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Maple by Renee – An ominous find on routine scan

Published on February 1, 2024.

Story from Maple by Renee – An ominous find on routine scan

Part I – A site for sore eyes

My beloved little sheltie boy Maple was 7 years old when one Friday afternoon I had to take him to his regular vet at Northside Veterinary Centre in Canberra, because the white portions of his eyes were turning red. We were given some drops to place in his eyes. The next morning, his eyes were getting worse, and they appeared glossy. So we returned to the clinic. At that point the vet was troubled that his eye pressure was very low, and he was also developing an ulcer. I was given more medication and instructed to go to an emergency after-hours hospital if his condition worsened.

That night, poor Maple was squinting and rubbing his face on the carpet. It was undoubtedly painful. I decided to take him to SASH – North Ryde Emergency as I knew they had an excellent reputation. I called them to say that we were on our way. I left Canberra around 8pm and had to stop several times to give Maple his prescribed drugs during the trip. We made it to SASH around midnight. In the parking lot, Maple was frantically trying to paw at his face – thankfully I had placed an Elizabethan collar around his head. He was in extreme discomfort and no longer able to concentrate on anything else!

The Emergency staff immediately admitted him for triage and gave him pain relief. By the time I saw him again a few minutes later, he was already looking better. Dr Salvador Wolf was the emergency vet looking after Maple and he took a very thorough history of his various ailments. Maple also has inflammatory bowel disease (more about this in Part II below) and is on multiple medications, so it was important to have time to discuss them. Dr Wolf admitted Maple to stay at SASH overnight for ongoing monitoring and pain-relief, and he told me he would arrange to have him seen by a Specialist Ophthalmologist the next morning: a Sunday morning! I expected great things from SASH, but that was well beyond my expectations. Little Maple would see a specialist the next day, on a weekend!

Indeed, the next morning Maple was examined by Dr Yvette Crowe and her team. She diagnosed that he had a very bad case of uveitis and a nasty ulcer covering most of one eye. She analysed the surface of his eyes using special tests, allowing her to see the types of cells that populated his eyes and to choose the best treatment for him. She suspected that something causing an allergic reaction had reached his eyes, potentially a toxin or a stink bug. Although the exact cause of the problem was hard to identify, the treatment was immediately successful and Maple started to recover quickly. It is clear to me that the ophthalmology and emergency teams saved his eyes that weekend. It was extraordinary to have such outstanding care outside normal hours.

But wait… There’s more! Maple does things with all his heart, and when it comes to making new friends at SASH, he is very keen to go back for more!

Part II – An ominous find on a routine scan

Maple has had a delicate stomach since 2019. He was diagnosed with inflammatory bowel disease and was placed on multiple medications to control it. He had been wonderfully well managed by his regular vets at Northside Veterinary Centre in Canberra. One day, however, a routine ultrasound showed that his gallbladder had suspicious signs of a disease relatively common in shelties, called ‘gallbladder mucocele’.

He was referred to SASH – North Ryde, where we met with Internal Medicine Specialist, Dr Lucy Kopecny. We discussed Maple’s case for over an hour, and she took extremely detailed notes about his condition and about my concerns and questions. We subsequently organised further visits, including further imaging (CT scan and ultrasounds) of his gallbladder, to assess the progress of his mucocele. It was only a matter of time before his gallbladder would need to be removed – nobody really knows how quickly the condition may evolve. We wanted Maple to be as fit as possible to undergo a minimally invasive surgery whereby his gallbladder would be removed via laparoscopy. This approach would allow the surgeon to remove his gallbladder without opening his abdominal cavity through a conventional, wide incision, but rather through small holes in his belly. If the condition progressed too far or too quickly, however, he would need an emergency procedure, a full incision of his abdomen, with possibly life-threatening illness. This was the last thing I wanted for our sweet Maple, and so I was very keen to intervene before this happened.

I met with Dr Julia Sumner – a Specialist Surgeon with advanced training in laparoscopic surgery, and we decided to go ahead and remove Maple’s gallbladder. He was a perfect candidate for this surgery, as his gallbladder was not yet too diseased. He seemed to love Dr Julia and clearly felt very cared for with her. On the day of his surgery, a nurse admitted Maple and kindly acknowledged my many minor concerns about him. For instance, I shared that he hates the smell of alcohol spray on his leg and tummy, he gets skin rashes with ultrasound gel, he obsessively licks any area where the hair has been clipped on his body and thus needs to wear an Elizabethan collar, he is on a very strict diet, he vomits when he has been fasting more than 6 hours, and he is oh-so-sensitive to mild discomfort—a small prickle stops him on a walk! I had a long list of such concerns and special considerations which were all noted and catered for as much as possible during his stay by the wonderful staff at SASH. I am so grateful that the nurses acknowledged my concerns and made Maple’s stay in hospital as pleasant as possible. I trust that he was a very gentle, cooperative and at times cheeky little patient for the nurses.

I was impressed to learn that Maple benefited from a regional block in his anaesthetic, whereby a whole area of his abdomen was desensitised using an analgesic injection (a bit like an epidural), allowing the anaesthetist to keep him on a lighter anaesthetic plane. He also benefited from being placed on a ventilator during the procedure, which also made me think he was getting care on a par with what you’d expect from a human hospital. Although I never met his anaesthetic team, I believe they did a splendid job.

The surgery was an unqualified success. His surgeon Dr Sumner called me at the end of the surgery and described Maple in his cage as acting like ‘nothing had happened’ – such was his comfort while in intensive care! He was discharged from hospital the next morning, his joyful self when we were reunited, and with adequate pain relief to make the journey back to Canberra. He bounced back faster than I’d ever thought possible after such a big surgery. There were no complications, all his blood tests were back to what was expected, and he made a full recovery.

I will be forever grateful to Dr Lucy, Internal Medicine Specialist, for her advice and guidance in the process, for the Diagnostic Imaging team for their contribution to the diagnostic process, and to the amazing surgery, intensive care and anaesthetic teams for their incredible skills. We love our little Maple to the moon and back, and we would gladly travel to SASH whenever needed for him. In fact, Maple continues to visit Dr Crowe several times a year to monitor his eyes. I always value the trip so much because of the fabulous skills of the vets there. Maple loves the staff (who seem to remember him each time we visit!) and he adores the attention he gets there.

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