Surgical removal of the luxated lens including the capsule (intracapsular lens extraction) in a bear

Belica_surgery118Dr Maria Savova

Veterinary Clinic NOVA

Sofia, Bulgaria

 

Violeta is a 37y.old brown bear form Belitsa Dancing bears park, Bulgaria.

She was suddenly blinded and had an urgent eye check.The ophthalmological examination revealed increased pressure (40mmHg) and displaced lens in the left eye.The cornea was mildly opaque and the lens was with senile cataract. No PLR. The retina was also degenerated resulting in marked tapetal hyper reflexivity.Belica_surgery30 Belica_surgery40

Lens subluxation (posterior) is partial detachment of the lens form the ciliary body, due to breakdown or weakness of the zonules.

We preformed surgical removal of the luxated lens including the capsule (intracapsular lens extraction).

In the “open sky” approach, the superior cornea was incised 120 – 160 degrees using a cornea knife. The lens and its capsule were removed together in one piece through the incision.Belica_surgery93 Belica_surgery100 Belica_surgery110

Hydrodissection was employed for the removal of lens. We left the eye without artificial lens (aphakic).

During the removal of the lens, prolapsed vitreous was determined and we removed it with scissors in the anterior chamber.

Following the irrigation of the anterior chamber, corneal incisions were closed by separate sutures using 8/0 polyglactine.

For the postoperative care, we applied systemic antibiotics for the first five days.Belica_surgery121 Belica_surgery126

7 days after surgery, the eye is calm; there is no secretion or swelling.

 

Now the bear is in preparation for hibernation and her eye will be examined in the spring.

Meningocele and meningoencephalocele in a dog

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Dr Svetoslav Penchev

United Veterinary Clinic

Varna, Bulgaria

 

8 mounts ,female dog with congenital meningocele and hydrocephalus . The dog is with normal behavior and without neurological deficits.1113

Meningocele and meningoencephalocele of the skull are congenital deformities. These deformities, which are observed as cyst-like swellings in the median part of the skull cap, occur very rarely. The intracranial material protrudes through a spontaneous cavity, such as the anterior fontanelle , and they are classified as encephalocele, meningocele, or meningoencephalocele according to the cranial bifida.111 1122

LEARN AND TRAVEL…..New story!

44621748_2183879854956768_4110182779130478592_nDr Jelena Micic has done he externship in Central Vet Clinic in Sofia Bulgaria. Let her share with us:

“Thanks to Vets on the Balkans and Luba Gancheva, I had a chance to spend time from 14th do 22nd October this year at a great Central Veterinary Clinic in Sofia, Bulgaria.

The clinic is amazing, with everything that you think you might need for veterinary medicine. Great place, which has stationary, x-ray, two amazing ultrasound machines, great laboratory, operating rooms, 24h service etc. and above all, experts in all fields of veterinary medicine, team that is not only made of great doctors but great people. First of all, I would like to thanks Dr Ranko Georgiev, who is amazing cardiologist with huge experience and unselfish of giving his knowledge to others. Open to all my questions and willing to answer all of them and explain everything from echocardiography, cardiology, x-ray and also abdominal ultrasound. As I started to write about cardiology, I had chance to meet Dr Marin Buchkov, a young doctor, who works alongside Dr Georgiev and probably is a future of Bulgarian cardiology. Now, about abdominal ultrasound that I am professionally interested in, I have to thanks Dr Miroslav Genov, expert in reproduction and Dr Kaloyan Voichev, who had patience for all of my questions and luckily I will attend at least one of his ultrasound workshops in the future. 44702825_443237652867945_6189133321910353920_n

Also, I saw some interesting cases in ophthalmology thanks to Dr Janica Dencheva. Interesting part of my externship was meeting Dr Gergana Georgieva and Dr Melinda De Mul, who are interested in exotic animals. Even I don’t have so much contact with these kind of pets, they explained me a lot of cases and give chance to see, for example, an ultrasound exams and x-rays of exotic. Also I had chance to see and learn from Dr Yordan Stoyanov, Dr Nadia Mihalopoulou and Dr Yordan Yordanov. Special thanks to (of course also great doctors) Dr Tome Peychinovski, dermatologist and ultrasonographer and Dr Iva Dimitrievska, who spend her free day for tour of Sofia with me , and gave me that privilege to meet their family and spend the beautiful day with them. 44797808_534785090279383_5473703989302263808_n

There wasn’t just work. We also spend very pleasant night out with delicious food, drink and talks, speaking in Bulgarian, Macedonian, Serbian and English. Contacts that I made during this stay at the clinic are, hopefully, something that will last for a long time. I was really lucky to have opportunity for this externship, thanks once again to Dr Luba Gancheva and great invention, Vets on the Balkans.”24246_103549239687374_288378_nlearn and travel

LEARN AND TRAVEL- Bulgarian vet in Belgium

Presentation3 Dr Anna Mircheva from United Veterinary Clinic has done her externship in Belgium with Dr Ann Criel.

She is telling us more about it:

“I had the great opportunity to spent the last week of September at Dierenartsen praktijk in Kermt, Belgium with the amazing Dr Ann Criel and her team.

The clinic is well structured and very good equipped. From the beginning I was greeted with smiles, open hearts and good clinical discussions.

Every morning began with some good coffee, discussion of the daily schedule and treatment of the hospitalized animals. Then we continued with the assigned operations and examinations.

Due to my interest of soft tissue surgery Dr Ann invite me in the operation room and I assist her from the first to the last operation. Without hesitation she answered to all of my questions, she explains every step of the operations, and she allowed me to do a lot of things by myself. She is the kind of doctor that you can learn a lot from, because she has the experience and the patience.Presentation2

Almost every day we had some great lunches – with Dr Ann’s family, team members and friends. I tried some delicious Belgian dishes in the company of amazing people.  Everyone that I met was really nice, smiling and intelligent – it was a pleasure to met all of them.

Presentation1

I want to thank Dr Ann because she opened her practice, her home and heart for me. Thanks to her team and family and of course one big Thank you to Vets on the Balkans- it was an amazing week.

Vets on The Balkans express our gratitude to our sponsor of the program for Bulgaria BLUE SKY COMMERCE! All is possible because of them.23316272_180060419216123_164154967085808895_n

OSTEOCHONDROSARCOMA- SURGERY

43715598_336141656947602_6782174039545741312_n(CASE REPORT)

DR LUCIAN FODOR HAPPY PET TIMISOARA-ROMANIA

Introduction:

Osteochondrosarcoma is an uncommon tumor that generally arises from the skulls of dogs (cranium, orbit, zygomatic arch, mandible, and maxilla) and can occasionally arise from the pelvis, ribs, and os penis. These tumors have a characteristic appearance on radiographs, CT, and MRI: generally the borders of the tumor are sharply demarcated with limited lysis of the adjacent bone, with a coarse granular density throughout. A popcorn-like appearance with stippled and heavily calcified or ossified regions has been described on survey radiographs.

Clinical signs are generally based on location and extent of the lesion; ranging from a palpable, fixed, and firm mass to pain on mouth opening for tumors involving the mandible and zygomatic arch, exophthalmos with infraorbital lesions, and neurologic abnormalities for tumors involving the cranium.

43950478_167475047490012_2226512029793910784_n

Fig 2

43514688_913495158846702_418217810473254912_n

Fig 1

43734015_173106753553540_5169187062804381696_n

Fig 3

Cara, a one year unsterilized mallinois female bitch, from the age of 7 months beggin to develop in the fronto-parietal region a globular formation(fig.1-2-3)

 

.She came to our unity with neurological manifestations, ataxia, deviation, refusal to rise from the bottom, bilateral midriasis.

Blood analyzes where in optimal parameters. After performing the CT, a giant extra and intra-cerebral form was noticed, being the imaging feature of the osteocondrosarcoma. (Fig.4-5)

43759528_484990658670865_14835555774758912_n

Fig 4

43788744_241906113168260_7429289207186587648_n

Fig 5

After consulting with the owner we decided surgery.

It was performed a large, circular craniotomy with a safety margin of one cm. The formation did not adhere to dura mater, only compressing the brain. (Fig. 6-7-8-9)43828104_267060260621234_1089416852607598592_n 43727747_1873646689408833_5453387625761079296_n

T43828915_108324666763855_6959109323293196288_n 43750703_2206611569596014_4590836245717843968_nhe bone reconstruction was accomplished with Collapat, a substrate of bone based on hydroxyapatite and collagen. (Fig.10)

Concluzion:

Post operator evolution was good, 48 hours after the surgery the patient was recovered neurologically(Fig11). At six (Fig12)and 12 months post surgery,(Fig.13) Cara feels good, fully recovered.

 

 

WSAVA Targets Welfare with Release of First Global Guidelines for Companion Animal Practitioners

AW GuidelinesThe World Small Animal Veterinary Association (WSAVA) has highlighted the key role of veterinarians as advocates for animal welfare with the launch of its Animal Welfare Global Guidelines for Companion Animal Practitioners and the Veterinary Team.

The Guidelines, launched during WSAVA World Congress 2018 in Singapore, aim to bridge differing perceptions of welfare around the world and help veterinarians to tackle the ethical questions and moral issues which impact welfare. They also offer guidance to ensure that, in addition to providing physical health advice and therapy to their patients, veterinarians can advocate for their psychological, social and environmental wellbeing. The WSAVA already offers Global Guidelines in key areas of veterinary practice, including pain management, vaccination, nutrition and dentistry.

shane ryanDr Shane Ryan, incoming President of the WSAVA and former Chair of the WSAVA Animal Wellness and Welfare Committee, said: “As veterinarians, our responsibility extends far beyond the physical health of our patients. Animal welfare as a science is a new and rapidly developing discipline and veterinarians need current, evidence-based information to enable them to maintain the highest welfare standards and to provide knowledgeable, accurate advice for pet owners and communities.

“Our new Guidelines provide recommendations, checklists and other tools to promote optimal levels of welfare throughout the veterinary visit. They also offer guidance on increasing welfare beyond the doors of the clinic through outreach activities.”

He continued: “As levels of pet ownership increase in many regions of the world, including Asia, it is essential that veterinarians champion animal welfare and the WSAVA hopes that these new Guidelines will encourage our members to adopt best practice and set the highest standards.

“I would like to thank the members of the Animal Welfare Guidelines team, who worked so hard to create them and, of course, our sponsor, Waltham®, whose constant support was instrumental in enabling us to deliver them.”

The WSAVA has called on its members to develop an animal welfare charter for their members and to adopt the Guidelines into daily practice. 32 WSAVA member associations have already endorsed the Guidelines with more expected to follow shortly.  During 2018-19, the WSAVA will develop relevant continuing education (CE) and provide additional tools and translations of the Guidelines text.

The Animal Welfare Global Guidelines for Companion Animal Practitioners and the Veterinary Team are available for free download at: https://bit.ly/2D3RAoc

The WSAVA aims to advance the health and welfare of companion animals worldwide through creating an educated, committed and collaborative global community of veterinary peers.  It represents more than 200,000 veterinarians through 110 member associations.

 

WSAVA World Congress 2018 is being attended by more than 3,000 veterinarians from around the world and brings together globally respected experts to offer cutting edge thinking on all aspects of companion animal veterinary care.  WSAVA World Congress 2019 takes place in Toronto, Canada, from 16-19 July.

WSAVA Vaccination Guidelines Group Project Continues in Latin America

logo-white-backgroundArtboard-1The World Small Animal Veterinary Association (WSAVA) Vaccination Guidelines Group (VGG) has held a series of meetings and continuing education (CE) sessions in Mexico.  It was the final country visit in its three-year project aimed at enhancing levels of understanding of infectious diseases across Latin America and advising veterinarians on ‘best practice’ in vaccination.

PNCQE5648

Members of the VGG at one of the small group meetings in Mexico. Left to right: Dr Richard Squires (James Cook University, Australia), Dr Cynda Crawford (University of Florida, USA), Emeritus Professor Michael Day (Chairman, UK) and Dr Mary Marcondes (São Paulo State University, Brazil).

The VGG visit to Mexico took place during August 2018 and included meetings in Mexico City, Guadalajara and Monterrey. Committee members, including VGG Chairman, Emeritus Professor Michael Day, met with veterinary association leaders, academics, first-opinion practitioners and government regulators. They also made site visits to practices in all three cities. To support veterinary education, they delivered three evening CE sessions. The CE session in Mexico City was also live-streamed and made available to registrants for 30 days after the presentation. Altogether, over 2,000 veterinarians were reached by the live or on-line programme.

 

In advance of the visit, the VGG circulated an online questionnaire to collect data on veterinary demographics, infectious disease occurrence and vaccination protocols.  The survey was completed by 552 veterinarians with the data presented during the CE events.

 

The VGG develops globally relevant recommendations for best practice in the vaccination of dogs and cats.  It has also created the World Small Animal Veterinary Association (WSAVA) Global Vaccination Guidelines, the latest version of which was released early in 2016.  WSAVA Global Guidelines aim to support veterinarians by setting minimum standards for care and recommending best practice in key areas of veterinary medicine.

 

The WSAVA represents more than 200,000 veterinarians worldwide through 104 member associations and is focused on enhancing the clinical care of companion animals.

 

Commenting on the visit, Emeritus Professor Day said: “The VGG was delighted with the success of this visit to Mexico; a country with an estimated 45,000 veterinarians with students graduating from approximately 45 public and private veterinary schools.”

 

“Mexican veterinarians are accustomed to the principle of annual revaccination of dogs and cats with multicomponent products, but those we spoke to were excited by the new concepts of less frequent and individualized vaccination, incorporated into a preventive healthcare package for pets. Vaccine-preventable infectious diseases such as canine distemper and parvovirus infections, remain highly prevalent in Mexico.  Increasing herd immunity by improving vaccination coverage is clearly an important goal for the Mexican veterinary community.”

 

He added: “We are pleased to acknowledge the financial and logistical support provided by MSD Animal Health for the work of the VGG and for this visit in particular. Colleagues from MSD worked tirelessly behind the scenes to ensure that our independent scientific programme ran faultlessly in Mexico.”

 

The VGG ran a similar programme of activity in Argentina (2016) and Brazil (2017) and, during 2019, a final white paper on the findings of the Latin America project will be prepared for publication.

 

Craniomandibular osteopathy in a young dog

421347_10151629937179640_1038846606_nDr Miroslav Todorov

Blue Cross Veterinary Hospital

Sofia, Bulgaria

Case report

40542605_382709382264902_1711454165768601600_nCraniomandibular osteopathy in a young Labrador retriever.

A 4 months old Labrador retriever was presented at the BlueCross Veterinary Hospital in Sofia, Bulgaria, with the owner complaining about painful episodes after touching the head of the animal.

Clinical examination: the dog is in a good clinical stage, no pathological heart or lung sounds.

The temperature was 39,5 C. No abdominal pain or other abnormalities.

The palpation of the skull was painful for the dog, there was slight dome shape of the cranium. The masseter muscles were atrophied. After palpation of the mandibula it was noted that the lower jaw of this dog looked enlarged. Pic 1

Considering the age, breed and the affection of the specific bones, the following list of differential diagnosis was made:

  1. Craniomandibular osteopathy
  2. Osteomyelitis
  3. Calvarial Hyperosthosis
  4. Neoplasia

We took a blood sample for CBC and biochemistry analysis.

On the CBC there was a slight decrease of the RBC – 5,36 (5.5- 8.5 x10/12/L) but this could be normal for younger animals.

On the biochemistry there was a slight decrease of the Total protein – 49 (51- 78) g/L and Albumin – 20(26- 41) g/L. Everything else was WNL.

The patient was sent for CT of the head to search for additional characteristics of the bones of the head and confirm my suspicion about the disease. We put an injection of NSAID for the pain until the test was done.

On the CT we discovered symmetrical bone proliferation of the rami of the mandubule and bone thickening of the calvarium of the animal. No underlying bone lysis was noted. Fortunately, till this moment affection of the temporomandibular joints was not discovered, but it is possible that this could happen during the next months.40574303_322560345178752_5208200230733873152_n 40589358_286835962116167_5128061020073361408_n 40589364_655681474803526_9092529697882898432_n 40623237_513632389060326_2736220804109828096_n 40764141_2203859333191397_5014338687031312384_n

There were not clear signs of neoplastic process or osteomyelitis. As a result, considering the information that we had, a diagnosis of craniomandibular osteopathy was made.

Craniomandibular osteopathy is a non neoplastic proliferative bone disease affecting immature dogs.

Usually the clinical signs start between 3 and 8 months of age. Common clinical presentation is pain episodes, fever, trouble chewing food, drooling and in more advanced cases – inability to open the mouth and eat. The etiology of this disease is unknown.40530022_1906226039680267_8977683290295107584_n

The first written description of CMO appeared in 1958.(9) It was described in five West Highland white terriers affected within a 2-year period. The most common breeds that are affected are West Highland white Terrier, Scottish Terrier, Cairn Terrier. The disease is described in other breeds – in Labradors, Boxers, Great Dane and a few more.

It is believed that this could be an inherited disease (autosomal recessive inheritance pattern) and as such it is advised for such animals to be neutered.

Commonly the affected dogs have bilaterally symmetrical enlarged mandibles and tympanic bulles, and affection of other bones of the calvarium. In severe cases those structures could fuse and this will lead to decreased range of motion of the temporomandibular joint. On examination, the temporal and masseter muscles may be atrophied.

In advanced cases, the diagnosis of craniomandibular osteopathy can be done with good positioned x-rays of the head of the animal. The advance imaging techniques, such as CT or MRI, improve the visualization and confirm the extension of the process.

On x- ray or CT increased irregular bone density is commonly observed –  symmetrical periosteal proliferation, in most of the cases primary affection of the mandibules- 84%; tymplanic bulles – 51% and in some of the cases bones of the calvarium -13%.

The treatment plan is symptomatic with painkillers and anti-inflammatory drugs – commonly used drugs are NSAID and Steoids. Such drugs are needed during pain episodes and fever. Placement of an esophagostomy or gastrostomy feeding tube may be considered in patients that have difficulty eating and their nutritional requirements are not being met. Soft or liquefied food may be easier for some patients to eat. A high protein, high caloric food should be offered in order to meet nutritional needs.

Surgery of the bone proliferated tissues is not helpful in those cases.

The prognosis for these patients depends of the extent of progression of the disease. In those cases where a severe bone proliferation develops, the result is fusion of the temporomandibular joint and the prognosis is poor. Most of those dogs are euthanized because of the extent of the disease. It has been a common observation that when the affected dog is approximately 11 to 13 months of age, the disease may become self-limiting. The growth of abnormal bone slows, often regresses, and sometimes recedes completely. This period of self-limitation coincides with the time of completion of regular endochondral bone growth and ossification.

Our patient felt great after one injection of meloxicam. He is feeling active and has no signs of pain and temperature. Unfortunately, we cannot say whether his condition will progress to the extent to affect the temporomandibular joints and lead to inability to open its mouth.

The owner will return the dog to the breeder. It was advised to watch the dog for any additional signs and painkillers were prescribed.

FIRST REPORTED CASE OF SYMPTOMATIC DIROFILARIA IMMITIS INFECTION IN A HOUSOLED DOMESTIC FERRET (MUSTELA PUTORIUS FURO) IN BULGARIA.

32480642_1950070525005966_7673581144482250752_nMihaylova L. DVM1.

1Veterinary surgeon in United Veterinary Clinic Bulgaria Varna 9000,

email: lillyvet@gmail.com

Heartworm disease in dogs and cats is well known in many European countries including Bulgaria. There are furthermore studies confirming dirofilariosis in wild foxes and Canis aureus i reports about heartworm disease in domestic ferrets in our country.

History

A 5 year old male, entire, pet ferret (Mustela putorius furo), weight 0,9 Kg was presented with labored abdominal breathing. The owner reported reduced appetite, difficulty breathing and restlessness. The ferret was not able to sleep or lie down for more than few minutes.  The ferret was used to live mainly indoor and allowed during the summer to be outside in the garden, for just few hours during the day, to be exposed to natural sunlight.

Clinical presentation and collateral exams

On presentation ferret was lethargic with abdominal breathing and breathing rate up to 90/minute. There was clear subcutaneous edema more prominent on the front and hind legs and ventral part of the abdomen. Mucous membranes were pale, while CRT was not possible to be assessed. Heart rate ranged in between 120-180 bpm. Pulses were weak even if assessing on the femoral artery was difficult due to the subcutaneous edema. Abdominal palpation was unremarkable, lymph nodes were normal in size. Thoracic radiograph showed loss of detail into thoracic cavity consistent with pleural effusion. Thoracic US was performed confirming pleural effusion and one hundred and twenty ml of modified transudate was drained. Brief screening echocardiography showed normal left atrium and left ventricle and severely dilated right atrium containing double line hyperechoic objects suggesting the presence of few adult Heartworms. (Fig 1). Right atrium was larger than left atrium. Doppler study and any further detailed investigation of the heart were not possible to be performed due the fact ferret became aggressive and owner declined any sedation or anesthesia. Snap® HTWM Antigen test (Idexx) on blood yielded negative result and at fresh blood smear examination no microfilariae were possible to be identified.  Knott test was not possible to be performed due to limited amount of sampled blood.

Diagnosis

On the basis of echocardiography findings diagnosis of HW disease was done.  Negative HW antigen test was assumed to be due probably due to juvenile D.immitis worms and right atrium localization to the small size of pulmonary arteries as described in cats and ferrets.

Therapy and Follow up

The ferret was treated with Advocate® spot on >4kg (half tube), Furosemide 2mg/kg twice a day and Prednisolone 1mg/kg daily both of them orally. The ferret was stable on that therapy. He was eating and drinking well regain the normal body weight 1.5 kg. no breathing difficulties were reported. He was rechecked 35 days after initial presentation. Echocardiography showed right mildly dilated atrium but no presence of HW (Fig 2). Only 10 ml of fluid was drained from the thoracic cavity. From that time he was stable with no owners complain for 6 month. Suddenly he developed respiratory distress and on presentation was with cyanotic membrane. Pulmonary thromboembolism connects to HW disease was suspected Owner elected euthanasia and no more investigations. Necropsy was declined.

Comments

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This case shows the in endemic area even indoor domestic ferrets may be infected by Dirofilaria immitis. and that the disease is difficult to be diagnosed and can lead to death. Suspicion about this problem and monthly chemoprophylaxis should be warranted in this situation as in dogs and cats.

Ilinca Zarinschi, our tech vet, and Learn and Travel with Vets on The Balkans

38912475_442896726119256_1830507085800931328_nIlinca Zarinschi, a tech vet from Cluj, Romania has done her externship at Clinica Veterinara Lago Maggiore, Italy with Dr Luca Formaggini and his amazing team. She will tell us more about this experience:

 

“How it all started
I had the pleasure to meet Dr. Luba Gancheva for the first time at the Feline Medicine Congress in Bucharest, talking about her amazing project, Vets on the Balkans. I was so impressed I decided to approach her and find out more.
She explained to me that, as veterinary technician, I could improve my knowledge and skills by signing up for her amazing programme and she thought the best option for me might be Clinica Veterinara Lago Maggiore from Dormeletto, Italy.
So, two months later, I was finding myself flying over the Italian Alps not knowing what to expect from this new adventure.

39008939_498327340608678_2724608909053526016_nGetting there
I took off from Cluj-Napoca, Romania on the 1st of August.
After a long flight and many delays, I landed on Malpensa Airport. Alberto, one of the nicest vet techs I’ve ever met, was waiting for me. He drove me to the Clinic and then to the Crazy Pub where Dr. Luca, Dr. Sara, Dr. Marta and Dr. Giulia and Dr. Cecilia were waiting for me, with arms wide open. It was such a lovely evening, I could hardly wait for the next day to start!

38997000_1870135039950117_1318943628642484224_nThe clinic and the team
My first impression was that the clinic is well equipped and highly organized. Everyone was really eager to explain and share their knowledge with me, even though there were certain subjects I was not familiar with (like operating the Radiology and CT units).
I was very impressed with the surgical ward, Dr. Luca being one of those doctors that you can learn a lot from, having both the patience and experience to share from.
One thing that I am very grateful for is that they taught me how to preform and epidural, something I don’t get to do everyday.
We had various discussions about protocols regarding anaesthesia, vaccinations, post-op therapy and I learned a lot of useful information, which I already passed on to my colleagues.

38750936_433439873818272_1938692870990987264_nA little piece of Italian heaven

During the 12 days I was there, I got the chance to experience a bit of the Italian lifestyle, I travelled to Milan and explored the surrounding area. I fell in love with Italian cuisine and warm summer nights spent with the girls, we shared stories and experiences and the most important part, I got the chance of rediscovering myself and what I was capable of.
Saying goodbye
I was really sad I had to leave, it was the best experience I’ve had abroad, I would love to be able to go back one day and I highly recommend it to everyone who is willing to broaden their horizons.
A big special THANK YOU from the bottom of my heart to Luba, who encourages and empowers me everyday, to Dr. Luca and his lovely, amazing team, to Giulia – who is also the best room-mate that anyone could want , to Marta, Sara, Mariangela, Cecilia, Anna, Chiara, and Alberto (Nayra and Nina too). And a big thanks to Pamas Trading, for making this happen, of course. 12814393_1673705086236432_1339900710371625092_n
Also, I would love to remind you, guys, again, that we have better cannulas but you have prettier pink alcohol, haha.
My best regards and warmest hugs,

Ilinca, “the hybrid” vet tech

39017847_235779323940471_323580860395683840_n 39020903_1823190841099828_7740281119005736960_n 39095656_505572619865056_8953206293150040064_n 39096436_1326484624154769_2308858991083520000_n