Archive for the Surgery Category

Welcome, Dr. Kim!

This week we welcomed Dr. James Kim, a board-certified surgeon, to our surgery team!

Here, he performs a fracture repair with Dr. Talli Hogen with assistance by several surgery team members.

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Snuggles Before Surgery…

Rhianna is an RVT who works in the surgery department at ACCESS San Fernando Valley. She’s seen here snuggling a very sweet pup while anesthesia medication is administered.

Our staff is highly trained in safe anesthesia protocol, and while it may not be in a textbook, snuggles and love are always included in our process.

Rhianna

How a Balloon Fixed This Pit’s Heart.

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Cranberry-sittingCranberry was diagnosed with severe pulmonary stenosis when she was just a few months old, meaning flow of blood from the right ventricle of the heart to the pulmonary artery was obstructed, causing pressure and stress on the heart.

Depending on the severity of the obstruction, it can cause issues like a murmur, an arrhythmia, or even congestive heart failure. Upon diagnosis, Cranberry’s regular veterinarian referred her over to Dr. Steve Cole, the head of Cardiology at ACCESS San Fernando Valley.

Cranberry was part of the rescue group Angel City Pits, who after meeting with Dr. Cole, decided they wanted to pursue a procedure that would correct the issue. Dr. Cole teamed up with Dr. Yonathan Buks, one of the surgeons at ACCESS, to perform a balloon valvuloplasty in our interventional radiology suite. Using fluoroscopy, they were able to see a live x-ray of Cranberry’s heart. They made a small incision to insert a catheter that was used to guide the balloon (see below) the exact point needed to repair Cranberry’s heart. The balloon was successfully inflated at the point of the obstruction to open the path and allow blood to flow properly.

Cranberry made a full recovery and will now live a full, healthy life. She’s now considered a “foster fail” as her original foster mom decided to adopt her and officially make her a part of the family! We are so happy we were able to help Cranberry and thrilled that she has found a loving forever home.

If you would like to support Angel City Pits, please visit www.angelcitypits.org

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Max the Terrific Tripawd…

Max is a lovable Pit Bull mix who came into our Los Angeles emergency room after being hit by a car in early 2016.

Luckily, Max was okay except for his front leg that was very badly injured. After the careful evaluations by our specialists and learning about all of their options, Max’s parents decided that the best course of action would be to amputate the leg. Even though Max’s injury was serious, he never lost his sweet and upbeat demeanor! Max wagged his tail during his examinations and gave kisses whenever he could. Before surgery, Max was snuggled by doctors and staff members and given medication to keep him comfortable.

The surgery was performed by one of our board-certified surgeons, Dr. Kim Carey and was very successful. After his procedure, Max was kept in our emergency room for 24×7 monitoring where he was given medication, love, and when he was ready, food. Our staff and Max’s family worked together to make sure Max healed up appropriately and learned how to walk on three legs safely.

In no time Max was up and running and we were thrilled to see him doing so well when he came back to us for a recheck!

Max

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Dr. Buks is Boarded!

After having completed veterinary school, an internship, and a residency in surgery, Dr. Yonathan Buks has worked diligently to further his education…  

Now, after years of hard work and long, late hours, he has successfully completed an intensive written examination, along with a required publication accepted by peer-reviewed journals, and  is a board-certified surgeon – in other words, a surgical specialist.

We are delighted to be able to celebrate his accomplishments – which also allows ACCESS Specialty Animal Hospitals to provide six day board-certified surgical coverage in the San Fernando Valley.

Outside the operating room, Dr. Buks, who is fluent in English and Hebrew, enjoys downhill skiing, cycling, cooking, and spending time with his wife and two kids, as well as the household cat named Betty.

 

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Sarah’s Survivor Party

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“If she makes it two years, I’ll throw her a party!” said Dr. Jana Norris.

Two years ago, Dr. Norris, the head board-certified surgeon at ACCESS, San Fernando Valley, performed a triple ventral slot procedure on Sarah, a procedure which would prevent this adult dog from becoming fully paralyzed. During the procedure, Dr. Norris found that she also had a thyroid anaplastic acinar carcinoma, an aggressive form of cancer.

This was tough news for the then ten-year-old dog and her family, but her owners were determined. They faced each challenge head on, not willing to give up on their furry family member. Sarah was able to be treated for her cancer by the Veterinary Cancer Group, and was eventually pushed through to remission by the wonderful specialists there.

Then, in August of 2015, we threw a party for Sarah the dog.

Sarah’s battle and recovery are truly amazing and it’s a case like this that reminds each of us why we are here and keep us grateful for the advances in veterinary medicine that make it possible for us to treat beloved animals. “Her prognosis with aggressive high grade and high stage cancer was poor all along, so it is amazing that she made it to two years post-op. That is a very good response to therapy and survival time after this diagnosis.” says Dr. Jana Norris.

We were happy to see Sarah back at our hospital, but this time, in our conference room! Dr. Norris provided a super-dog costume for super Sarah, who dined on gourmet dog treats; while the humans snacked on pizza. Sarah and her family brought a beautiful cake for the staff, and we all spent time talking about Sarah’s initial visit, her diagnosis, subsequent surgeries, and treatments.

We celebrate our patients each and every day, but it was nice to set aside special time for Sarah and her family.

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Life as an RVT: Puppy Anesthesia Challenges..

By Rhianna Depew, RVT…

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Dr. Steven Cole, our board-certified cardiologist, approached me and asked a very delicate question. “How do you feel about doing anesthesia on a two-week-old, tiny puppy?”

“Puppy” as she was aptly called, since she hadn’t acquired a name yet, was a cute and cuddly, and very fragile Burmese Mountain Dog neonate that was already having cardiac issues at her young age. She had patent ductus arteriosus, or PDA, which is a congenital vascular communication between the aorta and pulmonary artery. This is normal for humans and animals in the womb, however in some cases, this vessel fails to close normally at the time of birth.

If left untreated, a PDA can cause severe cardiac enlargement, and eventual congestive heart failure (fluid in the lungs), or pulmonary hypertension (high blood pressure in the lungs).
In fact, most dogs with an untreated PDA do not survive the first few years of life. Because of how tiny she was, she wasn’t a good candidate for the typical, minimally invasive technique with catheters. Instead, Puppy needed open chest surgery in order to accomplish the PDA ligation; but that also meant a lot of risk, and a whole host of potential complications.

Dr. Cole knew I loved challenges, and was always up for our most difficult cases, but this one was different—a suckling neonate under general anesthesia is extremely high risk. But we were determined to do everything we could to help this puppy, so I started planning ahead. I thought about this small, delicate puppy every day leading up to the procedure, as well as the night before. She kept me awake, going over every detail and making mental checklists of everything I needed to get her safely through her risky life-saving surgery.

That morning I woke up early and wanted to make sure I arrived at the hospital ahead of schedule to start planning and preparing. This was the smallest heart surgery I had ever assisted with. She would need the tiniest versions of all the equipment we normally used. Tiny catheters, tiny endotracheal tube, tiny, tiny doses of medication and anesthetic drugs. I calculated all the “what if” emergency medications ahead of time and went over and over again everything we needed. I went over to Puppy’s cage and scooped her up. She fit into the palm of my hand and had the typical clumsy movements of a newborn. She was incredibly soft, and made the cutest little squeaky puppy sounds.

She fit into the palm of my hand and had the typical clumsy movements of a newborn. She was incredibly soft, and made the cutest little squeaky puppy sounds.
I gave her a kiss and held her up to my cheek and told her that she was going to do great, and that there would be plenty of days of running through grassy parks, toys, and treats in her future. Then I placed her back in her bed of cozy blankets so she could get some rest before her big procedure, and so that I could go triple check that everything was in place.

When it came time for surgery, we prepped the puppy before we put her under anesthesia and had every warming device at our disposal to keep her temperature up. I gave her micro doses of anesthetic to get her sleepy, placed ET tube in her trachea to control her breathing, hooked her up to the anesthesia machine and patient monitor, listened to her little heart beating on the monitor, and gave her some tiny breaths.

Then, I remembered to breathe, as I was holding my breath with each step taken to prepare Puppy for her big procedure. We were on our way.

Our board-certified surgeon Dr. Jana Norris, along with Dr. Cole, arrived into the OR, and we wasted no time getting right to it. The room was silent. We were all hyper focused in our tasks at hand: to accomplish this procedure and get this puppy out quickly and safely. Dr. Norris’ skilled hands were each the size of the entire patient, and they worked precisely and efficiently around the puppy’s tiny heart and lungs. I continuously watched between my monitor, the patient and the doctors, monitor, patient, doctors, monitor, patient, doctors—trying to stay a step ahead at all times. You could cut the tension with a knife, and I don’t think any of us had taken a full breath, then….

Dr. Norris assured everyone in the room with a confident “I got it.”

Puppy was doing great under anesthesia, and knowing the mission was accomplished, I could feel some nervous tears welling up. We finished the surgery and gave each other well deserved verbal high fives. I brought our tiny patient into recovery and stayed by her side until she fully woke up. Within a couple of hours she was back to being her cute and wiggly self, and wanting to be bottle fed.

Puppy was able to go home a few days later and recently came in for a recheck with her beloved cardiologist. She’s doing very well and is expected to grow fully to her Burmese Mountain Dog size and live a long, happy life. Puppy will be a constant reminder that preparation, precision, dedication, and team work, are all crucial to saving an animal’s life. For now, Puppy will continue to steal our hearts and bring joy to the hospital with each and every visit.

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From Left to right: Dr. Jana Norris, Dr. Steve Cole, and Registered Veterinary Technician, Rhianna Depew.

Thank you…

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Dr. Annie Lo: A Cut Above the Rest…

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We are thrilled to announce that Annie Lo, DVM, DACVS is now a board-certified veterinary surgeon. Dr. Lo, a California native who grew up in San Francisco, received an undergraduate degree in Molecular and Cellular Biology from the University of California, Berkeley in 2000, after which she extended her studies with research in human hematology.

In 2009, Annie completed her Doctor of Veterinary Medicine degree at the University of Illinois, going on to complete a small animal surgical and medical internship at the University of Pennsylvania, where she stayed on as a Small Animal Surgical resident.

Today, fully entrenched in the Department of Surgery at ACCESS Animal Specialty Hospital in Los Angeles, she is a highly regarded doctor, with interests in minimally invasive procedures (laparoscopy, thoracoscopy, and arthroscopy), surgical oncology, reconstructive wound surgery, emergency surgery, urinary tract surgery, and various orthopedic procedures. Dr. Lo enjoys reading, gardening, and crafting. She has a special interest in origami, and utilizes her penchant for precision to create beautiful paper flowers.

We want to congratulate Dr. Lo on such an impressive accomplishment!

The Surgeon with the skull collection…

Jana-Norris-DVM-DACVS-ASFVJana Norris, DVM, DACVS joined our San Fernando Hospital in January 2013 to head up our new surgery department, though her road to veterinary surgery had quite a few twists and turns in it. Jana grew up as a child actor working in theater and received her Bachelor’s degree in Fine Arts from USC. After working as an actor for a few years, she literally “woke up one day and didn’t want to do it anymore”. We sat down with Jana to find out what led her to ACCESS Specialty Animal Hospitals.

How did Dr. Norris decide she wanted to work with animals?
When she was acting, her dream was to land a sitcom and make enough money to move to the country and live around animals. Jana decided to cut out the middleman and go right into veterinary school.

What is her favorite animal?
The Octopus. Why? “They can change color depending on their mood, they are the smartest invertebrates, able to learn a task in a single trial and remember it for the rest of their lives, and they can fit through a hole the size of their own eyeball!”

Why surgery?
Jana has always been into fixing things and finding out how they work. As a child, she used to like playing with tools, and even took apart the TV and phone, much to her parents’ dismay. She really enjoys “the structural approach to disease”. The chronic, inevitable decline of patients is too emotionally taxing, whereas surgery is repairing the issue at hand. Jana sees surgeons as “the cowboys of the hospital”; they’re able to come in, take a patient, and fix the problem they’re presented with.

What are the most challenging procedures Dr. Norris has ever done?
“Any critical care patient is stressful, because you know that there is a risk that what you’re about to do to help them has the potential to be unsuccessful, but they will not survive without your treatment.”

What is her favorite procedure to do?
Dr. Norris is heavily influenced by her past, enjoying ‘putting things back together’. In her words, her favorite procedures have to be “fracture repair and skin grafting & reconstruction!” The procedures are the same as they are with humans, and Jana enjoys being able to be creative with both art and structure to reestablish form and function with the surgical procedure.

What is her “bread and butter”?
“Cruciates! They are so well researched and such a common injury. We have excellent outcomes with the right approach, and when done correctly, have a 100% success rate.”

Why California?
Jana lived in California for 17 years before moving to the East Coast. She eventually ended up in Philadelphia, where she worked at the University of Pennsylvania with her then future husband, ACCESS Cardiologist Dr. Steve Cole. She loved California and what it had to offer, so after marrying Dr. Cole in Switzerland and having their reception at the Mutter Museum(!), Jana and her new family moved back to the sunny scenery of California.

Wait… they had their reception at the Mutter Museum?!
They sure did! Dr. Norris has a fondness for things many people would consider…unusual. She has a collection of 40 skulls, both human and animal. The smallest skull she owns is that of a vampire bat, and the largest bone structure is the entire spine of a calf. She even has a fully articulated canine skeleton in her living room! When she was a pre-vet student at Santa Monica College, she supervised a dermestid beetle colony. The dermestid, or carrion, beetles are used to clean bones as they are the most effective tool to clean the bone while also preserving it.

So, she has a skull and bone collection. What else is she into?
Dr. Norris’ home is quite the showcase for out of the ordinary collectibles. In addition to animal and human bones, she also has an array of vintage medical equipment and posters. Her collection includes decades old handheld Oster clippers, speculums, and glass syringes that are seen as pieces of art in her house.

What is her most prized possession?
“My father’s medical kit from the 1940s.” Dr. Norris’ Dad, Dr. Norris, is a Rheumatologist and gave his black doctor’s bag to Jana. Inside you’ll find a stainless steel emergency tracheostomy kit. It’s basically a Swiss Army Knife with tools used to stab, cut, and intubate a choking patient.

What’s her favorite dish?
“Beef tenderloin, rare, with my mom’s white spaghetti”. Dr. Norris also loves to cook and her Rum Cake is her specialty. She makes a ton of them around the holidays, as her family and friends are constantly requesting her delicious dessert!

Dr. Norris is one of over a dozen skilled and interesting doctors at ACCESS Specialty Animal Hospitals, and we are so grateful to have her on our team. She brings a fierce dedication, wealth of knowledge, and passionate enthusiasm to each day she works and is available Tuesday through Friday.

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Locations

South Bay

2325 Torrance Blvd., Torrance, CA 90501

Tel: (310) 320-8300 - Fax: (424) 293-7254

Los Angeles

9599 Jefferson Blvd., Culver City, CA 90232

Tel: (310) 558-6100 - Fax: (310) 558-6199

San Fernando Valley

20051 Ventura Blvd., Woodland Hills, CA 91364

Tel: (818) 887-2262 - Fax: (818) 704-0323

Central Valley

4300 Easton Drive, Bakersfield, CA 93309

Tel: (661) 281-1320 - Fax: (661) 302-4193

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