Just Breathe

I have some retired clients who really love their yorkies. As their old dog was winding down, they got a new puppy. "We forgot how much energy puppies have! He's too much! But we already love him."

When they finally lost their geriatric dog, I know the new puppy was a great comfort to them. He came in last week for booster shots, wriggling with zest for life.

Today they called and said he chewed through a Christmas light cord and was shocked. They rushed him in and did "mouth-to-mouth" in the car. He presented limp, cold, pale, and shocky. I was relieve that he did not have an electrical burn in his mouth. Xrays showed that he did have significant damage to his lungs - the shock causes fluid to fill the alveoli.

The little pup lay on a circulating warm water blanket all day, breathing in O2. All his energies were focused on breathing and healing. We treated him with diuretics and bronchodilators, but mostly he needs time to get better. He has to get better - I don't think these people could take another loss.

When you get the Christmas lights out this season, please watch your small creatures, and be aware of the dangers of electricity.

Notes from Colin's teacher today

Note #1

Dear Mr and Mrs Vetmommy,

Colin pulled his pants down in front of his friends and peed on our big tree in the playscape. Could you please talk to him about it.

Thanks,

Colin's teacher




Note #2

Dear Mr and Mrs Vetmommy,

Colin was chewing on the turkey baster and continued to put it in his mouth after I talked to him about it. The tip is all chewed up, and I told him he was responsible for bringing the class a new one.

--Colin's teacher



Two notes in one day - ay yai yai! "How come I never got any notes when I went there?" Anna asked, all jealous. Believe me, Anna, you don't want to get notes like this! Neither do I!

Less than Perfect

When I was in vet school, someone gave us a lecture that was supposed to be humorous at a student convention. He was an older vet who was a little jaded by general practice. He told us that he alerted his staff to pain-in-the-butt clients by putting an "A" with a circle around it on the front of their files. He thought it was brilliant, because if the owner saw it, they would think they were A+ clients, but everyone who worked there would know that they were a-holes from his crude symbol. Like I said, he was supposed to be funny, but he really just made us more wary of practice, and unapologetically showed us how mediocre he was.

He also said, "I guarantee every one of you will try to spay a tom cat and put an IM pin into your palm when trying to fix a femur." He knew that in a busy practice how easy it was to check an animal in for a spay, have your technicians prep it for surgery, and not realize until you were digging around in there for way too long for a non-existent uterus since the cat was actually a "HE." Damn, and you could've been at lunch already, since cat neuters only take about 5 minutes. Fortunately, I have never made this particular mistake, but I can see how it could happen. As kittens, the female and male genitalia look almost the same (especially on orange cats), so the owners may at the beginning think their cats is the opposite sex (and name it accordingly). Four months later before the big surgery, you should examine the animal, listen to its heart, but you might not actually inspect the privates. 60 minutes later, you are scrubbed in and presented with a cat, shaved and scrubbed for ovariohysterectomy, so that's what you try to do...

The old guy's prophecy has not come true for me (yet). So I would not think too poorly of a vet that accidentally tried to spay your male cat - if that was what was asked for, and as long as he only charged for the neuter, not the spay. Also, no vet should ever try to spay a male dog, since there is a big prepuce in the middle of their abdomen.

The other half of the prophecy hasn't come true either - although I can see how whilst trying to force a steel pin into a femur you could ram it right through the other side and into your palm. I don't do much orthopedic surgery, thanks to much more skilled surgeons being close by.

I have, however, made my share of mistakes, and I hope you'll forgive me for not exploring them further. Each one is too painful to recount, especially recent ones -- nothing fatal, thank god. This is the difficult part of the job for me, not dealing with death, which is usually a mercy, but when my lack of intellect or lack of attention causes an animal and its owner suffering. That's when I wish I had an easier job, not when it gets busy or when staff drama gets out of hand. Making a medical mistake makes me question everything.

Choose your words

Colin and I went grocery shopping today after I picked him up from school.

At dinner tonight, he said, "Mommy, can I have dessert?"

Anthony said, "We don't have any dessert."

Colin said, "I want ice cream."

Anthony and Anna both said, "We don't have any ice cream!"

I was so proud of my little boy, who although he is just 3 1/2, and not as articulate as his sister, clearly communicated to everyone. "Yes we do!" Colin said. "Mommy picked one out at the store!"

I rewarded the little tattle tail with an ice cream cone.

Its not TV. Its "Sex and the HBO."

Its been a great long holiday weekend. I'm ready to get on the couch and veg with some DVDs. This NaBloPoMo is wearing a little thin... thank goodness there's only 4 more days to go.

Anthony and I rented all the "Sex and the City," DVDs when they came out. We were too cheap to sign up for HBO, so we anxiously awaited the release of each one. I don't know how HBO subscribers could be satisfied after watching a single 30 minute episode. We always loved watching several, back to back.

When "Sex and the City" was over we were sad, and moved on to "Six Feet Under." Oh my God! what an incredible series. The characters were so rich, the story lines so fascinating and arching. The writers were true through the many years, and never forgot where their characters had been or what they really wanted out of life. Soon we were anticipating these DVDs in the mail as ardently as we had "Sex and the City."

So we called it "Sex and the Dirt."

Then "Sex and the Dirt" ended - and what a magnificent finale! I was sobbing at the end of the montage that shows you the ends of all the characters lives. How brilliant to show what happens to all these people we knew and loved, and especially to show their deaths since that was the other focus of the show. The next day I watched it again and again.

It was so great to enjoy and agree with the ending of a beloved series (both "Sex and the City" and "Sex and the Dirt") after being acutely disappointed with the endings of so many other network shows that I loved (Northern Exposure, Mad About You, Seinfeld, and Friends). Did they hire a completely different team of authors to write those other finales? Maybe the regular writers quit or moved on, so they just hired anyone off the street.

So now, we are hooked on "Deadwood," set in the 1800s gold rush town of the same name, written and directed by David Milch. He also did NYPD Blue, another favorite of mine. The style - jangling story lines and complex circuitous dialogue - is the same in both series, despite very different settings.

So we call it, "NYPD Sex in the West."

Another birth story

Back in my first year of practice, when I had to take emergency call and carry the dreaded beeper, I did several c-sections. Whenever a patient would try to have its litter but stall out, I'd give oxytocin injections to try to jump start that uterus but it never worked. By the time I saw them, surgery was inevitable, with one exception.

Once I saw a little white rat terrier, bloated with pregnancy. She'd been trying to push out the first puppy for several hours, but he was stuck. I gave her oxytocin, lubed her up, and helped pull the big puppy out. It was too late; he was already dead.

I chatted with the owners while we waited to see how her labor might progress. She was a young dog, and her owners were very sad about the dead puppy. I could feel that she had one large puppy still inside her. Nothing seemed to be happening, even after a second oxytocin shot. I feared her uterus was spent and that we'd have to do a c-section to get the last pup out. I decided to examine her one more time.

This time I could just feel the puppy's head. Female dogs have a contraction reflex: if you stroke the dorsal vaginal wall in an outwards direction with a crooked finger, they will have a contraction. It is appropriately called "beckoning." The young mother responded - she still had a little bit of push left in her! So, using more lubrication, I coaxed more contractions out of her and moved the puppy into the birth canal. The owners became very excited. Soon we could see the head in the sac starting to emerge. Using one hand to pull the puppy's head and the other hand's finger to beckon more contractions, she slowly made more and more progress until - BAM! - the puppy slid out. I pulled open the sac and rubbed her down. Mom got interested and began licking the puppy.

The dog owners were overjoyed to have a healthy, alive puppy without surgery. "We'll name her after you!" they said.

Caesarian fun!

Today at work I had a scheduled C-section. This doesn't happen often in our world, but when it does, its usually a bulldog (as was the case today). Bulldogs have been selected by their breeders to have large blocky heads that get stuck on the way out. Most puppies are like little fusiform sausages and are easily pushed out. Bulldogs are more like humans with big noggins that are likely to get stuck. All the c-sections I've done in my career were either bulldogs or little tiny dogs like chihuahuas or yorkies, who don't have the energy to push their puppies out. They usually need emergency c-sections due to uterine inertia.

I had not previously met the owners of today's patient, but apparently they have bred Cairn terriers before and had been to many whelpings. They were very reluctant to turn their dog over to me for the c-section; they wanted to watch. However we are not at all set up for an audience in our little surgery room. Besides, I knew there were 5 puppies, which meant at least 5 nurses in there reviving them. While I am pretty open about doing procedures in front of clients, the last thing I needed was these 3 people in the room, questioning everything ("Is that good or bad? Are you supposed to do that?"). Its not like a human delivery room where the dad (or which ever SINGLE support person) is standing by the mom's head - this would be lots of people who view this dog as their child, and I could tell already they would be touching my sterile field.

I assured them I would keep them as involved as possible and that I would take good care of their baby.

The poor mother-to-be was quite uncomfortable and already in the early stages of labor - pacing, nesting, gagging, grunting. Soon we got her under anesthesia and rolled her on her back to prep her huge protruding belly, the many nipples huge and prominent standing up on the surface.

I had an audience anyway. All the staff stopped by to see the enormous gravid uterus once I pulled it out of the abdomen. Humans have a T-shaped uterus, with one baby (occasionally more) in the main part. Dogs and cats have a Y-shaped uterus with fetuses packed in a row along the "horns." This girl's uterus was about 3 feet long end-to-end, full of pups. I made an incision in the middle and milked the puppies out, one by one, dropping them into the arms of a technician, who revived them.

In short order, all the "quintuplets" were out, squirming and breathing and mewling. Now I was all alone, sewing up her already shrinking uterus and closing the long line on her deflated belly.

Momma woke up after snoozing for about 45 minutes after surgery. She was sitting up looking at me, more relaxed than before the surgery. "Look what I have," I told her, as I brought one of her pups out of the heated padded box they were incubating in. As the pup was aloft in the air it squeeked out. As soon as she heard her baby's cry, that momma stretched out on her side, exposing all her big teats. Soon all 5 pups were attatched and nursing, and momma closed her eyes contentedly. Three boys and two girls.

In Summary...

The menu:

Smoked Greenburg Turkey

Cabernet Sauce

Mushroom and Herb Dressing

Roasted fall vegetables (including a butternut squash we grew!)

Autumn Succotash (with edamame instead of yucky lima beans)

Wild Rice Pilaf

Pumpkin Pie

Pecan Pielettes

French wine

4 generations around one long table in my dining room!

I'm too tired to write anything else....

Thanksgiving Eve Photos

We've been getting everything ready for the big feast, happening at our house this year. Today Grandad arrived, and our cousins Paige and Graham, Auntie Steph and Uncle Al soon after for a little extended family celebration. The cousins have all been anticipating this get-together, and it didn't take long to get them warmed up.


Artists, hard at work


My new helper, Paige, helping me make the arugula insalata.


Cousins!


Cousins in the tub! Won't be able to do this much longer...

Anna Conda

Sunday was so beautiful, I took the kids to the park for a picnic lunch. Afterwards they played a long time on the playscape. There were 2 other children there with their dad, close to my kids' ages. I said hello to their dad from a distance, then called my parents on my cell phone to finalize Turkey Day plans.

After I'd been chatting for 30 minutes, I saw the other dad hollering at his daughter, then haul her away by the arm. He was shouting to me, "Your daughter is in it, too!"

I told my parents I'd call them back, and said, "What?"

He said, "They found a condom. You may want to wash her hands."

Eeew, yuck. That is totally gross, but now this formerly friendly dad was dragging his kids to the water fountain to rinse their hands then to the truck. His daughter was crying that she didn't want to go home.

Anna came up to me, quietly weeping. She said she wanted to go home. She was crushed that this other dad had yelled at her. My heart instantly went out to her. It seems like this happened to me a lot as a kid - some other dad yelled at me, and I felt ashamed and terrified. I mean, it was scary enough when my dad yelled at me, but I usually knew what he was so mad about. When somebody else's dad yells at you, you feel terror and want to just die.

"Oh honey, you didn't do anything wrong," I told her. "Its just those things are really gross and he didn't want you guys touching it. You didn't know; its not your fault."

Anna said, "I thought it was just a dirty white balloon. What was it, Mommy?"

I said, "It was a condom, and they're pretty gross, so that's why he yelled, so you wouldn't touch it."

Anna said, "What's a Conda?"

Now, we're getting into touchy territory. I want to be honest without giving her more scary information than she needs. She already suspects its something shameful from the other dad's reaction. I need her to know the shameful part has nothing to do with her.

I said, "Its something that grown men put on their penis, and its pretty gross. It should not be left at a park where kids play. Its not your fault that it was there."

Anna asked, "Do men like Colin put it on their penis?"

I said, "No, only grown men."

Thank goodness she did not ask about men like her daddy. I held her hand all the way home, and then you can be sure we both washed up thoroughly!

Instant Gratification

Tomorrow is the Thanksgiving feast at both of the kids' schools. Colin was supposed to help make the mashed potatoes for his school. Anna had this task last year, and we peeled, boiled, and mashed the potatoes. She wasn't very enthusiastic, since she doesn't even like mashed potatoes.

I tried to get Colin interested before we left the house, but he was too busy playing trains. Then we stayed out way to late, shopping and eating. Now there wasn't even time for a bedtime story - just brush the teeth and get into bed.

So after he was asleep, I made instant mashed potatoes.

I feel pretty guilty about this. He didn't participate in the process, and they just don't seem authentic. But, I mixed in real milk, sweet cream butter, kosher salt, and it says its made with real Idaho potatoes.

That's what they call "phoning it in," Antonia!

Daddy's little helpers

We are starting a large new landscaping project. There are fancy plans drawn by a landscape architect and everything. No one is more excited than Anthony, who even went out last night to dig a hole in the dark. We have this great new oak tree that's dying to get in the ground.

It doesn't look like much with all the leaves gone, but its a Bur Oak, with huge leaves and gargantuan acorns - my favorite oak tree. Anna hugged the tree repeatedly and said it talks to her, telling her how much it likes her.


The kiddos enthusiastically helped their dad digging the last bit of the hole (this was the ruckus going on when you called, Emily). They were even better at filling it in once the tree was installed, taking turns using their little shovels to fill their wee wheelbarrow, and gleefully dumping the dirt in.

I guess there's no way to get them that enthusiastic about picking up their toys...

Very very extraordinary

As we were driving to the Farmer's Market today in our Prius (how virtuous!), Colin was spotting other Priuses (Prii?) driving along with us. He's very good at this, but when an Aztec pulled in front of us in his favorite color (yellow), he said, "There's a Prius!"

Definitely not, but it does have a very similar divided rear window. "No, Colin," I said, "The Prius is a very small vehicle and that one is very large."

It must be hard to be 3 and be corrected all the time. To save face Colin said, "No, Mommy, that one is very medium."

A day without Sunshine

That's what yesterday was. Our clinic is in a strip center. It is amazingly large and well designed, but has no windows. If I don't get out for lunch, I feel completely out of touch with the climate. No idea what the weather is like. Yesterday an emergency cat-trying-to-die-from-heart-failure filled my lunch. I got food at 2pm but no fresh air or UV. This time of year, its dark by the time I stumble out the back door to my car.

We've been very busy with an unseasonal increase in sick patients. Also, we have one doctor out on maternity leave. Then my boss's mom was hospitalized; she sadly passed away yesterday. We normally have 3 doctors a day but have been operating lately on 2.

And surgeries! In October there was plenty of room to schedule stuff, and we had tons of cancellations. The past few weeks the surgery schedule has been all booked up with no room at the inn. So when I see a dog with a painful, broken tooth, it can't wait 2 weeks for an appointment. Ditto the dog with metastatic cancer in a lymph node - wait 2 weeks and it may spread further. So we are shoving them in, anywhere we can.

Today I actually got to leave the premises for a 45 minute lunch! And the cat is no longer in failure, sent home on oral meds. Here's the best part: tomorrow is the first Saturday I won't be working in 6 weeks! Yippee!

The Deal with Celery

I love fruits and vegetables, and will happily eat ANY of them, with one glaring exception.

I HATE celery.

I really really loathe it. Its presence can ruin a meal for me. For example: the night before Anna was born, I ate salmon at a restaurant. The last bite that I put in my mouth was flavored with celery seed. You know, those little things full of concentrated celery flavor? It filled my mouth and sinuses with their icky presence. And it was the last bite, so I didn't have anything else to follow it with. And, I thought about how that celery laden bite was the last thing I got to eat when I was pushing her out (since wisely they won't let you eat until you're done with labor).

I HATE celery.

Its not the crunchiness.

Its not the long, fibrous strings.

Its that awful, overpowering flavor!

OK, here's another birth+hate of celery story: I went into labor with Colin while waiting to eat at a beautiful buffet line at a friend's wedding. I was so sad not to get to eat that food! Many hours later, the nurse scrounges something for me to eat. All she can find is a sad, old tuna fish sandwich. Well, I like tuna, and I'm starved, so I eat it.

Guess what? Full of celery. That's my reward for pushing out this 8+ lb boy in less than 3 hours from leaving the reception: celery. Grrr...

(BTW, awful day at work today. No way I would have posted if it weren't for NaBloPoMo.)

In Europe they call it Eee-Kay-Ah, not Eye-Key-Ah

After starting the long overdue laundry, then filling out the forms they sent home for Anna to be tested for gifted and talented (this was really hard! Does she have a large vocabulary? Yes! Give examples. Umm, er, ah, she uses big words all the time, can't think of any at the moment... Does she figure out the why of things? Give examples. Oh, geez, yes, but I can't think of anything specific to write down...) anyway, after a couple of hours of that, Anthony and I succumbed to our temptations and went to the IKEA grand opening today.

We weren't going to go the first day because we knew it would be crowded. People had been camping out since Monday in order to be some of the first ones in the store! But the lure of everything stylish, cheap, and Swedish overtook us and we headed north.

We had to go through the showrooms hastily, because we knew we had to pick up Colin from preschool by 2:30. We marveled at the sofas, kitchen sets, storage, pottery, wine glasses. Before I fainted from hunger, I steered Anthony to the cafe. "We could've eaten at home before we left..." he groused, until he sank his choppers into an amazing ciabbata sandwich with mozzarella and roasted red peppers. I had to get the classic SWEDISH meatballs, which were a little mass produced but delicious nonetheless. We split a slice of apple pie, so cinnamon-y, and drizzled with custard (not limp and wilted whipped cream). Then we rushed out of there, not buying anything this time, and totally skipping large sections of the store.

I told Anthony it was just an appetizer portion of the store we got today. Although some of the items make me think Ikea is stuck in a 70s European time warp, we loved the efficiency, the eye to form and function, the trash cans divided for recycling. Why can't Target and even WalMart be more like that?

I think we will have to go back this weekend. The cafe opens for breakfast before the store opens....

Ah-choo!

At my first vet job, I had to take emergency call, wearing that annoying little pager all weekend long. We could get called in any hour of the day or night, if the owner was willing to pay the emergency fee.

One Sunday afternoon my pager went off. The people on the other end had a dog that was violently sneezing. They were extremely worried. It came on their little dog suddenly and harshly. I had only been out of school one year, and really had no idea what I would do for the dog. They insisted she needed relief, so I agreed to see her.

I was greeted by a little Maltese who truly was sneezing a lot. I did my full exam, but didn't find anything. I decided to look up her nose as much as I could with the otoscope. I looked up the left nostril and saw nothing before she jerked away. Then I looked up the right nostril, and got a got a glimpse of a green blade of grass before she pulled back.

"I know why she's sneezing!" I told the owners. But I knew I couldn't get it out with her awake, and general anesthesia would take a long time. I decided to try to give her a sedative for which I had a reversal, a technique I had not tried before.

It worked like a charm. Once the pup was limp, I extracted the long blade of grass with some hemostats. It had gone up over her soft palate - no wonder she was so irritated! I gave the reversal, and moments later she was walking out the door with her owners.

I felt such relief that I'd found the problem and come up with a good solution. So many times the first year I was a veterinarian I felt like every patient was as bad as a stressful final exam, but this was one day when I started to feel competent and confident.

Sweet Potatoes (for Auntie Norma)

My MIL told me growing up in Germany they would never eat Sweet Potatoes. They disdainfully considered them animal feed, and only ate white potatoes. But now she loves them as much as me.

They are far more nutritious than white potatoes, with beta carotene and fiber. Anna ate so many of them, pureed, as a baby, that she developed a beautiful golden glow. "Is that baby jaundiced?" an ER pediatrician asked us. When we told her why she was so orangey, she said, "You need to stop feeding her so many sweet potatoes!" Why? To make it easier for you to tell if she's jaundiced or not? Forgettaboutit.

Sweet Potato Fries

Cut sweet potatoes into 1/2 inch thick spears. It is not necessary to peel them, but you may want to cut the skinny edges off. Coat with a thin layer of olive oil. Spread in a single layer on a pan and bake at 450 degrees F. Turn after 10 minutes, and bake 10-15 minutes more until done. Sprinkle with salt or seasoned salt mix. They will be a little soggy, but you can still dip them in ketchup!

Roasted Sweet Potatoes

Dice potatoes, toss in olive oil and chopped rosemary, roast in oven stirring occasionally until done. Season with salt and pepper. Sometimes I mix in white potatoes, pearl onions, and/or whole garlic cloves.

Grilled Sweet Potatoes

Fire up the barby! Slice sweet potatoes on the bias into 1/3 inch thick circles. Coat w/ olive oil, S & P. Grill on high, turning after about 5 minutes, when nice grill marks appear. When done will be soft to the touch.

Auntie Norma, you can also roast them then mash them, mix in a touch of nutmeg and the slightest bit of maple syrup or honey, or grate them with white potatoes to make nice potato pancakes.

Just don't make that horrible American creation, Sweet Potato Casserole, with gooey sickly sweet marshmallows on top!


Aahhhh!


Gross!

Party pooped

I'm pretty tired tonight because we had a nice little "Sip and See" party for a coworker who had a baby. We couldn't have a shower before he was born because she was on bedrest. This way was nicer anyway, because we all got to meet the new little guy.

Anna really liked him!

And to all of you blog readers who were invited but didn't come? The food was delicious and the mimosas were divine...

Close Call with the Chicken Angel of Death

When Anthony came home from picking up Colin from school on Friday, this is what he saw:

A huge red-tailed hawk sitting on our back fence. Looking at our chickens, with visions of KFC in his head.


To give you some idea how big he was, the boards on the compost bins in front of him are 6 inches across. He was at least 14 inches likely 16 inches tall.

Anthony took these pictures and a short video of him flying away, then checked on our little flock.


We have 5 hens. He saw 2 huddled against the fence. The other 3 seemed gone. Anthony looked around awhile, then finally found 2 huddled inside their nesting box.

Still one hen missing, the "blonde" one.

Under our bamboo bush, Anthony spied a lot of feathers. Then he saw the bird, huddled, still, under the bush. Like Lazarus she got up when he went towards her, and hurried home. In the chicken yard with her mates, she ate and made contented chicken noises. Anthony checked her out, and saw that one of her wings was hurt, but she seemed more stressed being handled than anything, so he left her alone. We figure the hawk must have tried to fly off with her, but she was a little too big and too fiesty, and she slipped his talon grasp.

By the time I got home, it was dark. The chickens go to bed as soon as the sun sets. They act comatose at night, just like in that movie "Chicken Run." So I let her sleep and didn't check her until this morning. She was active and eating, and her lacerations practically unnoticable. I gave her a shot of antibiotics into her breast (biggest muscle mass on a bird, like our gluteus maximus) and told her, "Have a nice day! Watch out for raptors!"

Freaky Friday

Its Friday, and that means I worked all day and it was crazy. I don't know why, but Fridays at my work are always madness. Today it was because one of our doctors was out with a family emergency, the elderly-parent-in-the-hospital variety. The other doctor's grandparent died, and will be leaving for a funeral ASAP tomorrow. The other two doctors in our employ were out of town on vacation and on maternity leave. Nose to the grindstone time.

I saw so many patients with such a dizzying array of problems today, as I sit down to dutifully blog my mind is still processing them. First was the poor little dog hit by a car last night, with such bad ocular trauma she'll probably lose her right eye. Her left eye will likely survive but was full of blood, so right now she's blind. Looks like she was struck on the right side of the face, then landed on the left, breaking several teeth. She had so much pluck, despite the visual loss and pain! Speaking of blindness, I saw a cat with hypertension-induced blindness. Also, a cat juandiced with hepatitis. A dog with Addison's disease (nonfunctional adrenal glands, which regulate your immune response and electrolyte balance). She was doing well, in for a check-up, owned by a wonderful deaf man. He brought along his (hearing) toddler son, and it was amazing to see them communicate in sign.

Otitis externa.

Conjunctivitis.

Flea allergy dermatitis.

Luxating patella.

Periodontal disease.

Lymphocytic Plasmocytic Stomatitis.

Obesity.

Osteoarthritis.

Upper respiratory infection.

Then the last: a sweet cat that I've only known a short time but really liked. His owners had moved from Florida after the hurricanes to New Orleans, and were greeted by Katrina. They landed here in Austin, seeking help for their diabetic, hyperthyroid, obese cat. He'd needed a dental cleaning for a long time, but it was put off several times with all the moving. By the time we got him stable and scheduled, I needed to pull 4 teeth.

Today he came in unable to walk. He'd developed cardiomyopathy, and that created a blood clot, which broke loose and was lodge in his distal aorta. It cut off the blood supply to one of his hind legs, causing paralysis and pain. Sometimes we can dissolve these clots, but the long term prognosis is poor. Most throw another fatal clot in less than 1 year.

They wisely elected to euthanize, and we all said a very sad goodbye. But then there were patients to discharge and ready for transfer to the overnight hospital.

Thanks to the help of my excellent support staff, despite the heavy schedule I got a lunch break and left only 30 minutes after close. I'll finish those last few records tomorrow...

Pet Meds

Hey, I really appreciate all the blog subject suggestions. Thanks to Chicken Flicken, I don't have to buy that book. I'll start with medications that animals take that humans also take. We are all mammals, with nearly all the same organ systems, just a few species idiosyncrasies, really.

Dogs and cats that get diabetes take insulin. Infections are treated with amoxicillin, cephalexin, clindamycin, etc - the antibiotics are all fair game. Heart medications are identical - vasotec, digoxin, lasix, etc. When your pet goes under anesthesia, the same cocktail you had may be used on your pet, and the same fluids drip in the arm. Even the same cancer drugs are used, expensively.

Its easier to talk about what animals can't take. Tylenol will kill your cat. Almost all of the human Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) cause toxicity in dogs and cats. Fortunately, we have veterinary specific ones that safely work well. NEVER give your dog or cat Ibuprofen (Motrin, Advil, etc) or Naproxin Sodium (Aleve).

Safe over the counter medications include benedryl (but the dose might be higher than you think!), chlorpheniramine, topical cortisone creams, neosporin, and saline eye drops. Aspirin can be given, but evidence shows that even in small doses, it can cause stomach ulceration.

Here's a real life story: I had a client with a cocker spaniel suffering from arthritis. I put the dog on one of my favorite NSAIDs for dogs: Rimadyl. This is a wonderful pain reliever, and can actually slow the progression of the arthritis if given regularly. I gave it to my own dog, Terlingua, for 5+ years. I give it post-operatively to nearly all my surgical patients. It is a safe, effective drug.

All drugs can have some side effects, and Rimadyl can cause a liver problem in a minute population of dogs. If this happens, the dog is very sick with vomiting and complete lack of appetite, so you wouldn't miss it. It is reversible (unless you ignore it too long and keep giving the drug). However, some people have gone CRAZY on the internet and written all kinds of bad stuff about rimadyl, with no scientific evidence, of course. One of these websites has a name like "Rimadyl Death" and has stories like, "My vet gave my dog rimadyl and he limped less, but I didn't like the way he looked on it, so I stopped it. He suddenly died 6 months later! I know it was that evil drug pushing vet and the rimadyl!" I'm not exaggerating.

So, my client returns 2 weeks later and says he's really upset about being given rimadyl. His dog was better, but seemed worse when he was "not under the influence of the drug." He could no longer go up and down the stairs. His wife read about how horrible this drug was on the internet, so he stopped giving it to the dog. However, he had been so painful he had to do something, so he'd given his dog a ibuprofen every morning the last 3 days.

I had been very calm, listening to his unfounded complaints, but when he told me about the ibuprofen I lost it a little, and blurted out, "Oh no! You didn't!" Then I told him we needed to check his dog's kidney enzymes and start all kinds of medications to protect his kidney and stomach! After I left the exam room, I literally beat my head with my clipboard. How could he stop a safe medication that had been working, and give something DEFINITELY TOXIC to dogs? If they had googled ibuprofen and dogs, they would have also known the real dangers of that drug. If only he had called me with his concerns, I would have been happy to address them. You can be sure I sent him home with lots of literature (which I probably should have done the first day). Luckily, his dog is fine, and is on a different pain reliever, since the guy is still skeptical of Rimadyl.

The moral of the story is, PLEASE call your vet before giving anything, even herbal supplements, to your pet. Most medications work, but the dose may be different. We'd much rather get a call BEFORE than AFTER an accidental poisoning.

Under the Wire

Whew! I thought I might not be able to post today. Blogger was down the first 12 times I tried to log on.

Not that I have a lot to say, but I feel the pressure of NaBloPoMo. I've never been one to just speak to fill the air with my own words. I usually prefer to be quiet until I have something thoughtful to say. Some might mistake me for snobby, but I'm just introverted. I prefer to say nothing rather than open my mouth and prove my stupidity.

Having to post all the time, I feel like I am at a cocktail party. Not one with all my favorite friends, but one where I hardly know anyone, and I have to chat them all up to impress them.

I am trolling my brain all day everyday for blog ideas, and discarding most of them. Anyone have any subjects they'd like me to expound on?

PG-13 stories

Thanks, all ye commenters, for your encouragement during NaBloPoMo! 1 week down, 3.25 to go!



Today I have some funny work stories for you. At my clinic, the foul language has gotten quite out of hand. We have a few employees that are quite colorful and creative with their profanity, and pretty soon it gets a little too contagious.

SO! At our last staff meeting, the hospital manager admonished us to clean up those potty mouths.

"Yes," said my boss in all seriousness. "Swearing just isn't professional. Oh Sh!t, I'm bleeding!"



Moving along, two of my adult coworkers were telling me today they went together to go see "Flicka." They were there with all the little girls watching the movie because they, too, love horses. Only one of them kept cursing during the "intense" parts of the movie, and was surprised when her companion kept shushing her, or that the mom in front of them turned around to give her the evil eye. (I told you that cursing was catching!)

At the end of the movie, they both started tearing up (because these movies are always emotionally manipulative and really drag out the sappy parts. That said, Anna and I were dry-eyed). Then my friends looked at each other, crying at this silly preteen movie, and started laughing at themselves.

Only now, they were laughing and crying, and it sounded like they were sobbing, SOBBING because HER DAD DIDN'T SHOOT FLICKA AFTERALL!


Hope I didn't spoil it for you.

Girls' Day Out

Anna's school was closed today, a kind of combined Veteran's Day/Teacher In-service thing. Colin's school was open, so we sent him off and spent the day together.

We went on a bike ride for exercise. Anna did really well. She still has a little bike with training wheels - a quadricycle - but has only recently gotten the knack of it. Today she gained confidence and longevity. We went about 1.5 miles! Afterwards she was tired, and happy to get into the bike trailer behind me, so that I could get a little more exercise than I did just coasting behind her.

Then we went to an early bird showing of Flicka, a pre-teen chick flick about horses. We snuck in our own popcorn. She sat in my lap most of the movie. It was cheesy and cliche, but we both enjoyed it, since we're both girls who love horses.

**************

I really jinxed myself with yesterday's post... I was awake, staring at the ceiling, 3-5 am. Grrr...

To sleep, perchance

Anna's been a little under the weather lately, and at night she's been getting up a lot more. I'm not sure if its the virus or the low dose of pseudoephedrine, but she has disturbed us multiple times the past few nights.

Well, disturbed us, but Anthony is the one who gets up and tends to her needs. He is more alert than me in the middle of a REM cycle, and he can also quickly resume sleeping (or snoring, as the case may be). If I am sufficiently roused in the middle of the night, it may be an hour or two before I fall back asleep. I'm tired, but not sleeping.

The multiple interruptions to our prescribed 8 hours really has an affect. I try to let Anth sleep in to compensate, but both of us are sluggish the next day. (I know it doesn't compare to caring for a newborn though, eh Joey?)

Dogs do not seem to be affected at all in this way. They can sleep at will, apparently. If I get up in the middle of the night, one of my canine companions has often padded out to accompany me. Sure, they don't have jobs to go to the next day, but they are just as happy as not to get up in the middle of the night and to get up early the next morning. Maybe they figure they'll catch a nap later, no worries mate. But, you can wake them from that catch-up nap, too, and they're again happy to go along with you. No post-nap grogginess or grouchiness.

The hormones of motherhood changed my sleep forever. I used to be a deep sleeper, now sleep has a much more fragile hold on me. The flick of lights across my retinas is enough to banish sleep. I can feel it drain out of me, like water from a tub, and I just want to stand over it calling, "Nooooooooo!"

I wish I could sleep like a dog.

Saturday sadness

This Saturday at work soon turned CRAZY as I did a work-in splenectomy on top of the usual busy schedule. OK, you guys know I get a real adrenaline rush with these surgeries. It was a huge 100 lb dog with a burst bleeding tumor in his spleen. We suctioned of 5.5 liters of bloody fluid from his abdomen before we could get to work. That's more than a gallon, folks! The surgery went as well as it could, and we transfered him to the emergency clinic just 1 hour after closing time. Unfortunately, it's most likely a hemangiosarcoma, a very aggressive tumor that will come back after just 2-3 months. Its the same tumor that took our sweet Terlingua. Her emergency splenectomy was on a busy Saturday, too.

Last Saturday I had an urgent case, too, that turned tragic. A little old lady brought in her dog for coughing and lethargy. A heart murmur was detected in August, but she didn't have money to work it up. When he started coughing, she gave him benedryl, hoping it was just allergies. I knew immediately it wasn't. Xrays confirmed his heart was huge and his lungs were full of fluid. Congestive heart failure.

I gave him a massive dose of lasix and put him on oxygen. I told the little old lady the goal was to get him out of this crisis so we could send him home on oral medications, but he might have to be transfered to the Emergency Clinic for more treatment before he became stable.

The little old lady's adult son had driven her there, and he told me that she had just lost her husband, his father, to congestive heart failure just 2 years ago. Watching this big, strong man who had loomed so large in their lives decline to nothing over a short time was extremely difficult for all of them. They weren't sure their mom could watch her dog go through the same fate.

I did improve the poor dog's condition, but he still wasn't stable enough to go home. In the end, they decided to euthanize him. I was a little disappointed, medically, but I knew it was the right decision for this family. Her two adult sons came to be with the dog when I euthanized him; the dog was obviously happy to see them, and they were obviously sad to say goodbye to him. His death was swift, peaceful, merciful.

It was sad but I understood. The dog had a terrible long term prognosis; I could maybe eek a few more months out of him. Seeing him suffer and saying such a long goodbye would be too painful for his elderly owner, would bring up too many painful memories.

I saw her again at the clinic this week. As I held her hand, she thanked me for helping her sweet dog. She told me how much she missed him, how "fast" he'd gone downhill, but it was obvious she was already healing. I embraced her and told her she'd made the right decision, letting her dog go last week. And, I really meant it.

Hypocritical

I was standing in line to vote early today. The woman in front of me saw her husband approach, and called out to him as he walked toward her, "Honey, I know we're going camping, but you don't even match!"

He was wearing: a black rugby shirt with a dark blue stripe, dark green pants, and black shoes.

He didn't match, but at least all the colors were in the same family.

She was wearing: a red ribbed sweater, navy knit pants - high waters, to show her fuschia socks, and black shoes.

Maybe they don't have a full length mirror at home.

'Shrooms, man...

I treated a cute little puppy today who was quite sick. She went out into the yard and ate all the mushrooms she could find. Then she came in and vomited her cute little guts out (vomited 8 times in less than an hour). Her owners adopted her just 2 weeks ago but already are totally in love with her, and they were very concerned.

They brought me vomited up previously chewed mushrooms in a ziploc bag. "I can't really identify these; I'm not a mycologist," I said. The owner said, "Its obviously some sort of puff-form fungus, with internal gills." I said, "You sound like you know more about it than me!" and she blushed and told me she was a biologist.

I knew we had to treat the puppy immediately for the nausea, and put her on fluids to flush any toxins out. We gave her a large dose of charcoal to absorb anything that remained. The owner sent me a digital image of some more mushrooms she found in her yard. They were a relatively nontoxic type, and should not cause any liver or neurological problems. To be safe, I sent her home with a liver protectant.

The puppy was beginning to return to her bright, perky self at the end of the day. She started out looking bleary-eyed, nauseated, and lethargic. Didn't seem like a very pleasant trip to me...

Hey, big spender

The tooth fairy got caught up in Anna's excitement at losing a tooth and left a Sacagawea Dollar. For my English readers, we Americans don't have any coins in regular circulation over 25 cents. A few years ago a beautiful golden coin was released with a portrait of the Native American woman who help Lewis and Clark explore the west. But people complained that it was too similar to the quarter in size, and too hard to carry around, and there was not room designated for it in cashier drawers or vending machines. However, they are not at all heavy compared with carrying a few pound coins in your pocketbook! So now, you hardly ever see Sacagawea dollars, and they tend to be hoarded and not spent.

Apparently, the tooth fairy overpaid. This morning Anna told me she was expecting maybe a dime and a nickel.