Saturday, May 5, 2012

Yoga

After months of deliberation, I've finally decided to take up yoga. It was actually a New Year's Resolution for me, right after "take riding lessons," which I've been doing for about 2 months now, and LOVE! :)

I love these rocks! From http://www.yogathailand.net/.
I don't know why it took so long to make this decision. For awhile I contemplated getting a yoga DVD and doing yoga at home, but came to the conclusion just the other day that this would never work out for various reasons. One - No one is there to correct me and help me get the poses right. Two - I will never be able to relax in my own space because I will constantly be thinking about dinner/the dishes/cats will be bugging me etc, not to mention cat hair getting on my new mat. Three - I will never, ever make time to do yoga at home. I know me. I'm lazy, and I can barely force myself to make dinner most nights. So - there was only one thing for it. Sign up for class.

I've wanted to do yoga for a long time now. In fact, I even took one intro class during vet school with my roommate. I got a great workout and I really enjoyed it. I read Eat, Pray, Love. It was okay. Although the part that took place in India was kind of the most boring, I also found it the most fascinating. After many years of struggling, I am {mostly} at peace with myself. However, I'm really interested in the benefits of yoga to my body as well as my mind. I want to do it for multiple reasons. Increasing core strength, learning to better control my breathing and body, having some time to meditate/reflect on life, overall being healthier. The strength and breathing thing will come in handy with riding, as I found out while riding Bobby, an Arabian, who was not rounding up nicely under me until my trainer said, "Remember to breathe!" and his back came up and he put his head down immediately when I took a great breath. At that moment, it hit me that I have not been breathing correctly for years, maybe my whole life. And that spurred me to finally go out and buy a yoga mat, and sign up for class.

Of course on the first day of class, which I prepaid for online, I got stuck at work and then traffic was awful. I made it to class with 5 minutes to spare only because of my mad driving skillz. (that was just a lil bit ghetto, I know). I think I did pretty good, all in all. I had to think a lot about what I was doing, but I know that will go away with time and muscle memory. I hurt... a lot, the next day. But what's the point if it doesn't hurt? If it doesn't hurt, it's not working.

When I got home, I saw Bella cleaning the back of her spine, without any trouble at all. I couldn't find a picture of that, but this one came to mind when I thought about cat yoga poses. I realized that all cats are born yoga masters.

Bella Pigeon Pose?




Friday, April 27, 2012

Real doctors treat more than one species


Someone posted this e-card on Facebook the other day, and I laughed out loud when I read it and showed it to two other vets who were in the building.

I was thinking about how vet school is a long, hard, grueling 4 years and how much each of us must want to be veterinarians, because that is the only way to get through. Sometimes I wondered why I was torturing myself so much, especially in the earlier years where we didn't do much with [live] animals. Sitting in class from 8 to 4, then studying from 4 to 11 was my usual status quo, at least for the first 2 years. And I know there were people who stayed up even later, and/or woke up earlier to get in a few hours of studying before class. Then in our clinical rotations, getting to school as early as 6 am to care for patients, working with clients and appointments all day while monitoring our in hospital cases and writing pages upon pages of discharge instructions, and staying until 10 pm to walk our dog patients, finish our surgery reports, then wondering why we should even bother going home and contemplating sleeping on the couches in the lounge downstairs. Four years to study countless species, anatomies, physiologies, normal and abnormal, pathology, histology, microbiology, parasitology, immunology, virology, diseases, zoonoses, behavior, preventative medicine, pharmaceuticals, public health, and about a million other subjects.

Then I thought about med school.

Four years, one species.

Today, a woman brought her golden retriever in for anal gland expression. She was a new client, and had never been seen by us before. Her dog was a total spaz for lack of a better word, and had clearly never been trained, socialized, or taught any manners whatsoever. I actually felt bad for her (the dog), because she was clearly very anxious and living that way is no fun for anyone.

Although it was a tech appointment, I ended up seeing her for an exam because the dog was acting like a bucking bronco and it was near impossible for the techs to express her glands. I examined the dog, who was on flea control only, no heartworm control, no parasite prevention, and was suffering from allergies. I spoke with her about sedation, which she did not want to do. She said she is always a bit "high strung," and even acts that way for her ears! No freakin kidding! We attempted expressing the glands one last time with the dog laying down, to which she eventually submitted. They were infected, and she also had an infection of her skin.

I spoke with the owner, recommended a skin cytology, antibiotics, heartworm and parasite prevention or at least a dewormer, to which she replied she had some antibiotics at home. Then came the dreaded words, "I'm a physician."

I explained why I would rather use the antibiotic I selected because it would affect both the skin and the anal glands. She said, "I can just prescribe some antibiotics for her myself, {silly little laugh}." I smiled, and said, "Don't tell me that." She declined heartworm prevention and the skin cytology, and when she saw the estimate for the antibiotics and dewormer, she declined both. She left just paying for the exam and anal gland expression.

I hope I never see her again.

I'm not sure what it is about human doctors, but they generally are horrible clients. Not all (I saw a wonderful internist on my internal medicine rotation whose cat we diagnosed with hyperthyroidism. He was very nice, despite feeling like he should have recognized the signs). But why are doctors so passive aggressive when they take their pet to the vet? Is it arrogance? Do they think they are better than us? Smarter? Most seem to think they know how to treat whatever their pet has, and have no qualms about prescribing medicines for their own animal. Which by the way, is illegal. MD's are only licensed to treat humans. DVM's, on the other hand, are licensed to treat anything but a human. Human doctors seem much more willing to blur the line between legal and illegal, or maybe they just think they know better. Most vets I know would never presume to choose their own antibiotic, or diagnose something in another human. (We may self-diagnose, I'll give you that, but in all fairness everyone self-diagnoses to some extent). Our response to human medical questions is "Go see your doctor!" In human medicine, doses are based on 'adult' and 'child.' In veterinary medicine, doses are based on weight. But doctors don't know this, because they only learn about one species. They don't realize that dogs are not humans, and cats are not small dogs. They learn next to nothing about zoonotic disease (diseases that can be transmitted from animals to humans). That's why veterinarians are on the front lines of public health.

Why do they get under our skin so much? Possibly because we hold them to a higher standard than the general public, and yet, we so often get let down. They should know what it's like when people blatantly disregard recommendations and fail to follow simple instructions. And yet...

In comparison, vets spend much more time explaining things to clients, looking at the whole patient, and thoughtfully choosing tests that will aid in the diagnosis but not break the bank. (A whole different rant, which others have already talked about here and in other posts). The point is, I'm proud to be a part of this honorable profession and wouldn't trade vet school for med school any day.

*All names and identifying details have been changed, and any resemblance to actual persons or events is purely coincidental.

Friday, April 13, 2012

Dusty the Wonder Horse

Today I was reading the news on LinkedIn, and came across this wonderful blog post called Fundraising Fridays. This is a blog dedicated to making non-profits successful, and every Friday they are encouraging people to donate $10 to a non-profit of their choice.


Dusty's Riders is a non-profit organization that takes at-risk and inner city youth on horse related outings to increase their self-esteem, self-worth, and confidence. Kids get to feed, lead, groom, learn anatomy of a horse, go on an hour trail ride, and get pizza for lunch. For many, it is the first time they have ever seen a horse, let alone ride one. Most say it is the best day of their lives. 


Dusty is a real horse, an appaloosa gelding who loves kids and watermelon. Dusty makes kids smile, kids who may not have anything else to smile about. He gives them confidence and a sense of accomplishment that they can carry home with them. The kids who come to us learn intangible concepts such as teamwork, self-awareness, the power of praise, the joy of shared experiences and memories, all through confidence building activities.


We are a 100% volunteer-driven organization, with zero paid staff, and 92 cents of every dollar raised puts a kid in a saddle. We have lots of exciting events planned for our future, and are hoping to add more activities and help more kids. We need your support!



Monday, April 2, 2012

Owners Say the Darndest Things

What follows are real conversation snippets between owners and myself.


"She's had these breast tumors for about 6 months. Is it cancer?"
Me: "Well I can't tell just by looking."
(incredulous) "You can't???"

------

Me: "So has there been any vomiting?"
Owner:  "No..."
--> Dog vomits right into owners hand.
Me: "Hahahahahaha!"

------

"There was a giant pus-ball back there this morning!"
Me: "How big was it?"
"Oh about...... (owner mimes approximately 2 mm.)

------

Me: "Are you breeding him, what's with the testicles?"
Owner: "Uh, haha no, uh we're not breeding him. We're starting to think about, ahh, having them, umm... I can't say it!"

------

--> I just explained why I want to give a cat a B12 injection.
Me: "It's not going to hurt her, and it might benefit her so I think it's worth a shot."
Owner: "No pun intended, right?"

------

"What are you, like 18?"

------

Owner: "He's been hanging out with this neighborhood cat, and this cat is like, street smart. I mean he knows not to cross the street. So I feel like Ed is safe with him, you know?"
Me: {face-palm}

------

Owner: "She doesn't like people or other dogs, and doctors make me nervous so I'm going to wait outside until you're done."
Me: Ok, well let's talk about what vaccines she nee-"
Owner: "I don't care, I'm too anxious to sit here any more!" (throws leash of land shark at me and walks out)

------

-->Grandma is never wrong. I am examining a dog for an ear infection.
Lady Owner: "There was this brown stuff on the inside of her ear this morning, but now its gone. What do you think it was?"
Me: "Was she shaking her head a lot?"
Lady: "Yes."
Me: "Well, she probably shook some gunk out of her ear and it got stuck on her hair."
Lady: "Well, I don't think that's what it was." (smiles in satisfaction that she is smarter than me)
Me: {benign smile}
Gentleman: "Now dear, she's the doctor. If you're not going to listen ... again.... then why are we here?"



Thursday, March 8, 2012

He didn't make a sound!

A middle aged couple brought their 8 month old Min-Pin-Chi puppy, Stoic, in for a check-up. They seemed normal, at first glance, but they kept tag-teaming on the questions and asking whole paragraphs before I could get a word in edgewise.

"Hi, I'm Dr. M. How are you?"

"We're fine, well, we're worried about Stoic you see, he's been limping for two days, and well we're not sure if he fell or jumped or whatever, you see we left the room, and we didn't hear anything! But then we came back and he was holding that leg up! What's wrong with him? Maybe this is normal, is this normal? We're first time dog parents and we don't know ANYthing about dogs!! This is the first time he's been to a vet."

"Ok, so what was it that he fell or jumped off of?"

"Well it was just the couch! I mean, the couch, come on! its only what, 2 feet off the ground. And the ground isn't even hard, its carpeted! Do you think that could have really hurt him? I find that hard to believe. We didn't hear anything!"

[silent] You find it hard to believe huh? You came all the way over here because you find it hard to believe?


[aloud] "So you left the room and he was on the couch, and when you came back, he was on the ground limping. Is that correct?"

"Yes, but we didn't hear anything! So we thought it was fine since he didn't make any noise or anything. I mean, he's not in pain."

"You don't think he's in pain? He hasn't put that foot on the ground in 2 days according to you, and you just think he's holding it up because its fun to walk on three legs?"

"Oh so you think he's in pain, even though he's not crying? Why wouldn't he cry? I find that hard to believe."

"Yes, I think he is most likely in pain. This is abnormal behavior. Right okay. Is he eating/drinking/vomiting/diarrhea/coughing/sneezing/urinating/defecating/ yes ok good. Let's take a look at him."


I examine Stoic.


"Hmm, he's got a little wormy belly." 


"Wormy? What does that mean? He has worms? Where could he have gotten worms? He barely even touches the ground! We haven't seen any worms. Have you seen any worms, no I haven't seen any worms either. What do you mean by 'worms' anyway?"

Cue launch into parasite life cycle discussion.

One leg is a teensy bit purple and swollen. I squeeze, bend and press on every single part of that leg, and Stoic does not make a single sound. Does not even flinch. Everything else checks out okay, including the testicles. Hmm, we will discuss those as well. Meanwhile, the couple is arguing about how many times he went to the bathroom that day. The dog, not the owner.

"Toy breeds like Stoic have very delicate bones, and can very easily break the two bones in this part of the leg. In-"

"Really? Even from a height of 2 feet?" "Less! One and a half feet really."

"Yup, even from the couch onto carpet. The problem is, there is very little blood supply in this area, so without proper fixation they have a hard time healing. I'm not sure if anything is broken, but we should take x-rays just to be sure."

"Well can we ask you some questions first?"


"Sure go ahead."

Then, The List appeared. It looked like it had about 25 line items on it. At this point I started to get annoyed since I had other appointments to get to, and this was supposed to be a limping appointment. Not a time-to-ask-the-vet-every-question-that-has-come-up-in-the-last-6-months-while-you-have-been-caring-for-this-first-time-puppy-and-never-took-it-to-the-vet-once-ever appointment.

Just some of the questions that we discussed: What should Stoic be eating? How much? Is this particular grain-free organic all natural uber expensive diet ok even though it gives him diarrhea? Should he be getting vaccines? Aren't vaccines toxic? Is there some type of training we should be doing? Why do puppies sleep all the time? He yawns a lot, is this normal? How many times a day should he poop? Should he be on flea control? When do you neuter dogs? Do you think its a good idea if we show him because our breeder wants to breed him before he gets neutered, shouldn't he have titles or something?

I patiently answered most of these questions, emphasizing that he should have finished all of his vaccines and been neutered months ago. But back to the matter at hand. It took them about 10 more minutes of arguing "should we, should we not do xrays?"

Finally they let us take some rads. And sure enough, there was a complete fracture present. I have to admit, I was surprised. Most little dogs scream at the top of their lungs at the slightest discomfort. Stoic still made not a sound.

They were still incredulous that a small fall could cause such a problem. At least now they believed he was in pain. We started talking about surgery, and I recommended referral for a surgical consult.

Then, after having neglected medical care for their precious dog for so long, they demanded an appointment with the surgeon that very afternoon.

Sigh, someone else's problem now!


*All names and identifying details have changed. Any resemblance to actual persons, animals or events is purely coincidental.



Friday, February 24, 2012

Please Don't Get Another Dog

The other day a dog came in to see me for not eating and vomiting for a week. I could smell the dog before I walked into the room. He was laying on the floor, too weak to stand or sit up, and could barely lift his head. There were two young men in the room, and they were laughing. Laughing? I stepped over the dog who had that look in his eyes, the look many of us know too well. Help.

I sat down and began questioning the owner. "What's going on with Fluffy today?" "He vomited a few times." A few times meaning.... the dog had been vomiting consistently for at least a week. "When was the last time he ate?" "I don't know, last week?" "Has he had any diarrhea?" "Oh, uh, I don't know, I haven't noticed." "When was the last time he had a bowel movement?" "What's a bowel movement?"

I kid you not.

By now, I was getting severely angry that these people had let this dog suffer for so long, and at their flaming ignorance. My voice was shaking as I explained what a bowel movement is. I examined the dog, who was icteric. Yellow eyes, yellow gums, yellow skin. Uremic smell. The smell of organ failure, combined with the smell of a rancid Gram negative ear infection. "Oh yeah," they told me, "he has had infections in his ears for awhile." His skin was discolored from infection.

I felt a mass in the dogs abdomen, and he was at least 10% dehydrated. He was nothing but skin, fur, and bones.

I began to explain the severity of the dogs illness, and the owner began to cry. Usually I feel bad when I have to make people cry. But not this time. On the verge of tears myself [anger], I watched the owner cry and was glad that he finally understood how he had let his dog suffer.

Thankfully, they elected euthanasia. At least they did one thing right for their sweet old dog.

Sunday, January 29, 2012

Grapefruit Juice & Other Things We Are Going to Die From

I was going through some piles of things from vet school and came across this list. It was compiled by my friends and I during basically years one and two. After that I became too apathetic to notice. Let me explain. Our professors were a pretty morbid bunch, although friendly about it, don't get me wrong. When we were discussing certain diseases or syndromes that were particularly nasty, they would often comment that it may be the death of us later in life. It became a hilarious list, and sometimes we added several deaths per day. Most of them can and do kill people, and I am NOT trying to make light of any of these often serious diseases. (I recognize they may only be funny to me, however decided to share it anyway. It's my blog and I can do what I want!)

Things We Are Going to Die From


1. Rabies
2. BSE
3. "Not healthy"
4. Heart disease
5. Cancer
6. Small pox
7. Flu pandemic
8. Homicide (if you're a zoo vet)
9. Contagious Pustular Dermatitis Virus
10. Anthrax
11. Monkeypox
12. Avian Influenza
13. Hypoglycemia
14. Acetaminophen overdose
15. Grapefruit juice
16. Suppurative Brain abscess
17. Moldy bread
18. Nasty Exam Cycle
19. Radiation excess
20. Lung disease
21. Tuberculosis
22. Mexico
23. Leptospirosis
24. Psittacosis
25. Vet school cookouts
26. E. coli O157
27. Dumb people
28. Etorphine
29. Listeria
30. Drinking salt water while on a raft on the middle of the ocean
31. Swine flu
32. Echinococcus
33. Trichinella
34. Screwworm
35. Stress (why isn't this higher?)
36. Sudden death from A-fib
37. Consumption of raw milk
38. Tilmicosin