Incidentally, chocolate is theoretically poisonous in humans as well, although we are much less sensitive. A person my size would have to eat about four and a half kilograms of baker’s dark chocolate, or an impressive 32.5 kilograms of milk chocolate, to be at significant risk of Death by Chocolate. I think that it is safe to predict that an array of increasingly distressing feelings would precede the fatal overdose and prevent you from getting to that point. But if not, imagine the obituary.
In the end it was not his zeal for foil-covered chocolate, or his sundry other dietary indiscretions, that did Elwood in, but rather an entirely unrelated kidney condition years later. I suppose he was in some way justified in his lack of regret.
The Ineffable Weirdness of Dentistry
A routine part of small animal practice is recommending dental work and then having the pet owner react as if you have just recommended Spanish guitar lessons for their dog or a set of encyclopedias for their cat. Some people view veterinary dentistry as evidence that we’ve gone too far in treating pets like people. These people (thankfully increasingly a minority, but a very annoying one) put it in the same category as pink leather jackets for chihuahuas and spa days for cats.
This can be true even when you show the client gum lesions that are exuding pus. Guaranteed, if you showed them lesions exuding pus anywhere else on the body, they would be horrified. They would expect immediate curative action. But not so for the teeth.
Why is this?
In part, it is because the teeth are generally not visible. That being said, I would like to note that sometimes the same people will then go on to show me a minuscule lump somewhere deep in the dog’s groin or be genuinely concerned when blood tests reveal a more minor issue in an internal organ that is definitely not visible.
Another factor is that animals do not show dental pain. This sometimes results in the reverse problem wherein the client will absolutely insist the cat isn’t eating because his teeth are bad. There are 968 common reasons for a cat not to eat, and that is not one of them. It is an uncommon reason for them not to eat. But the pain question is also only a partial answer as many other conditions that are not painful elicit far more interest from the dental-skeptical clients.
So then, what is my theory?
My theory is that we must blame the weird history of the human dental profession. Objectively speaking, teeth are part of your body. Actually, subjectively too. Teeth are part of your body: objectively, subjectively, factually. Agreed? Why then are they the only part of your body to have an entirely separate profession devoted to their care? It turns out to merely be an accident of history. We could have just as logically ended up with a separate profession focused on our fingers and toes. “I’m off to the digitist, dear!”
Before the 20th century, there was a division between physicians, who examined sick people and prescribed primarily quack remedies, and “barber surgeons,” who used their sharp razors and steady hands to perform surgeries ranging from lancing boils to amputating limbs as a sideline between hair appointments. Some also had a set of pliers handy to pull teeth (as did some blacksmiths). That was the sum total of historical dentistry — yanking festering molars. Carpenters and other tradesmen made false teeth. As regulations began to gel, the more ambitious of the razor-wielding barber surgeons craved the prestige the physicians enjoyed, and those professions gradually merged, more or less accidentally, leaving tooth-pulling behind and unregulated. Later on the medical colleges who began to shut down all manner of other trades that were practising medicine without a licence (midwives come to mind) ignored the tooth-pullers because they didn’t seem to be a threat and, some will darkly say, because they were of similar social backgrounds.
This has left us with a situation where in Canada, Medicare will pay to operate on your infected toe, but not to operate on your infected tooth. A situation where you have two incompatible sets of records regarding your health. A situation where some people see their teeth as being divorced from the big picture of their health. And for us poor veterinarians who have successfully kept the entire body of our patients under one umbrella, a situation where some pet owners have a different mental box for teeth than for the rest of Fido or Fluffy’s body. Arbitrary and weird. Dentistry is weird.
P.S. My dentist is great and hardly weird at all. I just think if he were an MD dental specialist, my life as a veterinarian would be simpler.
Feeling Ticklish?
I apologize for the egregious use of a lame pun as a title. I am defenceless against the ease with which one can make puns with the word “tick.” Even the national veterinary association has launched a “Tick Talk” (I can hear your groans from here) awareness campaign, complete with an entirely over-the-top horror-themed ad. It’s on YouTube if you’re curious.
I imagine that you have already heard a fair bit about ticks and about the diseases they transmit, so I’m not going to repackage that information for you here. The Veterinary Partner website is a trustworthy resource if you have specific questions. Instead I’m going to highlight a less often discussed aspect that is alluded to in the title: ticks going on people. More specifically, ticks going from your dog onto you.
Ticks are potential vectors for disease. The word “vector” just means transporter, a kind of living vessel that carries a disease-causing organism from one animal to another. Most famously the deer, or black-legged, tick is a vector for the Borrelia organism that causes Lyme disease. But what we don’t often consider is that your dog (and potentially, although quite rarely, your cat) could be a “vector for the vector,” a kind of “metavector,” to coin a term. Most people with tick-magnet dogs — you know, the dogs that disappear into the tall grass and come back with 20 ticks on them — are already familiar with the phenomenon of later finding ticks in the house, presumably having fallen off the dog. This could theoretically happen with any dog, particularly if they have darker or longer fur, as ticks can be very difficult to spot unless you are making a point of checking carefully. While I could find no studies that looked at the actual incidence of this, it is reasonable to assume that any dog could accidentally bring a deer tick home that could then infect you with Lyme disease. Eighty percent of humans who contract Lyme become ill, sometimes quite severely, whereas only about ten percent of dogs do.
And if that isn’t enough to make your skin begin to crawl,5 the less harmful but equally creepy brown dog tick can actually reproduce and complete its entire life cycle inside your house, causing a serious infestation. They like to crawl up walls and hang upside down. The good news for local readers here in Manitoba is that this type of tick is not, to the best of my knowledge, reported here (wood ticks, also called American dog ticks, are the other ones we see besides deer ticks), but we should remain alert as the American CDC considers the brown dog tick endemic in North Dakota and Minnesota, and it is common in Ontario.
Now I have totally freaked you out.
So let me conclude by trying to unfreak you. Fortunately this comes at a time when we finally have good tick medication. For years when people were concerned about ticks, we would more or less shrug and say something along the lines of, “well, you could try this, it helps a bit.” In the last two or three years new products have come along that are easy to administer, very safe and far more effective than the previous generation. I’ll leave the specific recommendations regarding which product is best for your dog to your veterinarian. None is 100% perfect, though, so I still recommend checking your dog over carefully after a walk on anything other than just the sidewalk. But at least now you have far less reason to feel . . . ticklish.
* * *
5Actually that crawling sensation you are feeling on your leg right now, or possibly in your scalp, is almost certainly not a tick as people generally can’t feel them moving about. Sorry, I think I might have freaked you out.
The Ballad of the Prairie Flea
I’m willing to wager that if you were
visiting your psychiatrist and he said, “What’s the first word that comes to mind when I say ‘dog’?” a reasonable percentage of you would say “fleas” (those of you who didn’t say “bone,” which is worthy of an essay on its own). Most cartoon dogs have fleas, and children tune ukuleles to “My Dog Has Fleas.” An itchy dog is presumed by many to have fleas. But not so fast. Some of you reading this live on the Canadian Prairies or in the drier parts of the US, and woe betide the poor prairie or desert flea. You see, fleas love heat, and fleas especially love humidity. Consequently, there are many, many, many fleas in Tallahassee (hot, wet) and no fleas at all in Tuktoyaktuk (dry, cold). For better or worse Winnipeg, and the rest of the Prairies, is a lot more like Tuktoyaktuk than Tallahassee. Next time you’re in Florida, pay attention to how many veterinary clinics you see. A lot, right? Fleas. It’s all because of fleas.
Despite this ground truth the culture still teaches people to assume that an itchy dog or cat has fleas. It used to be the number-one myth I would bust. We would see the occasional case of fleas, perhaps two or three a year, versus the literally hundreds and hundreds of dogs and cats itchy because of allergies (yes, allergies — extremely common). I would marvel at this tough or perhaps misguided little prairie flea and wonder how she got here and what her plan for the winter was. A year ago this would have been a quick and simple essay to write — your pet does not have fleas. Done. This last fall, however . . . something has changed. They are still very rare, but we had perhaps eight or ten cases, quadruple the average. We’re not becoming Tallahassee any time soon, but we seem to be inching a little closer. Add fleas to your running list of climate change consequences. Al Gore didn’t warn us about this.
And how do you know your pet has fleas? Ideally you see the mighty flea itself, but they are tiny and astonishingly quick, and they are only on the animal to feed. The rest of the time they are — gulp — out and about in your house. Instead, we rely on a gross flea fact. Fleas drink blood and then poop out the digested blood. Consequently, flea poop looks like little black dirt particles in your pet’s fur. Take one of these particles, place it on a white sheet of paper, wet it slightly and then streak it with your finger. If it streaks a rusty reddish brown, then you, my friend, have fleas in your house, and it is time for you to panic. No, I’m kidding — you should never panic, but you should be very slightly grossed out. (Note: cats may groom the flea dirt off, complicating matters somewhat.)
I won’t go into treatment in any detail except to say, perhaps predictably, that you should talk to your veterinarian as it is a bit complicated. However, I will say a word about flea collars. That word is “useless.” I have had clients come in and declare that the flea collar works well because Bozo doesn’t have any fleas. This is akin to the man wearing the tinfoil hat declaring that it’s working because aliens have not been able to zap him with mind-control beams. The prairie flea may have a little more swagger these days, but your pet would still have to be extraordinarily unlucky to encounter one. And if you’re in Vancouver or Boston or London, or any other more humid part of the world, you’ll be chuckling at all this. You know that your fleas have always had more than just a little swagger. They positively prance. No extraordinary bad luck required for your pets — just the ordinary garden variety.
There Are Worms in My Heart
OK, not technically right in the heart itself, but more on that later. And not technically my heart — at least probably not — but more on that later too.
Spring is heartworm season in Manitoba and in much of North America, I think. Yes, it is. If you work in a veterinary clinic it is unmissable, unmistakable, unforgettable. It’s not that our wards are packed full of dogs sick with heartworm disease; rather, it’s that testing and prevention has to occur in a fairly narrow calendar window. Compounding this, for most people it’s convenient to get all the other annual stuff done at the same time since they’ve dragged Fido in anyway (incidentally, no actual dogs are named Fido, or Rover, or Rex, or Spot; some cats are though). Consequently, most of us see as many patients in a week in the spring as during a month in the winter.
I don’t want to waste time spewing Basic Heartworm Facts. You can get those from reputable corners of the internet or, better still, from your friendly neighbourhood veterinarian. Some of you even are your friendly neighbourhood veterinarian, in which case spewing would be even more time-wasting. Instead I want to touch on a few of the more unusual Cool Heartworm Facts. (OK, some of you will consider these Gross Heartworm Facts, but I think they’re cool.)
Cool Heartworm Fact #1
Heartworm has probably been around forever (or such a very long time that it may as well be forever) with possible reports dating back to the 1500s. It was first positively identified as such in 1847 in South America and then in 1856 in the southeast USA. After that it continued to spread north and west, arriving in Canada just over a hundred years later. Now it is well established in the southern parts of Ontario, Quebec and Manitoba, with some cases also in BC’s Okanagan Valley and in Atlantic Canada. Nobody knows exactly whether it started in South America or came there from elsewhere in the tropics — possibly Africa — but it is now found on every continent except Antarctica, with the highest incidences being in the hotter and wetter parts of the world.
Cool Heartworm Fact #2
However, despite that spread, large areas of western North America and the Arctic do not have much of it yet. This is not necessarily because of a lack of mosquitoes, but because of a lack of positive dogs already there. Mosquitoes are just flying syringes moving heartworm from one dog to another. This is why the mosquito paradise of northern Manitoba is heartworm free. In the case of southern Manitoba, the population density in the corridor running south to Minnesota and on towards the Mississippi Valley is high enough to allow relatively easy dog-to-dog-to-dog transmission in a chain running south to north.
Cool Heartworm Fact #3
Heartworms can be huge, up to 35 centimetres (14 inches) in length. And they can be numerous, with infestations of over 100 worms reported.
Cool Heartworm Fact #4
The above-reported size and numbers are very rare, so most of the time “heartworm” is a misnomer. Most of the time the worms are hanging out in the pulmonary arteries leading away from the heart. Only if there are more than about 25 do they actually back up into the heart, and I have never seen that in my own practice. But “pulmonaryarteryworm,” while more accurate, is so much more unwieldly. Unless you are German like me, in which case you prefer more accurate words, especially if they are long and unwieldly. However, I am sadly forced to admit that the Germans have failed us in this specific regard as heartworm in German is simply “Herzwurm.” On the upside, though, the longest German word, nominated for “German Word of the Year” in 1999, is a semi-veterinary word! Rindfleischetikettierungsüberwachungsaufgabenübertragungsgesetz” means “a law to regulate the delegation of cattle marking and beef labelling.” So there.
Cool Heartworm Fact #5
Wildlife can get heartworm. Logically foxes, coyotes and wolves are most at risk, but it has also been reported in bears, raccoons, leopards, sea lions and, oddly enough, beavers. Cats and ferrets are at some potential risk as well depending on where you live, so check with your veterinarian. Heartworm prefers dogs though, so higher numbers of worms are required to infect these non-dog species, and consequently, the risk is lower for them. A scary fact though is that heartworm in cats rarely produces symptoms and is most commonly only identified on autopsy of a cat who has died suddenly and unexpectedly.
Cool Heartworm Fact #6
Perhaps the coolest fact: humans can also get heartworm. Heartworm-positive mosquitoes bite us and release microfilaria (baby heartworms) into our bloodstream all the time, but fortunately we are not good hosts, so 99.9% (and probably a few more nines after that) of the time, they die. However, there have been at least 80 cases reported in humans in the US, mostly in the lungs, but occasionally �
� shield your eyes if you are squeamish — in the eyes and the testicles (!). These have mostly been mild infections. The main problem is that on lung X-rays, a heartworm lesion looks very much like a tumour, prompting further invasive tests. Radiologists call it a “coin lesion.” So if you overhear the interns whispering about this while they shoot sideways glances at you, politely clear your throat, put up your hand and ask about heartworm.
A Dog’s Mind
“What do you suppose is going on in his mind?” Mr. Reynolds asked, smiling at Alf, his 12-year-old Lab cross. Alf sat patiently beside him, staring at me, not blinking, his eyes tracking my every move.
“We can only guess,” I replied lamely as I leafed through Alf’s file, trying to decipher the scribbles.
“He’s totally focused on you. Paying close attention to everything you do. Watching to see if you reach for a needle or a treat!”
Focus, attention, watching. Fully conscious and aware. Mr. Reynolds was absolutely right, and it got me thinking.
For most of Western history we believed that animals were not conscious in the same way that humans were. We believed that they did not have a “mind.” We believed that their behaviours were only the products of unthinking reflexes. In the 17th century René Descartes famously stated that an animal crying in pain did not actually feel it the way we did, no more than a machine felt the noisy grinding of gears. Denial of animal consciousness persisted deep into the 20th century. In fact, I am ashamed for my profession that up until the 1980s it was unusual for veterinary schools to teach much about pain control, in part because of lingering doubts regarding animal consciousness.
The Accidental Veterinarian Page 12
