Category Archives: Veterinary Specialists

Pet Cancer Awareness

Dr. David Hunley, DVM, DACVIM (Oncology) – Gold Coast Center for Veterinary Care

Cancer in dogs and cats

About 1 in every 4 dogs and cats will develop some form of cancer in their lifetime, and the incidence of cancer-development increases with age (there is a higher risk in dogs and cats over 10 years of age). Most of the cancers we treat in veterinary medicine occur due to genetic factors (often breed-related), so it is difficult to avoid the development of cancer in the majority of dogs and cats. Once cancer does develop, it is important to make a diagnosis as quickly as possible so that we can evaluate the various treatment options and make a therapeutic plan based on the specific cancer type.

It is always difficult to hear a diagnosis of cancer, whether it is in our human, canine, or feline family members. The word cancer carries with it a stigma that is different than most other illnesses, and it can seem like there is no hope once this diagnosis is made. The important thing to remember, however, is that there are many different forms of cancer, and no two cancers are exactly the same. Just as there are some situations where we are dealing with an aggressive cancer that has few treatment options, there are also many time when we can effectively treat, control, and sometimes cure cancer.

Signs of cancer in dogs and cats

Just like in people, cancer can affect any organ in the dog and cat, so we could have cancers that arise from the skin or from the internal organ. If any of the following symptoms arise, they could indicate that a cancerous process is present, so they should be evaluated, but other problems can cause these symptoms as well.

  • New or rapidly-growing lumps or bumps in or under the skin
  • Persistent non-healing wounds
  • Persistent diarrhea and/or vomiting
  • Persistent, unexplained pain or lameness
  • Bleeding from the mouth, very bad breath, or dropping food from the mouth
  • Bleeding from the nose
  • Abdominal swelling
  • Difficulty breathing or persistent cough
  • Sudden changes in weight or appetite

What to do if your pet is diagnosed with cancer

Your veterinarian will usually make the initial diagnosis of cancer and will discuss options with you. In some cases, they will be comfortable starting treatment, while in others, they may advise seeing a veterinary oncologist for a more detailed evaluation and discussion.

The role of a veterinary oncologist is to evaluate the individual characteristics of each dog’s or cat’s cancer and help make a plan for the best course of action moving forward. This plan will be determined in part by the type of cancer that is found, in part by the health of your pet, and in part by your comfort level with the treatment options that are available. There are some situations where no treatment is needed or when surgical removal of a cancerous mass is likely to control the cancer long term. Other times, medical treatment is recommended. Medical treatment options may include chemotherapy or other cancer-fighting medications.

Chemotherapy is a word that is generally associated with negative thoughts and feelings. This is because we know chemotherapy drugs can cause unwanted side effects. However, it is important to remember that there are many different types of chemotherapy and many different ways that chemotherapy can be administered. Also, certain types of cancer are more likely to respond to chemotherapy than others, so in some cases, it is reasonable to risk side effects while in others it may not be. It is often said that dogs and cats tolerate chemotherapy better than people do, and this is true in many instances, but this is partly due to the fact that we tend to be less aggressive with the chemotherapy dose and intensity in veterinary patients in order to avoid problems as much as possible. Despite this strategy of treatment, we still do see severe side effects in some dogs and cats, but the side effects in most veterinary patients are mild and tolerable, and there truly are many dogs and cats who have no side effects at all.

For many cancers, there are medical treatment options other than chemotherapy that may be less likely to cause side effects. These options vary depending on the type of cancer and the details of the disease, but they can be a more desirable approach for some situations. If less aggressive options are available, they will always be discussed during an oncology consultation.

Since each dog or cat is an individual, their cancer is unique, and their potential response to treatment is also unique. Therefore, it can help to discuss your pet’s diagnosis and your thoughts and concerns with an oncology specialist to make sure you have the most detailed information about your pet’s diagnosis and that you are comfortable with your decisions moving forward.

http://www.goldcoastcvc.com/veterinary-specialty-long-island/oncology.php

Surgery Patient of the Month- June- Portosystemic Shunt (PSS)

Nacho with his mommyCongratulations to Nacho for being our June Surgery Patient of the Month!

You would never know by looking at him, but Nacho was recently diagnosed with a life-threatening condition for which he showed no signs whatsoever! When Nacho turned one, his owners wished to have him neutered. He was an active and happy pup, and as expected, his exam was completely normal. As part of routine diagnostics done prior to any surgical procedure here at West Hills, Nacho had blood work performed. Results showed a single value related to liver health was slightly elevated. You might argue that a slight elevation of a sole value on a blood panel is likely insignificant, but at West Hills we are committed to practicing the highest standard of care for our pets. Therefore, Nacho’s veterinarian, Dr. Sikalas, recommended further testing to ensure it was safe for him to undergo anesthesia and surgery.

An additional blood test (called bile acids) was performed and Nacho’s results returned abnormal. When this occurs in a young small breed dog, a likely possibility is a congenital abnormality associated with the liver called a portosystemic shunt (PSS). In dogs and cats, blood carrying toxins, such as ammonia, from the digestive tract is first transported to the liver through the portal vein. The liver removes all the harmful substances before returning the detoxified blood to the general circulation. Nacho on Halloween!

In pets with a PSS, there are one or more abnormal vessels that bypass the liver, allowing those harmful substances to the rest of the body before detoxification occurs. Pets with this condition often times suffer from a smaller liver with impaired function, and can have stunted growth or abnormal neurologic behavior, particularly after eating. They may also have problems metabolizing medications, especially anesthetic drugs, and this can be fatal for some pets.

Surgery is frequently recommended for dogs with PSS and consists of an abdominal exploration to identify the abnormal “shunting” vessel and a procedure to redirect blood flow back to the liver. Nacho underwent surgery with our ACVS Board Certified Veterinary Surgeon, Dr. Marc Hirshenson, who identified an abnormal vessel consistent with a PSS. Dr. Hirshenson placed a small device called an occluder on the vessel. This allows for gradual closure of the vessel and redirection of blood flow to the liver.

Nacho handled surgery like a champ and recovered without any complications. At home, Nacho continues to thrive. More importantly, his most recent bloodwork showed normal liver values! Congratulations Nacho!

Minimally Invasive Surgery for Pets

Minimally Invasive Surgery (MIS) involves the techniques of using sophisticated surgical instruments with cameras and often, flexible fiberoptic instruments in order to accomplish procedures that have traditionally involved more invasive surgical procedures or “going under the knife”.  While MIS is not a substitute for all surgical procedures there is many that can now be performed using MIS techniques.  In human medicine we are all familiar with laparoscopic surgery, endoscopic procedures, and arthroscopy.  Thanks to technological advances these are now becoming more available in veterinary medicine.  The advantages of MIS are less extensive surgical cuts with decreased associated pain and discomfort and a resultant more rapid post-operative recovery.

At West Hills Animal Hospital & Emergency Center, our board certified surgeon, Dr. Marc Hirshenson is now able to offer MIS thanks to the investment in our state of the art Karl Storz Endoscopic and Laparoscopic equipment.  Procedures such as stomach and esophageal foreign body retrieval, stomach and intestinal biopsies, liver biopsies, cystoscopy to evaluate urethral and bladder disorders, arthroscopy, and bronchoscopy are now all within our realm.  In fact, the most common procedure we do, spaying, can now be done laparoscopically in addition to performing a gastropexy (tacking the stomach to the body wall) to help avoid bloat (GDV) in large breed dogs.

Talk to your veterinarian to see if MIS is appropriate for your dog or cat.

 

The Age of Veterinary Specialization

The Age of Specialization 

It should come as no surprise that, with today’s specialized services being the norm in everything from your hairdresser to your attorney, the profession of veterinary medicine has fundamentally changed as well.  In bygone days, your local veterinarian took care of all of your pets’ needs from birth through old age.  However, the past 10-15 years has witnessed the dawn of a new era – The Age of Specialization.

While your primary veterinarian will always remain the doctor you may lean on most for guidance, with the extraordinarily advanced care now available, it is no longer feasible for that doctor to be able to always provide what’s best for your pet.  It is essential for every pet owner to be aware that there are indeed specialists in virtually every discipline that we have come to expect in human medicine, e.g. surgeons, cardiologists, dermatologists, oncologists, ophthalmologists, etc.  In order to be considered a specialist in veterinary medicine, one must have completed a formal internship and a residency in a specific discipline and pass a certifying exam of clinical proficiency along with any number of other requirements as dictated by the various specialty boards.  The veterinarian would then be considered Board Certified and therefore recognized as a Diplomate in their respective area.  If the doctors are not Board Certified, then he/she may not represent themselves as specialists.

The list of specialty services seems endless, ranging from advanced orthopedic surgeries and arthroscopic surgeries, to laparoscopic or minimally invasive surgery, to complex cardiac diagnostics, to cataract surgeries, to chemotherapy and radiation therapy offered by oncologists, etc.  If you’ve heard of it being done in human medicine, it is now likely to be available in veterinarian medicine.

What will distinguish one general practitioner from the next will not only remain the care and compassion they provide to you and your pet, but their ability to recognize their limitations and their willingness to recommend specialists who may be able to provide a needed level of care that they can’t.   If your pet’s veterinarian does not approach the subject when your pet is having serious, more difficult, or lingering problems then it is up to you to be your pet’s advocate.  The same applies to hospitalization for your pet.  You must make sure that if your pet is being hospitalized for medical or surgical care that there is indeed a staff of nurses and doctors taking care of your pet 24 hours a day.   Don’t assume, ask!!!

Specialists will distinguish themselves not only by their abilities and the hospitals they work in, but by giving you and your pet the same tenderness and compassion that your family’s veterinarian and their staff provides.  You have choices and they do not have to be prohibitively expensive either.

At West Hills Animal Hospital & Emergency Center we have doctors and nurses working 24 hours a day, seven days a week for emergencies as well as routine care.  Additionally we have added a board-certified Surgeon offering laparoscopic and other minimally invasive surgery in addition to advanced soft tissue and orthopedic surgeries, and Cardiologists to our staff.  As always, if you ever have any pet questions that I can assist you with, don’t hesitate to reach out to me.

Sincerely,

Alan M. Coren, DVM