Hanging Out in El Centro
I'm doing relief work in El Centro for the next two weeks. It's been feast and famine so far as work goes. Yesterday it was non-stop from the moment I walked in. Today I had a dental procedure and four rabies vaccinations. Hopefully it will pick up this afternoon. A lot of business comes in between 5:00 and 6:00 after people get home from work and discover something that needs to see the vet NOW. Vomiting and diarrhea get most everyone's attention and the first thing I test for is parvovirus. It's endemic out here and made up four of my cases yesterday.
The dental cleaning became the all-mouth extraction I thought it would. The breath alone could deflect a zombie. Each tooth came out once the anchoring plaque was removed by the technician. My job was to make multiple buccal flaps and and close all the holes that were left. He's obviously feeling better already despite all the sutures in his mouth. The regional anesthetic blocks are probably helping with that.
At home Martha is dealing with our dog Kelpie who has developed progressive neurological signs over the past three weeks. At first it was just tremors when she got up. Other things have come and gone so I just watched it. When it developed into a head tilt to the right I had a *brief* look in her ears (she's very head shy) and was pretty sure the tympanic membrane was ruptured. There was no circling behavior or other sign of central nervous system involvement, normal bloodwork with a mild elevation of CPK, so I started a broad spectrum antibiotic treatment with the presumptive diagnosis of otitis media. Other rule outs were viral/fungal infection, parasites, neoplasia (cancer). Titers for common tick-borne infections were negative. After three days with no improvement - and no chance to look into her ears again w.o. sedation - I referred her to the Veterinary Specialty Hospital of San Diego.
Their initial exam came up with most of the same things I had found - and no better luck looking into her ears. This was a relief and worrisome at the same time. A relief because I hadn't missed something obvious and worrisome because a diagnosis may be hard to come by and unpleasant when it does. We booked an appointment with their neurologist for today. When I last talked to Martha the offered options were try for a diagnosis via MRI with CSF tap, or treat empirically with steroids. We are unanimous in selecting the former.
Hopefully it will turn out to be something curable or at least treatable for a significant period of time.
The dental cleaning became the all-mouth extraction I thought it would. The breath alone could deflect a zombie. Each tooth came out once the anchoring plaque was removed by the technician. My job was to make multiple buccal flaps and and close all the holes that were left. He's obviously feeling better already despite all the sutures in his mouth. The regional anesthetic blocks are probably helping with that.
At home Martha is dealing with our dog Kelpie who has developed progressive neurological signs over the past three weeks. At first it was just tremors when she got up. Other things have come and gone so I just watched it. When it developed into a head tilt to the right I had a *brief* look in her ears (she's very head shy) and was pretty sure the tympanic membrane was ruptured. There was no circling behavior or other sign of central nervous system involvement, normal bloodwork with a mild elevation of CPK, so I started a broad spectrum antibiotic treatment with the presumptive diagnosis of otitis media. Other rule outs were viral/fungal infection, parasites, neoplasia (cancer). Titers for common tick-borne infections were negative. After three days with no improvement - and no chance to look into her ears again w.o. sedation - I referred her to the Veterinary Specialty Hospital of San Diego.
Their initial exam came up with most of the same things I had found - and no better luck looking into her ears. This was a relief and worrisome at the same time. A relief because I hadn't missed something obvious and worrisome because a diagnosis may be hard to come by and unpleasant when it does. We booked an appointment with their neurologist for today. When I last talked to Martha the offered options were try for a diagnosis via MRI with CSF tap, or treat empirically with steroids. We are unanimous in selecting the former.
Hopefully it will turn out to be something curable or at least treatable for a significant period of time.