Thursday, December 12, 2019

Volume Two!

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!

It is titled, "How to Examine a Wolverine"!

About a quarter of the stories will be drawn from the blog and the rest will be new!

Thursday, November 14, 2019

It's The Dog, I Swear



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.  
            “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.
            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.
            “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.
            But why? Why are dogs such a farty bunch? There are two main reasons: gulping and fermenting. Let’s tackle fermenting first.
            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.
            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.
            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.
            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.
            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:
-          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.
-          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.
-          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.
-          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.
-          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.

            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.

Tuesday, October 8, 2019

The Other Duck



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.

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.

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.

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.

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.

“It’s his penis.”

It was becoming clearer why Mr. Bolton didn’t want to see the country vet about this.

“Oh? What’s wrong with it?”

“Jake’s a great breeder. Very enthusiastic. I think he injured it because it’s really swollen and won’t go back in.”

Sometimes my job is boring and routine, but often it isn’t, and when it isn’t it can take some truly odd turns.

“Ok, well, let’s have a look.”

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.

“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.”

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.

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.

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.

Saturday, March 9, 2019

The 80%


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.

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.

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.

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?

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.

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.

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.)

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?"

Veterinary medicine has changed and it is thriving like never before. I'll let you draw your own conclusions.


Thursday, February 21, 2019

Caturday


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.

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.

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.

Enter me. I don't mind being third string.

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.

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.

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.

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:
"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."

Happy Caturday Lucy, my old cat.

Thursday, February 7, 2019

Fido v The World


Urban wildlife encounters in three parts:

Part One - Sprayed

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??"

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.

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.)

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.


Part Two - Poked

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.

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.

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.

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.


Part Three - Chomped

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.

So let's unpack that.

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.

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.

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...






Wednesday, January 23, 2019

The Curious Tale of the Restaurant Next Door


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.

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.

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?"

I'll let that sink in for a moment.

"Is this the Marigold restaurant?"

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.

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.

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!

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.





Wednesday, January 9, 2019

Everything You Wanted To Know About Euthanasia But Were Afraid To Ask


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).

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.

Here then are the questions I have been asked:

Does it always work?
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.

Why do you sedate first?
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.

How fast is sedation?
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.

How does the euthanasia drug work?
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.

And how fast is this?
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.

Why do you put alcohol on the vein?
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.

Are there ever any bad reactions?
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.

Why don't they close their eyes?
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.

What happens to the body now?
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.

How do I know that the ashes I get back are from my pet?
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.

You're not going to do experiments on him now are you?
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.

Can I donate his body to science?
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.

Do you ever get used to having to euthanize people's pets?
No. Never. My heart breaks a little every time.

(If you have any questions of your own, please feel free to ask them in the comments section below.)