Queen street in Toronto

Queen street, one of the busiest east-west thoroughfares in Toronto, has only streetcars to transport commuters along this important commercial vein. Once called Lot street, Queen street runs approximately 16 km from end to end.
I take the Queen streetcar almost every single day and I tell you: it ain't fun. Because the street is so busy, it makes for a horrendous car trip. Because the streetcars are so nasty on Queen, those who can afford it choose to drive. A tad paradoxical? if there were a reasonably clean and efficient way to travel east-west, more people would leave the car at home, or give it up completely as I have. Of course, I have my regrets. I think it's about time the city bite its tongue and start digging (addendum: Forget Boston's "Big Dig") some new subway tunnels.

Toronto, time to get the shovels out again.

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Eating baseballs and such...

This week was tough. Good.... but tough. Saw a young American Bulldog - adorabale, but not the brightest bulb - that tore a baseball apart and swallowed it. This guy apparently eats whatever he can find. I took radiographs (x-rays) which were strongly suggestive of an obstruction, and the barium series confirmed it. The barium series was almost superfluous but I wanted to be near 100% CERTAIN that something was indeed there (a negative exploratory surgery IS STILL DIAGNOSTIC!). You can't always trust the history!
Barium is a contrast medium that is given by mouth and should normally pass from mouth to butt within a specific period of time. Radiographs are taken every half hour or so after the barium is administered. In cases of obstruction, the barium simply does not pass beyond the obstruction. In this case, the barium did not leave the stomach, even after one hour. This is not normal. I therefore had to open the dog up.

This radiograph demonstrates barium passing normally.

I found that a huge portion of the jejunum (part of the small intestine) was folded up like an accordion. This is classic for foreign bodies such as string and other linear things (rope, pantyhose, tinsel, etc.). I had to make three small incisions in the intestine to fully remove the obstruction, which was indeed the inside of a baseball. I examined the rest of the gut and lo and behold: there was more in the stomach. I had to make an incision in the stomach as well and successfully took out the rest of the shredded ball. The surgery took about two and a half hours. Ten days post-op and he's doing great, though still trying to suck up anything he can get his jaws on.

My patient
after
sur-
gery.

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Who's missing in this equation?

(Image taken from Haaretz.com)
Peace in the middle east seems almost tangible while viewing this photo. Remember, though, that Hamas plays a vital role in the outcome of this process. The onus rests on Hamas and their recognition of Israel's right to exist. When the fighting ceased between Israel and the Palestinians, it was the two Palestinian factions who took up arms against each other. These actions speak volumes.

Not the belts typically associated with Hamas and Hezbollah.

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Cycling in the winter

Many of you in the warmer parts of the world don't have to deal with cycling in sub-zero temperatures. Not only is cycling dangerous in Toronto in the best of conditions, but many granola crunchers find it necessary to ride their bikes when it's minus 20 C outside (I can't even fathom what the cold must feel like against your face). The roads are full of ice and snow, the streetcars and traffic preclude clear thoroughfares, and the drivers are nuts to begin with. If you ride your bike in the winter and this happens to you:






... then you deserve it.

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Worn and haggard

Do people nowadays not give a damn about what they look like? People used to go out, manifesting a certain aesthetic, now rarely seen. It astounds me how revolting people dress in downtown Toronto, especially witnessed (almost invariably) on the streetcar. How much do people really hate themselves? How much do people respect themselves, and others? Where's their dignity? Hanging out of that tube top? In those purple sweat pants? In that cowboy hat and poncho?

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Having four hospitalized patients over the weekend is rare. Four cats: two icteric (jaundiced, see my very first post) and two obstructed (urinary).
Jaundice is not a disease, but rather a symptom of disease. Almost invariably caused by liver disease - all sorts of liver disease - but a patient can also become jaundiced from pancreatitis (inflammation of the pancreas) or when red blood cells are destroyed by the immune system (called immune-mediated hemolytic anemia).

The obstruction in two of the cats were urinary in nature. Typically, in cases of urinary obstruction, crystals or actual stones (called urolithes) block the urethra and prevent a cat from urinating. It can be partial or complete. Imagine not being able to pee. Typically male cats are affected because, just like men, the urethra is longer and thinner and therefore easier to get blocked. Feeding a cat a high-quality, low-ash diet can prevent crystals from forming.
One of the jaundiced cats is not doing well but the other three will far likely recover.

This is a radiograph of a cat with a moderately distended bladder from urinary obstruction.

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Ok, this isn't me

I just thought I would post a photo of me after taking the streetcar car today.


(It's Gene Wilder from 'Young Frankenstein.' Hysterical.)

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Freezing outside

Waiting for the streetcar in this weather is not fun. I almost froze in my tracks walking to the streetcar stop. It feels like -22 Celcius, which is -7 F for those south of this frozen border. It may actually be warmer on the surface of Uranus.



This poor man is waiting in hospital after being found outside on a park bench. Note Sheriff's office next to hospital waiting room.

Most dogs and cats do not fare well for long periods of time in sub-zero temperatures. While I think most of the doggy clothing industry is pretty much nauseating and useless, some winter-wear is appropriate. Dogs wearing boots and coats will be more comfortable for longer periods of time in freezing weather, especially the thinner breeds like greyhounds and their ilk.
Take your dog in from the outdoors right away if you notice any head shaking, lifting of one or more paws, lameness/limping, or inactivity. If you tie your dog up outside in the cold, you should try switching places with your pet one day and see how comfortable it is. Again, some breeds tolerate the cold much better than others, especially the northern ones.




I think I'm going to &%$#*&! puke.

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What's a Catahoula?

It's a breed of dog. It's actually called a Louisiana Catahoula Leopard dog: Here's a photo:


Obviously not the same individual as in my first post (dog with prostatitis and pyelonephritis) but the same breed.
Well, the same guy as in my first post came in with a massive, painful swelling that had come up over about 3 days, located under and lateral to the left eye.
Opened his mouth and there it was: a draining tract just over the large, 4th premolar (carnassial tooth, 3-rooted tooth in the dog and cat).
Diagnosis = tooth root abscess. For similar case, see previous post with dental radiograph. Same diagnosis, different tooth.
For all you vets and non-vets out there: if you can't find the infection, look in the mouth!
For more info on the Catahoula: http://www.catahoulas.org/catahoula.htm

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