THE GREAT BLUE HERON WALKED ON SLENDER FEET

The Great Blue Heron walked on slender feet

And rain clouds drifted in the breeze

The wind imparted tiny waves like furrows

On the water by its feet.

A large Ibis with green and rusty feathers

Labored hard for food

Its large curved beak in mud

It thrust like spade.

A young alligator—a baby still—

Slow, out of water drew, and climbed to rest

On widened twigs by flowering plants

His yellow strips glittered in the air.

And Mallard ducks dabbed in green duck weed

 —Like carpet made of silk—

That clung to all that lived, in water’s

Slow persistent drift.

There I walked on wooden decks

And though I’ve seen and heard it all before:

The sound of wind through tree tops leaves, and

Birds’ songs, to each, to all, that found at last their niche

It stirred my heart and moved my soul to heights and peaks:

Crystal clear, where flowers in perpetual bloom

Sway within melodious tunes

By heart I knew before, and still recall.

                                                                                                            

                                                                                     Green Cay nature preserve, Florida.

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

THE DOG: A MODERN VARIATION OF ODYSSEUS RETURN HOME

Quivering stood the dog in rain

At street’s end

Watching people walk in haste

Ignoring a few extended hands

And some girls:

Called him by what they

Thought his name

But he refrained, unfazed

Waited in the rain

Then wagged his tail

Leaped content

Looking at the other end

Where just across the bend

Drenched his owner came

Not knowing

It was Argos waiting there.

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

Tumor Freezing-Cryosurgery-on the ear of a dog.

Molly, a 14 yrs old boxer was diagnosed with a Mast Cell tumor on her ear. Because of the location on the ear, surgical approach would have required the removal of the entire ear pinna, a very invasive surgery, for any patient, and especially in a senior dog like Molly.

Molly was given antihistamines and prednisone before the surgery, as mast cell tumors can release histamine and inflammatory substances. Large mast cell tumors are not good candidates for the procedure, but smaller ones, can be frozen.

The procedure was done as an outpatient with the owner present and with local anesthetic. Molly was very busy eating doggy treats and didn’t even know the procedure was being done.

Using an appropriate size cryo-chamber, that covered the entire tumor and surrounding area, the procedure was done with 3 cycles of quick freeze and slow thaw.

The procedure was a successes and the tumor has been frozen off, without any damage to the ear cartilage.

Although, tumor freezing–cryosurgery–is not the first choice for mast cell tumors, in this case it was, due to the location of the tumor, requiring the complete removal of the ear, and the age of the patient.

Molly is doing great and is very happy with the surgery and that her ear was preserved, and she didn’t need to go under general anesthesia.

Dr. Ehud Sela

The Gentle Vet

954-972-5900

Phone: 954-972-5900.

CRYOSURGERY; SKIN TUMORS FREEZING IN A WHITE HAIR BOXER

Kali, an eleven years white Boxer was presented for two small cutaneous masses that seem to be growing lately. Biopsy revealed benign growths. Kali has a history of malignant cutaneous tumors that required surgical removal under anesthesia. Due to her history it was decided in abundance of caution to cryo-freeze the growths.

The procedure was done in the exam room as an outpatient with local anesthesia. During the procedure Kali was given doggy treats and was very busy enjoying them.

Using the appropriate small size cryo-chamber the growths were frozen using 3 cycles of quick freeze, slow thaw.

The growths should recede and vanish within a few weeks.

Dr. Ehud Sela, The Gentle Vet.

954-972-5900

Successful Cryosurgery; Skin tumor freezing in a Labrador Dog.

Charcoal, a thirteen years old large Labrador was presented for a an ulcerating mass that was growing and disturbing him on his skin. Fine needle biopsy confirmed a tumor which was not malignant, but was growing fast and could transform into a malignancy.

In the exam room with local anesthetic and with Charcoal very busy eating doggy cookies,  the tumor was frozen using a small cryo-chamber that fit snugly on the mass. A few cycles of quick freeze and slow thaw were applied with no notable discomfort for Charcoal, who was pleasantly eating his favorite treats all along.

The mass fell off with 14 days and both Charcoal and his owner are delighted that general anesthesia surgery was avoided.

Dr. Ehud Sela

The Gentle Vet

Phone: 954-972-5900

LOVE AFTER LOVE BY DEREK WALCOTT

LOVE AFTER LOVE by Derek Walcott

Such a beautiful poem. Says so much with clarity and simplicity of words. Words that veil great depths of life experience.

Dr. Ehud Sela.

The Gentle Vet.

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

 

THE SHAMEFUL USE OF SCARE TACTICS AND GUILT TACTICS IN VETERINARY MEDICINE TO GENERATE REVENUE

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

http://www.thegentlevet.com

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

Renal disease, pyelonephritis, in cats.

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

954-972-5900

http://www.thegentlevet.com

IN MEMORY OF LEONARD COHEN

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.

Cryosurgery of a lesion on the tail of a cat

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

Phone: 954-972-5900