Some Updates...

Ack! It's been forever since I've written! Is seems like I'm at work all day, home by 8 pm, cook and eat dinner, clean, feed and pay attention to various pets, then hit the sack with a big sigh. Loving my job makes it all worthwhile, but I find I have little time to do other things, such as sit down and contribute to my blog! I shall try harder.

Molly, the little Cushing's dog, went a little too many days on her initial treatment and had to be put on prednisone. Her parental units weren't the best at following instructions, which is so critical in these cases. When we start these dogs on Lysodren, the owners have to watch for ANY sign that the dog is not itself. Typically, dogs with Cushing's are ravenous and attack the food bowl with gusto when it's offered. During the first part of treatment, I have owners feed the patients 2/3 of what they normally would to keep the patient hungry and assure that they'll want to eat when they're fed. The moment the dog so much as hesitates before eating, or even lifts his head and looks around between munches, treatment is stopped and the ACTH stimulation test repeated. In Molly's case, she was a 'nibbler' of dry food, never eating much at one time. However, she'd scarf canned food like it was ambrosia. My plan was to have her eat canned food during the initial part of the treatment, so that we'd know when her appetite decreased. Unfortunately, her parents refused to feed her canned food, no matter how I explained why it was so important. I failed Molly in that case. As a result, it wasn't until one of my daily calls to the owner when she told me Molly wasn't herself and was whining all the time, that I knew we'd better stop the drug and retest her NOW. When I redid her ACTH stimulation test (that's the one that checks to see how much cortisol her adrenal glands can possibly produce), it showed that her adrenals were now producing too little cortisol. Predictably, she developed diarrhea, vomiting and didn't want to eat. I started her on some predisone, to replace the hormone she was now lacking. Quickly, the vomiting and diarrhea stopped, and she started to eat. She'll stay on this for a couple of weeks until her adrenals recover, then we'll test her again. This has become a very frustrating case for me.

On a happier note, Bailey, the dog with the now-fused toes, is doing great! After a week in the splint, we moved to thick bandages and now to just a bootie over the healing foot. I'm impressed with the cosmetic effect of the surgery and Bailey is walking better than she ever has. Of course she still wants to lick the foot!! It's likely become a compulsive thing with her and if she continues to lick, even after the foot has completely healed, I may discuss some medication meant for this type of problem to her owners. I'll try to post a pic of the foot was it's completely healed.

Some things tend to come in threes, or fours... I have another cystotomy to do next week; yet another hunt for more bladder stones! Will keep ya posted!

Something's Afoot

Pretty gross, huh? Bailey had a similar growth removed from the same spot between 2 of her toes a couple of years ago. The histopathology (where a pathologist looks at the mass on a cellular level to try to find out what it is) had indicated that it was 'Interdigital Furunculosis'. This can be caused by an ingrown hair, allergies, or other foreign bodies, leading to secondary bacterial infections and chronic irritation of the surrounding tissue. Unfortunately, Bailey didn't respond to medical therapy for the problem when it occurred a second time (long term antibiotics, soaking the foot...) and the mass had been allowed to get so big that removing it was going to be a challenge.

Bailey had become obsessive about licking this part of her foot, even after the initial surgery. If she continued to lick the area between her toes after the second surgery, the problem could very well recur. That and because there wasn't going to be a lot of extra skin to close the wound I decided to try a procedure called a 'fusion podoplasty', a fusing together of the toes.

The procedure when really well. The before and after pictures are above. I've sent the mass off to the lab to make sure we're not dealing with a new beastie. Bailey has to wear a splint on that foot for a few weeks to allow it to heal without any pressure being put on it. I'll try to post a pic again once her sutures are removed and everything's healed. I'm crossing fingers that we won't have the problem return.