Tales of the Weird

Occasionally something will come into the hospital that can't be described as anything but just plain weird. Yesterday we had one of those patients: a canine hermaphrodite.

 Yeah, we don't know either.

When we saw him/her, he/she was in the hospital for an unrelated wound repair surgery. He/she had been neutered previously, but we weren't sure what kind of procedure was used. (All hermaphrodites aren't created equal, and from what I understand there's quite a range of hybridization that can be expressed, both externally and internally.) All we found was a tiny scar right of the midline just above the vulva. Dr. Boss Lady was fascinated, though, and wanted me to take pictures for possible future reconstructive surgery. She spent an almost uncomfortable amount of time studying the, um, region.

Also, this happened last night right as we were about to close.

Scene: A distraught lady came rushing in with her dead cat in her arms. The receptionist placed her in a room, and the senior assistant went in to get some information. Ms. Deadcat, upon being asked if her cat had been ill and how long, jumped down the poor assistant's throat. He left, and Dr. Boss Lady joined her soon after. At first Ms. Deadcat demanded a necropsy, but when she was told what it would cost, she declined, and then the meeting switched into therapy mode.

Ms. Deadcat: Dr. BL, ever since I've started coming to Kickass Animal Hospital, I've had THREE of my babies die!

Dr. BL, looking impressed: One more and you can get your name on the door.

When she came out of the appointment and told us, our jaws dropped. She high-fived the senior assistant and said, "That one was for you."

(To be fair, Ms. Deadcat has been a client of ours for a long time. She and Dr. BL are actually good friends and both pug owners. She was understandably emotional at the time, and that zinger was Dr. BL's way of snapping her back to reality. She later apologized to the senior assistant. It was still a great moment.)

Looks like there's going to be some inclement weather this evening. Fingers crossed we won't have any overnight patients, and maybe I won't have to come in tomorrow.

Experimental Treatment with Synthetic... Poop?

As many in the field of veterinary medicine know, Clostridium perfringens can mean bad news for animals. Certain strains of it cause diarrhea, and I'm not talking about your average mushy poop. C. perfringens diarrhea is its own special brand of disgusting. (Think pea soup. I'll wait while you picture that.)

Another species of Clostridium, C.difficile, has a nasty habit of infecting humans. Most often, infection occurs in a hospital setting after patients have been treated with a broad-spectrum antibiotic such as clindamycin. Once all the normal gut flora have been wiped out, C. diff comes in and takes hold, causing pretty severe symptoms. A bad outbreak can result in several deaths.

There is a treatment that has been gaining popularity recently. It's definitely one of the weirder ones out there, so brace yourself. Two words: Fecal. Transplant. Yes, that is a thing. They can actually take one person's poop and place it directly into some poor sap's small intestine. Not many studies have been done on the effectiveness of this type of treatment, but it does seem to work.

Well, researchers at the University of Guelph in Ontario, Canada decided to attempt to improve on this procedure, and perhaps degross-ify it just a little. They have actually created a synthetic, mechanical digestive tract. They call it the "Robogut." Seriously. They took a stool sample from a healthy woman and put it into their contraption, where they allowed it to percolate for a while. They then extracted DNA sequences of the bacteria that were present to make sure they knew exactly what they were dealing with. They selected 33 of the best ones, cultured them, and then put them all together into a bacteria "milkshake," which was inserted directly into their subjects' intestines during a colonoscopy.

And get this: in two patients, it actually worked. The good bacteria were able to take hold and kick out C. diff for good.

You can read the article from NPR about it here. Science is crazy and wonderful.

Rainy Day, Thoughts on Euthanasia

Worked a morning shift today and was planning on going for a double, but the schedule was pretty dead today, so I left at 2. And by "pretty dead," I mean Dr. Boss Lady had me, the new assistant, the senior assistant, and the receptionist on ladders, on the floor, and crawling around behind furniture looking for things around the hospital to "spruce up."

Later on in the day, the senior assistant got out the Dremel and the stainless steel brush piece so that he could, I wish I could say I was kidding, scour the kickplate of the door to the treatment area in an attempt to remove about three years' worth of congealed floor wax that had been splashed up onto it. It actually worked like a charm, and after a coat of Brass-O you could see your goddamn reflection in that kickplate. So add "door shine restoring" to the list of things that the Almighty Dremel can do.

I also spent about 45 minutes today going through our stock of Frontline and taping two extra doses to the front of each box, stamping the "buy 6 get 2 free" coupons with our Merial number, and carefully folding each one and tucking it between the freebies and the box. It's actually a pretty tidy little package that I make, if I say so myself. If I don't complete this ritual as soon as the new Frontline comes in, no one seems to be able to remember (1) that we have this awesome deal in the first place, which we should really be pushing after the Fleamageddon of Fall 2012, and (2) that we can't get reimbursed for the freebies unless we fill out the forms and mail them back to Merial, and nothing makes Dr. Boss Lady angrier than having to eat costs. I practically had to beg her to even bother with the discount at all, and promised her that I would personally oversee its implementation and even offering to take missed ones out of my own paycheck. (I really, really hate fleas!) It seems like there should be a less time-consuming way to work that whole system, though.

Patient-wise we started the morning off with a walk-in euthanasia. Those types of appointments always have me on edge, because the horror stories happen far too often, it seems. Dr. Boss Lady is particularly fond of telling us about the time that she worked at a large referral and critical care facility, and a lady brought in a completely healthy dog for euthanasia. After some careful questioning, she finally admitted that it was actually her neighbor's dog, whom she had dog-napped in a fit of frustration after it had woken her up in the morning with its incessant barking one time too many. Miraculously she was shamed into returning the dog to his home and fessing up to the neighbors, so the police didn't have to get involved, from what I understand.

One look at the dog that was brought in this morning, an ancient Shepherd mix, and it was apparent that the flea-infested, emaciated, and incontinent creature was more than ready to shuffle off this mortal coil. She was a sweet girl who still had life and intelligence in her big, tired eyes. The owner's story was that this was the last of the dogs that had belonged to her mother, who had passed away from lymphoma recently. The owner herself was not doing well health-wise, and was actually on the verge of being admitted to the hospital for long-term care following the onset of acute renal disease, and she could not take Sad-Eyes with her. I think she knew that Sad-Eyes didn't have long left, anyway. She hadn't been able to stand for the past two weeks.

After we put together an estimate, she admitted she was a few dollars short. Was there any way to bring down the bill? I told her she could always opt to take the dog home and bury her, which would save the cost of the cremation, and she seemed to like that idea. She wanted to bury her under the magnolia trees her mom had liked. I asked her as gently as I could if she had anyone who could come by and help her dig the grave, and her face fell and she admitted that, no, she didn't, and she wasn't well enough to attempt it herself. But she stepped outside and made some phone calls, and when she returned, she opened up her wallet and handed us her last of her cash, enough to cover the cremation. I gave her back her $10 in change, and that was all that she left with.

I held Sad-Eyes' head up as the doctor gave the injections, and I wasn't even bothered by the fleas she shared with me or the smells that came from under the blanket she was wrapped in. I told her she was a good dog and that propofol was really great stuff, she would see, and how nice it would be to rest. The owner and I both cried. When she left, she thanked us all, and we wished her the best with her treatment. I suspect we won't ever see her again, but I'm glad that she was able to come up with the money for the procedure. I hope that she didn't have to dig too deep. Sad-Eyes was a lucky girl.

So that, along with the rain that has been falling steadily for three days now, put a damper on the day that no amount of creative Dremeling could really shake. When the office manager came in at 1:30 and asked if I wanted to take the rest of the day off, I gladly accepted. I came home and hugged my kitty tight before taking a nap, a luxury that I haven't been able to afford in months. (And a rainy nap, too, which are always the best!)


Euthanasias aren't something I had much thought to before I decided on this career path. I've only been working at an animal hospital for five months now, and already I've experienced so much more emotion than I thought I would. I wouldn't really describe myself as a bleeding heart, and to be honest I thought I was going to be much more detached than I've ended up being about the whole thing. I've been present for probably around like 20 procedures, and intimately involved in perhaps a dozen.

One aspect of euthanasias that I had never really grasped when contemplating this career is how vastly different one can feel from another. I can watch a frightened wild rabbit with a broken leg take its last breath less than a half hour after some well-meaning person brings it in to the hospital, and my only thought is whether anyone would play Good Samaritan if they knew ahead of time that a wild animal with a broken anything is nearly always going to have the same outcome, and what that procedure would normally cost if it were someone's beloved pet. (With ill-fated rescued wildlife, our hospital's general procedure is to write up the full invoice for the procedure, show it to the hapless client, and tell them that we won't demand payment, but if they'd like, they can make a donation of $100 to cover our supply costs, or even pay in full in they choose. If they are able, most opt for the donation.) I might even feel a twinge of... not quite disgust, but sort of a mild feeling of distaste for the poor creature in its mindless, unfocused panic. For an animal that has never been exposed to humans for any long period of time, there is none of that (entirely irrational) sense of guilt or betrayal that can pop up when you have to put someone's pet bunny to sleep. Yes, that wild rabbit's last few moments in life were frightening and painful, but such is often the case for them. This time, for this rabbit, it was more drawn out, and involved some trauma, then pain, then brief flashes of human contact, followed by peace. For the next rabbit, it might be a shorter death at the talons of a red-tailed hawk, or an instantaneous one under a car bumper.

But for animals that have come to love people (each in their own way, no matter the species), the emotional burden of having to be the ultimate agent of that creature's demise, though merciful, can sting. Yet, that's really the greatest gift that we can give those animals who bless us with their companionship. We can offer them a detour, if you will, from the cruel ways of the wild. An old family hound facing what would be a painful and arduous battle with cancer can instead be given one final car ride to an end that is free of pain, where he can trust in and be comforted by his master's presence.

I know all of this. Some days it's all I can think about on the car ride home. I go over all the reasons why it's a good thing, because sometimes the grief wins out over reasoning.


I knew before starting this job that once I started seeing clients long-term, watching their animals grow and thrive, overcome setbacks, and ultimately decline, when the time came to end it, I would be pretty emotional. What kind of person wouldn't be? What I absolutely did not expect was the implausible-unless-you've-been-there idea that I could be so distraught over an animal that I had met just a half-hour beforehand. I will say that it does get easier, if only for the simple fact that once you've experienced that kind of situation the first couple of times, you start to learn how to prepare for it so it doesn't sneak up on you. I don't think it will ever be easy though.

Rainy day naps definitely help.

Why I Hate Pugs

Back to work today to start a new week! I generally work the afternoon shift, so there were already several animals in the treatment area by the time I got there: a pair of black Lionhead rabbits (drop-offs*), a cat with a leg injury, an extremely lethargic and sick cat, and a pug with probable kidney disease that had been with us through the weekend.

Which leads me to today's topic of discussion. We've been seeing a lot of pugs at the hospital lately, fortunately mostly for routine exams. For some reason, everyone seems to think that they are the most adorable little creatures to ever bless us with their presence—everyone, that is, except for me.

This is how everyone else apparently sees pugs.

 I am a tiny and adorable creature, please love me.

This is how I see pugs.

herp derp

 
Now before I get slammed by pug-lovers, which seem to number in the tens of billions, let me explain my rationale. All modern dog breeds are descended from gray wolves that were domesticated roughly 15,000 years ago. Since then, they have been selectively bred to exhibit an astounding variety of physical and temperamental traits.

The relationship of dogs and humans is one of mutual exchange and benefit. Dogs provide us with some form of specialized work or service that we are incapable of providing ourselves, and in return, we provide dogs with food and shelter, which, likewise, they are unable to provide themselves. The vast majority of modern dog breeds adhere to this time-honored symbiosis by protecting us, hunting with us, herding our sheep, getting rid of pests, or even fetching and carrying things for us.

And then there are the toy dogs. As their name implies, they are small. And, as their name also implies, they exist solely for our amusement. They have been refined and pruned over thousands of generations to look as un-wolfish and ridiculous as possible. The quest for their convenient lap-warming size has twisted their proportions, shrinking down their entire physical structure, except for their brains and, for some reason, their eyeballs.

Their poor, poor faces have been squashed beyond all recognition, collapsing their sinus cavity in on itself, and removing the natural buffer between what they stick their nose in (which is everything) and their already bulging eyes. I've seen pugs at our hospital with eyes that have become so dry that they thicken and scale up and become completely clouded over and useless. They're prone to life-threatening infections. One of our regular pugs had to have his eye completely removed because it was such a problem. And even if their eyes are healthy, they're always pointing in completely different directions and look utterly ridiculous.

Please sir, can I have a real face?

Because pugs are brachycephalic, they are prone to breathing difficulties. I don't think I've ever seen a pug that is not constantly making some kind of horrific snorting or sucking noise as it tries to breathe. Now, think back to the last time you laughed so hard you started snorting. Or if you've ever gotten any kind of liquid up your nose. It was kind of unpleasant, wasn't it? Pugs are cursed to doing that for their entire life. Every moment of every day they are struggling to breathe, even in their sleep. I've never met a  pug that wasn't constantly choking on its own epiglottis. And because their mouths are too small for their tongues, they're forced to wander around with their cracked and lifeless tongue hanging out forever.

Pugs also have terrible, terrible skin issues. The folds around their faces and their paws are prone to chronic bacterial and fungal infections. They tend to drag their feet, so any time they take a step on pavement, they're making direct contact with the ground without the protection of their paw pads. We're currently treating a pug who drags his back foot so badly that he's developed a huge, thick scab covering an infected wound that goes halfway up to his tarsus and his toenail is completely gone. The area is so degraded that it's beginning to impact the metatarsal bone, and eventual amputation of the digit and perhaps the entire limb is a very real possibility.

People say they like pugs for their personality. I have yet to meet a pug with any sort of personality. They just wiggle. Constantly. They get up in your face and snort on you and wiggle. Then they do a lap around the room and come right back and snort and wiggle some more. They seem like they're constantly in a panic. Maybe because they can't breathe.

I feel sorry for pugs. They didn't ask to be the way they are. But I can't help feeling a little bit of resentment for pug owners. By buying pugs, they're just contributing to the breeding of more miserable, gross little pugs who have to suffer through 10 years of health problems, and also 10 years of pug owners.

Dear god, why me?

But hey, at least they keep us in business, right?

* By "drop-offs" I mean that they were dropped off by their owner in the morning instead of coming in at an appointed time. We generally perform exams on the drop-offs sometime during the day, and give them baths, pedicures, or anything else they might need done, and then their owners pick them back up again in the evening. It's an important distinction, since the only other animals we keep in the treatment area are those that are "hospitalized," which usually means they're there prior to or after surgery, or are sick enough that they need constant care and monitoring.

So I started a blog... part two

So anyway, like I was saying before I was so rudely interrupted yesterday,* I moved back home around August. I decided to try to branch out from chemistry, and I was absolutely determined to avoid another desk job. I immediately hit upon veterinary medicine as something that would be fun, engaging, and rewarding.

Unfortunately, after a quick Google search, I discovered that veterinary assistants make minimum wage. But I also discovered that with a two-year Associate's degree and after passing a state licensing exam, I could become a Licensed Veterinary Technician** (LVT), and LVTs make, like, a little bit more than minimum wage, and they could also be a lot more hands-on than an assistant. Basically other than diagnosing, prognosing, prescribing medications, or performing surgery, LVTs can, in a legal sense, do anything a veterinarian is capable of doing. To me, that sounded pretty awesome.

I knew I didn't really have anything going for me in the way of experience or education in the field other than having taken four or five bio courses when I was in college. So I typed up a really bangin' cover letter, gushing about how eager I was to learn, and how I was enrolling in vet tech school, and how I was super smart and motivated and please, please hire me because I'm 27 and still living with my parents. Well, maybe not the last part, but I really sold it.

I sent out at least a dozen résumés to every vet in a 15-mile radius. I only got one call back. Fortunately it was from one of the more interesting facilities. It was an animal hospital that not only treated emergency cases, but also accepted exotic patients. (Score!) They called me in for an interview, and after spending a few hours shadowing one of the assistants there, I was offered a position at $10 an hour.

So, that's how I ended up where I am now. It took me about three months to learn my way around and observe enough patients that I was comfortable taking charge, but the other assistants I worked with and the two vets at the hospital were enormously patient and helpful. The sheer volume of information I've absorbed in the past five months is truly staggering. And there's so much more to learn. I really can't wait for classes to start!

*  I had a crucially important meeting scheduled for Settlers of Catan.

**  Depending on what state you're dealing with, they could also be called Certified Veterinary Technicians or Registered Veterinary Technicians (CVTs or RVTs).

So I started a blog...

My name is Lacy Entwhistle*, and I'm 27 years old. I work at an animal hospital in a small city somewhere in the United States. In about a week, I'll be starting online courses to work toward an Associate's degree in veterinary technology.

So I decided to start a blog, partly so I can share my experiences with other inquiring minds and individuals who are maybe considering the same type of program, but mostly because I canceled all of my MMO subscriptions and need something to procrastinate with now.

From what I understand from talking to others in the field, I have kind of an unusual background for someone pursuing veterinary technology. I graduated from a four-year state university with a Bachelor's in chemistry a few years ago. I had originally pursued biology, but switched majors in my Sophomore year because I discovered that most bio majors are preppy, annoying, and not very smart.

I was surrounded by starry-eyed girls (because, let's face it, most girls hate math, and bio is the only science that actively avoids anything harder than algebra, except for maybe psychology, but that's not really a science anyway) who all wanted to be doctors and vets, but who had completely unrealistic expectations of not only the basic fundamentals of science upon which the field of medicine is built, but also of the fact that, realistically, their chances of actually (1) being accepted into, and (2) graduating from any medical school were astronomically small.

Maybe I'm being cynical, or that was just the case at the school I attended, but either way, switching majors was probably the best decision I ever made.

After graduation, I would have loved to continue on and get a Master's in something like atmospheric chemistry, but financially, that wasn't really an option. I moved several states away from my hometown to live with a guy that I was seriously dating at the time, and started to look for jobs. Unfortunately, my location and timing couldn't have been worse. I was in an area that was heavy on technology and industry, but abysmally light on research, pharmaceuticals, private labs, or really anything that offered good prospects for a recent chemistry grad.

So I took what I could find and ended up working at an engineering consulting firm. The pay was decent and it was a steady, if boring, job. Then, a few months ago, the owner of the firm retired, leaving me jobless. I tried to go back to chemistry, but still got no offers. Around that time I also separated from my boyfriend and moved back home.

I'm out of time just now to finish the tale, but I'll resume here later. I bet you're dying with suspense.

*  Not really.

"Oh it's okay, she won't bite."