Monday, September 16, 2019

George



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.
            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 19th 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.
            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.
            “The wee fellow hasn’t eaten a thing in two days! Not even his favourite – tuna from the can.”
            George was hardly a ‘wee fellow’, but I let that slide as the tone of her voice was very serious and concerned.
            “How is his drinking and urination?”
            “Terrible doctor. He’s not doing any of either.”
            “And this started suddenly two days ago? Or had you noticed any changes before?’
            “No, very sudden. What shall I do doctor?”
            “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.”
            “Yes, I’ll come as soon as they let me.”

            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.
            “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.”
            “Please do whatever you need to do doctor.”
            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.
            “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.
            “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.”
            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.
            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.
            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.
            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.

Monday, July 22, 2019

Benji



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.

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. 

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?

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. 

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... 

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.

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. 

Wednesday, July 17, 2019

The Birchwood Story (Part 1)


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!

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.

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 All Creatures Great and Small, 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.

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. 

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.

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.

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.

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.

Dr. Frank Grant left for Vancouver in 1965 as Winnipeg was not big enough for his wife either.
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.

Thursday, June 6, 2019

There Are Worms In My Heart

An old but timely post:



Ok, not technically right in the heart itself, but more on that later. And not technically my heart, at least probably not, but more on that later too.

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.

I don't want to waste time spewing Basic Heartworm Facts. You can get those from, gulp, the internet (try www.veterinarypartner.com) 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).

Cool Heartworm Fact #1
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.

Cool Heartworm Fact #2
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.

Cool Heartworm Fact #3
Heartworms can be huge, up to 35 cm / 14 inches. And they can be numerous, with infestations of over 100 worms reported.

Cool Heartworm Fact #4
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.

Cool Heartworm Fact #5
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.

Cool Heartworm Fact #6
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 - shield your eyes if you are squeamish - 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...

Monday, May 27, 2019

Blog Update

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.

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. 

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.

Thank you for being one of those two or three and, as the saying goes, watch this space!

Monday, April 22, 2019

Launching "The Accidental Veterinarian"

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.
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). 

Thursday, April 4, 2019

Vets Abroad


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.

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.

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.

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).

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.

"You can spay the girls for me!"

I laughed and took another sip from my drink.

"No, really, I mean it! What do you need?"

"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."
I was going to change the conversation, but Leeann persisted.

"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.

"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..."

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.

"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."

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.

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.

Incidentally, I just Googled Malacapao and Leeann is still there and is still as eccentric as ever.