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Saying Goodbye: Part 1

This month I wanted to write my blog on the difficult process of making end of life decisions and euthanasia in veterinary medicine. I quickly realized there are so many facets to this very important topic, from addressing difficult emotions, vital decision-making, quality of life assessment, the procedure itself, and after care for both the pet’s remains and the grieving family. I have decided to divide this discussion into two monthly installments so as to fully address this complex subject, one that is a fundamental aspect of pet ownership as well as an every day reality for your veterinary caregivers.

Firstly, it is important to establish a long-standing and honest relationship with your veterinarian so that they can help guide you as medical issues arise. Maintaining this connection can help ease difficult decision-making if your veterinarian has had the opportunity to get to know you and your pet, their medical history, and also have a sense of the individual relationship you have with your companion.

However even with all the love and medical attention one may be able to provide it is almost inevitable that at some point a pet’s quality of life deteriorates to an unacceptable level. The pet may have a terminal disease, mobility issues, unmanageable pain, or multiple concurrent problems.

It can be helpful to use certain criteria when assessing your pet’s quality of life. Does he/ she still enjoy their favorite activities? Is he/ she comfortable or are they in pain? Is he/she still social with the family or have they withdrawn? Is he/ she eating well? Sometimes there are more emergent or traumatic situations when owners are thrust into having to make a euthanasia decision unexpectedly and hurriedly.

In either case owners will frequently experience a myriad of swirling emotions such as guilt, confusion, sadness, remorse, uncertainty, and grief. There can be added factors such as conflicting opinions amongst family members, navigating the discussion with children, or having to take into account the economic factors of pursuing a medical treatment. It is important to remember that making the painful decision to euthanize a pet is one made out of compassion, love, and respect for the bond you have with your friend.

Although this is a very sad decision to have to make, euthanasia should be viewed as a loving gift, allowing the pet to be free from suffering at the end of their natural life. As a veterinarian, I feel fortunate to have euthanasia as a treatment option for my patients. I make every attempt to help owners navigate through the multitude of factors and emotions that are involved in the decision-making process and the actual procedure.

 

In next month’s blog I will explain how the euthanasia procedure usually takes place, options for the pet’s remains, and resources available to help owners with difficult emotions.

 

 

 

 

Avian Influenza A

What It Means For You and Your Cat

A Bird and a Cat Meet

Diagnosis in New York

Recently, it has been reported that a shelter in New York has tested a number of cats who have been diagnosed as positive for Influenza H7N2. No cases have yet been seen in Washington State. As with last year’s outbreak of the “Canine Flu” (H3N2), Seattle Veterinary Associates is keeping abreast of the news and making sure everyone is prepared for what this means for our patients. Happily, so far the answer is “not much.”

This strain of Influenza commonly called Avian Influenza A is found primarily in birds and has had multiple outbreaks in poultry farms within the U.S. since 2002. As with all influenza viruses, there is a chance for the virus to mutate and infect animals of different species. In this case, a cat was likely directly infected by a bird before being surrendered at the shelter in New York. That cat came into contact with a number of other cats in a shelter setting and the illness spread quickly.

Signs

Signs of influenza in cats can include: coughing, sneezing, colored discharge from the nose or eyes, difficulty breathing, lethargy, and decreased appetite.

The majority of illnesses you or your pet might face cannot be passed between you. However, it is also important to remember that when either a cat or human is sick with an upper respiratory disease, it may possible for that illness to mutate to infect the other species. Because our cats are such an important part of our lives it can be difficult to maintain distance, particularly when one of you is sick. However, taking basic precautions can help keep both humans and felines healthy.

Basic Precautions

If you or your cat has signs of influenza:
• Do not nuzzle or kiss your cat. Facial contact makes transmission easier.
• Avoid sneezing on or being sneezed on by your cat.
• Wash your hands frequently before or after interacting with your cat, when handling food or water dishes, or cleaning kitty litter.

In Humans

The only human who was diagnosed as having caught the flu from the cats was a veterinarian who was helping to collect samples for testing. The veterinarian became mildly ill but has since completely recovered. Of the over 100 cats who tested positive at the shelter, only one died— a geriatric patient humanely euthanized due to pneumonia that was not improving.

Bringing Home a New Cat From the Shelter

Cats coming from shelters will often have upper respiratory infections and parasites that require care. Whether the infection is specifically Avian Influenza A or something else, it is important to have your cat checked by a vet if it is showing signs of illness. While there is no vaccine or cure for Avian Influenza, supportive care can help your cat feel better quickly.

Holiday hazards: Identify and conquer!

 

We’re sure you’re all busy making plans for a memorable Christmas holiday.  We’d like to provide you with information that will make it easier to include pet safety in those preparations and avoid common holiday hazards.

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The following are some of the top hazards pets encounter during the holiday season.

Christmas trees

Pets can incur injuries from tipping over and/or trying to climb Christmas trees.  Take care to anchor your tree to keep naughty and clumsy pets safe.

Ornaments

Fallen ornaments that break can have sharp edges which, when stepped on, can puncture and/or lacerate pets’ feet.  When picked up, their mouths and possibly their gastrointestinal tracts can suffer the consequences.  Take this into consideration when choosing ornaments for the tree.

Tinsel / Ribbon

Tinsel from the tree and ribbon from opened gifts can wreak havoc on a pet’s body when swallowed.  These can get stuck under the tongue or in the stomach and start to cut through the intestines, resulting in a life-threatening emergency.  Ideally, households with pets should forego using tinsel altogether, and ribbon from opened gifts should be promptly discarded.

Wires

Plugged-in wires such as those used for lights, when chewed, can result in burns in the mouth and/or fluid accumulations in the lungs (as a result of electric currents).  Keep wires out of the reach of pets when possible or unplugged when the room being lit is unoccupied/unsupervised. Keep in mind that chew deterrent sprays are not always effective.  When effective, these products should be reapplied regularly, sometimes even daily.

Poinsettias

Contrary to popular belief, Poinsettias are only mildly toxic, resulting primarily in gastrointestinal upset and irritation of the mouth when ingested.  Contact with the skin can result in skin irritation as well.

Holly

Holly, when ingested, can cause severe gastrointestinal upset. The pointy leaves can result in mechanical trauma both in the mouth and lower down in the gastrointestinal tract, compounding the inflammation caused by its toxic principles.

Mistletoe

European mistletoe is more toxic than the American variety.  Small ingestions can result in mild GI upset while larger ingestions are toxic not only to the GI tract but also to the heart (i.e. arrhythmias) and the nervous system (i.e. seizures).

Lilies

Different types of lilies vary in their levels of toxicity.  Adverse effects resulting from their ingestion can range from minor oral irritation (i.e. contact with so-called benign species) to outright failure of the kidneys.  The flowers, leaves, pollen, and even water from a vase containing toxic species, can be lethal.  Households containing one or more cats should avoid these flowers altogether.

Please see our Halloween article for information regarding additional concerns, including chocolate, xylitol, raisins / grapes, and candles.

If you find that your pet has become entangled with one of these or any other dangers during the holiday season, please remember that early intervention is always best. We hope you have a safe and happy holiday.  Happy Hanukkah, Merry Christmas and Happy Kwanzaa!

Dr. Joyeeta De

Green Lake Animal Hospital

 

Don’t Share Your Feast with Your Beast

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Prevention of Pancreatitis in Dogs

With the holiday season fast approaching, we want to help remind dog parents that even though it may be tempting to let your dog have some extra treats or table scraps, this may end up being very harmful to them.  Common problem foods include turkey and gravy and any desserts. When dogs get extra food items, especially very rich or high fat foods, they could be at risk of developing irritation of the gastrointestinal tract and/or pancreatitis.

Symptoms of Pancreatitis

The stomach and intestines can get overwhelmed with some food items which can lead to vomiting and/or diarrhea which may even contain blood.   Dogs can become extremely dehydrated and weak pretty quickly if this process goes untreated.  The pancreas can also become inflamed and lead to life threatening pancreatitis.

How the Pancreas Works

When fatty foods pass out of the stomach into the small intestine, the pancreas is responsible for releasing enzymes to break down these fats.  However, the pancreas can become overwhelmed if it is delivered large volumes of fat or rich foods that it is not accustomed to receiving.  The pancreas then releases an excess of these powerful enzymes and the organ becomes very inflamed.  Pancreatitis can cause vomiting, lack of appetite, abdominal pain, lethargy and/or diarrhea.   Treatment for pancreatitis requires aggressive fluid therapy, anti-nausea medication, pain medications and intensive care.  Pancreatitis, depending on the severity, can be lethal.

Avoid Table Scraps

Going into the holidays it is not uncommon to hear of pet parents “treating” their dogs to table scraps, extra treats, etc.  However, common holiday foods (gravy, turkey skin, desserts, etc.) are relatively high in fat, especially when compared to a dog’s normal diet.  Rather than using these foods as offerings for your dog, try to stick to normal dog treats or bland, gentle food treats.  If you get concerned your dog is showing any signs of vomiting, inappetance, lethargy, abdominal pain, etc., especially if there is any history of he/she getting extra treats or into the garbage, please seek veterinary care.

Lisa Edwards, DVM

Green Lake Animal Hospital

 

 

Halloween Safety Tips For Your Pet

The Holidays are fast approaching. When it comes to Halloween, our family pets often find the evening full of people, costumes, and noises overwhelming and even scary.

Here are a few things to consider when preparing for the festivities:

Candy

There are many potential toxic goodies this time of year.  Chocolate is the most concerning Halloween treat; eating even small amounts can lead to gastrointestinal upset, but in sufficient quantities it can be fatal. Raisins are another possible toxin and ingesting even a few can lead to kidney failure. Candy wrappers can become lodged in the gastrointestinal tract leading to bowel obstruction. Xylitol found in chewing gum can lead to fatally low blood sugar and liver toxicity. Overindulgence of candy in general can lead to painful and sometimes fatal pancreatic inflammation. It is not surprising that Halloween is the busiest holiday for poison control hotlines.

Decorations

Lit candles can easily get knocked over by wagging tails or cause burns to curious pets. Cats find glow sticks intriguing and if punctured the contents can cause painful oral irritation.

Escape

With all of the commotion and a constantly open front door, many pets escape and flee. Before the trick-or-treaters arrive, place pets in a separate room for safety.  Always be sure pets have proper tags and IDs, including a microchip.  Also be sure the tags and microchip are up to date with your most current contact information. If you have questions, we’re happy to check for a chip, place one if needed, and help you to make sure your pet is properly registered.

Noises

The constant ring of the doorbell, unknown voices and the sounds of children yelling and laughing can lead to anxiety..  Turning on the television or playing music to help cover the noises can be helpful.  Pets with excessive anxiety may benefit from behavioral modification training or additional medical support.  We can help you decide how best to treat your pet.

Pet Costumes

It is important to make sure that pet costumes fit appropriately. Pets can easily get entangled and may chew up and ingest costumes leading to intestinal obstruction.  Some pets find costumes to be upsetting and are best left out of the season’s entertainment.  No pet should be left unattended while wearing a costume.

Seattle Veterinary Associates is here to help you and your pet have a great and safe holiday season.  Please contact us if you have questions or concerns on how best to keep your pet healthy and happy!

Valissitie Heeren, DVM

Northwest Veterinary Hospital

Parasites: Your Pet’s Unwanted Friends

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When thinking of the word parasite, many things come to mind.  None of them are good.

No one likes a parasite.  Though they have evolved to exist and live beside or within the hosts they plague, they remain unloved and unwanted.  And that is just fine by me.

This common repulsive feeling is as natural as the relationship between these type bugs and their hosts.  The parasite’s goal is to live in conjunction with the animal they live upon or within.  They must coexist and obtain some benefit from the host organism in order to survive, multiply and procreate.  They don’t wish any major harm to come of the host, as it is often their meal ticket.  After all, the word “parasite” is derived from the Greek word “parasitos” meaning “one who eats at another’s table”.  Nevertheless, I want to focus on how these naturally evolved  bugs can be prevented or controlled, keeping our beloved pets and ourselves as free of them as possible.  Let’s look at two little vampire type parasites, fleas and ticks.

It is fairly likely that our pets will become infected with a blood sucking parasite, such as a flea or tick, at some point in their lifetimes.  Fleas are capable of jumping up on to dogs and cats from the environment they both share. They are very pernicious and establish infestations in our homes and yards relatively quickly if their arrival goes undetected, especially if the pet has not been using appropriate and effective preventative measures.

Ticks are less common in the urban landscape, but not absent.  They fall or jump down from brush or bushes onto the pet. These bad guys can affect your pet in a variety of ways, ranging from simple irritation to transmitting health-threatening conditions if left untreated.  If you hike or go for woodland walks with your dog from spring through autumn, your friend is more at risk of ticks than you might think. Most flea products will also have an effect vs ticks, but not all do, so ask your vet professional for advice.  Removing ticks takes some practice.

Fleas are small active insects that live and breed on the skin and fur coats of our pets.  They are hard to spot since they move rapidly and scurry along on the skin beneath the fur. But their effects and discomfort created while on the pet are more obvious. Itching, scratching and chewing at the body are classic potential signs of a flea problem.

The flea species commonly seen on the dogs of our area is actually the cat flea, Ctenocephalides felis.  Our flea season can be year round in Seattle due to our mild climate. It truly kicks into a higher gear from May through November most years.  It is essential to understand the flea life cycle in order to be most successful at preventing fleas from infesting your pet and its home.   Your veterinary team is the most informed about this important concept and what you can do to control these annoying pests.  The flea is a blood feeder in its adult form, and the females are quite prolific with the ability to lay upwards of 50 eggs per day for 3-4 weeks when feeding consistently on our pets.   That is a prolific parasite and a very disgusting pest!

Although your cat or dog may be harboring fleas, they are not always easy to find at first glance.

To check for fleas or their droppings:

Briskly comb a section of hair on your pet’s back while they are sitting on a white piece of paper. If your dog has fleas, black flecks that look like dirt (as a result, we use the term “flea dirt”) will fall onto the surface for you to see clearly. If you transfer these black flecks to a damp piece of paper towel or tissue, in a short time they will appear red or rust-colored. (The red color results because blood sucked from your dog is partly digested and passed in the flea’s waste matter. If the dirt specks do not turn red, then they are probably just plain old dirt.)

To treat flea infestations:

You must stop flea from reproducing and thus break their life cycle. Carpets, pet bedding, furniture, and other indoor areas where your pet spends much of its time will contain the highest number fleas in their immature stages.  Frequent vacuuming  (throw the vacuum cleaner bag away afterwards) and regularly washing pet bedding can greatly reduce the number of developing fleas inside your home.  In some cases, home premise insecticide spraying or even professional pest control help (e.g. Flea Busters) may be necessary once an infestation has been established indoors.

To avoid fleas infesting your home and yard:

Proactive prevention is the best solution, and it starts with treating your pet regularly during flea season.  Safe, convenient monthly flea treatments (either topically applied skin products, or tablets/chews by mouth) are available under the guidance of your veterinarian and should be used routinely even before fleas are present in the pet’s environment.

Remember that each and every pet has a unique and individual lifestyle and environment. Your veterinarian can help you customize a complete parasite prevention program that best fits you and your family’s particular needs.  Discuss how to be proactive against all potentially unhealthy parasites with your veterinary health team and then select what is right for you.  Making sure your pet is on a year-round parasite control program is best for your furry friends and their people, no doubt.

 

Mark Donovan, DVM

Ravenna Animal Hospital

Effects of Hypertension in Cats

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High blood pressure (hypertension) is a problem not just limited to humans. Animals can be subject to this disease as well. There are two common classifications of hypertension. Primary hypertension is a problem that is infrequently seen in pets. Secondary hypertension is much more prevalent. Secondary hypertension is a condition where the high blood pressure is secondary to another disease process. In cats, this is often seen in patients with kidney disease, heart disease or hyperthyroidism. These conditions create hypertension through different means but the end result can have deleterious effects on other organ systems. The following are a few examples.

Hypertensive Retinopathy – This is a condition where the blood vessels of the retina become distended and can potentially rupture leading to blindness. The feline species is especially susceptible to this effect as their retinas are quite vascular. Cats will present with evidence of bleeding into the eye or a detached retina from bleeding behind the retina. This can be catastrophic and is a medical emergency. Blood pressure must be lowered quickly if vision is to be restored.

Hypertrophic Cardiomyopathy and Other Cardiac Effects – The heart is significantly affected by hypertension. With high blood pressure, the heart has to work harder and it can manifest in the buildup of muscle tissue within the heart. Thus, a heart affected by hypertension is prone to heart muscle changes and abnormal heart rhythms leading to cardiac failure.

Kidney Disease – Although hypertension can be secondary to renal disease, it also can exacerbate the decline of this organ. Multiple studies have shown that cats in early states of renal disease are more prone to hypertension.
Neurologic Disease – Animals are often affected neurologically by hypertension usually secondary to bleeding.

Diagnosis and Treatment

Diagnosis of hypertension is done with the same instrumentation used in human medicine. It can be challenging in the feline patient as they are highly susceptible to “the white coat effect” – the stress of being in the hospital falsely elevates a patient’s pressure. For this reason, it is recommended to minimize a cat’s stress prior to the exam or better yet, have a mobile service come and obtain a blood pressure at home. This allows for less stress for the patient and better data for your veterinarian.

Treatment can be accomplished through two main types of medications: Calcium channel blockers and angiotensin-converting enzyme (ACE) inhibitors. These drugs work by relaxing and dilating the animal’s blood vessels. With these medications, hypertension is usually controllable and ultimately reversible if the underlying disease is properly addressed.

Jeb Mortimer, DVM
Green Lake Animal Hospital

Domestic Pets and Pokemon

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As Pokemon Go becomes more popular we are becoming aware of the danger this activity presents to our domestic pets. Something that seems like a game to people is real life for pets. People often enjoy bringing their dogs on walks to collect wild Pokemon. However it’s only a matter of time before animals start getting injured. As the temperature rises the likelihood of pets developing heat stroke from distracted owners failing to notice the effects of exertion or burns from walking on hot asphalt becomes more likely, The danger of distracted walking doubles when a pet is involved—either from an unnoticed vehicle or an unfortunate fall.

The largest concern, though, comes from the potential interaction of domestic pets with wild animals. Besides the obvious concern that either the pet or wild animal may injure the other, there are also concerns about diseases. There are currently no veterinarians in the state of Washington or in fact all of the US who are licensed to handle Pokemon or trained to recognize illnesses. It is likely that Pokemon carry common parasites like fleas and ticks but little is known about their susceptibility to diseases like distemper. Because there is no health care for Pokemon and therefore no vaccines, they are likely a vector for rabies.

Traditionally, people living in cities like Seattle have had little to worry about in terms of their pets interacting with wild animals. The majority of our urban wildlife limit themselves to nocturnal outdoor activities when our pets are usually asleep or indoors. There have always been minor concerns about rodents but these incidents are limited and generally do not cause illness. Raccoon have proven to be a problem in backyards causing wounds to pets and occasional scares for leptospirosis or distemper but even these interactions have been uncommon.

Since the release of Pokemon Go, wild Pokemon have been seen in places traditional wild animals avoid. People are finding Pokemon in their homes, backyards, at work, and even in schools. There seems to be no rhyme or reason for the appearance either in place or time. This puts even indoor cats in danger.

At this point, the best defense is a good offense. “When in doubt keep them out” is our current recommendation. If needed, seek the help of a professional Pokemon trainer to deal with infestations. There are many individuals and groups who would be willing to remove Pokemon from your property at no charge.

Keeping your pets up-to-date on vaccines seeking regular veterinary care and monitoring them for unusual symptoms will be an important way to avoid illness in your animals. If you choose to take your pet Pokemon hunting, be aware that your pet is a living being who may need time to become accustomed to new exercise as well as shade to rest in, and access to plenty of water.

Remember, if your pet is attacked by a wild Pokemon seek veterinary help immediately.

Can Dogs Catch the Flu?

Update: Canine Influenza

Can-dog-catch-fluThere have been two subtypes of canine influenza virus in the U.S. dog populations in the recent past. The first subtype H3N8 (equine origin) originated from Florida in 2008 and radiated throughout most of the country. There is currently a protective vaccine for this strain. The second strain of influenza H3N2 (avian origin) originated out of Korea, China, and Thailand in 2007/2008 and then emerged in the Chicago area in March of 2015. Shortly after its arrival in Chicago there were approximately 1000 cases documented in the metropolitan area and the disease then spread out to over 20 states in a matter of months. In early February, two cases were documented in a Kent boarding facility but to date we have not seen or been notified of any further cases.

There influenza viruses are respiratory in nature. Infected animals usually show signs of fever, nasal discharge, cough, and difficulty breathing. It can spread readily through the dog populations through muzzle to muzzle contact or direct contact with contaminated surfaces and objects. The virus can live approximately two days in the environment and on hands and clothing for up to 24 hours.

What about vaccinations?

We are not seeing any cases of H3N8 and do not recommend the vaccine at this time. We have H3n8 vaccine on hand in case there is evidence of an outbreak. However, we do not recommend vaccination for the majority of our patients for the following reasons:

  1. Lack of disease presence: no further cases have been documented since the original two cases were reported.
  2. Conditionally licensed vaccines: the H3N2 vaccines have been conditionally licensed—meaning they have been released early to help with a potential outbreak but they have not gone through the normal rigor of scrutiny that we expect from our standard vaccines. Further studies will be done to definitively determine safety and efficacy.
  3. Low morbidity/mortality: This disease itself can result in the death of immunocompromised animals but the majority of animals should be able to sustain an infection and recover (unlike other viral diseases such as Parvo and Distemper).

How do I limit exposure?

The animals most at risk are those that have a higher exposure such as boarding facilities, day care facilities, and dog parks—if you have an immunocompromised animal this may be something to consider. If you have an animal with respiratory signs, please let us know before you appointment so we can take the necessary precautions to treat your animal appropriately and eliminate the potential of exposure to other animals.

Ultimately, decisions on whether to vaccinate or change your pet’s level of exposure should be made based on a conversation with your veterinarian. At Seattle Veterinary Associates, we strive to partner with our clients so that you can make informed decisions about your pet’s health care. Please don’t hesitate to contact us if you have more questions or concerns about Canine Influenza.

Jeb Mortimer, DVM
Green Lake Animal Hospital
www.seattlevetassoc.com

Ultrasound in Veterinary Medicine

Diagnostic ultrasound has become an essential and widely used tool in veterinary medicine. This non-invasive and comparatively inexpensive technology has become a routine standard of veterinary medical care and can aid in the diagnosis of many conditions that can afflict our pets.

Ultrasound is very safe, non-painful, and does not emit radiation or other carcinogen exposure. High frequency sound waves are emitted from the ultrasound probe and are pulsed through the skin and into the body. These sound waves are then impeded by different tissues in the body (organs, fluid, gas) and are bounced back as echoes, which are then displayed by the machine’s computer as high-resolution cross sectional images. A trained sonographer guides the ultrasound probe over the area of interest in order to obtain the best images. In veterinary medicine, technicians or veterinarians with special training can obtain images, however a veterinarian must interpret the images to make a diagnosis.

It is important to realize that imaging an organ does not usually tell us about its function (or how well it’s working), but using ultrasound in combination with other blood work and testing can help complete the diagnostic picture. Most pets do not need any sedation for an ultrasound exam, but a few may require some light sedation to help them relax. Ultrasound can also be used to aid the clinician in safely obtaining fine needle aspirate samples of organs for cytology. In these situations, mild to moderate sedation is usually used for the pet’s safety so they don’t wiggle during the procedure.

During a complete abdominal ultrasound the sonographer images all of the major organs including the liver, gall bladder, kidneys, urinary tract, gastrointestinal tract, pancreas, spleen, lymph nodes, adrenal glands, prostate (in males), and uterus (in intact females). Ultrasound can also be used in select cases to visualize some structures in the chest, neck, musculoskeletal system, and eye. A special type of ultrasound exam, called an echocardiogram, is used specifically to image the chambers, valves, and blood flow of the heart. In this situation an echocardiogram does tell us about how the heart is functioning because the sonographer also measures blood flow and velocity, and specific pressures across the valves in the heart.

At Seattle Veterinary Associates we work directly with specialists who are board-certified in Radiology and Cardiology to provide you and your pet with the best possible ultrasound studies and medicine. Dr. Maryam Salt, at our Queen Anne Animal Clinic location, also has a special interest and some advanced training in ultrasound and can provide some services based on your veterinarians discretion.

 

Ultrasound

Ultrasound was used to diagnose a tumor inside the urinary bladder of a 16 year-old female cat that was presented by her owner for straining to urinate.

Maryam Salt, DVM

Queen Anne Animal Clinic