Pet Calls

The Night Call

It is 10:30 at night and I am trying to catch up with the hundreds aof emails that have been building up in my inbox. I subscribe to too many things. Then I hear the doorbell. No one rings our doorbell at 10:30 at night. I wonder if I had set up an appointment for someone to bring their pet by for a checkup or something or someone is coming to pick up some medication. Maybe a relative stopping by for a visit?

I open the door and it is two men, one holding  a bloody towel wrapped around his dog. "Gracie was attacked by another dog. Can you help us?" It is a nearby client of my with his Shih Tzu. She is is need of a haircut but her face and chest are stained with blood.

"Come in," I tell them. Part of me wants to send them to the emergency clinic. It is 10:30 at night. That is what the emergency clinic is for. But at least I can look at it. "Let's go to te kitchen." My kitchen table has been the scene of several minor surgeries in the past, including myself when I cut my hand cutting up an old oil tank on our basement. When we are in the bright light I take a looke at Gracie. She has a large gash on her chest. It is deep but most of the bleeding as stopped.

"She's going to need stitches," I point out the obvious.

"I can taker her to the emergency clinic," offers Gracie's dad. 

"No," I say, not regretting it for a moment. "I can do it here. It will save you the hassle and be a lot less expensive." I know I am giving up at least an hour of my evening but part of me really loves doing this stuff. Putting a dog back together.

I give her a sedative, antbiotics and pain medication and while they are starting to work gather up some surgical tools, sutures, gloves, and a drape. I get my medical bag with clippers and some anesthetic. I knock her out with a little ketamine and valium. It will last 20-30 minutes, hopefully long enough. The owner's cousin is sent home to update the family on what is going on but he stays to help.

My wife comes stumbling into the kitchen, disturbed from her slumber by my knocking around. "What's happening?" she asks before recognizing Gracie's owner. We explain the situation. She is a physician and despite her specialty being OB/GYN, she jumps in to help out, shining a light into the wound as I clip the hair around the wound. It is then we see how lucky Gracies was. Visible at the deep part of the gash is the pulsing carotid artery and jugular vein. Another millimeter and Gracie would have bled out before making to my steps.

I flush then suture the wound and Gracies starts to wake up. I get together some prescriptions for oral antibiotics and pain medication and make the owner promise to bring her back the next day for a recheck.

Gracie's owner is thankful. I think he knows how close she came to dying. I find out the other dog was not on a leash. I know that in the end the other dog's owner will end up paying the bill. Gracie's owner is a lawyer!

After sending her home I start to clean up the mess. It seems too much stuff for just a little cut. My wife tells me how shocked she was to see the depth of the wound. She normally never deals with anything in that region of the body. I have spent many nights and weekends doing emergency shifts in my youth so It was not that big a deal for me.

It is midnight by the time I get to bed. I know Gracie still has a hard recovery ahead. These wounds sometimes have hidden damage that is not readily visible. But I know I have done all I can for her. I will sleep very well this night.

8 Months

 

As the eight month mark has come and gone, I can finally start to let myself feel that it was worth it. What was worth it? Often as a vet I am asked, what would you do if it was your pet? Now I have a better answer for that question.

This past summer my 15 year old cat, Meg Ryan (named for the incredible actress,) started to show signs of weight loss despite having a great appetite. She was also throwing up her food a bit more than usual and having occasional diarrhea. I figured it was probably one of the big three for older cats. Hyperthyroidism, Diabetes or Kidney failure. I was a little concerned she might have Feline Leukemia or FIV but knew she didn't really have any exposure and was negative as a kitten.

In order to save her a trip to the clinic, and I I have done with hundreds of house call patients, I took a blood sample on my kitchen table. The lab does pick ups of the samples from my home so I called them then waited until the next day for the results.

Normal. Not just normal normal but perfectly normal. In most patients you expect to see one or two values slightly out of the normal range, but not Meg. Glucose NORMAL. Thyroid hormone NORMAL. BUN NORMAL. Creatinine NORMAL - everything was NORMAL.

Okay, that just changed by differential diagnosis list a little. Inflammatory Bowel Disease or IBD moved up to the top. The definitive way to diagnose that is with stomach and intestinal biopsies. I decided to do a trial of corticosteroids. If it worked I had a presumptie diagnosis. I checked her weight, gave her a shot of long acting cortisone and waited to see what happened.

She seemed a little better. The vomiting was still happening but not as much. The stools were almost back to normal. But she still kept losing weight. After 2 weeks she was down another half pound.

What I had tried not to think about was now starting to gnaw at me.

I had her stand up on my lap and grasped around her belly with my right hand. At her body condition it was pretty easy to feel every internal organ. Kidneys, nice and smooth, normal size. Spleen, no enlargement. Liver, normal. Intestines...lots of intestines to check...small bowel normal. Large intestines...

I wondered why I didn't notice it two weeks before. A mass the size of a walnut was present in her colon. My heart sank. It all fit. Meg had cancer.

She was fifteen. What could I do for her? I talked it over with my wife and it seemed that putting her to sleep was an option. We were getting ready to leave on vacation in 10 days and if she continued as she had been she might end up dying while I was out of town.

The kids said their goodbyes just in case and I took her into the clinic. Radiographs confirmed the mass in the large intestines but no signs of metastatic lesions in the lungs or liver. I decided I would do an exploratory surgery to have a peek and if it was as bad as I thought it was, she would never wake up from the anesthesia.

I thought about whether I would even be doing this if it wasn't my cat. The cost for surgery and recovery would likely end up in the $1,000 to $2,000 range. Would I even suggest the exploratory as an option?

But Meg was my cat and friend and family member. She was always there to keep my lap warm and curl up next to me in bed each night. I had to try.

I anesthetized her and clipped the hair from her belly, prepping her for the surgery. Her body was so thin I could see the organs under her skin. I made the incision, expecting a quick confirmation of terminal cancer and a quick injection to end her life.

I was a little surprised to see a normal liver. No unusual fluid or blood in the abdomen. These were good signs. I did find the tumor. It had almost totally obstructed her large intestine and the lymph node next to it was the size of a peanut, way too big. It had spread if just locally. I looked at her insides, considering the options.

I was considering options. No longer was putting her to sleep the only outcome available. I could remove it. If most of her problems were from the obstruction I should be able to make her better. Not cure her but keep her going a while. There was also the chance that it wasn't cancer. Maybe an infection or a foreign body that caused some severe inflammation.

I decided to remove it. I excised the mass and a few inches of normal bowel on either side along with the lymph node. I sutured the two ends of the intestines together then closed her abdomen, carefully putting her back together. Then I sutured up her skin, gave her a dose of pain meds and let her wake up.

Then the second thoughts came. What had I done? What sort of arrogant, self-serving, lover of animals was I? What sort of pain and discomfort had I set her up for? Would she even wake up? What made me think I could cure this creature and give her back the quality of life that had seeped away from her over the last month?

She did wake up. She was tired and worn out. I tooke her home and settle her into her cat bed. The boys had made a nice recovery area for her. But despite our attempts to ease her recovery while we waited for the lab results, all she wanted to do was hide in the basement.

The biopsy came back two days later. Adenocarcinoma. Cancer. Prognosis poor. Even though the margins were clean the lymph node was affected and it was likely to recur.

I tried to get her to eat. I bought every flavor of canned food they had at the Jewel. I gave her fluids under her skin to keep up her hydration. I gave her pain medication to keep her comfortable. Most of the time I had to find her hiding in the basement. The cat who had always managed to find my lap within seconds of me sitting down didn't want to be near me. Each day I expected it to be her last.

But it wasn't. She licked the gravy from the food. She put up with the subcutaneous fluids. She even purred, but she didn't seem to be getting better. She was just in a holding pattern and in a couple of days we would leave on vacation.

I suggested to my wife that we take her with but that didn't seem practical. I didn't want to leave her with the cat sitter. I could imagine her hiding and slowly dying of dehydration. My vet assistant, Amara, at the animal hospital offered to care for her. I seriously considered that it was time to put her to sleep. That I had put her through enough already.

But I guess I wasn't ready. I decided to give her another week. If she still wasn't eating by the time we came back that was it. If she got worse, the other vets at the clinic would do what I couldn't. The morning it came for us to leave she was nowhere to be found. Her normal spot in the basement was empty. I spent an hour looking for her. It was my son Trevor who finally did spot her on a chair that was partially covered with boxes.

She sat in my lap on the way to the clinic as we headed out of town. This might me the last time she sat on my lap. We set her up in the clinic and I said goodbye.

The week went by quickly as vacations tend to do. A mid-week update reported that Meg was eating. Not only the canned food but dry. There was no vomiting. No diarrhea.

We stopped by the clinic on the way home. I put her on the scale before taking her home. She had gained half a pound. Hope? That night she sat on my lap. She crawled into bed with me. The cat that had been scratching at death's door was now back to her normal self.

Her recovery has continued. She is back to her pre-illness weight. Still vomits the ocassional hairball on the dining room floor, but the diarrhea is gone and her appetite is normal. Every month or so I palpate her abdomen. Nothing abnormal. She chases our other cat. She tries to hurry me to the food bowl in the morning.

It has been eight months. She made it past my birthday. Past Christmas. Two gifts I never imagined that summer day I stared at the tumor in her abdomen.

I don't know how many more months she has. If the pathologist is right the tumor with come back. At that time there will be no surgery. She will have her dignified end.

I wonder what the odds are. One in ten? One in a hundred that a cat with her condition would not only survive the surgery but make a full recovery? So far Meg has beaten the odds. I like to think it was my great surgical skill that got her this far but I know there is more.

Would I recommend surgery to a client in the same situation? Would I be selling them false hope?

Yet if I were the client. If my cat had a less than 10 percent chance of waking up from the surgery let alone living eight months, would I do it? I don't think I can answer it. I'd like to think I would. I'd like to think that odds are just that, odds. In reality, the animals live or die. We can only hope to do the best for them.

Yes, Meg had the advantage of adopting a veterinarian as her human. A human who wasn't ready to give up on her when it looked like she had given up herself.

But in the end, all we have is hope. Hope we are making the right decision, no matter what. Hope that the promise to do no harm is fulfilled. Hope that the time we have with our four-legged companions will never end.

I will have to say good-bye for real to Meg someday. Maybe not for another 8 months. Maybe in less time than that, maybe more. But I have her friendship and companionship now. I have the last eight months.

I still have hope.

When an itchy dog might need surgery...

    When I look through the program guide for the North American Veterinary Conference I try to find things I don't know much about. I had to admit, I had never heard of Chiari-Like Malformations before. As the speaker promised, it is a disease that likely goes misdiagnosed or undiagnosed.

    The disease is a genetic condition primarily affecting small dogs, especially, but not limited to Cavalier King Charles Spaniels. It may take years to show clinical signs but because of a malformation that results in the skull cavity being too small for the dog's brain, there is abnormal flow of Cerebro-Spinal Fluid or CSF from the brain into the spinal chord causing a condition known as syringomyelia. This is basically a fluid build up inside the spinal chord.

    Clinical signs can be very unusual resulting in the disease being misdiagnosed. Dog may present with a very itchy face. They may rub their face on the carpet or scratch at it with the hind legs. In some cases they actually don't touch their face and appear to be doing "air guitar." They usually can be induced to do the behavior by palpating the upper neck and are often very painful in this area as well. Other symptoms include seizures, hind limb weakness, hearing loss and head tilt.

    The signs could be mistaken for severe allergies, epilepsy, intervetebral disc disease, or even obsessive compulsive disorder. Sometimes they will respond to treatment for these diseases further complicating the diagnosis.

    The malformation causes the brain to slouch in the back of the skull. The flow of CSF is partially blocked like crimping a garden hose, resulting in the high pressure turbulent flow that can cause the development of the syringomyelia than can start in the neck and progress all the way down the spinal chord. Diagnosis is made with an MRI which can easily detect the brain being pressed by the back of the skull and the fluid dilation in the spinal cord.

    Treatment requires surgery to relieve the pressure on the brain by cutting away part of the skull and the first vertebrae in the neck. The defect is covered by a dome of titanium mesh impregnated with a cement spackle to protect the exposed brain. Symptoms make take a while to resolve as the syringomyelia reverses but most dogs can make a substantial recovery. Relapses can occur if scar tissue forms over the defect.

    Screening is available for Cavalier King Charles Spaniels and includes a neurological exam, hearing test, CT, MRI, radiographs and thermography. With selective breeding, this disease can be eliminated in 10-15 years. Cost for diagnosis and treatment is subsidized for those who need it and participate in the ongoing studies and can travel to Long Island for the procedures. Screening runs $1,500 and surgery around $5,000. Other breeds are affected, in fact any dog under 30 lbs can develop the syndrome. It has even been diagnosed and treated in 4 cats.

    More information at www.CanineChiariInstitute.org or text CCI to 30364 from your cell phone.

    (From the North American Veterinary Conference)

One of my favorite things to do is go to veterinary conferences. I'm now at the North American Veterinary Conference in Orlando. Probably the biggest in the world. Flew down yesterday and got registered. Rented a car and staying at me Aunt and Uncle's house.
The lectures usually do a lot to reignite my passion about veterinary medicine. I like to pick topics that I know little about or things I'm really interested in and want the latest updates on. Today I got a little of both. I'll try and pass on some of the more interesting topics. The part I'm looking most forward to is the exhibit hall which opens tomorrow. It's so big it fills two hotels. The whole conference takes up three or four hotels.

It's been a long time but I am anxious to get back into this. As an update, while I still have my house call practice, I am now the owner of Merrick Animal Hospital in Brookfield, IL. It has been a little over a year and while it has been a very interesting and successful move for me, I still love my house calls. In fact, I am seeing some of my old house call clients there and have even made a couple of house calls to patients of that practice.
So, what's new? My favorite Heartworm Preventative is back on the market. Proheart 6 lets me give my patients a single injection to give comprehensive heartworm and intestinal parasite protection. It had been taken off to investigate safety concerns but found to have no problems at all. in fact it is the most widely used preventative in Europe and Australia.
I also will be appearing in an informative program by Riverside Brookfield High School TV, RBTV,. I will post information on show times and a link to the video when avaiable.
More later. Great to be back.

Has it been that long?

Today marks a significant anniversary for me. Twenty years ago today I received my DVM degree in a ceremony in the Krannert Center along with 78 fellow classmates. I was excited and scared and proud of what I had accomplished.

This fall we will be having our 20th reunion. I am looking forward to catching up with my classmates, most of whom I haven't seen since my 10th reunion.

It's hard to believe it's been twenty years. There are dozens of patients, including my own cat Patches, who I have taken care of from the time they were puppies and kittens until the owners had to make the compassionate decision to put them to sleep or they died on their own. Not many MDs can say that (fortunately)

It's been fun most of the time, hard work a lot of the time, and full of surprises, great experiences, and wonderful people I've worked for.

So much has changed in that time.

The discovery of FIV in cats.

The spread of Lyme disease across the country.

The change from annual vaccination to every three years for some of the vaccines.

I now have a patient side test for heartworms that also checks for Lyme diseae, Ehrlichiosis and Anaplasma. Previously I had to send blood sample to a lab for testing.

I have a portable ultrasound machine. Pretty cool.

All my medical records are computerized. When I first started out it was all written by hand, even the bills!

Thiopental and Metofane anesthetics are gone, replaced with ketamine and valium and Isoflorane and sevoflurane.

I have a digital anesthia monitor that watches blood pressure, ECG, pulse oximetry, temperature, respiratory rate and heartrate. In the good old days, you had the tech put their stethoscope under the surgical drapes to check on the patient.

I can do ECGs on my computer with a bluetooth connected machine, no more strips of heat sensitive paper and clunks machines.

Blood pressures and tonometry to check for glaucoma are everyday tasks, simplified by hand-held devices that weren't even imagined twenty years ago.

I check temperatures in the patients ears in one second. I really don't miss those rectal thermometers.

We know have over a dozen new pain medications avaialable for dogs to manage their arthritis. Previously we used aspirin or prednisone or both.

Joint supplements help dogs with hip  and elbow dysplasia live normal and active lives without surgery.

Still waiting for my medical tricorder like Doctor McCoy has...

I am looking forward to the next 20 years. At what advances and marvels we'll have then

I can see clearly now...

Every once in a while a potentially great new product hits the veterinary market.  I came across Ocluvet eye drops through a mailing I received recently. The product claims to be able to clear and possibly cure cataracts.

As with any new product that makes claims like this I am skeptical. Hopeful, but skeptical. But the idea of being to help patients with decreased vision see better is well worth giving it a try.

They are expensive. A 15ml bottle retails for around $150 to $200 through your veterinarian. Compared to cataract surgery, it's a bargain. I would recommend that you avoid buying this (or any veterinary product) over the Internet. For one, the product requires an evaluation by you vet before starting therapy. Improper use may cause further damage to your pet's eyes. Second, you can't guarantee the integrity of the product when it travels outside normal distribution channels. You may not be getting what you pay for!

Initial treatment requires a drop in each affected eye three times a day for the first 6 to 8 weeks. Clinical studies show improvement in 82% of patients treated. The best results are obtained when treatment is started early during the cataract formation.

After initial treatment maintenance therapy is continues at 1 drop a day in each eye.

Check out their website www.ocluvet.com and ask your vet to evaluate your pet to see if they are a candidate.

Pets don't tend to complain too much about their medical problems. They change their activity and adjust their lives. That doesn't mean we shouldn't treat them. Check out some of the testimonials on the website. Maybe your pet can see more clearly too.

I have been mentioning the product to every one of my clients whose pets have cataracts and have started four on therapy. I'll let you what sort of response I get. If you have any experience with the product, feel free to share it here.

The New Patient

I find the apartment building. It isn't far from my house. Shouldn't be too bad. I check my watch. I'm a little late but it shouldn't take long. Just a new cat for a checkup, blood test and vaccines.

This time of year is what I call "Heartworm Season." It is when I need to get all my canine patients tested and put on heartworm preventative. Because I recommend the preventative seasonally (In Chicago, mosquitoes can only transmit heartworms from dog to dog from May to October) I need to do this from March through May. Two hundred plus dogs in three months. I do appointments three days a week unless my wife needs me to stay home with the kids when she is on call. I need to average a little over 5 dogs a day. It comes out to almost half my business for the year in three months. Add in a bunch of cats who get their annual checkups at the same time, sick and injured pets, dental cleanings, spay and neuters, it can get a little stressful.

Normally during Heartworm season I don't take on new clients. This cat was referred by another client who is giving them one of their cats and they want to make sure he gets a checkup. No problem.

I come in and the owner greets me, grateful I could come. I need to check the cat for Feline Leukemia and FIV and update his vaccines. It has been a while since he's seen a vet. I slough my bags onto a couch and look for a flat surface for scale. The floor is carpeted, no good. I find a radiator cover across the room beneath the front windows of the second floor apartment. Perfect.

The cat, we'll call him Scratchy to protect his identity, is sitting in the owner's lap. He looks so calm, so peaceful, so happy. Still I'm worried some since I don't know Scratchy. I will need to get a few drops of blood from his front leg. Most cats tolerate this fine. Some...

I scratched Scratchy's head and he seemed okay. "Let's get his weight first," I said and I start to pick him up. The hiss and growl come too late as the cat bolts from the owner's grip, tearing into his flesh with nails that have not been trimmed - ever.

Okay. Not a good start. Sometimes when I have a "fractious" cat I have the owner put them in the bathroom. The enclosed space seems to keep them from wanting to bolt at the first opportunity. I can use the sink as an exam table and if things go bad, throw a towel over them.

"Let's put him in the bathroom," I suggest.

I start to gather up my stuff and get ready to follow the owner once Scratchy is reacquired.

A few minutes pass. "I have him in the bedroom," the owner announces.

Not quite the same as a bathroom, I think. Bigger space. Bed to hide under. Closets to hide in. Oh, well, maybe he will be calmer here. Maybe.

I enter the bedroom and close the door. The cat is on the bed. He sees me, hisses and makes a break for it. The owner tries to grab him. Bad move. Flesh is ripped off. Blood starts to ooze. It's not mine but it's still not good.

Scratchy is now under the bed. I see his face at the side. I go close. I don't try to pet him this time. I look into his eyes. "Go ahead," they say, "make my day."

I turn to the owner, "Yeah, I don't think so. We might have to do this another day."

The owner, despite the fresh scratches in his hand, takes a peek as well. Another hiss and Scratchy heads further under the bed.

I go back to the living room and look at my schedule. "Maybe Friday morning. If you can put him in the bathroom in a cat carrier, I can them work with him and if I need to, sedate him."

"How about I try to catch him now and you can sedate him?" he shouts back from the bedroom.

I look at my watch. I am supposed to be at my next appointment already. I didn't think Scratchy was coming out from under that bed today. I start to pack up, confident that more flesh wounds were in the immediate future.

"I've got him," says the owner. "I'll bring him into the bathroom."

"Great," I say, mustering some show of enthusiasm. I draw up some Ketamine and head in. Scratchy is in the sink. I squeeze behind the owner and close the door. "I"m going to shoot it in his butt. It might sting so just let go when he tries to jump."

I grab a hind leg and slip the needle in, pushing the plunger as I do in my one-handed, patented, palm injection technique. Scratchy hisses and the owner holds tight. "Let him go," I tell him. Scratchy is free but still in the sink.

"It'll take five to ten minutes. We should leave him in here so he doesn't crawl into someplace we can't get him out of." The words fall on deaf ears. The owner leaves the bathroom door open and Scratchy is out.

Okay, not useful.

Fortunately the bedroom door is closed. The owner shoes the terrified cat into the dining room. While we wait I get the computer work done. I then go to check on Scratchy. He is fighting it. Ketamine causes hallucinations in people. I suspect it is having a similar effect on Scratchy. He can't walk but he can flip his body in spastic motions. I go over to watch him, make sure he doesn't hurt himself. He crawls around my feet, hissing, growling, twitching, until the ketamine bathes his brain with enough strength to send him to lala land.

I pick Scratchy up - carefully. I've seen sedated animals take those last few milligrams of strength and make an attempt at showing me who really was boss. He is out for the count. Still, the first thing I do was cut the nails. I get my blood sample, do a checkup and give him his vaccines.

I am now ten minutes late for my next appointment. Next time I'd know to allow a little extra time for Scratchy.

New patients. Gotta love 'em.

Regenerative Medicine is Here

I have just recently returned from the North American Veterinary Conference. The fact that it is held in Orlando and that it was three degrees when I left Chicago is not important.

I always look forward to the conferences because they inspire me to try new things and I get to buy a gadget or two I need.

This year I stumbled into a lecture on Regenerative Medicine in the Management of Arthritis Pain. Regenerative Medicine is just the fancy term for stem cells. In this case, adult stem cells obtained from the fat tissue of the dogs being treated. There is a company in California, Vet-Stem, that can process the fat tissue and extract the stem cells. They are then sent back to the vet to be injected in to the patient. The study that was presented used the stem cells to treat arthritis joints. They actually injected the cells into the affected joints and followed the dogs out. The study was double-blinded. Half the dogs received a placebo injection and neither the vet or the owners knew which dogs had received the stem cell. The difference was astonishing. Dogs that owners were ready to put to sleep were now going out for two-mile runs and able to lead a fairly normal life that had previously been debilitated by degenerative joint disease.

After 90 days the dogs which had received the placebo got a real injection of their own stem cells which had been frozen and they improved as well.

I tracked down Vet-Stem at the exhibit hall and talked to one of their vets. They require the vets to take a credentialling course and then I would be ready to start treating patients. I signed up for the course and now I am the only credentialled vet for treating osteoarthritis with stem-cell in Chicago itself.

The possibilities for treatment extend beyond arthritis to tendon and ligament injuries, liver disease, renal or kidney disease and auto-immune disease. The treatment in the joints works by helping to reduce the inflammation and pain in the joint, not rebuilding missing cartilage, but the effects are incredible. They have previously been using the technology to treat over 3000 horses with similarly remarkable results.

I am very excited about being able to offer this therapy to dogs (and cats) in pain. While it does benefit dogs with severe disease, it's potentially more effective in dogs that have not progressed to very serious debilitation. (Veterinary Regenerative Therapy Center of Chicago)

The procedure involves doing an evaluation in consultation with the vets at Vet-Stem of the pet to make sure they are a good candidate for the treatment. They are then scheduled for the fat tissue harvest. Fat can be taken from the groin, behind the shoulder, or the abdomen. Up to 2 ounces of fat are collected and sent overnight to the lab. They are processed the next day and preloaded into syringes for the treatment. Any extra cells are frozen and kept by the lab for future use. The cells arrive about 48 hours later and are then injected into the affected joints with the animal sedated.

Despite the newness and novelty of this treatment, the cost is very reasonable. Total fees for evaluation, fat collection, tissue separation, stem cell injection and followup range from $1,500 to $2,500 depending on how many joints are affected. When considering the money owners are already paying for pain medications, supplements and the alternate expense for surgery, it's pretty reasonable.

I have two patients that are interested now and am looking for additional patients for treatment. If you are interest or have any questions, please call at 773-463-7422 or email me. I'd be happy to go over the whole thing with you in more detail and help you decide if this could benefit your pet.

I hope to put some of my cases up on this blog for people to follow along and give them a better idea what to expect.

I am very excited. I think this will be a huge benefit for the treatment of many conditions.

The Sample

I enter the house and there it is. The Tupperware. The plastic container. Sometimes it comes in a blue Tribune Newspaper bag tucked into a paper bag. It is - THE SAMPLE.

You'd think after 19 years I'd know to be more specific. Or that owners would realize what I mean by "a sample." To be nice, we have called it a stool sample. Less commonly but more acceptable is poop sample. If you want to get clinical, it is a fecal sample. There are the crude terms but my kids might want to read this someday.

I leave the sample for after the exam. I know once I open the Tupperware that will be all I smell. When I am finished and it is time to pack up my stuff, I go for it.

The stool sample is used to test for intestinal parasites. In some cases is can be used to look for digestive problems, but the annual fecal parasite exam is to see if the dogs and some cats have picked up worms or other intestinal parasites during their everyday life.

I use a container called the fecalyzer. Sounds great, eh? Kind of like Terminator shows up at the waste water treatment plant. It is nice because it can collect the sample, seal it up in a plaster contained no bigger than the average prescription vial, then when I get home to my lab, I can just add the salt solution. The fecalyzer mixes "the sample" with the solution then filters out the largest particles, allowing the parasite eggs and cysts to float to the top where they stick to the bottom of a microscope slide.

Now here is the important part. It only takes a sample about the size of the last knuckle of my pinky. There is absolutely no need to get the entire bowel movement. If I carried that much poop around in my car I'd have to have the windows open all the time. It's bad enough when a nervous dog has an accident in the travel cage on the way to get his teeth cleaned.

So once again I need to start telling people that all I need is a little bit of poop. Just the tip of a finger's worth. No more, no less. Just a sample.