cjsmith | Nanokitten, Tail Bite, and Wheezy

Wednesday: A nanokitten, on supplemental oxygen and warmers and hourly feedings. (Dr. S saw me come in: "Want a kitten?" Me: "I heard M was taking her home." Dr. S: "Oh, M's just going to nurse her." Ahhhh, now I see what you're asking, you sly dude.) She didn't make it. Poor thing. It's pitifully tragic when you bag one for cremation and the body takes up less than half of a sandwich Ziploc.

Saturday: The nastiest bite wound I have yet seen - small, but massively infected. [LJ-CUT TEXT="Discussion of goo"] Owner had been doing the hot-compress-and-then-squeeze treatment 3x/day for over two weeks. Dr. W's big contribution (other than the antibiotics) was finding the second hole. It exuded a bit of pus each time the clippers got nearby. Owner's partner actually got queasy and had to sit down. Just seeing it like that, I itched to squeeze it, but unless asked by the doctor or the owner, obviously I couldn't.[/LJ-CUT] That kitty will do fine, with the kind of care he's obviously getting. Owner has little money to spend at the vet's, which is why the antibiotics are only starting now, but anyone who will do that kind of treatment three times a day for over two weeks is going to pull that cat through.

Also Saturday: Respiratory emergency - laryngeal paralysis. Took hours to get that big dog stabilized. I need to get good at accepting my own helplessness, whether as the kennel cleaner or someday as the DVM. Yesterday I couldn't help stabilize her, but really, our doctors can't cure this either. We just hope that the next time it happens she's nearby a vet clinic again. That ailment is eventually going to kill that dog. If I had a veterinary medical degree I couldn't change that fact.

The new kitten and puppy appointments sure do help brighten a day like that. Hi, cute thing! Vaccination? Here you go. Oh, doggie kisses! What a sweetie you are.

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A friend linked me to your site, and i had to comment on the laryngeal paralysis.... The doctors can do surgery, fixing the paralyzed half of the larynx permanently in the open position. The dog is at an increased risk of aspiration pneumonia, but doesn't have the exercise restrictions, the lar par noise, the chronic dyspnea....

Its not the best cure, but it does make an enormous difference.

Oh cool! I wasn't aware of that surgery. (In this case the dog has both halves affected, but only some of the time, apparently triggered by stress. Does this sound reasonable or did I likely totally misunderstand the case?) I wonder if the owners simply don't have the money, or if the dog is old enough that such a surgery is quite risky, or... I don't know. Interesting to know that there's a possible avenue!

Bilateral lar-par is fairly common, and makes surgery a bit more difficult. Some doctors will choose to tie back one side and leave the other down. The surgery, formally, is a arytenoid lateralization. It isn't as huge of an aspiration risk that way. It is common for lar par to be a stress reaction so it sounds like you are describing the case accurately.

Conservative treatment would be the 02 and sedation, and some doctors will choose to add steroids (reduce inflammation) or bronchodilators (albuterol, in my experience) to maximize air intake and use. Intubation is obviously a huge help.

The other surgery is a ventral ventriculochordectomy. A full ventriculochordectomy is a debarking, so you know. They have about the same success rate ( http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1576902 ).

The tie back is quick and fairly simple. A lot of times, not doing it is financially motivated, or some vets don't feel comfortable with the procedure. The incision is made through the neck, a couple throws of non-dissolving suture are made around the arytenoid, and the doc closes.

Laryngeal paralysis is also found in horses, called Roaring, or Roarers Syndrome. You can find some good videos of an affected trachea when you look at the horse stuff.

In case you were wondering... I'm an RVT, and have worked in equine and emergency, but am currently working in shelter medicine at SF SPCA. Larry (LRC) is the friend that sent me your direction.

If you're ever interested in talking or swapping war stories, feel free to message me.

The O2, sedation, intubation, and *some* injected meds (albuterol seems right) all sound like exactly what our clinic did. They also made sure the owner was present when they brought the dog out of it, because apparently that's one time things could go south, and they didn't want anybody to wonder what happened and when.

That does sound like a simple procedure. I wonder if the dog is simply old. (Although with stress-induced lar par I wonder how she lived that long.) We also do see a lot of clients for whom finances are a big issue.

Where have you worked in equine? I'll soon be looking for a vet to shadow, or a stable where I can muck out stalls, or SOMEthing to get some experience around horses (preferably at least part in some kind of clinical setting). I know little about horses so far, and that's a big weakness I need to work on. Our clinic is small animal/birds/reptiles/exotics only - no farm animals, no horses, no wildlife.

I've friended you on LJ, so if you post about your work as an RVT, I'll enjoy reading!

Nanokitten, Tail Bite, and Wheezy

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