What, is that Smell?

I love mentoring because I usually learn as much as the mentored. Yesterday I was discussing a case with Dr. Berning, our new associate. My patient, an elderly cat had presented with decreased appetite and lethargy. With a history of hyperthyroidism, multiple missing teeth and several strokes that had resulted in hearing loss, there were many possible causes. In addition, through x-rays and ultrasound, we had discovered a large cyst in front of his heart.

We decided to tap the fluid off the cyst using ultrasound guidance, hoping that, if this was the main problem, we'd see immediate improvement. We also temporarily stopped the thyroid medication since long term use can result in toxicity in some cats. Dr. Berning suggested that another factor might be loss of sense of smell due to the strokes. This made sense since he seemed to prefer fish based foods. With this in mind, we recommended offering these foods, either alone or on top of the regular diet, warming the food, and continued use of an appetite stimulant. Thanks Dr, Berning!

(Interestingly, this patient was exposed to debris from 9-11. Living a mile downwind, he was outside when much of the debris permeated this neighborhood. I don't know that the cyst is related, but cysts are unusual enough that the link must be considered.)

Germs vs Man

Another recent headline: Iodine, Alcohol Prep Pads in Kits Recalled. Guess why.
Bacterial Contamination! Add this to the list of food and pharmaceutical recalls that have taken place over the past several years due to chemical, bacterial, and particulate contamination. In today's mass manufacturing environment, it isn't suprising that these recalls occur, but bacterial contamination of antibacterial materials stands out. Imagine the fallout if a production lot of hand sanitizer became contaminated! This is yet another reason for common sense prevention-hand washing with regular soap and water, sterile technique in hospitals, and judicious use of antimicrobials.

Dog Bite Prevention

A recent headline in one of our trade journals reads: "AVMA, Postal Service Join Effort to Prevent Dog Bites". Although this brings to mind an almost comical image of a mail carrier being nipped at by the family dog, anyone who has been bitten, myself included, knows this is no laughing matter.

Two stats from this article are worth noting. Medical expenses for the 5,669 postal employees that were bitten in 2010 amounted to $1.2 million. And one third of homeowners claims in 2010 were for dog bite related inuries, costing $413 million!

My two most memorable bites were early in my career. Actually the first was at a clinic where I was volunteering as a teenager. I was holding a large shepherd for an injection and he whipped around a grazed my shoulder. It didn't do much damage but seeing how easily my face could have been damaged gave me a healthy appreciation of adequate restraint and the ability to read body language.

The second was with a little terrier that I knew was a biter. She seemed relaxed so I carelessly reached into the cage and she bit me right through my fingernail. That little gift from her stayed with me for a good 3 months!

Biting is one of the most difficult behaviors to correct. Proper socialization and temperament testing can go a long way, so start early with your own pets and educate yourself and your children about approaching other dogs. More in this AVMA brochure.