SUMMER IS HERE!

SUMMER 2017 NEWSLETTER

3550 South Jason StreetEnglewood, CO 80110(303) 874-PETS (7387)www.vrcc.com

The VRCC Oncology & Radiation Therapy department is here for you and your clients. Established 24 years ago, the Oncology department at VRCC provides comprehensive cancer diagnostic and treatment options for the veterinary patient. Our primary commitment continues to be to ensure the quality of life of our cancer patients.

VRCC Oncology utilizes advanced diagnostic technologies to facilitate accurate diagnosis, disease staging and prognosis. Once diagnosis has been made, we are equipped with the most advanced treatment options including: chemotherapy, radiation therapy, surgery, treatment combinations and newer innovative therapies and periodic clinical trials where patients may be eligible to participate.

We have 2 board certified Medical Oncologists, Dr. Robyn Elmslie and Dr. Erin Arnold, and a board certified Radiation Oncologist, Dr. Nancy Gustafson, available for appointments. Between the 3 doctors, they have over 45 years combined experience. Our Oncology support staff team is made up of 2 lead CVTs, 6 CVTs, 1 VT and 3 client coordinators.

VRCC Oncology is available for appointments Mondays-Fridays from 8am-4pm. We also offer phone consultations to referring DVMs to discuss specific cases.

Medical Oncology: 303-874-2054

Radiation Oncology: 303-874-3234

The VRCC Emergency department has been a member of the Denver veterinary community for nearly 40 years and we consider it a privilege to serve the greater Colorado Front Range area by providing excellent medicine and compassionate care for pets and their owners. We would like to take this opportunity to introduce/reintroduce the VRCC Emergency team of doctors that is available to help you, your clients & patients. Please let us know how we can help you!

STAFF HIGHLIGHT: EMERGENCY

Staff Highlight . . . Continues on page 2

SPECIALTY HIGHLIGHT: VRCC ONCOLOGY & RADIATION THERAPYSummer is finally here! After the late snows in May, the warmer weather is a welcome

sight. This summer edition of our newsletter highlights our Ophthalmology, Emergency and Oncology teams as well as upcoming events and news.

Our Oncology department shares information about their practice, and history in the Denver veterinary community.

VRCC Emergency shares brief bios on all of the Emergency team doctors.

Our case study highlights Keratomalacia in a 2 year old, domestic medium hair kitty. Dr. Bradley Graham, DVM, MS, Diplomate ACVO (Ophthalmology) is the author of this case study and explains this condition along with the outcome for this patient.

Be sure to check out the VRCC news and announcements section. We welcome a new Internist to our team, and give details about the 6th annual Battle of the Vet Hospital Stars!

Happy summer to you and yours!

Your VRCC Team

Drs. Erin Arnold, Robyn Elmslie, & Nancy Gustafson

Debbie VanPelt, DVM, MS, DACVECC: Dr. VanPelt has been with VRCC since 2006. She went to Veterinary school across the border at the University of Saskatchewan. She is the Medical Director for VRCC and is available Mondays through Thursdays.

Julie Aiello, DVM: Dr. Aiello has recently returned to VRCC after a short time away. She has been doing emergency work since 1991. Julie graduated from Colorado State University College of Veterinary Medicine.

Terri Felske, DVM: Dr. Felske has been with VRCC since 2015. She graduated from the University of Minnesota College of Veterinary Medicine and did a rotating internship at Tufts Cummings School of Veterinary Medicine.

Vickie Fields, DVM: Dr. Fields has been with VRCC since 2011. She graduated from Tufts Cummings School of Veterinary Medicine and a rotating internship at the Animal Hospital Specialty Center in Highlands Ranch.

Simone Meyer, DVM: Dr. Meyer has been with VRCC since 2016. Simone graduated from University of Wisconsin School of Veterinary Medicine and did an internship at Fort Belvoir in Virginia. She worked in Japan and Australia prior to starting with VRCC.

CASE STUDY: OPHTHALMOLOGYStaff Highlight . . . Continued

“corneal melting”. Most of what appeared to be mucopurulent ocular discharge was actually degraded cornea that was still partially adhered to the corneal surface.

The patient was sedated. Some necrotic and devitalized corneal tissue was debrided from the corneal surface. A 72-hour collagen shield was rehydrated with tobramycin ophthalmic solution and placed on the cornea. The third eyelid was sutured to the dorsotemporal bulbar conjunctiva using 5-0 silk. Before recovering from anesthesia, the patient was treated with an injectable long acting antibiotic, and he was sent home with tobramycin ophthalmic solution, buprenorphine, and an Elizabethan collar.

Two weeks later, the patient was sedated again, and the third eyelid flap was taken down. The medial half of the cornea was fibrotic but healing, corneal thickness was more normal. Keratomalacia was isolated to central cornea. The lateral half of the cornea was clear. The third eyelid flap was replaced and medications were continued. After another two weeks, the third eyelid flap was taken down again and left down. Corneal thickness was normal, keratomalacia had resolved, moderate generalized corneal fibrosis and vascularization were present but are expected to decrease significantly over the next several weeks. The right eye

Keratomalacia in a cat

By: Dr. Bradley P. Graham, DVM, MS, Diplomate ACVO (Ophthalmology)

A two year old, neutered male, domestic medium hair presented to the Ophthalmology department for a corneal ulcer that started two days earlier, and was seen by his primary veterinarian the next day. He was diagnosed with a superficial corneal ulcer in the right eye with moderate blepharospasm, miotic pupil and mild mucopurulent ocular discharge. He was prescribed tobramycin ophthalmic solution and oral buprenorphine. The next morning, the patient seemed to feel better, but there was a strange film over the cornea, obscuring the view of the pupil. Primary veterinarian recommended a referral for him to see an ophthalmologist.

Two days after developing the corneal ulcer in the right eye, the patient was examined by VRCC Ophthalmology. The left eye was visual and comfortable. The right eye was visual, blepharospastic and had full thickness corneal disease involving approximately 80% of the cornea, with the lateral 20% of the cornea relatively clear. There was generalized inflammatory cellular and bacterial infiltrate, giving the cornea an off –white and yellow color. Degradation and disorganization of the corneal stroma were causing some layers of the cornea to slough, also known as keratomalacia, or

was visual, the intraocular exam was normal, and the patient was comfortable.

Keratomalacia, or “corneal melting”, is the rapid degradation of the corneal stroma caused by proteolytic enzymes acting on the collagen, proteoglycans, and other components of the stromal extracellular matrix. Microorganisms, inflammatory cells, and corneal epithelial cells release proteolytic enzymes. Endogenous proteinases are produced by host cells. Exogenous proteinases are secreted by infectious organisms. Tetracyclines, N-acetyl-cysteine, EDTA, and serum, are common compounds used to treat melting corneal ulcers. In this case, while additional medical therapy would have been preferred, it was not an option for this patient. Antibiotics were used to eliminate the bacteria contributing to the keratomalacia. It is best with most infected and deep corneal ulcers to leave them uncovered to possibly allow better penetration of medications and closer monitoring of corneal healing. Conjunctival graft was considered for this patient but risk for graft rejection was high with the severity of the infection, and the size of the graft would have likely led to a functionally blind eye. The third eyelid flap was used to support the cornea and provide tamponade while the corneal stroma reorganized and healed.

• VRCC was a proud sponsor for the 16th year of The Dumb Friends League’s annual Furry Scurry event at Washington Park. We want to thank the VRCC staff, friends, and family who helped set up and run the VRCC booth, and a special thanks to The Traveling Photo Booth who took pictures of race participants and their dogs throughout the day. It is always great to see our clients, patients and veterinary professionals at this wonderful fund-raising event.

Making a Difference in our Community!

John Oslick, Rocky Mountain Veterinary Neurology’s practice manager, was recently part of something very impactful in our state. In late March, he testified in front of the Colorado House of Representatives in support of the passage of House Bill 1179. The bill provides immunity from civil and criminal liability for a person who forcibly enters a locked vehicle for the purpose of rendering assistance to an at-risk person or animal. The bill was sponsored by House Representatives Lori Saine and Joann Ginal, and Senators Lois Court and Vicki Marble. In mid-April, Governor Hickenlooper signed the bill into law, and

it will go into effect starting the beginning of August.

Third eyelid flap

Right eye before surgery

Healed right eye

• VRCC Internal Medicine would like to welcome board certified Internal Medicine Specialist Danielle Bayliss to our team! Dr. Bayliss came to us from a specialty practice in Memphis, TN. She started at VRCC on June 1st and is ready to help you and your clients. The Internal Medicine team can be reached at 303-874-2055, or internalmedicine@vrcc.com.

• Registration for Battle of the Vet Hospital Stars is now FULL! But you can still be apart of this fun event! We are taking volunteers to help at the event. If you are interested in volunteering, contact Ruby Post at rpost@vrcc.com or 303-874-2053. Volunteer opportunities are available all day long from 7a-6p. The FUNraising competition is also open and will go through Saturday, September 9th. Visit www.coloradogives.org/battle2017 to donate. This year, the event takes place on Sunday, September 10th at Clement Park in Littleton. For more details, go to: www.vrcc.com/calendar-of-events/battle-vet-hospital-stars-2017.

• VRCC Ophthalmology doctors recently participated in the annual ACVO/StokesRx National Service Animal Eye Exam Event. They performed over 50 free eye exams to local service dogs during the period of May - June 9th. Nearly 8,000 service animals are examined each year throughout the U.S. and Canada during this multinational event.

VRCC NEWS & ANNOUNCEMENTS

Lindsey Mortlock, DVM: Dr. Mortlock has been with VRCC since 2016. She graduated from Tufts Cummings School of Veterinary Medicine and completed a rotating internship at VCA Shoreline Veterinary Referral and Emergency Center.

Megan Rector, DVM, MS: Dr. Rector has been with VRCC since 2010. Megan graduated from Colorado State College of Veterinary Medicine and did a rotating internship at Texas AM College of Veterinary Medicine.

Luke Rump, DVM: Dr. Rump has been with VRCC since 1997 as an Emergency Veterinarian. He graduated from Iowa State College of Veterinary Medicine and did an emergency internship in Milwaukee, WI before moving to Colorado.

Heidi Servi, DVM: Dr. Servi has been with VRCC since 2015. She graduated from University of Wisconsin School of Veterinary Medicine and completed an emergency internship at Lakeshore Veterinary Specialists in Wisconsin.

Luanne Strom, DVM: Dr. Strom has been with VRCC since 2016. Luanne graduated from Ontario Veterinary College and did a rotating Internship at Wheat Ridge Animal Hospital. She has also worked at Four Seasons Veterinary Hospital prior to starting with VRCC. Taylor White, DVM: Dr. White has been with VRCC since 2014. She graduated from University of Wisconsin School of Veterinary Medicine and did a rotating internship at VCA Veterinary Referral Associates in Maryland and a Neurology/Neurosurgery Internship at the Center for Veterinary Specialty Care in Texas. Andrea Zikovitz, DVM: Dr. Zikovitz has been with VRCC since 2015. She graduated from Ontario Veterinary College in the same class as Dr. Strom and did a rotating internship at VCA South Shore Animal Hospital.