bacterial contamination. Instruments, gowns, towels and other items such as scalpels and clamps are sterilized in an autoclave at 270 degrees under pressure for various lengths of time to kill any microorganisms. As well, the surgeon scrubs their hands and wears sterilized surgical gloves and also wears a gown if the surgery is more than a minor procedure. By adhering to sterile surgical techniques, postoperative infections are seldom encountered.

After any surgical procedure the pet’s owner is given a thorough description of what our surgeon accomplished and what is now expected of the pet owner in terms of post-operative home care.  And sometimes that can be a bigger challenge than the surgery! How do you make a happy and carefree dog "take it easy" for ten days? How do you make a cat not jump off the back of the couch? Nevertheless, aftercare is vital to the healing process. Now on to some of the surgical procedures we preform:

WHEN TO SPAY or NEUTER:  There is firm medical research indicating that if a dog spay or neuter surgery is performed before the dog's first estrus cycle (heat) the chances for developing mammary gland or testicular cancer later in life is nearly zero.  If a dog goes through one heat cycle and then is spayed or neutered, the chances of mammary or testicular cancer later in life are slightly reduced.  And if a dog has three or more estrus cycles and then is spayed or neutered there is no protective influence against developing mammary or testicular cancer.  In addition, any dog that is spayed will have no chance of developing a potentially fatal uterus infection called Pyometra.   Our veterinarians recommend spaying or neutering dogs at about six months of age, which is generally prior to a dog's first heat cycle.  Some veterinarians will suggest that the surgery be done at four or five months of age.  Be sure to have a discussion with one of our veterinarians about the "whens" and "whys" of spaying or neutering.  There is no particularly convincing reason to let a dog "have one heat cycle" or "just one litter" prior to spaying.

THE SPAY or NEUTER SURGERY:  The surgical procedures are performed under general anesthesia and employ sterile instruments and a sterile surgical field.  Medical emergencies can arise if a pet becomes infected during these procedures.  Our surgeons do not approach any surgery as if it were "routine" because every animal is unique, each surgery is different from every other, and while neutering might be deemed a minor surgery a spay certainly qualifies as a major procedure.

Essentially, the structures and techniques are the same for each dog or cat spay or neuter.  As you can imagine, though, there are some real differences between working on a 180 pound Saint Bernard or a 10 pound Tabby!  And an overweight patient makes the surgery more difficult and time consuming.

There are no medical, emotional or sociological reasons for a male or female dog or cat to "have just one litter". If you do choose to allow your dog or cat to have a litter, please be certain that there are committed pet caretakers waiting and wanting to provide a home for them.  You do have the power and intelligence to make a difference in the population of unwanted dogs and cats.

Intestinal obstruction from a foreign body is fairly common in dogs.  Dogs seem to like to chew on and even consume odd things at times; and there isn't a veterinarian anywhere that wasn't amazed on occasion at what ends up in the gastrointestinal tract of dogs and cats.  Obstruction of the intestines in dogs and cats is always considered an emergency situation.  In the case presented below the dog, a 60 pound mixed breed of six years of age, had been vomiting, had stopped eating for three days and although he was drinking water, at the time he was presented to the doctor he was vomiting any water he drank as well.  

Upon physical examination it was noted that his temperature was slightly elevated at 103 degrees.  His abdomen was slightly tense but the veterinarian was able to palpate (feel with his hands) a firm mass in the central abdomen.  The dog was taken to Radiology and you can see the x-ray image on the right.  Click on it to see a larger image of the x-ray of the intestinal obstruction in this dog.  Some routine laboratory tests were done to make sure the dog was not seriously dehydrated and that organ systems were working well.  

The patient was taken to surgery, an i.v. fluid administration line was inserted, antibiotics were administered and anesthesia given.  The surgery indicated that the rock was part way down the small intestine but due to muscle cramping around the object, it was "captured" by the spastic intestinal segment and was not moving any further.  Severe inflammation and swelling was present but the blood supply seemed intact so the surgeon decided rather than removing an entire section of the obstructed intestine that an incision over the obstruction and removal through the incised intestinal wall would be the ideal method of removal in this case.  On  occasion, if there is severe necrosis (death) of the intestinal tissue over an obstruction, the damaged section needs to be removed entirely and the open ends of the intestine are then sutured back to together at a point where healthy tissue is present.

It is interesting to note that smooth, rounded objects such as golf balls, marbles, coins and beads have a higher chance of obstructing the intestinal tract than irregularly shaped and sharp objects.  If a smooth rounded foreign object gets into the intestinal tract, the intestinal muscles seem to go into a spasm and constrict around the object, thereby creating an obstruction.  Usually when a sharp object enters the intestinal tract the sharp or pointed object will stimulate the intestinal wall to "back off" from constricting around it.  Eventually such items as wire fragments, bone shards, tacks and nails will make their way to the larger and more spacious colon to be passed out in the stool.

Mammary gland tumors are common in dogs, and surgery to remove cancerous mammary glands, called a mastectomy, is a routinely done procedure at The Animal and Bird Hospital of Clearwater.   Male dogs almost never get mammary tumors; as well, female dogs that have been spayed before their first heat cycle rarely acquire breast cancer.  Statistics demonstrate that if a female dog is spayed after her first heat cycle but before her second cycle, her potential to develop mammary tumors is slightly greater than the dog that was spayed prior to a heat cycle.  If two cycles occur, then the spay procedure, an even higher incidence of breast cancer is demonstrated.  And spaying after three heat cycles has no effect on diminishing the potential to develop mammary tumors.  In short, the sooner a dog is spayed the less the chances for mammary tumors to develop in the future; but after three or four heat cycles, spaying has almost no effect on protection against tumor development.  Keep in mind that spaying any dog at any time (as long as the patient is healthy) may be advisable to prevent a very serious uterine infection called PYOMETRA. 

Visual inspection and a physical exam probably will not be helpful in determining whether or not a growth is benign or malignant.  A biopsy can be done on these growths to determine the cell types, which are highly variable in canine mammary tumors, and to establish the degree of malignancy. Malignancy means that they have the tendency to spread invasively into surrounding tissues and also to be spread by the lymph system to other parts of the body.   Our veterinarians will suggest a chest X-ray prior to any mammary gland surgery to see if there is any evidence of metastasis (new tumors as a result of "seeding" from a distant, primary tumor).  If there is evidence of tumor spread to other areas, the decision to do a mastectomy may not be advisable because metastasis of mammary gland tumor to the lungs or other body tissues almost always signals a very poor prognosis for recovery in the dog or cat.

Chemotherapy for mammary gland cancer, and/or radiation treatment, can be done but the main effort of treatment is surgical excision of any suspicious mass. Please note The Animal and Bird Hospital of Clearwater does not preform this type of procedure and will be be referred to FVS (Florida Veterinary Specialists).

Bloating in dogs!  There are very few challenges in veterinary medicine that rival an emergency presentation of bloating in dogs.  Known by various terms, some more accurate than others, a dog with a bloating stomach has a short time to live without emergency veterinary intervention.  Once the stomach is unable to expel gasses produced from fermentation within the stomach,  a series of events occur that result ultimately in such intra abdominal pressure that the dog is unable to survive.  Circulatory collapse and heart failure ultimately result, after extreme stretching of the stomach wall, constriction of intra abdominal blood vessels, widespread death and destruction of the stomach wall, and release of intestinal toxins.  Let's explore what is known about canine bloat and actually see an unusual and  relatively uncomplicated case of bloat in a dog.

WHAT IS BLOAT?
Canine bloat occurs when there is gas production in the stomach and that gas buildup is unable to be expelled via belching or vomiting, or passed through the intestines and out of the dog as flatulence.  Some bloat cases occur very rapidly when fermentation of grains in the wet and warm stomach environment create gas.  The influence of grain in creating an environment conducive to bloat seems even more plausible in that it is very rare for dogs that consume meat-based diets to develop bloat.  Generally, bloat is the extreme dilation of the stomach as a result of gas buildup that cannot escape the stomach.

WHAT TYPES OF BLOAT ARE THERE?
GASTRIC DILATATION... is simply the expansion of the stomach due to the buildup of gas or material in the stomach.
GASTRIC VOLVULUS (TORSION)... is the condition where the stomach rotates (flips on its long axis) and thereby twists the esophagus and small intestine closed so there is no passage of stomach contents or gas in or out of the stomach.

HOW DOES BLOAT HAPPEN?  
Scientists have tried to decades to learn about how bloat occurs by setting up bloating conditions in the laboratory with laboratory dogs... and consistently have failed in producing the spontaneous bloating that occurs with canine house pets.  The usual history is of a dog of a large breed that has recently eaten a meal of dry dog food and then exercises or engages in some physical activity.  On occasion, though, there is no history of physical activity and the dogs is suddenly seen trying to retch and vomit unsuccessfully.  The dog paces, becomes uncomfortable, attempts to pass stool and repeatedly makes retching, gagging noises.  Salivation is common.  At this stage it is impossible to determine what type of bloat is occurring.   In the photos above, the fortunate Malamute had a simple Gastric Dilatation with no torsion or volvulus.  Once the stomach contents and gas were eliminated via a plastic stomach tube, and the stomach was flushed and antibiotics administered to prevent further bacterial fermentation and gas production, the surgery was over and the dog recovered rapidly and successfully.  With Torsion or Volvulus present, far greater damage occurs to internal blood vessels and stomach tissues, plus the spleen gets caught up in the twisted mess of tissues and becomes starved for oxygen along with the stomach.  Eventually the heart is affected due to the major interruptions in blood flow and heart rhythms;  plus the pressure on the heart and diaphragm prevents normal cardiopulmonary function. When the blood supply in the abdomen’s major arteries is compromised, blood flow to the heart and the cardiac output decrease, leading to low blood pressure, and eventually, shock. 

The production of gas in the stomach sometimes overwhelms the dog's ability to belch it away or pass it through the bowel as flatulence.  There are various theories about the gastric chemistry that occurs to produce this sudden buildup of gas.  Plus, many dogs that become uncomfortable as the gas builds up will begin to swallow air, compounding their dangerous condition.

HOW IS BLOAT TREATED?
Treatment needs to be undertaken immediately.  Time is a very decisive factor in the success or failure of correcting bloat.  Once presented to our veterinarians, a dog with bloat will become the center of attention and all other activities at the animal hospital assume a lesser priority.  Supportive medications such as cortisone, antibiotics and intravenous fluids are started immediately.  Our veterinarians may need to decompress the stomach initially (before surgery) by inserting a large diameter needle into the stomach right through the abdominal wall.  An audible hiss is heard as the gas passes through the needle.  Once this is performed the doctor administers intravenous anesthetic in very small amounts because the patient in this state of affairs requires very little intravenous anesthetic to facilitate the passing of the endotracheal tube through which the gas anesthetic is administered.  Some veterinarians skip the intravenous anesthetic and, via a face mask, administer gas anesthesia such as Isoflurane... once the patient is unconscious the endotracheal tube is passed into the trachea to allow continuous control of anesthesia.

Once anesthesia is at the proper level, a stomach tube is gently inserted down the esophagus in an attempt to gain entry into the stomach.  If there is a Volvulus present and the twisting of the esophagus/stomach junction prevents passing the stomach tube into the stomach, the doctor will need to incise the stomach to dissipate the gas and bring the stomach back to a reasonable state of size and pressure.  If no volvulus (twisting or rotation of the stomach on its axis) is present, with careful and gentle manipulation our surgeon within the abdominal cavity the stomach tube can be directed into the stomach and the gas and stomach contents can be drained by gravity out of the dog.

Once the intra-gastric pressure is lowered the presence or absence of rotation of the stomach can be ascertained.  Also, if a volvulus is present, the spleen is also involved and often its blood supply becomes strangulated.  Occasionally, our doctors will elect to remove the spleen at this time.  The health of the stomach is established... in cases where the gastric dilatation has been present for hours and the pressure is very high, the stomach wall will be very thin and stretched and there may be areas of necrosis (cell death).  In the photos above a well vascularized stomach wall is evident... that a god situation.  In severe bloat where the stomach is stretched for long periods, the blood supply is shut down and the stomach wall appears bluish or blackened.  This blackish coloration suggest permanent cell death and damage.  Any time there is necrosis of the stomach wall the prognosis for a successful resolution of the case is very poor.  The massive cell death and absorption of toxins through the stretched stomach wall creates severe cardiovascular damage and blood pressure problems.  Once a state of shock begins, the chances of recovery for the patient are slight.  Even dogs that survive surgery and seem to be recovering often succumb to endotoxic shock hours and even days after the procedure.

When the stomach contents are emptied through the stomach incision, the stomach wall is finally sutured closed.  If a volvulus is present our surgeon will rotate the stomach (and spleen) back into the normal anatomical position.  Then the stomach tube is inserted through the mouth into the stomach and additional flushing and antibiotic administration is done.  Before closing the abdominal incision the surgeon usually will tack (affix with sutures) the stomach wall against the inner abdominal wall (actually just inside the rib area) to prevent future episodes of gastric dilatation/volvulus.  This tacking procedure is excellent insurance against a volvulus happening again.

WHAT CAN BE DONE TO PREVENT BLOAT?
The best suggestions are to feed the dog two small meals a day instead of one large meal.  Do not allow the dog to drink large quantities of water at one time... have water available at all times.  Do not allow exercise or other vigorous activity for at least two hours after a full meal.  Feed a diet composed of more meats and less grain.

Bladder stones in dogs present an interesting medical and surgical challenge.  One of the most often-encountered health problems of dogs and cats is urinary tract infections.  A fairly large percentage of these infections are caused by or complicated by bladder stones.  Any persistent bladder infection should be carefully screened for bladder stones and if present, bladder stone removal should be considered.

There are quite a number of possible factors that interact to allow for the formation of bladder stones.  One of the most favorable conditions for mineral formation is urine that is alkaline rather than acidic.  In fact, bacteria seem to grow better in alkaline urine, too.  (That's why drinking cranberry juice may benefit us humans in preventing infections in the bladder... the cranberry juice promotes a more acidic urine.)  As you can see in the photo and X-ray the stones are of various sizes.  If just the right (or wrong!) size stone passes from the bladder into the urethra leading outside the body, and becomes lodged... we've got an emergency situation immediately!  Any dog or cat with a urethral blockage needs emergency veterinary help right now.

In dogs and cats, grain-based diets contribute to alkaline urine; meat-based diets promote a more acid urine.  If a bacterial infection does occur the waste products of those bacteria promote an alkaline urine.  Plus the bacteria may provide a nice little solid object upon which dissolved minerals can precipitate (come out of a solution and become a solid).  Any patient who has had repeat urinary tract infections should always be evaluated for bladder stones.  Kidney stones, fortunately, happen far less often in dogs and cats than bladder stones; but the possibility of kidney stones should always be considered in urinary tract disease.  Certain types of urinary tract stones can be prevented by special dietary changes.  Genetic programming of kidney function and structure plays a role in the formation of bladder stones and certain breeds (Schnauzers, for example) often seem more predisposed to kidney and bladder trouble than some other breeds.  The Dalmatian has a unique physiology and displays a type of stone formation called Urate Stones.   Modern veterinary medicine can be of great assistance to dogs and cats that develop bladder stones.  Good diets and follow-up care can help our dog and cat friends survive and thrive.

Abscesses In Cats One of the most irritating and debilitating conditions that cats seem prone to are abscesses.  When cats are afflicted with an abscess they generally run a fever, quit eating, sleep more than usual (like 22 hours a day instead of the usual 21!) and may exhibit pain.  The sooner a treatment for a cat abscess is administered, the sooner the health of the cat can be restored.

Most often the abscess is a result of another cat's claw penetrating the victim's skin during a street fight over whose turf is whose.   Otherwise, any cat that has access to the outdoors probably has developed the fine art of eliminating rats, gophers and squirrels.  These little rodents will fight back, too!  If seized by the tail they will turn and defend themselves by sinking scalpel-like incisors anywhere on the cat that is accessible.  These tiny bite wounds often go undetected for days, hidden by the cats fur. Most of the time they probably heal with no difficulty... the owner and the cat hardly notice such trivial battle wounds.

However, if the bite wound is contaminated by the bacteria from the rodent's mouth or bacteria dragged in from the cat's skin, the result very well could be an abscess.  And cat's toenails are notorious instigators of infection.  Many kinds of bacteria can be cultured from the area of a cat's toenails.

So... just exactly what is an abscess?  
It is a collection of pus and inflammatory fluids that develop at an internal site for the purpose of counteracting a foreign substance.  That foreign substance could be a sliver of wood, a broken toenail, colonizing bacteria or even a chemical. (We've all heard of the "local reaction" that can happen after a vaccination.  These usually are a response by the body to the chemical material to which the vaccine particles are attached. 

When the body strikes a response to these various invaders, all sorts of chemical messages are sent throughout the body calling for reinforcements in the form of white blood cells and blood-borne proteins.  These defenders can themselves be a problem when they and their casualties build up but cannot be carried off the field of battle.  So they build-up into a big pool of ... well, of PUS!  The enemy may have been neutralized long ago but now the body has a different problem and that is getting rid of this enlarging pool of dead defenders that itself triggers more reinforcements.  A cycle develops until the pressure under the skin eventually disrupts the blood supply and erodes through the skin... the abscess ruptures to the outside and the pressure neutralizes and all those dead and rotting defenders exit to the outside world where the cat's body could care less what happens to them!

Once the cat abscess opens and the pus has a way to escape, the healing process can take over.  The purpose of intervening in a case of a cat abscess to to assist the cat in this process by facilitating the escape and cleaning up of all those dead and dying defenders, plus, often when the pus drains the offending instigator of this whole process gets swept right out of the cat with everything else!  Some gentle flushing of the wound cavity cleans things up quickly, a touch of antibiotic prevents the damaged tissues from being re invaded, and the painful pressure from the abscess is relieved

Anal Sac Removal Often called ANAL GLANDS or ANAL SACS, these mysterious little anatomical wonders are really sacs or pockets... not glands.  Dogs and cats have these little pockets situated deep under the skin just beneath the anal sphincter muscles encircling the anus.  They aren't of much use other than imparting a truly phenomenal odor when the semi-liquid contents are expelled, hopefully outdoors when the pet has a bowel movement.  If the anal sac contents are deposited somewhere in your house...you'll know.  These glands (sacs) are similar to the scent glands of a skunk and the odor can really pack a whollop.  Most dogs and cats never have any problem with the anal sacs unless they become infected or the small channel leading from the sac to the rim of the anus becomes obstructed.

The inner lining of the anal sacs are continually secreting a semi-liquid material; so if the duct that leads from the sac to the outside becomes obstructed or is naturally very narrow, the material continues to build up within the sac.  This increase of pressure causes the dog or cat to lick the area, or commonly we will see the pet scoot along the ground (carpet!). The dog or cat can feel the pressure within the anal sacs and it can become very uncomfortable.  Our veterinarians may have to manually express the anal sacs to relieve the pressure. Often, these sacs will become infected and even swell into an abscess.  These cases will need some surgery to drain the abscess. In chronic problems the anal sacs are surgically removed... often resulting in a happier existence for the pet and its owners.

A hematoma is any abnormal blood filled space.  An Aural Hematoma is a collection of blood under the skin of the ear flap of a dog or cat.  (The ear flap itself is called the Pinna.)  Ear hematoma occurs much more commonly in dogs than in cats; a hematoma generally is the result of trauma to the pinna from an injury or from the dog or cat scratching at the ear.  The itchy ear can result from ear mites, allergies, infections or foreign matter in the ear canal.  Frequent scratching at the ear, or even vigorous shaking of the head, can result in a rupture of small blood vessels beneath the skin of the pinna.  Since there is little strength or depth to the tissues of the pinna, clotting may be delayed... especially if the dog or cat continues to upset the clotting by additional self trauma.

The entire ear flap can become swollen, infected and severely uncomfortable to the dog.  Hematomas can heal themselves but will leave behind a scarred, crinkled and shrunken pinna. And since the original cause is usually an infected ear canal, the original cause needs to be treated as well as the hematoma itself.  Our veterinarians generally will recommend surgery to open and drain the hematoma and remove dead and degenerating clots and fibrin.  Then sutures are used to tack the skin layers over the thin cartilage center tight to the cartilage to eliminate any space for more blood or serum to accumulate.  Of course this is done only under general anesthesia, and antibiotics and anti-inflammatory medication is used post operatively.  

During the procedure both ear canals are examined and any treatment and cleaning is done.  The sutures are left in place for two weeks, minor cleaning is done at home using peroxide, and the patient is readmitted for a final inspection and suture removal.  As with many kinds of ear troubles in the canine (allergies, infections, wax build-up, mites, etc), diligent aftercare is necessary to keep scar tissue and long term pathology from occurring.

Soft tissue surgery on dogs and cats is a big part of the everyday activities at The Animal and Bird Hospital of Clearwater.  Spays and neuters, lump removals, wound repair, intra-abdominal exploratory surgery, procedures to prevent tomcats from suffering from a blocked urethra... all can provide a great degree of improved quality of life for our pets.  Even the lateral ear canal surgery (see the image below) which some veterinarians utilize commonly for relief of chronically infected ears has its place in providing comfort and improved health for dogs afflicted with reoccurring ear infections.

Modern anesthetic procedures allow for safer, faster, and less stressful anesthetic/surgical procedures.  Many patients will have soft tissue surgery done and will return home the same day.  Be sure to obtain complete post-operative care information whenever your dog or cat has a surgical procedure.  Home care is almost as important as what goes on in the animal hospital.  Even after major procedures such as for pyometra or tumor removal most dogs and cats will recover quickly and be nearly completely healed within a few weeks.  Return to active endeavors, though, should be carefully monitored under our veterinarian's instructions. 

Cherry Eye in the dog is a picturesque term for Everted Third Eyelid.  The Third Eyelid is also known as the Nictitating Membrane.  It serves as added protection for the eye through an interesting ability to close upward and over the dog's eyeball.  The canine is able to retract the entire eyeball backward into the eye socket, and coupled with this retraction is the Third Eyelid's ability to slide up and over the retracted globe. 

On the underside of the Third Eyelid is a small gland. It secretes about 30 percent of the eye's tear production.  Some surgeons prefer to preserve this gland at the time of surgery to correct Cherry Eye, with the thought in mind that if the other tear producing apparatus ever fail due to infection, trauma, or autoimmune disorders, the gland of the Third Eyelid will be of benefit to the eye.  

Once the tear production of an eye fails, a chronic dryness ensues and adversely impacts the health of the eye surfaces.  This "dry eye" is called Keratoconjunctivitis sicca (KCS). 

Keratoconjunctivitis sicca (KCS) or "dry eye" describes the changes in the eye which result from lack of tear production. To understand "dry eye" it is helpful to know how tears help keep the cornea healthy. The cornea is the optically clear portion of the eye that allows entry of light into the eye. Like all living tissue, the cornea requires a supply of oxygen and energy to remain healthy. Oxygen and nutrients are supplied to most tissues by the blood that moves through the area in blood vessels. The healthy cornea has no blood vessels, if it did it wouldn't be clear, so the oxygen and nutrients are supplied through the three-layered 'tear film.'

Another Technique To Correct CHERRY EYE SURGERY The “pocket technique” has been recognized as one of the more successful techniques to correct this condition. Since originally described, several additional steps have been suggested to improve surgical success. The basic steps of the surgery involve creating two parallel incisions on either side of the gland. These two incisions are then sutured together with 6-0 vicryl as the prolapsed gland is positioned ventrally. Care is taken to either bury the knots or suture them on the palpebral surface of the nictitans. Several surgeons have suggested adding a second layer of suture material over first to decrease tension on the incision. In addition, knots are suggested to be tied on the palpebral surface (pass the needle through the nictitans) of the nictitans to avoid corneal frictional irritation.

Fibrosarcomas in cats are fairly commonly observed in veterinary medicine and occur in humans as well.  As with many kinds of cancer, the reasons a fibrosarcoma develops, and the location where it develops, may be at best speculative.  We really do not have all the answers yet.  On occasion in veterinary medicine we observe vaccine induced cancer called fibrosarcoma.

In recent years the topic of vaccine induced fibrosarcomas in cats has been a serious concern of cat caretakers, veterinarians, and the pharmaceutical companies that make vaccines for cats.  Unquestionably, vaccinations have prevented uncountable deaths in dogs and cats through the years.  Just as in human medicine where such diseases as smallpox and polio are no longer health threats due to wide distribution and use of vaccines, so too in veterinary medicine have serious diseases been kept in check by intelligent use of animal vaccines.  

However, there can be a downside to the wonderful miracle of vaccines.  On occasion, and that occasion may be only a single adverse reaction in 50,000, there may be an undesirable outcome for the patient receiving the vaccination. 

One unique type of adverse reaction is seen in cats after having been vaccinated for certain feline diseases.  Adjuvants are often added to killed (inactivated) vaccines to enhance the immune response; a common adjuvant is aluminum salts and these aluminum deposits are often seen in the microscopic analysis (histopathology) of a section of the offending tumor.  There is speculation that adjuvants may be the inciting agents that stimulate a reaction at the vaccine site and which eventually leads to cancer formation.  All the facts are not known at this time and many researchers are currently working to find the answers to the vaccine induced sarcoma problem in cats.
  
Progress is being made, though, and scientists and veterinarians are beginning to understand the complex variables that factor into tumor formation at vaccine sites.  Some of those factors are location of vaccine administration, type of vaccine and adjuvant, frequency of vaccine deposition in a localized area of the cat, and the state of health of the cat at the time of the vaccination.  Hopefully, in the near future these variables will be understood and adverse vaccine reactions will no longer be a consideration when we attempt to protect our feline friends from some very real and dangerous diseases. 

Aortic thromboembolism in cats is truly a complex and life threatening issue.  The multiple potential causes for the formation of intravascular clots makes therapy decisions troublesome.  There are a number of medications that can be employed in attempts to make the patient comfortable and that may assist in keeping further clot formation from occurring.  The origin of the intravascular clots appears to be in the chambers of the left ventricle of the heart and is often associated with underlying heart disease.  Heart disease in cats can often go undetected until something such as a saddle thrombus occurs. 

The cause of aortic thromboembolism in the cat is thought to be due to slowly circulating blood in what is called the auricular appendage of the left atrium of the heart.  This blind end allows stasis of blood and eventual clot formation.  If a large clot dislodges it often will be trapped far down the aorta at the branching of the vessel into the femoral arteries.  The longer the thrombus obstructs the blood flow the more tissue damage occurs.  Immediate surgery may be very beneficial, as in the case presented here.  The longer the patient suffers with oxygen deprivation of the tissues nourished by the femoral arteries the less beneficial surgery becomes.  These clots may develop again in the future so most cats surviving an episode of Saddle Thrombus do best if placed on long term anticoagulation therapy.

NOTE:  Sometimes our veterinarians believe these patients, when presented, should be euthanized immediately to alleviate the cat's extreme panic and pain.  Furthermore, it is believed that the survival rate for these patients is very low and that surgery will be unsuccessful.  This approach may be indicated for cats that display a saddle thrombus signs for extended periods or where the patient is in poor physical condition from other pathology.