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Hearing aids may be an effective treatment for someone with tinnitus, especially older patients.
The first step a doctor will take in striving to achieve tinnitus relief is earwax removal.
Because a cure for the syndrome is so elusive, a number of sufferers have sought tinnitus relief through the use of herbs and minerals. But when my wax was removed, my ears were treated with hot water injections to soften, then a very very painful removal. What I saw in the container was the black marble sized ear wax, but the wax looked like they were fuzzy. No matter what, my advice is be super careful with anyone trying to remove hardened wax build up. GOFAR Services, LLC - Appliance Repair Houston, TX - Chapter 4COMPRESSOR IS RUNNINGBUT REFRIGERATOR IS NOT COLDCOMPRESSOR IS RUNNING BUT REFRIGERATOR IS NOT COLDBefore you perform any of the other tests in this chapter, make sure that the compressor is running.
It is very rare that we need to remove tonsils as most cases respond to antibiotics and rest.
One of our clients was driving by, and picked her up and brought her straight to the surgery. We packed the wound with a special cream for burn victims (Flamazine) and bandaged it for 3 days. We placed Bully on an IV drip and anesthetised him with IV Alfaxan, and then placed him on Isoflurane gas.
The bandage was changed every 4-5 days, and it did not take long for some nice healthy granulation tissue to fill in the gaps to give us a smooth surface for the surrounding skin to run along and close the gap. Granulation tissue is the cherry ripe looking tissue in the middle of the wound that you can see in the post op photos.
Once it is laid down, the skin edges naturally creep along the top of it and new skin is formed.
By 30 days, the wound had completely closed over with fresh skin and Bully was a much happier dog.
On examination, her vitals were all normal- good gum colour, heart and lungs ok, temperature normal and she was reasonably bright and alert. We suspected a nasty tumour in the abdomen and offered exploratory surgery just in case it was benign.
Some cephalexin antibiotic powder was placed in the abdomen and we closed the wound using normal sutures. On cutting the mass in half, we found large chunks of food in the middle mixed with lots of inflammatory scar tissue. Over the weekend, she had to be force fed and given anti vomiting injections (Cerenia) and continued pain relief and antibiotic cover.
We thought she may have developed fatty liver necrosis (damage to the liver) as a result of the major surgery. On Sunday morning, she looked a bit stronger and she even ate a tiny amount of cooked chicken brought in by her Mum. She was given a nice low voltage heat mat to sleep on and her Mum kept up the nutrition, antibiotics and pain relief. This was one of our trickiest cases and just goes to show that even though I have been in practice since 1981, I still have not seen all the different possible medical and surgical cases that present themselves to vets.
In early December, late in the afternoon, we were presented with a 6 year old female kelpie, Molly who was slightly off colour and had a mild left head tilt and a throaty gag.
All the symptoms suggest an issue with the nerves that supplied the left head and neck area.
Well, after several extensive tick searches and an after hours clip, we had not found a tick or crater. We immediately setup two IV drips with a bottle of snake anti-venom in one and fluids in the other.
While the fluids and anti venom were running in, we drew up some bloods and ran them on our in-house laboratory. At 11.00pm, I came in to check on Molly, and lo and behold, she was sitting up and wagging her tail. On examination, his gums were nice and pink and filled up with blood quickly when pressed by a finger (capillary refill time). Mac was very uncomfortable when palpating his abdomen, even with a heavy pain killer sedation. X-rays showed a lot of gas building up in his intestines but no real evidence of a solid foreign body. The fact that he had severe vomiting and marked pain in his abdomen and gas building up in his intestines was enough to warrant us having a look inside straight away.
Mac was placed on an IV drip and anaesthetised with IV Alfaxan before being placed on Isoflurane gas.
We removed the dead piece of small intestine and then joined (anastomosed) the 2 fresh edges together. The whole area was flushed several tines with saline and then Cephalexin antibiotic was sprayed over the operating site.
Chloe was placed on an IV fluid drip and anaesthetised with IV Alfaxan followed by Isoflurane gas. The tumour was sent for pathology testing and came back as a soft tissue sarcoma which was more likely to regrow in the same area rather than spread to other parts of the body. The plan is to monitor the area regularly and give Chloe regular health checks to pick up any signs of regrowth or spread of the tumour. Victor, a 14 year old cat, was having a nice sleep on the front verandah when 2 stray dogs came along and tried to kill him. After 72 hours, we were not getting much fluid or air from the chest drain so it was removed.
On palpating his middle abdomen, a thick firm irreglaur shaped swelling approx the size of a plum, could be felt. Xrays showed a lot of gas building up in his small intestines and some faeces in his colon and an indistinct swelling in the mid-abdomen.
The fact he was in sudden discomfort from being a healthy happy cat, it was suspected he may have an acute intestinal blockage, intestinal thrombus or a tumour causing an acute abdomen. Chester was placed on a IV drip and anaesthetised with IV Alfaxan followed by Isoflurane gas. Surgery was scheduled using a new technique to deepen the groove in which the patella slides up and down.
The patella is attached to the big group of muscles at the top front of the leg- the quadriceps. In Hazmat's case, he had been born with a tibial crest that was off centre and was positioned too far medial (inside) which gave an unnatural "pull" on the patella tendon attached to it above.
Using a small bone saw, 2 parallel cuts were made in this groove running form top to bottom.
The next part of the operation was to move the tibial crest to a more outward (lateral) position in order to straighten up the pull of the quadriceps muscles on the patella.
The final part of the operation was to overlap the tissues (lateral fascia lata) on the outside of the stifle thereby pulling the patella laterally and away from its tendency to want to dislocate medially. The stifle was irrigated with sterile saline and a soluble antibiotic was placed in the joint. If your pet is unfortunate enough to have an encounter with a snake you can help by being aware of the signs and symptoms of snake bite, and getting the affected animal to the hospital as quickly as possible. The first clue that a pet has been bitten may just be a small amount of blood on the coat, face or limb with a some soft tissue swelling around a small puncture wound(s). Most snake bites in humans occur when people try to kill snakes, often after seeing them bite a pet. Calling ahead gives us critical extra time to make necessary preparations to ensure prompt and effective treatment. When you call, listen very carefully to the announcements, and then call the emergency mobile number on the message (Mark sometimes has a night off with the after hours phone going to another vet). If your pet has stopped breathing, attempt mouth to nose resuscitation and if possible continue this during transport of your pet to the hospital. These days the treatment of snake bite has a good success rate, and with appropriate and timely medical therapy many patients recover completely. The unfortunate animal will require constant monitoring, day and night, every one or two hours for the first 24 hours then every three hours for the next two days, with high rate intravenous infusions, blood clotting products and regular blood tests. If a snake needs removal from the property, contact WIRES to ask for theie recommended local snake handler. Hyperthyroidism in Cats: Great News!This is a very interesting disease of cats which we see in nearly any age group. Hyper-active thyroids (hyperthyroidism) make cats act like a car all revved up- ravenous appetite, hyper-active (just like my kids), under weight, often difficult to handle (again like my kids!) and may suffer from heart failure- rapid heart rate, shortness of breath, panting.
By performing a simple blood test, we can diagnose affected cats and institute therapy to knock-out the thyroid hormones causing all the problems. Left un-treated, hyperthyroid cats run the major risk of high blood pressure and heart failure. The ventricles become smaller and smaller and as a result, can’t fill up with the same volume of blood. Treated cases usually see an improvement in heart function and the removal of heart drugs from the treatment regime at this stage i.e. Blood test are performed before and 24-36 hours after starting therapy to ensure the kidneys can handle having the blood pressure dropped. Kidney DiseaseDogs and cats can suffer from either acute or chronic renal failure caused by many different types of illnesses. Kidneys have powerful protective mechanisms in place which kick into action if problems arise. Kidneys are also responsible for sending messages to the bone marrow telling it to make more red blood cells (RBC's) to replace the old ones which are "gobbled up" by the spleen and liver when they are worn out. As with most diseases, early detection and treatment is much more preferable especially for a vitally important organ like the kidneys. For all our renal failure cases, we use a Doppler machine to record elevations in blood pressure and measure response to blood pressure lowering medications. Force feeding using a stomach tube through which fluids and liquidised renal support diets can be administered.
For cases with elevated Phosphorous in their body, we can use drugs called phosphate binders.
For young cats in Australia with kidney failure, there is the possibility of kidney transplantation in Brisbane, but it is quite involved and the donor cat has to be taken on as a new family pet. Parvovirus- the Ebola equivalentWe all know about Ebola- one of the nastiest and most contagious viral diseases for man. Parvovirus has to be one of the nastiest and most infectious diseases of dogs causing severe suffering with a very high fatality rate despite all the best intensive care. Surprisingly, because Parvovirus has been around for so long, some pet owners have either forgotten what it does to dogs, or they were not yet born when it first arrived on the scene in a world wide epidmiec in the 1980's.
Parvovirus is a virus that attacks the lining of a dog’s stomach and intestines and literally strips it out. If pet owners are struggling financially, vets often have to euthanise infected dogs before starting any therapy. Camden vets had 10 Parvovirus cases in just one day, not to mention how many cases they had for a whole year! In a recent national study, there were 1,200 cases reported - and that was from only a small number of vet practices taking part in the survey. When Parvovirus first occurred in the 1980’s, people were not aware of just how tough and contagious it was. Well, the very fact that Parvovirus managed to spread across the world in just 2 years puts a few holes in this statement. A dog either brewing or in the recovery stage of a Parvovirus infection, sheds millions of the viruses into the environment. It does not take long for an epidemic of Parvovirus to occur if the general dog population has a low vaccination percentage. Parvovirus can affect dogs of all ages; however dogs less than one year of age are particularly susceptible. Treatment is difficult because there is no way to kill the virus once it has infected the dog.
Treatment is intensive and involves hospitalisation in an isolation ward (sometimes for many days), aggressive fluid therapy, antibiotics, pain relief and anti-vomiting drugs. Despite all of these treatments, a high percentage of dogs die a few days later leaving the owner with no dog and a very large vet bill. Malignant tumour of the adrenal glands- tumours made up of the cortisone producing cells of the adrenal glands make excessive cortisone.
Dogs with pituitary gland tumours can go on to live comfortably for some time until the tumour gets too big and starts to place pressure on adjacent parts of the brain.At this stage, we might see symptoms such as blindness and other hormone imbalances.
Unfortunately, adrenal gland tumours are often malignant and can spread to other parts of the body.
Suspected cases have blood tests done to try and find out where the excess cortisone is coming from.
Until recently, most cases were treated with a drug called Lysodren which destroys the parts of the adrenal glands that make cortisone. Many cases on Trilostane can have the dose lowered after a few months, which helps with the budget.
Diabetes is commonly seen in Cushing's cases, probably as a result of cortisone interfering with the action of insulin. Before embarking on treatment, owners need to be very aware of the expensive nature of treament. In human medicine, pituitary gland tumous can be removed by specialist surgeons operating through the nose or roof of the mouth.
Increased Thirst (Polydypsia)There are a large number of causes of increased thirst (polydypsia) in pets. Blood tests (biochemistry and full blood count) give an overall picture of a pet's health. Pets and humans can donate a kidney (and therefore be down to 50% total kidney function) and still lead a healthy life with no elevation of kidney blood tests or polydypsia.
If their remaining kidney becomes diseased, and loses over half of its ability to function, kidney blood test start to rise i.e. When there is 25-50% of healthy kidney function, kidney blood tests are often normal, but the urine may be dilute (low specific gravity). Between 50-100%, the urine will still be concentrated (high specific gravity), and bloods normal.
It is important to check a urine sample as it can detect kidney failure long before a blood test. These chemicals travel down a special tube from the pancreas into the first part of the small intestines (the Duodenum). Sometimes as pets get older and fatter, the pancreas gets inflamed or worn out from too much of a workload e.g. Traveling through the pancreas is the bile duct- a tube connecting the gall bladder in the liver to the duodenum. We normally see pancreatitis in older overweight dogs or dogs being fed too many fatty meals e.g. From the history, breed, sex, age, symptoms and clinical examination, a vet usually has a pretty good idea the pet is suffering from pancreatitis. A special in-house blood test ( Idexx SNAP CPL) gives an accurate positive result in pancreatitis cases (blue dot on the right is the same or darker than the dot on the left- see picture).
Other blood tests may show elevated white blood cells combating inflammation and infection and elevated liver enzymes if the bile duct becomes blocked.
As mentioned above, the inflamed pancreas can block the bile duct, so jaundice is a common symptom, sometimes seen 1-2 days after the start of the condition. Cases failing to respond to therapy may require surgery to rule out pancreatic cancer or to gently flush the affected area to try and settle the inflammation.
Repeated episodes of pancreatitis can destroy the ability of the pancreas to produce food digesting acids and alkalis, resulting in chronic diarrhoea. In humans, there is an overall 20% fatality rate, usually due to a secondary infection developing in the affected areas of the abdomen. Dogs with pancreatitis and diabetic keto-acidosis have a poor prognosis and despite the best of efforts, may die from complications. Treatment can be very costly due to the length of stay in hospital with intensive care, drugs, repeat blood tests and fluid therapy. Boxer CardiomyopathyThis condition is characterised by feinting (syncope) and sudden death in Boxer dogs. The problem is due to a run of extra heartbeats interrupting the normal flow of oxygen rich blood to the brain. These extra heartbeats originate in damaged heart muscle in the right ventricle (ventricular premature contractions -VPC's).
A run of several or more VPC's can cause sudden death which is a common consequence of the condition.
By listening to the heart for several minutes with a stethoscope, a vet may detect a skip in the normal heart rhythm although this is not a sure fire way of detecting a problem as affected dogs can go for several hours without as much as one skipped VPC.
Similarly, connecting a dog to an ECG machine to record the heartbeat for a few minutes may miss a run of VPC's.
Listening to the heart or recording an ECG while the dog has a syncopal episode would be ideal way to diagnose the problem, but these events tend to happen away for vet surgeries and owners can be too stressed to  think about recording the heartbeat while their unconscious dog lies at their feet.
Specialist cardiologists can loan out 24hr ECG recording machines (Halters) which attach to the trunk of the body in special leather harnesses. Quite often it is astounding to see how many runs of VPC's occur while the dog is asleep. Atrial FibrillationSome dogs with dilated cardiomyopathy and left A-V valve disease get a life threatening arrhythmia called atrial fibrillation.
Each time the damaged atrium contracts, it tries to sends an electrical signal to the ventricles below telling it to contract as "its their turn now". The refractory period may only be a split part of a second, and follows a normal ventricle contraction. In effect, the atria are doing their own rapid irregular heart beat and 8 times out of 10 their extra contractions cause the ventricles to contract. As a result, we see the ventricles pumping at a much faster and irregular rate than in a dog with no atrial fibrillation.
If a dog has either A-V valve disease or dilated cardiomyopathy, the ventricles are already having a hard time. Cardiac output is reduced in A-V valve disease and dilated cardiomyopathy, so oxygen rich blood does not reach vital organs e.g. But don't forget the heart which is the most dynamic oxygen hungry organ (next to the brain). The last thing the diseased ventricles want is atrial fibrillation causing them to contract even faster.

Atrial fibrillation can very quickly cause the ventricles to fail and lead to sudden heart failure and death. On exmination, the heart rate is very rapid and irregular- often over 200 beats a minute (nearly 3-4 beats a second). A normal ECG has one P wave (atrial contraction) followed by one QRS wave (ventricle contraction) and a normal heart rate of approx 100-140. Atrial fibrillation shows rapid irregular spaced ventricle heartbeats (QRS waves) and no regular P waves. By providing us with personal information you consent to us maintaining, using and disclosing your personal information in the way described.
If you are a new client to the area and would like to be placed on our database, please download the new client form and bring it along to BHVG. Whilst offerring readers an insight into the world of veterinary scinece at BHVG, the authors have provided a very basic level of information. We are very happy to have the excellent backup of various referral services for those cases requiring specialist care. David owns and runs the North Parramatta Specialist Centre where he performs major soft tissue and orthopaedic operations. I have a passion for keeping up to date so I can offer all of my patients the latest care, and look after them as best as humanly possible.
I spent 9 years in the UK where I received a Certificate in Small Animal Cardiology from the Royal College of Veterinary Surgeons (London). In 1991, I established Balgownie Veterinary Hospital in Wollongong, with my then partner, Stephanie. Before purchasing BHVG from Steve Henry in 2011, I did locum work close to Wollongong where my much loved children Hugh (18) and Margot (15) were based.
I have lived in Berry and Shoalhaven Heads for the last 15 years, and enjoy playing tennis at Shoalhven Heads Tennis Club and squash at Bomaderry Squash and Fitness Centre. I would love to meet both you and your pet(s), have a chat and give you a tour of the clinic, and see how I can help you.
If you have ever had seats located too close to the speakers at a rock concert, or happened to be standing too close to a firecracker when it exploded, you have likely noticed a ringing, whistling, or buzzing noise in your ears. This is because the problem is not a disease in itself, but rather a symptom of some undiagnosed problem that has caused damage to the cells of the inner ear.
For some people, an abundance or hardened, impacted earwax may be the culprit behind the problem. White noise machines might be helpful, as they provide soothing sounds that make sleeping easier. During this period I have entered the last phases of menopause and have seen an incredible increase in ear wax production. I understand the hairs in the bottom of the ear situation, and was told that wax doesn't get that far down.
If it is not running, see Chapter 5.Some refrigerators are very quiet and smooth when they operate. It contains a tetracycline which is renowned for its effectiveness in respiratory tract infections.
X-rays showed she had fractured 5 ribs on the right side, and her right lungs had filled up with blood (pulmonary contusion). A needle biopsy of the lump failed to show any malignant cells so we decided to have a go at removing the tumour from the toes. At the first bandage change, the wound was a bit messy so we cleaned it up with sterile saline and repacked it with Flamazine.
It been slowly growing for 2-3 years, but had reached the point where it was uncomfortable. We made a 1cm margin cut around the base of the tumour and, using blunt dissection, slowly peeled it away from the underlying tendons and bones. The wound was packed with Flamazine ointment (used for treating burn victims), covered with sterile gauze then bandaged. It is unusual to need skin grafts in dogs and cats as they are pretty good at this type of healing. Priscilla had some bloods taken and all the biochemistry and haematology results came back normal. She is eating 7-8 times a day, running around following her Mum everywhere she goes and demanding to be allowed on her lap at every opportunity. It was a great result and one where we just had to go with the flow and get on with the surgery and intensive care. On my final tick search, I was running my fingers very tightly down the edges of Molly’s left ear flap and felt a tiny area of swelling and heat approx. We ran the anti-venom in over 60 minutes and had adrenaline drawn up and ready to inject IV in case of an anaphylactic allergic reaction to it. The owners mentioned they had found some piles of vomit in the yard which I suspect was the dog’s initial response to the snake bite. We were concerned he may have a foreign body in his stomach or intestines or had some kind of blockage in his intestines. Upon opening the abdomen, there was fresh blood lying around and a very nasty looking section of bleeding and dying small intestine. 50cm of his small intestine had slipped through a naturally occurring small hole in some tissue called the mesentery, and then twisted around and cut its own blood supply off.
Luckily, there was 1.5cm of normal small intestine to work with before the junction of small and large intestines was involved (where the appendix is). We then wrapped the anastomosis in some tissue called omentum which has great at healing powers and is good at sealing any small leaks.
Each breath he took would result in air from outside his chest being sucked in then pushed out as the lungs inside his chest collapsed and expanded. Other drains that had been placed under the skin where the torn muscles were were removed on day 4. On examining his intestines,  we found a 10cm section of small intestine which was very inflamed, thickened and swollen. On examination, he had a dislocating kneecap (patella) which continually locked itself in an abnormal position on the inside (medial aspect) of his knee (stifle).
In Hazmat's case, the inside (medial) ridge of this groove had flattened out due to the patella continually dislocating medially and wearing the ridge out.
The patella is attached by a tendon on its lower edge to the tibial crest ( a ridge of bone on the top front of the tibia).This is the same tendon the doctors tap on to test your reflexes. The rectangular block was then replaced into the deepened groove giving a nice ridge to stop the patella from slipping out of the groove. Dogs, cats and horses are all at risk, although curious dogs are the most frequently affected. Tiger and Brown snakes are also prevalent, especially on Coolangatta Mountain and adjacent flat lands.
But don't waste time trying to find it as we stock a multi-snake anti-venom that covers Black, Tiger and Brown snake bites.
If we are at home, have the after hours going to another vet, or are out on a house call, you will be using up what might be precious time - always call first!
But treating snake bite is always arduous for the affected pet, as well as for the vet and the nurses. Consequently, it can be expensive, although it may be covered by pet health insurance if you have it. With the rapid heart rate, the heart muscles get thicker and thicker- its a bit like a weight lifter doing extra work. Less blood in means less blood out of the heart, and reduced blood supply to the body and its vital organs eg kidneys, liver, heart.
In some cats, the high blood pressure from hyperthyroidism is keeping their poorly functioning kidneys going.
Should your remaining kidney lose up to 50% of its ability to concentrate urine, you can still appear normal although you may be drinking a bit more and making dilute urine. A Senior Pet Health Check urine examination looks at the concentrating ability of the kidneys to detect early reduction in kidney function. In other words, the pet makes more urine than normal because the kidneys can't re-absorb the water out of the urine like they did when healthy.
We would rather diagnose renal failure before clinical signs or blood tests indicate its presence. It is very accurate at detecting early kidney problems long before blood tests start to indicate a problem.
It can survive up to 18 months in soil or concrete and needs strong disinfectants to kill it. International travellers and infected or recovering dogs being flown to other countries would infect healthy dogs upon their arrival- either by direct contact with another dog or with their clothing, bedding and foot wear. It is vital all puppies and adult dogs are vaccinated against parvovirus and your vet will advise on the appropriate vaccination schedule.
Referral to a specialist may be an option if the tumour is in just one adrenal galnd and not adhered to any vital structures e.g.
They must be fully committed and prepared to put up with regular blood tests and expensive drug bills. Besides the expected increase in thirst with hot days, exercise or change to a drier food,  any pet showing polydypsia over 2-3 days should be examined by a vet. The pancreas is a special organ that makes many different chemicals such as insulin, acids and alkalis which help digest and process foods.
Repeating these tests during the dog's stay in hospital gives the vet an good idea on how the dog is going.
Diabetes and all of its associated complications (keto-acidosis) can be a life threatening presenting sign. It is unlike the traditional form of cardiomyopathy we see in large dog breeds (most of the time). By the time they do have a feel of the heartbeat or pulse, the rhythm may be back to normal as it may have just been a run of several VPC's taking up less than 1-2 seconds of time.
A computer runs through the 24hrs of recording in seconds and prints out a report highlighting all the abnormal heartbeats. The damaged area fires off its own electrical current causing the atrium to contract very rapidly (sometimes as much as 200-300 times a minute). Not every electrical impulse gets through to the ventricle as a number of these extra charges arrive at the ventricle when it is in a "none-responsive" state (refractory period). Once it has passed, the extra electrical signals from the damaged atrium above can trigger off a ventricle contraction.
Any reduction in output means less oxygen for the heart muscles, so they can't pump as well as they would like.
There is often evidence of left sided heart failure - coughing, weakness, pale gums, weak thready rapid pulse. Now he has his own Aussie Pooch Mobile Dog Wash and he and his daughter Katelin would love to see you. Our staff will be more than happy to place you and your pet(s) on our computer system and setup an annual health check, vaccine, worming and other reminders. Should your pet(s) have any specific conditions or problems, please consult your own vet(s) for more up to date and accurate treatment.
Our clients think the world of David, who is very dedicated to his profession and performs highly skilled operations. If you cannot find the answer to your question, please use the search at the top of our site, or send us an enquiry.
Blood pressure monitoring involved an invasive procedure only performed at specialist centres, and we could not measure blood oxygen levels during surgery. I play too much squash at Bomaderry Squash and Fitness, and enjoy organising teams to play in our local and Illawarra competitions. I know your line of thinking when it comes to pet care and treat client’s pets the same way I would treat my own.
Other vices include learning to surf, mountain bike riding and bush walking (and the occasional ale).
That means you see the same vet each time you visit, just like I personally prefer to see my own dentist, GP, car mechanic and accountant (except when the bill arrives of course).
All the staff have lived in the area for a very long time, and know the local pet health issues inside out. Tinnitus can occur due to injury, illness, prolonged exposure to loud noise, the loss of hearing due to age, an adverse reaction to pharmaceuticals, or myriad other factors.
If a person exhibits signs of vascular disease, of which tinnitus is often a symptom, medication or surgery may alleviate the problem.
For a percentage of the affected, especially older people, hearing aids or cochlear implants improve hearing to the point that natural noises somewhat override the annoying sounds of tinnitus. Some people have also reported tinnitus relief after acupuncture treatments and hypnosis sessions. What I do know is that the removal of that wax was super painful, and while the muffled sound is gone, the 15k high pitch ringing is still going on. This had happened due to the whiplash effect of internal organs from direct blunt trauma to the body. The oxygen was continued, but the rate of IV fluids was lowered in case it had started to leak out of the damaged lungs. It looked pretty nasty and we were worried it was malignant and may have spread to other parts of her body. At the second bandage change, it looked a lot healthier and the skin defect had filled in with granulation tissue.
There were several tough adhesions that had to be cut, and numerous blood vessels had to be clamped and tied off to prevent bleeding.
Being a Friday evening, we decided to open her up just to check there were no adhesions or leaking for the stomach wall surgery site. However, when we spun the blood down in our centrifuge, the serum (the watery part of the blood) was tinged red rather than being clear. It looks like she got just a small amount of venom when bitten and it only affected the local nerves near the bite wound, but the discoloured serum was a warning to more serious things on the way.
Using blunt dissection and tying off blood vessels attached to the tumour, it was eventually removed after approx. We placed some sterile saline over the closure to check for leaks which would show up as bubbles.
There was a lot of free clear watery fluid in the abdomen, possibly leaking from the swollen intestinal surface. If you feel that tendon, you can see how it is attached to the ridge of bone below your knee- the tibial crest. The constant "pulling" made the patella slide out of its groove and flatten the inside ridge. The chisel was then placed at the top and bottom of the block and the whole section was gently lifted ff the bone.
It was moved approx 3-4mm laterally before it was pinned in its new position using 2 thin orthopaedic pins (K wires).
But it’s always better to keep your pets out of likely snake habitat and avoid the risk. This thickening happens at the expense of the chamber (ventricle) sizes, and is called Hypertrophic Cardiomyopathy (HCM). Dialysis is performed in people with renal failure to filter out the waste products that the kidney normally places in the urine. When we run blood tests on renal failure cases, we see elevated levels of urea (Blood Urea Nitrogen- BUN), Creatinine and Phosphate. More urine going out of the body automatically triggers a chemical release in the brain which makes the pet thirsty. If the kidneys are not working properly, chemicals are released which elevate the blood pressure in an attempt to improve the flow of blood through the kidney and remove waste products that are building up in the body.
Because RBC's are responsible for carrying oxygen around the whole body, the pet is quite weak and easily fatigued. Treatment involves intensive care, fluid therapy, pain relief, blood transfusions and no guarantee of success.
In a very old patient, no treatment may be a more preferable propositon especially if the owners are on a budget. When making the appointment, try to bring along a fresh urine sample as a lot of information can be found by examining it. In other words, we don't normally see elevated kidney tests in chronic renal failure until there is only 25% of healthy tissue left. The kidneys aren't doing their job of "recycling water" by sucking water out of the urine before it goes to the bladder to be voided.
This small amount of inflammation results in leakage of acids and alkalis both inside and adjacent to the pancreas. Some older dogs can develop pancreatic cancer which looks just the same as normal pancreatitis. Dogs must go onto an IV drip to correct dehydration and reverse shock and damage to the kidneys. This is important to provide fluid and nutrition to the cells lining the stomach and intestines.
It is vital that repeat episodes are avoided as too much damage to the pancreas can result in lack of insulin (diabetes) or the inability to digest and absorb foods (pancreatic exocrine insufficiency). Boxer cardiomyopathy is also known as "Boxer arrhythmogenic right ventricular cardiomyopathy". A special thank you also to Simone who we called so early for assistance, she was wonderful and extremely professional. I did numerous "sex change" operations on male cats (female cats have wider plumbing so to speak) who were repeatedly getting blocked bladders from crystals forming in their urine.
Following a partnership split, I became the first  Partner in Practice at the University of Sydney Veterinary School where I gave final year students an insight into life as a vet surgeon.
I love the latest mod cons of vet practice and look back at the early 80's and marvel at how things have changed so much. Simone has a keen interest in all aspects of small animal practice but particularly enjoys soft tissue surgery and has an interest in further developing her small animal medicine skills. For the afflicted person, the cause is not nearly as important as the goal of receiving tinnitus relief. Certain drugs can also lead to the maddening, non-stop ringing, and a doctor may advise altering dosages, switching drugs, or stopping the ingestion of a medication completely. Anti-depressants and anti-anxiety drugs are sometimes administered, and while they will not alter the condition itself, their calming effects may assist in relieving tinnitus.
Medical and homeopathic doctors alike recommend cutting back on, or totally avoiding, alcohol, nicotine, caffeine, and food with a high sugar content. As a precaution, we gave an IV injection of a diuretic to try and shift some of the bloody fluids inside her lungs. We flushed the abdomen with sterile saline several ties, and placed more antibiotics inside.

On shaving the area very closely, we found 2 tiny snake bite marks surrounded by some bruising. This was due to the snake toxin damaging red blood cells and causing them to leak their contents into the blood stream. Once it slips through, the intestine twists around on itself and cuts its own blood supply off.
At stitches out 10 days post-op, he was bouncing up our stairs eager to get his special treat before having his stitches removed. There was also a smaller soft mobile lump just in front of the bigger one, which on examination of a needle biopsy turned out to be fatty in content (lipoma).
We opened up the skin wound on his chest to find a large hole looking straight in at his lungs and beating heart. The incision was closed using a soluble suture in an inverting continuos pattern (Connell Cushing).
In other words, the whole patella apparatus was out of alignment with a natural tendency to pull the patella out of its groove in a medial direction.
If they are inactive (hypo-thyroidism), pets are lazy, over weight, have skin problems and greasy coats. In fact, many dogs only survive 2-3 days with this intensive care before dying, leaving pet owners with huge vet bills and no dog.
It did not take long before surrounding parks and streets were covered in millions of viruses.
This means a dog may appear healthy, but can be excreting virus particles in its faeces and so become a source of infection to other dogs while the disease is brewing in its intestines. As a result, bile "backs up" in the liver and can cause a yellow staining of the blood, skin and gums (jaundice). Dehydration and shock quickly follow, making the dog thirsty, however each time it drinks, more leakage of the acids and alkalis occurs. If they are very rapid, the ventricle does not have time to fill up to the top befoire it is "told" to contract.
We remain with only our 2 indoor cats at the moment but the temptation to rescue some dogs is present.Mark as you would know its no coincidence Dotty lived so long and we also wanted to thank you for your expertise since you took over from Steven Henry. I would visit local hospitals to see the brand new and hugely expensive cardiac ultrasound machines in action, and have a chat to the human cardiologists. An incision was made in the stomach wall around the attachment’s base and the hole that was left was closed using a double layer of inverting dissolving Monosyn 3-0 sutures.
This is very painful, and it is not long before the intestine dies and leaks all the food and bacteria it contains into the abdomen causing sudden death. One of the nurses did his breathing for him by filling and gently squeezing his breathing bag on the anesthetic machine in time with his own breathing.
The area was washed in sterile saline several times then a soluble antibiotic (Cephalexin) was applied to the area.
The brain realises it is losing more "water" than it should be from the body, so it activates the "thirst centre" in the brain which makes the pet look for water.
Acute secondary kidney failure can occur due to the large amount of fluid loss causing thickening of the blood and decreased blood flow to vital organs. These days, I can sit down with a toastie and a glass of wine at home, and log onto a live online seminar beaming in from the USA- incredible! Heartworm had just started to appear in Sydney with almost 45% of un-protected dogs contracting the disease. The medical professionals will always make a mountain out of a molehill, so keep it simple and do it yourself!
The incision was covered by omentum (fatty tissue in the abdomen), which provided an extra seal to the wound.
Daily preventative tablets were the first products on the market, but had a 25% overall failure rate. More damage to the pancreas means more leakage and it does not take long for massive inflammation and tissue destruction to occur.
If you are still unsure and you own an ammeter, test the current draw of the compressor at the compressor leads. If the knob has an "off" setting which stops the compressor from running, it is thecold control.In the absence of an "off" setting, the easiest way to tell them apart is to pull the plastic knob off the control. The idea is to keep the compartment at a different temperature from the rest of the food compartment; a more optimum temperature for the particular food that you're keeping in these compartments. This is known as "sweating." So-called "Energy Saver" switches control small, low-wattage "mullion" heaters in the side and door panels that prevent the outside of the refrigerator from getting cool enough for sweating to occur. Air flows over it by convection; the warm air rises and is replaced by cooler air from below. Feel for a steady flow of warm air from the drain pan side; it should be obvious (see Figure 11).
It has the veryimportantjob of directing airflow beneath the fridge, assuring that the condenser fan is drawing air over the condenser and not just sucking air in through the back of the fridge.
They are sealed units and cannot be rebuilt.Replacing the condenser fan motor can be dirty and difficult.
When installing a new motor with bracket mounts, it may be easier to install the brackets loosely on the motor until you can locate the mounting screws in their holes.
Thus, when trouble-shooting the evaporator fan, you must depress the door switch(es).Open your freezer door, depress all door switches and listen for the evaporator fan.
Look first for a separate access panel or a tower within the freezer that houses the fan (Figure 14). Check for anything that may be blocking the fan, including ice from a backed-up defrost drain or a frost problem. If nothing is blocking the fan and it still does not run, check for voltage across the fan motor leads (with the door switch depressed, of course.)If you have voltage across the fan motor leads, the fan motor is bad. Itcancause ice to build up in the internal ductwork.If you hear a "whistling" or "warbling" noise emanating from the fan motor itself or from the inside of the food or freezer compartment, it is probably coming from the evaporator fan motor. They don't cost much.REPLACING THE EVAPORATOR FAN MOTORIn replacing the fan motor, you must make sure that the rotation of the new fan motor is the same as the old one. The easiest way to do this is to look for the shading poles on the old fan motor (Figure 16).If they are on opposite corners from the ones on the new fan motor core, it is a simple enough task to reverse the new rotor in its core. Do not remove the icemaker (if installed.)Look at and feel the panel covering the bottom or back of the freezer compartment.
You will see a removable panel covering the entire back or bottom of your freezer compartment. Make sure the power is off the refrigerator before disassembling any lighting circuit.On some bottom-evap models, you may have to remove some of the plastic moulding around the door frame to access some of the evaporator panel screws. This can usually be accomplished by placing a pan of very hot water in various places on the panel, or by blowing warm air on it with a blow-dryer.
Therefore, when you are diagnosing a defrost problem, it's a good idea to try to avoid melting the ice encasing the terminating thermostat until you've made your diagnosis.
If the thermostat opens before you've had a chance to see if the heater works, you'll have to by-pass it.
There are many styles, but most are variations of the three types pictured in Figure 20.Aback-evaporatormodel is one with the evaporator mounted vertically against theinside back wallof the freezer compartment.
These may be bottom freezer models, side-by-sides (Figure 17) or top freezer models (Figure 18.)Abottom-evaporatormodel is one with the evaporator mounted horizontally (flat) beneath a panel on thebottomof the freezer compartment (Figure 19).
Does it have a fluffy (snowy) white consistency, or is it solid and clear-ish or slightly milky white-ish?Check the frostpattern. Or is it not frosted at all?On back-evap models, examine the drain pan directly beneath the evaporator.
Is it clear, or is it filled with solid ice?Each of these symptoms indicates a different problem. If you have lots of white, snowy ice, keep reading.4-5 DEFROST SYSTEMIf the frost is snowy and white in appearance, you have a defrost problem.
The three main components of the defrost system are the defrost timer, the defrost heater and the terminating thermostat.4-5(a) DEFROST TIMERS AND ADAPTIVE DEFROST CONTROLIn most older refrigerators and some newer ones, a motor-driven timer (Figure 21) is used to stop the compressor and initiate a defrost cycle. If you have a Whirlpool or Kenmore refrigerator with a flex-tray icemaker, the defrost timer is integrated into the icemaker. This is true whether you are using the icemaker to make ice or not; it is running constantly to time your defrost cycles. If you have a defrost problem and you have one of these machines, follow the instructions in section 4-6.Nowadays, refrigerators are being made as efficient as possible, due in no small part to government energy efficiency requirements.
Defrost heaters use a lot of energy, so designers are mimimizing the total amount of time that the heater is energized.
Such factors include ambient humidity and temperature, the water content and temperature of the food you put into the fridge, icemaking within the freezer, and how often the door is opened and closed.For example, if you go away on vacation for a week, the refrigerator door will obviously not be opened for a long time. Less humid air will enter the fridge than if someone was at home, and opening and closing the door. Frost buildup will be much slower than usual, so the refrigerator will not need to be defrosted as often as normal. It also will not need to be chilled as often, so compressor run times will be shorter and less frequent.Designers are using microprocessors (on solid state circuit boards) to adapt defrost intervals and durations to compensate for differences and changes in operating conditions. Such techniques are calledAdaptive Defrost Control, commonly abbreviated as ADC.To make decisions about the correct defrost duration and interval, the control board must have input about the conditions that the fridge is operating under.
Each manufacturer uses a different logic scheme and different inputs, such as door open time, compressor run time, duration of the previous defrost cycle, and duration and intervals of door openings.Door open info is provided to the logic board by the door switch - the same one that controls the refrigerator's internal lights.
For example, the ADC is programmed with a maximum amount of time that the heater can stay on; say, for 16 minutes. Often they are mounted under a cover plate or in a bracket that hides all but the advancement pinion.
The easiest way to recognize them is that the harness connection is always labelled with the compressor, defrost heater, L1 and L2. The easiest way to see the heater is to look for the heavy, rubber-coated wires leading to it; one on each end.
The element has no protective tubing and generally wraps around beneath the evaporator in a large "U" shape.You must exercise caution when handling these heaters to prevent burning yourself. If that happens, you want to turn the heater off soon after the ice melts, to prevent the evaporator compartment from heating up too much.
If theterminating thermostatsenses too high a temperature in the compartment, it opens, and cuts power to the heater. The thermostat will then stay open until the compartment again reaches a very low temperature.
In other words, it waits to reset itself until the cooling cycle starts again.If the evaporator is more heavily frosted, the ice may not all melt within the time allotted by the timer.
The heater will stay on until thetimerstops the defrost cycle, and restarts the cooling cycle.If you initiate defrost (turn the timer on) and the heaterdoes notheat up, then usually the heater or terminating thermostat is bad.
If you initiate defrost and the heaterdoesturn on, then usually the timer or ADC board is bad, and you must replace it.To diagnose which component is bad, you must initiate the defrost mode, or test continuity through the defrost heater and terminating thermostat.
Within ten minutes (usually much less) you should be able to see a red glow from the defrost heater(s), which is (are) mounted beneath the evaporator.If you have an aluminum-tube heater as described in section 4-5(b), it will not glow red, but youwillsee ice melting away from its coils. Timers can get old, worn and coked up with dust, and may develop hard spots in the bearings.
If youdo nothear or see indications that the defrost heater is working, then it is necessary to investigate a little further. If you cannot tell for sure, get the information for your model fridge from your parts man.
DIAGNOSIS: DEFROST HEATER AND TERMINATING THERMOSTATIf you do not hear or see indications that the defrost heater is working, you could be looking at one of several different problems.
The heatermaybe so icebound that it would takehoursfor the heater to melt enough ice for you to see the heater begin to work. If they are not connected to a terminal block, you will need to cut the leads to test for continuity. Make sure you're not testing continuity across the terminating thermostat too; it may be wide open above 40 or 50 degrees. With glass-tube heaters, be careful that the glass is not cracked or broken and that you do not cut yourself. It's cheap.If you have an ammeter, try to determine if the heater is drawing any power before you melt any ice. In trying to find the heater leads, be careful that you do not melt so much ice that the terminating thermostat opens. If you suspect that the terminating thermostat might be open, temporarily bypass the terminating thermostat with an alligator jumper as described below.If you cannot find the heater leads, an alternativeis to check the current in one lead of the main power cord. Double-check this diagnosis by jumping across (shorting) the terminating thermostat with your alligator jumpers. If the two thermostat leads are not on a terminal block, you will have to cut the leads to jump the thermostat. Remember that it's a wet environment.LIFTING THE EVAPORATORIf you have a bottom-evap model fridge, replacing the heater will involve the delicate task of lifting the evaporator up to get to the heater. If you break or puncture one of those tubes, you're looking at a potentially expensive sealed system repair.Thaw out the evaporator as thoroughly as is humanly possible.
Remove the evaporator mounting screws (if there are any) and gently lift up the end of the evaporator opposite the tubes.
Prop up the evaporator with a blunt instrument (I use my electrical pliers or a flashlight) and change the heater. Do what you went in there to do, but as much as possible, avoid moving the evaporator around too much.When you finish, gently lower the evaporator back into place. The hard tray is finished in a dark gray or black color and has rotating fingers that eject the cubes from the unit; the flex-tray has a white plastic, flexible tray that inverts and twists to eject, much the same as a manual ice cube tray would work.
The hard-tray and separate defrost timer is by far the more common arrangement.This defrost system has the same components described in the defrost system in section 4-5, except that the defrost timer is integrated into the icemaker.
However, the actual switch that controls the heater is accessible.Remove the icemaker and the evaporator panel as described in section 4-4. Take the plastic cover off the face of the icemaker and remove the three screws holding the metal faceplate to the icemaker head.
Plug the icemaker back into its electrical socket and observe the drive motor in the upper lefthand corner of the icemaker head.
The defrost switch is the small, rectangular switch in the upper righthand corner of the icemaker head.
Using electrical tape, tape it out of the way so it does not touch any other metal object in the icemaker head.
Using your resistance meter, you should see continuity (and no resistance) between the empty terminal (where the BLACK lead was) and the PINK terminal.You should see NO continuity between the empty (BLACK) and ORANGE terminal.
When the switch toggle is depressed, continuity will be just the opposite: BLACK-ORANGE-CONTINUITY, BLACK-PINK-NO CONTINUITY.
If the switch is okay, the problem is probably your defrost heater or terminating thermostat. Alignment of the gears is critical; follow the instructions that come with the gear sets carefully.
If you replace the motor, you will have to re-align the defrost timing gear mechanism.RE-ASSEMBLYIf you have not removed the defrost timing gear housing from the back of the icemaker head or the motor from the front of the head, you will not need to re-align thedefrost timinggear mechanism. However, youwillneed to realign thedrivegear mechanism.Align the hole in the small drive gear with the alignment hole in the icemaker head and install the gear. If they do not line up perfectly, momentarily plug the icemaker in or apply 110 volt power to the two center leads of the plug This will turn the drive motor slightly. Lift the spring-loaded shut-off arm (ice level sensor) as you install the cam and let it rest in the cam hollow. Carefully install the metal cover plate, making sure the end of the wire shut-off arm (ice level sensor) is in its pivot hole in the metal cover plate.
Make sure the icemaker is turned on (ice level sensor arm is down) or it won't make ice.4-7 HOT GAS DEFROST PROBLEMSIf you have a refrigerator with a hot gas defrost system, the defrost mechanism is somewhat different from those described in previous sections of this book. If you suspect that you might have a hot-gas defroster but you are not sure, ask your appliance parts dealer. Most of these refrigerators were built before 1970, but not all.The main difference in a hot gas system is that there is no electrical heater or separate terminating thermostat.
The defrost cycle is controlled by a defrost timer similar to the one you'll find in electric defrost systems, but the timer controls asolenoid valveinstead of aheater. These units have a temperature sensing bulb, similar to that found on the cold control (see section 4-9 and Figures 21 and 33) as a part of the timer. Its function is to sense the temperature of the evaporator so the defrost mechanism knows when to shut off.Troubleshooting a defrost problem in this system involves two steps. Wait and watch your evaporator for 10-15 minutes.If the frost starts to melt, then your defrost timer has gone bad. Thoroughly melt the rest of the frost from your evaporator and replace the defrost timer.If the frost doesnotstart to melt, then your defrost solenoid is probably bad. Fortunately, the defrost solenoid is usually designed so the electrical coil can be replaced without cutting into the sealed system. Trace the Freon tubing until you find electrical wires joining the tubing at a certain point. UNEVEN FROST PATTERNS, OR NO FROST AT ALLThe evaporator should be bitterly cold to the touch.
If the evaporator is either slightly cool or not cold at all, and your compressor is runningconstantly(not short-cycling; see section 4-9) you have a more serious problem. The same diagnosis applies if just the first coil or two in the evaporator is (are) frosted and the rest are relatively free of ice or perhaps even lukewarm.What's happening is that the Freon is not getting compressed enough in the compressor. This could be due to two causes: either the amount of Freon in the system is low, or the compressor is worn out.
Itmayonly require recharging the Freon system, which, depending on the refrigerant used, may cost you a little, or a LOT. I have only seen one exception to this diagnosis, and this is described in section 7-2.Don't let the age of the refrigerator affect your diagnosis. Not too long ago, one of the largest appliance companies put out a series of refrigerators with compressors that were either poorly designed or poorly constructed; I never did find out which.
These were their giant, 20 to 25 cubic-foot flagship models, with techno-marvelous gadgets like digital self-diagnosis and ice and water in the door, and they were built with compressors that wore out within 2 years.Fortunately, the biggest and best companies warrant their refrigerators for five years or more, so these refrigerators were still covered under warranty. COLD CONTROLIf your refrigerator is cold but not as cold as usual, and you cannot trace it to any of the other problems in this chapter, your cold control may be defective. To test its cut-in and cut-out temperatures, you can try putting the capillary bulb in ice water and measuring the temperature with a thermometer, but it's a wet, messy, job and it's difficult to control the temperatures. The capillary tube is the liquid-filled temperature-sensing element of the cold control, and operates in the same manner as a thermometerbulb; in fact, the end of the capillary tube may have a bulb.
The tube and bulbmaybe coiled right next to the cold control, or they may be led away to another part of the compartment.If you are justtesting(electrically) the cold control, you can jumper directly from one wire lead to the other. By doing this, you are closing the switch manually, and assuming the machine is not in the defrost mode, the compressor should start.If you arereplacingthe cold control, it will be necessary to trace where the capillary tube goes, and remove the whole tubewiththe cold control.

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