TFV's Trees

Before you’ve even stepped into our office, they have perhaps already made an impression on you. The two towering trees in front of our office parking lot have been there ever since I can remember, over 20 years ago. We took a moment to research a little bit about them.

Apparently, the seemingly interminable number of figs the trees drop are edible, though we’ve never tried them ourselves...

Apparently, the seemingly interminable number of figs the trees drop are edible, though we’ve never tried them ourselves...

They’re Ficus microcarpa, more commonly known as Indian Laurel Figs. Indian Laurel Figs are a species of ficus indigenous to Malaysia; as it turns out they’re actually among the most common non-native trees in Southern California. Travel a few blocks around our Southern California suburbs and you may get lucky and find one, though you’re far more likely to see much smaller specimens, making ours nearly unrecognizably large.

Once a commonly planted tree in California, Ficus microcarpa has largely fallen out of favor among planters for several concerns. For one, its non-native status makes its planting immediately questionable. Second, the roots of Ficus microcarpa are known to be particularly destructive to sidewalks (where it is most commonly planted).

But that is okay. Our trees have been (literal) fixtures outside of our clinic for decades. For me they’re guardians of our facility much as Patience and Fortitude guard the New York City Public Library, looking down upon our little clinic and making sure that everything is alright. I’ve seen them provide shade when it’s unbearably hot outside and I’ve seen them provide shelter from the rain when it’s pouring outside their canopy. Just last week I saw them provide shelter to a Cooper’s Hawk looking for unsuspecting pigeons, and I see American Crows and Common Ravens use them as rest stops in our otherwise concrete jungle nearly every day.

Guardians of our clinic.

Guardians of our clinic.

Every day Dr. Tran and I begin and end our days looking up at the ficuses that have shared their lives with us for so long and seeing what surprises they may or may not bring. I wonder what they’ve seen and what wisdom they keep to themselves.

Source: Ritter, Matt: A Californian's Guide to the Trees Among Us, 2011.

Pacific Veterinary Conference

This past weekend we had the opportunity to attend the Pacific Veterinary Conference right here in our own backyard in Long Beach. There were vendors and many other veterinary professionals, and, of course, a wide variety of educational courses. Topics ranged from to "Legal Issues Confronting Veterinary Practices" to "Issues with Homemade Diets."

It is always great to see and meet so many professionals dedicated to providing the best possible care for our companions.

Case Report Short: Elaine Tran

Today we begin a new occasional blog series called "Case Report Shorts." As their name implies, "Case Report Shorts" will be short summaries of cases that we come across. In order to make these "Short Reports" possible, brevity and clarity will be emphasized. Our aim of these reports, as with our blog in general, will be to both to enlighten and inform others of the complexities involved in companion animal health care. Our first Case Report Short is Elaine Tran.

Elaine and Dr. Tran in July

Elaine Tran is Dr. Tran's own 11 year old pit bull mix. Even though Elaine seemed fine (she had been acting fine, eating fine, etc.) in September Elaine had a blood test administered as part of a routine senior and pre-dentistry check-up. Some of the results were somewhat abnormal but since Elaine was otherwise fine, Dr. Tran decided to postpone the dentistry and re-retest her a few months later. 

In January Dr. Tran proceeded with the follow-up diagnostic tests. Unfortunately, the follow-up blood test was much worse. It was now obvious that Elaine, still acting "fine on the outside," was having some type of serious medical problem. As a result of that follow-up test, Elaine had an xray, then an ultrasound a few days later. The xray seemed to show some sort of round mass in her abdomen; the ultrasound confirmed the mass to be a "splenic mass." Even though the splenic mass did not appear to be at risk of rupturing, Dr. Tran elected to have it removed as urgently as possible.  Elaine's liver also appeared abnormal on the ultrasound (which was not surprising considering the abnormal liver values on her blood test); so the initial plan was to biopsy (to get some samples for testing) her liver during surgery. 

 Lateral (side) view of Elaine's abdomen. Red arrows outline the round mass on her spleen.

Less than a week after the ultrasound, Elaine was admitted to Animal Emergency and Medical Center in Torrance for her splenectomy (surgery to remove her spleen).  Surprisingly, her pre-surgical blood test showed an anemia that was not there a week ago.  The reason was revealed when the surgeon entered Elaine's abdomen.  The splenic mass had developed a small crack and had started to bleed.  The surgeon was met with another surprise when he checked the liver --- a large mass occupied one of Elaine's liver lobes.  In addition to removing the spleen, the surgeon had to remove 2 of her liver lobes to completely remove the mass.  

A 4-inch mass in Elaine's liver

 

A 3-inch mass on Elaine's spleen

Indeed, even though Elaine was "acting fine" on the outside, it is conceivable that had she not had that surgery, she would, at the minimum, have developed a hemoabdomen (blood in her abdomen) as her splenic mass had started to bleed. Or she would have developed more complications from the liver mass.

The surgery proved complicated and long, but was successful. Still, her recovery was somewhat difficult. She wouldn't eat or drink and she remained very weak. When she finally had an appetite, she would vomit anything she ate the first couple of days.  It's been 2 weeks since her surgery and Elaine is finally showing glimpses of her normal self.

The growths themselves were tested.  The growth on Elaine's spleen was a benign mass -- surgical removal was curative.  The growth on her liver was a well differentiated hepatocellular carcinoma. Although we have to monitor her other liver lobes (via ultrasound) for recurrence, the overall prognosis is good for Elaine. We could not have wished for a better outcome. 

Today (February 14th) is Elaine's 12th Birthday. Thanks to the help from AEMC, we hope to have Elaine with us for many more to come.
Elaine a couple of weeks after her surgery, February 2013