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.
Betty is a 10 year old diabetic cat. He was diagnosed with diabetes in October last year and has been having twice daily insulin injections ever since. Diabetic cats are very special and can go into “diabetic remission”, this means that if the diabetes is well managed cats can recover and be cured of their diabetes.
Betty was at home one evening, he had his insulin as normal then went out for a night on the tiles as usual. What we had not realised is that he was starting to go into remission. The next morning Betty was discovered lying outside in the freezing cold, crying out and trembling uncontrollably. His Dad rushed him straight into us.
Luckily when Betty arrived at the practice Katherine was free (well she was drinking her morning brew but as she is a very dedicated vet she put this down and rushed to see Betty). He was in a state; he was so cold we could not get a temperature reading, he was trembling, randomly meowing and was very disorientated. He was started on warmed intravenous fluids and surrounded by heat mats, blankets and beanies in a attempt to warm him up. Hypothermia like this is life threatening and Betty was in an extremely critical state. It was still unclear was what had caused him to collapse in the first place – had he been hit by a car, or eaten something toxic or was he having a hypoglycaemic crisis?
Blood tests showed that Betty's blood glucose was normal at first but as we warmed him up it starting dropping to dangerously low levels. So he was started on a special drip with glucose in it.
It took three hours of intensive warming and monitoring for Betty's temperature and blood glucose to be back within the normal range. During this time Betty transformed back into his normal self, he stopped trembling and vocalising and he seemed much more aware of his surroundings. Within 5 hours of being admitted he was up and about, eating and drinking as normal, like nothing had ever happened! That evening he was discharged from hospital and went home.
The reason for Betty's collapse was that he had started going into diabetic remission. Owning a diabetic cat is hard work and takes a lot of care and dedication. Cats are so much more subtle than dogs, so early warning signs of a hypo episode can easily be missed. Betty is still diabetic now although he is only on a tiny dose of insulin. He is simply a gorgeous boy who has a true desire to live!
Congratulations Betty the Boy on being our patient of the month for March
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!
Baloo woke up and was feeling rough. He felt weak and standing up was far too much effort. His eye and cheek hurt and when he caught sight of it he looked like he'd gone 4 rounds with Mike Tyson, but he didn't remember it at all. Mum offered him some breakfast but despite his inner Labrador self, he just couldn't face it.
A trip to see the vets was called for.
Sarah had a look at him and was worried. His gums were white and he was coughing. When she listened to his chest it sounded loud and crackly. He had a swollen cheek and he had a haematoma in the conjunctiva so it was difficult to see his eye but no one knew why this had happened.
The main thing we were worried about was where had his blood gone all of a sudden?!
To start with he had some blood tests to try and figure out what had happened. There wasn't much wrong with the bloods other than a low PCV (packed cell volume) which meant he was definitely severely anaemic.
There are a few things that can cause a dog to become anaemic but only a few that cause their blood to stop clotting and we suspected that Baloo had a clotting disorder given the excessive injury on his face with no history of trauma.
A clotting disorder is something that can occur for various reasons that prevents an animal's blood from clotting as normal. This means they can bleed a lot from what would normally be fairly minor injury and eventually they can bleed to death.
Lung worm infection can cause clotting disorders as well as a cough so this was one of the first things we ruled out. We ran a test for this which came back negative.
Next, we xrayed Baloo to find out why his chest sounded so terrible. On the xray we could see that his trachea (wind pipe) looked very narrow which can be a sign of rodenticide poisoning (rat bait poisoning).
Baloo hadn't knowingly eaten anything unusual but we were concerned that maybe he had been helping himself to things he shouldn't have been (he is a Labrador after all!).
Even though Baloo's owners didn't think he could have had access to any, sometimes when dogs go roaming across fields and getting into mischief they may accidentally find rat bait that other people have left out. Unfortunately, I think Baloo had been one of the unlucky dogs that had done this and it was likely he had been getting access to it for a while.
Vitamin K is the treatment for rodenticide poisoning so we dosed Baloo up with lots of it but it takes some time to work. It was getting touch and go whether he would have any blood left by the time the medicine started to work so we decided we needed to step in and help him out.
Peaches, our Vet Nurse Heather's dog stepped up to the rescue as she was a suitable blood type for Baloo. She came in and we took 350ml of her blood and then slowly transfused it into Baloo.
Although he had the transfusion very slowly over about 4 hours, his temperature started to rise and he still looked very poorly. We were all very worried about him.
A few hours later, once the transfusion had stopped Baloo started to feel like himself again. He snoozed overnight and by the morning felt like a new dog, tail wagging and appetite back.
He went home that evening, still on the vitamin K tablets and had to be very careful not to bump himself for a few days so lots of rest and relaxation was on the cards.
After a rodenticide poisoning the Vitamin K tablets have to be continued for a long time, about 2-4 weeks depending on the type of rat poison they have eaten. As we don't know which poison Baloo had we sent off some blood to the lab so that they could tell us how long to continue with treatment for.
When Baloo came back in for his recheck a few days later, he was bouncing off the walls and looked unrecognisable to the collapsed, poorly dog that first came in to see us. It was great to see him back to his usual happy self.
Because he was such a fighter Baloo has been crowned October's patient of the Month!
Chime was heavily pregnant and fed up, she felt terrible. Her owner had been watching her closely and trying to convince her to eat but Chime wasn't having any of it. So she was packaged up and taken off to see Katherine the vet. Poor Chime was very dehydrated and weak, so onto a drip she went and blood tests were taken. Tests showed that Chime was severely anaemic but for now she was stable, so Katherine went off to the vets’ clinical meeting.
However, come 10pm there was a surprise waiting when she headed back for late checks; Chime had started giving birth prematurely. Katherine donned her midwife hat and put the kettle on; it was going to be a long night! By morning Chime was completely exhausted but she had three live kittens. She was doing her best to nurse and care for them but she was too weak so the decision was made to hand rear them. Convinced that Chime still had more kittens inside, Katherine performed an ultrasound. It was amazing, there was a kitten and against all the odds it was still alive, its little beating heart could clearly be seen. Chime was too weak to give birth naturally so the hard decision was made to take her to surgery for a caesarean. Incredibly she took the surgery in her stride and had an uneventful anaesthetic and recovery. An oesophageal feeding tube was also placed so that nutrition could be given to Chime who was still refusing to eat. The new kitten was taken home by Katherine, with its brothers and sisters, so that feeds could be given frequently throughout the night.
The next morning Chime was even weaker still, her anaemia was now life threatening, if she was going to pull through she needed a blood transfusion. Chime’s owner suggested using “Chudley”, a very handsome strapping male Siamese, who was Chime’s son from a previous litter. They were both blood typed and, very luckily, were a match. Chudley was lightly sedated for the blood donation but he was so good he hardly needed it; in fact he was a total hero throughout!
Chime was started on her blood transfusion and monitored very closely by Claire and Heather. The transfusion went like a dream and the difference in Chime was instantaneous: she went from a depressed, non-moving, non-caring feline to a walking, shouting feline in 4 hours! Chime stayed in hospital for the following few days, having regular tube feeds and lots of cuddles and love, each day we saw a very slight improvement.
Chime was then discharged and her amazing owner took up her care (as well as hand rearing Chime’s four kittens!). Over the following weeks Chime gradually started eating again and slowly her strength returned. We removed her feeding tube when she was eating normally. Her anaemia is also slowly resolving and she is now being a mother to the kittens again.
The exact cause of Chime’s anaemia remains a mystery to this day. We are all so chuffed that she is doing so well with the treatment she has been given. Chudley also deserves a special mention because he truly saved his Mum’s life!
Congratulations Chime on being September’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 Ltd
Unit 7-8, Brownlow Street Arcade
Sat 8.30am - 12.20pm
Leonard Brothers Veterinary Centre Ltd
501 Crewe Road
Opening summer 2019
Leonard Brothers Veterinary Centre Ltd
Unit 2, Nantwich Trade Park
Beam Heath Way