Solarium

 Repurposing the guest bedroom. Best seat in the house on a cold but sunny winter morning.

Digging Out and Warming Up

 By no means did central Arkansas get hit as hard as Texas by this terrible week of terrible weather. Sure, there were some power outages, some burst pipes, but these were isolated incidents. For the most part, everyone hunkered down for a week, waiting for the snow to stop, waiting for it to warm up. 

I ended up getting more than 20" of snow at my house. The daytime temps remained in the teens, nighttime temps dropped into single, even negative, digits, for almost 5 days in a row. 

I overestimated my van's ability to handle the snow and ice, and got it stuck trying to leave the subdivision on Thursday. There are only two ways out of my subdivision, and both require climbing multiple, steep hills. At least I managed to slide it parallel to the curb on a relatively flat spot of road located about 0.5 miles from my house. That night, I made two trips to the van with my cart, hauling expensive dog crates back up the hills to my house. When its wheels iced up, I dragged the cart over icy ruts.

On Friday, the sun rose in a clear sky that morning, and it was 36F by 3pm that afternoon. I visited my car twice during the day. But the icy, packed snow was too deep and the roads were still too treacherous. I whiled away the hours by shoveling my very long driveway, front walkway, and back deck. I had to use a regular shovel, which just sucked. 

I anxiously waited for sunrise on Saturday. I planned my morning to the minute and arrived at my car just as the temperature reached 34F. It was going to be a warm, sunny day (it's 45F as I write this) and large sections of the road were now covered with icy slush. 

Using another shovel that I had left in the car on Thursday, it took me almost half an hour to dig my car out so I could get it up onto the packed snow/slush on the road. I managed to white-knuckle that van up and out of the subdivision at last! I aged 10 years and acquired more grey hairs in the process, but once I hit the main road, which had been sanded and plowed, I started breathing again.

Apparently my nutritional choices diverge from a lot of other people's because although there were plenty of bare shelves at Trader Joe's, I managed to get enough food to last for another 10 days or so. I stocked up on cat litter at PetSmart, and decided that was enough of an outing for the time being. I'm back home, van parked in the driveway again, planning to spend the rest of the day cooking.

Disposition of Remains

 The lab director and I often talk about lab activities that would make good PR photos and short articles in the Department of Agriculture and State Veterinarian newsletters. The Pathology section of the lab almost never makes the cut (heh, unintentional pun there). There is no way to make a necropsy visually palatable for public consumption. There is no way to make slicing up hunks of formalin-fixed cow liver into thin sections to make microscope slides fun. And there is a very important component of our section that we can't ever discuss--the incinerator.

I didn't anticipate becoming an expert on incineration as a part of this job, but so it has come to pass. While the monthly totals vary wildly, our small lab incinerates about 25 tons of animal remains a year. Somebody has to be in charge of that, and that somebody is me.

The lab building was constructed around 1973 or 1974, and there is an incinerator built into the necropsy floor. I've been told tales of former pathologists who would perform necropsies on cows and other large animals hauled up on the hoist directly over the old incinerator. Fortunately, that generation isn't in charge anymore, because while it may be efficient, that sort of thing is fucking appallingly sloppy. By the time I arrived at the lab, the old incinerator was being decommissioned and the new one starting up.

The new incinerator is a stand-alone unit attached to a very large propane tank, located in a fenced lot across the street from the lab. It took almost six months of nearly weekly crises to get that damned thing up and running. I made significant contributions to that success, and consider it a professional achievement that I mention on my resume. 

If you were paying attention, you may have noticed that I mentioned the incinerator is across the street from the lab. So how exactly do we get those 25 tons of animal remains over there? It involves very large woven plastic sacks designed to hold many hundreds of pounds, large containers, a truck, and a forklift. It required a lot of planning and training to work out the details. We had to consider optics (can't be hauling bloody bits and leaking bags across the street) and safety while still designing a process that would work.

I know how many pounds we incinerate per time unit, how many gallons of propane we use per hour, the cost, in propane, per pound of material incinerated. Based on observations of burn efficiency, I developed a simple formula to calculate the number of hours we need to run the incinerator per 100 lbs of load. I analyze temperature logs of every incineration event. I have the cell phone number of the propane delivery driver. I arranged forklift operation and safety certification for 10 lab personnel, including myself. I have been on top of the incinerator messing around with one of the thermocouples a dozen different times. I wrote instructions on how to trouble-shoot the controller on wet days. I have chipped ice out of the tracks that the lid travels on to get the incinerator open. I have spent hours out there in all weather with various repair and maintenance guys learning how the burners work. I made worksheets for the technicians to collect the information that I need to fill out official logs related to our operating permit, and when those worksheets proved to be a bit too complicated, revised them and revised them again until everyone can use them correctly.

I expend mental and physical energy on the incinerator nearly every week. The skills I've gained seem fairly esoteric, but they are actually part of the general problem-solving aspects of my job. Incineration of animal remains is an important contribution made by the lab to general public health, but we'll never be able to "showcase" it.

Deep Freeze

 It's cold in central Arkansas. Oh, I already mentioned that, didn't I. But it's REALLY cold, 9F and snowing heavily as I write this. There is so much snow falling that the dogs have been out four times this morning, and other than some undulations of the snow drifts on the deck stairs, you can't tell they were out there at all. 

Snow is usually a fun prospect for most dogs. Not at 9F, however. Azza and Archie are all business, done in a few minutes and ready to come back in where it's warm. 

I am grateful that my house is proving to be fairly well insulated. I added insulation and weatherproofing around the doors when I moved in. I also imposed significant organization on my garage last summer so I can park my van inside. I did it mainly to be able to protect it from all of the sticky tree pollen that falls in April. Little did I know that I would also need to keep almost a foot of snow off of it.

View from my kitchen window.

 

It's going to drop below 0F tonight, and more snow is coming on Tuesday night and Wednesday. Today is a state holiday and the lab is closed anyway, but I expect it to remain closed for most of the week. Little Rock isn't really prepared for a foot of snow that doesn't melt on its own.

Super Easy Egg Bites

 It's super cold here in central Arkansas. I can't work in the yard or play outside. So what's the best way to pass the time, in between reading and napping? Cooking, of course!

I make these easy egg bites fairly often. They are full of flavor and protein, travel well, and don't need to be re-heated. This version is meat-free but not vegan.

Preheat oven to 350F. Place paper muffin cups in a standard (12) muffin pan. 

Chop half of an onion and 6 or 7 mushrooms. Saute gently with olive oil until soft. Set aside to cool.

Chop two large handfuls of fresh spinach and add to a large mixing bowl. Add 1/2 cup of grated parmesan cheese. Add 1/3 cup of milk. I usually only have half-and-half on hand, which works fine too. Break 6 or 7 large eggs into the bowl. 

Add 1/3 cup of chopped tomatoes to the mixing bowl. I use canned tomatoes, which I drain first. You can also use dried tomatoes but the egg bites are more moist if you use fresh or canned. 

Put in whatever spices make you happy. I usually only put in fresh ground black pepper, but basil, garlic, thyme, oregano, and chili powder are all nice choices. 

Add the onion and mushrooms, making sure to scrape all the lovely browned olive oil into the mixing bowl too. Gently whisk until well mixed. Spool into the muffin cups. To make clean up a little easier, wipe up any spills from the surface of the muffin pan before you put it into the oven.

Bake for 25-30 minutes. The bites will puff up a little. When they are done, a fork stuck into the middle will come out clean.

This is an extremely loose recipe--the only limit is the volume of the muffin cups. Don't like spinach? Try fresh basil. Want some animal flesh? Add chopped (cooked) bacon. Want puffier egg bites? Hand-whip some air into the mix before adding to the muffin cups. Black olives, pesto sauce, sunflower seeds or walnuts--let your imagination and contents of your pantry run free!

Head Count

 I performed 259 necropsies in 2020. This represents 63% of all necropsies that we did at the lab last year. Officially, I only do necropsies on Mondays and Tuesdays, so you'd think I'd end up with two-fifths of all the cases, certainly not more than half. But Mondays can be quite busy, and Fridays can be quite slow. And because I'm the supervisor of the Pathology section, I will sometimes take cases that come in on other days that are of interest to me.

One third of those necropsies were avians. And because this is Arkansas, by avians I mean chickens. Okay, we had a peacock, goose, and macaw, and a couple of quail cases. But by far, most of our avian cases are chickens. About half were backyard birds (single bird necropsies) and the other half were commercial chickens--broiler breeders who lay eggs from which broilers are hatched, broilers, and table egg laying hens. Commercial poultry cases generally include 10 or more birds per case. I did 57% of all the poultry necropsies. I see a lot of chicken innards.

Previous occupants of my position had necropsy case turn-around times of 20, 60, even 100 days or more. That's astonishing. There is no justifiable reason for this, even if you wanted to run every test available (and some of them did!). When I started this job, my case turn-around time was around 20 days. Within 3 months, I had dropped that to 10 days, and I maintained that throughout 2020. My colleague and I work very closely together, and since we have similar approaches to selecting diagnostic tests for each case, his turn-around time for 2020 was also 10 days. 

This is a useful metric, but it's more than just a number. Short case turn-around times mean vets and food animal producers get information about herd and flock health issues when it is still useful to them, allowing them to implement effective treatment plans. I don't treat, and I don't prescribe. My job is to diagnose. If I do that job well, it has a direct impact on animal health, food safety, and public health. No pressure or anything, though.

Let's take a look at September. There were 22 working days that month. I was on the necropsy floor for 9 days and ended up taking 16 necropsies. Here's a list of my cases from that month:

• pure-bred Highlander cat with severe cardiomyopathy which we ended up deciding was congenital
  
• puppy with parvovirus
• backyard guinea hen with no determined cause of death
• dog with heartworm
• kitten with the blood parasite Cytauxzooon, spread by ticks
• puppy that died of bacterial sepsis
• another puppy with parvovirus
• alpaca with right-sided heart disease and intestinal parasites too numerous to count
• another kitten with Cytauxzoon
• cow with an intussusception in its small intestine; this is when part of the intestine gets entrapped inside an adjacent part, like one of those finger trap toys; very bad
• calf with aspiration pneumonia; it actually died of bacterial sepsis, not the pneumonia
  
• calf with necrofibrinous pleuropneumonia; very bad
• goat that had so many blood-sucking worms in its stomach that it died of anemia and malnutrition
• kitten with bacterial pneumonia
• another kitten with Cytauxzoon
• backyard chicken with a bacterial infection in its mouth and crop, bacterial pneumonia, and coccidia in its gut
  

Some types of cases are seasonal. Ticks are more active in the summer, so we see an increase in cats that died from the Cytauxzoon felis blood parasite. Small ruminants with anemia died from infestations of the strongyle Haemonchus contortus until proven otherwise. Calves pretty much always have pneumonia until proven otherwise.

Knowing about these kinds of patterns helps us develop a list of differentials for each case. I make a short list for each case before I even change into scrubs, based on chatting with the submitting vet, the owner, or reading the history they provided on the submission form. Sometimes the signalment alone is enough to suggest some differentials (signalment to a vet usually means species, breed, age, sex, and breeding status). I modify my differential list based on gross findings during necropsy, and I select diagnostic tests that will help me rule in or rule out one or more things on the list. 

Sometimes cases can be closed using necropsy findings only. The cow with the intussusception is an example. I ran a fecal egg count as a courtesy to the producer, but her cause of death didn't represent a herd health problem. Just a case of bad luck for that cow. 

Necropsy findings in some cases can reduce the differential list down to just a couple of things. The calves with pneumonia are examples. It was obvious at necropsy that they had pneumonia, but was it viral? Bacterial? Multi-factorial? I could just order all the tests but that is lazy pathology, bad science, and a waste of money and resources. It is far more challenging to select the "right" tests for each case. 

And sometimes we just can't determine why an animal died. Or rather, we can't reduce the "why" down to one thing we can verify with testing or observation. 

In a way, I'm still in vet school. I learned something from every one of those 259 cases--technique, differentials, diagnostic tests, how disease develops and presents itself.