Birds in the Nest!

Yesterday I found a nest of baby birds in the backyard! I'm not sure what species they are as of yet. I have yet to see the parents. Hopefully I'll be able to post fairly regular pictures showing their progress!

There are two chicks in the nest, which is well-made and nestled nicely in the branches of a small tree right next to the house. I only found it because I had the dogs outside and heard a chirping sound. Even then, I had to search for it even though it is a fairly small tree. They are fairly small, but they do have their pinfeathers.

Beagle Brigade

What beagles were bred to do!

UK Beagle Pack

Walkback Friday

At the clinic, "walkbacks" are patients that were scheduled for an out-patient appointment and end up an in-patient. These critters can be something as routine as a dog that needs a urinalysis (a procedure that takes all of 2 minutes if the patient is cooperative) to a complete work-up with bloodwork, radiographs, ultrasound, intravenous fluids, etc. The techs always know something is up when one of the vets comes out of an exam room with an animal in their arms and a record in their hands. We joke at work that each vet is allowed one major walkback a day. Well, I've been out-doing my limit of late.

Today was a great example. It was already a somewhat different Friday. Typical Fridays are "all girl days." The schedule works out so just female vets and techs are in on Fridays. However, there were several last minute surgery add-ons on Thursday that necessitated the fourth vet to come in as well. And the surgeries were certainly not run-of-the-mill! There was a hit-by-car (HBC) dog that needed a fracture repair, the type of my boss hadn't done in 2 years. A local human dentist came in and did a root canal on his own dog. A "blocked" male cat (a stone gets lodged in the urethra, preventing urination; an emergency situation) needed a perineal urethrostomy (a procedure that essentially changes his anatomy to that of a female cat!). Another HBC dog came in that had broken its back up by her shoulder blades (she was eventually euthanized). This afternoon, a poodle came in that had eaten a stuffed toy (she ended up going to surgery to remove the mass of stuffing that had clogged her stomach and the beginning of her intestine). A very anemic dog came in that needed a blood transfusion. On top of this were the usual influx of vomiting dogs, sneezing cats and all the rest.

Enter my patients: I spent most of the morning helping with surgeries. I saw a few critters for vaccinations, anal glad expression, itchy ears, the usual things. Then I saw a dog with what we are treating as a "hot spot," a very severe, very sudden, very painful bacterial infection of the skin that needs a fair bit of work to get under control. While that was being dealt with, the rooms were getting full again so I went up front to take another patient. My next critter was a new kitten exam. Simple enough, right? Well, this kitten had not one but two cuterebra (fly larvae) living in it's neck. These disgusting creatures burrow holes into the skin of kittens, and you can see their breathing tubes as they stick them in and out of the cat's skin. Of course, we had to get those out. And, while he was under, the owner wanted him to get neutered, front declawed, vaccinated, tested for FeLV/FIV, a CBC (complete blood count) ran, a pain patch applied, and treated for ear mites and intestinal parasites.

Yeah, that was quite a walkback!

Three Little Pigs

It is strange the power of one meeting. Several weeks ago, a new client came into the clinic with her three guinea pigs. She wanted to get their nails trimmed, certainly a routine procedure. So, I pulled out a towel to put on the table and encouraged the owner to hold them on the towel while I trimmed their claws. One...two...three; we finished with the last one without any problem. There was a little bit of squeaking as one would expect, but not anything out of the common way. We put the last pig back into the box and the owner thanked me, voicing her surprise at how easy and stress-free it was. Apparently, she had gone elsewhere before and it had always been an ordeal that she had dreaded. This time, it had been nothing but pleasant.

I didn't think much about it until she returned today for another nail trim on the pigs. Again, it went very smoothly without any struggling or undue squealing. Again, she thanked me, saying that she will never take her pigs anywhere else, and she asked me questions about some of her other pets, specifically her chincilla.

Who knew that the simple act of trimming nails could gain a client? Or lose one, for that matter...?

County Fair

On Monday I certainly got a unique experience: I was invited to participate in the vet checks at the county fair! I helped checking in the dairy cattle. The basic idea is that each animal needs to be checked and certified free of signs of infectious disease. Things that we look for in cattle include pinkeye, footrot, ringworm, warts and respiratory disease. Sounds easy, huh? You just need to pull the cattle that have lesions on their skin or a cough, right?

Well, it isn't quite that easy, as I found out. Sure, there may be some lesions on the skin of a calf, but what is the cause? Is it a patch of hair that was rubbed off in the trailer? Is it a scar from dehorning? Or is it a wart that was cut off? It can be very hard to tell! And the exhibitors certainly aren't helpful. They are there to show and to win. They are not there to be honest with the vet who has the power to summarily toss their cattle back into the trailer and order them out of the fairgrounds.

Case in point: I started to look over a Holstein calf and knew there was going to be some problems. The calf came off of the trailer with long tendrils of white mucous hanging from her nose and a distinct, hacking cough. Knowing as I looked over her that I was going to dismiss her, I stalled for time. I called over the other, much more experienced vet to take a look at the calf, telling her my opinion. She agreed. The owner was certainly not amused. A younger guy, but much taller than me, he approached so he was towering over me.

"What, you are sending me home because of a snotty nose?"

"Yup," was my very articulate reply.

He was flaming mad, and that much was obvious. However, I had the last say and was not going to back down. It certainly helped to have the other vet there backing me up as well. There were several other cattle that were dismissed, including two for warts that tried to come back through after spending some time in the parking lot frantically cutting the warts off. Yes, they were sent right back out.

Now, I don't want to leave the impression that everyone was sneaky and conniving, trying to get diseased cattle by us. The contrary was true. The vast majority of the animals looked fantastic, the sleek Holsteins, Jerseys, Ayrshires, Guernseys and Brown Swiss heifers and cows models of health. And most of the handlers were helpful and skilled, answering questions if not with complete openness, at least with civility. There were certainly a fair few of clearly nervous folks, scared that I would find something on their cattle. But about 95% of them had nothing to fear, from me at least. If they got something passed me, I don't know about it. I certainly did my best to catch the most obvious problems, but I know I likely missed something.

It was certainly a great experience, and I look forward to doing it again next year, if they need me. On Friday I will be going back to do the vet checks on the "pet show" animals. I will be looking for much of the same problems in them as in the cattle, so it should be interesting!

First Thank You!

Related to the previous post on parvo virus, I have received my first official "thank you" as a veterinarian! The owners of one of the puppies I treated for parvo my first week out in practice sent me a surprise gift and card last week, thanking me for saving their dog. I was both shocked and humbled to receive such a gift." While it is certainly nice to get such a nice bouquet, the old "I'm just doing my job" line comes into my head. Yes, it may sound a bit silly, but it is true! I'm pretty certain I didn't do much more or less than any other vet would do. Still, the flowers are beautiful and the card sits within easy reach on my desk so that I can see it and realize that every time I look at it, it gives me a nice "warm fuzzy feeling" that only the grateful thanks of a client can give. What a great profession!

Two weeks in...

...and I've been woefully tardy in updating you all on my adventures in veterinary medicine. The short, quick story is that I've seen a lot, and learned a lot. Too vague? Perhaps, but so much happens in a day that it gets difficult to get it into some concise, understandable statement. So, I'll just focus on a few cases with big lessons that we all can learn.

Lesson: Vaccinations are a good thing
For most of my first week on the job, I didn't have my official license. This limited a lot of what I could do. I couldn't officially diagnose, treat, or prescribe any medications. I couldn't even vaccinate anything. Therefore, when we had two puppies come in on the same day that tested positive for parvovirus, I volunteered to take care of them.

For those of you unfamiliar with this disease, here is a brief overview. Parvo is caused by a nasty virus that primarily affects puppies. It's main target is rapidly dividing cells in the body, specifically the cells that line the intestinal tract, and bone marrow cells which produce red and white blood cells. As one may expect, the primary signs of this disease are vomiting and diarrhea. These are very sick puppies! The most optimistic survival rates are no better than 50/50. Puppies quickly become depressed and dehydrated, and they simply due not have the body stores necessary to survive for long with the combined anorexia and fluid loss. Due to the bone marrow effects, these puppies have a profound "neutropenia" (low numbers of neutrophils, the "front-line" of the white blood cell defenders). This makes these puppies extremely susceptible to secondary infections on top of the terrible toll the virus itself causes. The virus is very hardy and extremely contagious. It should be considered present in most environments, particularly those in which a puppy with parvo has lived before. Even a puppy that is not yet clinically ill with the virus can shed large amounts in their feces, contaminating even clean areas with large loads of virus. The virus can live for years in soil, not overtly affected by many disinfectants or weather changes.

There are only two good things about parvovirus: (1) it is easy to test for, and (2) it is easy to prevent. If a puppy is suspected of having the disease, all that is needed is a rectal swab and a handy SNAP test. A typical SNAP test is pictured at left (I won't talk more specifically about how those work unless someone asks!)

As for prevention, the current vaccinations -- if used appropriately -- are highly effective in inducing protective immunity in puppies. There are some tricks to it, though. When puppies are nursing, they typically receive a high level of protective antibodies from their mothers. These antibodies do a pretty good job of protecting the puppy. However, they also interfere with vaccines, and will actually prevent the puppy from being able to mount their own, protective immune response to the virus. The end result is that puppies are typically recommended to receive three vaccines one month apart starting at about 8 weeks of age. The idea is that puppies of this age have typically been weaned for about two weeks, and the antibodies they received from their mom are waning. As those antibodies decrease, the puppy will be able to respond to the vaccines and produce their own antibodies.

That is the idea, anyway. So how did my two patients catch parvovirus? Well, one hadn't received their last booster on schedule, and there was some question as to when she had last nursed from her mom and received her first shot. The other puppy had never been vaccinated. He actually came in because he "wasn't feeling good, and, oh, by-the-way, can we go ahead and vaccinate him while he is here?"

Well, long and messy story short, both puppies received treatment and both went home! However, the owners of both puppies certainly received a hit to the wallet as well. Due to the intensive care, fluids, etc, required for treatment, beginning estimates on treating a dog with parvovirus hover around $500. The final bills on both of these puppies were above that. And remember: you can expect to pay all of that and still end up with a dead puppy. These cases are typically very "up-and-down." A puppy that looks like it is doing well one moment will be crashing the next.

So, the lesson here is to make sure you vaccinate your puppy! Vaccines are a lot cheaper than the disease. Even though no vaccine is guaranteed to provide protection 100% of the time, the vaccines to protect against parvovirus are generally thought to be very effective. And your puppy (and your checkbook!) will thank you!