” A neoplasia in left midbrain in dog”


Dr Dimitar Ivanov

Dr Dimitar Ivanov,
Veterinary surgeon, Neurology specialist
Dobro hrumvane veterinary clinics
Sofia, Bulgaria




Case report

Dog, Bleki, toy terrier, M, 5 yo.

Came in the clinic on 11.04.2017 with left circle movements, menace deficit on the left and no reaction when stimulating the nasal mucosa.  On the right, spinal reflexes are decreased and there are no conscious proprioception.

Doubt for brainstem problem.

Differential diaggnosis:

V – vascular – it’s with peracute onset

I – inflamatory – it’s possible but no changes in blood sample

T – toxic – The dog did not take any medication, fed the same food and was not seen taking unusual things, but it’s not unpossible

A – anomalous – тhe dog is 5 years old and it is unlikely that there will be any manifestation of these diseases

M – metabolic – there is no other clinical signs or any changes in blood samples.

I – idiopathic – there is no seizures and vestibular signs

N – neoplastic – it’s more possible

D- degenerative – the dog is too young for cognitive dysfunction and too old for other degenerative diseases.

We made MRI on 12.04. and found a lesion in the left mesencephalon.

dhs dhs1 dhs2











The final diagnosis is neoplasia in left midbrain.


We started to prepare for surgery.

The antibiotic preoperative was Ceftriaxone 30 mg/kg i.v., Manitol 1 g/kg i.v. and Methylprednosolone 20 mg i.v.

The surgery was on 22.04.2017 and we made a left craniotomy and displacement of the temporal lobe dorsolaterally until the lesion was reached.

Bleki preoperative video:


Pic 1


Pic 2

The skull was open and we enlarged the hole with Kerrison rongeur (pic 1 and 2)



Pic 3


Pic 4

We aspirated the brain liquor and very slowly reverse the left temporal lobe.( Pic 3 and 4)


Pic 5

When we found the lesion we punctured the cyst formation and drew the liquid contents.( pic 5)











The reason to do this surgery was to try to reduce the pressure in the tissue and to improve the dog’s condition.

After surgery we continued the antibiotics in the same dose and methylprednisolone in the same dose for three days. After then the dose was reduce to 2 mg /kg.  After few days the methylprednisolone was change with prednisolone and started to reduce the dose.

Until the methylprednisolone is reduced, the patient is better every day, improves motor activity, appetite, but fails to maintain a constant temperature. A corneal ulcer of the left eye appears – I guess the cause is a trauma to the left oculomotor nerve and reduced lacrimation.

On 28.04. we included one more antibiotic – amoxicillin with clavulonic acid.

On 29.04. the prednisolone was reduced to 0,5 mg/kg, the dog was with anisocoria (myosis on the right eye and mydriasis on the left). On 30.04. the circle movements on left started again.

We tried to find Lomustine for chimiotherapy but we couldn’t and increased the dose of the prednisolone to 2 mg/kg


Bleki 22 days after surgery:



Bleki 23 days after surgery

The dog is good, he walk normally but when he stops, he start to make circle movement on the left.


WHO ARE Vets on The Balkans? Veterinarians speak…..

10334323_1650417485231859_7490271749546982451_nLUIGI VENCO, DVM , SCPA, Dipl EVPC, Pavia, Italy


It ‘s a wonderful Journal.  Open source. Clinical cases and tips useful for the reader. Not just a display of vanity for the authors. Congratulations to the editors for strong expended effort




Dr Constantin Ifteme – Center of Veterinary Endoscopy and Minimum Invasive Surgery


Vets on the Balkans it is more than a promoting platform of all successful projects from the veterinary medicine in the Balkans region.  It can be compared with the Olympics of the veterinarians from this geographical area, with major involvement in training and continuous learning of the veterinary community.



Dr Iuliana Ionascu, DVM , PhD, member ESVO


Vets on the Balkans is the meeting point of the specialists, the friends and of the people who have the joy of sharing their experience in areas of interest in veterinary medicine.Vets on the Balkans helped us by placing us in direct contact with specialists and taught us how to work together. The first step is done. The next step is one that I want from the bottom of my heart:  to write therapeutic guides together.So, Vets on the Balkans, my dream has to be your accomplishment in the years to come.I love you for what you created. Good luck on your wonderful journey!


 Dr Alexandru Diaconescu, DVM, PhD, Senior Lecturer


I think it’s a great idea! All the vets in the Balkans area can learn from each other’s experience, we can share opinions, interesting clinical cases, etc.

I wish you good luck!


Dr Rares Capitan , DVM, resident ECVD

I think is a good interesting idea. I really hope that this project will  continue for a long time and collect many vets as want to share their experience. So the whole community from the Balkans will progress in a good way.


Dr Ana Maria Boncea, DVM, resident ECVD

“Vets on the Balkans” is like a fresh air for all the vet’s from every place…Is an open door for sharing your experience, upgrading your knowledge and enjoy the vet’s life spectaculy. Let’s share together all beautiful insides of our job!


Dr Vladislav Zlatinov – Central Vet Clinic in Sofia, Bulgaria

 It is so great to have such a professional forum, connecting Balkans (and not only) vets! I literally see people from different countries in the region, getting to know each other because of your journal.  The “Vets on The Balkans” deserve all the compliments for your great positive initiative and work!


Dr Stefan Savov- Ditton  Reach Veterinary Surgery, England

 The journal is a really brilliant idea. I read all the articles. I find some really good examples there. It has proved that veterinarians on Balkans are no worse than the colleagues in the western countries. I wish you more and more interesting cases shared on the pages of the journal and lots of luck.



Dr Mila Bobadova ( Veterinary Clinic “ Dobro Hrumvane”  in Sofia, Bulgaria)

 We needed that kind of journal at Balkans, a connection spot and an open source. It brings veterinary medicine to a new level, but most of all it helps all the vets from Balkans to get to know each other. For that I am very thankful and I am sure it will make a difference.


Dr Svetlina Aleksandrova ( Veterinary Clinic “Light Vet” in Sandanski, Bulgaria)

 Vets on the Balkans is great new way for communication and learning. The reality is that we can not know everything for any condition. The learning process continue until the end of our lives. I love the case reports – a lot of photos and good explications. The Learn and Travel initiative will make a lot of collegues better in their prefered section of veterinary medecine. Please, dr Gancheva, continue to do what you do in the best way – connect!


Dr Liliya Mihailova ( Veterinary Clinic “ United Veterinary Clinic “ in Varna, Bulgaria )

 According to me ” Vets on the Balkans “o is one of the greatest way for many veterinarians to communicate and share knowledge and experience. Because is a new and modern way to connect veterinarians not only from countries of Balkan peninsula but also from countries all over the world. Moreover It provides the latest scientific information about news in veterinary medicine and useful personal professional experience.


Dr Spas Spasov  ( Veterinary Clinic “ United Veterinary Clinic “ in Varna, Bulgaria )

 I want to extend my greetings to the great work you do with the magazine. It is very interesting and useful. I wish to become more known. I wish to be ever visited. I think the idea to united vets on the Balkans is realized.



Dr Vanya Stoyanova – Veterinary Clinic Provet in Plovdiv, Bulgaria

 Useful  veterinary journal,creative realized idea.
Like to read the letters ,interesting posts ,new information for me and classified my level where I am on the market with the Balkan colleagues .Receive information for future symposiums,Conferences and Webinars. Thank You  Luba Gancheva & Co
Wish you continue enjoying with your fantastic work!!!


 Dr Dimitar Djambazov Veterinary Clinic Sofia in Sofia, Bulgaria

 Vets on the Balkans is a unique in its respective category as a journal who strives to connect the countries on the Balkans- a highly diverse and interesting set of countries.

The journal provides easy-to-reach and concise practical knowledge as well as the opportunity for interviews, presentations and step-by-step guidelines for management of specific problems.

From where I stand as a practitioner the case reports are by far my favorite method of acquiring new information in the veterinary field. That is of course after one has a strong basic knowledge on a given subject.

And here’s where the next indispensible role of “Vets on the Balkans” becomes evident. The journal not only acts as a mean of learning and developing oneself as a veterinary professional with blog posts but also serves as a connecting point between the countries and veterinarians in the region, as to promote and organize practical sessions, continuing education projects and various externships. This is indispensible help, strongly appreciated by many and luckily gaining more and more popularity among animal caregivers on the Balkans.
The effort invested in the journal by its creator and her collaborators is immense and undoubtedly greatly acknowledged as we all know how hard it can be to sustain such a project, be a practicing veterinarian at the same time and have a life from time to time as well.

As a young and still lacking a certain amount of experience, vet, I appreciate the Vets on the Balkans journal as a source of CPD, but also as a opportunity to reach and connect to our neighbors on the Balkans.



 Dr Emil Ofner – Veterinary Clinic More in Sibenik, Croatia

 Task for every journal is to have a good impact factor on its readers. Vets on the Balkans journal doesn’t do just that, but it also successfully ties up vets from different Balkan countries and others. It is the first of its kind in the Balkans and for sure it will facilitate further development of the veterinary profession. Hopefully it will become a great online tool for improvements of veterinary skills and knowledge.

 Dr Mario Kreszinger – Veterinary Clinic Kreszinger in Zagreb, Croatia

 It very useful easy approachable source of informations we need in everyday Jobs routine.


Dr Nikola Bunevski– Veterinary Clinic Kreszinger in Zagreb, Croatia

 Sharing is caring. Every information is priceless. We are working near each other we have similar problems and questions, it will be better for each of us if we share those questions and problems to one another, we will come to answers faster and painless. Vets on the Balkans can serve that purpose.Thank you for having me.




 Dr Zoran Loncar- Veterinary Clinic Novak in Belgrade, Serbia

 Vets on the Balkan is refreshment and result of people with good energy and wish to improve our region. We live in small countries and if we cooperate together we have better chance to improve ourselves.


Dr Nikoleta Novak- Veterinary Clinic Novak in Belgrade, Serbia

I read the interview you had with our colleague Nikola Bunevski, and I think he said it perfectly; “Sharing is caring. Vets on the Balkans can serve that purpose””Vets on Balkans” is really a great idea and I do wish you all the best on this exciting and high-minded mission.



 Dr Marko Novak- Klinika Loka in the city Škofja Loka in Slovenia

 I came across VTB when I was scrolling down the facebook and I saw these interesting articles from guys doing great job. I think it is one of those starters that help people to become better at what they do.



 Banu Dokuzeylul, DVM, PhD ,Department of Internal Medicine

Faculty of Veterinary Medicine

Istanbul University, Istanbul, Turkey

 I like reading. One day I found myself reading a case from Vets on The Balkans Online Journal. This subject was one of my interesting areas in veterinary medicine. With this article, I couldn’t imagine a good collaboration and friendship start. With Dr. Luba Gancheva’s support, I was invited to seminar in Bucharest. As I see until today, the journal improves day by day. Instead of giving important information, this journal combines the colleagues on the Balkans. If you want to be a part of a great friendship and have a vulnerable data, you must start to read the journal as fast as you can.10334323_1650417485231859_7490271749546982451_n



LUIGI VENCO, DVM , SCPA, Dipl EVPC, Pavia, Italy

gigi vbLUIGI VENCO, DVM , SCPA, Dipl EVPC, Pavia, Italy

Graduated in Veterinary Medicine  in 1987 from the University of Milan, after that obtained  the Specialization in Small Animal Practice  and in Veterinary  cardiology . Stayed for study, research and teaching, for several months, at University Veterinary Schools in  U.S.A  (Athens GA, Davis, CA, Philadelphia, PA, Ft Collins CO) and in Japan (Gifu) and was invited speaker  in over 100 courses and conferences in Italy, USA, Japan, Cuba, Croatia , Serbia, Bulgaria, Slovenia, Spain, Poland, Romania, Czech republic. He is author and co-author of more than 40 publications in “peer-reviewed international journals “, 2 books on Heartworm disease 3 on CVBD  on one about Veterinary Cardiology. Collaborates in research projects with the University of Milan, Parma, Zagreb and Salamanca. He is member of the American Heartworm Society,  Feline Heartworm International Council,  SOIPA, ESSCAP and WAAP, and is vice President of the European Dirofilaria Society. He is an  EVPC (European College of Veterinary Parasitology) diplomate. He deals with Parasitology, Cardiology and Cardiac Surgery both in  Italian Veterinary Hospitals (Clinica Veterinaria Lago Maggiore, Ospedale veterinario Città di Pavia, Ospedale veterinario Poggio Piccolo, Istituto Veterinario di Novara) and abroad (Spain and Hungary)


Who is Luigi Venco?


He is a 27 year old vet with 28 years of experience.

Lucky enough to start working when veterinary medicine started to catch up with the human one.

Lucky of having had great teachers in Italy and around the world and being  grateful to them. Lucky of having had the opportunity to work in many countries. Lucky to have found true friends and wonderful colleagues anywhere. Lucky to still have a lot of enthusiasm in his work and to have the strength to be happy for a life saved and grieve for a lost one.

Just lucky13403164_1605949529716424_8575905289380343021_o


We know you work with many vets from the Balkans. People say we are different. What do you think?


Absolutely different. Full of enthusiasm and with great sense of friendship and collaboration. As young boys in love with what they do.



Tell us more about your daily work and your problems( as well your solutions)  ?


The every day  work of is full of joy for the victories and sorrows for defeated. It collides with little or too much love for animals. With the economic problems of the owners. With what we would like and we can not. It ‘s a battle to fight with your heart and your mind. The solution, at the end of a tiring and stressful day, is to be able to sleep thinking: “I do not know if I was perfect. But I did the best I could. Tomorrow anyway  I will do better”12038965_1504257143218997_269021453342248416_o


Can you share with us your “golden rules” for better practice?


– Be critical of yourself, not of others, you can do  better always

– Not justify your mistakes but learn from them

– Do not be afraid to teach everyone and be humble to learn from everyone

– Never think you’re the best, always think that you will become

– You are taking care of a life, not a number or a name. Always look in their eyes and listen to what they say

– Nothing is useless. Also visit a healthy dog. Only by knowing what is normal you will be able to understand what is not normal

–  Never stop studying and to update you.  Veterinary medicine runs in a hurry


What do you think about the level of vet medicine on the Balkans( you receive so many vets, who come to learn from you) ?


I believe that the level of veterinary medicine in the Balkans is growing every day. As in Italy a few years ago. And it runs very fast. Thank you for transmitting us this feeling


What do you think about vet online journal Vets on The Balkans?


It ‘s a wonderful Journal.  Open source. Clinical cases and tips useful for the reader. Not just a display of vanity for the authors. Congratulations to the editors for strong expended effort

Two portal laparoscopic ovariectomy in obese dogs


Emil Ofner, DVM

Authors : Emil Ofner, DVM

Ivica Ukić, DVM

Davor Crnogaća, DVM

Silvijo Tarasić, Eng; OLYMPUS d.o.o. Zagreb


Small Animal Veterinary Clinic More, Šibenik, Croatia


Key words :  Gyrus PKS plasma SORD, Laparoscopic ovariectomy




Since the beginning of 2012 two hundred laparoscopic ovariectomyes with two – portal method was done in veterinary clinic More. The average body weight of female dogs was 25 kg. While no surgical problems were encountered in small and medium size dogs, overweight and obese patients demonstrated to be more challenging both for the surgeon and anesthesiologist. Because of problems encountered in large and obese female dogs, especially the difficulties of removing easily ovaries with large ovarian bursa, it was necessary to find new easier and faster way for removing such ovaries through laparoscopic portals without elongation of incision. That was reason for implementation of high frequency bipolar morcellator Gyrus PKS plasma SORD for fast removal of ovaries and its adherent burse in large and obese patients.


Materials and methods


All dogs were sedated using alpha-adrenergic agonists or acepromazine. Induction of anaesthesia was done with propofol. After intubation patients were maintained on  isofluran.  Analgesia during surgery was provided by constantrate infusion (CRI) of fentanyl. Most patients were breathing  spontaneously and ventilatory assistance was used if needed.

To facilitate ovary visualization laparoscopic positioner was used. Ovarian fixation for resection was done with a percutaneous needle technique. Resection of ovaries was done with  bipolar forceps (Grus PKS) or ultrasonic knife (Ethicon). For large and obese female dogs removal of resected ovaries was done by bipolar high frequency Gyrus PKS plasma SORD morcellator.




A total of 200 laparoscopic two portal ovariectomies were done from the beginning of 2012.  A body weight span of dogs was from 4.0 kg to 65 kg. The average body weight of female dogs was 25 kg. Of all dogs 29 % (58 dogs) were characterized  large (above 30 kg) , overweight or obese (body condition score > 4) .

Time for ovary resection and removal in small and medium size dogs was similar like in large and obese dogs when using PKS plasma SORD morcellator. For both groups surgical time in most of the cases was under 40 minutes. For dogs under 30 kg average time was 23.45 minutes, and for large and obese dogs average surgical time was 34 minutes.

Only one dog had a postoperative wound infection which was managed with antibiotics and in one dog (8 years old Alaskan Malamute) we couldn’t establish pneumoperitoneum because of huge deposits of intra-abdominal fat tissue so we proceeded to open laparotomy.



Veterinary laparoscopic ovaryectomy is traditionally done by three – portal method and we can call it a universal method for every type and size of the patient. But, it’s not as minimally invasive as two and single portal method.

Single portal laparoscopic ovariectomy is only method which is the not universal or ideal for every patient because of technical, intraoperative difficulties (especially in obese and large female dogs) mostly related to difficulty in viewing anatomical structures for precise surgical resection. Single portal ovariectomy in our opinion can be only ideal for small and medium size female dogs from 7 to 20 kg especially before the first heat (5-7 months old female dogs).


Picture 1

Two portal method has some disadvantages, but we can also call it universal method for every type and size of dog. The main deficiency of two portal method was difficult removal of large ovaries with its adherent burse thrue laparoscopic portals in obese and large breeds of dogs. Also, using a percutaneous needle technique in two portal method for fixation of ovaries in the abdomen makes them very often hidden behind its adherent bursa and difficult for viewing in order to do a precise disection to get a smaller tissue piece for easy extraction (Picture 1).

Ovaries with adherent bursa in large and obese female dogs by our own measurements  can be over 6 cm in diameter. The traditional method for removal of large ovaries was an elongation of laparoscopic portals by scalpel No. 11. Unfortunately, if you are using threaded trocars (we use endotip trocar type) this can be little challenging. Also making portal larger by incision is abandoning basic principles of minimally invasive surgery and causes more intraoperative trauma. Size of elongated  incisions of laparoscopic portals is getting close to standard open laparotomy incision size and then we can’t absolutely say that we did minimally invasive surgery.

Problem of removal of large ovaries in three portal method is not so important because the surgeon can easily use scissors and forceps to divide such ovaries intra-abdominal in two or more segments and take them out separately but that also lengthens operation time.

Removing ovaries with large ovarian bursa is very often time-consuming and elevates stress on the surgeon and its assistants, also lengthens anaesthesia time and increases risk for the patient.


table 1

Also, there are mortality risks in obese patients during and after laparoscopic surgery  that are proportional to operative time which is often increased in these patients. Because of that operative time becomes very important factor (Table 1).


Taking into consideration things mentioned above, we tried to make two portal method easy and fast even in large and obese patients (> 30 kg) with large ovarian bursa making surgical time for resection and removal of both ovaries under 30 minutes.


picture 3


picture 2

To achieve this we started to use human gynaecological bipolar morcellator  Gyrus PKS plasma SORD (SORD – solid organ removal device) and HF generator Gyrus G400 (Picture 2, 3 , and 4).


Picture 4

Picture 4

Main advantages when using  Gyrus PKS plasma SORD are :

  • easy to use (Plug and play)
  • fast
  • small diameter (12 mm / 15 mm)
  • light (250 grams)

Main disadvantages are :

  • single use instrument (can be reprocessed)
  • smoke production (use of insufflators with the automatic smoke evacuation system resolves this problem)







Two portal laparoscopic ovariectomy using Gyrus PKS plasma SORD morcellator makes this method suitable  for technically demanding ovariectmies especially in large and obese dogs.  Difficult ovariectmies in these patients are done with minimal intraoperative trauma without elongation of laparoscopic portals and short period of time (up to 30 minutes). After 3 years using  Gyrus PKS plasma SORD morcellator we can conclude that to us it’s  become a crucial instrument in every two portal laparosopic ovariectomy of obese dogs. Using this instrument makes two portal laparoscopic ovariectomy universal, fast and safe especially in large and obese dogs. Only downside of using Gyrus PKS plasma SORD morcellator is its price.


Soft palate and tonsil resection using PlasmaKnife dissector in dogs with brachycephalic obstructive airway syndrome – A novel technique


Dr Emil Ofner

Authors : Emil Ofner, DVM
Marina Barižon, DVM
Mario Grubišić, DVM
Silvijo Tarasić, Eng; OLYMPUS d.o.o. Zagreb

Small Animal Veterinary Clinic More, Šibenik, Croatia

Key words : Brachycephalic syndrome, PlasmaKnife


Brachycephalic obstructive airway syndrome is chronic, repetitive and life threatening disorder and because of that it often requires immediate surgical intervention. In literature, there are many described surgical techniques to treat different aspects of brachycephalic syndrome. The soft palate and tonsil resection using Gyrus PlasmaKnife dissector is a novel technique which is in our opinion ideal for every veterinary practice.


Brachycephalic Obstructive Airway Syndrome (BOAS) is a complex chronic condition characterized by narrowing or collapse of the different airway passages. This disorder is hereditary and because of that associated with different breeds of dogs. Depending on general skull morphology dogs can have brachycephalic, mesaticephalic and dolichocephalic heads. Phenotypic selection in search for round heads and foreshortened nose in brachycephalic breeds of dogs resulted in loss of sagittal crest and a braincase longer than the facial bones. Rostral shortening of the skull in brachycephalic breeds, without paralell reduction in the associated soft tissues, results in disproportion causing abnormal airway resistance. These primary anatomic defects lead to secondary changes over time (Table 1). At the time of presentation, clinical sings can be mild, moderate or severe. All moderate and severe cases are accompanied with sleep difficulties, coughing, dyspnoea, gagging, retching and syncope. While moderate and severe cases need prompt surgical intervention only mild cases can be managed conservatively.

Patients and methods

Picture 1-1

Picture 1

Picture 2-1

Picture 2

Picture 3-1

Picture 3

Picture 4-1

Picture 4

Picture 5-1

Picture 5

Picture 6

Picture 6

Last decade, there is a huge increase of pure breed dogs and breed related disorders in Dalmatia. Brachycephalic breeds which have round heads resembled those of human infants are becoming very popular. Among breeds presented with BOAS in our clinic overrepresented breeds are Pugs, French Bulldogs and Cavalier King Charles Spaniels.
Most patients in time of presentation have serious and life threatening symptoms. Because of that diagnostic procedure needs to be done quickly with skilled team. In Veterinary Clinic More all patients with BOAS are put under general anesthesia, intubated and after radiographic examination, laryngo-tracheo-bronchoscopy procedure with or without rhinoscopy is done. After a complete examination of upper and lower respiratory pathways we prepare surgical planning. In almost all situations we do a soft palate resection. If needed, vertical or horizontal external nares resection, tonsillectomy or everted laryngeal saccules excision is done also.
To clearly and precisely visualize the surgical site is critical in all surgical procedures involved in BOAS. Because of that, all patients should be positioned in sternal recumbency with maxilla resting on the perch and the mandible should be suspended by rolled gauze ventrally (Picture 1 ). If soft palate resection is going to be done all tissues extending mid to the caudal aspect of tonsillar crypt should be excised. The soft palate is grasped with Allis clamps, pulled rostrally and dissected with PlasmaKnife dissector (Picture 2). If tonsils are enlarged in order to clear out as much space as possible we also do unilateral or bilateral tonsillectomy.


Picture 7

Picture 7

Picture 8

Picture 8

Though in available literature, there are lots of papers about soft palate dissection we didn’t find anything about using PlasmaKnife dissector for soft palate and tonsil resection. Traditionally resection is done with sharp dissection using Metzenbaum scissors or monopolar electrocautery. Other reported techniques include bipolar sealing devices (LigaSure), laser or harmonic scalpel. Surgery time for soft palate resection was about 12 minutes for sharp dissection, and about 5 minutes for laser surgery.
PlasmaKnife dissector is triode-tipped bipolar instrument (Picture 3) which attaches to the Gyrus G3 WorkStation generator (Picture 4). It uses PlasmaCision technology that enables both simultaneous and sequential hemostatic sealing and cutting. PlasmaCision leverages the electricaly conductive properties of tissue fluid to form a tightly defined low temperature plasma field over the active pole of the triode tip. The instrument has two main modes of operation, PlasmaCision cut phase and pure coagulation phase. In cut phase a low-temperature plasma field precisely divides tissue and coagulates blood vessels. In pure coagulation phase tip delivers controlled radio frequency energy for sealing larger blood vessels ( Pictures 5 and 6). Tip design has both convex and flat surfaces. The convex part for pin point accurate dissection and flat surface provides maximum tissue contact for effective hemostasis along with a suction channel for blood and vapor (Picture 7). Switching between modes is done by foot pedal.
Surgical time for soft palate resection with PlasmaKnife dissector was average 63 seconds and 44 seconds for unilateral tonsillectomy. Realized time was about 10 times faster in comparison to traditional sharp dissection and 5 times faster comparing to laser surgery. Production of smoke and vapors was minimal and suction channel was not needed. Postoperatively, all dogs received local dexamethasone to reduce swelling (Picture 8). We didn’t have any postoperative complications.


PlasmaKnife dissector in combination with Gyrus G3 WorkStation generator is multi – functional instrument and provides versatility, efficiency, clean incisions, and hemostatic performance with minimal tissue damage.

Again, we are thankful to Mr. Silvijo Tarasić and Olympus d.o.o. Zagreb who recognized our enthusiasm and provided technical expertise that greatly assisted us in implementing new technology improvements in our practice.

PETCODE Veterinary Hospital on the Balkans….. is it real?

PETCODE ANIMAL HOSPITAL; where our dreams came true

Just before starting to make our new  animal hospital I asked my collegues to write me about their dreams. I was not wondering what we can do,  I was wondering  about a small animal practioner’s dreams . It is not easy to understand the meaning of these dreams for a vet working  in Germany, Holland or England but I am sure you can understand  how important this is for us. In countries like Turkey or in Balkans, there is always some thing is absent while we are practicing. I asked the same question to some of my patient owners. I was sure that as the people who love their pets they would also have dreams about a perfect hospital.  I knew that it was impossible to make a perfect hospital  but I believed that all these dreams will guide us  to create a close one.IMG_1122IMG_1125

After I collected all these notes from my friends  I read them may be a hundred  times. I saw that some of my friends  was dreaming about wider and bigger spaces to practice, some of them was dreaming about high technologies  like MRI and CT, some about a better laboratory and etc. The list was so long but we did our best to make them true one by one. Of course we could not manage to make them all but we are still on work and continue .That is why I am not calling PetCode as  “the perfect animal hospital” I am calling us as “The hospital where the dreams come true.”

Now I will try to tell you about Petcode, the sum of  our dreams.IMG_1121IMG_1123

Our Petcode Animal Hospital is serving  in a 1400 square meter building and it is physically  the biggest animal hospital in Turkey. We are using 2 different entrance and 3 separate parts in Petcode. In polyclinics section you can find our account office, secretary and information desk, pharmacy, a wide waiting room with different waiting areas  for dog  and cat owners, two examination rooms for dogs and two examination rooms for cats, physical therapy and rehabilitation service with a hydrotherapy pool, hemodialysis unit, pet coiffeur and meeting room. In hospital section we have emergency entrance, emercency waiting and examination room, computered radiography, colored doppler ultrasonography, electrocardiography and office rooms, hospitalization section, central examination room for hospitalized patients, reanimation rooms,  oral health and dentistry unit, surgery preperation room, half sterile room and full sterile operation room. You can enter our hospital’s third section  with our elevator and here you can find computered tomography, restaurant  and, changing rooms for our staff, laudry and storage.IMG_1124

In PetCode Animal Hospital we believe that  “ Cats are not small dogs ” and  with  this policy we divided our wide waiting room  to 2 parts,  one is for dog owners and the other  is for cat owners. There are 4 routine examination rooms in our hospital and 2 of them is for cats and 2 for dogs. Dogs are never alouded to enter cat examination rooms just to reduce the stress of cats. We have special hiding places in our cat examination rooms so when they jump and escape from the examination table we never try to catch them because we already know  where they will enter.

“Physical Therapy and Rehabilitation”(FTR)  is one of the most popular branches in veterinary medicine all over the world. The high percentage of geriatric animals among the pet population,and the important  tendency of dogs and cats to obesity is increasing the risk of osteoarthritis. Osteoarthritis  creates the main need for physical therapy and rehabilitation in most cases. The increasing  number of advanced surgeries we are performing  is also increasing the demand of patient owners for a better and faster recovery period. So physical therapy and rehabilitation is becoming more and more popular every year and of course we made a big investment  for FTR in PetCode. Our hospital has a hydrotherapy pool supported with a lifting crane for paraplegic animals. We have a  gait analysis system which shows given weight to each extremity quantitatively . Our treadmil, electrotherapy, therapeutic ultrasound, laser therapy and laser acupunture systems are the other feautures of Petcode FTR service.

Petcode Hemodialysis Service is the only hemodialysis  chance for dogs  in Turkey so patients with kidney failure and differenttoxications are coming to us everywhere from Turkey. Of course keeping a chronic renal failure patient alive just with hemodialysis is so expensive and not efficient and logical most of the time but we are mostly helping acute renal failure patients successfuly. Our hemodialysis machine is just suitable for patients over 15kg and we are performing peritoneal dialysis for our smaller dogs and cats.IMG_3087

According to American Animal Hospital Association veterinary dentistry creates the biggest income for every small animal practice in USA and in Petcode we made a serious  investment for veterinary dentistry. We are not only performing tartar cleaning and teeth extractions we are also using intraoral cameras, taking x-rays,  performing fillings, coverings and implants.

In PetCode we are  closing our polyclinic section everyday at 20.00 but emergency entrance is open for the rest of the night with an on duty veterinarian and a veterinary technician. When we had a surgical emergency we always call all our surgical team and perform the surgery.IMG_7684

During day time all our staff  pass the hospital section  door with a card reader. Our patient owners are not alouded to enter to the hospital section by themselves and even for visiting for their patiens we always guide them. They can pass to hospital section just with special plastic overshoeses, galoshes.

Because of our huge street animal population Turkey is a heaven for all kinds of infection diseases and in  PetCode we are fighting with hospital infections seriously. We are using hepafilters in all risky points, all our cages are made from chrome-nickel steel  for better disinfection, and they all have full glass doors to prevent the spread of infections via splashig, coughing, sneezing. We keep patients with infectious diseases in an isolated room. We are always  trying to obey high standart disinfection and sterilization rules everywhere in the hospital.

Oxygen is life and in PetCode we produce our own oxygen with a very special system and we safely use this oxygen in our anesthesia machine, intensive care units and everywhere in our hospitalization section.IMG_0549IMG_1831

Our hospitalization service has 4 sections.  We keep our patients with all kinds of infectious diseases in our infectious disease room. Our staff enter this room with special outwear. There is a special antibacterial plastic curtain in the entrance of this room which keep the infections inside and we are using special hepafilters  for the ventilation  so that possible infections are not entering to the general ventilation system  of the hospital. When we have patients that we are not sure about their health and vaccination status we keep them in cages in our  quarantinedepartment until we feel sure that they do not carry any kind of infectious disease to our other visitors. In our regular hospitalization section we have 2 parts and of course one is for dogs and the other one is for cats. All these parts are openning to a central examination room and we carry our patients here for their regular applications.

In PetCode we are able to perform almost all kind of surgeries. We are doing a lot of brain and spinal surgeries,total hip replacements,  tuberositas tibia advancements, tuberositas tibia transpozitions, eksteranl fixators, vertebral stabilisations, ventriculoperitoneal and syringosubarachnoid shunts,  different types of reconstructive and oncological surgeries, and eye surgeries including phacoemulsifications. All these advanced surgical procedures  give us a big responsibility as well.

. If you are planning to perform that sort of sophisticated and advanced surgical procedures , of course just good surgical skills are not enough for these plans. You need experience, a good team, perfect medical equipment and a very sterile surgical room.FullSizeRender

That is why Petcode  brought  “Full sterile operation room term”  to Turkey.  We enter to our operation room through a half sterile room always with head caps and masks. Floor surface of our operation room is made from esd conductive, antistatic and antibacterial material. Our walls are covered with chrome- nickel steel  because bacterial contamination of this material is  diffucult and disinfection is always easy. IMG_6016IMG_6010Ventilation of this room is special because air is entering to the room through hepafilters and a system always aspirates the dirty air inside the room again through hepafilters so there is always positive pressure inside the room and air entrance is limited even we are openning our doors during enterance. Our surgical room is also full of state of art medical equipments that allow us to perform all kind of surgeries.

Petcode is the one and only private animal hospital that has  its own computered tomography machine in Turkey. With the help of our  three dimentional reconstruction programmes we use,  we are able to obtain very high qualified images almost compatible with high field  magnetic resonans images so we can diagnose several  neurological and oncological problems easily.1424295_1650399288567012_3625160114951452674_n1497350_1650399538566987_593934141063559119_n

As you can see, PetCode Animal Hospital is the biggest investment done for small animal practice in Turkey  but we are still dreaming about a perfect animal hospital with our  lives coded to animal love,and veterinary medicine.

Dr Valentin Nicolae….The most special person on The Balkans!


Dr Valentin Nicolae

Who is Dr Valentin Nicolae? Let’s people say this:

1.Dr Wolfgang Dohne

Vice president of FECAVA
Owner of  Virginia Water Veterinary Clinic


He has been at his association’s FECAVA director for many years and I always found him very pleasant and approachable.

With his help the Romanian association has progressed a lot over the last 10 years and his association is now running a very successful annual congress.

Valentin very much enjoys the social side of FECAVA and is a surprisingly good dancer.


Senior President of AMVAC

Both he and Robert Popa are outstanding representatives of their association.

2.Dr Robert Popa

Vice president of AMVAC/RoSAVA

Owner of O&R veterinary clinic



Dear Valentin! You are that kind of persons who never gives up. You had a dream to make a a decent veterinary association in Romania and you did it. You were the first, you were the leader, sometimes the dictator but you never ever avoid to take responsibilities. No mater that it was a good thing, when it is easy, or a bad thing, when is the moment of truth of for real leaders. It will always be a pleasure to shake your hand, have nice talk in a beautiful environment, near a good glass of wine. Thank you my friend and keep going!

3. Dr Tache Epure

The president of Romanian Feline Medicine Society



Valentin I’ve known for many years, before AMVAC site to represent something veterinary medicine in our country. Charismatic personality made him noticed which I had meetings at various congresses, conferences or Work-shops related to pets, but also the great value professional after … which is currently on a human quality is excellent but a young spirit, always searching for new. Generous with colleagues and friends but especially young doctors who always showed them everything he knows, and many of them now being competitors, doctor Nicholas stands today as a true thought leader, always consistent, punctual and good organizer.

3.Dr Sinziana Radulescu

The President of Hemopet Blood Bank

There are some people that you meet and then your whole world changes forever. I think this is actually a popular subject for essays in English tests: write an essay about a person that changed your life! Although this is not an English test, it still feels like that’s what I’m doing here.

I remember being so young and naïve with no clue on how a carrier in veterinary medicine should look like. I was so proud of being part of the biggest veterinary event in the country: AMVAC/RoSAVA International Congress. I will never forget Dr. Nicolae Valentin’s words: “It takes a lot of passion and a fair amount of craziness to make this possible.” I understood right then, whatever it is that you do, it takes passion and a fair amount of craziness if you want to do great things.

“See, all of this here is possible thanks to you!” he used to tell us, a bunch of 2nd year vet students who knew nothing about life. I did not completely understand then, but I understand now the power of leadership. If small animal veterinary medicine in Romania had only one leader – Dr. Nicolae Valentin would be the one. He can bring people together to share his passion and craziness until perfection is achieved. He would ask for your help and you would feel grateful he did. He would give others credit while he would stay humble and smile.

On top of all this, Dr. Nicolae Valentin is one of the first vets to go abroad and bring the world back to Romania through his small animal clinic in Ploiesti. “My prices are not low, I have to admit. If clients are not able to afford them I will gently recommend them to go to my competition, where they would still get good service. But our prices are the product of all the things we have learned and all of the investments we’ve made to keep our medical services at this standard. And this is something I care too much about.” What a valuable business lesson, don’t you think?



I feel the luckiest person in the world to have met him and worked with him to achieve a common purpose: make the veterinary world in Romania a better place. His influence will always guide my actions: Think big. Be passionate. Be crazy. Stay humble. Work hard. Do the impossible! 

5.Svetlina Aleksandrova, DVM, Member of ESVD

     Owner of Lightvet Veterinary Clinic

We met a couple of years ago in Budapest and my first impression of him as a positive, kind and very dynamic person stays the same for years. Now I can add that he is a real treasure as a friend, as a vet and as a part of our society!12189380_428904733970157_5303852493900633428_o

6.Dr Rares Capitan DVM, resident ECVD

Owner of Veterinary Clinic Regatul Animalelor

Dr. Nicolae is more then a role model, he is full of inspiration. I have known him since I was in 9th grade in high school and the experience I gained in his clinic has followed me throughout my career. I believe that most of the successful vets in his town and more have worked in his clinic for a period of time, either during their university years or at the beginning of their career. Most important to me was his strong nice character, good heart, high professionalism, charisma, and his interaction with people.

7.Dr Daniela Enache,DVM,M.Sc.,PhDS

member of the team Vets on The Balkans

Few years ago, a new world was opened to all Romanian veterinarians with the contribution of an optimistic, proactive veterinarian and his team. Being a professional and loving his job, Dr. Valentin Nicolae, dedicated with enthusiasm his time to big and interesting projects from which AMVAC is one of them, but as well he started also a successul activity in his own clinic. By organizing several veterinary events for the vets from everywhere, dr Valentin Nicolae showed to all that continuing education is an useful and important part of our job, who complete the clinical activity. For me, dr Valentin Nicolae is an extraordinary example: a wonderful veterinarian with successful career, a trusted friend who helps you unconditionally and who will never disappoint you, finding solutions for any situation

I’m very happy to be part of the world that he created! Thank you for all!!!12322532_1640029786270629_4467346060229231885_o

8.Dr Luba Gancheva, DVM, M. Sc. Infection diseases, PhDS

The main editor of Vets on The Balkans

Dr Valentin Nicolae…. hm…He changed my life! He was the person who invited me first time in Romania and now I am living in this country! Who is he? All the words will be not enough to describe his personality! He is real leader, the best organizer, wonderful vet , but when you look at his eyes the you can understand who is Valentin. So much goodness in one soul ! THANK YOU that I met you and I can be a part of your professional road and not only!

9. Dr Gizem Taktak

TSAVA director for FECAVA and WSAVA

Owner of  Ataşehir PatiSev Veteriner Kliniği

When I first saw him with a pleasent smile and thought about what I will going to talk in long way trip. And on our way I saw very polite and open person if he can not speak fluent english. I am very happy to meet him and find my father in Romania. 1397077_761534410585943_5276769957689416636_o

Dr Nikoleta Novak- veterinarian, mother, writer…. successful lady on the Balkans

My dog Rasha and me

Dr Nikoleta Novak

1.Who is Nikoleta Novak?

Nikoleta is…
Nature lover. Social bee. Passionate reader. Wise Owl for close friends. Open-minded.. “Half-full glass” type of a person…
Apart from that Nikoleta is veterinary surgeon working in Veterinary Clinic Novak dealing with cardiology cases, but also seeing first-opinion cases and doing some soft tissue surgery.
She is also a mother of two girls, a writer of children’s books and the owner of a dog, cat and 55 years old tortoise.

2.Do you think is hard to be professional in veterinary medicine on the Balkans nowadays?

ESAVS cardio course Luxenburg

ESAVS cardiology course in Luxenburg

When one of my friends, who is also a vet, first time visited England, he said : “This is a Disneyland for a vet!” For veterinary practice on Balkans nobody will say such a thing. Here you need to struggle with lots of problems, drawbacks, lack of medicines ,equipment, different mentality of clients… On the other hand, being a vet on Balkans is more challenging. You need to think differently, to look for solutions outside the textbooks, be ready to be a service provider both for your clients and for your equipment, even if you are not a creative person you are forced to become imaginative and resourceful …

3.Why you didnt leave your country? (vet like you has many opportunity to do this)

EHO workshop with June Boon in Italy

Ultrasound workshop with June Boon in Italy

big patients1


One part of you really wants to be in Disneyland. Me and my former husband set and passed RCVS exam (exam set by British Royal College of Veterinary Surgeons) and became their members which means we could work in the U.K or other E.U. countries. (Serbia is not part of the EU). The whole of our staying in the U.K. and the exam itself was a great experience for us and we enjoyed every moment of it, even very hard studying . But then it was a life decision: starting a new life in the U.K. or going back home and continue the life we left. We decided to go back and never regretted this decision. Why? There is a list of reasons, but for me probably the strongest one was a family. On the other hand it is not the same if you are just visiting Disneyland and if you live in it.

4.What do you think about the level of veterinary medicine on the Balkans?

It is getting better and better, but still we all have to put much more effort and more work. We need to educate both ourselves and our clients.

5.You are a writer of children’s books. I read some of them.They are amazing. Tell us more about this part of your life?

2015 book fair anouncment for my novel promotion

2015 book fair anouncment for her novel promotion


one of her books

Belgrade book fair - my dog as a character in one of my picuter books

Belgrade book fair – her dog as a character in one of her picuter books

My new novel and the main character

Her new novel and the main character

Visting Children's book fair

Visting Children’s book fair

Since I was a child I loved to read and write. I even wrote my first picture book before starting school. It was about animals of course (smiling). Throughout my life I was a keen reader but the only things I wrote were professional articles. Then by lots of connected coincidences I was contacted by a children’s book publishing house “Pčelica” (www.pcelica.rs). They asked me to write a manual for children about pets. And that’s how it all started. Now I have three serials of eight picture books each, one manual and most recently, a novel published by “Pčelica”. So all together, I have 25 books published. I managed to connect my three loves together: love for children, for animals and for books – as I write books for children and most of the characters are animals. In my books I try to show children how amazing animals are, and to evoke love for animals in them, but I also do address some important human values, dilemmas and problems, on children’s level of understanding of course.

6. Tell us more about your project “Blue dog” ?

blue dog part of the team

Blue Dog -part of the team

Blue Dog workshop

Blue Dog workshop

Blue dog is an European project designed to promote the education of children in their relationships with dogs  . The first resouce was the interactive CD-ROM with its printed parent guide. This was well received in scientific circles. However, promoting a prevention message to the public proved to be challenging in Serbia but also in all other countries which are participating in the program.
As a member of the Blue Dog team in Serbia. I really do enjoy working with children but all the other issues connected with it (writing projects, raising money for it etc.) I personally find hard to deal with. That’s why the Blue Dog team needs to have people with different knowledge and skills involved in it’s work.
In Serbia we had lots of workshops and other kind of activates in preschools, schools and different public happenings designed to teach the children safe behavior towards dogs and to promote and spread the Blue Dog project idea.

7. What do you think about “Vets on The Balkans” ?

my girls and our dog

her girls and her dog!

I read the interview you had with our colleague Nikola Bunevski, and I think he said it perfectly; “Sharing is caring. Vets on the Balkans can serve that purpose””Vets on Balkans” is really a great idea and I do wish you all the best on this exciting and high-minded mission.


The team of Vets on The Balkans would like to express their gratitude to this brilliant veterinarian from The Balkans and we are proud to have her as a colleague and friend!


Dr Nikoleta Novak


Nikoleta Novak BVSc MRCVS, surgery specialist, graduated in 1995 from the Faculty of Veterinary Medicine, University of Belgrade. She attained her surgery specialist degree in 1997. From 2000-2002 she expanded her professional knowledge in Great Britain, mostly in Cambridge veterinary school.
Nikoleta has been a Member of the Royal College of Veterinary Surgeons (MRCVS) since 2002. More recently, she obtained three parts of ESAVS certificate in Small Animal Cardiology, and continuing to expand her knowledge in the veterinary cardiology area by attended June Boon’s Echocardiography courses in Belgrade and Italy, over the past few years. She has attended more than 50 various continuing education programs, congresses, symposia, workshops, round tables, professional meetings beside those where she was involved as an organiser.

Nikoleta was a member of the Scientific and Professional Committee of Serbian Association of Small Animal Practicioneres (SASAP). as well as a member of the Editorial Board of the SASAP Bulletin for eight years.

She works Small Animal Veterinary Clinic – Veterinary Clinic “Novak” ; which is an institution that provides general and specialized veterinary medicine and surgical services for small animals.

Nikoleta is the leader of the Blue Dog Project in Serbia. (European project on safe behavior between children and dogs).

In 2010 Nikoleta wrote a short manual for children “Let’s learn about pets” for the publishing house “Pčelica” . Continuing this successful partnership, she published 3 serials of 8 picture books each, and most recently a novel for older children.

AMVAC/RoSAVA Congress 2015

17618_853276644745052_6817822360719382112_n (1)Every year in november AMVAC(RoSAVA) organize their annual congress. This year the team of Vets on The Balkans visited this gorgeous place Sinaia, which is a small town in a mountain area in Romania.


The exhibition





The congress is very well organized. There were 4 rooms with different subjects and big exhibition

Speaker as Chris Lamb, Michael Lappin, Bruno Pierone, Norin Chai and Federico Fracassi made this congress priceless. They shared their knowledge and experience with over than 700 participants from the Balkans. This year around 100 bulgarian vets visited this event. There were vets from Macedonia, Serbia and Turkey.




Veterinary Management

There were many games of the sponsors with different prizes, gala dinner and nice meetings with a lot vets


Orthpedic workshop


Orthopedic workshop


Dermatology workshop


Feline Medicine Day with Dr Michael Lappin


Ophthalmology day


Beautiful Romania !!!


Vets on The Balkans

Pre –congress day was good organized with 5 workshops- Ophthalmology, Dermatology, Orthopeady, Feline Medicine and Imaging

Thank you AMVAC about your hospitability and especially to Dr Valentin Nicolae, Dr Robert Popa and Dr Timen Andrei.

Polycystic kideny disease (PKD) in ferret


Dr Krasimira Kodjanikolova, DVM, Mr Sc Imaging diagnostic

Dr Krasimira Kodjanikolova, DVM, Mr Sc Imaging diagnostic

Veterinary Clinic NOVA, sofia,Bulgaria

Clinical case

Ferret Sunny, 5 years old, castrated

Anamnesis :


Fluid therapy in ferret

The feret presented at the clinic apatic,not active from 1 month, the appetite went down, dehydratated.


Normal temperature

Blood test: light form of anemia, the biochemical part of the test was normal.

Ultrasound examination:

Ultrasonographic evaluation indicates the presence of cysts of varying size in the right kidney, as the body has lost its normal arhistructure.

Single cyst in the left kidney associated with renal pelvis;


Right kidney


Cyst of the right kidney


Right Adrenal Gland


Right Adrenal Gland


Left kidney


Left Adrenal Gland

Adrenal glands –without changes.


Fluid therapy and NSAID