E.V. Dog & Cat Clinic

21/01/2025

Active wound drain has a lot of advantages when it comes to wound management compared to other method of wound drain such as the penrose drain which rely solely on gravitational or capillary flow of wound fluids.

With close type drains, (similar to those we normally used in most post surgical wounds or infected wounds or wounds associated with severe soft tissue trauma and inflammation) it acts independent of gravity, but it acts by negative pressure. Because it is sealed and close, the negative pressure produce by the bulb continously drains fluid from wounds without risk of ascending infection commonly reported with passive drain like penrose drain.

16/01/2025

In most patellar luxation (PL), tibial tuberosity transposition (ttt) or shifting of the tibial tuberosity either laterally (MPL) or medially (LPL), is commonly performed to align the patella relative to the trochlear groove. But how to fix the transposed tuberosity is a matter of choice of the surgeon. The standard procedure involves the use of two pins and a tension wire. The pins can be horizontal or vertical to each other.

However, our method is differenf from the usual technique. We always looking for new and innovative ways to simplify and make things easy without compromising result and outcome. In as much as possible we avoid using two pins and cerclage wire which is more time consuming. Longer procedure means longer anesthesia time and longer anesthesia time means increase surgical risk and complications.

12/01/2025

We are thankful for a succesful operation for this 8-year old dog for a second chance to live, free from life-threatening infection and septicaemia due to a close type pyometra. Lucy, a calm, senior and affectionate aspin was presented very ill and in the brink of possible death due to septic shock. Lucy was lethargic, dehydrated, with pale mucous membrane, poor tissue perfusion, hypothermic, and abnormal cardiac rhythm though still responsive. Blood examinations revealed leucocytosis and elevated creatinine, elevated total protein and serum electrolytes abnormalities. Three days after surgery, Lucy is returning back to normal activity and resumed her normal food intake. Wishing her faster recovery. evdogcatclinic

31/12/2024

This what keeps us awake last night.

Patient yesterday, a 4-year old, shihtzu, referred and presented with caudal, unilateral mandibular, close, transverse fracture due to unknown trauma, underwent open reduction and internal fixation with mini t- plate.

29/12/2024

Midnight planning with vpop pro for tomorrow's TTT with posssible sulcoplasty and soft tissue augmentation repair without DFO to treat grade 2 MPL in a 2-year old, Siberian Husky.

23/12/2024

Happy holidays! ☺
From: EVDCC Fam

20/12/2024

Old but gold.

Epidural anesthesia help minimize anesthesia risk in a senior dog for inguinal and scrotal hernia repair.

19/12/2024

Sven, a friendly and optimistic, 4-year old, intact male, Beagle has been with us admitted and confined in the past few days for surgery. Sven suffered, chronic pain, discomfort and limited mobility due to non-functional hind leg after a failed fracture fixation with pin and wire from previous vet clinic (Radiograph A). According to Sven’s owner, the pin and wires were removed by same vet clinic after six months.

Small displaced fragments were evident in the radiographs that caused open wound leading to chronic pain and infection in the thigh region of the affected leg. We examined Sven and treated accordingly to prevent spread of infection and possible life threatening complications with antibiotics, pain medications and nutritional support.

Two orthogonal views radiographs were taken (Radiograph A and B ) in our clinic for thorough assessment. The stiple developed arthrosis or stiffening due to severe, chronic muscle contracture, scarring and muscle atrophy. There’s shortening of the major segments with massive callus along fracture end and non-union fracture also developed. With careful consideration between risk and benefits, we finally arrived with the best recommendation of amputating the infected leg.

The affected leg was prep; hair was clipped around entire left hind leg extending from below the hock to midline abdomen and dorsal aspect of the pelvis. Soon after sterile prepration, Sven underwent leg amputation via coxofemoral disarticulation. Despite a little delay due to lost of muscle orientations, contracture and atrophy, the entire procedure and anethesia recovery went well.

Sven got home yesterday with his caring owner. He is very much active and much happier with his three legs than before with four legs.

Our job as Vet surgeon is not only to save bones when it’s broken. Our important job is to help arrive with the right decision with the pet owners for the best of their pet’s well being. Part of our job is to calibrate, re-assess, override benefits vs risk and provide strong recommendation. While for other, amputation is a radical procedure, a dire need for removing the damage and infected leg is more important before life-threatening and irreversible complications ensue.

18/12/2024

Neuter made ridiculously simple.

16/12/2024

https://youtube.com/live/NohQXqNsZPg?feature=share

Capital Physeal Fracture - FHO in a dog

16/12/2024

Live stream Femoral head ostectomy in a 7 month old dog with capital physeal fracture. --------> https://youtube.com/live/NohQXqNsZPg?feature=share

16/12/2024

The left hind leg of this patient developed non-union fracture of left femur after a failed fixation by other practice a year ago. The stiple joint developed arthrosis due to muscle contraction and severe scarring. Bone segments shortened due to dysplasia secondary to non-union fracture. There’s an infected open wound that developed in cranial thigh caused by bone fragment that pierced through the muscles and skin.

A regional block (epidural) anesthesia together with other analgesia and anesthesia regimen were employed for this patient who underwent hind leg amputation.

14/12/2024

Challenging case of the week:

Signalment: 2-yo, IF, Shihtzu

Presented weak, slightly dehydrated, >2sec. CRT, rapid regular pulse and HR, Temp 38°, diffuse hematoma in ventral caudal abdomen, non-weight bearing, still alert, but lethargic and blood in the urine were noted. No open wounds, except bruising in pelvic and thigh regions.

Suppotive thearpy provided with oxygen, iv fluids (LRS), antiinflammatories and pain meds.
The patient condition apparently improved in 24 hours and able to p*e with clear urine, all vital paramaters almost back to normal.

No significant findings in the chest and abdominal radiographs, but in pelvic regions, major traumaric injuries both the pelvis and left femur were evident in the radiographic examinations.

Dx: Hematoma and soft tissue contusion in the pelvic region and left thigh region, short, reducible close fracture of the left caudal ilium near the acetabulum (socket), shattered (comminuted) fracture of the p***s, avusion of the right ischial tuberosity, and close, long oblique fracture of distal left femur.

Sx/Tx: The distal femur fracture was fixed with two 2.0 cortex screw as lag screw by technique to stablized and compress the long oblique farcture and an appropriate size regid titanium alloy DFO plate as neutralization plate with combinations of bicortical and monocortical locking screws were used. The diversity of plate system we have would allow us to use a T-plate, instead of using long contoured plate to stabilized and fixed the ilial fracture.

Postop: Surgery went well. The patient recovered smoothly from anesthesia. Tye patient is provided with combinations of opioids, non-steroidal anti-inflammatories, gabapentin, iv antibiotics in in first 24 hours, continous iv fluids and crystalloids and monitoring. 24-hour post op, the patients is able to eat and more active and no signs of complications except swelling. Patient will stay in confinement for 3-5 days for continous monitoring and medications. Cage rest and limited activity with lease walk will be allowed after discharge. Recheck examinations and follow up xrays will be recommneded until bridging healing callus are observed.

Wishing this lovable patient her fast recovery.

13/12/2024

Case of the day:
2-yo, IF, Shihtzu, presented with severe multiple pelvic farcture and distal femur fracture due after being hit by a car around 24 hours ago.

The patient was stabilized in the past 24 hours and ready for fixation surgery.

13/12/2024

Thankfully, we got the right implant with the right software for the right patient.

12/12/2024

The concepts of bone healing reflects a very complex relationship between biology and biomechanics. When these two important elements does not cooperate to each other, the goal of bone healing cannot be achieved. Using the analogy of a musical concert that when symphony is not in harmony, a satisfying melody cannot be attained.

Therefore, when these two important elements, the biology and biomechanics act in harmony, bone healing often proceeds melodically to a satisfactory bone union-Glatt

09/12/2024

Max, an adorable, 4-year old, shihtzu, presented with unstable lower jaw, stinky salivation due to a month old fracture of the right mandible. The injury goes unnoticed by the owner until Max was brought to the primary care Veterinarian for dental check and cleaning. The Vet examined and found out, there’s some crepitus and unstable lower jaw, the reason Max was sent to us for surgery.

Initial exams, assestment and minimum blood work were done and Max was hooked up to gas anesthesia machine. Dental cleaning, radiographs were taken followed by extraction of the fractured molar tooth by sectioning.

Radiograhs showed non-union, close, transverse fracture at the molar region in right mandible.

The procedure didn’t end there. With ET tube and iv fluids still attached, Max was prepped and transferred to the operating room for surgery.

About 4-inch skin incision, a little offset or paramedian in the ventral mandible was made to approach the fracture. Massive soft callus and fibrous tissue along fracture line at the level of the right first molar (409) was removed to faciliate bone reduction.

An 8-hole titanium alloy mini plate, 2 cortex, 4 locking and 1 screw plug were used to fixed the fracture leaving interfragmentary gap which cannot be avoided due to bone and tooth lose. The screws was placed monocotically to avoid damaging the roots of remaining healthy teeth.

Max recovered smoothly from anesthesia with apparent improvement in over the past 24 hours post op.

Wishing Max a fast recovery.

08/12/2024

As a human being, I admit we are all unique and different individuals, but remains equal.

From our very existence, we realize that throughout our lives we continue learning. Learning is a continuous process and this is what we have in common at mind. As Veterinarians in today’s challenging and highly demanding environment, we find ourselves continuously seeking for excellence not to compete with each other because I believe, life is not a competition.

One can walk faster over the other, but we are walking at same direction towards working each other for the benefit of our patients who cannot speak for themselves.

Before NOVSI, I feel like life as a Vet was a very intimidating profession. With NOVSI, I started to learn and admit life is really easy. The way I see it, it’s because, every time we are presented with surgical case, from a simple routine elective spay to a complicated multiple pelvic fracture, it doesn’t matter even the most challenging case.

We always tried the best we can for the animal. We have options; we can either refer the case to a colleague whom we know, a colleague with good reputation (because it doesn’t mean you can, you should) or you have option to treat the animal in your facility by your own team of dedicated clinicians with full confidence.

I know that you know, what made life difficult as a Vet Surgeon? It’s the pet owners. “I am not saying lahat ng pet owners problema”. I hope, we agree with this common belief. Whether we agree or not, it’s basic human nature which makes life complicated.

Most of the problems in this evolving world is interpersonal relationship.

Fortunately, here comes NOVSI with Dr. Laraya, he taught us through his solid practical experience not only complicated surgical cases, but dealing both with problem clients. His skill is unparalleled. He is unique in his method and mentorship. In the past two years with full-pack lectures and hands-on surgical approaches and techniques using euthanized specimens we learned more than what we expected. Our scalpel blades started cutting from the most superficial, but largest structure (the skin) deep down to other systems, organs, soft and bony tissues to the most complex nervous system. We cut them through for the sake of knowledge and mastery in this art of surgery.

The entire process is not without challenges and deep work. It comes with the frightening part, the written exams in each modules. Finding the correct answer is beyond imaginable that even AI, google, and even available popular surgical text books and related literatures can’t provide. There’s no correct answer for every question, but one must know the qualities of a good Veterinary surgeon: being able to weigh between risk and benefits to arrive the best recommendation and treatment options, and to be able to “see between the line” as Doc Jopeth once said.

The whole process was tough, but we made it through as we built strong friendship and camaraderie, full of laughters. “Syempre, hindi mawawala ang kulitan at kantiyawan”.

We always find ways make life easy.

I admit, in my 20 years as companion animal practitioner, I made lot of mistakes. With Doc Jopeth’s expertise and wisdom, I learned a lot and I was taught to see the whole picture rather than to dive directly into complex details.

For instance, when we are presented with trauma patient such as those hit by car or motor vehicle accident, we see broken bones as the most dramatic conditions, but we learned to see the patient as a whole and that we need to attain the most life threatening condition and recognize concurrent injuries before specific surgical interventions. The patient must be examined as a whole to the most detail aspect of the problem because “the devil is in the detail”. Being a vet surgeon, we are not only dependent on the scalpel and surgical skill. We must be skillful enough in critical care management because animals are commonly presented critically-ill overlooked by their owners and even during presentation.

As a vet surgeon, guided with the principles and fundamentals of surgery, I feel now equipped with the practical knowledge to further hone my surgical skill to produce the desired result. We need results.

“A dream is just a dream without a goal. A goal is just a goal without result”.

Marcelo T. Evangelista, DVM, DPCCFP
Practice owner
EV Dog & Cat Clinic