MRI patient Abby

Abby is a lovely, joyous Frenchie with an unusual condition … diabetes insipidus (not to be confused with diabetes mellitus which requires insulin). Abby’s condition requires that she receive medication every 8 hours to help her concentrate her urine. For some dogs, this is due to something that they were born with. For others it can be due to head trauma or possibly a small growth on the pituitary gland. MRI is a great way to get this answered.  For Abby, MRI will help her veterinarian determine if surgery could be an option.

Abby getting her scanAbby arrived this morning full of spunk and ready to go! She was given a little sedative and an injection of anesthesia. Her brain was scanned repeatedly without and with contrast agent. The images will be submitted to a neurologist for interpretation so that Abby’s veterinarian can help determine the next best step. Stay tuned as we update you with results!

At $975, about 1/3rd the cost of many MRI procedures (high field), we hope to be able to help Abby and pet owners get answers to help them live a better life.

Here’s Abby after her procedure!

Blood Donors Needed

 canine blood donorBlood can be life-saving
July 16th, 2016 9-2 PM: AVC  Manchester is having a Blood Drive … for people and pets! The Red Cross will have its van outside to take donations and we will be taking blood samples from dogs inside to screen for potential donors. We want this to be a great success. We all know how important and life-saving blood is for humans. It’s the same for dogs (we have a kitty donors already). Blood is only good in storage for 30 days, so we rely on people helping us with their dogs as donors. Please consider! The ideal donor would have the following:
-a pet owner willing to participate
-a calm disposition and not easily stressed
-weigh at least 55 lbs (but not overweight)
-male or female but if female no history of having a litter
-be 6 years old or younger
-not on any medications
For pets donating 4 times per year, the following benefits are available at no charge
-annual blood testing for general organ health(liver/kidney/bone marrow) and infectious disease including heartworm and Lyme
-routine annual exam
-fecal testing for parasites
All donors receive a $35 credit to their account for each donation.
Please email to learn more!

Canine Vasectomy

Canine Vasectomy

Most of us spay and neuter our pets at 6 months. Animal shelters control pet over-population with spay and neuter as early as 6 weeks. The obvious reason for the spay/neuter trend has been to decrease the number of pets entering shelters and being euthanized. Spay/neuter programs have been key in this endeavor. But there may be other unanticipated effects long term. Recent studies show not so surprising results when it comes to cancer rates and cruciate injury. Of the 759 client-owned dogs, there was a 5.1% and 7.7% higher rate of cruciate injury for the neutered males and spayed females respectively. For lymphosarcoma, neutered males were 3 times more likely to develop lymphoma than the intact males. Hip dysplasia and other cancers were also studied. Another study which looked at Vizslas was done in 2014. It also found similar differences with respect to cancer in intact vs. gonadectomized dogs.

There are a few key points that one should understand prior to making the decision to leave a pet intact (with sex organs). Male dogs will continue to display typical male behavior including marking (hopefully outside); show interest in female dogs when they are in heat; could develop prostate enlargement/infections later in life. For females that retain their ovaries (the uterus is removed to prevent pregnancy and pyometra, a deadly infection within the uterus) they will continue to cycle and have vaginal bleeding for a few weeks out of the year. And they will be attractive to those intact male dogs!

So who would want to leave their dog intact? Most likely people who want their dog to perform at a high level in agility or other sport such as field trial. But even the average pet owner concerned about the potential downside of spay/neuter may simply want the option to increase the chances of a longer, healthier life for their pet.

Surely this will be a controversial topic for many years to come. But for the pet owner wanting to preserve good muscle tone, decrease the risk of certain cancers and likely prolong their pet’s life, an alternative to traditional spay/neuter may be appealing. The video below demonstrates this intact, although sterile, male’s excellent condition at the age of 6 years. We expect him to maintain this condition throughout much of his life. (surgery performed less than 24 hours ago; incision less than 2 cms).

My Blocked Cat Needs Surgery … Now What?


Urinary obstruction is an all too common phenomenon in the male cat. Cats as young as 8 months have been seen with this condition in our emergency hospital. Current diets are generally the culprit for most cats with dry food being one of the most important factors. Cats eating canned only food are much less likely to become obstructed. This is likely due to the higher water content and better quality protein in the diet of canned foods.

For the poor kitty that becomes repeatedly blocked, surgery to widen the urethra (the small tube which he urinates through) is generally recommended. The procedure is often referred to as a PU which is short for perineal urethrostomy. It is an overnight procedure. Cats are monitored in our 24 hour emergency hospital and treated for any discomfort or bleeding. If after 24 hours, the cat appears comfortable and there is no significant bleeding from the surgery site, they are discharged from the hospital. Owners are instructed to give their cat medication to treat pain and inflammation over the following 3-5 days. An E-collar is worn for about 2 weeks to prevent any licking/chewing at suture material. Sutures dissolve over time and do not require removal.

Potential complications for this procedure include:

  • infection
  • closure of the surgically created opening-this can be due to infection or trauma from licking/rubbing
  • bleeding

A small percentage of cats will also have stones within the urinary bladder that are too large to pass through the new opening. These cats must also undergo surgery at the same time to remove these stones from the bladder. Ultrasound is performed prior to surgery to examine closely for stones and determine the size of any stones found. Some are small enough (3-4 mm) to pass once the urethra has been widened.

Fortunately for most patients, the procedure results in an excellent outcome and the surgically created opening allows the cat to avoid future events of urinary obstruction.

How much does the procedure cost? It depends on where you go.  We have seen estimates in the Boston area as high as $4,000 for the surgery alone.  The total cost at our facility is between $1,200-$1,400 including hospitalization, surgery, and medications.  There are no hidden fees.  We know that this is often a life or death decision for pet owners.

Don’t hesitate to call us if you have questions regarding this procedure.


Canine Flu … and what to do!

Just like people, animals can get the flu (although a different strain), and just like people very few animals die from it.  Sometimes viruses jump from one species to another, which can be concerning depending on the severity of the disease it causes. Horse flu has been recognized for about 40 years.  In 2004, racing greyhounds in Florida were found to have an unusual respiratory illness. Investigators eventually found that the cause of the illness was the dog version of the horse flu (H3N8). There was much press surrounding the outbreak. However, most cases have been confined to shelters and kennels where large groups of dogs are housed together.  In 2009 a vaccine was developed against this new dog flu.

As we have experienced in people, flu vaccines are not a ‘one size fits all’ solution. This past April we were introduced to a new type of dog flu, H3N2, originally found in birds. This flu was originally discovered in 2004 in South Korean dogs but has just now made it the U.S.

The bottom line: the flu vaccine developed in 2009 is unlikely to offer any protection against the new H3N2 strain AND if there is any similarity to the human flu, there is something called antigenic shift. This is where a virus is completely changed and no longer recognized by the body’s immune system. Hence, a vaccine developed prior to the shift is unlikely to be effective after the shift.

Before getting your pet vaccinated against the flu educate yourself:

– Vaccines are not benign and the true benefit of the vaccine should outweigh the risk of the disease.

– The chance of dying from the flu is very low.

– Can you help your pet avoid exposure to the flu  (areas of crowding to include kennels/boarding facilities)

Most dogs that get the flu will have symptoms of coughing, runny nose and fever. Most cases are mild but a small number can become more serious due to secondary bacterial infection causing pneumonia and a smaller number of dogs can die. If your pet does show signs of coughing and decreased appetite, it is important that he/she be seen by a veterinarian. You should alert the hospital staff prior to bringing your pet into the animal hospital that your pet is coughing. Often, a broad spectrum antibiotic will be prescribed to help prevent secondary infections.

The recent outbreak in the Chicago area demonstrated that dogs suffering from the flu have less than a 0.2% chance of dying from it. This number is likely even lower as not all cases of flu were reported and not every pet with mild illness would have been brought to a veterinarian to be treated.

So before you panic about dog flu and find that most clinics have run out of vaccine, take a deep breath and remind yourself … it’s just the flu.

Why Is My Pet Vomiting?

why is my dog vomiting

We see pets that are vomiting present through the ER for all sorts of reasons. In young animals, the most common cause is due to foreign body ingestion such as socks, underwear, sticks and other items found around the home.  These items are usually not visualized with x-rays unless they are made of rock or metal. In middle-aged and older animals, pancreatitis (inflammation of the pancreas) and cancer tend to be more common.

Blood work is often normal if the vomiting has not been present for long but tends to become abnormal with more serious causes of vomiting (prolonged presence of a foreign object in the intestine, pancreatitis and sometimes cancer).

Ultrasound is widely used in determining the cause of the vomiting. While many facilities do not have ready access to ultrasound, AVC is fortunate to have this valuable diagnostic in both locations. Patients can receive ultrasound within 24 hours which helps determine the course of treatment.

Food allergy is also a common cause for vomiting in any age pet, but especially the young dog. Dogs with food allergy tend to have a long history of intermittent vomiting, weight loss or decreased ability to maintain weight. Some will have soft stool  and itchy skin as well. The ultrasound exam often will demonstrate mild lymph node enlargement and changes in the intestine compatible with inflammation. Cats with inflammation of the intestine tend to be middle-aged and older. Their condition is likely more immune mediated rather that dietary. Cats with a true food allergy generally present for intensive scratching at the head and face rather than vomiting.

In my opinion, no pet with serious vomiting should go without ultrasound. It is affordable and highly diagnostic. If foreign material is present within the intestine it should be removed as soon as possible to prevent life-threatening damage to blood supply and intestinal wall integrity.

If your pets needs an ultrasound, I will do my best to help you as quickly as possible.

Ultrasound exams generally do no require sedation. The atmosphere is with low-lighting and most pets seem relatively relaxed during the scan. If you have blood work or radiographs, it is helpful to bring them to the appointment. It is also best to have your pet scanned on any empty stomach (no food within about 6 hours) but this is not necessary.

An ultrasound scan at AVC costs $290. In general there are no other fees. I have 20+ years with ultrasound and recognize this to be a tool that needs to be affordable and accessible if we are going to be able to help pet owners help their pets.

Nasal Bleeding and Chronic Sneezing

dog nose bleed

One of the more common reasons for performing CT on a patient at AVC is for chronic sneezing and/or bloody nasal discharge. In most cases, the patient is a dog, but sometimes cats are seen for this condition as well. CT is a highly sensitive tool in determining the cause of the bleeding or discharge from the nose. The information gained helps determine  prognosis and the best course of treatment.

Unfortunately, many patients are referred too late when the underlying problem is cancer. If many months have passed and a dog has undiagnosed nasal cancer (usually adenocarcinoma), bony destruction and extent of disease is usually so advanced that treatment is no longer an option. For dogs where adenocarcinoma is detected early and is localized to a small area, prognosis can be very good when radiation therapy is pursued. Survival rates at 2 years for patients receiving radiation therapy ranges from 10-48%. The smaller the tumor and the earlier the detection, the more likely that a dog will have an almost 50% chance of survival at 2 years. For more information on nasal tumors, please visit

There are certainly other causes for nasal bleeding, discharge and sneezing. The most common cause tends to be rhinitis, which is inflammation of the nares. These patients tend to be of large breed with long noses. Biopsies are taken with a small instrument at the time that the CT  is performed to confirm a diagnosis of rhinitis.

Unlike people, nasal polyps are very uncommon in dogs but are sometimes seen in cats. Fungal infections are also uncommon but sometimes diagnosed. Approximately 10% of patients with disease of the nares will have an underlying fungal infection. In our experience, these patients are young and tend to have originated from southern states.

X-rays are often not sensitive enough in evaluating the nasal cavity. Anesthesia is required and multiple views need to be taken. CT on the other hand is very sensitive in evaluating the small bones in the nose, the thin bone that separates the nasal cavity from the brain, and the bulla of the middle ear. Although anesthesia is required for CT evaluation, the procedure is fast and the anesthetic agents used are short acting.  Patients are discharged soon after the scan. CT images are uploaded to the internet and sent off to a boarded radiologist for review. In most cases results are available within just a few hours after submitting the scan.

Please don’t hesitate to contact us if you have questions about CT and whether or not it may help with a particular nasal problem in a pet.

Urinary Obstruction in Cats


Blocked cat

Urinary obstruction is one of the more common problems seen in the ER. It is a life-threatening situation not only from a medical aspect, but a financial one as well. Cats with this condition present for straining to urinate and are unable to pass urine due to either ‘grit’ or ‘sand’ within the urethra. This is more common in males than females due to the very small opening of the male urethra. These cats require general anesthesia and the passing of a small catheter into the tip of the urethra/penis to flush back any blockage. The catheter is left in place for a few days and then removed. Most cats will then be able to urinate on their own. However, some cats have underlying stones which are causing the blockage and require surgery.

There have been many discoveries during the past 10-15 years with respect to feline nutrition. Although we have always known that cats are carnivores, we have not been feeding them as such. Dry cat food is carbohydrate loaded and not the appropriate diet for a cat. Many cats, however, will not eat canned. For the ‘dry cat food junkies’ it is possible to eventually wean them onto canned food. Dr. Lisa Pierson has a very thorough article outlining the process (warning:it’s a long article!): Rehab for the Dry Cat Food Addict

Cats that are maintained on an appropriate diet do exceptionally well and in my experience, there have been very few failures with respect to urinary obstruction (none that I can actually remember). Feeding canned food is important for a few reasons. One being to increase the moisture content in the diet. The other being to decrease the carbohydrate content.

A question I am often asked is: “do you think my cat got the ‘sand’ from the litterbox”? The answer is no. The ‘sand’ is actually created by your cat. If the environment within your cat’s body is just right (PH, ash content of the food, water content, maybe genetics), sand, or grit is formed and causes the blockage. Stones are simply a more exaggerated form of sand (when you think about rocks and their relationship to sand for instance). Interesting, the ‘sand’ often looks like silica. It is usually white in appearance, almost glass-like and very tiny. It feels ‘gritty’ on your fingers.

Although I love helping people with their pets, it always puts an ache in my heart when I see something I may have been able to help the pet owner prevent. I hope this information will help keep your pet healthy. Pass it on to a fellow cat-lover!


CPR and First Aid for Your Pet-Applying a Bandage

How To Apply A Bandage and Control Bleeding

Allergic Reactions-When to be concerned

Allergic reactions to food, insect bites, pollen are relatively common in pets. Itching and swelling (ears, skin, feet) are the most common symptoms. Clinical signs can last anywhere from a few hours to the whole season. Certain breeds seem to be more prone to allergic reactions than others. For instance, Chihuahuas, Bulldogs and Boxers commonly present to emergency room soon after being bit by an insect. These guys seem to be ‘frequent flyers’ for these events. Some respond to a few doses of benadryl at home while others require a trip to the veterinarian for steroids. Although pets initially respond to treatment, the allergic component remains in the body for a few days and despite medication the pet may experience return of hives and facial swelling, although less severe, over the following 48-72 hours.

chihuahua allergic reaction

While dogs tend to have hives and facial swelling, cats seem more apt to develop red ulcers, called ‘rodent ulcers’ on the lips, red itchy lesions above the eyes or on the temple region of the head. Food allergies frequently result in intense itching of the head and face.

cat with ulcer

These types of common reactions are irritating, inconvenient but generally not life-threatening. They can be managed with a few medications and in a pinch, a cool ice-pack.


The more serious condition, called anaphylaxis, is a rare event where a pet goes into shock immediately (within minutes) after being bit by an insect or receiving a vaccine. These pets often will collapse and experience vomiting and diarrhea. Breathing may become difficult as well. It is not unusual for a pet owner to not even realize that their pet has been stung by an insect and these guys can stump even experienced veterinarians when they initially present to the emergency room. As they present for shock, however, they are generally treated for shock, and measures to increase blood pressure are taken. This often includes giving a dose of steroids if blood pressure does not respond to common measures taken with shock. If a pet owner has a dog or cat known to have anaphylaxis, an EpiPen or syringe of epinephrine should be kept at home and taken with the pet when away from home. Dogs weighing over 45 lbs can use the standard 0.3 mg epinephrine EpiPen. Dogs weighing between 20-45 lbs can use the EpiPen Jr. For dogs weighing less than 20 lbs and cats, it may be more appropriate to have a syringe at home containing the proper dose as even the EpiPen Jr. may be too much. Your veterinarian can show you how to administer an injection to prepare you for an emergency situation.

IV fluid puppy

If you have given your pet an injection of epinephrine due to a severe allergic event, he or she may look great, but keep in mind the epinephrine is very short acting and you need to take your pet to the emergency room immediately so that longer acting medications and supportive measures can be given.

In Summary signs of anaphylaxis:

*vomiting/diarrhea soon after being stung
*collapse/weakness after being stung
*signs of shock without any known sting is possible (but rare)