Dr. Phil Zeltzman’s Blog

Ace, a 6 month old Pit bull, was playing outside.

At one point, he jumped up, landed wrong and collapsed. He was painful and held a back leg up.

Ace’s owners took him to the emergency clinic, where X-rays showed a fracture of the left shin bone, called a tibial tuberosity avulsion or tibial crest avulsion (compare the broken part to the right leg, which is normal).

This type of fracture only occurs in growing puppies because it happens through a growth plate. This area allows bones to grow longer. It’s however a weaker area and makes it more likely to break after enough trauma.

I repaired the fracture with 3 stainless steel pins to reattach the fractured bone to the main part of the shinbone.

Ace stayed overnight and went home with a plastic cone, antibiotics and pain medications. He had to be confined strictly for 6 weeks. The owner was given instructions to do simple physical therapy exercises.

6 weeks later, X-rays showed nice healing of the bone and Ace continues to live a happy, playful life.

Phil Zeltzman, DVM, DACVS, CVJ, Fear Free Certified

Dr. Phil Zeltzman is a traveling veterinary surgeon in Pennsylvania & New Jersey. An award-winning author, he loves to share his adventures in practice along with information about vet medicine and surgery that can really help your pets. Dr. Zeltzman specializes in orthopedic, neurologic, cancer, and soft tissue surgeries for dogs, cats, and small exotics. By working with local family vets, he offers the best surgical care, safest anesthesia, and utmost pain management to all his patients. Sign up to get an email when he updates his blog, and follow him on Facebook, too!

Scout, a 9 year old female Labrador, had been having urinary issues for weeks, including frequent urination, accidents in the house and bloody urine.

These are classic signs for a urinary tract infection. So Scout was treated with antibiotics. There was no improvement. Another round of antibiotics was prescribed: still no improvement. When antibiotics don’t resolve a presumed bladder infection, it’s time to explore other less obvious diagnoses…

An ultrasound was recommended. It revealed a big mass in Scout’s bladder (see yellow arrows below. The mass is grey-ish, urine is blackish).

This was bad news since, statistically speaking, the vast majority of masses found in a dog’s bladder are cancerous (most often transitional cell carcinoma).

Regardless, Scout’s loving owners elected surgery to give her every possible chance. Scout underwent a laparotomy (abdominal surgery) to have the bladder mass removed and biopsied. The mass was the size of a walnut. About one third of the bladder had to be sacrificed. The rest of the bladder was reconstructed with multiple stitches. Surgery went smoothly. Scout recovered well, and was sent home the next day.

As expected, she did have a few days of bloody urine immediately after surgery, but it cleared up after a few days.

The mass was sent to the lab for biopsy. After a week of agonizing wait, the biopsy revealed… that the tumor was benign! Despite the statistics, despite everybody’s opinion, and despite the ultrasonographer’s impressions, the mass was… a benign polyp. This was amazingly good news for Scout and her owners!

Three weeks after surgery, my nurse removed Scout’s stitches and commented: “She’s doing great. She’s urinating normally, eating and drinking well, and super happy. Her owners are super happy and thanked us up and down for all our help.”

Remember: a mass is not cancer until the biopsy says so. Please don’t make any drastic decisions based on assumptions and statistics.

Scout was supposed to have bladder cancer, yet ended up with a benign polyp, which will not at all affect her lifespan.

Phil Zeltzman, DVM, DACVS, CVJ, Fear Free Certified

Dr. Phil Zeltzman is a traveling veterinary surgeon in Pennsylvania & New Jersey. An award-winning author, he loves to share his adventures in practice along with information about vet medicine and surgery that can really help your pets. Dr. Zeltzman specializes in orthopedic, neurologic, cancer, and soft tissue surgeries for dogs, cats, and small exotics. By working with local family vets, he offers the best surgical care, safest anesthesia, and utmost pain management to all his patients. Sign up to get an email when he updates his blog, and follow him on Facebook, too!

Kado, a 4 year old Husky, had a tumor (grade 2 mast cell tumor) near the tip of his prepuce (ie sheath). It is actually a common tumor, but a tricky location.

The only way to completely remove it was to remove the entire prepuce, and therefore, sacrifice (i.e. remove) his entire penis. A new opening was created to allow him to pee (urethrostomy). One year after surgery, his owner KM writes:

“Hi Dr. Zeltzman, It has been a year since Kado’s surgery (see picture above). He is doing great. He will be celebrating his 5th birthday on Monday. He is a very happy dog and full of energy and loves playing with our other dog. We just love him so much.”

So? Crazy surgery? Or life-saving procedure?

Phil Zeltzman, DVM, DACVS, CVJ, Fear Free Certified

Dr. Phil Zeltzman is a traveling veterinary surgeon in Pennsylvania & New Jersey. An award-winning author, he loves to share his adventures in practice along with information about vet medicine and surgery that can really help your pets. Dr. Zeltzman specializes in orthopedic, neurologic, cancer, and soft tissue surgeries for dogs, cats, and small exotics. By working with local family vets, he offers the best surgical care, safest anesthesia, and utmost pain management to all his patients. Sign up to get an email when he updates his blog, and follow him on Facebook, too!

Didder, a beautiful 2 year old indoor/outdoor cat, was found limping.

His femur (thigh bone) was absolutely shattered (see preop pictures). How many pieces can you count?

I count at least 15 pieces!

If that wasn’t enough, he also suffered from a fracture of the mandible (lower jaw).

We discussed leg amputation as one possible option. But I thought that we should give Ditter a chance, and try to put this thigh bone back together. And that’s what his owner decided to do. So we took this poor kitty to surgery.

His femur was repaired with a plate, 10 screws, 3 wires and 1 pin (which later had to be removed). To speed up healing, a bone graft was added.

His jaw fracture was wired back together. He had an uneventful surgery and anesthesia. He then had to rest very strictly for 2 months to allow the bones to heal.

Didder’s owner learned from this experience, and wisely decided to keep Didder indoors from now on. Stories like Didder’s are sadly not rare in my practice, and there is no question in my mind that cats are far safer indoors.

Two years after surgery, Didder’s owner writes: (…) “You’d never know anything happened to Didder – which is greater than any outcome we could have imagined the sad night we found him so horribly broken! (…) Our family is grateful that you were able to successfully rebuild our baby boy.”

Phil Zeltzman, DVM, DACVS, CVJ, Fear Free Certified

Dr. Phil Zeltzman is a traveling veterinary surgeon in Pennsylvania & New Jersey. An award-winning author, he loves to share his adventures in practice along with information about vet medicine and surgery that can really help your pets. Dr. Zeltzman specializes in orthopedic, neurologic, cancer, and soft tissue surgeries for dogs, cats, and small exotics. By working with local family vets, he offers the best surgical care, safest anesthesia, and utmost pain management to all his patients. Sign up to get an email when he updates his blog, and follow him on Facebook, too!

One of my nurses who works at an emergency clinic told me a crazy story that is a great reminder this summer.

She had seen yet another curious dog who couldn’t resist the urge to play with a porcupine… Of course, porcupines always win. The dog’s head, lips and tongue were covered in quills.

Depending on where you live, porcupines may be coming out of the woodwork. Dogs often think of a porcupine as a playmate. This could be very painful mistake. I suspect the picture tells the whole story.

This is a fairly classic situation at emergency clinics in my area (Pennsylvania and New Jersey). The Poconos are a beautiful mountain range but there are full of porcupines. The treatment for this situation is to anesthetize the dog, and remove the quills, one by one. And when there are hundreds of quills, it’s a lengthy procedure!

The bigger problem with porcupine quills is that they can occasionally migrate through the body. I remember participating in a surgery at the Colorado vet school, where a quill was literally inside the wall of the heart!

So please be careful, please keep your dog on a leash and please never ever think that your dog will learn from one bad experience. Experience proves that there are many repeat offenders, summer after summer…

Porcupines may be fascinating creatures, but they have no intention of playing fetch with your dog.

Be safe.

Phil Zeltzman, DVM, DACVS, CVJ, Fear Free Certified

Dr. Phil Zeltzman is a traveling veterinary surgeon in Pennsylvania & New Jersey. An award-winning author, he loves to share his adventures in practice along with information about vet medicine and surgery that can really help your pets. Dr. Zeltzman specializes in orthopedic, neurologic, cancer, and soft tissue surgeries for dogs, cats, and small exotics. By working with local family vets, he offers the best surgical care, safest anesthesia, and utmost pain management to all his patients. Sign up to get an email when he updates his blog, and follow him on Facebook, too!