Your Pet's Best Friend

Did you ever have a Tarzan swing?

There are some things that are inherently dangerous, but if you start them early enough as a kid, you just don't think about it.  Working with horses is like that.  Intellectually you know it's potentially very dangerous, but when you grow up doing it, you just aren't scared (cautious, yes, but not quaking and shaking). 

I was not an athletic kid, but I loved climbing trees and swinging on a rope like Tarzan (sort of like Tarzan in the movies, anyway -- I wasn't exactly "speeding through the upper terraces").  Sure, you could fall out, but if you start young enough, you don't think about that so much.  Then, after you've done it, you know you can and so you don't worry about it.  That's the point of getting Scouts through the Challenge Course.

When I was a kid, we had a big cottonwood tree in our yard.  It was too big around to climb the trunk, and the first branch was way high off the ground.  It looked to me then the way this tree does to me now.  My nephews need a Tarzan swing and this looked like a great place to put it.  When I was a kid, I'd throw a rope over the limb and climb up hand over hand ["Go play outside."].  I cheated today and used a ladder to reach that first limb. [Zoom in: I'm on that limb in the middle somewhere. Cousin Max is on the ground, looking up.] 

The hardest part was getting from the ladder onto the limb.  After that, I felt pretty secure -- there was no wind, and that limb is so big that you feel like you're sitting astride a horse -- it didn't take much balance.  Then it was just a matter of "scooching" [I thing that's a contraction of scooting and ouching.] out till I got where I needed to be.  I used parachute cord to haul up a piece of carpet to protect the limb, then some rope to tie the pivot ring, and finally the swing rope and the shackle to hold it.

The second hardest part is the dismount, but I'd done it a million times as a kid.  Lean over, grab the rope with both ends, and slide off.  The hard part is pretending you're a kid when you're fifty-four.  Scouting helps with that quite a bit.   

I'd hoped for more pictures of my descent, but I didn't waste much time getting down. 

After I hit the ground, I found that my adrenal glands had been working overtime.  I hope I don't need to get excited again for a while.

And here's the finished product: cousin Joe swinging.  Cousin Max was swinging so fast I couldn't get a picture of anything but a blur, so imagine a blur.

Proptosed Eye = Eyeball out of socket

Warning: There is a gross "before" picture at the bottom of this post.

Some time ago, in my discussion of bug-eyed dogs, I touched on proptosis globus.  This means that the eyeball has been popped out of the socket.  Since the bug-eyed dog has a shallow socket and a big eyeball, it doesn't take much force to do the deed. A slap to the head, a rough grab of the neck scruff, a scary movie ... (I made up that last one.)   

This guy looks like he's more than half-way there, and it's just an average day for him (we fixed this guy later, by the way).  One good thing is that if you can catch it right away, these eyes can often be saved.

For an animal with a normal eyeball-socket relationship, it takes a much greater trauma, and is a rare injury.  If there's enough force to pop that eyeball out, the rest of the head will probably have a lot of other problems... like a skull fracture, and it's unlikely you could just pop it back in.  That's why I was really surprised to see this kitten with a proptosed eye with no other major injuries (the gross picture is at the bottom).  Apparently a big dog grabbed his head and squeezed. The eyeball was unsalvageable, so we just had to remove it so the little kid wouldn't be in pain (plus we gave pain medicine, of course).

So, here we are after surgery.  You have to remove the tear-producing glands, and the third eyelid (with its tear-producing gland) or the thing will open up later and ooze.  You trim off the edge of the eyelids and sew it all together, nice and neat.  Doesn't it look nice and neat?  It doesn't?  Well, it will when the hair grows back.  Fortunately, the socket doesn't sink in and need a glass eye.

Of course, you could always go pirate, but you really don't have to.

Here's what it looks like when the sutures come out.  The hair hasn't all grown back yet, but you can see that it looks pretty good already.   When it's soft and furry, she'll just look like she's giving you a sly wink.

Here are the gross pictures.  

Navy Band comes to Kennett

If you're a regular reader, you may recall that I'm a band nerd, and an old euphonium player.  Tonight I had the rare pleasure and privilege of seeing and hearing the United States Navy Band in concert right in my old home town.  Despite the funky acoustics of the high school gym, the sound was wonderful.  I'm not given to superlatives, but this concert deserves them.  I am greatly indebted to the hard-working folks who managed to put Kennett on the band's 27-day concert tour.

I particularly enjoyed hearing Roger Behrend play his "Nautical Variations".  He is a virtuoso euphonium player, one of the best in the world.  I like to think I got a little more out of his performance than the non-band-nerd-non-euphonium-players, but who knows? 

Every moment of the concert was transporting.  If you could have been there tonight and weren't, you missed a chance to enrich your life.

Goats are not our specialty

As I said, goats are not our specialty.  We rarely see one and don't pretend to any expertise in that department.  Many veterinarians don't care to see anything but the dogs and cats that they feel most comfortable with.  I mean, if you only see a goat once every five years, how good are you going to be in that department?  I don't turn people down flat (we looked at a mouse with skin problems yesterday), but I do try to send them to the doctor I think can help them the most.  Sometimes that's me, but sometimes it's not.

So... when these folks called 4 weeks ago, and said their goat had a bad leg, I recommended that they see a doctor who sees more livestock.  So they did that, but when it got worse they showed up back here instead.  Of course, at this point, the foot is unsalvageable.  I don't know what it looked like a month ago, but I'm pretty sure it didn't look anything like this.  That's an open fracture and the foot has gangrene.  I'm not giving you a close-up, and you should be glad we don't have "smell-O-vision". 

I wish that the folks had given the first doctor the opportunity to recheck the goat periodically.  I feel sure that he would have picked up on the situation before it got this bad.  Instead, we spent 2 hours on Saturday afternoon (one hour of it actually in surgery) amputating that mess.  Thank goodness for Veterinary Information Network.  The last information I had on goat anesthesia was dated 1992, and I was glad to have immediate access to more current information. 

Here's Shannon with our patient post-op.  Anesthesia went really well. Five minutes after this the goat was up walking on three legs again, minus the gangrene.  She's home with antibiotics and pain meds now.  I was going to show a picture of myself gazing down at the goat (the very picture of "the gentle doctor"), but I was having a bad hair day.

Helping other veterinarians

It's always nice to have a chance to give back.  Today was a good day for me in that regard.  One of my colleagues in a near-by town was the victim of a fire which totally destroyed his clinic.  He is practicing out of a house in which he has improvised a temporary clinic.  You never have enough insurance, and even if you did, you can't wave a check at something and fix it.  When lightning blasted my old X-ray machine, it took six weeks to get a new one installed.  He is without X-ray capacity right now and they brought one of their patients over to our place today.  Helping out was no problem;  I was just so glad that my own clinic wasn't burned down.

Another colleague had made an unusual diagnosis and begun treatment for his patient.  This is a 16-months old Weimaraner who began coughing up blood on Sunday.  Despite the young age of the dog, and it's alleged history of heartworm preventive medicine (and the people have only had the dog for four months -- before that we really don't know), the diagnosis was pulmonary arteriole rupture due to heartworms.  Even though the dog has quit coughing up blood (has quit coughing completely, in fact), and is feeling good (which he wasn't before), the owner just had a hard time believing the problem could be heartworm disease.  I don't blame her.  Even with NO heartworm preventive, we usually wouldn't see signs of disease before the dog was three to five years old.  So, she came to me seeking a second opinion.   We X-rayed the chest, and the signs were all there (not to mention the dog's great response to treatment). Unusual as the case was, I was able to restore the lady's confidence in her regular doctor.  That's a good thing.

The third service was more unusual.  This goes on my "list", along with riding to hounds, delivering a eulogy, playing the piano at a wedding, and so forth.  One of my veterinary school classmates was looking for something different on Valentine's day, and came up with the idea of a "singing valentine", and called me.  I haven't talked to the guy in five years, and today I delivered a singing valentine to his wife's cell-phone voice mail.  ["If I Could Be With You (One Hour Tonight)", in case you wondered].   At least his wife will know he tried.  I'd have to put this in the category of buying flowers that turn out to produce a violent allergic reaction in your sweetheart.  But he tried.

Wednesday Music Club

I like a lot of different kinds of music.  My favorite is vocal ensemble close harmony.  Think Barbershop Quartets, the Mills Brothers, The King's Singers, the Andrews Sisters, Rockapella, Take 6, and cowboy songs (of course).  I like brass quintets, Renaissance and Baroque music, and Sousa marches, among others.  Upbeat, peppy Bluegrass and old-time thumping bass-line gospel music are good, too.  I don't much care for music that's depressing or whiney or things that sound like a drum-track waiting for a melody (i.e. a great deal of current "popular" music), but that leaves me a pretty big variety to choose from.

That's why I often get a call to help with programs for the Wednesday Music Club (is that an imaginative name, or what?) The last gig was to celebrate Founder's month.  Since the Federated Music Clubs were founded around the turn of the (last) century, they wanted music from the 1890s and early 1900s.  Those are some of my favorite songs, plus I got to work with one of my favorite performers.

Brandt Roberts is in town for a while.  He got his theater degree, then did some professional gigs for six months. I supect he'll be treading the boards again pretty soon, but you should have been there for his rendition of "Who Threw the Overalls in Mistress Murphy's Chowder?".  For just a little while we turned the Presbyterian Activity Center into Murphy's Saloon.

He is NOT too old to get his teeth cleaned.

This "Beau".  He is thirteen years old, and this picture was taken about 15 minutes after we finished cleaning his teeth.  His teeth were really covered with calculus (tartar), and he had a little gum disease.  Cleaning his teeth was especially important because of his other medical problems.  Not his lower back problems (which have been really bad at times), and not his low thyroid condition (for which he takes medicine twice day), but because he has severe heart problems. 

Beau has congestive heart disease.  He has been on twice-daily medications for four years.  You may not have looked at many chest X-rays, but take my word for it:  this is a big heart.  It looks like a basketball, double the size it ought to be.  It's not big and strong, either.  It's stretched out of shape and weak and flabby.  His cardiac output when he's wide awake is worse than most dogs while they are under anesthesia.  SO... who's up for knocking him out to clean his teeth?  [I can't hear you.]

Anything you do involves making a decision as to whether the risks outweigh the benefits.  When they dropped off Beau, the last thing the owners said was, "Don't kill him."  Hey, no pressure.

First the Benefits: clean teeth, fresh breath, healthy gums... so what?  Just don't look at his mouth and you can pretend he has all those.  Then there's the fact that you get rid of the zillions of bacteria that his mouth is constantly dumping into his bloodstream -- bacteria that are clogging up his kidneys and damaging them, and that would love to colonize his damaged heart valves.  Okay, that's a little harder to ignore.

What about the Risks?  Well, he's thirteen years old and has had heart disease for four years and he might die with clean teeth.  We could have stopped right there, but we didn't.  We decided to look at his actual risks.  First, his bloodwork is good -- no problems with liver or kidney function.  Second, if you look at that chest X-ray again, you'll see that the lungs are clear -- no fluid and looking good.  Third, his electrocardiogram got a pass from the cardiologist at Idexx telemedicine.  So...a lot of his "risk factors" are actually not so risky.

We put Beau on I.V. fluids and kept his anesthesia light (with easy-to-adjust Sevoflurane gas), monitored him closely, and I worked at a furious pace.  My receptionist wandered back to see how we were doing and said, "Your next appointment has cancelled, so you can take your time."  Wrong.  No matter how good his labwork was, there's no point in pushing our luck with that big, weak heart.

The point of the post is this:  you folks with your 9-year old dogs with healthy hearts have got to stop using the "he's too old" excuse for not getting those mouth problems handled.

Bug-eyed Dog follow-up

I wrote about Bugsy's surgery in July.  He was in today for a check-up and the owner told me, "He is really seeing better.  He goes up and down the stairs now.  He was afraid to do that before."  Also, his eyes don't look painful anymore. Both are good things.  Yay.

Success story... sort of.

This is Coco.  She doesn't look very remarkable, but she is.  If you were reading here last August, you may remember when I wrote about performing my first pericardiocentesis.   Coco had developed a huge accumulation of fluid around her heart, and this was interfering with it's ability to keep her going.  I felt at the time (and still do) that  a tumor within the pericardial sac is producing the fluid.

At the time, I thought it remarkable that I had been successful in temporarily relieving her situation without damaging her in the process.  She actually did really well for about 10 weeks, when she began feeling as bad as before.  In October, we repeated the procedure.

And on February 4, we did it again.  Six months later, and she's feeling good again after her third experience with an ultra-sound guided needle next to her heart.  This is a small dog, and we got TWO of these babies full of fluid (7 ounces total) out of that sac surrounding her heart.

I still think she's living on borrowed time, but we're getting better terms than the sub-prime mortgage people.  So it's a success story... for now.

Blood vessels are slippery for a reason.

It's time for that yearly check-up again.  Have you ever been a little frustrated when the venipuncture technician had trouble "finding your vein"?  Did they ever have to poke you more than once? Don't you hate that?

This is my hand.  They don't have trouble finding my veins.  Sometimes I do have trouble finding the veins on my patients.  They can't roll up their sleeves -- for a routine yearly physical, most people are not crazy about you shaving their dog's leg.  Plus some patients have an extra layer of fat around the leg that makes it more difficult to visualize or to feel the vessel.   Sometimes, though, the problem is not finding the vein.  The doggone thing just keeps slipping away from the needle.  Those things are slippery for a reason.  I guarantee you that if I cut my little hand, I'm glad that big nasty vein is very likely to slip out of the way instead of turning into a gusher.

We had some bad storms last night, and some of this mare's barn blew off into the pasture.  We figure the metal siding is what sliced into her fetlock.  The vein did not slip out of the way.  This horse was streaming blood like a faucet running.  In this picture, we're all sewed up and bandaged.  If you look closely, you can see a lot of bloody gauze on the ground.

It's wounds like this that give me more patience when some vein is slipping around and doing its best to avoid my needle.  I wish that horse's vein had been just a little more slippery...  I would have wound up wearing a lot less blood.