veterinary

Missy and Hypoglycemia

/ Dr. Christine McFadden / Leave a comment

She was so small that her big sister was a Beanie Baby. She’d been sold straight from a cardboard box in the parking lot of a Big Box store. Her owners were entranced from the moment her fluffy 1 ½ pound body hit their hands. The sellers were short on details like birthdates. We guessed her to be 2 months old? She was christened Missy, her basic exam checked out, and she had her first vaccination before they took her home.

The roller coaster ride had begun. Sadly, Missy had already been exposed to Parvo virus. Parvo is dreaded throughout our Valley, as we seem to see a lot of this viral disease in young, usually unvaccinated dogs. With no immunity, they fall ill, exhibiting extreme vomiting and a watery bloody diarrhea. The virus further attacks their body by dropping their white cell count, so they can’t fight off the infection. Many puppies die from the disease. Supportive therapy in-hospital with intravenous fluids and medication provide life support while their body recovers. It’s a puppy’s best chance to survive. Missy was sick so quickly we knew that she had been incubating the disease when she was brought in and the vaccine wouldn’t have had time to provide protection. (The vaccine itself does not cause the disease) Further complicating matters was her very small size. She had no body fat to speak of. Placing an intravenous catheter in her threadlike leg vein was a miracle. And like many tiny, tiny puppies she couldn’t keep her blood sugar up without constant eating – and Missy couldn’t keep anything down. If her blood glucose levels plummeted she might faint, seizure or even die. To counteract this, we added dextrose to her IV fluid drip. And then we worried about overloading her tiny body with fluids or we might flood her heart! We have an IV syringe pump that carefully meters each drop to these most extremely small of all patients.

Missy was a fighter. She gamely held on and after four days Missy turned around and successfully fought off parvo. Hurrah! But within days it became obvious that Missy’s body couldn’t regulate her blood sugar levels on it’s own. She would appear dazed and weak at home for no obvious reason. I had to explain that Missy couldn’t waste a mouthful on treats – many treats are high in sugar (check the labels for corn syrup, dextrose, sugar beets, etc) and just as with diabetics, it gives a quick sugar high and then just as quickly dips back down. The dangerous Sugar Rollercoaster. Don’t take that ride! Missy needed to eat dog food, with protein, fat, slow-release complex carbohydrates (carbs are the sugars in food) and the calcium, vitamins and minerals a growing puppy needs. For several days she had to be fed every two hours, including at least once during the night. We expected her to outgrow this…. but when?

Missy’s body did learn to self-regulate. She grew to over 4 pounds. She finished her series of puppy shots and had no further health set-backs. We set the date for her ovariohysterectomy /spay for 8 months of age, when I could reevaluate her teeth – tiny dogs often have delayed dental eruption (they are slow to lose their baby teeth) and if retained, the baby teeth will crowd the adult teeth, trapping food particles and eventually rot out both teeth! It is so much easier on the puppy to remove these excess baby teeth under the same anesthesia they undergo for their spay / neuter surgery. We schedule the surgery when the adult teeth have come in. The big day came. We checked Missy’s blood sugar before surgery. Normal. We checked her teeth – she had retained three deciduous canine (fang) teeth. We extracted them. Hurrah!

Monitors beeping calmly, we proceeded to spay Missy. She acted like a completely normal patient, recovering beautifully. Hurrah! Postoperative blood glucose tests were all normal. Another hurrah! I don’t know if her little feet ever touch the ground (spoiled by love), but in addition to all the other miracles, Missy is a superb outgoing doggie friend to everyone she meets. Hurrah!


Christine B. McFadden, DVM
drmc@mcmenagerie.com

Hysterical Clients

/ Dr. Christine McFadden / 1 Comment

Who said veterinary medicine wasn’t fun?

There’s the man who got out of jail (he didn’t say why- either for going in or getting out) and came home to find his dog sick. This enraged him. We know this because he brought the dog to us (he was passing by, thought he’d drop in) and he was very thorough in his explanations to us of society’s injustices, particularly that he might have to take financial responsibility for his pet. We couldn’t diagnose the illness without a blood test – and magic wands are out of date, though I kept one on my desk for years. We’ve kept statues of the Virgin Mary, Buddha, dice, and a crystal ball. We do not turn our nose up at anything that might intervene on behalf of our patients. In the science-based world of medicine we have seen miracles – but we have also seen cases where the pet should have lived, by all rights, but died. In the end, we fall back upon diagnostic tests because they do just that: they help us to diagnose your pet’s illness, to unlock the pieces of the medical mystery so that we may help the patient.


This man was very angry. The time spent in jail seemed not to have been used for self-reflection or internal contemplation. It seemed unlikely that he read poetry. We thought we should focus on the dog. We weren’t entirely sure he could focus well enough to drive. He had no interest in paying to care for his dog nor did he wish to surrender it to a Rescue group. So he left. Only to return a half hour later, which we noticed immediately because his car was sideswiped as he drove in to the parking lot. While he was waiting for the police to show up (to investigate the accident) he surrendered the dog to Rescue. Post-script : dog did great.

And I fondly recall Crack-A-Nose. Her name alone kinda gives you a heads-up, yes? A pitbull, she had a huge pink mass of doughnut-shaped tissue protruding from her vulva. Bigger than your fist. It was very dramatic. This dog had a condition called vaginal hyperplasia, or swollen vaginal tissue. It is not a true prolapse of the vagina nor a cancerous tumor. It occurs when a female dog has been in heat, producing high amounts of estrogen. The swollen tissue will shrink back to normal size when the estrogen hormone has declined – and the fastest, most effective and permanent cure for that is to recommend an ovariohysterectomy or spay. I explained all of this to her owner, a young woman who was rail thin with blond hair, beautiful, a little twitchy. The young woman pulled a fistful of hundred dollar bills out of her bag. She requested that I perform whatever services were required and informed me that she would pay in full right then. I agreed to her terms and performed surgery successfully that night. I figure the dog must’ve been a great guard dog for some very important stash, oops, stuff.

Now stop me if I’ve told you this one before. This was when I worked in a small office off Highway 59, still called “J” street back then. I remember the skirt I was wearing because it was the last time I’d ever wear it. It was quiet, around lunchtime. A man in his twenties came in. He announced that his dog had been run over by a mower. I was nearby and nodded, told him to bring the dog in. Occasionally you see an overactive puppy bouncing around a lawn mower and accidentally getting a toe clipped. Not very serious. He stared at me. But he’s bleeding, he said. I nodded again. This was to be expected. Please bring him in.

And he did. Only he hadn’t been talking about some little push mower, he meant a tractor hay/disc mower (the tractor weighs over a half ton) and it had practically amputated the dogs’ leg, so the “bleeding” he’d mentioned was an enormous spraying jet of blood from the severed femoral artery. The dog was going to bleed out – I was surprised it hadn’t died already. I stepped in with a pair of hemostats to stop the gushing fountain and got lucky. I completed the amputation in a sterile surgery and the dog lived. But my clothes were history.

Christine B. McFadden, DVM

drmc@mcmenagerie.com

My Husband’s Hospital Vacation

/ Dr. Christine McFadden / 2 Comments

My first indication that text messaging had gone too far in my household was the afternoon I checked my phone and discovered the following message : “Just wanted to let you know. I thought I might be having a heart attack so I checked myself into the hospital.” It had been sent from my husband’s cell phone.

 

What you need to know were the events preceding this text message. My husband had taken our children skiing two days earlier. On this morning, he had done some moaning and groaning around the house. The problem is, I not only have to get ready for work myself, but I oversee care of the kids, the cats and the chickens before leaving. Getting to school on time is a mountain we climb every day. If it’s not worth opening your mouth to speak up about something, I’m not going to slow down long enough to start an inquiry. He knows where to find his Advil.

 

I confess I felt more irritation than anxiety when I read the message. Really? I’d had a full day and no lunch up to that point. So I called him. He answered. He sounded cheerful. Enough hours had passed before I’d discovered his message that he could assure me that his chest x-rays, his blood tests and his EKG were all normal and he wasn’t having a heart attack. So why are you still there? I reasoned. Well, he rambled on, this doesn’t explain the pain. “What about arthritis?” I asked. Oh no, he assured me, I’ve never had arthritis here. It’s on my right side. I was driving myself to the golf course and felt pain in my right arm, so I pulled over and googled heart attacks. It said they would be on the left side, but I thought I should be sure. They’re going to run another test to see if I have blood clots. If it’s abnormal, I’ll stay for a CT scan.

 

OK, honey. I returned to my own patients. There was a cat that had been tumbled in the dryer for 7 minutes. She appeared dazed, with tiny bruises starting to appear on her skin where patches of fur were missing. She was a lucky cat; only last month, another cat had actually died in a similar accident. We began treatment for shock and started the cat on IV fluids.

 

It was closing time when my husband called. My test is abnormal, he said. “What’s the name of that test, hon?” D-Dimer. We use the D-dimer test in veterinary medicine. Platelets, the cells that help blood coagulate or clot so you don’t bleed out, will slowly break down after they’ve served their purpose. If your body is forming big blood clots where it shouldn’t, the by-product of platelet breakdown will be very high in the blood stream. The D-dimer test measures this level.

 

For a variety of reasons, I didn’t believe it. So while getting the kids squared away I researched the normal blood levels for humans. Armed with this info, I went down to visit my husband in the ER. He looked remarkably fit. In fact, he wasn’t feeling any pain, though he’d not been given any medication. I asked his nurse for the actual number on his D-dimer test. It was less than 200. I stared at the nurse. “But that’s normal”. Yes, the nurse agreed. I stared at my husband. “Who told you it was abnormal?” He frowned, concentrating. He wasn’t sure (What else did he have to do?). About then they came to wheel him down for his CT scan. They said it would be read that night. Forgive me my skepticism, but having assured myself that my husband was doing very well, I kissed him and told him to enjoy his scan. At this point I reflected that if they did find something wrong with him, it would not be what he’d gone in for. I slept poorly (despite my brave front). At 2:20 in the morning (5 hours later) my husband sent a text message that he had completed his CT scan but it wouldn’t be read until the next day.

 

I visited him on my way to work the next morning. He was cheerful and even complimentary on the hospital breakfast. They were going to run some more blood tests. I left him to it.

 

At work, my own patients were well. My dryer tumbled cat looked much better and was enjoying a hearty breakfast herself. Her bloodwork was excellent. By early afternoon I was discharging my patient to her ecstatic owner. Back at the human hospital, my husband had been leaked the information that he had a “non-displaced hairline fracture in his right rib”. My husband was now being offered an echocardiogram and had begun to call me every hour or so. I told him if he couldn’t relieve the babysitter by 3:30 to let me know. If he wanted to stay another night in the hospital that was on him. I was worn out.

 

Once he knew it was just a cracked rib, my husband felt lots better. I arrived home that night to find he had invited several people to dinner and cooked up a storm. Even better, he could go on his golf vacation next week.

 

I am SO grateful my patients can’t talk!

 

Christine B. McFadden, DVM

drmc@mcmenagerie.com

The Large Animal Vet

/ Dr. Christine McFadden / Leave a comment

 

 

Perhaps the title sounds misleading. A “large animal” vet develops a veterinary practice caring for the needs of livestock such as cattle (dairy or beef), sheep, goats and pigs. A “small animal” veterinarian like me is usually slotted into the care of companion pets such as dogs and cats. So when I examine a 200 pound dog, it is still a small animal and likewise there is often confusion about whom to call when the patient is a pot-belly/miniature pig. Not me.

 

The life of a small animal vet and that of a large animal practitioner are markedly different. One works almost exclusively indoors, dressed neatly, white coat in place. The other weathers life outdoors, facing extremes of blazing heat to icy cold, rain and snow. One always has a sink handy to tidy up. The other uses outdoor hoses more than they’d like. A dairy vet may check over 100 head of cattle in a morning and four “farm calls” make a full day. A small animal vet may follow the medical strands of more than 25 patients a day, winding through exams, blood results, x-rays and working in a surgery or two.  All juggle the demands of unexpected emergency work.

 

Being in an office most of the day, I rarely interact with my brother and sister large animal veterinarians. So when the pygmy goat from the petting zoo fell over dead I was unhappy, but proceeded to perform a post-mortem examination and sent tissue samples off to our regular lab. I had overseen the care of these goats for many years, but they were on the back burner when it came to my interest in the truly exotic Zoo collection. My concerns centered on whether or not the public might have fed something odd to the goat? (I’ll jump ahead here : No. The public did not harm the goat). I mulled over the problem but prepared to wait until the pathology report was finished sometime in the next week. And then another goat died.

 

I was unnerved. The goats were being closely watched and none had shown any outward signs of sickness. They had all lived for more than 8 years at the Zoo and had never, collectively, suffered a single injury amongst themselves. I immediately sought the expertise of a Large Animal veterinarian. The Goat Expert was on a dairy farm. The return call came in as I was finishing one surgery and about to start another. Gloves still on, I was staring at some x-rays

in-between these surgeries when they told me they had Dr. B on the line. Multi-tasking at its best.

 

I hurried over, snapping gloves into the waste receptacle and grabbing pen and paper. I introduced myself and LAUNCHED into a recital of my goat woes. I verified that he had goat experience? Yes. I gave him dates, genders, date of deaths, lack of lab results, still pending. I drew breath to spew forth another list of details and heard him gently respond, “Yes…. I think…. I might be able…. to help”. His measured tones were from a man used to the gentle rhythms of milking machines, contented cows swishing their tails, chewing their cuds. Da-dum da-dum to my staccato dop-dop-dop-dop-dop! I managed to squeeze in a few more hurried sentences (surgery! Waiting!) before he responded calmly, “I think I drive past your practice on my way up from this dairy….”. I opened my mouth. Closed my mouth. I could hear the clouds, feel the sunshine, almost see the shining black and white hides of the gentle Holsteins he surveyed as we spoke. It was all there in the rhythm of his speech. I told myself to stop yapping before he decided my goat problem would be too stressful for him to bother with.

 

An hour later Dr. Thomas Bauman drove up in a large truck outfitted for all manner of veterinary ministrations. He spent an hour and a half doing a post-mortem on one goat. He had a wicked knife and mulled over the cause of sand in the stomach. He felt it was too much. Did we feed on the ground? No. But little kids feed the Zoo goats oat hay pellets and they often dropped to the sand, with all the goats scrambling to get their share. Hmmm. He gave the problem his full attention and we submitted a gazillion samples to the State Lab, including an intact eyeball because it would be useful for trace metal analyses. The final answer was a copper deficiency in the feed, to which Pygmy goats are especially susceptible. Hay grown in the San Joaquin Valley is often deficient in copper. The salt lick fed at the Zoo did not have added copper because Alpacas are in with the goats and they are susceptible to copper toxicity (too much) if supplemented. So we now feed our goats little capsules of copper wire every six months and all is good. But sometimes I find myself wishing that I was a Large Animal veterinarian. Just so I could slow down and smell the …..never mind.

 

Christine B. McFadden, DVM

drmc@mcmenagerie.com