Welcome to the next installment of the Sunstone Vets Blog! This week, we will be talking about one of our favorite, minimally invasive diagnostic tools…..endoscopy! Endoscopy is a catch all term for a variety of procedures that allow us to examine the inside of the body. The medical suffix “-scopy” simply means to use an instrument for examination or viewing. When combined with other terms, it describes the body area we are looking at. For example: Rhinoscopy (the study of the nasal cavity); Cystoscopy (study of the urinary bladder); Bronchoscopy (the airways); Gastroduodenoscopy (stomach and small intestine); Colonoscopy (large intestine)…. you get the idea! In this and the next blog, we will describe each endoscopic procedure that we offer here at Sunstone Vets and what you can expect for you and your furry friend.Continue…
By the time you get to Sunstone Veterinary Specialists for your pets Initial Consultation, we know that you have likely already invested time, energy, money and worry into their illness. You may have been referred to us by your family veterinarian or maybe you simply decided to seek another opinion. However you found us, we want to give you the tools to help ensure a successful first visit. Read on for insider tips on what to expect at your pets Internal Medicine Consultation.Continue…
If you are reading this blog, your pet has likely been advised to have an abdominal ultrasound for some type of health issue they are having. So, what exactly is an abdominal ultrasound? What are we looking for? What will happen to your pet during this test? This blog will cover the basic questions and concerns you may have regarding this common diagnostic procedure.Continue…
It seems safe to say that winter has officially fallen upon the Pacific Northwest! Mount Hood got a foot of new snow the past few days (good news for all you skiing and snowboarding enthusiasts)! Down here in the valley we are all enjoying the magical time of year when you don’t even need to look at the weather app to know ‘cold and rainy’ is in the forecast. But what does this change in seasons mean for our four legged friends? Read on for some winter weather pet safety tips to help keep your fur babies warm and cozy.Continue…
Help! My vet told me my dog needs a TPLO! What is that, exactly?
Cranial cruciate ligament (CCL) injury is one of the most common reasons for dogs to have a hind leg limp. The CCL is one of the major ligaments in a dog’s knee, it is the same as the ACL in humans. Its main job is to keep the shin bone (tibia) from sliding forward in relation to the thigh bone (femur). Partial or full tearing of the CCL results in an unstable and painful knee which causes a limp.
Some dogs tear their CCL completely and may suddenly stop putting weight on their injured leg. But the most common story I hear from clients is that the limping comes and goes. Their dog might have been limping off and on for weeks to months (or sometimes years). At the beginning, the limping would get better with rest and pain medications, but the latest episode of limping is worse than before, or didn’t get any better with rest. Worsening of limping often happens when a long-standing partial CCL tear becomes a full CCL tear. Or when dogs with a CCL tear also tear their medial meniscus. The medial meniscus is one of the shock absorbers in the knee. About 50-60% of dogs with full CCL tears and 5-7% of dogs with partial CCL tears will also injure their meniscus.
Diagnosis of a CCL tear is based on finding cranial drawer (instability between the shin bone and the thigh bone) during an orthopedic exam. While most dogs are able to be examined awake, some dogs may be too painful, tense, or anxious to allow a complete exam without sedation.
There are many procedures available to treat CCL tears in dogs. One of the most common CCL surgeries is the TPLO (Tibial Plateau Leveling Osteotomy). The purpose of a TPLO is to change the forces going through the knee so that a dog WITHOUT a CCL can have a stable joint to walk and run on. This is done by making a curved cut in the shin bone (tibial osteotomy). Taking the cut piece of bone, rolling it down the curve that was made, and stabilizing it in the new position with a bone plate and screws. By flattening the top of the shin bone, the thigh bone has a more stable platform to rest on, and other muscles and ligaments are recruited to help keep the knee stable.
Having performed and assisted in over 500 TPLOs, I consider the TPLO to be a very good and very reliable surgery. In the hands of an experienced surgeon, most dogs that have a TPLO have a good to excellent chance for a full recovery with a low likelihood of complications. But, as with most things in life, the TPLO is not perfect and certain individual factors may influence the success of the surgery.
To accurately plan for a TPLO surgery, specifically positioned and calibrated x-rays of the knee and shin bone are taken. Precise measurements of the shin bone are made and our bone cut is planned before surgery. That way I know what size saw blade I will use, where on the shin bone to make my cut, and how far I should rotate the joint surface to achieve a TPLO. Depending on the shape of your dog’s shin bone, whether or not they have torn their meniscus, or if they have other problems in addition to their torn CCL (i.e. a dislocating kneecap), changes may need to be made to the surgery. In some cases, a different procedure may be recommended.
At Sunstone Veterinary Specialists, a TPLO for one knee for dogs under 100 pounds typically costs $4000 plus the cost of medications to go home. Our package pricing includes post-operative rechecks at 2-weeks and 8-weeks. * The initial exam and consultation with Dr. Su and any additional diagnostics (such as bloodwork) are not included.
*Extra-large or giant breed dogs (>120lbs) would have extra fees to cover the additional medications, disposables, and resources required. This estimated cost includes the surgical visit (which includes a night in hospital) and routine follow-up (2 and 8-week post-op rechecks).
Lillian Su, DVM, MVSc, CCRP, Diplomate ACVS-SA
Board Certified Small Animal Surgeon
Keep your fur friends safe during this heat wave. Follow some simple tips to stay safe in the heat:
1. No car rides! Leave the pups at home. Even in the morning time, your car can rapidly heat up, and that cracked window does nothing to keep them cool. A car can overheat in minutes at 70 degrees.
2. Exercise them in the early morning, when the air and pavement are coolest. Hot pavement can easily burn their paws, and exercise in the hot afternoon can lead to heat stroke.
3. Make sure they always have access to cool water. Use ice cubes, give them frozen veggies as snacks (mine love frozen green beans and carrots). You can even make frozen low sodium broth cubes in ice cube trays to encourage hydration.
4. Keep them safe at the river/lakes. Bring potable water with you for them to drink and prevent them from drinking from river/lake. If you wouldn’t drink it, don’t let them drink it. If they are swimming, use a doggy life jacket to keep them safe. Keep an eye out for algae advisories-some locations have toxic algae blooms going on, and this is dangerous for both humans and dogs. Also, watch out for dead fish!! Dogs love to snack on them, but in our area they can get a parasite from eating fish that can make them very ill (commonly known as salmon poisoning, although other dead fish can carry it).
Have a Pet Safe Spring!
What has certainly been a LONG winter will soon be coming to a close. Colorful blossoms and sunny days are more than welcome and hopefully will be here soon. Spring is right around the corner! Unfortunately, parasites and other seasonal risks can put a damper on all the fun. However, you and your furry friend can still look forward to this wonderful time of year by following some of these basic springtime pet safety guidelines.
Road Trips and Outdoor Activities
One of the first things you may want to do as the weather turns warm is travel. This may include a day trip to a beautiful outdoor park or a vacation to a new destination (spring break, anyone?). When traveling with your pet, keep the following safety precautions in mind:
· Make sure the destination is truly pet-friendly and that your pet is travel-ready. When in doubt, consider a good boarding facility.
· For road trips, don’t forget your pet’s crate or seatbelt harness. Bring plenty of water and other daily care essentials.
· If your plans include hiking, avoid a wildlife encounter by keeping your dog leashed, vaccinated, and supervised. Remember, skunks, coyotes, and other animals can transmit deadly diseases.
· Microchip your pet and keep ID tags updated.
Lawn and Garden Care
Spring is a great time to tackle the yard and clean up the garden. But wait! Many products can be toxic to dogs, cats, and other animals. Before beautifying your backyard, be aware of the following poisonous products:
· Mulch containing cacao bean hulls
· Slug and snail bait
· Rose care products
· Compost (often contains potentially toxic foods and dangerous molds)
· Plants such as lilies, sego palms, and crocuses
· Fleas, Ticks, and Mosquitoes…Oh My!
Although parasites can threaten the health of pets (and people) any time of year, spring can be when most fleas, ticks, and mosquitoes come out in droves. That’s why it’s critical to keep your furry pal on a year-round preventive. Remember, administering an over-the-counter product without consulting your veterinarian can place your pet in harm’s way.
Another springtime risk to keep in mind includes protecting your pal against allergies. If you notice your pet itching, losing fur, sneezing, or developing hot spots, please contact your Veterinarian. There are many great treatment options available to ease the discomfort of your pet’s seasonal allergies.
In general, spring means more outdoor time with our pets, which means greater distractions and more risks. If you are in doubt, remember to contact your Vet about any products that could be harmful to your pet.
We hope these tips can help you spend more quality time with your pet and enjoy a much deserved springtime. Remember awareness and preventative action is everything!
The Chronicles of Hank!
My husband Cory and I recently adopted a 10 week old Labrador mix puppy! This is our first foray into dog ownership together and his first dog ever. To say that Hank has changed our life for the better is an understatement. While there are challenging moments, (do you have to chew on EVERYTHING??) Hank has enhanced every aspect of our life.
Hank came to us from California. His mom was found as a pregnant stray and was taken in by a foster family down there. She gave birth to 11 puppies (!!) and they all lived in their foster home for about 8 weeks. Some of the pups were adopted in California, and the rest came up here for adoption via the Oregon Dog Rescue. My friend Alysse ended up fostering two of the male puppies for them. She knew we were in the market for a puppy, but that I wanted to adopt one instead of buying from a breeder. So, when we got the text with the adorable photo of the one she thought we would like, we had to go meet him!
We met him one night at her team’s flyball practice. I was surprised at how tiny he was! We fell in love and adopted him 2 days later on a snowy Saturday morning. Since we have brought him home, he has more than doubled in size from 10lbs to over 21 now! He is such a sweet friendly guy who loves people, kids, dogs and cats (though our cats Mama and Zoe are not too sure about him and would prefer that he went back to where he came from.) I am extremely lucky that he gets to come to work with me every day. He was not a fan of being in a kennel, but he is now the Sunstone mascot and lives up front with our referral coordinator, Sarah. Our clients love him and Aunt Sarah even plays him animal videos!
We have been going to Puppy Kindergarten classes at Dog Days NW in Vancouver, WA. At our first class, Hank got put into the “Small and Shy” play group, where he promptly bowled over a little Cavalier King Charles puppy. He now plays in the “Rough and Tumble” group and fits in much better! He loves the obstacle courses they have and has learned sit, down, stay, roll over, shake, and spin! Hank has taken a week-long trip to Trout Lake with my friend Alicia and I where he got to play in his favorite thing – snow! He also had his first beach trip last weekend. He is pretty sure the beach is the best thing ever!
He is now about 99% potty trained and is almost sleeping through the night. Potty training was definitely challenging but with consistency and positive reinforcement, he caught on pretty quick! We will also be happy when he outgrows the “puppy teeth chew on everything phase”, though I know that this phase of life will pass all too quickly. Being a veterinary technician, I work with dogs all day long. I typically see them when they are older and sick so I know all too well how fast the time goes by. Hank makes Cory and I laugh every single day and has brought so much joy to our lives. We are so grateful to everyone involved in bringing us together and also to my work family who loves Hank and puts up with his shenanigans.
This is only the first installment of the Hank Chronicles. Stay tuned for more…..
Potty Training Pitfalls
My friends recently got an adorable new puppy who is just the sweetest little girl who caught onto potty training very quickly. She is now about 3 months old; and, as soon as she comes inside from going potty, she’ll go pee on the carpet by their bedroom. Not a lot but it was really starting to annoy them. I received a text recently asking what they should do as they were just about at their wits end and had gone through more carpet cleaner than they’d like to admit. I smiled reading her text as I knew exactly what they were going through all too well, having been there 3 times with my dogs when they were just wee little ones that liked to wee in places they knew they shouldn’t.
Why, oh, why does she still pee inside?
It sounds as though your pup may not fully have control of her bladder. She is a puppy still, and though she has the basics down, she may not be completely emptying her bladder when outside. So when she goes back inside, she realizes this and just finishes up. Here are some tips to help get you through those piddle situations!
Tip 1: Stay outside a bit longer and see if your pup pees again. If she does, that’s a sign that she doesn’t empty enough the first time. Some pups may do this even 3-4 times given the opportunity. If your puppy pees quickly and then runs off to play in the yard, keep her on leash.
Tip 2: Take her to the same potty area each time. This will help to teach her that when she is taken to this specific spot, pottying is what needs to be done. No playing or other shenanigans in this area.
Tip 3: Don’t be a distraction. If she is outside peeing and you are too fast in praising/rewarding with a treat, you may be interrupting the urine flow. Don’t praise and/or give her a treat until she is completely done peeing and is moving away from the potty spot. And don’t walk away while she is peeing! Stay stationary as she may stop mid stream to try to follow you.
Tip 4: If she is treat motivated, and knows which hand/pocket/bag/etc they are in, she may not finish up doing her business completely because she wants that treat. And, at this point, reward her only when you are headed inside and you are sure that she has completely emptied her bladder.
Basically, your pup peeing inside after you’ve recently been outside is COMPLETELY NORMAL and just means her body is still learning, growing, and may need a bit more time outside (with some modifications).
On occasion, some pups may develop a bladder infection causing them to piddle inside more. If you believe this may be the case, please consult your regular veterinarian.
Happy potty training!
One of the most common things I hear from clients calling to schedule with Dr. Elliott, the internal medicine specialist here at Sunstone, is that their primary care vet is recommending an ultrasound as the next step for their pet. Indeed, the ultrasound is one of our most valuable tools for diagnosing the pets we see, but many people are surprised to hear that it is an option and may not know why it can be so useful.
There are several different options for imaging when a pet gets sick. The most common is the X-Ray, which most veterinary practices have located right in their clinic for easy use. Less common are ultrasound, CT and MRI. CT and MRI are considered more advanced imaging and are usually only found in a few specialty practices. Ultrasound machines are more common than CT and MRI, but not every veterinarian is trained to use the machine or feels comfortable interpreting the images, so they may refer their patient to a specialist like Dr. Elliott.
The key to deciding which form of imaging a pet needs lies in where the doctor is trying to look. X-Rays work by sending a beam of radiation through the body at undeveloped film for a very brief moment to create a single image. These pictures are very useful for evaluating bones, lungs and giving a general view of soft tissue structures within the body. Ultrasound, on the other hand, uses sound waves to create images. Very similarly to the echolocation used by bats, the ultrasound machine can interpret how the sound waves bounce back, forming a picture. Air and dense structures like bones bounce back the sound waves, while soft tissue structures like the liver and kidneys let some bounce back and some pass through. Because bones and air don’t let waves through at all, ultrasound is not a good tool for looking at/behind bones or within air-filled areas, like the lungs. However, it is excellent for looking within the abdomen.
One of the biggest differences between these types of imaging equipment is that ultrasound produces a live video stream of images as the doctor moves the probe around. This lets the doctor see organs from many different angles, which gives them a lot of detailed information. Sometimes there are visible changes, and being able to see those changes gives us a diagnosis. However, in many cases these changes could happen for a variety of reasons and the only way to tell the cause is to look at the tissue on a cellular level. For these times, Dr. Elliott can use the ultrasound as a guide to take a small sample of the organ in question, which is then looked at with a microscope.
In my two and a half years with Dr. Elliott, I have probably helped with somewhere between 1-2000 ultrasounds, so I have seen firsthand how much information can be gathered with this tool. I have also seen when the answer was found with an X-Ray, or a blood test, or a stethoscope. These are all important tools, with their own strengths and weaknesses, for gathering information to piece together the puzzle of what is happening inside each pet.
Internal Medicine Assistant