Thursday, May 29, 2014

When Desexing your pet gets Complicated

(graphic photo alert at the end of the post)

Any surgical procedure on any living creature has the potential for complications.  Yet, when it comes to some pet owners, it is one where they feel they should shop around for a price for which fits in with what they feel it is worth.  What many pet owners don't know is that in the majority of veterinary hospitals, it is usually offered at a heavily subsidised price (which very few people are grateful for).

What has brought on this discussion?  

Well, it all started with a situation in the US where a dog was desexed at a veterinary hospital, who then developed complications that night.  The owners were forced  to visit their local Emergency Clinic.  Emergency Clinics are common in the US, with local veterinary hospitals not answering their phones after hours, but referring all sick or injured pets to a fully manned "emergency only" facility.   This after hours clinic then was  unable to treat the poor dog because the owners had no funds to authorise life saving surgery.  All of the pet's signs pointed to internal bleeding, which required emergency surgery. This costs money, which the owners just didn't have.

 Part of the problem in this situation was that the patient was part of  a "promotion" where there was a discount on the desexing (20% off type scenario), and there was a debate on whether corners were cut. Vets do not cut corners, even during promotions like this, as the animal's welfare is always paramount to them. Anyway, that has always been my experience with colleagues.  However, vets who do "production line" desexings, may feel rushed due to the sheer numbers they have to get done.

We don't do desexing promotions at Russell Vale Animal Clinic , nor do we operate as a "production line", simply because I could not perform the procedure any more cheaply than I am offering now  - I have no wiggle room with respect to prices or speed.

Back to this poor American dog -  The information I have heard is that no corners were cut  with her -  it was just a sad fact that a complication occurred from her surgical procedure.

An Emergency Vet!
The owners were justifiably upset because they could not contact their vet that night for advice and help. They vowed to never have a vet they could not contact after hours.  This is going to be hard as the situation is always going to be that as emergency clinics open, vets are not going to answer their own phones.

(At Russell Vale Animal Clinic, we do our best to answer our mobile at any hour of the day or night, but sometimes, technology does fail us. We are human and we are not perfect.)

It was a very very sad situation for everyone - it  echoed through the veterinary channels....and I heard about it even in our little neck of the woods in Russell Vale (Wollongong, Australia).


Well, beauty of the internet is that things goes viral - and bad news travels fast -  but in all fairness  - it is a scenario that could've played out in any veterinary hospital, anywhere, that performs surgery on any animal -  anaesthetic and surgical complications can and do occur, and owners need to be aware of that.

It took a tragic situation to highlight this very important fact.

It doesn't matter if the surgery is "routine" or "commonplace", if it is a "desexing procedure", it is still going to be the only major surgery that the pet is ever likely to  have in its entire life.

And with  any surgery, things can go wrong.

I have had some very unusual, technically difficult desexing procedures in the past, and so I know, that each pet is unique.  It is a fool who is complacent about anaesthetics and surgery. And I am no fool.

What about the funky female desexings?

I have had a female dog with only one uterus and one ovary (the other side were just a strip of tissue) - this is called uterine unicornus and is rare.  I have had another dog whose uterine body was so long, that I had to extend my incision to three times my usual length to be able to remove the entire tract.  Then there are the fat ones - they are always difficult, as there is usually a bulb of fat around the ovary too .

We don't desex dogs when they are in season, but some vets do.  I have had situations that externally looked ok, but internally were "in season" still.  The risk of complications increases in situations like this, so  my only advice here is - don't do it!

The testicle on the left is the normal one,
and the one on the right was the
"retained" one. 

Then there are the "fun" pets - where things aren't what they appear! 

Both testicles failed to descend in this adult
dog  - through careful palpation and
skill the surgery was a success.  X marks
the spot where the scrotum sits, and where
the testicles should be sitting.
there was this one dog that looked like a girl externally, but was a "boy" internally (this dog was a hermaphrodite).  That was a very interesting conversation with the owner that day!

 At the end of the day, though,  it was going to be an "it", irrespective,  so it didn't make a big difference. Cost wise, it was the same to the owner, as it was a "female" desexing procedure (with the "twist" for free).

 I shouldn't forget to mention the cryptorchid pets (they have either 1 or none  descended testicles, with the hope that we are going to be able to find the missing one, and they are just not missing in action.

 Missing (ie the pet never had them at all) testicles can happen.  The retained testicle is half the size of the normal testicle, so it can be a challenge to find, especially as it can be located anywhere from the base of the kidney to the inguinal canal, if it is in the abdomen. Or anywhere in amongst major vessels and nerves in the inguinal region if it is between that and the scrotum.

And let us not forget the older pets with problems 

This uterus weighed 2.8 kg  and an
estimated diameter of 10 cm,  (when it should actually be
measured in grams and be the width of a normal
2B pencil. 
And then you get the older female dogs with pyometrons (pus in the uterus), who are true emergencies (the last one I did was 7 pm on a Friday night, and the uterus ruptured just after I took it out of the abdomen - one very very lucky dog).

 In this case, the uterus weighed 2.8 kg!

Or the older male dogs with testicular cancers - one testicle can be the size of a mango whilst the other the size of a cherry tomato.

Complications of the actual surgery are very rare,

but I have had dogs with suture reactions, and some have had minor haemorrhage from the skin itself (not internally, thank God).  But as a pet owner, you need to be aware that these can occur, and you  need to be prepared and budget for this.

 Complications are usually at the expense of the owner, not the vet.  When I have had surgery myself, and complications arose, I had to pay for those bills, so there is no difference in my view,  when it comes to the animal side. Of course, there is always going to be flexibility in this, but owners usually need to pay the extras.

When I first graduated, I had seen several dogs (none of my own surgeries to my knowledge), where the abdominal wound had broken down, and the intestines had fallen out (with the dog chewing on them).  Those were the days of "cat gut", but this suture is rarely used (at least, I last used it in 20 years ago, so hopefully it is rare).

 Nowadays, I hear stories of desexings done elsewhere where the skin sutures have been pulled out. Or the stitches are too tight. As we use dissolving skin sutures at Russell Vale Animal Clinic, that complication cannot occur here.

Desexing your dog or cat (or rabbit or guinea pig) is a surgery like any other surgery - it requires skill, expertise, gentle handling of tissues and awesome technique. 

It is not a procedure that doesn't have consequences, and it is definitely one in which every vet should discuss with every pet owner on whether it is right thing to do for them.  In many dogs, it may be in their best interest to delay the procedure until their are skeletally mature, and in many cats, it should be done as soon as possible.

What we always aim for here, at Russell Vale Animal Clinic, is to make recommendations that are the best for your pet, in the short and long term. 

We don't like "complicated", and we know you don't either. 

I am Dr Liz, the mad vet from Russell Vale Animal Clinic.  If you have any questions about your pet's desexing procedure or any comments let me know.  We are always happy to answer any questions.

Sunday, May 18, 2014

Dr Liz's Gratitude Project 2014 - Happiness is....

Welcome to Dr Liz's Gratitude Project 2014.

Did you know that gratitude and happiness are linked?  That is, those who are able to express gratitude are more likely to feel happy?

And those that are happy, are grateful for what is around them?

Yes?  No?

Does part of our unhappiness occur because we are ungrateful for what we currently have, and envy someone with something that we want?

I am grateful for.... the opportunity to debate what does and does not make me happy, and then take steps towards true happiness. 

There are some exercises that need company, but there are some that can be done in the privacy and comfort of home.

Gratitude is one of those home exercises - reading someone elses gratitude is a step, but don't you think it's time you started your own?

A Sunday Story about George

I had originally written this for my facebook page , but by the time I had finished, it was "this" long - and it is hard to edit a story where with each word written, you are reliving the fear you felt when you thought you had lost George.  So here it is....

"I won't follow Pandora, promise"
says George!

Don't you hate the feeling when you have lost your pet?  That horrible sick feeling?

Well, George did that to me this morning - I have come into work to finalise my bookwork (tax stuff), and let him out.  He followed me outside, and then I had to go back in to make a cup of coffee.  He had watched intently as Pandora went under the deck at the back.

It didn't occur to me that he would follow her. 

Two minutes later, I went out to check on him in the backyard, and he was nowhere to be seen.  My heart sank!

I checked his bedroom, and he wasn't there.  I checked the backyard again. He wasn't there.  So, I went through  many of the  rooms in the clinic, my heart sinking each time I couldn't see him. 

"Food is served" hears George!
I was not going under the house to get him - Dirk can barely fit under there at the best of times, if I went under there, I can only imagine what the headlines would read!

Finally, went into the last room I thought he would venture into - Pandora's bedroom!  


George in our backyard at work
 He was there gazing out her window whilst she was out!  Her view is a bit better than his! (she is the boss after all).

 "Breakfast is served", I informed him, and watched him run (seriously) to his bedroom.

Our animals are so precious and beautiful, and so, losing them is painful. 

It is a lesson to appreciate each moment we have with our family (of all creeds), as we never know when we may ever have that opportunity again.

I am Dr Liz, the mad vet from Russell Vale Animal Clinic.  My family is "big" in my mind, as it includes every pet that I see (whether I continue to see them or not).

My immediate family includes - Dirk (hubby), my human children (Tegan, Haiden, Sean and Paige), and my animal family - Pandora and George (at work), and Piper, Pusski and Dash (at home).  I also have to include the neighbours cat, Feral (they named him, not us), who, like any neighbourhood kid, loves to sponge a free meal now and then.
Pandora (the boss)

Piper (Practice Manager)

An older (but still appropriate)
photo of my children

Friday, May 9, 2014

Wollongong Dog Parks - Part Two

Did you miss Part One?  Go here to read how Piper and us scored Eleebana Reserve and Oak Flats Park.
This is Elebeena Reserve "off leash area", which
we visited in "Part One"

In this part, we are still in the Shellharbour area, looking at two very common and two very popular "off leash" areas.

 Do you have anything to add?  We would love to hear your thoughts on dogs and the areas that our councils provide for their "off leash" run around.

Whilst I live in an older suburb (developed in the 1970's), and even with the newer subdivision within 500 m (with over 300 houses on it), my area is devoid of children play areas, and definitely, no open land where kids or dogs can play.

Walking around my street would see children playing in the streets because they have nowhere else to play, so it should be as no surprise that there is nothing close by for our pets either. ( My family and I live in Mt Brown (near Dapto)).  It is always sad when money speaks louder than the right thing to do.

Whittaker Street

Wow!  This area was such a pleasant surprise, that we stayed there the longest!   This area is totally fenced off, and has three exits/entrances.  At each gate, was a bin, a bucket, water tap, and poop bags.
Whittaker St only offers one covered seating area for
two legged animals.
 Sadly, though, on the day we attended, all three poop bag dispensers were empty.

The landscaped gardens around the edges allowed dogs to hide from other "bully" dogs, but the worry I would have, being so close to the fence is, it did make observation of dog interactions a wee bit harder.

At one end there were a few dog agility activities, such as poles to weave through, some fences to jump, and a hole to jump through.  But really, the fun was being able to run off the lead totally.  We felt comfortable letting her off her leash, as the area was fully fenced.  Finally, freedom to run, in the knowledge that she wasn't going to run onto a road, or into a creek.
No "double gates" but Piper doesn't care -
she still wants to
go in to play!

But, there was only one area to sit and read, so it didn't work well if there was already someone there. All poop dispensers were empty, and sadly for Piper, there were no mud puddles for her to jump into. 

But is this a "dog park" or a "dog agility park" (as on the Shellharbour City Council website).  Actually, it isn't.  The gates are not ideal, the park corners are at 90 degrees, not at an angle, and there were no separate small and large dog areas.

It is just a fenced "off leash area". 

Is this area worth the drive?  For us, it was, and is. 

Piper's Score 8/10

"I loved meeting Daisy - we were kindred spirits"

Our Score 8/10

"It wasn't perfect, but had the potential to be a great spot to take your pet and family"

Bass Point

"I am sure there is a criminal in there" sniffs Piper
This is a beach "off leash" area, and was the only one that also had toilet facilities close by.   Now, if you were a parent with young kids, you know how important toilet facilities area, otherwise, the kids learn to toilet au naturale. (aka pee or poop on the grass)

It is beautiful, but likely any location close to nature, there were problems too.  There was plenty of parking, but it was a walk from the car park to the beach.  And as it was a popular area, we were sure to run into quite a few other dogs too. 

The ones we did run into were friendly, but still not a great thing for one dog to run up to another at full pelt.  We always try to encourage Piper to interact in a gentle way, but it is hard when other dogs go from zero to full steam!

The beach has always been my favourite place when I was growing up.  Watching and listening to the ocean is so peaceful, don't you think?

Obviously, no fences at the beach, and sadly, poop control is poor as some owners seem to think burying it as good as picking it up (it's not!).

Piper rating  7/10

"I love the beach, and the rock pools, but the waves? not so much"


Our rating 7/10

"The beach is always great fun - the sea breeze, the ocean, the rock pools always enjoyable."

Do you have anything to add? Did I miss anything in assessing each area?


I am Dr Liz, the mad vet from Bellambi, and owned by Piper (and four cats - Pusski, Dash, Pandora and George).

Piper is our new family member, and she has taught me a lot about the services that are available for our pets in Wollongong. 

Saturday, May 3, 2014

Dogs who Poop and Fart too much - A universal problem

Seriously! - dog's poop and farts are a real challenge to the usual loving relationship between pet
I hate being blamed for your farts, Dad!
owners and their pets.

I know that this problem does not compare to child soldiers, domestic violence, abuse, civil war, inequality, poverty, starvation, the homeless, and other really serious hardships that exist in our world.  I have no solution for these world problems, but do try to practice compassion and kindness to all  in my corner of the world, so I hope to make a little difference there. 

But poop and farts is a world wide serious pet problem.  In many households, pets are delegated to the outdoors as a result of their farts.  Many dogs are forced to travel in the back of the car or not allowed to travel at all as a result of their odorous contribution to the environment.

Let us start with farts. 

 It is something that every species does (not sure if there is a non farting species, so if you know, I would love to know).  It is all about how well your pet is able to digest its food, and if undigested or partially digested foods hit the large bowel, then gut bacteria cause gases to be produced, which then results in the good old fashioned fart. 

To my surprise, this is a surprise for many pet owners.

They don't realise that there is a connection between the quality and quantity of the food they feed and the farts their pet produces.

But it can also be a sign of intestinal infection too.  With Piper (our dog) her farts were strong and foul for a few weeks.  We accepted that as part of being a

Eating different foods can often cause
living creature, as she was still a puppy (although it did strain the night time sleeping arrangements).

We were using a lot of different foods for treats, so they also got the blame.  It was only when her diarrhoea began, and her giardia infection identified, then treated, that we realised that her farts were due to the giardia infection.

And more recently, when we ran out of her usual food, and had to purchase a supermarket brand to tide us over,we  found out again, that she was not a welcome bedfellow with the windows closed!

There is only so much you can blame on the other person in the bedroom!

Now onto poop. 

  Have you heard the phrase "rubbish in rubbish out" - well that usually relates to data, but it also applies to dog poop.

Discussion about nutrition is always a controversial topic with owners, especially with the plethora of "nutritional experts" on the internet.  My position is always "what is the right food for that particular animal", rather than generalisations (which includes comments such as "BARF is best", "commercial dog food is best", "Pet mince is best" - these are generalisations and are NOT in the best interest of the individual animal).

 My only two generalisations is that there is a big difference in the super premium foods and the general common food brands, and that home cooked/raw diets are not the best thing for your pet (unless they are specially formulated). 

I come from the generation where the supermarket had two brands of foods - Pal and Chum for dogs, and Whiskas and KiteKat for cats.  Pet shops sold pets, not food, and vets didn't sell anything much. The cat foods were tuna or chicken, and the dog foods all looked the same.

 And we saw a lot of nutritionally based diseases that are uncommon now, as many people also  opted to "home cook", hence my absolute dislike of them ( unless they are specifically designed for that pet).

Excessive poop and obesity is on the increase.  Is there a link? 

Let us explore this big,  big question. 

Yes, there is a link.

 Obesity occurs when too much energy goes in and insufficient energy goes out - i.e too much food, not enough exercise.

Too much poop occurs when too much food goes in.  

The common link? 

 Too much food.


We adopted Piper from the RSPCA at Rouse Hill, and they strongly promoted the super premium foods.  As a vet, I fully support that, so we also fed her a superpremium food (but not the one they used).   Everyone who meets Piper always comments on how shiny her coat is, and this is a lot to do with her great nutrition.

This is the amount we
would feed her of her
"usual" super premium
brand of food.
This is her daily intake.

Yesterday, we were running out of her usual food, and my vet hospital (sadly) was also out of it.   So, Tegan went to the supermarket and bought a bag of food which she said was "one of the better brands".

This is the amount of food we now need to feed
her of the "new" supermarket brand of
food.  This is her daily intake.
Since Piper came into our household, her food is measured out daily and placed into a container, as we then use this for her treats for training, her Kong wobbler, as well as for meals.  When Tegan went to measure out Piper's new food with the recommended amount for her age and weight, she got a shock!

There was a huge difference between the two brands of food. 

That isn't a surprise for me, as changing a brand of food is one of the more commoner causes of weight loss or weight gain in any pet.  People, being creatures of habit, would feed the same amount, no matter what brand it is.

If we didn't look at the "feeding guide" on the side of the bag, and filled out the same amount of food for Piper, we would be wondering why she was losing weight on the new food.
An example of a "feeding guide" - be aware that these are
"guidelines" only, and you should always go back to
your pet's activity and other food treats.

But looking at the amount of food we need to feed her of the new food, the change in poop volume should be no surprise.

No wonder dogs poop a lot if this is amount of food going in.
And as a result of being on this new food for two days, the farts have been pretty awful too!

How does obesity occur if you are feeding using the food guidelines? And not feeding (much) treats?

Well, guidelines are just guidelines.  These guidelines assume you are feeding absolutely nothing else to your dog, but we all know that for most of us, that doesn't happen.  They get the leftover kiddie breakfast, the bikkie at morning tea, a pigs ear here and there, the greenie or dentastix for dental health, and whatever else they can snaffle from someones dinner plate (they are good like that, aren't they).

Obesity occurs because there is a mismatch of the energy going in and the energy going out.  To stop obesity in our pets, we need to always be aware of our pets weight through regular weigh ins.  At Russell Vale Animal Clinic, every pet always gets a weight chart, and sometimes a stern talk from Nurse Dirk if there has been too much weight gain since the last visit.  And sometimes, we get to rejoice on the weight loss too!

We are fortunate that we don't need to run obesity clinics at our vet hospital, as we have very few obese animals (we do have them, but not enough to justify a weight loss class).

I am the mad Dr Liz, and I hope that this helped you solve this common problem in you and your pet's life.  Never let it be said that I won't tackle real down and dirty real world problems.

 But just in case you missed the "take home" message - a high quality food is worth every cent. And if farts persist, seek veterinary advice (there could be an underlying gut infection).

Want to weigh your pet?  Our walk on scales are available for everyone (including luggage if you are travelling - seriously, we have had people come in for this), and we do not charge for any weigh ins, of pets or luggage.