Thursday, March 5, 2009

The butcher - quality cuts of meat!

In my first job, sometimes, we had to perform post-mortems on animals that had suddenly died or if they passed away without a diagnosis. The purpose of a post-mortem is to find out the cause of death for the owner's peace of mind or for our future reference.

Post-mortems involve dissecting the body of the animal. The whole body is cut up and then closely examined. Tissue samples are also taken for analysis. There was one old Border Collie dog that had suddenly died with no previous signs of deterioration and the owner was curious to find out the cause of death.

The dog presented to my clinic late in the evening on a Friday night. The dog was already dead but the owners wanted a post-mortem to be performed to investigate the cause of death. Normally, post mortems are best performed as soon as possible when the tissue is still relatively "fresh". So I was given the joyous task of cutting up the body and taking samples. The owner had agreed for the dog to be cremated straight after the post-mortem. Owners are aware that a post-mortem is a bit of a butcher's job; chopping up the body and taking pieces from it to send for histopathological analysis.

I proceeded with the unpleasant job of mutilating this dead Border Collie. I made a huge incision from the chest and along the abdomen. I took samples from all the vital organs and found that the dog had multiple tumour nodules in the lungs. After chopping the poor carcass into pieces, I had finished a thorough post-mortem and collected enough samples to send for analysis.

Because the owner had already agreed for the body to be cremated (not buried whole), I made the decision that I would not stitch close the chest and abdomen after the post-mortem. My reasoning was that it would take quite a long time to do and since the dog's body was going to be burnt anyhow, it would have made no difference. So I proceeded to place the mutilated dog's body into a bag and then into a freezer awaiting collection from the pet crematorium.

I went off for the weekend thinking no more of the dog. Over the weekend, our clinic allocated one vet to be on duty - dealing with any emergencies. The vet on duty that weekend was a lovely girl called Sharon, who went out of her way to accommodate clients. That Sunday, the owner of the Border Collie rang Sharon asking her if it would be possible to see the dog's body for one last time. Normally, the dog's remains would have been sent to the crematorium immediately but since it was the weekend, the body was to be collected on Monday.

Being a sweet person, Sharon agreed to come into the clinic and prepare the body for viewing, not aware of how I had left the remains. When she arrived at the clinic, she took the dog out of the freezer and removed the body from the bag. To her surprise, she found the dog in the mess that I had left it in; with the body open and the organs dangling around! She obviously knew that this image was not appropriate as a last visual memory of the owner's cherished pet. She kindly decided to suture up the body for presentation to the client. The problem was that the body was completely frozen and rock hard - impossible to stitch up.

Sharon needed for the dog to thaw before applying her cosmetic touch! Anyone who had ever defrosted any meat is well aware, this can take some time. She informed the owner that they could come and see the corpse later as she was busy at the moment. Normally, microwaves are great for defrosting meat for consumption but I've never seen a microwave big enough for a Border Collie (which is a good thing!).

Sharon decided to allow the cadaver to thaw and warm up naturally. She placed the dog next to a radiator on maximum heat and on a electric heatpad. On top of this, the dog was covered in hot water bottles. After a few hours, the body was softer and Sharon was able to stitch the dog up. The owner came in and had their everlasting image of their beloved pet imprinted into their memory bank. If only they knew how much effort Sharon had made!

When I heard the story on Monday after coming back from a pleasant weekend, I felt terrible and awfully guilty. I bought Sharon a bottle of wine to apologise for creating so much stress and work for her. After that weekend, I think Sharon wanted a nice break to unwind - maybe a spa. My boss at the time maybe should have installed a sauna into the clinic - for vets to relax and for quick defrosting of dead bodies!

Thursday, February 26, 2009

Hot dog!

Alan was an interesting character. He was a vet who had qualified from Cambridge university. He was obviously intelligent but also somewhat a maverick. He drew great amusement from being controversial, as well as being witty to the clients.

I remember in one of his consultations, an owner of an epileptic dog (where the brain goes through episodes of spasms leading to fitting/seizuring), brought the dog in for recent fitting. This dog had been diagnosed for sometime with epilepsy and was prescribed the appropriate medication for the dog to decrease/stop the fitting. Unfortunately, the owner was not giving the medicine so the dog continued to seizure with increasing severity. Alan decided that the best way to illustrate the importance of medication, was to draw a picture of a dog standing with some round circles (representing tablets) and a "+"sign on the whiteboard in the consult room. This was his illustration for the dog on medicine. He then proceeded to draw another dog upside-down dead beside the first drawing. This he explained was the dog with no medicine!

Anyhow, there was one memorable incident involving Alan. On one particular day, an owner brought in her Golden Retriever dog who was off her food and showing signs of a brown vaginal discharge (pus). Alan went through the consultation discussing the signs the dog was showing and began his physical examination.

Alan often multi-tasked during consults, like a head chef in a busy kitchen! So he put a thermometer into the backside (anus) of the dog to take her temperature. The thermometer, which Alan used, was a traditional glass tube/straw with mercury inside. Normally it takes a couple of minutes for the thermometer to register the dog's body temperature.

Most vets hold the thermometer in place when taking the temperature. Alan however decided it was always more efficient to leave the thermometer in place (sticking out the backside!) and continue doing something else. So Alan continued to examine the dog from the head end - checking the eyes, gums and so on, while the thermometer was pointing out the dog's anus.

After a few minutes, Alan went to remove the thermometer to record the temperature; only to find that the thermometer had vanished! The dog's gut had sucked the thermometer into the dog just like a vacuum cleaner! Gentle probing with a gloved finger in the anus found nothing! The owner wasn't aware of what had happened so Alan acted calmly like nothing was wrong! Being made of glass and containing mercury, the thermometer could not be left in the dog and left to pass out naturally.

Fortunately, the dog had a serious infection of the uterus (pyometra) and so needed surgery to correct the condition (remove the uterus). Alan told the owner that the dog was in a serious condition and needed surgery as soon as possible. The owner agreed to allow Alan to operate so he took the dog straight to surgery (with the aim of removing the uterus and retrieving the lost thermometer).

Surgery to remove the uterus went well and Alan found that the thermometer had moved high up the colon. He massaged the gut wall pushing the thermometer downwards and eventually out of the anus (browner and smellier than before). The nurse removed the thermometer and put it safely away (from Alan!).

The dog made a full recovery from her uterine infection and surgery, although Alan never really did find out what her temperature was!

Tuesday, February 24, 2009

An eternal flame

One of my colleagues, Kevin, was an experienced vet who once had an interesting tale to tell. One day when Kevin was working, an owner rushed in with her Pekingese dog. This dog was a 13 year old female dog that had a long standing heart problem. The heart valves of this dog were not operating well. Normally, heart valves allow the blood to circulate inside the heart in one direction. This allows the blood to flow well and the heart to be able to efficiently pump the blood around the body.

This dog was diagnosed with this heart problem for a few years and was on the appropriate medication for the condition. Unfortunately, this type of condition is progressive, meaning that it will get worse with time despite medication. The drugs that were used had the effect of slowing the deterioration in the heart and minimising any problems associated with a faulty heart. The dog had been stable for many years but the owner was aware that at some point, the dog may rapidly worsen and pass away.

One day when Kevin was in the clinic, the dog was rushed in as an emergency. The dog had collapsed and stopped breathing for at least 10 minutes before being brought into the veterinary surgery. The owner was in hysterics and crying loudly. On examination, the dog was found to be dead - no heart beat or breathing. The owner was understandably in a complete state of shock but wanted Kevin to do everything possible to try and resuscitate her little baby.

Because this dog had been dead for at least 10 minutes, the prognosis really was hopeless for this poor little girl. Despite this and as a result of the owner's insistence, Kevin decided to proceed with resuscitation of this dead dog. He rushed the dog into the operating theatre and gave the dog oxygen into the airways and fluid into vein to try and maintain the blood pressure. The nurse performed fast chest compressions to try and help the blood circulate around the body. Kevin also administered the appropriate drugs to try and stimulate the dog back into life.

None of Kevin's attempts as a faith healer, were having any effect at all and so Kevin decided to try and shock the heart back into action. There was a new defibrillator in the clinic and Kevin thought this was the patient to try it out on. A defibrillator is a machine that delivers an electric shock to the heart to try and stimulate the heart into action. A defibrillator consists of 2 handles with metal plates that are pressed onto the patient's chest. In all honesty, these devices aren't that useful in veterinary medicine unless used during surgery when the heart can stop suddenly and then be immediately energized. Also they are often used for certain abnormal rhythms of the heart, which are more commonly encountered in humans than animals.

Defibrillators are powerful machines sending strong electric shocks/pulses through the body. When the shock is being given, it is very important for others to stand away from the person administering the electric pulse and for there to be no metal in contact once the shock is given. So Kevin charged up the machine, shouted "Clear" and administered the first shock - unsurprisingly, the dog was still dead; no pulse, no heart beat and no breathing.

Undeterred, Kevin decided to administer another shock. This time however, once the shock was given, the dog's fur caught fire and began to smoke!! This dog's coat was burning with a small flame and setting off the smoke alarm!! Maybe this was Kevin's way of warming up the body or sending smoke signals to other dogs to let them know that this dog was well and truly dead!

Kevin and the nurse threw a wet towel on the dog to put out the fire and informed the owner that resuscitation was unsuccessful. The owner decided to cremate the dog's body and have the ashes buried. I suppose that if Kevin had continued trying to defibrillate this dog, the owner may have saved money on having to pay for a cremation service!

Wednesday, February 18, 2009

I seek her here, I seek her there, I seek her blo*dy everywhere!

Yesterday at the clinic, we had quite an amusing story worth telling. We often work closely with some welfare/charity groups, who occasionally catch/trap stray animals. These animals are brought into the clinic to be checked over for any disease and then de-sexed, wormed, given flea treatment and vaccinated. More often than not the animals brought in are cats and the majority of these strays are naturally scared and nervous around people.

Some of the cats become used to human interaction and can then be sent to loving homes, whereas others prefer to remain as free spirits and so are returned to a life on the street (makes them sound like prostitutes!). So yesterday at the clinic, one of these street cats was brought in - she was quite young but absolutely terrified. On a positive note, she didn't seem aggressive like some of the ones we experience - no hissing, no swiping through the cage and no attempts to claim a souvenir of human flesh!!

This poor little kitty was so petrified that she obviously wanted to escape at the first opportunity. We decided that the best course of action was to leave the cat in her own kennel for a day or two. This would allow her to adjust and familiarise herself with her new surroundings. We decided we would do nothing with her apart from provide her with fresh food, water and litter for the first day and then try to see if she would be responsive to any human interaction.

But cats don't always follow the rules!! After being in the kennel for only a few hours, the cat made a complete mess of her new residence! She was like the tenant from hell - who had just decided to have a massive rave party and turn the place upside-down. We decided that we would not disturb her and leave for one day and night and then once she had calmed down and was less stressed - we would proceed with the necessary veterinary treatment. Simple plan - what could go wrong?!?

Just before closing the clinic (once all the consultations had finished), one of the junior nurses, Jane, noticed that this stray cat's kennel was messy and decided that being a caring soul, she would clean it so that the cat would have a comfortable night! As soon she opened the kennel door, whoomph!!! The Harry Houdini of the cat world had made her great escape!!!! The nurse ran frantically looking for the cat but she was nowhere to be seen. She ran to front of the hospital in a panic letting us all know that there was a cat somewhere loose in the clinic.

Fortunately, all the doors and windows to the outside world were firmly shut so we knew the cat was somewhere in the hospital. We began a search party - with 3 vets (one of us being the boss) and all the nurses looking all over for this escapologist!! We looked high, we looked low, we looked under and above cupboards/shelves, in boxes - we looked everywhere we could. This cat was nowhere to be seen. We even had one of the nurses' dogs, a West Highland White Terrier in the clinic - although, he decided he couldn't be bothered to look - not very terrier like, I must say!

After one hour of making the hospital topsy-turvy, Jane, the junior nurse, found the cat in the boss' office (very tempting to just leave the cat there)!! She was feeling extremely embarassed and guilty for this whole episode and tried to remedy the situation all by herself!! She tried to pick up the cat herself and then carry the kitty back to the kennel! As I arrived at the boss' office, I noticed Jane coming out looking pale, covered in scratches and dripping with blood (like a scene from a horror movie!). The cat had won the wrestling match with Jane!!

There was absolutely no way this cat was going to be handled, so we had to try and trap the cat into a mobile crate/cage. The best way was to keep the cat confined in the office and put the cage down on the floor, draped with a towel and the door left open. Cats like dark, secluded places and so hopefully, this towel-draped crate was going act as a nirvana for this little kitty. We just needed to convince her to go in (or more precisely, chase her in!).

The office wasn't very big, so being "The Boss' Private Area", he decided to be part of the duo that were going to force the cat into the cage. The other part of the duo was the Head Nurse. The rest of us remained outside the door listening intently to what was going on inside! For 10 minutes or so, there was clattering, crashing, hissing, shouting and f-bombs! It was like there was a riot inside!

But then joy behold - the cat was successfully trapped in the cage and then released back into her original kennel -with a new sign in big, black bold letters saying "DO NOT OPEN!!".

As for the boss' office, the papers were everywhere and the stationary all over the floor - a total and utter mess with the added frosting of being smeared with cat urine, faeces and the fish-smelling anal gland secretions. What a bonus for the rest of us for having to stay an extra hour after work!!

Sunday, February 15, 2009

Kidney beans!!

The following story was one of the most shocking that I know of as a vet. Fortunately, incidents like the one I am about to recall are rare and not often encountered.

My veterinary clinic had been dealing with this geriatric male German Shepherd (13 year old) dog for several years (since the dog was around 6-7 years old). German Shepherd dogs (GSD) are often hosts to many different diseases and as a result don't often live much beyond 12 years of age. This dog had been in good health for many years but now in the twilight years of his life, he developed problems passing stools and urine.

He was finding it painful to go to the toilet normally and seemed in quite a lot of discomfort. As a result of his pain, he was becoming increasingly tired and inappetant. When the vet (Mark) dealing with the case, examined the dog, he found him to have a very painful prostate gland (male sexual organ sitting at end of the bladder). Tests were run on the dog including blood samples and diagnostics (xrays and ultrasound) to allow visualisation/examination of the prostate.

The blood tests showed the old dog's bodily organs to be functioning normally. However, the prostate gland looked quite abnormal and large. Mark the vet seemed quite surprised by the findings since the owner had insisted that the dog had been castrated (desexed) at another veterinary practice when he was a young puppy.

Our clinic had no record of the castration since he only became our client once he was middle-aged and the surgery had already been performed. The reason I mention castration - is that a lot of prostate problems develop as a result of the hormone testosterone. Therefore, it is unusual for castrated dogs to develop prostate problems later in life because the testicles (which produce the testosterone) have been removed.

So anyhow, this dog should not have had a prostate problem. The scrotum (testicular sack) was empty (no jewels in the purse as we say!). Mark confirmed with the owner that the dog had definitely been castrated as a puppy. The owner was absolutely certain - he even had the bill from many years ago for the castration at the other practice!

On the bill, the owner had certainly been charged for a castration. The owner was charged more than the normal cost of the surgery because one testicle was retained in the abdomen (cryptorchid). Cryptorchidism is when one or both testicles have not descended into the scrotum. They normally are either stuck in the abdomen or somewhere in the groin. These testicles can become problematic later in life, as they don't always develop properly. Surgery to remove a retained testicle takes longer than a routine castration and so naturally, justifies a higher fee.

So this dog had everything proving it had been castrated: an empty pouch and a bill charged for a castration. So Mark decided that this likely prostate problem needed sorting either way and recommended going surgically into the abdomen to examine the organ and to get a biopsy (sample) of it for analysis. Surgery for the abnormal prostate went well - it was examined and the organ biopsied.

When Mark was in the abdomen, he checked the other organs of the body at the same time to see that they all appeared to be normal. Everything seemed fine except that there was an additional resident in the abdomen.There seemed to be a testicle inside. Puzzled, Mark decided that this needed to be removed and sent away to be analysed. This wasn't the end of the story - full examination of the abdomen revealed only one kidney. The other kidney was absolutely nowhere to be seen - a Houdini organ!!

After completing the surgery, Mark confirmed with the owner that the dog had never had any other surgeries except castration at a young age. The client had owned the dog since he was a very young puppy and could confirm that castration was the only surgery. The biopsy result confirmed that the tissue Mark removed was a testicle!! The dog also unfortunately had prostate cancer, which resulted in a very poor prognosis. Incidently, prostate cancer (although rare) seems more common in castrated dogs.

So the only logical conclusion was that the vet performing the castration on this dog (when he was a puppy), accidently mistook a kidney for a testicle. This led to the dog living most his life with one kidney and still with one testicle. I have heard of people meeting strangers in bars and then drugging them to steal one of their kidneys to sell as a transplant. But I very much doubt this old dog got given a date-rape drug when looking for a date!!

Kidneys look quite different from testicles. For one, they are normally much bigger and secondly, they are a reddish-brown colour whereas a testicle looks pink! Fortunately, animals and humans can happily survive with one kidney providing the other kidney is healthy. This dog was luckily unaffected by being an involuntary organ donor!

The irony was that surgery to remove a kidney is actually far more technical than simply removing a testicle. The bill showed that they only charged for a castration, whereas really a nephrotomy (kidney removal) is far more expensive!!

Saturday, February 14, 2009

Vodka drops - apply on back of pet's neck for flea control!

When I used to work for a charity clinic, I ended up often seeing all sorts of clients. One memorable character I encountered was a middle-aged lady who brought her dog in for a skin complaint. The dog was a large crossbreed, who was scratching and licking himself excessively all over (not just the butt and genitalia and then your face - like most dogs do!). This was a result of him being itchy and so his skin looked red and irritated.

I examined the dog while the nurse held him on the table for me. On his fur, there was an army of fleas all over. His body was crawling with the little blighters! Not only that all the faeces they had produced (black specks) made him look like a walking flea sewage system!! Poor dog I thought to myself.

I explained my findings to the owner (a little surprised she hadn't noticed the fleas herself). My recommendation was to initiate some flea treatment (drops on the back of the neck) for the itchy boy and give him some tablets to stop the scratching in the meantime. I also recommended that she treat her house for the flea eggs.

So what was her response? "Thank you - how kind of you to treat my dog. I appreciate your professional advice and of course, I will take your recommendations and start relieving the discomfort of my poor dog". I wish it was that easy.......nothing close!!

This lady was absolutely drunk. The alcohol on her breath was so strong, that her just breathing on the dog would probably have been enough to kill the fleas (or at least make them intoxicated enough to fall off sideways!). Her response to my advice, was that I had no idea what I was talking about and that all her dog needed were steroids to stop the scratching. She denied that there were any fleas whatsoever on her dog.

At this point, I tried to point out the fleas for her to see with her own eyes, the little parasites crawling around her dog's body. The fleas were absolutely all over the dog, with a population density like Singapore, with bodies everywhere. The owner said that I was lying and there was nothing there. Understandably, I was getting irritated by this lady's stubborn and drunken behaviour.

Eventually, I lost my cool. I pointed out to the lady that both myself and the nurse could clearly see the fleas and that if she didn't have her beer goggles on and could actually see with any clarity at all, she would also be able to see them! I told her that she clearly didn't value my professional opinion and promptly sent her and the poor dog on their way (probably back to the pub!).

The following day, the lady returned to my clinic and sheepishly apologised for her behaviour the previous day. She agreed that my diagnosis was correct and took both the flea control and medicine I recommended. I think she probably bought for me a bottle of wine as a peace offering but ended up drinking it herself in the end!

Friday, February 13, 2009

Biggles the flying hamster!

One story that is very common amongst vets is problems with hamsters! I have heard many stories regarding these small furry and seemingly innocent creatures.

Hamsters are by nature nocturnal (awake at night) and a prey species (meaning larger animals such as birds of prey, hunt them for food). As a result of this, they often aren't too happy by having to come to the vet clinic. Once they arrive in the consult room during the day, they are normally trying to sleep and get pretty fed up by being disturbed (like anyone of us would). They normally arrive in a cage and hiding in some small plastic container (takeaway meal?). So as vets, we need to put our hand into the tiny door of the cage and then pick up the hamster.

From the hamster's perspective, what they see is a big clumsy hand blocking out all light and trying to grab them. So it is not unusual for them to wriggle around, try to escape and fight for their life! I know of one vet called Robert who once was examining a Syrian hamster for a minor ailment, when all of a sudden the hamster bit him.

Syrian hamsters in particular are known for biting and not being the most friendly of creatures! It may sound pretty pathetic, but I can definitely confirm that a hamster bite is excruciatingly painful. Their teeth are like needles that lock onto your finger and will not release under any circumstances. It seriously hurts!!!

So anyway, this particular hamster decided to sink its teeth into Robert. Robert's natural urge was to pull away his hand as quickly as possible. Unfortunately, Robert's sharp and swift instinctive withdrawal of the hand resulted in the hamster being propelled towards the back wall of the consult room! This flying hamster went splat into the wall and fell promptly to the ground.

It had instantly died with its posterior being the last thing to go through its mind!! The poor little fellow had bitten to try and escape with its life but ended up dying as a kamikaze! Obviously the owner was both stunned and upset by the rapid unfolding of events! Robert was lost for words and extremely embarassed by being a rodent murderer. If only they made parachutes and small helmets for hamsters - a lot of injuries could be avoided!