April is National Heartworm Awareness Month!

Heartworm Awareness and a Very Special Update

April is National Heartworm Awareness month, and our cardiologist, Dr. Gretchen Singletary, DVM, DACVIM (Cardiology), has some information for all dog and cat owners about this dangerous, but highly preventable disease:

"Heartworm disease affects increasing numbers of dogs and cats in the US every year. The disease is transmitted by mosquitoes and is most prevalent in warm and humid climates. Peak transmission usually occurs during July and August, although pets in certain areas such as the Southeastern US may be at risk year-round. Heartworm disease is a serious, sometimes fatal condition which can be safely and easily prevented using a monthly heartworm preventative medication. Yearly testing for heartworm is recommended for all dogs.

Pets infected with heartworm can develop damage to their blood vessels, lungs and heart. Symptoms include coughing, difficulty breathing, decreased ability to exercise and weakness. Severe infections can result in heart failure or death. There are approved treatments for infected dogs - including injections of a medication to kill the worms and removal of the worms using a minimally-invasive surgical procedure. There are no approved treatments for heartworm infections in cats. Prevention is key when it comes to heartworm disease!"

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 Dr. Gretchen Singletary, DVM, DACVIM (Cardiology)

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We at CUVS can't think of heartworm without also remembering Lucky. In 2011, we posted about Lucky, the mixed breed dog who was rescued in Los Angeles, and brought to CUVS by a New York rescue organization. When he was first brought to us, Lucky had suffered gunshot wounds to his legs, and needed several surgeries. While his injuries were already certainly enough for the scrappy dog to handle, it was discovered that Lucky was also suffering from a severe heartworm infection of his pulmonary artery. Fortunate for Lucky, our cardiologist was able to expertly remove the heartworms using flouroscopy and an incredibly steady hand. While heartworm extraction is a complex procedure with many risks involved, Lucky sailed through the procedure and after a night of recovery in CUVS' Intensive Care unit, went home heartworm free.




When Lucky was brought to CUVS, his injuries were severe.

 

Cardiologist Dr. Kleman was able to remove a sizable group of heartworms from Lucky's pulmonary artery.


Lucky then underwent surgery to repair the damage to his front and rear legs, caused by serious abuse before he was rescued. Thanks to the skill and care of CUVS' surgery department, Lucky's limbs were skillfully repaired and Lucky was able to regain full use of all his legs. At the end of Lucky's journey here, one of our staff members adopted him and provided Lucky with a happy ending in his new forever home. 

Lucky with Dr. Kleman, members of the nursing staff and his rescuers on his way home.


Lucky attended our Courageous Companions event in April, and CUVS staff had the opportunity to reunite with him and his supportive family. We're happy to say that he looks incredible, and along with his supportive family, enjoyed the spotlight with his colleagues.

Lucky attended the reunion looking better than ever!

Lucky was fortunate that his heartworm was discovered before it had progressed any further, and he serves as an example of why heartworm prevention is so vital to a pet's well-being. Speak to your primary care veterinarian about the prevention options available to you and take care of all those hearts that are so dear to yours!

PDA

Patent Ductus Arteriosus (PDA)

 Jamie was a 6 and a half week-old puppy when she was first brought to Dr. Chuck Noonan at Animal Doctors of Weston. She was acting normally and seemed to have had no issues in her first weeks of life. Dr. Noonan examined her and listened to her heart only to discover a significant heart murmur that was continuous throughout her heartbeat cycle. Dr. Noonan astutely recognized that this was likely a very significant heart defect that she was likely born with and recommended that Jamie’s mother take her to a veterinary cardiologist.

A week later, Jamie was seen by Dr. Mandi Kleman, a board-certified veterinary cardiologist at Cornell University Veterinary Specialists. Dr. Kleman performed an echocardiogram (ultrasound of the heart), which revealed a structural abnormality called a patent ductus arteriosus (PDA). A PDA is a congenital cardiac abnormality in which a connection exists between the aorta (the major systemic artery) and the pulmonary artery (the major vessel to the lungs). This abnormal connection results in the heart becoming overloaded by recirculating blood and typically results in heart failure within the first year of life. It was imperative, therefore, that we correct Jamie’s PDA.

There are 2 ways to correct PDAs. The first is via open chest surgery, to locate and ligate (tie off) the abnormal PDA vessel. This is the traditional method. The second option is to occlude (close off) the PDA vessel via an Interventional Radiology technique. Interventional Radiology is a method of surgery that uses video xrays (fluoroscopy) to allow the surgeon to see into the body and manipulate structures. This is a new technique in veterinary medicine, available at few academic and specialty institutions, including Cornell University Veterinary Specialists. The advantages of these techniques are that they are less invasive; there is no open surgery and thus, less pain and a faster recovery. For PDA correction via Interventional Radiology, an Amplatz ductal occluder or embolic coil can be inserted via a blood vessel until it is placed across the abnormal PDA vessel. The device then causes obstruction of blood flow across the PDA.

Here, at CUVS, both techniques are possible. In Jamie’s case, however, it was decided that surgery was her best option given her very small size. Dr Oli Morgan, staff surgeon at Cornell University Veterinary Specialists, performed the surgery - a left lateral thoracotomy via the 4th intercostal space. The PDA was carefully dissected and ligated, restoring normal blood flow. Jamie recovered smoothly in the Intensive Care Unit. Her heart murmur resolved. That evening she was already standing and eating! The next day, she was giving kisses and behaving like a puppy again. She was discharged to her owners care for at home recovery. After two weeks of exercise restriction she was healed. Her prognosis is excellent with a normal life expectancy.

Dr. Oli Morgan joins CUVS

CUVS Welcomes Dr. Oliver Morgan, VMD, DACVS, on board as our new staff surgeon!

As we bid a sad farewell to Dr. Alon Kramer, who has moved back to Portland with his family, we are excited to introduce Dr. Oliver “Oli” Morgan as the newest member of our medical team. We are so lucky to have found a surgeon of his calibur, and his communication skills and core values lend themselves very well to our atmosphere here. We're thrilled to have him on board, and he is undoubtedly a great match for our team here at CUVS!

We had a chance to catch him in the middle of a busy day here to ask him a few questions:

Q. Where are you coming from - where did you work before CUVS?

A. I am moving from Los Angeles, California where I worked at a large multispecialty referral hospital (Advanced Critical Care at the City of Angels Veterinary Specialty Center).  I am returning to Connecticut where I grew up with my wife and 1 year old son not only to work at CUVS, but also to be close to family.

Q. How have your first few days been here at CUVS?

A. My first few days at CUVS have been great with everyone being extremely welcoming.  The atmosphere within CUVS for both clients, patients, and new doctors is very similar it seems!

Q. How is CUVS different? What do you like about working here?
A. CUVS represents a new paradigm in veterinary medicine that is directed at providing a mix of the best of private practice with the best of academia.  I am so excited to be working in an environment with specialists that both love what they do and are excellent at what they do with a central dedication to client service and to our referring veterinarians.  The technicians and staff are excellent and also clearly have a deep-seated dedication to the care of our patients and that carries through in all their interactions with our patients.

We're so happy to have Dr. Morgan on board and are looking forward to a great future with him as part of the family. Welcome!

Best Pet Winner

WE HAVE A "BEST PET" WINNER!

As you’ve probably guessed, the Chihuahua Mia F. won our “Best Pet” competition by a landslide! The littlest gal in the running received by far the biggest show of support in the competition, and it’s no surprise.

Mia came to CUVS in the Fall of 2011 with a collapsing trachea. She was a patient of ours for several months and while her medical condition was one of those incredibly complicated cases that we could not ultimately save, we’ve yet to see a more dedicated owner than her mom Kelly Falconieri, and a bigger show of support from her many admirers. During her time here, and through Kelly’s tireless efforts on Facebook and IMOM.org, Mia captured the hearts of hundreds of people, many of them strangers, who donated to Mia’s cause and to her treatment. We even had people calling us here to contribute to her treatments! Although Mia is no longer with us, it is obvious that she is still in the hearts of the many who supported her through her treatment, and gaining followers even now!

Not only was Mia an incredible little girl, but Kelly is a great example of an absolutely incredible pet owner, and we’re pleased to announce them both the winners. Kelly will be receiving a gift certificate to Pet Pantry Warehouse, one of our favorite spots to get ANYTHING you could need for your pet and more.

Thank you again to everyone who sent us pictures of their pets – it was a wonderful week getting to share your furry friends and see everyone’s enthusiasm and love for their animals.

Thank you to the Pet Pantry Warehouse for this great prize!

Pet Dangers During the Holidays!

All of us at CUVS wish you and your family a wonderful holiday season! Because we’re always looking out for your four-legged family members, we’d like to share some common dangers to avoid during this joyful, and sometimes chaotic, time.

High Fat Holiday Foods
Although it is tempting to let everyone sample grandma’s great cooking, holiday foods are not a good idea for your pet, even in small quantities. Meals with a high fat content are one of the most common causes of pancreatitis in dogs. Pancreatitis (inflammation of the pancreas) can result in a reduced appetite, severe abdominal pain, vomiting, and in severe cases, can be life-threatening. High fat foods and abrupt changes in the diet can lead to gastrointestinal problems, such as vomiting and diarrhea.

Chocolate
Most of us know that chocolate can be toxic to dogs; however, few know the reasons. Chocolate contains theobromine, a chemical compound of the cocoa bean which is a strong stimulant, closely related to caffeine. In large doses, theobromine and caffeine can cause excitation, cardiac arrhythmias (abnormal heart rhythm) and seizures. Dogs are particularly sensitive to the effect of theobromine and caffeine. Chocolate should be stored far from your pets’ reach, especially dark, semi-sweet, unsweetened chocolate and cocoa nibs, since these have higher concentrations of theobromine than white or milk chocolate.

Raisins & Grapes
Raisins and grapes are extremely dangerous for dogs, as they can cause severe kidney failure. Keep in mind that raisins are commonly found in holiday treats such as bread and desserts.

Alcohol
We all like to relax and enjoy the spirits of the season. Just keep in mind that even small amounts of an alcoholic beverage can significantly affect your pet. Pets, especially cats, are not as efficient at breaking-down alcohol, and could end up in an ethylic coma. Please avoid sharing your drink with Fluffy, and keep the booze out of reach at all times.

Household Plants
If you share your house with a dog or a cat, always investigate your indoor plant choices before you consider making them an integral part of your household. Keep this in mind when receiving flowers as a gift. Poinsettia, the Christmas flower, can cause mouth irritation and gastroenteritis, but is not considered lethal. Various types of lilies, however (Easter Lily, Day Lily, Tiger Lily) can be lethal. These lilies cause severe kidney failure when ingested, even in small quantities, by your feline companion.

Holiday Decorations
Nothing sets the holiday mood like decking the halls and dressing your tree. However, many of these decorations can be hazardous to your pets. Tinsel and other string-like decorations can be a tempting treat for your cat or dog. Sometimes, parts of these decorations can get caught around your pets’ tongue or elsewhere in the gastrointestinal system and cause life-threatening problems that require emergency surgery. The same goes for other non-string-like decorative items, which can get lodged in the stomach or intestines, causing a blockage. Electric cords (such as for lights) can also pose a problem if your cat or dog has a tendency to chew on things they are not supposed to. Because of the danger they pose, make sure to hang your tree ornaments and other decorations out of the reach of your pets.

Please keep your pets safe this holiday season. And keep an eye on them. If they are lethargic, not eating, acting abnormally or exhibiting vomiting or diarrhea – seek medical attention.

Alex Rousseau, DVM, DACVIM (Internal Medicine), DACVECC

Wrap up: "The First 24 Hours" Continuing Education Lectures & Labs

Dr. Kleman leads her lecture on heart failure emergencies.

 On Sunday, October 23rd, many of CUVS's specialists lectured at a one day continuing education seminar for veterinarians titled The First 24 Hours: A Multifaceted Approach To The Emergency Patient. Over one hundred veterinarians attended the six lectures which were held at the Hyatt in Old Greenwich, CT.  The lectures, which covered a broad range of emergency topics, were led by veterinary specialists from Cornell University Veterinary Specialists as well as the Cornell University College of Veterinary Medicine.

Following the lectures were two labs which allowed veterinarians to get hands-on experience with either CPR using a virtual model or emergency radiology of the thorax and abdomen using a computer-based laboratory.

Dr. Fletcher leads the CPR lab with a high-tech virtual dog model.

The feedback from the attending vets was very positive and we all enjoyed meeting up with local veterinarians face-to-face. Although the veterinary field is a small community, and we do refer cases back and forth, it is not often we can meet up as a group to get to know one another. It's nice to put faces to names so that we can forge stronger bonds with our referring veterinarians moving forward.

Dr. Forman lectures to a full house at his Endocrine Emergencies lecture.

Lectures presented at "The First 24 Hours" included:


• Critical Thinking in the Critical Patient: 30 Minutes to Save a Life (Dr. Sergi Serrano LV, DVM, DACVECC)

• Getting to the Heart of the Matter: The Emergency Heart Failure Patient (Dr. Mandi Kleman DVM, DACVIM (Cardiology)

• Hematology in the Emergency Setting (Dr. Deanna Schaefer DVM, MS, MT(ASCP), DACVP)

• Endocrine Emergencies: A Case-based Presentation (Dr. Marnin Forman DVM, DACVIM (Internal Medicine)

• Making the Cut: The Fine Line Between Urgent and Emergent Surgery (Dr. Alon Kramer DVM, DACVS)

• Breaking Myths: Teaching Old Dogmas New Tricks (Panel Discussion- Dr. Daniel Fletcher, Dr. Susan Hackner, Dr. Alex Rousseau, Dr. Sergi Serrano)


Labs presented at "The First 24 Hours" included:


• Cardiopulmonarycerebral Resuscitation (CPR) Using a Virtual Model (Dr. Daniel Fletcher DVM, PhD, DACVECC)

• Emergency Radiology of the Thorax and Abdomen (Dr. Margaret S. Thompson DVM, DACVR)

Continuing Education: The First 24 Hours: A Multifaceted Approach to the Emergency Patient

REGISTER BY OCTOBER 13TH

A Day of Practice Relevant Continuing Education

THE FIRST 24 HOURS: A MULTIFACETED APPROACH TO THE EMERGENCY PATIENT

8 Hours Continuing Education for Veterinarians and Technicians*

SUNDAY, OCTOBER 23, 2011  9AM-6PM

Greenwich Hyatt, Greenwich, CT

Program Information and Registration

*Technicians welcome to the lecture portion of this program on a space available basis.

Silver Program Sponsors: Hudson Valley IT Solutions • Pfizer Animal Health • SoundEklin

Bronze Program Sponsors: Butler Schein Animal Health • CareCredit • Covidien • Final Gift Pet After Care Services • Hill's Pet Nutrition • IDEXX Laboratories • MWI Veterinary Supply • Petplan Pet Insurance

CUVS Performs a CT Scan on Arizona, a Galapagos Tortoise

Arizona, a Galapagos tortoise, arrives at Cornell University Veterinary Specialists in Stamford, CT.

We had quite a unique event this past week when Arizona, a 300-pound Galapagos tortoise, came into the hospital for a CT scan. Arizona's owners, who live in Westchester county, noticed that he was not putting weight onto one of his hind legs. Arizona's regular vet, Jeremy Sabatini, DVM of the Pleasantville Animal Hospital, referred Arizona to CUVS so that we could perform a detailed computed tompography (CT) scan. Dr. Sabatini was on hand to lend his expertise while we performed the CT scan.

Positioning a 300-pound tortoise takes many helping hands, including those of CUVS CMO Dr. Susan Hackner (right).

First we positioned Arizona on the CT scanner's motorized bed. Then we anesthetized him with gas, using an anesthetic mask which is more commonly fitted on the muzzle of a dog or cat patient. After Arizona was sedated, we backed him up to the CT and positioned his affected limb so the images could be taken.

Arizona, sedated and on the CT scan.

While preparing Arizona for this procedure took some time, the CT scan itself did not take long. Soon after, Arizona was waking up and on his way back to his sanctuary home. While CUVS frequently treats exotic species, this particular visit did garner quite a bit of media attention. You can find other articles about Arizona's visit here.

Q & A: Canine Influenza Virus

What is Canine Influenza? 

Canine Influenza Virus (CIV) is a respiratory virus of dogs. It has been identified in several states, including Connecticut and New York. A relatively small number of cases have been reported in Hartford, New London and Fairfield counties.
Influenza virus was first identified as an infectious disease of dogs in 2004. The first isolation of the virus was done at the Animal Health Diagnostic Center at Cornell University involving racing greyhounds. Within a year of the discovery, CIV was found in pet dogs in Florida and in the New York City area. Since that time the virus has been found in different areas of the US. CIV continues to move slowly through the canine population. It is highly contagious. Risk factors for the infection are having dogs in closely confined conditions such as in boarding kennels, day care setting and animal rescue shelters. Animals being relocated from the rescue shelters seem to be a main source of the movement of the virus to new locations.

How do I know if my dog has CIV? 

The clinical signs associated with the infection are indistinguishable from the traditionally defined “kennel cough”, now more appropriately referred to as acute respiratory disease. They include coughing, nasal discharge, fever and often inappetance. These symptoms are not unique to CIV, so it is important that the dog be thoroughly evaluated and tested. CIV infection compromises the normal defense mechanisms of the respiratory tract so that secondary bacterial infections (such as pneumonia) are common sequelae.

How is CIV diagnosed?

The diagnosis of CIV necessitates the identification of the virus in the acutely infected dog (via PCR testing) or demonstrating antibodies in the later stages of the clinical event (via serologic testing). Samples for PCR testing should be taken within 4 days of onset of clinical signs and the sample of choice is a nasal swab. For serologic testing, an acute and convalescent sample (10-14 days apart) are optimal, but in areas of low CIV prevalence, a single sample taken > 7 days after acute onset may be sufficient. Both PCR and serologic testing are performed by The Animal Health Diagnostic Center at Cornell University.

What is the prognosis for dogs with CIV? 

Since CIV is a relatively new (novel) disease, few dogs have natural immunity built up to protect them. As a result, a high proportion of dogs exposed to the virus become infected; approximately 80 percent develop symptoms, while another 20 percent do not become ill. Fortunately, most dogs recover within two weeks without any further health complications. However, some dogs progress to pneumonia, which is usually due to secondary bacterial infections. This is frequently curable with appropriate medical care. Dogs are generally free of CIV by 7 days post onset of clinical signs. They may cough for several weeks beyond this, but they are not contagious at this time.

Is my dog at risk?

The risk of infection is increased by exposure to other dogs. Dog shows, dog parks, kennels, grooming salons, dog day care centers, or anywhere dogs gather increase risk of CIV infection. Risk also depends on the prevalence of the virus in the area in which the dog lives or travels.

How do I prevent CIV infection?

CIV is best prevented by avoiding unnecessary contact with other dogs, particularly if your dog is particularly young or old, or has a compromised immune system. A vaccine is now available, that is effective in preventing CIV-related symptoms.

Should my dog be vaccinated against CIV?

The vaccine should be considered for dogs whose lifestyle puts them at greater risk (see above). Due the contagiousness of this virus, some kennels and grooming salons now require this vaccination to prevent an outbreak. Aside from these situations, the decision to vaccinate should be discussed with your primary care veterinarian, taking into consideration your dog's risks and the CIV prevalence in the area in which you live or to which you will be traveling.

Can humans or other pets get CIV?

In spite of monitoring by the CDC, the transmission of CIV to humans or to pets has never been demonstrated scientifically.

For more information on Canine Influenza Virus, please go to: http://ahdc.vet.cornell.edu/news/civ.cfm

-Susan G. Hackner, BVSc, MRCVS, DACVIM, DACVECC

Chief Medical Officer & Chief Operating Officer

May 21: FETCH Scavenger Hunt and Family Picnic at Stamford Harbor Park

A Dog-Centered Scavenger Hunt and Free Family Picnic to Benefit the Riedel and Cody Fund.
333 Ludlow Street- Stamford Harbor Park- (right behind the Cornell University Veterinary Specialists hospital)

FETCH stands for Funding Education and Treatment of Cancer Hounds, an event organized to benefit the Reidel & Cody Fund.

Fairfield County families and pet owners (with their dogs) are invited to participate in a scavenger hunt organized by FETCH to benefit dogs with cancer. Starting at 9AM, participants will receive clues either electronically or at the event site, answer questions, complete tasks and collect clue items by traveling around Fairfield county by car, motorcycle or bicycle. At 12:30PM, participants are to return to Stamford Harbor Park to turn in answer, items and activity stamps collected over the course of the morning. The award ceremony will be held at 1:30PM.

There will be games, activities and a concert for people of all ages. The first 100 participants to register will receive a free swag bag. The requested donation per participant or vehicle will be $25. To register, donate or get more details, go to RCFfetch.com or call (203) 295-0355.

CUVS is proud to not only sponsor this event, but to provide an Emergency Care Station to take care of any pet emergencies. The station will be staffed by one of our own veterinarians, technicians and staff members.

Little Dogs with Big Hearts: A Free Lecture at CUVS on May 15, 2-3:30 PM

Little Dogs with Big Hearts: What Does this Mean for My Pet?

On Sunday, May 15, at 2-3:30 PM, Dr. Mandi Kleman, DVM, DACVIM, will lead a free lecture in the auditorium at Cornell University Veterinary Specialists animal hospital at 880 Canal Street in Stamford, CT.

The topic of this lecture will be heart disease in dogs and it will serve as an overview of Mitral Valve Disease for dog owners. Dr. Kleman will briefly outline the disease process, the diagnosis, the possible symptoms, and how to care for a pet with Mitral Valve Disease.

Heart disease is not just an ‘old dog’ disease and certain breeds are more prone to it than others. 50% of our beloved small breed dogs over the age of 10 have heart disease. Valvular heart disease can be compared to the slow aging process of joints, which may result in arthritis. In small breed dogs, the valves within the heart can also degenerate with age. As these valves become more abnormal, blood begins to flow backwards within the heart and results in a heart murmur.

Cornell University Veterinary Specialists is proud to provide pet health educational sessions for owners.

If you are interested in attending any of these classes or learning more about our pet health educational sessions, please call us at 203-595-2777 or email us at info@cuvs.org. Space is limited and reservations are required for attendance. All classes are held at CUVS. Please check back often for session updates.

Rookie's Foreign Body

Rookie waking up from anesthesia.

Rookie is a 2-year-old male domestic shorthair cat who was recently admitted to CUVS. Rookie's owner noticed a couple things that spurred her to bring Rookie in: he had started acting differently and dry heaving occasionally without bringing anything up. He was eating and drinking less than normal and his bowel movements were infrequent. As an indoor cat, Rookie normally doesn't get into much trouble (besides finding hair ties on the floor and batting them around). However, his owner also noticed a lump that had formed under Rookie's jawline, and at that point she decided to bring Rookie to CUVS.

Close-up view (inset) of the end of the needle (with black thread) embedded in Rookie's throat. Click to enlarge image.

Rookie was seen by emergency veterinarian Dr. Michael McCann, DVM, who performed a physical exam and found that Rookie had an elevated temperature, and that the composition of the submandibular mass was abnormal. Palpation of the mass revealed the suspected presence of a hard object within the swelling. Together, Dr. McCann and Dr. Melissa McDaniel, DVM, MPH, performed an exam of Rookie's mouth and throat. A sharp metal object was seen protruding from the right ventral oropharyngeal region, just caudal to the back of the tongue (behind the tongue, protruding from the bottom right side of the wall of the throat).

Two radiographic views showing the location of the foreign body.

Dr. McCann ordered two radiographs of the neck and head. A linear metal object of uniform thickness from end to end was visualized adjacent to the mandible. Rookie was then intubated and prepared for surgery to remove the foreign object. A hemostat was clamped onto the foreign object from within the oropharynx to prevent accidental loss of the object into the mouth upon removal. An incision was made in the skin just over the top of the mandible, not only to easily remove the foreign object, but to allow the wound to drain afterward. The incision revealed the foreign object to be a sewing needle with a few millimeters of thread still attached. The needle and thread were removed, along with some purulent debris (commonly called pus). The wound was cultured and sent out to the lab for analysis, and it was thoroughly irrigated with sterile saline.  The surgery went very well and Rookie recovered uneventfully.  Rookie spent the night at CUVS to continue to receive supportive care, pain medication and antibiotics. The next morning he was discharged back into the care of his observant and concerned owner with more antibiotics and pain medication. 

Close-up of the needle and thread removed from Rookie's throat.

While the above case sounds fairly simple and uneventful, it should be noted that this particular cat was very lucky: lucky to have an attentive owner, lucky to be seen quickly at a high-tech animal hospital, and lucky that he did not sustain more serious injuries from ingesting the needle. This is a great reminder to all of us: cats and dogs frequently play with and explore objects with their mouths. This is a natural behavior that can lead to big trouble if they find something dangerous. We should all take the time to pick up and put away anything potentially harmful to our pets so we can keep them safe.

Zolty's Heart Surgery at CUVS

Zolty is an amazingly sweet 9-year-old Golden Retriever who was born on Valentine's Day in 2002. Zolty's owners recently noticed an acute onset of extreme weakness, prompting them to take Zolty to see Dr. Nolan Zeide, their regular vet at Bull's Head Pet Hospital. After a thorough examination, Dr. Zeide found that Zolty suffered from pericardial effusion and a condition called cardiac tamponade. In layman's terms, pericardial effusion is the accumulation of excess fluid around the heart. Cardiac tamponade is the compression of the heart that occurs when blood or fluid builds up between the heart and the outer covering of the heart. Dr. Zeide referred Zolty to Cornell University Veterinary Specialists for further evaluation and treatment.

When Zolty arrived at CUVS, he was extremely weak with a fast heart rate and weak pulses. His heart sounds were barely audible with a stethoscope. One of the first diagnostic tests run on Zolty at CUVS was an echocardiogram, which confirmed Dr. Zeide's findings of pericardial effusion and cardiac tamponade. Additionally, a mass was located on the right side of Zolty's heart.

In order to alleviate the stress created by fluid buildup on the outside of Zolty's heart, criticalist Dr. Sergi Serrano, LV, DVM, DECC performed an ultrasound-guided pericardiocentesis. In other words, Dr. Serrano used ultrasound as a means of guidance to insert a needle into the sac surrounding Zolty's heart and remove the excess fluid that was trapped there. After Dr. Serrano removed 100mls of fluid, Zolty's tampanade resolved on its own and his heartrate returned to normal. While this remarkable turnaround sounds exciting, it was simply a temporary fix for the symptoms associated with a larger problem: the mass on Zolty's heart. It should be noted that Zolty still had arrhythmias, or abnormal electrical patterns within his heart, and that the fluid would have continued to fill up within the outer covering surrounding Zolty's heart if no further action was taken.

After a consultation with Dr. Serrano, Zolty's owners decided that they wanted to have the mass removed from Zolty's heart. A second consultation with Dr. Mandi Kleman, DVM, DACVIM (Cardiology) involved more detailed and extensive analysis of Zolty’s heart and the mass. Using echocardiogram, Dr. Kleman found that the pumping function of Zolty's heart was moderately depressed. Additionally, she described the location, size, and appearance of the mass within the edge of the right atrium. Based on these findings, she suspected to be a malignant type of cancer called hemangiosarcoma.

Zolty's large run allowed him to stretch out and relax post-surgery.

After the values of a full blood test were found to be favorable, and no metastatic disease was discovered on abdominal ultrasound, Dr. Alon Kramer, DVM , DACVS scrubbed in to perform Zolty's heart surgery. Zolty’s surgery involved a thoracotomy (open chest surgery) to allow exposure, and careful excision of his heart’s right atrial mass. Dr. Kramer also removed part of Zolty’s pericardial sac (the outer covering of the heart) to prevent any future fluid accumulation. The surgery went very well, despite being a technically difficult procedure. Zolty recovered recovered uneventfully and was comfortable in our ICU shortly afterwards. After the surgery, the mass was sent out to the lab for a histopathology and analysis.

Zolty relaxes in his run in ICU while we monitor his heart functions post-surgery.

Zolty stayed in the ICU for four days after surgery for close monitoring and pain and arrhythmia management, during which time he successfully won over every single employee that participated in his care.

Zolty and critical care technician Stephanie Phillips, BA, AAS, LVT

After his stay in ICU was over, Zolty was discharged to his owners with a Holter Monitor, which is an ambulatory device that measures heart rate and rhythm for 24 hours. The beauty of these devices is that they can be worn by the patient while resting in the comfort of their home. The dog can relax while the Holter monitor acts like a portable ECG, recording information about the heart that can be downloaded later for analysis. Heart rhythm abnormalities can vary from hour to hour, so without a portable device like the Holter monitor, the animal could experience abnormalities while away from the animal clinic that would otherwise be missed by the doctor. Zolty stayed at home resting for 24 hours while wearing the Holter monitor, and then he was brought back to CUVS to have the monitor removed. The data was then downloaded and analyzed. We were all pleased to find that the Holter monitor showed no evidence of concerning arrhythmias post-surgery.

The histopathology report on the heart mass did reveal cells consistent with hemangiosarcoma, confirming Dr. Serrano and Dr. Kleman’s pre-surgical suspicions. Hemangiosarcoma is a form of malignant cancer. Zolty is currently being seen by CUVS oncologist Dr. Edwin Brodsky, DVM, DACVIM (Oncology) who has begun treating him with chemotherapy. Chemotherapy does not usually make animals feel ill like it can do to humans. The use of chemotherapy in animals is not meant to absolutely cure the cancer; rather, it is a way to prolong a good quality of life. As such, we are very happy that we were able to give this wonderful dog more time with his owners. Zolty is an amazing animal who deserves to live a comfortable life, and we all feel blessed to be able to help with that.

Inside Cornell: Cutting Balloon Valvuloplasty for Subaortic Stenosis

Our own Dr. Mandi Kleman, DVM, DACVIM (Cardiology) and Dr. Susan Hackner, BVSc, MRCVS, DACVIM (Internal Medicine), DACVECC (and CMO of Cornell University Veterinary Specialists) participated in the most recent Inside Cornell event in New York City. Dr. Kleman discussed treating subaortic stenosis (SAS) in pets utilizing novel balloon valvuloplasty with cutting balloons and high-pressure balloons. The video can also be viewed on Cornell's website, and the Inside Cornell event is discussed on the CU in the City blog.

Human pain relievers are toxic to dogs and cats

This past week we saw a couple cases of ibuprofen toxicity in dogs- one was an intentional dosing of the dog by the owner, and the other was a case of the dog finding the bottle of pills and ingesting them. While these are two very different situations, the end result is the same: two very sick animals. Cats and dogs that ingest ibuprofen (the active ingredient in Advil), acetaminophen (Tylenol) or aspirin experience a wide range of negative effects such as severe vomiting, gastric ulcers, kidney failure, liver failure and, if the animal is not treated medically, death.

The dog we treated that accidentally ingested the ibuprofen pills arrived at CUVS comatose, with constricted pupils. She was unresponsive but trembling. Our team sprang into action by administering fluids and the appropriate drugs, placing a nasogastric tube, suctioning her stomach and giving her charcoal and gastroprotectants. Her blood values were closely monitored overnight and by the morning she was awake and aware, although she did stay in the intensive care unit for three more days. Despite the severity of this case, both dog and owner are very lucky: the attentive owner figured out something was wrong and rushed his dog to the vet. This quick thinking saved the dog's life.

The case described above provides two valuable lessons for pet owners:

#1: Make absolutely sure that all of your pills at home are locked away securely.

#2: Do not give any pills to your dog or cat without seeing your vet first.

We all know that dogs like to jump up and see what's on the counter or table, and cats have a truly remarkable ability to jump onto the highest shelves. A bottle of pills left out on a flat surface is a tempting target for both dogs and cats.

If you feel like your pet is in pain, always bring her in to see your vet. The vet will advise you on the proper care for whatever is causing the pain, and you can be certain that the prescription he writes for you will be safe.

Here is the rule of thumb we'd like you remember: dogs and cats cannot take the same pain relieving pills as humans.

Casey's Abdominal Surgery at CUVS

   Casey is a mixed-breed spayed female dog owned by Suzanne, who is the Senior Client Service Representative at Bull's Head Pet Hospital. Casey was referred to CUVS from Bull’s Head after Dr. Nolan Zeide diagnosed her with a large abdominal mass, hemo-abdomen and a fever.  Casey was admitted to CUVS for observation, supportive care and a further work up under the care of Dr. Rousseau, DVM, DACVIM, DACVECC.

An ultrasound at CUVS revealed a large mass potentially originating from the liver, an abnormal spleen and a probable left adrenal mass. Casey underwent abdominal exploratory surgery with Dr. Alon Kramer, DVM, DACVS, during which a large, ruptured splenic mass and a ruptured liver mass were found. A splenectomy, a liver lobectomy and an adrenal biopsy were performed. (Her spleen and part of her liver were removed.) Casey also received a blood transfusion during surgery, a routine part of splenectomies as it combats anemia.

Post surgery, Casey stayed in our ICU for four days for pain relief and continuous monitoring. Attentive post-surgical monitoring is important for splenectomy patients to make sure that there are no complications. Lab results came back showing liposarcoma of the intermediate grade in the spleen, hepatoma in the liver and suspected pheochromocytoma in the adrenal gland.

Once Casey was stable enough for travel, she was sent back to Bull’s Head so her regular veterinarian could continue caring for her. Casey was a lovely patient for us and although we are happy she was discharged from CUVS, we were sad to see her go!

CUVS Featured on Channel 12 CT's Pet Talk TV Show

Dr. Susan Hackner (CMO) and Dr. Mandi Kleman (Cardiology) are interviewed by Lauren Collier on Channel 12 CT's "Pet Talk" TV show about the opening of Cornell University Veterinary Specialists.

Lipton: First Emergency and First Surgery at CUVS

Lipton in the ICU of CUVS

Lipton was Cornell University Veterinary Specialists' first emergency case on January 14th, 2011. She was referred to us by a local veternarian because she was lethargic and had collapsed on more than one occasion.

Upon examination, our criticalist Dr. Sergi Serrano, LV, DVM, DACVECC, suspected a possible hemoabdomen (blood in the abdominal cavity). Our team began stabilizing Lipton and performing diagnostic tests, which included bloodwork, abdominal ultrasound, thoracic radiographs and echocardiography. These tests confirmed the hemoabdomen and Lipton was rushed into surgery with Dr. Alon Kramer, DVM, DACVS. 

Dr. Kramer and Dr. Serrano perform surgery on Lipton

Exploratory surgery revealed multiple splenic masses, one of which had ruptured and was actively bleeding. Dr. Kramer performed a splenectomy (removal of the spleen) and Lipton was then admitted to ICU for recovery and monitoring. Lipton stayed in our ICU for three days, during which she received a blood transfusion to treat her anemia. Attentive pain management and lots of love from our staff made Lipton's extended stay at CUVS as comfortable as possible.

Cornell University Veterinary Specialists profiled in the Stamford Advocate

Check out this great article in the Stamford Advocate which covers CUVS, the services we offer, our high-tech equipment and skilled staff!

Cornell University Veterinary Specialists is open for business

We are proud to announce that Cornell University Veterinary Specialists is now open and currently treating patients at a brand-new facility in Stamford, CT.  CUVS opened its doors on January 14th! A crowded ribbon-cutting event was held during the final open house on January 12th, 2011. The ceremony was attended by the mayor of Stamford, Michael Packs, several K9 police officers, the media, animal lovers, and the friends and families of hospital staff.

From left to right: Carl Kuehner from BLT; Dr. Susan Hackner, CMO of CUVS; Dr. Michael Kotlikoff, Dean of the College of Veterinary Medicine of Cornell University; Stamford Mayor Michael Pavia; Daniel Gurvich, CFO of CUVS; and Paul Kuehner of BLT.

As the largest university-affiliated veterinary referral center in the country, CUVS is driven by the mission of bringing together the best of specialty private practice with the best of academia to benefit pets, the people who love them, and the veterinary profession. CUVS provides exceptional medical care by integrating the latest medical and scientific advances with personalized, collaborative and efficient service.

With a state-of-the-art facility and a convenient location close to I-95, downtown Stamford and the Stamford train station, CUVS promises to deliver the highest level of specialty care to animals in need. CUVS features an 24-hour emergency department serving walk-in animal emergencies all day and night. Referral-based appointments with specialty veterinarians are available in the following departments: Cardiology, Critical Care, Diagnostic Imaging, Internal Medicine, Interventional Radiology, Oncology, Orthopedic Surgery and Soft Tissue Surgery.

Driving directions to CUVS are available here or by calling (203) 595-2777. You may email Client Services at info@cuvs.org, follow CUVS on Twitter and "like" our page on Facebook.

Cornell University Veterinary Specialists

880 Canal Street

Stamford, CT 06902