level of anthro­por­phism.  I think part of this is due to the fact that rats use their front paws like hands and will push away med­ica­tions they do not want and use their paws to eat favorite foods. I also find that rat own­ers are very pro­tec­tive and I can actu­ally really appre­ci­ate this. Many peo­ple look at rats as ver­min and have instinc­tual fears. I find I usu­ally have to show my clients that I like rats, I know how to pet them and make them bog­gle. Once you gain the trust of the patient and the client, then you can help pro­vide med­ical care. I had one client that would fax me pages of infor­ma­tion from a self pro­claimed rat expert and I would have to read through the infor­ma­tion and then dis­cuss it with him. It was quite chal­leng­ing at times, espe­cially when I did not under­stand the med­ical rea­son­ing behind this person’s sug­gested ther­a­pies or when there was no proof of safety. So we would nego­ti­ate on our plan of action with every call. Ah, the age of the inter­net. Even­tu­ally, this client moved out of state and he would still con­tact me regard­ing his rats since he could not find a local vet that would see rats. After his last rat passed away, I believe he opted to not adopt any more, it was just too emo­tion­ally drain­ing when they became sick or aged.
When the movie Rata­toulle came out a few years back, I was so excited.  It shed light and humor on the rela­tion­ship between peo­ple and rats. Depend­ing on the con­text, a swarm of sewer rats can be scary and dis­ease rid­den. But one or two pet rats can bring humor and com­pan­ion­ship to a family. To know them is to love them.