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Sunday, October 31, 2010

Chupacabra Revealed

Here's a story that's perfect for Halloween.

For those who aren't into cryptozoology, the chupacabra is a creature seen in parts of the Americas that has a legendary status similar to Bigfoot and the Loch Ness Monster. The name literally means "goat sucker" based on its behavior of drinking the blood of goats and other farm animals. The Wikipedia entry on chupacabras lists the following description:  
The most common description of chupacabras is a reptile-like being, appearing to have leathery or scaly greenish-gray skin and sharp spines or quills running down its back.This form stands approximately 3 to 4 feet (1 to 1.2 m) high, and stands and hops in a similar fashion to a kangaroo. In at least one sighting, the creature was reported to hop 20 feet (6 m). This variety is said to have a dog or panther-like nose and face, a forked tongue, and large fangs. It is said to hiss and screech when alarmed, as well as leave behind a sulfuric stench. When it screeches, some reports assert that the chupacabras' eyes glow an unusual red which gives the witnesses nausea.

Here are some images of what the chupacabra is supposed to look like...

There is no scientific proof for this creature, though biologists and other scientists have tried to prove or disprove its existence.  As shown in a recent Discovery News article, most mainstream scientists believe that sightings of a chupacabra are actually a case of mistaken identity with the actual creature being an extremely mange-ridden coyote or wild dog.  Compare the images above to the pictures and video capture below.
I've always had a passing interest in cryptids, having learned a lot about the Yeti and Sasquatch as a child and having been to Inverness and Loch Ness as a teenager.  Besides my interest in the fantastic and mythological, I also find these creatures intriguing because of my background as a biologist and veterinarian.  In the case of the chupacabra, the thing that fascinates me the most is that the type of mange scientists believe are affecting these canids is scabies (Sarcoptes scabiei).  I've treated many cases of these mites!

This is actually a not-uncommon external parasite of dogs and can affect pet dogs.  In the huge majority of cases the pets see us vets long before they get to the point of complete baldness, as the mite causes intense itching.  It's also a mite that is relatively easy to treat through several methods and is not considered a major health concern. Yet in wild animals the mite can lead to severe skin disorders and even death due to weakness and secondary infection.

Does the chupacabra actually exist?  My instincts say no, though I'm sure there are cryptozoology aficionados who can argue otherwise.  Other cryptids?  I think the jury is still out on some of them.  And frankly, I like the idea of there still being some mysteries left in the world.  It keeps things from being too boring.

Happy Halloween!

Thursday, October 28, 2010

A Little Stardust

A new adventure has begun in the life of the Bern family.  Today we brought home our new puppy.

After losing our dog, Guinevere, to lymphoma in the brain back in August, my wife had been wanting to get a new puppy that she could bond with and have as a snuggle-buddy.  Last month we found a Labrador retriever breeder that had a litter of puppies born September 15th.  My wife picked one out, we waited until she was old enough, and today we brought her home.

Little Yvaine (pronounced "ee-vane"; "Evie" for short) is named for the female lead in the movie Stardust.  Played by Claire Danes, Yvaine is a living star that falls from the sky and is discovered by a young man named Tristan who has left his home to recover the fallen star for the woman he thinks he loves.  Yvaine and Tristan go on an adventure as he brings her back, and the two end up falling in love.  It's a great fantasy and romantic comedy, one which I would recommend to anyone who likes happy endings.  And Robert De Niro has a very memorable role as a tough skyship captain who has a secret affinity for frilly dresses.

Our Yvaine slept the whole way home and has had the typical puppy pattern of moments of playfulness interspersed with deep sleep.  She is a really sweet girl but with a bit of a rotten streak.  She is pretty courageous, already having dared going up and down the stairs at our house, something other dogs have taken months to master.  Right now we're trying to get her to calm down enough to go to sleep, and it's a bit of a challenge.

The cats are avoiding her so far, and don't seem too eager.  Our oldest cat, Pooka, isn't as upset as we thought he would be, as this is the third dog that has been brought into his house during his lifetime. Maybe he's getting used to it.  Our other dog, Inara, was eager but unsure at first.  She is still very curious and is starting to play, though Yvaine startles her a bit at times.  Once Inara gets used to the newcomer, I can see them terrorizing the house with their play.

The kids are pretty obsessed with her, which is understandable right now.  As is typical for children their age, they're arguing over who gets to pet her or feed her.  But they are responsible kids, and it's always been important to me that they learn how to properly handle and care for pets, so I know they'll settle down into a normal pattern within a week or so.  By then my son will be back to his video games and my daughter will be tired of cleaning up puppy poop.

My wife is thrilled.  After all, this is her baby, and something she really wanted.  Yvaine is already bonding with her and I came home from shopping this afternoon to find the two of them curled up next to each other on the bed taking a nap.  She's going to spoil this little girl, but I must say that I love seeing the glow in her face when she kisses the little puppy's nose.

And the adventure begins again.  Housebreaking, obedience training, dealing with a whining puppy, handling her chewing on things she shouldn't, cleaning up messes....all of that over again.  But it's worth it to have the little bundle of fur cuddle next to you and see those deep brown eyes.

Wednesday, October 27, 2010

Yodeling Veterinarian?

For those who aren't familiar with VeggieTales, let me give you a little peek.  Created as a children Christian video series, the appeal of the CGI cartoons has reached the mainstream.  Besides the Biblical lessons and values they are also just fun and entertaining.  One of the key features in all of the videos is "Silly Songs With Larry", one of the main characters, who happens to be a cucumber.  These silly songs are just for fun and can make even adults laugh.

A few years ago they produced one Silly Songs entry about a veterinarian.  Of course this caught my attention, and since then it has become one of my favorites.  Enjoy!

Tuesday, October 26, 2010

Questionable Anal Mass

Gayle sent this in...

Bandit has always been a healthy Dog!!
but recently he has developed a problem there is a round marble size blood red thing that keeps coming out of his anas he 's not able to have a bowel movement my husband keeps pushing it back in and Bandit seems very happy for the help lol but I'm worried and normally would have him at the vet but we have been out of work for 6 months we have to wait for some money to come in please tell me what this could be and where i can do some research on it thank you so much 
Gayle, I know these are financial hard times for many people, but this is something you really need to see a vet about as soon as possible.  If he is having problems defecating it can be a very serious problem. Several things could be the cause, including a hernia, rectal polapse, polyp, or tumor.   If it's a tumor it or hernia, it would need to be corrected as soon as possible, and would require surgery.  Without actually seeing the pet I couldn't be more specific than this.

Earlier this year I had a similar problem in a patient.  There was some bleeding from his anus and we thought it was colitis or a similar problem that would cause blood in the stool.  The owner thought they had seen a small mass, but I had done rectal exams and not found anything.  One one follow-up visit they brought some pictures of the strange mass, taken on their cell phone camera.  It was definitely a polyp of some sort, so I did another rectal exam.  This time since I had an idea of what to look for I was able to feel a very small mass on the "roof" of the rectum that could be easily pulled outwards with my finger.  It was a soft mass and almost blended with the rectal wall, which is why I had missed it before.  We scheduled surgery and I was able to remove the polyp without complications.  It was a benign growth and healed normally.

I know this is a difficult financial time, Gayle, but not being able to have a bowel movement is a serious problem and you need to see a vet this week.  Good luck.

Sunday, October 24, 2010

Yes, Males Have Them

One of my favorite humorous web sites is Not Always Right. Today I came across this post under the title "Nip-Picking".  Though I've not dealt specifically with this situation, the idea of males having nipples seems to be a strange concept for many people to understand and I've certainly had to try to convince clients of this biological fact..  Enjoy this real-life encounter.


Vet | Ontario, Canada
(A customer brings her dog to the front desk in a panic.)
Customer: “My dog has fleas, so I need you to help me. I have been using the flea medication you gave me, but I can still see flea eggs.”
Me: “Ma’am, you can see flea eggs?”
Customer: “I have been trying to pick them off, but they seem to be stuck.”
Me: “Ok, can you show me the eggs you have been trying to pick off?”
(Customer lifts up the dog to show me it’s belly.)
Customer: “See! These!”
Me: “Ma’am, those are not flea eggs, they are his nipples.”
Customer: “Nipples? But he’s a male, how does he have nipples? They have to be flea eggs.”
Me: “I assure you, he has no fleas, and the ‘eggs’ you have been trying to pick off are in fact his nipples.”
Customer: “Get the vet, you don’t know what you’re talking about, he’s a male! He can’t have nipples.”
Me: “Ma’am, do human males have nipples?”
Customer: *stares blankly for a moment* “Well s***!” *walks out*

Saturday, October 23, 2010

Both Ends And The Middle

Doesn't it sometimes seem like your life is crazy and nobody else can compare?  Sure seems that way to me.  We go around in our lives with a "to-do" list as long as our arm and try to survive what it takes to get through it.  That can mean that when we're interacting with others we may be a bit short-tempered, never realizing that they are going through the same things.

I'll see this often with my clients.  They are hoping to rush in and rush back out since they have to pick up the kids, plan for a party, clean house, and so on.  When we don't usher them from the front desk to the room and back out again in 10 minutes, they get a bit miffed.  After all, they have so many other things to do, they can't take the time to wait like a normal visit, and expect us to hurry it up.  Unfortunately, quality service usually can't be rushed.

Now this isn't really a complaint against my clients.  Actually, it's a realization from the other side of the fence.  Lately my wife and I have been burning the proverbial candle at both ends AND the middle.  Here's a quick list of the things that keep me busy in my life....
Hospital manager
Father to two
Volunteering in community theater
Leading a geek/fan ministry online
One of the leaders in my local church
Teaching online for a local college
And that's just a list of my regular responsibilities, without getting into the details of the numerous things I do for each.  That also doesn't include things like helping my wife keep the house picked up and trying to find time to simply relax, peruse the internet, read, or blog.

Today I was rushing to the theater to get ready for the show.  I'm managing the lobby and have it decorated for Halloween and have to bee there at least 90 minutes before curtain to make sure everything is in order, as well as put on my own costume.  I was sitting in the drive-thru at a fast-food restaurant waiting at the window for my order and started to feel very impatient.  If I didn't get my food quickly, I was going to have to rush even more! I started tapping my fingers on the steering wheel and could feel my muscles tighten.  They were making fresh fries, so it was taking longer than normal. But I had to get going! At that point I made myself realize that they were doing their job, I was going to get fresher food, and it wasn't their fault that I was the one in a hurry.  There was no reason for me to take it out on them by getting short-tempered.

When I'm at work I have to try and put aside the thousands of other things running through my mind and concentrate on my cases.  But while I'm reading lab results I may start to think about the decorations I need for the theater.  While I'm doing a spay my thoughts may drift to the exam I need to make for the online class.  Like everyone else, I often have to juggle multiple ideas and priorities, keeping them all straight.

So the next time any of us get hurried and stressed, remember not to take it out on that doctor, waitress, cashier, or any other person.  Chances are that they have just as many things that they're dealing with also.  Let's show each other a tad more courtesy.

Inaction On Seizures?

Jessica sent this in yesterday....

A night or two ago, my mom called me at school hysterical, saying that something was wrong with the dog.
She described to me that the dog, a Boxer/Beagle mix named Cooper, had fallen to the ground, couldn't stand up, and was foaming at the mouth. He peed himself and I guess it looked pretty bad. Then in less than three minutes apparently he was up and wagging his tail.
I'd never seen him do that, but before I went to university my sister woke me up one morning, freaked out, saying that something was wrong with the dog and he was growling at her. I got up and checked on him and he was laying on the couch. He seemed fine and wasn't acting out of the ordinary but when felt him his chest was soaked and I noticed there was some remnants of foamy saliva on his mouth. At least one other time before leaving I found him with spit all over his chest. I thought that he must have eaten something strange that made him salivate heavily like that, like when our last dog somehow stole a whole pork roast off the counter and ate the whole thing... in one gulp.
But when my mom told me about this I thought something must be wrong with him neurologically. I work at a doggy daycare and I know of a few dogs that are on seizure meds and what happened to him sounded like a seizure.
I told my mom to call the vet and they said to bring him in, but he would be fine, but when they ran the bloodwork everything came back positive. I thought it was strange that they would run bloodwork for something that seemed neurological but they said they wouldn't do anything for now and that he might have to go on meds if it kept happening.
I thought that their inaction was REALLY strange. What do you think? Can you tell me more about identifying seizure problems and its treatment? I'm puzzled by this. Especially since evidently he's had more than one in a short span of time. Maybe two or three months tops, he's had at least three, the last one being fairly serious. 
Good questions, Jessica, and I'll try to answer them.  There is a lot that goes into seizures that people may not think about, and it's not always a simple situation. A seizure is basically a mis-firing of the neurons in the brain.  Imagine a city with lots of one-way streets and traffic flowing fairly well along the roads.  Then all of a sudden cars start going in directions that they shouldn't, ignoring stop lights, and pretty much moving around erratically and with no regard for the normal rules of the road.  Chaos would ensue and the city would be tied up in gridlock.  In a very simplistic nutshell, that's what happens during a seizure.

Seizures can be caused for numerous reasons.  Certain toxins can cause seizures, including many over-the-counter flea preventions.  Low blood sugar (hypoglycemia) can also lead to seizures, as well as liver dysfunction or failure.  Brain tumors and even infections can affect the nervous system and lead to various neurolgical disorders.  And then there is epliepsy, which in dogs is a seizure disorder with no discernible cause.  Once other causes have been ruled-out, a good rule-of-thumb is that if the seizures start at or before five years old, it's probably epilepsy; if they start after five years old there is a high likelihood of a brain tumor.

When we're examining a pet for seizures, the first set of testing that we do after the exam is basic blood testing.  As I mentioned above, there are many reasons why various metabolic and organ disorders can impact the nervous system, and we want to screen for infection, toxicity, and other disorders. Any of these problems are treated very differently from each other, so we need to try and figure out what it may or may not be.  

If all of the tests are normal, this is a good thing.  It means that the vet has eliminated many disorders and in this case indicates that we likely have epilepsy.  This disorder is not life-threatening and doesn't normally cause long-term damage to the brain or nervous system.  It can become worse with time, but there is no way to predict ahead of time whether this will happen.

Treatment is normally reserved for very severe or frequent seizures.  The medications must be given twice daily every day on an ongoing basis in order to effectively prevent seizures.  These medicines also can have some significant side-effects and can damage the liver, so we don't normally use them in mild cases.  My own rule of thumb is that I start to consider anti-seizure medication when the patient is having a seizure every month or more frequently.  Short seizures that happen every few months aren't normally treated, as in these cases the risks of the side-effects of medication don't outweigh the benefit of controlling the seizures.  In cases like this it's common to NOT treat and observe for worsening, at which time we can consider treatment.

So basically it sounds like your vet did what I would normally do and made similar recommendations.  Hopefully you understand a little better the reasoning behind those decisions. If you have any further follow-up questions, feel free to ask.

Wednesday, October 20, 2010

Incorrect Heartworm Prevention

Here in the US heartworm preventative medications are sold as prescription drugs.  Depending on where you get it and the size of your pet, a six-month supply normally costs from around $30-60.  Honestly, this is a good price considering that treating heartworm disease can easily run $800-1000.  Suddenly $5-10 per month doesn't sound so bad.  But even with that minimal cost many people try to find ways to do it even cheaper and avoid having to do the annual heartworm testing required by most veterinarians.

Most horse antiparasitic medication is easily available over-the-counter at farm supply centers, and people will try to use this instead.  On first glance, it seems like a good idea.  The main ingredient in the most common heartworm preventions is ivermectin.  This is also a common ingredient in many horse dewormers, and these equine medications are usually much cheaper.  So some pet owners will purchase horse medications and give it to their dogs as heartworm prevention.  Theoretically there isn't anything inherently wrong with this method.  However, there is a significant danger that most people aren't aware of.  In high enough doses, ivermectin can be toxic.

A single tablet of ivermectin-based heartworm prevention for the largest category (51-100 lb dog) contains around 0.27 mg of ivermectin.  Horse medication is much more concentrated since it is designed to treat a 1200 pound animal at a dose of around 0.09 mg per pound.  Dosing based strictly on weight, a 100 pound dog would then receive 9mg of ivermectin rather than 0.27mg!  This 33 times the recommended dosage!!!!  If someone is not VERY, VERY careful with the dosage, it's easy to overdose a dog using horse medicine.  And this happened in my clinic yesterday.

A small dog came in very lethargic after having been given horse dewormer as heartworm prevention.  The dog was sedated and showing slight neurological signs, classic symptoms of ivermectin toxicity.  The owner's neighbor used horse dewormer as heartworm prevention, so she decided to do it herself.  Unfortunately she gave far more than was needed and the dog suffered because of it.  Thankfully, the toxicity was mild enough that the dog will recover.  In many cases of ivermectin overdose if you stop giving the medication immediately the symptoms will resolve.  But in severe cases you can see severe neurological disorders that can be very harmful.

There is also a problem in certain breeds of dogs, mainly herding breeds (collies, border collies, and related breeds).  These dogs have a genetic quirk where they lack a gene to produce an enzyme that will break down and eliminate ivermectin from the body.  This abnormality makes these breeds especially sensitive to ivermectin.  The doses found in heartworm preventions are low enough that there isn't a concern, but when using doses higher than this you can run into toxicity very quickly.

The bottom line is that you should only use medicines that your veterinarian specifically recommends.  Doing otherwise could lead to harm for your pet and potentially expensive veterinary visits to treat unwanted consequences.

Monday, October 18, 2010

Being The Boss

Sometimes I really don't like being "the boss".  I'd love to be able to expect everyone to do exactly what they should every time, but unfortunately that's not always the case.  I've been dealing with some issues with my staff for some time now and today had to get hard with them.

I have a good staff overall, and everyone has very good technical skills.  However, several of them have been having some bad attitudes.  We've admittedly had a lot of changes in our procedures and patterns over the last few months, including a new head technician.  And things haven't always gone smoothly.  But this has turned into a lot of complaining, bad-mouthing other staff, and leaving work for others to finish.  People are complaining about each other, and I've seen situations where they complain about something someone else has done, yet they've done something similar.  It's been really affecting the performance of the team and our efficiency, so something had to be done.  I've talked to some individually, but this needed to be addressed as a group.

So today we had a staff meeting, and I laid it out.  I talked about the problems I've been seeing and the performance issues.  I also had to tell them that I would no longer tolerate these behaviors, and if they continued I'd be happy to accept their resignations or would pursue further disciplinary actions.  We're already short-handed and in the process of hiring, and it would hurt us to loose more people suddenly.  But at the same time I'm willing to deal with that short-term problem to fix a long-term issue.

I hate having to deal with people like this, as I'm a basically non-confrontational person.  But at the same time I'm ultimately responsible for the performance of the clinic and the staff.  So over the years I've had to fight against my natural inclinations and actually discipline and discuss difficult subjects.  It hasn't been easy, and I've certainly made my mistakes, but I've also developed some skills that allow me to actually make it through these times.  But yeah, being the boss sometimes sucks.  Still, you have to take the bad with the good, and I accepted this responsibility.

Now we just have to see if the sterner measures will result in a difference or if I'll have to take it to the next step.

Friday, October 15, 2010

Rescuing From Abuse

Don sent in this poignant and powerful story, which I've edited a bit for the sake of brevity...

I was wondering if you have had any experience in helping abused animals and law enforcement? The reason I ask is I am trying to help an abused dog.
Last month our next door neighbors had a woman move in with them. She brought a dog. They put the dog in a cage ( 4 by 4 feet) with a tarp over the top. The cage has a wood floor. There is nothing else in the cage. No toys, chews, hay, dog house..nothing. They give the dog food and water in the morning and that is it. They never speak to the dog, pet it or pay any attention to it.The cage floor was kept clean.  I did nothing at first because i was not sure if this was a temporary situation and perhaps the woman was down on her luck and was maybe looking for a place for her and her animals. Anyway about a week ago I began to notice the woman was no longer around. The floor of the cage began to pile up with feces. I went over to our neighbors and asked about the dog. The owner of the property said that woman had to leave for a few days and he said he does not really like the dog and he is scared of it. So I offered to walk the dog and look after it but the man said he will have to ask her first....Anyway two nights ago there was a big rain storm with lightening and thunder. So again I went over and asked the owner of the home if I could put the dog in an enclosed shelter for the night: out of the rain. I told him we have an enclosed shelter.  He agreed and we took the dog into our home. He was so thirsty and hungry, he drank five bowls of water and ate three full cans of wellness. Now I have been checking on him and I see they give him food so I am not sure why he was so hungry. Here is the other strange thing. From looking at him through our window it is hard to see him clearly but once we had him in the house it was clear he is extremely under weight. You can see his spine and ribs easily. I picked him up and he did not weigh more then 20 or 30 pounds...He also is kind of wobbly on his feet, (like a man that has one drink to many). One side of his face is pulled up higher than the other side. He has a cyst on his chest that when touched is painful to him. I could see him wince. he also has hot spots on his feet...The next morning the woman who owns the dog came by to get him from me. I tried to keep it lite and i told her how nice and smart the dog is. She gave me a phony story about how she was in a car accident and that is why she was not around, she even added a tear in her eye to show how concerned she was. She told me she has owned him since he was three and he is twelve now. She then said in a song song voice " mommy is taking you home now". Apparently home is back to that cage because that is where he is now.
I found a rescue group that is dedicated to helping chained and penned dogs and there is a person that I am in contact with. They are helping by listening to me and offering advice. 
In fact the woman that started this group was arrested once for taking a dog off a property. The dog had been laying on it's side for three days in a yard and could not get up...So she had no choice but to take the dog and bring it to a vet. So she was arrested for stealing the dog. Long story short she refused to give the dogs location and the dog lived in a secret home. The prosecutor and AC refused to look at the photos and video of the dog in the yard. It is a well documented story with news paper articles to back it up. It all seems very grim and stupid.
Here is my plan. I am going to tell the woman that I have been looking for a nice friendly pit bull like her dog for a while now and I will offer to buy it. I don't want to go on about how much better i will treat it because I don't want her to be defensive. I will just keep it short and sweet. If she wants more info then I will explain that I plan to keep it as part of the family and take care of it etc....
I have already called animal control ( our animal control officers seem to be very concerned about animals unlike the other stories I have read ) and checked with them. Terry and Debbie ( we have two AC's) said that the dog must have a shelter not a pen by law and also if he needs medical care the owner will have to provide it. I explained my plan about offering to buy the dog and they think it is a good idea. They are on standby and are waiting for my follow up.  If the woman does not want to sell the dog then I will make a complaint with AC and ask them to investigate. I will then keep in touch and follow up. If the woman does not want to help her dog I am hoping the pressure from AC will either help the dog or cause the woman to sell it to me.
Is there any advice or experience you might have? I am willing to help this dog in whatever way I can.
Don, these are always difficult situations, and honestly it sounds like you're doing the right thing.  You do have to be careful in situations like this, as legally the lady owns this dog and if you take him, even for good reasons, it's no different than you taking her TV or couch.  However, there are laws against both abuse and neglect.  Abuse is usually more straightforward as there are wounds and signs of being physically beaten.  However, neglect can be just as bad or worse, and is also just as illegal.  You can't in good conscience ignore either situation.
In this case it sounds like it's neglect, and based on what you've described it's probably criminaly prosecutable.  First I'd say try to get photos and videos of his normal environment.  This will help support the case if it ever ends up going to trial.  You've already done the next step of contacting your local animal control division, and thankfully it sounds like you have some good people there.  Most animal control officers really do care about the pets they investigate, but this is also one of the most under-funded departments and they usually don't have the resources to fully investigate every case like they wish they could.  But in order for anything to be legally done, the officers have to be the ones involved as you can't bring a criminal case against someone without being in law enforcement.
I really admire how you've decided to handle the situation.  Offering to take the dog sounds like a great solution and if it works would likely take care of everything.  However, I have a feeling that she won't be willing to give him up, which will complicate things.  I can't give better advice than what you're doing, and think you should proceeded as you've laid it out here.  You seem to have things well under control.  
But please let me know how things turn out! 

Sunday, October 10, 2010

Important Differences

One of the challenges of being a vet is that there are differences between the kinds of patients that we see.  There are some pretty big differences between dogs and cats, including their physiologies, tendencies for diseases, normal laboratory values and so on.  There can also be significant differences between breeds within a species.  Some examples...

*Cavalier King Charles spaniels have giant platelets.  These platelets are larger than in other dogs, but function normally.  The problem is that the automatic blood analyzers we use in our hospitals measure cells based on size.  Because these platelets are larger than the machine is expecting, it will give a lower platelet value than actually exists.

*Greyhounds have a higher percentage of red blood cells in their blood than other breeds.  A high percentage of cells can indicate dehydration or certain diseases, but is normal in greyhounds.

*Asian breeds can have a higher than normal potassium level.  This includes chows, Akitas, and others.

As far as I am aware, differences this significant don't really exist among human races.  There are some racial and regional differences, but some of the largest ones are due to environment and not genetics.  For example, people who live at higher elevations have a higher density of red blood cells than people who live at lower altitudes; but this can change the longer you live at a given elevation and so is a physiological adaptation and not a genetic difference.  I would be very interested if anyone has examples of true racial differences as significant as those seen in animal breeds.

Such differences can make a veterinarian's job challenging.  When we're interpreting lab values the analyzers will give us a range of "normals" and will let us know when something is outside of that normal range.  We then have to figure out of that out-of-range value is truly significant, incidental, or related to the breed.  Determining disease is not as straightforward as it may sometimes seem.

Remember a veterinarian's motto:  "Real doctors treat more than one species!"

Friday, October 8, 2010

Priorities, Please

Because I'm the Chief of Staff at my hospital I sometimes get calls on my days off.  That's usually not a good thing, as most of the time it means that there's a problem of some sort.  Yesterday I received one of those calls.

Wednesday I received a call from a client with a bearded dragon.  Apparently it had a swollen, white eye and she was wanting to know what to do.  I was concerned that there was an infection or injury and asked if she could bring it in.  She had some things to do, but said that she would be there in 30 minutes.  Two hours later we closed and I hadn't seen or heard from her.

Then yesterday she brought him in to be seen by one of my associates since it was my day off.  The doctor determined that it was a shedding problem and began to moisturize the eyes, working on getting the improperly shed skin off.  While the beardie was in the clinic a serious emergency came in.  A client's cat had been attacked by a dog and there was a deep wound fully into the abdomen where the bladder was visible.  So my associate rushed the cat into emergency surgery to try and save its life.

Here's where it gets crazy.  The owner of the bearded dragon came by the clinic even though she hadn't been called.  She insisted on talking to the doctor, but she was in the middle of the surgery at the time.  The client was told about the emergency surgery and that the doctor could talk to her later.  The client began to get upset and wouldn't be satisfied with this explanation.  She actually wanted to go into the back and talk to the doctor about her lizard while the doctor was in the middle of a life-or-death surgery!  The client didn't care what the doctor was doing, she wanted to speak to her RIGHT AWAY!

Ummm...priorities, please?  That was a very selfish client.  Yes,  I know that she was worried about her lizard, but he wasn't critical.  Emergencies happen and need to be given priority, which my associate rightly did.  The client also wasn't satisfied with what the doctor told her was the problem since I had mentioned an injury or infection on the phone.  Keep in mind that I'm always careful with my wording and I had told her that it sounded like an injury or infection and didn't sound like a shedding problem.  Based on that she felt that I had told her that it definitely was an infection, and so wasn't accepting what the other doctor (who actually EXAMINED the pet) told her.

So I got a call about all of this.  And I supported whatever my associate saw and decided, and agreed that the client would have to wait until  the cat was stabilized.  The client was being unreasonable and if we end up losing her over this I won't be upset.

Thankfully, most clients are understanding in situations like this, and we rarely have problems in these circumstances.

Thursday, October 7, 2010

Back To Life, Back To Reality

First, let me say that Disney World was great. The kids were completely surprised, and it was wonderful to see their excitement at being where they had dreamed about.  In fact, the first day we were there the kids kept talking about how they felt like it wasn't real and were worried that they would wake up. We wore ourselves out, though.  Since we were only there for four days, we wanted to maximize what we saw and did.  Each day we got there as the park opened at 8 or 9 o'clock.  We then stayed until the last park for the day closed, and didn't get to sleep until 11-12:00 each night.  This meant that we got around six to seven hours of sleep each night.  By the last day we were absolutely wiped out.  Even so, we didn't want to come home.  The Disney company may have its faults, but they really do make a magical experience at their parks.  We're already planning when we can go back.

Unfortunately, the fairy tale had to end at some point.  The worst part of any vacation is coming back and seeing what fell apart while you were gone.  In my case I returned to find more staffing problems that I have to sort out.  I lead a fairly dysfunctional working family and some interpersonal problems have been getting worse. For whatever reason it came to a head while I was on vacation so I came back to have that issue to resolve.  Isn't that the way it always happens?

But now I have some great memories with the kids and the joy on their faces.  I have literally hundreds of photos and a few dozen video clips to look back on when things get crazy at work, all of which will help me remember a more magical time.