Moving On

I really enjoy my job. I get to see an amazing array of animals and diseases. I am constantly learning new things. The lab’s clients are interesting and entertaining. It’s a work in progress, but I think that the lab section that I supervise is running pretty smoothly. 

But this job doesn't define me entirely. As much as I look forward to coming in to the lab each morning, I don't live to work.  

The stress points of this job have changed over the years I’ve been here. The old incinerator was a huge source of drama and stress. We got a new unit in the fall of 2024 but the hoped-for reduction in drama and stress didn’t show up right away. There were significant operational growing pains and I was still spending entire days and even weeks on the phone with the manufacturer trying to diagnose problems. I performed many of the repairs myself. But things finally settled down with that.

In the past year or so, an entirely new source of stress has popped up. Arkansas currently doesn’t have a school of veterinary medicine, but by this fall, it might have two! Arkansas State University in Jonesboro is nearing the end of the approval process with the AVMA and hopes to start their program this fall. The other school is associated with Lyon College. This private school of vet med is being backed by venture capital. Neither school is building a teaching hospital. They are using a distributed model in which third- and fourth-year students complete required rotations in private clinics and at other vet schools. Both ASU and LC want to send students to my lab for necropsy training.

Our lab is old and small and resources are limited. ASU is being reasonable and has agreed to send no more than 40 students through our lab each year. That is a lot but it should be manageable. Lyon College is not being reasonable. They want us, that is, me, to deliver necropsy training to entire cohorts.

Putting aside the fact that the mission of the lab does not include teaching, the fact that I’m only one person, the fact that we literally don’t have enough space to have that many more people in necropsy, there’s the issue of Lyon College itself.

Lyon College will have few entrance requirements beyond the student’s ability to pay. The VC funding behind the new school is focused on profit, and the losers in that scenario are the students. The dean they hired has a particularly unsavory past. I’ve repeatedly expressed my concerns about the lack of space and resources as well as my reluctance to partner with Lyon College in general. I’ve been told that this partnership will happen no matter what.

The people making that decision are not factoring in one very important variable. I have a choice. And I’m choosing to retire far sooner than I would have if they had not forced Lyon College on me. I will be out before the first students from either ASU or LC come to the lab.

I met with my financial advisor yesterday. He assured me that my portfolio can accommodate this change. We had a great in-depth discussion about my options. He’s good at his job and has really listened to me. I’m already making plans!

 

Ice Storm Hijinks

 It has been a warm, dry winter in central Arkansas this year but January is always full of surprises. Last weekend, we got hit with a thinning edge of the big storm that affected so much of the rest of the country. Arkansas is not prepared for ice and predictions were dire. I stockpiled water and food and staged blankets and crates in the upstairs guest room in case we lost power and I needed to set up a warm room. Since I don't eat much processed food, I cooked for a couple of days and filled all my food containers. 

We didn't lose power or water, thankfully, but we did get hit with three separate deposits of sleet and ice. The dogs are okay with going outside on their own but when it was o'dark thirty and blowing horizontal ice, Frankie had to be pushed. They did a lot of their business directly under the deck.  

The storm had mostly finished by Sunday morning so I opened the garage door to assess the situation. I found a 2 foot tall, 3 foot tall berm of ice snugged up against the length of the garage door. I obviously wasn't getting the car out until that was gone. It took me 3 hours of shoveling to move the berm. 

 

 While I was out there, I did some exploratory chipping and shoveling a little farther out on the driveway to see what I was dealing with. It didn't look good. Since it was mostly ice, the snow shovel wasn't rigid enough. I had to stab down with a regular shovel to break it apart then use the same shovel to move the chunks.

 

The weather on Monday was clear and sunny. I waited until around noon then spent 4 hours clearing the upper half of the driveway. My driveway is long with a slope to the street. This took another 4 hours of work with the regular shovel. The ice was too thick and the chunks were too heavy to move with the snow shovel. It was quite tedious. I finished the job on Tuesday and spread some grit I had left over from my wall projects on the remaining patches of ice. The street was still impassable but that was going to take more than my efforts to resolve.  

 

The fox terriers were running around in the backyard across the top of the ice like Legolas from LOTR, leaving no footprints. We went out every afternoon and played fetch with a tennis ball. It was very cold but sunny and clear. 

With time, the ice compacted down to a glass-smooth surface. So yesterday, when Frankie blasted down the deck stairs and headed out to make her usual perimeter run, she slipped and fell on her side. She had a lot of momentum and started sliding across the sort-of flat middle part of the yard, bounced off the top of a rock wall (I thought for sure she would fall over the edge), and finally slid to a stop against a tree. She easily covered 50-60 feet on her side. She stood up, gave herself a shake then very carefully began to make her way back up to the deck stairs. Since my seat in hell is already reserved with an embossed place card, I was on the deck doubled over with laughter for the entire performance. 

 

Reminder

 Locum work, also called relief work, has always been a thing in both the human and veterinary medicine fields. Oddly, it seems like it's mostly nurses from the human side who do locum work, while it is DVMs who travel around in vet med. When the world turned upside down during COVID-19, locum work really took off to the point where it has become a solid career option for some veterinarians. 

Some assignments can last for months, such as covering maternity leave for a regular employee, while others consist of an occasional overnight or weekend shift. Some practitioners use locum work to travel widely, while others stick closer to home. There are companies who will find locum assignments for you (for a fee usually), or you can arrange them yourself through personal connections. 

Locum work can pay really well. DVMs covering overnights at an emergency clinic can earn over $1500 for a 12-hour shift. That's a car or student loan payment or money saved for a trip. You can be paid as a regular W-2 employee or as a 1099 contractor, which is a bit more complicated for tax reporting. You have to arrange DEA licenses for each location that you work at. And if you travel, you'll need a license to practice in each state. All of that is just bookkeeping. Quite manageable. 

Locum work isn't for everyone. It takes a certain personality and ability to walk into a strange clinic with pre-existing technical protocols and interpersonal drama and get right to work treating patients. To add to the stress, a DVM, locum or otherwise, is expected to be a team leader. It doesn't matter if you don't know where the bathroom is. A relief practitioner needs to both check their ego and take the lead. 

I've started picking up Saturday shifts at a local clinic. I only do one shift per month, and sometimes skip a month. The clinic is corporate, meaning it is owned by a much larger company, so I was hired as an hourly employee with W-2 wage and tax reporting. 

Why would I do this when I have a perfectly good job? There are lots of reasons! For starters, when I pick up a Saturday shift, one of the regular vets gets to spend that day with their family. Burn out is a problem in vet med. I'm helping out my colleagues.

While that sounds terribly noble, there is also a selfish reason that I'm doing it. I get to put my hands on living animals. I get to practice medicine. I absolutely thrive as a veterinary pathologist and am good at it, but working a Saturday in the clinic reminds me why I spent all that time and money getting the DVM degree. 

Because of the many bad habits I've picked up from being a pathologist, I told this clinic that I would absolutely not do surgeries, dentals, or even laceration or wound repair. I would only take wellness clients. I would be okay with giving vaccines, but no other sharp things should be put in my hand, ever. And they are fine with that! 

I see between 14 and 18 clients per shift, which is a lot. Each time I do a relief shift, my hands and brain remember physical exam skills that I learned in school but haven't had a chance to use since I graduated. Sure, we do physical exams before a necropsy but we are evaluating very different things about the animal in front of us.

 The owners I work with are in a different place too. They are bringing their pets in for wellness exams, vaccines, parasite preventatives, nail trims. Simple stuff. Basic health care. For the most part, they are relaxed and calm. It's a different world.  

There's another reason I'm doing this. I've already started to think about retirement from my current job. I'm still a couple of years out but now is the time to start planning. By keeping my skills up and my connections solid, I can step from my current job into part-time relief work without a break. I am grateful that I have that option. 

 

Wall

 My backyard is quite steep, the soil is poor, thin, and rocky, and there are lots of mature oak and walnut trees. Erosion is a problem and I’ve been experimenting with different ways to manage it. I don’t want to put down sod because I don’t want to waste water on it or deal with the tons of chemicals it would need to remain alive on the aforementioned shitty soil. Clover does okay in some spots. It dies back in the summer but the roots remain and they help hold things in place. Throwing clover seed around isn’t going to solve the erosion issue however.

The biggest drainage problems are in the two farthest corners of my yard. After watching dirt pile up against the fence in those corners, I needed to get serious about fixing the problem this year.

I decided to build a retaining wall using those 22 lb paver blocks. Going into the project, I wasn’t sure I could do it. Conceptually, building a retaining wall with pavers isn’t hard. But there were complicating factors for this particular wall.

This was my first attempt at such a project, and of course I chose an area where I had to step up the bottom course FIVE TIMES to accommodate the natural change in elevation. It also took more blocks and paver base than I expected. 

 

 

 

Since I wasn’t ready to commit to an entire pallet of blocks, I got 18 blocks at a time from Home Depot. Because they are heavy, I could only move 4 at a time in the wheelbarrow. And because my yard is so steep and there are other barriers in place, I had to navigate half a dozen switchbacks for each trip. It took me an hour to move 18 blocks from driveway to the job site.

I teach dog classes on Sundays, so I could only work on the wall on Saturdays. Like most normal people, I have other stuff I also need to do on the weekends so I really could only work on the wall for a few hours each Saturday morning. It took 5 weeks to build it, including 6 hours to dig the initial trench. 

 

Is it perfect? Of course not. It’s not even all the same color because Home Depot ran out of grey blocks and I had to finish the wall with tan ones. But it’s reasonably level. I managed to work out the step-up process after a couple of false starts. And I did it all myself. 

 

 

There Are Always Surprises

In the lab, we conduct necropsies on all species, including companion animals (dogs, cats, small exotic mammals, reptiles); horses (racehorses, horses used for trail riding, barrel racing or other sports); wild animals; food and production animals (lots of poultry); animals used for research; animals kept in zoos or raised for display or exhibition; animals submitted by rescue organizations, animal shelters, or law enforcement that are involved in cruelty or abuse cases…the list goes on!

In the past couple of months, this is a cross section of cases I’ve worked up.

Chukar (a type of partridge) and quail raised for commercial hunting operations. One of each was submitted for necropsy. The birds were wasting and dying. I noted that the mucosal layer of the crop of both birds had thick rumpled folds. Histopathology identified crop worms (Capillaria spp.). That was the second time I’ve seen that pathology in quail.

A five-year-old blue and gold Macaw. Three weeks of listlessness, anorexia. Found dead in the cage. I noted that the proventriculus was dilated and flabby. Approximately 50% of the mucosal layer had been eroded off and the tissue was so thin it was transparent. Proventricular dilatational disease is a viral disease that affects psittacine birds. The virus causes neuropathy, most often in the nerves of the digestive system. It’s so common in macaws that it is informally called “macaw wasting disease.”

A dog that was found dead in the neighbor’s backyard. It was submitted by animal law enforcement officers from a nearby city. They suspected that the neighbor’s dog had killed it. I documented extensive lesions and trauma consistent with an attack by a larger animal. While we photograph nearly every necropsy case, legal cases like this one result in more extensive photo documentation.

A piglet that was part of a heart valve transplant research program. The piglet developed a persistent infection along the line of the surgical incision in the chest and body wall that was made when its main pulmonary valve was replaced with a valve from another piglet. Because it was on so many immunosuppressive drugs as part of the transplant protocol, antibiotic treatments could not effectively clear the infection. While not a legal case, the purpose of this necropsy was to document everything so these results could be factored into the research project.

A dozen, 15-day-old commercial broiler breeder pullets. Histomonas meleagridis is an amoeba that lives in the guts of cecal worms, a type of round worm with the formal name of Heterakis gallinarum. The worms are specialized to only live in that part of the chicken’s intestinal tract. Most chickens have a few cecal worms, and usually the amoeba isn’t a problem. But if the cecal worm burden gets too heavy, the amoebas can migrate out of the cecae and into tissues such as the liver where they cause severe systemic disease. The amoebas can also be shed in feces and can persist in the environment for quite a while. Fifteen days is too short for these birds to have developed a heavy burden of cecal worms (the worm life cycle is longer than that). Instead, the birds had to have picked up the amoebas directly from the litter. Where did the amoebas come from? From worms in the guts of previous flocks of birds run through that poultry house. In the US, litter is not cleaned out of poultry houses between every flock. As many as five or six flocks may be run through one house before all the litter is removed, the house is disinfected, and new litter put in.

Raccoons with distemper. Dogs with heartworm disease. Cats with feline hypertrophic cardiomyopathy. Rabbits with respiratory disease caused by Pasteurella. Cows with pneumonia and emphysema caused by eating perilla mint.

Veterinarians are expected to have knowledge of anatomy, physiology, and pathologies of many species, and how those vary with age, sex, and reproductive status. We also need to have some idea of husbandry and how the animals are used. The differentials for a 3 week old calf are quite different from those for a 5 year old cow who had her third calf earlier in the summer. And those differentials are a universe away from what I need to consider for a backyard laying hen or a kitten from a shelter.

Nothing is routine about being a veterinary pathologist. You have to pay attention because there are always surprises. It takes a lot of work to build and maintain a solid foundation of knowledge and expertise. And it’s not accomplished by one person working alone. I’m lucky to have reasonably sane colleagues and hard-working technicians. 

I like this job a lot. It opens a fascinating window into the pathology of so many different types of disease. It can sometimes be emotionally stressful for us, but it can be very satisfying to work up a case and get a definitive answer that can help a pet owner find some closure or help a farmer be more successful going forward.  

Afternoon Sun

 Frankie is a very busy dog. She will not settle as long as a person is around who could be cajoled into throwing a ball or toy for her. When I am in the kitchen, she will forcefully push a toy into the back of my legs or repeatedly drop it on my feet. Oh, you think that just ignoring her will cause her to stop? She interprets that as you not liking that particular toy and will bring you another one in short order. She is relentless, confident that she will wear you down eventually.

She is quite good in pens and crates, however, and will settle quickly. Many calm evenings are spent with Frankie in her playpen in the living room and Archie stretched out next to me on the couch while I read or watch TV. At trials and during class, she waits calmly in her crate. 

With the arrival of cooler weather, I've been putting her in an expen in the backyard when I come home for lunch. This has several advantages: Archie gets to hang out with me, I am not constantly harassed to play, and she gets to sunbathe. 

 

I know the picture is blurry. There is a double-paned window, screen, deck railings, and expen between the camera and Frankie. But she's calm and relaxed, soaking up the afternoon sun.

 

Up Close And Personal With The Anaerobes

Earlier this week we had a cow on the necropsy table. Various factors, including the fact that we have to incinerate during the day and the long holiday weekend, resulted in this cow being in our walk-in cooler for 6 days before we could get to her. The owner had dropped her off with another cow. I tried to talk him out of bringing two but he insisted. So now I had to do a necropsy on a rotten cow that was going to have zero diagnostic utility. 

A few minutes into it, I stabbed my arm with a very sharp, very contaminated knife. The wound was not large, and we quickly cleaned it with alcohol and slapped some antibiotic ointment and a bandaid on it. But as the day progressed, things began to head south. The area around the wound became firm, hot, had a faint purple tinge, and was welting up. It hurt to move my arm. Even brushing my arm against my shirt was quite painful. By early evening, with this progression of clinical signs, I realized that this was not a routine nick.

Off to urgent care I went. Once I went through the progression of clinical signs and emphasized "clostridium," the staff jumped into action. 

Because of a high risk of exposure to tetanus as a veterinarian in general and as a pathologist in the specific, I get boosters every 5 years. The last one was in 2020, so I was due anyway. Yes, tetanus booster please. 

Then they came in with the antibiotics, a broad spectrum cephalosporin. This one goes IM in the bum and it stings like crazy. I'm writing this more than 2 days after I got this shot and it still stings. 

It took two good nights of sleep and patience, but the miracle of pharmaceuticals knocked that nasty infection down. I have a healing nick in my skin and some bruising (that kind of acute inflammation causes a fair bit of collateral tissue damage), and a sore bum. But I will be fine.

In hindsight, I should have headed to urgent care much sooner, and I will chalk that up to a lesson learned. 

I am grateful that I have a job that provides decent insurance. I am grateful that I have access to health care for acute, emergent problems like this. I am grateful to the NPs at the urgent care who responded quickly and professionally even though it was the end of a long day for them. I am grateful that tetanus vaccines still exist (since I expect vaccines to become unavailable/hard to find/not covered by insurance in the coming months to years, I got measles and shingles vaccinations earlier this year). I mention these things because they are now in jeopardy for many citizens of this country. I'm worried.