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Grand Opening: The Pawcurious Surgical Training Centre

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So, every year I attempt some form of creative teaching enterprise at the kids’ school, and some years go better than others. This year, in a school I really like, I think things went well. I was asked to do a “veterinary science station” for the annual Science Fair, and I thought back to what I was excited about when I was a kid:


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Playing with guts! And I thought to myself, I bet I could create a dog version of this anatomical model. So I went to Joann’s, bought a bunch of random attachments and fabric bits, and commandeered one of my daughter’s stuffed animals to volunteer to be my surgical model.

Step one: preparing the abdominal cavity

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I chose a mottled red fabric for the interior of the dog, and sewed a pouch to contain the abdominal organs. After cutting open a midline incision, I removed a bit of stuffing then sewed in a zipper. (Do this before sewing the pouch in, or you’ll end up with the zipper seam showing.) Then you can sew the top ends of the pouch to the edges of your incision and voila!

Step two: making organs

You can go kind of crazy with this stuff, but I tried to hold myself back to the main parts (no spleen, pancreas, etc). All of the organs were secured to the abdominal wall with Velcro so they would remain in the right place but they could be removed if the kids really wanted to see what was in there.

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I tried to keep the organs moderately accurate, but I was limited by my own sewing experience and what I had on hand, which is how I wound up with lavender sparkly kidneys and a two-lobed liver. For the bladder we filled a white balloon with rice. The kids don’t care too much about accuracy.

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The intestines were a long tube of velour that I sewed and then had to turn inside-out. I didn’t think that one through ahead of time. I debated leaving it a giant intussusception but I eventually got it figured out with actual surgical tools. Next time, forget it.

In the interest of simplicity, the loop represented both the large and small intestine. I had some nubby yarn that I really, really wanted to throw in there as omentum but I held myself back.

The stomach needed to be fairly correct as a gastrotomy was going to be one of the two surgeries the kids could do. It’s a fleecy material with the nubby side on the inside (rugae! yaay!). I ended up using ribbon “stitches” sewn into the sides of the incision, which was a smart choice once the fifth graders started yanking on them full-force.

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For the uterus, I sewed two red socks together at the toe (worked like a charm!) and bought a handful of small puppy toys. The ovaries were little white yarn pom-poms.

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I sewed a snap into the tip of both socks to keep the “uterus” closed. I also put in a piece of stretchy rubber ribbon on both sides of the abdomen that the uterus held to with velcro but that was overkill with these kids so I didn’t use it. Feel free to use it for the vet student in your life, though- they’ll have to get used to wrestling with that thing.

By the time everything got stuffed in there it was actually a shockingly decent approximation for the surgical experience- you look in and think, what the heck am I looking at? So I made a legend as well.

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With all of that in hand, as well as a bunch of gloves and masks we didn’t end up using, we headed off to the science fair.

Step 3: The actual test

We had a lot of competition at the science fair. Computer programming, dry ice, slime, rockets, frogs. Since the kids didn’t know they were going to be doing surgery until they came up and asked what was going on, they all freaked out a little and then said, let’s do it!

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I used some of the radiographs readers shared with me. The pregnancy one was a big hit!

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A small cardboard tube served as a trachea and the kids intubated with a See’s candy stick.

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An old pillowcase with a rectangle cutout in the middle served as a surgical drape.

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For the case where the dog was vomiting, we used our legend to try and determine what we were looking for (something big and pink.)

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The kids got to pull out the assortment of items our patient ingested: a ball, a sock, a rock, and to see how they would lodge in the pylorus as there was no way they’d fit into the intestines.

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I could easily have had two dogs going, but as I had to re-stuff the dog after every surgery I had my assistant prepare the surgery table while the next group waited.

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Unsurprisingly, the c-section was a big crowd pleaser. We had only one person run off in horror when they figured out what was going on, and it was a dad.

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I wrapped the puppies in saran wrap “membranes”. For the little kids who weren’t quite up to delivering a puppy, the bigger kids could hand them a puppy to wrap in a towel, remove the membrane, and stimulate them to breathe (you see one in the lower left corner). Worked like a charm.

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Even the moms learned something, as in, “dang, that’s a big uterus.” Yes, it is.

The kids were all very concerned after to make sure the dog was closed and “woken up” after surgery was completed, all except the older boys who wanted to pull all the organs out and play with them. There’s something for everyone here at the clinic.

And the best part of the night were the kids who realized there were two surgeries and came back for more. Mission Minion recruitment accomplished!

Filed: Blog, Daily Life, Featured Posts, Goofball Antics, Lifestyle, Mother of the Year Tagged: , ,

Two things people always say when a pet dies at home and other DeathLord lessons

Life is weird in lots of way. Things happen for a reason, and you have to kind of be open to what life’s going to throw at you because you certainly aren’t going to expect most of it. Even the good stuff. Especially the good stuff, which is often hidden in bad stuff.

When I go to a house for a euthanasia, people invariably say one of two things:

1. This must be so hard.

2. I wish we had this for people.

The answer to both is “I agree.” The interesting part is that they co-exist.

Lots of things we deal with in life are rotten: losing an eyeball, I imagine, would be hard. Crawling through the Amazonian rainforest naked and afraid with no water. Chaperoning a group of fifth graders on an overnight field trip on a boat you can’t escape from. All of them hard, and none of them leading me to say, “gee, I wish I could replicate this experience for my family and loved ones.”

Death is hard. It can also, in certain circumstances, be good. Not always. Sometimes deaths are horrible and tragic and cruel, and when we see that we fear it, and forget that many times it can also be meaningful and loving and bittersweet. We need to cherish those experiences to give us the strength for the times it is not. We need to learn that we can talk about it and lean on each other and be there, really be there, in every way we can.

This is what I do as a hospice vet, and while it is very true that this is in my opinion the best way for a pet to experience death, I have found the ones who benefit the most from the experience are the people, not only for their pet but for their whole idea of what death is about.

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Pets don’t know what death is or that it is coming. The fear they exhibit in the clinic euthanasia appointment is fear of the clinic thermometer, because when I go into a home to euthanize a pet I cannot tell you how many very ill pets look up, give me a wag and a lick, and in essence signal to their families that they are ready. It’s quite stunning to see.

When I submitted a talk for Ignite San Diego titled “I’m the Angel of Death, Now Gimme Your Kids” I think I freaked out a good 95% of the attending audience who had no idea who I was or why I wanted to steal their dumplings. By the end, though, I think they all realized that no, really- it’s a good thing to learn to move forward without fear. Pets teach us so much, from the moment they arrive to the moment they leave us. Yes, even then, if we are open to seeing it.

If you want to hear me sum it up in 5 minutes on the nose, here’s the link:

Filed: Blog, Daily Life, Featured Posts, Features, Musings Tagged: , , , , ,

Vaccine vs Disease, Parvo Edition: an Infographic

Vaccines are a complicated topic, let’s start with that. It’s impossible to break down the conversation into something so simplistic as “Vaccines: yes or no”. Some are more effective than others, some prevent more severe diseases than others. There are some vaccines I did not recommend (hello, FIP) and others I was adamant about (parvo!) when I was in general practice. This is why you should have a good relationship with a vet you trust, who is willing to have a dialogue.

On the other hand, when people are wading into the quagmire of what to vaccinate for and when to boost it versus titer it, one thing stands: ALL puppies should have ALL the core vaccines: parvo, distemper, adenovirus-2, and rabies. What you do after the one year booster is between you and your vet, but basic risk/benefit is indisputably on the side of vaccinating young dogs for the above vaccines on schedule.

I think sometimes people forget how awful some of these vaccine preventable illnesses are. If you’ve ever seen a puppy dying of parvo, you would never miss that vaccine for your pet again.

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Filed: Blog, Daily Life, Dogs, Featured Posts, Features, Health Tagged: , , ,

Candy Pee and Me: How Big Pharma Seduced Me at NAVC

It’s been entirely too long since I’ve posted, and for that I apologize. I’ve been terribly busy responding to nastygrams depositing my checks from Big Pet Food sneering at plebians going to a continuing education conference this past week, and what a week it was.

Like many of you, I read the Indy Star’s expose about the loose strings of pharmaceutical companies (or, in internet conspiracy parlance, Big Pharma) at continuing education conferences such as the one I was going to attend, and also like many of you, I was surprised. And excited. I had no idea this was what I had to look forward to! I thought I was just plunking down a couple grand in fees, airfare, and hotel for a measly week of polishing my science know-how, and here’s this whole seedy underbelly of riches I had no idea existed.

I arrived in Orlando for the North American Veterinary Community Conference with 16,000 of my closest friends energized, ready to be plied with jewels, cash, and cars. Kind of like The Price is Right, but with drugs.

In the past, I’ve wandered the exhibit hall for a breather in between talks, taking a peek at the new products on the market. Sometimes the companies would give us candy, or pens- enough to get us to stop by and familiarize ourselves with the product, but not enough to justify actually changing how we practice medicine. I would have done it anyway. Because becoming familiar with new products is, you know, what we’re supposed to do.

I wanted to start my day with one of the storied free food lectures, hoping to begin my morning with roasted pheasant and perhaps a fluffy souffle. Then I learned you had to get up at 6:30 and the most they could guarantee was that the food was “hot,” so I passed and had a Kind bar instead.

"All we need is cantaloupe and these vets won't know what hit them."

“All we need is cantaloupe and these vets won’t know what hit them.”

After a few am lectures about respiratory distress, where the speaker (and every other one at NAVC) carefully informed us about their financial ties- or lack thereof- to the topics of their talk, I hit the exhibit hall in search of fortune.

Somewhere past the forceps booth and to the left of the lasers, a long line started to snake through the aisles and out into the halls. Whatever they were giving away, that had to be good.

“Excuse me,” I said to the woman at the end of the line. “Is this where they’re handing out free cars?”

“No,” she said. “This line is for Build-a-Bear.”

“This huge line is for Build-a-Bear?” I asked somewhat incredulously. The three men in front of her turned around and to a one muttered something about little girls at home. It’s cool, guys. Everyone likes Build-a-Bear.

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“Where’s the contest where everyone wins something?” I asked, and they directed me over to the east hall, where a bored looking woman instructed me to spin a ‘wheel of parasites.’ I won a chapstick with a picture of a tapeworm on it.

As I continued to wander, I heard some grumbling from around a corner, where four people were congregated around a woman clutching a big bag. “Where’d you get that?” they asked her, and she pointed to another long line snaking through the hall.

“Is that the jewelry line?” I asked.

“No,” they said. “This is for the stuffed Olaf.”

“Like Olaf from Frozen?” I asked.

“Yes,” a woman replied, “but you have to be careful. They’re really hard to get. You have to go through a screening process.”

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“What sort of screening process?” I asked.

“No one knows,” she said. “All I know is that they keep turning people away who don’t own practices. I think they sell some sort of financial services. It might involve an application and a credit report.”

“I’ve tried three times for an Olaf,” said another woman. “They’re not very nice about it.”

“Isn’t Frozen kind of old news anyway?” I asked, but that was apparently not the right question to ask.

Dispirited, I walked into the booth of a large pharmaceutical company. “If I listen to your spiel,” I asked, “What do I get?”

“Information,” the rep said, pulling out a sheaf of papers.

“No car?” I asked, disappointed. “Or a trip somewhere?”

She dug into her pocket and pulled out some mints. “I have these,” she said, then brightened. “Or a pen! Do you want a pen?”

“I’m OK,” I said. “I think I just need something to drink.”

“They have coffee over by that pet food display,” she said. “I think the line’s down to 15 minutes.”

By this time, the line for the Build-a-Bear had disappeared, and in exchange for giving a journal my email address, I was presented with a small, naked bear.

“We’re having a contest tomorrow for some scrubs,” the booth person said.

“For me?” I asked. “Or the bear?’

“For the bear.”

After an hour or so of this, my tally of freebies was as follows:

-One naked bear

-A bedazzled lanyard

-chapstick

– 15 pens

-one urine container filled with yellow candy (this was actually my favorite)

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“Why do you think these lines for all these freebies are so long, do you suppose?” I asked my friend Kristen. “Are we that hard up for stuff we’d wait for half an hour just for a chance to win a free ipad?”

“You’re veterinarians,” she said. “Of course you are.” Touche.

After a long day of lectures and wandering, I had worked up an appetite, so I set out in search of the free feasts. I searched every corner of the hotel, and couldn’t find a single one. I realized everyone must have gone to the free rock concert instead.

“Free concert?” I said, intrigued. Maybe there was some credence to this Indy Star thing after all! “Who’d they get? Dave Grohl? Bruno Mars?”

There was a long pause as my friend flipped through the conference brochure. “38 Special,” she said.

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“38 Special?” I replied. “Are those guys still alive?”

“Apparently.” Pause. “My dad’s gonna be so jealous. He almost took a cruise with them last year.”

Hungry and alone, I went to my room at 10 pm and decided to order room service. After 15 minutes on hold, I placed an order for a Cobb salad and was told it would be an hour and a half, because shutting ourselves in our rooms alone with our papers is apparently a popular choice for veterinarians. I’m so predictable.

 

Filed: Blog, Daily Life, Goofball Antics, Lifestyle, Musings Tagged: , , , ,

On the tenth day of clinics…

On the tenth day of clinics, my clients brought to me:

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9 beggars prancing

8 screws a-stabilizing

7 mites a-swimming

6 Old Souls Graying

5 Moldy Rings!

4 Gastric Grommets

3 Dead Pens

2 Blown Up Gloves

And a linear Foreign Body!

Filed: 12 Days of Petmas, Blog, Daily Life, Features Tagged: , ,

On the ninth day of clinics

My boarders gave to me:

beggars

Hold on! That’s eight? Where’s number nine?

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Hamming it up by the ham, of course.

8 screws a-stabilizing

7 mites a-swimming

6 Old Souls Graying

5 Moldy Rings!

4 Gastric Grommets

3 Dead Pens

2 Blown Up Gloves

And a linear Foreign Body!

Filed: 12 Days of Petmas, Blog, Daily Life, Features Tagged: , ,

On the eighth day of clinics

Hey everyone, thank you for all your kind words and your sharing the piece I wrote the other day. All of the commenters coming on here and talking about how much they love their vet and feel they have a wonderful collaborative relationship is the best Christmas present you could give me. Truly. OK! Now I have to get back on schedule so we’re done by Thursday on the 12 days of clinics!

My Newfie gave to me:

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7 mites a-swimming

6 Old Souls Graying

5 Moldy Rings!

4 Gastric Grommets

3 Dead Pens

2 Blown Up Gloves

And a linear Foreign Body!

Jessi, who sent me this radiograph, writes: “this is my Newfie, Xander after his first TPLO — 8 stainless screws….”

Note the way she said “first”. BTDT! Thanks Jessi and Xander!

Next one also coming up today! Stay tuned.

Filed: 12 Days of Petmas, Blog, Features Tagged: , ,

On the seventh day of Clinics:

My bald dog gave to me:

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6 Old Souls Graying

5 Moldy Rings!

4 Gastric Grommets

3 Dead Pens

2 Blown Up Gloves

And a linear Foreign Body!

Filed: 12 Days of Petmas, Blog Tagged: , ,

On the sixth day of clinics…

My clients brought to me:

 

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5 Moldy Rings!

4 Gastric Grommets

3 Dead Pens

2 Blown Up Gloves

And a linear Foreign Body!

Filed: 12 Days of Petmas, Blog, Daily Life, Features Tagged: , ,

On the fifth day of Clinics

On the fifth day of clinics, my ref lab sent to me:

moldy rings

 

4 Gastric grommets

3 Dead Pens

2 Blown up Gloves

And a linear Foreign Body!

Filed: 12 Days of Petmas, Blog, Daily Life, Features, Goofball Antics Tagged: , ,

On the fourth day of clinics

My clients gave to me:

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3 Dead Pens

2 Blown Up Gloves

And a linear foreign body!

 

Thank you to Jessi J for the radiograph! She writes: “Boo ate a leather drawstring bag, and my only clue were a few remaining pieces of string. The radiograph was our confirmation…” 

Filed: 12 Days of Petmas, Blog, Daily Life, Features Tagged: , ,

On the third day of Clinics…

 

On the third day of clinics, my best tech gave to me:

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Two blown up gloves

And a linear foreign body!

 

 

Seriously, the agony of a stack of dead ballpoint pens when you just want to finish your records and go home still haunts me.

Filed: 12 Days of Petmas, Blog, Features Tagged: , ,
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