The Exotic Vet

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Sep 2
This is a radiograph of a female Gopher tortoise that came in for having lethargy and a runny nose. The radiographs were taken to check for lung disease and I was shocked to discover a fairly large urolith! She will be heading off to surgery for removal after we get her stabilized and healthier.

This is a radiograph of a female Gopher tortoise that came in for having lethargy and a runny nose. The radiographs were taken to check for lung disease and I was shocked to discover a fairly large urolith! She will be heading off to surgery for removal after we get her stabilized and healthier.

Sep 2

Mistakes in Medicine

Anyone in the medical field should watch this. Anyone that will be seeing a medical professional should watch this.

Sep 2

wnycradiolab:

The 2014 “They Ate WHAT?” X-Ray Contest.

Sep 1

VCPR (AKA: “I can’t give you any medical instructions over the internet.”)

thevetsaidwhat:

So I waited until I was sure I hadn’t had any asks in a while before making this post, because I don’t want anyone to think that I am accusing them of this. None of my askers have been anything but polite—although a couple have stopped following me. No, I’m preparing this post as a back-up for those people who could get snarky. Because believe me—I’ve seen my fair share of it happening by watching other veterinarians.

So what’s the post about, you ask?

It’s about the Valid Veterinarian-Client-Patient Relationship (VCPR) how it pertains to Tumblr, and how words are not the same thing.

From the AVMA website:

A VCPR is established only when your veterinarian examines your animal in person, and is maintained by regular veterinary visits as needed to monitor your animal’s health.

Bold is my emphasis. Most VCPRs are invalidated if we haven’t seen your pet in over a year, but that’s not my point. My point is that as much as we would LOVE to help you and your pet with any illness they have, and as much as we HATE that we can’t help you… there is usually very little advice that we as veterinarians can give over the internet. This is because… and yes, it’s selfish… we like our jobs. We like doing veterinary work. And if we got sued because we gave advice out on a pet we hadn’t seen, it’s our jobs on the line.

Example (totally made up):

Someone messages a Tumblr vet, asking for advice on a dog that’s vomiting. This vet figures what’s the harm, they probably just ate something gross, and recommends some bland food and a little bit of an antacid. Well, this dog DID eat something—a big old corn cob. But because the owner didn’t go to a vet and have an exam in person (thinking the tumblr vet’s advice was perfect), there was no way to know that and the dog got very sick, and the eventual bill was much worse because of all the supportive care that was needed. So this owner now has the right to sue that veterinarian because their pet was very poorly taken care of based on the advice of a professional.

Not saying this would happen but have you seen some of the social justice posts out there? People get angry quickly and it COULD happen, and as I said… we like our jobs.

You might think “well if I describe it all really well, surely they will know what’s going on.” Maaaaaaybe—but likely not. Do you know what the difference between firm and hard is on a body? Do you know what marijuana toxicities look like? How about what it means to smell ammonia on breath, or the many different reasons an abdomen can be swollen, or how to test for those reasons. How to interpret those tests.

It’s one thing to tell us to try and do all of this over the internet, and another to have us there, in person, able to feel/see/smell/taste (in horrible instances) what is going on. And when an owner declines diagnostics of any kind while the pet is there in the office, that is the owner’s decision and they are the ones failing the VCPR, not the doctor. Whatever the reason may be.

So. My point is this… please don’t think we don’t want to help. Don’t think that when we say “I can’t help you” that we aren’t wishing we COULD do something. We can offer up hypotheticals on what the problem might be (and some of the hypotheticals can be dire) but we cannot tell you which one is most likely or what to do other than to go see your veterinarian as soon as possible.

I know that I personally would love to hear what happens, though. Tell me they got better! Tell me what the vet said! I am rooting for your kiddo and for you.

(The AVMA page, if you are interested.)

Sep 1

Question regarding the goatsmilk: I kind of understand how people might (incorrectly) think it okay to feed to mammalian neonates, but what sort of explanations have people given you for the birds and reptiles? That just seems like an odd leap of logic to make :/

"Because it is easy for them to digest" is honestly the most common answer I get. I have no clue how that idea got so firmly entrenched in the public mind but it did. It is easy to forget (and I work very hard to remind myself of it often) but basic science understanding in the USA is very poor. People not in some kind of science based field just simply do not understand how their own body works and many assume a lizard works the same as a bird works the same as a dog. Quite a few people believe all babies require milk regardless of their species or at least feel since babies can eat it, it must be good for everything.

The road to hell is paved with good intentions and the river that runs alongside is filled with goat’s milk.

Vast numbers of neonatal wildlife have died with bellies full to bloating and faces covered with goat milk. Deer, mice, squirrels, raccoons, opossums, ducklings, starlings, porcupines, iguanas, puppies, kittens, the list goes on and on. All have come into the hospital not doing well and the common denominator is they have been living on mostly goat’s milk for a week or so.

Why is this the case? Many people say that is easier to digest and that is true, for humans. Goat’s milk has slightly less lactose in it than cow milk and the fat is in smaller globules so it is in general easier to digest. But neonatal mammals have plenty of lactase to digest milk and non-mammals can’t digest it no matter how little there is. Adult mammals do not produce lactase either and so they can’t break down what little lactose is present.

The nutritional content of milk from various species also differs and is tailored to ensure that the species the milk is intended for gets the maximal benefit from it. They all differ in calories, fat, protein, carbohydrates, and vitamins/minerals. As an example, cow milk is about 4% fat depending on the breed, deer milk is around 20%, and goat milk is about 3.5%. So when a baby deer is getting goat’s milk it is not getting enough calories and will slowly starve. For non-mammals and adults the milk can cause very severe diarrhea which dehydrates them and prevents them from absorbing any nutrients at all.

So what do baby animals that do not have a mother eat? Milk replacement formula for their species. There is milk replacer for just about any species you can think of from llamas to squirrels and even rhinos. For animals like reptiles and birds there are non-milk formulas they can eat that are made for their particular physiology.

Another problem with feeding babies is that people have all kinds of ideas about how much, what temperature, and how often to feed. I once had a woman who told me she knew when to stop feeding her baby macaws when the food started pouring out of their mouths. A kitten owner syringe fed so much milk that it began pouring out of the rectum because the GI tract was overloaded. Animals are often over or underfed and they do not do well either way. Another common issue is food being aspirated into the lungs of the animal from incorrect technique. Once this happens they develop severe pneumonia and almost all die. This happens in baby birds often. Yet another problem is food that is too hot. Birds can get severe crop burn and other animals can have their mouths and esophaguses burned so badly that the tissue sloughs and leaves necrotic holes.

So what to do if you find a baby animal? Call a veterinarian or a wildlife rehab facility. They have all of the tools and training to do the job properly and ensure the animal is healthy.

explosionsoflife:

The blue coral snake (Calliophis bivirgata) is sometimes colloquially referred to as the “100-pace snake” because it is said that a human can make it 100 paces away after sustaining a bite from this animal before they die. However, there are not many recorded cases of human fatalities due to this snake, which hints that the snake gets a worse reputation than it deserves. Its typical prey is other snakes.
(Photo © Tom Charlton)

explosionsoflife:

The blue coral snake (Calliophis bivirgata) is sometimes colloquially referred to as the “100-pace snake” because it is said that a human can make it 100 paces away after sustaining a bite from this animal before they die. However, there are not many recorded cases of human fatalities due to this snake, which hints that the snake gets a worse reputation than it deserves. Its typical prey is other snakes.

(Photo © Tom Charlton)

Pardon my ignorance, but what exactly is egg cutting and why is it wrong? As far as I could tell it's cutting open eggs to prevent potential issues. It seems like this would be more of a case-by-case thing?

Anonymous

markscherz:

Egg cutting is the practice of slicing or snipping open the eggs of a reptile, typically a large constrictor. It is done for a variety of reasons, including checking on the condition of the developing embryo and helping the animal to hatch.

The problem is exactly that: cutting open the eggs to ‘prevent potential issues’. My argument is that the issues should be allowed to run their natural cycle. Weak, deformed or otherwise unfit babies should not be helped out, but should face that barrier on their own strength. It weeds out weak genetics that, in the wild, would not survive.

Because it is impossible to assess the state of the embryo prior to cutting the egg (except by candling, which, let’s face it, is pretty useless in the later stages of development), this cannot be a ‘case-by-case thing’.

Thanks for the suggestion! I was also thinking about doing a project on the correlation between high white blood cell counts and flea infestation. I intern at a vet's office so it wouldn't be too difficult. What do you think? Is it ethical to use

There are no HIPAA rules in veterinary medicine like there are in human medicine. Technically you could just use data from diagnostics without letting anyone know but it is probably better to get permission. Just draw up a permission form explaining what the project is about and what information exactly will be used and get the owner to sign it. That way you are covered just in case and it is more ethical.

Research Surprise: Many Birds Exposed to Eye Disease, but Only Finches Get Sick

Keep your bird feeders clean!