One of my tasks as a board-certified veterinary internal medicine specialist is interpreting a wide variety of diagnostic tests. One of the most common laboratory abnormalities for which patients are referred to me is elevation of an enzyme called alkaline phosphatase, often abbreviated as SAP, SALP, and ALP. There are…
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Idiopathic Sterile Nodular Panniculitis – An Important Skin Condition in Dogs
I don’t like skin diseases, so I’m very thankful for folks like board-certified veterinary dermatologists who do! This week my family’s dog, Tobyas, required urgent dermatologic care for an immune-mediated condition called idiopathic sterile nodular panniculitis. Thanks to the wonderful veterinary dermatology team at Angell Animal Medical Center in Boston,…
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IMN: Immune-Mediated Neutropenia in Cats & Dogs
It should come as no surprise to anybody who follows this blog that I love hematology and immunology! In previous posts I’ve written about various immune-mediated problems, including immune-mediated hemolytic anemia, immune-mediated thrombocytopenia, and immune-mediated polyarthropathy. This week I’m sharing information about another immune-mediated condition: immune-mediated neutropenia or IMN. I…
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ITP – Immune-Mediated Thrombocytopenia
I love immunology (the study of the immune system) and hematology (the study of blood). I once contemplated completing a PhD in these fields, but two residencies was enough. Immune-mediated thrombocytopenia or ITP is an immune-mediated disease that is personal. My own dog was diagnosed with this disease during my…
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Multiple Myeloma in Dogs & Cats – A Cancer of the Immune System
As a board-certified veterinary internal medicine and emergency/critical care specialist, I’m used to seeing unwell patients. The sickest of the sick. But this week I saw cancer patient after cancer patient. Beautiful pets with committed families. I’m not a cancer specialist, and unfortunately the closest one in three hours away.…
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Mast Cell Tumors in Dogs – A Common Canine Skin Cancer
Mast cells are unique cells of the immune system that are involved in the body’s response to inflammation and allergies. Unfortunately, these cells can become cancerous to affect different areas of the body, particularly the skin. Given their commonality in our canine companions, I wanted to dedicate some time to…
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Myasthenia Gravis – When the Muscles & Nerves Don’t Talk
Nerves send vital signals to muscles throughout the body. When these chemical signals don’t interact with muscles normally, one possible result is profound muscle weakness. A unique disease caused by this very scenario is called myasthenia gravis, and has been documents in dogs, cats, and humans. This week I share…
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Immune Mediated Polyarthropathy – A Joint Attack
My favorite aspect of practicing medicine is treating diseases caused by dysfunction of the immune system. In previous blogs, I reviewed two common immune-mediated diseases – immune-mediated hemolytic anemia and immune-mediated thrombocytopenia. A less commonly appreciated condition of immune system dysfunction is immune-mediated polyarthropathy or IMPA, a disease where the immune…
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Empirical Therapy – Can’t You Just Treat It Doc?
I have the privilege of evaluating patients and conversing with their families every day I’m in the hospital. Although I rarely meet healthy patients, I find tremendous satisfaction sitting on the floor with them in my consultation room, examining (and cuddling) them and chatting with their parents. As my patients are invariably…
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Steroid Trials in Dogs and Cats – The Good, The Bad & The Frustrating
A clinical scenario I face almost on a daily basis is a pet that is presented to me for failure to positively respond to a steroid trial initiated by a family veterinarian. A primary care doctor initially evaluated the fur baby, and subsequently made a presumptive clinical diagnosis of a disease…