E.V. Dog & Cat Clinic

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

07/12/2024

Here’s Coco 2 weeks post op now with 3 very strong functional legs. Coco is able to adopt and compensate her weight with her remaining pelvic leg. We are glad to see Coco back happy and pain free.

01/12/2024

A 2-year old, female Beagle, named Fendi was presented non-weight bearing due to traumatic close fracture of left foreleg. Radiographs showed major short spiral oblique and two short incomplete oblique making a butterfly fragment in the medial aspect near the junction of mid and proximal third disphysis. There’s also a short monocortical vertical fissure runs along the long axis between these major fargments near the lateral cortex. The small butterfly fragmented bone was displaced medially. The major distal segment was also displaced slighty medially. There’s no cranial or caudal displacement of fragment nor major segment as seen in sagittal plane.

A 1.5mm titanium alloy cortex screw was used as lag screw (by technique) to fix the small butterfly fragment. Though it wasn’t perfectly placed, it works to fix and compress the small fragment anyway. A second lag screw to fix the distal segment might be an option, but a strong pre-contoured, 9-hole limited contact plate was used as neutralization plate and the primary fixator instead. The third locking screw from the most distal screw of the distal major segment was inadvertently placed near the fracture line, but it works to provide strong fixation and neutralization anyway.

The patient is fast recovering and started weight bearing anyway.

28/11/2024

We elected leg amputation in this patient, a 6-year old, sweet, intact female american bully named Coco, due to severe soft tissue damage, degloving injuries and highly comminuted, open fracture in left proximal tibia and mutiple fracture of the digits and metacarpals after being hit by a car.

Surgery and open wound management have been tried in the fast few days and still be an option, but due to the nature of injury and the degree of soft tissue damage, treatment is highly damanding and the risk infections, long term complications, and potential treatment failure are unpredicatable.

Amputation via coxofemoral disarticulation went well for Coco. No worries pain is gone. With just three legs, coco can compensate and able to do her routine activity soon.

We are so thankful to Coco’s loving owners for bringing her to us and for their invaluable understanding.

28/11/2024

We’ve done excision arthroplasty of both hip joints in a one-year old, 30 kgs. Golden Retriever due to advance stage CHD and OA.

Though FHO is not regarded ideal for bigger dog, we still recommend doing it to treat pain
and to prevent further irreversible complications.

We have performed several FHO in both smaller dogs and larger breeds of dogs and even cats with good outcome. The goal is to help our patients towards pain-free, drug-free and limp-free mobility.

Similar to other orthopedic conditions, the ultimate success of FHO relies on the post op rehabilitation to regain musculotendinous function and this include early thearapeutic exercise by the animal to regain strength, muscle mass, coordination, agility and cardiovascular function.

Some fundamental techniques such as PROM, cold/hot packing, controlled exercise, water and threadmill will help boost recovery.

24/11/2024

12/11/2024

One of our successful Medial Patellar Luxation cases in a 5-year, old, spayed, Pomeranian. At six weeks post op, she came back super active and playful with her caring owner.

The simplified transposed tibial tuberosity works fine with sign of healing bone callus around osteotomy.

04/11/2024

Our very own Dr. Marcelo Evangelista, our surgeon was personally invited among others to joın ArixVet Symposium in S. Korea. In line with his principle to never give up in achieving his goal to further enhance and develop his skill. He believes that in the road to achieving your goal, one must be committed and be consistent.

. 🦴🐶😻🩺👨‍⚕️

29/10/2024

Margaux, a 1 year old, intact female, toy poodle who was presented lame with her right foreleg due to traumatic fracture of radius and ulna.

We wish to thanks Margaux very caring owner for being consistent and compliant in all the home care and for bringing Margaux for recheck examinations.