Holidays and Your Pets, precautions save a visit to your vet.

HOLIDAYS AND YOUR PETS, precautions save a visit to your vet.

By:  Dr. Taylor Parker

Happy Holidays!

Here are just a few precautions to consider during this holiday season

 Avoid feeding your pets holiday food

–          Most foods are too rich for our pets and can cause vomiting, diarrhea and anorexia.

–          Bones may be present in the turkey or ham; this can be dangerous if ingested and may cause obstructions which may lead to surgery

–          Onions and garlic can lead to anemia in pets

–          Alcohol is NEVER recommended and yeast dough can also lead to alcohol poisoning

Decorations may be dangerous to pets if ingested or played with

–          Items like tinsel can be swallowed by pets, especially cats and lead to obstruction which my lead to surgery

–          Ornaments made of glass can cut or puncture skin, tongues, etc.

–          Decorations or trees can sometimes encourage urine marking, especially in cats/dogs prone to urine marking in the home

–          Any decorations that require sharp nails, tack, hooks etc. may also lead to injury or ingestion

–          Trees can lead to climbing, which can lead to disaster

–          Lights are great, very pretty, but require electric cords and extension cords, keep pets away from chewing them because it can lead to electrocution

Plants are pretty, but can be toxic when ingested

There are several plant species that we love to keep inside during the holidays, some species include;

–          Poinsettia

–          Holly and Mistletoe

–          Lilies and daffodils

–          Amaryllis

–          Also, watch out for liquid potpourri, this is also toxic when ingested

Guests

We love our family and friends, but they come with their own possible “side effects”

–          Remind guest that feeding your pets table food can be dangerous

–          If any guest use prescription medications be sure they keep them out of reach from your pets

–          Even vitamins can be dangerous if taken in large quantities

–          Guests may accidentally leave open doors or gates, make sure your pet had proper updated tags and microchip

ALWAYS BE PREPARED

ASPCA Animal Poison Control Center

1-888-426-4435

http://www.apcc.aspca.org

HOLIDAYS AND YOUR PETS, precautions save a visit to your vet

dr parker webpage

By:  Dr. Taylor Parker

 

Happy Holidays!

Here are just a few precautions to consider during this holiday season

 Avoid feeding your pets holiday food

–          Most foods are too rich for our pets and can cause vomiting, diarrhea and anorexia.

–          Bones may be present in the turkey or ham; this can be dangerous if ingested and may cause obstructions which may lead to surgery

–          Onions and garlic can lead to anemia in pets

–          Alcohol is NEVER recommended and yeast dough can also lead to alcohol poisoning

Decorations may be dangerous to pets if ingested or played with

–          Items like tinsel can be swallowed by pets, especially cats and lead to obstruction which my lead to surgery

–          Ornaments made of glass can cut or puncture skin, tongues, etc.

–          Decorations or trees can sometimes encourage urine marking, especially in cats/dogs prone to urine marking in the home

–          Any decorations that require sharp nails, tack, hooks etc. may also lead to injury or ingestion

–          Trees can lead to climbing, which can lead to disaster

–          Lights are great, very pretty, but require electric cords and extension cords, keep pets away from chewing them because it can lead to electrocution

Plants are pretty, but can be toxic when ingested

There are several plant species that we love to keep inside during the holidays, some species include;

–          Poinsettia

–          Holly and Mistletoe

–          Lilies and daffodils

–          Amaryllis

–          Also, watch out for liquid potpourri, this is also toxic when ingested

Guests

We love our family and friends, but they come with their own possible “side effects”

–          Remind guest that feeding your pets table food can be dangerous

–          If any guest use prescription medications be sure they keep them out of reach from your pets

–          Even vitamins can be dangerous if taken in large quantities

–          Guests may accidentally leave open doors or gates, make sure your pet had proper updated tags and microchip

ALWAYS BE PREPARED

ASPCA Animal Poison Control Center

1-888-426-4435

http://www.apcc.aspca.org

Meet Our Staff

Each month we will introduce you to a staff member allowing you to get to know the people who care for your pets.

amberAmber – Receptionist

Amber, a true Las Vegas native,  worked for LMAH in 2007, left our hospital to work on the people side of medicine.  We lured her back in 2011  to the animal world and has been a steady rock in reception ever since.    You might notice Amber always has a smile on her face whether she is talking to you in person or on the phone.  Amber has a household that includes her husband, daughter, 2 dogs Pepita and Estrella, and a bird name Jupiter.

When we asked Amber the following questions she said:

If you had one box for all your stuff, what would you put in it?

Her daughters baby book and family photos

What would you do if you won 50 million dollars:  Buy a new house here and Mexico, travel, adopt 2 kids and more pets, donate to a childrens foundation/orphanage in LaMision, Mexico

Tristan – Veterinary AssistantTristan

Tristan started at Lone Mountain Animal Hospital as a kennel attendant in 2008, he moved to treatment a few years later and has become an even more integral part of our care team. He has quite the sense of humor, which he won a certificate and crown for in 2015 as he was voted most humorous by the staff!

When Tristan was asked the following questions he answered:

If you had box for all your stuff, what would you put in it?

My computer and my Nook

If you won 50 million dollars you would:

Ain’t nobody got no time for that, donate it all to charity!

Maddie – Reception

maddieMaddie left Missouri and headed west with her husband a few years ago and ended up at Lone Mountain Animal Hospital. She not only has her hubby at home, but she also has her Doberman Dexter and Diablo and Velma, her cats. Maddie loves spending time at home and throwing clay on a pottery wheel in her spare time. She is quite the traveler too, she went to Hawaii to meet her new niece and has been to Italy also!

Maddie’s answers to the following questions:

If you had one box for all your stuff what would you put in it? Depends on how big the box is……

What would you do if you won 50 million dollars? Travel, share with family and donate.

Jennifer – Kennel

jen molinaJennifer has lived in Utah and Idaho, but now calls Las Vegas her home. She shares that home with her husband, 2 dogs and her Iguana named Elliot. Jen joined our staff in 2013 and has a great love for taking care of the animals. Her favorite past time is hanging out her her hubby and little four legged family members. We asked Jen what a couple of her pet peeves are and she told us she really did not like bad drivers (she may find a few in Las Vegas) and people who interrupt.

We also asked Jennifer the following questions:

If you had just one box for all your possessions what would you put in it? Hairbrush and lip balm

If you had 50 million dollars I would: Pay off my house/bills, pay off my moms house, buy a house in Utah and donate to an animal shelter.

Michelle – Reception

MIchelleMichelle orginally hales from “The Bronx” New York”. She worked for lmah many years ago when she decided to take some time off to raise her babies. In 2014 Michelle came back into the LMAH family and we are so happy to have her in the reception area with her great smile to greet every client and pet that comes in the door. Michelle still loves her family time and that’s why her favorite thing to do when not at work – spend time with her kids and hubby.

When asked the following questions Michelle answered:

If you had just one box for all your possessions what would you put in it? Photos and items from her family.

If you had 50 million dollars I would: Travel with my family, Pay off my debt, put money into savings.

 

Caren – Licensed Veterinary Technician

 

caren

Caren is originally from California and shares her home with her 2 corgi’s, one tortoise, one hamster and one fish. She attended CSN (College of Southern Nevada) – veterinary technician program where she graduated with honors, just as she did in high school. Caren was originally hired at our sister hospital Craig Road Animal Hospital, but when we needed help she volunteered to join our staff. Caren loves hanging out with her family and enjoys drawing, puzzles, movies and roller coasters.

Caren really does not like people who text and drive, so make sure you follow the road rules around her, although she no longer drivers her first car which was a 95 Pontiac Sunfire. If she finds out you are headed to Australia she may try to tag along, so watch your bags.

When we asked Caren two very important questions she answered as follows:

If you had just one box for all your possessions what would you put in it? cell phone, laptop, photo albums, puzzles (she did say she likes to do puzzles) and favorite horse models.

If you had 50 million dollars I would: Travel the world, buy a house, horses and exotic animals.

 

 

 

Are we loving our pet into obesity?

janieJanie, one of LMAH exam room assistants and a Hills certified pet advocate, talks about personal experience with pet obesity.

We adopted Prince when he was just four months old. He was the cutest black Labrador retriever I’ve ever laid eyes upon. He was smart too, already potty-trained and understood basic commands by the time we brought him home. Our family loved him and we took him on every family vacation as he was such a wonderful dog. His happy-go-lucky demeanor was contagious. We just loved having him around

Sometimes we showed our love by giving him extra treats. A little chicken here, some chips there. His favorite snack were the little crunchy cheeseballs, which we made sure to share plenty of those. Eventually Prince wouldn’t even bother to wait for a snack from our hands, he was a magician at making food disappear from counter tops and tables.

One day Prince was having diarrhea. He had gotten into a bag of Hershey’s kisses and we took him to see the veterinarian right away. At the age of five, we were told Prince was overweight and needed to lose a minimum of 10 pounds.

Our family led a pretty active lifestyle and we took Prince out for regular exercise, so we didn’t quite understand how he became overweight. You see, Prince didn’t look obese. But we changed his exercise habits and took him out for more runs. But we never changed his diet, and continued to feed him table food. After a few more years of this habit, Prince weighed in at 110 pounds. A few years later, Prince had been diagnosed with cancer. We placed him on palliative care and we were able to have him in our lives for a few more months. But we then had to make one of the most difficult decisions for any pet owner. The day we put him down was the worst day of our lives. He was only 11 years-old. I can’t say that Prince’s cancer was a direct result from his obesity, but I do know that it didn’t help his condition.

When I started working for Lone Mountain Animal Hospital, I was given the opportunity to become an advocate for Hill’s pet nutrition. I became certified in 2015 and I cannot express how much I wish I knew what I know now. The program enhanced my ability to understand, communicate, and advocate proper pet nutrition.

IS YOUR PET OVERWEIGHT?

Obesity effects over 50 percent of the American dog population. Obesity can lead to many different health issues such as arthritis, diabetes, bladder cancer, and heart disease.

A healthy pet will have a tucked abdomen, and you would be able to see his waist when viewed from above. The ribs should also be easily felt.
Your pet may be overweight if he has a sagging stomach, a broad flat back, and you can’t view the waist from above.

WHAT CAN WE DO?

Proper nutrition is essential to optimal health and enhances their quality of life. Depending on the age of your pet, we recommend bringing him in for a wellness exam once a year. The exam will check his heart, lungs, weight, skin, eyes, and give you the opportunity to ask us questions. I always thought Prince looked fine, it wasn’t until we brought him in for an emergency and the doctor weighed him, that we found out he was overweight.

Diets are also specialized for your pet. If you have a dog that is more relaxed and less active, they may not need a high calorie diet. This is why it is important to read the labels. Prince was being fed a high fat diet, which I was unaware of before I really started to take a look at the labels. If your dog has an active life style, skin allergies, or a senior, it is best to ask your veterinarian what is best for your pet.
Snacks and treats are fine to give your pet, they can be one of the best tools used during training. It’s okay to give him a treat or two here and there but it is important to take that into consideration when it comes to feeding time. If he was given a few snacks throughout the day, change his normal four cups a day to three cups. These small changes can really help keep your pet at a nice, healthy weight.

Keeping your pet healthy is a round the clock job. We all love our pets, and we show our affection in many different ways. For Prince, it was by giving him table snacks. Now I show my pets I love them by sharing a well-balanced diet.

Heartworms: What are they and how to prevent them

dr lee new bio photo 2015Veterinarian Mary Lee of Lone Mountain Animal Hospital in North West Las Vegas discusses how heartworms can affect your pet’s health and the importance of prevention

Heartworms do not discriminate.

They can affect any pet in the United States and many other parts of the world. Heartworms can live in dogs, cats, ferrets, and sometimes, even humans. Heartworm cases are found in many urban areas due to coyotes and foxes who are large carriers of the disease.

Heartworm disease can cause long term damage to the heart, lungs, kidneys, and arteries. One thing unique to this disease is the negative affect the parasites can have on the health of your pet long after they are gone.

The mosquito is the most common culprit in spreading the disease from one affected animal to the other. Adult female heartworms living in an infected mammal produce tiny baby worms called microfilaria. These microscopic baby worms circulate in the bloodstream and when the mosquito takes its blood meal, these worms are ingested as well. The baby worms then mature into larvae which is the “infective stage” over the span of 10 to 14 days. These larvae are then transferred through the mosquito’s bite wound on the next animal.

It takes six months for the larvae to mature into adults after entering the new host. Adult heartworms can live anywhere from five to seven years in dogs and two to three years in cats. These worms can reach up to 14 inches in length and your pet may show no symptoms until serious disease appears in the heart, lungs, kidney, and liver. By the time the heartworms make themselves known, your pet may be experiencing coughing, lethargy, or fainting spells.

Heartworm may not be as prevalent in Clark County as in southern states, but that doesn’t mean it doesn’t exist. According to the Companion Animal Parasite Council (CAPC) 16 positive cases of heartworm have been found out of the 2,708 dogs tested in Clark County. That number may seem miniscule, but when we break it down, that’s 1 out of 169 dogs-60 percent of positive cases of heartworm cases in the state of Nevada are found in Clark County. There are a number of factors that can affect these results such as the lifestyle and region your pet lives in and of course, parasite prevention efforts. Families that take their fur buddy on a trip to nearby states like California increase the risk of him being infected.

Veterinarians suggest to start preventative care for your pet when they are young. Puppies under seven months can start preventative care without a pretest. They should go on monthly preventative life long and annually receive testing after the first year to ensure they are heartworm free.

It is harder to detect heartworm in cats as they are more unlikely to have them. There are a few different methods to test for the disease in cats, and it is best to discuss these options with your local veterinarian. Cats should be tested before starting prevention and then re-tested as the doctor deems fit for your cat. There is no approved treatment for heartworm found in cats which means that prevention can be very important in the health of your pet.

Prevention is easy and less expensive when compared to treatment for a positive result. Annual testing for dogs is necessary, even if he is on year-round prevention. Heartworm medications are highly effective but nothing is guaranteed. If one dose is missed or given late, your dog goes unprotected. The best chance you can give your loved one against this parasite is prevention.

New addition to the pet family? Find out how to introduce to the other family members.

dr g for blogVeterinarian Talia Gattenuo of Lone Mountain Animal Hospital in North West Las Vegas discusses how to help introduce a new addition into a multi-pet household.

Meeting and greeting. Socialization is important for your dog or cat because it can reduce his stress, and make him more comfortable when encountering new environments, people, and other pets. It can be beneficial for his overall health, making him a friendlier, happier, and more predictable companion.

Under-socialized pets can become aggressive, anxious, shy, and fearful, especially at the veterinary hospital.  We love our pets, and we know these are the last things we would want him to feel. Puppies that are under-socialized and playfully aggressive, often grow into adulthood with the same habits that were once believed to be cute.

Many adopted pets show these same behaviors for a number of different reasons. There is no way to truly understand the entire history of an adopted pet, and sometimes these traits are a result of an abusive environment or neglect. But there is hope. A little patience and extra TLC can help turn your fearful pup into a friendly one.

Socialization is a lifetime lesson and should not be neglected as they get older. It is also important to understand the personality of your dog or cat. As for any pet, some are just more social than others. A kitten might be more susceptible to making friends with a dog other than the 6-year-old cat that has never had to share your affection. But no matter the age, it doesn’t make this feat impossible.

Confinement of the new pet might be a great start. Keep the new pet in his own room with his own toys, litter box, food, and away from the resident pets. Feed both pets at the same time on each side of the door so that they can both get used to each other’s smells while doing something enjoyable (food makes everyone happy). Over time, move the food dishes closer and closer towards the door keeping them on their own side during their meal. Dogs can do well with a high, sturdy baby gate between the two. Remember that this type of gate will not prevent a cat from jumping over. Reinforcing positive conduct with a favorite treat and affection can help solidify good behavior.

Once a new pet is acclimated to the new environment let him run around and explore your home while the old pets are in confinement. Do this several times a day but only when you are home to supervise. Once you feel comfortable with allowing them to begin to interact, you can try having them meet face to face but pay attention to their body language. Cats with flattened ears, crouching, and hissing are showing signs of aggression. Dogs will bare their teeth, growl, or become stiff-legged. You can clap, spray them with a water bottle or throw a pillow in another direction to distract them. If a standoff ensues, very carefully separate them until they calm down. Placing a leash on each pet, before interacting, helps to separate them if an aggressive behavior is elicited without getting the pet or you injured. Never get in the middle of a fight, you can get hurt. By paying attention to their body language, you may be able to prevent a fight and have time to use the necessary steps before it occurs.

It is very important to stay patient. Forcing your pets to get along will diminish your chances for success and might create a negative experience for both. Remember to work at their pace, not yours. The more patient you are, the higher your chances are of success. All interactions must be closely monitored and supervised until you are absolutely positive they are comfortable and safe within each other’s company.

This can take anywhere from one week to months depending on your pet. If you feel these tips may not be working, try discussing other options with your veterinarian.

Good luck, you’re on your way to having a larger and happy family.

 

Xylitol – buyer beware, danger to your pets

By:  Dodr-calloway-156ris Calloway, DVM

Recently, I’ve noticed that there has been a lot of articles on various social media sites about xylitol and its danger to dogs.  I have had several friends and family forward me articles asking if they were true.

Unfortunately, the articles are true.  Xylitol is extremely toxic to dogs (and ferrets!).  Deadly, actually.

Xylitol is a low calorie sweetener found in many human products:
-Chewing gum
-Toothpaste
-Breath sprays
-Mouthwash
-Sugar Free Candy
-chewable vitamins and other nutritional supplements
-cough drops/lozenges
-baked goods (especially low carb/low sugar varieties)
-peanut butter and other nut butters
-baby wipes and diapers!
-drink powders
-BBQ Sauce, Ketchup, pancake syrup and other condiments
-protein powder
-Lip Balm/Lipstick and other makeup (even foundation)
The worst thing?  Its in some products manufactured specifically for pets.  A trip to my recent pet supply retailer revealed that a few brands of drinking water additives and dental sprays sold for pets contain xylitol!  The lesson there is buyer beware.  Read all labels carefully.

So what exactly happens?  Well, there are two phases.

The first phase causes life-threatening hypoglycemia, or low blood sugar.  Even though xylitol is low calorie in people, in dogs it somehow manages to trick their pancreas into producing insulin.  It essentially causes an insulin over-dose, which in turn causes extremely low blood sugar.  Symptoms include seeming “drunk”, wobbly, sleepy, and can progress to seizures and coma.  You may also see vomiting during this phase.  This usually happens minutes to hours after ingestion.  In some cases where dogs have ingested gum this can occur up to 12 hours later.

The second phase is liver failure.  This happens 12 hours to 3 days after ingestion occurs.  This phase can still occur even if your dog does not suffer from low blood sugar.  In fact, you are MORE likely to see this occur if your dog does not get low blood sugar.   The signs you may see for this phase are very non-specific.  Lethargy, vomiting, and diarrhea are usually what you see in this phase, but you may see signs of more severe liver failure: yellowing of the whites of the eyes and skin (jaundice) or urine that is very dark yellow or orange.

Sometimes during the second phase we can also see problems with the blood’s ability to form clots.  You may see bloody stool or vomit, bruising anywhere on the body, petechiation (small dots of blood on the skin surface), red/bloody urine, or unexplained bleeding anywhere.

So, what do you do if your dog eats something with xylitol in it?  GET TO THE VET. NOW.  It’s worth the cost of the emergency fee to have a professional make your dog vomit and remove as much of the xylitol as possible.  Your vet will probably also run blood work and  start your dog on IV fluids +/- IV dextose (sugar) if your dog gets low blood sugar.  It may seem expensive to do this, but it’s actually far cheaper than treating your dog after he’s already in liver failure and has a poor chance of survival.

Read all labels carefully and try not to purchase products that contain xylitol if your dog is the type of dog who chews on things.  Use trash cans with lids and baby locks on cabinets if you have a super-motivated dog who routinely gets into things.  I have noticed that I also have to be very watchful when my kids are brushing their teeth (they always seem to want to offer the dog their tooth brush).

If you are unsure if a product has xylitol after your dog has eaten it, you can either go to your vet, or you can call animal poison control (there is a fee).

Please leave any comments or questions below!

Why can’t my pet get vaccines if they are sick?

dr-calloway-156
By: Doris Calloway DVM
 
You have to bring Fido to see the vet for his diarrhea.  He’s due for his vaccines, has not been vaccinated yet and you think he may have Parvo, can’t you get his Parvo vaccine now to help him? Unfortunately, the answer is no.  
 
Vaccines are great – they protect against horrible diseases that there are no cures for.  They work by telling the immune system to make antibodies against those diseases. This is great when your pet is healthy, but not when he’s sick.   When your pet is sick, vaccines basically act like a distraction – they pull your immune system’s attention away from focusing on why your pet is sick. 
 
If Fido is having diarrhea (or has an ear infection, or is coughing, etc), we need his immune system to fight whatever’s wrong with all its might.  One hundred percent of his immune system needs to be fighting whatever is causing his diarrhea.  We don’t want to have his immune system giving 50% of it’s attention to make antibodies for the vaccine.  
 
If we give vaccines while something else is going on, he could potentially get sicker.  It’s just not worth the risk to vaccinate while your pet is sick.  It’s much safer to wait until Fido’s recheck and have the vaccines done at that time (assuming Fido is all better!).
 

Meet our staff

Each month we will introduce you to a staff member allowing you to get to know the people who care for your pets.

 

 

MIchelleMichelle – Receptionist

Michelle was born in Bronx, New York, but has lived in Las Vegas for many years.  She shares her home with her husband, children, 2 dogs, a snake and a bird. 

Michelle was an employee of Lone Mountain Animal Hospital over 10 years ago, she left when her and her husband started their family.  One of Michelle’s favorite memories is holding her babies for the first time. She  also loves going on adventures with her hubby and kids.  Michelle came back to Lone Mountain in 2014.  Many things have changed at LMAH while she was away, but she has acclimated great and we are glad to have her back. 

We asked Michelle the following questions:

If you had just one box for all your stuff what would you put in it?   Makeup

If you won 50 million dollars you would: Buy and island for hubby and me.  Invest the money and share with my kids.

 

 

 

Caren – Licensed Veterinary Technician

 

caren

Caren is originally from California and shares her home with her 2 corgi’s, one tortoise, one hamster and one fish.  She attended  CSN (College of Southern Nevada) – veterinary technician program where she graduated with honors, just as she did in high school.  Caren was originally hired at our sister hospital Craig Road Animal Hospital, but when we needed help she volunteered to join our staff.  Caren loves hanging out with her family and enjoys drawing, puzzles, movies and roller coasters.

Caren really does not like people who text and drive, so make sure you follow the road rules around her, although she no longer drivers her first car which was a 95 Pontiac Sunfire.  If she finds out you are headed to Australia she may try to tag along, so watch your bags.

When we asked Caren two very important questions she answered as follows:

If you had just one box for all your possessions what would you put in it? cell phone, laptop, photo albums, puzzles (she did say she likes to do puzzles) and favorite horse models.

If you had 50 million dollars I would: Travel the world, buy a house, horses and exotic animals.

Lumps and Bumps

By:  Dr. Callowaydr calloway

I noticed this lump on my pet.  Do I need to be worried about it?”  I get asked this question by animal owners several times a day, about all sorts of lumps and bumps in all sorts of places.  My answer is usually, “well, maybe”. 

I know it’s not a very specific answer, but it’s the truth!  The good news is that a lot of the lumps and bumps you can feel on your dogs skin are benign.  The bad news is that there are some that are malignant (cancerous).  It’s absolutely impossible to tell by look and feeling it which of the two categories it falls into.  In order to know if you need to worry about it, we need to do testing.

One type of testing we can do is called a fine needle aspirate.  Basically, it involves poking the lump with a needle to collect some of the cells.  We put these cells onto a slide, and then send the slide to the lab.  A specially trained veterinarian, called a pathologist, will look at the cells underneath a microscope and give their opinion as to whether or not the lump is malignant.  This is a great starting point and the least expensive option – if the pathologist can give you an answer.  Unfortunately, the pathologist cannot always give you an answer – sometimes the lump is so solid that we can collect enough cells, or collecting the cells is too bloody and the pathologist can’t differentiate between the cells in the blood and the cells from the lump.

Another type of testing we do is called a biopsy.  This is the “gold standard” and the ONLY way to get a certain, definitive answer as to whether or not the lump is cancerous.   This requires your veterinarian to surgically remove the lump, or sometimes sample a piece of it.  The entire lump is sent to the lab and the pathologist can then look in more detail at what kind of tissue the lump is made up of.  This is more expensive than the fine needle aspirate because usually full anesthesia is required, and the lab usually charges more for this service.  However, it usually possible to entirely remove the lump during this procedure, which may be the only treatment needed if it turns out that the lump is cancerous! 

I wish I had a crystal ball or x-ray goggles so that I could tell you what kind of lump it is by looking at it.  But until those have been invented, we have to actually send the lump to a pathologist to see what it is!