Sunday, September 25, 2016

Vaccinations and Titre Tests - Protecting Fionn and other Furbabies

As a practicing veterinarian in 2016, I am extremely thankful for vaccinations - for the health for my human and animal family that I love so much. 

In the human side, we have been able to eradicate many diseases, such as small pox, and reduce the incidence of many others, such as measles, polio, whooping cough, rabies.  On the veterinary side, parvovirus is not as common as it used to be, and I cannot remember the last time I saw a distemper or infectious hepatitis case. Rabies vaccinations in our dogs and foxes (in those continents where it is still a disease) has reduced the incidence of disease in us humans. 

In other words, vaccines are not evil, and vets (and doctors) are not "over-vaccinating" our pets and our children. 

As parents we should be asking (not assuming) that those around us are vaccinated (or if they aren't, what is their medical/veterinary reason for not getting it done). 

Vets are your friend, not foe.

A big congratulations to all loving pet owners who take the responsibility of ensuring their pet is protected against these horrible, fatal diseases.

So what do you do if your pet gets sick from the very thing that is supposed to protect them? 

As a mother, my own son had a vaccination reaction.  I spoke with my GP, and we were able to come up with an option that ensured he was protected, and kept healthy too.  I take vaccinations seriously.... it is not a "jab and run", and I acknowledge that it is not risk free either.

As a furbaby mother, you need to do the same thing. Speak to your vet about your concerns - in many cases, what your pet experienced had nothing to do with the vaccine, and everything to do with a "big day out" and "sensory overload". If it was a vaccine reaction, there are things we can do to make sure your pet is protected.

If you are part of our animalclinic family, then we will discuss with you what is the best thing for your pet - whether it be re-vaccinating, or re-vaccinating with supporting medication or supervision, or titre testing. 

At Russell Vale Animal Clinic, we remain up to date on all things relating to our animals under our care - whether it be vaccinations, surgical sterilisations, microchipping and of course, all of the medical and surgical diseases also. 

We have been providing Triennial vaccinations and Vaccine Titre testing since they were available in Australia, and in recent years, also perform our vaccine titre test on site (faster turn around of results).
Meet Fionn
This is very useful in those cases, like Fionn, who was very sick after his second vaccination when he was 12 weeks old. He was sick for two days.  Whilst he wasn't sick enough to require medications or to be hospitalised, he was sick enough to look at what the options where for him when it was time for his third vaccination.

This is where vaccine titre testing is useful.

It lets us know whether another vaccine will be of any extra benefit for him, and let us determine whether the risk of the vaccine outweighs the benefits. 
You see, as a veterinarian, it is all about risks and benefits.  Nothing in life is risk free - crossing the road, buying a house, meeting your life partner, to something inane like buying a pair of sunglasses.  If you buy the wrong pair, thinking they will protect you against UV light (and they don't), they can still cause damage to your corneas. 

The last thing I wanted to do was to disregard Fionn's parent's concerns.  He was genuinely unwell, and they were scared (understandably so).  My role as a veterinarian was to reassure them that Fionn would be fine (he was), and that we had his best interests at heart (which we do).

We opted to perform a Vacci-chek Titre Test, in accordance with with 2015 World Small Animal Association Vaccination Guidelines.

 It starts with taking a blood sample.  Then when we have 45 minutes clear dedicated time, our vet nurse Tegan runs the test.   For Fionn, it was after our usual consultation time on Saturday afternoon.  Fionn's pet parents were concerned, and wanted fast answers.  Our onsite titre test allows us to do just that.

After going through the various steps (it is 12 step process), the strip magically changes colour. 

We match the top dot against the control.  And that sets it up for the remaining three "dots".

All of Fionn's results were high positive (> 6).  This meant that for him, any vaccination was not going to be of any further benefit for him.  This is great news, as the last thing I wanted to do was to downplay or disregard his parents concerns, but neither did I want to subject him to something that had the potential to cause him harm. 

As a veterinarian, I take what I do extremely seriously, after all, it was all I wanted to do and be since I was in fourth class.  The absolute central core of what I do is what is the best thing for my animals - what is the best thing to keep them happy and healthy always.   

I am Dr Liz, the mad vet from Bellambi.  Please, do not ever use the word "over-vaccinating" in front of me, as I hate that word. 
 Vaccines are still the best line of defense we have against many of the diseases that afflict our world. I clap my hands in support of all of the scientists and researchers who work so hard to find cures for the illnesses that affect us and our beautiful animals.

Saturday, September 24, 2016

Five things that Warms this Veterinarians Heart

 Recently, I wrote a post about the five things that hurts a veterinarians heart.  Like anything in life, when there is a downside, there is always an upside.  It is the upside which gets me jumping out of bed in the morning, excited to get to work.

It is too easy to focus on the negatives.  We need to remember that life is not fair, bad things happen to good people, and we need to always look at the good in people and in life.

So now I am sharing some of the things that encourages me to jump out of bed, excited about what the day may bring (Honesty moment here - I have to admit that I am one of those people where the line "I don't like Mondays" rings true, so I don't get excited about Mondays.).

Puppy Breath and Kitten Meows

Ah, the sweet smell of a puppy, or the cute "Meows" of a bubba kitten.

There is something very special knowing the joys of a new furbaby starting its life journey with its forever family.
Tegan and Paige on the day we met our new puppy, Piper

With each puppy breath, you visualise in your head the walks on the beach, the hugs on the lounge watching their favourite TV show, the learning on both sides of the tug toy.

With each kitten Meow, you see them prancing, climbing curtains, and sitting on someone's chest purring loudly with contentment. 

Life is always about shared experiences with family, as it is those days that we treasure when we are on our deathbed (or so I am told, as I am not quite there yet). 

When I can say "your pet is awesome"

Followed up by " Despite my best efforts, I can't find anything wrong".

Smiles all round. I love those happy visits.
"You  are awesome, Ms Patches"

When we ask the important questions on what they are on for Heartworm prevention, intestinal worming, flea control, what they are eating, and what they are using for their pet's coat needs - we get the answers.  

It is alot better than some of our usual answers of "the other half does it", " its the spot on the back from the supermarket", or "its the food from the second shelf, and it has round bits and long bits in it".

When I hear "they love coming in"

We love it that many dogs run up our front ramp and can't wait to come in.  Or, when they are told that they are off to see Auntie Liz or Uncle Dirk, their little tail wags in excitement.   Or when the pet owners turn the corner, the look in their pet's face changes (and it is not sheer terror), at the excitement of coming in.
Dr Liz getting a free face wash from Lillie.

It is exciting when they run into the consult room and sit in front of the back bench (the place where all awesome things come from - like the thermometer, the stethoscope and the home made liver treats).

Admittedly, it is not something I hear often when it comes to our cats, although I do have a few that are happy to come in, walk around and enjoy our treats (Caash is one of them - he also likes to brush his teeth, so he is a superhero also). 

When I read "excision is complete" and other news of a job well done

One of the hard things of being a grown up adult, is that you no longer have teachers giving you a star for good work, or an A+ on the school report.  One of the lessons learnt as a qualified veterinarian, is that we have to take any positive as a "win", as there are always going to be moments and days when nothing seems to go well (for you and the pet).

Lumps and bumps on our pets are sometimes challenging - some of the lumps can be cancerous, and the surgery can be technically challenging ( like the one I did recently that was adjacent to the anus, or the lump I removed of a dog's nose the other day). I was ecstatic when the reports came in that said those very words "your diagnosis is confirmed, excision is complete".

Knowing that a pet is no longer in pain -

Pain - our pets are sentient beings, and they feel pain.   Why so many still deny this very fact, I do not understand!

Pain management has come a long way, with a whole plethora of medications available now, that were not available  years ago.

Piper - a happy dog at the dog park.
It puts a smile on my face when I am able to remove those infected teeth, and being told by the owners that their pet is acting like a puppy or kitten.

The other day, when I removed dust and debris from a dog's eyes (Olivia had very sore eyes), her owner made the comment that Livvie looked like she was actually smiling by the time I was finished.

Even something like nail clips  and expressing those smelly anal glands is rewarding - as it makes every pet more comfortable afterwards.

This is is also why letting a pet go to a better place, may be physically and emotional painful to me as a veterinarian, but being able to do so means that I have completed my veterinary oath to this pet - I have alleviated them of further pain and suffering in the most gentle and compassionate way I can.

My vet team - Tegan, Dr Liz and Dirk
Finally.... being a vet is like being the ping pong ball, being hit from one side of the table to the other - one side is called "highs" (when things are going well)  and the other side  is "lows" (when you have a day you would rather forget).  

In any given day, we are hit from one side to the other in such a short time that it can be hard to catch one's breath. 

And there are some days, when you always seem to be hitting the net, stuck on the "low" side, never seeming to get over the net, no matter how many times you try.  What I tell myself when I do get stuck on the low side, is that at some point, I am going to get over the net back into the "high" side.  I always do, and know I always will.

I am Dr Liz, the mad vet from Bellambi. 

We love seeing puppies and kittens of all ages, and we promise to make every effort to make their visit with us as calm as we possibly can. 

Friday, September 16, 2016

Why do you need to do Dental Radiographs?

"Why do you need to do dental xrays on that dog?, asked a veterinary colleague recently.

How do I explain to someone who, by the tone of their voice, sees it like an unnecessary waste of time.  After all, what would radiographs show that you can't see yourself with the naked eye?

"If there is periodontal disease, you don't need dental radiographs to show that.  "  says my veterinary colleague.

"True" I say. " If that was the only reason I would be doing them then you would be completely right."

Periodontal disease is not the only disease that occurs in our pet's mouths. There are so many things that can wrong in there, that it would require multiple volumes to do the topic justice (which is why those textbooks exist).

So, let me see if I can convince my colleague that dental radiographs are necessary, and along the way educate  pet owners that when they are choosing a vet hospital for their pet's next "dental" they should choose one that routinely includes dental radiographs even in the lowest grade dental procedures.

For example, our Grade 1 dental procedure includes two dental radiographs, and in our Grade 2 (and 3 and 4) dental procedures, we always xray the entire mouth.  They are not an optional extra, they are part of our dental packages.


To make sure as  much pathology that is humanly possible to find, is found and treated.

The Wobbly Tooth

Periodontal disease is not the only reason a tooth may wobble.  It may be fractured under the gum, like this one was.  And sitting right next to that was a tooth root from a previously fractured tooth.

If you just removed what you could see (without radiographs), the pet would have nice white teeth, but still be in pain. 

Moth-eaten teeth (aka resorptive lesions)

All vets have seen those typical "neck" lesions on cats, when you touch them with a probe, watching the jaw shudder.  Painful.  But easy to pick up.  

What about those that extend a bit further? You need xrays to find those (which is why our Grade 1 mouths in cats now  always include full mouth xrays the first time we do them). 
Twosome or threesome ? (two roots or three)

It is easy to forget that many pets "Do not read the textbook".  The pictured  tooth that is fractured  is the third upper premolar (of the right), and the textbook says this tooth has two roots.  

The dental charts from all over the world will draw this tooth with two roots only.  

So, without dental radiographs, you would remove the fractured crown, and you would remove two roots.  Most would pat yourself on the back for a job well done.  But,  a tooth root would have been left behind, and be a source of ongoing pain.

Me, as a vet, I would NOT be happy with that at all.  Me as a pet owner, I would be downright angry and disgusted the moment I found out that had happened (the retained root can be a cause of ongoing pain, and sometimes abscessation).

 "Evil" Curve 

 It is not uncommon for us to radiograph a normal looking mouth, and find tooth roots going at 90 degrees at the end.  We warn pet owners about this, as these angled roots make extraction more difficult if they need to be done in the future - more bone needs to be removed, more pain for the pet.

Extraction is not necessarily necessary in all pets - if you keep the teeth healthy through regular oral care, then many pets can keep most, if not all of their teeth well into their senior years. 

 There are some pets that are so genetically flawed, that extractions are going to be necessary, but these should be the exception, not the rule.

 Hide and Go Seek (the unerupted tooth)

This is a radiograph of my own dog, Piper, when she was 7 months old.  The lower first premolar on both sides was not visible.  So why is this important to know?

In any dog with missing teeth, we need to radiograph to make sure that the tooth is truly missing, rather than fractured  or unerupted.

If we, as veterinarians, say that we believe in Animal Welfare, and that we believe in preventative medicine, then what does it say about us, as professionals, if we say "but why do we need to do dental radiographs".

Hallo Halo (aka the tooth root abscess)

 All vets are familiar with the tooth abscess look on the dog - with the painful swelling on the side of the face, or under the eye. The most common tooth that is the culprit is the fourth premolar (second tooth from the left), whereas the problem tooth is the first molar (the first tooth from the left). Radiographs show this up very very clearly.

I once had a case where the dog had wear on all of her teeth, and a swelling along the jaw - it was only with radiographs that we identified the correct tooth causing the abscess (it was her canine), extracted that one only, and problem was solved.

A dead tooth

If you look at the xray closely, you will see that one big canine is different to the other - the pulp (the centre part) is wider in one tooth, which is not normal.  It means that the tooth died a while back.

The teeth are living things within our bodies.  When they die, they cause pain.  Whenever we look at radiographs, we can determine many many things - such as the age, sometimes the breed or breed type, whether there has been previous dental work done.

Dead teeth need either a root canal or extraction. But if I just looked at the tooth visually, I would not have picked it up easily.

So, what do you think?  Was my argument convincing? 

I am Dr Liz, the mad vet from Bellambi.

 Admittedly, I try to be thorough in all aspects of the services that we offer at our veterinary hospital, and dental radiographs are one of the essential core components of our dental services.

At Russell Vale Animal Clinic, we offer free dental checks every day that we are open, all the time. Our dental checks are there to help you continue to keep your pet's teeth healthy, and to recognise all of your hard work in doing so. 
We know when a pet owner has been good (being proactive in their pet's dental health), and not so good (room for improvement).