Max is a 14 year 10 month old doggie who is a regular here for his monthly cartrophen injections to help with his joints and mobility. As part of these appointments he gets a full health check every time he comes in and it was at one such health check we first noticed that he seemed uncomfortable in his abdomen and palpated a lump.
He came in the next day for a scan and x-rays to ascertain what the mass was attached to. It appeared to be his spleen. The worry with splenic masses is that they can rupture and cause a big bleed into the dogs abdomen which can be fatal, or that the mass may be cancerous and unfortunately there are some very aggressive types of splenic tumour which are fairly common.
After chatting through our findings with his owners, we decided to go ahead with an exploratory laparotomy which is an operation to look inside his abdomen and hopefully remove the mass.
During the operation his spleen (which was enormous and lumpy!) was removed and the rest of his abdomen checked to make sure it looked normal. Max's liver also looked slightly unusual so it was biopsied and sent of for histology along with the lumps from the spleen.
Max was very brave and made a good recovery. It took him a couple of days to get his appetite back after the operation but since then he hasn't looked back. We all had to nervously await the results from the lab and when they arrived everyone was relieved to here that the lumps were benign (not cancerous)! Great news!
Having a surgery like Max did would be a big deal in a patient half his age, but he yet again shows that with the right care and dedication, surgeries on senior patients really are possible and can be associated with an excellent outcome.
Due to Max being so brave and his brilliant recovery for a senior doggie we have decided to make Max our 'Patient of the Month' for December.
Herbie is usually a very handsome black and white cat but on the morning of the 11th August he had definitely lost some of his usual good looks. He was rushed down to us because his very caring and dedicated owner had noticed he was breathing funny. By the time he arrived at the practice he was panting and in serious distress. He was immediately put in an oxygen tent and left to calm down. Cats are very fragile when they are in respiratory distress and need very gentle handling. Over the next 15 minutes his breathing rate decreased from 120 to 60 and Katherine felt it was safe to examine him. His chest sounded terrible, his gums were pale and he was clearly very ill indeed.
A small amount of sedation was given and an x-ray was taken of his chest. This showed Herbie had a pleural effusion (fluid around his lungs) which needed draining as soon as possible so that his lungs could start inflating properly again. The whole team went to work, the nurses clipped up and scrubbed the side of his chest, Katherine scrubbed her hands and we all wondered what the fluid was going to be. A small needle was inserted into his chest, Herbie was still slightly sedated and on oxygen so he didn't mind at all. The fluid we got out surprised us all – pus! Herbie had a “pyothorax”. This is where pus accumulates in the chest, it is a rare condition and can be caused by several things. It is still not clear what the underlying cause was in Herbie.
Herbie really was very ill, and he was going to need serious intensive care to get through this. His owner wanted us to do everything we could so we went ahead with life saving treatment. He was started on intravenous fluids, a chest drain was placed so that all the pus could be drained and his chest “flushed” with sterile saline. A feeding tube was placed as there was no way that he was going to feel like eating. He was also started on pain killers and a combination of three antibiotics. His blood tests showed that this infection was very close to over whelming him and we had only just got to him in time. We all worked very hard over the following days and nights, Herbie was a true team effort.
Herbie was a simply amazing patient, he took everything in his stride. It took about 48 hours for him to start showing a good response to treatment. He stayed in hospital for a total of 8 days then went home, still on antibiotics but his chest drain had been removed. He came back in on the 24th of August for reassessment and more chest x-rays. They were amazing, his chest looked more or less normal and his blood results were completely unremarkable. We were all chuffed to bits.
Herbie is due to finish his antibiotics in the next few days which should (we all hope!) bring this whole episode to a close. He will always remain a special patient to the staff at LBVC. Well done Herbie, you are a truly amazing feline person.
Jess was usually a typically nutty Boxer dog, but over the last couple of weeks she had been feeling distinctly under the weather. Food just wasn't on her mind and anything that went down was coming straight back up so it was time to go and see the vet.
Sarah took one look at Jess and knew she wasn't right. Her tail was still trying to wag but all four legs were on the floor rather than bouncing around like usual and she thought she could feel a lump in her tummy.
Jess was admitted for some blood tests, x-rays and put on a drip. Her blood tests were nice and normal other than dehydration so this was a relief. The x-ray didn't show any evidence of a foreign body...so what was this lump?
Sarah and Andy scanned Jess and could see it but couldn't tell exactly what it was attached to, so it was decided that Jess needed an exploratory laparotomy to see what and where this mass was and hopefully to remove it.
The following day Jess was operated on and the mass (which looked like a weird jellyfish!) was found to be in the middle of the jejunum (part of the small intestine), which meant Sarah could perform an end to end anastomosis (cut the mass out and suture the two ends of the intestine back together) to completely remove the mass with good margins.
With this type of surgery there is always a risk the sutures could break down and the patient could develop peritonitis, so even if the surgery goes well, everyone has to hold their breath until at least 5 days after the operation when the risk of this happening is much reduced.
After a rocky first night, Jess did brilliantly and the following day she was eating, bouncing and generally ready to go home.
The histology confirmed the mass was a type of cancer but as Sarah managed to remove the whole tumour, the prognosis is very good and we hope the surgery will have been curative.
She has recovered completely and after being so brave we are pleased to make her January's Patient of the Month!
Baxter first came into see Katherine at the end of May because his lovely and very dedicated owners had found a mass on his left elbow. The mass was soft, squishy, non-painful and felt like an innocuous fatty lump. However, Baxter is a [very handsome] Golden Retriever and this breed are predisposed to a type of skin cancer called a Mast Cell Tumour. Thus Katherine advised that a sample was taken of the mass so a diagnosis could be reached. Everyone kept fingers and toes crossed while we awaited the results.
Sadly Katherine's worst suspicions were confirmed and a diagnosis of a Mast Cell Tumour was made. Now, these tumours are very tricky and can be really invasive. Baxter was going to need surgery, however this was not going to be straight forward because a 2-3cm margin must be taken all the way around the mass to ensure that all the cancerous cells are removed. As the mass was over Baxter's elbow this would mean we would not have enough skin to close the wound – problem!
Katherine consulted her much more learned [and older!] colleague Andy and together they decided to perform a skin graft. Skin would be taken from Baxter's side and placed over the deficit on his leg. This procedure is tricky but it is the only way to safely remove this tumour from Baxter's elbow so we went ahead with the procedure. Surgery went well and although Baxter looked slightly like Frankenstein with his 116 stitches and large wound we were happy that all the tumour had been removed, which was our main objective!
72 hours after surgery however things had turned sour. Parts of Baxter's skin graft were turning black, the graft wasn't taking. This happens in about 2% of cases, so unlucky. The area had to be bandaged, so Baxter spent a lot of time looking very handsome indeed in various t-shirts and even some of the vet's scrub tops! Over the next few weeks Baxter spent most days in hospital with us, while Mummy and Daddy went to work. During the days spent with us he had his dressing changed, his outfit changed, a groom, walks to the park and loads of love!
Three weeks after the initial operation a revision surgery was performed to close the deficit that the failed graft had left. This procedure went well and now only a very small area at the bottom of the wound was left open. This healed really nicely over the next week and the whole sorry story finally came to an end!
Baxter and his family have been simply amazing throughout. Sometimes things don't go to plan, especially with surgery, there is no guarantee. But Baxter has remained cheery throughout and his family have trusted us 100% to do the best for their special dog. Baxter will always be a patient very close to our hearts.
Congratulations on being July's patient of the month!
Poor Bobby was having real problems with his ear. It was sore and infected and despite lots of hard work with ear drops it just seemed to be getting worse and every month he seemed to be back at the practice with another painful ear infection.
Eventually the damage to the ear was so advanced and there was so much scarring and change to his ear canal that the only way forward was to admit that his ear was never going to be normal without surgery. Every year we get one or two doggies like Bobby who need surgery for recurrent ear problems. Mostly our patients with ear disease are treated medically with antibiotics, anti-inflammatories and ear drops, however for some dogs this is just not enough.
Bobby was booked for a Total Ear Canal Ablation with Lateral Bulla Osteotomy (TECA-LBO). This essentially means that we would remove Bobby's entire ear canal right down to his middle ear, and even remove part of the bony casing of his middle ear. After the surgery Bobby would look similar in that he would have his ear flap (pinna) still intact, but below that there would be no opening, just a line of stitches. As the procedure removes the middle ear and ear drum then Bobby would be effectively deaf in this ear, however even before his operation his ear was so damaged he could hardly hear anyway. Pardon.
It is a very delicate operation and one which needs lots of patient dissection so as not to damage any vital structures such as major blood vessels and nerves near the ear canal. On the day of his big operation Bobby came through just perfectly and the diseased ear canal was removed without complications.
After the surgery he did very well and was a very good boy taking his tablets. He does look a little bit funny with his shaved head, but we all love him and so have made him our patient of the month for July 2013.
It was a glorious bank holiday weekend, people all over the land were lighting BBQs, sipping cool beers and getting sun burnt. Cindy, however, was not embracing the good weather. She felt sick, all hot and bothered and had the worse tummy ache of her life. A trip to the vets was in order. Steve, being the good vet he is, quickly spotted her dehydration, temperature and sore tummy and responded with IV fluids and some good drugs. But what could be wrong with Cindy, could it be a tummy upset, or was Mr pancreas cross or worse still was Miss uterus cross and infected?
The next day Cindy was much more herself although the reason for her illness was still proving elusive. Back at home, Cindy was miserable again so Tuesday morning back to the vets. Poor Cindy’s tummy ache was so bad now that she needed an operation. When Katherine opened her abdomen, copious yellow fluid spilled out onto the floor – OH GOSH! But why, where is it coming from? Suction please! Oh no, Cindy has a ruptured gall bladder because of a gall stone! This is so rare, even Andy hadn't seen this before (and he has been graduated for so long he used to treat poorly Triceratops!) What should we do? Sarah then joined the party in theatre and together we decided to remove Cindy’s gall bladder. This procedure went well, Katherine and Sarah were feeling pretty chuffed with their handy work, so all that was left to do was close up. However, as they are good veterinary surgeons (like Steve) they checked the rest of her abdomen first. What is this….!! Cindy has a pyometra as well! What are the chances of that, poor Cindy, what a very unlucky dog. Thus, the surgical team set to work spaying Cindy before finally closing her up.
Cindy was a very poorly girl, having a ruptured gall bladder and uterine infection in one. However, being a terrier she is suborn beast and she was not going to be beaten!
Wednesday morning, we have a new dog on our hands. Tummy ache gone, breakfast, yes please! Cindy had her final post operation check last week, she is now a totally different dog, it’s like it never happened, what an amazing little girl!
Max was feeling pretty weird. Over the last few days his belly was behaving very oddly. Labradors normally rarely see their food as it disappears at the speed of light, but poor Max was getting a second look at his dinners as they shot back out of his mouth at an alarming rate. And what was coming from his back end was none too pleasant either. Having a tremendous sense of smell is not always a good thing. His mum was very worried and took him to LBVC.
Over his 6 years Max was no stranger to the vet and had had tummy bugs in the past but this wasn't settling down the way things normally do. He knew he shouldn't have licked that dead pheasant the other day (but it smelled soooo good!).
Gentle hands poked his belly. Definitely a little tender but nothing too alarming found. Max had happily given up swallowing toys - that was for puppies and he is a big boy now. Katherine the lovely vet gave him some medicine to stop him feeling sick and help with the diarrhoea. Hopefully he'd be back to his normal bouncy self soon.
A few hours later and Max was agreeing with The Verve that the drugs don't work. His mouth felt like a sauna floor and his head was banging. He was back at the vets and on a drip - he had become quite dehydrated. Even food was unappealing, it was like he wasn't a Labrador anymore! At least his bottom seemed to have dried up.
The following day Max was still not right so off to sleepy land and a couple of Xrays were taken of his naughty belly. This did not look normal. It didn't look normal at all. The difficult decision to take him though to surgery was made.
Looking inside Max's belly, Steve and Sarah were initially a little perplexed. His small intestines were all happy and unexciting but Mr Stomach seemed very large and gas filled. Twisted stomachs are a very dangerous condition and one vets see fairly commonly but his Xray did not have the classic 'Smurf's Hat' appearance of this condition at all and Mrs Spleen was completely normal and happy which would be impossible with a twisted stomach as she and Mr Stomach are very intimate.
Once untwisted and freed to allow to move Sarah and Steve discovered the gas filled organ was really Mr Colon masquerading as Mr Stomach! A twisted colon is a very rare event indeed. A once in a career finding! If not untwisted it would have closed off it's blood supply and rapidly become life-threatening. Sarah, Steve and the team of nurses were overjoyed to see Mr Colon was a nice healthy pink. They were all less overjoyed as the small warm operating theatre filled with the terribly stale gas that had to be drained before everything could be put back in place.
Max awoke feeling tender and disorientated but without the feeling that he needed to do the biggest fart in the world. Within days life was returning back to normal with food becoming one way traffic again. He was a Labrador again!
A Big Thank You...
...to all our patient's owners who gave their kind permission to share their stories
Sat 8.30am - 12.20pm
Leonard Brothers Veterinary Centre
501 Crewe Road
Sat 8.30am - 12.20pm
Leonard Brothers Veterinary Centre
Unit 7-8 Brownlow Street Arcade