At the Fairfield Veterinary Centre we are accustomed to seeing difficult cases from other practices. This can occur either by referral from another veterinary surgeon or occasionally clients seeking a second opinion from their own veterinary surgeon.

It is important in either situation to obtain accurate clinical records about the patients medical history. This will then allow us to develop our strategy or plan of action to best serve the interests of the patient.

So it was with Molly Fisher, a toy poodle, who was booked into see my colleague Ingrid, who specialises in dermatology.

Molly's problem was a condition known as Cushing's syndrome: a disease which, through the overproduction of cortisone, causes baldness and a pot belly amongst other symptoms.

Once Ingrid had discussed the problem and it's treatment medication was prescribed. Unfortunately, very soon after Molly developed a severe left hindlimb lameness. I was then asked to use my specialist knowledge to confirm that Molly had indeed ruptured her cruciate ligament.

It is often the case as in human medicine that one patient may have several clinicians and surgeons. When a patient such as Molly has more than one problem it becomes very important to prioritise each condition. In this case, since Cushing's syndrome delays wound healing and predisposes the patient to secondary infection it is very important to treat this primary condition first before considering any surgery of the affected limb.

This ensures as far as possible that we are not undertaking any unnecessary risks when considering the benefits of joint repair. So until Molly starts to grow more hair and loses that "pot belly" I shall keep sharpening my scalpel.............and review my own symptoms to see whether I might have "a touch of Cushing's" myself!!

Terry Dunne BVMS, Cert SAO, MRCVS

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