Saturday, September 3, 2016

Cryosurgery of a lesion on the tail of a cat




A 16 yrs old cat was presented for a tail lesion that kept oozing and crusting over and bothering the cat. Fine Needle Biopsy, done as an outpatient revealed benign a sebaceous lesion. 
Due to the age of the cat a non surgical approach was elected. Using Cryosurgery, liquid nitrogen was applied to the lesion. A 6 mm Cryo-chamber was used and 3 cycles of quick freeze, slow thaw were applied to the lesion, reaching at each freeze cycle Cryo-adhesion. The cat was not bothered at all by the procedure and calmly lay on the exam room table--table that is softly padded for the patients' comfort--while the owner was petting him. The entire procedure took about 25 minutes and the cat went home with his owner.
The lesion is expected to slowly regress within the coming weeks. 
Cryosurgery is an excellent technique for many skin lesions and, or, tumors, that is not invasive and with hardly any discomfort to most patients.
Dr. Ehud Sela-The Gentle Vet
Gentle Vet Animal Hospital
Margate, Florida.
Phone: 954-972-5900

Thursday, July 21, 2016

HEARTWORM DISEASE TREATMENT OPTIONS UPDATE.




My Philosophy in medicine is of a measured and conservative approach, and to try and look for less invasive, safer, and less costly treatment options.
In this regard I have been using the so called "European protocol" for treatment of Heartworm disease. It is so called because a research paper first published in Milan, Italy described the protocol. The protocol has been used in the States also by various veterinarians that are familiar with it. It involves the use of Doxycycline and Ivermectin based Heartworm preventive. It's a slow kill of worms approach, and that is why I like it, as I find it safer--as compared to fast worm kill--and less costly. Of course each patient is an individual and a veterinarian needs to asses him and discuss with the pet owner the options.
My bottom line is always: if it safer and appropriate for the patient it should be the first choice.
Dr. Ehud Sela
Gentle Vet Animal Hospital
954-972-5900
© Dr. Ehud Sela. No work herein may be reproduced in any way without expressed permission from the author.

Tuesday, July 19, 2016

THE ART OF MEDICINE




Medicine is an art, good medicine that is, both in Veterinary medicine and human medicine.

In Veterinary medicine this art is more difficult as the patients can't tell the doctor what is bothering them.

Therefore, a complete physical exam, and a detailed history is imperative in order to achieve a diagnosis.

Of course, an experienced eye with many years in practice is an essential element.

Unfortunately medicine has become in some instances not an art, but a blanket approach in which based upon algorithms--and not critical thinking--a myriad of tests are done, and these tests can be costly.

I believe in diagnostic tests; they are essential, but I also believe in a logical approach and fine tuning the tests to the case in front of me.

I regard in many cases the art of medicine to be like a detective work in which a methodical and logical approach is applied.

Yet, always remembering that the first rule of medicine is do no harm.

And, always remembering that in front of me is a pet that feels and is a member of the family.

The Art of Medicine is not just a cliche but something to strive for and always practice.

And like any form of art, there are good artists, not so good artist, and exceptional artists. 

In medicine the exceptional doctor has that additional spark of compassion and wisdom that sets him apart.

Dr. Ehud Sela

Gentle Vet Animal Hospital

Margate, Florida

954-972-5900.


© Dr. Ehud Sela. No work herein may be reproduced in any way without expressed permission from the author.

Tuesday, July 12, 2016

GOOGLE DELIBERATELY FOSTERS, FESTERS AND HARVESTS WITH GLEE BAD REVIEWS.



First Part, 7/12/16
To the public at large and those among you that are small business owners and professionals: Google deliberately fosters, festers and harvests with glee bad reviews. It's a money making machine for them, as within not a long period of time afterwards they will address you with online ads' offers. In my opinion any merchant or professional that finds that through Google reviews he has been maliciously hurt, do not listen to their advice as to the response, as it only serves them, but respond truthfully and strongly to defaming words. Unfortunately, through their friends in congress Google is immune from defamatory law suits when publishing them--a thing that the print media does not have, and rightfully so. Let us hope that we the people will be able to change this unsavory and cozy relationship of money and power.
Let us all try from now on not to “Google it” But let us “Bing It.”

Second Part, 7/15/16

Let us expand more about Google shady practices: This actual conversation took place and it is here brought not verbatim, but the essence of the conversation and its content and meaning and implication are  accurate. Of course this is a brief synopsis of the conversation.

Phone call to Google Merchant Services:

Myself: I would like to report a fake malicious review by a person that is homeless goes online by the name of  Gutter Punk--on multiple online platforms--and has been found on the property when the office is closed at midnight, eating, drinking and loitering, causing a sensation of fear and discomfort to exit the vehicle and attend to a sick patient late at night that I had to get some medications for a house call.  The police has been informed and I'm presenting to you all the information on this person and its lifestyle and activity including arrests and loitering and voiding body fluids in public. This person boasts online of its lifestyle and trespassing and living on the streets. Also, this person is not a client of the business and never set foot inside the office.  Yelp has been informed of the above, given exactly the same information and immediately this person was removed from Yelp. Finally Google, you have promoted this individual to a local guide and reward him with gifts and seek reviews from him. What is wrong with you, don't you even bother doing a minimum of screening?

Google's response: Let me review the information and the review. A minute later: It does not violate our policies.

Myself: how can that be, as your policies themselves state that a review has to deal with nature of the business reviewed?

Google response after a slight giggle they couldn't resist making: It was on your property so it's related.

Dismayed I asked: You are kidding are you not? This person was trespassing at midnight sitting in the dark parking lot. How can you even utter such a response?

Google; No we are not kidding.

Myself: Let us take it to the extreme and let me ask: let us assume that a business owner has an argument with a person, like waiting in line somewhere or let say a minor fender-bender happened and while waiting for the police the other person finds out where you work. Let assume you wear a shirt with the business logo. Then this person goes online and writes a fraudulent malicious review about the business, I'm sure you will remove such a review, correct?

Google: No!

Myself: This is unbelievable, you must be kidding, this has nothing to do with a business reviewed and the nature of its business.

Google; No, we are not kidding.

I think it's clear from this conversation how Google Fosters, Festers and Harvests with Glee bad reviews. It makes them money as they can try and have the merchant purchase ads.

At this point I tried a little experiment with Google and asked about a positive review.

Myself: what if an employee of a business also uses the business services and has a great experience and want to share it with the public.

Google: Absolutely not, an employee can't do it.

Myself; what if it's the reverse happens and the employee writes a negative review.

Google: Yes, that is allowed.

I didn't even bother at this point to try and find what convoluted and bizarre explanation Google might come up with. So I ended the phone call.

To all professional, merchants and the public at large; Avoid the trap set by Google. Use Bing, that doesn't get itself involved in reviews, and the obvious conflict of interests involved with it. 

Dr. Ehud Sela

The Gentle Vet.

Thursday, May 26, 2016

COOPER THE GENTLE GIANT




This morning I examined Cooper a ninety pounds doggy, with blue eyes, and such a tender and loving personality.

Cooper had strong back pain—as he loves to play and wrestle with his canine brothers at home.

Cooper is not aware of his size and power, and he is afraid of so many things in life; that’s why I call him the Gentle Giant. 

Cooper doesn’t like the exam table—although we have a nicely padded table that is also a scale and is at ground level and can be raised. Yet Cooper morally objects to stepping on it.

So I examined Cooper on the floor, sat near him with my veterinary assistant, of course with his owner—mother—present.

Cooper doesn’t like his paws touched. He thinks that when his paws are touched it means a nail trim. He doesn’t like nail trimming as he thinks that pedicure and manicure are way overrated.

Never the less, with gentle voice, gentle persuasion and the assistance of tasty but healthy treats, I was able to collect a blood sample and Cooper didn’t feel a thing: he was too busy savoring the treats.

Blood work was normal, so I started Cooper on medication for his pain and inflammation.

I advised Cooper that he must take it easy for the coming weeks, so he doesn’t aggravate his back pain. Cooper barked and nodded and said he will give it serious consideration.

His mom told me that she will make sure that he takes it easy.

This is the story of Cooper, the blue eyed Gentle Giant.

Dr. Ehud Sela

The Gentle Vet

Margate, Fl 33063

Phone: 954-972-5900

© Dr. Ehud Sela. No work herein may be reproduced in any way without expressed permission from the author.

Monday, May 23, 2016

WHAT PROPER HEALTH CARE IN VETERINARY MEDICINE SHOULD CONSIST OF?



What proper health care in veterinary medicine should consist of? Seems like a simple rhetorical question, doesn’t it? Of course, you would say, and me too: good and loving and caring health care; first and utmost.
Sadly, as over the years big nationwide corporations infiltrated the profession, the answer is far from obvious for these companies. For example: look at Banfield Pet Hospitals. Do scratch the surface of your internet search engines a little deeper and search under law suits.
It seems that financial gains come first! Like so called wellness plans with so much fine print and such difficult escape clauses that would make even a lawyer blush—and I do have great respect for the law professionals, the majority does their job diligently and ethically.
Examples in my profession that disappoint me, to say the least:

I) Why to perform a nail trim, or advise a nail trim on every or most patients? If it's needed, yes, of course, but if it's not truly needed, and in some cases, in stressed pets, it can be harmful. Why to do it?

The answer, sadly, to the above question is financial gains. Let's do some simple numbers here: if the national company makes a 1000 nail trims per week--a not far fetched number-- at a minimal cost of $10.00 per nail trim, that comes to $10,000.00 per week. Multiple by the number of weeks in a year: 52 weeks, that comes to $520,000.00 per year, just for nail trims. But I believe that the numbers are significantly higher than that. 

II) Why does a sick pet need to be vaccinated? Why does a pet need all vaccines available regardless of health status and regardless of the pet’s life style? The answer, sadly, is financial again.
III) Why do simple procedures such as vaccines or blood draw need to be done away from the owner? What is there to hide? I actually find that pets are so much more comfortable with their owners present.
IV) Why to have incentive programs that reward the selling of products and expensive diagnostic tests? The answer is, sadly, financial gain. A reward should be given for excellent care that makes a pet feel better. That’s it!
Veterinarians should have only one guideline and goal: make the patients feel better, help and improve the bond of pets and people, and comfort and help at times of severe illness that cannot be helped.
Trust is the key word. Trust in our true love as veterinarians for pets and their wellbeing.
And if we do offer wellness preventive plans—as I do and believe in—make them transparent, make them a good value—and value that goes beyond monetary value—make them flexible, make them common sense and not a contract replete with smoking mirrors.
Dr. Ehud Sela-The Gentle Vet
Gentle Vet Animal Hospital, Margate Florida
Phone: 954-972-5900.

© Dr. Ehud Sela. No work herein may be reproduced in any way without expressed permission from the author.

Tuesday, May 10, 2016

THE PROBLEM WITH VETERINARY WELLNESS PLANS THAT FAIL TO DELIVER WHAT THEY PROMISE





In my practice I strongly believe in the great value of a true wellness plan for our pets as a great tool for early diagnosis and treatment.

My concern is of wellness plans offered to the public by a major national veterinary company, like Banfield Pet Hospitals, that as an underlying current—but a potent and motivating current—intend to tie the person into the contract for the full length of the contract and with heavy financial costs associated with early termination. The inducing factor of these plans is a convenient—so to speak—monthly payment, but, of course, and here I’m more than sarcastic, a nice down payment to join a plan.

As a matter of principal, and as matter of our liberty as consumers, all plans and programs joined should be fully transparent, and the cost of cancellation cannot be punitive, but instead, just and fair.

In addition the plans should list specifically what tests are included and not just generally speaking about diagnostic blood tests or fecal tests. There are various levels of blood tests and fecal tests available and the consumer should know exactly, and by a specific name what they are.

Furthermore, there should be no ambiguity as to the terms used and what they mean. An example, from a pamphlet from Banfield Pet hospitals: using the luring term unlimited office visits, and in the same time, a few lines further down using the limiting term comprehensive physical exam (2x/year). I believe the problem here is clear: what does an office visit include if not an exam? Does it include a non complete exam, thus providing poor health care? Or does the national veterinary company offering such services intends for this so called office visit to be an occasion for a social visit with tea/coffee and some biscuits? But, sarcasm aside, we as consumers should always safeguard our freedom to choose, or change or cancel at a reasonable cost and not a punitive cost.

We should ask ourselves if the wellness plans offered to us have the health of our loved pets as their first priority, or the bottom line, is the company’s financial bottom line, disguised and sweetened so we don’t see it for what it is!

Dr. Ehud Sela

The Gentle Vet

Gentle Vet Animal Hospital

Margate, Florida

954-972-5900

© Dr. Ehud Sela. No work herein may be reproduced in any way without expressed permission from the author. 

A SHORT STORY ABOUT A CAT NAMED BAXTER


Baxter is a 15 yrs old cat very sweet very friendly, with a few health issues.

Firstly, Baxter is a diabetic. Baxter watches his diet very carefully and his diabetes is due to his genes—the genes we come to this world with, they haunt us, alas. Anyway Baxter handles his diabetes very well and understands that he needs to get insulin injections twice a day to maintain his health.

Over the weekend sweet Baxter developed some serious neurological issues, unrelated to his diabetes. Baxter has dealt with his problem bravely and with a positive spirit, and with the excellent loving care of his owners and best friends, Baxter is walking again, slowly, but steadily improving.

And here are the best news of the day: Baxter is a pacifist and will not hurt a living thing, yet Baxter has a collection of toy mice that he controls and makes sure they are well behaved. Every night about 11 pm, Baxter will carry them in his mouth, bring them to the bedroom and declare in a loud meow that all mice are accounted for and the lights can be turned off and the family can sleep in peace. Baxter stopped doing it the last few nights due to his health problems, but the world can sleep in peace again, last night Baxter has returned to his toy mice duties. Who needs Superman, even more, who needs NATO; we all can sleep in peace as sweet Baxter is guarding the world’s night sleep.

I thought these are very worthy news and need to be shared….

Dr. Ehud Sela

Gentle Vet Animal Hospital

Margate, Florida

954-972-5900.
© Dr. Ehud Sela. No work herein may be reproduced in any way without expressed permission from the author.

Thursday, March 31, 2016

TARGET MY 17 YEARS OLD FELINE PATIENT



Target is a 17 years old spayed female cat that reaching this senior age, developed a few health issues.

Target is very particular about her privacy, so I will protect her name by calling her Patient T. Oops… I just realized I have already called her Target, oh well, I’m sure she will be OK with it, I will send her a nice email apologizing, but we'll continue calling her Patient T, as it sounds so much more mysterious.

Patient T hasn’t been feeling very well lately. She was losing weight, was vomiting and was hiding a lot at home. Also, Patient T, is very vocal and expects her owners to wake up at a certain time in the morning and freshen up her food; giving her the well-deserved attention she needs and expect.

Her owners noticed that she was much more silent and hardly complained to them. Mind you, when she complained she was always right, she has been on this planet for 17 years and she knows what to expect.

Her concerned owners brought her to my office and we brought her back to her usual vocal self with reasonable appetite and enjoyment of life: watching the birds and lizards, and those so very dangerous squirrels….

Patient T sees me often, she was coming twice a week, but now we are on a once a week schedule and her health needs are addressed and treatments added and modified if needed.

I treat her as an outpatient as I think more often than not pets do much better treated like this, staying at their home environment; that they know and feel secure.

Last but not least, if you come across Target, please call her Patient T, as she thinks, and I agree, it adds a certain level of sophistication to her.

Dr. Ehud Sela-The Gentle Vet

Gentle Vet Animal Hospital 

Phone: 954-972-5900

© Dr. Ehud Sela. No work herein may be reproduced in any way without expressed permission from the author.

Tuesday, March 15, 2016

THE CASE OF THE COLLAR, OR, ROSIE'S COLLAR, OR SHERLOCK HOLMES AS A VETERINARIAN.







Sweet Rosie, an eight weeks old Standard Poodle puppy has reached her loving new family.
Rosie is an amazing dog, tender, loving, intelligent and within the first few hours bonded with her new family.

Rosie’s owners called me very concerned the day following her arrival because Rosie has developed what they thought were severe orthopedic and possible neurological problems. Rosie every few steps would pull one of her hind legs forward, trying, and at times reaching her body with her paws. “The owners conducted extensive research consulting Dr. Google,” and it was clear and obvious that poor Rosie had something severely wrong with her.

Upon presentation Rosie appeared happy and content and an amazing Puppy. Rosie whispered in my ears as I was examining her, that she thinks her new family thinks there is something wrong with her, but she senses that she is doing very well, and with a lick on my face asked me to tell her family that she is just fine, and that she would love to be a member of the family for many years to come.

Rosie was right! Her physical exam revealed no abnormalities at all, but when we went to the lobby and let her run with her owners, she definitely would stop every now and then and presented the above mentioned symptoms. As Rosie is still a little puppy, and a little klutzy, she would sometimes trip over and it was a little humorous, but not to offend Rosie, I kept a stoic expression.

It appeared that Rosie was trying to itch her body, but no skin lesions were seen. Why Rosie would be itchy? I asked myself, and mainly while running and playing? I further pondered, then, like in all great mysteries, the truth become apparent to me: it was her collar. Rosie received her new collar yesterday evening, and she was trying to remove it, as it was mainly bothering her while running and playing.
I removed Rosie’s collar, and all symptoms were resolved, no more neurological, orthopedic, or skin problems.

As good old Sherlock Holmes would have concluded the case, he would have called it not the “The Hound of the Baskervilles,” but The Case of Rosie’s Collar.

One final note: upon leaving the office content with all her problems resolved, Rosie told me that if the collar had diamonds, she might consider it in a much more positive light.

Dr. Ehud Sela, the Gentle Vet

Margate, Florida

954-972-5900


© Dr. Ehud Sela. No work herein may be reproduced in any way without expressed permission from the author.

Thursday, February 18, 2016

Dr. EHUD SELA: ETHICAL AND COMPASSIONATE VETERINARY MEDICINE.




It is essential that the decision making as regards to a patient’s well being is firmly founded in Ethical and Compassionate approach.



In my mind the role of a Veterinary Doctor is, first and utmost, to try and make the pet feel better. Quality of life is essential to all of us: humans and pets.

Yes, medicine has costs—inevitable costs—associated with it. But good communication with the owner, tailoring only the needed tests—not a blanket approach that runs every possible test available—should be practiced.

Also, it’s essential that there will be a good level of trust between the doctor and the pet’s owner, so when treatment decisions are being made, they are being made with consultation and explanation of the possible outcomes.

In conclusion: The love of pets should be the guiding light as to how a Veterinary Doctor should approach his patients.


Dr. Ehud Sela

Gentle Vet Animal Hospital

Margate, Florida.

Phone: 954-972-5900  

© Dr. Ehud Sela. No work herein may be reproduced in any way without expressed permission from the author.

Thursday, February 11, 2016

THUS SPOKE TO ME OLIVE THE PUPPY





The cycle of life in my veterinary practice is constantly visible to me.

Last month, sadly, I've had a few geriatric and middle age patients, dogs and cats, that due to illness of a severe nature, and a grave prognosis, I had to perform euthanasia for them.

Death always deeply pains me, and in my practice I give a strong battle when the angel of death shows—and alas he does make his presence known.

But life goes on. Today Olive the puppy walked into my exam room, happy: full of life.

She placed her paw in my hand looked at me with her big puppy eyes and introduced herself. She told me with her big trusting puppy eyes: Life begins and ends for all of us, accept it Doc, it’s the cycle of life; it’s the river of life.

© Dr. Ehud Sela. No work herein may be reproduced in any way without expressed permission from the author.

Wednesday, January 20, 2016

CANINE BREED ANALYSIS & GENETIC SCREENING





As Veterinary Medicine advances the genetic knowledge of our canine friends is of utmost importance.

At Gentle Vet Animal Hospital we are happy to offer Canine Breed Analysis and Genetic Screening test.

The test goes back three generations as to the breed of the dog. In addition, it screens for hundred and thirty genetic markers for possible diseases. This screening will enable early diagnosis of possible serious diseases.

Carrying the genes for certain diseases doesn't necessarily mean that the disease is inevitable. At times the occurrence of the disease can be delayed or prevented with appropriate measures.

Our genome interacts constantly with the environment--internal and external--and adjusting the internal or external environment can be beneficial.

Knowledge is power, knowledge is prevention, and knowledge should be used in pursuing a better and longer life for all of us.

Dr. Ehud Sela

The Gentle Vet

Gentle Vet Animal Hospital

954-972-5900.

© Dr. Ehud Sela. No work herein may be reproduced in any way without expressed permission from the author.