I am often faced with patients who have been repeatly treated for ear infections. These dogs have usually been treated with multiple agents and often many times. Otitis Externa (OE) is the medical lingo for an infection of the outer ear canal. These infections can be bacterial or yeast. So the first step in evaluating ear infections is to do a full physical exam because OE is symptom, not a diagnosis. There is always an underlying cause and so additional symptoms need to be detected. The second step is to do a cytology to determine whether we are dealing with bacteria or yeast and this is needed to select the appropriate drug. Beyond that a true diagnosis needs to pursued. The most common cause of OE is allergic skin disease. This may be confusing at first until you view the ear lining as a continuation of the dog's skin. It is specialized skin, but skin regardless. So ear infections often become a heralding sign of progressing allergic disease. The other disease that leads chronic ear infections is hypothyroidism. Both allergic disease and hypothyroidism require a thorough diagnostic work-up. Once the cause is determined then the real treatment can begin. Without a diagnosis owners are usually resigned to treating OE over and over. So next time your dog is shaking his ears make sure you insist on a complete workup. Anything else is like rearranging the deck furniture on the Titanic.
Yesterday I had a rare opportunity to speak at a really fantastic practice in Winter Haven, FL- Veterinary Healthcare Associates. Many of you know I get to speak all over the country at some very nice clinics. What made yesterday so special was the clinic was owned by best friend since 7th grade, Dr. Loren Nations. We were close throughout high school, and Loren reminded me that of the 21 classes we took we had 19 together. He has a wonderful practice and a really great staff. His hospital manager is a friend also, Julie Poncier Stewart. Julie used to work at Town & Country many years back. That evening, I spoke to the RIdge VMA group in Lakeland. I got a chance to catch up with the doctors I worked for when I was in undergraduate, Drs. Fleet Ryland and Tom Schotman. It was nice to return to see the home town again and reminisce. Loren is still better looking, but I have more hair (but not by a lot).
No matter how long I have been in practice I still get kid-like excitement when I do a c-section* delivery. This little guy had just been birthed and was in the treatment room being revived. He had a rough time coming out and was pretty exhausted by the time we got to surgery. This video is of the staff stimulating and encouraging him to breath and wake up. You get to see some the first breaths the kitten takes and the first time her mama gets to see her. It was one fine Wednesday.
*LINGO ALERT: The c stands for caesarean, because Julius Caesar is reported to have been delivered in this manner.
This is yet another example of a dog's "Sod Philosophy.” What is "Sod Philosophy"? Any day you are on the green side of the sod is a great day. This is how most animals view life. I often am faced with cases that require decisions regarding life and death. To me the deciding factors are those regarding quality of life, can it be achieved or maintained. Pets do not concern themselves with all the emotional and psychological trappings that we do. Eating, sleeping, interacting with love ones, and being kept free from pain are the main focus. Beyond that they are easy to keep happy. This little guy is a prime example of that philosophy. We have seen many similar such cases at the clinic (Shout out to Cocoa). Too often we are quick to dismiss the value of life because it doesn't fit our expectations. Sometimes euthanasia is necessary and compassionate, but occasionally some little pup comes along and reminds us how precious is the gift of life.
Joel Sailor DVM
Dr. Sailor shares his thoughts about varied pet subjects, life in a veterinary practice, and anything else that comes to his "Labrador Retriever Like" mind.