Lacking Passion For School And Science

Here's an email from Emily.....

 

I am currently a sophmore at Western Michigan University studying Biology and am running into a rough patch during undergrad. All of my life I have loved animals and have thought I have wanted to be a Vet. I even have job shaddowed my local small animal veterinarian and loved every minute of it so I thought this will be the perfect job for me, but now I am doubting my choice.

I was always good in school during high school and got a 3.84 GPA at the end of it and I enjoyed my science classes. Then I started college, my first semester I did great! All A's and B's, then came second semester taking General Chemistry and Molecular and Cellular Biology, I studied hard and ended up getting two DC's on my transcript and retook them the next semester and got B's in both subjects. This brought my GPA down to 3.04. Anyways I am just about to finish my sophomore year of college and am starting to question my choice in pursuing a veterinary career. I love animals, but I feel like my passion for science and school work is definitley not what it used to be. I find it very interesting but I am not good at it and also adding another four years to my college career seems frightening and I have read blogs about people's live in vet school and it doesn't get any easier. I am thinking of becoming a Vet Tech, but my parents discourage me saying that I am smarter and should try to pursue my original dreams of becoming a Vet. How do you think I can decide between the two careers, Vet tech seems like the easier way out, but still rewarding, just less money. But Vets don't make that much considering the amount of money they put in for their education. I am in a pickle, I just don't know if I have the passion for school to succeed in vet school.

 

First, I'd suggest doing some keyword searches on this blog, as over the years I've talked a lot about the pros and cons of a veterinary career and whether or not it is worth it.  You'll find similar questions to yours and various answers that I've provided.

 

Simply put, if you don't have a strong passion for being a vet, don't do it.  Going through vet school was the hardest and most challenging thing I've done in my life, and that includes having studied for and received a Master's Degree just before that.  Vet school is actually more grueling than human medical school because you have to know so many different kinds of anatomy and physiology.  For four years you'll have little to no personal life and won't have time to hold down more than a part-time job.  Once you graduate you can expect long, hard hours and make a fraction of what you really should make.  Current average debt load coming out of vet school is around $160,000, yet average starting salary is around $60,000.  A recent study showed that the return on investment (ROI) for veterinary school is so bad that an average vet will be 65 years old before they break even for the amount of money and time they put into their education.

 

So with a bleak picture like that, how do we do what we do?

 

Passion.  Passion for pets, passion for medicine, and passion for the people who have pets. 

 

This is not an easy job, and it can be a struggle for newly graduated vets to make a living nowadays.  But it can still be very rewarding, which is why people continue to do so.  My rewards are not from my salary, though I'm paid decently.  I keep doing this because I get to make a difference in the lives of people and pets, I get to teach and train my staff, and I simply find medicine and surgery to be fascinating.

 

Stop and think for a few minutes.  What is it about veterinary medicine that excites you?  Are you comfortable with the idea of doing surgery every day on pets?  Do you think how a body works is really cool?  Do you want to interact with people and teach them how to be better pet owners?  Can you handle when cases don't go right or when a client refuses needed care?  Are you prepared to work you tail off to make a comparably small amount of money? 

 

There is nothing wrong with changing your mind about your career.  You have to have a huge desire and passion for science and school in order to survive a veterinary education.  No, we really don't like all of the study, but it's a necessary evil and you need to see this as a true calling rather than simply a job.  Because you have to look back on it after graduating and being in practice and ask "was it worth it?"

 

Becoming a veterinary technician is not a second choice!  It doesn't mean that you aren't smart enough to be a vet!  I have known many techs who have just as much intelligence as the veterinarian for whom they work.  Becoming a vet doesn't mean that you're "smarter" than a tech.  Many people chose to be a tech as their first choice, and are happy in that career.

 

Do some soul-searching, Emily.  If becoming a vet seems like more work and hassle than you are willing to do, then it's not going to be a career in which you are happy.  Besides....you can become a technician and still go on to vet school later if you decide that you really do want to be a doctor.

 

That actually brings up a related question by a reader, which I'll post in a few days.

Wild Poop And Pond Water

This is a question I received from Crystal....

 

A recent question from another reader regarding horse poop is somewhat similar to my question. We have a variety of wildlife that come through our yard. Our puppy has sniffed out wild turkey and wild rabbit poop and it is in her mouth before we can get her away from it. We are trying to teach her to leave it but so far have not been succesful. We are concerned about what she might pick from eating these nasty treats.

We also have a koi pond that she likes to drink from. We are providing clean water in a dish outside for her but drinking from the pond is more fun.

Should we be concerned about either of these?

 

In either case you can have a risk of bacterial contamination, leading to digestive upset.  The koi pond may not be as much of an issue if you have good filters, but then you have to worry about any chemicals that are placed in it.  However, if it's safe for fish to live in there probably isn't a big risk for a dog.

 

A bigger concern with the wild animal feces would be parasites, especially from mammals like rabbits.  Several intestinal parasites (worms and single-celled organisms) have rodents as intermediate hosts and eating the feces could transfer those parasites to your dog.

 

Unfortunately there is little you can do to prevent your dog from eating these "treats", since it's so common around you and she is so fast.  I would recommend training her to a "leave it" command so that you can stop her with verbal orders.  Any good trainer can help you with this kind of training.  You should also make sure to have her feces checked by your vet twice annually to screen for parasites.  Keeping her on heartworm prevention should help prevent against a few intestinal parasites (especially roundworms and hookworms) but there is no preventative that will cover absolutely everything.

The Missing Doctor-Actor

Yes, I've been a bit AWOL from this blog for the last several weeks, but I'm now back to writing.  I typically write entries for my blog during slow periods at work or evenings at home.  Business has really picked up in the last two months (a good thing!) keeping me from having time to sit down at a computer during the day.  Additionally, I've been in rehearsal for a play which just finished its run this past weekend.

My whole family does community theater, and though it's an interest of mine it is a real passion for my wife and daughter.  Most of my evenings for the last few weeks have been taken up with rehearsals or performances, typically after work.  Recently I have been leaving for the clinic at around 8:15 in the morning, working until 6-7pm, then driving to the theater where I would stay until 10-11pm.  That made for some very long days!  And I didn't feel like doing much when I finally did make it home about 15 hours after I had left.

The play I just finished was Exit The Body, a mystery farce and one of the funniest plays I've had the pleasure to be part of.  It was especially enjoyable as my wife was cast as my wife in the play, so we got to do the show together and act "mushy" on stage.  My character was a bit of a departure for me, a rather effeminate or "fopish" New York socialite in the fashion industry.  It was a great part and one that allowed me to stretch my comedic acting skills.

Here are photos from one of the rehearsals.  Nobody is in costume.  I'm the one on the left with the beard.

And here's a picture from backstage at one of our performances.  The guy in front on the left is one of our friends in the theater, Mike.  The beautiful woman in the middle is my wife.

These are some photos from the show.  For some reason I get my picture taken when I'm near those doors on stage right!

And a group photo of the cast and crew.

Several of my clients know that I participate in community theater and have asked about coming to shows.  One of them has taken to calling me "doctor-actor" whenever I see him.  This time one of them actually did show up, and she had a great time.

There will be auditions for another play in a few weeks, and we're going to try out for it.  This one is a comedy, Duck Hunter Shoots Angel, written by Mitch Albom (who did Tuesdays With Morrie).  We'll also likely be cast in Arthur Miller's classic The Crucible later this year.  But for now things have calmed down and I can get back to a regular routine!

Questions From A Prospective Vet Student, Part 4

New readers may be a bit confused at the title of this post.  About four years ago I answered a series of questions from someone wanting to enter vet school (Here, here, and here).  I recently received some questions from a different person, but thought it could actually fit with the previous discussions.

 

I am allergic to cats and am very interested in veterinary school and working with dogs. I am open to allergy shots, but do most veterinary schools mind this?

 

A vet school isn't going to care that you're taking allergy shots as long as it doesn't interfere with your studies and clinical duties. This is something that should be discussed with your own physician or allergist, as it may be a big issue of your allergy is severe.

 

I went to a very good University for undergraduate studies, however my GPA was around a 3.0. It is difficult to gauge which schools, if any, I should consider applying to. If I do not get in the first time, is it easier to get in if I receive a masters or vet technician certification first? What about working in a clinic for a year?

 

To be perfectly honest, a 3.0 isn't competitive. Most vet schools accept 80-100 students per year, and there are typically 300-500 applicants for those positions. Competition is pretty fierce, and GPA is a quick and easy way for the admissions department to weed people out. I'm not saying to avoid applying, but be aware that there is a good chance of getting denied. Working for a vet won't overcome a comparatively low GPA. A Master's might! However, I absolutely would not recommend getting another degree unless you really wanted it and would consider using it instead. Getting a Master's Degree simply to get into vet school will possibly be a waste of time and money.

 

I do not have all of the required courses needed for most veterinary schools, as I am missing a biotechnology course. Can I take this course during the DVM program or do I need to complete it before, and where can I take those courses once I have already graduated undergrad?

 

You're going to have to get all required courses before applying.  I can't rule out the possibility that a school might make an exception, but you'll have to check with each individual admissions department to see if this is the case.  I really would expect that a school simply would pass you by, especially with a 3.0 GPA.  There are much more competitive students who would have completed their requirements and it is simpler for them to consider those candidates rather than make an exception.

 

I actually had a similar situation!  While my undergraduate GPA was 3.495 and therefore very competitive, I wasn't able to get my last organic chemistry course before the registration deadline.  I was faced with either taking a year out of school and working, or getting a Master's Degree.  At the time I was strongly interested in animal behavior (and still am), so I decided to pursue a MS in Ethology with the thought that I might actually go on to a PhD.  While in the program I decided that I didn't want to do research and ended up going to vet school.  But I was considering not being a vet so the Master's program wasn't a place-holder decision for me.  I also took my last organic chemistry class while getting the MS and was able to qualify for vet school.

 

Best of luck!

Sinuses Or Esophagus? What To Do Next?

Here is a recent question from Joanne....

 

My husband is a cardiac surgeon and I am a PA. We therefore tend to have differential dx in our head when there is a problem with our canine kids.

 

We have a now 5 yo neutered yellow lab named Oliver.

In July 2014 Oliver started to reverse sneeze on a daily basis approx 2-4 times a day. He had bilateral clear nasal discharge and started swallowing at night when he slept. He sounded as if he had a cold when breathing.

We took him to the University of FL to be seen by IM. Bloods and urine WNL. They took him in the back for an exam. The resident dx Oliver with allergies. No meds were given.

 

There was no reverse sneezing Aug, Sept or Oct. it started again in Nov and lasted 3 weeks.

I began to notice that Oliver sounded as if he refluxed at night (GERD) and again sounded like he has a cold when he breathes.

March 1st at 3 a.m. And 5 a.m. He vomited clear thick mucous. At 6 a.m. He vomited mucous streaked with blood. His stool also had some blood in it.

 

At that point we brought him to a specialty hospital to be seen by critical care. During all of this he was acting normal and wanted to eat and drink. Bloods, urine, fecal were normal as was an abdominal ultrasound.

Dx was reflux and he was placed on sucralfate 1 g po bid ac and pepcid 20 mg qhs for 2 weeks. Reverse sneezing stopped as did night time reflux. Fifteen days after the tx ended his sx's began again.

I questioned why an eval of his esophagus wasn't done either via barium swallow or upper endoscopy and was told that we usually don't do that since vomiting blood doesn't have the same implications as it does in a human. I'm not a vet but I don't buy that reasoning. Please explain if you could.

 

So now we are on sucralfate 1 g po bid ac and pepcid 20 mg po q12h for 3 weeks. Then d/c the sucralfate and continue peocid for 2 weeks then d/c all meds.

 

Today Oliver was having a Beams dehydrated fish skin treat which is about 5 inches long and an inch wide and rigid. He put the entire piece in his mouth and he usually chews it. This time he attempted to swallow it and started rapidly swallowing to no avail. The treat was not visible in his mouth but luckily I was able to put my fingers down his throat to grab it and pull it out.

 

When I did there were a few specs of blood on it with clear thick mucous. I am assuming that just like a person, with his repeated swallowing, the treat could have scratched the mucosal surface causing it to bleed. Can that assumption hold true for dogs?

 

Oliver seems to produce a large amount of clear thick mucous which he is always swallowing and again sounds as if he has a cold since last July when all of this started. I am at a loss since a university dismisses it as allergic rhinitis and a specialty hospital critical care vet does only an abdominal ultrasound without evaluating the esophagus.

Local vets do not have the capability to scope. How useful is a barium swallow in dogs? I am assuming it would delineate a mass if present as it does in people by indicating what we refer to as an "apple core" appearance. Wouldn't this also tell us about his esophageal motility as well as stomach emptying?

 

Are these symptoms due to diet? I asked my local vet who admitted she hasn't a clue about nutrition. Right now I am at a loss.

 

 

Interesting case, Joanne. And I don't think you're off base with your concerns and thoughts. While there are significant differences in anatomy and physiology of dogs and humans, there are also a lot of similarities.

 

I would start by investigating the cause of the reverse sneezing. There isn't anything about reflux that would affect the sinus passages. However, problems in the sinus passage could drain down into the throat and esophagus. Reverse sneezing is typically due to minor sinus irritation and isn't harmful by itself. Usually over-the-counter antihistamines are sufficient to help the symptoms. But this sounds like there is something else to the case. And I could see a situation where the persistent nasal drainage is leading to reflux and esophagitis.

 

Based on your descriptions, if this was my patient here's how I would proceed.

1. Sedate/immobolize and do radiographs of his skull and sinuses. Any good general practitioner should be able to do this. While it won't typically give you a specific answer, you can see destruction of the nasal turbinates and possibly an increased radiopacity in one area to indicate a mass effect. This may help you localize if there is a lesion in the sinuses.

2. If that doesn't give a clear answer, refer to a facility with a small, flexible endoscope. This is commonly used to go into the pharynx and then retrograde above the soft palate to visualize the caudal nasal sinuses. At the same time the endoscope could be used to evaluate the esophagus and stomach.

3. A barium swallow is really most effective when done with fluoroscopy, which not even many referral practices have. You may have to end up at a veterinary college for that. It's the only way to actually see the true motility of the esophagus. And upper GI barium series could determine gastric emptying time and could potentially outline an esophageal mass, but could also miss a small mass. I'd rule out the sinus problems before focusing on the esophagus, as it seems like it all started there.

4. If none of the above gives answers, then a CT or MRI would be indicated to get better imaging of the inside of the sinuses and look for subtle changes.

 

As medical professionals you and your husband know that some cases aren't exactly straightforward. The patient and the clinician must both be politely persistent in pursuing the diagnosis. I certainly think that empiric treatment has it's place, and that's what's being tried. But when that doesn't work you go to the next step. If you strongly requested any of the above diagnostics, I'd be surprised if any vet would refuse to do any of it. Other than minor risks inherent to sedation or anesthesia all of these procedures are safe and minimally invasive to non-invasive. I would agree with the other vets that upper GI studies aren't first on our list and we don't jump at these diagnostics for a potential case of reflux. However, if the symptoms persist we have to re-consider doing them.

 

I don't see that the reverse sneezing would be in any way related to diet. While I'm no expert, I do find pet nutrition interesting and can't think of any dietary disorder that would lead to sinus inflammation. Reflux could be related to it, but I don't know that this is the primary problem.

It's always hard (if not impossible) to make a diagnosis based merely on a written description. But I can certainly see a situation where there is a mass or foreign body in the nasal passages that are causing drainage into the esophagus. In fact, that makes the most sense to me based on the description. My thoughts might change after looking at Oliver myself, so I'll hedge my bets a bit.

 

In the end, a lot of this depends on how much you are able and willing to do. All of these diagnostics aren't cheap, but they are absolutely possible in veterinary medicine. You might want to respectfully and politely push for more advanced diagnostics. But keep in mind how you or your husband would feel if a client pushed you in this way. There is an appropriate way to do it.

 

I hope some of this helps, and I hope you can get Oliver's problem figured out!

 

 

Horse Manure Toxicity

Stefanie emailed me with the following....

 

I ran across a couple of warnings on line about the dangers of dogs eating horse poop because of the potential of horse wormer being present. This is one of the sites: http://beingstray.com/dogs/eating-horse-manure-dangerous-to-dog/.

I'd like to know if you've ever experienced anything like this first hand or heard of it? My dog loves horse poop - and given all the hiking we regularly do, we run into it pretty regularly, so it is an on-going training process in getting her to leave it alone. Or maybe I am being overly cautious and should just let her have her dog fun?

 

 

I'll admit that this was the first time that I've heard of this particular problem.  However, I've always practiced in suburban areas with few livestock around so it's never really been a concern.  With that in mind, I read the blog post above with interest and did some digging on my own.  And I do think that there is a cause for concern.

 

Intestinal parasites are common in horses and can really affect their health.  Because of this risk horse owners commonly use over-the-counter dewormers as a routine treatment or even in the feed.  Most of these dewormers contain ivermectin or moxidectin, as these products are very effective against a broad spectrum of parasites.  They are also considered very safe to horses and have been used extensively for decades.

 

Some of the dewormer can be excreted in the feces, though it's less than they ingest.  The problem isn't that the chemicals are inherently toxic.  Ivermectin is found in the majority of heartworm preventatives on the market and moxidectin is found in ProHeart (an injectable heartworm preventative for dogs).  At appropriate doses these compounds are very safe, even for collie breeds that contain a mutation making them more sensitive to side effects of this category of drugs.  However, the horse products are far more concentrated and contain a far higher dose than is used in dogs.  Remember, virtually all dogs are going to weigh less than 100lbs (45kg) and horses can easily get over 1000lbs (450kg).  It's this higher concentration that is the concern, and can be found in potentially dangerous amounts in horse feces.  Side-effects of ivermectin or moxidectin are typically neurological and if treated appropriately most dogs can make it through if the symptoms aren't too severe.

 

So yes, there can be concern from eating not only horse manure, but the feces of any livestock.  Cases have been documented by vets, and the amount of ivermectin found in manure has actually been studied.  It's a pretty low concentration, so a dog has to eat a fair amount to become toxic, but it can happen.  The half-life of ivermectin in horse and cow feces has been measured at as low as 11 hours and as long as 9 days.  That means that it can take up to 9 days for half of the ivermectin to become inactivated, then up to another 9 days for half of the remaining amount, and so on.  Realistically you can have measurable ivermectin in the manure for 1-2 weeks.

 

Stefanie, I think that answers your question!  Don't let your dog eat livestock manure. 

What Defines Dog Size?

Here's a question from a reader.....

Why does the canine world categorise dog breed size using its weight?
Why don't they use height instead?

Pet food company sell food meant for large, medium, small, toy breed by categorizing them through weight. What about the dogs on the cusp? For example, a female Belgian Shepherd could be 25kg, the male Belgian Shepherd would be well over 30kg. Does that mean a certain breed needs different sized pet food for differrent gender?

I understand pet food are formulated taking into account of kcal, minerals ratio for a certain size, however, a tall dog can often be thin, think greyhounds etc. Does that turn them into a medium breed?

What do you think of the categorisation? How did it came to be in the first place? Who placed the call to set the figures as such initally? I think this should be very interesting.

I'll start with the last questions.  I honestly don't know how categorizing dogs into "small", "medium" and "large" came to be, and I don't think it can be traced to a single person or moment in time.  This has kind of developed and become accepted without there being hard and fast rules.  Some of the breed clubs do have rules as to what weight a dog of a given breed should be, but that doesn't translate across all breeds.

In general we consider dogs to be "toy" if they are under 10lbs, small if they are under around 20-25lbs, medium from around 30 to 50lbs, and large if they are over 50lbs.  However these are not hard, set rules, and there can be variation around the borders of the categories.  It also depends on what that dog's normal weight should be.  If a dog who should weigh 8lbs actually weighs 13, we'd still consider it a toy breed because of the normal weight range.

Height is irrelevant in determining general size for food, as the calories and nutrient requirements are based off average basal metabolic rate, which is closely tied to weight. Two 60 pound dogs (assuming both are of the same body condition, i.e. neither is over- or underweight) would burn a similar amount of calories even if one was short and stocky and the other was tall and lean.  The height of a dog is determined by bones and the genetics of their development rather than the soft tissue structures.  A basset hound is short because of their leg structure, but they are rather stout dogs.  If their genetics caused them to have longer legs, they would still be of the same body size.

We also don't "split hairs" (no pun intended) when it comes to gender.  In the reader's example of a 25kg female and 30kg male, those 5kg really don't make a big difference.  The average of the breed determines whether it is small, medium, and large, not the individuals within the breed.  Also, the actual amount fed is determined by the individual dog's weight.  Labrador retrievers are considered a large breed, but I've seen normal weight vary from 60lbs to 90+lbs.  We obviously wouldn't feed individuals on either end of the range the same amount of food.  The smaller lab would need far fewer calories than the larger one.

Really, we don't need to over-think this.  Sometimes the only difference in the foods is the size of the kibble and not the nutrient content.  If you have questions about which food to feed your own dog, ask your vet.