Geophagy

As vets we are exposed to all sorts of bugs, germs and parasites, some of which can cause serious disease (such as Leptospirosis causing liver or kidney failure, Rabies, or nasty bacterial infections from bite wounds). There has been increasing paranoia about working with horses in Queensland due to the resurgence of cases of Hendra virus, which I have luckily managed to avoid by referring any dodgy sounding cases to the "equine specialist" down the road (hey, he wanted to specialise in horses!).

I often joke that I should de-worm myself more often, but "my tapeworm keeps me skinny". Apparently it can also keep me healthy according to articles I have been reading on the "hygiene hypothesis".

In medicine, the hygiene hypothesis states that a lack of early childhood exposure to infectious agents, symbiotic microorganisms (e.g., gut flora or probiotics), and parasites increases susceptibility to allergic diseases by modulating immune system development. Scientists speculate that young children's habit of putting everything in their mouths (and I mean EVERYTHING, kids are gross) helps to stimulate their immune system, and thereby reduce the development of auto-immune disorders. Essentially what this means is that in a sterile environment where anti-bacterial soaps kill EVERYTHING, the immune system gets bored and decides to defend the body against itself...sometimes the immune system can be pretty dumb.

They've found that people in undeveloped countries where parasitism is more common, have fewer auto-immune disorders such as asthma and gut problems. Sure, they have all sorts of other issues related to parasites, but that's just because they aren't using the RIGHT ones. Helminthic therapy is the treatment of autoimmune diseases and immune disorders by means of deliberate infestation with a helminth (worm) or with the ova (egg) of a helminth. Helminthic therapy is currently being studied as a promising treatment for several (non-viral) autoimmune diseases including Crohn's disease, multiple sclerosis, asthma, and ulcerative colitis. Autoimmune liver disease has also been demonstrated to be modulated by active helminth infections.

Which is all pretty interesting really. I found a photo the other day which explains why I never had any problems with immune-mediated diseases.


As you can see, my mum was way ahead of the times. Thanks mum.

Off-road...literally

I recently completed a 4WD course and it got me thinking about all the times I could have used a 4WD on my first job, where I was expected to drive some pretty dodgy roads in a 2WD truck (especially in winter in New Zealand when everything is covered in mud).

Like the time my colleague and I had to pull over to allow a truck to pass on a narrow farm road and, despite the fact that I specifically kept two wheels on the road, managed to get stuck. Luckily I wasn't on my own and my colleague had enough muscles to get us back on track. Though she wasn't too happy about getting covered in mud as the wheels sought traction in the wet ground.

Or the time I was directed into a sheep yard which was only covered in about 2 inches of mud, but felt the wheels start to spin and had to do a very rapid turn and fishtail straight back out again before getting stuck, scattering mud-spattered sheep and shepherds as I went.

The icing on the cake however, was when I was directed down the wrong road in the middle of nowhere only to find it ending in a deep mud pit. Unable to turn around, I had to reverse carefully back down the road. On one side was a steep embankment (more of a cliff-face) and on the other, an equally steep, muddy slope dropping about 2-3 storeys into a yard, also filled with mud. As I reversed, my mantra was, "Don't hit the edge, don't hit the edge!" As though this was more a prophecy rather than warning, I felt my rear tyre slip ever so slightly downwards.
"Oh crap!" I yelled and slammed the gears into first in a desperate attempt to halt the slow downward slide. But it was too late, the truck was sliding on the slick clay and all I could do was clutch the steering wheel helplessly and hope like hell it wasn't going to roll. Actually, I even recall thinking, "Hmmm, always wondered what it would be like to roll a truck!"

I had plenty of time to contemplate my impending doom as it all seemed to be happening in slow motion. Though, I must say, as my life didn't flash before my eyes, I assumed it wasn't yet "the end of the road" for me. The truck slid gracefully SIDEWAYS down the slope and came to a stop with the cab at a 45degree angle in the muddy yard. I opened the door and fell out into the knee-high mud and, if there hadn't been an old fulla watching the whole scenario from where he was working on his tractor, would have fallen to my knees and kissed the muddy ground. As it was, I tried to act cool (not that I wanted him to think I did this sort of thing regularly!) and nonchalantly called out to him,
"Yeah, thought I might take the shortcut back. Any chance of a tow?"
"I can't believe you didn't roll mate," he said as we hooked the truck to the tractor. "You got bloody close!"
I looked back up the slope and realised just how close I had come, not to death, but to the far more mortifying situation of having to explain to my boss why the truck was upside down in a mud pit in the middle of nowhere.
"Oh well," I joked, "when you live on the edge sometimes you get a bit too close!"

We managed to pull the truck out in one piece and I thanked my lucky stars that the old guy had been there. Though, to be fair, he was the one that sent me down that bloody road in the first place! Okay, so now he thought I was the worst driver in the world (believe it or not, I'm actually NOT that bad) and would have a great time regaling the story to all his mates in the pub, PLUS I wasn't exactly anonymous with our clinic's name plastered all over my bright red truck BUT at least I was able to drive home, wash the truck down, and have a few day's grace to break the story to my co-workers before the grapevine did!

Never make a bet with a vet

When I was still a student I want out on a farm call with a recently qualified friend of mine. We were to check a cow that had been steadily deteriorating since she had calved a few weeks previously. The farmer was convinced that she was anaemic from an "internal bleed" after calving.

Upon physical examination there were no clinical signs of anaemia, although the cow was pretty weak and depressed. A rectal examination revealed adhesions within the abdomen, and that along with the high temperature and her general demeanour, suggested peritonitis (an internal infection) rather than anaemia. We gave her antibiotics and anti-inflammatories but warned the farmer that the cow was pretty sick and most likely on her way out. We requested to come out and perform an autopsy "when" she died. He agreed and ended up calling us that very afternoon.

When we arrived he said to us, "Yeah, didn't think she'd make it. That internal bleeding always gets them in the end."
"Ummm, nooo," my friend said, " I'm pretty sure it's peritonitis."
"Nah," he insisted, "It's a bleed. I've had a cow die from it before."
"Oh," I said, now thinking that maybe he knew something we didn't, after all I was a student and my friend a new graduate so maybe he did have some secret farmer knowledge, "Did you autopsy her?"
"Nah."
"So how did you know it was an internal bleed then?"
He leaned back and fixed me with a knowledgeable smile, "Twenty years of experience!"
Riiiight. By now my mate was grinning.
"You care to make a bet on that?" She was pretty confident in her diagnosis.
"What did you have in mind?"
"Um, bottle of rum?" (And she's not even an Aussie!)
"Alright then!"
So, with bated breath, we sliced open the poor old cow and found...sheets of fibrin absolutely covering all the abdominal organs and originating from what looked like an old hardware disease site (where a piece of wire penetrates the rumen and results in an infection that is often walled off). Classic signs of, that's right say it with me, PERITONITIS. The uterus was in perfect condition and there was no evidence of any "bleeds".
Doctor Farmer was by now looking very subdued while my friend was not too professional to do a little gloating.
"Learn something every day eh?"
"Hmmmm."

We didn't actually expect him to come through with the spoils but the following week a bottle of rum was left anonymously at the reception desk with my friend's name on it. Who needs flowers when you have rum!

Who wants to be a mother?

So I've just found out that three more of my friends are pregnant. There must be something in the water and, with my impending travels, I am glad I'm not drinking it!

That said, we've had to babysit a couple of puppies recently and I've decided they are just like babies. Cute when they are asleep. Lucky not to be suffering "shaken baby syndrome" when they are awake...and howling or barking ALL THE TIME. Like another vet colleague in the UK, I too had to spend an afternoon with one of these darlings on my lap just to get some peace and quiet. You can only sedate them so much...




Though I used to say "all babies are cute" until I saw this little darling with a face that only a mother could love...

Brain drain

I'm starting to organise my notes/textbooks/downloaded articles in preparation for the big migration to the UK where I will soon be spending a couple of years terrifying (I mean treating) all manner of weird and wonderful creatures (like rabbits and guinea pigs and...shudder...birds) and I've come to a conclusion. I am useless at keeping up with further study.

Don't get me wrong, I am all for continuing education, and would love to be more educated...if only I had more time. During the day I will often do quick searches on current cases and find many very interesting articles, but don't have time to really take them in (just tell me where the "treatment" section is!) and so I download them in the hope that "one day" I will read them properly. I must confess that after a long day at work, the last thing I feel like doing when I get home is read medical journals or study textbooks. A big glass of red wine or cold beer is always a more attractive option. And so, I'm left with a computer full of downloaded articles that I'm sure are extremely useful, and an ever-increasing guilt that I am not expanding my knowledge. In fact, I'm pretty sure I am losing knowledge from Uni at a steady rate of mental atrophy.

But, as I sip my wine after a hard evening of surfing, I can be safe in the knowledge that it is all in my computer...just in case...

Flying solo

I was doing a bitch spey the other day when it got me thinking about the first time I attempted to do a bitch spey solo. The key word in that last sentence was "attempted".

It didn't start out well. I have a theory that you can always tell which way surgery is going to go based on how the prep & anaesthesia is going - aggressive dog, difficult to anaesthetise, lost surgical kits = never a good sign (yes, I also avoid black cats and walking under ladders). This surgery began with the complication of the senior surgeon being held up in a meeting just as the dog was being anaesthetised. We assumed she would be out by the time the dog was prepped but no such luck, she was still stuck discussing ways we could establish "gold standard" practice in the clinic (i.e. using the highest standards of treatment). When the nurse went in to inform the vet that the patient was ready, she was told to "keep it under" until the vet was ready...not exactly gold standard practice. She stormed into the surgery with the bang of the door and said to me (as I cowered out of her path), "Come on, you're doing the surgery!" Um, okay, totally unprepared but in I go, sink or swim.

I opened her up to find a massively enlarged spleen blocking my path. This is common in some animals under barbiturate anaesthesia, but certainly doesn't make things any easier for a new vet. All I could think was, "Don't hit the spleen, don't hit the spleen!" I slowly edged my spey hook past the spleen (as it's name suggests, it is a small hook used to pull the uterus closer to the incision) and, as I very carefully retracted it, the spleen sprang into action and IMPALED itself on the hook kamakazi-style. Arg!! Now, the spleen is essentially just a bag of blood, so when a hole is punched into it by a metal object, it tends to react by bleeding...copiously...and when further holes are made in an attempt to close the first hole it just bleeds MORE (no I did not even attempt to stitch it). I stuck a swab onto the hole and, to my credit, calmly called for the nurse.
"Um, I seem to have impaled the spleen."
"What?"
"The spleen," I pointed with my eyes as both hands were involved in blood stoppage, "it has a hole where a hole shouldn't be. Help?"
So then she had to interrupt the meeting a second time to tell the senior vet that she was needed in surgery as the new grad had impaled the spleen and the dog was bleeding.

And I still hadn't found the uterus...

Post-script: We stuck some clotting gel to the spleen and the dog was fine...minus her uterus.

Snake snacks

Snake with possum in belly
(Image courtesy of Simon Grainger)

So it's been a bit of a snake-week. First my mum rings me up to tell me the dog just wandered obliviously past a 2m long python while my parents were screaming at her to RUN AWAY, then I actually have to hang up from that conversation to take a call from the owners of an 8 week old kitten whom they have just pulled from the jaws of death (another python). Other than being in shock (to which I replied, "Well, if something just tried to eat me I'd be in shock too!), the kitten was okay, and they brought her into the clinic the following morning to have a wound on her leg checked. After the call I rang my mum back and we wondered how anyone could let their little kitten outside at night in Australia and NOT have something try to eat it.

Turns out the cat wasn't outside, the snake was inside...under the dining room table...hoping that no-one would notice it trying to make a meal out of their pride and joy. The owner said she had never even touched a snake before and they were all panicking so she just "did what they do on TV" and grabbed it by the neck behind the head, twisting it as far as she could until it let go of the kitten's paw, while her husband uncoiled its body from the rest of the cat, which takes more than a little strength as those buggers are STRONG. They are now getting a builder in to completely snake-proof the house. I would hope so - imagine if one of those found you while you were sleeping! Small vets could disappear without a trace...

And this isn't the only case we've had. A few weeks ago another client brought their 9 week old fluffy puppy in to be checked out after he had pulled it out of a python's grip. To be fair on the snake's part, it DID look a little like a rabbit. Apparently he had to hit the snake with a boogie board to make it let go of the pup. I know it's a horrible situation but I can't help chuckling every time I picture the guy whacking a snake with a boogie board. The pup was fine but no doubt traumatised for life and I don't see it ever learning to fetch sticks.

I was also told about a guy who had five chickens in a pen and a python managed to get through the wire. When he went to check on the chickens the following morning the only sign of life in the pen was one snake too fat to fit back through the wire due to five chicken-sized lumps in its belly.

So the moral of the story is to keep an eye on any pets that are small and fluffy and look like tasty snake-treats, or otherwise just have a python as a pet and hope no bigger snake comes along looking for dinner.

New year, new dramas

So it's been a while. I managed not to overeat (much) nor oversleep (much) but was in for a rude awakening when I arrived back at work. The boss was away for 2 weeks and I was "in charge". Now I was prepared for this. What I was not prepared for was the manic week that would ensue, with every man and his dog (literally) wandering in for the post-New Year rush. I managed to fill two afternoons bringing puppies into the world - after 6 months here they were the first two caesarians that we had and of course waited until 3pm in the afternoon when there were only 2 people in the clinic! The surgeries went well, recovery for one of the dogs however, was a little dodgy.

I had just placed her in one of the upper cages (about 1m off the floor) when the drip line caught and I turned away FOR ONE SECOND to pull it loose. In that second the dog managed to ROLL out the cage and landed on the floor with an audible THUMP! I think it was her head hitting the ground. Fortunately she was still very groggy and is not a particularly intelligent dog anyway so I don't think this had any effect. Unfortunately we had a couple of clients in the kennels picking up their dog. Why do things like this always happen at the most inappropriate times? I grabbed at the dog with an audible expletive, and the woman remarked, "Wow, she just rolled straight out there!"
"Yep, she'll be fine though, she's still sedated," I replied, hoping that they didn't think that this sort of thing happened all the time. Now, I occasionally accidentally knock the odd head on the cage door as I pull dogs (or cats) out of their cage, and have been known to bump a head or two when carrying animals through doorways...but this was the first time an animal had actually DROPPED two feet to the ground. Oops. Luckily the owner, who was sitting out front, was none the wiser. Though the nurse did ask me what the big bang she heard from the front desk was!

For anyone concerned, no dogs were harmed in the making of this blog. She was fine and had 4 beautiful fat puppies...and a bit of a headache.