Finding the right mentor is key to happiness

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Dr. Jonathan Mitelman speaks to the graduating students at the Ontario Veterinary College in Guelph.

By Barbara Kelly

Dr. Jonathan Mitelman, of VETS Toronto at the Kingston Road Animal Hospital, himself a graduate of the Ontario Veterinary College in 2002, lectured to the up-and-coming graduating class on “What should I know as emerging veterinary school graduate?”

Although many topics were covered during his hour-long, lunch time presentation, the question on everyone’s mind concerned mentorship.

The new doctors are interested in finding a clinic or work situation with a supervisor or hospital owner that is not only willing to teach and instruct, but be a “mentor” to them.

Dr. Mitelman describes a mentor as someone who cares about the outcome. This will influence the quality of teaching, interaction, comprehension and this individual will use feedback to modify interactions. The pairing will be nurturing and reflective.

It is possible to start out as a teacher and instructor but with time develop into a mentor. The pair works together and the new grad will not feel left on their own, but supported, challenged and encouraged to grow.

The truth is new graduates will enter the veterinary workplace as both a doctor and a student. Their new employer will be making a considerable investment in this individual. Both new grad and employer must feel there is compatibility in needs and expectations.

The question of how one approaches this vital part of the job search process was asked of Dr. Mitelman. He suggests being straightforward during the investigative stages and interview itself. The new grad should express the hope to find a mentor and the desire to be taught and guided by this person.

The new grad should gauge the response accordingly. The age of the prospective mentor should not necessarily be the determining factor. Rather maturity, mindfulness, awareness, recognition of skills and patience are all to be considered.

A mentor is one who was likely mentored.

Dr. Mitelman himself has been on both sides of this. As a new grad he researched many hospitals and interviewed at many clinics. He knew the fit was right with Dr. Morris Samson, founder of the Kingston Road Animal Hospital.

He was hired at the clinic upon completion of his DVM and has worked there since.

With Dr. Samson as his mentor he achieved partnership in the clinic in 2005 and together they have grown the business and responded to the needs of the ever-changing veterinary community.

Now in a position of recruiting and hiring doctors for his 24-hour emergency hospital and day clinic, Dr. Mitelman has some additional words of advice to new grads.

He stresses the need for them to enter the interview process with a sense of humility, acknowledging that one does not know everything when coming straight out of vet school. Learning from one’s mistakes is part of the process.

And he feels gratitude goes a long way. Thank the new boss for the opportunity and investment of time and commitment and show a desire to contribute to the team.

Finally, will the connection or bond with the new mentor be immediate? In some cases it might be, but more often it will be realized with trust and over time.

VETS Toronto at the Kingston Road Animal Hospital has been operating in the same Toronto location for over 25 years. It is a full-service veterinary emergency hospital offering a regular day clinic and after hours, critical care and referral services. If you wish to contact Dr. Mitelman, he can be reached at 416 690-0625. Please visit the hospital’s website at www.vetstoronto.com

Tessa’s spleen was all wrapped up

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Dr. Mitelman with Tessa, who is doing well after her spleen surgery.

By Barbara Kelly

When Tessa, a five year old German Shepherd, showed signs of decreased appetite her owner thought it might be as a result of candy wrappers the dog had eaten a couple of weeks earlier.

As the dog’s condition continued to worsen and weight loss was becoming apparent, Tessa’s owner sought emergency medical attention for her at VETSToronto at the Kingston Road Animal Hospital.

Her owner had been reading about ultrasound on the clinic’s Internet blogs, and came in to discuss possible treatment options.

When Dr. Jonathan Mitelman performed a physical examination he found Tessa to be at least 10 pounds underweight, cachexic (weakened, emaciated body condition), boney, and presenting with a pendulous abdomen with a large mass in her belly.

Recent blood work done at a previous clinic showed anemia and low protein, but no specific cause. Dr. Mitelman advised further diagnostics were necessary at this time in order to determine the cause of the dog’s declining health.

Radiographs showed a large abdominal mass displacing the stomach craniad (toward the front) and intestines caudad (toward the back). The presence of free fluid distorted the abdomen. However, the chest looked fine.

An abdominal tap was done revealing pink translucent (serosanguinous) fluid.

Blood work was repeated and the results showed the anemia was worsening, but regenerative. This was a sign that the body recognized the problem at least five days earlier and was attempting to rectify the anemia.

Dr. Mitelman performed an ultrasound. He found a very large homogenous spleen taking up a lot more space than it should be, without blood flow in and out through the normal pathways (splenic artery and veins). There was no transcapsular venous blood flow.

The spleen was obviously abnormal. Was it a tumour? Was it twisted? Or was the spleen just dead? Whatever the case, why did this happen and was this curable?

Dr. Mitelman explained surgery was the only option, the pathologic spleen had to be removed. Although the hope was that a splenectomy would be curative there was still a possibility that cancer may be hiding somewhere within.

Tessa’s skin and abdominal wall were incised with a surgical laser. Dr. Mitelman was greeted by the abdominal organs bathed in a large volume of bloody fluid.

The huge necrotic spleen had rotated 360 degrees or more on its axis and was encased in an omental wrap, which surrounds the inflamed tissue and provides nourishment. The splenic vein and artery had twisted, preventing blood from entering and exiting the organ, leaving a vital organ dead inside.

Moreover, the splenic artery was as tough as wire. The normally delicate tissue could not be cut with a sharp scalpel. It even sparked with the laser. Oversized orthopedic wire cutters were actually used to do the job.

All of the abnormal tissue was removed. Tessa did well with the surgery and the recovery was unremarkable. Tessa went home two days later, bouncing as though nothing had happened.

Did the candy wrappers play a role? In this case, they did not. Her declining health was caused by a combination of a torsed and necrotic spleen, venous thrombosis, and osseous metaplasia of the splenic artery.

What this means is the large, dead, engorged with blood, filtering organ twisted on itself. The venous blood outflow was blocked, and arterial blood inflow was cut off. In addition, there was boney matrix growing in the splenic artery.

Her anemia resulted from blood leakage into the abdominal cavity. Weight loss was associated with insufficient calories and marked inflammation.

VETSToronto monitored Tessa’s progress for the two weeks after her life-saving surgery. She has since returned to Black’s Toronto Veterinary Hospital for further follow up and regular veterinary care.

Lessons learned:

1. It is always wise to have your pet checked by a veterinarian if you notice changes to appetite and sudden weight loss.

2. A pet owner should explore all treatment options available in order to make well-informed decisions. Veterinarians are open to consults and referrals, don’t be afraid to suggest and discuss this with your pet’s doctors.

3. Diagnostics are essential to determine the root of a pet’s illness. Sometimes what is assumed to be obvious, in this case some ingested candy wrappers, might be unrelated to the actual cause.

4. VETSToronto at the Kingston Road Animal Hospital is open 24/7/365. Know the location of your nearest veterinary emergency hospital. There are times when pets need treatment outside of your regular clinic’s hours. Minutes can count in emergency situations.

Nickle’s injury comes up two heads

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Nickle had two heads removed from his femurs. He's doing just fine.

By Barbara Kelly 

A sudden onset of non weight-bearing lameness of Nickle’s right hind leg prompted the cat’s owner to take him for assessment at the Brimley-Lawrence Animal Clinic.

She explained to veterinarian Dr. Chari Paneeru that the 20-month-old Domestic Shorthair climbed bookcases and likely was hurt from a fall.

Dr. Paneeru examined the cat, viewed the radiographs and consulted via telephone with Dr. Jonathan Mitelman at VETSToronto at the Kingston Road Animal Hospital.

Nickle was in pain and Dr. Paneeru advised the owner that VETSToronto was a 24-hour emergency hospital where the cat could be stabilized and monitored overnight.

Upon arrival at VETSToronto, a thorough history was taken, revealing that Nickle had some previous lameness in the left hind leg. The examination showed the 12 pound cat to have good body condition.

In addition to the non weight-bearing right hind leg, the right hip was painful and had palpable crepitus (crunching sound). There was bilateral patellar luxation (kneecaps able to pop out of the groove).

This was a developmental issue but likely not contributing to the current presentation.

The radiographs showed a fracture of the right femoral neck with displacement (the femur was broken between the head and neck, with both parts separated).

There was also a line of radiolucency at the femoral neck of the left femur. The growth plate was not fused, therefore had a weak spot in the head and neck connection that was visible.

This explained the bilateral nature of Nickle’s lameness. A fall from the bookcase was not the cause. Faults in the growth plates of each hip left him with a weak point. Any jump or fall would stress the weak point in the bone, causing it to shear and fracture.

Dr. Mitelman consulted and verified his findings with a local orthopedic specialist and online with a surgeon through VIN (Veterinary Information Network). He discussed available options with Nickle’s owner.

These fractures are not amenable to repair reduction of fracture segments since there is little bone with which to anchor, and poor blood supply.

What was required was a femoral head osteotomy (FHO) or excision. In other words the head of the femur is removed, and the surface is smoothed allowing for a non-rubbing and not painful joint.

Cats do quite well with this procedure. Hip replacements are not typically done as they do so well with FHO’s.

But both hips needed to be done. Should the surgeries be staggered so the right one was done immediately, the left one in six week’s time? Or should both hips be done at the same time?

The cat would not be mobile for about two weeks. There would be some pain but experience shows that cats tolerate that well. Attempts to avoid additional hospitalization and anesthesia were noted.

It was important to present all options and discuss this openly with the owner. The consensus was FHO’s would be performed on both left and right hip joints concurrently.

There was excessive pre-existing scar tissue as a result of the growth plate weakness.

 While immobile, a urinary catheter was put in place to keep Nickle comfortable.

Although wobbly, the cat was up and walking within six days. At the two week post-op check Nickle was walking well. He has returned to Dr. Chari at Brimley-Lawrence Animal Clinic for his follow up care.

Lessons learned:

1. Cats are rarely lame without a good reason. It is always wise to check it out.

2. A weakness in the growth plate such as this can sometimes be chronic, but more often will be a sudden surprise.

3. It is always good to explore and discuss your options when faced with medical decisions. Consultations with specialists can help both the primary veterinarian and the pet owner with understanding the medical condition and the treatment plan.

What Galway’s life taught us

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Galway lost her brave fight with cancer.

By Barbara Kelly

Galway’s owners noticed that their normally active, four year old Bernese Mountain Dog was not herself.

For about three-to-four days her behaviour had changed, she was showing reluctance to sit properly at her food bowl, she didn’t come to the door and had difficulty ascending the stairs.

Normally together with the family’s other dog, both full of mischief, she now was not as interested in their usual playful antics.

Galway’s concerned owners brought her to VETSToronto at the Kingston Road Animal Hospital, where Dr. Jonathan Mitelman and Dr. Morris Samson were responsible for the case.

Dr. Mitelman performed a physical exam, assessed the hips, spine and stifles. There was mild hip dysplasia present along with steep tibial plateaus, but no significant arthritis or cruciate instability.

Otherwise, Galway presented as frisky and happy. The situation would be monitored and follow up to be done.

On the next visit, the owners said Galway was still “not quite right”. The situation seemed to be quickly worsening.

She was still responsive and bright, but not her bouncy self. She had begun gagging randomly, even when she was not at her food dish and lagging behind on her walks.

There was a decreased appetite, but that was coupled with weight gain. On touch, Galway’s backbone felt more boney than usual. When Dr. Mitelman assessed the belly to be heavier and fuller than normal he recommended an immediate ultrasound.

The ultrasound showed abdominal fluid that was tapped and the blood removed. There were multiple, variable-sized, non-homogenous spherical masses throughout the abdomen that were everywhere and attached to everything.

Galway’s blood work had been almost entirely normal except for evidence of new red blood cell regeneration. She wasn’t even anemic. Blood tests, unfortunately, can appear normal in the face of cancers.

At this point the doctors and owners were faced with a number of what if scenarios.

Should a biopsy be done to get concrete evidence (risking complications such as uncontrolled bleeding)?

Should an exploratory surgery be done with the hope and intention of debulking the tumours (again risking complications, post-op problems etc)?

Should they forego any procedures and do euthanasia without pathology evidence?

Every decision was a difficult and painful one to make.

Galway’s owners opted to take her home with pain medications. Despite all of this, she still had bursts of normal activity. Did she even know she was sick? Everyone wanted to make the most of their remaining time together.

Sadly, the situation worsened overnight and an at-home euthanasia was done the next day, Galway surrounded by those she loved.

The pathology revealed a form of cancer called a myxosarcoma, one so aggressive and pleomorphic that it was not possible to identify the tissue of origin. This explained her rapid decline near the end.

Lessons learned:

1. Some animals mask their illnesses so easily. Owners know their pets best. Any changes that are concerning should be discussed with the veterinarians.

2. Pet owners often are faced with some difficult decisions. It is wise to explore all of your options. Medicine will guide you.

3. Does a post mortem assist with closure? That is all so personal. Some might see the results confirmation that they made the best decisions for their pets.

4. It is hard to lose a companion, regardless of how long they have been on this earth.

Please have a look at our euthanasia blog for more information.

Groucho shows small marks can hide big trouble

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Groucho had a small wound that hid some real trouble. He's doing fine now.

By Barbara Kelly

Following a fight in the park with another dog, Groucho’s owner brought her injured, mixed breed dog to VETSToronto at the Kingston Road Animal Hospital.

Although there seemed to be just a small bite wound, Groucho felt pain at his owner’s touch. 

Dr. Arif Memon examined the wound area on the dog’s left flank, finding  no surface bleeding. But  he detected a small bulge beneath the puncture wound.

Dr. Memon admitted Groucho, always the correct treatment plan in the case of bite wounds. One cannot tell by sight what internal damage is present. Time acts as a magnifying glass.

In addition, Groucho’s severe pain needed to be addressed. He was put on IV fluids and given pain medication and antibiotics. The puncture site was flushed and disinfected.

The next day, Dr. Jonathan Mitelman joined Groucho’s care team. The radiographs showed the dog’s abdominal contents were present beneath the skin. An exploratory surgery was a necessary diagnostic in this case.

When a tooth enters the body, the gnashing and tearing action creates a swath of damage, pulling and ripping the flesh. Due to the skin’s elasticity, only the entry wound remains visible. Innocent on the surface, destructive forces lie beneath.

There is risk of having injured the kidney, ureter, colon, intestine, vertebral muscle etc.

Dr. Mitelman determined Groucho’s abdominal wall (three layers of muscle) was torn. The abdominal contents that pop through in these cases end up pinching off their own blood supply and become necrotic.

Corrective surgery was necessary as soon as possible.

Fortunately, Dr. Mitelman found that Groucho had enough healthy muscle left over to repair. Often there isn’t and a deficit needs to be patched with synthetic screen graft.

The surgery and recovery went well. The good use of combinations of pain medications relieved the discomfort. Groucho was up, walking and functional two days after the injury and was discharged after three.

He resumed normal activity after one week.

Groucho returned to his regular veterinarian, Dr. Judy Au, at Danforth Veterinary Clinic, for follow up care.

Lessons learned

1. Keeping your dog on a leash while in public not only adheres to city by-laws but helps to protect your pet from fights with other dogs.

2. Non-neutered males (intact) are sometimes targets since in the dog world they are seen as a threat to neutered males.

3. Puncture wounds can penetrate deeply and cause significant damage not visible to the eye and often not palpable. Just like a bullet wound.

4. Be aware of the nearest 24-hour emergency animal hospital. In this case, Groucho’s owner had a card from VETSToronto, picked up at her regular vet clinic. This ensured prompt medical care was readily accessible in a true emergency situation.

Looking towards an exciting 2012

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Join Dr. Samson and Dr. Mitelman in celebrating the clinic's 25th anniversary

Happy New Year Everyone!

Vetstoronto and the Kingston Road Animal Hospital are entering 2012 with energy and optimism.

We value collaboration with pet owners and collegial relationships between referring veterinarians because it promotes animal wellness and client satisfaction.

As a full-service animal hospital, we are open 24/7/365, with a doctor on site around the clock. We welcome new, and long standing clients at our day clinic and provide emergency, after hours, critical care and referral services for pets in need.

Patients from other clinics will be stabilized and returned back to their referring veterinarians. Follow up is always done with both pet owners and doctors.

We are celebrating our Silver Anniversary Year at the Kingston Road Animal Hospital. Dr. Morris Samson opened the clinic’s doors 25 years ago and it operates from the same location today. We are proud that our hospital continues to grow and evolve with the ever-changing needs of the community.

Realizing the relevance and impact of social media, we have jumped in enthusiastically.

We have launched our new-look website at www.vetstoronto.com. Dr. Jonathan Mitelman and Barbara Kelly collaborate on weekly blogs, sharing heartwarming pet stories, cases and educational material.

These can be found at http://www.vetstoronto.com/blog. We also have an ever-growing presence on Twitter (@vetstoronto), Facebook (www.facebook.com/vetstoronto), Ask the Vet, Linkedin and other social media platforms.

Both Dr. Samson and Dr. Mitelman will be attending conferences and lecturing at such places as the Ontario Vet College in Guelph and the New Brunswick Veterinary Medical Association. Both doctors act as consultants to other veterinarians and animal hospitals.

The relationships we value are cemented by our core beliefs: knowledge, respect, experience and compassion. We look forward to continuing to care for your much loved family pets.

Wishing you all of the best for 2012.

Dr. Morris Samson, Dr. Jonathan Mitelman and the team at VETSToronto and the Kingston Road Animal Hospital.

Remembering friends old and new

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Dr. Jonathan discovers social media.

By Dr. Jonathan Mitelman and Barbara Kelly

Barbara: What a year it’s been for this blog.

We’ve learned so much about our animal heroes including Abner, the chocolate lab who ate the cheese wrapper and developed an obstruction. He’s doing fine, now, bringing great joy to his family.

And Nikko the cat, whose owners thought he’d never come back, but he did – injured but still full of fight.

Not to mention Ruby, the terrier mix, who almost died on the operating table after being brought in by good Samaritans, only to pull through and then find a “forever home” through a partnership with the Toronto Animal Services and CP24.

And Copper, the viszla, paralyzed from the neck down and whose owners opted for surgery and put in so much work on recovery. He’s back to 90 per cent and the family is so happy to have him.

Just four of the more than two dozen stories we’ve brought you in 2011 thanks to social media.

Jonathan: We at VETSToronto and the Kingston Road Animal Hospital emerged from the social media cave earlier this year and acknowledged the warmth of progress.

Once a Luddite brandishing a notepad and pen, I myself began to embrace devices and techniques we now know to be more powerful and user-friendly than our desktop computers, static websites and traditional advertising methods.

Enter the new world of the direct and word-of-mouth marketing potential of content-rich and avenue-expansive social media.

This was new to us. The concept of communication by way of sharing, interacting and informing on multiple platforms felt like an insurmountable task.

Early on we jumped into an agreement with a company to create a Facebook presence for us. But the “cookie cutter” approach really did not reflect our uniqueness and individuality.

We needed something to make us stand out. A voice.

We found one, in Barbara Kelly, a professional writer and client-cum-social media expert and problem solver.

Barbara: For me, it all started with a simple review I did of the hospital and the way they helped us with Billy, who Jonathan now calls our “giant dachshund.”

Before you knew it, I was managing the social media profile of VETSToronto and the Kingston Road Animal Hospital.

People were talking about our clinic on-line, but we had no idea who they were or what they were saying. We began to understand the realities of the social media.

It would affect us whether it “found” us or we chose to embrace it. We decided the latter was the best way to go.

So a new partnership was formed and Jonathan and I embarked on quite a journey into the unknown together.

Being married to a professional journalist had already taught me to work and live on an always changing, unpredictable schedule.

Working with and having a writing partnership with an emergency hospital veterinarian and surgeon was no different. Middle of the night emails, midnight phone calls and writing at the last minute to meet our deadlines became our “normal”.

Thank goodness Jonathan and I share a wacky, even dark sense of humour. We stuck together through the frequent bumps in the road, not always easy, and came to a comfortable and productive place.

Jonathan: I spend an average of 10 hours a week now on creating blog content, handling Ask the Vet questions, discussing ideas with Barbara and mulling ideas around in my head. Then Barbara takes her turn.

Our chosen platforms are Twitter (@vetstoronto), blogs and Facebook. The neat part about them is that they feel alive – interaction and reaction amongst users creating a changing environment.

Our Twitter personality was chosen and developed first. It was based on our business’s core values of integrity, respect, honesty, experience and quality of service.

We wanted followers to know who we are and what we stand for without overtly marketing ourselves. Through conversation we have built a custom base of over 440 dedicated followers.

Our blogs this year have covered interesting medical cases, medical technologies and concepts such as euthanasia.

We have joined forces with other on-line journals and write articles for them. On Jana Rade’s @DawgBlogger site we tell the story of the trials and tribulations of the Billy, the giant dachshund.

Over 20 chapters detailing the saga of his medical events have been written specifically for this purpose.

Many important relationships with our readers have developed through our website and Twitter feature, Ask the Vet. It has brought us together with many dachshund lovers/owners, rescue groups and other parties.

Veterinarian-specific questions could be posed and responded to quickly (within reason, of course).

Social media has brought us closer to pet owners whose nearest veterinarian can be hours away.

It has brought us closer to such groups as the Atlanta-based Dream Dachshund Rescue (@DREAMRescue), the doggy daycare service @PackofPawsLV and #doxieposse members who reach out to offer support to others with similar experiences.

A continued challenge is to engage in online discourse, attract new ideas and get involved.

Do YOU have some to share with us?

Holiday season pet safety: Just in case

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That Christmas sweater may keep him warm, but not safe from other hazards.

By Barbara Kelly

We all have our amusing holiday pet stories. Mine is about our then three year old standard dachshund Billy. Spending his first Christmas with our family, and the freedoms he was not accustomed to, brought with it some challenges.

Our guests were due to arrive and I was just putting the finishing touches on my finely decorated dining table. As I rounded the corner I found Billy, standing on the table, eating anything and everything in sight.

Lucky for us a frantic clean up was the only result. Billy did not even have an upset tummy, despite eating large amounts of pickles and butter. And our guests did not find out until much, much later.

Not all pets’ holiday stories are humorous ones. As an emergency animal hospital, VETSToronto at the Kingston Road Animal Hospital sees its share of serious and life threatening situations. Dr. Jonathan Mitelman and I have put together some recommendations to help you and your pets stay safe and healthy through this busy and festive time.

1. Holiday gifts often involve toys and gadgets that require batteries. Please ensure these are kept well out of your pet’s reach. If the paste leaks, the alkaline material is caustic and will burn mucosal lining. Dr. Mitelman has seen this with some devastating results. If batteries are swallowed whole the electric current sets up between the terminals and is carried through the short distance of gut causing electrical burns and necrosis.

2. Parties and entertaining house guests can be a stressful and overwhelming experience for your pets. Unfamiliar faces, lots of noise and commotion can cause or increase anxiety.

An often opening and closing door can give access to outside when not normally allowed to roam.

Platters of food on low lying tables and open garbage receptacles offer temptations to food-loving beasts.

Little ones roaming around with handfuls of treats, they too overwhelmed by the festivity, might be in harms way, again with that food-loving beast.

Consider leaving your pets with friends or boarding them at your vet clinic.

3. Pets are not appropriate gifts. The recipient might not be prepared for or willing to assume the responsibility for a surprise pet present. Children might be ecstatic to receive a cuddly, furry pet but who will take care of the animal after the initial excitement wears off? Pets will suffer if this is not thought through ahead of time.

4. Chocolate, consumed in even small amounts, can result in serious damage. Dogs ingesting overdoses of chocolate suffer methylxanthine toxicosis (hyperexcitation and seizures) and can develop pancreatitis from the fat content.

Dogs can sniff out boxes of chocolates given as gifts and innocently placed under the family Christmas tree. A wrapped package offers little challenge for a determined pup.

5. Ribbon and tinsel look just as shiny and pretty to cats as they do to us. Dr. Mitelman has performed surgeries to remove these items from cats’ intestines.

6. Toothpicks holding together dainty holiday sandwiches or in items on cocktail party platters can splinter when ingested, stick in the throat or puncture vital organs.

7. Keeping your dog outdoors for extended periods during holiday festivities offers some risks. Cold temperatures can lead to frostbite. Icy walkways and steps can aggravate sore joints in dogs with pre-existing joint disease. Fractures and torn ACL’s are also possible. Again, a safe boarding situation offers a better alternative.

8. Human food and beverages are best left for the humans. Ingestion of holiday treats may just cause a mild tummy upset. Or rich, fatty foods might cause inflammation of the pancreas and other life threatening conditions. Caffeine intake can cause seizures. Alcohol in any amount is not safe for pet consumption.

Turkey carcasses have bones that could become lodged in the esophagus.

9. Toys that are projectile launchers pose dangers to unsuspecting pets. Dr. Mitelman recently removed a BB pellet that was lodged in a bunny’s skull.

10. Eating the leaves and blooms of plants can cause a range of digestive upsets to life threatening situations.

Poinsettias, mistletoe and holly consumption will likely cause vomiting. When a cat ingests a lily acute kidney failure can result.

You will be busy with guests and enjoying your holiday cheer. Supervising your pet’s every movement might not be possible. Awareness and prevention will be your best offense to keeping your pets safe during the holiday season.

Learn the location of your nearest veterinary emergency hospital. Post it somewhere where everyone can easily find the information. Just in case.

VETSToronto at the Kingston Road Animal Hospital is open 24/7/365. We have a veterinarian on site around the clock, 416 690-0625. Just in case.

With a little help from Ruby’s friends

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By Barbara Kelly

When strangers come together with a common goal, sometimes great things can happen.

At the centre of our story is Ruby, a young terrier mix, who was found badly injured, likely from a collision involving a car, by some local area residents.

Knowing the little dog needed immediate medical intervention these good Samaritans brought her to VETSToronto at the Kingston Road Animal Hospital.

The dog was recumbent (lying down), unable to stand, pale and in shock.

Dr. Jonathan Mitelman, Dr Morris Samson and their team decided that despite having no identified owner, they would take responsibility to preserve Ruby’s life. She was admitted and stabilized.

In the meantime, the injured dog’s owner was located. Unfortunately, as the owner was unable to manage the pet’s care, the dog was surrendered to Toronto Animal Services. At this point, another key partnership in Ruby’s journey was established.

VETSToronto agreed to a much reduced rate for the required surgery and treatment and Toronto Animal Services agreed to have Ruby treated by the hospital and would take responsibility for the remaining costs, recovery and re-homing afterwards.

Radiographs showed a pelvic fracture of the right ischium (lower hip bone), and left sacioliac subluxation (lower back pain). All were stable since the pelvis remained stable.

However, the left femoral head was fractured in three segments and could not be saved.

Her chest, lungs and gut appeared normal. The ultrasound showed no fluid or overt trauma.

Dr. Mitelman performed the orthopedic surgery the next day. He did a femoral head excision arthroplasty (removal of ball from femoral head), to allow use of the leg again. Ruby was also spayed while under anesthesia. The surgery went well and she was monitored over night.

The next day, Ruby’s breathing was laboured. Radiographs showed that the right lung field had something else in there and the heart was displaced off centre to the left. This indicated there was a tear in the diaphragm and abdominal organs had snaked into the chest.

An ultrasound confirmed this.

Diaphragmatic hernias can occur, but the tears or rents themselves are not visible unless an organ herniates.

Dr. Mitelman knew Ruby needed an immediate second surgery. It required multiple hands on deck, an anesthetist and constant ventilation.

Collapsed lungs that are re-inflated succumb to effects of reperfusion (free radical oxidization effects, and release of inflammatory chemicals into the bloodstream). You can’t control this, so the subsequent 24 hours are critical. Even if the surgery goes well, the patient still can die.

Thankfully, Ruby pulled through.

After a short stay at VETSToronto, Ruby joined the Toronto Animal Services where she would be cared for until she was well enough for adoption. On discharge Ruby was stable, walking and breathing well. And her tail was wagging and spirits high.

A few short weeks later, Ann Rohmer of Animal House Calls on CP24 invited Nicola Ware of the Toronto Animal Services to present Ruby’s heartwarming story. Ruby was featured, happily reclining in her doggie bed. It was now time to seek out a forever family for the little dog.

(You can see Ruby’s appearance at CP24 Animal House Calls, click on Nov. 22, Part 2).

Only a short time later we were updated with the news an adoption for Ruby was pending.

Ruby has captured the hearts of all involved. From the concerned area residents, to our doctors and hospital staff, to all those at Toronto Animal Services associated with her case, to Ms. Rohmer and her associates at CP24 and finally to Ruby’s new family.

This has been a true journey of partnerships and collaboration, to give a seriously injured little dog a second chance.

From Dr. Jonathan Mitelman, Dr. Morris Samson and all of the staff at Kingston Road Animal Hospital, we wish to extend our gratitude for supporting us in our role to help Ruby.

LESSONS LEARNED

1. Dogs should be leashed. Loud noises, moving traffic etc. can startle your pet and serious accidents can happen without warning. Please keep your dog safe.

2. Injury from trauma/vehicular accidents may not be apparent immediately. Surprises can pop up and must be dealt with quickly.

3. Never underestimate the kindness of strangers and the dedication of the veterinarians, staff and caregivers of animal hospitals and services. Partnerships and associations are formed quickly to help pet patients in need.

4. Please remember the following: FOSTER, ADOPT, DONATE, VOLUNTEER. Ruby has a second chance at life due to people who believe in supporting our animal welfare and rescue agencies.

Billie Jean, from a longdog lover

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Billie has perservered through three bouts of IVDD.

By Barbara Kelly

We would like to introduce you to a group known on Twitter as #doxieposse. They come from all age groups and walks of life, literally spanning the globe.

However, despite their diversity, there are two beliefs that each and every one of the members share:

The first is an unconditional love and devotion to dachshunds, or “longdogs” as they are affectionately called.

The second is an overwhelming, and often-voiced contempt for Intervertebral Disc Disease.

Several #doxieposse members have agreed to share their IVDD experiences with us. The first is Brenda Johnson, or @longdoglover, on Twitter. She tells us her heartwarming story of her dachshund Billie and their life with IVDD.

Billie Jean is my heart. She came to me when she was 9 weeks old. A puppy mill product, she was rescued by my fabulous dad and given to me for my birthday. We lost my dad in an auto accident that day and having Billie was my touchstone. Billie is my heart.

When Billie was diagnosed with IVDD I knew NOTHING about the condition despite having dachshunds my entire life.

It started with one dragging leg and a terrifying trip to the vet. Over a course of three days, Billie became paralyzed, losing the use of her bowels, bladder, tail, and both legs.

We saw a specialist vet who said there was less than a 25% chance of recovery, even with surgery, and that we should euthanize her. My vet seemed to be both poorly informed and uninterested. This was so frustrating and sad.

We decided to wait it out. We couldn’t even consider putting her to sleep. I cried for six days, and on day six of paralysis, her back left leg gave a little kick. It was a miracle! Little by little over the course of the next three weeks she regained her mobility.

The diagnosis of IVDD left me terrified. I always believe that knowledge is power so I set out to educate myself about the condition and was shocked by the lack of resources in Canada for dachshunds with IVDD.

I was finally able to find help through a wonderful web site called dodgerslist.com.

On this site an incredible woman named Linda Stowe helped me with the journey of IVDD. I emailed her about Billie’s condition (there was still partial paralysis). Within minutes I had a phone call from her and help had arrived.

With Linda’s help Billie did water therapy in our bath tub and I learned about the dos and don’ts of IVDD care. I learned that IVDD most commonly presents itself between 3 to 6 years old. Billie was 4 years old. I learned that a lot of specialists believe that IVDD is a product of bad breeding, and yes, Billie is a puppy mill product.

The first, and most important thing that Linda told me, was to get Billie into a crate and KEEP HER THERE.

So, for the next six weeks Billie slept, ate, and complained in her crate. Immobility is crucial to the healing process. One very frustrating thing to me was that my vet had not told me to do this, nor had the specialist that we had seen.

We would carry her crate outside so she could go to the bathroom and then put her right back into the crate and carry her back inside. To this day she hates that crate. If she sees the crate she will stay at least six feet away from it.

Things in our home had to change. No more flying off of the couch to run for treats or greet someone coming in the door. I had a new command to teach, and that command was ‘no jumping’.

The first few months were easy since every movement was painful for Billie, but when she started feeling better the challenge of ‘no jumping’ became real, and difficult. Billie is a standard size and her favorite place had always been to perch on the back of the couch and look out the window. IVDD, sadly, put an end to that.

We had to add ramps at the back entrance as stairs are one of the worst things a dog with IVDD can use. Teaching Billie and our older Dachshund Freddie to use the ramps was a very big study in patience and perseverance – and cheese – lots of little pieces of cheese up and down the ramp.

Billie’s IVDD is with us daily.

This past summer during a thunder storm she was badly scared and wiggled her way under our bed when no one was home (our mistake, we had not shut the door). She is much too big to fit under the box spring and she was stuck. We came home to hear her crying and had to lift the frame up so we could get her out.

Her tail was paralyzed this time. Back into the dreaded crate she went for 3 weeks. Her tail function returned within 3 days, but in the crate she stayed.

If Billie jumps, if she twists, if she does her happy puppy dance, I hold my breath.

IVDD is a roller coaster. It leaves us with fear, terror, sadness, resignation, and a strong resolve to do all that we can to give Billie a good life. If (I hope never) IVDD leaves Billie paralyzed there will be no talk of “putting her to sleep.” Instead, we will have a Wheely Happy Doxie who can zip around on wheels and still have a happy full life.

Billie has many other health issues, some from the IVDD and some from genetic issues from the breeding practices of the puppy mill. Congestive heart failure, dental problems and allergies, to name just a few. But she has given us so much more than we could ever have imagined.

She is a joy. She is my heart.

LESSONS LEARNED

1. What was once an isolating and frightening time can now be one of support and connections through the social media. You can reach out to people far and wide and find comfort and information from virtual strangers who have knowledge and experience with IVDD.

2. Each case is so completely different. Each dog should be assessed by a veterinarian and treatment plans made accordingly.

3. There are many products and assistive devices available to help you through all stages of your dog’s injury, surgery, cage rest period and recovery. We will be posting some of these links and resources in an upcoming blog. If you have any questions, please email us at: vetsdrjm@gmail.com

We would like to thank all of our Twitter connections for their ongoing dialogue with us around IVDD. If you are interested in following us on Twitter we are @vetstoronto and @iambillysmom

UPDATE: Since Brenda wrote her story on this blog, Billie has suffered another setback and is currently resting comfortably (but unhappily) in her crate. Dr. Mitelman and I send good wishes her way.