NOW OFFERING: Laparoscopic-Assisted Ovariohysterectomy (Spay) by Dr. Nadia Rifat

We’re so excited to offer a less invasive, less painful, way to spay your dog! Keep reading for more information and give us a call at 925 937 5000 to schedule an appointment with Dr. Nadia Rifat

Why does a dog need to be spayed?
Spaying a dog consists of performing an ovariohysterectomy (OHE). The reasons we spay dogs is to reduce pet overpopulation, reduce the chance of mammary cancer development (must be done at a very young age to gain this benefit), and to prevent a life threatening uterine infection (pyometra). Approximately 25% of intact female dogs by 10 years of age will develop a pyometra.

What are the surgical options for spaying my dog?
The traditional open ovariohysterectomy, or a laparoscopic-assisted ovariohysterectomy. The traditional open ovariohysterectomy has been performed for many decades, and when performed by an experienced veterinarian there are rarely any complications and the recovery is typically quick. More recently, laparoscopic-assisted ovariohysterectomy surgeries have become another surgical option for medium to large breed dogs. The difference is that the laparoscopic-assisted ovariohysterectomy incision is smaller than the open approach because visualization of the organs and surgery is performed through the laparoscope.

What is the benefit of having my dog undergo a laparoscopic-assisted ovariohysterctomy vs an open ovariohysterectomy?
Although there are few pain studies to compare laparoscopic procedures to an open traditional surgical approach, the opinion of veterinarians performing laparoscopic-assisted ovariohysterectomy procedures is that this approach is less invasive and less painful than the open approach. Dr. Chad Devitt evaluated the laparoscopic-assisted ovariohysterectomy versus an open traditional ovariohysterectomy (Duration, complications, stress, and pain of open ovariohysterectomy versus a simple method of laparoscopic-assisted ovariohysterectomy in dogs. J Am Vet Med Assoc. 2005;227:921–927). His conclusion was the laparoscopic-assisted ovariohysterectomy procedures caused less surgical pain than the traditional open ovariohysterectomy procedures and may be more appropriate for an outpatient setting.

What are the potential complications of a laparoscopic-assisted ovariohysterctomy?
Complications from laparoscopic ovariohysterectomy are rare but can include: hemorrhage, subcutaneous emphysema, iatrogenic perforation of the splenic capsule during trocar placement, inability to complete the procedure requiring conversion to laparotomy, pain, seroma formation, and rarely infection.

How do I schedule my dog for a laparoscopic-assisted ovariohysterectomy?
Make a pre-surgical appointment with Dr. Nadia Rifat, who is the surgeon that performs the laparoscopic-assisted ovariohysterectomy procedures at Encina Veterinary Hospital. She will perform an examination on your dog and talk to you about the procedure. We will schedule your dog for surgery and submit pre-anesthetic bloodwork to make sure your dog is in good health. If your dog is at risk for a GDV (see information about laparoscopic-assisted gastropexy) that surgery can be scheduled concurrently.

NOW OFFERING: Laparoscopic-Assisted Gastropexy by Dr. Nadia Rifat

Laparoscopic-assisted gastropexy

What is a GDV?
Gastric dilatation volvulus (GDV) is an acute emergency medical condition characterized by gastric distension and abnormal twisting of the stomach. This causes the stomach to become over distended. have a decreased blood flow, and eventually lead to circulatory shock and death. The lifetime risk for a large or giant breed dog developing GDV is 24% and 21% respectively and their risk of dying of GDV is 7%. Even with appropriate medical and surgical intervention, case fatality rates between 10% and 33% have been reported.

Why do dogs develop a GDV?
No single cause of GDV exists. Reported risk factors for GDV include a familial history of GDV, lean deep chested breeds, older dogs, dogs that eat quickly, dogs that eat from a raised bowl, and dogs that only eat dry food and/or a single large meal, and dogs that have a fearful temperament. Dogs that have had a splenectomy also might be at greater risk for development of a GDV.

Does my dog need a gastropexy?
There are many breeds that are at risk for developing GDV. The most at-risk breed is the Great Dane (40% will develop a GDV). Other breeds that are at risk include Irish Setters, Weimaraners, Standard Poodles, and Rottweilers. In general, this condition can occur in any deep chested large breed dog. Most surgeons agree that a prophylactic gastropexy in patients considered “at risk” for GDV (gastric dilatation and volvulus) is a worthwhile procedure.

What is a laparoscopic-assisted gastropexy?
Laparoscopic-assisted gastropexy is a minimally invasive surgery that allows the surgeon to perform the surgery through a smaller incision than the typical surgical approach used to perform a gastropexy. During the laparoscopic-assisted gastropexy, one small incision is made just behind the ribs on the right side of the abdomen. It is through this incision that the laparoscope is introduced into the abdomen and the gastropexy procedure performed. With this surgical technique, there is less pain and the recovery much quicker compared to the typical gastropexy approach with a large incision.

Can there be complications from the gastropexy?
Multiple studies about laparoscopic-assisted gastropexies showed only the following minor complications: temporary skin fold at the side of the of the gastropexy immediately after the surgery (47%), seroma formation at the site of the gastropexy (6%), and iatrogenic perforation of the splenic capsule during trocar placement (12%).

When should I schedule my dog for a laparoscopic-assisted gastropexy?
The timing of the gastropexy does not seem to be critical. The stomach can be successfully attached to the abdominal wall in puppies, without compromising gastrointestinal function, which means the gastropexy can be incorporated into the same procedure as a spay or castration, or when the abdomen is being explored or opened for another reason. Alternatively, it can be performed as an elective procedure.

How do I schedule my dog for a laparoscopic-assisted gastropexy?
Make a pre-surgical appointment with Dr. Nadia Rifat, who is the surgeon that performs the laparoscopic-assisted gastropexies at Encina Veterinary Hospital. She will perform an examination on your dog and talk to you about the procedure. We will schedule your dog for surgery and submit pre-anesthetic bloodwork to make sure your dog is in good health.

call us today at 925 937 5000 to schedule an appointment with Dr. Nadia Rifat to see if your dog is a good candidate for laparoscopic-assisted gastropexy

February – April 2018: Save $100 Off Dental Cleanings with Wellness Exam at Encina Veterinary Hospital

Dear Clients of Encina Veterinary Hospital.

It is very important that our pets get proper dental care. It is estimated that 85% of our pets will have periodontal disease by the time they are 3 years of age. Periodontal disease is a progressive disease of the supporting tissues surrounding teeth and the main cause of early tooth loss. In the early stages of periodontal disease, food particles combine with bacteria to form plaque on the teeth. Within days, minerals from saliva bond with the plaque to form tartar, a hard substance that adheres to the teeth. The bacteria will travel under the gums and cause gingivitis, which is inflammation of the gums. As the bacterial infection progresses the supporting tissue around the teeth become weakened, which leads to tooth loss.

The proper way to address your pet’s dental disease is to have a veterinarian perform a dental cleaning under general anesthesia. While a patient is anesthetized we have a breathing tube in place to provide gas anesthesia and oxygen, have intravenous fluids going into the patient during the entire procedure, have extensive monitoring equipment (EKG, pulse oximetry, blood pressure, capnograph) attached to the patient, and one anesthetist monitoring the patient under the supervision of the veterinarian. This allows the veterinarian to do a full examination of the teeth and supporting structures, and to take x rays of all the teeth to assess the roots and supporting bone. Following the evaluation, the veterinarian will remove the plaque and tartar from the teeth and clean below the gum line. It would not be possible to do this properly without the use of general anesthesia. Unless your pet needs extractions the final step is to polish the teeth.

The benefits of a proper dental cleaning are that the plaque and tartar can be removed from the teeth and below the gum line along with the bacteria that can lead to periodontal disease. It is important to know that gingivitis is reversible, but periodontal disease is not reversible. If you notice your pet has bad breath or their teeth have gingivitis or plaque/tartar it is not too soon to have your pet scheduled for a dental cleaning.

As a way of promoting dental health for our patients we are offering our clients a $100 discount on dental cleanings for each pet that is scheduled during February, March, and April 2018, with Dr. Aengus, Dr. Milauskas, or Dr. Rifat. All you have to do is give us a call at 925-937-5000, schedule your pet’s dental cleaning during the above months, and provide us with the dental cleaning coupon at the time you bring your pet in for the scheduled cleaning. You can find the coupon at the bottom of this email for convenience.

We look forward to seeing you in the coming months as we continue our partnership to provide your pets with the veterinary care they need to remain healthy.

Regards,
Dr. Peter Nurre
Medical Director

January – February 2018: Save 25% on Comprehensive Lab Panel with Wellness Exam at Encina Veterinary Hospital

Dear Clients of Encina Veterinary Hospital,

Encina Veterinary Hospital prides ourselves on providing the best possible care for our patients, and part of this includes the recommendation that each of our patients have regular wellness examinations, which allows us to detect medical conditions in the early stages. When we detect medical conditions in earlier stages it is more likely to be treated and resolved with less expense, less difficulty, and better success. It is all too often that we diagnose medical conditions in the late stages when our patients are very sick and need more intense treatment.

A wellness evaluation consists of your veterinarian taking a detailed history about your pet, performing a physical examination, and possibly performing diagnostic tests to evaluate for conditions not detected on a physical examination, such as kidney disease. If kidney disease is diagnosed in the early stage it can sometimes be treated by simply changing your pet’s diet. Whereas, if kidney disease is diagnosed in the late stages then treatment might consist of hospitalization with intravenous fluids and other supportive care measures before being discharged on multiple medications and often times a short survival time. This is one example of the value of wellness exams.

As a way of promoting the value of wellness exams we are excited to announce that we are making January and February our Wellness months. During these months (01/01/2018 – 02/28/2018) we are offering our clients a 25% discount on comprehensive laboratory panels that we perform on any of your pets. All that we require is that you have a wellness examination for your pet in the month of January or February and present the wellness laboratory panel coupon at that appointment. You can find the coupon at the bottom of this letter and you are able to either print the email or present the coupon to your doctor’s assistant on your smart phone.

We look forward to seeing you soon with your pets to start the new year thinking about the health and wellness of your furry family members.

Wishing you the best in 2018,
Dr. Peter Nurre
Medical Director


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