Dr. Tan works at our San Fernando Valley Hospital and her special interests include feline medicine, gastroenterology, and endocrinology. Dr. Tan enjoys doing endoscopy and feeding tube placement and can fluently speak Mandarin.
Dr. Elana Hadar explains how ultrasound works and what we commonly use it for in this quick video! Dr. Hadar’s professional interests include gastroenterology, immune disorders, and oncology, and is an active member of the American College of Veterinary Internal Medicine and the American Veterinary Medical Association.
In an ultrasound examination, a probe sends sound waves to the body and receives the echoing waves, creating an image on the screen. It’s a great way to examine the inside of the body in a painless, non-invasive way.
Here Dr. Gideon Daniel, one of our Internal Medicine specialists, demonstrates some of his techniques on a mango! He showed us how to perform an ultrasound as well as how to collect a sample—we commonly take urine and fluid samples during an ultrasound to run further diagnostics.
This is such an honor, as nominations are made by pet owners and community members. We would like to congratulate all of the winners of the Pet Plan awards this year and look forward to the 2017 nominations!
Dr. Adam Eatroff, our newest internal medicine specialist, joined me on visits to primary veterinarians to spread some holiday cheer recently!
The ‘sleigh’ was packed and bells were jingling, and we got the word out about him starting our Nephrology Department at ACCESS Specialty Animal Hospital in Los Angeles. Dr. Eatroff was able to answer numerous questions for primary veterinarians about hemodialysis, and looks forward to more visits in the New Year!
Director of Community Relations | ACCESS Specialty Animal Hospitals
Dr. Erinne Branter and Koda
Belly Full Of Metal Leads To Diagnosis Of A Congenital Liver Shunt.
Koda’s Second Chance!
Koda Taylor, a striking, young Siberian Husky, was living in a local shelter when his new mom found him, hours before he was scheduled to be euthanized. After being adopted, Koda was taken to a primary veterinarian for an examination, as his history was unknown and his new family wanted to make sure he was getting the best start to his new life.
During the exam, the doctor noticed something wasn’t right. After some x-rays were done, it was revealed that Koda had a ton of metal in his belly! A buckle, a bolt, some pins, parts of leashes—it was apparent that this pup need help and quick! Koda had surgery done with his primary veterinarian to remove the foreign objects and the surgery was successful, but something still wasn’t right. Koda went on to see several primary care veterinarians, a few told his mom to euthanize because something was wrong with him mentally.
A buckle, a bolt, some pins, parts of leashes—it was apparent that this pup need help and quick!Koda’s mom had a hunch that this pup had something else going on, so she continued on, and found a neurologist to evaluate his abnormal behavior. The neurologist referred them to an internal medicine specialist who finally saw what was causing the trouble, this time, it was Koda’s liver.
Koda’s liver was small and his bloodwork revealed his liver values were very high. His internist diagnosed him with liver shunt, an intrahepatic portosystemic shunt, to be exact. A liver shunt is a blood vessel that carries blood around the liver instead of through it. In some animals, they are born with a liver shunt (congenital) though in others, multiple small shunts can form because of severe liver disease. If left untreated, a liver shunt can cause toxins to build up in the bloodstream or kidneys as well as abnormal behavior, and eventually liver failure. Koda was prescribed a strict diet and medications to help him through the time between the diagnosis and his next appointment and was referred to Dr. Erinne Branter, an internal medicine specialist and the head of the Interventional Radiology and Endoscopy Department at ACCESS LA.
Dr. Branter recommended a contrast CT angiogram and this found that young Koda had one large right sided shunt. Options were discussed with Koda’s family such as; surgery and medical management vs. a minimally invasive approach via a percutaneous transjugular coil embolization, or PTCE. They agreed that the best choice for their family and Koda would be the PTCE, which is a minimally invasive procedure that would correct the intrahepatic portosystemic shunt in Koda’s liver with much less risk than traditional surgery.
Between the adoption fees, foreign body removal, examinations, medications, CT scans, and more, the bills were starting to pile up. Wanting to provide her sweet pup with the best care possible, Koda’s mom looked for help with a group of local Husky lovers. They helped her create social networking pages to raise money and awareness for Koda, who was suffering from a congenital liver shunt. So began Koda’s Hope. Relying on the kindness and generosity of others, the Taylor family began their fundraising journey. Little by little, donations came in and Koda’s family was able to pay for his surgery.
Then, in July of 2015, Koda and Dr. Branter met again. Koda was placed under anesthesia and brought into the very first purpose-built interventional radiology suite for animals on the West Coast. From there, Dr. Branter used fluoroscopy, a live video x-ray, to perform the PTCE, where a catheter is inserted into the jugular and is guided it all the way down to the liver. Dr. Branter then used an angiogram, which is an x-ray test that uses a special dye and fluoroscopy to take pictures of the blood flow in an artery or a vein, to confirm the size and location of the shunt.
Once the location was confirmed, Dr. Branter placed a caval stent, then brought six embolic coils down to Koda’s liver and placed them at the location of the shunt entry into the cava to increase the pressure around it and divert blood flow back into the liver.
Koda had very little recovery time as opposed to a traditional surgery.In just a few hours, Dr. Branter had successfully corrected the liver shunt and Koda was waking up from surgery. Being that the PTCE is a minimally invasive procedure, Koda had very little recovery time as opposed to a traditional surgery, and was able to go home in just two days. Of course, with any surgery, there are precautions one needs to take—Koda wasn’t allowed to have any leashes or collars around his neck and was ordered to kick back and relax for the first few days home to ensure his body healed properly.
Everything went well and Koda healed beautifully. He now has a long, bright future full of loving his family and raising awareness for liver shunt in dogs like himself.
Keywords: liver shunt, congenital liver shunt, percutaneous transjugular coil embolization, minimally invasive treatment of liver shunts, caval stent, liver failure, elevated liver enzymes
We take care of every patient at ACCESS Specialty Animal Hospitals as though they were part of our own family. Occasionally though, our staff members experience medical emergencies with their own pets which reminds us how it feels to entrust others with the care of our furry family.
This is exactly what happened to Kristen, a surgery assistant to Jana Norris, DVM, DACVS.
Kali, her dog, wasn’t eating, had vomited a few times, and just didn’t seem like herself, so just in case, Kristen brought her to work.
It’s a good thing she did. A physical examination, blood test, and an ultrasound by Dr. Elana Hadar revealed an enlarged and very inflamed kidney that was near failure. At that point we knew what had to be done: she needed her kidney removed, and it needed to be done quickly.
Kristen responded to the news as a loving and worried pet owner and not as an employee. She felt confident all would be well, but struggled to keep back the tears and needed a hug. So instead of her usual role of being part of the surgical process – helping owners admit their pets into the hospital, prepping animals for surgery, and assisting the surgery team – Dr. Norris and the rest of our staff insisted that they would handle everything.
So Kali was prepped for surgery, protocol was set, and the team at ACCESS San Fernando Valley swung into action.
Good news! It wasn’t long before Kristen was told that the surgery went very smoothly, and the prognosis for Kali’s recovery was excellent. Kali, who had won the hearts of all who cared for her, recovered quickly and comfortably, and continues to improve at home, looking and acting better than ever!
Go Kali and Kristen!
We know that you love your pet – your companion and your friend. We also know the stress and worry that comes along when they are sick, and we know the pain and heartache when tragedy strikes. We love our pets and would do anything for them, which is why we take care of every patient as if they were our own, because we know how much you love them.
When Zane’s buddy wanted to show him support, she dressed-up for the occasion.
How cute is that?
Zane was presented for anemia* from an unknown cause. After checking blood-work and abdominal imaging, Dr. Amanda Blackburn (Department of Internal Medicine) was able to diagnose Zane with an immune condition that attacks the red blood cells (immune mediated hemolytic anemia) and begin treatment.
At his check-up appointment last week Zane was responding very well and is feeling good. To ensure all goes well, which will no doubt please both him and his little princess, the team at ACCESS Speciality Animal Hospital in Los Angeles will be rechecking his progress and adjusting his treatment plan over the next three to four months.
*Anemia is the result of an abnormal breakdown of red blood cells, and as this is where Hemoglobin delivers oxygen to the tissues and cells, symptoms resulting from a ‘lack of oxygen’ can be ‘pale or white gums’, lethargy, shortness of breath, and a general lack of stamina.
“Bo Bo Kitty”, our most handsome patient of the day, sits patiently with his mom at ACCESS Specialty Animal Hospital in the San Fernando Valley while waiting for his appointment with Internal Medicine Specialist, Dr. Elana Hadar.
(Understandably, where “Bo Bo Kitty” wants to sit, “Bo Bo Kitty” sits…)