Scout’s big bad bloody bladder surprise…

Scout, a 9 year old female Labrador, had been having urinary issues for weeks, including frequent urination, accidents in the house and bloody urine.


These are classic signs for a urinary tract infection. So Scout was treated with antibiotics. There was no improvement. Another round of antibiotics was prescribed: still no improvement. When antibiotics don’t resolve a presumed bladder infection, it’s time to explore other less obvious diagnoses…

An ultrasound was recommended. It revealed a big mass in Scout’s bladder (see yellow arrows below. The mass is grey-ish, urine is blackish).

This was bad news since, statistically speaking, the vast majority of masses found in a dog’s bladder are cancerous (most often transitional cell carcinoma).

Regardless, Scout’s loving owners elected surgery to give her every possible chance. Scout underwent a laparotomy (abdominal surgery) to have the bladder mass removed and biopsied. The mass was the size of a walnut. About one third of the bladder had to be sacrificed. The rest of the bladder was reconstructed with multiple stitches. Surgery went smoothly. Scout recovered well, and was sent home the next day.

As expected, she did have a few days of bloody urine immediately after surgery, but it cleared up after a few days.

The mass was sent to the lab for biopsy. After a week of agonizing wait, the biopsy revealed… that the tumor was benign! Despite the statistics, despite everybody’s opinion, and despite the ultrasonographer’s impressions, the mass was… a benign polyp. This was amazingly good news for Scout and her owners!

Three weeks after surgery, my nurse removed Scout’s stitches and commented: “She’s doing great. She’s urinating normally, eating and drinking well, and super happy. Her owners are super happy and thanked us up and down for all our help.”

Remember: a mass is not cancer until the biopsy says so. Please don’t make any drastic decisions based on assumptions and statistics.

Scout was supposed to have bladder cancer, yet ended up with a benign polyp, which will not at all affect her lifespan.

Phil Zeltzman, DVM, DACVS, CVJ, Fear Free Certified


Your dog had WHAT removed?

Kado, a 4 year old Husky, had a tumor (grade 2 mast cell tumor) near the tip of his prepuce (ie sheath). It is actually a common tumor, but a tricky location.

The only way to completely remove it was to remove the entire prepuce, and therefore, sacrifice (i.e. remove) his entire penis. A new opening was created to allow him to pee (urethrostomy). One year after surgery, his owner KM writes:

“Hi Dr. Zeltzman, It has been a year since Kado’s surgery (see picture above). He is doing great. He will be celebrating his 5th birthday on Monday. He is a very happy dog and full of energy and loves playing with our other dog. We just love him so much.”

So? Crazy surgery? Or life-saving procedure?

Phil Zeltzman, DVM, DACVS, CVJ, Fear Free Certified


Didder the broken kitty makes a full recovery

Didder, a beautiful 2 year old indoor/outdoor cat, was found limping.

His femur (thigh bone) was absolutely shattered (see preop pictures). How many pieces can you count?

I count at least 15 pieces!

If that wasn’t enough, he also suffered from a fracture of the mandible (lower jaw).

We discussed leg amputation as one possible option. But I thought that we should give Ditter a chance, and try to put this thigh bone back together. And that’s what his owner decided to do. So we took this poor kitty to surgery.

His femur was repaired with a plate, 10 screws, 3 wires and 1 pin (which later had to be removed). To speed up healing, a bone graft was added.

His jaw fracture was wired back together. He had an uneventful surgery and anesthesia. He then had to rest very strictly for 2 months to allow the bones to heal.

Didder’s owner learned from this experience, and wisely decided to keep Didder indoors from now on. Stories like Didder’s are sadly not rare in my practice, and there is no question in my mind that cats are far safer indoors.

Two years after surgery, Didder’s owner writes: (…) “You’d never know anything happened to Didder – which is greater than any outcome we could have imagined the sad night we found him so horribly broken! (…) Our family is grateful that you were able to successfully rebuild our baby boy.”

Phil Zeltzman, DVM, DACVS, CVJ, Fear Free Certified


Beware of porcupines!

One of my nurses who works at an emergency clinic told me a crazy story that is a great reminder this summer.

She had seen yet another curious dog who couldn’t resist the urge to play with a porcupine… Of course, porcupines always win. The dog’s head, lips and tongue were covered in quills.

Depending on where you live, porcupines may be coming out of the woodwork. Dogs often think of a porcupine as a playmate. This could be very painful mistake. I suspect the picture tells the whole story.

This is a fairly classic situation at emergency clinics in my area (Pennsylvania and New Jersey). The Poconos are a beautiful mountain range but there are full of porcupines. The treatment for this situation is to anesthetize the dog, and remove the quills, one by one. And when there are hundreds of quills, it’s a lengthy procedure!

The bigger problem with porcupine quills is that they can occasionally migrate through the body. I remember participating in a surgery at the Colorado vet school, where a quill was literally inside the wall of the heart!

So please be careful, please keep your dog on a leash and please never ever think that your dog will learn from one bad experience. Experience proves that there are many repeat offenders, summer after summer…

Porcupines may be fascinating creatures, but they have no intention of playing fetch with your dog.

Be safe.

Phil Zeltzman, DVM, DACVS, CVJ, Fear Free Certified

5 (more) tips every cat owner should know

Cats are very independent and at times they may seem indestructible. But the truth is, they are just as fragile as any other pet. Many conditions require a surgeon to fix things up. Here are 5 more tips to help your cat avoid visiting your favorite vet or surgeon.


6. Mass removal

When skin masses are allowed to grow, they may become so large that an amputation is the only option. It stands to reason that a small mass requires a much less invasive surgery than a large mass, so don’t procrastinate.

7. Avoid fights

Cats are more fragile than they look. They can get into a fight with a housemate — canine or feline — causing extensive damage. Bites, although they may seem minimal on the outside, can go very deep and cause serious internal damage. Solutions include feeding your pets in different locations or at different times. Again, please keep your kitty indoors.

8. Recognize pain and suffering

Most cats are very stoic. They may hide, or move less, or stop eating. It can be very difficult, but is very important to recognize when they are suffering. Don’t procrastinate, seek help as soon as you notice something abnormal.

9. Get pet insurance

Pet insurance can make all of the difference in your cat’s life. If you cannot afford thousands of dollars in emergency or medical care, please consider getting pet insurance. And do your homework, as there are some really bad and really good companies out there.

10. Know thy enemy

Anesthesia is not the enemy. Surgery is not the enemy. Your cat’s condition is the enemy. We are here to help you choose the best weapon to fight the enemy.

Phil Zeltzman, DVM, DACVS, CVJ, Fear Free Certified