Sharing is Caring ?

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Dr Ates Barut with 3 beautiful romanian vets in Petcode Veterinary Clinic

What means the words “work ethic “?
I am sure, everyone has different answer. It depends, first you are employee or manager or owner of veterinary clinic.
If you are employee, for sure, you think about your relationship with your colleagues in the clinic, where you are working. May be you have “problems” with some of them. But it is so normal. Veterinarians on the Balkans, and not only, work a lot of hours. When we spend a lot of time with someone is so normal to have different points of view, because we are different people and we cannot be the same.
If you are manager or owner of veterinary clinic, you think about you colleagues, who are owners as well and they are your “competition”. It is again the same situation- “different people, different concepts”.
Veterinarians are more passionate, more ambitious, more powerful part of the humanity. Sometimes they are so purposeful in this, to be the most professional, to be the best. And we all forget that we all are at first people. We all have our own battles, our own fears, emotions problems, which are outside veterinary world. So, we all go to work every day with our “luggage”.12794640_1670287506578190_2957541388445004614_n1936380_1670287533244854_3334487040095222071_n
If we try to see with “the eyes” of the other, if we help and support each other , we all will live in better veterinary world.

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Dr Robert Carst with the brilliant team of Blue Cross Veterinary Clinic

We are really proud and happy to announce that it happens on the Balkans. Dr Anca Cucos, Dr Bianca Bofan and Dr Gina Girdan, all of them PhD students in Veterinary Faculty in Bucharest, Romania, they are doing their internship at PetCode Veterinary Clinic in Ankara, Turkey. We would like to express our gratitude to the owner and main veterinarian Dr Ates Barut for the hospitability and for his “sharing” of knowledge and experience. Other veterinarian from Bucharest, Romania , Dr Robert Carst from Speedvet Veterinary Clinic starts his internship of Orthopaedy in Blue Cross Veterinary Clinic in Sofia, Bulgaria. We would like to express our gratitude to the owner Dr Borislav Georgiev and the whole brilliant team for everything!
You guys show us what means the words “SHARING IS CARING”
Lets be better people!

Treatment of uterine leiomyoma , Case report

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Dr Miroslav Todorov Blue Cross Small Animal Veterinary Clinic , Sofia, Bulgaria

Uterine tumors consist of 0.3 to 0.4% of all canine tumors. Leiomyomas and leiomyosarcomas are the most common, accounting for approximately 90% and 10%  respectively. These are tumors which arise from smooth muscle cells. The gastrointestinal tract is most commonly affected, but these tumors could affect also the genitourinary tract, the spleen, the liver and the subcutaneous tissue.

The etiology of uterine tumors is still unknown. Mutations of the fibroid-type mediator subcomplex 12 gene (MED12) have been found in a few canine genital leiomyomas but the role of these mutations in uterine tumors is unknown. Canine uterine leiomyomas may be hormone-dependent, as this appears true in humans and in the case of canine vaginal/vulvar leiomyomas.

Uterine tumors can be clinically silent for a long period of time. Intact females may exhibit abnormal estrous cycles, with or without vaginal discharge. Dogs with uterine neoplasia may be infertile. Stranguria, dysuria and or constipation may occur secondary to physical obstruction by the mass. Abdominal distention, with or without a palpable abdominal mass, may be detected. Nonspecific signs of anorexia, lethargy, depression, weight loss, polydipsia, polyuria and vomiting may also be present. Some of these signs may be related to concurrent pyometra within the abnormal uterus.

Paraneoplastic syndromes associated with these tumors (more often with gastrointestinal location) are hypoglycaemia, diabetes incipidus and secondary erthyrocytosis.

Case history:

A  6 year old huskey, female intact was presented with complaints that it hasn’t been able to defecate normally for about a week. The dog was anorexic and during the last 2 days it started vomiting.

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Blood test

Clinical examination: The dog was in a depressive state, with normal temperature – 38,6˚C. The dog felt discomfort after abdominal palpation. The heart and lung sounds were normal. After examination of the genital area pale secretions from the vulva were discovered.

We took blood for blood count, biochemistry analysis and heartworm testing. The results on the blood count were WNL. From the biochemistry there were only increased numbers of ALAT – 116,9(5 – 60) IU and ASAT – 244.8 (5 – 55)IU. (fig.1) Heartworm – negative.

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x-ray

An X-ray of the dog’s abdomen was taken and a large mass located at the caudal part of the abdomen was discovered(fig.). This mass was compressing the urinary bladder, and the small and large intestines. The rectum was empty. After that we did an ultrasound of the abdomen and we found that this is a solitary mass, with hyperechoic density. Before going to surgery we took another X-ray of the thorax – everything was normal.

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Fig .3

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Fig. 4

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Fig.6

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Fig 7

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Fig. 5

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Fig.8

The dog was put under general anaesthesia and diagnostic medial laparotomy was performed. A large mass, coming from the uterine cervical area, was discovered. This mass was connected with the rectum and the urinary bladder (fig.3;4)The surgery from the begging started as normal ovariohysterectomy. The two ovaries were visualised and a ligature was placed on around the suspensory ligament and the vessels of the ovaries within the broad ligament and after that the uterus was separated from the mesometrium. When we reached the mass, we started to bluntly dissect the mass from the urinary bladder and the rectum. We managed to remove the mass from the rectum without complications. We separated the urinary bladder and about 3 cm of the urethra (fig.5). We did one linear cut of the proximal part of the mass – about 1-1,5 cm away from the urethra. This was tissue that was covering the tumor and when we opened a hole in it the neoplastic lesion was accessible for removal (fig.6). Slowly we separated the tumor from the rest of the tissues and we put a circular suture around the remnant vaginal tissue.Additionally we put several simple interrupted sutures of the same structures and at the end we managed to close the defect (fig.7 and 8).

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Fig. 9

After that the area was cleaned with saline and the surgery was finished in a standard way.

 

 

The removed mass was with size 27/14 cm and weight of 1,3 kg. This is the biggest uterine mass removed at this point at my practice (fig.9). The mass was sent to a foreign laboratory for histology (fig.10). The results were consistent with Leiomyoma.

 

The only complication during the postoperative period was urinary incontinence. We treat this with Propalin(Phenylpropanolamine) but to this point the dog didn’t respond and is still incontinent. During the last conversation with the owner we discussed control check-up and additional treatment plans for the incontinence.

Leiomyomas are benign tumors that comprise 85-90% of all canine uterine tumors.2 They tend to be slow growing, noninvasive, and do not metastasize.Usually  an ovariohysterectomy is curative.