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


“Miracle Maggie”

On February 23rd, the world dimmed a little bit and a new star was created in the sky. Maggie, a long time patient of ours, was returned to heaven. We often find that we get attached to many of our patients because so many of them come in so often for their advanced diseases or health conditions, and Maggie was no different. Maggie burrowed her way into all of our hearts and when she passed, we all felt the loss. While we smile knowing that Maggie is healthy and happy, frolicking in the pastures near Rainbow Bridge, we frown because we no longer have her here with us or expect to see her soon.

Her furparents put together a beautiful video dedicated to the celebration that was Maggie. And even if you never met Maggie, we hope you take a moment to remember the wonderful times you’ve had with your furkids who have crossed the Rainbow Bridge and are now another star in the sky shining over us:


A special heartfelt thanks to the doctors and staff at Encina Veterinary Hospital, most especially, to Dr. Stephen Atwater. It is due to Dr. Atwater’s exceptional skills as an oncology specialist that “Miracle Maggie” became one of the most famous patients in Contra Costa County. An additional thanks to Drs. Peter Nurre and Jenifer Wang for their expertise in internal medicine and for helping greatly enhance Maggie’s quality of life in here final years.

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!

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

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.

Update on Ice Bear, One Cool Cat

Excited to be home at last!

We received an update from Ice Bear’s parents, along with some recovery pictures, enjoy:

“He is doing extremely well. Stitches out, and now he gets to go outside. He doesn’t seem to wander much yet, just content to hang close. That’s fine by us.”

Dreaming of the days when he can go back outside...

Stitches out, stockingnette off!

Lazing in the grass at last (under supervision)!

A Foxtail Tale With a Happy Ending

Ice Bear Fashionably Recovering

You may recall a blog post from last month regarding foxtails, one of summer’s most common veterinary snafus. We recently had a peculiar case in which a foxtail ended up in a very unlikely place. Dr. Nurre recounts the tale of Ice Bear’s illness and recovery (warning, some of the pictures are graphic):

“We recently had a cat, Ice Bear, referred to our hospital with a week long history of not wanting to eat , slight cough, and being very lethargic.  His signs were vague and could have been caused by many different underlying medical conditions.  The referring veterinarian had done bloodwork and taken radiographs of the Ice Bear’s entire body.  There was a subtle abnormality seen radiographically in one of the cat’s lung lobes.

After I examined Ice Bear it was apparent that he was feeling very sick.  I recommended using ultrasound to visualize Ice Bear’s internal organs.  The owner consented.  First, we ultrasounded Ice Bear’s abdomen which looked normal.  Then we ultrasounded his chest.  Ultrasound evaluation of his heart looked normal.  No leaky heart valves, contractility [the ability of the heart to contract] appeared normal, and no evidence of heart chamber enlargement.

Around the heart and lungs I could see a large amount of fluid which was very abnormal.
Using ultrasound guidance I passed a needle into his chest (careful not to hit his heart or lungs) and extracted some of this fluid.  The fluid analysis confirmed it was pus.  Then the question was what caused the pus to build up in the chest?  With ultrasound I could see in the left caudal  lung lobe an unusual structure that resembled a foxtail.

The red arrow on the ultrasound image indicates the location of the foxtails within the lung

I discussed with the owner that if this was a foxtail we would need to remove it to give Ice Bear a chance to survive.  The surgery was risky, but our board-certified surgeon, Dr. Carl Koehler, did a great job.  He successfully removed the 2 foxtails and lung lobe, because it was so diseased, and flushed the pus from the chest.  Ice bear recovered well and went home  the following day eating and acting quite normal. ”

The Foxtails Embedded in the Lung

The Troublesome Pair of Foxtails Following Removal

Congratulations to Ice Bear on a successful recovery! If you suspect that your pet has inhaled a foxtail, or if you notice swollen lumps or bumps on your pet that popped up quickly, call us 24 hours a day at (925)937-5000.

Big Al's Glamour Shot

Over the Shoulder Smoulder

There was apparently some confusion when Big Al agreed to star in his very own blog post. You see, Alex recently became a big brother to a child of the human variety, and he was under the impression that this blog would be solely about him…just like a baby blog. He has grown to be quite the doggy-diva since becoming an Internet sensation as our premier blood donor. In order to appease him, I have agreed to post a glamour shot of Big Al from time to time just to keep the world apprised of his good looks. So without further adieu, feast your eyes on what I call Alex’s Over the Shoulder Smoulder (patent pending). This alluring stare has been known to garner treats and hearts alike from passerby of Encina’s A-Ward, also known as Tommy’s Ward, also known as Alex’s office.

Big Al, Lifesaver Extraordinaire

Big Al Enjoying a Day Off in the Sunshine

Many people are surprised to see the list of animal blood donors on the board listing our staff members in the Encina lobby. Blood donation just seems so human I suppose, most of us associate it with the emergency room antics of doctors that we see on TV. What many of our clients don’t realize is that with so many specialists on our team, we see a lot of very sick animals that often go through dramatic shifts in health while staying with us. Some of the reasons why we do blood transfusions at Encina include treatments for low platelet count, complications from disease, and blood clotting disorders.

Included in our blood donor list is our most prolific giver of blood, Alex P. Nurre, to whom I affectionately refer as “Big Al”. Alex was rescued by Dr. Peter Nurre, one of our hospital’s co-owners, in 2002 at the age of 1 ½ from the San Francisco SPCA. It was puppy love at first sight for Dr. Nurre, but Mrs. Nurre (a.k.a. Dr. Jenifer McBride, also a talented veterinarian) wasn’t so sure. She was looking for a dog to scare off potential attackers during her nightly runs, and at a very slim 60 pounds Alex wasn’t very intimidating. Eventually Dr. Nurre sold the Missus on Alex’s sleek black physique, and home they went.

Flash forward to today, and Alex weighs in at an impressive 85 pounds (hence the nickname, “Big Al”). The black and white charmer graces us with his presence every day that Dr. Nurre works, and has saved many lives just by being a great blood donor candidate that is readily available. What makes a great donor, you ask? A calm temperament and the right blood type, and according to Alex, his good looks don’t hurt either. There are over a dozen blood group types in canines, and we use a cross-matching kit to determine if a donor’s blood is safe to give to a potential blood transfusion recipient. Alex happens to have a type of blood that does not tend to cause a strong antibody response, in which the patient’s existing blood cells react to and destroy the transfused blood cells, which can be problematic for an already sick dog.

I recently asked Dr. Nurre to tell me the story of Alex’s best “save.” It was hard to narrow it down to one, but about a year ago we had an emergency case in which a dog was rushed in on the brink of death, bleeding into her chest from a necrotic (dead) lung lobe. We had no time to thaw frozen blood, but thankfully Big Al was “working” that day. We were able to draw a pint of blood from him without sedation, which was probably the difference between life and death because the extra time needed to sedate a donor may have been deadly for the critical patient. When we rushed the patient into surgery she still had a pulse (just barely) thanks to Alex’s donation. Dr. Koehler opened her up to find that she had several liters of blood in her chest cavity. He clamped the “bleeder,” removed the problematic lung, and the patient went home the next day. Big Al got an extra meal for his troubles, and we added another tally to his list of lives saved.