Saturday, December 29, 2012

Adventures in Emesis

One of our clients brought in her dog because he chewed open a bottle of anti-histamine and may have eaten some unknown quantity. Luckily, it wasn't the kind with pseudoephedrine in it (which can cause a fatal arrhythmia in a dog, frankly people probably shouldn't take it either) but we decided to make him vomit anyway just to be sure.

The little maltese got some lovely apomorphine and surely surely, started puking away. His stomach contents were FULL of rice, plastic, and ... BACON!!!! WTF????

No pills were seen.

Bacon?!?! I have to say, it still smelled good.

I walk out to the owner and say, "So, I don't see any pills, but I do see lots of bacon pieces. Did you give him bacon?"

She sheepishly grins and says, "Yes."

I say, "Not a good idea. At ALL. You will be in here spending a $1000 to fix pancreatitis. Stick to dog food."

"Oh, okay."

Whatever, I know you went right home and gave him more bacon.

...............


A woman calls (never before seen client) and in broken english says her dogs have been poisoned by a neighbor. She and her friend, sister? rush in with two little dogs.

It turns out the dogs may have eaten rat poison. This is a bad thing, a very, very bad thing. The ladies are furious that their neighbor apparently tried to poison their dogs.

We give them an estimate for emesis, charcoal, Vit K etc.

They can't afford any of it and want to take the dogs home and "teach their neighbor a lesson."

We make the dogs puke anyway. Apomorphine to the rescue!

One of them vomits up the characteristic bright green pellets of rat poison. The other one doesn't.

Since that's all we can do based on finances, I write a script for Vitamin K tablets (This is a cofactor in the coagulation cascade and is needed for blood to clot. Many rodenticides cause depletion of clotting mechanisms - the rat (or dog) bleeds out).

They took the script and the dogs, who were actually very sweet, and left still threatening their neighbor.

They called about a half hour later to ask what the pills were for and did they really have to get them. Sigh.

YES! WHAT DIDN'T YOU UNDERSTAND ABOUT DEATH! RAT BAIT! DEATH! Ugh.

...............

Lots of candy is around over the holidays. A client calls and tells us her dachshund somehow managed to get on to the dining room table and broke into a bag of individually wrapped chocolate covered almonds.

Her chart tells the whole story: virtually every visit has been some kind of candy ingestion.

The owner is a heavy drinker. She thinks it is a secret, but everyone knows.

As it turned out we didn't actually make the dog vomit. What I wanted to know was... how did the DACHSHUND get on the dining room table?

Life's mysteries.



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


Thursday, November 22, 2012

Thanksgiving

I just recently returned from a vacation which involved visiting several countries in MesoAmerica. Coming from one of the richest countries in the world, it was easy to see why so many people want to emigrate to the US. Most homes that we passed on our way to visit places would barely be considered 'houses' in America. Some were without roofs or had no doors or windows. Most were put together with rotten old boards, thatch, whatever materials could be found. The area surrounding the houses was generally full of trash, debris, and a few chickens pecking at the ground.  There were dogs, so many of them. Unneutered, flea ridden, mangy, starving dogs. I felt so guilty, just for being there, riding past in a sleek, air conditioned bus, staring out at poverty.

The people there had nothing. They had even less than what we would consider as nothing. It really put things into perspective with Thanksgiving right around the corner.

I am thankful for my health, happiness, and all the privileges given to me just by virtue of being an American. I am thankful for my freedom, my ability to work, and my wonderful job helping animals and their people.

I am thankful for my wonderful, supportive husband who gives me everything I ever need all while putting up with the crazy. I am thankful for our three four legged children, who bring joy to me every day. I am thankful for my family and my friends, who love me for who I am.

I am thankful I have many places to call home, delicious food to eat, and so many wonderful things that I take for granted virtually every day of the year.

Thank you, Thanksgiving Day, for reminding us of what we have that is so precious.

Roatan Island, Honduras 

Thursday, November 1, 2012

Another new vet school

Ok, are you freaking kidding me?

http://www.buffalorising.com/2012/08/source-kaleida-picks-vet-school-for-gates-site.html

Another new vet school? Because the ones in Alaska, Utah and Arizona aren't enough? Because we really need more vets, especially in the densely populated Northeast? Because we don't want a building to go to waste and we need more jobs????? REALLY?????

Creating more academic jobs and more "long term" jobs for hospital workers is not going to solve any problems. There is no "big money" in veterinary medicine. Opening a new school will not bring economic growth to the area.

Creating MORE veterinarians than there already are, with multiple new schools in the works, is going to ruin this profession, as echoed by colleagues herehereherehere, here and others elsewhere on VIN, and other forums.

There is no shortage of veterinarians. In fact, there are already too many. But the AVMA and academia are apparently ignoring this fact, and presenting a picture to new vets that is very different from reality.

I fought when my school decided to add 20 more seats to the class size (they did it anyway) while they were telling me that they needed the increased tuition dollars to keep their doors open. If a veterinary school, who gets millions of dollars each year from tuition, plus grants for research, donations and the income from it's referral hospital is having trouble staying afloat, how can you expect small business owners to do it? Especially with new grads coming out of school with hundreds of thousands of dollars in debt and not enough cases to pay the salaries they deserve.

Veterinary medicine is a calling, and I am not sure I would have turned away from it even if I knew the current state of things. However, making it easier to go to vet school is making it harder to find a job, harder to earn a living, and harder to love this profession.


Friday, October 26, 2012

REALLY low blood sugar, Or...

I, sadly, was not at work the day this occurred. I heard about it from the girls at work when I got back.


A woman called and exclaimed that her dog was having a hypoglycemic crisis.


"Her sugars are low, she's cold and she's acting strange and I don't know what to do!"

Receptionist: "Ok, well you need to bring her in right away."

"I don't know what to do, she has low blood sugar!"

Receptionist: "Ma'am, you need to bring your dog here right now!"

"Ok." »click»


Ten minutes later the woman rushes in with the dog over her shoulder. We grab it and rush it to the back.

She was right about one thing: it was cold. And stiff. That's right people, it was in RIGOR!!!!

The doctor noticed that there was a ton of food stuffed in the dog's mouth between its stiff jaws. He went out and said to the owner:


"I'm very sorry to have to tell you this, but your dog has passed."

Here is where it gets really interesting. The woman says:

"No she hasn't! She's diabetic and she just has low blood sugar!"

....

Dr.: "Um, yes she's gone, actually, she must have died at home."

"No, I'm telling you she's not dead! She just has low blood sugar! I'm getting a second opinion!"

She demands to have her dog back, swings it with a thump over her shoulder, and rushes out the door.


You CANNOT make this shit up. Thanks to KL for relaying the story.



All names and identifying details have been changed to protect the idiotic. Any resemblance to actual persons or events is purely coincidental. 

Tuesday, October 9, 2012

Does Comfortis kill bed bugs? And other thoughtful questions

Bedbug ... ewwwwwwww
Client to Receptionist: "Does Comfortis kill bed bugs?"
Receptionist to me: "Does Comfortis kill bed bugs?"
Me: "OMG WTF who cares!!! Just ditch the mattress, call an exterminator and get rid of them for good, freaks!!!"


I thought about this for awhile, and although it may be a silly question (not because comfortis may or may not kill bed bugs, because that is actually a very thoughtful question, but because if you have bed bugs just hire a professional right off the bat, I mean gross....but I digress) it is actually a very significant question. 

This person actually chose to call their vet, who is presumably well versed on all things dog and pesky parasite, so it makes sense right? Now of course I don't know who or where they looked first, still though, they did call us. But I think that is the rarity... I have actually had clients tell me, "Well, I searched online, talked to the guy at the pet store, called the groomer, and asked the neighbor's pet parrot what to do before calling you."

????

What is it that makes people believe the high school kid at the pet store over their vet? I honestly want to know.  If anyone reading this is not involved in the veterinary world and has any insight at all - please share.

Is it just because they believe whatever they heard first? And anything after feels false? Is it that they really don't trust their vet (still begs the question why they trust the pet store more)? Is it that they don't understand how much education their vet has had? (I have had people ask me, "What is that, like a 2 year degree or something?" Uh no, asshole.      Sorry.)

For some reason this is really bugging me. Ha, bugs.


Incidentally, we do not know if Comfortis does in fact kill bed bugs. Bed bugs prefer humans as their blood source, much as fleas prefer animals as theirs, which means no one is going to undertake a huge study to find out, so I doubt we shall ever know. 

Tuesday, September 18, 2012

Baby-Mama

"[Veterinary medicine] is a profession of the heart. It has nothing to do with mind-set or the economy; it's the heart that rules everything." Dr. Mark Russak, AAHA President.


Hello, followers. All ten of you :).  I wanted to share a lovely story today [for once]. A story about new life, love, and the reason most veterinarians stay sane.

In the middle of the morning rush, a young man and his brother came in with a 6 month old kitten. She was a cute little thing with a very big belly. The owner had found her as a stray about a month before and decided to take her in. That morning, he had come home to find a squealing newborn kitten underneath his bed, placenta still attached. He brought both mom and baby to the clinic.

As we warmed the baby kitten, and I examined the mother (still a baby herself - it was like an episode of 16 and Pregnant in here) we talked about potential scenarios. This could be the only kitten (unlikely), the other kittens could be alive and well, they could be dead, one could be stuck, she might need surgery, she might not accept the kittens, he might have to nurse them all around the clock or find someone else to, etc etc. To my surprise, this guy really wanted everything to work out for the best and he seemed committed to making it happen. Of course, the next part was up to mom.

We happened to have our radiologist here with her ultrasound, and so we got to do a little sonogram on mom kitten. And sure enough, we saw a couple of little beating hearts in that tummy. We took radiographs, and there were 4 more little babies waiting to enter this world.

I  recommended leaving mom kitten with us for the day so we could get the kittens to nurse and help them if necessary.  We held mom still and encouraged the first born to nurse. She did, and then the magic light bulb went off in mom-kittens brain (Oh! That's what happened? Give me that baby!) And she began to clean it and wrap herself around it.

I put some food in her cage and she gobbled up every bit, and then soon enough, another kitten was born, then another, then two more. All were born healthy, and began to nurse soon after birth.

When it was time for the little family to go home, all were cleaned, warm, fed and happy. Once they left, we all stared at the empty cage and became sad that we would no longer hear their cute little cries or get that warm fuzzy feeling watching mom take care of her babies.

The next day I called to check on the kittens. All were doing well and mom was nursing and taking care of them. And, the owner had already found homes for several of the kittens.

Not only did everything work out the best way it could have, but it put everyone in a great mood. Its these kind of cases that keep us going.


Wednesday, August 29, 2012

Why I hate Breeders (And Bulldogs)

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


Dog breeders are a special species of human. And not in a good way. (yes, yes there are lots (a few) good breeders out there, who actually care about their dogs and not money and do the right things for their animals, blah blah etc etc. This post is not about them).

English Bulldogs ..... oh, English Bulldogs.


Seriously, Brits? What were you thinking creating this monster? I mean any dog who's breed standard includes an underbite ... really? It can't breathe, it can't walk, it can't do anything in hot weather, it can't have babies the natural way, it can't swallow, it can't, in short, survive without serious human intervention. If left to its own devices, it would become extinct. As it should.

Most dog breeders are under the impression that they know much more than any vet about the care of their dogs because of their 'years of experience' breeding. They pass on all kinds of information to their unsuspecting buyers that is often wrong or even dangerous. Sometimes it is hilariously funny, case in point.

Yesterday my boss saw an emergency that came in in the afternoon. It was a new client with a bulldog puppy. The puppy was flat out on its side, had a high fever, and was barely responsive. It was wrapped in a wet towel. It turns out the owner was the breeder of the puppy, and had five more at home.

My boss did a physical exam on the dog and asked the owner some questions, all of which he answered with an attitude and while on the phone. The puppy had had zero vaccinations. When asked why the puppy was covered in a wet towel, he replied that it was the only towel in sight and he just grabbed it. My boss suspected heat stroke, although several other disorders were possible. The owner was insistent that the dog had been inside in the air conditioning. We recommended initial basic tests which included bloodwork, x-rays and a parvo test.

When the owner saw the estimate, he became irate, and asked why we wanted to run all these tests when we didn't even know what was wrong. {They're called diagnostics, dude. The point is to help us diagnose things}. He stormed out of the building with the puppy. My boss hurried out to stress that the puppy was in serious trouble, but he just blew off the warning, said something about money grubbing vets and left.

Okay. Veterinary care is not free. We have bills to pay, staff to take care of, and loans to pay back. Veterinary care is a service. But before I get into a crazy outburst about that, let me just say that we are not trying to gouge anybody. We are really just trying to find out what is wrong with the pet, so that we can fix it.

Bulldogs have lots of problems. Anybody that is breeding them is crazy and should be shot  needs to be aware of this fact, and willing and able to provide the care these dogs need, financially, physically, financially, financially etc. Bulldogs will cost their owners tens of thousands of dollars over the course of their lifetimes.

Breeders like that guy are the type that don't vaccinate or vaccinate their own dogs without the care of a veterinarian, don't care about the type of owners that get the dog, don't guarantee their dogs, don't fix congenital problems before selling them, don't care about the bloodlines they are adding to the population, and don't want to pay for services that are required to help their dog because they know better than the vet. We felt sad for the puppy, but good riddance to the owner. Take your 'tude elsewhere.


(The moral of the story is: Adopt don't shop!! And if you must go to a breeder, research them. Make sure they are doing what they do for the love of the breed, not love of money.)


Sunday, August 12, 2012

Melancholia

Once, when I was in Ohio (where there are no beaches anywhere near, unless you count Lake Erie, which I don't) I was pretending to be at the beach. I put beachy music on in the car, looked up only at the deep blue sky, and felt the breeze. I was telling someone about this, and I said, "If I close my eyes and listen hard enough, I can almost hear the ocean."

They said, "Um, you can't hear the ocean from here. It's too far away."

.....

Yeah, I know, thanks for a) not understanding imagery and
                                                    b) ruining the fantasy.


Well, after over a year of living in California, I finally made it to the beach last weekend.  A friend and I drove to Malibu, plunked our stuff down on the white sand, and breathed deeply the ocean air.  The Pacific Ocean is of the bluest blue, beautiful, and it is, in a word, frigid.  I could waste away staring at the ocean, the ebb and flow. But from the warmth of the beach, not while in the ocean itself. I can't believe people actually swim in it. But I guess, if that's all you know, you just do it.




The Atlantic Ocean, however, is warm. It has a more greyish hue, more restless somehow. Especially off New England. I love to walk along the shore and pick up shells and feel the ocean tug and pull at my feet. Come to me, it says. Its what I grew up with. We didn't live close to the beach, but because my parents liked to go, we went fairly often during the summers. Although I never actually spent much time in the ocean itself, I love going to it. When your destination is 'the ocean' it makes traveling more like a pilgrimage. I will come to you, and lay on your shores, and stare at you with longing until my eyes can't stay open anymore. I feel like I am always trying to get there, some place in the depth of my being.


It was good to get to the beach, with a friend. But I will always and forever be an east coast girl, and I will always long for my grey, restless sea.


Friday, July 27, 2012

Face-Palm

Dr. M: Don't let her lick [the wound] because she'll introduce more bacteria, if she's licking she'll need an e-collar.
Granola: I thought dog saliva was an antiseptic?
face-palm


--------


Dr. M: How long has the vomiting been going on?
Mr. Nip it in the Bud: Oh, several months. But I brought her in because I didn't want to wait till it was too late like with my other cats.
face-palm

--------

Just Crazy: Can I take my cat camping?
Dr. M: Um, no I don't recommend that.
Just Crazy: Why not?
Dr. M: Because your cat just escaped his carrier in our office. You take him into the wide open campground with no walls and see how well that goes.
Just Crazy: Well I have one of those line things with a leash attached.
face-palm


--------

Miss Nose: What do you think about potty training cats?
Dr. M: Well, I don't recommend it for various reasons. Why do you want to do it?
Miss Nose: Well her poop really smells.
Dr. M: Yeah, poop smells.
Miss Nose: Ohhhh......
face-palm


--------

Mme Repeat: She's been limping since last night after she got hurt, and she was crying in pain so I gave her a baby aspirin.
Dr. M: Ok, she didn't get the toxic dose, but its not a good idea to give your dogs human medications.
Mme Repeat: Well I just thought it would take the edge off.
Dr. M: Ok, just don't give it again.
Mme Repeat: Yeah, well, I just thought it would, ya know, take the edge off.
Dr. M: Ok, I understand why you gave it, I'm just saying DON'T give it again.
Mme Repeat: Well, see I just kinda thought it would take the edge-
face-palm


-------

Speedtalker: I-really-love-her-and-I-don't-ever-want-her-to-die-so-I'm-going-to-breed-her-when-she-is-10-years-old-so-I-can-have-another-one-of-her-and-then-I-will-breed-that-one-when-she-is-10-and-so-on.Oh-and-what-kind-of-food-should-I-feed-I-started-feeding-her-a-raw-diet-because-that's-what-they-recommended-at-the-pet-store-
face-palm

-------

I seem to have blocked all other conversations from this week as this is all I can remember. Face-palm.


*All names and identifying details have been changed. Any resemblence to actual persons or events is purely coincidental. 



Thursday, July 12, 2012

A Bad Week For Cats

Monday: A middle aged man brings in an older cat with fleas. The cat is apparently healthy, although it has a history of eating a lot and drinking a lot, and probably has something else going on, although it is likely mild. Despite my best effort to convince him otherwise, the man wants to euthanize the cat because he can't take care of her anymore.

Tuesday: A woman calls at closing time to ask if she can bring in her cat which she ran over that morning. The cat apparently ran off and has now been found hiding under the bushes. He comes in with a smashed hind leg covered in feces, but miraculously everything else seems ok. He will live... with amputation.

Wednesday: I am in a car with our vet student, K, on our way to a C.E. dinner, and she points to a restaurant and tells me they are filming Kitchen Nightmares there. And as we pass, Chef Ramsey is standing outside, by himself, half hunched over next to a board blocking the restaurant's front door. This has nothing to do with cats but we needed some comic relief this week, so there.

Thursday: A man who is a known hoarder brings in a kitten. It was born to a feral queen about 9 weeks ago. It is half the weight it should be, white as a ghost, weak, skin and bones, and SAR in its abdomen (something ain't right). It had an obstruction, which was likely cat litter. It was probably eating cat litter because it was anemic from flea infestation. We had to euthanize her.


I am so glad I am leaving town tomorrow......



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




Friday, June 22, 2012

Professional Courtesy and Pay-It-Forward

Dublin 
Today I took my 6 year old male cat Dublin to the cardiologist. It was time for his yearly echo to monitor the changes in his heart. He has a genetic disease called hypertrophic cardiomyopathy, in which the heart muscles get thicker. It can either be benign for the life of the cat, cause sudden death, or be somewhere in between. His disease is stable and he had very minimal changes today compared with last year, which made me very happy.


His cardiologist has been seeing him for the past 3 years. When I was in vet school, he very nicely gave us a professional discount that was not insignificant, and which we appreciated very much. He was under no obligation to do this. Today, my first visit as a full-fledged veterinarian, he charged me absolutely nothing. I couldn't believe when I heard the receptionist say I was good to go, as I fully expected to pay the whole amount this time.

I left feeling amazing. Not so much because we won't have another few hundred on the credit card bill this month, but because someone did something nice and unnecessary for me. Just because. And I felt so honored, and that I am truly valued as a client - and as a referring DVM. That's the real value of what happened. I plan on sending a thank you of some sort next week, as well as pay-it-forward.

I hope that every time I give something to a client for free, it lifts their spirit and they feel compelled to do something for someone else. The world can be a better place... one random act of kindness at a time.


Monday, June 4, 2012

Airing Grievances

I'm very sorry that you cannot afford minimal care for your ancient, flea-ridden, filthy dog. But let's first be honest about "cannot afford" and "will not" afford.

When you say you "cannot afford" radiographs, then whip your iPhone out of your Marc Jacobs bag to text your friend with your recently manicured nails about what I can only presume is something about how unreasonable I'm being, and then go out to your brand new car, that is "will not" afford.

I am completely amazed by how many people complain about money almost constantly and then get a new car. Or a new phone. Or discuss what TV show they watched on one of their premium channels last night. Newsflash.. you can't get those things without money.

Now, if you are using credit to get those things.. and you don't actually have the cash.. that's called stupidity. And poor money management. And one day, when your credit is shot, and your nails are broken, and your cable gets cancelled, then you can tell me that you have no money. And I might - just might - believe you.

If you come in here and tell me you only have $300 to spend because you just dropped $900 on a spa day, I'm very sorry, but I do not feel bad for you. You have an animal, which is a living, breathing, feeling being, and you have a responsibility to provide for its needs, medical and otherwise. Not me.


When I was working at the ER, an intact (not spayed) female Maltese was presented to emergency for vomiting and diarrhea. She was carried in on a pink fluffy dog bed by her owners, who were in total distress that their beloved Muppet was sick.

The owners happily signed an estimate for some bloodwork and radiographs, a typical starting plan for the problem at hand.

Meanwhile, they went outside to wait in their .. wait for it.... brand new BMW SUV.

Initial diagnostics revealed that Muppet most likely had a pyometra, a condition resulting in unspayed females where the uterus becomes infected and filled with a purulent material. This condition can be life threatening, and requires emergency surgery (Spay your pets!!).

When informed that their precious Muppet needed surgery, suddenly the tune changed, and the owners became quite belligerent and claimed that they had no money for such a surgery, and couldn't we just give her a magic injection that would fix everything so they could take her home?

No, sorry, I left my wand at home.

Can we just do the surgery and not charge them for it? Why, in fact, no, no we cannot do that.

Can we take an international credit card (without a valid US license?) No, no sorry we can't do that either.

Can we take traveler's checks? Nope.

Finally the owners decided they were going to try to get something for nothing at another hospital. They didn't even want to pay for the diagnostics that had already been performed. There was a tense moment when we thought they were going to barge into the treatment room to get their dog. Then, the woman pulled out A ROLL OF $100 BILLS from her purse. There must have been $2000 in there.

So, excuse me if I don't quite seem sympathetic when you say you "cannot afford" treatment.


If you have pets, have a plan for how you are going to pay for their [inevitable] medical bills.

Sorry for the rant!

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


Wednesday, May 30, 2012

Lay off the pipe, Rosie

It is the end of a typical day, and as usual it has gotten busy in the last half hour. There is an 'urgency' appointment that just showed up ... not quite an emergency. I walk into the exam room.

"Hi, I'm Dr. M, what's going on with your pup?"

The owner, a man with a shifty glance, lots of tattoos and a small dog in his arms, begins explaining.

"She stopped eating today and she's just been really, I don't know, listless."

I glance at Shifty. He's twitching his leg, keeps alternating between petting the dog, scratching behind his ear, toying with his belt. The dog, a terrier mix, looks nervous but alert.

He's got maybe a minor stutter, but its more like he's thinking the words faster than he can get them out. I ask all the usual questions (any vomiting, diarrhea, coughing, sneezing, get into anything etc), get all negatives, then start examining the dog.

While I'm doing my abdominal palpation, and the dog is getting even more nervous, he says, "This might sound like a stupid thing, well I don't know..."

I give him the 'concerned, go right ahead' look.

"Well, I had a buddy over, visiting, and well, he-he's a cop. And he asked me, 'what is that smell?' And I-I was like I don't know! But I keep smelling it, I mean I've been smelling it a few times now when I've been home. And it turns out, later on the cops show up to my neighbors and arrest them. Turns out they were in there smoking crack! I mean, ok its not a good neighborhood. And I kept feeling weird every time I smelled that smell so I thought, since dogs have a better sense of smell maybe it was affecting her too.

He goes on:

"I know I might look weird and have tattoos and everything but I don't do drugs, I'm just freaking out that something could have happened to her."

I am pretty speechless at this point. I mean, what?? That's not a question I get every day, and by that I mean never.  I glanced at his body language again, and the tattoos were not the problem, I can assure you. I finished my exam, finding nothing abnormal, and managed to say that I had no freakin clue if that would affect the dog, but that I would go do some research and let him know.

At that point, he became very anxious to leave, saying that he had to go open his store, and practically ran me over on his way out.  Perhaps it was just anxiety relating to the dog's condition and the time, but  he never stopped fidgeting the whole time he was there.

Think what you will, I suppose. The dog was fine by the next day.

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

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

Wednesday, January 25, 2012

Lies Never get you Anywhere

All names and identifying details have been changed and any resemblance to actual persons or events is entirely coincidental. I've been waiting to tell this story. It's a good one.

A young woman brought in a kitten one night because it had been attacked by her dog. The kitten was breathing heavily and was unable to stand, so we placed it in a warm cage with oxygen while speaking with the owner.

The owner was a 5 ft tall Hispanic woman with short shorts, long hair, and about 10 months pregnant. She was incredibly distraught about her kitten. She could not sit still, was drinking coffee like it was her job, and kept checking her cell phone. She was likely a tweaker according to more informed sources. (I had to look this up, it means meth user).  Yep, and she was pregnant. And had two other young kids at home. What a Bad Mother.

She signed an estimate for over one thousand dollars, after it was made clear that by signing it she was required to pay that amount. She went out to the front desk and said she didn't have any money or credit cards or ID because she forgot her wallet, as she was in such a rush to get the kitten to the hospital. She went out to her car and made some phone calls. 

In a few minutes she came back in with a credit card number, and lo and behold, she managed to find her ID.

Receptionist Extraordinaire: "Is your name on the credit card?"

Bad Mother: "Yeah."

Receptionist Extraordinaire: "Are you sure, because when I punch it in the name will come up."

Bad Mother: "Oh...uhh no its my boyfriends."

Receptionist Extraordinaire: "Well can your boyfriend come down here?"

Bad Mother: "No, he doesn't have a car. I could go get him."

Receptionist Extraordinaire: "Unfortunately you can't leave while your pet is here unless you leave a deposit."

Bad Mother went out to the care to make some more phone calls. Soon enough a squealing of tires was heard as she drove out of the parking lot as fast as possible.

Receptionist Extraordinaire called her cell phone. Bad Mother answered. She said, "Oh, I just went to Jack-in-the-Box to get something to eat." Really? Because you told us you had no cash. 

A while later, a Small Man came in the door and said he was there to pay the balance for Bad Mother. Receptionist Extraordinaire walked away from the desk for a few minutes, and the small man looked around, spotted a donation box, grabbed it, put it under his shirt and ran out of the building, which we all saw on camera.

Yup.

The next day, the owner of the hospital called the woman to tell her that we would be pressing charges against the theif, unless he returned the donation box.

Meanwhile, the kitten was slightly improved, and was able to stand, eat, drink, poop etc.

A day or two later, Bad Mother showed up with a Big Guy. A guy different from the one who stole the box. We knew this because, as before mentioned, the first guy was small. Short and squat. The guy she showed up with, well, let's just say you wouldn't want to come across him in a dark alley.

When they showed up, we called the cops.

Well, we only said we wouldn't press charges, not that we wouldn't report them. We asked Bad Mother to sign the kitten over to the hospital. Meanwhile, the cops talked to them both. Then the cops searched their cars. This was allowed because as it turns out, Big Guy is wanted on drug charges. Sure enough, the cops uncover meth in the guys car, and he is escorted off to jail.

The kitten was adopted and is doing great.

I would just like to point out that this would NEVER have happened if Bad Mother had just told the truth at the beginning. We could have reduced the estimate or tried to work with her so she could afford the care.  Lying never gets you anywhere. Truthfully, the kitten deserves a better life than she could have given it so I'm glad it all happened. Plus it makes for a good story. 



Friday, January 20, 2012

Stranger in a Gas Station

Years ago, my parents, sister and I were on our way to Virginia for my aunt's wedding. We got off the highway in some semi-rural town and stopped at a gas station. I saw a man with dark hair and a very distinct face wearing a ratty tee-shirt and blue jeans get out of a pick-up truck and begin pumping gas. There was a tear in the shoulder of the tee-shirt, which was a washed out pale green color.

Soon we left the gas station and about 20 minutes later pulled into a convenience store parking lot. (I think we were lost). As we were waiting for my dad to come out of the store, I saw the same man from the gas station. He was leaning on a car, a blue car, not the pick-up truck he had at the gas station. His hair ruffled in the wind, and he seemed like he wasn't really on his way to anywhere. I quickly looked for the tear in his shirt to make sure it was really him, and there it was. Just as we pulled away, he turned and looked right at me.

I saw him for the third and last time at an intersection down the road. He was at the corner to our right in the pick-up again, driving. He pulled away from the four-way stop without a sideways glance. By this time I was a little freaked out. I never saw him again.

Who was he? Was it really the same guy? Was he real? I will admit I had a very active imagination as a kid, but I have to believe that I wasn't making things up. I am a very visual person and remember almost every picture I've ever seen. I'm very good with faces. I had forgotten all about this stranger in a gas station until I read a story that triggered the memory. Could he have been a figment of my imagination? Was he a criminal, or was he a guardian angel of some sort? Who knows. Maybe I'm just crazy.

Monday, January 16, 2012

Some short stories from the ER

All names and identifying details have been changed.

It was late one night and the receptionist was on lunch, so there was no one at the front desk. I was in a room with a client, heard the door alarm go off signifying that someone came in, and maybe 2 minutes later walked out of the room to find two civilians in our treatment area.

Lady Intruder: "There was no one up front so we just walked back here."

Me (thinking): Really? You think you are entitled to just walk to the back of a veterinary ER after having been waiting in the lobby for no more than 2 minutes.

Man Intruder: "We are the owners of Very Sick Cat." 

Me (aloud): "Well visiting hours were over 2 hours ago, but you are welcome to visit." 

Man Intruder, referring to Lady: "Well she was out of town and just got back."

Me (thinking): That still does not give you the right to walk to the back of my ER. Do you just walk through the doors at a human ER? No. Why? Because they are LOCKED. Maybe we need locking mechanisms on our doors. 

The Lady Intruder opens the cage, picks up her cat, and disconnects the line containing the insulin CRI, and informs me in a condescending voice that they are taking the cat home tonight.  Fine, you so clearly know better and can take much better care of your cat at home, so go ahead. They ended up leaving him with us. 


--------------------------------

Phone conversation:

Caller: "Can you give Pedialyte to a dog who's been vomiting a lot?"


Me: "No, if your dog has been vomiting a lot you should bring him in to be seen."


Caller: "Ok thanks bye." click

.... You're going to do it anyway, aren't you.


--------------------------------

About 5 people come to pick up at cat with head trauma. One seems to be the speaker for everyone so I address him. He informs me that he isn't the owner, just a friend from their church. Right. I ask who the owner is, and its a small dark haired woman who tells me she is a "nurse." Ok fine. Whatever, I don't care. Here are the instructions for your cat, who really shouldn't be going home yet but since you are insisting we will do the best we can to make you understand what needs to be done. 

Lady 'nurse' owner: "Ok so I give this IV right?"

Me: "No, its given by mouth. We will be removing the IV catheter before you take him home."

Lady 'nurse' owner: "What? But this is an IV medication. You should leave the catheter in."

Me: "It can be given orally in cats, and that is how you are going to give it. We do not send animals home with IV catheters."

Lady 'nurse' owner: "But I am a nurse. You can leave the IV catheter in for me. I give IV drugs all the time."

Me: Well, you won't be giving any IV drugs to your cat. You may be a human nurse but you are not a veterinarian or a veterinary technician and have no training in that respect. And, we do not send animals home with IV catheters, even with veterinary nurses.

Lady 'nurse' owner, muttering under her breath to her friend, but I can still hear with my superhuman hearing: "I will just give it IV at home."

Me, alarmed and a little angry: "You will NOT be giving anything to your cat IV. We will not be sending home any needles. This medication is effective orally. If you go to your place of work and steal needles to give meds IV to your cat, you could seriously hurt or even kill him, not to mention be breaking ethical and moral code, (silently) you asshole."


--------------------------------