tag:blogger.com,1999:blog-52072868107511867792024-02-29T23:22:03.837-08:00VETOGRAPHYPronounced like biography or photography.
I am a writer and I am a veterinarian. Sometimes I am just one or the other. Sometimes I am both at the same time.Philipp Schotthttp://www.blogger.com/profile/03308988842276050743noreply@blogger.comBlogger98125tag:blogger.com,1999:blog-5207286810751186779.post-7820799146132057502024-01-09T14:04:00.000-08:002024-01-09T16:26:10.081-08:00Old Dog Lessons<p>For the re-awakening of my blog after a long siesta, I've chosen to pull a story from my third published collection, "The Battle Cry of the Siamese Kitten" (ECW Press 2022). I chose this one specifically because it features Orbit, our Shetland sheepdog who suddenly passed away at the end of last year. I'm trying to find ways to honour his memory and mark his impact on my life. Since I'm a writer, what better way than to write about him.</p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgqg1fdj17HX9MAmIDn9PUTI3N3SymTJvQSG1IOq52ziJ5u7DOwO0u5nyw6HH12l-jGYwJCLzZCJH4kNbbsMXDR-tNcQKNujOkyt7nA0pBwF2zCbma1LCP8RqCwSdzrBZk5Zvo26lWSIIjZPVVUxaknMcoKsl9zc_7F3m__DZuQBPLCQ69_vRRW7IZ_ToAM/s3280/PXL_20231012_200044559.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="2464" data-original-width="3280" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgqg1fdj17HX9MAmIDn9PUTI3N3SymTJvQSG1IOq52ziJ5u7DOwO0u5nyw6HH12l-jGYwJCLzZCJH4kNbbsMXDR-tNcQKNujOkyt7nA0pBwF2zCbma1LCP8RqCwSdzrBZk5Zvo26lWSIIjZPVVUxaknMcoKsl9zc_7F3m__DZuQBPLCQ69_vRRW7IZ_ToAM/s320/PXL_20231012_200044559.jpg" width="320" /></a></div><br /><p></p><p align="center" class="MsoNormal" style="text-align: center;"><u><span lang="EN-US" style="font-family: "Times New Roman",serif; font-size: 12pt; line-height: 107%; mso-ansi-language: EN-US;">Old Dog Lessons</span></u></p>
<p class="MsoNormal"><span lang="EN-US" style="font-family: "Times New Roman",serif; font-size: 12pt; line-height: 107%; mso-ansi-language: EN-US;">The title is
misleading. The dog giving the lessons, Orbit, is not “old”. Naturally, he is
showing some signs of aging, but that is of course a constant process, right
from birth. We all only stop aging when we die. As I write this, he is eight
and a half years old - “middle-aged”, let’s say. I won’t think of him as old
until he’s in the double digits, which is only a year and a half away. But
let’s not dwell on that. For now, he’s still middle-aged, but “Middle Aged Dog
Lessons” doesn’t have the same ring.<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="EN-US" style="font-family: "Times New Roman",serif; font-size: 12pt; line-height: 107%; mso-ansi-language: EN-US;"><span style="mso-tab-count: 1;"> </span>As an aside, this is a good time to
address a top ten question asked of vets: “How old is my dog in people years?”
There used to be an easy way to answer this, but unfortunately it was wrong. We
used to simply multiply by seven, and presto, there was your answer. A
ten-year-old dog was 70, which sort of almost maybe made sense back when most
dogs were lucky to see their teens. But that rare 20-year-old Chihuahua was
140! Amazing. Even more amazing was the routine fact of puppies going into the
equivalent of puberty at 6 months of age, or 3 and a half human years! Imagine
your toddler’s voice cracking and a wispy moustache appearing on his upper lip.
Or needing a training bra and feminine hygiene products. But we cheerfully
ignored these quirks of the “seven times” math for decades. Now we know better.
Now we do something much more complicated. Are you ready? Here’s the formula:<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="EN-US" style="font-family: "Times New Roman",serif; font-size: 12pt; line-height: 107%; mso-ansi-language: EN-US;"><span style="mso-tab-count: 1;"> </span>At 1 a dog is 15 in human years.<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="EN-US" style="font-family: "Times New Roman",serif; font-size: 12pt; line-height: 107%; mso-ansi-language: EN-US;"><span style="mso-tab-count: 1;"> </span>At 2 a dog is 24 in human years.<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="EN-US" style="font-family: "Times New Roman",serif; font-size: 12pt; line-height: 107%; mso-ansi-language: EN-US;"><span style="mso-tab-count: 1;"> </span>After that, add 5 human years for
every dog year for most dogs, but add 4 for very <span style="mso-tab-count: 1;"> </span>small dogs, and 6 for giant breeds. <o:p></o:p></span></p>
<p class="MsoNormal"><span lang="EN-US" style="font-family: "Times New Roman",serif; font-size: 12pt; line-height: 107%; mso-ansi-language: EN-US;"><span style="mso-tab-count: 1;"> </span>Got it?<span style="mso-tab-count: 1;"> </span><o:p></o:p></span></p>
<p class="MsoNormal"><span lang="EN-US" style="font-family: "Times New Roman",serif; font-size: 12pt; line-height: 107%; mso-ansi-language: EN-US;"><span style="mso-tab-count: 1;"> </span>(Incidentally, if you’re doing the
cat age math, the formula is the same, with cats equating to small dogs.)<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="EN-US" style="font-family: "Times New Roman",serif; font-size: 12pt; line-height: 107%; mso-ansi-language: EN-US;"><span style="mso-tab-count: 1;"> </span>So, by this formula,
eight-and-a-half-year-old Orbit is 24 + ((8.5 – 2) x 5) = 56.5. That
20-year-old Chihuahua is now 24 + ((20 - 2) x 4) = 96. And sadly, a 12-year-old
Newfoundlander is already 24 + ((12 – 2) x 6) = 84. By the way, I hope all those
nesting brackets haven’t given any of you math anxiety flashbacks. If you
prefer, the charts are easy to find on the internet.<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="EN-US" style="font-family: "Times New Roman",serif; font-size: 12pt; line-height: 107%; mso-ansi-language: EN-US;"><span style="mso-tab-count: 1;"> </span>But Orbit is, like I said, middle
aged. In fact, at 56.5, he’s only a year older than I am right now. He passed
me late last fall sometime. <o:p></o:p></span></p>
<p class="MsoNormal"><span lang="EN-US" style="font-family: "Times New Roman",serif; font-size: 12pt; line-height: 107%; mso-ansi-language: EN-US;"><o:p> </o:p></span></p>
<p class="MsoNormal"><span lang="EN-US" style="font-family: "Times New Roman",serif; font-size: 12pt; line-height: 107%; mso-ansi-language: EN-US;">Consider the
foregoing a bonus story. It was not what I intended to write about. I intended
to write about what Orbit is teaching me as he ages.<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="EN-US" style="font-family: "Times New Roman",serif; font-size: 12pt; line-height: 107%; mso-ansi-language: EN-US;"><span style="mso-tab-count: 1;"> </span>I’m not a nickname kind of guy. A
small number of people - none of them family or close friends - call me “Phil”,
but that’s a contraction, not a nickname. One classmate back in veterinary
school tried “Flip” on for size, but that didn’t stick. However, when I worked for
Dr. Bruce Murphy over several summers while in university, he started calling
me “Flying Phil” and that became widespread among the graduate students in his
endocrinology lab. <o:p></o:p></span></p>
<p class="MsoNormal"><span lang="EN-US" style="font-family: "Times New Roman",serif; font-size: 12pt; line-height: 107%; mso-ansi-language: EN-US;"><span style="mso-tab-count: 1;"> </span>Bruce had noticed a fundamental
truth about me. I am quick. I walk quickly, I talk quickly, and I eat quickly.
I consciously try to slow the latter two down because I know that they are not
good things. The walking quickly is mostly positive, unless I’m walking with my
family and annoying them by constantly surging ahead, but the talking and
eating are problems. Yet, despite knowing this, and despite decades now of
trying to slow down, my default is still to be quick. I’ve made my peace with
who I am, but that doesn’t mean I don’t want to keep trying.<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="EN-US" style="font-family: "Times New Roman",serif; font-size: 12pt; line-height: 107%; mso-ansi-language: EN-US;"><span style="mso-tab-count: 1;"> </span>Orbit is helping now. He’s still an
energetic dog and can easily keep pace with me, when he wants to, but since
becoming middle-aged, increasingly he doesn’t want to. When I say, “Do you want
to go for a walk Orbit?”, he hears, “Do you want to go for a sniff Orbit?” In
common with most dogs, he’s always been an enthusiastic sniffer, but in the
last couple years this has apparently turned into his life’s primary mission. Whereas
a simple tug on the leash used to be enough to stop him from sniffing and get
him walking again, now I have to yank hard, and drag him. Literally. He puts on
the brakes by bracing his legs and leaning away from me, and he adopts what I
can only describe as a stubborn facial expression. As I haul, the collar rides
up against the back of his head, pushing the fur forward, and he locks his legs
in position. I’m bigger and stronger, so I win, but at a cost. Orbit is
disgruntled. People stare. I feel judged. I want Orbit to enjoy his sniffing,
but, damn it, even more so, I just want to go!<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="EN-US" style="font-family: "Times New Roman",serif; font-size: 12pt; line-height: 107%; mso-ansi-language: EN-US;"><span style="mso-tab-count: 1;"> </span>Then slowly I started giving in more
frequently, and this became a feedback loop because he saw this as an opening.
So, he tried stopping even more, and I gave in even more, to the point that
some of our walks now consist mostly of meandering and sniffing. None of this
high velocity arrow-straight ambulation. For a smell connoisseur, it must be
like powerwalking through the Louvre. Sure, you’re getting exercise, but you’re
missing all the best stuff! When I have a busy day, this is as painful as
getting in the slowest check-out line at the grocery store. Mindfulness gurus
will tell you to actively seek these situations out. It’s easy to be mindful at
the beach or during an interesting movie, but for true practice, pick something
that would normally frustrate you and make you impatient. So they say. Orbit turns
out to be a mindfulness master. Most animals are. I am trying to learn from
him. While he slows down to smell the pee, I’m trying to slow down and smell
the roses (mostly metaphorical, especially during the winter). As an aside, I
originally planned to title this story, “Slow Down and Smell the Pee”, but I
didn’t want people to skip it.<o:p></o:p></span></p>
<p class="MsoNormal"><span lang="EN-US" style="font-family: "Times New Roman",serif; font-size: 12pt; line-height: 107%; mso-ansi-language: EN-US;"><span style="mso-tab-count: 1;"> </span>Now, when I want to walk quickly
with Orbit, because I still prefer that and because he still can keep up, I
pick routes that take us across as many open fields as possible. He still finds
the occasional apparently well perfumed blade of grass that requires deep
sniffing, but otherwise we’re able to go straight and fast and far, neither of
us old in any way.<o:p></o:p></span></p><br /><p></p>Philipp Schotthttp://www.blogger.com/profile/03308988842276050743noreply@blogger.com1tag:blogger.com,1999:blog-5207286810751186779.post-54225983842632044332020-02-06T09:07:00.000-08:002020-03-05T14:43:28.765-08:00Zoonoses<div dir="ltr" style="text-align: left;" trbidi="on">
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgGWTxXw87Qss0_GmI6UkxZKjYJMT2TMuOdEyXPk8xlJV7kwhxohNrxbAmb0faAkf3ujmDS-5dYkhOWn07UiLiyoA65GNmhNFpmuwMdC_GKG6xsY9LSd5JAL1YAbOZzjJvhDZLaRfH-7nRG/s1600/dog-air-filter-pollution-mask-e1504533309877.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="613" data-original-width="959" height="204" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgGWTxXw87Qss0_GmI6UkxZKjYJMT2TMuOdEyXPk8xlJV7kwhxohNrxbAmb0faAkf3ujmDS-5dYkhOWn07UiLiyoA65GNmhNFpmuwMdC_GKG6xsY9LSd5JAL1YAbOZzjJvhDZLaRfH-7nRG/s320/dog-air-filter-pollution-mask-e1504533309877.jpg" width="320" /></a></div>
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<span style="font-family: "times new roman" , serif; font-size: 12.0pt; line-height: 107%;"><br /></span></div>
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<span style="font-family: "times new roman" , serif; font-size: 12.0pt; line-height: 107%;">No, not the noses of zoo animals, but the diseases
that can spread from animals to humans. It comes from the Greek “zoon” for
animals and “nosos” for diseases, whereas the nose on your face gets its name
from ancient Anglo-Saxon roots. Coincidence. <o:p></o:p></span><br />
<span style="font-family: "times new roman" , serif; font-size: 12.0pt; line-height: 107%;"><br /></span></div>
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<span style="font-family: "times new roman" , serif; font-size: 12.0pt; line-height: 107%;"><span style="mso-tab-count: 1;"> </span>Zoonoses
have been on my mind because of two items in the news recently. One is at the
top of every news feed right now and the other you’d have to scroll some
distance to find, and only on certain sites. <o:p></o:p></span><br />
<span style="font-family: "times new roman" , serif; font-size: 12.0pt; line-height: 107%;"><br /></span></div>
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<span style="font-family: "times new roman" , serif; font-size: 12.0pt; line-height: 107%;"><span style="mso-tab-count: 1;"> </span>The
first is coronavirus. <o:p></o:p></span><br />
<span style="font-family: "times new roman" , serif; font-size: 12.0pt; line-height: 107%;"><br /></span></div>
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<span style="font-family: "times new roman" , serif; font-size: 12.0pt; line-height: 107%;"><span style="mso-tab-count: 1;"> </span>Depending
on happens with the current coronavirus epidemic in Wuhan, China, and depending
on when you’re reading this, you may have to look back through the news
archives to remind yourself of the details, or you may be dead from it, in
which case you’re probably not reading this anyway. Some strains of coronavirus
can be considered zoonotic. The current one in China, for example, is thought
to have originated in wildlife, possibly pangolins. Middle Eastern Respiratory
Syndrome (MERS) is another coronavirus, and it jumped from camels to people.
SARS was also a coronavirus, and it seemed to have been passed from civets (a
kind of cat-like creature). <o:p></o:p></span><br />
<span style="font-family: "times new roman" , serif; font-size: 12.0pt; line-height: 107%;"><br /></span></div>
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<span style="font-family: "times new roman" , serif; font-size: 12.0pt; line-height: 107%;"><span style="mso-tab-count: 1;"> </span>And
now I have shocking news for you. Are you ready? Dogs get coronavirus too.
Quite commonly, in fact. This is common enough knowledge that vet clinics have seen a surge in requests for coronavirus vaccination in the last few days.
Yes, we do have a vaccine, but we rarely use it. We rarely use it because it is
a really mild disease, at worst causing diarrhea, mostly in puppies. It has
nothing to do with SARS, MERS or Wuhan corona, other than belonging in the same
very general family of viruses. Being afraid of canine corona because other
coronas are potentially lethal is like being afraid of garter snakes because
cobras and rattlesnakes can kill you. For sure, some people are afraid of all
snakes, but they (hopefully) understand that this is an irrational phobia, not
a rational basis for decision making. Ditto for viruses. I get it if you’re germophobic,
but don’t panic as a result. Your dog’s diarrhea will not kill you. It might be
the end of your carpet, but not of you.<o:p></o:p></span><br />
<span style="font-family: "times new roman" , serif; font-size: 12.0pt; line-height: 107%;"><br /></span></div>
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<span style="font-family: "times new roman" , serif; font-size: 12.0pt; line-height: 107%;"><span style="mso-tab-count: 1;"> </span>The
other zoonosis in the news is, I think, more interesting. A woman in Alberta
was diagnosed with rare and aggressive liver cancer. In a surgical Hail Mary
pass, the doctors planned to remove a large part of her liver and a number of
nearby tissues. Then the surprise. It was not cancer, it was a parasite. It was
a zoonotic tapeworm called <i>Echinococcus multilocularis. </i>Creepy, eh? This
has been around for millennia, but in parts of the world, including western and
northern Canada, it may be on the increase. Nobody knows for sure where this
woman contracted it, but normally it’s through canid feces. <i>Canid</i>, not
necessarily <i>canine. </i>But possibly. <i>Echinococcus </i>cycles between a
definitive host, usually a coyote, wolf or fox, and an intermediate host,
usually a rodent.</span><span style="font-family: "times new roman" , serif; font-size: 16px;"> The adult worm sets up shop in the intestines of the definitive host, shedding eggs in the feces for the intermediate</span><span style="font-family: "times new roman" , serif; font-size: 12pt; line-height: 107%;"> host to ingest. The eggs then hatch into larvae
which migrate and form cysts somewhere in the intermediate host, such as in the
liver, waiting to be eaten by the definitive host and thus completing one of
nature’s more disturbing circles of life (</span><span style="font-family: "times new roman" , serif; font-size: 12pt;">cue Elton John).</span><br />
<span style="font-family: "times new roman" , serif; font-size: 12.0pt; line-height: 107%;"><br /></span></div>
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<span style="font-family: "times new roman" , serif; font-size: 12.0pt; line-height: 107%;"><span style="mso-tab-count: 1;"> </span>Now
read back over the third last sentence in the paragraph above. Note the use of
the word “usually”, twice. The definitive host is <i>usually</i> a coyote, wolf
or fox, but it could be a dog if the dog eats rodents. And the intermediate
host is <i>usually</i> a rodent, but it could be a human if the human snuggles
with their rodent-eating dog and then goes to eat a corned beef on rye sandwich
without washing their hands first. To be clear, it doesn’t have to be a corned
beef on rye, or any sandwich at all, but I’m sure you sorted that out for
yourself. I was just trying to create a more memorable mental image. So, if you
suspect your dog of eating rodents you should mention it to your vet (we don’t
always ask, although I think we will be doing so more often now) because there
are effective deworming medications for this, and you should always wash your
hands before eating. I know I sound like your mother. Well, she was right. At least about this. Just
imagine how much more insistent she would have been if she knew about worms
that formed giant cysts in your liver.<o:p></o:p></span><br />
<span style="font-family: "times new roman" , serif; font-size: 12.0pt; line-height: 107%;"><br /></span></div>
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<span style="font-family: "times new roman" , serif; font-size: 12.0pt; line-height: 107%;"><span style="mso-tab-count: 1;"> </span>This
is still very rare, so please don’t panic. However, while no concern whatsoever
is warranted for canine coronavirus, some mild attentive concern is appropriate
for <i>Echinococcus</i>. This frontier between human medicine and veterinary
medicine is fascinating. One list I saw had 64 different zoonoses on it, from
African sleeping sickness (from cattle via tsetse flies) to Zika fever (from
primates via mosquitoes), and while most are tropical and passed through insect
vectors from their animal hosts, some are direct from your pet to you. Of
these, really only rabies is fatal and it is very rare here because of
vaccination. Everything else, from ringworm (incidentally, not a worm and not
always in a ring – rashfungus would be a better name) to scabies to giardia are
not especially common or especially serious, unless you have a weakened immune
system. <o:p></o:p></span><br />
<span style="font-family: "times new roman" , serif; font-size: 12.0pt; line-height: 107%;"><br /></span></div>
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<span style="font-family: "times new roman" , serif; font-size: 12.0pt; line-height: 107%;"><span style="mso-tab-count: 1;"> </span>In
closing, I have to wonder if camels at the zoo with MERS sneezed on you, would
that be a zoonosis from zoo noses? (Sorry.)<o:p></o:p></span><br />
<span style="font-family: "times new roman" , serif; font-size: 12.0pt; line-height: 107%;"><br /></span>
<span style="font-family: "times new roman" , serif; font-size: 12.0pt; line-height: 107%;"><u>Update</u>: </span><br />
<span style="font-family: "times new roman" , serif; font-size: 12.0pt; line-height: 107%;">Today there was an item in the news reporting that a dog in Hong Kong had caught the corona virus, now officially known as COVID-19. This will cause silly people to panic. In case you are feeling like you are in peril of becoming silly yourself, let me explain why you shouldn't do that.</span><span style="font-family: "times new roman", serif; font-size: 12pt;"> </span><br />
<span style="font-family: "times new roman" , serif; font-size: 12.0pt; line-height: 107%;">First of all, this is all highly unsurprising. COVID came from another mammal in the first place, so it reasonable to assume that it could pass to yet more different mammals. This is in no way unusual. Ferrets can get human flu for example. The happy news though is that when a virus jumps species it always changes. Usually it gets much weaker. Sometimes, rarely, it gets stronger. Given the thousands of dogs and cats exposed, if COVID was getting stronger after going into them, we would know about it by now. This is one single dog and this dog isn't even sick, he just tested positive. COVID apparently isn't even replicating in this dog, so he definitely can't pass it on. The virus has indeed gotten much weaker. So don't be silly and panic. Not about this, anyway. There are plenty of far worthier things to panic about.</span></div>
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Philipp Schotthttp://www.blogger.com/profile/03308988842276050743noreply@blogger.com1tag:blogger.com,1999:blog-5207286810751186779.post-78274190401845853032020-01-15T13:05:00.001-08:002020-01-15T13:05:42.200-08:00Thank You For Thank Yous<div dir="ltr" style="text-align: left;" trbidi="on">
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<br /><br />Dear Client, <br /><br /> It may not always seem that way when I’m in my confident professional mode, but I can be socially awkward at times. Sometimes I don’t have a good instinctive grasp of the social norms. My kids are on the Autism spectrum, so perhaps I have a little touch of that as well. The one social norm that continues to confuse me is whether one ever says thank you for being thanked. Taken to an extreme, this could obviously spiral out of control. <br /><br /> “Thank you!” <br /><br /> “Thank you for saying thank you!” <br /><br /> “Well, thank you for saying thank you to my thank you…” <br /><br /> Ridiculous, right? Best nipped in the bud after that first thank you. Yet, this doesn’t entirely sit right with me either. This is why I am writing this open letter. To all of you who have sent me thank you cards, and thank you emails, and bottles of wine, and cookies or chocolates, and framed photographs of your pets, and other tokens of gratitude – to all of you I say a very sincere and heartfelt thank you. I am thanking you for thanking me. If this is socially inappropriate, so be it. It’s how I feel. <br /><br /> If you, the reader of this letter, have sent me one of those cards, you should know that I have kept it, no matter how long ago you sent it. I have kept all of them. I literally have a large drawer full of thank you cards. One day I will count them, but there are hundreds and hundreds. Sometimes when I’m feeling down about work, I’ll just pull that drawer open and look at them all stacked in there and I will feel better. Occasionally I’ll even pull an old one out and reread it, even though sometimes this will be bittersweet as you usually send me a thank you card after I have put your pet to sleep, although I know that you are not thanking me for that service specifically, but rather for the care throughout your pet’s life. But the sweet outweighs the bitter by far because time does heal many (although perhaps not all) wounds and as time goes on I will mostly smile at the memory of your pet and I will think about the relationship you and I have as people. As I have often said, veterinary medicine is not an animal business that happens to involve people, but rather it is a people business that happens to involve animals. And it is people like you who keep me in it. <br /><br /> Veterinarians are often sensitive people. It is a highly complex job, which means that things sometimes do not go as planned, so criticism, disappointment, annoyance and even anger from clients is inevitable. As sensitive people we take this to heart. We really take this deeply to heart, so a sharp word from an upset client can fester in our minds for a very long time afterwards. We should be able to just shrug it off, but it’s not easy. The only true antidotes are our own confidence that we’re doing the best we can, and the thank yous from clients like you that remind us that what we do is actually appreciated by so many people. If only the patients could express their gratitude as well it would be perfect, but until that magic Dr. Doolittle day, the fact that you did is good enough. <br /><br /> So, thank you for saying thank you. You have no idea how much it means to me. <br /><br /> Sincerely, <br /><br /> Dr Philipp Schott BSc DVM <br /><br /> <br /><br />p.s. Please do not feel badly if you’re reading this and are realizing that you have meant to send a thank you card, but never got around to it! Don’t worry! In no way do I expect to be thanked, nor do I notice when I haven’t been. And I totally get it! Even though I feel grateful for all sorts of professionals and other people who keep my life on track, I am terrible at remembering to thank them. Thanking really is such a tricky business. </div>
Philipp Schotthttp://www.blogger.com/profile/03308988842276050743noreply@blogger.com5tag:blogger.com,1999:blog-5207286810751186779.post-84705124574535309502019-12-12T08:40:00.001-08:002021-09-24T06:50:43.398-07:00Volume Two!<div dir="ltr" style="text-align: left;" trbidi="on">
I am delighted to announce that ECW Press in Toronto will be publishing my second collection of veterinary anecdotes, stories, and essays on September 28, 2021!<br />
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It is titled, "How to Examine a Wolverine"!<br />
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About a quarter of the stories will be drawn from the blog and the rest will be new!</div>
Philipp Schotthttp://www.blogger.com/profile/03308988842276050743noreply@blogger.com4tag:blogger.com,1999:blog-5207286810751186779.post-77753171586264600902019-11-14T06:36:00.001-08:002019-11-14T07:13:39.713-08:00It's The Dog, I Swear<div dir="ltr" style="text-align: left;" trbidi="on">
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<span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-US;">Ranger, an elderly black lab,
lay obediently on his right side on the ultrasound table while I performed the
abdominal scan. The room was quiet and dark but for a soft glow from the
ultrasound screen. Ranger’s owner was at his head end, stroking him, and a tech
was beside the owner, gently holding Ranger’s legs, although he was so calm
that it probably wasn’t necessary. Then it hit. A wave of intense odour
suddenly filled the room. It was incredibly pungent and impossible to ignore.
It was as if someone had, inexplicably it must be said, carefully inserted
something dead and rancid into each of my nostrils. <span style="mso-spacerun: yes;"> </span><o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-US;"><span style="mso-tab-count: 1;"> </span>“It’s the dog, I swear!” the owner said, laughing. Ranger
had, as the polite phrase puts it, “broken wind”. Had he ever. We all did loud
stage coughs and in the semi-dark I could see the tech waving a hand in front
of her face, trying to dispel the cloud. She was closest to the source. <o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-US;"><span style="mso-tab-count: 1;"> </span>Who among us dog people does not recognize this scenario?
Who has not hastened to point at the dog when heads turn and noses wrinkle? To
be fair, it often is the dog, as they are a farty bunch. In Ranger’s case we
had additional evidence as on ultrasound I could see a lot of gas in
his large intestine.<o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-US;"><span style="mso-tab-count: 1;"> </span>“Good news! There’s more to come!” I cheerfully announced
and pointed at the screen. Veterinarians and clinic staff are more or less
immune to bad smells and so, apparently, was Ranger’s owner, so it was safe for
me to be jovial about it. You do have to judge your audience carefully though.<o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-US;"><span style="mso-tab-count: 1;"> </span>But why? Why are dogs such a farty bunch? There are two
main reasons: gulping and fermenting. Let’s tackle fermenting first.<o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-US;"><span style="mso-tab-count: 1;"> </span>Fermentation is the process by which microorganisms in an
anaerobic environment (i.e. one with no oxygen) break down larger molecules
into smaller molecules, often releasing gas molecules in the process. When
bread rises or beer bubbles it’s because of the gas produced by the yeast
fermenting the grains. In the case of Ranger’s large intestine, it’s bacteria fermenting
food molecules that didn’t fully digest higher up in the small intestine. It’s
impossible to know specifically which food molecules, but, much like in humans,
peas, beans, dairy, complex carbohydrates and high fibre ingredients are at the
top of the list. The list is really long though, so if the gas is a problem,
the best first step is to switch to a new food that’s as different in its
ingredients as possible. And when I say “problem”, I don’t just mean from a
human olfactory comfort standpoint. I also mean from a canine abdominal comfort
standpoint. I routinely have patients referred to me for abdominal ultrasound
because of vague pain symptoms. Usually the referring doctor is trying to rule
out a tumour, but often I end up finding excessive gas. Pardon me for asking a
personal question, but have you ever had bad gas cramps? Gas is either
embarrassing or funny or both until you have gas cramps, then you no longer
care about the embarrassment and it sure is not funny anymore.<o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-US;"><span style="mso-tab-count: 1;"> </span>The second major source of gas is gulping and this, in
turn, happens for two different reasons. The first is that some dogs simply eat
too fast and swallow a lot of air in the process. Correction – most dogs simply
eat too fast. Humans are more likely to burp up swallowed air because of our
vertical anatomy, but in dogs it tends to cruise on into the digestive system
and pick up poopy odour molecules on its way to the rear exit. If you’re
concerned about this you can try a so-called “slow feed” bowl, which typically
will have a hump in the middle, forcing the dog to chase his food around the
resulting doughnut. I have also heard of people scattering kibble across a
cookie sheet to achieve a similar slow-down. The other reason for gulping is
anatomy. Dogs with squishy faces such as boxers, pugs, Boston terriers,
bulldogs etc. often have very narrow nasal passages, so they are forced to
mouth breathe and consequently can swallow a lot of air.<o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-US;"><span style="mso-tab-count: 1;"> </span>While fermenting and gulping account for most doggie
flatulence, gas can occasionally also be related to disease in the digestive
system, so please do mention it to your veterinarian, especially if there has
been a sudden increase in the amount of gas. <o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-US;"><span style="mso-tab-count: 1;"> </span>And what about cats? With the exception of cats who are
given too much milk, farting is pretty unusual in this species. Their diets
usually contain far fewer fermentable ingredients and although they can eat
quite quickly, they do not generally gulp with the same wild “eating like
nobody’s watching” abandon as the average food crazed dog. <o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-US;"><span style="mso-tab-count: 1;"> </span>Before we leave this fascinating subject, I’ll give you a
few nuggets of trivia for the next time conversation lags at a dinner party:<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpFirst" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-US; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-fareast-font-family: Calibri; mso-hansi-font-family: Calibri;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-US;">The scientific study of flatulence is
called flatology. This is pronounced with a long a, as in slate or fate. So now
you can add flatologist to the list of career ambitions for eight-year-old
boys.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-US; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-fareast-font-family: Calibri; mso-hansi-font-family: Calibri;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-US;">Dog farts objectively smell worse
because of their higher protein diets. Protein digestion can produce sulfur
containing amino acids that mix with the fermented gas to produce an especially
fetid smell.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpMiddle" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-US; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-fareast-font-family: Calibri; mso-hansi-font-family: Calibri;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-US;">In 2001 the Waltham Centre for Pet
Nutrition in England performed a study which involved fitting the subject dogs
with special fart suits allowing them to collect the gas and analyze the sulfur
content. I am 100% serious. Google “dog fart suit” if you don’t believe me.
There are pictures too.<o:p></o:p></span></div>
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<!--[if !supportLists]--><span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-US; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-fareast-font-family: Calibri; mso-hansi-font-family: Calibri;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-US;">The average human produces 476 to
1491 ml of fumes per day, divided over 8 to 20… er… events. As the dog fart
suit does not measure volumes, we sadly do not have this data for dogs, but, as
I have outlined, they are a farty bunch, so even accounting for smaller size, we
are talking about a lot of gas.<o:p></o:p></span></div>
<div class="MsoListParagraphCxSpLast" style="line-height: 200%; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<!--[if !supportLists]--><span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-US; mso-ascii-font-family: Calibri; mso-bidi-font-family: Calibri; mso-fareast-font-family: Calibri; mso-hansi-font-family: Calibri;"><span style="mso-list: Ignore;">-<span style="font: 7.0pt "Times New Roman";">
</span></span></span><!--[endif]--><span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-US;">Although the exceptions are
hilarious, most dog flatulence is silent. The reason for the difference with
humans is anatomical. In deference to my more sensitive readers I will not
expand on this. Yes, believe it or not, even I have my limits.<o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-US;"><span style="mso-tab-count: 1;"> </span>Ranger’s ultrasound was ultimately normal. He had no
tumours, or anything else of concern, and the amount of gas was not unexpected
for an old lab. He was just slowing down, which was also not unexpected for an
old lab.<o:p></o:p></span></div>
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Philipp Schotthttp://www.blogger.com/profile/03308988842276050743noreply@blogger.com2tag:blogger.com,1999:blog-5207286810751186779.post-63128540811035967882019-10-08T06:28:00.000-07:002019-10-08T06:28:44.986-07:00The Other Duck<div dir="ltr" style="text-align: left;" trbidi="on">
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<br />I have seen two ducks in my career and both ducks merit stories. That’s a story to patient ratio of 1:1, which puts ducks ahead of any other species I have seen more than once. That’s how cool ducks are. I suspect that goats would also generate a high story to patient ratio, but sadly, my career path has taken me well away from goats. More’s the pity. <br /><br /> The first duck was named Puddles, a white farm duck who waddled into the clinic (with his owner) for regular check-ups. His story was in my last collection and it remains one of the most popular. As I said, ducks are cool. This second duck was named Jake, and he was in many ways the opposite of Puddles. While Puddles was supremely relaxed in the clinic, Jake was terrified. While Puddles was surprisingly large, Jake was surprisingly small. And while Puddles was pure plain white, Jake’s feathers were all the shimmering dark green of a mallard’s head while his bill was jet black. Jake was an East Indies duck and he was stunning to behold. I had never seen such a beautiful duck. In fact, I had never imagined such a beautiful duck could exist. <br /><br /> Jake’s owner, Mr. Bolton, was a quiet, polite man about my age. He seemed every bit the average suburban dad, right from the way he dressed (t-shirt, jeans) to what he drove (minivan), until you found out that he had a duck fetish. And I mean fetish in a good way, not in some disturbing way. While other suburban dads tended to their lush backyard lawns or their patio barbecue set-ups, Mr. Bolton had apparently turned his entire backyard into an elaborate duck habitat. He showed me pictures. These ducks had it good. As Jake’s appearance suggested, these were not just any ducks, these were “fancy ducks”. And I mean “fancy” in the technical sense as opposed to just meaning deluxe or elegant. There is, apparently, a whole sub-culture of duck fanciers out there, as there are guinea pig fanciers, pigeon fanciers and goldfish fanciers, and they breed striking looking ducks to qualify as “fancy” in the duck show world. The East Indies duck turns out to have nothing to do with the actual geographic East Indies, but rather was just an exotic name dreamed up by a past duck fancier for his exotic looking creation. Mr. Bolton had several East Indies ducks and also a few Mandarin ducks – eye-catching purple, teal, orange and cream-coloured feathered confections. These seemed tastelessly garish though beside the posh East Indies ducks. <br /><br /> Mr. Bolton had brought Jake to me because the country vet he normally dealt with for his ducks was starting to come across as dismissive and unsympathetic. He apparently viewed Jake and his friends through the livestock lens rather than the pet lens and was not interested in spending the time required for the latter approach. I don’t recall who this vet was, and it’s entirely possible that Mr. Bolton’s assessment was unfair and that he was perhaps being overly sensitive to something the vet said, but regardless, Mr. Bolton wanted to try a pet vet. The fact that I had only seen one duck before didn’t faze him. <br /><br /> After the initial introductions and greetings, I asked Mr. Bolton what his concern with Jake was. Jake was an anxious duck, so he was in a crate on the floor beside his owner, only his dark green head and shining little black eyes visible. <br /><br /> “It’s his penis.” <br /><br /> It was becoming clearer why Mr. Bolton didn’t want to see the country vet about this. <br /><br /> “Oh? What’s wrong with it?” <br /><br /> “Jake’s a great breeder. Very enthusiastic. I think he injured it because it’s really swollen and won’t go back in.” <br /><br /> Sometimes my job is boring and routine, but often it isn’t, and when it isn’t it can take some truly odd turns. <br /><br /> “Ok, well, let’s have a look.” <br /><br /> Mr. Bolton crouched down, opened the crate and very gingerly lifted Jake out, all the while making soft cooing noises. Jake was even more spectacular up close and in person (in duck?) than I had anticipated from the photos. The way the light caught those gleaming emerald feathers was breath-taking, especially contrasted with his jet-black bill, eyes and feet. Those were not the only black parts. His penis was black too and it was hanging down, like a sad little sausage. Normally their penises are corkscrew shaped (no, I’m not making this up), but the swelling had eliminated the twists. <br /><br /> “Oh my,” was the best I could muster. I got a light and a magnifier and had a closer look. Jake was very quiet and didn’t struggle, but he was also very tense. Not surprising I suppose. A swollen black duck penis is probably gross enough for most readers, so I won’t describe it in more detail, but suffice it to say that based on careful inspection of said swollen black duck penis I concluded that poor Jake was suffering from balanitis, which is infection of the penis. “I think it’s infected,” I told Mr. Bolton, “but honestly I don’t know much about this, so let me double check the literature before we decide on a plan.” <br /><br /> I excused myself from the exam room and went into the office where I logged on to the Veterinary Information Network, a subscription service that has a massive database of opinion, data and case reports on every conceivable veterinary scenario. I typed “duck balanitis” into the search bar. Zero hits. Apparently, this was not a conceivable veterinary scenario. I then went to Google. This was a bad idea. I’m so naïve. In any case, I do not recommend you use it for any even vaguely penis related searches. So, I resorted to a more fundamental veterinary tool – extrapolation. If this were a dog, I would use antibiotics and anti-inflammatories and advise the owner on regular gentle cleaning at home. I thought there might be a wacky duck specific angle to consider, but if there was, I had no way of knowing. <br /><br /> A week later Mr. Bolton phoned to let me know that the penis was still enlarged and protruding, but perhaps less so, and Jake seemed happier. I asked him to call again in another week as at that point the meds would be finished. He did, and the report was the same – some improvement, but not cured. I decided to try a different antibiotic and I re-crossed my fingers. To move rapidly to the end of a prolonged and somewhat dull medical story, we went through several rounds of this and the answer was always the same. Eventually Mr. Bolton and I agreed that management of Jake’s balanitis was the best we could hope for. A cure seemed out of reach. Evidently there was some unknowable wacky duck specific angle at play after all. The ultimate solution would have been a phallectomy. I’ll let you work out for yourself what that means. Nobody, including Jake one presumes, thought that that was a good idea. He could no longer be Jake the Drake, stud duck extraordinaire, but he was reasonably happy for the rest of his days. Sometimes reasonably happy is the best we can hope for. Actually, it is often the best we can hope for. <br /><br /> </div>
Philipp Schotthttp://www.blogger.com/profile/03308988842276050743noreply@blogger.com2tag:blogger.com,1999:blog-5207286810751186779.post-34136649538461089352019-09-16T07:05:00.000-07:002019-09-16T07:05:55.980-07:00George<div dir="ltr" style="text-align: left;" trbidi="on">
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<div class="MsoNormal" style="line-height: 200%;">
<span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-US;">Another big orange cat. But this time not quite as big and this time a tabby, not a lion. George was one of my favourite
patients and Mrs. Mackintosh was one of my favourite clients. This was many
years ago, not long after I started in practice, and Mrs. Mackintosh was one of
the first clients who began asking to see me specifically. My one boss had been
there for over thirty years and his clientele was extremely loyal. My other
boss was the first fulltime female veterinarian in the practice and she had
rapidly built a following based on her more modern approach, and based on the fact that
some animals are less fearful around a gentle woman than a boisterous man. Not
that all women are gentle or that all men are boisterous, but that was the
situation then at Birchwood. In any case, even though I was kept busy, it was not
easy to attract regular clients and I was immensely pleased by the vote of
confidence that Mrs. Mackintosh gave me.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-US;"><span style="mso-tab-count: 1;"> </span>Mrs. Mackintosh was an elderly lady with a soft Scottish
accent and a seemingly limitless supply of cat themed sweaters. I suspected
that she had been a war bride, but in those days, I felt compelled to employ a
rather narrowly defined version of professionalism and it didn’t occur to me to
ask any personal questions. George was a young male orange tabby. Mrs.
Mackintosh explained that he had been named George after her father. Give her
age, I reasoned that George Mackintosh Senior must have been born in the 19<sup>th</sup>
century back in Scotland. I smiled at the thought of how he would have reacted
to know that a cat in Canada a hundred years later would be named after him. <o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-US;"><span style="mso-tab-count: 1;"> </span>Orange tabbies tend to be big and they tend to be
friendly. George was both, in spades. He was an enormous teddy-bear of love.
Examining him was a challenge because he constantly wanted to head-butt my hand or rub against my arm, and he purred so loudly I swear the table shook
from it. I loved this cat. He was perhaps the first patient I really bonded
with. Consequently, it was with special concern that I listened to Mrs.
Mackintosh describe his symptoms to me on the phone one grey November day.<o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-US;"><span style="mso-tab-count: 1;"> </span>“The wee fellow hasn’t eaten a thing in two days! Not
even his favourite – tuna from the can.”<o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-US;"><span style="mso-tab-count: 1;"> </span>George was hardly a ‘wee fellow’, but I let that slide as
the tone of her voice was very serious and concerned.<o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-US;"><span style="mso-tab-count: 1;"> </span>“How is his drinking and urination?”<o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-US;"><span style="mso-tab-count: 1;"> </span>“Terrible doctor. He’s not doing any of either.”<o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-US;"><span style="mso-tab-count: 1;"> </span>“And this started suddenly two days ago? Or had you
noticed any changes before?’<o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-US;"><span style="mso-tab-count: 1;"> </span>“No, very sudden. What shall I do doctor?”<o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-US;"><span style="mso-tab-count: 1;"> </span>“Please bring George this afternoon if you are able.
We’ll probably need to run some tests. I’ll transfer you to the front desk to
set up a specific time.”<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-US;"><span style="mso-tab-count: 1;"> </span>“Yes, I’ll come as soon as they let me.”<o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-US;"><span style="mso-tab-count: 1;"> </span>George still purred, but he did not have the energy to
head-butt or rub up against my arm. He was dehydrated and his breath was very
foul. It smelled like a nasty men's urinal. I had a sinking feeling.<o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-US;"><span style="mso-tab-count: 1;"> </span>“Ok, we’re going to run some blood. I’m worried about his
kidneys. We’ll hook him up on intravenous fluids while we wait for the
results.”<o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-US;"><span style="mso-tab-count: 1;"> </span>“Please do whatever you need to do doctor.”<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-US;"><span style="mso-tab-count: 1;"> </span>The test results confirmed my suspicion. His kidneys were
in appalling condition. He had something called anuric acute renal failure.
This means that his kidneys had suddenly shut down and had done so so severely
that they no longer were able to make urine at all. This might not surprise
some readers as people often assume that a lack of urine production is a common
sign of kidney failure, but in fact, it is almost always the opposite. Usually, as kidneys fail, they actually produce more urine because their ability to
concentrate the urine and conserve water for the body is impaired. It is only
in the very last stage that they stop making urine. Why this would happen to
George, who was only five years old, baffled me. I explained this to Mrs.
Mackintosh.<o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-US;"><span style="mso-tab-count: 1;"> </span>“Is there anything we can do for him? Is there anything
at all?” She was a tough lady, but her eyes were red, and her voice was
quavering.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-US;"><span style="mso-tab-count: 1;"> </span>“Yes, let’s keep him on the IV for 48 hours and see if we
can kick start the kidneys. And let’s do a few more tests and try to find the
cause.”<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-US;"><span style="mso-tab-count: 1;"> </span>I don’t know how good she was at picking up on body
language, but I know that I did not really believe what I just said. I could
not face telling her the truth that there was no hope and that finding the
cause would not actually be helpful. George needed a kidney transplant, and
that was just not possible. Certainly not in Winnipeg in the early 1990s. After
saying this I talked myself into thinking that maybe there was just the
slenderest hope of recovery. Maybe the tests had been wrong.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-US;"><span style="mso-tab-count: 1;"> </span>The tests were not wrong. George stayed in hospital on
aggressive IV for the two days. He purred whenever Mrs. Mackintosh visited him
and whenever I handled him for examination or treatment, but he looked so sad
otherwise. This was not the George we knew and he was becoming less so by the
hour. By the second day, I had my answer. He had been poisoned by anti-freeze.
Often, we can see the characteristic crystals anti-freeze produces on the urine
test, but for some reason these were absent in the particular sample or had
been missed. Instead we saw on x-ray that his kidneys had essentially turned to
solid stone. There was truly no hope and he was suffering. He died peacefully
in Mrs. Mackintosh’s arms as I infused an overdose of barbiturate into the IV
line. We both cried.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-US;"><span style="mso-tab-count: 1;"> </span>We never did find out whether the poisoning was
deliberate or accidental. George did like to roam to the neighbours, but
everybody loved him. Mrs. Mackintosh preferred to assume that it was
accidental. Anti-freeze is sweet and is irresistible to cats and dogs.<o:p></o:p></span></div>
<div class="MsoNormal" style="line-height: 200%;">
<span lang="EN-US" style="font-size: 12.0pt; line-height: 200%; mso-ansi-language: EN-US;"><span style="mso-tab-count: 1;"> </span>Two weeks later Mrs. Mackintosh was back in the clinic.
She had a kitten with her. It was an orange one again, but this time a female.
She called it Anne, after her mother.<o:p></o:p></span></div>
<br /></div>
Philipp Schotthttp://www.blogger.com/profile/03308988842276050743noreply@blogger.com3tag:blogger.com,1999:blog-5207286810751186779.post-78784578581868422282019-07-22T08:10:00.000-07:002019-09-16T06:40:22.020-07:00Benji<div dir="ltr" style="text-align: left;" trbidi="on">
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhfxmUFcZ7Xy_hsNqjUvhiSKutB6zlU6MGgGdqCJ4wYSqiNtuU94K5bSgP7EVdAg25sRn0R-iOJ-3Gg5KJNvEXN-r-nfoEvRd7IxK02YGEtUnDva3NGQ6uiOtwr9lipeXtOpAYDedZ-iGXl/s1600/Al%252C+Benji.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1200" data-original-width="1600" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhfxmUFcZ7Xy_hsNqjUvhiSKutB6zlU6MGgGdqCJ4wYSqiNtuU94K5bSgP7EVdAg25sRn0R-iOJ-3Gg5KJNvEXN-r-nfoEvRd7IxK02YGEtUnDva3NGQ6uiOtwr9lipeXtOpAYDedZ-iGXl/s320/Al%252C+Benji.jpg" width="320" /></a></div>
<div style="text-align: center;">
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<br />
This is Benji's story. Benji was arguably the most unusual patient ever to come to Birchwood - more unusual than the giant Burmese pythons and more unusual than the deadly poisonous fish. This kind of ranking is very subjective of course, but in my opinion, Benji comes out on top. Benji was an African lion. He was a cub mind you, but an African lion nonetheless.<br />
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Benji came to Birchwood well before my time, so it is not technically "my story", but it's the clinic's story and it's my clinic, so I'm going to claim it as part of my series of posts about the history of Birchwood Animal Hospital. </div>
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<div>
Dr. Al Clark doesn't remember exactly when this happened, but the mid 1960s is likely. One morning he got a call from the Hudson's Bay Company downtown. It seems that Sunbeam, the makers of small kitchen appliances, thought that having a live lion cub in their display would make for a nifty promotion. It was the mid '60s, so people did stuff like that. And they used words like "nifty". This three-month-old cub was in a small cage beside the stand mixers and blenders. His name was Benji and he was extremely cute. Whether this helped sales or not is unknown, but it certainly attracted attention. The Bay was on the phone because Benji had become ill. Could Dr. Clark help them out? It was basically just a big house cat wasn't it? Same diseases and disorders?</div>
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Al immediately did two things. The first thing was that he told them to bring Benji right down. The second thing was that he found the phone number for the top Sunbeam executive in Toronto and gave him heck for subjecting a lion cub to that kind of stress and absurdly inadequate housing. Once Benji arrived at the hospital Al declared that he would have to stay and would not be sent back to sell toasters and electric can openers. Benji was basically depressed and poorly cared for and had picked up a secondary opportunistic infection. Chastened, there was no argument from Sunbeam or the Bay. </div>
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The nurses then set about pampering Benji back to robust health. Initially, they went down to the Dairy Queen at Ronald and Portage every day and brought back hamburgers for him. Then it occurred to someone to phone the zoo and ask for advice. With his diet improved and with all the medicine and care, Benji was soon on his way to a full recovery. Once he was well enough to leave the hospital, Al would take him home sometimes and the neighbourhood kids would play with him in the yard. Can you imagine? Your neighbour is a vet and brings home a lion cub and lets you play with it? Different times... </div>
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After a couple of months Benji had grown from cocker spaniel size to small Labrador size and was becoming "a little nippy". Clearly, a long-term plan was needed. This had been on Al's mind for a while and he had made inquiries. The best solution seemed to be the Okanagan Game Farm, a sprawling exotic wild animal park near Penticton, where there were other lions and there was lots of space for Benji. It was tearful day for everyone when he was loaded into the back of a staff member's car and they headed west down Portage Avenue.</div>
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Several years later another staff member was on vacation in the Okanagan and decided on a whim to try and visit Benji. She walked up to the fence and peered out across the fields and clumps of trees. There were no animals in view. In the heat of the day the lions were probably in the shade somewhere. So she called out, "Benji! Benji!" and wouldn't you know it, but a beautiful fully grown male lion came bounding up out of the distance and put his paws up on the fence. It was Benji. </div>
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Philipp Schotthttp://www.blogger.com/profile/03308988842276050743noreply@blogger.com0tag:blogger.com,1999:blog-5207286810751186779.post-52998695823988374362019-07-17T08:31:00.001-07:002019-07-17T08:31:35.299-07:00The Birchwood Story (Part 1)<div dir="ltr" style="text-align: left;" trbidi="on">
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgcnOUBLW8TFGTsyfrOXtW3QWNTDFK5s94DVUz62tufrCDEIhAzz1kGMZAxHf2ZlhklTO61dVxjZmhSG6zkOXY50DMx-R3YRTxZ2Y2G9DCbNETs9IidJTMMGo7Hzck3ILHv_DxoGHcGsB4D/s1600/Birchwood+1959b.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1199" data-original-width="1600" height="239" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgcnOUBLW8TFGTsyfrOXtW3QWNTDFK5s94DVUz62tufrCDEIhAzz1kGMZAxHf2ZlhklTO61dVxjZmhSG6zkOXY50DMx-R3YRTxZ2Y2G9DCbNETs9IidJTMMGo7Hzck3ILHv_DxoGHcGsB4D/s320/Birchwood+1959b.jpg" width="320" /></a></div>
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I apologize that this subject is not a perfect fit for this blog. The number of people interested in the history of a specific veterinary clinic in Winnipeg is probably quite low, lower even than the number of people interested in reading why urine is yellow or how you give a pill to an ostrich. However, it is certainly a better fit for this blog than it is for my whisky or travel blogs, so here it goes!<br />
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His friends call him Al and his former clients know him as Dr. Clark, but when in 1939 at the age of 12, he decided that he was definitely going to become a veterinarian, he was Elmer. Elmer grew up on his parent's dairy farm near Hartney, in the far southwest corner of Manitoba. He was surrounded by animals from the very beginning. The farm not only had a herd of milking Holsteins, but his dad, who had flown Sopwith-Camel biplanes in World War One, also had a large team of award-winning Clydesdale draft horses. The family's border collie, Major, also made a big impression on the future veterinarian. Elmer loved to follow his dad out to help milk the cows at 4:30 in the morning. At the time they had 41 cows, of which 29 were milkers. Major would zip off into the pre-dawn dark and return a short time later with exactly those 29 milkers, not one more, not one less, leaving the other 12 on the pasture.<br />
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The local country vet, Dr Houck, let Elmer ride with him on his calls, sometimes in his truck and sometimes even in his horse-drawn buggy. If you've read or watched James Herriot's<i> All Creatures Great and Small</i>, you'll have a good mental image of what these farm calls were like because this is the same era and the same type of practice. These experiences confirmed Elmer's choice of future career, so in 1946 he applied to the Ontario Veterinary College (OVC) in Guelph, which at the time was Canada's only veterinary college. He didn't get in then, so he began to study Agriculture at the University of Manitoba instead. Dr Houck, who had in the meantime become the provincial veterinarian for the Province of Manitoba, was convinced of his potential, so he arranged a special bursary whereby Elmer would have a spot assured at OVC, paid for by the government, in exchange for a commitment to spend a minimum of five years in practice in rural Manitoba. There was a great shortage of large animal vets then, much as there is now, 70+ years later! He started at OVC in 1947. Because of his year in Agriculture he was able to graduate with his Doctor of Veterinary Medicine just four years later, in 1951.<br />
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Now officially "Dr. Clark", he set up practice in Morden, Manitoba, where there hadn't been a vet for a number of years. His nearest colleague was Dr. Ken Warren in Killarney, 85 miles to the west. For a big chunk of south-central Manitoba, the newly graduated Dr. Clark was "it", 24 hours a day, seven days a week, 52 weeks a year, for every living creature from litters of barn kittens all the way up to expensive prize bulls. He loved the challenge and the variety and the people, but he knew that the pace was going to burn him out, or even kill him. Moreover, he was newly married and his wife, a city girl from Guelph, was increasingly showing the strain of living in a small town with a perpetually absent husband. So in 1958, Dr. Clark bought a piece of undeveloped land on what was then the western edge of Winnipeg and he made a trip to Ontario to visit his old OVC classmates, Drs. Blake Graham and Dick Ketchall, who had recently opened Amherst Veterinary Hospital in Scarborough. <br />
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Dr. Clark came back from Scarborough with a set of blueprints rolled up under his arm - Blake and Dick had given him the plans for Amherst for free. His next stop was to visit Dr. Bill Jones at Pembina Veterinary Hospital, the closest of the two existing small animal practices in the city (the other was Anderson Animal Hospital In St. Boniface, owned by Dr. Norm Anderson). He went, in his words, "cap in hand" to let Dr. Jones know of his plans to open a new veterinary clinic. That's a level of professional courtesy that has sadly faded into history! Birchwood was then built, more or less as a clone of Amherst, through the cold hard winter of 1958/59 by Malcolm Construction, with Jack Ross as the local architect. In the meantime, Dr. Clark acquired a partner.<br />
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Dr. Frank Gulyas was a refugee from the failed 1956 Hungarian Revolution. He was in practice in Carmen during the last two years Dr. Clark was in Morden. They would sometimes meet halfway to chat. As the development of Birchwood was ramping up, Dr. Gulyas approached Dr. Clark with a proposal. His wife, having come from high society in Budapest, was having an even harder time than Marjorie Clark with prairie small-town life. Could they be partners at Birchwood? Splitting the costs and the risk seemed like a good move, so Dr. Clark readily agreed. Gulyas changed his name to Grant (this was an era when "foreign" names could cause problems) and on July 11, 1959, Dr. Clark and Dr. Grant opened the doors of Birchwood Animal Hospital for the first time. They saw 7 patients that day, which they thought was a pretty good start.<br />
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Providing a living for two families from a newly opened small animal clinic was not realistic though, so Dr. Grant continued to do some shifts in Carmen. An opportunity to earn some extra income soon fell in Dr. Clark's lap too. Dr. Anderson had also been doing post-race testing for the horses at the race track, but his son was a jockey, so the commission decided that this was a conflict of interest and approached Dr. Clark to take it over. He had loved horses ever since being around his dad's Clydesdales, so this was perfect. From this, he also developed a small hobby horse practice on the side at Westgate, with, among others, the wealthy Richardsons as clients.<br />
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But then in 1960, the massive Westwood suburban development was announced. Within a couple years Birchwood was booming as new families and their pets flooded into the area.<br />
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Dr. Frank Grant left for Vancouver in 1965 as Winnipeg was not big enough for his wife either.<br />
Dr. Al Clark continued to work full-time at Birchwood until 1995. As of this writing, at the age of 91 (92 next week!), he is still full of energy and full of stories and full of passion for veterinary medicine.<br />
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Philipp Schotthttp://www.blogger.com/profile/03308988842276050743noreply@blogger.com5tag:blogger.com,1999:blog-5207286810751186779.post-57790055921368993472019-06-06T12:51:00.001-07:002019-06-06T12:51:34.101-07:00There Are Worms In My Heart<div dir="ltr" style="text-align: left;" trbidi="on">
An old but timely post:<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEigRiGYi4sb5EvOe10eFGmMWiTx6xcXj9wzQdmxA-q1ocGy6JlqxAnBQNzpCUM5K9u8TZQ09CCS79D0En3troztzGpMt7Wl5_-wc3rKopklA0NGKqJcgpi59oXdhNgkz1HwYPazggI__m8G/s1600/no-heartworm.gif" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="244" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEigRiGYi4sb5EvOe10eFGmMWiTx6xcXj9wzQdmxA-q1ocGy6JlqxAnBQNzpCUM5K9u8TZQ09CCS79D0En3troztzGpMt7Wl5_-wc3rKopklA0NGKqJcgpi59oXdhNgkz1HwYPazggI__m8G/s320/no-heartworm.gif" width="320" /></a><br />
Ok, not technically right in the heart itself, but more on that later. And not technically <i>my</i> heart, at least probably not, but more on that later too.<br />
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It is "Heartworm Season" in Manitoba. Yes, it is. If you work in a veterinary clinic it is unmissable, unmistakable, unforgettable. It's not that our wards are packed full of dogs sick with heartworm disease, rather it's that the testing for and prevention of has to occur in a fairly narrow calendar window. Compounding this, for most people, it's convenient to get all the other annual stuff done at the same time since they've dragged Fido in anyway (incidentally, no actual dogs are named Fido, or Rover, or Rex, or Spot; some cats are though). Consequently, most of us see as many patients in a week in the spring as during a month in the winter.<br />
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I don't want to waste time spewing Basic Heartworm Facts. You can get those from, gulp, the internet (try <a href="http://www.veterinarypartner.com/">www.veterinarypartner.com</a>) or, better still, from your friendly neighbourhood veterinarian. Some of you even are "your friendly neighbourhood veterinarian", in which case said spewing would be even more time wasting. Instead, I want to touch on a few of the more unusual Cool Heartworm Facts (ok, some of you will consider these Gross Heartworm Facts, but I think they're cool).<br />
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<i>Cool Heartworm Fact #1</i><br />
Heartworm has probably been around forever (or a very long time that may as well be forever) with possible reports in the 1500s. It was first positively identified as such in 1847 in South America and then 1856 in the southeast USA. It has gradually been spreading north and west since, arriving in Manitoba in the 1980s.<br />
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<span style="font-style: italic;">Cool Heartworm Fact #2</span><br />
However, despite that spread, large areas such as Saskatchewan, the Arctic and the West Coast do not have it. Not necessarily because of a lack of mosquitoes, but because of a lack of positive dogs already there. Mosquitoes are just flying syringes moving heartworm from one dog to another. This is why the mosquito paradise of northern Manitoba is heartworm free.<br />
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<i>Cool Heartworm Fact #3</i><br />
Heartworms can be huge, up to 35 cm / 14 inches. And they can be numerous, with infestations of over 100 worms reported.<br />
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<i>Cool Heartworm Fact #4</i><br />
The above-reported size and numbers are very rare, so most of the time "heartworm" is a misnomer. Most of the time the worms are hanging out in the pulmonary arteries leading away from the heart. Only if there are more than about 25 do they actually back up into the heart. But pulmonaryarteryworm is so much more unwieldy. Unless you are German like me, in which case you prefer more accurate but long and unwieldy words.<br />
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<i>Cool Heartworm Fact #5</i><br />
Wildlife can get heartworm. Logically foxes, coyotes, and wolves are most at risk, but it has also been reported in bears, raccoons, leopards, sea lions and, oddly enough, beavers. Cats and ferrets are at some potential risk as well depending on where you live, but that is a big subject best addressed separately.<br />
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<i>Cool Heartworm Fact #6</i><br />
Perhaps the coolest fact. Humans can also get heartworm. Heartworm positive mosquitoes bite us all the time and release microfilaria (baby heartworms) into our bloodstream all the time, but fortunately, we are not good hosts so 99.9% (and probably a few more 9s after that) of the time they die. However, there have been at least 80 cases reported in humans in the US, mostly in the lungs but occasionally - <i>shield your eyes if you are squeamish</i> - the eyes and the testicles (!). These have mostly been mild infections. The main problem is that on lung x-rays a heartworm lesion looks very much like a tumour, prompting further invasive tests. Radiologists call it a "coin lesion". So if you overhear the interns whispering about this while they shoot sideways glances at you, ask about heartworm...<br />
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Philipp Schotthttp://www.blogger.com/profile/03308988842276050743noreply@blogger.com0tag:blogger.com,1999:blog-5207286810751186779.post-58751787878372203482019-05-27T08:54:00.000-07:002019-05-27T08:54:11.078-07:00Blog Update<div dir="ltr" style="text-align: left;" trbidi="on">
The two or three of you who regularly read this blog may be wondering what is happening. The last few years I have posted more or less regularly every two weeks, but now it's been over a month! Have I run out of things to say? Have I retired? Has the success of the book killed the blog? No, no and no.<div>
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I have plenty more things to say, I am far from retired and the book, while successful, will probably serve to drive more readers to the blog (four or five, instead of two or three! ;-) ) rather than kill it. But, all that said, launching the book and the associated media work is taking some time, plus it's the busy season at work and, most critically, I would like to focus on a few other writing projects right now, so Vetography is going to go into light hibernation for a short while. </div>
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So, much like a bear or a raccoon who snoozes through most of the winter, but still wakes up at random intervals to sniff the air and feed, Vetography will still wake up from time to time to share a brief post or perhaps re-post an old essay that seems relevant. Although this will be for the summer rather than the winter, and posting to a blog is not at all like feeding. Come to think of it, it's really a pretty shaky metaphor. I apologize.</div>
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Thank you for being one of those two or three and, as the saying goes, watch this space!</div>
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Philipp Schotthttp://www.blogger.com/profile/03308988842276050743noreply@blogger.com1tag:blogger.com,1999:blog-5207286810751186779.post-22984176041125742202019-04-22T08:44:00.001-07:002019-04-22T08:44:52.911-07:00Launching "The Accidental Veterinarian"<div dir="ltr" style="text-align: left;" trbidi="on">
For those of you who are unaware, parts of this blog have been turned into a book that is being published by ECW Press in Toronto. The official launch is at McNally Robinson this Thursday evening (April 25) at 7:30 pm, and everyone is invited! RSVPs to caroline@ecwpress.com are preferred but not required.<br />
After that, the book will be available at McNally, Chapters, on Amazon and at independent booksellers throughout North America (and, curiously, Poland, Russia, and Hungary as translations have been sold there). <br />
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Philipp Schotthttp://www.blogger.com/profile/03308988842276050743noreply@blogger.com5tag:blogger.com,1999:blog-5207286810751186779.post-13715549471711026532019-04-04T11:11:00.002-07:002019-04-04T11:11:41.736-07:00Vets Abroad<div dir="ltr" style="text-align: left;" trbidi="on">
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We've just returned from vacation overseas and although we saw loads of animals (mostly sheep if you're interested in trying to guess where we were), happily none of them were visibly ill or injured so we were able to comprehensively disengage our veterinary brains. That is not always the case. Over the years in various countries Lorraine and I have tried to help goats with infected udders and cats who were bleeding internally. However, the most memorable vet abroad episode occurred twenty years ago in the Philippines when Leeann insisted we spay her dogs on her kitchen table. Let me explain.<br />
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Lorraine and I had found our way to a little island called Malapacao, off Palawan in the southwest corner of the Philippines. This was a tropical paradise straight from the tourist posters and, in fact, the view from our beach was used as the cover photo of the Lonely Planet guide to the Philippines. Yet it was very quiet there as it was hard to get to and there was only one place to stay, a resort consisting of a cluster of thatched huts run by an older Australian woman named Leeann. A polite one-word description for Leeann would be "eccentric". To begin with, she regularly practiced naked yoga on the beach near our hut. This is not nearly as cool as it sounds, and it probably doesn't sound all that cool. Also, she had strict no alcohol and no smoking policies. The latter wasn't a problem for us or for the only other guests, John and Jesse, a gay couple from New York City (fun guys - one a Pulitzer Prize-winning journalist and the other a fashion show producer), but it was a problem for a number of people who attempted to come and were consequently turned away. In fact, we got really good at spotting them as their boats approached the beach. Middle-aged dude in a speedo with a paunch: probably a smoker. Cool. We liked this because Leeann let us have the "premium" huts at the regular price so long as nobody else came who wanted them.<br />
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The no alcohol was an issue though. Leeann would make her "Malapacao Special" virgin punch for us every evening before the group dinner, but it so desperately needed a kick. We quickly found a workaround though. Malapacao is a saddle-shaped island with dramatic limestone cliffs to the east and west, Leeann's postcard beach to the north and then, over the jungle-clad saddle, a little Filipino fishing village to the south, only a 15 minute walk away. One of us would sneak over with John or Jesse and buy a small bottle of the local hooch, small enough to slip into a pocket in our shorts, so we could quickly spike the drinks while Leeann rambled on about chakras and cosmic vibrations and whatever. Dinner was a lot more fun this way.<br />
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This is where we begin to approach the veterinary portion of the story for you patient readers because the same village supplied not only liquor, but also randy male dogs (so drugs and sex, only the rock and roll was missing).<br />
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Leeann had two lovely female dogs. They were the classic "beach dogs" one sees the world over - lean, lanky, short fur, curled tails, a bit wary, but ultimately super pleased to receive kind human attention. And they were not spayed. There were no veterinary services anywhere nearby. As soon as Leeann found out that we were veterinarians her already unnaturally lit eyes became even brighter.<br />
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"You can spay the girls for me!"<br />
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I laughed and took another sip from my drink.<br />
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"No, really, I mean it! What do you need?"<br />
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"No Leeann, it's just not possible. A spay involves abdominal surgery so we need general anesthetic and sterile conditions, as well as all the surgical tools etc."<br />
I was going to change the conversation, but Leeann persisted.<br />
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"No problem. I have connections on the main island. It's the Philippines. I can get anything you need. Anything. Just give me the list." She pulled out a pad of paper and a pencil and looked at me eagerly.<br />
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"Ha, no! Really, we use gas anesthetic which involves complicated equipment although..." I began to waver a little, "... I suppose injectable anesthetic might be possible..."<br />
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Lorraine shook her head vigorously no. I looked at the two dogs and their giant nipples and deep-chested shape and considered that these would be tough spays at home even. I know that some of my colleagues are guffawing now (I'm looking at you, Colleen and Jonas) as you have probably done spays in Mexico using a Swiss Army knife, a headlamp and some dodgy expired ketamine for anesthesia, but Lorraine and I were (are) spoiled and soft. There was no way we were going to do this.<br />
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"But it's just so risky Leeann. You love these girls. You don't want to take that chance. In addition to the considerable anesthetic risks, there's the fact that we can't sterilize the equipment or create clean enough conditions here."<br />
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At this point Lucas, the cook, flashed one of his enormous smiles and chimed in, "No problem! I clean the kitchen table very well Mr. Philipp!" He made a vigorous wiping motion with his right hand.<br />
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The argument went back and forth for a while, but we were determined not to attempt a tropical kitchen spay. We felt bad though, so when we returned to Canada I bought a large tub of a medication that can work as an oral contraceptive in dogs and shipped it to her. I never heard back. To this day, twenty years later, I still sometimes wonder whether we could have pulled off those kitchen spays after all.<br />
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Incidentally, I just Googled Malacapao and Leeann is still there and is still as eccentric as ever.<br />
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Philipp Schotthttp://www.blogger.com/profile/03308988842276050743noreply@blogger.com0tag:blogger.com,1999:blog-5207286810751186779.post-3221373842644284082019-03-09T06:02:00.000-08:002019-03-09T08:06:13.011-08:00The 80%<div dir="ltr" style="text-align: left;" trbidi="on">
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Yesterday was International Women's Day, so I thought I'd take a moment to point out a fact that you might not have noticed or considered: no other profession has experienced as great a shift in gender balance as veterinary medicine.<br />
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In 1970 barely 10% of veterinary school students were female, now over 80% are. And the trendline is continuing upwards. In some schools, it's 90%. In contrast, medical school is still 50% male, as is law school, and dental school is 62% male. The 50:50 crossover point for veterinary medicine occurred in the mid-1980s. My own school, the Western College of Veterinary Medicine in Saskatoon, was ahead of the curve as my first year class in 1986 was already about 70% women.<br />
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In 1970, a tiny number of practicing veterinarians in Canada were women, now 60% are. These women are on average 10 years younger than their male colleagues, so this number will steadily rise as the men retire and are replaced by the 80% of graduates who are female. In the span of a half century the profession has gone from being overwhelmingly male to being overwhelming female.<br />
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Why is this? Part of the answer lies in the changing nature of the work. Over the same time period as the gender shift, the profession experienced a parallel shift from rural and farm animal oriented to urban and companion animal oriented. The fact that women continue to bear the primary responsibility for childcare in many families makes the more regular and predictable hours of the latter much more accessible and attractive. Farm practice can be 24 hours a day, 7 days a week at times, with hours and hours on the road away from home. But that factor alone should have only lifted barriers and given more equal opportunity to women, not pushed them to a predominant position. Why have they shot past the 50:50 equilibrium one might otherwise predict?<br />
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It's complicated. One factor is that competition to get a spot in veterinary school is ferocious, more ferocious than for any other profession, and young women are increasingly in a better position to win that competition. Women now dominate in academics, often occupying the top rungs in the lists of the best students in any given class. The reason for this is beyond the scope of this post, but just Google the subject and you'll see that the falling academic performance of young men is the cause of much hand-wringing.<br />
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Another factor is that veterinary medicine pays less well and is perhaps less prestigious than many of the other professions. This is a terrible statement about the state of gender relations in our society, but women historically have accepted lower pay and men historically have been encouraged to seek prestige. These things are changing, but some ingrained cultural norms will take a long time to truly fade away.<br />
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And finally, veterinary medicine requires more empathy than any other profession. If you are reading this blog then you already know why this is true. Again, this is likely more a statement about our culture than anything else as I don't think I am any less empathetic than my female colleagues, but perhaps I am less concerned about those subtle cultural signals. This is not to absolutely deny the influence of biology. In a survey of very anxious dogs, 7 out of 10 preferred a female veterinarian. Something about men's deeper voices and harder features freaks them out. (I'm joking, of course. To the researcher's endless frustration the dogs were unable or unwilling to answer the questions. But the observation is generally true.)<br />
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None of this is black and white, all of this is just tendencies and trends. But look where those tendencies and trends have brought us. When I think back to when I graduated in 1990, it's astonishing how things have changed. Even though I looked like I was 12 years old, I was male and I was immediately assumed to be the doctor, whereas many of my female classmates struggled for years with reactions along the lines of, "When is the real doctor coming in?"<br />
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Veterinary medicine has changed and it is thriving like never before. I'll let you draw your own conclusions.<br />
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Philipp Schotthttp://www.blogger.com/profile/03308988842276050743noreply@blogger.com0tag:blogger.com,1999:blog-5207286810751186779.post-4404052026451551952019-02-21T08:05:00.001-08:002019-04-04T12:31:39.032-07:00Caturday<div dir="ltr" style="text-align: left;" trbidi="on">
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The downside of the whole nine lives situation with cats is that when they have run through all nine and have come to the natural end of their lives and no longer find any pleasure in their daily routine they tend not to just pass away peacefully in their sleep. They tend to need to come into the clinic to be given that final gentle nudge into the great beyond. Cats are that tough. Consequently, we see a lot of really ancient, really skinny, really creaky cats come in for euthanasia. Often they are accompanied by entire families, sometimes including older teenagers who have never known life without that cat.<br />
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It's been a long time since I've had to say goodbye to my own cat, but after the last old cat euthanasia at the clinic - an 18-year-old torti named Kitten - it's been on my mind. Kitten reminded me a lot of our oldest cat, Lucy, also a torti. I recalled that Caturday would soon be upon us. Lucy was a stray and we have no idea when exactly she was born, so making an educated guess we assigned her birthday to the first of March. Gabi, the second oldest cat, has her birthday in September (we think...), but the newest beast, Lily was probably also born in early March. It was then that we decided to make the first Saturday in March "Caturday" to mark both Lucy and Lily's birthday. This Caturday Lucy will be thirteen and will officially be an old cat. Not ancient by any means, but old. Old enough that I look at her a little differently.<br />
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I came home after Kitten's euthanasia, made myself a mug of tea and sat in my usual spot on my usual couch. Lucy was sleeping on the other couch but stirred when I sat down. She looked over at me, stretched, leapt down and made her way over, purring loudly. Oh yes, she definitely still can leap. In fact, there's nothing about her that would hint at her age except for the fact that she has become thin. She was always the fat cat - the fat boss cat who would prowl about the house, keeping the other pets in line, handing out swats and issuing hisses as she deemed necessary and appropriate. But in the last couple of months, she has very gradually become thinner. She seems healthy enough in every other respect and she is still just as bossy with the other animals, but the other change is that she has become friendlier to me. She was never unfriendly, but she always favoured Isabel and Lorraine. However, the arrival of Lily (aka The Hellbeast, aka The FK - I'll let you figure that one out) resulted in a slow-motion shuffling of loyalties. From the start, Lily was Isabel's kitten. Lucy still wanted to be with Isabel, but she could not be in the same room with Lily, so after a few months of cats screaming at other cats, she stopped trying as hard. In the meantime, Gabi, the "middle cat", cemented her position as Lorraine's cat. Lucy and Gabi could have shared that role as they used to be best friends, but some subtle cat politics were at play wherein Lily's arrival cooled their relationship.<br />
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Enter me. I don't mind being third string.<br />
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I petted Lucy absentmindedly while checking my emails. When I was finished I looked more carefully at her. Yes, she was definitely not just thinner in the sense of happily no longer being fat, but thinner in the sense of possibly being too thin, making her look older than her almost thirteen years.<br />
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My thoughts then drifted to how she was snuggling. She never used to do that, at least not with me. It made me think of Kato, the cat Lorraine had when she was a student. Kato was a Siamese cross and was named for Inspector Clouseau's sidekick in the old Pink Panther movies. Like her film character counterpart, she would ambush you with frightening savagery at the most unexpected moments. I learned to enter Lorraine's place with extreme caution. When we moved in together it was to a pet free apartment and Kato went to live with Lorraine's parents. It was only much later, when we had a house and Lorraine's parents had passed on, that Kato came back to live with us. By this point she was a very old cat and she was a completely changed cat. No more ambushes. No more savagery. In her old age Kato had become mellow and affectionate. Letting her go when her time finally came tore our hearts out.<br />
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Lucy apparently had enough snuggling and stretched and sat up, looking about her. Lily had entered the far side of the room. Lucy tensed and jumped down. As she stalked towards Lily I took note for the first time how boney her hips were. Yes, I would have to take her to the clinic and run some tests. She had had a full check-up and blood tests within the last year, but a lot can change quickly in an old cat. Old cats need special attention and special love.<br />
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My grandfather lived to the age of 93. Shortly after he died I was talking to one of my uncles. I don't recall exactly what I said, but I must have implied that it is easier to let go when the deceased is very old. I may not remember what I said, but I do remember my uncle's reply very clearly:<br />
"Philipp, just because someone is very old doesn't mean that you love them less. In fact, the older they are, the longer they have been part of your life and it is possible that you love them even more."<br />
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Happy Caturday Lucy, my old cat.</div>
Philipp Schotthttp://www.blogger.com/profile/03308988842276050743noreply@blogger.com2tag:blogger.com,1999:blog-5207286810751186779.post-48259485433373570202019-02-07T10:15:00.000-08:002019-02-09T07:13:04.649-08:00Fido v The World<div dir="ltr" style="text-align: left;" trbidi="on">
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Urban wildlife encounters in three parts:</div>
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<u>Part One - Sprayed</u><br />
<u><br /></u> Before I even saw him, I could smell Brownie. The whole clinic could smell Brownie. Probably the neighbours could smell Brownie. Maybe even the people driving by on Portage Avenue could smell Brownie. But Brownie didn't care. He was still the same old happy tail wagging chocolate Lab we loved, or at least we used to love until he came in and made everyone go, "Oh my God! What is that smell? Is that skunk??"<br />
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Yes, it was. Brownie had been skunked. He may not have cared but his owner was in a state of some considerable distress. She kept apologizing for bringing him in, but she didn't want him in the house and he had met the skunk in the yard, so she didn't want him there either until she was sure that it was safe, and it was a hot summer day, so she couldn't leave him in the car. The only place left to go was the clinic, where she was desperately hoping we could help. We did have "Skunk-Off" in stock, so a brave vet tech put on a large smock and led Brownie, tail still wagging, to a distant room to apply it. Brownie was lucky because he hadn't gotten it in the eyes, where it can be quite irritating, and he was lucky because he was up to date on rabies vaccines and it didn't look like he had actually come in direct contact with the skunk. Skunks are the most common carriers of rabies in Manitoba.<br />
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Now some of you, especially those of my generation and older, will be thinking about all those old classic television shows where skunked dogs were bathed in tomato juice. Don't do it. First of all, it is easily more expensive than an enzymatic cleaner, secondly, it is ridiculously messy, and thirdly it doesn't actually work. It only seems to work because of something called olfactory fatigue wherein your nose has become overwhelmed by the combined tomato-skunk stench and calls it quits. Anyone new encountering the dog will still smell the skunk until their nose packs it in too. And then the competing tomato smell wears off and you have a pink stinky dog. If you really need a home remedy, the recipe you'll see online for 3% peroxide, baking soda and dishwashing soap does work. (If you're reading this you presumably have internet access, so just Google "skunk spray peroxide recipe" for detailed instructions.)<br />
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But on the plus side you and your dog have been exposed to a marvel of nature. Skunks can spray three metres from their little anal sac nozzles, their spray odour can be detected up to 5 km away and it only takes 10 parts per billion to make a stink. So mix a little wonder into your horror.<br />
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<u>Part Two - Poked</u><br />
<u><br /></u> In porcupine country, every clinic has these. In the city perhaps only one or two, but in rural areas probably quite a few. I'm talking about "quill dogs". We call them quill dogs because there appears to be a circuit in the canine brain that is dedicated to solving The Mystery of the Spiky Beast. You would think that getting a faceful of quills would be a deterrent to approaching the Spiky Beast again, and that's certainly what said beast intends, but to a quill dog, this is just a mystery that absolutely needs to be solved. A puzzle that needs to be figured out. An enigmatic opponent who needs to be bested. And this mystery is almost never solved. The Spiky Beast almost always makes a getaway.<br />
<br />
The practical consequence of all this is that these quill dogs will present again and again to the vet to have the quills removed. This is rarely medically serious, but it is often a significant nuisance. On the rare occasions where it is serious, it is because a quill has gotten in the eye, or deep in the throat. In even more rare occasions they can migrate deeper into the body. Usually though it's just a matter of giving the poor bewildered dog an anesthetic and painstakingly searching for the quills. Once you find them they're easy to remove. "Once you find them..." Please do not be upset at your vet if he or she missed a few quills! Ones that have broken off at the surface can be very difficult to find. And please do not consider this a DIY project - you will miss far more if your dog is not sedated or anesthetized, and it will be painful.<br />
<br />
On the upside, porcupine quills are coated in an antibiotic substance. We will still often prescribe an antibiotic as a precaution, but getting quilled leads to far less infection than you might expect. You might wonder why the porcupine is being so kind to others? It's not. It's being kind to itself because the animal most commonly poked by a porcupine is the porcupine itself when it accidentally falls out of a tree! This is more common than you might think. They are not especially elegant creatures.<br />
<br />
And before we move on to Part Three I want to dispell a porcupine myth. They cannot shoot or even toss their quills. What they can do is jump very quickly towards their opponent and then lash out with their tail before jumping away again. Not elegant, but lightning fast.<br />
<br />
<br />
<u>Part Three - Chomped</u><br />
<u><br /></u> As the saying goes, there's a first time for everything. And I suspect that this may also be the last time I see something like this. Mrs Bernard brought Duffy, her beautiful golden retriever, in after he had fought with a beaver and lost. He had a set of perfectly chisel shaped puncture wounds on his paw. Yes, a beaver. Yes, fighting with it and losing. And yes, right here in the city of Winnipeg.<br />
<br />
So let's unpack that.<br />
<br />
Last thing first. Winnipeg is a city of rivers and streams and beavers are actually quite plentiful here. They keep to themselves though and I suspect that the majority of Winnipeggers have never seen one, but if they walk their dogs near these rivers and streams, their dogs almost certainly have smelled them and are almost certainly intrigued. Well, Duffy was intrigued. He was intrigued enough to dive into the creek and investigate the source of that smell.<br />
<br />
This brings me to the next thing, beavers and fighting. There is a general prejudice about beavers that they are amiable but dull-witted. People have a cartoon image of a good-natured, hard-working, basically passive animal going about its business without paying attention to much else. Well, they are hard-working, but they are as mentally sharp as any rodent and they are only amiable, good-natured and passive if you leave them alone. Duffy did not leave the beaver alone. The beaver tried to swim away, but Duffy followed until they got close to the lodge when the beaver decided to make a stand. It whipped around and chomped the surprised dog on the paw. It was a one-sided fight. Duffy may have intended to bite the beaver, but quickly changed his mind and splashed back to his shocked owner.<br />
<br />
In 2013 a beaver attacked a 60-year-old fisherman in Belarus. The bite severed an artery and the man died. Kind of gives you new respect for our supposedly comical national animal...<br />
<br />
<br />
<u><br /></u> <u><br /></u> <u><br /></u> <u><br /></u></div>
Philipp Schotthttp://www.blogger.com/profile/03308988842276050743noreply@blogger.com0tag:blogger.com,1999:blog-5207286810751186779.post-67783707390158741082019-01-23T14:37:00.002-08:002019-01-23T14:54:18.429-08:00The Curious Tale of the Restaurant Next Door<div dir="ltr" style="text-align: left;" trbidi="on">
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The Marigold restaurant recently closed its doors after fifty years of being our neighbour. It was bittersweet news as it's hard to see iconic businesses and institutions close, but on the other hand, to be honest, I was never really very fond of their style of North American Chinese food, with its dayglow pink sauces and its anatomically improbable chicken balls. Moreover, their Friday lunch buffet often caused problems as large van-loads of Marigold enthusiasts from the country, in town for a day of shopping, would clog our parking lot, either in defiance or in ignorance of our signs.<br />
<br />
But maybe our signs needed to be larger because whenever I think of the Marigold restaurant I think of one incident in particular. This might have been fifteen years ago or so and it was a Friday in the summer. It was a reasonably busy day at the clinic when a nervous-looking looking middle-aged couple came in through the back door. The clinic is relatively long and narrow, with the parking lot out back and the front facing a busy street, so it was not unusual for people to try to come in that way. We generally keep the back door locked though because it can be crowded and chaotic in that part of the clinic and it's not really meant for through-traffic, but sometimes we forget. That day we forgot.<br />
<br />
The couple walked slowly past the grooming area, and past the kennel areas full of dogs and cats, and through the treatment room with staff in scrubs scuttling about and pets on stainless steel tables and various machines going "ping". They walked past all of this and made their way to the reception counter at the front of the clinic. There they stopped and the man smiled shyly at the receptionist, cleared his throat and quietly asked a question. He asked, "Is this the Marigold restaurant?"<br />
<br />
I'll let that sink in for a moment.<br />
<br />
<i>"Is this the Marigold restaurant?"</i><br />
<i><br /></i> The most astonishing part isn't that they would walk into Birchwood thinking it was the Marigold. The back of the clinic and the back of the restaurant look pretty similar I suppose. And sometimes your brain just blanks out signs. I get that. It's probably happened a few times before and people just giggled at their error and made a quick about-face.<br />
<br />
And the most astonishing part isn't even that after seeing everything they just saw, and hearing everything they just heard, and smelling everything they just smelled, that they would think that this could possibly somehow still be a restaurant. That's really astonishing, but it is not, in fact, the most astonishing part. These looked like trusting, innocent and, dare I say it, unsophisticated folk.<br />
<br />
No, the most astonishing part is that after everything they saw, heard and smelled they were still hungry and apparently still interested enough to ask that question!<br />
<br />
The Marigold is being replaced by a funeral home, so the parking will only get worse. And I sincerely hope that it doesn't generate any funny stories.<br />
<br />
<i><br /></i> <i><br /></i> <i><br /></i> <i><br /></i></div>
Philipp Schotthttp://www.blogger.com/profile/03308988842276050743noreply@blogger.com2tag:blogger.com,1999:blog-5207286810751186779.post-77777615931561098692019-01-09T14:09:00.002-08:002019-01-23T12:53:36.479-08:00Everything You Wanted To Know About Euthanasia But Were Afraid To Ask<div dir="ltr" style="text-align: left;" trbidi="on">
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I imagine that many people didn't make it past the title, and that's ok. This post is not intended for everyone, but the last post reminded me that I wanted to have something on the record regarding this. It's a heartbreaking subject, but it's an important one. I understand that it could be too disturbing or emotional for some readers, and that others would just rather not know. Have no fear - if you're in either category you can happily skip this post and look forward to the next one instead (which I promise will be on a light topic).<br />
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There is a general rule that for every person who asks a question, there are ten others who have the same question but did not want to ask. I have no idea where this little bit of folk wisdom came from, but it strikes me as roughly true for many situations other than euthanasia. When it comes to euthanasia however, because of the intense emotions involved, I think the ratio is closer to a hundred to one.<br />
<br />
Here then are the questions I have been asked:<br />
<br />
<i>Does it always work?</i><br />
Yes, it does. It's poignant to consider that while veterinarians spend their careers trying to save lives, the one service they provide that is absolutely guaranteed to be effective is ending life.<br />
<br />
<i>Why do you sedate first?</i><br />
Not everyone sedates their euthanasia patients first, but I almost always do. To begin with, I want to make sure that the pet is not picking up on everyone's emotions at the end. They are often very attuned to this and can become frightened, especially in a vet office. Secondly, especially in ill patients, finding a good vein for the euthanasia injection is not always that quick. Sedation can go under the skin, but euthanasia needs to be in a solid and reliable vein. I don't want the patient to become anxious if we're taking a few moments to secure a good vein, nor do I want them to move while we're injecting the euthanasia solution.<br />
<br />
<i>How fast is sedation?</i><br />
It varies quite a bit, but usually ten minutes or so. We wait until they are woozy and unaware. Some individuals will become fully unconscious with the sedation alone.<br />
<i><br /></i>
<i>How does the euthanasia drug work?</i><br />
We use an overdose of an injectable anesthetic. It's in the barbituate class, therefore similar to some sleeping pills or the anesthetic you might have had to get your wisdom teeth out a few decades back (safer drugs are used now, you'll be pleased to hear). We use such a high dose that all parts of the brain fall asleep - first the parts that keep a patient conscious and thinking, and then the parts that control breathing and the heart beat. Because it is an anesthetic the sensation is like that of falling rapidly asleep.<br />
<br />
<i>And how fast is this?</i><br />
Very fast. Once we get a vein it can go very quickly. Depending on the size of the patient it may take a few seconds to inject the entire dose, but they are always completely unconscious before the injection is even done, and often have stopped breathing as well.<br />
<br />
<i>Why do you put alcohol on the vein?</i><br />
I hadn't considered how this looked until a client asked, "Why are you sterilizing that when he's going to be dead in a minute anyway?" Good question, but I'm not sterilizing it. Alcohol helps make the vein stand out better.<br />
<br />
<i>Are there ever any bad reactions?</i><br />
The great majority of the time everything goes smoothly. The sedation we use can sometimes briefly sting a little as it goes in, but very soon after they start to feel good. And on the odd occasion while the sedation is kicking in the pet can seem disoriented, but this passes quickly. Bad reactions to the euthanasia itself are extremely rare and usually take the form of vocalizing. This is very distressing to the owner, but the pet already has enough drug in their system that they're not really aware of what is happening, or in control of the sounds they're making. And again - it's extremely rare. They do sometimes take a couple of deep breaths at the end though, when they're already fully unconscious.<br />
<br />
<i>Why don't they close their eyes?</i><br />
When you die all your muscles relax, including those in your eyelids. Eyelid muscles have to contract to close. Incidentally, bowel and bladder muscles can relax too, so sometimes they will release these as they die. They are of course completely unaware of this.<br />
<br />
<i>What happens to the body now?</i><br />
The crematorium doesn't pick up every day, so in most cases the body will be kept in a dedicated freezer until they come. You are probably going in a special fridge for a short while after you die, so it's really very similar.<br />
<br />
<i>How do I know that the ashes I get back are from my pet?</i><br />
We trust the crematorium, we know the operators well and we have all had our own pets cremated there. You are also welcome to visit the facility and even take your pet's remains there yourself.<br />
<br />
<i>You're not going to do experiments on him now are you?</i><br />
No. The fact that I have actually been asked this more than once underlines how little some people understand about science, let alone professional ethics. Not only is the very idea repugnant, but there are honestly no useful "experiments" that can be done in this scenario.<br />
<br />
<i>Can I donate his body to science?</i><br />
In rare instances, maybe. Every now and then there's an odd case where we might learn something from the results of an autopsy. While this is not really "donating his body to science", it's kind of the same idea. We would never do so without asking permission first though. As we often feel too awkward to ask, autopsies usually only get done when a client suggests it themselves.<br />
<br />
<i>Do you ever get used to having to euthanize people's pets?</i><br />
No. Never. My heart breaks a little every time.<br />
<br />
<i>(If you have any questions of your own, please feel free to ask them in the comments section below.)</i><br />
<br /></div>
Philipp Schotthttp://www.blogger.com/profile/03308988842276050743noreply@blogger.com7tag:blogger.com,1999:blog-5207286810751186779.post-74126413009321142162018-12-29T10:15:00.000-08:002018-12-29T10:15:22.260-08:00When Darkness Overwhelms<div dir="ltr" style="text-align: left;" trbidi="on">
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<span lang="EN-CA"><i>(Updated from the original August 2016 post.)</i></span></div>
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<span lang="EN-CA">This essay is going to be a departure from my
usual lame attempt at a lighthearted tone. This essay is
going to be about suicide in the veterinary profession. Statistics are not
available for Canada, but in Britain two separate studies found the suicide
rate among veterinarians to be four to six times that of the general population
and do</span><span lang="EN-CA">uble that of dentists and physicians. The American Centers for Disease Control did a
survey of 10,000 veterinarians and found that a shocking one in six had
considered suicide. I personally knew two colleagues
here in Manitoba who took their own lives, and in 2014, a prominent and very
well-liked behaviour specialist killed herself, drawing some media attention to
this little-known aspect of the profession.</span></div>
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<span lang="EN-CA" style="color: black;">To the casual outside observer this will be
unexpected and possibly even slightly bizarre news. Aren’t veterinarians
generally well respected? Isn’t it a secure, interesting and rewarding career?
Isn’t it a dream job for so many people? Isn’t it wonderful to heal innocent
animals and get paid to play with fluffy kittens? All of that is true. Except
the part about the fluffy kittens. Why, then, does darkness overwhelm so many
of my colleagues? There are three significant reasons.<o:p></o:p></span></div>
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<span lang="EN-CA" style="color: black;">The first reason is that veterinary medicine
attracts a disproportionate number of idealistic, introspective and sensitive
people. Sensitive to the point of neurosis. This is true of all of the health
professions, but it is even more so in veterinary medicine. Some of these
introspective people are more comfortable around animals than around other
people. They do not fully understand that it is actually a people job that
happens to involve animals rather than the other way around. Grappling with
this reality can be very problematic for some. Add to this the fact that
competition to get into veterinary college is extremely high, and success
favours perfectionists who can produce high marks. Perfectionism and idealism
are fated to be brutally ground down by the chaos of reality in practice. And
then their innate sensitivity lays them wide open to the second reason: the
inherent and often surprising multi-factorial stress of the job. <o:p></o:p></span></div>
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<span lang="EN-CA" style="color: black;">Of immediate relevance to sensitive people is
the fact that a veterinarian is at times marinated in death and grief. There
are weeks — many weeks in fact — where I perform one or more euthanasias each
day. Sobbing, crying, wailing, grief-stricken people, some of whom we’ve known
for many years, are a routine part of our day. And for those of you who think
this is simply a question of overwrought crazy cat ladies or frou-frou poodle
people who too much resemble their dogs, I have two things to say to you. The
first is that if you have not experienced a deep bond with an animal, then you
are missing out on a key human experience, one shared by people from all walks
of life, all backgrounds, all levels of intellect. It is one of the richest
threads we weave. The second is that you have no more right to judge the grief
of someone closely bonded to their pet </span><span lang="EN-CA" style="color: black;">than a blind man has to judge a photography
exhibit. Simply trust me that these are normal people with legitimate and
intensely felt grief. Additionally, a veterinarian is expected to be competent
across a range of species and a range of disciplines, from dentistry to
radiology to dermatology to . . . you name it, wedging the door wide open to so
many opportunities to fail. And remember: “sensitive.” Mix sensitivity and
failure and see what happens. And I haven’t even mentioned the financial stress
of trying to be affordable to clients yet still able to service sometimes
enormous debt burdens and meet payroll, etc. Or the stress of being a manager
when you went to school to be a vet, not a manager. Or the angry clients. Or
the angry spouse, upset because you’re stuck late again.<o:p></o:p></span></div>
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<span lang="EN-CA" style="color: black;">The third reason is that we know how easy it is.
How easy it is to die. Those daily euthanasias are consistently peaceful,
painless, quick and reliable. One hundred percent reliable. We know the dose.
We know the delivery methods. We have the drug right there. Can you see now why
it happens too much?<o:p></o:p></span></div>
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<span lang="EN-CA">And to make things worse, this is clearly an iceberg situation,
where the suicides are only the visible tip of a massive mental health problem
in the profession. According to an exhaustive American Veterinary Medical
Association survey, just under a third of all veterinarians have experienced
depression at least once since graduation. A smaller Canadian study found that
1 in 10 veterinarians were <i style="mso-bidi-font-style: normal;">currently </i>classified
as having depression, and another 15% were borderline. Also, a third of
veterinarians in that study were suffering from anxiety, and a shocking 47%
scored high on measures of emotional exhaustion. Clearly the problems run deep
and run wide. <o:p></o:p></span></div>
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<span lang="EN-CA">Fortunately, our professional associations are beginning to take
notice, and mental health support is increasingly being incorporated into the
services they provide. And w<span style="color: black;">hat can you, the reader,
do? You can’t do much about the first and third reasons listed abo</span>ve<span style="color: black;">, but you can definitely do something about the second. If
your friend or family member is a veterinarian, do not trivialize their stress.
Understand that the real job is far more complex and serious than you imagine.
Offer to listen with an open heart. And if you are a client and </span>your<span style="color: black;"> veteri</span>narian has done something to make you angry,
please recognize their human fallibility and frailty, and try to find a calm
and respectful way to address your concerns.<span style="color: black;"><o:p></o:p></span></span></div>
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<span lang="EN-CA" style="color: black;">And what about me? Well, fortunately I had a
“happy optimist” chip deeply implanted at birth. The zombie apocalypse could
roll into town and I would say, “Cool, this will make for some excellent
photos!” And, “Maybe brains are better with a bit of smoked paprika?” I have
painted a bleak picture when in fact most veterinarians are fine — even better
than fine — but burnout is very real, and depression is very real, and, for a
small, tragic minority, suicide is very real too. </span><span lang="EN-CA">Not
only in veterinary medicine, but in society at large, we must work to demolish
the stigma that still surrounds mental health. If your leg is broken, everyone
wants to talk about it, but if your brain is broken, hardly anyone does. This
is wrong, and it is doing so much harm.<span style="color: black;"><o:p></o:p></span></span></div>
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<i style="mso-bidi-font-style: normal;"><span lang="EN-CA" style="color: black;">This is
for Terry and Craig and Sophia.</span></i><span lang="EN-CA" style="color: black;"><o:p></o:p></span></div>
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Philipp Schotthttp://www.blogger.com/profile/03308988842276050743noreply@blogger.com0tag:blogger.com,1999:blog-5207286810751186779.post-14206981504858335492018-12-20T11:54:00.000-08:002018-12-20T12:58:02.027-08:00Snoopy's Magical Digestive System<div dir="ltr" style="text-align: left;" trbidi="on">
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When I'm in exam room #2 around Christmas I sometimes still think about Dixie Pawluk. I sometimes still think about her even though this was close to twenty years ago, and even though the display of "odd things removed from pets" that we kept in that room appears to have been thrown out, probably by staff tired of being grossed out every time they dusted the jars.<br />
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Dixie came in on the first day we were open after Christmas. She was normally a very lively little Cairn terrier - lively even by the peppy standards of the breed - but that day she was quiet. Normally she would run up to me and cock her head with that s<i>o, are you giving me a treat? </i>facial expression if I went anywhere near the treat jar, but that day she just lay by Mrs Pawluk's feet and did not look up at me at all. Mrs Pawluk was a widow and none of her children lived in Winnipeg anymore. Apparently she had some friends who she played poker with every Friday night, but otherwise Dixie was by far her best friend and closest companion. She had had a succession of Cairns over the years, but she told me more than once that Dixie was the best of the lot. She often wore sweaters with pictures of Cairns on them. She had a new red one on that day sporting a large tartan applique Cairn.<br />
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"So, Dixie's not looking too well today. When did this start?" I asked.<br />
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"The day before yesterday, on Christmas Day, she did not want to eat, not even her favourite treat. I thought maybe she just ate too much on Christmas Eve so I didn't really worry, but yesterday it was the same thing." Mrs Pawluk had Parkinson's and her hands were shaking as it was always worse when she was anxious.<br />
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"Ok. Has she vomited at all?"<br />
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"No, but she does this." Mrs Pawluk mimed a dog opening its mouth open wide, as if to yawn, while stretching her neck out. "There's no sound at first and then a little gag at the end. Do you think something could be stuck in her throat doctor?"<br />
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"It's not likely, but it's possible. Did you feed her anything unusual on Christmas Eve?"<br />
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I know that a few of my colleagues read this blog and that most of them will immediately recognize my error. Perhaps they're even sticking their arms in the air and saying "oh, oh, oh" like Horshack on Welcome Back Kotter when he knows the answer to a question. In my defense I will remind them that this was a very long time ago and assure them that I definitely learned from my mistake. But back to Dixie.<br />
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I was about to ask a few more questions when Dixie stood up and retched a couple times in very much the fashion that Mrs Pawluk described, although the sound at the end was louder, wetter and more violent than I expected. I picked her up and put her on the exam table. Her lungs sounded clear and her belly felt soft and empty, but she had a slight fever. The only other abnormality was that by palpating her windpipe I could get her to cough a little. To allay Mrs Pawluk's worry about something being stuck I opened Dixie's mouth and looked in as far as I could, which was not very far. I put her back on the floor and then sat down on my stool to deliver the verdict.<br />
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"I'm pretty sure Dixie has a form of kennel cough. It's unusual for them to go off their food with this, but she has a bit of a fever too so she may have some bacterial complications. It will clear up with time and antibiotics."<br />
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"Thank you doctor, I'm so relieved it's nothing more serious!"<br />
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<i>Cue ominous music.</i><br />
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I saw Dixie again four days later on New Year's Eve. She still hadn't eaten and she had become increasingly depressed, hardly moving at all now. Mrs Pawluk would have come in sooner, but the weekend had intervened and she wanted to wait for me rather than go to the emergency clinic. Now I was worried too. This was obviously not kennel cough, or any other sort of respiratory infection. We ran blood and took x-rays. One of the nurses grabbed me and said, "Philipp, come and look at this x-ray. There's something weird in there."<br />
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Indeed there was. In Dixie's chest, slightly ahead of and above the heart, was a very dense, irregularly shaped object, perhaps half an inch across. It was a piece of bone and it was lodged deep in her esophagus, the tube that leads from the mouth to the stomach. Mrs Pawluk had been right, sort of. Certainly more right than me.<br />
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As we were closing for New Year's, and in any case are not set up to provide the overnight care she needed, we transferred Dixie to the emergency clinic. I don't think enough of you are interested in the gory medical details to warrant a complete telling, so I'll summarize what happened next by saying that they ultimately decided to try to remove the bone with a scope. They got the bone, but unfortunately they found a large tear in the lining of the esophagus that could not be repaired. Poor Dixie struggled along for another couple of days, but it was hopeless and Mrs Pawluk had to make the heartbreaking decision to let her go.<br />
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A week or two later Mrs Pawluk came in with a thank-you card, that I was not sure I deserved, and to talk. I felt terrible that I had missed the diagnosis initially and she felt terrible that she had fed Dixie pork ribs as a treat. She said that Dixie got rib bones regularly. It was her usual treat for special occasions. She never had a problem before. She had told the truth when I had asked her whether she had given Dixie anything unusual to eat.<br />
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Before she left she handed me a small object wrapped in brown paper. It was the bone. I put it in a jar and set it up on the shelf in room two, beside the giant stone that had filled Guido the tiny Pomeranian's entire bladder, and beside the rogue's gallery of pickled parasites. Dixie's bone was there to remind me that I should always ask, "Could she have eaten anything other than dog food?" rather that "Did you feed her something unusual?" It was also there to remind me to tell people that Charles Schultz, bless his soul, did the dog owning public a grave disservice by depicting Snoopy powering through a stack of bones like they were Pringles. But then Snoopy is clearly a magical dog. When your dog starts fighting the Red Barron and decorating Christmas trees we can talk about feeding him bones. Until then, know this: bones can be so dangerous, especially pork and poultry.<br />
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To be honest, the bone in the jar was kind of gross, so I understand why it's gone. And I remember these things anyway.<br />
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p.s.<br />
Some of you reading this will protest that the dog you had growing up on the farm ate nothing but bones and lived to be 103. Or something like that. This was likely the same dog who never saw a vet, not even once in his unnaturally long life, and the same dog who ran twenty miles through a blizzard to get help when grandpa got his arm stuck in the snowblower. All I can say to you is that I guess they don't make dogs like they used to.<br />
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p.p.s.<br />
A small but measurable percentage of you will now have the Welcome Back Kotter theme looping through your brain for the next two days. No, there's really no need to thank me.<br />
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Philipp Schotthttp://www.blogger.com/profile/03308988842276050743noreply@blogger.com0tag:blogger.com,1999:blog-5207286810751186779.post-26405446181890326172018-12-06T14:01:00.000-08:002020-02-06T16:25:45.160-08:00Monty's Story<div dir="ltr" style="text-align: left;" trbidi="on">
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Little gets a veterinarian's attention faster than a person running in the door screaming, "Please help me! My dog collapsed in the parking lot! I think he's dead!!"<br />
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One of my colleagues and two of our nurses jumped up and ran out to help. A minute later they came back in carrying a medium sized mixed breed dog on a stretcher. He was not dead. His name was Monty Jacobs and while he was not dead he was clearly in trouble. His breathing was laboured and his gums were pale. Mrs Jacobs was freaking out. My colleague is a very calm person and she was able to reassure her that we would do our best to stabilize Monty and get to the bottom of whatever was going on as quickly as possible. </div>
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Sure enough, 15 minutes later we had a chest xray. The heart looked enormous. </div>
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"Oh no, it's another right atrial hemangio," I said when I was asked to look at it. I was referring to a common cancer that can cause bleeding on the outer surface of the heart. The blood becomes trapped under the pericardium - the membrane that wraps around the heart - which causes the entire heart shadow to appear enlarged on xray.</div>
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"Do you have time to do an ultrasound to confirm?" my colleague asked.</div>
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"Yeah, I can squeeze it in. Sadly for the dog it's going to be quick as these are really easy to see."</div>
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But I was wrong. It was not quick and Monty did not have a bleeding cancer. Monty had dilated cardiomyopathy. Dilated cardi... what? I'll break it down for you. Dilated means what you think it means - stretched out. Cardio means heart, myo means muscle and pathy means disease. Put it all together and you have a disease of the heart muscle causing it to become so weak that it becomes baggy and stretched out.</div>
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This made no sense. We only see DCM (the easier to remember abbreviation) in a small handful of specific breeds because it is a genetically determined disease. Monty was maybe terrier, mixed with maybe husky, mixed with maybe German shepherd, mixed with maybe... who knows? A classic "Heinz 57". I was stalling for time by describing some of the less important things on the screen before getting to the inevitable 'why' question when suddenly a little (metaphorical) bell rang inside my head. Bing.<br />
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I turned to the owner and asked, "What do you feed Monty?" She named a brand of food I hadn't heard of before and said that it was grain-free. Now I knew.</div>
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Last year reports began to bubble up of dogs developing something that looked like DCM but who did not fit the usual breed profile. Individual private practitioners did not detect a pattern because they would only see one or two cases, but cardiologists did see a pattern. All of these dogs had been on "BEG" diets - "boutique", "exotic ingredient" or "grain-free" diets. </div>
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To expand on this a little, by "boutique" we mean relatively small batch foods produced by companies that do not have a certified animal nutritionist on staff and who are not able to do proper scientific feeding trials. "Exotic ingredient" refers to lentils, chick-peas, fava beans, tapioca, alligator, kangaroo, ostrich, pomegranates etc etc. Please know that this is a tiny sample from the list of exotic items that are popping up in pet foods. Unfortunately until this gets figured out everything that was not traditionally fed to dogs needs to be considered "exotic" and viewed with suspicion. "Grain-free" is self explanatory, but read on. </div>
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I know that grain-free diets are enormously popular at the moment, but I have no hesitation in saying that this is a fad built on two fallacies. The first fallacy is that allergies to grains are common. In fact, allergies to grains are quite rare in dogs. Moreover, when there is a grain allergy it is usually to a single type of grain, such as wheat for example, not to all grains. The second fallacy is that dogs are essentially wolves and therefore should not eat grains. Your dog is no more a wolf than you are a Neanderthal (mind you, I'm making an assumption about you). We now know that evolution works much faster than we used to think it did. A lot has changed in their and our biology since those good old wolf and Neanderthal days.</div>
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I apologize for the digression. Back to BEG.</div>
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Many theories have been put forward as to why some BEG diets are damaging the heart, but as of now (February 2020), nobody knows with absolute certainty yet. Is it the absence of a key nutrient that is in the traditional foods? Is it the presence of too much of something new that was put in to replace the traditional ingredients? The leading theory currently is the latter. There does seem to be an association between high levels of peas, lentils or potatoes and this problem. These have been put in to balance the protein and carbohydrates when the grain is taken out, but may be throwing off the metabolism of specific amino acids.</div>
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We expect that only a small number of BEG diets are involved, however that list is growing so we cannot be sure yet that any specific BEG diet is safe. So although there may be many fine diets under the BEG umbrella, at this time we have to recommend that you feed a traditional diet from a well-established company that has a solid footing in nutritional science. Ask your veterinarian for a list of these companies. And please don't panic if you are feeding a BEG diet, this problem is not that common, but you really should talk to your veterinarian about switching. And please don't feel guilty either, many of the BEG diets are particularly good at marketing in a way that appeals to our desire to do the right thing. </div>
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There are good drugs for DCM and most patients can be stabilized if it is caught early enough, but the terrible thing is that there can be no warning signs. Monty had just been a little weaker for a few days prior to the collapse and had been breathing a little harder. This is typical. We expect that by changing his diet we can stop further heart damage from occurring and we hope that maybe even some of the damage can be reversed. </div>
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I have seen a few dozen more cases since Monty. Two tragically didn't survive, but Monty is doing ok. And he likes the new food.</div>
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Philipp Schotthttp://www.blogger.com/profile/03308988842276050743noreply@blogger.com4tag:blogger.com,1999:blog-5207286810751186779.post-16102958714633210122018-11-21T16:09:00.000-08:002019-01-30T08:41:05.488-08:00The Envelope Please<div dir="ltr" style="text-align: left;" trbidi="on">
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As in, "Oh God, please please please let this be <u>the</u> envelope." Yes, that envelope.<br />
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It's May of 1986 and I'm standing in Dr Bruce Murphy's laboratory on the second floor of the biology building at the University of Saskatchewan and I'm pipetting mink serum into tiny vials when the phone on the far wall rings.<br />
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"Philipp, it's your mom!"<br />
<i>My mom never phones me at work. Never. Either dad died or the envelope arrived.</i><br />
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"Yes mom?" (Cautiously, in German.)<br />
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"There's a letter for you from the veterinary college!" (Excited, in German.)<br />
<i>It's the envelope! Or, more accurately, it's <u>an</u> envelope.</i><br />
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"Is it thick or thin?" I ask.<br />
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"Thin. Is that good or bad?"<br />
<i>Bad bad bad I think. Shit, it's thin.</i><br />
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"Um, neither I guess. Go ahead, open it"<br />
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Ripping sounds at her end of the line. Panicky breathing sounds at my end. Long pause and then...<br />
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"You got in!"<br />
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I got it! It was <u>the</u> envelope!! It's hard to describe how this feels. Like winning the lottery (although I have never done that). Like getting an Oscar (never done that either). Like having your marriage proposal accepted (did that one!). Elation. Validation. Magic. In one instant your previously murky future suddenly comes into crystalline focus. And this coming from someone who only decided to become a veterinarian a few years prior (see: <a href="http://vetography.blogspot.com/2017/11/the-accidental-veterinarian.html">http://vetography.blogspot.com/2017/11/the-accidental-veterinarian.html</a>). Imagine how this feels for all the people who have wanted to become a veterinarian from before they even knew the word.<br />
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This coming spring fifteen Manitobans will have that feeling. In 2020 possibly only ten will. The Manitoba government is considering a plan to drastically reduce the number of students permitted to study veterinary medicine. And this is an extraordinarily bad idea.<br />
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Let me explain.<br />
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First of all I should clarify what I mean by "permitted to study veterinary medicine". Manitoba is far too small to have it's own veterinary college. Prior to 1965 all Canadians who wanted to study veterinary medicine went to Guelph, Ontario, but the profession was expanding so rapidly that this was no longer tenable, so a regional system was set up. The four western provinces banded together to select a reasonably central site for a joint Western College of Veterinary Medicine. Lloydminster not having a university, Edmonton and Saskatoon were considered, with the latter ultimately getting the nod. After 1965 Guelph would only take students from Ontario east and all western students would go to WCVM at the University of Saskatchewan. Each participating province funded a set number of seats. Manitoba currently has 15.<br />
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There are a handful of veterinary colleges in North America and the Caribbean that permit non-residents to study there, but at full price, which is five to ten times what one pays at WCVM. As a nation we decided that post-secondary education is essential to our future, so we subsidize it. We recognize that it is better to keep the system open to talent than just open to deep pockets. So if Manitoba cuts the seats it funds, the five prospective students who could have gone to WCVM - to our college that we built - will have to move much further away and go even far more absurdly into debt to follow their dream. Very very few will be able to do this.<br />
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This is a problem. A big problem. The demand for veterinarians continues to grow. Animal welfare, biosecurity and food safety are all hot topics that are not going away any time soon. In Manitoba especially we have a hard enough time attracting people from out of province (due to weird and unfounded biases, but that's another subject...), so we count on Manitobans coming back. Yes, some students who go to vet school don't come back to Manitoba, and by the same token many med and law and dental and engineering students who study here leave Manitoba - that's life and it is after all a free country - but if we send less, even less will come back. It's a downward spiral.<br />
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I get it, the government wants to balance the books. Let's assume for a moment that you don't give a rat's hindquarters about young people's dreams or pet doctoring or prudent antibiotic use on farms or exotic diseases jumping to humans. Let's assume that. Let's assume that you just care about the economy in the most narrow sense of the word. Well, guess what? Veterinarians are also small business people. This government is supposed to love small business people. In very rough figures we contribute 180 million dollars to the economy every year and that's growing at about 5% a year. We employ large numbers of skilled people and pay taxes, lots and lots of taxes.<br />
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And then there's the question of fairness. If you really feel you need to balance the books by cutting postsecondary education funding, then cut evenly across all programs. Is the law faculty funding being cut by 1/3? Dentistry? I doubt it very much. The cost of those five vet school spots represents a rounding error in the government's budget, but for our small profession it has a huge impact.<br />
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In survey after survey children list veterinarian as one of their top ten dream jobs. And not just children feel that way. So many people want to become veterinarians at the supply end and so many jobs are open for veterinarians at the demand end, but there is a very tight bottleneck jammed between that supply and that demand. This bottleneck is your government. And this is a democracy, so your government is you. Do something about this.</div>
Philipp Schotthttp://www.blogger.com/profile/03308988842276050743noreply@blogger.com2tag:blogger.com,1999:blog-5207286810751186779.post-6819134084332806382018-11-07T16:27:00.002-08:002018-11-07T16:36:15.609-08:00The Life and Times of George Ramirez<div dir="ltr" style="text-align: left;" trbidi="on">
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George Ramirez lived a long full life punctuated by adventure and surrounded by love. Given the relative nature of time and how subjectively its speed of passage is felt, I'm sure that in his admittedly minuscule mind he lived the equivalent of a hundred human years. We don't know where or exactly when he was born and we don't know who his parents were, but every aspect of his subsequent life was lavishly documented by his companion and guardian, a ten year old girl. It is astonishing that something weighing only 45 grams could live such a rich life. And it is perhaps astonishing to some that something weighing only 45 grams could be loved so deeply and loved so truly.<br />
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George Ramirez was a teddy bear hamster.<br />
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His full name was actually George Ramirez Penner, as he was owned by the precocious Chloe Penner. I say precocious because the first time she brought George Ramirez in she was in the exam room by herself. Her parents had decided that as he was her hamster she should be fully in charge of his medical care, so they sat out in the waiting room. (I think they still paid the bills though.) To be frank, sometimes this type of arrangement is irritating to the veterinarian as it can effectively double some of our work when we have to repeat everything to the parents later. But not in Chloe's case. She was attentive and sharp and clearly capable of following my advice. Such as it was. Really, she was fully on top of things, so on that first visit when George Ramirez was brought in for a check-up my role was primarily to confirm for her that she was doing everything correctly. She showed me pictures of his cage, from which sprouted an elaborate network of clear plastic pipes leading to various chambers, including, if memory serves, one made to look like a little space capsule. George Ramirez was going to have a good life.<br />
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At this point I should offer up a confession. I love all types of patients. I do not favour dogs over cats (or vice versa), or rabbits over guinea pigs, or budgies over canaries, nor do I shy away from snakes or rats or hedgehogs or ferrets, to name just a few that sometimes elicit bias. But I was long a secret hamster skeptic. It's funny because my wife had hamsters when she was young whereas I had a gerbil, so we would sometimes engage in hamster versus gerbil debates. I felt I had solid facts on my side. And I had been bitten by more hamsters than all other rodent species put together, so that might have biased me a little as well. But then George Ramirez came along. He did not bite. He was clean. And he was cool. This was a hamster I actually looked forward to seeing.<br />
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Normally hamsters do not go to the vet. There are no vaccines for them and we do not need to (or even want to) spay or neuter them. Moreover, they are really pretty rugged, so not all that much tends to go wrong in their short lives. But perhaps the most common reason that they don't go to the vet is that unfortunately many people view spending money on their medical care as silly, putting them more in the goldfish category of pet than in the dog and cat category. I wonder why this is? Is it because hamsters are cheap to acquire? But then so are many dogs and cats (and heck, human children come into the world free). Is it because they are so small? If so, then does that mean that Great Danes deserve more care than Chihuahuas? Is it because they are loved less? I suppose that must be it. But that was happily not the case for George Ramirez.<br />
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I think I saw George Ramirez five times in his three years. Once for the initial visit, twice for annual check-ups and twice for medical reasons. The first time was for what is referred to as "wet tail". "Wet tail" is a euphemism. The tail is not wet with water, it is wet with liquid poo. Much like diarrhea in every other species "wet tail" is not a single specific disease but rather a symptom that has a range of causes. These little creatures can dehydrate quickly, so it can be serious, but fortunately George Ramirez revived right away when we sorted out why it was happening.<br />
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The second time I saw him sick was when Chloe brought him in with what she thought was a tumour on his face. She was clearly really upset, but trying hard to be brave. George Ramirez had an enormous irregularly shaped lump in his right cheek and he had stopped eating. Hamsters are prone to cancer, but this was not a cancer. When I palpated the lump and pried his tiny mouth open to peer inside I was as surprised by what I found as Chloe was. He had somehow filled his right cheek pouch so full of food that it had become impacted and bulged out to roughly equal the size of the rest of his head. And because he had jammed unshelled sunflower seeds in there it felt very odd and lumpy on the outside. We both knew that hamsters had large cheek pouches, but had no idea that they were this large or that food could get so badly stuck in there. The solution was gratifyingly simple. I simply turned the pouch inside out like the pocket in your jeans. He was weak enough that he let me do this awake.<br />
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I know you're expecting a sad ending, but the cheek pouch incident isn't it. George Ramirez bounced back yet again. Just like with wet tail. Just like when he did an EVA* from his capsule and was found three days later in the heating ducts. Just like when the Penners got a cat and the cat knocked over his cage. Eventually Father Time caught up with him and he died peacefully in his bed at the ripe old age of three and one third years. I found this out when Chloe came in with Edna von Trapp, a new young female hamster. Edna von Trapp had an evil glint in her eye and proceeded to bite me savagely at every opportunity, thus proving, in case proof was needed, that hamsters are not interchangeable. There are a lot of stories of parents sneaking out to the pet store without telling their children to get a look-alike replacement when a hamster dies. I suspect that the child almost always knows, even if they don't let on. Sort of like a Santa or Easter Bunny scenario. And Chloe definitely would have known.<br />
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*Extra-Vehicular Activity. It's an outer space thing.<br />
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Philipp Schotthttp://www.blogger.com/profile/03308988842276050743noreply@blogger.com2tag:blogger.com,1999:blog-5207286810751186779.post-73944400984509282202018-10-25T11:00:00.001-07:002018-10-27T07:05:38.808-07:00Three And A Spare<div dir="ltr" style="text-align: left;" trbidi="on">
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"See that bright white line? That's normal bone." I was showing Jake's x-ray to the Folsoms. "Then see here?" I pointed to an area of the humerus that was both wider and fuzzier looking, as if someone had smudged the picture there with a cheap eraser. "This is abnormal bone. I'm really sorry, but I'm afraid this looks like bone cancer."<br />
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Mr and Mrs Folsom said nothing for a moment while Jake, a slender 7 year old yellow Lab cross, wagged his tail and looked up at them.<br />
Then Mr Folsom said in a flat, very controlled voice, "So he's done then. You're sure?"<br />
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"We should do a biopsy to be sure because the way this looks it could be something else, but I doubt it. I'm sorry, I know that this must be a terrible shock for you. However, if the biopsy confirms cancer that doesn't mean he's done. In that case I will recommend amputation and..."<br />
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Mr Folsom cut me off, "No way. We're not doing that. We can't let him suffer."<br />
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Mrs Folsom put her hand on his arm to shush him and turned to me, "We'll talk about it doctor. Let's get the biopsy first and then we'll see."<br />
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So this is what we did. Within a week we had the diagnosis confirmed - osteosarcoma, malignant bone cancer. We also did a series of tests to check for visible metastases, or spread of the cancer to other parts of the body. Finally some good news - these tests were negative. They wanted to come down to discuss the options in person with their teenage kids present.<br />
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After introductions, plus cookies for Jake, I began, "If Jake were my dog I would amputate. He is still young enough and healthy enough that he is a good candidate. Without amputation he is at a high risk of breaking that leg because the cancer has weakened the bone so much. If we do nothing his life expectancy at this point is about 6 to 8 weeks on average."<br />
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"Is that it? Just 6 to 8 weeks?" their daughter asked.<br />
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"Yes, that's the average, some shorter, some longer, but none very much longer. This is why I want you to think about amputation. That immediately gets rid of the pain and obviously eliminates the risk of a fracture. With surgery plus chemotherapy the average jumps to almost a year, with 20% of dogs living longer than two years. And a year is a really long time in a dog's life. Also, chemo is usually much gentler in dogs and has far fewer side effects than in people."<br />
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"But how's he going to manage on three legs?" Mr Folsom asked, his arms crossed, his expression clearly skeptical.<br />
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"That's the beauty of being a dog or cat. They do so well on three legs! You'd be amazed. In 28 years I honestly have never had anyone come back later and say that they regretted doing it. Obviously we have to make sure that his three remaining legs are in good shape, but otherwise it's just not a barrier."<br />
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"It's like he has three and a spare!" the daughter said. Mr Folsom was staring straight ahead.<br />
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Exactly. I couldn't have put it better myself. Three and a spare. It can be such a hard procedure to convince people to do, but it's one of the ones that brings the most obvious and immediate benefit to the patient. It's not just helpful for scenarios like Jake's, but also for some complicated fractures. I liken it to pulling a bad tooth. At that point the tooth is just a liability. It no longer provides benefit, only pain and risk.<br />
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Clearly this is not for every dog or cat with bone cancer. I don't want any of you who may have been through something like this and chose not to amputate to feel bad about your decision. The age of the pet can be a significant factor. For every year beyond middle age the decision becomes more complicated. And the bigger the dog, the faster they age. Also, as I mentioned, the other legs need to be healthy, and if it is cancer, it can't have spread. And finally, to be honest, I wish it didn't have to be about the money, but sometimes it does have to be. Surgery plus chemo runs into the thousands.<br />
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Incidentally, this general principle of being able to remove prominent parts of the body to benefit the patient goes for the eyes too. In some cases of glaucoma, which is high fluid pressure in the eyeball, the medications stop working and the eyeball painfully swells. At that point it is a liability, like a rotten tooth, or like a cancerous leg. People are sometimes aghast when we recommend removing the eye (a procedure called enucleation), but just like with amputation, once the owners get over the psychological hurdle, nobody ever regrets having the eye removed. Nobody.<br />
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This is one of the beautiful things about animals. They have very little in the way of body image hang-ups. They just do not seem to care how many teeth or eyes or legs they have. Terry Fox would be proud.<br />
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As I'm sure you guessed, three of the Folsoms ultimately out-voted the fourth and they opted for surgery, and Jake, being an above average dog in a lot of other ways, lived an above average length of time. He had 16 good months before we had to let him go.</div>
Philipp Schotthttp://www.blogger.com/profile/03308988842276050743noreply@blogger.com0tag:blogger.com,1999:blog-5207286810751186779.post-23817312496649955432018-10-11T05:52:00.000-07:002018-10-11T05:56:34.037-07:00Love<div dir="ltr" style="text-align: left;" trbidi="on">
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"I've been spending the nights with him on the living room floor, by his favourite spot. I keep worrying he's going to stop breathing, so I'm not sleeping much. I know his time is coming soon. I didn't want to bring him today because I'm so worried you're going to say I have to put him down." Mrs. Gagnon's eyes were red rimmed and her voice trembled as she said this.<br />
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I looked down at Edwin, an elderly black cocker spaniel. He was wheezing a bit, but at first glance he did not appear to be on his last legs. I crouched on the floor and offered him a liver treat, which he happily took, wagging his little stub tail. As I dug around in the treat jar to get another one I thought about Mr. Wilson who had taken the day off work to sit with his cat Parsnip while he was being treated for complications from diabetes. Parsnip would be in all day and Mr. Wilson would be there the whole day too, reading a little, patting Parsnip and generally just being there with him. I thought about Mr. Wilson because Mrs. Gagnon reminded me of him. She reminded me of him because they were both here for the same reason: love.<br />
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I am in a very privileged profession. What other professionals are you primarily motivated to visit because of love? Family doctor? No. Lawyer? Ha. Accountant? Double ha. Dentist? Triple ha. The list goes on. In fact, the only other similar profession I can think of is pediatrics. I have often joked with my kid's pediatrician that I practice furry four-legged pediatrics, or he practices hairless two-legged veterinary medicine. For sure many veterinary clients (and parents of children?) are also motivated by a sense of duty, a desire to do the right thing or even feelings of guilt, but the basic driver is usually love.<br />
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This is where the conversation can become awkward around people who don't have pets. Love? Really? Isn't that a bit overblown? Too sentimental? A sign that they are lacking human love? No, no and no. Forgive me if I am, as the saying goes, preaching to the choir, but the following is for the benefit of the occasional non pet owner (can I call them muggles?) who stumbles on this blog and thinks, "wtf?"<br />
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Part of the problem is language. English is a wonderful, rich and expressive language, but it has some gaps. We have an exhaustive list of words to chose from when it comes to describing and naming objects, but rather less when it comes to relationships and emotions. Think for example about the word "uncle". In English this can describe your parent's brother, or it can describe the random dude your parent's sister was briefly married to. It can even sometimes describe an older male family friend. There are many languages that have distinct titles for each of these, but may not have separate words for all the different kinds of car shapes or shoes styles or couch configurations. I'll let you draw your own conclusions regarding what this says about our culture.<br />
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In any case, so it is with the word love. There should be more words to describe all the kinds of love. Does your love for your parents feel the same as the love you feel for your spouse? Or your children? Or your siblings or best friends? They are all closely related emotions, but they are not the exact same. So it is with the love many people feel for their pets. If we're stuck with this one word, "love", then it has to be big and it has to be inclusive. Comparisons between the different flavours of love are not useful. Sure, in a "Sophie's Choice" nightmare scenario all of you would chose to save your child at the price of losing your dog or cat (or almost all of you... most of the time...), but that is never a real life choice.<br />
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With respect to it being sentimental, yeah, I suppose it can be. So what? Isn't the appreciation of much of what makes life worth living often somewhat sentimental? Good music, movies, art and literature all make use of emotional response to draw you in and involve you. Loving and appreciating the company of a pet is broadly similar. Can you imagine a world where sentiment was banished and everything had to be cold and practical?<br />
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And as to the love people feel for their animals indicating the need to fill a void, this has been amply proven false for the majority of cases. There certainly are many lonely people who find solace in the company of their pets, but pet owners represent the widest cross-section of society, including many of the most gregarious and outgoing "people people". In fact, my experience has been that the more capacity a person has to love an animal, the more capacity they often have to love people too.<br />
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Both Edwin and Parsnip did ok. I won't say that it was the power of love that made them better, but it certainly didn't hurt either.<br />
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<i>"We can judge the heart of a man by his treatment of animals."</i><br />
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<i>-Emmanuel Kant</i><br />
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Philipp Schotthttp://www.blogger.com/profile/03308988842276050743noreply@blogger.com0