Oct 18, 2014|
Saturday October 18, 2014
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 goalie with -- your questions. 5708830098. Or 18043700982. And now the pants and specialty events on WYAOK. Good morning everybody this is doctor called another I'm one of those surgeons at veterinary referral and emergency center and I'm here with doctor. I DN Ferguson who -- one of our internal medicine specialist. Veterinary referral and emergency center is a 24/7 365. Emergency and referral hospital. And this is -- and specialty that's it is a call in radio show please feel free to call in with any questions that you might have. -- -- Is a standalone facility we don't do any general Madison but we obviously receive emergency. Patience as walk ins and or referral and walk ins for our specialty. -- medicine which is internal medicine surgery neurology. Cardiology. Com we have a full nuclear. Department and we have the only MRI and northeast Pennsylvania outside of Cleveland that does 24 sevenths. MRI. Imaging which is one of my favorite things about us. Good morning actor Ferguson's a funny how -- Delayed again. I want to make two quick announcements and then doctor Ferguson wants to talk about kind of a hot topic for us but. The two announcements I wanna make is. That this week he is veterinary technician week for those of you don't know and veterinary technicians. Really essentially the analogy is that they are veterinary nurses. And we just want to take this time as it is. A national sort of I guess holiday you'd call it but it's tech -- tech -- weakened appreciation exactly. I just to say thank you to all of those hardworking dedicated compassionate wonderful people. -- For every doctor that's out there and you've probably got Tony Bennett a technicians and. Madison could not move forward without them so I just want to acknowledge and say it's a great week of appreciation. Yeah I think a lot of people don't realize that they're trained professionals. You know. Veterinary technicians. Certified and licensed technicians. I'm not just people that we train on the job there are people that decide to do this with their lives and they go to school and they learned the physiology the Madison and they learn about the diseases. You know they they have a good knowledge base and then they -- men and have on the job training and experience as well so. You know our technicians are pretty amazing and they aren't impressed with them every day and there and her eyes and ears because. They're checking our patients you know in a hospital situation like we have where patients are just kind of coming in and out. They're checking our patients you know every thirty minutes every fifteen minutes every hour -- whatever they can. And there are no one's going. -- -- she doesn't look like she did earlier please come look at those sort. The hurry stop the blood pressure is changed. They're once picking up on these things to bring it to our attention because you know we're busy and going through. Bunch of patients through the day so it's really important they're kind of our first signed. And so important to patient care and some burden and making sure I'm missing something so. There under appreciated I think by. A lot of people but they're they're so important. And so appreciated -- asked her surgery she and I am glad to technologists and then the other kind of containing facts stresses. For those of you that don't know right here in northeast Pennsylvania we have Johnson college which has a veterinary technician program which is phenomenal. We're so lucky to have that in our backyard training -- veterinary nurses technicians for everyone nationally in Ireland yeah absolutely. And then the last announcement that I wanted to make is for those of you who may not know there is a wonderful events taking place this weekend it is a pet expo. I was on the first day was yesterday it's on again today and tomorrow the hours for today or ten. So starting ten minutes ago until 6 o'clock this evening and then tomorrow from eleven till five. It's being held at the Kingston armory. Admission to the pet expo is only three dollars. What better way to spend some time around some great animals. And 50%. Of that three dollars. Is going to be donated to lose blizzard in county SP CA so this is a. Great event. And great proceeds going to help animals at the Kingston. -- get to go and see tons of stuff. I'm probably pick up some fun stuff for your four legged children at home. There's also I think. Some donkey. Like a little petting zoo when you can go hunt the donkey is a two doesn't want a hunk I don't yeah. And that I think there's pony rides and all kinds of fun stuff and it looks like it's becoming a gorgeous afternoon sometimes get out there. OK doctor Ferguson let's get serious here. Well she knows Ebola is all over the news to personally am really sick as. The thing in Iraq by the union says. And it it's it's a really sad situation and how. But he. You know it's been interesting to me to see kind of dogs being focused on with Ebola you know it's kind of unexpected starting and I think with the nurses dog in Spain and I think it was actually before that there was a dog euthanize. By another patient in another country kind. And then the fifth the next step was this nurses dog. Was this -- going to be euthanized or not that's the one locally I think there was a dog in Spain that was euthanized and now -- I guess yes. And -- so you know -- obviously a lot of confusion about what part animals play NSA and Tom certainly when it comes to. -- this disease is highly infectious. And fruit bats carry the disease. As well but inside the US they're not any animals that have ever been known to be infected with Ebola. They have done some studies where they've shown and -- bunnies and dog's blood. Which shows that you know they've been exposed to it. But they've never been documented to come down with an iron sounds so I think the risk is steadily pretty low because in these countries where able is pretty rampant are -- dogs around. And -- you know there are obviously dogs are gonna be exposed to bodily fluids and things like that which is how this disease. That is spread. But -- feel you know are looking for more specific information they're there are some little Q any kind of web sites if you go it's huge. That the eighty amazed so that's for American Veterinary Medical Association. AV MA dot work. You can go. They have a slash Ebola they have a special section that kind of linked to the CDC in just kind of have some questions and answers on merit. They're pretty much you know that's the concern is pretty low. It's never been documented. So it's it's not really something that you should be worried about your -- coming down with the virus or spreading the virus. But just wanted to to mention that because it has been in the. News and kind of acknowledged that -- -- -- to tell you how many people I'm sure contacting CDC and ADM -- you know what about my animals yes that immediately just kind of popped up all over the place as -- disease that should've been the news. The media -- needed to respond sound. Well it's sad to know about the dog in Spain. You know the panic that comes about. And I know that the I think it's the dog that's in Texas is in quarantine yes. -- -- -- king Charles Kelly yes. Adventures. Not -- -- I certainly hope nobody in Pennsylvania is worried about having a bola but. I guess knowing now it's OK your dogs -- gonna give it ten death so. You know what's what's on the front in the internal medicine and -- see doctor Ferguson. The well you know we we have had a couple of cases of kidney disease coming recently. Hands but you know that's that's been sad to see how kind of different. Manifestations of kidney disease but. The kidney diseases is it's pretty complex and difficult to understand because there's a lot of different. Causes that we see but the ones that even seeing have been coming in. Very very sick with very high values and of course. The question that the parents are always asking -- is what happened you know why is my pets sick they were fine. And there are a lot of different answers. To that question how. I'm so kind of the frustrating thing as a -- trying to figure this out as we don't know. A lot of times what their blood work was like before so. You know dogs can have kidney disease with absolutely no signs -- does play a good idea. To have their regular blood work with your veterinarian. You know we definitely recommend as -- get older just every year kind of everything everything checked out so senior veterinarian to get out. That regular blood work and that's helpful. You know if we find that they have some kidney disease which we would just -- sheriff kidney disease so basically they're getting older in their kidneys are breaking down that can happen. Pounds but you know sometimes we don't know what the state was before they can came in very sick. And sometimes ultrasound is very hopeful so you know I had a couple of patients and and one of the patients the kidneys looks very normal so we're kind of hoping. That the kidneys were normal before they got sick in any other patient had. Horrible looking kidneys so we can definitely tell that. Do you know things had been troubled in the past and and and that dog really did not do well so it kind of gave us some information that. Probably they had some past infections or something like that and then now that they're sick again with it. If it's going to be harder for them to get through -- Found but just laid there infections that we worry about the big one that we worry about is a disease called left -- assists and there's a couple of reasons and it's a big worry. Number one is that it's. It's something that they can pick up in the environments. That specifically attacks the kidney and liver and they can get extremely sick with it. The other really big worry is it's infectious to people. And not necessarily let your dog would give it to you. Bill that could happen if you've contacted your pets here and but if you're -- -- got it and you're in the same environment with your darned. That's something you need to know about so any time we see a dog with a a sudden kidney infection. More we'll assess them for that because we want the pet parents to know what's going on you know in our yard or homer whenever and as. Especially if we have owners that are pregnant or children or anything that may be more susceptible to this disease but. But anyone can get -- and it can be very serious. We also worry about toxins so a lot of people know now -- some people don't know they shouldn't give your dog grapes or reasons they can cause. -- They can cause I'm -- insult. -- -- never want to avoid those but also Ibuprofen. Tylenol things like that can damage their kidneys. -- -- I think pretty much knows about and a freeze being bad for dogs but that's definitely one that we see with the kidneys. But unfortunately -- -- If we don't catch that really quickly they they usually don't make it mound so there's just kind of did it's it's really sad when they come and that's sick because it it can be quite a search to try and figure out. You know where we started what happened. And then trying get them through it and unfortunately. Time gives us the biggest answers as far as how they're gonna do it's kind of taking it day by day. Monitoring how they do and see you know are the numbers going down are they feeling better. Or are we kind of stuff question this is the damage has happened in the kidneys kidneys don't regenerate like delivers so. They can recover a little bit how but once those values kind of stay where they are. That's kind of what we're left Clinton -- just didn't you know do we have quality of life with those levels the same question. According to take a break in the second here but when we come back I think let's talk more about and kind of go because you hit upon a time difference. I'm sort of -- I guess in regard to kidney failure renal failure so we can kind of review some of those. A little bit more to try and answer some questions and I'm sure people have out there but if you do have questions about real -- or anything else. I do feel free to Colin doctor Ferguson you actually got the number in front of you want to come with a telephone numbers. She says I don't. Think it's okay. It is 88300. And Amy. So calling their questions we're gonna take a short break pats and specialty that's will be right back. You were listening to -- and specialty -- With the doctors from veterinary referral -- emergency centering clarks summit. On WYOK. Good morning everybody and welcome back you're listening to -- and specialty that's I'm doctrine called -- -- surgeons at seminary referral and emergency center. Located south and south Huntington township also known as clarks summit. And I am here with my wonderful colleague doctor DR Ferguson on the interns so at the hospital. This is they call in radio show so please feel free to Colin the number here at WI OK it's 570. 83. 0098. Or you can call toll free 180437009. -- -- before we took her last break. Doctor Ferguson was starting to discuss this I'm -- disease and renal failure meaning kidney. Disease and kidney failure and talking -- Not only some of the ways that we start to detect when. Patient I kitty cats or dogs. Kidneys or may not so healthy and some of the reasons why we must commonly see best. And during the break I'm Deanna and I were talking about you know how some. People. There they're Camille Little sort of frustration unfortunately very unfortunately. With their primary care veterinarians because they feel as though going in every year for examinations. Is not too. Somehow worthy or they don't wanna spend the money or there may be questions about as my cat or dog actually need vaccines are -- I don't go. That's definitely come rescission to have with your primary care about but. Both the and I were talking in the green you know annual blood work just like. You know maybe you don't go to see your doctor every year to get a full panel blood when you're twenty years old as a human. But boy by the time -- turn 3035 you know you're seeing them much more frequently and are certainly running more tests and there's reasons but ages and a disease the diseases come with age. So we were sort of saying you know it's great when primary care veterinarians are doing these. Manual tasks and looking a blood work because obviously if something changes and we have a foundation that we know that something's off. There's also a lot of things. That they pick up. That you may not notice because you're what's your pet every day cell -- sometimes. You know old. They may comment and say wow. Plus she's lost two and a half pounds -- you end zone and that's pretty significant and you know it's just a -- she -- conversation -- you know where you trying to lose weight to be changed the Dieter re more active. You know actually trust is not as active. Well maybe we should look into that because it weight loss can be tricky and if it's if it's gradual a lot of people don't notice it. And that tackles for any of us it's it's just different when you see them every day vs seeing them once here every six months or whenever it is it can be much more dramatic. And I can be. Sometimes that's the first clue that something serious is going on. Just -- kind of keeping up Google's weights and vitals and things like that even just decides what we're just a really good physical exam every year so important. Little lumps and bumps and things like that town just to see here is those are changing showing up. You know what your veterinarian thinks about that. Because sometimes people kind of take it for granted -- hill that that. -- -- -- -- -- Well may be one of them ends up not being willing Pullman you know the veterinarian feels it and says you know this doesn't quite feel right wanna check it out -- Just kind of -- -- lumps and bumps every year. Now back among keeps track of them burial. It's it's important just like it is for us Arabs to get things turned out for yeah I absolutely. But the blood work is very helpful because it definitely helps us. When a pet is sick and they -- men and there are some things off with a kidney values or -- values. Where is their glucose is higher whatever it is to go back and go. Wow you know -- public works three months ago and all of this is perfectly normal something changed. And that can be an important piece of the puzzle that you know only don't have it there's just nothing we can do to go back in time and get that information unfortunately. We just kind of have to do our best when we don't have that so it's important even if even I feel like I how to do this every year it's normal every year actually normal means a lot. Especially when something changes. You know normal good -- first of all we like normal. But you know even if you think. I was normal last time when I have to check -- again we'll someone may not be and they are gonna miss that. So it is important. And I can say my own personal experience I had dog I -- who at the age of 55. Years old that's a baby in my book. Had -- failure and I ended up passing away just seven weeks after her diagnosis and it came it seemed to have come out of nowhere. So you know I can certainly be someone who can take off the doctor had put on the mommy had to say. There's reasons that we checked things -- Silently and so I think. And you know listen when it's chronic Reno failure how it's it's a whole different picture so beat the acute renal failure. Typically see there a 100% good. And then suddenly very very sick and not the difference that we often young blood work is that the blood work is crazy how I. But it was chronic real failure sometimes the picture can can be a little bit trickier to pick up because they may seem like very normal. In the mail blossom lane. But those values that actually have an abnormal for some time. Or it actually starts just by them not being able to concentrate carrier and so that's the first thing that happens those ideas can be normal for a long time so you actually need to lose. 75%. Of your -- functions so that's a kidney and a half. Both -- shows up I'm -- where so you know your analysis is even more sensitive. But the credit cases the value is just kind of slowly climb with time -- can I just -- I just not sure there's other 'cause I know sometimes the way that I think of things is maybe I'm trying to think how a person might say oh what is thought. IQ just meaning happens suddenly chronic meaning happens over time and a downside with the acute or the quick. Is that your body doesn't have time to compensate whereas over time. It can kind of hide those signs because it's sort of adjusting as you -- Yeah and then they actually the chronic cases actually kind of get used to their values because those Kenny values that are measuring are actually. We would call them toxin -- in your blood so your kidney filters things out. And so when -- Kinney isn't working those things that are supposed to be filtered increase. And actually makes them feel bad. But when it's chronic they adjust to some of those levels so. And it's different for every animal so when animal you know just take -- number don't worry about what it is but say one not one animal may have a number of -- And maybe eating great you know showing no signs at all. One animal have may have a number three and be vomiting and not eating so it's just kind of however comes on and what their bodies used to. But you know we know if we're not checking it regularly air for not checking and when -- while we kind of don't know what is. You know in -- normal for them. And so when they come and -- with the elevated values and that's where it gets a little bit confusing because we don't know. We're kind of trying to get them down as much as possible but they may never come down to what's normal for healthy captain they may have their own normal that they live list. I -- and that's kind of what we have to figure out who had a -- information. It's a good reason. I went you know doctors talk about we're not treating the numbers were treated it treating a patient actually so -- kitty cat could have a high a blood value but just be doing phenomenal. Absolutely we don't we don't look at the numbers and say how you know this is this is terrible terrible. You know if the patient is eating an acting great. You know there are other factors that we worry about kind of the the absolute worst thing that we can see is actually when they stopped making hearing northern not making enough here and so. -- a lot of people kind of think -- -- spirit they have kidney failure they wouldn't be -- so much. Actually listen to your common kind of kidney failure meaning the kidneys just not working right now. If you don't drink enough water you're not gonna. In in a sick animal or person that the kidneys don't work there's nothing that can be done and so if they're not drinking enough water. They're gonna get really dehydrated or third -- -- having diarrhea they can't hold on to any more fluids. It just kind of goes right in and out like the kidneys not filtering anymore -- kind of think that that way so they get there really susceptible to dehydration. -- but kind of the end stage of kidney disease which we see more. Typically with a sudden severe infection or severe insult like a toxin is -- the kidneys don't even produced here -- anymore. A man in those situations. The prognosis. You know really goes down and then that giving fluids doesn't help. Because the -- he's not doing anything come at that point the only thing we can do is dialysis. And that dialysis. For this kind of situation is not what you think about with people with chronic kidney disease a lot of people think of beaten people in all I have kidney disease that -- dialysis unit they go get their dialysis they go home. They kind of come back next -- kind of -- dialysis for an acute kidney insult when the kidneys are functioning at all. They literally goal on the machine and they don't come off until they're better. I'm so it's a really intensive situation. And you know not many facilities offer that. And it it's intense and you know we never know what the outcome is going to be so it's not something that we. We recommend a lot -- that sometimes we get into that situation where it's the only option then it's a decision point how many cases. Do you think that we see on an annual basis that would be going down that path towards dialysis. You know I don't think it's too many I would say probably. Two or three a year when they're getting to that severe point two pounds. But. You know we Jeff -- kidney patients that. Even though they are making hearing they're just so sick you know. -- -- there and they're not gonna wanna eat and they're not getting better -- on the downside for veterinary medicine is dialysis. Facilities to do appropriate proper dialysis are very far and few between because. We don't see this as much that's not the reason not to have a but also it is suction specialized specialized specialize medicine. You know in my mind I would probably say that there's. Five nationally that are really devoted towards performing dialysis. And if your fortunate to be in the region where there is one great and if you're not year you know and you wanna do this it's. It's like doctor Ferguson -- intensive unfortunately expensive. And you're gonna end up traveling to have to have this done. Yeah I miss something and worked with a lot in my residency and we're literally talking about. You're sitting next about -- 24 hours a day so -- sitting with that dog trying to round today and every 51015. Minutes. We're checking vials were checking pressures are doing calculations. Where we're giving blood transfusions where we're giving. I'm blood dinners where you know. Watching them really Cox. So it's extremely intensive. Very rewarding when they get through it but. Heartbreaking when they don't because some. You know you spend so much time with those people on those pets. And it's it's done on the edge of your -- situation that's for sure. Itself you know IA. They're the closest place's place that we have really hearing now was the EMC -- and Manhattan have mass which is at least you know personally it's yeah it's. It's drivable. When we needed. And luckily it's not something we need to Bosnia and. Don't anybody out there saying thank you know when your. If your veterinarian ever tells you that your dog or cat has real disease or criminal failure that you're gonna end up doing what we just talked about I certainly don't wanna make etc. Debbie downer moment. We can manage. Renal failure is just like doctor Ferguson said depends on the patient how manageable. Each individual case. Is going to be so I mean are most common kidney patients are our cats and they have the chronic kidney disease and most of them. Do very well I'm if they're well managed not to say that a fat cat doesn't do well it doesn't mean they're not well managed but. And a lot of it has to do with the cooperation of the cat I think. -- changing the diet is a big factor they have special kidney diets that are low and proteins and phosphorus and those are. Really important to kind of I'm slowing down the breakdown of her kidneys so if you have a cooperative -- that's willing to eat that sometimes they won't. And just really close monitoring for all the things that can make -- kidney disease or worse like. Infections. Because their parents really watery they can get an infection. High blood pressure just like people with kidney disease they get high blood pressure and I -- insist their kidneys even more. Following their values and looking at things like that so. Can't careful observation monitoring pound and guess a lot of times. Changes to their lifestyle can can make them go a lot further you know cast are filling tanks can -- forever have you had a tough. They're tough and and being. Client advocate out there if somebody wanted to sort of say OK well. Maybe a cat that I had in the past have been a fan and I wasn't aware -- may be my cat now might have something I know what mckinny's what are you. Clientele are some of the first signs to get their cats and and obviously this is not. If they have the sign it does not mean that they have real failure but these are things to watch far. Yeah I mean that. It's it's usually just varies aids signs of them being -- -- well so any weight loss. Vomiting diarrhea could be assigned but. Kind of the specific things would be there's a lot more urine in the litter box. You know that would be a big thing to notice like this that they. And make a lot more you're in when their kidneys don't work is they can't concentrate so. Sometimes people say they noticed their cats are drinking more cats are pretty sneaky about drinking so a lot of people don't notice sent. But some people that are very observance or. You know just that particular -- they may notice that not all the time usually it's the litter box that we noticed this or skip scooping and knowing that I have this so much. Larry I know you -- Those would be the big things. And then like I said if if we know that they have kidney disease. How much do recommend that they had their blood pressure. The kidney values. And there are urine checked regularly come because those are things that are very important to him. -- well everybody you're listening to -- and specialty that's we're gonna take another break now remember this is a call in show feel free to call in with any questions about the topic we've been discussing are any topics you'd like to discuss. The number here WLK is 570883. To 0098. Or 1804370098. Talked to -- It's -- pants and special leave that site. With the doctors from veterinary referral and emergency center in clarks summit. On WI LK. Good morning everyone and welcome back to catch a special team that's I'm doctors pulled another on the surgeons veterinary referral and emergency center and I'm here with doctor Ferguson owner of the internal medicine specialist Santana and her for an emergency center. Pets and specialty -- is a call in radio show. So we talk about topics every other week and we do you have now two callers on the line we're gonna take the first caller who is -- And she says she knew a doctor Ferguson hi Emily good morning -- And I think it could be. Out that I owed them. I'm and then and they can't -- if I had so maybe MD doctor -- at bat at all in the book and your record lookup -- out of -- I can't actually in my except it's guessing we'll come back and they looked at the fact if you can -- And you let them aspect and can -- yes -- know -- initiated legal content that. Hang in fact maybe get a great grandmother or something I guess I'm Indian so. That's adorable. I don't know I am you know that's my married name so she wouldn't be my great. And my husband but I think. So now we're gonna have to find out from mr. Ferguson -- he has relatives from Connecticut. They keep it would admit it direction it in the money just. You can never know now we don't know well that's really cute and down and keep listening and thank you for that -- story but I will we'll find out -- now. Thank you mayor Larry great day to -- what I. And now we've got barber on the line she's calling from looks very -- Barbara Anderson you've got an older -- with some dental problems. Yes he he's not about eight people removed about two months ago should if it's funny because he he seemed to be doing well and then -- Well so uncomfortable again and when when he's eating monkey thinking yelling in pain. I've done just about everything I can't forums on steroids and everything. I would do something I mentioned I mean much after -- and dental surgery is there still a chance that there's -- -- -- going on in there he's about eleven. Yeah -- going -- and so he you know without us looking and we can't see for sure. You know there's just regular dental disease where they have -- and inflammation and and you get them cleaned her mood and then they're good and then there's a disease called stomach tightness and that that's a disease where for whatever reason. That the kiddies are very sensitive to the bacteria and our mouth and they have -- are a reaction to it and inflammatory reaction. How we see a lot and caps that have a virus called FID that we CNN healthy cast as well. And it with those cast it can be so severe that we actually have to remove all of their teeth. And when I see all of their teeth that also means their roots as well so even if there is. Just -- that you can see if there's routes underneath that still have bacteria into the stock to them. They can still has severe inflammation so you know I don't know what that says the case is with your kid -- And you know is available dental accessories would be a good idea to look at those -- through it's just like we have. And because but you know I don't know what the situation is but those are kind of the two scenarios with Donald disease that can be very different and how they respond to their treatments. And I don't think I NS can be very frustrating. Yeah. It seems to be incumbent discomfort again in the kind of like a month in the relationship and again you know but I will follow up on that thank you for your help. Really he'll be feels better soon -- And has a -- respective also and that you know I would it's made the cut the same comment Brady grass because in case there was an extraction or it may be. You know group was left behind or it could -- -- -- generalized stomach -- as -- -- -- pain and things like -- -- -- OK sorry good luck thank you can't I can't YouTube's online. -- we've got another call and it's Christine is calling from planes and she wants to know this is definitely for doctor Ferguson how does a dog get beyond -- what we also call it terrorists hi Christine how -- Thanks -- And I actually -- the fourteenth at the -- protect the sweat equity. -- know exactly what we're happy children which I consider it she just liked to chart for the worst ever admit that yeah. He did record everything except that it got got talent and -- The only act presents its site which are bad it's good I mean I think he just -- to get tickets to the constant. Okay okay okay yeah it's it well it can be pretty complicated and so John this is what we call it terrorists and that is when we're measuring the Billy -- levels in the blood if it's high enough you can actually see them turn yellow. -- and it can come from a couple different sources. They can either come from their red blood cells or they can come from the liver gallbladder disease. And soul with -- with a red blood cells there's actually Billy revenge in the red blood cells. And so they have a lot of red blood cells break down at one time they can get yellow from that usually we'll see you're really severe Anemia are red and and red -- low -- cell count without. With liver disease and it can't the you know the possibilities are kind of endless and usually really go to ultrasound without. A look at the gall bladder liver so that can beat cancer that can be gallbladder obstructionists like gallstones or mucus. You can be severe infections of the -- Around you know it's really pretty and less but basically that the two different things that we're looking are there red cell rules and the liver gallbladder -- as far as why they would turn I don't know. But it is it is a serious signs so you know he had to make that decision it probably wasn't the wrong thing to do now. I -- but saying what was going on it can be tricky without testing -- right. And I can -- -- like -- become when actually they. Even though. No it's definitely a serious disease states so -- something was going on but you know it definitely -- cancer more commonly -- older animals so you know as far as age I would say that's a possibility. Rangel that we could have developed cancers so it could have been nap but you know it's definitely a serious thing that. Happens when OK thank you very nice -- -- problems so sorry I think it's actually. And that's certainly one of the things you know where. Deanna and I work very closely together it's not uncommon that we have a patient that's diagnosed. And that we find out it's something to after an ultrasound and something to do deliver the gallbladder and then surgery may be indicated but there's certainly lots more testing that would have been needed for the I think. Yes definitely but -- all matters a tricky thing because I'm virtually. Without ultrasound it's difficult to know much about it on an act straight he may be able to see gallstones sometimes. But you may not and if it's just to end in kind of obstructed for other reasons like the file can get really sick in kind of gummy. It's not something that you would really CNN acts and more inflammation or infection in the gall -- -- without ultrasound it's hard to say. Am so. Especially something that has been more -- dyeing mills probably in the last five to ten years now that ultrasound are readily available. We certainly see a lot of diseases more commonly than we used to I. And I think sometimes. People forget about it. Annan. That because something that's come a running total. We've got another call it is filled from Hanover township. And filled you have a -- super. -- as a problem. Fallen -- -- difference got a bit of a problem for me or him. Our players like -- told -- no. And he -- believe -- ear wax on a morning news. That's just because they love zero. The Philippines is not forever but we're pretty fast stop putting your ears and chicken broth and -- innocent. And the upper hand once and I was about one call that style. And he's still there Burt and I got another thing isn't -- -- oversexed. This is being neutered -- many people who already don't have sexual -- MacWorld you have those. The -- named Jeremy and that's probably not gonna go away but as far as the grooming that's and that's something the dogs dude should -- love and summation I mean I. I have. A big dog that's older and I have a little guy that's younger and all he wants to do is -- -- -- all day. Guys I mean I local -- let's invade -- I I saw that program a couple weeks ago that. My dog is looking in your. Yeah yeah yeah. Then there's a chemical released in those UN and and and the -- that's the same chemical that's released. You know I don't know why when somebody tells us that they don't have animals or they don't like some that you should just walk the other way and I don't feel OK there it. Now but that it's very true I mean -- there's a lot of physiological studies that have been done both for animals and for humans. You know they can take people who are very ill -- in some kind of say for example hospice setting. Or a nursing -- setting or just us at home watching TV and you know I think. You don't have to be a scientist to know that if all of a sudden you're watching television -- -- stressed or you don't feel good and a cat or dog sitting with you in your petting them just the mere fact of doing vast. That animal. Pet animal bond. Which humans is great for us your great. Graham I saw these are doctors psychologists and psychiatrists I truly monitored these chemicals that were released yes and you have to and the animal. And they big cat -- could put advise him to campaign. -- I think actually put a link to does summary article to that on her FaceBook page. Really I thought it was really really interesting -- personally don't you know that we all knew our guys love desk at the chart in the world will boost car. I have come. Actually it is listed if you wanted to fill doctor Ferguson had actually posted a link to that on our FaceBook page says he did DR ECPA. On FaceBook -- -- scroll through our page you'll actually see that there's going to that as well. And I just I -- Ferguson -- got your verdict for you probably could -- probably bring up these are all CPA and and then if you go to our FaceBook page it's going there as well. Okay thanks a lot -- -- a very gab and good luck with your ear wax yeah. Okay -- they have a good afternoon and I. How was a great question and angry. My great points you know event. There's behaviors that sometimes we think are a little off but they're actually our cats are not saying I love you -- your pardon my pack. I am I used to do pet therapy with my pets and take them to nursing homes and it's. It's just so amazing. -- so -- -- I mean there there are people. In these homes that no one ever visits he -- also they have caretakers but you know they don't get. Hugs and kisses you know they don't get that contact. And they can do that list with these animals that you -- -- and it. They don't even know them they've never met this dog before about -- he'd teach them how intense person you've never met before. But something with a little plus on at all sucks and all those barriers go down. And I mean even and even people that she can't even talk anymore or lock anymore. You just see their eyes light up then and they wanted to punch that pet and it's just amazing what -- do for us unconditional love it's just. You know we can't do what they do yeah it's a special thing and well as we get. So we throwing down her clothes a dishonor remind everybody. About the pet expo that is going on at some Kingston armory today and tomorrow so speaking about pats go and hunt a -- We talk about -- -- things I know my blood pressure drops when I -- I don't think so. -- but lots of fun family events and lots of things to do and fun stuff to purchase. And I do understand that there are some critters to patent hug and I think pony rides as well also go participate and it's turning out to be a beautiful day out there. And once again acknowledging that it's at tech week so for those wonderful professionals. Have you ever considered getting involved in veterinary medicine and you don't want to endure the pain. I think that we know is and hopes to pay down debts and yeah that's involved with medicine but you cannot see inquired Johnson college right here in northeast PA. Pets and specialty that's we're going to be back in two weeks so two Saturdays from now. And it's the doctors from veterinary referral and emergency center -- clarks summit and we look forward to talking to -- in two weeks take care everybody.