Don’t let your dog get fat!

The internet is obsessed with chonky, fluffy, and thicc dogs. Sure, there’s more to love and more to squish. Who doesn’t like watching a chubby, wrinkly pug roll around the floor, perhaps even off the side of the couch when dozing off? If you’re the Instagram account administrator of the aforementioned pug, you probably get plenty of likes and a nice paycheck from Instagram too. It all seems well – you’re happy, your dog (seems) happy, and everyone gets a good laugh. But it must be said, these chubby internet famous pets are slowly dying inside.

To all pet owners, and even to myself who has a chonky dog, we must ask ourselves some important questions: is having a fat dog, ok? Is it bad? Is it inhumane? I unfortunately think it is, and here’s why.

Just like in their human counterparts, obesity predisposes dogs (and in reality, all pets) to many types of cancer, diabetes, heart disease, high blood pressure, and a slew of orthopedic diseases like arthritis and joint pain. A recent multi-institutional study published in the Journal of Veterinary Internal Medicine titled “Association between life span and body condition in neutered client-owned dogs” reported that the lifespan of overweight dogs was up to 2 ½ years shorter on average than the lifespan of dogs with a healthy body weight. This result is revealingly sad, and I see it as a call to do everything we can to help our dogs lose weight. There are plenty of ways to accomplish this with exercise, dietary management, and lifestyle modifications, but perhaps the simplest place to start is with a quick calculation using a standardized formula.

70(Bw).75

Here, Bw is your dog’s body weight in kilograms (you can take your dog’s body weight in pounds and divide by 2.2). Raise that to a power of 0.75 and then multiply by 70. This will give you the total number of kilocalories (or kcals for short) your chubby little dog needs in one day (treats included) to achieve a healthier body weight. You’re probably now asking, “what is my dog’s ideal body weight?” I say perform a quick google search of the typical body weight of whichever breed your dog may be and use that. Once you calculate the total number of kcals your dog needs in one day stick with it.

It may seem like a small amount of food. It may seem like your dog is starving. But it will be ok. Your dog will thank you when he or she lives a longer, leaner, and happier life. Get calculating!

A lesson on reciprocity from vampire bats

Vampire bats usually, or perhaps quite frequently, freak us out. Goosebumps immediately pop up when seeing or even thinking about their thin webbing between their long digits; their sharp, tiny fangs and their black, beady, little eyes. But an interesting and evolutionarily advantageous behavior of theirs may freak us out even more, and not because it’s spooky. It’s good. It’s quite amazing. They help each other out. They scratch each other’s backs (not literally). They reciprocate – something we as doctors and even as humans often have a difficult time doing. Reciprocation is hard but it’s extremely beneficial for all involved in both the short and long term. If little vampire bats can do it, I’m sure we can too!

Here’s the lesson. After a successful night of bloodsucking vampire bats will regurgitate blood into the mouth of another genetically unrelated vampire bat that was not successful in their hunt. The unsuccessful bat will then remember the good deed of the kind bat and reciprocate in the future. Furthermore, the unfortunate vampire bat will share blood primarily with those bats who had helped them before. And again, they aren’t even related.  What a nice relationship!

I feel as humans we don’t think twice about helping relatives, but we often must consider things before helping an unrelated person. As doctors, too, perhaps we are more likely help our friends or give preference to a client we know versus an unknown doctor or unfamiliar client. Either way, reciprocation is an important part of veterinary medicine and we should think about it more. Just like we fear little vampire bats sucking our blood, we should let reciprocation haunt our dreams and completely take over our minds.

A human’s near-death experience during a dog’s humane euthanasia

It wasn’t the best circumstance, but it just happened that way. It was interesting, humbling, dark (literally), and quite revealing about the nature of humanity and our understanding of life and death. As we know it, death is the same throughout the animal world. We all share it, and we will all meet this end eventually. Fortunately, though, and maybe this is what separates us from other animals in the animal kingdom, some of us can visit that ethereal place, the void, the serene darkness (or whatever we want to call it) and come back to tell the tale. To actually describe what dying is like – crossing the river Styx, opening the gates of Heaven, breaking the endless cycle of attachment and suffering – some of us can, in vivid detail.

Here’s the story:

I was out on the water. On a boat with some friends in my early twenties. Thought nothing of the day. It was sunny, the water was clear, the air crisp. Smack! My vision gone. Sparkles clouding my vision. A deep red hue obscuring my vision. No noise. No sensation. Complete darkness. I was falling through a void. Lifeless. Eventually it stopped and I was floating, peacefully. No worry or doubt in the world. Complete relaxation. Contentment. Pure bliss. And then a voice. The voice was not separate from me, it was me, and I was the voice. It was all knowing, at least I felt it was. It’s difficult to describe. But it asked me a question. It asked me if I had hurt anyone. I didn’t hurt anyone. It kept asking me that same question until I realized I had been hurting myself. I accepted that, and in accepting that, zoom! I was sucked back up through the void. Ambulance sirens, heart monitor beeping, commotion. I learned I was struck by a boat, suffered a massive seizure, and (almost) life-ending brain hemorrhage. 

Then I, the emergency veterinarian, pushed the propofol and followed it with euthasol. The canine patient dying of metastatic hemangiosarcoma.

I wonder what the dog was experiencing and if it was anything like his owner’s story?

Get Pet Health Insurance!

This is not going to be a lengthy, in dept post about the benefits of Pet Health Insurance, which ones are the best bang for your buck, what it includes, what it covers, and where to get it. This is merely a public service amount, a PSA if you will, to get Pet Health Insurance! Even if you do not imagine your pet getting sick. Even if you only ever bring your pet to the vet for vaccines. Even if you do not have a pet. Get it. Get it in anticipation – anything can happen. 

 With the human animal bond becoming stronger by the minute, prices at the vet are going up (also by the minute – I’m seeing this happening right now working in corporate medicine). And so, too, is the desire for specialized veterinary medicine. So many people want their pets to see a surgeon, an internist, an ultrasonographer, an acupuncturist, or a shockwaver (aka a veterinarian familiar with the use of extracorporeal shockwave therapy). This highlights the reality that going to the vet is not just vaccines and cardiopulmonary auscultation and ear swabs. It is essentially on par with going to a human doctor who treats your own human ailments, expect the doctor (the vet in this PSA) does not actually like people. They are just doing it for your fluffy little fuzzball. So, do it for them, get Pet Health Insurance. 

We honestly all like our pets better than other people, which is all the more reason to get it. Our pets deserve the best. They deserve what we deserve. They need to be insured so that they can live without fear of falling out of a building, eating xylitol bubblegum, getting stung by a bee, developing cancer, being attacked by a housemate, or wasting away from chronic diarrhea.

Wildlife in the Digital Age

Wildlife in the digital age is wild no more. It is noise emanating from a Bluetooth speaker. Pixels glitching across a screen, bound by four sides 10.1, 13.5, 11.3, or 15.6 inches in length and width. Artificial colors straining our retinas and aching our brains (see, you need blue light filtering glasses!). And now, with the coronavirus pandemic, we too share this experience. We too are bound by four walls for what seems like is going to be an eternity. Oh, the irony. Complex biological life enclosed by four sides, viewing a digital representation of other biological life that they re-created for their own viewing pleasure. We are so intrigued by and obsessed with the true wildness of wildlife, but not obsessed enough to protect its natural boundaries and save it from immortal confinement in cyberspace. One must ask, “are we heading for this same end too?” 

Regardless of our fate, the fate of wildlife and the natural world was sealed from the moment early humans planted the first seeds and domesticated the first wild animals. From here, wildlife and wild things have been removed from the natural world and, up to present day, transferred into mere code and algorithms. They are glorified in documentaries, docuseries, dramas, and short films and worshipped in playlists, podcasts, pictures, and prints. How fascinating, we say, when we are viewing these productions. But as quickly as our forebrains are stimulated and shocked, we click the remote, close the screen, turn off the speaker and return to our modern, detached, synthetic world. 

 It truly is a strange, unfortunate, depressing, disconnected, and lonely world we live in nowadays. But there is hope, maybe not for us, but surely for what will survive the disaster that is us. As a veterinarian and ecologist, I do believe in the greater good of humanity, the resilience of wildlife, and the unbendable force that holds all of the natural world together. We, as humans, just have to be a bit more respectful, a lot less wasteful, and more kind to ourselves and other forms of life. We also have to move our screens away from our faces and pay more attention to what is behind them. What is truly important to see does not require blue light filtering glasses. 

What Dying Pufferfish in the Caribbean Can Tell Us About Mental Health

It’s going to be a stretch, but let’s start here.

Puppies. Dogs. Grouchy couch potatoes. The furry little family members. Whatever age they are and whichever name we give them. They make us happy. They fix all of our problems and give us the courage to confront our colossal qualms.

Dogs help. They improve our emotional well-being and they keep the ground steady below our shaky legs. There’s a reason we train Goldens and Labs to be emotional support animals. Check out the research on it.

There’s also research on the mass mortality events of pufferfish in the Caribbean Ocean. Meet the Caribbean Sharp-nosed pufferfish! A small pufferfish with one of the most potent neurotoxins in the animal kingdom, being almost one-thousand times more toxic to humans than cyanide. These small creatures; in response to stress, resource limitation, and disease can wash up on beaches throughout the Caribbean in the thousands. Dead.

And so begins the de-stretching of the story.

You’re on that beach with Captain Sniffer, unknowingly, after one of these mass-mortality events (maybe brought on by climate change, plastic pollution, a nearby oil spill, the possibilities are endless nowadays) and Captain Sniffer is doing a little too much sniffing. He eats a few, perhaps he eats twenty or thirty of these of pufferfish.

The seizures start.

Captain Sniffer is sniffing no more. He’s having a grand mal seizure. Your head is spinning, you feel as if you just skipped the prodromal phase yourself and are heading right into the aural and then ictal phase alongside Captain Sniffer. But wait. The ever astute and prepared veterinarian that you are remembered the activated charcoal and midazolam you just so happened to have in your adventure bag.

Phew. Even on an exotic beach in the Caribbean, without any fancy monitoring or equipment, you fixed him. Captain Sniffer is safe to sniff another day. Your travel buddy is safe, and your mental health preserved.

This story tells us a lot. It tells us that really everything is connected. I mean c’mon – an oil spill (or some other environmental stressor) leading to thousands of toxic pufferfish dying, washing up on the beach, being consumed by an emotional support dog who then seizes and almost dies from fatal neurotoxicity, sending his owner into a state of depression and emotional turmoil from losing their best friend?

This is a very real situation. It happened, and it reminds us that, regardless of our focus of study or career, we should get comfortable with situations like this because as time moves forward the interconnections between seemingly disconnected things will only get closer and messier and more stressful and more regular. We all really need to work together to better understand the many problems that presently plague the planet. It's 2020. We have a lot to think about. Our society, and planet, is fragile. 

How Fungi Shape a Small Part of Veterinary Medicine

Fungi truly are dimorphic in the field of veterinary medicine (although not all fungi are dimorphic, only the ones that exist in both a mold and yeast form). You can say this because fungi can both cause disease and treat disease, and in some cases the same exact one.

 Say your dog is outside, running around the forest after a rainy night. She finds some mushrooms on a decomposing log in a shady area. Maybe she eats a few. Maybe she also sniffs a little puddle of urine from a wild animal (say a deer). Whoops! You call her back inside after seeing what went down. She comes back in. 

 A few days later she begins to show neurological signs and her eyeballs are yellow. You rush her to the emergency room, the veterinarian does some bloodwork and imaging, and they unfortunately diagnose her with acute liver failure secondary to mushroom toxicity. 

 The veterinarian tells you the mushrooms she ate most likely contained amanitin, which is the active, toxic component that causes acute hepatic necrosis and hepatocyte death. Ouch. After reminding the veterinarian about the puddle of urine your dog encountered, he decides to start her on penicillin, in addition to the other medications to support her liver.  

 Why?

Because Leptospirosis, the bacteria spread in the urine of wild animals, has been shown to also cause acute liver failure in dogs, and we could also be dealing with that here in addition to the mushroom toxicity!”

Got it.

 With that, you think back to your Microbiology class in college and remember that penicillin, the broad-spectrum antibiotic, was originally obtained from the Penicillium molds P. chrysogenum and P. rubens. Interesting. Your dog probably doesn’t think so, but she’s just happy to be alive after a week in the hospital. 

Will Artificial Neural Networks Replace Veterinarians?

A simple neural network was described on paper and then modeled using electrical circuits in 1943 by the neurophysiologist Warren McCulloch and the mathematician Walter Pitts. This idea was advanced through the 50’s, 60’s, and 70’s mainly as academic pursuit, until the 1980’s when the “instant physician” showed promising clinical application. This neural network stored a massive number of medical records, learned from those medical records, and could determine the best diagnosis and treatment when presented with a set of symptoms. Just like a human doctor; but more accurate, unbiased, and a heck of a lot quicker.  

The “instant physician” is just one of many Artificial Neural Networks, or ANNs, which are mathematical algorithms generated by computers that capture knowledge contained within data and analyze it. Essentially, they are artificial human brains that learn things, remember those things, and then use those things to figure out other things that are often not grossly apparent in large swaths of data. They receive inputs (information we give them), think about it (process the inputs), and then generate an output (an answer). More often than not these answers are a yes or no or true or false, like, is this disease present? Is this person at risk of developing a specific disease? Will this person die in the next 5 years given the disease they have?

Nowadays, however, ANNs are much more sophisticated and integrated in many parts of human medicine involving clinical diagnosis, prediction of cancer and length of stay in hospital postoperatively, speech recognition, predicting risk of heart disease and osteoarthritis, radiograph and ECG analysis, and drug development. They are also used in more nebulous endeavors like clinical modelling and detecting nonlinear relationships in research that the human brain often cannot comprehend. And, even now in veterinary medicine, these networks can read radiographs and predict chronic kidney disease in cats. But ANNs in veterinary medicine are nowhere near as complex as those in human medicine. 

But they will get there. As we know, veterinary medicine always trails behind human medicine and much of what we do in our field is often modeled off the successes of our anthropocentric colleagues. 

The utility of ANNs will surely become more apparent as veterinarians strive for efficiency, accuracy, automation, and getting as close as possible to gold standard care. We all want that as veterinarians, right? Wouldn’t it be awesome to be able to predict the risk of osteoarthritis in a 6-month-old German Shepherd so that preventive measures can be taken sooner? Or determine the presence of a fragmented medial coronoid process radiographically, without having to perform a costly CT scan? Or determine the risk of surgical/post-operative complications in a brachycephalic dog prior to surgery? These would all be great, and owners would love it.  

When questions are asked, boundaries are often lifted, and advancements are made. I don’t know anything substantial about computer programming, writing code, artificial intelligence, or designing ANNs but I believe those who do fashion these networks to process information and think like us. They are pushing the threshold of machine learning and ANNs will, without doubt and in time, become so sophisticated that they will begin to think on their own, without our input. They may even replace us. What will we, as veterinarians, do then? 

Lab animals are the true heroes during times of pandemic

A good friend of mine posted this on Facebook:

Shout out to all the lab rats that will give their lives to develop COVID-19’s vaccine. Often times mice and rats get a bad rap for living so close to humans, but they are mini super-heroes in medical research.

I think he’s onto something. He’s thinking of something very big picture. He’s ripping open the cage-wire doors to the reality of how dependent the fields of human and veterinary medicine are on lab rats and mice and all animals living their entire lives in laboratories throughout the world. Irrefutably, medical research in its entirety relies completely on lab animals to design experiments, test hypotheses, and make advancements. This reliance allows us, as a society, to explore treatment options for the most serious syndromes and, ultimately, cure disease. Aging, Alzheimer’s, cystic fibrosis, polio, and hopefully COVID-19 are just a few of the diseases we understand better today because of our animal models. Furthermore, these models allow us to focus our medical lens on the future in which specialized, precision medicine enhances the baseline health of our society. 

…and we are doing all this without giving lab rats and mice a choice. 

I think this is what my friend is trying to say. Human scientists, doctors, and health care professionals are undoubtedly heroes in medical research and in supporting the structure of our society, but lab animals are the true unsung heroes. They are the true embodiment of selflessness. Without them, science in its simplest form would be at a virtual standstill. 

This is especially important to realize during hysteria-ridden, politically charged, society altering pandemics like the one we are experiencing right now. These mini-superheroes allow us to crack viral codes and solve RNA jig-saw puzzles, but more importantly they provide our society with peace, stability, confidence, and unity. They provide us with so much more than vaccines, medications, and treatment regimens. They provide us with a comfortable, predictable, and stable life. They provide us with human life as we know it.     

It is indisputable the debt we owe to lab animals. Again, they are not given a choice in any of this. So, the least we can do? We can begin to see these creatures not just as mini-superheroes but as mega-superheroes. They deserve it. They deserve the recognition. 

The solution to the modern, global-scale health disaster? Just do the right thing.

It just feels like the right thing to do. 

It just feels like the right thing to do. Not much thought is put into it. Ego is pushed deep into the pockets. Hands are out ready to wield instruments, perform tests, auscultate hearts and lungs. Arms are outstretched, open, inviting. Personal protective gear is on. 

Lives are put at risk, but only because the lives of others are also at risk. Again, not much thought is put into this because helping just feels right. It is the right thing to do. 

Whether it be in response to natural disasters like earthquakes, hurricanes, or tornadoes; violent war, human rights catastrophes, or human health epidemics like the one we are experiencing right now with COVID-19, health care professionals make a joint decision, and I bet with most surety, with very little hesitation and doubt. They feel it was and is the right thing to do. 

We humans have a crazy capacity to deeply think, balance pros and cons, consider options, process situational computations at lighting speeds, make clear and informed judgments, and see the big picture for what it really is. But in times of disaster, in times when life is so quickly and quietly leaving the lungs of thousands around the world, not a single breath is held in making the decision to answer the call to help. This is being human – not taking a breath to think so that another breath may be had by someone else who needs it. This is just the right thing to do. 

To all healthcare professionals (human doctors, nurses, veterinarians, technicians, public health workers, researchers, etc…) working during past times, this time, and all future times – think diligently, work tirelessly, and stay safe. To all the patients suffering – stay positive, do not lose hope, and pray to your god(s), your doctors and nurses, and to science because all three are on your side. And, to the world leaders, politicians, and businessmen – global scale disasters like this are only going to become more frequent and more deadly so long as human activity, use of resources, and our interaction with the environment goes blatantly unchecked. Today, the connection between us, wild animals, and the grounds upon which we all stand is so very real, so very fragile, and quite literally the only reason we exist today. This pandemic you are dealing poorly with now, that is straining the global health care system and world economy, that is breaking the hearts of thousands of families, is a direct result of lax policy, abhorrent carelessness, crippling greed, and absolute disrespect for humans and non-human animals. 

If we want to prevent disasters like this from happening in the future (because they will), we all need to start acting like health care professionals, right now, in the cities and affected areas around the world. 

For the sake of all existence and life as we love it, do the right thing.