Dr Paws

✨Appendicular Osteosarcoma✨ ✨ Diagnostic radiographic image of Sunbrust Pattern✨ Mario is a 7y old Golden retriever dog represented to our clinic with history of intermitten lameness and and signs of forearm swelling which elicit pain upon palpation. 📌 Most common type of eldery canine bone tumors, pathophysiology behind it is quite interesting; supposing there's tumorous nuclei within the intramedullary diaphysis or methaphysis *which's enriched with blood supply*, normal bone replace with tumours bone and it grows depending on the blood supply of this area. Tumorous bone is not strong as normal one which could be fractured easily consequenced with new bone formation, periosteal reaction due to uncontrolled osteoblastes which appear as ch.ch sunbrust. 📌 Core biopsy was recommended to confirm the osteosarcoma with histopathology, and in these cases limb amputation required to resolve pain and lameness. By: Dr. ahmad tarek Barakat Dr. Nadia Essam

♦Accidental Head Trauma and pelvic fracture♦ Soka is 1y old stray intact female cat presented with significant trauma following a car accident. The owner reported that the cat has been disappeared for 2days then found in deteriorating status can’t bear weight on her hindlimbs suspecting vehicle accident. ✨ Physical Exam: Patient presented pale, hypothermic, was in obvious pain and distress, non-weight-bearing on the hind limbs exhibiting a hunched posture. Painful swelling in Lt. Hindlimb and around the pelvic area, Palpation of the pelvic region produced pain especially when moving the left pelvic limb, exhibited signs of hypovolemic shock, tachycardia, hypotension, and cool extremities. ✨ Neurological examination: Preformed due to altered mentation and ataxia in addition to Hx of suspecting an accident. • Panniculus reflex: +ve • Perineal reflex: weak +ve (hyporeflexia) • Withdrawal reflex: +ve in all limbs • Deep pain sensation: +ve in all limbs • Extensor Carpi reflex: hyperextension (radial nerve) • Sciatic reflex: flexion was weak +ve in Lt. Hindlimb, +ve in Rt. Hindlimb • Patellar reflex: No extension -ve in Lt. Hindlimb, weak +ve in Rt. Hindlimb • Delayed Proprioception knuckling reflex in hindlimbs • Altered Proprioception hopping reflex in hindlimbs • Palpebral reflex +ve in both eyes • Pupillary light reflex Altered pupil size and slow pupil constriction in the Rt. eye. Opacity in the Rt. eye appeared after 6hrs from presentation which indicate head trauma and disturbance intracranial pressure. ✨ Diagnostic imaging: -Radiography: Revealed left sacroiliac luxation resulted in malalignment of the vertebral segments, fracture of the left hemipelvis involved the pubis and ischium, resulted in collapse of the pelvic canal caudally. Both hip joints appeared normal. -Ultrasonography: AFAST& TFAST scans preformed to assess if there’s internal bleeding. (DH): 0 (SR): 0 (CC): 0 (HR): 0 Abdominal Fluid Score: negative in all quadrants. DH view: Pleural effusions absent, Pericardial effusions was mild. -MRI for assessment of the intracranial injury was recomended. ✨ Treatment Plan: 1. Pelvic Fracture Management: Surgical intervention required and the owner informed about it, pended till stabilization. Pain killers and cage resting. -Meloxicam 20mg as NSAID, Gabapentin 100mg to relief the neurological pain. 2. Head Trauma and altered ICP: -Mannitol 20% to drain the interstitial fluids to the vascular compartment, Furosemide as a diuretic, Neuroprotective medication. 3. IV fluids to restore circulating volume, Colloids to correct the hypovolemia. 4. Lactulose aid in bowel movement during concurrent pelvic canal narrowing. Follow up: Elhamdullah Soka regained appetite eating on her own without force feeding, Improved mental state and resolve the eye opacity from the 3rd day, Good awareness and retain consciousness from 4th day, Move dragging her hindlimbs and vocalize seek for feed on the 5th day.

Minimal invasive techniques such as endoscope save time, efforts and definitely lives! 💡 💫 Cats always has the eager to discover everything around, but this time our patient was discovering by tasting which consequenced by swallowing her owner's airpods! 💫 Radiography was unremarkable but the ultrasonographic ex. confirmed the presence of f.b in the stomach with ideal shadowing. 💫 Under general anesthesia, With endoscopical exploration we found out the airpod trapped between rugal folds of the stomach and we retrieved it successfully elhamdullah. 🐾 Comparing the minimal invasive endoscope with the traditional laparotomy, it eliminate and protect from serious complications like bleeding and infection, transfer of microbiota from the gastrointestinal tract to the surgical field could occur in traditional laparotomy which called contaminated operation.. it confine the microorganisms to the tract without any leak, eliminate the instruments and time. Endoscopist: Dr. ahmad tarek Barakat

-🔼Corneal Ulceration🔼- Is an open wound or sore on the surface of a dog’s eye that can be painful and, if left untreated, may lead to serious complications such as blindness. 🔼Causes: -Trauma or Injury: Physical damage to the eye, such as scratches from foreign objects. -Infections: Bacterial, viral, or fungal infections. -Dry Eye (Keratoconjunctivitis Sicca): from tear deficiency or chronic irritation. -Eyelid Problems: Conditions like entropion or ectropion. -Foreign Bodies: Dust, sand, or other small particles in the eye can scratch the cornea, creating an ulcer. -Chemical Exposure: Certain chemicals, such as cleaning agents or strong medications, can irritate the eyes and cause corneal ulcers. -Other Health Conditions: Diabetes, immune-mediated diseases, -Breed predisposition: such as brachycephalic dogs like Bulldogs are more prone to corneal issues. -Diagnostic approach- 🔼Through physical examination should be preformed. 🔼Fluorescein Staining Test: highlight green color of the ulcer when examined under blue light. 🔼Schirmer Tear Test: was 10. 🔼Culture and Sensitivity Test 🔼Treatment: -Mechanical debridement using cotton swab -PRP from dog's blood -Protection by E-collar -Artificial Tears -eye lubricants Thanks for our talented Professor of Ophthalmology for his extraordinary efforts, you always exceed and beyond expectations and we're totally honored to be closely working, handling such complicated cases, getting educated by you.♥ Dr. Mohamed fouda

💡Tibial Plateau Leveling Osteotomy💡 -TPLO is a common surgery performed on dogs with cranial cruciate ligament (CCL) injuries. 💡The surgery involves altering the angle of the tibial plateau to reduce stress on the damaged ligament. During the procedure, the tibia is cut and rotated to change the angle of the plateau, stabilizing the knee without relying on the damaged ligament. special TPLO plate and screws are used to secure the bone in its new position. 💡TPLO is typically recommended for active or larger dogs with CCL tears, as it offers a high success rate in terms of recovery and return to normal activity. Orthopedic surgeon: Dr Esam Almenshawy Dr. ahmad tarek Barakat

🐾Feline Leukemia virus progressive form in 1y old queen with signs of salvation, vomiting and paleness shedding virus in saliva, which took the virus from close contact, through saliva and transmammary through milk of the infected the dam. 💫FeLV is an interesting retrovirus composed of ss RNA encircled with envelop, sensitive to environmental conditions and that's way requires close contact for infection. genome of FeLV contain reverse transcriptase and Integrase enzymes. -RT- which transcript the RNA sequence into ss DNA then form the complementary DNA strand to be double stranded. -Integrase- which integrate the provirus into the host genome. Then the host polymerase translate the virus integrated sequence with the host DNA into mRNA which in turn transcript into new virus genome and proteins giving rise to multiple copies of the virus able to infect new cells again and again. 💫CBC showed anemia and leukopenia, sequential blood pictures revealed there was non-regenerative anemia which directly referred to the nature of the myelosuppressive and immunosuppressive oncovirus.

💫Acetaminophen Toxicity💫 Acute oral intoxication resulting from acetaminophen-containing medications (usually human OTC products), ch.ch by methemoglobinemia, acute hepatic damage, or both.

💫Acetaminophen Toxicity💫 Acute oral intoxication resulting from acetaminophen-containing medications (usually human OTC products), ch.ch by methemoglobinemia, acute hepatic damage, or both. 💫1st Drug toxicosis in cats, more prone >10X than dogs due to deficiency in glucuronyl transferase enzyme rendering it nontoxic. Pikachu is 4y old tom cat represented to our facility with signs of salivation, vomiting, dyspnea and severe cyanosis developed acutely and progressively. By asking the owner to attain more info about the initiating cause, he clarified that Pikachu was coughing and sneezing so that, he decided on his own to give him human medication for common cold which on investigation was containing paracetamol. 💫Physical ex.: Revealed hypothermia, dyspnea and tachycardic on examination. Drawing blood sample for blood works it altered to brownish color, detecting the methemoglobinemia by dropping blood on filter paper and it appeared brown which mean metHb >15%. And in this case presentation it was >20- 40% due to signs of dyspnea. 💫Lab findings: Revealing Anemia elevated ALT and Bilirubin. Preforming blood film revealed >10% Heinz bodies. 💫Treatment Plan: • Begin with stabilization Oxygen supplementation, E-Heater, warm isotonic crystalloids. • Decontamination by activated charcoal. • N-acetylcysteine, it's the specific antidote and protect hepatocytes& RBCs. Loading dose = 140 mg/kg, repeat at 70 mg/kg q 6h. • Ascorbic acid 20-30 mg/kg q 8h for 3 days; useful antioxidant; may protect liver or RBCs by capturing/neutralizing toxic metabolites. • Isotonic fluids 60ml/kg/d After 2 days of treatment with love and care, mucosae cyanotic color resolved and on the 5th day warrior Pikachu regain his normal activity again Elhamdullah.💙 Thanks to our critical care interprofessional team, working in physically, emotionally and definitely the most stressful challenging environment, all their collaborations led to effective and integrated teamwork to provide continuous, high quality health care for the sickest and most vulnerable patients in the hospital. 👏 Cases by: Dr. Nadia Essam Dr. Ahmed Bahr

Car accident rescued dog, poor Dahab suffered from double fractures in fore and contralateral hind limbs after traumatic injury:"(. Challenges raised from the nature of the fracture which were opened complicated fractures. We've begin with the worst one which was the supracondylar femoral fracture, open reduction preserving the normal alignment and fixation with INTRAUMA S.P.A. distal Femur v3006 plate. Then the radius and ulna fracture reduced using Arthrex 2.0 plate. After intensive course of rehabilitation Dahab's mobility and activity improved Elhamdullah, and owner advised to continue rehabilitation schedule post operatively. Orthopedic surgeons: Dr. ahmad tarek Barakat Dr. Nadia Essam Radiologist: Dr. Afnan Elznati Anesthesiologist: Dr. Ahmed Mohamed Abd Elhafiz

Feline Patient suffered from Grade III patellar luxation in Rt. Hindlimb consequence by tibial torsion and collateral ligament rupture of the stifle joint. Pushing the patella out from the trochlear groove, patella attempted to be relocated in normal position and reluxate when manual pressure released.