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Pets & Specialty Vets

Sep 11, 2014|

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Automatically Generated Transcript (may not be 100% accurate)

It's time to talk pants and specialty events. With the doctors from veterinary referral and emergency center and clarks summit. You can call in with your questions. 570883009. -- Or 1804370098. And now pets and special events on WYAOK. Good morning everybody because this is doctrine called another I'm one of the surgeons at veterinary referral and emergency center and you're listening to cut a special team that's. I'm here with doctor but he -- too is the director -- -- neurology service and doctor Julia it's. Food is one of our fabulous internal medicine specialists. And also I should probably introduce although she may not be directly on the microphones this morning is Amylin who is. How one of the future veterinarians at -- -- in her Furlan. -- -- -- Daughter for doctors yeah. -- So as many of you know we usually start the top of the show just by a discussing a few things installed -- get to a couple topics I wanna make everybody aware of class person for a most pets especially that's it's a call in radio show. I -- it's a B I'll KC you can call in with any questions that you might have. 570883. To 0098. Or you can call toll free 180437. 009. Eighths we also have a fun feature for those of you who don't wanna be -- on the air but maybe wanna just text us a question. You can text the word talk. 299404. And then enter your question and we will see those text into questions and hopefully be able to provide an answer on the Air France. She veterinary referral emergency senator is a 24/7 365. Animal -- -- -- which provides. 24 hour emergency service you can just walk and for emergency service we also have what we call referral services which means. Generally you need to have a referral from your veterinarian. Or you can come and make an appointment directly with one of those services but we have critical care emergency. That's for the walk ins and an internal medicine surgery neurology cardiology and we also have -- excuse me a fully functional nuclear medicine service. Which is sort of an advanced. Radiology services you well. We also have an on site MRI which many of you know we talk about quite often very very lucky to have in this area. Announcements so we wanna make -- veterinary or -- emergency is a couple things first off we would like to welcome doctor Brittany gross cash cash is one of the new emergency clinicians with our emergency service we are very very happy to have her onboard. She is a University of Pennsylvania graduate. And she completed -- intern ship a one year small animal rotating internship. And pretty well known hospital. Out in Portland Oregon and that hospital's name is -- Lewis. And she has just recently come on stuff and she is Simon has tons of fun to anybody obviously we understand you don't wanna see an emergency doctor. But if doctor gross is on staff when you when you're a baby comments I can say you're going to be very well taken care of should we also have another -- -- is again another new addition doctor. Joanna Malloy. She is also a University of Pennsylvania graduate. And she. And there's a rating arousal and approval right there how. And she's she just finished her small animal rotating intern ship and New England medical center which is often Massachusetts. Ironically doctor gross and doctor Lloyd were actually classmates at University of Pennsylvania so they know each other very well it's kind of nice just she trying to hit the ground running with a teammate and somebody that you spent four years and that's -- -- and some. So hopefully you know again we get that you don't wanna see either of those doctors. An emergency service but can't feel free if you've got questions for them specifically Thais call hospitals say hi stop and whatever the case may be. -- -- wants to announce that we're having. This is a new events we've never done this before and we're hoping it's going to be a great success but we're having -- come. Community yard sales. Come for those of you know the facility know the area you probably realize we have -- -- -- large parking lot. Which is often filled with many many cars. But there's a section that we are going to kind of cordoned off and we are going to hold the community yard sales. This yard sale is really a wonderful event for all of us to bring things that we'd like to sell an Odyssey also make some purchases. Because it's in one large location hopefully we'll have a large drop people for selling and buying which makes it far more. Convenient and hopefully. I'm more fun and more things being exchanged because it's large and in one site so it will be held on Saturday September 13. The setup is going to be at 7 AM and the cell starts two 8 AM. If you are interested in selling items instead of holding in your house sent on your yard common do with Austin. -- you can contact the hospital. At 570. 5877777. On the table is free so as many tables as you may need. This latest free all you need to do is bring your stuff and set it up and be part of the yard sale so again call the hospital 57 -- -- -- -- 877777. And done you can actually ask for Heather. And she will make arrangements to make sure that you have space set up and it's gonna be great event -- a thing to let you know is that whatever proceeds. Now one. Should have from the event we're gonna donate 20% of that to the Angel fund. And the Angel fund for -- C is a fund that's set up for some patients who need specialty care. Whose parents at that time might not be able to afford all or some about. And so again these proceeds go towards that Angel fund south. Give us a call and hopefully we can get that organized -- I think it's going to be a lot of fun I know personally I'll -- you Joba I am a ton of stuff to bring. We have a few things so far I can't. I actually have been -- just knowing that it was coming up I have boxes. Just set up in the garage with yard sale or non mormons -- lots of good stuff tonight. And unfortunately I suspect they'll sell as much as I'm gonna buy -- and a that's what gets -- in journalism that's -- area but hopefully like I say it's for good causes we almost sounds. Come. Well and I again the VI OK it's over. Pets especially that's is a call in radio shows -- he's a free calling with any questions you have 8830098. I kind of thought I would launch this morning with a topic for some people out there and that's in regard to. Anesthesia. -- and how we kind of do anesthesia and veterinary medicine I know that there's. Many many pet parents out there that are always and even in -- but very very nervous about anesthesia. I think one of the first things for people pet parents out there to know is that really anesthesia and veterinary medicine. And in human medicine should not differ and is often. The same. So the medicine's that we use the medications. The anesthetics drugs are you want to term them. They should be essentially the same medications that you and I would receive if we needed to have either sedation or an anesthetic announced. There's lots of confusing terms out there people talk about twilight anesthesia. That's kind of really just a heavy sedation. So if you want to think about it from the least to the most. They're sedation just something to make you sort of feel relaxed and maybe a little bit cross -- I'm and it's usually just an injectable drug that your. I have provided sometimes it might even be some oral tablets or something like should. Then there's twilight which is probably really more of a heavy type of sedation and there's really anesthesia or when your -- sanitized and that is something. That can be done one of two ways if it can be done just with injectable medications. And so -- you haven't either anesthetized for an anesthesiologist. Who's giving you. A drug via an IV catheter at a rate just enough to keep you. Kind of unconscious. But you don't need to have someone take control of an airway or something of that nature. And then the other form and anesthesia is where we actually -- and in production agent. I'll talk about I'm a little bit. And then you actually have a two bit or what we call an under a tree killed two meaning insider trades just -- to this -- and your trachea and we control your breathing and we. Providing gas anesthetic so instead of giving and through the IV it's now something that you inhale and that's what keeps us under anesthesia so. That's kind of just an idea of the confusing terms and how many people out there hurt. The drug list this is always one that I think people kind of laugh but one of the most common. Induction agents that we uses something called Propofol. I mean. Pat and I say this sarcastically it is funny but it's also kind of seriousness. It's an agent that if you saw the liquid itself it's pure white that looks more white than milk. And we often jokingly call it milk of amnesia. And yes this is the drug that people have heard about because it unfortunately it was brought to win the nation's attention -- it was the drug that some unfortunately. Cause the death of Michael Jackson so it is not something that. You should be used other than inducing anesthesia period but yes we use it in animals it's the most common induction into. One of the things do we do we use all the same type of pain management that you would have a few received. Drugs or surgery so. Drugs that you may have heard of things like -- more phone it's an injectable pain medication. Drugs like methadone that's another pain medication that we used. -- -- -- gas anesthetic that we uses the exact same thing that we use and human hospitals we have the exact same monitoring that you would have a -- needed to be an asset size. The same anesthetic machines everything can really identify. Hunt and I bring this topic up because I think all three of us sitting here have had patients excuse me. Pet parents. Say something to us like anesthesia is in a dangerous. Well the risk of anesthesia in the pet population is point oh -- 4% to you're talking four and a thousand patients has some form of complications with anesthesia. Now that take a complication. Generally is what we talk about what just every day. Anesthetic and and so obviously if you have an animal that's more sick or something else is going on there facilitated. -- underlying cardiac disease and certainly those risks are increased. But I would always tell parents don't hesitate if something needs to be done. You know obviously we're gonna dean whether or not a patient is safe for anesthesia. And it's not cola and you have to land the most common questions I get is oh my -- ten years old -- eleven years old or fifteen years old and you know does not put the -- -- no they done and diseases just a matter of what are their other problems that are gonna put them at risk for anesthesia -- is there an otherwise healthy dog and a fifteen year old dog should have no problem. You know I should have the same risks says one year old going ran a seizure first base now. -- comments and easier to and sometimes an older mature human geriatric -- and a puppy because they have more money -- Are there any easier and easier to somehow regulate things like thank you very true hero himself because I'm not actually prefer you know the message that's in all -- yeah. Yep absolutely. I'm Jill it's. It's always prayed for all of us because it's like we all share one mind and that was the next time which is ages disease we all it's like a -- for veterinary medicine because. You know that I mean I don't deny that -- if my. Nine year old grandmother had to go on for surgery would be one of the questions and I -- complex but it's the same for -- fifteen year old cat. We're gonna have to do some diagnostics to deem whether or not they're safe for anesthesia time. I guess so I just put the word out there because it's it makes people so nervous pressing needs something done. You know honestly. We need to get son's -- Somewhere and take our first break once again you're listening to pass a special team that's -- call in radio show ask your questions at 8830098. And we will be with you again shortly after -- break. You were listening to pets and special -- that's the with the doctors from veterinary referral and emergencies centering clarks summit. On double BYAOK. Welcome back everybody this is -- -- -- -- that's where the veterinarians from that an air patrol and emergency center located in south Abington Township we are 24/7 emergency and referral hospital and -- referral we mean basically specialty services of internal medicine and surgery urology cardiology. And we also have -- a -- 24 sevenths emergency services while although all of those services and hospital are always available planned for someone. And I'm here -- doctor bogey and doctor Julie gates doctor -- it's is our neurologist and doctor Julie gates is on of our internal medicine. Doctors should and before the break we were talking about anesthesia. -- again this is a call in shows so feel free to call in with any questions you may have 5708830098. You can also Texas questions by texting the word talk to 99404. And then lastly just so people are where we do have a FaceBook page gets its sub BR. ECPA. And so if you go to FaceBook and typed that in you should be able to finance and there's lots of good post on there and pictures and then community involvement sound so -- so. Hopefully you'll feel free to reach out to us us. I think directory it's still do you talk a little bit about something to do with internal medicine I think you might have wanted to mention some inflammatory bowel disease issues. Yeah. My pets -- missing on us if. It's a very common disease that we get a and -- -- we we diagnose and we get a lot of patience and both cats and dogs. I'm quite frequently that I have a history end either crowning diarrhea. Chronic Obama mania -- even just says that little as. They're uncomfortable after their eating or their burping aren't a lot or they have a lot and gas. Those are all signs that there is something going on with the deicing system. And a lot of animals will get then they have a history in this sensitive stomach called their life. And meaning that you know certain foods will trigger them says throw up or. You know sometimes they can how they'll have diarrhea after eating certain things as well. And most of big animals we have and are beyond those sensitive diet sensitive stomach diets that you can pick up Alaska. The pet stores and and unfortunately some of the whose diets are actually not the appropriate diet that they need to be aren't. So just because it's so sensitive stomach doesn't mean that it's gonna actually help them. Yes because unfortunately. Some of the dogs that how of these underlying GI disease may actually have food allergies. And at some of the highest. Causing allergens for food allergies is pulling him. Beef and -- again and that is that most common ingredients and a lot of those sensitive food diets. Don't ask me why I have no idea why beaches it's. Annoys me that they would put land and those sensitive diets look I take you away. From just IBD component just -- and so people know and I know Odyssey directory it's SS. When animals. When their bodies or we when we -- novel proteins meaning the first time in animals even lamb or say the first time and animals even. And say salmon. If they have an underlying food allergy and you give them something like that but you're not controlling all the other allergies and that. -- -- salmon becomes a component now and what they're allergic to. And so. Yes it cracked. And that's. That's one of the biggest problems that we see you know it may help them out initially but then the owners don't start they won't see any universe sponsor they they start going back to where they were before I went. It is their diary or -- any. And when we talk about inflammatory bowel disease which is one of the most common. On the other than food allergies as planned the most common causes for these underlying GI diseases. It's inflammation of the GI tract and -- A lot of times it's the immune system inside of that GI tract that's reacting to those proteins that they're taking and and there are ways to try and diagnose it. A lot of times we'll try and diet change -- to either a novel protein diet like you're saying in the most common ones we use our. Venus and beast or word stock based and we try to -- she is very strict. Veterinary diets prescription diet for those. The ones that -- -- over the town where they are limited to a degree but they're not fully limited they will have some other carbohydrates -- they will have. And some other proteins and there and that may trigger response as well. In fact it's a battle the food companies they've even come out with diet that includes kangaroo -- and that's how novel we had to get kangaroo notes and there's actually a company and Louisiana and us -- on an alligator diet -- wow it's -- -- And so we can go to another protein diet and the other type of diet that we will change them over to his high July's diet so it's got the normal proteins that you would see in most diets but their broken down so teeny tiny that the body can respond to it anymore. And so they don't have those inflammatory responses from it. And both of those diets actually very palatable for dogs so they'll eat them a lot more readily sometimes. Excuse me. And one of the complaints a lot of times is decreased appetite so we get well my guys are really evenings so their darling I'm gonna eat a diet. -- and yeah let's try it and see and then we'll go from there. And when we put them on these food trials where words choosing one of these novel protein high July's diets. It is that diet and that diet alone -- an -- six weeks and it's hard because it's no flavored medication and -- including heartland prevention and not know outside street CEO we can cook. -- could be canned food into trees -- Ken you know try different things with fat but it is really hard trying to. Limit them -- for that sounds come. And we're gonna interrupt just for second is we have a call -- come and it's from my call him and he's from Scranton and he hasn't this may be a doctor but need to question I can't read all of it but it says eleven year old lab. That has trouble getting up there's more about we'll have Michael explain what the questions. I'm Michael welcome here on pets and specialty that's. It's actually Michael I mean I'm so sorry I'm actually sorry you had an eleven year old collaborative old that's having trouble getting up on the -- -- getting up into the car he'll put its front pocket up the I have to lifted by the into the car the bad. -- wondered if he would recommend any supplement. Or anything that I could possibly do for him to make it easier this. Well I and they come. -- this is a big. We see a lot of this where you know. Older kids. Have trouble getting now Verizon in nor are sending out boring inning and you know in automobiles and a lot of times. We try to determine and it's really hard to determine even more more so over. The radio we try to determine business Merrill logic in origin sources orthopedic and origins. -- and so a lot of times -- -- you know our man doctor curry were never going consoles and on the same case because you know I may see some. Things that are now playing Carolina in origin and also. You know made me orthopedic. Miso orthopedic his bone or logic is -- this final word -- our roots. You know so. They've -- and sometimes it is a combination of those who enemies and even more difficult. You know. Then the number one supplement and I recommend orthopedic diseases this is orthopedic diseases in my opinion is that's aquarium. It's it's a better they only products is. You know FDA regulated as far as the I'm also. Supplements and then actually you won't help not only those back -- little help any so no real join him in any enjoying their produces -- it -- so long held every -- -- produces flu shoulders. Knees hips things like self. You know without actually seeing the -- we can tell you 100% alert. How many could be either or at this point. Hello how long's it been going on. I'm doing it for maybe a year now sometimes he has no problem he'll just jumped right up no problem other times he does have the issue. And does it seem to be getting worse or kind of just. Staying the same. And then the current path. And yeah I mean noticed him and you're hanging has mangle things -- dollars and not at all. And using do you think he warm like -- warm out of him in as the worst in the mornings after he's been playing now all male or after a long now. Okay so there there again this kind of one of those things learn some of that cellar of the inning and then some missiles barrel on the. It is heads. Deathly could be like Colombo say cruel disease or something -- -- yeah. And has he ever had any radio -- of his pelvis or his his -- served in the first -- of what we would term like the lower backs fine. -- -- Yeah I mean I would definitely also recommend you know aids we just we all get stiffer and have a harder time doing things but when. To talk about a challenge jumping off -- or climbing inning -- climbing stairs that's usually the hit some of the lower -- Columbus say prone region. -- a corner -- a clinic doctor Yates is talking about sometimes even a non circle anti inflammatory. Like. Rim -- which is called her pro offend or there's another medication called Miramax which is a drug called Derek Cox said those are. Those are kind of the canine version of Ibuprofen for us because dogs can take Ibuprofen can. But I would strongly. I mean my recommendation as you also want to know what you're treating what's the underlying cause for this so maybe even starting with something as simple as -- Grasso his -- to know because if this is -- a train this. Then there's your answer and there are some dozen medications and supplements to help a great thank you yes thanks for the call that problem. So. That's -- this is my favorite part of this radio show because we can jump from -- inflammatory bowel disease to neurological orthopedic doctor Harrington it's what we love doing -- And I see you're talking about diets and be immune system kind of response. Yes so if we try them money strength. This restricted diets board. You know either the novel protein and -- hi guys diet for a minimum of 68 weeks. And we're so nice seeing great improvement and then and it's a time that we have to decide on doing additional diagnostics and the next step turnout would be doing. Biopsies of there and test ends and it easily. Will start our appointments usually -- an abdominal ultrasound as well I just a look and see what the contestants look like on ultrasound. And look and see if there's anything else going on does the -- look okay does this clean look okay. I their lymph nodes in the belly that look normal or abnormal and that also will determine how weak. Ultimately recommend getting biopsies for these cases to. Tonight I wanna ask a question just as I'm trying to sort of put myself and -- parents your shoes. So do you have a cat or dog that has. What we sort of term chronic bombing and -- area. Mean what is that is -- you know my cat's been running for three years intermittently or is it yes the last six weeks. Both. I'm both of those can't will definitely fed and a lot of cat owners will say oh they vomit once or twice a week care balls you know he's always on -- That's not normal Yang and the first some long haired cats yesterday they can be normal because they will groom themselves alive but. The frequency if they're doing every single week and they're throwing up hair balls. That's not normal and we there's probably some kind of underlying GI disease go. I'm going I'm -- I think it's one of the most common except it. You know practices that. Oh they're running it's normal. Everybody just Charlie -- and they do it's very it's very common and then we get the ones that you know it diarrhea all they have diarrhea after a couple of days and then it goes away and then they'll come back you know 102 later. -- and that's still -- history of it that they're having chronic intermittent diarrhea. And so those are we just look at the whole history -- ask donors all the way back until when owners are Scott and you know what. Has -- in the history as far as vomiting and diarrhea going you know what have they seen. And this sounds sort of terrible I always -- I -- like throw in the devil's advocate here but. If it were you and you had diarrhea once a week all the time like you produce your doctor that's not only owns yeah exactly it's odd that we sometimes allow our cats and dogs to do these things and it's like but it's unacceptable for me so why is it acceptable brand. And do we find a lot of excuses post. You know fluffy something yesterday you know -- we find excuses -- they should pray that it's acceptable -- for them to be doing whatever they're doing. So it's. It's one that we battle alive we see a lot of it. And I think it's one of the most under diagnosed diseases because we do just put excuses so why they're summoning her right there having diarrhea a lot of times. And it's not just the parents traders though that's out there -- I'm happy we all can -- say don't worry about it don't worry about it or exactly. Yeah. I think we're all at fault for many times and and sometimes it's just you know. You know enough and owners coming and then you know firm vomiting and diarrhea. For that one time and a lot of times we don't look at the rest of the history either and so we're just treating that one case and for that 11 episode and we forget about all the other times and so I think that happens a lot as well interests in common is that weird. Kind of tunnel vision. Tunnel vision things what's happening at this moment and not what has happened in the. Ask this is an awesome topic I love this so I'm we're gonna take a quick break and when we come back and doctor Yates can talk a little bit more about this is. We're kind of just opening up. The -- -- -- -- -- Not -- really although that may be a component we'll talk about to be -- say you're listening to -- specialty that's WI LK and it is a call -- radio show after the break please call in with any questions that you might have 83009. May well be right back. Basically his pants and specialty -- -- with the doctors from veterinary referral and emergency center in clarks summit. I'm on WYOK. -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- And you're listening to pets and specialty that's it's a call in radio show it to ask questions about time that -- Madison but specifically emergencies or referral. And my referral we mean sort of advanced types of specialty medicine -- internal medicine surgery urology cardiology -- she indeed radio show telephone number is 8830098. And before the break doctor Yates was talking about inflammatory bowel disease. Which are gonna continue until I actually think this is a great topic. But while we're on break Matthew called and then he's from Scranton he has a question about his -- -- I'm asking -- to Dario great. Tom I -- we called people and I would suggested that I would not unlike. We so -- car rather Alito attached it's OK and -- And restore and data -- -- nipple guard play and didn't read it can be that I -- feeling that because there aren't any kind of medicine into them and -- kill. He you know from the sound that bad because she's just an -- we called puppy so there's many different types of harness is available number one. I'm not sure which one you have but some of the market down sort of sent explicit ones which looks like caller. But there are obvious in -- harness can be a little bit abrasive and we often find that some dogs have likes her loss from the rubbing it. Well either find they -- now make these sort of cloth like a match like. Tackle Chester -- so that you want I'm fine back. And really the best way to alleviate the problem Matthew I hate to say this but don't use that harness and it's funny just because she's a young part B and it's probably just a breeding her skin. Then she may have to find one that's softer or put a little T shirt on her and then the harness or just get a different -- or you could go to a neck -- -- dollar means. And I mean those aren't bad it's just if you're doing training Mike's even anti vaccine could be doing that concern is banking on her neck -- causing any kind of trauma and something about nature. And I can I do I share I am. Or -- -- teachers are also trying to get back into it so. And they do you have these incredible. Mesh cloth harnesses that they make now that are far. Nicer and more comfortable for them to where she might want it's more like wearing sort of a jacket for them instead of straps for harness so -- -- yeah. Yeah thanks so much. And though we do have another call coming in but I don't have the information yet so I'm gonna. Just a doctor -- it's kind of finished with her continue with the conversation about inflammatory bowel disease to the second call -- and yes so I'm. When we went separate they're attacking me and finished kind of talking about well what happens after the diet trial and we may not be seeing a Fuller response. Com with just the diet not only decide if we are gonna go forth and do mortar. Diagnostics -- trying to figure out what's going on in what the underlying problem is. A lot of times when we start the diet we will get them a broad spectrum. It's very common dress -- do that even if they're on month in her room prevention we will add and just a broad spectrum to -- to just. Get that out of the way in just make sure that that's not what does not reaction founder yeah. And then no we also will put them on an antibiotic for the GI tract called either -- -- -- -- all or tireless and powder. And -- antibiotics they have great anti inflammatory properties to help reduce some of that inflammation that may be going behind. And some dogs will respond says. -- -- and that's not respond to just. The antibiotic allowed into the some of them have. A tireless and responsive diarrhea. And that's great if that's what the problem you know that helps the problem is tireless and as one of those drugs that we can actually use up. Now I hope you don't mind me kind of flushing itself but you're telling I think it was you were telling me a story about a patient that recently came men. Can tell that story because I think that this gives everybody an indication how we can sort of ignore and or mask the issue gas so I had to a little. -- -- didn't mini coup miniature Poodle. Come and this week and she had a history for the past year and just having a lot of gas and burping -- was her main complaint. -- every now and then she would have some diarrhea. And it's been going. On and off -- him out of the past year. Well she's one of the little light fluffy dogs and she has that says -- -- staining that happens in the corner of their eyes. And so they were using a product called Angel eyes -- Angel eyes is Tyler -- And -- -- made note that wind she is using Angel eyes. The dogs seemed better. Interesting and then when she would get off of the Angel eyes that -- probably get worse again and what an -- -- parents and you know best and I told her that as I am most most clients probably wouldn't notice fancy you know that it was associate -- -- improvement in this one medication and the reason is -- and is used for the GI track and it is used for inflammatory bowel disease so. I do suspect that Doug has inflammatory bowel disease and we and we -- her over to diet you know enough and the high July's protein diet to CF. What shall do in the next six to eight weeks that. A lot of these cases we will also send out lowly college G I -- and then GI panel looks at certain pancreatic enzymes. I'm which can cause GI disease. And also to vitamins so vitamin -- mean vitamin B twelve and then folate vitamin B nine. And if those tire. Skewed and then that definitely tells us yes there is underlying GI diseases there abnormal and that's because. Indeed so -- called is usually low it's inflammatory bowel disease it's it's affecting a certain part of the intestines called that Williams missed the last part of the small intestine. And if there's enough inflammation going on the body can't absorb the B twelve that they're taking an in their normal diet yeah. And B twelve is needed for those contestants to regenerate their cells and to be healthy again -- bad blood test can give an indication that there's some are going -- idea and that act. Absolutely. -- and then not fully when the Foley aide is lower high eighteen give us an indication that there's definitely some kind of abnormality in the bacteria of GI tract. And it can tell us if yes he has there's something going on there's you know either inflammation that's causing abnormality year. You know something else it won't give us the exact diagnosis of inflammatory bowel disease. But it kinda leads us in the direction that yes there definitely is enough and. A nation that's -- -- diagnostics coming compact. We're gonna -- another call and then we can talk about those diagnostic tests so Barry's on the line from Wyoming and he has a four year old. The -- upon so I'm assuming Pekingese I'm Pomeranian Macs that licks his and it looks like I'm hoping sheets. -- very hey you're on with pets and specialty that's aria. I -- I -- I can't afford your old -- -- Political blog. At. What about if I Murphy's six slots and so he's confident who it's hard and chewing your mail. Scoring is such -- -- grip or could be culture related. So. And it could be either and certainly can be behavioral. A lot of times when they start linking certain. Like their cause there there are lakes or something -- what happens is they end up releasing endorphins that the body masons so. Every now and then -- alone every now and then when they do it it makes them feel better. And so it can't get into a behavioral things. The other thing is that. If they are licking our hottest thing yes that certainly can be allergies especially when that green. They can have allergies either seasonal allergies allergies to. The grass or something like bad or it can be food allergy related to. So. Very when does he do it. Final but hopefully at night. And and it started just recently used the I think within the last six months and -- more action to -- -- think it'll last about three months. A kind. And since he started. Even though he's just doing -- at night is it like every single day or does he go for weeks doing and then weeks without tomorrow and I'm -- True they recruit older you have time. I mean you know the hard part is because it's just been the last six months it could. And I hate says say this but it could be that something. Environmental is happening in the last six months so it's what we call you know topical allergies. And yet unfortunate because it's not been if you had said all he's been doing this for a year and a half minutes nonstop the because we're going through an entire annual cycle than it would make us more suspicious than its. Like a food allergy because he's constantly getting enough food and so is constantly alert Jack. She hit hit fair -- some type of blood test certain everything that they veterinary might be able to do to determine what. What what they don't know. Yes -- there are. There are blood tests for allergies. There's also skin test the blood tests are sometimes not as reliable and so it is. Better to get the skin testing done it's the skin test just like we have when we go get a allergies done as well. The blood test is a whole lot easier to do in a whole lot easier to get our hands on it and do it but it's just not as reliable. There for a lot of allergens that are out there and so it can be done the other thing is I. You know if you go to your veterinarian can certainly take a look at and they give you recommendations of certain antihistamines. To try and help -- it is allergy related. Then antihistamines. And there's a few out there that we use for dogs but. You know I would recommend getting in touch with your baton. And just getting their appropriate dose for your pop based on the end their week is how we dose a lot of these medications. But then a drill for thin -- I mean and Hank Johnson -- -- the three most common and a hissing means that we use and -- Hombre I don't think an -- works as well as we like -- too. And so a lot of times -- for an air meaner hydroxy Xena in good drugs that I go to for his her. For allergies. I'll stay there if you -- second part to this call came in its food related I would think he doesn't culture that we saw whopping -- abnormal. Yeah yeah. It can be aspect and that's ethical and don't try again and people you know we we eat certain foods and it will make us. -- each other dogs will do that too but also that certainly can be a sign of food -- you still. -- OK I want I don't disagree that centered about food earlier. If it possibly anything and here's stripe who might be related to belching and possibly be -- -- us off. He absolutely and that's the whole. That's it you know exactly what we've been talking about is a lot of these diets the proteins that are in there isn't what is making them. How these allergies most of the time it's the proteins and there and they are common proteins -- -- in Atlanta and -- that will cause food allergies. Well -- first step. It popped -- to get through to me how can -- And yeah I mean I -- -- your -- and -- -- they probably would -- send antihistamines firsthand about not giving him relief and he's still doing and then the next that would. Potentially -- is either see a dermatologist. To get the skin testing done. Poor you know us if you guys want to try the blood test we insert you know your bag can certainly. Get that done and send out and see what Allard Venus you at that says and then based on those you know we made recommend doing diet change at that point if it does look like there's allergies to food. Paul thank you very much for your time wolf -- -- condition. Great thanks for the call very very -- He and the other message I think you know my two cents in this is for Barry and everyone out there who have dogs who are licking and there's questions about food allergies or or. Environmental allergies is don't. You know this isn't something that needs to go on for years and years and years there are people who are out there suffering and the vets tried everything and they've tried everything you know get a referral firm dermatologist go -- -- -- skin specialist and often after one visit you can be on the road to success -- yet. -- I am so we've got probably about 56 minutes left so let's some I wanna hear but is diagnostic yeah. So we talked about the ultrasound we talked a dollar to. Around the GI panel that we send out if those don't get us though we need the next step would be doing biopsies of the intestines. And there's two different ways that we can go about getting biopsies Ryan is with and endoscopy so just the same as people would do. And if you have an upper GI's go for something like batter kaleidoscope. Those -- what we are talking about we can do those animals as well. And just again just quickly throw this out there so we're talking brief anesthesia and who we pass an instrument down through the mountain into the esophagus into the stomach in the intestines and with a special is instrument you just grab a small piece of tissue pulled and it's done so brief quick and lots of answers. Yes exactly. And that we trying get a couple of pieces and each little segment of -- that we can get if we do just enough where we can only get the stomach in the first part of this -- tests and if we do a lower scope we can get a colon and the last part of the smiling tests and so. The limiting factor for a scope is that we can't get every single part of the intestines. And sometimes that makes a difference especially with what we see an ultrasound let me make a difference as far as what we recommend how often do you think that's fourteen like what percentage do you think you don't get an answer because unfortunately you can't. Get to all contestants by -- it's hard to say his lead off. We don't really know we do know that there's definitely been researched that and one section of the intestines it can be mild disease and then another section Nadine my -- here disease so. And different segments of the intestines didn't we can get different answers got you so. Ideally we trying got as many you know segments that we possibly can. But a lot of people don't wanna do surgery they know full blown surgery for a but sometimes we have to do. And the benefit of surgery itself is bad. Not only do we get full thickness biopsies of those and -- -- the leaking collective from every single part of the intestines. And if we see anything else wrong in the liver or the lymph nodes. Or anything else -- -- -- any abdomen. The surgeons can certainly take a look at that and get a sample of that as well to make sure that we're not missing something else yeah. So there's pros and cons to both of that but what we're looking for with those is. The degree of information that we're seeing is that mild moderate or severe and then also what type of cells are we've seen. Is it just went -- -- the Atlanta sites and plasma sites which are all white blood cells that we can see causing this information. Do we CE is senate bills and there. If we see is senate bill is then not automatically makes me think this is either food allergies or this is gonna require steroids to try and fix the stock. I'm forecast so and it and cats and it comes down to a lot of difference and -- Is this just inflammatory about busy yeah. Or are unfortunately sometimes we're looking for certain cancers like lymphoma. And it's I'm not speak up and say it's not uncommon that I know that you guys see patients and internal medicine who have had a yearlong chronic history. And you -- start down the road and inflammatory bowel disease and lo and behold because somebody -- may be the primary that was giving -- -- they weren't masking assigns an actual underlying lymphoma absolutely that's one of the biggest problems that we we will run into is that they've just received steroids recently and unfortunately once they have steroids he can't necessarily do -- -- right then and there we have to wait at least four weeks to be able to go back and get biopsies being. On the system to try and diagnose and it's it's the biggest problem for cats because there is such and a fine line between diagnosing inflammatory bowel disease vs small cell lymphoma in those cases so I prefer people that are out there listening so no we're just coming kind of include to a close and last minutes of the show about what's like the big take home message and you know what you wanted to say as an internal medicine doctor. Yeah I think the the biggest takeaway message is that it's. If you're worried about beer -- and you are seen that they are having your current issues of vomiting or diarrhea. -- there's other GI problems like the one I saw this week that was just her being and and gas. That then that's an issue that you need to bring up here veterinarian so that we can get to her right diagnosis because it's not comfortable for them it's not comfortable for us. And so it shouldn't be fair to them just have to live with it and you know. Yeah I'll be there are so okay we can get to a diagnosis and get them feeling better so call their veterinarian and or you know they can set up an appointment directly with internal medicine service at the start the process. That's a great talkback -- everybody it's another wonderful Saturday were coming to a close thanks for being a part of -- and specialty that's our next show is Saturday August 23. And we look forward to seeing -- I --