One Small Act. One Giant Difference.

Today, I was reminded of the fragile nature of life and how one action can make a difference. A woman came into the clinic to have her dog checked, because the dog had been urinating more frequently and had blood in her urine. While the assistant was getting a history, the client’s phone rang. Although, we normally frown upon people talking on their phone during their appointment, the woman answered her phone.

Her nephew had just the left her house and was involved in a serious car accident involving a school bus. The woman was crying and shaking. I could hear every word from the other side of the clinic. She started making calls, alerting family members to the event and attempting to coordinate getting everyone where they needed to be.

As the staff members began arranging for the dog to stay for the day, I stepped into the room. The woman’s phone rang again. The nephew was being transferred to a local hospital. As she hung up yet again, I took a step towards her and wrapped her in a hug.

She clung to me.

She shook and cried harder.

Her hug back tightened.

Then she whispered, “Thank you.”

After a few moments, she let go, stating she had to call Grandma. She was shaking so hard she couldn’t hold her phone still enough to get to her contacts list. I held her phone with one arm over her shoulder until the call was made.

She struggled to get the words out to meet at the hospital, she would be there soon. I knew she was in no shape to drive right then. I apologized that I needed to get some information about her dog. I got her to focus on the dog for long enough that her breathing started to steady and she could answer some simple questions. We discussed what the plan would be for the day, and that I would call her as soon as I had any information. I had her take a few breaths and she signed the paperwork for her dog. She was calm enough to drive.

Throughout the day, I made contact with her to update her on her dog’s status, always asking about her nephew first. Although the dog was my patient, my heart broke for this woman and her family. I knew I was needed in more ways than just my role as a veterinarian. As we went through the tests, we found that her dog did not just have a urinary tract infection. She had never been spayed and was recently in heat. The blood in her urine was caused by a pyometra, a uterine infection that, if not treated, could be fatal. The pup needed an emergency surgery to remove her infected uterus.

The family did not have a lot of money, only a couple hundred dollars available, but they made some calls and found friends that would help. She called back and told us to go forward with surgery.

Surgery was a success, and I was able to call to share the good news. I was greeted with news that the nephew would also be alright.

After leaving his aunt’s house, his car went under a bus. He was pinned in the only portion of the car that was not crushed. The woman’s daughter was supposed to be with him that day as they were supposed to carpool. The bus needed to be lifted by a crane to remove the car from beneath it. The daughter would have been dead. The nephew survived with few injuries amazingly; damage to his hands, cuts and bruises to his body.

When she picked up the dog at the end of the day, she wrapped me in a giant hug, and then she showed me pictures of the car. No one should have been alive with the extent of the damage. Her hands were steady, but her voice still shook. She gave me another hug and whispered, “You were my angel today. Thank you for being there. Thank you for saving my baby’s life. You are a blessing from God.”

I fought tears that swam in my eyes. I am so thankful that I was present today; that I was willing to do more than “just my job.” I was able to be God’s hands and feet on earth. I am so thankful that I was given the opportunity to help someone. What I did wasn’t much, but it was everything to this woman and her dog.

Please, take the time to do something small (or large) to help someone. Listen when they are in pain. Be there when they need a shoulder to cry on or a hug to lean into. Please keep this family in your prayers.

Merry Christmas 2014!

This past year has been an adventure. Seeing the joy of Christmas around the world has brightened my day and brings me great happiness.

For the past month, I have been working on St. John in the US Virgin Islands doing relief work. I have had many crazy experiences and have been blessed to meet many wonderful people. Although it is hard to be away from home for the holidays, I am thankful to be here. I would like to share a couple of stories from the St. John Animal Care Center, the only shelter here on the island. Since I am working at Canines, Cats, & Critters, the only veterinary clinic on the island, we see all of the animals.

The first is Churchill. Churchill is a spunky little guy that unfortunately had a run in with another dog the other day. After some immediate treatment to keep him alive and supportive care, Dr. Laura, the owner of CCC, came over from one of the offices on another island and performed surgery to close the hole in Churchill’s chest wall and repair his broken ribs. He is a fighter and is doing well now. Hoping to find a forever home!

Churchill the day after surgery.

Churchill the day after surgery.King on

The second is Dulce. Dulce is a sweet little girl that was brought into the shelter with the rest of her litter. She has been nice and healthy. Due to the generosity and love of others, she was able to leave for her forever home on Christmas Eve. Dr. Laura was delivering her to her new family in Maine. Many of the dogs from the island get adopted by people, most often living in the USA. Many of them will have a human escort to get to their new family. Others fly solo. Thankfully, Dr. Laura was able to go home to visit her family in the northeast USA for Christmas this year and take Dulce at the same time.

Dulce says goodbye and thank you!

Dulce says goodbye and thank you!

My final Christmas star, is King. King has had a rough life so far. Thankfully, his former owner brought King to the shelter when he finally realized that he could not care for him. King had stopped eating and his previous owner could not afford veterinary care. The ACC took King in and brought him to us at CCC. King weighed in at 38 pounds upon arrival and it has been a tough road getting him to eat anything. King is heartworm positive and extremely malnourished, although he has started to gain a little weight. We are doing all we can to get him strong enough for heartworm treatment. He is a very sweet boy, although not really a fan of other animals, he LOVES people! Today, King celebrated Christmas at CCC with a big squishy bed that was donated by a wonderful family for his comfort.

King on Christmas morning.

King on Christmas morning.

Please remember everyone, human and animal, that is in pain and alone this Christmas. Consider a donation of food or clothing, or even better, friendship, to someone that needs it. Consider a donation to a local shelter (human or animal) that provides for those in times of crisis.

If you want to help support the Animal Care Center and help provide for the cost of Churchill’s or King’s care, or any of the other animals, please contact the ACC here.

With the help of The Pet Apothecary, we are able to get some much needed medications for the cats with unresolved upper respiratory infections at a great discount. That being said, we still need to raise some money for the medications (about $100) and shipping to get it here.

Have a very merry Christmas (or whatever celebration you may wish to celebrate) and take time to make a difference in someone’s life today!

When Will It End?

I remember my first thoughts of suicide were when I was in fourth grade. I did not have a particularly difficult childhood, there was no abuse or neglect. I may not have been popular or had a lot of friends, but I was generally a happy kid. I don’t remember why I had these thoughts. I do remember going for long walks. I would sing at the top of my voice in the middle of no where. I would cry to let out pain that I didn’t understand. I remember being depressed in high school and college. Not just the “I’m sad today” or “regular teenage angst,” but the black abyss with no light and no hope for the future. I would have trouble getting out of bed, but I would do it so no one would know that anything was wrong.

While in college, I finally discussed my problems with a doctor. I was diagnosed with moderate depression with generalized anxiety. I did not get any treatment at this time. I felt somewhat vindicated as when I had spoken with people prior (not medical professionals), I would be told, “Get over it. It is all in your head.” Now, I knew it was all in my head, but now I knew why. This explained why when someone was late, my brain went to one of two scenarios: 1. The person/people hated me and were not coming or 2. They were in a major accident and were on the side of the road bleeding to death. I am not sure which scenario was more difficult, although the second made me feel guilty for being angry that they were late while they were dead.

Fast forward to September 11, 2001, thousands of people did not go home to their families that day. This shook me to the core. I finally went for help. My first few years of veterinary school were split between school and seeing a psychologist. They wanted to start me on medication, but due to some personal issues with medication and suicide (another story that I may never share on a public forum), I couldn’t bring myself to take them. I knew that one of the potential side effects was to have enough energy to actually commit suicide. I couldn’t do that to my family and friends.

At the same time, studies were coming out about veterinarians having the highest suicide rate of any other professional. I don’t remember all of the numbers at the time, but it was significantly higher than the general population and other professionals. I petitioned the school to have a counselor on site – in the veterinary school building, not just on campus. I spoke with multiple people. I went into my final year, but no longer had the time to see the psychologist or to continue petitioning the school. When I came back to school after an externship out-of-town, I learned that another veterinary student committed suicide while I was gone. I was devastated. I felt guilty; that I should have been able to prevent this, despite only knowing the individual in passing. Since then a counselor has been placed in the veterinary school for students, staff, clients, anyone that needs the support.

I graduated from veterinary school over 9 years ago. Since then, I know many veterinarians that have committed suicide and many more that have attempted suicide. The problem has not been improving. There are more studies being done to figure out why the rates are so high, but there has not been a solution found. Hopefully, anything that is found will help not only the veterinary community, but also the general public. Mental illness, depression, suicide are all topics that get pushed under the rug until something happens to spotlight them.

Today, I learned that Dr. Sophia Yin, an amazing veterinarian, animal advocate, lecturer, and person died via suicide. I don’t know what her struggle was. I don’t know why she chose this path to death. I don’t know a lot of things, but I do know that the world lost a beautiful person. I do not condone the action of suicide, but I do understand why people can feel it is the only way out of a mind fraught with anguish. My heart, thoughts, and prayers, go out to the Yin family, friends, the veterinary community, and the world.

When on those walks many years ago, one Bible verse would repeat in my head. Isaiah 40:31, “They that wait upon the Lord shall renew their strength. They will rise up with wings as eagles. They will run and not grow weary; walk and not faint.” It was a long road, one I still sometimes struggle with, but when I wait upon the Lord, my strength is renewed. When I no longer try to hold the world in my control, I can let Him take control and life is not as hard. I have had people tell me this makes me weak. That I am less of a person. That I am stupid, illogical, and uneducated for believing in God. I will tell you, yes, I am weak, that is why I need Him. I am not worthy of His love, yet he grants it to me. I am not stupid. I am not illogical. I am not uneducated. I am honored to place my trust and faith in God.

If you, or someone you know, is thinking about suicide or that life is just too much to handle please, ask for help. Call the Suicide Prevention Lifeline at 1-800-273-8255 (in the USA) or find a professional that can help. You are not alone. There is a light, even if you can’t see it right now. It takes a long time to retrain your brain, it may require medication, but life can get better.

 

 

World Rabies Day 2014 and Animal Bites

Today is World Rabies Day 2014

I have posted about rabies multiple times(here and here), because I feel that people, especially in developed western cultures, do not understand the true implications of rabies. It is estimated that 200 people die every day worldwide from rabies. If you have a place to get your dogs, cats, ferrets, horses, etc. vaccinated for rabies, please do so. You can save a life. When I came home from Mongolia, in the two weeks that I was working, I had two cases that were placed in quarantine – 60 days for each animal. One had exposure to a raccoon, one to a bat. Thankfully, both had been vaccinated previously. Is rabies highly likely in Wisconsin? No, but it is possible.

On a happier note, the first person to survive rabies without post-exposure vaccination (or previous vaccination), Jeanne Giese, got married last weekend. That is pretty exciting. She was even able to walk down the aisle. Congratulations!

What should you do if a person or animal has contact (bite or scratch) with wildlife?

This depends on where you are to some extent, but the essentials are:

1. Clean the wound with soap and warm to hot water (not scalding) for a minimum of 10 minutes.

2. Seek medical attention – medical doctor or veterinarian depending on the species affected.

3. An animals rabies vaccination should be updated immediately.

4. If the animal that has bitten or scratched is available for testing, then it should be caught and submitted for rabies testing. A big mistake that is often made is that the animal is either hit or shot in the head – DO NOT DO THIS! The brain needs to be tested, so damage to the head often makes it impossible to test the brain. The animal can either be given to your veterinarian or to the local health department, which will then submit the proper specimens.

5. If the animal is not available for testing, then a person will generally go through post-exposure treatment. An animal will have its rabies vaccine updated and then be placed in a 60 day quarantine, although this can be longer if it had never been vaccinated previously.

What if you or your pet are bitten by a domestic animal?

1. Clean the wounds with soup and warm to hot (not scalding) water for a minimum of 10 minutes.

2. Seek medical attention – medical doctor or veterinarian depending on the species affected.

3. The animal that has bitten should be placed in quarantine at the direction of the local health or police department. The animal will likely be placed in a 10 day quarantine. Sometimes this can be in home, sometimes it will be in a controlled facility – this is determined by the authorities, and has to do with vaccination status. An animal that has been vaccinated will usually be an in-home quarantine. During this quarantine, the animal will need to be examined by a veterinarian three times – the day of the bite, 10 days after the bite, and one day in between. The reasoning is that if the animal has rabies, it will show symptoms and die within the 10 days.

4. If the animal is not available for quarantine, then a person will generally go through post-exposure treatment – multiple injections. An animal will have its rabies vaccine updated and then be placed in a 60 day quarantine, potentially longer if it had never been vaccinated previously.

The most important part is to receive medical treatment. It is easy for a bite to turn bad, very quickly. Wildlife can carry multiple diseases and will generally stay away from people if they are healthy, so interactions that result in bites are usually interactions with sick animals. Dog bites generally cause crushing injuries that may not be apparent immediately. Cat and ferret bites generally are deep punctures that leave bacteria deep in the wounds – these are most likely to cause severe infection and loss of limbs. Waiting until signs of infection appear is not a good idea for many reasons.

Mongolia Update (August 18-23)

August 18, 2014

Today dawned with a little sadness as I recognized this was my last week in Mongolia and there was still so much to do before leaving. I have been writing teaching handouts and clarification pieces for the veterinarians so that when someone isn’t there, they have documents to refer to. I love the looks in their eyes when a new piece of information locks in and they are able to use it with their patients. It took me awhile, but I finally am comfortable enough to hold impromptu teaching sessions, well, that and there is finally a couple minutes of “free time.” The clinic has been so busy, that a time when there was a free veterinarian was difficult. Today, things finally slowed down enough that we could gather 1-5 people and have a session. As these young veterinarians move forward, I pray that they have many people to come in and mentor them. Although their knowledge is good, the implementation of the knowledge and the overall application of techniques need to be honed. It is easy to treat the immediate problem for which a person brings their pet into the clinic, but to address the entire animal by obtaining a complete history and performing a comprehensive exam is so important to the welfare of the animal and it is easy to overlook. It was a good reminder for me as well with my return to the USA.

Today was also interesting as the power was a little less trusty. It went out in the morning, but thankfully did come back on. The fallout from this is that when we went to lunch, my food (meat of course) was not completely cooked. I ended up grabbing something else at the mini market, because I didn’t want to risk getting sick again! Dinner was a lot better with my food being cooked, and then I was given the adventure of going to a hair salon in the basement of a building where my hair was greatly shortened. A bit shorter than I am used to and what was requested, but the woman did a lovely job. Another first, getting my hair cut outside of the USA.

August 19

Apparently, yesterdays teaching sessions went over well, because now the veterinarians are asking for more impromptu sessions. Of course, the first one they asked me to do, I didn’t have anything planned, but that is quite alright. “The Coughing Dog” was a great topic and not one that I would have thought to make a handout for previously. Most non-medical people do not realize how “coughing” can mean so many things – bacterial or viral infection, parasites, heart disease, asthma, bronchitis, cancer, and the list goes on. This also took us into evaluating various lung patterns on radiographs (x-rays). Hopefully, they will start using the books more frequently – especially those with pictures – to be able to recognize different patterns in the future. I know there are times, I still need a refresher and reminder of the various pattern and what they mean for the patient. We also worked on parvovirus. A disease that is preventable with vaccination, but unfortunately many people don’t realize it. I can’t tell you how many puppies would be lined up in cages, set up to their IV fluids, receiving medications, and being cared for, but just don’t make it. They are so tiny and usually at the beginning of their lives, but they aren’t able to pull through. It breaks my heart here as it does at home that lack of education of the people causes so much suffering in the animals.

I went out to Ultziit again to visit with the Spence family and two other Americans that are over for the Fast Horse Training. Tom and Johnny have been coming to Mongolia for the last 15 years or so to teach veterinarians – specifically to care for horses. I am so impressed by the work and dedication that they provide to the Mongolian people. I cannot say how many lives (both animal and human) their training has saved over the years. They spoke of veterinarians that are using a stethoscope for the first time and hearing hearts beating after 20 years in practice. It is amazing! Johnny also shared about a wonderful program that he has been involved with recently called Victory Junction, a camp for children with chronic illness and disease that allows them to have a week where their disease does not stop them, does not control them. This camp is amazing and such  a blessing to have available to children.

Despite having another wonderful time, I just wasn’t feeling good overnight, but finally got some rest. I think I had a fever and it finally broke overnight. Not sure if it was the undercooked food from the day before, but am I glad that it didn’t progress to have me end up in the hospital again!

August 20

I had a day off today to get some more shopping done, to start packing, and to go to the Ensemble – a Mongolian cultural show. It was an amazing event! The throat singing and music were interesting and I have no idea how the throat singing works (you should not only hear it, but watch it!) The craziest part of the show was the contortionist. My joints still feel sore just from watching her. Absolutely amazing!

It is really hitting me that I will be leaving soon. I miss my husband, cat, family, and church, but I really want to stay here!

August 21

I have been reminded again about the difficulties in practice here. Here, I am “the specialist.” The one with experience. The one that is supposed to have the answers. Today, I was faced with a pup that I knew what needed to be done, but I didn’t have the equipment, medications, or specialists needed to treat the pup. At home, it normally comes down to money – people can afford to treat or not, they want to treat or not. There is a specialist somewhere that can take care of the situation in many cases.

This is the story of Coco. Coco is a tiny Chihuahua (1.6 kg, about 3.5 pounds) that was given large amounts of vodka and had fallen off of a bed two days previous. Now, she has torticollis (her head and neck are tilted around making the head almost look like it is upside down), nausea, and anisocoria (her pupils were of different sizes). She also has bulging of her skull between the eyes. Normally, one would place her on oxygen, monitor her blood pressure, and a wide variety of other things (MRI, CT scan, etc), but I can’t do any of those things here. Thankfully, I have access to the Veterinary Information Network (VIN), which includes veterinarians, including specialists, from around the world that I could request help from. We were able to find some Mannitol – a medication that helps decrease brain swelling – at the corner pharmacy, so we could start that treatment. Sadly, there is no overnight care or monitoring here, so she was sent home with her owners with instructions to come back first thing in the morning. We all prayed that she would survive the night.

We also had a young kitten (maybe 3 months old) come in that had fallen off of a balcony. The family had never had a cat before and were watching her for a couple days. The family knew nothing about cats, so they left her on the balcony while they went away for a short time. They couldn’t find her upon their return on the balcony and finally found her on the ground 4 floors below. She had a broken leg (fractured femoral neck) and a pneumothorax. Thoracocentesis was performed to remove the air, and we will have to see about the leg. It is a type of fracture that can be repaired, but could also potentially be left to have the femoral head dissolve on its own. We will wait and see what happens over time.

That evening as a thank you, I purchased pizza for the entire clinic. Something that is so simple and easy that it is one of the most common things to do in America, but for them is often cost prohibitive. For about $45, I was able to blessed with their joy and fellowship.

August 22

I gave my farewell devotion this morning and was brought to tears multiple times. I, of course, stood out as emotions are not often shown in Mongolia. I on the other hand tear up at Hallmark commercials, so it wasn’t a far stretch for me to cry now. There were hugs all around and such amazing love, support, and acceptance. Thank you for allowing me to be here and to hopefully have made a difference!

The clinic itself had a slow day, but we continued to work with Coco. She even began to show her Chihuahua nature again and started to growl at me. She had some nystagmus (rotation of her eyes) today, but wasn’t rolling quite as much. She still has significant swelling of her head, but I think she may have a chance. Perhaps will never be 100%, but she has a chance to live. Enkbeyer is doing a great job. Although he is quiet and hasn’t needed a lot of help, I am happy to have become his friend.

Coco on her way to recovery

Coco on her way to recovery

I tried not to cry when the time came to say good-bye, but that didn’t happen. I was able to keep most of the tears in until I started to walk away. A part of me will remain here forever.

Dinner and then the trip to the airport went well, until I realized I had neglected to hand over my apartment keys!  Oops! The airport allowed me to call Mary, but due to the way security is set up, no one is able to come and get the keys. They will need to be mailed to the next shuttle (person traveling over to work at the clinic) when I get home. I did get to have a lovely conversation with a Pilipino woman that had just finished a trip around Mongolia. Despite living in California for the last 56 years, she still travels all over the world. I will keep her in my prayers as she was so sad that all of her traveling companions are passing away. She was very sad.

Final devotion, Final picture

Final devotion, Final picture

August 23

Despite a lot of turbulence, the flight home was good. I was able to get more sleep than on the way to Mongolia. The man next to me was a lovely gentleman from Thailand, that now lives in the USA. He travels frequently for work, and was excited to get home to his wife and high school aged twins. He recommends a trip to Thailand, I think that is a good idea!

I was then double blessed upon arrival to see my husband and Laura and Steve – friends from church that offered to pick me up. After a short chat, we walked out to the parking lot where we were also met by more church members – Gary, Ann, and Addi – I didn’t expect to see them 3 hours from home, but they were in Chicago and saw my plane landing, so they hopped into the van and found us in a parking lot at O’Hare without a telephone call or anything. If God wasn’t in that, I don’t know what else to say!

Thank you to everyone that has followed my journey. I hope that it will happen again. I will share more in the future as tidbits of my time in Mongolia come back, but the great story of this trip is over. Perhaps it is just the beginning of many more though!

May you be blessed and find a way to make life a little bit better for someone around you today.

Hope for Marc

A couple years ago, I made a new friend on Facebook, Marc. We chatted a few times online, but hadn’t met. When I started my blog and shared my story about being diagnosed with a pituitary tumor and how my faith was changed, Marc contacted me again and we started to talk more frequently.

Marc had been diagnosed with a severe heart condition, was given a very poor prognosis, and had to drop out of school. His dream of becoming a pediatric cardiologist gone. After years of not having any resolution to his medical problems, he went to Mayo Clinic in Rochester, Minnesota where he learned that he had been misdiagnosed with a heart disease. Instead, he was found to have a pituitary tumor and a cancer related testicular disease. It was at this point that we began to speak more frequently, especially about faith and the fear related to diseases. Every time we attempted to meet in person, a medical problem would crop up and we would not end up being able to meet.

This past winter, I got the message that Marc had to go back to Mayo Clinic suddenly and his apartment was filled with black mold. I met his home health aide when she brought Marc’s cat in to Mishicot Veterinary Clinic late in the evening. Marc was too sick to come in. Not long after, his apartment was cleared out of mold and he was back from Minnesota, I finally met him.

Marc is a gentle soul with many talents that he does his best to share with others. He loves his cat and his girlfriend. He loves his girlfriends daughters like they were his own. Since October 2012, Marc has lost over 450 pounds and is still shedding the weight, but it has not been due to diet and exercise, it has been from the diseases and complications taking the nutrients from his system. He can’t eat or drink without vomiting.  Fluid is building throughout his body, causing swelling all over. Through it all, Marc has kept a smile on his face, trying to cut down on the stress and anxiety for those around him.

Marc before his first surgery and now - over 450 pounds lost

Marc before his first surgery and now – over 450 pounds lost

This past week, Marc was told to get his affairs, including his will, in order as the doctors have been unable to find all of the causes or a way to treat his problems. When they got home from Mayo Clinic, their truck broke down, the bills were piled up, and they had a threat of eviction as well.

I ask you to keep Marc, his family, and the doctors and nurses in your prayers. Prayers of healing and guidance. Prayers of love and rejuvenation. Prayers that Marc would truly know how much God loves him.

If you find it in your heart and are able, please also consider supporting this young man financially. An account, Hope For Marc, has been started to raise money so that they can have one less thing to worry about.

Dear Lord, You are the Great Physician. You can heal with a word or a touch. You have given us great talent and skills to be Your hands and feet on this earth, to touch the lives of others with love and respect. Marc is a lost sheep, looking for Your great love. Please open in heart to Your love, comfort, peace, and healing. Please work a miracle within him. Guide his doctors and nurses. Comfort his family. Please give them all strength to deal with the struggles they have now and in the future. You are amazing, Lord, and we thank you for all of the gifts You have already bestowed upon us. In all things, may Your will be done. Amen

Z is for Zoonotic Diseases

Z is for Zoonotic Diseases

A to Z 2014

A to Z 2014

This is my final 2014 A to Z Blogging Challenge posting. Today we will come full circle as many of my topics have been zoonotic diseases.  It has been an interesting and informative month for me, I hope it has been for you!

zoonotic disease is a disease that is transferred from animals to people either directly from saliva, urine, feces, or tissues to vector transmission (ticks, mosquitoes) to ingesting infected food or beverage. This past month zoonotic diseases have been discussed at length here at “Days In the Life of A Christian Veterinarian” including: Anthrax, Ebola, Tularemia, Giardia, Leptospirosis, Monkeypox, Q Fever, Rabies, West Nile Virus, and Yersinia pestisBlastomycosis was also discussed, although technically isn’t really a zoonotic disease, as it is a fungus from the environment, but can be spread with animal contact (beaver dams, etc.). There are many more out there, so please keep educating yourself. You can speak with your human medical doctor and/or your veterinarian about what is common in your area. You can get a lot of great information on the Center for Disease Control and Mayo Clinic websites, there is even an A to Z listing of many animal transmitted diseases on the Washington State Department of Health website. Be cautious when doing generic internet searches though as there is a lot of misinformation or out there.

Red-eyed Frogs (Photo Credit: Scott Robinson)

Red-eyed Frogs (Photo Credit: Scott Robinson)

To bring you back to A, I would like to introduce a term that is not commonly used: anthroponosis – infection spreading from humans to other animals. Some people just call this revere zoonosis, but really that is not nearly as much fun! An example of this, is when you handle a frog with your bare hands (no gloves) you can transmit a fungus from your skin to the frog causing the disease Chytridiomycosis. Many people have commented their surprise at the diseases we have discussed and their detriment to people. This disease that we spread has decimated and caused extinction of amphibian populations around the globe.

Boots and I bid you Farewell, and hope to see you again!

Boots and I bid you adieu, and hope to see you again!

Thank you for joining me this past month, and I hope you visit again. I may not write as often, but will update when I feel like I have something of value to say, or at least just need to share. I appreciate feedback, likes, comments, and shares! I am more than happy to answer generic questions, but will always recommend that you see or speak with your veterinarian or doctor for specific information. For me to give out specific diagnostic and treatment advice could potentially result in the lose of my veterinary license, so please don’t make that a problem for me (or any medical professional in the blogosphere).

Photo Credit:

Red Eyed Frogs: Scott Robinson via Photopin.com under Creative Commons Licenses

Y is for Yersinia Pestis

Y is for Yersinia Pestis

Salem Friendship (Photo credit: Josh McGinn)

Salem Friendship (Photo credit: Josh McGinn)

Fall 1347 – I begged my parents to allow me to bring the harvest to town today. I have always loved watching the ships come into harbor and see the wares offloaded. The fabrics and fruits from The East ensnaring my attention, even though I know I will never have them. I visualize the colors dancing before my eyes. I watch the flags wave in the wind and the rats scurry down the hold lines. I hear the calls from the sailors to the shore, there is a flurry of activity and shouting. I don’t have time to investigate, I need to sell what I can and get home before nightfall.

As I return home with an empty cart, I mindless scratch at my ankles and legs, picking off the fleas and crushing them. Today’s produce sales were good. My parents will be proud. For the next two days, my parents allow me to bring the produce to town, but on the third day, I can barely walk. My mother applies poultices to my ankles and legs where the skin is torn and bleeding. There are swellings in my groin and armpits that stretch the skin painfully, finally bursting to drain pus and blood. Despite extra blankets and laying near the hearth, I shake from chills and fevers. The cough begins a few days later. I look down, I am covered in blood. As I lean back into my blankets, I smell smoke in the air.

†  †  †

Yersinia pestis model at the Smithsonian Natural History Museum (photo credit: Tim Evanson)

Yersinia pestis model at the Smithsonian Natural History Museum (photo credit: Tim Evanson)

Yersinia pestis, a gram negative rod-shaped coccobacillus, is the bacteria responsible for The Plague. In October 1347, 12 ships arrived in a Sicilian port, the crews were dead or dying, despite the attempts to turn them away, it was too late. The Black Death had arrived. The rats that traveled on merchant ships from Asia began to die off as well. The fleas that infested them needed a new source of food, so they began to feed off of humans. In the process, the fleas transmitted Yersinia pestis when they would vomit the rat’s blood into their human victim. The bacteria replicated at the site of flea bites and then spread through the lymphatic vessels, causing lymph nodes to swell (buboes) before erupting. Sometimes, the bacteria would cause sepsis (a severe blood infection) or spread to the lungs. These are the three forms of Plague: Bubonic, Septicemic, and Pneumonic.

From 1347 to 1353, one-third of Europe’s population died from “The Black Death” (the name given to this second Yersinia pestis pandemic). There was no escape from The Black Death in Europe. The cities were full of death, people would flea to the countryside, but the fleas followed infecting people and animals. Entire towns died off. In an attempt to prevent spread of disease and because there were few to bury the remains, homes and bodies were burned.

Today, although outbreaks still occur, Yersinia pestis can be treated with antibiotics.

Yersinia pestis found in a liver - note yellow spots (Photo credit: Jennifer Stewart, DVM)

Yersinia pestis found in a liver – note yellow spots (Photo credit: Jennifer Stewart, DVM)

Animals are also at risk, although cats are more prone to having and spreading infection compared to dogs.

Prevention is the best protection though.

  • Be aware if you live in an endemic area
  • In endemic areas, keep dogs and cats protected with flea prevention medications year round
  • In endemic area, do not allow dogs and cats to sleep in bed with you
  • Decrease rodent populations around homes, barns, businesses, and recreation areas
  • Use insect repellents when in areas that fleas are common
  • Wear gloves and other appropriate gear when handling animals or specimens that may be infected with Yersinia pestis

 

Photo Credit:

Yersinia Pestis Model at Smithsonian Museum of Natural History by Tim Evanson http://www.flickr.com/photos/23165290@N00/7283938624/ via Photopin.com http://photopin.com with Creative Common License https://creativecommons.org/licenses/by-sa/2.0/

Ship Josh McGinn http://www.flickr.com/photos/svenstorm/1548728822/ via Photopin.com http://photpin.com with Creative Common License https://creativecommons.org/licenses/by-nd/2.0/

Yersinia pestis in a liver by Jennifer Stewart, BS, DVM, DAVCP, MRCVS

X is for Xylitol Toxicity

X is for Xylitol Toxicity

A number of years ago, I received a telephone call while on-call. The person informed me that her dog ate a piece of chocolate cake. I asked some more specific questions: What size is your dog? How much chocolate cake did it get? Was it a cake made from a box or from a gourmet bakery? Etc. Based upon her answers, I informed the woman that the likelihood of her dog having any problems was minimal (pretty much zero) as it only took a small bite and it was a box mix which does not have much chocolate in it. The woman than said, “I don’t know if you know this, but chocolate is toxic to dogs.” I thanked her for the information, and yes, I was aware, but the toxicity is based on type of chocolate (milk chocolate is not as bad as dark chocolate which is not as bad as baker’s chocolate), size of the dog, and the amount of chocolate eaten (a bigger dog can eat more than a small dog with less complications). I told her what to watch for in case there were any problems and asked her to call again if she noticed any. There have been other times in my career that I have had a very different conversation when it comes to toxicity. In 2004, the conversations about toxicity started to grow as a new toxin emerged on the veterinary scene: Xylitol.

Xylitol used for baking (SocialAlex and www.mixedfitness.com)

Xylitol used for baking (SocialAlex and http://www.mixedfitness.com)

Xylitol is a chemical compound that is made most commonly from birch trees and is used as a sugar substitute. It is most commonly found in sugar-free gum, candies, and in many forms of toothpaste. Some people, especially diabetics, use it as a sugar substitute in cooking. Due to the slow absorption in people, there are very few side effects, although some people complain of diarrhea after ingestion of even small amounts. When reading labels you may also see xylitol listed as Eutrit, Kannit, Newtol, Xylite, Torch, or Xyliton.

In dogs there is a very fast absorption rate, often within 30 minutes, and signs and symptoms of xylitol poisoning can develop rapidly. That being said, since toxicity normally develops from eating the gum which is meant to be chewed, it can take up to 12 hours for symptoms to develop since dogs rarely chew and just swallow the gum. The most commonly seen sign is severe hypoglycemia (low blood sugar) that comes as a result of rapid release of insulin from the pancreas into the blood stream. If the dog’s blood sugar drops low enough, coma and death can occur rapidly as well. Other side effects include liver disease with secondary bleeding, liver failure, and death. Cows, goats, and rabbits also show a significant release of insulin in response to xylitol. At this time, it is unknown how cats respond to xylitol.

How much xylitol does it take to make a dog sick?

Spry sugar-free gum

We know that as little as 100 mg/kg (45 mg/lb) requires decontamination and monitoring, with dogs receiving more than this requiring supportive care. In the case of baking xylitol (the granulated form), 1 cup weights 190 grams. When it comes to gum and candy, the difficult part is that manufacturers do not always list how much xylitol is in their products. Estimates range from 0.9-1,000 mg per piece of xylitol containing gum. Clinically, we can see toxicity in a 20 pound (9 kg) dog with as little as 1 small piece of gum. Therefore, it is essential to contact your veterinarian (or veterinary emergency clinic) immediately upon knowledge or suspicion of ingestion of sugar-free products. If possible, have the packaging available when you speak with the veterinarian or bring it with you if going straight to a veterinary clinic or hospital. In the United States, you can contact the Pet Poison Hotline at 800-213-6680 or the ASPCA Poison Hotline at (888) 426-4435, although there is a fee associated with the call it may save you some money when going to the veterinarian.

What should I expect when I get to the veterinary clinic?

Photo courtesy of Sean94110 https://www.flickr.com/photos/sean94110/

Photo courtesy of Sean94110 https://www.flickr.com/photos/sean94110/

You should expect to have a history and complete examination performed. If your dog is not showing symptoms and the ingestion was recent, he or she may be given medication to induce vomiting which will hopefully remove the ingested substance from the stomach and then do appropriate diagnostics and supportive care. If your dog is already showing signs of toxicity, the veterinary team may obtain blood and urine samples and place an IV catheter. Blood tests should include chemistry, electrolytes, and complete blood count (CBC). They may also check clotting times (PT and aPTT) and fibrinogen levels, especially if there are already signs of bleeding. Once low blood sugar has been documented, then IV fluids containing dextrose will be started. Your dog may need to remain on IV fluids for 24-72 hours or until the blood glucose has stabilized. Multiple checks of glucose will be performed (usually only needing a few drops of blood) and liver values will also be monitored to make sure there is no worsening or liver disease.

If caught early in the process or if it is a mild case, the prognosis is generally very good. Waiting to seek medical attention until after symptoms start or in ingestion of large amounts of xylitol, prognosis worsens significantly.

Ways to prevent xylitol toxicity include not having xylitol containing products in the home or keeping them far out of reach of animals (which can be difficult if there are children in the home) and knowing what is in the products you have. Double check all products labeled as sugar-free.

Remember that although this can be fatal, it is usually treatable. What should you do if you suspect or know that your pet has been poisoned? Click HERE.

For a list of the Top 10 Pet Poisons of 2013 click HERE and for an alphabetical list of animal poisons click HERE.

Xylitol photo credit: SocialAlex at Photopin.com using Creative Commons Licenses

Spry photo credit: Katherine of Chicago at Photopin.com using Creative Commons Licenses

Dog photo credit: Sean94110 at Photopin.com using Creative Commons Licenses

W is for West Nile Virus

W is for West Nile Virus

Mosquito Bite1937 Omogo, Uganda (West Nile District) – During research on Yellow Fever, a 37 year old woman is the first known patient to have West Nile Virus (WNV) isolated from her blood.

1957 Israel – An outbreak of WNV is shown to produce meningioencephalitis in elderly patients.

1960s – Horses are effected in Egypt, France, and throughout Europe, southwest Asia, and Australia.

1999 College Point, Queens (New York City) – Horses, dogs, cats, and humans infected with WNV

From that initial point of contact in the USA, West Nile Virus, a mosquito-borne arbovirus spread rapidly across the country. Birds, specifically crows and Blue Jays, were found dead throughout the country. Local and state agencies began testing the birds and found West Nile Virus. Surprisingly, as it is a disease of temperate and tropical locations, not what comes to mind when you think of Wisconsin and Minnesota! For many years, the question of how WNV spread so quickly went unanswered. It was well documented that birds are the only species that can build up enough WNV to allow transmission to other species via mosquitoes. Migratory routes and other factors were taken into effect, but it still didn’t make sense. The crows and Blue Jays were dying, so how was the disease still spreading? The culprit was finally found in 2011 – the American Robin.

American Robin (Keith Williams)

American Robin (Keith Williams)

The American robin has a unique feature in that the mosquitoes that carry WNV love to feed on their blood (I wonder if I am part robin as they appear to feast upon me quite readily as well). The robin is a mainstay in the upper Midwest and has a large migratory pathway. Between the mosquitoes and the robins, they were able to quickly spread across country and since robins weren’t dying from the disease regularly, they were flying under the radar for testing.

Most people that contract WNV never have any symptoms. One in five people will develop flu like symptoms with fever, muscle aches, and lethargy being the biggest signs, and they can hang on for weeks to months, sometimes these may require hospitalization for IV fluids and other medications. Only 1% of all people infected will develop severe disease including meningitis and encephalitis. Of those individuals that develop neurologic signs, 10% will die.

There are no vaccinations for people, although there are WNV vaccines for horses.