Monthly Archives: February, 2013

Charleston offers your pets the best from the veterinary and human medical fields

 

“Why didn’t you become a real doctor?” This is often the first follow up question I hear after I tell people I am a veterinary neurosurgeon. While many people do not realize what they are suggesting with that statement, I think there is a general feeling among much of the public that we are NOT “real doctors”, or RD’s as we like to call them. Surprisingly, when I interact with an “RD”, they are always so interested to learn about what we do as veterinarians and I very rarely see an air of superiority from them. This interest has allowed much collaboration in research and clinical cases between the human medical and veterinary medical fields.

Fortunately, the local medical professionals are more than happy to discuss cases with us. Tam Tam is an 11 year old, Siamese cat. I saw Tam Tam in October 2012 for a sudden inability to use any of his limbs. A similar episode had occurred 8 months prior but resolved on its own. Examination of Tam Tam demonstrated a problem affecting his cervical spinal cord (in his neck). In order to determine the cause an MRI was performed and demonstrated a fibrocartilaginous embolism (FCE; essentially a spinal cord stroke).

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 No underlying cause was found for the FCE and Tam Tam made a good recovery and was able to walk again within a few weeks. At that time, however, he developed some unusual movements while he slept. Tam’s owner told me there was some “twitching”, but I was surprised to see how dramatic the episodes were, sometimes even falling off of the bed, when I saw the video.

Here is a link to the video on my Facebook page: https://www.facebook.com/photo.php?v=464074526996531&set=vb.100001819627696&type=2&theater

Further description of the episodes by Tam Tam’s owner suggested this was NOT a seizure. If his owner would wake him up as the milder movements started, the more severe movements would be prevented and then he would fall back asleep and they would start again. This would be consistent with a group of conditions known as abnormal sleep movements. Movement disorders are uncommon in veterinary neurology, and I personally had never seen a case such as this one. Fortunately, I have had the pleasure of interacting with the epilepsy department at MUSC in Charleston. We have enjoyed discussing the similarities and differences between our patients, the conditions we treat, and how we diagnose them. They invited me to be a guest speaker at their lunch-time rounds so they could see what a day in the life of a veterinary neurologist is like and there was a huge turnout. This relationship has also allowed me access to a great resource for unusual cases such as this, and I have been helped tremendously by their insight and comparison to human conditions. I sent this video to the department members and their suggestion was to consider a condition called REM Sleep Behavior Disorder. While people and animals are in REM sleep there are centers within the brain that inhibit the movements elicited from brain activity that occurs while dreaming. It is suspected that the pathway of these inhibitory signals was injured in the spinal cord from the stroke, resulting in uninhibited movements while Tam Tam was sleeping. We are currently trying to treat Tam Tam’s sleep movements with Melatonin, and we may also consider Clonazepam. The pets in Charleston are very fortunate to have so many great veterinarians available to help care for them. They are also fortunate that the medical professionals in the area are so interested in helping us as colleagues to help care for your pets as well.

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About Sugar

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You would never think that a dog that was hit by a car can be described as lucky but this dog was just that.  “Sugar” was found on the side of the road by a local veterinarian.  Dr. Smith of Olde Towne Veterinary Clinic was on her way home from work when she saw a small dog on the side of the road.  She stopped to see what had happened and this sweet dog lifted her head and wagged her tail.  It was obvious that Sugar was seriously injured.  I happened to be on my way to work at the emergency clinic when Dr. Smith called me to tell me that she had found this dog.  I quickly left and went to meet Sugar.  She was in rough shape.  There were obvious broken bones and she looked to be in shock.  However, she still wagged her tail and let me pick her up to put her in the car without a growl.  Once at work we treated her for pain and shock.  We used a hand held scanner to check her for a microchip to see if we could locate an owner but she was not chipped.  She had no collar and no other identification.  We were hoping someone would call the clinic and report her missing.  We took radiographs and found that she had a fracture of her left humerus (long bone in her front leg) and a fracture of her left femur (long bone in her rear leg).  In addition, her left hip had come out of place.  The majority of orthopedic injuries are not life threatening and do not require immediate treatment so managing her pain was our first priority.  Unfortunately, by morning Sugar’s heart rate was extremely elevated, she would not move from lying in one place, and she looked like her condition was quickly declining.  We placed an ultrasound probe on her abdomen and found a large amount of fluid in her abdomen.  Sugar had yet another problem; she had a ruptured urinary bladder which is a life threatening condition.  I contacted Dr. Bianucci to let him know the situation.  We were torn as to what to do from here.  We had this stray dog with no owner that had multiple problems which all required surgery.  It is never an easy thing in our profession to make decisions based on money but it has to come into play.  The surgeries that Sugar would need along with the aftercare would be well over $5000.  Dr. Bianucci, Dr. Smith, and I decided this dog deserved a chance.  We did surgery on her bladder through the emergency clinic that day.  One of our technicians came in to volunteer her time and I stayed past my shift to do surgery.  The following day Dr. Bianucci repaired the fracture in the front leg and the day after that he repaired the femur fracture.  Through all of these surgeries countless people volunteered their time and the clinics (Olde Towne and Veterinary Specialty Care) donated their supplies to ensure this dog got a chance to recover.  Sugar took several days to recover but she made progress every day.  She had yet one more surgery to go through for the dislocated hip.  Dr. Schlicksup was nice enough to volunteer his time for this surgery which was performed about one week later (we needed to give her a break from anesthesia and surgery).  After all of her surgeries Sugar was then moved to Olde Towne Veterinary Clinic to recover.  She has started physical therapy and is working with a trainer as well.  Bark Busters trainers is volunteering their time to help us train Sugar to be a good pet.  She has not lived inside and is still getting used to being a pet rather than a street dog.

This story is more than about saving a life.  The number of people that came together to make sure Sugar was well cared for was amazing.  This is why we go into this field; so that we can save lives and help animals.