Tuesday, May 22, 2007

Mixed Feelings

For those of you who know me personally, you are well aware of my concern for the future of animal legistlature. Many people are in the dark about how much animal law is growing in this country; in fact, there are a number of law schools that offer an entire course on animal law. My greatest concern is with that of the Guardianship Campaign. There is a well-supported push across this country to legally promote the status of companion animals from property to wards. While this may seem insignificant, this would mean that when suing someone over the life, health, or welfare of their companion animal(s), they can receive non-economic damages (i.e. emotional damages) from their suit. Personally, I am really torn about the whole issue. For the most part, I can understand the purpose of the campaign and agree how we in the United States have certainly elevated the status of pets from their utilitarian purpose to that of family member. Being a veterinarian in training, I should appreciate this more than most. On the other hand, this will result in some serious economic ramifications that many don't realize. My theory is that once this becomes nationwide, there will be an excessive number of these lawsuits and the law will be greatly abused. Just go here to understand where I'm coming from. Most importantly, I feel there will be a great change in the costs of small animal veterinary services. With so many people becoming sue-crazy, there's not a doubt in my mind that malpractice insurance costs for veterinarians will skyrocket to match those of human physicians, thereby causing veterinary services to likewise skyrocket in cost.

Again, I will point out that this movement is for a good purpose and it has already been used to great effect. A professor I had in my first year told me about a case where a woman in Kentucky sued a ranch over her two appaloosa horses. The owner was a professional and traveled for months at a time for her job, while boarding her horses at this ranch. She came back after a month of traveling to find that the owners of the ranch had to send her horses to some other ranch they owned on the far side of the state. Concerned, she drove all the way to the address given to her, only to find that the place didn't exist. After hiring a private investigator, she found out that the ranch owners sold the woman's horses to one of the last remaining horse slaughtering facilities down in Texas, to be sold to the French, Canadians, etc. She, of course, sued the ranch owners and received an enormous cash settlement. I also see the the guardianship changes having positive results in reducing the number of malicious poisonings of pets across the country. I don't know the statistics, but veterinarians everywhere see dogs and cats that have been poisoned with ethylene glycol (antifreeze), rat poisons, insecticides etc. At the moment, when you sue someone for mistreatment of your animal, all you can be awarded is the property value of the pet. So to put it in perspective, sueing over an 18 year old diabetic cat isn't worth the hassle. What are your thoughts on the whole campaign? I'm interested to see what other people think and see if they have the same concerns.

(In regards to my work, I'll post again probably this weekend. There is an exam for the whole lab services block this Friday that I have been studying for all this week, preventing me from posting in much detail. Stay tuned!)

Tuesday, May 15, 2007

One week down, 51 to go

Well, so far so good. My first week (last week) went very well. So far I've done a necropsy on a foal (the one described previously), an adult horse with Ehrlichia and possibly Equine Protozoal Meningoencephalitis, a pig, and a goat (I don't remember what the latter two had wrong with them). I'm beginning to get used to the smell, but there are still some that are giving me problems. Without question the most interesting case thus far was another horse that needed a necropsy yesterday. Because of some work being done to the roof of the large animal facilities at the vet school, all of the patients had to be moved over to a research barn for a day or two. Go figure a patient is placed over there who later became suspect of having a disease caused Strangles: a highly contagious disease where a bacteria (Streptococcus equi) causes many problems inside the horses body, but most notably invades the lymph nodes right behind their jaw on each side, resulting in severe enlargement of those nodes. This often results in difficult breathing and eating, amongst other systemic signs. The students and clinicians isolated the horse and treated it appropriately for Strangles, and it appeared to begin improvement, but at 4:30 AM yesterday the technicians found it dead in it's stall with blood everywhere.

Because of the bizarre nature of this case, the horse was transferred to us on necropsy. We let the pathologist on duty do the honor of dissecting the head because it requires experience and precision when dealing with this disease. Upon opening the head and examining the throat area, the pathologist found a 5 cm long piece of metal wire that the horse had ingested that forced it's way back up into it's head, resulting in an infection with an abscess that resulted in the enlarged lymph nodes. To explain the bleedout, one must be aware of a lil anatomy. Horses (for whatever reason), have these two empty spaces inside their head just below their brain, but behind their throats called Guttural Pouches. These can be infected with many different infectious diseases as a separate entity, but the wire made it's way inside the right pouch. More importantly, right behind each pouch is the internal carotid artery, the primary blood supply to the brain. The carotids are under extreme pressure, so when lacerated by say...oh....a wire.....the horse (or any mammal for that matter) can die of blood loss and lack of oxygenation to the brain in a very short period of time. Overall cases like this are very rare in horses because they are selective, careful eaters. Usually cases of eating foreign bodies are reserved for cattle....or as I call them, the dogs of the large animal world :).

On a completely different note and per request from a previous post, I'd like to tell the story about how I got my cat, Kahlua. Last fall, when my classmates and I were first learning surgery, there were a total of three surgery labs over the course of the semester prior to that practical final I mentioned before. Two of these labs were spays on dogs, and one on cats (the surgeon that day gets to do both a spay and a neuter). The staff just assigned who was doing which surgery and they asssigned me to the cat procedures. All students are required to go to the school at 5:00 PM the night before the surgery to do a pre-surgery physical exam, do bloodwork and urinalysis to ensure the cats/dogs are satisfactory patients for anesthesia. Upon examining my patients, I found that the male was perfectly ok, but the female was another story. She was depressed with a heart rate of 240 beats per minute (200 is the most you can accept, and even then it's only if the cat is scared or excited), had difficulty breathing because of a mucous discharge coming out of her nose and eyes, had a heart murmur, and a temperature of 103.5 F (101-102 is normal). My partners and I kinda looked at each other with confusion and hesistation, so we decided to call over the surgeon on duty to take a look at the cat. His response was "Oh this cat's fine, just check the temperature in the morning just to be safe." Doing as we were told, we repeated the entire exam the next morning to find that nothing had improved, and the tempurature was up to 105.1 F. There was no surgeon to be found anywhere, so we just explained our concerns to a technician who said she'd leave a note for a surgeon once one came in for the day. After three hours of lectures in the morning, I came down to find out that the sickly cat had been taken away and replaced by a beautiful Birman cat named "Mese" because the rescue group thought she looked like a siamese but with long hair (and to be honest with you, I would've made the same mistake b/c I've never seen a Birman in person before). I was then forced to skip my 11:00 lecture to hurriedly fill out all the necessary paperwork and perform all the stuff done to the previous cat the night before. I say hurriedly because I still needed to eat lunch and all animals are expected to be anesthetized by 12:30. Thankfully, "Mese" was friendly and in perfect health. My groupmates joined up with me shortly afterwards and I performed my first surgery without complication.

Looking back, there's not a doubt in my mind that the previous cat would've died on the table without me even cutting it. From what I heard, it recovered and was spayed successfully at a later date. All of the dogs used in the surgery are owned by local clients, however the cats are all from a rescue organization and need homes. I saw that Mese needed a home, but found out that there were 14 other people interested as well. Being a vet student and the one who spayed her, I was bumped up on the list as far as possible, but they had already started the interviewing process for the first prospective adopter. I waited a couple days, then was contacted by a fellow student who said the interview didn't work out with the person because neither she, nor any of her references could be contacted after repeated attempts. So after much anxiety, I was selected to get her as my own, my very first every surgery patient. In fact, as I write this she is laying across my lap, making typing very difficult. She's a friendly, beautiful cat who thankfully doesn't hold it against me how I took away her womanhood ;). I don't have a good picture of her at the moment, but I'll take one and post it here this week.

Monday, May 7, 2007

The die is cast...

Well, it's a done deal. I am now officially a senior student gettin' my learn on :P. The first day was both exciting, strange, and depressing all at once. Depressing because the now graduating seniors had to come by the school today to transfer over their cases to us before 8 AM, then proceeded to drink in the parking lot, while cheering/taunting myself and other classmates as we approached the school. Never once have I felt such a strong sense of jealously in my entire life. Strange because it's odd to now see myself and my classmates wearing the navy blue clinician's jackets and running around like crazy people instead of it being a mere aspiration. Exciting, of course, because this is why I came to school and how 90% of what is learned/retained happens this year.

My first block is in "lab services" which, thankfully, is a good transition block into 4th year because it is one of the more laid-back services in the school. Because the pathologists, bacteriologists, parasitologists, etc never directly deal with clients, we don't have to abide by a true professional dress code (which is nice for me since I despise wearing ties :P). Each day consists of reviewing concepts and techniques from classes such as bacteriology, toxicology, virology, parasitology, clinical pathology etc all morning; then the afternoons consist of performing necropsies on deceased animals. Today, we spent the entire morning looking at fine-needle aspirate cytologies (where you just stick a needle into a lump, shoot the contents onto a slide and look at it under a microscope) and reviewing how to differentiate normal tissue from an inflammatory process or even cancer. We even talked about how to identify certain types of cancer with this diagnostic tool. Personally, I am very thankful for this since almost all classes thus far have talked about how to read and diagnose biopsies, which your general practicioner never does and just sends off to a lab. Fine needle aspirates however are easy, cheap and readily done in private practice.

This afternoon however was when things got really interesting as I performed my very first necropsy. It was done on a 9-day old Thoroughbred foal who, most likely, died of failure of passive transfer. In all mammals, a neonate acquires some immunity from its mother to keep it protected for the first few weeks of life until its own immune system develops and begins to function. In humans, dogs and cats this is done while still a fetus inside the mother. In cattle, horses, sheep, goats etc however, this occurs through ingestion of antibodies in the milk. Unfortunately, these antibodies in the milk are only present for the first few days of the animal's life so, if for any reason the animal does not nurse, it is left without an immune system for a few weeks. This foal in particular had a severe infection that made it's way into the bloodstream (which is real bad news), and resulted in some severe lesions around its lungs, in its stomach, and in its intestines. I had to think to myself, "Now this is how you start a senior year" as I was hacking away inside the chest cavity. I say this in jest because this was a very disgusting process. There were a few gallons of fluid inside its chest that I just had to slosh around in while removing the lungs and heart (both of which needed to be removed for microscopic examination). Not all animals have such distinct lesions so while of couse it was bad for the horse, it was good for us since it helped us reach a diagnosis.

I apologize for the gross details; they won't really continue after this block is over....hell, I'll probably get too grossed out talking about them. Needless to say, I'll probably become a vegetarian until this block is over. :)