Thursday, December 17, 2015

the greatest gift

Love is that priceless joy of stroking a kitten sitting contentedly on your lap, her wanting to be right there more than anywhere else in the world, that, when she is suddenly, tragically, gone, leaves a hole in your heart big enough to drive a truck through it.  My wish this Christmas is that even in these troubled times, this season and ALL of God’s creatures remind us again of what love is and what it isn’t. That there may be Peace On Earth.

Friday, June 13, 2014

Pepto and Chicken Soup

Pepto and Chicken Soup for a Diamond in the Ruff
     Diamond is a very sweet, very smart, very pretty female pit bull terrier at the Lycoming County SPCA.  Whoever takes her home is getting a great dog. She also is one of the pioneers in Lyco SPCA’s new in-house surgical/medical program. I’m Dr. Lund and I have the honor and privilege of being head of that new division in this progressive, upbeat shelter’s efforts to make every animal’s time spent in their cages the best thing that ever happened to them…instead of the worst.
     Yes, you heard all of that right. I just used the words “sweet,” “smart,” “pretty,” and “great dog” to describe a pit bull. If that doesn’t fit for you, a visit with Diamond and some of our other pit bulls just might change your mind. Have our trainer Tracy tell you about them. She gets to know our dogs very well so as to carefully help the staff match them with the right home. And I just described shelter work as an “honor,” and “privilege,” as well as “upbeat.” Surprised me, too, that this is the reality and how I’ve felt about this incredible job/place every week for the ~six months now that I’ve been there.
     We spayed Diamond last week so she’s forever part of my career as one of my teachers as well as one of Lyco’s pioneers. So what’s the big deal about a dog being spayed? In my heart surgery is a BIG deal for any animal that has to have it. You see I went to vet school late in life, so I’m a “new” vet (just starting, at 55 years old, to perfect my surgical skills). I’m old enough to remember when “routine” and “surgery” were not words commonly associated with each other. Shoot, I’m old enough to remember Hippies, bell bottom jeans, and when we said dorky things like “groovy” and thought we were cool. I was eleven when I watched Neil Armstrong take those first steps on the moon in real time…on black and white tv…with no cell phone or social media to chat about it—not even a microwave to make popcorn to eat while witnessing one of the most incredible accomplishments of all time for the human race from this planet Earth. So I also remember a time when surgery and the decision to take life into human hands was something that was always taken very seriously…as it still should and always be.
     Diamond’s spay went very well—Thank you Diamond for being one of my heroes who have helped me build my skills, confidence and knowledge. Diamond’s recovery did not go well. Don’t panic. She woke up well (amen—anesthesia, common though it may be is still one of medicine’s miracle mysteries. It works, but we still don’t really know why…nor why it sometimes doesn’t) and she was a typically stoic pit bull for a few hours about the fact that she’d just had surgery. But she started puking after that, rapidly feeling more and more horrible, even letting out a short low growl at one point when people were trying to help her with positioning and clean bedding—this was an extremely uncommon thing for her to do according to the kennel staff that knows her well. Actually she had started puking even before she had the surgery equally stoically so we didn’t know about it until she was already unconscious from the pre-op shot (which most likely is what made her feel like vomiting). At that point going ahead and doing the surgery was still the best choice.
     Because I love animals and I DO take the power over life and death very seriously I have a lot of angst about surgery, especially with these elective procedures because whatever happens to my animals because of surgery is something I’ve done to them. They didn’t ask for it, nor did they have a choice. God made sure I can really relate to my spay patients because I had to have my own overohysterectomy (because of a tumor) six weeks before I returned to school at 36 years old when I entered the veterinary professional degree program at the University of Pennsylvania. Like Diamond I’m also extremely sensitive to the potent drugs used for medical procedures. I know what it’s like to feel nauseas and to puke when your abdominal muscles have all just been cut and you’re already suffering the pain of someone lugging and tying and cutting on some of your inside parts. It ain’t pretty.
     It was late (past 6pm) when Diamond yalked the first time as she tried to take her first couple laps of water after her operation. Because we’re a relatively new hospital we have a good supply of drugs on hand for things we know will happen, like pain (even though it is expensive, all of Lyco SPCA’s surgical patients get state of the art pain protocols—they’re not “just shelter animals” to us and never will be), but we’re not well stocked yet with some of the modern miracles to treat things like this that might happen. Because we’re a non-profit that is very conscientious with donated dollars there always has to be a balancing of cost versus ideal preparedness. I’m also conservative about how quickly I add one drug to try to counteract a bad side effect of a previous one (I’m old enough to be out of that era of medicine as well). Since Diamond’s throwing up had started with her trying to drink, we decided to just hold off all food and water for the night. We gave her another injection of pain meds since she couldn’t handle anything in her stomach, and hoped for the best by morning. She’d had intra operative fluids so dehydration wasn’t an immediate concern.
     I went home thinking about Diamond. I slept thinking about her. And I woke up thinking about her, hoping she felt better, hoping there was a practice near us that could spare a dose of Cerenia (modern anti-nausea drug) for her if needed even though I’d never prescribed it before.  The shelter enjoys a good relationship with the nearby veterinary practices, and I’m sure one of them would have helped us but just in case when I spied my bottle of “the pink stuff” as I left my house I took it with me. I could relate to Diamond’s pain and distress because my own body has similar reactions. It wasn’t unreasonable to hope that she might also have similar reactions to remedies that work for me. Along with Hippies and Neil Armstrong, Pepto Bismol (cost to treat a dog about $0.10 if that) is one of those things I remember. Mostly I remember it working, almost instantly.
     Diamond was reported by the staff to have already tried to toss her cookies several times by the time I got to the shelter on post-op check day. This was truly bad now because it was dry heaves… with just cut abdominal muscles. And at this point I did have to start to worry about dehydration and that making her even more nauseas.  She was still being tough, still wagging and responding to her favorite kennel staff folks, but the look in her eyes showed she was struggling.
     The pink stuff was worth a shot because she could get it immediately rather than having to wait till we located and picked up a dose of Cerenia or whatever. She hesitated just a moment as the syringe was brought to her mouth. This dog was smart enough to know at this point that she felt worse whenever she tried to eat or drink anything. But trust prevailed with this good dog. She took her dose of Pepto from Monica without complaint. I watched intently. I exhaled as she also “smiled” when instead of feeling like she needed to yalk again after swallowing something she suddenly felt better. (I remember that smile—it was the one on my face when my mother gave me that slightly minty pink potion when I was similarly sick as a kid. I remember how immediate the relief is.) Her pink tongue came out to catch the last pink drops that hadn’t quite made it past her lips. I do believe she liked the minty taste, too.
     We gave her another dose about an hour later with the same “I feel a little better” result. It was time to try to get some water and nourishment into her. Straight water is usually not the easiest thing for a recently upset stomach to accept so I again went back to my often sickly childhood for more remedy. Coca-cola for the pit bull probably was not a good idea even if it worked well for me, but chicken soup, now that had potential. We went to the canned dog food cupboard, on a mission now because I really wanted to get this poor dog back on food and drink. I read the label on the two gastrointestinal veterinary diets we had…and was appalled. No, not my Diamond—How on earth do they think that junk is “good” for a touchy gut? Kelli located a can of Iams chicken and rice. Now we were talkin’. “Chicken” and “rice” were the first two ingredients in that order. Imagine that. And the rest of the ingredients weren’t obscure organ parts or other items that sounded like discards from the slaughterhouse floor or worse like the “veterinary” diets (I wondered if I should be embarrassed by that label).
     We took just about an eighth of a can and mixed it with a good amount of warm water to offer Diamond some “soup,” for her touchy tummy. She gave both of us a look that said, “Are you sure?” when we placed the bowl in her cage. Trust was part of this treatment protocol, too.  She’s a dog that’s very polite about food. She waited till we closed the kennel door, got up carefully, and took a sniff and then a lap or two. She got that same little “smile” as she realized it wasn’t coming back up. Even though it was obvious that this tasted VERY good at this point in her ordeal, she still consumed it slowly and carefully.
     She took several more similar small meals I offered her throughout the day, with one more dose of Pepto later for insurance. Our Diamond was doing ok. I was getting wags now when I peeked in to check on her just like her favorite kennel people. I again counted my “blessing” of a lot of illnesses and injury in my life that let me relate to my patients far more than I believe I could if my life had been a model of perfect health. Silver linings come in the oddest packaging at times, but I do now know God has given my life the path it has had for some very good reasons. We will continue to mix the best modern medicine has to offer with inexpensive old time remedies (that work), throw in some seasoning of trust and common sense…and love…along with dedicated work, commitment, and a little veterinary/ scientific ingenuity (maybe I will write about cat cures with horse flu vaccine next time… or good ‘ole penicillin…the heebeegeebee shot according to Hayley) to bring a brighter light of hope, health and home to the path of each of these animals whose walk in life intersects with our own.