So much catching up to do - part 1

Wow, it's been some time since I've posted! I've been very busy with work and running around for the Holidays, but all is well. Soon I'll post on some of my best on-call moments from the recent past.

For now, back to where I left off. Sue came down to visit me for about a week over Thanksgiving and brought along a few of her dogs. Dad was so kind as to keep the old boys back home in PA. We had a fun time visiting my favorite dog spots, and we got to work sheep here as well as with Christine and Julie and Laura. Julie and Laura took us to a cool place to eat where Sue and I had our first taste of fried green tomatoes - YUM! I am so Southern these days, ha!

On Thanksgiving day we went hiking on the Trail and stopped to enjoy a wine and cheese picnic. It was too bad that Ella couldn't join us for our outings since she was on crate rest for her shoulder.

Poor Ella missed out on visiting one of her favorite swimming holes

Wet Jed

Jed's the only one who doesn't think the camera will steal his soul

Cow-calf-watching

A 2-headed Smoothieface Monster; the sisters are worn out.

On to Ella's shoulder: after speaking with Canapp I had her on rest and Deramaxx for 10 days. She didn't improve, but rather got worse. I was a little annoyed that Canapp didn't seem to be concerned with MY concern. After a total of 4 weeks rest with no improvement, we road-tripped back up to VOSM. We saw Deb Canapp who confirmed that the pain was in her repaired shoulder. No dogs have ever needed another surgical repair in the previously repaired shoulder. The ones that have had to be re-cut had problems in the elbow or the other shoulder. This is out of 400 borders collies who have had RF treatment of medial shoulder instability, and apparently half of these dogs participate in both herding and agility as Ella does. We set-up a surgery date to re-scope her shoulder, and we discussed repair vs. reconstruction. Few dogs have had the shoulder reconstructed, and of those, she couldn't tell me of any that were highly active dogs. Excellent.

While I was waiting for my chart to come to the front desk, Deb came out to ask if I could wait a minute longer so that Sherman could have a look at Ella. She had pulled him away from another appointment to discuss her findings and he was very worried. He got his hands on her and agreed with what Deb found: the shoulder was painful and elicited the spasm characteristic of MSI, though it felt strong and tight (actually tighter than the good shoulder). We had just decided to go ahead with the scoping, and I was going to scrub in as well, when I gave him one last piece of info. I told him that I had the feeling that Ella looked "crooked" when she was looking at me head-on. When I looked into her eyes, it seemed as if they were not on the same level. I'd actually mentioned this to Sue one evening, but she thought I was crazy! This really is the kind of thing you'd write off as "crazy overly concerned owner" stuff, but I just threw it out there. He considered briefly and instead of calling me crazy, suggested that I take her to a good chiropractic vet for neck evaluation.

The VOSM consult was on a Friday, I pulled some strings and got in with Regina Schwabe outside of Appomatox, VA that Monday. She discovered that Ella had a severe misalignment in her neck and a strained teres major (shoulder muscle). Regina adjusted her neck and we took her right outside to watch her go...I'll be darned if she didn't look 75% better just like that! We decided that Ella didn't need surgery because it was not actually her joint that was the problem; it was her neck and a muscle strain. Her treatment regime included several holistic components and exercises to bring her back to full strength over the next 2 months. What great news!!

On the mend

So while I've been rehabbing Ella, I've continued to work with Rae. The big snowstorm that hit near the holidays kept us out of practice for a bit, but I was fortunate enough to be able to move my sheep to a new site that has tons more training opportunities and thawed/melted way before surrounding areas. When we trailered them, I stopped by the clinic to ultrasound the adult ewes. Turns out 2/4 are pregnant! Who knows if they'll keep, but I'm hoping. They are now happily grazing across the street from the clinic, a mile from my house.

Good News/Bad News

The Good News...I now have my own flocklet! Last weekend I brought home 4 ewes, a ewe lamb, and a wether lamb from my instructor. They are living at my boss' place, a short mile from my house. My sheep are dorset x cheviot, which seems to be an interesting cross: some of them favor the dorset in look and disposition, some favor the cheviot (*ahem*, running thru electonet), and the lambs are cute little muttley types. Dad was here and we put in a lot of work to build Ella a training pen. There was a wooden horse pen in place, so we put up some interior wire fencing and rounded it out to make an oval pen, about 60' by 90'.

I use Rae to move the sheep from their home paddock, down a little chute, and into the oval pen. Sometimes we gate sort; that is, when the neighboring goats aren't hanging around causing trouble. Other times we shed prior to pushing them down the chute. .

Last week Ella was getting to work 1-2 times a day, and was getting better each time out. Her flanks were shaped nicely (though still a little zippy), she was taking her downs well, and we were doing a lot of wearing. When she's excited she has a tendancy to overflank. It's not that she is loose-eyed, moreso that she's just not thinking as much as she ought to. When she settles down she comes in on balance nicely and walks confidently onto her sheep. She is very keen to get to their heads, so I often have to remind her to stay behind them and not sneak up to catch the lead ewe.

Rae and I have been working on a lot of paddock work, since right now I don't have big fields on site. For me, she has had a tendancy to get the zoomies when working up close, being slicey and fast. So we are working on corner work and on widening her out when she feels tense. I am also practicing shedding with her.

Sorry, Rae, no big field to work in here.

The Bad News...after working Thursday, Ella came in the house, got a drink, lied on the floor for 30 seconds, then got up nearly 3-legged lame...on her leg that had extensive shoulder repair!!! I freaked out. She walked it off a little, but was still very noticeably lame. By Friday morning she had improved, but I still could see that she was off. I took her in to the clinic and had everyone watch her go. The equine vet joked at how hard it was to watch a dog lameness exam vs. a horse, dogs being so much smaller and quicker! Everyone did see what I was talking about...a very subtle shortened stride and a mis-step when turning to her left. One vet manipulated her leg and we decided it was definitely that bad shoulder that was painful. Ugh.

I've been trying to contact her surgeon and am having a difficult time. Ella is 9 months post-op radio-frequency treatment of medial shoulder instability. All that means is that her "rotator cuff" was hamburger and needed to be repaired via arthroscopic surgery. She was operated on by the very famous Sherman Canapp at Veterinary Orthopedics Sports Medicine in MD. The rehab was extensive and included hobbles for 3 months, daily exercises, severe activity restriction (not allowed off leash for 5 months), and magnetic/laser/massage therapy.

Two days post-op. Hobbles on, scope portals covered by yellow Ioban. The bare patch on her thigh is where the laser was grounded.

The hobbles were to prevent shoulder abduction (moving away from the body) in order to allow the tendons to scar and tighten up the joint.

By September we'd worked back to some agility (no contacts or weaves), and she looked so good that I trialed her in a few runs. She ran very well for me, Q'ing and winning 3/4 classes, and earning her first title! Since then, she's been running, hiking, and playing ball at full strength. This incident is the very first time I've seen her off.

Photo by Carl Photography

I have been resting her and she seems to be getting better. One of these days I'll have everyone watch her go again. I need to see what Canapp says about all this. Should I be panicking? Will she need another surgery? If so, it's likely she'll need the "tightrope" procedure, which is to reconstruct the shoulder vs. just repairing it. Will that mean the end of working sheep and agility? Canapp has left me a message in which he kept using the word "tweak," so I'm hoping that it's not a big deal, but I need to discuss with him what I can look for to see if she needs to be hauled 6hrs back up to VOSM. I'm also going to get in touch with her sports rehab vet Chris Zink. She told me that Ella would be able to do any activity and never look back, but I'm certainly worried.

I don't know what happened Thursday to make her go lame. I wonder if the way she moves her body when she's feeling her sheep at top speed is hard on her shoulder. There's a lot of one-legged juking and jiving, and I guess it would be the same kind of stress that would come with too much weaving in agility. The weaves were to be the last piece of equipment to add back, and I actually haven't weaved at all with her since her surgery. I don't know if 2x a day on sheep was too much, or maybe she slipped in the mud or got tangled in her line. I don't know if this surgery ever "fails;" it was emphasized to me how well dogs do and that they have no trouble returning to top levels of competition.

Funky weave photo, showing her "slalom" style. A bad motion for shoulders, I could maybe re-train hopping for weaving, not so much for stockwork.

I sure hope that Ella will be able to continue both activities, I'm so worried.

Sheep peak

Details to follow...

All Work, No Play

I missed out on the Rural Hill trial last weekend. Four out of six doctors were at a continuing education event in Raleigh, and as a new grad I don't need CE this year, so I had to stay behind at work. I was really bummed.

So was Rae.

On Friday and Saturday there were times when I was the only doctor in the hospital, as the other had to run out to some farm calls. And on Saturday evening and all day Sunday I was on-call with a college student to help me. It figures that during those times I saw some difficult cases: a dog with retinal detachment in one eye and glaucoma in the other, a dog with a pyometra, a kicked-by-cow cattle dog, a vestibular dog, and a seizuring dog. There was a fading puppy, a chihuahua who weighed 0.4 lbs at one month of age, had a huge open fontanel (hole in skull where the bones don't fuse), heart murmur, pneumonia, and constipation. There was a pyrenees who was found under the porch foaming at the mouth and unable to get up. It came to the clinic and was very neurologic as we tried to examine it. The dog became maniacal; luckily we'd gotten a muzzle on it. It was flinging foamy saliva everywhere, biting and chewing at every inanimate object in sight, and becoming violent towards us. It was screaming and thrashing about in response to me grabbing it's tail in order to take it's temp. He was falling all over himself, knuckling, getting stuck in the corners and hung up on table legs. I was scared, and it was only me and my one helper at the time, who was also freaked out. The owner was likely high and was completely oblivious. The dog had a questionable rabies vaccine history, so we decided to put it in a stall in the barn and just let it alone. Long story short, on the 3rd day it was almost normal, just dazed and disoriented. I gently asked the owner if it could've gotten into any perscription drugs, toxins, or any illicit drugs (I said something about neighbors so as not to imply anything) and he sort of chuckled. I'm pretty sure the dog ate some pot, it fits the clinical picture perfectly (rabies did, too, except that it got better). When the other doctors got back they told me that if I'd known about this client, I'd have probably suspected drugs before rabies. Ha. They did get a kick out of the fact that I'd seen pot dogs come through school; we even have drug tests in the Emergency Service.

I also had to see a paralyzed dachsund who'd been through 3 back surgeries already and who hadn't peed in a day. The folks weren't from around here, so essentially they just wanted me to express the bladder and give them pain meds til they got the dog back to it's neuro vet. The little doxy was so tense that I couldn't palpate a bladder, so I put an ultrasound probe on it, found the bladder, and guided a needle into it's abdomen and then into the bladder to suck out the urine. I'm not sure how I had the guts to do that, as I've *never, ever* done that before. But I was on my own, so I had no choice. I was soooo relieved to see that syringe fill up with urine as I pulled back!

So not impressed.

Then, while I was placing a drain in the side of coon hound after I'd pulled out a wad of black, stinky pus, a receptionist came back to tell me there was a lab trying to die in the waiting room. I went to see the lab and it was pretty much flat out. It could barely walk, so I took it straight back to a treatment room. The dog was completely fine the night before, but had gotten into the trash that morning. I did a PE and found that the dog was pale, had a low temp, was really weak, and was breathing hard. I ran some blood work and nothing was obviously wrong. The red blood cell count was low, but not as low as I'd expected it to fit with how sick the dog was. I figured the dog must be bleeding somewhere...chest was lower on my list since the lung and heart sounds were fine, but if it ate rat poisoning that's where I'd expect bleeding. Abdomen was on my list, since I was thinking it may have eaten something sharp, though that shouldn't cause the dog to bleed out. Pancreatitis crossed my mind since that often results from trash-eating. I decided to go with a "chabdomen" series of radiographs...the girls hadn't heard that one before (chest + abdomen = "chabdomen"), but it gave me a partial view of the chest and most of the abdomen. The lungs were clear but the abdomen was filled with blood. There weren't any signs of a metallic or bony foreign body, but the small intestines were pushed off to the side due to an enlarged spleen. That's when it became clear to me...splenic hemangiosarcoma rupture. This had popped into my head while I was waiting for the x-rays to be developed, and as soon as I had the first film on the viewbox and saw a belly full of blood, I knew that's what was going on. I remembered seeing a lab that looked just like this at school. It was flat out in the Emergency treatment room and had gone from normal, happy lab to almost dead in a matter of a couple hours. Upon further questioning, the owners reported that this dog's mother had died of "splenic cancer." This dog had a mild episode similar to this about a year ago, which was possibly a small bleed that clotted, allowing the dog to resorb the small amount of blood in its belly. Splenic rupture is a very unfortunate thing for owners to experience; many times dogs are just found dead.

This was the first time I had to deliver bad news to owners. Livestock people, they just accept it as a part of the business, but pet owners, that's an entirely different audience. I showed them the x-ray and explained what was going on. It seems the trash incident was a red herring. I offered sending them up to Tech, but was up front with them in that they could spend a lot of money and do everything medically possibly to try to save the dog, and it likely wouldn't be enough. He needed surgery to remove the spleen, yet he was in no condition to go to surgery, he'd most certainly die on the table. I offered keeping him at our hospital and doing our best to nurse him along, transfusions, supportive care etc, though that would only be a temporary fix. He might make it a week, a day, or maybe an hour. I offered euthanasia, which is a difficult thing to bring up. There are times where I think euthanasia is in the best interest of the animal, but it's a little weird to suggest that to someone you've never met who is clearly very attached to their pet. In the end, they decided to take the lab home to die; they wanted their time to say goodbye. I helped them carry him out and load him in their truck, not knowing whether he'd make it home alive. I felt very sad for those people.

And if the weekend hadn't been crazy enough, it ended with me having to go out to an employee's house to put one of her dogs to sleep. I've put plenty of large animals down, but never a pet. It was not fun.

Thank goodness Monday finally came and I got to take the dogs to work sheep. Both did a great job! Ella was walking onto her sheep thoughtfully and under control, with really nice feel and showing a good amount of eye. Rae got to do the "fightin' bitin' Rae" exercise, which she really seems to enjoy! We worked on some shedding and then worked on re-lifting tired, stalled-out sheep during fetches. I was very happy with both dogs, and they were very happy to be out of the house after being cooped up while I was stuck at the clinic.

Oh, I have an exciting project in the works...more on this later!

Ella's looking forward to it!

Suffolks revisited and lesson day

This post will hopeully make Deb happy (here's to a speedy recovery!), since it is all about working dogs! I can't get to the Rural Hill trial this weekend since 4 out of 6 doctors will be away for the ENTIRE weekend at a conference, leaving me and the fella who is gearing down for retirement. EEK! The trial is a short 1 1/2 hours away, but I can't even slip out to run Rae since I'm desperately needed at work. Oh well.

I decided to go try the Suffolk breeding ewes again since I'm not gearing up for the trial. I figured I had 2 lesson days before Tom Forrester's to clean things up, so why not give it a go?

Dad was in town to celebrate his birthday (mmm Smokehouse!) so he got to come along for the fun. As we drove in, the whole flock of about 40ish, mostly mature ewes with a handful of spring ewe lambs, mobbed the truck. Not a good sign. At this point in our dog-sheep relationship, I knew they would run over Rae had I used her to gate sort, so Dad held them to me while I sported a bucket of grain. I was hoping to be a little more selective about who I chose to work, but it was pretty tricky trying to sort them. I ended up taking 3 volunteers who were keen to the bucket and popped them into the next lot.

First I walked them around the lot and had Rae stay behind them. They were mostly concerned with trying to shove their heads in the bucket, but I wanted them just to get used to having Rae back there. I tried sending her to their heads, but one just would not cooperate, and Rae was starting to lack confidence. So I switched that ewe out for 2 lambs. These lambs were a little on the stupid side, but did serve to lighten the group. I sent Rae for them at about 25yds, draw behind me to the rest of the flock on the other side of the gate. When she got behind them and got stuck in a little stare-down, I shook the bucket, they turned, and she brought them to me. We got a couple small successful fetches this way, where essentially it was the grain that was bringing them, but with good timing, Rae got to think that she was moving them.

Then I let that group out with the whole flock and had Dad hold the bucket while I walked part way out with Rae. I sent her the rest of the way, which was about 25 yds, and when she got behind the whole flock, Dad shook the bucket. Most of them went running to him, and the stragglers who were challenging Rae decided to turn and run to the bucket. So Rae got to think she moved the WHOLE flock! How brave of her! I decided not to push my luck, and we quit after that.

Monday was my lesson day, so I wanted to do some work to make sure Rae hadn't lost any of her confidence as a result of the scary Suffolks. I penned them with her (so Ella could have a turn), then I put Rae in the round pen and I stayed on the other side of the gate. I had her bring them to me and then got her as fired up as possible by verbally encouraging her. At first she was being polite, just holding them to me. She glanced up at me out of the corner of her eyes as if to say "Have you lost your mind?!" I kept egging her on til eventually she pushed on them enough to make them squirt away. She found it very fun to catch and turn them, and things progressively got more and more exciting. Soon I started asking her to hit noses, something she's never done for me, and she took to it with no hesitation. I'd find one staring at her, fire her up, and she'd hit it cleanly and squarely, and go right back for more! What a good girl! Eventually I will work up to asking her to do this while I move further away from the pen, so that she may learn to have that confidence when I am not right there with her.

Next we worked on a little control and obedience work in the field. I've been having trouble getting her to give up the reins on the fetch, so I flanked her the whole way around them a couple times to get her listening to me. To mix it up, she was given the green light to bring sheep as fast and crazy-like as she wanted, with me not giving her any commands other than getting her excited. It's so nice that I can micro-manage her and get her moving as slowly and methodically as I want, then flip a switch and have her up and pushing hard as ever. She is very versatile, I'm just learning how to get that out of her.

Don't let that sweet Smoothie Face fool you, deep down she's actually Fightin' Bitin' Rae!

Ella and I did our best ever. I had my instructor work her first, then I worked her. It's hard for me not to get too tense with Ella, we've had such a frustrating history on sheep, but I could see how calmly my instructor worked her and tried to be more like her, instead of a screaming, flailing idiot. I'm getting better. And when I stay calm, Ella stays calm, without so much buzzing or gripping. I was playing around with body pressure, and Ella is becoming much more responsive to me. She is uber-respectful of my trainer, no troubles there, but again, our difficulties in the past is making progress a little slower for the two of us. I'm happy to see her kicking out nicely when I step into her, and she is taking my downs, even when not on-balance. I had been taught to only ask for downs on-balance, but since she can easily slip into mindless orbiting if she doesn't feel that she has control, she is learning that "lie down" means *now*, *no matter what!* I've learned that my correction of "hey!" is completely ineffective; somewhere along the line she's learned to ignore it, probably due to poor timing on my part. It sure was difficult for me when I was just starting out with Ella...she's been described as "a fast little shit," and "one hard f'ing dog" (courtesy of Lisa, after Ella plowed head-first into a tree while chasing Bob, had to be drug out of the pen to stop working, and then had seizures for 7 days as a result of the head trauma). Yep, the Merling Dervish...with teeth. But she is really thinking more and more lately, and I am very happy with her progress :) She only lost her mind twice, grabbing a leg both times. No flossing, *that* is progress!

She tries to be a good girl, but sometimes the Dark Side overcomes her.

I'm going to see if I can set up a packed pen with the Suffolks for Ella. I feel pretty sure that she'll get her teeth out, so that might help to convince the sheep that they have to listen to the dogs. It may also help Ella with her gripping, even though it has improved remarkably over the last couple lessons. I'm planning on having my instructor bring some of her powerhouse dogs over to hopefully get the Suffolks working well. It sure would be nice if we could get them in shape for dog training. Plus, it would be a help to my boss come lambing, as Rae would love to take the place of the 4-wheeler!

Water Cress Trial and a Celebratory Weekend

Last Friday I was fortunate to be able to run in Jan Thompson's lovely trial in Limestone, TN. It was a short and easy drive compared to trips I've made for North East Border Collie Association trials, so I had no trouble making it a day trip so I could be back for work Saturday. The farm was located in a beautiful spot, we had great weather Friday (minus the brief threat of rain as a direct result of me putting on sunglasses), and I got to visit with some of my new friends!

Rae and I ran last, which meant that there was plenty of time for me to sit there and get nervous. My plan was to run her slowly since the sheep were fairly light, and since I need to work on handling her in a way other than balls to the walls. I sent her left into the pressure, because the lay of the field to the right would've shot her back into Virginia, I'm sure. She's generally a bomb-proof outrunner, but for whatever reason, she actually pulled up short *in front* of her sheep. There was a strong draw behind her to the holding pens (which Laura's Nick was stoically protecting), so I think she just got locked up and couldn't give up the pressure. I hollered "you get out of that" and she did...She kicked out and went around behind them, only to stop short again. I flanked her, she stopped, I whistled her on again and she got around to lift them properly. Looking back I maybe should have corrected her instead of directing her since she ought to know better, but I wasn't really mentally prepared for this to happen. Good lift and the fetch was nice and controlled and straight, but I'm an idiot and never got her to flank off the pressure enough to get her back on line after a bobble at the top. I fell back into the bad habit of not correcting her for stickiness and just kept blowing flanks. I'm frustrated that I can't get over that. We came down the field and around the post as slowly as we've ever done. Drive-away was very nice, good turn, good cross-drive line with nice pace...I have no idea how I managed to blow the panel high. The pen was at a tricky spot, you had to bring them around to the back side, with the gate opening the "hard" way (that I've never done before)...ie you had to pass the exhaust and then wrap them around the gate, instead of the gate opening so as to catch them as they were coming back from the cross-drive panel. We worked very methodically and slowly and got them right in.

In summary:

Good things = finally handled in a new way...sheep weren't upset from being pushed too hard. First time I didn't blow a wrong flank. Clean turn to set-up the cross-drive, where we've had trouble before.

Bad things = maybe ran her too slowly. She eyed up on me a little, especially by the time we got to the pen. I had to sternly tell her to "get up" a couple times. It was painful for me to run her so slowly, the "other" me would've made it around the course twice in that amount of time :) So I need to find a happy medium in the pace department. And I'm so mad at myself for accepting an off-line fetch, I see it happening, don't know why I don't do enough to fix it.

Saturday was Ella's birthday, but I spent a good portion of the day at the clinic. That afternoon I took her over to our agility field where she got to play around a little, and then we had some frisbee time.

Ready!

Whee!

Then we paid a visit to the Suffolk breeding ewes owned by my boss.

Rae bravely marches into battle.

That didn't go so well. The area was cross-fenced into 4 square lots, about 2 acres each. These ewes had never seen a dog before. They moved off me just fine, so together Rae and I could drive them anywhere. But anytime she got to their heads, they either stood her down or chased her off. She tried hard for me but they were very intimidating to her. I tried splitting a couple off the group and pushing them away to set up a draw back to the flock, and this half-worked. She could lift a few of them and get them going, but each little packet I pulled off had at least one who would challenge her. Then I tried sorting a few into one lot and setting up a draw across the gate to the flock in the other lot. This had no effect on the group we were working so I eventually gave up and went home.

Sunday we had a nice hike at Gambetta on a perfect fall afternoon.

Chestnut River

Bridge, 3 miles in

Typical: Rae coming, Ella going

Pretty

The New River

I like to take photos of the dogs, but Ella is always ahead of us playing stalking games and Rae is pretty much glued to my side hoping I might get out the ball or maybe a treat.

Watch out behind you, Rae!

You gonna get that ball out anytime soon?

Taking a break from being the Energizer Bunny to bask in the sun.

Monday the celebration continued as the dogs got to work sheep. My instructor wasn't available so I had to work Ella, and we did our best *ever*! Not that it's near the quality of work that she gets out of her, but I was very happy. Rae and I have some things to work on but in light of recent events (being chased off by Suffolks and by LGDs twice on lesson days), I put them on the back-burner and instead made sure she was working happily and with confidence. She took that freedom to run sheep at MACH 5, so once I saw her enthusiasm I went back to a little drilling.

Oh, and what birthday would be complete without cake?! Homemade *gizzard cake* at that!

Did you say cake??

So.wrong.

I'm not quite sure how to play this...I thought food on the floor was fair game.

Polite dog

Possessed dog

Happy Birthday, Best Friend!

First on-call

Tuesday night was my first night on-call. I was scared. I've had bad on-call karma throughout school. My first clinical rotation of 4th-year was orthopedics, and one night I spent the ENTIRE night in the OR. I ended up working a whopping 36 hours straight...not even a chance to change clothes, I was wearing scrubs from day 1 of surgery that lasted into night 1 of surgery that lasted into day 2 of appointments. I felt really gross seeing appointments in grody scrubs, especially since everyone else was dressed in their clinic best (slacks, dress shirts, white coat). And the surgeries were B-A-D bad! The first was a doberman who had a history of 2 foreign body removal surgeries (ate things she shouldn't have, towels I think), and had presented to the emergency service shocky and severely depressed. She hadn't been eating, drinking, or acting herself for days, and the owners chose to just sit on it. Her blood values were all over the place, but she was in danger and we had to take her to surgery right away. We got her on the table and started looking for infected or dead bowel, but instead found a belly full of blood. We searched and searched but we couldn't find where it was coming from. The dog went into cardiac arrest, and the surgeon cut through her diaphragm and manually massaged her heart to get it working again. We stitched up the hole in her diaphragm and went back to investigating her abdominal bleeding, but she developed a serious cardiac arrhythmia. We sent someone to call the owner, and after spending a few horrible moments in lingo...dog's heart fluttering feebly trying to keep her alive...we ended up euthanizing her. I remember that it was after midnight when I rolled the body down to the cooler in the basement of the hospital; how freaking spooky!

Before we'd even gotten done with her, we'd heard there was another emergency surgery waiting for us down in the emergency service. This was a cat that had complications after a spay. She was febrile, depressed, and had some omentum (a sac of fat in the abdomen) protruding from her incision. We opened her up and it was a pathetic attempt at a spay. Now, I understand that some people perform an ovariectomy (remove ovaries) instead of an ovariohysterectomy (remove ovaries and uterus), but this was just wrong. The ligatures around the ovarian pedicles were not secure but just resting in place, there was a large rent in the broad ligament (the tissue that holds the uterus in place) that had trapped a portion of the small intestines and was subsequently squeezing it to death, and the body wall that ought to have been sutured back together along the incision had not even been apposed; the sutures were so loose that the incision was still a gaping hole. It's really scary to see that this is what so-called professionals are doing in the real world. Now, this was a case from a very low-cost practice in a bad part of the city, and the vet was a graduate of a foreign country...so it does make you wonder. Fortunately we fixed this little cat up and she was just fine.

So my next rotation in school was Large Animal Emergency, and we were absolutely swamped, but I enjoyed it immensely. I'd survived a rotation from hell and it was my last night on call when this happened:

At the salvage yard.

I'd picked up a Giant salad and was driving back to school when Omar Sanchez Quintero tried to make a left hand turn in front of me, and POW! Next thing I know I'm trapped in the car and some Mexican who can't speak English is trying to pull me out. He spoke no English; I speak essentially no Spanish (abierta = "open" when preg checking cows, that's about the extent of my knowledge). He didn't have a driver's license or American ID...awesome. A neighbor came out and called the police, and by the time the cop came, the word had gotten out amongst the Mexican population of Chester County. Pickups were rolling up, and a bed-load of men would hop out and gather around until a sizable crowd had formed. I'd called my friend Flo to come save me, but she was engulfed in Jeopardy and wanted to wait til Final Jeopardy was over. To this day she denies it, but that's what happened, I swear! A rotation-mate of mine finally did come, and the scene was getting a little unsettled by then, and the cop had called backup. At this point, my Nextel goes off and the front desk is calling me in for an emergency. Dammit, I can't come now, call the medicine student!!! The cops find out that I'm on-call and offer to give me a police escort back to school, which is only like 2 miles away. They're anxious to get me and Jen out of there so they can deal with the mob of onlookers. Jen tried to talk me into it but I wouldn't go for it. She drove me back to school and, after being yelled at for wearing jeans (not clinic attire), I find the emergency to be a horse with a SLIGHT fever of 101.2. AND the medicine student was there taking care of it. At this point I was thoroughly annoyed and explained the whole situation...and got sent home.

The car, which belonged to my grandmother, was deemed a total loss and was destroyed instead of being repaired. Awesome. Fast-forward a month and I'm driving to school in my new car for a Field Service emergency when I run over a skunk. That night we got lost five hundred times, got detoured by an Amish barn fire, and when we finally reached the barn, had no power due to that darn barn fire. We had to euthanize a horse who'd colicked badly and smashed himself to smithereens while thrashing in his stall...by truck headlight.

After these cases, and numerous other calls, I used to have nightmares about being called in. I'd wake up in the middle of the night to the sound of the Nextel: BEEP-BEEP, "This is the front desk. You have a colic coming in half an hour", only to realize I wasn't on-call and hadn't been for months. Ugh.

So I'd figured I was doomed for my first on-call in the real world. One of our regular bovine clients had prank called the clinic earlier in the day saying that he needed help with his monkey, that he'd run over it with the tractor while out mowing hay. I heard all about the prank calls of the past and thought I was due for one that night. My phone rang a couple times early on, and each time I had a mini-panic attack til I saw familiar names showing up on my phone's screen. Phew.

I had to go back to the clinic for bed checks about 9:30. I was kinda scared to be by myself in the dark so I took the dogs with me. Rae stayed in the truck while Ella got to come in. She wandered around the hospital while I checked on everyone, and I'd call her from time to time to check in with her. One time when she was off on her own, a thought struck me: we have an excessive amount of Halloween decorations all over the clinic (including a giant inflatable, mechanical, glowing black cat on the roof...scarecrows, pumpkins, lights, spiderwebs, etc etc), I don't suppose Ella's found the ghoulish urns in the exam rooms that are each filled with about 5 pounds of dog treats. Of.course.she.had. I found her gorging herself in one of the rooms, happy as can be, sneaking in one more mouthful as I told her off.

Trouble's my middle name!

Then we went up to the barn to check on the horse. Ella hasn't been in the barn before, so she had much to explore. She found a pile of manure and hoof trimmings to snack on (you'd think I never feed her), and then I encouraged her on over to see the horse. She wasn't sure what to think, but tried to be brave and visit with it through the stall door. He belonged to my colleague and was a good boy, so it was a perfect opportunity for Ella to meet a horse in a controlled manner. She did a fine job.

At least now Ella has gotten over her uneasiness at the clinic. She was a little nervous when I first brought her and Rae in to meet everyone, but I think now she associates the clinic with snacks galore. And Rae...she was unsure for a whole 5 minutes...I found her head first in a bag of dog food multiple times, and then on the way out, she chased Larrietta, one of the clinic cats, far, far away, out the parking lot and down the road. Thank goodness we're rural.

Oh, I never did get any emergency calls. Not that I didn't wake up time and time again to check my phone for missed calls.

Marco...

...Polo.

(sportpolo.com)

Last week we had some routine work to do at a big time polo pony farm. The place is super cool. This farm has millions of dollars worth of polo stock that is shipped out to Florida and California seasonally. In the off-season, the horses come back to the Blue Ridge Mountains for turnout to graze the hills and spend some time just being horses. We were called out to do some Coggins tests for a group that was soon to head out for the season. In order to cross state lines, each horse has to have a negative Coggins test. This is a blood test for Equine Infectious Anemia, a debilitating virus that is transmitted by mosquitos. It falls under the category of regulatory work and so can only be performed by a USDA-accredited veterinarian. The requirements vary by state, but in order to gain accreditation we have to attend lectures and take tests regarding identifying and preventing the spread of certain infectious diseases that pose great risks to the animal or human population.

The paperwork that is to be submitted with a Coggins test is fairly straightforward and involves drawing identifying marks on horse sketches that must identically match the horse being tested. This includes drawing all color patterns, whorls of hair, and brands seen from 3 views of the horse: from the left, right, and head on. Usually I like drawing on the little horse figures...not so much this time.

Coggins test paper

For the first group we did, the hands had athered 10 horses to be tested and put them in a small paddock. The horses were straight off the hills, some rather worked up and none of them haltered. They weren't known by names (way too many on the farm, and they were always coming and going), and they didn't have any means of identification such as lip tatoos. They were all thoroughbreds, all bays or chestnuts. So we had 10 unidentified horses that varied only slightly in appearance...a star (white mark on forehead) just above the eyes vs. one in line with the eyes...a white sock on the left front leg vs. one on the right front...a whorl in line with the eyes and no other markings vs. a whorl off-center and no other markings. You get the point...Well we had the papers from last year and we were to figure out who was who based on matching them to the drawings on their previous papers. Of course the drawings are to be as accurate as possible, but it's not as if a professional artist was hired to scribble in circles and lines on the outlined figures on the paperwork. So figuring out which old paperwork matched the horse brought in to be bled proved to be way more complicated than it needed to be. It didn't help that the wind was fierce and was trying to rip my papers away from their makeshift paperweights of drug bottles! We mixed up a couple of the horses and had to change numbers on blood tubes, but in the end everyone was properly identified and had corresponding blood samples.

Hooray! (sportpolo.com)

We did a few more at another site that was owned by the same farm, and fortunately they were much more distinctively marked and the hands knew who was who. Much better, thankyouverymuch.

After we'd gotten the Coggins work out of the way, we had a couple sarcoid rechecks from our last trip out 2 weeks ago. Sarcoids are tumors that are unique to horses, donkeys, and mules. The veterinary community doesn't fully understand them...they are sort of a combination between a cancer of connective tissue and a virus. Often they start out looking like a wart or small nodule under the skin but can grow quickly and ulcerate. They don't metastasize but become locally invasive. If you surgically excise them, they grow back bigger and angrier. Sarcoids are unsightly and can be painful to the horse, especially if they interfere with tack.

Sarcoid on upper eyelid (Merck Veterinary Manual)

Our choice of treatment is to inject the sarcoid with the chemotherapy drug 5-fluorouracil. Epinephrine is added so that the drug concentrates in the tumor, thereby limiting its systemic absorption. This is done every 2 weeks until it sloughs off or shrinks enough to be treated by an ointment.

We had 2 horses to treat. The first one was less-than-thrilled with our intervention last time, and even with normal horse sedation on board, she reared and clocked her head on the eave of the barn. So she had a second helping of drugs and still was not very sleepy, and still was not so tolerant of her injection. This time we had her number and gave her a whopping dose. Good sedation = good horse. The only problem we encountered with her was dragging her back up the hill to the pasture. She didn't go down, she was just verrrry slow and reluctant to move. Her sarcoid was significantly improved; it had shrank to about 1/3 of the size it was 2 weeks ago. The other horse was a good patient and her sarcoid was nearly gone. So we were happy with how both horses had progressed. It's nice to actually be able to follow your cases over time as compared to during clinics in school where you'd have moved on to a new rotation by the time your patient comes back for a recheck.

In other news, my photos and videos have now all made it on to my new computer! If the computer guy didn't get it straightened out after the THIRD time I explained it to him and literally peered over his shoulder as he worked, I would have had to release The Merlefriend:

Sometimes she's very angry.

Catching up

My laptop died. For good this time. But now I'm back up and running on my shiny, new Not Dell. However, the computer-fixer-guy who was supposed to transfer everything from my old, dead computer to my new, alive computer didn't do a very good job...we'll be paying him another visit tomorrow since I'm missing thousands of photos as well as my photo-editing program. Not to mention all of my agility and sheep work videos. Not acceptable. I am less than happy.

Now to catch up from the last few days. Dad came to visit for a long weekend. He brought Chloe along, too.

Dad on the porch with the dogs. Right after taking this, Rae tried to help herself to the plate of cheese and crackers sitting out. BAD!

He helped accomplish a lot of projects while he was in town, like getting my VUE fixed in Winston so that Ella is no longer at risk of getting locked in with the windows up like happened at Robin's trial (thanks to Kelly who saved the day!). My car had developed a mind of its own and was constantly locking itself of its own accord. It would lock itself hundreds of times a day...in the driveway, while driving, in the parking lot, overnight. Over and over and over. Though the dealership was stumped and had never encountered this problem, they found something a little off in the driver's side door...it's been a week and so far so good. Dad and I worked around my house and yard, went out to eat, and did plenty of sightseeing in the country. I showed him some of my favorite dog-hiking spots, and we even found a couple new places on the Trail.

Ella in the New River at Fries (old photo - leaves are still green!)

On the Trail at Chestnut Yard Access; Ella finds sheer joy in playing in the creek.

Rae, on the other hand, doesn't find water so inherently exhilerating. She needs a little bribery to get in.

Chestnut Falls

One evening we met my boss' dog training group. They get together to work on obedience and rally, and several of the members have certified therapy dogs and participate in those programs. We all set up Ella's agility equipment in one of the small paddocks - which happens to be bordered by goats on one side, horses on another, and show lambs on yet another. Talk about distractions! Ella and I did a little demo and she was smokin! She sure loves showing off! Then the others played around with their dogs well after dark. We had a cookout in the barn and it turned out to be a fun evening.

My front porch now has a better view of the mountain thanks to Dad's work on the pines. We had a couple days of nice weather where we enjoyed sitting out there and having happy hour. One of my neighbors supplied appropriate entertainment in the form of her banjo-pickin and singing. It's nice, but I'd appreciate it if she'd learn a couple new songs to mix things up a bit!

I have a lot of work-related stories to catch up on later. We've done some interesting work in the country lately.

Small animal surgeon?

We've still been having some slow days in the country, so yesterday I was thrown into Small Animal Land to play surgeon. I did two dog neuters, then was presented with a tumor removal case in a 12 year old dog. I'd seen the dog as an appointment last week when we diagnosed her with mammary adenocarcinoma. She had a very large mass associated with one of her mammary glands near her belly and a series of ugly nodules under her armpit. She was a lovely dog who was otherwise in top shape for her age, so her owners decided to go ahead with the surgery to remove the masses.

So I had just finished the second neuter when one of my bosses tells me that I'll be doing the mastectomy. Umm, I've never even seen a mastectomy, let alone done one. I figured that he'd be scrubbing in with me, but I found myself alone in the OR with the dog prepped and ready for surgery. I called to my boss to make sure he knew that I'd never seen or done this before, and I asked him if I could approach it like a bad calf hernia. He didn't seem concerned about my inexperience and said "just watch out for a big vessel that comes into the gland." Right.

Now, I certainly don't pretend to have a lot of small animal experience. Sure, I learned a lot in school, but I did very little small animal work during my clinical year (by choice). At the time school was over, I'd planned to do strictly dairy medicine, and maybe branch out to include a little horse work if absolutely needed. I never dreamed that I'd end up in a mixed practice. In fact, this is what happened to my small animal notes:

Let the sacrificial bon fire begin

Years' worth of papers makes for lots of smoke

At first my game was dumb, but wouldn't you know, by the end everyone was joining in the fun!

So here I am about to attempt a totally less-than-routine dog surgery. Take a deep breath, drape dog, pick up scalpel. One of my favorite pick-me-up songs comes on the radio (Black Eyed Peas "I've Got A Feeling") and I'm ready to go. I made a neat elliptical incision through the skin and WHAM! here come the bleeders. A fundamental principle of surgery is "all bleeding stops eventually"...well, preferably that's as a result of the surgeon's actions and not due to the death of the patient. So I grabbed every single hemostat (clamp) I have in the pack and then had to resort to tediously tying off vessels. I tied and tied and tied as I slowly dissected out the mass, and finally it all came out in one neat little package WITH NO BLEEDING AT ALL! HOORAY!

One of my cases from school, an example of a mass removal (fibrosarcoma in an 800lb pig); my main frame of reference

Calf hernia, looks a little like what I took out

OK, now comes a big challenge: closing the gaping hole where the mammary gland used to be. Instead of panicking or asking for help, I used my brain (for once) and cleverly put in some stay sutures to pull the skin together, thus letting up some of the tremendous tension on the incision. AND, I even whipped out a super-secret knot that I learned from a very famous French-Canadian bovine surgeon at a conference...it was the first time I'd ever tried it, and it worked like a charm! I was thrilled with how well the wound closed, and I hated to put skin sutures in because it obscured my artwork. Feeling all smug, I then realized I still had to tackle the nastiness under the armpit.

By this time another of the doctors had come in to work, so she decided to hang out with me and help. The area we were dealing with was huge...the more we kept digging, the more nodules we uncovered. We had to be very careful and try to keep the incision as small as possible for fear of being unable to close the skin. We took a lot out of this area, and the defect was sorta L-shaped with some zig-zaggy margins. I again used my slick stay-sutures and fancy knot, and I was pleasantly surprised with how well I got it together. Actually, I've never been so proud of my work! We laughed about the fact that it turned out to be a "cosmetic tumor removal." Again, I was sad that my masterpiece was covered up, this time with staples. Darn.

So that's the story of my first non-spay-or-neuter surgery. I have to remind myself that surgery is surgery; the same principles apply no matter what you're working on. I put in a lot of time in the OR at school assisting our food animal surgeon, so I must have passively absorbed some of her skills. That's a nice thought.