Meet Ashley Amaral, DVM

Ashley Amaral, DVM

Ashley Amaral, DVM

Tell us 3 fun facts about you.

  1. I have an extreme phobia of animal hair.
  2. I could eat Mexican food for every meal.
  3. If I wasn’t a veterinarian, I would be a forensic pathologist.

Where are you from?

The beautiful San Luis Obispo!

 

 

What drew you to veterinary medicine as a career?

I grew up working on family ranches all over the Central Coast.  I fell in love with production medicine first which quickly translated to a love of all veterinary medicine.

 What kinds of cases have you seen in the last week?

It’s the season of itchy dogs!  I’ve seen tons of appointments for fleas and skin allergies. 

Tell me about your favorite veterinary experience so far.

We have one amazing client here that constantly tells each staff member that they are appreciated.  I was having a hard day, and this client told me how much I was appreciated. That one comment has really stuck with me.

What is the most challenging part of being a veterinarian?

One of the challenges as well as the perks of our field, is that there is a constant influx of new information.  The ever evolving nature of our field makes veterinary medicine exciting, but it also takes a lot of work to keep up to date on the most modern approach to treatments.

What are you going to be for Halloween?

A nerd  (and I don’t really even need a costume J) 

What are 3 words you would use to describe the Animal Hospital of Salinas.

Integrity, quality, sincerity

What is one career lesson you’ve learned thus far?

Veterinary medicine is as much about treating owners as well as pets.

Nutrition Tidbits

Al and I recently attended a couple of nutrition lectures sponsored by Purina and I came away with some helpful tidbits:

1.  What is the difference between supermarket brands and pet store brands of food?

  • I can only answer this question as far as it pertains to Purina as they were the only pet food manufacturer at this talk, but I imagine that the answer correlates fairly well across pet food companies.  Their answer is that the source of the ingredients is all the same (as in there is not inferior meat or grain in the less expensive brands), but there are more bells and whistles (ie: essential fatty acids, prebiotics, meat as the first ingredient, glucosamine, increased palatability, increased protein, etc.) added to the premium brands. As our speaker put it, ‘You can drive a Ford Pinto or a Mustang, both will get you to work, but one is a better ride.’

2.  Should I feed my cat wet food or dry food?

  • I’ve always come down on the side of personal preference for this one, but I think that may be changing. Our speaker cited a recent small study that links satiety, the sense of fullness, with water content of food.  So wet food may help cats feel fuller and, therefore, help prevent overeating/obesity.
  • But what about dry food keeping the teeth clean? With the exception of a few specific dental diets, please see the Veterinary Oral Health Council website http://www.vohc.org/accepted_products.htm for a list, it is widely accepted that most dry foods do not appreciably affect plaque buildup.
  • One more thing, since cats develop food preferences early in life, our speaker recommended feeding kittens their first taste of canned food by 16 weeks of age and then continuing to offer it occasionally, so that the possibility of feeding canned food would be available even if you chose to feed dry food the majority of the time.

3.  How to pick a good pet food:

This last one is probably the most controversial as there are so many different and often opposing opinions on what constitutes optimum nutrition. Certainly a good place to start is to get a recommendation from your veterinarian. Here are some other things to look for when you make your decision:

  • The AAFCO (Association of American Feed Control Officials) Nutrition Statement  Pick a food for which the AAFCO nutrition statement indicates that it provides “complete and balanced nutrition” for your animals life stage (growth/pregnancy or adult maintenance) based on “feeding tests/trials”.
  1. Feeding tests/trials indicate that the food has actually been fed to animals as opposed to meeting nutrient profiles which means that a computer has determined the food to be complete, but it has not been fed to animals to be sure it is digestible.
  • The bag or can has a phone number on it to allow you to contact the food company with questions or concerns.
  • The company has a veterinary nutritionist on staff.
  • The food company has been in business for a while and has a good reputation.

I hope you find these tidbits helpful. If you have any pet health questions that have been plaguing you, feel free to comment on the blog and I will see if I can answer them for you.

CE Update 2013

I’ve always had an interest in surgery and have always sought continuing education on that subject, especially with orthopedics.  At the Animal Hospital of Salinas, Dr. Max Kennedy was able to perform simple fracture repairs prior to his retirement, and he left behind all of his equipment when he left.  So when I heard about the NAVC Institute taking place in Orlando, FL, I jumped on the opportunity to take an intensive, 5 day course on fracture repair.

The course itself was very well organized and I learned a lot!  There were about 40 veterinarians taking this particular course from all over the world.  One vet had even traveled from France for this conference!  Over the next five days, we learned about the techniques and theory behind fracture repair and we were able to practice these skills in lab.

The last day of the conference was Friday, May 24th.  Coincidentally, Disney had recently announced that they would be keeping the Magic Kingdom (along with Disneyland and California Adventure) open for 24 straight hours from 6 am to 6 am to kick off the Memorial Day Weekend.  My flight back was not until the next day, so I thought “Why not?”  What better way to get back on Pacific time than to pull an all nighter?  So when the conference ended, I made my way to Walt Disney World and the Magic Kingdom.  Boy, was it crowded!  But I managed to stay in the park until 6 am the next morning.  You might ask “Why would you do something like that?” and the best answer I can give you as a Disney fan is “Because they let me.”  Having a special event T-shirt that was only available for purchase that day didn’t hurt either.

Animal Hospital of Salinas goes to Walt Disney World and Magic Kingdom

My ultimate goal is to be able to provide more orthopedic surgery options at the Animal Hospital of Salinas.  I still have a lot to learn and I’m hoping that our local surgical specialists will assist me there.  Overall, I had a great time and look forward to more continuing education opportunities!

Also, a big special shout out to our former classmate and friend, Dr. Aysha Taff, who filled in for me while I was away. She handled a lot of tough cases with expert care and even worked in an acupuncture appointment. Thanks again!

Acupuncture for Dogs

Heartworm Update

Even as a veterinarian who knows the risks associated with heartworm, I think it is easy to become complacent. We see so many negative tests that it can come as a shock when one comes back positive. That’s what recently happened in our clinic and it had us all revisiting the subject of heartworm disease and how to prevent it.

Monterey County is an area where 1 out of every 205 dogs test positive for heartworm or, put another way, the average veterinary hospital in Monterey County has 1-5 dog patients with heartworm each year and the incidence is gradually increasing.

There are plenty of articles out there on heartworm disease and I don’t think I need to rehash them, but if you are interested in learning more I would point you towards the Companion Animal Parasite Council website (www.capcvet.org) for basic information or the American Heartworm Society website (www.heartwormsociety.org) for more in depth information.

What I did want to go over were some interesting points about treatment that make it more obvious why we recommend prevention for all dogs and cats so that treatment isn’t even a necessity.

• One of the most important parts of treatment is exercise restriction. This is because as we kill off the heartworms, or even as they die naturally, they drift off in the blood vessels and lodge in the little arteries of the lungs, stopping blood flow to parts of the lungs.  With exercise it is thought that bigger chunks of worms will lodge in bigger arteries and make the lung disease that comes secondary to treating heartworm disease that much worse, even fatal. Exercise restriction should begin at diagnosis and continue for up to 2 months after the final treatment resulting in a total of about 5 months of exercise restriction. Can you imagine only taking your dog out on a leash to go to the bathroom, not walk around, and then bring them inside and cage rest them for close to 5 months? If your dog is needing to be cage rested, please see this video of how to keep him/her mentally active during his/her confinement: Crate Rest Activities for Dogs

• Another difficulty with treatment has to do with the expense and supply of the medications used. Melarsomine is the drug used to treat heartworm and it is, and has been for over a year, on manufacturer hold which means they are not making more. There is a small supply available, but as you might expect, this costly drug is now even more expensive due to its scarcity. In addition to Melarsomine, part of the treatment for heartworms is giving an antibiotic, Doxycycline to kill the bacteria that live within the worms. This antibiotic has been back-ordered and, again due to scant supply, is quite expensive and can be difficult to get in stock.

• As if those two issues weren’t enough then we come to cats who are always a little different than dogs. In the first place, the testing that we routinely do for dogs doesn’t really work in cats. This makes diagnosing cats with heartworms more of a challenge, but it doesn’t mean that they don’t get the disease. Even being inside is not protective enough as 25-30% of cats that are diagnosed with heartworms are, according to their owners, indoor only cats. Cats get more respiratory problems than dogs do with heartworms and sometimes they can have gastrointestinal or even neurologic symptoms.  In addition to being harder to diagnose and getting different disease symptoms, there is also no drug for the treatment of heartworms in cats, so in their case we have to put them on a preventative and other supportive care and then either surgically remove the heartworms or wait the 2-4 years for the heartworms to die of natural causes.

I think when one considers the difficulties of treatment in terms of cost, changes in daily routine, and with cats the difficulties of diagnosis as well as treatment, that prevention becomes a much more obvious choice. If you would like to discuss heartworm prevention for your dog or cat or have other questions or concerns about heartworm disease, please call us (831) 424-5707.

Heartworm Preventatives

Memorializing Spudge

You may remember that eight months ago I was told that my dog, Spudge, could die at any minute. In addition to sending me into a tailspin of grief it also prompted me to look into ways I could hold on to his memory. I already knew about several options: making a paw print to put in a frame or hang as a decoration, keeping some fur, garden statues or grave markers, cremation urns, and donations in your pet’s name. Once, when I was in Vet School, I even researched taxidermy and freeze drying a pet as options for a woman to whom I had spoken while staffing the Pet Loss Support Hotline.

While these are all fine memorials, none of them worked for me, so I did a Google search and came up with: having your pet’s ashes shot into space, turning the ashes in to fireworks or gemstones, or storing them in Victorian Mourning Lockets or other jewelry. These were all new to me, but still none of them struck me as a way to celebrate Spudge or ease my pain at his passing.  So I went with my hobby of digital scrapbooking and made a page that included many of my memories of him from his whole life. It felt good just to write them down and know that many years from now I would remember these little parts of our relationship that otherwise might fade from my recollection.

 

I was satisfied with my scrapbook page and with my plans for what to do with Spudgy’s body when he did pass, at least until he actually died. Before, thoughts of what to do with his body were abstract and I could change my mind about what I preferred, but now I had one chance to make my choice and that decision would be permanent. We placed a “hold tag” on his body and kept him in the freezer at the hospital.

For me the difficulty with getting his ashes returned is that you either have to keep the ashes on display or say good bye all over again, and neither of these held much appeal. So after deciding that I didn’t want his ashes back, not even to be turned into a diamond or launched into space, we took the hold tag off his body, and I thought that was the end of the story. But my staff surprised me with a succulent garden with stones spelling out his name and I was truly touched with how thoughtful a gift that was. It sits on my front step and both remind me of Spudge and also of life since it is green and growing.

 

An even bigger surprise was a hand drawn portrait of Spudge from our Lead Technician, Adrienne, who was able to put so much life into his eyes. I cried when I saw it because it is so amazing. I had never even considered a portrait of him, although that is an option I ran across on my Google search.  I thought no one would be able to capture his essence. Adrienne did a fantastic job and she is willing to draw other people’s pets for memorials or otherwise. She can be contacted at our hospital if that is something in which you are interested.

 

I am looking forward to hanging his portrait when we get it back from being framed in the next week. In the meantime I am left with what to do with Spudgy’s collar which still is hanging on the hook by the door, leash attached and ready to be used. No amount of searching on Google or Pinterest has turned up an option that appeals to me. I’m looking for an idea that is useful beyond a shadow box or just keeping it in a drawer somewhere. If you have any suggestions, please reply to this blog.

When is it Time?

How do you know when it’s time? That is a question I get a lot when pet owners are faced with an aging or perhaps terminally ill pet. I have a fairly standard set of criteria: when he stops eating, becomes less interactive, and/or when he can no longer do the things that gives their life joy. Sometimes I say, “When the bad days outnumber the good days.”

Recently I experienced being on the other side of this question for the first time in over a decade. My dog, Spudge, had just turned 15. I brought him in to our hospital for some routine labwork. While he was getting urine, Al decided to take a little peek at the rest of his abdomen with the ultrasound; he was shocked to find his liver looking really unusual. I took Spudge to the Internal Medicine Specialist right away who did an official abdominal ultrasound and diagnosed Spudge with a “Large Cavitary Multichamber Hepatic Mass” and a “Right Adrenal Mass.” In other words his liver was almost completely obliterated by multiple fluid filled structures and his right adrenal gland near his kidney was enlarged. The most likely cause of these masses was at least one kind of cancer, maybe two.

I spoke with a Surgical Specialist who said that, although he never liked to call things “inoperable,” Spudgy’s liver mass was as close to that as possible. He would be willing to try as long as I understood that Spudge would probably die on the table.  I looked at my more or less healthy dog and decided that I would rather have good time with him than take the risk.

Oh, and by the way, because the mass was made up of thin walled sacs of fluid it was quite possible that they would rupture and cause him to die at any moment. I began to grieve the imminent loss of my dog who was a part of my life before vet school, before I met Al, before I had kids.

I made sure to say good bye to him every night before bed and would dread going downstairs in the morning because he may have died while I slept. Sometimes during the day he would sleep so deeply I would have to watch for several moments to be sure he was still breathing.

Time passed and life continued. Spudgy had already been getting stiffer and slower before his diagnosis, which I understood as just part of the aging process. He gradually got weaker, but it happened so slowly that I didn’t really notice.

Eight months after his diagnosis he began to have what I would count as “bad days.” He seemed to be having difficulty urinating so we drained his bladder through a catheter. That day he walked around the house for 15 minutes checking for cereal my toddler had dropped. It was then that I realized how far down he had gone. I couldn’t remember the last time he felt strong enough to cruise for food.

His improvement was short lived and now I was faced with the question, “How do I know when it is time?” He still had a great appetite. He still seemed bright and interested in his surroundings. He could no longer do his most favorite thing of running in between two people playing catch, but he hadn’t been able to for over a year, maybe two.

My main concern was that he be comfortable. As far as I could tell he wasn’t suffering and I wanted to be sure it was “time.” Over the next couple of weeks he continued as he had been, but with the realization that he really wasn’t able to do most things except eat and be pet, it began to become clear.  I began to realize that his time was coming, but still I didn’t feel like it was here yet. I wondered if it would ever feel like the right time.

It was a beautiful, sunny Tuesday morning. I greeted him first thing as had become my custom. He was lying where he had been the night before. He still wanted to eat breakfast, but he seemed more inwardly focused than before.  I wanted to take him out to enjoy the sunshine. When he didn’t want to go outside I knew. I knew it was time and with that knowledge came a measure of peace.

I spent time that day saying a final goodbye. Al brought the necessary equipment home from the hospital. On some level, ever since he was young, I dreaded the moment I would hold his paw and inject the fluid that would end his life. But in the end it was, as I often tell my clients, a gift that I could give to him because he was ready. It was time.

10 year Vet School Reunion at UC Davis!

Rachel and I recently attended our 10 year Vet School Reunion at UC Davis! Wow, has it really been 10 years already? When we graduated, we were fresh faced and full of energy, ready to go out there and make a difference. Aside from our families meeting for the first time (which is a story unto itself), our transition from school to our first jobs was relatively smooth. Little did we know how much more learning there was to do in the “real world.” But that’s a future blog post.

The Class of 2002 graduated at an awkward time. In 1998, our freshman year, the Vet School was placed on limited accreditation due to its aging facilities and we all wondered if the piece of paper we would receive at the end of our journey was going to be worthless (had we graduated one year later, our diploma would have been signed by the Governator! That would have been worth something!). On the bright side, we didn’t have to pay the exorbitant tuition fees that current vet students suffer. It wasn’t until 2005 when the school was restored to full accreditation status.

Seeing the updated facilities at the reunion brought back lots of memories for Rachel and myself. The new Anatomy Lab’s ventilation system left no hint of formaldehyde in the air, whereas our old lab’s scent permeated our nostrils and clothes long after we left. Each student now has their choice of either a Macbook or a PC laptop upon entry for notes and syllabi. Our class felt privileged to get our own ucdavis.edu email address! The new lecture classrooms were amazing, and the chairs now allow students to recline to a more comfortable napping position. In the micro lab, instead of raising our hands for a question and waiting to be noticed, students now have a system akin to the flight attendant buttons on airplanes.

Despite the changes to the learning facilities, the Veterinary Medical Teaching Hospital remained largely the same. Rachel and I walked those hallways and reminisced about old times and memories we’d shared there. The last year of vet school is undoubtedly the most intense, and many hours are spent on clinics learning about what we would encounter after graduation.

There were many other class reunions going on simultaneously, too. The inaugural Class of 1952 even had one member attend, I believe! Our classmates have scattered across the US and gone on to varying careers. Several of our classmates went on to get advanced degrees in different specialties such as surgery and emergency care. A couple of our classmates are doing shelter medicine and one is teaching veterinary students at the Cornell School of Veterinary Medicine.

Much has changed in both our personal and professional lives in the past 10 years. But we still believe that veterinary medicine is the best profession in the world and we love what we do.

Animal Hospital of Salinas AAHA Accreditation

We have wonderful news.  Our AAHA accreditation has been renewed.  For those of you who don’t know, AAHA (American Animal Hospital Association) has a list of 950 standards that have to be met to become accredited.  This is a voluntary process for those hospitals that want to make the commitment to meeting the standards for highest care.  Once accredited, the hospital is reviewed every 3 years to be sure that they are keeping up with changes in the standards and are continuing quality care.

We have spent the past several months updating the hospital and making sure we are in compliance with the standards.  On Sept. 6, an official reviewer came to inspect our hospital, watch us in action, and look at our records, logs, and protocols.  We are proud to announce that we passed with flying colors!

animal-hospital-salinas-aaha

Animal Hospital of Salinas will become a paperless practice!

We would like to announce something exciting that is happening! We have recently updated our practice management software to a program that we feel is more efficient and have installed all new workstations! But probably the biggest change is that we will become a paperless practice! In an effort to increase efficiency and to spare the environment, we will no longer be using paper records. Of course, all this change will come with headaches and growing pains. We will be updating our client records, so we may ask for your updated contact information when you arrive. Also, we anticipate soon giving our clients the choice between email vs. regular mail for a contact method. We ask everyone to please bear with us as we make this change and iron out all the kinks that will inevitably arise. We’re very excited for everyone to see the end result! Please email us with questions at ahosvets@gmail.com. Also, be sure to like us on Facebook at www.facebook.com/AnimalHospitalofSalinas!

Animal Hospital of Salinas is a paperless practice

Welcome to the Animal Hospital of Salinas blog!

The hospital has been under new ownership for the past 10 months and has seen some dramatic changes.  We’ve updated our in house laboratory machines, replaced our old X-ray film processor with a new digital radiography system, started a social media campaign, developed a new website (www.ahsalinas.com), and next week, we will become a paperless practice with new management software and new computers!

For those existing clients of the hospital who were used to Drs. Kennedy and Stroshine, we would like to thank you for your continued loyalty and patience as we go through these changes.  And for those who have come over specifically to see Dr. Chan or Dr. Sage, we would like to say “Thank you!!”  It has been an amazing experience and we have thoroughly enjoyed meeting with our clients and patients, both new and old.  Having Dr. Stroshine stay on to help has been a true blessing and we have enjoyed getting to know him both professionally and personally.

Our Veterinarians

Animal Hospital of Salinas – Our Veterinarians

With this first entry, we’d just like to introduce ourselves again and give everyone a way to get to know us.  We’ll be posting major announcements, pet news, medical tips and advice, basically anything related to the hospital or veterinary medicine!  If there’s anything you would like to read about, feel free to ask us!

Be sure to like us on Facebook at www.facebook.com/AnimalHospitalofSalinas and check back on our blog, as we will be adding to it regularly.  If you have questions or suggestions for future blog posts, please email them to ahosvets@gmail.com.  Until next time!