Hospital News and Views

After the first Chemo treatment

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Today is 4 days after D.J.’s first chemo treatment and he seems to be back to his old self.


During the week between his diagnosis and first treatment there was a noticeable decline in his health. He was lethargic and had difficulty eating due to the size of the lymph nodes on his neck. Our appointment with Dr. Richardson at the Ontario Veterinary College Oncology Center couldn’t come soon enough.


At our appointment I learned about the proposed treatment protocol and D.J. had an exam, blood work and an ultrasound. The blood work determines whether or not he can have the scheduled treatment and will be repeated before each treatment. The ultrasound was an investigation to make sure he had no other concerns and to assess the size of his internal lymph nodes. Ultrasounds will be repeated and changes in the size of his nodes will determine his response to the treatments.


Despite being unwell for his first visit, he still required sedation for his ultrasound. He is a super nice dog, but even at the best of times he doesn’t like being held still. When he had his chest X-rays last week at my clinic, my associate exited the room shaking her head. Apparently, even when sick he is strong. Although the sedation knocked him back for a few days, within 24 hours of his first treatment his lymph nodes were smaller.


He has continued to improve every day and today seems to be himself again. The only adverse effect other than the slow recovery from the sedation is that one of the medications makes him drink more and therefore he needs to urinate more. He had 1 accident in the house. Everyone assured him that it was OK and not his fault and gave him treats.


He will be having 1 treatment weekly for 8 weeks. First he had an injection of vincristine. Next week he will get an oral medication, cyclophosphamide. Week 3 is another injection of vincristine and week 4 is an injection of doxorubicin. This 4 week cycle is repeated and then continued with 2 weeks between treatments.


There are many factors that affect the decision to have a pet undergo this type of treatment: side effects, remission rate, and life expectancy. I decided to treat D.J. because he had no other health problems and there was a good chance that the treatment would achieve remission and he could survive to a natural life expectancy. I will not continue with treatments if they make him unwell or he becomes unwell because they are not working.


There are a few other determinants of treatment that I did not consider before embarking on this journey. The entire 6 month protocol costs $5000. And each visit to OVC will require 5 hours of my time. Finding $5,000 is a challenge but finding 5 hours every week is almost a bigger challenge. Fortunately, the costs are paid at each visit and not as a lump sum and qualifying to participate in some of the ongoing studies subsidizes some of the costs. As for time, I have had a few friends offer to take D.J. to his appointments.


To have D.J. seem healthy again with no side effects from his first treatment makes the investment of time, money and emotions all worth it.

A Vet’s Pet Gets Sick – After the initial diagnosis

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This is what happens when you diagnose a pet with lymphoma:


  • The very next day he seems to be lagging behind on his walk.
  • The very next day he seems to be eating more slowly.
  • He gets way more attention from everyone in the family.
  • He gets more treats and develops diarrhea.
  • Every time he coughs it is very concerning.
  • He hears how good he is all day long.
  • His bed doesn’t seem cushy enough.
  • He needs his water refreshed more than once daily.
  • The other dog gets in trouble for playing too rough and too much.
  • He gets checked on in the middle of the night.
  • He is excused from a much needed bath because he doesn’t like them and is a bit smelly for his introduction to the oncologist.

A Vet’s Pet Gets Sick

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Last Thursday was my day off. The plan was to tackle a long around-the-house to-do list. I started the day as usual; feed the pets, run, feed horses, clean stalls, and then walk the dogs. I have 2 Labs, 10 year old D.J. and almost 3 year old Blue. I gave them a pet after our walk and my day changed dramatically. I felt a lump under D.J.’s jaw. I felt another one on the other side of his neck and a few more below these. Immediately, I knew I needed to test the lumps, run some blood tests, take chest X-rays but there was only one possible diagnosis for what I had found. D.J. had lymphoma and this was going to end his life.

I felt it all; my heart sank, I had a lump in my throat, my energy faded, my mind filled with too many thoughts.

I had talked the talk many times. Lymphoma is treatable but not curable.
Treatment options include:
• a 6 month multi-drug protocol can results in an 80-90% remission rate and an average life expectancy of 12 months including the 6 months of treatment;
• a single drug protocol every 3 weeks for 5 to 6 treatments for a 70% remission rate and average survival time of 9 months;
• oral palliative chemo every 3 weeks with an average 4 month survival time.
Having talked the talk, I now had to walk the talk and I had no idea what to do.

Is it fair to put D.J. through 6 months of chemo so I can have him a bit longer? Well, pets are supposed to tolerate chemo better than people do. Where would I find the time to get to treatments every week or two? I could probably do some of the treatments myself. An average life expectancy of twelve months isn’t very long. But 12 months means we might have him next Christmas and that is a long way away. We would have spring, summer swims in the pool and autumn bush walks.

With my head far to full of questions, I gave up on my to-do list and took D.J. to the clinic to start the testing. The roller coaster ride this day was going to be continued.

When I arrived at the clinic I was immediately informed that clients, whose dog I diagnosed with lymphoma a few weeks ago had called wanting their dog euthanized that day. She was no longer responding to palliative treatment. They requested me for the appointment but were informed that it was my day off. My associate would be helping them and they were scheduled to arrive at any moment. I was now there and wouldn’t hide. I decided to greet them, take them into the quiet room and explain why I was there. They took the time to give me a hug. I offered to try to do the appointment and if needed my team would assist. I shut down the pet owner part of me and helped them say good bye to their beloved pet.

I needed this roller coaster of a day to slow down.

The next event at the clinic was just what I needed. An internist was scheduled to arrive to consult on a complicated case. I stole a few moments of her time. She palpate D.J.’s neck. “You poor thing.” She also did not need any further testing to diagnose lymphoma. I told her I didn’t know what I was going to do. She put things in very simple terms. I shouldn’t think about a 6 month commitment to weekly visits and $5000. I should just try one round of chemo (3 weekly treatments) and see what happens. One round will show how D.J. tolerates the medication and will determine if the lymphoma responds to the treatments. Decision made. We will try one round of chemo.

I had to remind myself that I hadn’t yet confirmed the diagnosis. I planned to do blood work and X-rays but diagnosing lymphoma meant taking a sample of the lumps and submitting the sample to a pathology lab. I have worked with a local pathologist for 25 years but he recently stopped reading this type of sample. I really trusted his work. I sent him a message asking if he would consider reading this cytology for me. He answered by personally calling the clinic to say he would be happy to help. Without me knowing, arrangements were made that one of my assistants would drive the sample to the pathology lab and he would read the sample that evening so I would have results the next day. The support network was starting to form.

My family was still unaware of D.J.’s condition and the events of the day. That evening we had a family meeting the outcome of which I already knew. The usual decision at family meetings about pets is that since one of us is a vet that member should make the decision.

The report came the next day. It included some supportive comments and the words “no charge” but confirmed the diagnosis of immunoblastic malignant lymphoma. I called OVC (Ontario Veterinary College) Oncology Center and D.J. starts treatments on Thursday. I am expecting another day off full of emotions and questions.

Kittens Looking for Loving Home

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Meet Whelan and Olive. Both of these precious kittens are currently at our clinic and we are trying to find loving homes for them.

Whelan is the Orange and white kitten. He is 5 months old. He has been vaccinated, dewormed and neutered.

Olive is the Black kitten with splashes of white. She is 10 weeks old. She has received her first set of vaccinations and deworming.

Both are playful, curious and love lying around.

Please let us know if you are interested in bringing one of these little darlings into your home!

Ticks can be active starting at 4 degrees!

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March 1st 2017 Elmira’s daytime high reached 12 degrees Celcius! Yes I was excited I didn’t have to endure the battle of the snowsuits for my two young girls but another thing it brings up is new recommendations regarding Tick prevention. Over the last few years, Dr. Hirzer and I have been seeing an increase in Tick cases and are encouraging using prevention against them for dogs that live an active outdoor lifestyle. Ticks can become active at temperatures starting at 4 degrees and with predicted day time highs of 10 degrees again next week we are recommending starting prevention now in March and continuing until November.

Dr. Julie Fell

Tick Attack

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EngorgedTick ticks on finger ticks_on_dogs_2

Drop by the hospital to see Dr. Linda’s tick collection. She estimates that over the past 2 decades she encountered ticks on pets about a dozen times. Then, last summer alone she matched this, collecting over a dozen ticks from patients. Ticks are in the news as their populations seem to be growing and spreading.

Ticks are mysterious little creatures. They are lurking on the ground and vegetation waiting for their next meal to come along. The meal they are waiting for could be you or your pet. The following links provide current and accurate information about ticks and our pets.

This website provides a general overview of ticks and pets.

See live action video of various tick species.

The following link provides instructions on how to remove ticks.

A video of how to remove a tick.

Prepare yourself and your furry family for this season’s tick attack.

When you think of ticks think T I C K=TEST+INSPECT+CLAW+KILL


Test your pet for exposure to diseases that are spread by ticks. These include Lyme disease, Anaplasmosis, and Ehrlichia. With a few drops of blood we can test your pet for antibodies to these diseases. The presence of antibodies indicates your pet has been bitten by a tick and has been infected by one of the above diseases. Pets that test positive can then be further assessed for evidence of ongoing infection and can be treated. Many pets with antibodies will have eliminated the infection but the fact that they were exposed is important information for their human companions. Evidence that your pet has been bitten by a tick means you were and may continue to be at risk.


Tick season begins as early as March so we are well into tick season now. Inspect your pet for ticks after outdoor activity.


Check out this video on how to remove a tick from your pet. We have a supply of Claws to help you with the process. Drop by the clinic for your free tick removing claw.


The apparent increase of ticks in our area has resulted in the licensing of several new products that can help control ticks on your pets. Nexgard and Bravecto are chewable treats that will kill ticks on your pet for 1 to several months. Revolution is applied topically and will prevent heartworm, ticks and fleas. Call or visit us and we will customize a parasite control program for the individual needs of your pet(s).

There was nothing wrong with this sick dog.

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 sick shi tzu

Keya is a long term patient of the North Waterloo Vet Hospital. We have been taking care of her for most of her 15 years. This summer, she was travelling with her owners, and had to visit a vet in the U.S. because she was limping. An exam and x-rays found nothing wrong with Keya. She was treated with antiinflammatory medication and her lameness improved. In September Keya came to see me becaue she had a poor appetite and was losing weight. She had a complete physical exam and blood testing and I could find nothing wrong with Keya. Even her occasionaly sore leg seemed to be fine. I decided she might have stomach irritation from taking the medication for her lameness and began treatment for an upset gut. She came back 2 weeks later. Now she was not eating at all and was very weak.  She could walk, was willing to eat treats and was alert but she seemed to have no energy. She had another physical exam and xrays and once again there was nothing wrong with Keya.

Keya was sick, but no one could find anything wrong with her.

I reviewed Keya’s health over the past few months with her pet parents and the topic of ticks emerged. They had had to remove several ticks from Keya over the past year. We collected another blood sample and sent it to the lab to be screened for tick borne diseases. Keya tested positive for Lyme disease. The signs of Lyme disease include lameness and loss of appetite and in dogs it can cause serious kidney disease.

Keya is currently being treated for Lyme disease and is responding.

Dogs that have had exposure to areas where ticks are present can be easily and inexpensively tested for tick transmitted diseases. Consider having your dog tested yearly.

For more about tick borne diseases:


When a Dog’s World Ends-Thunderstorms & Fireworks

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This is the time of year thunderstorms and fireworks can make some pets’ lives a living nightmare. Fears and phobias intensify over time. When dogs are young and their reaction to frightening things is mild the problem is easily overlooked or, at least, easy to live with. But when the fear intensifies and their reaction becomes destructive or dangerous, suddenly the pet parent is faced with a problem.

scared dog


The following articles will help you monitor and support your pet if they are developing a fear of thunderstorms and/or fireworks or are already terrified by these events.

This is a general article about fears and phobias:

This article is more specific to storm and fireworks phobias:

And this last article discusses treatment of these fears:

Please contact us if you think your pet is developing or is suffering from loud noise phobia.

Summer Teeth

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Meet Zoe, another one of North Waterloo Vet Hospital’s super cute patients. When I was checking her mouth, during her annual wellness visit,  her owner told me she had summer teeth. I looked at her a bit bewildered. She explained as I looked at Zoe’s teeth, “some are here, and some are there!”. It was a good description. It’s a good thing dog’s don’t smile.