Cats really do all these things

As someone who never really knew what cats were like before getting Taiko, I have to say that I have seen him do every single thing in this video. From Simon's Cat:

Day 3

OCD could stand for Obsessive Compulsive Disorder (which pets can suffer from), but today it stood for Osteochondrosis (or Osteochondritis Dissecans). OCD is a developmental orthopedic disease that typically causes lameness in puppies 7 to 12 months old, and most commonly affects the shoulder, elbow, stifle, or hock joints. OCD occurs when part of the smooth cartilage that lines the joint surface doesn't form correctly, resulting in a defect in what should be a nice smooth joint surface. The joint ends up arthritic and painful, leading to limping in puppies that should be bouncing off the walls.

In the case today, we saw a 9 month old female Goldendoodle with forelimb lameness. She was painful on manipulation of her shoulder joint, and her radiographs showed the typical abnormalities associated with shoulder OCD. Unfortunately for her, the options for treatment are either surgical removal of the abnormal cartilage or long-term medical management for arthritis. And while dogs usually return to full function after surgery, the joint usually (eventually) goes on to develop arthritis anyway. And the disease is very commonly bilateral, which means her other shoulder will probably become sore soon and require the same sort of intervention.

This is a major financial burden for a pet owner who thought the most expensive surgery her pet would be facing is her spay. It's also disappointing for the owner, who thought her pet might make a competitive agility dog. She also thought that getting a "mixed breed" dog would lessen the likelihood of congenital disorders... but unfortunately, Doodles are just as prone to the developmental disorders of Goldens as are purebreds, and they're also prone to the developmental disorders of standard poodles.

So, today I learned:

• it stinks to tell a pet owner that their animal has a limp that won't go away on its own, that requires surgery to correct, and that will give the pet lifelong predisposition to developing arthritis
• it stinks to see a happy bouncy puppy walking with a painful limp
• it can be hard to convince an owner that, despite being happy and bouncy, your puppy is in pain (otherwise, why would she be limping?)
• sometimes pet insurance really is worth it
• don't buy into that "hybrid vigor" nonsense that breeders of "designer dog" breeds try to push
  

Day 2

Arizona is a very dangerous place to be a domesticated animal. Here is a list of presenting complaints that have come through the clinic while I've been working:

• attacked by javelina
• attacked by coyote
• attacked by Africanized killer bees
• ran through cactus
• stung by scorpion
• bitten by rattlesnake
• bitten by spider
  
• Colorado river toad intoxication
• Valley fever
• Tick fever
• heat stroke

So, if you are a pet in Arizona, stay indoors, stay on leash, and don't exercise in the heat!

What I learned today

Hmm. I've been stuck in a blogging funk lately, writing posts that sound a little too negative to actually publish... I don't want to turn this blog into a spot to vent, but I hate to let it sit idle too!

So, here's my goal for the next month: one post a day about something I've learned- about medicine, or surgery, or Tucson, or communication skills, or whatever. An internship isn't valuable if you don't take time to reflect on it. So, here goes day 1:

Feline malocclusions. A fancy way to say that the teeth aren't lined up right, malocclusions are much more common in dogs than cats because dogs' heads come in a much wider variety of shapes and sizes. The photo to the left is a canine (dog) canine (tooth) malocclusion, in which the lower tooth is contacting the upper hard palate, causing damage to the tissue. Despite being more common in dogs, cats do indeed get malocclusions, and I learned that thanks to my own kitty, Taiko.

Taiko turns 7 months old tomorrow (happy birthday kitten!), and so just finished getting his adult teeth in. I was trying to be a good cat mom and start brushing his teeth early, so that we get used to the routine. A couple of weeks ago, I was brushing and noticed that his breath smelled extremely foul. A 6 month old kitten should NOT have stinky breath (of course, neither should older cats- halitosis is a sign of dental disease as well as many other diseases). I examined his mouth a little closer and discovered that he had a malocclusion of his fourth premolars (teeth #108 and #208, for you Triadan folk). They were set too narrow, so the sharp points of his premolars were digging painful pits into the soft tissue and gingiva of his lower jaw. The foul smell was the infection setting into the gingival tissue. Taiko had both of his 4th premolars extracted and had x-rays taken of his lower first molars to assess the damage caused by the malocclusion. While he had some damage to the gingiva and some horizontal bone loss, he was able to keep his lower molars for now- hopefully we stopped the damage early enough that the integrity of the molars wasn't too compromised. In some specialty dental centers, the sharp points of the 4th premolars can be smoothed down and the teeth can be spared, depending on the severity of the malocclusion. In dogs, some malocclusions can be corrected with orthodontics (yes, seriously).

So, lessons learned:

1. Always check the occlusion of teeth in puppies and kittens- even babies can have dental disease
2. Cats get malocclusions too
   
3. Foul odors in the mouth of any animal should be investigated ASAP

Guess who's 5 today?!

Happy Birthday Pooh Bear!

Life after vet school

Wow- long time, no blog! It's only been a couple of months since graduation, but it feels like forever since the last time I was in VMC. Since then, I've been across Europe and back, up to the cabin, and on a marathon 33 hour drive from Minnesota to Tucson. We managed to squeeze everything that I thought I'd need for my internship (including the cat and the hedgehog) into the Fit. I brought every book and set of notes that I thought might be useful, which turned out to be quite a lot... and poor Chris had to haul all my boxes of books into the new apartment in 108 degree temperatures. Welcome to Tucson!

We spent the first week in Tucson exploring, looking especially for the best food Arizona had to offer. We found the best tacos at the Taqueria Pico de Gallo, a little hole-in-the-wall that used to be a taco stand. They've since grown to have enclosed seating, but you still bus your own food and clean up after yourself. They make fresh corn tortillas while you wait, and serve a type of pico de gallo made of big chunks of fruit covered in chili powder and salt. Yum! The farmer's markets had the best tortillas and salsas, although fresh produce is sort of lacking at this time of year.

We also discovered tamales, delicious concoctions of corn masa and some other delicious filling (like peppers, mushrooms, corn, cheese, etc), wrapped in a corn husk. We visited the Tucson Tamale Company based on an article from roadfood.com. When we told them we were new to Tucson and to tamales, they served us a free tamale and taught us how to prepare and eat them. Delicious, cheap, and easy to prepare? We were hooked, and have a freezer full of tamales to show for it.

After a week of getting oriented to Tucson (and trying to adjust to the temperatures), it was time for Chris to head back to Minnesota and for me to start my internship. I was a little scared that after six weeks of thinking about anything but veterinary medicine, I would be completely useless as a new doctor. Of course, I hadn't forgotten everything, but I've also been eased into my role as an intern. We spent our first week getting oriented to the clinic, learning where things are and how things work. The next week, we split into our separate shifts- I started on days, and the other intern started on nights. We'll spend two weeks on each rotation until October, when our rotations switch to three weeks long.

So, what did I learn during my first couple of weeks as a doctor?

• private practice medicine and university teaching hospital medicine are very different things- at the university, most people are coming in knowing there's something really wrong with their pets. In private practice, someone might come in for what they think is a routine wellness exam and leave with a diagnosis of heart failure or cancer. You surprise people a lot more often in private practice.
  
• sugar gliders make terrifying sounds and will definitely bite you given half a chance.
• my hands, generally pretty steady through things like surgery or blood draws, get shaky during euthanasias.
• good technicians are worth their weight in gold (I already knew that, but now that I'm a doctor it's even more obvious).
• During vet school, I got very good and thinking very thoroughly- we saw relatively few cases each day, so there was a lot of time to dig into the disease, the pathophysiology, the pharmacology of the medications involved, or all the different possible approaches to the surgery or procedure. At my clinic (and in most private practices), the pace is much faster and I'm going to have to get a lot better at thinking on my feet and trusting the knowledge base that I built during clinics.
• puppy and kitten visits are important antidotes to euthanasia appointments.
• I'm still not used to being called Dr. Schommer, but I kinda love it when clients call me "Doc".
• tortoises can be hypothyroid. Who knew? (I feel like "How can you tell your tortoise is hypothyroid?" is sort of like "How can you tell your accordion is out of tune?").
• baby hummingbirds are the most adorable animals ever.
  

I think everyone who went to an internship after graduation was a little nervous about what their clinic would be like- we all heard stories about programs that use interns as slave labor rather than doctors, or programs where the residents get priority for interesting cases, procedures, surgeries, etc and interns get whatever is left over. I've only been at my clinic for a few weeks, but I feel lucky. There aren't any residents to compete with, the doctors are supportive and always open to answering questions, and we're treated as full-fledged doctors (even if we're still just partially-fledged doctors ;) ).

Tonight, I start my first stretch of overnights. Wish me luck!

Fitting in the Fit

It worked!

Megan's Graduation

It has been quite a trip, but last night Megan graduated from the University of Minnesota with her Dr. of Veterinary Medicine. We started writing here on October 16th, 2006 during the first few weeks of Vet School. So much has changed since then! Megan has put in countless hours these past four years, and has truly transformed herself into a doctor. We are looking forward to more good things to come, but first here are some pictures from last night!