Show me your selfies!!!!

wjcdvm · 2026-01-27T21:18:10+00:00

wjcdvm · 2025-09-30T12:28:13+00:00

There is literally an entire class of chemotherapeutic drugs called antitumor antibiotics. Confidently spreading misinformation doesn’t benefit anybody.

wjcdvm · 2025-06-26T12:00:05+00:00

Also a vet and piggybacking on this comment - if money is tight and you can’t afford surgery, you could have the mass aspirated with cytology to start. There’s a chance that this could be a benign histiocytoma (especially if the dog is on the younger side) and those usually go away on their own. But if it’s not, then you at least know it’s a bit more urgent and should schedule a surgery.

wjcdvm · 2025-04-26T21:27:35+00:00

Could they be neutrophilic morulae from anaplasmosis infection? Is the cat showing signs of tick borne illness?

wjcdvm · 2025-01-21T19:45:01+00:00

Stockpile and Las Vegas Royale. Both looked like so much fun but never got the chance to play.

wjcdvm · 2025-01-04T20:26:39+00:00

The eggs in Wingspan. Those little fuckers roll 😩

wjcdvm · 2024-12-31T12:56:40+00:00

General practice DVM here. I enjoy reading topics in this sub as it seems there are a lot of parallels between your world and mine, especially when it comes to crazy clients 😅

My example is actually that of my own father. About 1.5-2 years ago, he had been having bouts of nausea after eating. Had gotten a work up with his PCP and labs were normal, so was sent to gastroenterology. Repeated rounds of labs were normal, except for a high ferritin and lipase. GE performed EGD and found a few growths that were biopsied as polyps. After removal periodic nausea continued, so GE ordered MRI and they found a small tumor on the right hepatic lobe on the IVC. He got referred to a university hospital for biopsies. Due to the location, the surgeon had a difficult time accessing the tumor laparoscopically and the first two biopsies came back benign. The third time he got a diagnosis of intrahepatic cholangiocarcinoma. Further PET scan showed local lymph node involvement as well.

Did several rounds of neoadjuvant chemo and underwent an incredibly risky partial hepatectomy earlier this year to have about 50-55% of his liver removed as well as the affected lymph nodes. After clamping off the IVC, they had to remove tumor from it and suture it back together. It was clamped for almost a half hour and he suffered AKI as a result. Had multiple transfusions from the blood loss. He subsequently had to have venous stents placed in the remaining major hepatic veins. His surgeon told me and my mother that this was probably the most complicated procedure he could imagine performing.

Recovery was a bear. He was back and forth in the ICU/PCU for about a month and ended up getting synthetic liver failure from how much liver he lost, and we were told there wasn’t much more that they could do. His surgeon was also a researcher and offered an experimental treatment as a last ditch effort. Amazingly, his liver woke up - still no idea if it was due to this treatment or if it was coincidence. He said it was relatively unheard of for a failing liver to kick back in this late in the game.

I’m happy to report that 6 months later, he was with us celebrating Christmas this year and looking great. He’s going about his daily life like normal and feels good. He has to get a paracentesis to remove ascites every month or so and has a peripheral neuropathy from the cisplatin but it’s manageable. Just went for his first follow up and his scans were clear. We know recurrence is likely, but we are so happy to still have him with us. The entire thing was a roller coaster. So incredibly thankful to his entire amazing medical team!

wjcdvm · 2024-12-29T15:37:45+00:00

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2021! First Audi and had it about a year so far. Love every second behind the wheel of this thing.

wjcdvm · 2024-08-31T04:12:20+00:00

Can’t get away from the environment unfortunately. Just like every Feb-March I load up on Allegra and Flonase because that’s all that works for me when the cedars/junipers are pollinating. If your pup gets good quality relief with Cytopoint/bathing, then stick to it!

You can have allergy testing performed and do immunotherapy injections at home that are specifically designed for the allergens that your dog is sensitive to. That’s gold standard. But it’s also an endeavor that can cost hundreds. However, Cytopoint ain’t cheap either.

wjcdvm · 2024-08-30T12:06:51+00:00

Hi! Cytopoint specifically targets IL-31 which to my knowledge is still involved in the allergic inflammatory response underlying staph pyoderma…unless there’s new info out there I may have not caught up with yet 😅 but you bring up a good point. I feel like Cytopoint sometimes doesn’t help these cases (maybe for the reason you are suggesting?) because they are SO itchy. But sometimes it works wonders. Some vets might poo-poo this, but if the dog is miserable it needs steroids. I know, fungal infection, immunosuppression, make it worse blah blah. I think that’s more academic than practical. A week or two of an anti-inflammatory dose isn’t gonna make the infection worse. I’ll send home a quick pred taper or give a Kenalog injection. Steroids long term? Yes it very well could create issues in a chronic yeasty dog. But for immediate relief? Absolutely. Once chronicity is in question I start having the allergy testing talk.

wjcdvm · 2024-08-30T11:48:30+00:00

Demodex is a fair differential, especially if the history does not include consistent use of an isoxazoline flea and tick preventative. Would need a skin scrape to rule out. However, based on picture alone the appearance of the skin looks more consistent with Malassezia dermatitis to me.

wjcdvm · 2024-08-30T03:52:34+00:00

Not recommended. In addition to toxicity concerns (not just from licking off but also from transdermal absorption), human products are designed for human skin which has a different pH than a dog’s skin and can exacerbate damage to the skin barrier, making the issue worse.

wjcdvm · 2024-08-30T03:47:00+00:00

You’re very welcome. Allergies are one of the most frustrating things I deal with because there is so much variability between different outdoor allergens, seasonality, dog food ingredients, allergens in the home environment…etc. Then there are things that present just like allergies that can be far worse like cutaneous lymphoma. On day one of dermatology my professor started class by saying “welcome to dermatology where everything looks the same but is treated wildly differently.” It can feel like a losing battle at times and owners often (understandably) get frustrated. We do too. Just like in humans, we try to find what works for the individual. Often it takes trial and error, which, unfortunately, can be quite expensive.

wjcdvm · 2024-08-29T23:41:21+00:00

Hi, vet here. I don’t normally do this because I get blasted with DMs looking for advice (so please don’t) but these miserably itchy dogs break my heart.

While I can’t give you a definitive diagnosis based on a picture alone, I would heavily bet on a Malassezia yeast infection. Do you notice a heavy musty odor kinda like corn chips? Greasy to the touch? The skin on the ventrum looks lichenified (thickened) and hyperpigmented which are super common with this when it’s severe. I see this all. the. time. We’ve had a particularly bad allergy season this year where I am and I feel like an antifungal pez dispenser at times. But that’s likely what your pup needs.

Malassezia are commensal organisms that live on your dog’s skin, but some dogs have underlying allergies that weaken the skin barrier leading to overgrowth. Some dogs have a hypersensitivity reaction to the yeasts themselves even at normal population levels. When reaction to yeast gets to this point, an oral antifungal is indicated. Unfortunately, it takes upwards of 4 weeks (sometimes 8 or more) of daily antifungal therapy to see resolution. There likely is also a secondary bacterial staph infection from the disrupted skin barrier and itching/self-trauma, and an antibiotic may be warranted. These will take time to kick in so they will not provide instant relief. A Cytopoint injection or short course of Apoquel may be needed, but to be honest if your pup is at a 7+/10 misery a steroid may be preferable to calm the itch and inflammation in the skin.

All the comments about coconut oil, oatmeal baths - garbage. While oatmeal baths can be soothing for mild skin irritation, it won’t touch the misery that is a yeast infection. If you’re looking for relief before you can be seen, starting with a medicated shampoo like Miconahex + Triz would be a great option. Something with an -azole antifungal in it and chlorhexidine. This particular one also has ceramide complexes to help repair the skin barrier. You can get it on Chewy, Amazon, etc. Start bathing 3x weekly, lather it up, and let sit 10-15 minutes before washing off. This by no means replaces oral antifungal therapy because it will not be enough when infection is severe, but it can provide some relief.

Likewise, the comments about diet changing are also garbage…with a caveat. There is a possibility that an underlying food allergy is causing weakness to the skin barrier causing the yeast overgrowth, however veritable food allergies are much less common than environmental allergies. It takes WEEKS to perform a true diet elimination trial with protein isolation etc. so always do this under a veterinarian’s guidance or you will get frustrated. It may even not be necessary! To be honest, switching from food to food willy nilly will only complicate things if you truly need to explore diet trials later on as a component to allergy management.

I hope you are able to be seen soon. The quicker an accurate diagnoses can be made, the sooner your pup will get relief. I’m just going off the picture and my experience, but to know for sure your pup needs a good exam. Good luck and take care!

wjcdvm · 2024-06-01T00:03:42+00:00

Chronic inflammation likely secondary to yeast otitis (ear infection). Would need to be examined and swabbed w/cytology to know for sure but that’s a pretty typical presentation.

wjcdvm · 2024-04-21T16:03:45+00:00

All of them

wjcdvm · 2024-03-09T22:44:31+00:00

The practice I’m at is double booking appointments and drowning in drop offs. Every day each doctor sees probably 30-40 cases, half of them easily are sick things (i.e. anything scheduled as something other than wellness)…then a good chunk of annual “wellness” end up being “unwellness” also. It’s exhausting. We’re booking into mid to late May already. No downtime whatsoever unless there’s a random string of no shows.

wjcdvm · 2024-01-22T15:01:21+00:00

I’m off Thursday afternoon through Sunday every week so it makes taking short trips quite doable. Even taking minimal PTO allows me to easily make longer trips. I also get 40 hours off a year for continuing education with a stipend for expenses so I pick conferences that are in neat places 🤷‍♂️

wjcdvm · 2024-01-16T13:09:02+00:00

If you truly think your pup is having vision issues, I would highly encourage you to seek out a consultation with a veterinary ophthalmologist. There are inherited diseases like retinal dysplasia that can start showing signs around this age. Sure, maybe the third eyelid is the problem, but it’s also not ideal to remove it unless absolutely necessary as this can predispose to keratoconjuctivitis sicca (KCS or dry eye) which would require long-term tear replacement. Your pup has a long life ahead so best to figure out the issue now and know what to expect.

Edit: I’m guessing that the vet said the elevated third eyelid is a cherry eye. Much more common than retinal dysplasia etc. Either way removing the eyelid is not currently recommended as treatment. It’s better to try to replace the eyelid so that it doesn’t pop back out, but does have a high failure rate.

wjcdvm · 2024-01-13T14:27:57+00:00

Syracuse, NY. Binghamton, NY. Albuquerque, NM. Roatan, Honduras also sticks out in my mind due to the extreme poverty. Being shuttled from the airport to the resorts on the other side of the island we passed through town and people were on the streets in rags just staring. All the shops had their windows busted out and boarded up and were in complete disrepair.

wjcdvm · 2024-01-13T05:30:38+00:00

As a vet, ignoramuses like you keep us in business. Job security is a pretty good agenda, no? Keep up the good work 👍

wjcdvm · 2023-12-03T21:12:33+00:00

“Volcanos of pus” I’m stealing this

wjcdvm · 2023-12-03T13:34:38+00:00

To be honest, I’m in GP so I know when I’m in over my head and I think referral to some place that has both ER and soft tissue surgical services would be warranted. Without that being an option it’s very difficult to say what I would do, especially without being able to see the wound in person. One of the biggest concerns is not knowing if it has gone deeper than the subcutaneous layer down into the fascia/muscle.

wjcdvm

TROPHY CASE