Tinkerbell Hanson’s Life Story, Remembering

We recently said our goodbyes to a dear patient of ours, Tinkerbell. Here is her story, written by her wonderful human, Diana:

Tinkerbell Hanson’s Life Story

To Dr. Wang, Suzanne and the Staff at East Bay Veterinary Hospital,
I wanted to share with you Tinkerbell’s story

I was driving home June 2nd 2017, a Friday night around 5:00 after work, and I usually go over the Altamont pass and take the back roads home through Byron because of Vasco Road traffic. When I got near the bottom of the off ramp (click the link https://www.google.com/maps/@37.7402525,-121.5857948,467m/data=!3m1!1e3 to see how isolated this area is) in the middle of nowhere I saw a gray tabby in the dry grass just about 10 feet from the road. She was sticking her head up, looking for someone, but then ducked back down. I put my window down and called to her. Cars were coming up behind me so I had to pull away. I felt terrible and thought about the kitty throughout the evening.

The next morning, I woke early and went to visit my dad who had dementia, as I did every morning, who was in a memory care residence in Pleasanton. I left my dad’s around 9:45 am and headed home. I was going to take Vasco home since there is not much traffic on the weekends. At the very last second I remembered the kitty and got back on the freeway and went over the Altamont Pass knowing that it was impossible for that cat to still be at the off ramp. Yes, as you probably guessed she was in the exact same spot! I pulled as much to the side of the off ramp as I could and got out of the car. I went into the dry grass probably filled with snakes! The kitty ran from me a bit but I was eventually able to catch her! Then she got scared and started trying to get out of my grip and I didn’t have anything to put her in to secure her for the drive home. It breaks my heart to say I had to let her go. I knew I would go home and recruit help. I didn’t feel safe being alone there in the snaky grass in the middle of nowhere.

I got home and started asking for help. My sister has a friend in walnut creek that fosters kitties and has rescued many cats. She now has the feral cats living safely in her yard and they are cared for beautifully. My sister calls it a sanctuary and she is right! My sister and the gal named Cricket were at a swim meet for the kids and couldn’t help me at the time I called, but Cricket said she would take the kitty if we caught her.

I messaged my best friend Lori in Dublin and she and her husband Mike dropped everything and met me there at the off ramp. No kitty! Mike went a few feet away from where I had seen the cat and there was a flattened cardboard box. He lifted the box and the cat ran out. Lori ran interference and made sure the cat didn’t come down to the lower road. Together Mike and I tried to catch the cat and the cat ran up the hill to the freeway! The cat was about 6 feet from the traffic zooming by. I closed my eyes and prayed. She then ran under the overpass in the dirt section that runs under it. She was at the top and it was a challenge to get up the hill. Mike was climbing up the grassy, snaky hill under the overpass. Mike managed to carefully get close to the cat and got a hold of her after a few minutes. The kitty seemed to trust him right away. Once he had a hold of her he was petting her and she seemed ok. So I came up the hill with the carrier and finally made my way to them and a motorcycle came by which scared the cat as we were trying to get her in the carrier. She scratched Mike. Thankfully he is ok. We did get the cat inside the carrier.

I loaded her in the car and took her to Cricket in Walnut Creek after picking up my sister Sue. Cricket was so lovely and caring and made a safe and secure spot for the kitty to get settled after a traumatic few days at least. Cricket’s family was so sweet and welcoming about helping this kitty. Cricket said the kitty was dehydrated. I am not surprised by that since it was hot and there is nothing for many miles out in that area.

My sister gave me an update from Cricket that night. This is what Cricket had said, “I just hung out with her in the bathroom and she rubbed up against me and I petted her. She is totally tame.” She also said, “she would start eating then stop and come over to be pet because she was so happy to have attention.” I think that this is the first time in days that the kitty felt safe.

They named her Diana Prince Wonder Woman! Cricket asked me to take the kitty since she had so many feral cats at her house and this kitty was very tame. I had not planned on getting a cat since my cat that I had for over 18 years had passed away not that long before.

My dad with his dementia was my focus. Every morning at 5am I would leave home with coffee and toast with dad’s favorite jelly and get to his facility by 6 am to spend an hour with him before I went to work. It was an important routine since he still responded to me during those visits. I didn’t feel like I could manage having a new cat while my focus was my dad.
But…. I guess it was meant to be.

The journey began. I picked up Tinkerbell in Walnut Creek and renamed her Piper because the way I go home at night takes me by the Byron airport and Piper is a kind of airplane.

I never regretted the choice I made to adopt her.

Shortly after spending time with her I realized that by the way she runs everywhere with a wonderful bounce that she is Tinkerbell!
She adjusted to her new home easily and was affectionate and sweet every moment. She loved every one that she met. When the doorbell rang (most cat owners know that cats hide when the doorbell rings) Tink ran to the front door to greet whoever was visiting. She expected and got attention from the visitors and made herself at home on their lap.

After a few months Tinkerbell had an episode that brought us to East Bay Vet for the first of many times. She was anemic. We met the wonderful Dr. Priest. She was so kind to us (my sister and I) and took us through what was happening and how they were going to help Tinkerbell. I spoke to doctors on each of the shifts and felt so good about the care Tinkerbell was receiving and how well they knew sweet Tinkerbell and each had stories about her. We have had a few evening visits that brought us back to Dr. Priest and each time she was so supportive. The first time was a scary few days. Little did we know then that it was going to be a journey. Tinkerbell has probably seen every doctor (and loved all of them) at the hospital at one time and many specialists across the country know about this mystery kitty.

The evening and overnight Doctor’s, techs and staff played a significant role in this story as well. They are not forgotten by me as I know they spent many evenings and nights with Tinkerbell and caring for her. I knew that she was in great hands and probably loved all the attention she got from them.

I have heard more times than I can count that Tinkerbell had no idea how sick she was and that she had more lives than any cat because of her strong will and love for people.

Over the past several months I heard stories every time Tinkerbell and I came to Encina of the sweet encounters staff had with Tinkerbell, from Tink always being held, meowing at staff as they walked by her cage to give her attention, purring so loud they couldn’t hear her heartbeat and the sweet nicknames that staff had for her. Brianna, during one of Tinkerbell’s overnight stays, went in the back to get Tinkerbell so I could say goodnight before I left. She said that when she went in the back asking for Tinkerbell that Tinkerbell answered her from her cage.  Like, oh that’s me, I am right here.

Even with the many visits we made to Encina there were staff I didn’t recognize but as soon as they saw Tinkerbell they would say, “I know Tinkerbell” or if they saw us in a room would ask if they could say hello to Tinkerbell.
The staff from the front to the back have made me and Tinkerbell feel special over the past year.

Suzanne was always there for us and nothing was ever too much to ask. She was our link to Encina and made sure whatever we needed or asked for we received without hesitation. She greeted us warmly and said nice things to Tinkerbell. She brought Tinkerbell food and water in the room when we were there for appointments because she knew that Tinkerbell was hungry after an hour drive there and hour in the back having tests. Tinkerbell loved to have a snack before we got on the road to head home.

The Hero:
It was Dr. Wang who lead the charge to figure out what was happening to Tinkerbell. She was so patient as we tested, retested, tried this medication and that medication to first try to diagnose the cause of her trouble and try to cure her and then just to keep her stable. It was a balancing act for sure. Dr. Wang called on every resource she had to help Tinkerbell. We had many successes in her treatment and many setbacks but Dr. Wang never gave up trying.

It was a long journey. I can’t express enough how much I appreciate Dr. Wang and everything she did for Tinkerbell. She never gave up or asked me to give up.

But we both knew that one day, as Dr. Wang said, we would not be able to turn things around.

She said that one day it may be “time” and I knew that she would guide me to when that “time” was.

We faced that on Wednesday. A heartbreaking day for me and I am sure for Dr. Wang and the staff at Encina. I could not face being there but I knew that during this time there was no place on earth with as many people who loved Tinkerbell than at Encina. Dr. Wang was so sweet and called me that evening to check on how I was doing. She gave me comfort by telling me that Tinkerbell was held as she passed and that it was peaceful.

My heart was broken and still is over losing Tinkerbell.

She has been such a treasure. I have never, ever met a cat with as much love and charm as Tinkerbell. Thank you for helping me have the past year with Tinkerbell.


Riley the Dog’s Prosthetic Orthopedic Foot

Riley is a 1 year old mixed canine who was recently adopted from Guatemala! With the help of OrthoPets: Orthotics and Prosthetics for Animals, Board Certified Veterinary Surgeon Dr. Carl Koelher will be creating a prosthetic foot for Riley the dog. Here’s a few pictures of the process:

A Thousand Thanks from New Mexico

Back in July of 2011, we received a phone call from a gentleman named Kyle who was looking to schedule an appointment for a rhinoscopy for his pooch. Everything seemed fine until he explained to us he is currently in New Mexico and lives there as well. Kyle was doing some online research on what could have been causing his pooch, Oakum, to sneeze excessively, when he came across a previous blog entry of ours on a patient named Ice Bear who had a foxtail or two lodged in his lungs. This story prompted Kyle to give us a call and schedule an appointment with our Board Certified Veterinary Surgeon Specialist, Dr. Carl Koehler to help figure out what was going on with his beloved dog, Oakum.

Below you will find the detailed recount of events that Kyle went through as a pet owner with a pet in distress; the moment of panic, the numerous veterinarians and the lengths we as pet owners go to for our pets.

    As we all know, our lives change day-to-day, and often are not even remotely predictable. Events occur in an instant that can completely alter the course and thrust the most well meaning and responsible travelers on that familiar road into a fork, and an unmarked one at that. Life doesn’t come with an ‘‘instruction manual’’, and choices have to be made daily, hourly, minutely, and even second by second. Any one choice can be the wrong choice, and the devil of it is, you almost never find out until it’s too late to select ‘‘reverse’’.

    Living with an animal companion can be a very worthwhile and rewarding experience. Unfortunately, every reward carries it’s own distinct and definite risk. Illness is a very powerful force against those of us who have the fortune to be alive, and just because we love someone or something very much, doesn’t always protect the subject of our respect and our well-wishes. Love can help a great deal, but modern medicine is the only real foe for illness. The claws of medicine are instruments, it’s gaze is one of knowledge. The skill and strategy of medicine lies in the learned, and articulation and agility is empowered and enforced by scholars. To have all four in one place is certainly remarkable, and that is exactly what I found at Encina Veterinary Hospital. I traveled over a thousand miles to challenge my expectations, and when I arrived, I found them distinctly defined, and most certainly exceeded. Quantity is almost never an acceptable substitute for quality, whether it is in a book or a play, in a relationship, or even with veterinarians, quality pays for itself.

    My limits of attention were tested one evening, as I went into the backyard to work on one of my many projects. My dog followed me outside into the yard with which I share with a neighbor, and although I had asked her to keep the gate latched and shut, one way or the other it was left open by mistake, and my dog quickly exited to her delight, as to prowl and ponder the neighbors bushes and lawn. It couldn’t have been more then a minute from when I walked outside and from when I decided that it would be a good idea to check that the yard was secure and everything was OK before I set to continue construction on my home air purifier project. I let the dog out several times a day, and I try to always check that the yard is secure, but it is easier said then done, because the yard is long and the gate is around a blind corner. The dog has gotten out before, for this very same reason, so I was well aware of the danger of the risk of my neighbor leaving the gate unlatched. I had drawn up plans for a supplementary positive latch for the gate, but soon became conditioned after finding the gate closed several hundred times in a row.

    I found the dog right outside, about 20 feet from the gate, and I was quite relieved that I had found her quickly. As I got closer however, something was immediately apparent. My dog was sneezing quite violently, which is something I wasn’t accustomed to. My dog Oak was standing smack in the center of a Foxtail weed thicket, and as I looked closely, I could see that one of the crisp, lightly colored seeds had entered her little black nose. I told her to stop sneezing (a lot of good that did…) and attempted to prise the seed free with one of my fingernails. I have plenty of tools, and I even carry a select general few with me (knife, disposable lighter, ball point pen), but in the short seconds I had to attempt to fasten onto the seed and recover it, my attempts proved vain, and quite hampered by the fact that the animal was having a sneezing fit, and with each sneeze, the seed traveled further and further into the nose. A few sneezes later, it was too late, the seed had entirely disappeared into her nose, and I had to make a decision about what to do next. With my dog continuing to sneeze, I became on the verge of a panic. I figured that the seed could most certainly lodge in the throat of my dog and prevent breathing, (something that may have been entirely incorrect), and feeling totally helpless, I decided to seek assistance at the local emergency clinic. I called on the way to the clinic and was greeted coolly and not-quite-so cordially. Upon arrival, I found only that my helplessness was furthered, after waiting 8 hours for my dog to be sedated and examined with only the short stub of an otoscope, which I could have likely produced myself in that amount of time, and with a far lesser charge. The clinic was dirty, it smelled bad, and the nurses assistant acted like she had gotten in to the medicine cabinet and gave herself a little ‘‘treatment’’. I didn’t have a good feeling, but I couldn’t just change the plan now and give up! Not surprisingly, no seed was located or recovered, and I found myself wondering what to do with the rest of my weekend. Over the course of the weekend my dog continued to sneeze, and so I brought her to my usual general veterinary practitioner. This time, we held Oak to a metal table and again the vet used an otoscope to observe the immediate area local to the opening of the nostril. With the same result of no seed being observed, I again began to wonder about what to do next, as the vet had instructed me to ‘‘wait and see what happens’’. Several days passed, and my dog continued to sneeze and choke, and she became more and more out of character, as she layed around and seemed to be in somewhat of an agony. In my spare time, I researched foxtail seeds and the prognosis. I found that generally, acute foxtail inhalation usually was treated as an emergency, and that it wasn’t so unusual for the seed to enter one of the lungs and cause pneumonia, or pass through the lungs into a blood vessel and end up in the heart or brain and cause death that way. The seed could of course just remain local, and cause infection to the sinus cavity, or it could be expelled or swallowed.

    I’m not the kind of person who just sits by idly, likes to be told what to do, or even does what other people think I should be doing! I just feel better making proactive decisions that change the course of my life the way I feel it should be going. I decided that I again would seek professional assistance to fight illness, and this time I would take the most decidedly extreme approach I could afford or even design. I find that usually if you throw everything you’ve got at a problem and give it your full attention, it has a tendency to wither and disappear, and quickly. I called Denver, Phoenix, Ft Collins, and Santa Fe. In addition, I called every clinic that anybody that had a recommendation had, and still I found that I was either treated queerly and coldly, I was never given a return call, or most importantly, the equipment to look inside of the nasal cavity was not available. I must have called over ten DVMs in all. The stand-out was Dr. Köhler at Encina. I found the clinic while researching. Not only did he actually call me back and took the time out of his busy schedule to answer every question I had (I had plenty), he recommended that I see somebody closer to New Mexico. That was the silver bullet. I knew that someone who would recommend another’s services instead of himself had indeed the character of true responsibility. I again called around Denver and was told that ‘‘no information can be given without an examination of the animal.’’ That’s a nice rule to follow, but rules aren’t always the most practical items.

    My friend helped me drive to make the appointment at 9:15 am in California. We left Albuquerque. at around 2pm and drove through the night to arrive at Encina Veterinary Hospital at 9:10 am. Driving is not the safest of tasks, and my friend and I took quite the risk doing it. If you have one problem, you will be stuck on the side of the road with a sick animal, possibly in severe desert heat. We had no major problems getting to the clinic, but that could have certainly been different. I did have mechanical trouble (wheel alignment) that prevented me from leaving San Fransisco immediately. So take this medicine with a pinched nose, and be sure to explore all the information you have before making a decision.

    Using fiber-optics, there was a determination made that irritation was most certainly present in the side of the nostril that I saw the seed enter. No seed was found however, which indicates that it had become mobile and exited the body or located itself in another part of the body. It could most definitely have been swallowed, and since the chest radiograms were clear, and Oak is no longer sneezing or showing any symptoms, I may never find the seed, and I hope I never do 🙂

A thousand thanks from New Mexico,
Kyle C.

Kyle has sent us an updated picture of Oakum and has shared with us that he has trained her to now respond to a hand-bell so she comes inside to a pleasant sound!

Bernie: A Golden Story of Triumph

Below you will find a blog piece written by one of our former Doctor Assistants, Ashley. While with us, Ashley had the privilege of meeting and working with “Bernie,” a patient of ours who continues to amaze us each and every time we see him. Through out all of his ailments in 2011, Bernie continued to be a burst of positivity for us and we’re grateful he’s doing so much better, thanks to his doting father, Forrest.

    I originally met Bernie the golden retriever a few years ago during an annual exam. I was immediately taken by two things, 1) Bernie’s exuberant personality (he was all wags and barks) and 2) how much his parents cared for him. My coworkers and I became steadfast fans of Bernie’s infectious outgoing energy, so you can imagine our dismay when our lovable golden friend’s health began to fail two winters ago. It began with a diagnosis of diabetes in early December of 2010. Bernie mysteriously stopped eating, a sure sign in most retrievers that something has gone awry. Dr. Peter Nurre started Bernie on Humulin insulin. Soon after his change in medication, Bernie came in feeling crummy, and Dr. Roger Johnson performed an abdominal ultrasound on Bernie to find that he had an infection in his abdomen. Surgery was necessary to search for the source of infection, which is typically a perforation (hole) somewhere within the bowel, but in Bernie’s case the source of infection was not a perforated bowel, and remained a mystery. Dr. Johnson cleaned the infection out of the abdomen as best he could and stitched Bernie back up.

    After surgery Bernie’s troubles were not over, as he had several mysterious post-operative infections in spite of being treated with a battery of antibiotics. Soon after surgery Bernie went blind from cataracts, a common problem for diabetics, but had lost so much weight that the corrective surgery could not be performed as a result of the fact that his eyes were sunken into his skull so much. When I caught up with Bernie in February of 2011 I was shocked to see that he had dropped from a robust 80 pounds down to a paltry 55 pounds. His tail still wagged, but he was so thin he was nearly unrecognizable. It is hard to admit, but I was starting to lose hope for my furry friend. However, Bernie’s dad Forrest was vigilant during the whole process. Utilizing the latest in iPad applications and spreadsheets to track Bernie’s blood glucose and insulin doses, Forrest communicated regularly with Dr. Johnson via e-mail in hopes of controlling the diabetes.

    Bernie’s health seemed to decline even further when his jaw seemed to stop working in March of 2011, as he was diagnosed with a condition known as trigeminal neuritis by Dr. Filippo Adamo, our neurologist. This rare condition effects the nerves that wrap around the face, which control the ability of the jaw to open and close normally as well as the blinking reflex of the eyes. The symptom Bernie experienced was that of a “dropped jaw,” in which the jaw cannot close properly. Forrest had to hand feed and water Bernie for six weeks until the condition spontaneously resolved. During Bernie’s bout with trigeminal neuritis he would often bleed profusely from his mouth because when he would drink water, he would take in such large amounts that he would rupture blood vessels near the back of his tongue.

    After the trigeminal neuritis resolved Bernie began to gain weight again, and he was able to have cataract surgery in June of 2011. Bernie’s parents were thrilled when he regained his sight the same day as the surgery, and according to Forrest, the golden retriever’s happiness returned with his vision. Forrest noted the intense eye medication regimen that followed surgery, but Bernie’s renewed sense of self made the process worthwhile. Bernie’s eating stabilized, and in July of 2011 Dr. Johnson wrote the phrase, “getting fat! :)” in his chart.

    I caught Bernie and Forrest in the clinic a few months ago during a recheck visit to see Dr. Johnson, and I was thrilled when Bernie barked at me for attention as Forrest was showing me the latest blood glucose monitoring applications on his iPad. He looked like his normal Bernie self, and his wagging tail never stopped moving the whole time I was in the room. Dr. Johnson found some discrepancies within Bernie’s blood work recently (high tryglycerides and evidence of blood proteins), and he has since began a medication regimen to treat those conditions. Clinically, Bernie looked fabulous! I am happy to report that this past December the ten year old golden is once again at his fighting weight of 77.5 pounds. Dr. Johnson and the staff at Encina would like to commend Forrest for his vigilance in monitoring and caring for Bernie.

Please follow Bernie on Twitter @BernieLitke

A special thanks to Bernie’s dedicated father, Forrest Litke, for his contribution of information and pictures to this blog, and for allowing us to share Bernie’s story with everyone!

Hyperthyroidism in Cats: Introducing Hill’s y/d Diet

    As devoted pet owners we know that as our pets’ age, they become more susceptible to illnesses and health conditions. One of the most common diagnoses in older cats is hyperthyroidism; hyperthyroidism is when the thyroid gland (located in the neck) makes too much thyroid hormone for the body.

   Often times the symptoms of hyperthyroidism are not visible, but over time and as the condition worsens, symptoms become noticeable. The most common symptoms are weight loss, frequent urination, increased thirst and appetite.

   When a cat is suspected of suffering from hyperthyroidism, the veterinarian will first feel the neck of the cat to see if he or she can feel if the thyroid gland is enlarged. Often times, the thyroid becomes inflamed when suffering from hyperthyroidism and swells a bit. Heart rate and blood pressure may also be checked because when a cat suffers from hyperthyroidism, it causes the heart to work faster and harder which can eventually lead to an enlarged heart. After the exam is complete, a blood sample is taken from the cat and sent to the laboratory to analyze the present thyroid hormone.

   Should your cat be diagnosed with hyperthyroidism, you should know right away that there are options. Encina Veterinary Hospital in Walnut Creek offers two key options for treatment: medication or a diet change. We know that many pet owners have a difficult time medicating their cat for multiple reasons; this is why we are big fans of feeding Hill’s Prescription diet y/d Feline Thyroid Health brand pet food. It carefully limits the levels of dietary iodine to reduce thyroid hormone production and help restore health without the need for any other therapy.

   Once your feline friend has been prescribed the new y/d diet, you will gradually introduce y/d over a 7 day period by mixing y/d with your cat’s current food, gradually increasing the amount of y/d until only y/d is fed. Once your cat has been eating y/d exclusively for 2 weeks, you will then remove all thyroid medication from his/her life. In the 4th week after starting y/d, your veterinarian at Encina will then perform a recheck to see how the thyroid is doing compared to before the diet change.

   One of our recent patients, Autumn Pumpkin, was diagnosed with hyperthyroidism and was given numerous medications to manage the condition. This was not only a stressful situation for both the owner and cat, but it was costly as well. 3 weeks after Autumn Pumpkin began the y/d diet, she was completely taken off of all medications and maintains healthy thyroid levels on the y/d diet alone! WAHOO!!!

   The most challenging part about feeding your cat the y/d diet is the fact that you can no longer offer the range of treats and snacks you once did. It’s important your cat eats the y/d diet exclusively to ensure it works. However, Hill’s has been working very hard to come up with ways that cat owners can still spoil their feline friends and developed several recipes for loving cat owners to make hyperthyroid safe snacks!

Click here to download the recipe for Snack Triangles from y/d Canned Food, Gravy from y/d Canned Food and Snack Cookies from y/d Dry Food

Pascal’s Thankful Thanksgiving

    Pascal is a very sweet Bedlington Terrier that has been a patient of mine since 2003. We diagnosed him with copper storage liver disease in 2003 and have treated him with medications and a prescription diet. Copper storage disease is when the liver begins to accumulate an abnormal amount of copper, which in the long run can cause liver cirrhosis and is actually common in Bedlington Terriers, Doberman Pinschers and Labrador Retrievers. Since his diagnosis, Pascal has done well and there has been no evidence that his copper storage liver disease has progressed.

    In late November, just before Thanksgiving, Pascal was rushed to us on an emergency. He was reported to have become acutely very sick and was vomiting, lethargic, and not wanting to eat. On physical examination, he appeared very depressed, dehydrated, had abdominal pain on palpation, and a fever. We hospitalized him and started intravenous fluids, pain medications, gastric protectants, and broad spectrum antibiotics, and of course took a blood sample to analyze to see what exactly was going on inside of Pascal.

    Once his blood work came back, it showed us an elevation of liver enzymes and an elevated white blood cell count. We then preformed an abdominal ultrasound on Pascal which showed one abnormal liver lobe and free fluid in the abdomen. A sample of fluid was taken from his abdomen and after looking at it under the microscope; we saw that it showed evidence of a bacterial infection. Based on these findings, our primary differential was a liver abscess.

    Liver abscesses are rare in dogs. Some potential causes are sepsis (bacterial infection in the blood), trauma to the liver, and diabetes mellitus. Pascal did not appear to have any of these underlying causes. It is possible that his copper storage liver disease predisposed him to a liver abscess but this has never been reported.

    I discussed with Pascal’s owner that this is a very serious condition and without surgical removal of the abscessed portion of his liver, Pascal might die. Pascal’s owners elected to pursue surgery and we were able to isolate the section of the liver that was abscessed (the left medial liver lobe) and remove it successfully. We flushed his abdomen cavity with warm saline (salt water) to remove residual infection that had spread throughout his abdomen.

    Pascal has recovered well from surgery and it is great to see him back to his normal activities. You would never know that just a few months ago Pascal was deathly ill and had major surgery!

                                      Written by Dr. Peter Nurre, DVM, Dipl. ACVIM

Pascal’s owner Judy had some beautiful words for Dr. Nurre that we would like to share with you:

Dear Dr. Nurre,

   I sat down to write you a “thank you” note and I’m finding it very difficult to say what I feel. I don’t have the words to express how much Pascal means to me and then I realized that it’s okay because I think you know.

   Thinking and thinking and thinking – how can I possibly convey the flood of gratitude I feel for your incredibly generous offer to save Pascal’s life. You are in every way extraordinary special; both as a person and as a doctor!

   I normally don’t consider myself to be a lucky person but whenever I think about November of 2011, that’s the word that comes to me – lucky! I’m the luckiest person in the world to have miraculously had the good fortune to have Pascal in your care. This was a thanksgiving I will always remember. We will forever be thankful to you!

   I very best thing I could ever wish for you is that should you ever find yourself in the worst of situations, as I was, one that seems hopeless – the best thing that could happen to you is for there to be someone just like yourself, right there for you, like you were for us!

   The words “thank you” don’t even begin to come close to how grateful we are, but please except them and know that they mean infinitely, so much more.

               Wishing you the very best!
                      Judy and Pascal

Peanut the Miracle Cat!

Peanut's Baby Picture

It is said by many that cats have nine lives, as it would appear in the case of Peanut Matthews. Peanut, a very sweet seal point Siamese, has proven herself to be a survivor not once, but twice. Found by her human dad at St. Mary’s College (my alma mater) in August of 2010, she is the only kitten out of her litter of six to survive. Peanut came to us on the brink of death earlier this year, after her brother found her curled up against the back door of their house, crying, barely conscious. Dr. Johnson brought her back using life-saving measures that night, and Dr. Christine Fabregas recalls her story below:

Dr. Fabregas, attempting to get Peanut's blood pressure

“Peanut” Matthews, a 1 year old female-spayed Siamese cat, who was found by her owner at the age of 4 weeks. Peanut’s new family bottle feed her and nursed her to a healthy kitten. She was an indoor/outdoor kitten that loved to adventure through the neighborhood. On October 13, 2011, Peanut was presented to Encina Veterinary Hospital comatose, very low body temperature and blood pressure; neither was able to be registered. At this time the thought was that there was a traumatic event that occurred such as a hit by car. Her skin was bruised on her limbs and abdomen. She did not have any fluid in her chest or abdomen when scanned with the ultrasound. An IV catheter was placed and blood work was ran revealing a very low red blood cell count (8%) and her clotting factor time was out of range. Her limbs became rigid and she began to arrest. Emergency medicine was instituted with epinephrine and atropine injections. Her cardiac electrical conduction revealed ventricular fibrillation on ECG. The doctors defibrillated her chest and brought her back to life. She was given a blood and plasma transfusion, and Vitamin K1 injection for the possibility of a toxicity. She was intubated for oxygen therapy and protection of her airway. Blood was noticed within her airway tube and suctioned out. She began to regain more energy and her airway tube was removed. She was maintained in an oxygen cage, on IV fluid and medications for the next 24 hours. Her pupils were dilated and fixed, unsure if she has vision.

Peanut getting a blood transfusion, with Dr. Johnson & Barb's help

Peanut’s owner called later that evening stating the high likelihood of rat-bait toxicity found in their neighbor’s yard. We continued treatment for D-con poisoning. D-con is an over the counter rat poison, an anticoagulant. The mechanism of action is to cause bleeding, most commonly into the abdomen, chest, or subcutaneous. This also occurs in cats and dogs if they ingest the poison itself or if they ingest a rat that has ingested the poison. If you notice that rat bait has been ingested by your pet, it is recommended to bring them in to the veterinary hospital for assessment. This rat bait ingestion can be fatal if not treated.

Peanut in the Oxygen Cage

Peanut required multiple plasma transfusions to increase the amount of clotting factors in her blood to stop the bleeding. She had a few seizures over her first night in the hospital and the following day, which were treated and subsided. Medication was given to decrease the pressure around her brain. An IV catheter was placed in her jugular vein(neck vein) for ease of blood sampling and fluid administration. Peanut did not seem to be neurologically appropriate, because she was just laying on her side, not responsive to her surroundings. She would vocalize when pet, but was not completely aware. She was not eating or drinking on her own. A feeding tube was placed to increase her nutrition and prevent any potential liver disease. She was fed a/d slurry and administered oral medications through her feeding tube. Chest X-rays were taken and showed an area of a bruised lung. She began to have episodes of agitation to stimuli outside of her cage.

Peanut following the placement of a feeding tube

With time and intensive care, Peanut continued to improve everyday. She was noticed grooming herself, walking around in the cage, vocalizing,and more alert to her surroundings. She was slowly transitioned out of the oxygen cage into a regular cage. Her vision was still questionable, but her touch and light reflexes were present. Her temperature, blood pressure, and blood work were reaching normal values. She began to eat small amounts of food on her own. Her tube feedings were reduced prior to discharge from the hospital. Her bruising on her abdomen and limbs were greatly improved. Peanut was discharged from the hospital with instructions on proper feedings and administration of medication via the tube. She was responsive to her owners.

Peanut eating on her own!

On recheck examination, Peanut was active and alert with partial visual improvement. Her feeding tube was removed since she was eating well on own. She was grooming herself in the examination room in the arms of herloving owner. We wish Peanut and her family the best of luck in the future.”

Peanut feeling much better following a few days of intensive treatment

I spoke with Peanut’s dad recently, and he said that she is up to her old trick of hiding in the hallway and grabbing the legs of unsuspecting passerby.  Her vision has returned completely, all the better to find her targets. Peanut’s  spunky personality is still very much intact, and she has even learned not to use her claws when playing with her human family. We at Encina are very happy have been able to witness Peanut’s miracle recovery, and wish the best of health for her for the rest of her life!

Peanut's Unbreakable Spirit is Evident in Her Beautiful Eyes

Also, as a fun bonus, please check out Peanut taking her medication right out of her owner’s hand! Dr. Johnson and I have never seen a cat take medication so easily!  Peanut Taking Pills


Sophie’s Story, An Addisonian Crisis Averted

Dr. Dorothy Hoppe recently had a case that she found to be very interesting, and so we invited her to guest blog about it. Please read on for the story of Sophie, a dog that was close to death and had an amazing comeback!

Sophie, a 5 year old spayed female shepherd mix, came in one night at midnight. She was so weak she had to be carried in. Physical exam showed an extremely dehydrated dog, who was in profound shock. Her heart rate was unusually low and her blood pressure was so low it was difficult to detect. Sophie was literally on the verge of death. The history provided by the owners was not an unusual one for a dog coming in on emergency. Sophie had begun vomiting and having diarrhea that day. She vomited several times and become progressively more lethargic. She was known to chew on sticks and had access to a yard. However, her alarming state was not consistent with your run-of-the-mill vomiting and diarrhea. Something more serious was happening. The answer was quickly revealed by Sophie’s bloodwork. Not only did it show she was profoundly dehydrated, her electrolytes were extremely out of balance. This can happen with vomiting, but the pattern of her electrolytes was classic for a disease called Addison’s disease.

Addison’s disease is a disease of the adrenal glands. The adrenal glands are located above the kidneys and are very important! They produce adrenaline, the sex hormones testosterone and estrogen and the steroid hormones. The steroid hormones include glucocorticoids and mineralocorticoids. The glucocorticoids are important in the response to stress: they gear the metabolism towards the preparation of burning rather than storing fuels so as to be ready for a fight or flight situation. The mineralocorticoids are essential for electrolyte balance, which in turn regulates water balance. In short, steroid hormones are needed to adapt to stressful situations and without these hormones, even small stresses could lead to physiologic disaster.

In Addison’s disease, steroid hormone production is inadequate.  The body is thus unable to handle the stress of even a minor illness. Thus Sophie went from vomiting and diarrhea to severe shock in the space of twelve hours. She was in an Addisonian crisis.

Fortunately, an Addisonian crisis is very treatable if diagnosed and treated aggressively. Large amounts of intravenous fluids are critical, as is a dose of the missing steroids. These dogs often also require other supportive care such as anti-nausea medications and antibiotics, since their intestines are usually compromised and may be a source of bacteria. Within a couple of hours, Sophie was sitting up in her cage wagging her tail, and in the morning she was still a little weak but greatly improved.

Long term treatment consists of daily prednisone therapy to replace the missing glucocorticoids, and intermittent injections of Percorten, a drug that replaces the missing mineralocorticoids. Electrolytes are checked monthly to determine when more Percorten is needed. In times of stress, such as boarding, the prednisone dose is often increased to help the body cope. Dogs can live a long and healthy life with the appropriate treatment.

How is Sophie? She recently came in for an electrolyte check and was a happy, bouncy dog and was eating well; a very different dog from the one I first met.

Sophie (left) and Her Brother Lucas Enjoying a Day at the Beach

Albuterol Inhaler vs. Bella

Recently, a client of ours brought their precious dog Bella into Encina Veterinary Hospital on an emergency basis, after the owner noticed Bella had chewed on an Albuterol inhaler. While at home, Bella’s owners noticed that Bella had became very restless and had an extremely rapid heart rate while at rest. She even tried to eat but ended up throwing it all up soon after. They knew they had to get her emergency care right away.

What Bella had chewed on is a very common medication found in American households; Albuterol inhalers. This inhaler is commonly used in human medicine to help relieve bronchospasm associated with conditions such as asthma and chronic obstructive pulmonary disease (COPD). Albuterol is also used in animals for similar reasons to help alleviate cough.

But a too high of a dose can be life threatening, elevating the heart rate to life-threatening levels. Toxicity can also cause very low potassium levels in the blood which, in turn, leads to extreme weakness, in-coordination, and, potentially, death. Other signs which are often seen in dogs that puncture albuterol inhalers include vomiting, dilated pupils, severe agitation/hyperactivity, elevated blood pressure and vomiting.

Bella was admitted to the hospital for overnight treatment and monitoring. Blood work was performed to reveal any electrolyte abnormalities, as albuterol toxicity can cause a decrease in potassium and other important electrolytes. Low potassium can have severe consequences on an animal, as it is necessary for all muscle and nerve function. Too low of a potassium can lead to difficulty breathing and irregular heart beat.

Fortunately for Bella, her potassium levels were only slightly lower than normal. She was supplemented with potassium and her levels were normal by morning. Bella also received a drug that helped stop the effects of albuterol, allowing her heart rate to decrease and reducing her excitability.

By morning, Bella seemed much improved. She was now resting comfortably and had a normal heart rate. Bella was sent home later than morning, and owners report her to be back to her old self again!

Dr. Nadia Rifat

Dexter the Wonder Poodle

In June of this year a special puppy named Dexter walked into our clinic with the NorCal Poodle Rescue group. The little black poodle had been rescued from a homeless encampment in Sacramento, where he was not able to receive the veterinary care that he desperately needed. Dexter was not classically good looking by any means, as he was suffering from demodex (a parasite that lives in the hair follicles of mammals) and was more or less hairless. However, his personality shined through his soulful brown eyes, and he quickly won over the hearts of everyone at EVH, Dr. Jill Christofferson in particular. Jill led the charge in collecting donations and organizing surgical treatments to give the sweet poodle the chance to live a life that was pain free.

Dr. Christofferson was able to treat Dexter’s demodex (parasitic mites of the hair follicle), and also donated her time to perform entropion surgery to correct the fact that Dexter’s eyelids folded inward causing his eyelashes to rub on his eyes. During all of his treatments, Dexter never so much as lifted a lip at our staff; his patience and tolerance truly amazed us.

For more information on Dexter’s story, please see Dr. Christofferson’s YouTube video “Dexter’s Story”

And be sure to check out the NorCal Poodle Rescue Summer/Fall 2011 Newsletter, which honored the contributions of Dr. Christofferson and Dr. Nurre in Dexter’s journey to health.