Medical – Mary Carlson, DVM

Dog surgery 101

Hello, this is Ivy here. I had my dog surgery yesterday. It wasn’t bad-everyone was so nice. But Mom had left! Would I ever see her again? Oh well, they love me at the dog hospital because I am sooooo pretty.

I already had blood work, so all they had to do was the procedure. I was taken back to the work area. I got a peek at the room where I was going to be. The nice women who work in the back put a thing called a catheter in my arm, and started a bag of some liquid going into ME!

Next was the night night drug. Ahhhhhh. I was gone. I only remember waking up and I was whining. I don’t whine!

So here is what was done to me after I was asleep: I had a tube in my throat so gas would keep me asleep. My right hind leg was shaved and cleaned, and I guess I was taken into that scary-looking room with the huge light fixture.

The doctor made a cut, incision it’s called, around the tumor on my leg. It didn’t take very long to cut it out and label the edges for the pathologist to check margins to see if they are clean. I don’t understand all this stuff, but Mom explained it.

Mom picked me up a couple of hours later. I was pretty loopy, and those people put the “cone of shame” on my neck. Mom hates those, so she took it off, and to stop me from biting the staples in my skin, put some stuff called bitter apple around the staples.

I slept all day yesterday. I looked so comfy that Mom decided to sleep with me on her bed. And here came Frank.

Today, I can run a little, but am stopped from doing that, and I am not ‘3-legged lame.’ I still love to sleep on the patio. The new house we are moving into has a smaller patio, and Mom talked to a man who is going to build me a dog pen. The new house is not what something called an HOA says it should be, so she had to get plans into the HOA.

I have to be still until the staples come out, so I’ll just chill, and watch Downton Abbey, my fave. Gosh, I wish the theater would let me in to see the movie. Guess I’ll wait until Mom gets the DVD.

Keep you posted on the pathology report.

Love,

Ivy

The William D. Carlson DVM, PhD Radiation Physics Laboratory

Phaneuf,Aaron
Sun, Oct 13, 6:49 PM (14 hours ago)

to me

Hi, Mary –

Thanks for reaching out. The paperwork has been signed and no hurdles remain! Now, I need to discuss with you and potentially the family (if they are responsive) what should appear on the plaque. Once that is up, we can coordinate a small gathering to commemorate the moment.

I will call you early this week to discuss the language for the plaque.

Talk soon, Mary.

– Aaron

AARON J. PHANEUF
Director of Development
College of Veterinary Medicine and Biomedical Sciences
Colorado State University
970.821.6557 | Mobile

Just wanted you to know that the William D. Carlson, DVM PhD Radiation Physics Laboratory located in the Flint Cancer Center at the CSU Veterinary Teaching Hospital is almost ready to go, or RTG when we vets use abbreviations. No one deserves an honor like this more than my late father-in-law. Bill really did “invent” veterinary radiology by transposing human information into veterinary knowledge by doing a radiology residency at the CU med school, human of course, getting his PhD, then went on to teach many, many graduate veterinarians.

I would like to thank Aaron Phaneuf for being persistent and getting this done. He’s fairly new at his job, and must have found a million notes from me saying Bill really ought to be recognized for his ground-breaking work. I don’t have $75M to donate for naming the Radiation and Radiation Biology building, but Aaron and his co-workers were so kind to think up a lovely memorial to Bill in relationship to cancer in the radiation physics specialty.

If you would like to contribute to this or any other vet school projects, all you need is the zip code, 80523. The rest of the address is under Aaron’s info. Thanks for walking with me on this journey, Aaron.

BTW, when Aaron refers to the “family,” it is Earl’s family. They pulled up stakes as soon as Earl stopped breathing, and haven’t spoken to me since. Earl died ten years ago. They pushed through a church service which Earl strictly forbad, accused me of changing the service (!); and in the parking lot of the hospital watched me put his things into my Subaru, then announced: “We are going out to dinner. Are you OK getting home alone”? Ah, no….And now, they are remodeling the old farmhouse Earl and I adored, doing things we never were allowed to do, like having the landlord, his mother, fix the windows that we had to close (stuck) for winter, and open with a crowbar for the summer, held open by a stack of books. When the last window went, our cat, Matthew, was in it, and was caught between window and screen, breaking two bones in his paw. I put in Pella windows (do not buy Pella windows), for $9K, on a house I didn’t and never would own. Never compensated for things landlords are responsible for-carpet, paint, etc. I was told I had “lived for FREE for 27 years; and my mother-in-law said she was going to hire a lawyer to draw up a lease for me (I was moving to Texas;) but when I said, “I don’t know my status with this house” and was told “Everything goes to Tudy.” His sister. All of this was after Bill had died. We had asked Earl’s parents during our first year of marriage if we could buy the house. They declined, and we paid rent, the same amount for 27 years, with no or few improvements, unless they came from me.

I hope they know how hard I have tried to have a memorial to Bill Carlson, and would let up on the hate I know they carry in their hearts. Bill had no such feelings of hate or anti-Semitism, which I am sure the rest of them carry in their hearts while calling themselves Christians. Sorry, no they aren’t. Earl and I had a wonderful marriage. Sometimes downright scary due to his health issues and kidney transplant, but we shared everything, including the loss of my family members one by one over the years. Although he would never go to church, Earl was a true Christian who right now is at the right hand of G-d.

Animals grieve

I wanted to write a post about Cowboy Joe’s death July 15, but this is the first time I can type with some decency. I’m writing more now that a splint is on the hand with the thumb fracture (Bennett’s fracture if you are a medicine geek like me.)

I’ve posted about C.J.’s euthanasia. I always euthanize my own pets, even my horses. All I could do this time with my casted arms was have Dr. Thomas insert the needle into the catheter in my anesthetized Joe’s vein, and I pushed the plunger, delivering the solution into his body. It is my way of honoring my pets to do it myself. In my book, Drinking from the Trough, I discuss this more.

Between the time Cowboy was anesthetized, and being given the last shot, I was given time alone with him. Of course, the waterfall of tears fell. I talked to him the entire time, alive and dead.

Nancy was with me to drive, carry the carrier, 11 # lighter than before CJ got sick. She was in the room when he went to the Rainbow Bridge.

As is my nature, I worried about Franklin, CJ’s littermate. They were close brothers. Not one to anthropomophize animals, I do know the horror of losing a sister. Frank has cuddled close for the last month; I leave the bed unmade so he can sleep against the pillow; he talks more; and most interesting to me, started lying on the table in the TV loft where his brother hung out with the rest of us. Frank even kicked off the table one of the Longhorn cattle coasters I bought at Texas Tech just as Joe used to do.

Frank has Ivy, whom he loves, and vice versa. Ivy gives him kisses. Frank, almost 16, looks good, but has a significant heart murmur. I was going to put Joe to sleep when I go to Arizona this coming December, but he didn’t stay comfortable that long. I wonder about Franklin, but all things considered, he’s doing fine, stealing my pens and yelling about this, prompting Ivy to run and get it. Ivy used to chew them to oblivion, but now she brings them to me.

Will Frank be able to be driven to Arizona at the end of the year with a stop in NM to visit Ivy’s sister, Cali, and her family? I can’t predict, but I’ll do right by him, count on it. My squishy, cuddling, purring Frank will get all the attention I can give him to get him through his grief all the way to his own end run.

Cowboy Joe Carlson

December 2003-July 15, 2019

May your memory be a blessing

A long good-bye

I needed some ear cleaner for Ivy, so I contacted a classmate’s clinic, which is just around the street for me. I asked for my friend, and was told she was out with medical issues. I contacted my go to vet, and was told, “The news is very bad indeed”.

I’m 66 years old, and other than horrible migraines, I’m fine, even with the orthopedic injuries I have had. I count my blessings every day.

The “very bad news indeed” turns out to be early onset Alzheimer’s that is rapidly progressive. My God, she isn’t even sixty!

I talked to her husband this morning, and could hear the pain in his voice. He had told his wife that I was in town, and she remembers me. This week is crazy prior to the holiday weekend, but I will go see her with Ivy in full therapy dog mode. Her husband thinks it will be good for her.

I kept telling him how sorry I am. Then I said I wouldn’t say that any more. We had a long chat, and he offered information about her condition. I did not ask.

This bright and brilliant lady is in the throes of the “long good-bye” as Ronald Reagan put it when he wrote a letter to everyone in 1994. While I’m not using any names or locations, please pray for her, and especially her wonderful husband who will care for her always. Thank you.

A follow up: Regina passed away in October, 2019. May her memory be a blessing.

The horrible secret behind Lippazaner shows.

One day, Earl and I went to a traveling Lippazaner show at the Larimer County Fairgrounds. Apparently, there are several groups that travel the nation so people can look at these magnificent horses which were saved during World War II by General George S. Patton.

We watched the magnificent jumps. The highlight of the jumps is the Cabriolet, where the horse jumps high into the air, then kicks his rear feet back. Astounding.

Since we were veterinarians, after the show we went behind the curtain of the arena to see the horses up close. We were promptly yelled at to get out. We explained that we were vets, and just wanted a closer look.

The mood changed immediately.

The head person in charge said they were out of Adequan, a powerful anti-arthritis drug, ridiculously expensive. I said I could get some, and would meet them there the next morning. I bought some at the veterinarian supply store, not a store like PetSmart, but one focusing on medicine and specific supplies.

I bought a box of Adequan with the caveat that I would be allowed to return it. The manager agreed. I went back to The Ranch, the name of the fairground complex in Loveland, and was told to get out by the security guards. When I explained myself, I was allowed to the area where the horses were.

In veterinary medicine, you must have a doctor, client, patient relationship to sell pharmaceuticals. In other words, you have to examine the animal. The head man said he just wanted to buy the stuff because he had some lame performers. I said I brought my horse bag, and would look at the sore animals. No, the man said.

I turned and walked to my car to the swear words of this man because I wouldn’t sell him drugs improperly and risk losing my license. I returned the Adequan to the store.

I got a horrible feeling in my gut. These people were using these magnificent horses daily, lame or not, and pumping them with drugs so they could perform. Then they traveled to the next city. Horses can develop stomach ulcers by daily travel and stress.

I stopped going to circuses long ago. I will not have anything to do with performing elephants. I have such high regard for the elephant. Circus animals are so abused so the companies can make money. Sick.

Thank goodness that now, Ringling Brothers shut down because of complaints by the public on how animals were treated.

There are many other ways to watch an amazing show. Cirque de Soleil uses human performers. These people have the gift of choice. Animals do not.

Please boycott traveling animal shows. My exception is a good rodeo if there is no steer roping, which is incredibly cruel to the steer. Steer roping is only allowed in two states.

Earl and I went to Chicago when my stepmother died. On the Hertz bus was a total cowboy in full Western dress. We asked him where he was going. For the first time ever in Chicago, the Built Ford Tough circuit of bullriding was in town. The rider was Wiley Peterson, 27, already a millionaire.

How are these animals treated? With the utmost care. Earl, I and my vet friend, Ruth, went to look at the stock. The man there pointed to a phenomenal looking bull. “See that bull?” he said. “That’s a million dollar animal.”

These prize animals are cared for with the utmost of patience. You won’t see handlers begging for pain killers. A veterinarian travels with them.

Pease be aware that there is a dark side to animal shows.

How much is enough?

Euthanasia is a gift we in which we vets can release suffering animals. But vet med has changed so that many clinics no longer do euthanasias. Why? Because a specialty now is euthanasia at home or a special homelike facility. Veterinarians specialize in humane euthanasia, taking special care to take care of the family.

I still do euthanasias, but my method in cats is different than other vets. It is much simpler, and easier when a sick and old cat’s vein is the diameter of dental floss.

All vets anesthetist the patients first, I am sure. Then they put a catheter in a vein. Then into the sleeping cat goes the solution. I don’t need a catheter. Horses, yes, dogs, some, cats, no. The problem is, euthanasia solution is as thick as sludge. You draw it up in a syringe with a large needle. Then, I switch out needles to the smallest regular needle, not an insulin needle, for instance. With a sleeping cat, it makes no difference which needle size you use, but if you use the large needle, you do need a catheter so the vein won’t blow.

With the smaller needle, you can hit the smallest vein, and the cat dies just as humanely as the catheter method.

There are many solutions used. The oldest one was deemed inhumane, T-61. It is no longer made. It was horrible when used on an awake animal. It was ok with a sleeping patient, such as one on the operating table that was not to be recovered.

The two solutions now are Beuthansia D and Fatal Plus. Now think about Fatal Plus. What is the plus after fatal? Anything more that needs doing after the animal is dead? I think more vets use this product. In the movie “Gifted”, the little girl’s one-eyed cat, Fred, winds up at a shelter. It is his last day, and the girl’s uncle breaks into the room where a technician or vet is getting ready to unnecessarily kill the three cats of the day, and rescues Fred. On the Mayo table, there is a bottle of blue solution, Fatal Plus.

I don’t get it. I don’t know what’s after life that needs “Plus.” I guess I’ll wait until someone from the company reads this post and explains it for me.

Once a month

I just gave Ivy her monthly Heartguard and NexGuard. The Heartguard chew is for heartworm prevention, and the NexGuard chew is for other parasites like fleas and ticks.

To Ivy, these are treats. To me, they prevent the evil worms that circulate through the body. Actually, we don’t have much of a problem with worms, except that pups and kittens are born with them. A quick mosquito bite from the nasty proboscis, if infected with heartworm, then infects the animal.

I once was in anatomy lab opening a feline heart. I never did learn how to properly open a heart. What I found stunned me-one heartworm. One. That all it takes to kill a cat.

Treating a dog for heartworm is dangerous, and the medicine contains arsenic. It used to be just treating for prevention was in spring and summer. Now, it is year ’round. I don’t treat the cats with anything, they don’t go anywhere.

Even though Ivy has been tested and treated for worms, she still must have an annual fecal test for worms to remain a certified therapy dog. Oh well, there are worse things.

The clock is ticking

Resting on my lap, always purring, is Cowboy Joe. Cowboy and his brother, Franklin the author of part of my book, are fifteen years old. They are the sweetest cats. I got them in 2004 on our wedding anniversary. Earl was delighted. As I wrote in my book, Drinking from the Trough: A Veterinarian’s Memoir, now available in audio book, we only wanted one cat. Well that plan fell through when Fletcher started defecating on the guest bed after I returned from a year working in Virginia. We got him a buddy, Kitty Al, who died of renal failure at, yep, 15.

At fifteen, there are the three most common conditions that cats get. The most common is renal insufficiency, or kidney failure. By the time the lab work shows this, 75% of kidney function is gone. It is treated by diet and later on, fluids.

The next is diabetes mellitus. It is treated by insulin and diet.

The third is hyperthyroidism. This last can be cured with radioactive iodine, but is very expensive. People with these cats have a decision to make. Most choose medicine and diet.

Cowboy has thyroid disease. The antithyroidism medicine, methimazole, used to come only in pill form. It is a joy to pill a cat-not. Now, it is compounded into a plastic pen where you twist it to get the medicine out, then apply it to the inner pinna of the ear, where there is less fur. Cowboy prefers a gloved finger putting in his ear. I have to be careful because I have hypothyroidism, and I don’t need my thyroid gland suppressed any more.

Joe has lost about ten pounds so far. That’s a huge amount of weight. He was a huge cat, eighteen pounds. Now, he is what we called in vet school a “rack of bones.” The funny thing is that he has such a luxurious coat, and the longest, fluffiest tail in history, that you can’t see now thin he is. As time has gone by, I can feel all the parts of the bones we learned first year in vet school. He likes to eat Ivy’s dog food; but I recently took all three types of cat food I have tried, three bowls, and the cats can eat what they want. I fill the small-size bowls to the top so I can see if food has eaten.

Matthew, 17, is doing fabulously. He has renal failure with normal blood work. His urine is just very dilute. He is still Top Cat. He has surpassed Pruney’s record, and is the longest-living cat Earl and I have had.

Cowboy Joe is comfortable, rests on my lap or the bed, and purrs all the time as he has always done. The medicine keeps the litter plans drier, and he is calmer because his metabolism has calmed down.

I worry a little because I am only taking Ivy to Tucson. Lately, he has started to labor when he breathes. Frank, with his heart murmur and kidney failure, does too, but they are comfortable. Open mouth breathing is a sign of major distress.

That will be the time to give up, and remember what great brothers they have been. It will be hard, because I named him Cowboy Joe in honor of the University of Wyoming sports teams, and Earl was a rabid fan. One day, they will be in the Wyoming stands, Cowboy Joe resting on Earl’s lap, cheering on the ‘pokes.

Glad you’re still around, Franklin

On April 27 of this year, with a grade III heart murmur, dyspnea (difficult breathing), in this case an extra effort to expire-maybe not the best word to use-I took Frank to my colleague to be euthanized. This was difficult. First, Frank is tied for second as my all time favorite cat. Second, when we got to the clinic, I opened the carrier, and out walked a purring, happy cat.

The vet looked at me incredulously, as I did her. No way was this a cat ready to be put down. But I had prepared myself, and gotten him there. Dr. Kelly examined him, heard the murmur, and watched the breathing. How could we euthanize my special boy? Yeah, he used to be eighteen pounds, so much so, that I had to get him groomed for mats and a bath every other month. He just couldn’t move around his whole body to groom himself. No more, he can clean himself. And for the little mats I find, he is cooperative.

Kelly and I did a lateral radiograph of his chest, which surprisingly was perfectly normal. Go figure. Kelly laughed when I said to Frank, “Well, Frank, I guess you aren’t going to die today.”

I thought about another very important part of separating pets you shared with your spouse now deceased. I still have all three cats Earl and I shared: Matthew, 17, looking well and still Top Cat. Franklin and his brother, Cowboy Joe, are 15.

Cowboy has hyperthyroidism, and I medicate him twice daily with methimazole which, in my day of practice, was only available in pill form. Now this is in a cream in a measured plastic tube. You turn the tube twice, and apply the medicine to the inside of the ear where there is less fur. We recently measured his T4 levels, and where it was almost off the chart high, is almost normal. Good stuff. I have to wash if my skin touches it because I have hypothyroidism, one of those older age “welcome to the club” disorders.

My joy with Franklin now is how loving and content he is. All the cats love Ivy, and we all sleep on the bed after Ivy gets out of her crate in the morning to go out. When she comes back in, we all snuggle. If I am lying on my left side, Frank, who sleeps on my right, will tap my shoulder so I turn around to pet and hold him. I really love that. He is a happy guy, which is all I want and expect at this point. At normal weight now, Frank even looks right. And after seven months of extra life so far, I am really happy to have him. Let’s see what happens when I drive to Arizona with three elderly cats and a young dog.

I am blessed with animals that fill my life with love, and take away some of the hurt of losing Earl. I’ve been on my own nearly ten years. People pretty much stay away, but with my new career of writing, I can handle it better.

So, Franklin Irving Carlson, here’s to you! Some reviewers have even said the chapter he wrote in Drinking from the Trough, a Veterinan’s Memoir, is their favorite one.

I hope you can get a copy of the book and enjoy it yourself.

Cheers!

Renewing my DEA License and other tales of the weird

I just got a notice that my Drug Enforcement Agency License would expire next month. Yes, I have retired from private practice, but I still have animals, especially Hannah, who lives with my sister’s two horses.

When I graduated from vet school in 1987, a three year DEA license was a mere $60. Then, this DOJ agency said, “Hey, wait a minute, these people HAVE to have this license to do their jobs. What the hell are we charging only sixty bucks for them?” Duh.

I now pay over $700 for a three year license, far more than I spend on medicines. OK, I’m a captive. At least it was easy to renew, and I didn’t throw my MacBook against the wall. You have four pages of questions to fill out. I get it about the name, address, and state and license information. But there was a whole page on if I’ve ever had my license, DEA or state(s) pulled, committed a crime involving controlled substances, or taken away one of Ivy’s dog toys against her will.

No doctor of any kind can have a license for a Schedule I substance like heroin. I remember long ago, as he was born 100 years ago next month, that my physician father and the pharmacist across the street from his office found a large, old bottle way in the back of the locked closet. The bottle contained medical grade heroin. Remember, people used to use heroin and cocaine legally up until I think the 1920’s. Think Sherlock Holmes stories and the book, the Seven Percent Solution. It was legal to use and prescribe these now Schedule I drugs. Dad and the pharmacist disposed of the contents of the bottle. I have a collection of Dad’s antique medicine bottles, and they are really strange. The one thing of his I wanted was the beautiful jar that said, “Leeches.” It was prominently displayed in his office. The man had a strange sense of humor, OK? The leech jar disappeared somehow when my step-siblings, my husband and I were going through Dad’s and my stepmother’s things after she died. Gone.

Within the DEA application was a checkbox for forms to order Schedule I or II narcotic drugs. Why oh why do they want us to have forms to order Schedule I drugs when we can’t have schedule I medicines? Perhaps it is because medical marijuana is available, but I don’t see (haven’t checked, that is) that pot store owners have medical licenses, DEA licenses, and forms to order Schedule I narcotics.

The last thing the form asked was if I had taken an optional course on the dangers of prescribing narcotics. I checked no, because I don’t remember getting a notice for this, and I don’t prescribe narcotics. I do have a Schedule 2N on my license, along with Schedules 2,3,4 and 5, but I used the 2N only once, when I first opened my cat clinic, never used the medicine, and sent it to the DEA for disposal when it expired.

My two year license to practice veterinary medicine is expiring Oct. 31, as it always does in the even years. More bucks. I’m staying active in the profession. I don’t want to say I’m a retired veterinarian. I am retired from private practice. I can still be an extra pair of hands for a colleague, spay cats for rescues, or neuter tomcats on kitchen tables for law school classmates as I did in Texas (boy did that go around the law building at the speed of light!) And yes, I was fully licensed in Texas with one more license, the DPS, Department of Public Safety.

So, for three more years, I am a financial captive. But it makes me proud to be fully licensed in a field I worked so hard to belong.