A sad case

A young, two year-old cat presented to me in severe and acute respiratory distress, severely hypotensive (low blood pressure), and vomiting clear fluid. The cat's gums were extremely pale and his temperature was a freezing 34.5 degree C (94.1 degrees F), indicating that the cat's extremities were very poorly perfused (no/little blood flow). The owner brought the cat in immediately after hearing the cat suddenly screech. There were no toxins to which the cat was exposed. On examination, the cat's veins were hair-thin, so tiny that it was difficult getting an iv catheter in one of them - but we did. After giving the poor gasping cat a tiny dose...

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Happy Birthday

It's Christmas day, and the kids got up early to see what Santa brought them.  My wife and I exchanged some additional presents, and we have cinnamon rolls baking in the oven (a tradition in our house).  We're enjoying some relaxing family time, as well as the gifts we were given.  It's a pretty typical traditional Christmas.I don't regret the secular aspects of the season, but sometimes we have to be reminded of the rest of it.  Did you know that today is a birthday?  How many of you have forgotten this?  Okay, yes, I know that Jesus was likely born in the Spring and that many "traditional" Christmas beliefs and decorations are related to pagan celebrations.  Christmas is a celebration of the birth of Jesus, and that is the focus of the holiday.  People...

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The Night Before Christmas

It's Christmas eve, a day of excitement in our house.  It's our tradition, based off the Swedish customs, to open family presents on Christmas eve (Santa's presents are for Christmas morning).  Today is also special for our kids because we're going to see the new Alvin & the Chipmunks movie, which they have been anticipating for months.  Like most people, this day is about being together as a family.I've taken this week off work to relax and have time with my family, and am so glad for that.  I can't remember the last time I've had this much time off to be at home.  Honestly, I probably needed it.  It's been...

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Facebook Follies

I've avoided joining Facebook for a long time. I'm not a highly social person, preferring a small circle of friends. For the most part I've kept in contact with those I wanted to (some better than others), and have no great desire to meet random people. I also saw how many people were clamoring to join Facebook, and didn't want to go with the crowd. I often said that I wouldn't join just out of principle.Ooops.A few days ago I joined. Most of it was due to my wife's gentle pressure, talking about how I could get in touch with some of my old friends better. Partly I also saw there were some interesting games, and I could put my pages in pirate lingo! So in the end, I did finally join. Little did I know what I was getting myself into.Now I'm playing eight different games, have 41 mateys...

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Time for Muppets

I grew up watching the original Muppet Show, and have never stopped loving Jim Henson's creations.  I have watched every movie and incarnation of the muppets since they first came on TV.  No matter how many times I see them, I still laugh at the same things.  Though all of them are great, I think that Animal is my favorite.  Just about everything he does makes me bust a gut.Did you know that the muppets have their own YouTube channel? I just recently discovered this!  So here's a couple of my favorite clips from their MuppetsStudio (notice that both prominently feature Animal...

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The Humor In A Vet's Life

For all of the hardship, heartache, and difficult decisions in a veterinarian's day, there can be a surprising amount of humor.  Some of it happens naturally.  For example, a year ago I blogged about a particularly funny incident involving a canine University of Tennessee fan.  Some times the humor is completely incomprehensible to others, such as when one of my techs had his pants slip a little while handling a dog, exposing his "crack" a little.  One of the other techs stuck a catheter cap into the space.  Yeah, a bit childish and weird, but we all had a good laught about it.  Other times the humor is forced as you try to find ways to cope with a particularly difficult situation.I certainly don't consider myself a humorist, though I would love to be.  I'm...

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Coming out...

...as depressed may be more difficult than coming out of the closet. As some of my regular readers may know, I have not posted very recently in many months, since the rupture of a long-term relationship. Since then, I have entered into a "circumstantial" depression, call it what you will... Right now, I am actually on my way out of it. My life from the outside is fully functional, I continue to work, and to love work. In fact, in all modesty I don't think I have ever been a more caring and empathetic veterinarian, and have never felt like such a good diagnostician.A part of me is hiding, though. A significant part of me hides behind a very...

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An Allergic Vet?

Here's an interesting and excellent question...My name is Jennifer. I am a student at West Valley College in Saratoga California. My assignment is to write a paper on a dream career or mine. I picked becoming a veterinarian, and found your site. My question is, Will having my allergies to certain animals (dogs, cats) affect me being a veterinarian? It would be greatly appriciated if you could get back to me Asap. Thank you so much. Jennifer, this is more common than you might think. As you mention, allergies tend to be to specific animals and not to all animals.  And there are ways around this problem.  If you have been working with an allergist, talk to him or her about desensitization medications or other ways you can medically handle the allergy.  In some cases regular...

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Practice Makes Perfect

Being a doctor isn't easy, and I don't think anyone would disagree with this comment. One of the hardest things to learn is how to take the information from the classroom and textbooks and apply it in a clinical setting.  This is why experienced doctors tend to make better clinical judgements than new graduates (everything else being equal).  It may not seem like it, but there can be a bit of disconnect between what is reported in the texts and what you may actually see.It's common for doctors to talk about whether or not a patient "reads the textbook". This means that some cases present exactly like is described in the textbook.  For example, a hypothyroid patient would have a thinning coat, weight gain, and persistent skin infections.  However, some cases don't have classic...

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Never Be Afraid To Ask

In her comments to my last post, Stefani made these statements....I get records every time I leave, and I go over them. I review bloodwork. I ask lots of questions about anesthetic protocols and monitoring. I go a place that uses licensed techs. I make specific requests. I wanted to bring these up for those who don't read the comments because they are great words of advice.  While I think that the average professional deserves some degree of initial trust (or you would never follow any recommendations the first time to went anywhere), I also think that full trust needs to be built.  Part of that depends on the professional you see acting in an appropriate, open, and ethical manner.  But a large part of that  depends on you as the client to do your part. A common...

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A Few Bad Apples

Over my lifetime (all 40 years of it so far) I have seen many people do reprehensable things.  Professional businessmen and CEOs who embezel and drive companies into the ground.  Ministers who steal or hire prostitutes.  Teachers who seduce and sexually abuse their students or other children.  Police officers who abuse their charges, physically beating them.  Respected officials who abuse their power.  Celebrities who are supposed to be role-models falling to drug and alcohol addiction.  And don't even get me started on the problems with politicians.There's the old adage that a bad apple will spoil the whole bunch.  And I guess that it's human nature to see a prominent figure as a representative of their "type".  But is that really fair?  In...

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Caffeinated Happiness

I have discovered a very important thing about myself.  I am a much happier person when I am full of caffeine.  I'm not much of a coffee drinker, but I drink sodas almost daily (diet only...trying to keep at my goal weight).  Yes, too much caffeine is bad for you, especially with some diseases.  But I'm otherwise healthy so I don't worry about it.  Caffeine doesn't really hype me up too much.  It does get me energized when I'm dragging, but I normally don't get hyperactive on it.  Does that mean that I'm addicted?  Probably.  But I'm not as bad as some people I've known.  I don't keep an energy drink around, and rarely even buy them (y'know, Red Bull and similar drinks).  I have at most 2-3 sodas per day, and if I have coffee it's no more...

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Phosphorous Problems

This question comes from Barbara...My question is what is the highest abnormal phosphorus level that a canine has ever been successfully treated for without total loss of kidney function and maintained on diet & medications. And is there a citable article in any journals?First, a little bit of explanation on what abnormally high phosphorous levels mean.  There are several things that can cause the phosphorous levels in the blood to increase. The most common reason is for renal (kidney) disease.  As the kidneys fail in their function, phosphorous is retained in the body rather than being expelled.  Other causes can include low parathyroid hormone levels, increased intestinal absorption, acromegaly (a growth disorder), destructive bone lesions, and normal bone growth (mainly...

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Sue For Emotion?

It happens from time to time that people will threaten to sue for one problem or another.  Here in the US, as well as in many parts of the Western world, there are people that are ready to jump into the legal system to solve their problems.  Often, this is because of money rather than a true need for justice.  When human medical malpractice settlements and judgements can easily be in the millions of dollars, it's easy to see why some people would be tempted.  But it is quite different in veterinary malpractice claims. Pets are considered a special kind of property by the legal system.  Due to this status, a pet owner can only sue for the actual value of the "property" and any medical costs incurred.  For a breeding animal this dollar figure can be in the...

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Fun With Words

Here's a weird thing about me (one of many)....there are certain words I just love to hear and say.  I don't know why, but some words simply sound interesting to me, or I love the specific meaning that they give.  Here are some examples....PlethoraUbiquitousPurulentBorborygmiOrnithology Language can be fun, and I enjoy learning about the origins and underlying meaning of words and phrases.  The English language is such a hodge-podge (there's another good one!) of words from other cultures and languages and is constantly evolving that some people spend their lives studying it.  Unfortunately, people often butcher words, usually unintentionally.  I have learned to live with these mistakes, but it still bothers me sometimes.  For example, there is no such word as...

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Cat Vs. Fan Belt

As the weather in the Northern Hemisphere gets cooler, everyone needs to be aware of a very tragic possibility.  When temperatures drop, cats will often dry to find warm, dry places.  This all too commonly includes a car's engine.  The cat will climb up into it from underneath and make themselves cozy.  The person doesn't notice the cat there until the engine is turned on and the cat gets caught in the fan belt or other moving parts.  And this can be a very, very bad thing.Today I saw a cat unfortunate enough to have this happen to her.  She was an indoor cat that had somehow managed to sneak out without the owner knowing.  He got into his truck and drove to his mother's house.  He never knew that she was in the engine until he turned the motor off and...

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Never Work With Children

An adage in Hollywood is that you should never work with kids and animals.  I'm finding this out all too clearly.  My family is currently involved in a production of The Best Christmas Pageant Ever.  Most of this cast is children, about 20 in total.  And oh, my gosh this is crazy! I wasn't planning on being in another play so soon, but got talked into it by my darling wife and the director.  Thankfully I only have five lines in one scene, so it's a pretty quick and easy appearance.  Unfortunately, that means that I spend most of my time backstage, trying to wrangle a couple of dozen teens and pre-teens that don't seem to understand the meaning of the words "keep quiet". There is constant chatter and noise, which can be heard in the theater if we're not careful....

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Thanksgiving

Today in the US was the holiday of Thanksgiving.  The origins are meant to celebrate how some of the original English colonists made it through a hard winter with the help of Indians and gave thanks afterwards. But nowadays it is mostly a time to get off work, eat a ton of food, hang out with family, and prepare for huge after-Thanksgiving sales in the stores.We're also supposed to reflect on the things we are thankful for.  Many people find this difficult in the current economy, with job losses, lower pay, and less joy overall.  But I think if anyone tries hard enough, they can find something to give thanks about.I'm thankful for God and His blessings.  For my beautiful and wonderful wife, who is endlessly patient with me.  For two great children who fill my life...

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A Cat's Dietary Needs

Clearing out my inbox, Jodi poses this set of questions about feline nutrition.why does it seem that so few veterinarians are interested in nutrition?? I believe a cat is a carnivore .Isnt an ideal diet one that consists of high qulity meat, very little carbohydrate, and no grain? My mothers cat has struvite crystals and bladder stones......all he has eaten is good quality canned food and very little dry. the special diet the vet wants him to eat is garbage!Since when do cats eat corn? and wheat? and by prodcuts and artificial (and toxic) preservatives?Isn't there a way to feed him and acidifying diet that has good quality nutrition? Even if this diet gets rid of his problem how can it be good for him?? He'll be free of crystals but malnourished!Thank you for any help or resources you...

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A Medical Mystery

Here's a truly bizarre case sent in by Erin. Okay, this is going to be kind of long so I apologize in advance. Let me just say first that we have had our 4yr old beagle, Daisy, to at least 11 different vets, including one internist in Jacksonville, FL as well as the vets at Auburn University's small animal clinic. Whew! :) Okay. After seeing all of those vets and endless tests we still do not know what's wrong with her. Here are her symptoms:About every 3-7 days she'll have what I call an "episode" where out of the blue she'll start frantically licking the floor (or anything else), and swallowing in a very exaggerated manner. She'll make this sucking noise through her nose (not  reverse sneezing) and swallow more as if she can't get something down. She will also occasionally hack...

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Sore Throat

Matt sends this in,The last couple of days my dog has been yelping out of nowhere, and when she barks it is a bark that quickly turns to a yelp.  We removed her collars thinking it was maybe constricting her throat but in the last day she has been less active and just lays around yelping occassionally.  She still has an appetite but you can tell that it is difficult for her to swallow.  Is there anything we can do to cause her to expel the object and help it's way down the rest of the way if you feel it is indeed an object in her airway?If there was something truly stuck in her throat, she likely wouldn't be eating, or would have more difficulty breathing.  Honestly, "stuck in the throat" is a common concern of clients but is a rare occurence.  She could have laryngitis...

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Reverse Sneezing

It's common for vets to get clients concerned about a strange coughing/sneezing/hacking/wheezing in their dogs.  It's a scary thing to watch, as it seems like the dog can't breath, and people worry that they might die or have severe problems.  Most vets, myself included, have actually gotten pretty good at duplicating the noise as we try to figure out what the problem is.  But now I can go one better.  Here's a video...This condition is called reverse sneezing, and it's just like the name implies.  It's basically a sneeze that goes backwards in the throat rather than forward out the nose.  Anything that irritates the nasal passages can potentially trigger it, such as allergies, dust, strong odors, or even rapid movement of air through the nose.  As disconcerting...

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Reverse

...

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The Joy Of Play

There's a video making it's rounds of the Internet that you may have seen.  A lecturer at the conference I attended last week had it in his presentation, and my father sent it to me today.This is incredibly adorable and cute!  But I think it reminds us how important play is.  As adults we get so bogged down in our work, bills, and life troubles.  We wish we could be as free as our kids, and marvel at how much they enjoy playing.  Don't we forget to play enough? How many of us can just revel in the sheer joy of the moment?  We forget what even animals know.  As part of my degree in animal behavior I studied play behaviors.  One thing that surprised me is how universal certain stances and actions are across mammals.  Wide eyes, open mouth, a lowered...

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Skeeter Update

Back in July, I received a question about a very strange case (you can review it here).  Last week I received this update from Denise.I am sure you remember me, I have the cat 'Skeeter' and you ran a post on her and helped me when her wrists had broken down.  I wanted to update you.  Skeeter deserves to be on the show Medical Mysteries.   When the 8 kittens went to kitten food, I had them on Purina One Chicken and Rice Kitten.  At about 6 or 7 mos old I believe, could have been sooner, I switched them to Diamond Naturals Kitten food.  If you recall she was about 10 mos when I noticed the wrists breaking down. ...

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Oh, My Achin' Butt

It's time for continuing education again, something that most professionals have to do. Once or twice each year I go to a conference to learn about new developments or procedures in veterinary medicine, refresh my memory on things I thought I knew, and get free stuff from the various vendors. It can be very interesting and educational, but most of us run into a common problem...butt fatigue.You see, most vets are pretty active people at work. We're going from room to room and case to case. On our busiest days we may never sit down and may not even have time for a lunch break. Our minds are having to shift gears every 10-20 minutes as new patiets come in, hospitalized patients get discharged, or lab results become available. Mentally and physically we're pretty much on the go for the whole...

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No Longer "Swine" Flu

The spread of the H1N1 influenza virus, commonly called swine flu, has been a bit of a panic for many people world-wide. Back in September I blogged about the flu, and said that pets couldn't get it.  I made that statement because at the time there was no evidence of that.  I now have to change that opinion. Here in the US it has been confirmed that at least one cat became sick with H1N1, though it survived.  Several ferrets have been confirmed to contract it and died.  This last fact is not surprising, as ferrets are very susceptible to human influenza viruses.  But the fact that a cat contracted it is more concerning.Viruses can mutate to change and affect different species.  The virus we now call parvo mutated from the feline panleukopenia virus to be...

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Too Easy Tech?

My associate vet told me about a rather strange situation that happened to her.  When her husband looked at their cell phone bill, apparently there was $80 in songs downloaded to her phone.  She had no idea how this had happened, as she didn't do it herself.  After some investigating they realized that their 16 month-old daughter had done it!  Apparently if you hit the "Select" button on her phone three times in a row, you've gone through the proper menus to order a song.  So their little girl was playing with the phone and by simply pressing buttons had ordered dozens of songs!  Her mother didn't even know how to do it!My kids are older, 6 (almost 7) and 8, and they have been able to use the camera on our cell phones for a few years now.  It took them no...

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Rockwilders and Datsuns

One of the things I have to sometimes snicker and shake my head at is the way that many people butcher the names of certain breeds.  It's even more amusing and pitiful if the client actually owns that breed!  And having practiced in many parts of the country, I can't say that it's localized to one region. I can somewhat understand that people may have a problem with some names, as many breed names are from countries that don't have English as the primary language.  But these people usually are completely confident in what they call the breed and are completely ignorant of the proper name.  Let me give you some examples....Rottweiler--I commonly hear them called "rockwilders", which butchers the name in so many ways.Dachshund--I've heard both "datsun" and "dash-hound"Shih-tzu--Oh,...

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Leave The Horses Alone

So this month's poll is finished, and it probably isn't too surprising.It is acceptable to slaughter horses for food:  18%It isn't acceptable:  66%Not sure:  15%As I mentioned when the poll began, eating meat has a cultural bias.  What might be perfectly acceptable in one country would be completely abhorent in another.  In this case, eating horse meat is considered common and even a delicacy in many parts of the world, including parts of Europe.  In the US I bet there are many people who aren't even aware that this goes on, let alone that there is a controversy.  Because of the bond that Americans have with horses and the importance that these animals have had in the development of our country, it would be strange for most people to consider killing them...

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Boo!

Though practiced in many countries, I believe that Halloween and trick-or-treating is biggest in America.  I know that I grew up loving the holiday, and had a lot of fun.  Some of my best memories of childhood are wandering through the neighborhoods begging for candy with a simple "trick or treat!"  One year my parents and a few other neighbors designed a haunted woods that wound through the suburban forest behind three houses.  There were elaborate spooks, decorations, and even a miniature Dr. Frankenstein's laboratory with a brief skit (I was Igor!).  All of it was safe, mildly frightening, and always fun. As I grew up I realized that I still enjoyed Halloween, with all of the spooky decorations and costumes. Now I get to pass it on to my own kids.Nowadays are different,...

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Brad's Guide To Veterinary Medicine

A vet I know named Brad sent me a list of 31 rules he has developed over a lifetime around veterinary medicine (his father is also a vet).  Here are a few of the choicer ones.  These are all tongue-in-cheek, but also give some profound truths about life as a vet.Rule #6--The condition is never an emergency until 3 a.m.Rule #8--The more money spent on procuring the animal, the less spent on maintaining it.Rule #11--The more ignorant the client, the more certain they are that they know more than you do.Rule #12--The nicer the clothing, the more nasty, disgusting, and malodorous a procedure you will be asked to perform.Rule #17--If the client does not comply with orders and the animal gets worse or dies, it is your fault.Rule #18--All lesions occur overnight ("Really, Doc, he was fine...

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Helpful Paranoia

Remember my "almost-deadly mistake" of last week?  Today I did my first neuter since then, on a dog about the same size.  Last week's case was running through my mind the whole time, and I was extra careful.  I watched my suture placement more closely than I have since I first started doing this surgery, despite the fact that I've done thousands of these procedures.  This is something that I'll probably do quite a bit in the future, not being as comfortable and complacent as I have in the past.Honestly, this isn't necessarilly a bad thing.  I realize that I'm only human and mistakes will happen (not just as a vet but in my life in general).  However, I hope that I learn from my mistakes and never make the same one twice.  I can clearly remember each slipped...

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Private Vs. Corporate Medicine

Here in the US we have two basic business models for veterinary practices.  The most common is the standard private practice.  Most are owned by a single veterinarian who has a single practice location.  However, it's not uncommon to have 2-3 partners owning a practice together and perhaps having a couple of locations in an area.  A corporate practice is run a bit differently.  There are multiple locations within a region or nationally who are run as any corporation:  there is a president, board of directors, location managers, and so on.  In the US the two biggest corporate practices are Banfield, The Pet Hospital and VCA, each having hundreds of locations.  However, there are also smaller, regional corporate practices that may have a few dozen clinics.What...

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Almost-Deadly Mistake

I've mentioned this before, but it bears repeating.  Veterinarians (and other doctors) are humans; therefore they can and do make mistakes.  The bad thing about these mistakes is that when things go wrong it can affect the life and health of the patient. I just had a mistake that was almost very, very bad.Yesterday I neutered a Yorkshire terrier.  This isn't normally a big deal, as by my calculations I have performed over 2,000 of these surgeries.  This case was slightly complicated by the fact that one of the testicles had been retained in the abdomen (a condition called "cryptorchidism"), which means we have to make a second incision and go hunting after it.  Again, this isn't normally a real concern as I've done several dozen cryptorchid surgeries over the years. ...

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