Saying Goodbye

Recently, I did one of the hardest things I have ever done. I had to put “Daisy Duke” to sleep. I have been practicing for 38 years. I have performed euthanasia for many patients over the years. It is ALWAYS a sad event to end the life of a beloved family member, friend and companion. Our clients are our family and their pets are our pets too.

Euthanasia is one thing that I won’t miss when I retire. It is an emotional drain on all involved. It is so hard to come to the decision when the time is “right” and it is just never “right”. It just has to be done because we have run out of the ability to provide quality of life through treatment and loving care at home.

The reason it was so hard with “Daisy Duke” is that she belonged to my daughter and son-in-law and their two kids. Not only was I the caregiver but also part of the grieving family trying to be supportive as a doctor, father, and grandpa plus having all those feelings myself. It was a tough job.

Daisy is in a better place now and free of pain. The grandkids wrote letters to God to look after her and give her treats and we are all recovering.

As I look back, it gives me renewed insight on just how bad it is to have to put a pet to sleep. It hurts in so many ways, yet it may be the last, kindest thing you can do for your pet.

Why do I need bloodwork before anesthesia and surgery?

So you’ve been told your pet needs surgery. For many, hearing those words brings on all kinds of emotions, fears and anxieties. Seems everyone knows someone who knows someone who has an unpleasant story to tell either human or veterinary, with regards to either anesthesia or the surgery itself. There are many kinds of surgery performed in veterinary medicine from the cosmetic bump removal to the most extensive of orthopedic reconstructions. Some veterinarians specialize in only certain surgeries, I.E. veterinary ophthalmologists and eye surgery. Others are limited to only soft tissue surgeries and yet others, only orthopedic surgery. But common to all is the need for anesthesia, a procedure by which our patients are rendered immobilized, unconscious, and free of pain and anxiety before, during, and after the procedure is performed.

Humans come in all sizes and shapes but the variability in size, body conformation, weight, and even species is far greater in the veterinary setting. To compound this even further there are species specific issues and even individual breed variabilities within a species that play a role in deciding what is the best and safest protocol for a given patient. In many instances, particularly the elderly or very sick, or severely injured patient, the anesthesia is the highest risk part of the overall surgical event. Unfortunately, we cannot always wait for the patient to get better to do their surgery as the surgery itself may be the only way to get better.

Every patient undergoing anesthesia at our hospital is given a physical exam prior to administering any anesthetic agents. This is on top of the exams that have been done in establishing the reason for surgery, either by our own doctors or the referring doctors. In addition to physical exams, preoperative bloodwork is routinely done. While the physical exam is very important, many things cannot be determined by the exam alone. Bloodwork is our means of assessing the internal functions of the animal and combined with exam, help us to choose the best, safest means of anesthesia that allows for the procedure to be completed. Like the scan tool used to diagnoses automotive problems, bloodwork can uncover issues before they are even noticed by the owner as an issue, Considering a liver could lose up to 80% of its functional ability before liver disease is seen or it may take up to up to 66-75% loss of kidney function before obvious urinary/kidney disease signs are reported, bloodwork becomes very important to the overall assessment of a patients overall health. Our goal is have the entire surgical experience be successful and this includes being able to wake up from the anesthesia and not suffer from some other disease process that the anesthesia was detrimental to. With all this said there are still some issues that exam and bloodwork are simply incapable of predicting. Allergic /hypersensitivity reactions, blood clots to name just a couple. While adverse reactions under anesthesia are uncommon, we do whatever we can to know the potential for one beforehand AND be prepared for the unknowns during. The placement of IV catheters and fluid administration during surgery is the norm to aid in maintenance of blood pressure, perfusion of vital organs with oxygen carrying blood, aid in elimination of anesthetic drugs afterwards and to provide a port for the immediate administration of emergency drugs should the need arise. In addition to all these measures, monitoring of the anesthetized patient by trained veterinary technicians and is carried out throughout the whole preoperative time.

Thankfully “problems” during anesthesia and surgery are rare thanks to the exams, tests, agents used and monitoring. But, when they do occur, being trained to recognize it early and prepared to respond to it can be the difference between a pet owner still having a successful outcome or having an unpleasant story of their own.

Tick-borne Diseases: Lyme Disease

Following the lead of our colleague, Dr. Miller, we will take a closer look at Lyme disease, our area's most common tick-borne disease. Lyme disease (named for the Connecticut town) has been around for over a century but did not gain public notoriety until the 1980s. The Northeastern US and upper Midwest represent disease “hotspots,” but with warming temperatures, the disease is spreading. While we see scattered cases throughout our clinic's areas, the Goose Lake region especially represents a regional/local hotbed. Lyme disease is caused by a bacterium, Borrelia burgdorferi, which is transmitted by Ixodes ticks, in our area better known as the deer tick.

Map of the State of Illinois Canine Lyme Disease Prevalence for 2014. (CAPC)

Lyme disease, or Borreliosis, while also a well-known human disease, manifests itself differently in our canine patients. Greater than 90% of dogs who are infected with the organism are not “sick” because of it and are asymptomatic. In dogs, the disease may not manifest itself for weeks to months after infection and they may present with signs of arthritis or perhaps a fever. Fortunately, symptoms of the disease respond quickly to a course of appropriate antibiotics. Although rare, the most serious potential long-term effect is kidney disease. Due to this potential risk, in some cases we may recommend a urinalysis be checked to look for any possible indications of kidney involvement. Lastly, while cats may become infected with the organism, they appear more resistant to its effects, do not develop clinical signs and currently, the disease is not regarded to be of clinical concern in our feline patients.

As noted earlier, the deer tick transmits the bacterium, causing infection. There are three life stages involved: larvae, nymph and adult, that utilized various-sized 'hosts' for their feeding (blood sucking!). These hosts range from small (white-footed mouse) to large (dogs, deer, humans) depending on the life stage of the tick. Not surprisingly, the mouse and deer are quite prevalent in our area. Whit the tick feeds on its host, it requires a minimum of 48 hours to pass the bacterium, thus, if the tick is removed within 48 hours of attachment, the bacterium cannot be transmitted and the host will not get the disease.

Diagnosis of Lyme disease is confirmed through blood testing. When performing our recommended yearly heartworm testing, the test also checks for three tick-borne diseases: Lyme, Ehrlichiosis and Anaplasmosis, the latter two being less common in our are. Remember, simply having a positive result does not constitute illness. However, if the patient is exhibiting joint pain and maybe a fever, we may prescribe a course of antibiotic therapy. Treatment does not eliminate the organism, it will remain in a low latent state, similar to the 90% of infected dogs who do not experience illness.

Tick control is the hallmark of Lyme disease prevention. Ticks can be active year-round and continuous protection is recommended. We carry and utilize monthly topical applications or a new chewable monthly medication, all of which kill ticks before they can transmit disease. In addition to these products, vaccination offers additional protection against Lyme disease. The vaccine inactivates the bacterium within the tick. While we do not vaccinate ever canine patient, it is recommended for patients who reside in regional hotspots, those individuals whose lifestyle is higher risk such as hunting dogs, or individuals who travel to other geographical hotspots such as Wisconsin.

Remember, prevention is the key to protecting both our canine companions AND their human friends, as we take to the woods and fields in our area!

Click here to find more information about CAPC prevalence maps for pet parasites.