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.