Well, now I’ve done it!

Filed under: @ 8:13 am

As if there wasn’t enough on my plate during the spring and summer, I had to go and get all intellectual.

I signed up for an online review/prep course to start the process of pursuing my ABVP certification next year.
I’m not sure whether to be excited or apprehensive about this. I’m a good, practical doctor, but the details and pathophysiology of what I do every day have, in large part, faded into the background of my brain. Now I’ve got to dredge them back up, dust, polish, and wax them as well as add in the new bits that have been worked out in the sixteen or so years since I was cramming for my national board exams.
Fortunately these courses are ONLY covering dogs and cats so I don’t have to try and stuff ruminants and horses wholesale back into my head, but still.
I know a lot, but there’s a lot more that I’ve forgotten.

This is either going to be terribly exciting or a real live pain in the ass.


Additional Random Neural Firings

Filed under: @ 7:57 am

If the plural noun for a group of crows is a “murder”, is the plural noun for a murder of crows a “massacre”?
See I ask because I was on my way home from work the other day and stopped at an intersection in Southcenter I was struck by the huge number of crows there were flitting about. Literally hundreds of them, all calling to the point where I could hear them with my windows up and my stereo going.

Why do people think it’s less disgusting if they pick up and bag their dog’s poop then leave the tidily bagged poop in other people’s landscaping? Along my walking route there are at least two dog walkers (or one person that uses two distinct types of bags) who pick up after their dog, tie off the bag, and then leave the bag tucked away in a bush somewhere. WHY is that less gross than just letting the dog take a dump and leaving it? At least if the poop is un-bagged it has a chance to be washed away when it rains. People confuse me.

Seen on a roadside sign on my way home….


I don’t live in Sea-Tac (and here I will restate my protest at having a town/city/municipality named after an airport that is named after two large cities. Silly if you ask me.) so I’m obviously missing something but…. GWUH?

There’s a reason that your physician tells you to take deep breaths when they’re ausculting your chest. That reason is this: If you’re not involved in taking deep breaths when there’s a stethoscope on your chest, you’ll be tempted to talk to the person on the other end of the stethoscope. I know this for a fact because people think that the very best time to talk to their veterinarian is when she’s listening to their pet’s heart.
What is it about that action, the placement of the ear pieces in the ears, that makes people garrulous? Why…… Well, I know why. People don’t think, that’s why. Thus at least once a day when I’ve got a stethoscope in my ears, my head bent over a cat or dog, and a watch in my hands on which I am concentrating intently, a client will START TO YAP.
It may be a sign of maturity, it may just be that I’m getting crankier as I get older, but I’ve gotten to the point now where I don’t even respond. I used to pull the stethoscope out of my ears, raise my head and listen politely. Now I’ve just gotten to the point where I ignore people completely if they’re talking to me when I’m listening to a chest. I suppose the “crankier” diagnosis is probably more appropriate, because I also get a little twinge of amusement listening to their muffled voices trail away as they realize that I’m ignoring them completely.

If you wouldn’t bring your dog to your kid’s doctor’s appointment, why would you bring your kid to your dog’s veterinarian’s appointment?

And I really would love to know this one. Every so often, actually about once a week in the spring and again in the fall, we’ll get a flyer of some sort left on our front porch by a local landscaping or lawn care company (not the same one every time, there’s a bunch of them). Obviously the people who deliver these missives have either walked THROUGH my front garden to get to the front door, or have walked up the driveway and up the stairs FACING my front garden to get to the front door. So I gotta ask… Does it LOOK like I need a landscaper or a yard service?

Two types of peas, two types of beans, three types of spring onions, and a mother lode of radishes have been planted. Along with a BUNCH of flowers. It was a great but very, VERY short weekend.


An oldie, but a goodie

Filed under: @ 5:59 pm

Well, okay, in relative terms a goodie.

I was reminded of this at work the other day when we became entangled in an odd series of events involving a dead Portugese Water Dog in a large Coleman cooler, a pathology lab in Utah, and a really wigged out UPS store employee. Understand that the current story really has nothing to do with all of the above, but you’ll see the parallels.

When I was working for Dr. Ratbastard in Olympia I was presented with a largish hound type dog with the complaint of a persistent cough. Largish hound dog was 12 years old and had lived nine of those twelve years in Texas without being on any type of heartworm preventative.
And really that made my diagnosis pretty darned easy. See, if you’re a dog living in Texas without heartworm prevention, the reason you develop a nasty cough is most likely because you’re infested with heartworms and your heart is in the process of failing in a truly spectacular manner.
Which was, indeed, the case. Largish Hound Dog (LHD) had stage 4 heartworm disease and was so classic for progressive heart failure that they could have written the book just by her symptoms.
Persistent and progressive cough worsened by exercise (or, really, any movement).
Profound dependent edema –swollen legs, swollen feet, the works.
Marked abdominal distention secondary to ascites from failure of venous return — we pulled three or four liters of fluid out of her abdomen that afternoon.
And just to add a seriously oogy bit of oomph to the diagnosis, when we pulled blood from LHD the blood in the collection tubes was wiggling because of the huge numbers of microfilariae (baby heartworms) in the circulating blood.
Basically LHD was on her way out. There certainly wasn’t anything practical that I could do. If I’d referred her to a teaching hospital they would have been able to put a tremendous amount of effort into saving her and she’d have died anyway.
And in the gentlest way possible I told the owners that. Fortunately they were able to hear the words “your dog is dying and no one can help her” and make compassionate and rational decisions about her.
And I think part of that capacity was because I was so wound up about seeing a case of heartworm disease.

For those that don’t live in the Pacific Northwest I’ll explain.
Dirofilaria immitis is transmitted from dog to dog (and occasionally to cats) through a mosquito bite. If you live in an area where the proper species of mosquito lives, your dog is at risk as long as the mosquito season lasts (year round in some areas). For whatever reason, D. immitis hasn’t figured out how to use the species of mosquito that are found in the Northwest.
For which I am profoundly grateful. I don’t WANT to have to deal with heartworm, I don’t want to have to argue with people about using the preventative (I have a colleague on the east coast who was told by a client, in all sincerity, that “my dog can’t get bitten by mosquitos because I live in a gated community”), and I certainly don’t want to have to treat the nasty ass things which, up until just recently, involved a medication that was a derivative of arsenic. For the record the treatment has improved somewhat, but treating heartworm is still a bitch.
Veterinarians in the northwest almost never see a case of heartworm. I was a young doctor, I never thought I’d see a case of heartworm and I certainly never thought I’d see so classic a case. As a scientist this is an exciting thing and LHD’s owners picked up on my scientific excitement. Since they couldn’t do anything practical to save their dog they decided that they “wanted her death to mean something”.

Could they, they asked, donate LHD’s body after she was euthanized so that someone could actually learn something from her death?
Well, lemme see what I can do.

I called the pathology department at WSU’s veterinary teaching hospital. I spoke with the head of the pathology department who said that they’d be delighted to have LHD’s thoracic viscera from the larynx to the diaphragm to use as a teaching specimen. Veterinary students in the northwest almost never get to see this sort of thing, especially not as such a classic presentation. Dr. L gave me the department’s FedEx number, told me how to package the specimen, and requested copies of all the diagnostic testing I had done, the chest x-rays, and a case summary.
No problemo! Can do.
I went back to the owners and told them what I’d arranged. They were as happy as could be expected under the circumstances.
They wanted to take LHD home overnight so she could have one last night with the family. It was Thursday evening. I didn’t work the next day, but I got everything worked out that they would drop LHD off mid-morning on Friday, the office manager would give me a call when she was dropped off and I would run out to work, euthanize the dog, do the dissection, package everything up, and run the package to the local FedEx depot so that the package would arrive in the pathology lab in Pullman early Saturday morning.
A tidy arrangement and it would have been very successful except that Dr. Ratbastard’s clinic was owned, run, and staffed by (with a few outstanding exceptions) useless fruit loops.

I sat at home, doing my usual Friday things, waiting for a phone call from the clinic that LHD had been dropped off and was waiting for me to show up and perform a final mercy.
10 a.m. passed.
Noon passed.
2 p.m. passed.
I knew that the FedEx depot closed at 5 p.m. and I knew that there was NO way that I was going to be able to pull this off if the dog was euthanized Friday and the viscera waited until Monday to get on their way to the university. So at 3:30 when I had chewed my fingernails down to the wrist I called the clinic and asked whether or not LHD was there.
“Oh yes!” came the bright and brainless reply “Her owners dropped her off about 10:30 this morning, we’ve been waiting for you.” (and so NONE of the FIVE people that had been there the evening before who were also there that day remembered my instructions, that when the dog was dropped off they were to CALL ME?!)
Sour grapes. I have no doubt that all of the useless fruit loops have gone on to bigger and fruitier things.
I grabbed my new pair of hedge trimmers and bolted.

Got to the clinic, euthanized the dog. I’m sure she was grateful.
Got a rather delicate dissection done in what must have been record time and left with a squishy, triple bagged package on ice in a styrofoam cooler inside a cardboard box, leaving a horrendous mess for one of the few competent and sane people employed there to clean up (sorry about that).
I didn’t have time to prepare the case history, to make copies of the lab results, or properly package the radiographs that I had taken the day before, but I figured there wasn’t going to be any problem. I would get the perishable stuff to the path lab at WSU ASAP and then arrange with Dr. L to fax and courier the rest of the case across the state come Monday. My repulsive box and I sped through downtown Olympia, out to the freeway, and at top speed (at least the top speed allowed by my aged Toyota Corolla) to the FedEx depot in Yelm.

I screeched into the FedEx depot at 4:55 p.m., skidded into the building with a squishy box full of dog viscera and waited my turn.
I got to the counter got the thing addressed, put my name and the clinic address (this will be important later) as the return address and asked the weary FedEx drone if there were any stickers that I could add that would make it obvious that the package needed to be opened immediately.
“See, it’s kind of perishable and I don’t want it to sit around all weekend. I know it’ll be delivered on Saturday, but if no one opens it until Monday it’ll be ruined. Something like “BIOLOGIC SPECIMEN OPEN IMMEDIATELY” or something like that?”
I swear you could hear the FedEx drone’s eyelids snap to full open and alert from three blocks away.
“WHAT is in that box?”
“Um, well, it’s kind of gross. It’s a specimen for a laboratory at WSU.”
“WHAT. IS. IT?!” (clenched teeth and all, I swear!)
“Well, it’s nothing infectious or anything. At least, not unless you’re a dog.”
“I’ve gotta go get my manager. Don’t go anywhere.”
A little confused, but yet unwilling to let her know that she was going to be dealing with a box full of dog guts — that sort of thing being a little disturbing for those of a delicate constitution — I waited for the manager.
Manager shows up.
“Ma’am, what is in the box? We can’t ship unless we know that it’s not a biohazard.”
Throwing caution to the wind, I explained what was in the box and I got exactly the results you’d expect.
To his credit the FedEx manager dealt with it pretty well, even going so far as to slap about two dozen “PERISHABLE OPEN IMMEDIATELY” stickers all over the box once he’d stopped gagging.
With a sense of triumph I turned around and went back home, thinking the job was done, LHD’s owners would have their wishes fulfilled, and some second year DVM students would get a decent look at something that is pretty darn rare in this state. All’s right with the world.

Except that Dr. L, who of course didn’t work Saturdays, didn’t ever talk to his residents.
The package arrived at the path lab at the WSU VMTH early Saturday morning. A package of dog viscera sans explanation, sans any sort of lab submission form, sans case history, lab reports, or radiographs. A package slapped with two dozen or so bright orange “PERISHABLE OPEN IMMEDIATELY” stickers. A package whose only identifier is my name with my clinic address on it.

Andrew and I like to sleep late on Saturday mornings. That particular Saturday we slept until 10 or so, got up, made pancakes, and went back to bed to eat them.
So when the phone rang I was sitting in bed with a plate of pancakes in my lap and I was unwilling to leap up and answer the phone. Answering machine came on, from across the house we heard a male voice talking to the tape. We figured it was my brother and that there wasn’t any urgency in calling him back so we settled back into our pancakes.
And our books.
And our cats.

Around noon or so we finally got out of bed and went into the kitchen to see what the answering machine had to say.
At that point in time our answering machine message was:
“You have reached (the incorrect phone number) which is odd because you dialed (the correct phone number). Perhaps there is something wrong with your phone.”
On the tape was a hopelessly confused second year pathology resident from WSU who was trying to get ahold of me to find out what the box full of dog guts was all about.

I still have to laugh. The poor man. Early Saturday morning he’s delivered a large package marked “OPEN IMMEDIATELY” which he opens only to find an anonymous dog’s innards. Looking to the return address he figures if he calls the clinic from which the innards originated he’ll get some sort of explanation, but he doesn’t because I’m not there and the place is run and staffed by incompetent fruit loops. The fruit loops give him my home phone number which he promptly calls only to be told by the answering machine that he’s reached a different number than he’s dialed.
If I knew who he was I’d call up and apologize, but even almost 15 years later it’s still danged funny.


Cue Spit Take….Aaaannnnnd….ACTION

Uncle AndrewUncle Andrew
Filed under: @ 11:44 am

Now personally, I hates me some Oscars. I may or may not take some of my movie-viewing cues from what people I’ve never met in my life have to say about a given flick, but I have zero tolerance for the pimp and circumstance of Hollywood award shows. Overcelebrated people gathering together to further overcelebrate themselves—huzzah!

But even with fewer than half a dozen Oscar ceremonies under my belt, this little scrap of genius, sent to me today by Shawn, seemed to me to hit it right on the mark. View and enjoy. 😀

Singularly Swift Condiment

Filed under: @ 9:58 am

Serious bonus points to those who can translate my words into the actual title of this post.

There may even be a booby prize but I’ve used that one once.


I’m working five days a week which cuts into my blogging time especially since I’m currently working swings (11 a – 7 p) which seriously sucks, but at least allows me to walk in the mornings (some days when I can get myself motivated) and also get a soak in the hot tub.
What it does NOT do is allow me to do things like -oh- go to Costco during the week which means that our Costco runs are limited to *shudder* weekends, or get laundry done in the evenings. Or get any afternoon gardening done, or do the bills in the afternoons, or, or, or.
I am not sure how two people working full time are supposed to maintain a house when both are working five days a week and still have any time on the weekends to do things like interact with friends and family, or do such things like RELAX. I may be spoiled, but I’ve always considered the way Andrew and I live our lives as a fairly organized interaction, but I can NOT figure out this schedule at all. My weekends seem to be a rush of activity and then it’s Monday again. Maybe those of you who haven’t had my odd schedule can comment, but how do you do this?
And it’s gonna get worse. I mean, granted I’m only working swings every other month and it IS coming up on spring and the days are going to be long enough that I can get out in the evenings and get some garden work done at least, but….
It’s coming up on spring and the amount of garden work is going to triple, quadruple, octuple. Even with the garden weekends that Susan and I have planned over the next two months or so, the garden is going to run me over. I’m thinking seriously about taking prep courses so I can sit for my ABVP boards either this winter or next spring, and, whatever sort of weird loon that I am, I’ve signed up to walk again. Anyone wanna come with me this September? I’ve got a hairy lot of walking to do between now and then. Maybe I can get some of my ABVP texts on disc so I can iPod them while I’m walking.

So back to the aforementioned condiment.
The clematis is in full bloom. The hyacinths are popping and the daffodils are up. The lillies are poking their noses up out of the ground, my brainless peonies are almost grown out of their cloches so if they freeze their silly little tips off it’s their own damn fault. Nuccio’s Pearl is in full bloom, and as soon as my pelleted peat pots are fully expanded I’ll have peas started in John Coldframe which Susan and I, in our first garden frenzy of the spring, got put together last weekend.
Andrew came up with a vicious cold last weekend and spent much of his time snerfling and/or up to the eyebrows in Advil Cold & Sinus, taking a major break on Saturday to help Shawn take about a thousand photos of Anastasia and I dissecting Anastasia’s first frog in the driveway. She’s got this upcoming school science fair thingie so I volunteered to talk her through the test frog so that she can be *really impressive* with the second frog for the actual fair. Kid’s got talent, I can tell you that. And a fantastic sense of delight at the inner workings of living (or formerly living) things. I was grossed out by some of it, but Anastasia thought it was pure D cool. She didn’t even mind the smell, which she described as “It smells kind of like pudding!” (really, REALLY don’t want to know what her mother is feeding her if a formaldehyde frog smells like pudding to her, but regardless). I’ll post photos at some point.
The other cool thing that’s been happening ’round here is that Andrew has taken up with a local charity and is refurbishing semi-obsolete computers. I’ll let him fill in the details, but he is absolutely thrilled with being able to take what most people see as dusty junk and have it be a thrill for someone.

No further condiments at this point, I’ve got to get this cat off my lap and go shower so I can get to work.
Weird damn shifts. Mother chocolating economy, get better dammit. I want a third doctor back at my practice so I can have an off day during the week to get my chores done like a normal person.

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