Cushing’s? What’s that?

Cushing’s Disease? What’s That?

David Moores, DVM

Tchefuncte Animal Hospital

209 Hwy 21, Madisonville, LA 70447

985-845-7484

www.tchefuncteanimalhospital.com

As anyone who has had the pleasant experience of owning or even meeting a Boston Terrier can tell you, these little guys and gals are a bundle of energy. Sam is your typical Boston Terrier. Throughout his life, he never slowed down. Always jumping, running, barking, exploring, and getting in trouble pretty much sums up Sam’s life with the Adams family.  

Sam had just celebrated his 8th birthday, complete with ice cream and assorted treats, which Sam consumed with gusto. Sam’s owners had invited some friends and family over for the occasion. Mr. Adams’s outspoken friend, Thomas Paine, hadn’t seen Sam in a few years. His first comment about Sam was regarding Sam’s prominent pot belly.  

Hearing that comment, several others at the party mentioned that Sam appeared to be entering into male pattern baldness. One other guest made a point of mentioning that Sam had been drinking out of the toilet and the guest’s glasses as well. Mr. and Mrs. Adams were slightly offended at first, but when they sat down later on after the guests had taken their leave, they both agreed that Sam hadn’t quite been himself lately.  

A few days later, the Adams family found themselves at the veterinarian. They discovered that it had been a few years since Sam had been in to see his doctor. Dr. Revere listened to the Adams’ report about Sam and completed his physical exam. After he finished, he told the Adams that the symptoms their friends had noticed were significant, and he believed that Sam may have a disease called Cushing’s disease. 

Cushing’s disease is a common hormonal disease in which the body suffers from an excess production of a hormone called cortisol. Cortisol is a natural steroid produced by the body and is necessary for a number of body systems to function normally. Sometimes, whether it is from a small tumor of the adrenal glands, a tumor of the pituitary gland, or from an animal receiving steroid medication, the body acquires more cortisol than it can handle.  

There are many different clinical signs of Cushing’s disease, and each patient appears slightly different. Some common signs include: drinking a lot of water and urinating frequently, a large appetite, a potbelly, hair and skin changes, panting constantly, muscle wasting, and behavior changes. 

Dr. Revere collected a blood sample from Sam as well as a urine specimen. Cushing’s disease can mimic a wide array of other common diseases, such as diabetes and liver disease, so it is important to rule these other diseases out. Sam’s blood work revealed a problem with his liver enzymes, high cholesterol levels, elevated white blood cells, and decreased thyroid hormone levels. Sam’s urine tests ruled out a bacterial infection, but showed some protein present. 

Since Sam’s blood and urine tests along with his clinical signs supported Cushing’s disease and not another disease, Dr. Revere had Sam return for a battery of specific tests to definitely diagnose and pinpoint what type of Cushing’s disease Sam had. After several days when all the tests had been completed, it was determined that Sam had a common type of Cushing’s disease that was caused by a small, benign tumor in his pituitary gland. 

Sam was started on a drug therapy regimen designed to decrease the levels of cortisol through its effects on production. Dr. Revere provided very specific instructions on how the medication was to be administered, and the Adams were given the responsibility of watching Sam’s response to the medication. If the medication is not administered or monitored properly, it can be dangerous. Sam was scheduled to return at specific intervals to have his blood checked in order to ensure that the medication was working properly. 

After some time, the Adams began to notice that Sam was displaying some of the same energy and behavior that he was famous for in his younger years. His appearance also improved, and he stopped drinking and urinating all the time. The Adams realized that signs that they chalked up to “old age” were actually a serious disease that is progressive, ultimately resulting in death.  

The best way to guard against such an illness is to be an alert, observant pet owner. Changes in behavior or appearance that seem unrelated or insignificant may be put together in a puzzle that ultimately results in a diagnosis that could improve or even save your pet’s life. 

Adopt-A-Less-Adoptable Pet Week Sept 17-25

Please take a minute to visit www.petfinder.com and perhaps seize the opportunity to adopt a less-than-fortunate animal during petfinder’s adopt-a-less-adoptable pet week this week.

Many factors can make a pet seem “less adoptable.” To promote these unusual (or, in some cases, too common) animals, Petfinder has designated Sept. 17-25, 2011, as “Adopt-A-Less-Adoptable-Pet Week.” Petfinder-member shelters and rescue groups to nominate a very special pet in their care who is waiting for a home. Check them out in their gallery, then use their pet-search tool to find a special pet for adoption near you.

David Moores, DVM

The Dreaded Bloat

Of all the potential emergencies that dogs face, there is one condition that stands out and is one of the most dreaded of all: gastric dilatation and volvulus (GDV).  This condition, often incorrectly referred to as bloating, requires immediate treatment or death will follow.

This serious condition affects mostly deep-chested breed dogs such as Great Danes, St. Bernards, Weimaraners, Rottweilers, Setters, Retrievers, However GDV can occur in any dog.  Normally, the stomach is positioned high in the abdomen and holds a small amount of gas, fluids, and any food being digested.  The stomach undergoes a rhythmic cycle of receiving food, contractions, grinding, and emptying.

Sometimes, the stomach can become distended with gas or ingesta. This accumulation of gas and/or food can stretch the stomach to many times its normal size which causes tremendous abdominal pain. This grossly distended stomach has a tendency to rotate up and over itself. This rotational motion causes the esophagus (inlet) and duodenum (exit) to twist along with the stomach.  These actions cut off the blood supply to the stomach as well as the exit routes for gas and food. (Hence the non-productive retching.) This situation is life-threatening and the dog will die a painful death within hours unless the condition is treated immediately and properly.

Signs of GDV may include an obviously distended stomach especially near the ribs but this is not always easily noticeable especially in obese dogs.  The most important sign of GDV is the nausea with non-productive retching. (Dog is trying to vomit but nothing is coming up.) If you see abdominal swelling, nausea, and unproductive retching, you need to seek veterinary care immediately, especially if your dog is one of the at-risk breeds.

Treatment of GDV usually involves decompression of the stomach along with aggressive treatment for shock as well as a cardiac evaluation followed by surgery to correct the stomach torsion.  Even following aggressive treatment, the mortality rate is very high, so this condition can still be fatal even if caught early.

There are some measures owners can take to lower the chances of GDV like adding canned food, feeding twice daily, etc.  For some at-risk breed owners, there is a benefit of having a prophylactic surgery performed at the time of spay/neuter that can decrease the possibility of GDV.  If you have any questions or want to learn more about preventative measures, please contact your local veterinarian.   

David Moores, DVM

Tchefuncte Animal Hospital, LLC

209 Hwy 21

Madisonville, LA 70477

www.tchefuncteanimalhospital.com

985-845-7484

Oprah’s Not So Great Escape - If she were only a few pounds thinner.

Oprah is a 5 month old lab mix who has been at St. Tammany Humane Society for about three months. She came in with her brother Stedman as a stray, abandoned to the winds of fate that eventually delivered her to a safe haven. We are never short on black lab mixes here at STHS, and at times those delightful shaggy souls seem to just blur past your vision into one big black lab lump. Perhaps it is a visual adoptive handicap or perhaps it is just human nature to desire something that is rarer. Whatever the reason, those precious pups are more difficult to adopt than other smaller breeds or dogs of different colors or markings. And so little Oprah sat in her kennel and watched as dogs around her were adopted to new homes, while she not-so-patiently waited until her big day would arrive.

Now once in a while we will get a dog here at the shelter that, very much like myself, lacks the virtue of patience, often resulting in minor mishaps. Did our Oprah fit into this accident prone category? Yes, although I would love to report that what happened to Oprah could be considered a minor mishap. It was more like a cataclysmic catastrophe.

Oprah, grown ragged and weary of giving friendly barks and expressing her mad desire to go home with visitors with manic tail wagging, one day decided to take matters into her own paws. To put it simply, she decided she wanted out. She tried ramming through her kennel. No dice. Can’t jump over. Can’t dig under. There was, however, a small space under and around her kennel door. Was it possible to reconfigure herself into the shape of a pancake and just slide through or under? It was definitely worth a shot.

And that was the last idea of escape that passed through Oprah’s mind before Jacqie, our Kennels Manager, happened upon her yelping in excruciating pain. It seems that in her twisting and turning in the vain but admirable hopes of freedom, little Oprah got her two back legs caught in that once-so-promising sliver of space. She was rushed to Dr. Newfield, and after taking x-rays, she suggested sending her to a specialist, as her injuries were complex and extensive. Oprah was then brought to our hero, Dr. Bob at South Paws Veterinary Surgical Specialists. The diagnosis: Oprah suffered an avulsion of the tibial tuberosity in one leg and fractured proximal tibia and fibula in the other. Translation: Both legs were badly broken, requiring pins to repair the severe damage. These injuries required surgical repairs by an orthopedic specialist. Cost with post-surgery medication: $1100.

And that is how our little shelter dog Oprah landed herself in our Second Chance Program. She has had her surgery, and is on the road to recovery, but we desperately need to raise the money to pay for her surgery. Until we raise this money, we are unable to help another dog in need through this special program. So please donate whatever you are able to at this time. We and Oprah thank you in advance from the bottom of our hound loving hearts. Oprah is also available for adoption, so if this little shaggy rebel is a dog after your own heart, please contact Jessica at the St. Tammany Humane Society for more information on adoption!

You can also help by voting for the St. Tammany Humane Society at bit.ly/ijqLlU we could win $50,000!

Vaughn Maurice
Executive Director
St. Tammany Humane Society

Growing Pains

As the St. Tammany Humane Society expands both virtually and literally, we are now faced with the necessity of accommodating our growing number of fans….I mean, clients and potential adopters by adding more parking area to our small shelter (a good problem to have, if you’re going to have one). Over the last 3 years St. Tammany Humane Society, as I alluded to previously, has grown exponentially in terms of community outreach, new programs, vet clinic growth, and a huge increase in adoptions. Most of these positive changes can be attributed to innovative and dynamic leadership, and a hardworking caring staff.

However, another factor that has been instrumental to our recent growth and success is the help and support of Ian Somerhalder, star of the TV series Vampire Diaries. Ian is a St. Tammany native, and his relationship with the St. Tammany Humane Society began about 2 years ago, shortly after the devastating oil spill in the Gulf. Ian reached out, using his resources in aiding his hometown and local community in a cause that is close to his heart: animal welfare and rescue. His PSA urged people to not only be aware, but actively assist in any way they were able in helping to stem the loss and devastation to the environment and state wildlife as a result of the oil spill (special emphasis on the Louisiana Brown Pelican).

Ian’s work for those who have no voice did not stop there. After visiting STHS directly following the tragic oil spill, he became actively involved with our no-kill shelter. His role as chairperson of our annual Fall fundraiser “Unleashed” brought fans (who are now some of our most generous donors and supporters) from around the world. “Unleashed 2010: Bash on the Bayou” was our largest event to date, bringing in much needed proceeds which were used to make improvements and additions to our 50 year old shelter. Among Ian’s myriad contributions to STHS include spotlighting some of our hard to adopt pups, donating proceeds from his autographed picture to the shelter, publicly supporting our no-kill shelter and mission whenever he can, and joining with us in spreading awareness in many facets of animal welfare. Ian’s newly formed non-profit organization, the IS Foundation, touts the mission statement, “The IS FOUNDATION aims to empower, educate and collaborate with people and projects to positively impact the planet and its creatures.” Animal welfare is a main focus of the IS Foundation, and his active role in this arena has not gone unnoticed by many animal advocates around the globe.

So, in returning to our humble St. Tammany Humane Society…….and our parking lot in progress. In addition to the necessities and pragmatics involved in the construction of our new parking area, we thought that a little touch of ancillary aesthetics for your viewing pleasure would be in order: a beautiful flower garden adorning the perimeter of the parking area. This would serve a dual purpose. Not only would you have a visual sensory overload when you pulled into STHS (which can be quite pleasant), but also a gorgeous background to showcase all of our adoptables on the website. The garden’s beauty will demand that it have a name… The name, in honor of our supporter that has made it possible in the first place: The Garden of Ian.

For more information and how you can help please visit http://bit.ly/mGaPmF

Vaughn Maurice
Executive Director
St. Tammany Humane Society

20 Informative Web Forums to Keep Your Pets Healthy

By Tina Marconi
June 28, 2011

Keeping your pet healthy is essential for their well-being. Vet bills can add up quickly, so it’s important to watch your pet’s health and keep a log if their eating habits or behavior begin to change. For young pets, pet health insurance can usually be purchased that will make vet visits less costly as the pet grows into adulthood. For those searching for quick remedies or tips on how to feed your pet properly, these pet health blogs and websites will offer free help. Remember if any problem persists for a few weeks, it’s best to visit the vet to be certain the problem isn’t a symptom of a serious illness.

Top Pet Health and Safety Blogs and Websites
Keep your pet in shape and well fed with these blogs and websites which focus on pet health.

1. Pets WebMD
Pets get their very own WebMD to help you diagnose common pet illnesses and give you the basics on how to care for your pet. There’s also an extensive section over puppy training.

2. Pet Health 101
At this site you can check out the pet health diagram to see the condition of your dog or cat. There’s also an active message board and tips on dealing with heartworms, epilepsy, diabetes and other pet illnesses.

3. Pet Health
At this pet health blog, you’ll find help for caring for the usual suspects like cats and dogs. There’s also posts over caring for fish, hamsters and snakes. If your family has a wild bunch of animals, this is the blog for pet health tips.

4. Pet Finder Pet Health
We love this site because it’s packed with health information on all of the pet food that’s out there. Remember that buzzwords like “all-natural” and “eco-friendly” are just that and doesn’t ensure a product is healthy for your pet’s digestive system.

5. Healthy Pet
This site has information over accessing dog behavior and has referrals for finding a quality vet in your area. It’s important to do your research when finding a vet, especially if your pet is young and you think you’ll be a client for a long time.

6. MSNBC Pet Health
This blog of MSNBC discusses pet topics of every variety. It serves as a feed of sorts for posts around the web with pet health in mind. Read up on organic pet food products and how to cook green for your pet at home.

7. Pawn Nation
This site has pet product reviews, pet news and section over dogs and cats. Dog owners will appreciate the hefty section over canine health, including how to care for your dog’s teeth and gums between vet check-ups.
8. Veterinary Partner
At this blog you can find health information on dogs and cats, plus reptiles and horses. It’s an informative site with insight on complex diseases that are only vaguely touched on by other pet health blogs.

9. Natural Pet Care
If your focus is eco-safe pet care, this is the site for you. This pet health blog has tips for natural remedies and pre-cautions that every pet owner should take when shopping for products for their pet.

10. Home Vet
This vet sticks to the facts of caring green for your pet. This blog has an active forum for those learning about homemade organic pet food and treating simple illnesses with home remedies.

11. Natural Wonder Pets
This pet blog is devoted to natural health. When it comes to your dog’s teeth or cat diabetes, this site believes that going green is the best route for your animal’s well being.

12. Precious Pets
This blog has articles over probiotics and how they affect a pet’s digestive tract, plus tips on how to feed your pet quality holistic food on a budget. Remember that the pet food industry is not regulated by the FDA, which results in low quality ingredients in a lot of mainstream pet food brands.

13. Pet Care Naturally
This doctor is dedicated to caring for your pets naturally and regularly posts articles about caring for your animal’s joints, digestive system and vision. This is a must-read blog for those looking to learn the basics of homeopathic methods for pet health.

14. Barf World Blog
This is a fantastic pet health blog that covers all natural pet care, from food to medicine. This blog is updated often and focuses on your pet’s dietary health, including homemade recipes you can whip up for Fido in your kitchen.

15. Pet Grub
This blog offers free all natural pet recipes to owners. The recipes are easy to follow and it’s clear the blogger has a genuine passion for animal health and believes the knowledge of natural pet food should be shared with pet owners to improve an animal’s health.

16. Pet Health Forums
This site has forums for discussing your cats and dogs, but also a section over hamsters, gerbils and rabbits. There’s also a fun area where members post pictures of their pets.

17. Pet Lovers
This forum is a must for bird owners due to the sizable section over caring for them. At this site you’ll also find sections over rodents, cats, dogs and even farm animals.

18. MedHelp – Animal Health
At this site, members post questions about their pet’s health and others answer based on experience. We aren’t suggesting you take serious medical advice from others on the Internet, but it does help give you direction on questions to ask your vet when you take your pet in.

19. Pet Discussion
It’s everything from horses to wild animals at this site. This message board also has a forum for grieving when a pet passes away, which can be difficult for those who’ve had a pet for decades.

20. Web MD – Pet Health Exchanges
The difference between this site and other pet health message boards is questions are answered by a licensed vet. The answers are fairly brief, but give readers direction on how to treat their pet or what to approach their own vet with when taking their pet in.

Caring for your pet is a big responsibility. Going green ensures you’re aware of the ingredients in your pet’s food, which is usually easier for them to process and digest. Read all natural pet health forums for tips on holistic medicine and keep your pet’s health in mind when reading the ingredients of anything your animal consumes. Make friends on pet health message boards to see the tried and true methods of those who love animals as much as you do.

Summertime and Heat Stroke

Summertime and Heat Stroke

David Moores, DVM

Tchefuncte Animal Hospital

June 08, 2011

Summer is here!  The warm weather and increased daylight makes life fun for all but it brings a serious danger to our four-legged friends.  Heat stroke is a serious condition that, unfortunately, we see far too often in veterinary medicine.

Our pets, especially our dogs (but any animal or human can be at risk!), do not dissipate heat as well as we do and they are at a higher risk for overheating.  In our climate, a dog can easily be overcome and suffer heat stroke in less than 20 minutes.

Signs of heat stroke include, but are not limited to, heavy panting, hyperventilation, increased salivation early then dry gums as the heat prostration progresses, weakness, confusion or inattention, vomiting or diarrhea and sometimes bleeding, and death.

                If you suspect your pet is suffering from heat stroke, immediately cool him off first by dousing him with cool water.  If ice packs are handy, place some in the armpits, around the neck, and between the hind legs.  Place blowing air via a fan or A/C unit over him at the same time. Once you get him cooler, transport your pet to the veterinarian or emergency clinic as oftentimes there can be delayed complications that can be serious or fatal.

                In any case, the best treatment for heatstroke is prevention.  Please make sure Fido has easy access to plenty of cool shade, a fan, and generous amounts of cool water. Avoid having him outside or exercising in the heat of the day. Heat stroke is a preventable condition but can be serious and fatal if it happens.

David Moores, DVM

Tchefuncte Animal Hospital

209 Highway 21

Madisonville, LA 70447

www.tchefuncteanimalhospital.com

985-845-7484

Online Pharmacies…Are they worth it?

Online Pharmacies…are they worth it?

                Many people utilize online pharmacies for their convenience when ordering medications and various other products for their pets. Hundreds of different products can be found online with heartworm preventatives and NSAIDs/analgesics being the two most common items ordered.   Not only can it be convenient to order from your home at any day or time, sometimes these products can appear to be cheaper than what you can find at a local drugstore or your pet’s veterinary clinic.

                These conveniences can sometimes come with a price. Many manufacturers provide guarantees on their products so if there is a problem or an apparent failure, the manufacturer will cover any costs of treatment and provide replacement products.  However, in most cases, these guarantees are null and void if the products are purchased through a third party, specifically online pharmacies.

                For example, Novartis Animal Health produces several widely-used heartworm preventative products such as Interceptor and Sentinel.    These products can sometimes be found online but Novartis does not extend their guarantee to these products purchased online as they cannot guarantee their safety since the products aren’t sold directly to the online pharmacy but instead come through another party.  In rare cases, it is possible for these products to be imported from a foreign country and its efficacy becomes unknown.   If a pet comes down with heartworms while on a product purchased online, Novartis will not cover the cost of treatment.

                Most online pharmacies have their own guarantee policies but it is up to the individual to locate these and determine if it is satisfactory for them or not.

                In order to combat these issues and to make sure pets are properly protected and also to protect their clients from being taken advantage of,  many veterinarians have collaborated with their authorized distributors to utilize the internet to provide their clients with the same conveniences and pricing as these major online pharmacies.   This way, all the products will be sold through authorized distributors under the supervision of the pet’s licensed veterinarian and the manufacturers’ guarantees stay in full effect.  Also, products such as Trifexis and Comfortis, which aren’t usually found on most online pharmacies can be found in this medium.

For example, at Tchefuncte Animal Hospital’s website; www.tchefuncteanimalhospital.com, clients can join the online store and order whatever products they require for their pets and be confident the products are of the highest quality and guaranteed by the manufacturers as well as enjoy low prices and other similar benefits.

David Moores, DVM

Tchefuncte Animal Hospital, LLC

209 Hwy 21

Madisonville, LA 70447

985-845-7484

www.tchefuncteanimalhospital.com

In Ultra-need for an Ultrasound!

St. Tammany Humane Society, the largest no-kill shelter in the state of Louisiana is much more than just a shelter. In addition to many other furry facets, we also run a full service vet clinic, offering services not only to our shelter animals and adopters, but to the general public as well. But don’t let the word ‘largest’ fool you. This refers to the large number of dogs and cats we are able to save each year, but (our being a private non-profit organization) it definitely not does reflect our budget or a large, well equipped facility. Our shelter has, indeed, grown in leaps and bounds over the past three years, but we woefully lag behind in up-to-date veterinary equipment that is key in providing quality animal health care to those who rely on us when they’ve nowhere else to turn.

Most of us are aware of how widespread ultrasound imaging has become in human medicine. With our pets experiencing similar problems and circumstances, veterinary medicine also calls for this now almost-standard diagnostic tool to better and more accurately diagnose and treat our four legged family members. And because animals cannot speak to describe their pain and symptoms, ultrasound machines can also act as a communicator on their behalf when the alternative is more poking, prodding, and (albeit educated) guesswork.

If you are half as smart as I hope you are, you see where I’m going with this…… St. Tammany Humane Society, safe haven shelter for the downtrodden homeless and abandoned animals of our community, is in dire need of an ultrasound machine. We are not asking for the latest and greatest model (though we wouldn’t turn that down), but are merely trying all measures at our disposal to acquire medical equipment that is now almost a fundamental fixture of every vet clinic. Fluffy is dying (perhaps literally) to know what object he swallowed while vigorously trying to win that game of tug of war with a toddler, Fido wonders if all the beer he’s licked up over the years has caused any liver damage, and Mittens is anxious to find out how many kittens she will have and if she can support them on her limited teat-flow.

All joking aside folks, if anyone out there has resources or connections that will aid us in acquiring a much needed ultrasound for the sole purpose of helping abandoned animals in a no-kill shelter and the less fortunate pet owners in need who cannot afford the much higher vet costs of a private practice, please contact me.

UPDATE:  Many thanks to Pinnacle Medical of Covington who donated the much needed ultrasound!

Vaughn Maurice
Executive Director
St. Tammany Humane Society
985-892-PETS ext. 107

Online Pharmacies…are they worth it?

Online Pharmacies…are they worth it?

                Many people utilize online pharmacies for their convenience when ordering medications and various other products for their pets. Hundreds of different products can be found online with heartworm preventatives and NSAIDs/analgesics being the two most common items ordered.   Not only can it be convenient to order from your home at any day or time, sometimes these products can appear to be cheaper than what you can find at a local drugstore or your pet’s veterinary clinic.

                These conveniences can sometimes come with a price. Many manufacturers provide guarantees on their products so if there is a problem or an apparent failure, the manufacturer will cover any costs of treatment and provide replacement products.  However, in most cases, these guarantees are null and void if the products are purchased through a third party, specifically online pharmacies.

                For example, Novartis Animal Health produces several widely-used heartworm preventative products such as Interceptor and Sentinel.    These products can sometimes be found online but Novartis does not extend their guarantee to these products purchased online as they cannot guarantee their safety since the products aren’t sold directly to the online pharmacy but instead come through another party.  In rare cases, it is possible for these products to be imported from a foreign country and its efficacy becomes unknown.   If a pet comes down with heartworms while on a product purchased online, Novartis will not cover the cost of treatment.

                Most online pharmacies have their own guarantee policies but it is up to the individual to locate these and determine if it is satisfactory for them or not.

                In order to combat these issues and to make sure pets are properly protected and also to protect their clients from being taken advantage of,  many veterinarians have collaborated with their authorized distributors to utilize the internet to provide their clients with the same conveniences and pricing as these major online pharmacies.   This way, all the products will be sold through authorized distributors under the supervision of the pet’s licensed veterinarian and the manufacturers’ guarantees stay in full effect.  Also, products such as Trifexis and Comfortis, which aren’t usually found on most online pharmacies can be found in this medium.

For example, at Tchefuncte Animal Hospital’s website; www.tchefuncteanimalhospital.com, clients can join the online store and order whatever products they require for their pets and be confident the products are of the highest quality and guaranteed by the manufacturers as well as enjoy low prices and other similar benefits.

David Moores, DVM

Tchefuncte Animal Hospital, LLC

209 Hwy 21

Madisonville, LA 70447

985-845-7484

www.tchefuncteanimalhospital.com