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An interesting new genetic study about the Domestic cat

 

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Sick Dog

I have been encountering over the last years more more the use of words that tend to convey to the pet owner a sense of guilt and fear.

The following statement with some variations is used: You have declined diagnostics and treatment at this time, as well as humane euthanasia. It is very likely that your pet will continue to decline without treatment and may die at home.

Wow! What a statement; how frightening.

So, are there cases when a pet is so critical that the above is true? Of course there are. But I have encountered cases—and too often—in which the statement is used to scare and create a feeling of guilt.

A true assessment needs to be done, and if true financial hardships are present, then a less costly venue can and should be pursued. In my practice I explain in detail the possible differentials of the illness, being frank and open. Often, with the understanding and acceptance of the owner, a course of treatment will be ensued, and if feasible, and most time it is, I send the patient home, where they are more comfortable. Usually a follow up visit is set for the next day. I explain that this approach has significant limitations, as at this point we do not have a diagnosis, but we can try and see how we are doing with treatment that addresses the symptoms. Of course some medications cannot be started without diagnosis—as they can do harm in certain situations—but at least we are trying to help the pet and the family.

If the patient improves, then, gradually and judiciously we’ll do tests to further define the illness, continue or modify the treatment, and try and get a prognosis.

The bottom line has to be compassionate veterinary care with good communication with the owner, and a relationship of mutual trust.

Dr. Ehud Sela

The Gentle Vet

Margate, Florida.

954-972-5900

http://www.thegentlevet.com

 

© Dr. Ehud Sela. No work herein may be reproduced in any way without expressed permission from the author.

maine_coon_

Chronic Renal disease is a common problem in cats. Blood work can detect it, but once the blood work shows abnormalities changes already were established in the kidneys and often, at that point, the treatment is for control of the disease rather than prevention.

One of the diseases that cats can have is an infection of the kidneys called pyelonephritis. It is often an insidious disease and does not become manifest until late in the disease process.

I am a strong believer in early detection and prevention. In my geriatrics cat patients, I often advise routine urine analysis. It’s a simple test and the owner can easily collect the sample at home.

I also routinely perform abdominal ultrasounds and have found pyelonephritis in cats before the kidneys suffer irreversible damage.

These geriatric cats might have nonspecific mild syndromes with slight weight loss, and just seem to the owner that they are not doing right, in a mild nonspecific way early in the disease process.

These cats usually respond nicely to antibiotics and the owner notices an improvement in their general wellbeing.

Dr. Ehud Sela

Gentle Vet Animal Hospital

Margate, Florida

954-972-5900

http://www.thegentlevet.com

 

 

IN MEMORY OF LEONARD COHEN

leonard-cohen-and-marianne

You have completed your journey; Rest in Peace.

So long Marianne

Lyrics

Come over to the window, my little darling
I’d like to try to read your palm
I used to think I was some kind of Gypsy boy
Before I let you take me home

Now so long, Marianne, it’s time that we began
To laugh and cry and cry and laugh about it all again

Well you know that I love to live with you
But you make me forget so very much
I forget to pray for the angels
And then the angels forget to pray for us

Now so long, Marianne, it’s time that we began

We met when we were almost young
Deep in the green lilac park
You held on to me like I was a crucifix
As we went kneeling through the dark

Oh so long, Marianne, it’s time that we began

Your letters they all say that you’re beside me now
Then why do I feel alone?
I’m standing on a ledge and your fine spider web
Is fastening my ankle to a stone

Now so long, Marianne, it’s time that we began

For now I need your hidden love
I’m cold as a new razor blade
You left when I told you I was curious
I never said that I was brave

Oh so long, Marianne, it’s time that we began

Oh, you are really such a pretty one
I see you’ve gone and changed your name again
And just when I climbed this whole mountainside
To wash my eyelids in the rain

Oh so long, Marianne, it’s time that we began

Songwriters: LEONARD COHEN
© Sony/ATV Music Publishing LLC
For non-commercial use only.

happy-cat-268x300

A 16 yrs old cat was presented for a tail lesion that kept oozing and crusting over and bothering the cat. Fine Needle Biopsy, done as an outpatient revealed benign a sebaceous lesion.

Due to the age of the cat a non surgical approach was elected. Using Cryosurgery, liquid nitrogen was applied to the lesion. A 6 mm Cryo-chamber was used and 3 cycles of quick freeze, slow thaw were applied to the lesion, reaching at each freeze cycle Cryo-adhesion. The cat was not bothered at all by the procedure and calmly lay on the exam room table–table that is softly padded for the patients’ comfort–while the owner was petting him. The entire procedure took about 25 minutes and the cat went home with his owner.

The lesion is expected to slowly regress within the coming weeks.

Cryosurgery is an excellent technique for many skin lesions and, or, tumors, that is not invasive and with hardly any discomfort to most patients.

Dr. Ehud Sela-The Gentle Vet

Gentle Vet Animal Hospital

Margate, Florida.

Phone: 954-972-5900

dogs'exam

Just like with us, in Veterinary medicine, early diagnosis and screening tests can save lives.

Often, when symptoms are already present a certain amount of damage has happened, and at times this damage is not reversible and lead to long term consequences.

In my practice I recommend every 6 months some basic and non invasive tests, such as: urine analysis, and complete blood work, that will help us detect signs of possible illness before they become clinically apparent. A urine analysis can detect signs of a urinary infection, renal disease, diabetes, among other serious diseases.

Complete blood work gives us an indication as to how the internal organs are functioning, and at time can help in detecting early signs of certain cancers.

I also often advise screening ultrasounds, as they do not involve radiation, and give us a non invasive visual on the structure of vital internal organs.

In conclusion: Early diagnosis and screening tests are an essential tool in the maintenance of our pets’ health. As, sadly, the life expectancy of our pets—dogs and cats—is much shorter than ours, our pets move quickly from infancy, to adulthood, to middle age, and before we know it they are senior-citizen-pets.

The more we know about their health, and the earlier we know it, can keep them with us alive and happy for as long as possible.

Dr. Ehud Sela

Gentle Vet Animal Hospital

Margate, Florida.

954-972-5900

Dogs-Heartworm-Disease1

My Philosophy in medicine is of a measured and conservative approach, and to try and look for less invasive, safer, and less costly treatment options.

In this regard I have been using the so called “European protocol” for treatment of Heartworm disease. It is so called because a research paper first published in Milan, Italy described the protocol. The protocol has been used in the States also by various veterinarians that are familiar with it. It involves the use of Doxycycline and Ivermectin based Heartworm preventive. It’s a slow kill of worms approach, and that is why I like it, as I find it safer–as compared to fast worm kill–and less costly. Of course each patient is an individual and a veterinarian needs to asses him and discuss with the pet owner the options.

My bottom line is always: if it safer and appropriate for the patient it should be the first choice.

Dr. Ehud Sela

Gentle Vet Animal Hospital

954-972-5900

© Dr. Ehud Sela. No work herein may be reproduced in any way without expressed permission from the author.

 

 

THE ART OF MEDICINE

the art of vet medicine

 

Medicine is an art, good medicine that is, both in Veterinary medicine and human medicine.

In Veterinary medicine this art is more difficult as the patients can’t tell the doctor what is bothering them.

Therefore, a complete physical exam, and a detailed history is imperative in order to achieve a diagnosis.

Of course, an experienced eye with many years in practice is an essential element.

Unfortunately medicine has become in some instances not an art, but a blanket approach in which based upon algorithms–and not critical thinking–a myriad of tests are done, and these tests can be costly.

I believe in diagnostic tests; they are essential, but I also believe in a logical approach and fine tuning the tests to the case in front of me.

I regard in many cases the art of medicine to be like a detective work in which a methodical and logical approach is applied.

Yet, always remembering that the first rule of medicine is do no harm.

And, always remembering that in front of me is a pet that feels and is a member of the family.

The Art of Medicine is not just a cliche but something to strive for and always practice.

And like any form of art, there are good artists, not so good artist, and exceptional artists. 

In medicine the exceptional doctor has that additional spark of compassion and wisdom that sets him apart.

Dr. Ehud Sela

Gentle Vet Animal Hospital

Margate, Florida

954-972-5900.

© Dr. Ehud Sela. No work herein may be reproduced in any way without expressed permission from the author.

google-bad-practices-p

First Part, 7/12/16

To the public at large and those among you that are small business owners and professionals: Google deliberately fosters, festers and harvests with glee bad reviews. It’s a money making machine for them, as within not a long period of time afterwards they will address you with online ads’ offers. Yelp for example requires a head photo before posting a review and take their time approving it; of course for Google such rules do not apply. In my opinion any merchant that finds that through Google reviews he has been maliciously hurt, do not listen to their advice as to the response, as it only serves them, but respond truthfully and strongly to defaming words. Unfortunately, through their friends in congress Google is immune from defamatory law suits when publishing them–a thing that the print media does not have, and rightfully so. Let us hope that we the people will be able to change this unsavory and cozy relationship of money and power.

Let us all try from now on not to “Google it” But let us “Bing It.”

 

Second Part, 7/15/16

Let us expand more about Google shady practices: This actual conversation took place and it is here brought not verbatim, but the essence of the conversation and its content and meaning and implication are  accurate. Of course this is a brief synopsis of the conversation.

Phone call to Google Merchant Services:

Myself:

I would like to report a fake malicious review by a person that is homeless goes online by the name of  Gutter Punk–on multiple online platforms–and has been found on the property when the office is closed at midnight, eating, drinking and loitering, causing a sensation of fear and discomfort to exit the vehicle and attend to a sick patient late at night that I had to get some medications for a house call.  The police has been informed and I’m presenting to you all the information on this person and its lifestyle and activity including arrests and loitering and voiding body fluids in public. This person boasts online of its lifestyle and trespassing and living on the streets. Also, this person is not a client of the business and never set foot inside the office.  Yelp has been informed of the above, given exactly the same information and immediately this person was removed from Yelp. Finally Google, you have promoted this individual to a local guide and reward him with gifts and seek reviews from him. What is wrong with you, don’t you even bother doing a minimum of screening?

Google’s response: Let me review the information and the review. A minute later: It does not violate our policies.

Myself: how can that be, as your policies themselves state that a review has to deal with nature of the business reviewed?

Google response after a slight giggle they couldn’t resist making: It was on your property so it’s related.

Dismayed I asked: You are kidding are you not?

Google; No we are not.

Myself: Let us take it to the extreme and let me ask: let us assume that a business owner has an argument with a person, like waiting in line somewhere or let say a minor fender-bender happened and while waiting for the police the other person finds out where you work. Let assume you wear a shirt with the business logo. Then this person goes online and writes a fraudulent malicious review about the business, I’m sure you will remove such a review, correct?

Google: No!

Myself: This is unbelievable, you must be kidding, this has nothing to do with a business reviewed and the nature of its business.

Google; No, we are not kidding.

I think it’s clear from this conversation how Google Fosters, Festers and Harvests with Glee bad reviews. It makes them money as they can try and have the merchant purchase ads.

At this point I tried a little experiment with Google and asked about a positive review.

Myself: what if an employee of a business also uses the business services and has a great experience and want to share it with the public.

Google: Absolutely not, an employee can’t do it.

Myself; what if it’s the reverse happens and the employee writes a negative review.

Google: Yes, that is allowed.


I didn’t even bother at this point to try and find what convoluted and bizarre explanation Google might come up with. So I ended the phone call.

To all professional, merchants and the public at large; Avoid the trap set by Google. Use Bing, that doesn’t get itself involved in reviews, and the obvious conflict of interests involved with it.

Dr. Ehud Sela

The Gentle Vet.

 

WHEN ADOPTING A NEW PET

dog-adoption-shelter

Adopting a new pet is a wonderful act of love.

Often, and sadly, these pets come from difficult circumstances and need an adjustment period.

I often see new adopted pets that are shy at the beginning and at times do not have the greatest appetite or interact slowly with their new family.

If the physical exam is normal I often advise patience rather than performing multiple tests that can be stressful to the new pet and at times unnecessary.

Plenty of love and reassurance and perhaps offering a very palatable pet food can improve appetite.

I always advise a followup within a week, and of course if any signs of illness develop to return immediately.

Often: “The tincture of time” and being patient is very important.

Tests should be done wisely and correctly, only if needed.

It is a wonderful act of kindness and love to bring a new pet to the household, and like every new relationship it takes time to develop.

Dr. Ehud Sela

The Gentle Vet

Gentle Vet Animal Hospital

Margate, Florida

954-972-5900

© Dr. Ehud Sela. No work herein may be reproduced in any way without expressed permission from the author.

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