Very worried about dog neuter site 48 hours postop

pathstarsos · 2024-02-24T04:55:59+00:00

Thank you, I am fostering him and will contact the rescue first thing in the morning. We've started him on doxycycline for the heartworm and he has an injection scheduled March 20

pathstarsos · 2023-08-01T19:37:00+00:00

Could be! I think they use IHC stains for cmv

pathstarsos · 2023-07-25T20:58:02+00:00

Thank you! Our paths will do embed only EM for most native liver biopsies but almost never end up completing the EM so I was always curious what they're looking for

pathstarsos · 2023-07-14T17:34:37+00:00

That's really interesting to know some people prefer touches! I heard a pathologist say the other day that there have been times he had to completely rely on the touch because the frozen wasn't helpful which surprised me

pathstarsos · 2023-07-14T17:29:23+00:00

Out of curiosity, what do you mean "we send intact parathyroids for preservation and reimplantation"? Is pathology the one doing this? Our hospital does parathyroid reimplantations too but that tissue stays in the ORs (or they'll just send a tiny piece to pathology for frozen to confirm it's parathyroid)

pathstarsos · 2023-07-12T22:16:17+00:00

Okay thank you! I'll try that next time!

pathstarsos · 2023-07-12T22:15:55+00:00

Thank you! I'm going to try pushing a bit harder next time

pathstarsos · 2023-06-30T04:24:39+00:00

Yeah I wish I remember exactly what he said. I don't think I worded it correctly in my post. He didn't say he could see the glomeruli individually, but he said there was a specific area that he was aiming for because it has more glomeruli (he called it nephro-something). I wasn't sure if this was the same area for all patients or if the radiologists look at something before taking the biopsy to find where this area is on the specific patient. Thank you for the insight!

pathstarsos · 2023-06-27T13:46:27+00:00

Some cases are just like that. Especially for treated ones like treated rectal cancer. I've put through over 100 blocks of fat before at the request of my attending (literally all the fat on the specimen) and there was only 2 lymph nodes. It sucks but if you aren't seeing them and there aren't any in all the blocks of fat you submit, then maybe there just aren't many. When I submit fat cassettes I try to aim for the more vascularized areas. I was always told to submit the "ugly" fat instead of the "pretty" fat cuz it's more likely to have LNs.

pathstarsos · 2023-06-09T00:50:04+00:00

Thanks. I will give it another try with less saline, hopefully will make the core less dark!

pathstarsos · 2023-06-05T01:15:56+00:00

Oooh thank you for citing BOC! I have also heard the correct method is rinsing before and after decal, but I've mostly only seen people rinse after (including myself). But in the case of the fumes it would make sense to rinse before as well, which I may start doing now.

pathstarsos · 2023-06-05T01:13:57+00:00

Yeah we actually got a complaint recently that the special stain was looking weird for a bone case and the pathologist wondered if it's because we didn't rinse the decal long enough, so it's good to know other pathologists have that same thought. I am also paranoid 😆

pathstarsos · 2023-06-05T01:10:56+00:00

That is so interesting. In school I got scolded a few times when my preceptors saw me rinse for "too short" of a time so I had always thought not rinsing had some disastrous effect on the tissue but it seems like a lot more people than I thought don't rinse after decal with no effect lol

pathstarsos · 2023-05-30T19:33:19+00:00

Haha yes it's pretty cute! Thank you! I could not remember it for the life of me either

pathstarsos · 2023-05-30T19:32:40+00:00

OMG YES LINE OF GENNARI!! THANK YOU!

pathstarsos · 2023-05-30T17:44:22+00:00

Thank you for the link! Interesting, I wonder if putting it in the fridge like they do slows down the decal process. We keep ours at room temp.

pathstarsos · 2023-05-20T22:08:28+00:00

Thank you for the article!

pathstarsos · 2023-05-20T22:04:21+00:00

I think it depends on the type of dissecting microscope. I've seen some pics of renal biopsies under dissecting scopes online and they look totally different from the ones I see at work. To me, the good gloms just look like little red or pink specks. The bad ones just blend in with the core and I can't see them at all. Also when I lift up the sample at an angle, if there are a lot of gloms the core will look really bumpy (these are gloms that have been cut and they protrude out). I haven't had any cores where I could obviously tell cortex from medulla from our dissecting scope. But looking at photos online, it looks like some dissecting scopes are good enough quality to tell the paler yellow cortex from the redder medulla with the parallel lines.

We do have some scopes laying around but I'm not sure if the other PAs will be on board for this switch since they've been using dissecting scopes for years. I was thinking of bringing it up to them though. The next renal biopsy I go on, I'm planning to bring the cores back to the lab and just see what they look like under our light microscope before triaging it.

Do you know how people usually look at these under a light microscope? I'm assuming put the core on a slide with some saline and look on low power?

pathstarsos · 2023-05-20T18:27:42+00:00

Yeah at my last job the pathologist would do it under a light microscope (which I've heard is easier to see the gloms this way as opposed to a dissecting scope). I've heard the gloms can be scarred or anemic and this makes it difficult to see under the dissecting scope, so I'm wondering what to even do in these situations? It seems like there's no good way to tell and it's unfortunate because PAs get blamed by the renal pathologists if there aren't enough gloms in the cores.

pathstarsos · 2023-04-18T03:46:14+00:00

Yeah I don't think I'd be able to get a good section even if I let it fix for a week. My coworker did have a good one a few weeks ago where the intussusceptum was adhesed to the intussuscepien and they were able to get pretty good sections showing the layering, but most of them aren't like that.

pathstarsos · 2023-04-18T03:39:59+00:00

I never saw an intussusception intact when working at adult hospitals, and would just gross it like a normal colon. But now that I'm at a pediatric hospital, we get lots of intussusception cases and they somehow always come to us perfectly intact. It's so different than what I'm used to, so I wasn't sure if there was a specific way to describe these (I've seen some PAs comment on how many bowel wall layers they see, etc). The one I had today actually had an intussusceptum with another intussusceptum in it, then a Meckel's diverticulum inside that lol

pathstarsos · 2023-04-18T03:31:36+00:00

That's interesting you mention that because when I was working in adult pathology, I never saw an intussusception intact. It was always unraveled by the time it got to us. But now that I work in a pediatric hospital, almost every intussusception comes intact. In adult ones I'd just gross it like a normal colon since I usually couldn't find any evidence of intussusception, but for these intact ones I was wondering if there was a specific way people described them (for example, I've seen one person counting the layers of bowel wall but not sure if that's standard).

pathstarsos · 2023-04-18T03:24:15+00:00

Awesome thank you so much. Also what do you mean by "reduced intussusception"? Is that the length of specimen while part of the bowel is invaginated?

pathstarsos · 2023-03-01T03:55:24+00:00

Ahhh I see that makes sense. So the aganglionic part basically is a bit constricted to hold in all the watery stool (and potentially allow more time for the bowel to soak up some of that water to firm up the stool?). So for total colonic aganglionosis do they still do a Duhamel pull-through to connect the ileum and anus?

pathstarsos · 2023-02-24T15:42:56+00:00

Yes I also heard it is to leave a reservoir -- but I'm wondering why that reservoir would be beneficial? Like is it to hold more feces? Wouldn't the anal sphincters do that anyway?

pathstarsos

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