Saturday at the Vet Clinic

 

When I started picking up the occasional Saturday shift at a local clinic, I insisted that I only wanted to see wellness clients. But not every pet that comes in just needs an exam and vaccines. Ears, skin, vomiting, and diarrhea cases began showing up on my schedule, although I am still able to duck lacerations and other cases that required suturing. (This clinic only does dentals and surgeries during the week, so that was never going to be a problem.) The reason is that I simply don’t trust my skills with cutting and suturing living animals. I’ve developed habits that help me do necropsies efficiently but these absolutely do not translate back into the GP world.

On a recent Saturday, things shifted quite a bit, taking me pretty far outside that wellness bubble. A regular client came in with their 14-year-old Chihuahua laterally recumbent and unresponsive. The dog was being treated for congestive heart failure, a chronic, progressive disease. The other vet working that day and the entire team of techs jumped into action, setting up for intubation, oxygen, placing an IV catheter, giving drugs, and performing chest compressions. It was impressively smooth and professional teamwork. Realizing that I could contribute nothing to that effort, and at best would only be in the way, I focused on the owner, collecting more history, giving her information, and helping her work through the many decisions that she needed to make quickly. I work with grieving owners all the time in my job at the lab and am comfortable communicating in that setting. Sadly, they couldn’t restart the dog’s heart.

Of course, I received training in how to treat these kinds of emergencies. But I haven't applied that  training in over 7 years. Like any specialized knowledge, if you don't use it regularly, it atrophies. 

But that wasn’t the only curve ball thrown on this day. The last appointment of the day, assigned to me, arrived around 5pm. The owner had taken the dog, a 2-year-old female pitbull mix, to a low-cost spay and neuter clinic two days earlier. The dog had developed severe bruising on her abdomen and was “dumpy” and lethargic at home, although she still had an appetite. The dog wasn’t messing with the spay incision site, which was a bit scabby but healing. However, there were massive, dark purple bruises on her abdomen and large pockets of fluid under the skin. Alone, these weren’t an emergency even though they looked scary. Large, deep-chested dogs can sometimes be difficult to spay and there can be trauma to the body wall, leaving bruises and subcutaneous edema. But it was the reported lethargy that set my spidey senses tingling.

I’ve seen the absolute worse cases of post-spay deaths presented for necropsy, including ligatures coming off, cutting but not ligating ovarian arteries, accidental avulsion of renal vessels, complete transection of the intestine (we still don’t know how this happened as one does not insert scalpels into the abdomen for a spay), and contamination of the abdomen or the incision site. There are lots of ways for spays to go wrong.

The dog’s physical exam was normal. The owner reported that the dog had pooped since the surgery. Still, the case just didn’t feel right to me. I said, I want to run full bloodwork. And it turned out that the dog had a severe, active infection. If the dog didn’t receive immediate treatment, it would probably have died. We sent the owner home with 14 days of a broad-spectrum antibiotic plus a steroid for inflammation and another drug to address pain.

Regular GPs see these kinds of cases every day. This was a normal Tuesday, or rather Saturday, for that clinic. 

I’m a decent diagnostician, and as I learn more about the pharmacy available at this clinic, I get more confident in selecting tests and treatments. But I still have a lot to learn. I am lucky that my forays into GP veterinary medicine are being supported by such a well-trained and compassionate team. 

Sample Wall of Shame

Under the umbrella of Pathology, the lab section that I supervise has two main functions: necropsy and histopathology.

Histopathology refers to both the study of disease in tissues and the process of preparing tissue samples so they can be examined under a microscope. Tissue samples are systematically collected during necropsies. Histopathology is one of the many tools we use to help determine the cause of death of an animal. Veterinarians (and doctors) also remove tissues during surgical biopsies and submit those for histopathology. In those cases, we are not necessarily looking for the cause of death but examining the tissues to determine if cancer is present, or to identify the cause of a persistent lesion or disease state in the animal.

Tissues slated for histopathological analysis must first be fixed. The most common fixative is formalin, an aqueous solution of formaldehyde. Formalin causes cross-links to form between proteins and makes tissues stiff. Formalin-fixed tissues don’t decay (they can degrade over time, but we will let this oversimplification go). Once the tissues are stiff, they can be cut into very thin slices and placed on microscope slides. The rule of thumb for proper fixation of a tissue sample is a 10:1 ratio of formalin to tissue.

But this post isn’t about what goes on in a histopathology lab. It’s about the containers that veterinarians choose to hold tissue samples and formalin that they then ship to us. I keep pictures of the more creative choices in a folder that I labeled “Sample Wall of Shame.” Here are some of the best. 

 

This container is for food, human food.

 

So is this one. It was sealed with packing tape and formalin leaked out during transport.

 

 

This vet submitted the uterus of a dog in a Gold Peak tea bottle. When collected at the time of surgery, the tissue undoubtedly went into the bottle easily. We had to cut the bottle apart to get the fixed tissue out. And yes, that is a zip tie that was used to close off part of the uterus. We still don’t know why.

 

This vet chose a pill bottle which does not have a liquid-proof seal. They thoughtfully folded the submission form into the same baggie as the pill bottle. Formalin leaked onto the submission form.

 

 

This vet chose a glass mason jar and opted to seal it with packing tape instead of wax film. Glass is an insanely terrible choice. And the submitter still didn’t have enough formalin for the size of the sample.

 

 

This vet used an appropriately sized, commercially prepared jar with sufficient formalin to fix the submitted tissue samples. They had marked one of the samples with a suture, a common way to differentiate multiple samples placed into one jar. Unfortunately, the suture caught in the threads when the jar was closed and most of the formalin leaked out during transport, contaminating other samples in the same shipping box.

 

 

There was not enough formalin in this commercially prepared jar for this large tissue sample. 

 

Why does any of this matter? Formalin can leak out of poorly sealed containers and contaminate submission forms, packing materials, and other samples in the same shipping box. Leaks expose shipping, receiving, and histopathology personnel to formalin, a carcinogen. Tissues that don't get fixed completely can rot, obscuring diagnostic details. Glass containers can break, creating sharps hazards. 

Sure, the commercially prepared jars that I showed in the last two examples cost money and some vets may want to cut costs where they can. But selecting any old container that comes to hand creates unnecessary risks, potentially ruins samples, and shows poor attention to detail and poor understanding of the requested diagnostic test. 

To be sure, this is not a problem unique to our lab. All diagnostic labs have to deal with improperly packaged samples. We wear PPE and use biological safety cabinets and fume hoods to handle samples to mitigate risks on our end. And of course we educate clients who submit samples like this as often as we can. 

Even so, I regularly add photos to my Sample Wall of Shame folder. 

 

 

DNF

 When I was much younger, it bothered me when I was unable to finish a book. It felt like a mixture of disrespect to the author and laziness on my part. And after a certain point, the sunk cost fallacy would kick in and I’d think, I’ve made it this far, might as well finish it. Not anymore! These days, my patience is tissue-thin, and I will drop a book in just the first few pages if I am not enjoying it.

My three biggest reasons for not finishing a book are poor (or absent) editing, YA fantasy that wasn’t marked as YA, and sloppily researched, key plot points, usually involving a subject that I know something about.

Why no YA fantasy? I am an adult woman. I don’t want to read a story targeting hormonal 12-year-olds.

The best example of sloppy technical research is anything churned out by Frieda McFadden. Even the laziest writer can read a Wikipedia article to find out some basic facts about how trains or credit cards or grocery stores work, for example. God help us when she veers into medical-adjacent plot points. Sheer nonsense. Was she trying for fantasy on top of the psychological mystery angle? She, and her readers, apparently don’t care. Count me out.

I recently added a fourth reason for DNF: florid, overblown writing. I don’t encounter this very often because I don’t read genres that tend to the florid.

I had already passed over a new biography about Hedy Lamarr several times. Although “The Only Woman in the Room” seemed to be an intriguing story, I never could get hooked enough to check it out. But I’ve got several holds pending at the library and I decided to fill the gap last week with this book since it was available.

I was horribly disappointed. I couldn’t make it past 20 pages. It seemed to have been written using an algorithm that specified that every noun had to have one or more adjectives and every verb one or more adverbs. It was ponderous. Adding insult to injury, verb choices were always the most complicated possible. No “she said” for this author. It would be “she breathily intoned” or some other tortured word choice. Even more insulting, key points were repeatedly repeated. I don’t want to be hectored when I am trying to escape into a story (looking at you too, Louise Penny).

I can’t believe that people read this and thought, wow, such a good book. The fact that it was on the NYT Best Seller List means nothing since those rankings are easily manipulated. This book was so overdone that I am not sure if humans were involved in its writing or editing. Either way, it was DNF for this human.

Spicy

I’ve been working through some training issues with Frankie in the past few months. If I am honest, these are things I should have been addressing when she was a puppy. I had no idea that she would turn out to be such a spicy little speed demon.

Her performance in the competition ring is quite different from what she does when we are training. The biggest problem, and there are several, is that she won’t come to me at the end of a run.

I’ve done pattern games. I’ve worked on building value for the leash. I’ve dropped leashes all over the training field and interrupted her runs to ask her to run to a leash for a reward. No problem! But in a trial, her brain leaks right out of her ears. I can usually (but not always) get a full run out of her but we rarely finish the course together.  After she clears the last obstacle, she takes off and runs around the ring, refusing all recalls and attempts to catch her. She’s even become wise to people holding out food. She doesn’t take any obstacles, just runs around at top speed. I’ve been complimented many times on how fast she is … while she is running around like a feral beast. Not her finest moments. 

My interpretation of this behavior is that she is so overstimulated that she simply can’t stop at the end of the course. She still has energy to burn.

So what’s the solution? Her drive is off the charts on a normal day. She can ramp up in seconds. I want to use that drive, not squash it. Since I don’t think I can bring her arousal down in any substantial way, I need to try to plane off the spikes. 

On recommendation from friends, I consulted with a local trainer who has a reputation for working with spicy dogs like Frankie. She said, “Look, you aren’t going to wear this dog out by throwing a ball at the trial.” I agreed. Besides, playing with balls and tugs ramps her up even more. Then she dropped this: “But wearing her out shouldn’t be your goal.”

What a revelation! Of course. I need to find ways to shape her drive and help her with impulse control. Trying to make her tired doesn’t address either of those things.

This trainer recommended sniff walks before every run. Those are 10- to 15-minute walks in which I ask nothing of the dog. Frankie sets the pace. If she wants to sniff one spot for 5 minutes, that’s fine. The only requirement is that she not pull on the leash. Sniffing releases endorphins. Walking and sniffing are gentle, steady stimulation, not rapid jerks and spikes like play brings.

I tried this at the last trial in February. It was a challenging task with morning temperatures in the teens, but I managed to pull it off four times each day. The time management was exhausting. But I did see a small difference even though it was the very first time I tried this. Frankie’s focus was better at the start of each run. But she was still running off at the end, especially on the second day. While sniff walks are an important addition to our trial routine, they won’t solve everything. There’s still some training to do!

Since early December, I’ve been training Frankie in contact heeling and its related movements. I will try to remember to film one of our training sessions, but you can check out videos of this online. It’s used to train dogs who do bite and protection work. It’s also used for reactive dogs.

 It’s not just about heeling but about positioning the dog in space. What sets it apart from old-school obedience training is that the dog remains in close physical contact with the handler. Plus, a lot of the contact heeling trainers use positive training methods, even for dogs training for bite work, and I’m all about that. No leash corrections or e-collars for us. Once I learned about contact heeling, I realized it was a missing piece for Frankie! I had already noticed that she likes to be touching me. I realized I could use this training to build more value for being with me, build routines that include movement (Frankie wants to go go go all the time), keep up a high rate of reward, and be able to take all of this on the road, that is, use it at trials, not just at home.

We are by no means experts, and I have no intention of training her up to competition level, but I am seeing a shift in her focus and attention. I’ve added contact heeling moves to our gate and start line routines for agility. Instead of trying to distract her with treats before we go in the ring, which only ramp her up, I ask her to calmly and smoothly move around with me in coordinated, set patterns that she knows and has been rewarded for many, many times.

Frankie will be a life-long project. But I am grateful to be learning so many new things with her.

 

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. 

 

More Than You Ever Wanted To Know About Intestinal Parasites in Small Ruminants

 Whenever we have a small ruminant (sheep or goat) necropsy, the rule of thumb is that it is intestinal parasitism until proven otherwise. 

Cows get intestinal parasites too, but for the most part, due to differences in management and physiology, weaned animals and adults rarely develop such a heavy parasite load that it leads to death. There are always exception, especially for calves that are still nursing.

Sheep and goats have a particular problem with the roundworm Haemonchus contortus. The adult worms are small, around 1 cm long tops, and very thin. In small numbers, they are easy to miss. Haemonchus prefer to take up residence in the abomasum, the glandular part of the forestomach between the rumen and the duodenum. The adult worms and late-stage larvae burrow into the mucosa of the abomasum and feed on the blood of the animals. Heavy or even moderate but chronic loads of Haemonchus cause the animals to become anemic. When the animals begin to show clinical signs of the anemia, the owners deworm them but it's usually too late. Severe anemia secondary to Haemonchus parasitism is the cause of death of most of the sheep and goats that we see. 

 Coccidiosis is the other player in this small ruminant gut roulette. Coccidia are protozoal parasites, not worms. Infections have to be treated with entirely different products. For most of their lifecycle, coccidia are tucked deep into the intestinal mucosa. The result is erosion of the structure of the mucosal layer. The animals can't digest food anymore and often develop diarrhea, which is not usually observed in cases where only Haemonchus is present. But severe coccidiosis can also cause anemia! 

Many sheep and goat owners are small flock hobby farmers. They don't have a lot of space and can't rotate pastures. The animals shed ova and oocytes in their feces and repeatedly re-infect each other. Some of the owners decide the solution is to treat their animals constantly with dewormers and coccidiostats. The result is a short-term drop in adult parasites. But the treatments do nothing about ova and oocysts in the pastures. They are highly resistant to heat, cold, UV, etc. and sporulate into larvae to start the cycle anew. And overtreatment can result in the creation of drug-resistant populations of parasites. 

 One of the tests we try to run on every small ruminant necropsy is a fecal egg count. The result of this test is a count of ova or oocytes per gram of feces. Here is a graph showing the results of 47 fecal egg count tests during a two-year period. The left hand scale is a log scale, so each horizontal line increases by a factor of 10. Coccidia are Eimeria spp. and strongyles (strongyloids) are for the most part Haemonchus. Some animals only had Haemonchus, some only Eimeria. Some had both (the paired lines). Most of the animals represented here were severely anemic. 

 

 

 

The winner is the lamb necropsied by my colleague that had more than one million Eimeria oocytes per gram of feces. Truly astonishing. 

 Today I necropsied a lamb that wasn't anemic. No adult Haemonchus were in its abomasum. The general presentation of the lamb was consistent with sepsis, and while that was the cause of death, that's not a proximal diagnosis. What caused the sepsis? I kept looking. The animal had severe diarrhea and there was no digesta in its intestinal tract or feces in its colon. Nothing but gas. I started looking into the large bowel and found many adult roundworms. They weren't delicate, hair-thin Haemonchus but they were definitely strongyloids. The mucosa of the large bowel sections was eroded and irregular. Then I moved up to the small intestine. Surprise! Tapeworms. Adult tapeworms that were many, many inches long. 

Since we don't see intestinal worms very often in sheep and goats, I did a little research and decided that the worms were probably Trichostrongylus spp. They can also cause anemia like their cousin Haemonchus but they live in the intestines instead of the abomasum. Since I didn't see evidence of anemia, I thought that the tapeworms were probably the more significant problem. 

And the cause of the sepsis? Well, it's a cascade of unfortunate events. The intestinal mucosa is damaged by worms and larvae cavorting about. The tapeworms consume digesta (competing with the lamb for nutrients). The intestines stop functioning and no longer send proper signals to the rumen, which stops trying to send stuff into the intestines. Eventually, the intestinal environment becomes so compromised that gut bacteria decamp into the bloodstream. 

What had me scratching my head with the case was the fact that tapeworms are extremely easy to treat. We usually only see them in small animal cases associated with neglect and rarely in production animals. That problem was resolved when I called the owner and she told me that they hadn't dewormed ... in years. 

It's not a problem until it is, I suppose. She's now lost 6 lambs due to that decision. 

 

Frankie and JWW--Out of Novice At Last

Frankie and I have been struggling to advance in AKC JWW (Jumpers With Weaves). She's been stuck in Novice since I started trialing with her. At first she knocked bars, oh so many bars. That problem fixed itself as she started to understand the game better and learned to balance her speed with better take offs.

At the Novice level, the dogs are allowed a couple of errors but knocked bars are always an elimination. Bars down lost us a lot of Qs. But in JWW, the dog also can't take any wrong obstacles. Frankie has a tendency to curl into me so even when I want her to take 4 jumps in a straight line, she usually turns towards me and takes an off course. 

That's what happened in the video I've attached here. The third jump she takes is not the correct one even though I was doing my best to keep her from turning into me. I stopped and chose to use the Fix-N-Go option where you can go back and correct that mistake. The run is no longer scored or timed. I turned her around and wrapped her around the first jump (backwards, but it didn't matter anymore) and on the second attempt, she ran the course correctly. She bobbled the weave entrance but that's allowed in Novice. She rarely misses weaves in practice on grass but on this fast turf, she comes into the weaves very hot and sometimes misses the entry. I lifted her up like Simba at the end because she stayed with me all the way to the leash. 

 

 I only needed one more Q to get her (and me) out of Novice. And we pulled it off the next day! She almost breaks at the start line--that scooting forward is a problem and I'm working on it. Notice how she curls into me as she comes out of the tunnel. That's partly because that's what she does and partly because I wasn't in the right position to get her over the next jump. She never took any obstacles and she never crossed the plane of the next jump so the judge didn't call any faults while I was fumbling around getting her lined back up. It was just time on the clock, not errors. She hit the weaves super hot but managed the entry this time for a nice clean finish back to the tunnel. 

 

 I've learned a few things while trialing with Frankie this summer. She is true to herself. She becomes extraordinarily overstimulated in a flash of a second but is still predictable and trainable. Frankie is not Archie--she isn't looking to please me. She is willing to go along with my rules, more or less, so she can get what she wants. And what she wants to do is move. I may never have clean start lines with her. She crouches down like a sprinter in the starting block (good). Her focus forward training means she doesn't look at me but at the course in front of her (good). She drools (eh). She creeps forward (not good). Clearly I can shape some of that but I can't change her fundamental nature. 

I'm making peace with that because she's starting to get good at this agility thing. People stay late to watch her run, and although smooth fox terriers are in general crowd pleasers, they are staying late to watch because she's doing great things in the ring. I lost count of how many people told me at the trial how much progress she has made this summer. And I agree.   

Invite to the Agility Invitational

Archie got his third invite to the AKC Agility Invitational! He is the second-ranked Smooth Fox Terrier in the Preferred class. That's pretty good for my old man--he will be 10 years old in September. He's had a decent run of successes in the past few months and the invite is evidence of that.

 This is my fourth invite to the Invitational. My first was with Iz back in 2006, at the very first Agility Invitational event. 

Big events are not my thing. I don't like the crowds. I really don't like the Orlando venue. That's a lot of money and leave time to set aside for an event I don't want to attend. And Archie of course doesn't care. So I'm going to decline, opening up a spot for the next Preferred SFT in the rankings.  

 

Cicada

I was smacked in the head by a cicada heading for the backyard deck floodlights one early morning last week when I was taking Frankie out to potty. I gave a bit of a shriek and swatted it to the ground.

 Frankie was on that cicada like, well, like a terrier on a bug.

I let her chase it around for a while. It was probably near the end of its life anyway since it didn't seem to be able to fly well, but Frankie certainly didn't help. She isn't a gentle dog and all of the pawing and nosing disabled it further until it could only fly a foot or two. At last it lay buzzing on the ground and I figured that was enough cicada torture. It was time for Frankie to pee so we could get back inside.

As soon as I stepped towards her, she grabbed that damned cicada and took off trotting. I could hear it buzzing inside her mouth and I could see one of its wings sticking outside her muzzle. Fox terriers get this weird pooch to their face when they are trying to hide something in their mouths. It's terribly obvious what they are doing, which makes it funny. But it is summer in central Arkansas and the weather even at 5am is hot and humid. I wasn't all that amused. I just wanted to go back inside and get on with my morning.

I followed Frankie as she did the grand tour of the backyard, cicada buzzing away in her mouth. Her recall is a thousand times better than it used to be but I didn't bother. I just trailed after her, stumbling over rocks and tree roots in the dark areas in the back forty (what I call the lower end of the yard). Finally she made her way back up to the house. I grabbed her and pried her jaws open. The cicada, stunned, dropped to the ground. It was still alive but I decided Frankie was done. I picked her up and carried her up the stairs. 

I gave her a treat anyway when we got back in the house. She wasn't naughty. She was just being a normal fox terrier.

  

Summer Training Goals

 My training goals for Frankie this summer are to expand her repertoire of skills. I'm particularly focusing on skills that are needed to run the more international-style courses such as AKC Premier. For those courses, the dog needs to have many different collection and turning cues, far more than are needed to fumble one's way through a regular AKC course. 

AKC got rid of the pause table in Excellent/Master classes last year. This was a long-overdue decision. Nobody will miss it. However, the pause table was often used by judges in their course design to create a hairpin change in the dog's path. Rather than toss out their old course designs, many judges replaced the pause table with a wrap on a jump, in which the dog approaches a jump, collects, and turns very tightly around the wing, usually with a 180 degree change in direction. While wraps were used before the pause table was removed, we are seeing them in almost every Excellent/Master Standard course now. 

Frankie doesn't like to collect. It's a common problem with some dogs that want to go go go. Collection means slowing down. It's not that they can't collect, it's that they don't want to. It's a training problem. So one goal for this summer was to help Frankie learn to collect more reliably.  

To make this even more complicated, the dog can wrap to the handler or wrap away from the handler. In a wrap away, there is a side change (dog ends up on the other side of the handler) and a lead change (dog changes lead leg at the wrap). Jumps have two wings. So which wing is the best choice for that wrap in that location on that course? I tell my students, once you identify a wrap on a course, you start with that question--which wing? The decision depends on many factors: the path the dog is on as he approaches the jump, the path he will be on after he lands and comes around the wing, the lead leg the dog is on as he approaches and the lead leg he would be on after the wrap, the dog's ability to turn, the distance between the wrap and the next obstacle, the position of off course obstacles around the wrap, etc. It's complicated!

 It's a core tenet of dog training that if you expect different results, you need to apply different handling. That means different handler body motion and position and different verbals. You can't use one command for five different things. How will the dog know which one you mean? The result will be a dog that slows down until the handler sorts their shit out, a dog that starts taking any obstacle he sees, or a dog that gets very frustrated very fast. So another part of this summer's training is to expand the verbal commands I use with Frankie.  

Here is a list of the skills that I am working on with Frankie, and the verbal commands I'm using for them. She already knows several of these but I am doing a lot of drills to solidify her performance. 

• Jump in extension (jump, go on)
• Wrap to (check)
• Wrap away (dig)
• Soft turn (left, right)
• Rear cross (switch) 
• Backside wrap (back) (handler on landing side)
• Backside slice (push) (handler on landing side)
• Tunnel threadle (look)
• Threadle pull (look)
• Inside slice (in) (backside with handler on takeoff side, another type of threadle)

Everything starts with one obstacle, usually a jump. You gradually add handler motion. Then you gradually add distance. Then you add another obstacle or two so the skill is performed with more speed in a sequence and go back to working close to the jump. It's a slow process. There's a lot to keep track of. 

I am by no means a top tier handler and I have no interest in going to big events. But Frankie has a ton of potential and I want to explore more challenging courses with her. 

Frankie's Big Feelings

There are some skills that I never really had to train with Archie. I just did the handling, he read it correctly, and that was that, more or less. I mean, there still had to be some proofing and refining, but he has always been an easy dog to train.

For example, there is a handling move called tunnel threadle. When the dog is facing a curved tunnel, and their line is taking them to one opening of the tunnel but you need them to go into the other opening, you execute a tunnel threadle: raise the arm opposite the dog about waist high to pull the dog off their path, across your body, and scoop them into the correct tunnel entrance. The tunnel threadle usually has a verbal associated with it. I use "look look" with Archie. He sometimes makes a mistake when he's got a head of steam but he's pretty reliable. I've certainly not had to spend days or weeks training that particular thing.

Frankie knows what tunnels are. She has decent obstacle independence and will send to tunnels 20 or 30 feet away. But when I tried a tunnel threadle with her, her brain leaked out of her ears and she started spinning in place. I could be standing inches from the tunnel opening, and if I raised that opposite hand and said "look look", she started spinning. I could not get her in the tunnel. But if I stepped back, lined her up, and said "tunnel tunnel," she would shoot into the tunnel. 

This was such bizarre behavior that it made me think more about what was going on and how to fix it. When Frankie starts spinning like that, she is so far over her arousal threshold that she can't function anymore. She rockets into that state in a fraction of a second. She can't hear. She can't continue forward. She certainly can't learn. At that point, it's not even a matter of the timeliness of my commands. She literally can't do anything except spin in circles. I need to interrupt that behavior and help her move into a different, hopefully lower, state of arousal.  

I've been taking a lot of online training classes to learn how to use pattern games to help dogs change their state of arousal. I don't want to get into the weeds of that training here, but I can summarize it like this. Food releases endorphins. Executing a familiar pattern, essentially falling into autopilot, releases endorphins. Combine them and you have an exercise that can help lower a dog's level of arousal. I've been working through pattern exercises with Frankie for about 4 months but I wasn't really sure how to apply them to her specific problems in agility. 

 I finally put it together last weekend. In this short training video, she rockets into over-arousal twice. Both times I stopped moving and waited. In the most simple pattern game, the dog gets a treat for making eye contact. Notice how quickly she stops spinning and sits in front of me and looks at my face. I give her a treat or two then calmly line her up and ask her to continue, which she was able to do. 

 https://youtu.be/p1eTiTfVIRs 

Of course I can't give her treats like that in the competition ring. But I hope that I can help her learn that she can control her own emotions, and that when she does, she can keep on doing agility, which for Frankie is another type of reward.  

 

(Sorry, can't embed the video. Blogger isn't cooperating. The link should work.) 

A Tired Dog Is A Good Dog

 It's summertime, and I'm not teaching agility classes. But agility training and trialing don't stop just because I'm not teaching. 

My goal this summer is to step up Frankie's training with a focus on more elite skills. I want to help her be more successful in the competition ring. I could of course have not said a word to anyone and trained all summer on my own. I get up very early even on weekend mornings, and there's no doubt that I could have come and gone at the club's training field before anybody else showed up. But I like training with others--my social world is tied up in agility. 

I invited some of my students to join me on weekend mornings at the club for informal training on weekend mornings for the next couple of months. These students are the most successful teams in my classes because they invest at least a little bit of time in training and are making great progress with their dogs. Plus I like them and their dogs. 

Last summer, I got pressured into inviting people to join a training group whom I don't like personally and whom I don't respect all that much as agility handlers. So judge away, but I don't want to spend my limited personal time doing agility with people like that. I preempted that this summer by selecting the people I want to train with. Does that make it a class? No, because others can drop in and join us if they want. I don't turn people away. I'm not that much of an asshole.

Saturdays are for skills work--drills, high rate of reward, limited equipment. On Sundays, I set up a full course that gives us an opportunity to apply the skills with more equipment. 

We are going hard at it. We spent nearly 3 hours yesterday on skills and another 2 hours today working on a course. 

Frankie is a social dog who has never shown issues with being crated but she doesn't often relax in an agility context. By 10am this morning, she was lying on her side in her crate, head propped up on her water bowl, blinking at me. She was exhausted. 

We got home and I put the dogs outside while I unloaded the car. I had a snack then we took a nap for an hour. That is the most luxurious thing I can do with my weekends--play hard, nap hard. 

Frankie loves the skills work, and is soaking up all kinds of new things, but she still finds course work challenging. That's helpful for me to work through, and it helps me understand why she is performing so poorly in the ring. She will not be successful in the competition ring until she can cope with the same stresses in the practice field. 

I trust my training. I know Frankie has the physical and mental ability to succeed in agility. She's struggling with stress and anxiety that are expressed as over-arousal. I'm hoping that working with her in a high pressure, high reward training program this summer will help her push past the anxiety and allow her to go into the competition ring with confidence and focus. 

Reminder

 I'm having some fairly big problems with Frankie in the agility ring right now. I'm still processing the issue and what to do about it. Until I work through it, I thought it would be nice to remind myself of how far she has come. 

 Here is a training video of her in the weaves, taken in my garage in December 2023. I use the 2x2 method to train weaves plus a remote treat dispenser to keep the dog's head down and facing forward. 

 

And here's a clip of her a year later (January 2024) performing 12 weaves off the table in an AKC Open Standard run.

 

 

She's fast! I didn't get quite far enough down the line for that front cross before the tunnel. You can see her little hop to the side as she turns to the tunnel because I'm in her path. 

I'm feeling frustrated with the backwards progress in her trialing. But she's healthy. She loves agility. She has drive. Oh, so much drive. And she is smart. We will get through this rough spot.  

 

Train the Trainer

In early 2022, I began teaching a new class at the club. Handlers that were moving into the agility track (Intro to Agility, Beginner Agility, etc.) from Beginner Obedience weren't working with their dogs as a team. The handlers had no idea how to train a dog. Sure, they could drag a dog in a circle around a ring indoors on lead and maybe they stuffed a few treats in its mouth now and then but they weren't really communicating with their dogs. I thought, here's a knowledge gap that I think I can fill.

When I first proposed the class, to be held on Sunday mornings inside the club, the reaction of the old guard was so extreme that you would have thought I had proposed slaughtering puppies on their own front lawns. The inside of the club was sacrosanct, to be reserved for clean obedience training (of course, based on punishment), not dirty training with treats! The club had never offered classes on the weekends! Training with clickers would disturb other people who needed to train indoors! The wailing, the gnashing of teeth, and the rending of garments was extreme. 

So I spent several weeks going to the club on Sunday mornings and documenting exactly who was using it and what they were doing. It was empty, week after week.

I resubmitted my proposal and was grudgingly granted permission to teach this new class for one session, with said permission given provisionally, ready to be yanked back if there were "problems." The Four Horsemen of the Apocalypse didn't make an appearance during those 8 weeks, so I kept going. 

I just finished the thirteenth 8-week session of my class. I guess weekend classes weren't such a bad idea after all because there are now Puppy Kindergarten, Beginner Obedience, and Scent Work classes offered on Saturday and Sunday in addition to mine. 

The class is called Teamwork. It's all about teaching handlers how to communicate with their dogs consistently and reliably. I use positive training methods and actively discourage negative markers and punishment. I teach handlers about rate and placement of rewards, how to use a clicker, and how to train behaviors with luring, targets, and shaping. Most of the exercises are flatwork, done with no equipment. As their skills progress, I add exercises with cones, platforms, and perch bowls. After 8 weeks, if they are paying attention and working at home between classes, the handlers and their dogs can execute all sorts of things that they will actually use in agility, obedience, and rally. 

What's so interesting about the class is that all of the training is for the handlers--but they don't know that at first. I mean, some dogs are a bit rambunctious and excited but what I am asking the dogs to do is pretty simple. Most dogs pick up the exercises right away. 

The origin of the idea for this class goes all the way back to the teaching I was doing in Saudi. I saw then that I could make a meaningful difference by helping pet owners communicate better with their dogs. It morphed to have more of an agility focus, of course, but the essential idea is the same. Owners that are reliable and predictable in how they communicate and reward their dogs will elicit reliable and predictable behaviors from their dogs.

The course content has evolved, of course. The addition that I am most proud of is what I now set up for the last class of each session: a series of exercises using hoops. Hoops are an agility obstacle used by the agility organization NADAC. Hoops don't require any jumping--the dog runs through them (see the picture below). I built four hoops to NADAC specs.

 

 

I start the last class by letting handlers introduce their dogs to the hoops by navigating a simple circle through them. Each sequence gets more complex and requires more handling. By the end of the hour, handlers and their dogs navigate a 10-obstacle sequence with hoops and cones and side changes. 

 

This is a course map. Squares are 10 x 10 feet. The shaded dots are cones. The oval things are the hoops. Obstacles are performed as numbered. 

 

Most of the students taking Teamwork have never competed in organized dog sports. They've maybe heard of agility or rally and maybe want to take more classes. They usually come to me with no more training than a session of Beginner Obedience. But after 8 weeks of Teamwork, they are successfully completing a short obstacle course. 

I developed Teamwork to be a bridge from Basic Obedience into one of the performance sports. Is it working? Well, last night, the Intro to Agility instructor announced at the Board meeting that she wanted to make Teamwork a prerequisite for her class. She said that handlers who had taken Teamwork understand how to train a dog, and that it was night and day obvious who had taken my class and who hadn't. Teamwork students are more successful and advance more quickly in her class.

I couldn't be more pleased. It's validating to have an instructor I like and trust to explicitly say, Teamwork has a measurable, positive impact. Let's have more of it!

I love teaching agility, and many of my agility students become great training partners. But Teamwork is my passion project. I am lucky that I have the opportunity to share that passion.