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Ingesting hops can be highly toxic to susceptible dogs. Hops can act as an inciting cause or trigger for malignant hyperthermia but it seems the animal must have a genetic pre-disposition for this to occur.

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Scientific Name: Humulus lupulus, Family: Cannabidaceae

Malignant hyperthermia, an uncontrolled increase in body temperature, is a rare life-threatening condition usually triggered by exposure to general anesthetic agents, most commonly volatile anesthetics, in certain genetically susceptible humans, pigs and horses. Caffeine can also act as a “trigger”. Hops have been shown to trigger the reaction in susceptible dogs and cats. The triggers can induce a drastic and uncontrolled increase in oxidative metabolism, the utilization of oxygen, in skeletal muscle. This overwhelms the body’s ability to regulate body temperature. The result is high fever leading to circulatory collapse and death if not immediately treated.

The susceptibility to malignant hyperthermia is often inherited as an autosomal dominant disorder, for which there are at least 6 genetic sites of interest. In 50–70% of cases, the propensity for malignant hyperthermia is due to a mutation of the ryanodine receptor located on the sarcoplasmic reticulum of skeletal muscle cells where calcium ions are stored. The ryanodine receptor acts to open calcium ion channels that allows the ion to enter the skeletal muscle cells and initiate contraction. Malignant hyperthermia results when the normal processes of entry and subsequent removal of calcium ions from the muscle cells are interfered with. The process of sequestering excess calcium ion within the cell consumes large amounts of adenosine triphosphate (ATP), the main cellular energy carrier, and results in the generation of the excessive heat (hyperthermia) that is the hallmark of the disease. The muscle cell is damaged by the depletion of ATP and possibly the high temperatures and cellular constituents “leak” into the circulation.

The other major known causative gene for malignant hyperthermia is the protein encoding a different type of calcium channel. There are two known mutations in this protein. When these mutant channels are expressed in human embryonic kidney cells, the resulting channels are five times more sensitive to activation by caffeine (and presumably volatile anesthetic agents and hops). Other mutations causing malignant hyperthermia have been discovered but. in most cases. the relevant genes remain to be identified.

Research into malignant hyperthermia was limited until the discovery of “porcine stress syndrome” in Danish Landrace and other breeds of pigs. This “awake triggering” was not observed in humans and cast doubt on the value of the animal model. However susceptible humans were discovered to develop malignant hyperthermia the “awake trigger” in stressful situations. This supported the use of the pig model for research.

Pig farmers began to expose piglets to halothane. Those that died were malignant hyperthermia-susceptible, thus saving the farmer the expense of raising a pig whose meat was not marketable. This also reduced the use of breeding stock with the genes. The condition in swine was also found to be due to a defect in ryanodine receptors. The causative mutation in humans was only discovered after similar mutations had been described in pigs. Another argument for the use of animal models in research. Sorry, that was my career for thirty-six years and I still have to climb onto the soap box from time to time.

A causative mutated ryanodine receptor gene has been identified in Quarter Horses and other breeds and is inherited as an autosomal dominant. It can be triggered by overwork, anesthesia, or stress. In dogs the susceptibility seems to be autosomal recessive.

A malignant hyperthermia mouse model has been developed using molecular biology techniques. These mice display signs similar to those in susceptible animals when exposed to halothane as a trigger. This model was used to demonstrate that the injection of dantrolene, a muscle relaxant, reversed the response to the halothane in these mice and in humans. The current treatment of choice is the intravenous administration of dantrolene, discontinuation of triggering agents, and supportive therapy directed at correcting hyperthermia, acidosis, and organ dysfunction. Treatment must be instituted rapidly on clinical suspicion of the onset of malignant hyperthermia. After the widespread introduction of treatment with dantrolene, the mortality of malignant hyperthermia fell from 80% in the 1960s to less than 5%. However, the clinical use of dantrolene has been limited by its low solubility in water. This means it must be dissolved in large volumes of fluids complicating clinical management. Azumolene is 30 times more water-soluble than dantrolene and also works to decrease the release of intracellular calcium by its action on the ryanodine receptor. In susceptible pigs it was just as potent as dantrolene. However it has not yet been approved for use in humans. Hopefully those clinical trials are in progress. Research in mouse models continues in efforts to more completely describe the genetic mechanisms that trigger this condition.

So we know that hops can be poisonous to at least some breeds of dogs and also sometimes to cats. The cones are the culprit when enough of them are eaten. The initial symptoms are restlessness, panting, abdominal pain and vomiting. In serious cases, symptoms progress into seizures, rapid heart rate and life-threatening high body temperature. Greyhounds seem to be the most susceptible breed but also susceptible are golden retrievers, St. Bernards, Dobermans, border collies and English springer spaniels. Hops grown by aficionados pose a threat when the mature cones are low enough for the animal to reach or drop to the ground. With home-brewing becoming more popular we could see an increase in hops poisoning. A potentially bigger threat than hops plants is dogs getting into bags of stored hops or spent, dumped hops sediment.

Dogs are far more sensitive to ethanol than humans. Even ingesting a small amount of a product containing alcohol can cause significant intoxication. No matter how popular beer drinking dogs are on U-Tube hops poisoning is probably not a threat but intoxication from the alcohol is. Alcohol intoxication results in vomiting, loss of coordination, disorientation and stupor. Sound familiar? In severe cases, coma, seizures and death may occur. Dogs showing mild signs of alcohol intoxication should be closely monitored, and dogs that are so inebriated that they can’t stand up must be taken to your veterinarian.

 

Ernest Hemingway in “For Whom the Bell Tolls”

It is early May, after a spring snow storm, Roberto and Maria are together in Roberto’s sleeping bag, outside, in the mountains of Spain.

“Then they were together so that the hand on the watch moved, unseen now, they knew that nothing could ever happen to the one that did not happen to the other, that no other thing could happen more than this; this this was all and always; this was what had been and now and whatever was to come. This, that they were not to have, they were having. They were having now and before and always and now and now and now. Oh, now, now, now, the only now, and above all now, and there is no other now but thou now and now is the prophet. Now and forever now. Come now, now, for there is no now but now. Yes, now. Now, please now, only now, not anything else only this now, and where are you and where am I and where is the other one, and not why, not ever why, only this now; and on and always please then always now, always now, for now always one now; one only one, there is no other one but one now, one, going now, rising now, sailing now, leaving now, wheeling now, soaring now, away now, all the way now, all of all the way now; one and one is one softly, is one longingly, is one kindly, is one happily, is one in goodness, is one to cherish, is one now on earth with elbows against the cut and slept on branches of the pine tree with the smell of the pine boughs and the night; to earth conclusively now, and with the morning of the day to come. Then he said, for the other was only in his head and he had said nothing, ‘Oh, Maria, I love thee and I thank thee for this.’”

At three-thirty in the afternoon we started looking for an RV park. We passed several that were not worth turning around to go back to before stopping at a grocery store in Gualala, CA. I purchased some fresh vegetables for dinner and the checkout lady told me how to find the California State Salt Point campground. At the gate was a friendly park ranger who was talking to a young couple. I stopped and he told me to just pick a spot and then return and fill out an envelope from one of those in a box at the gate. Put five bucks in the envelope and I would be registered. I drove through the entire campground where all the spaces were empty. Too many choices.

I returned to the gate and stopped without getting out of Old Blue. The ranger turned from the young couple he was still talking to.

“You decided not to stay?”

“Nope,” I answered “couldn’t find an empty spot.”

He looked at me incredulously until I smiled, and then he laughed politely at my lame joke. I climbed out of Old Blue, retrieved an envelope and made the loop again. I consulted with Charlize and we picked a spot, filled out the envelope, put my five bucks in and walked back to the gate to deposit the envelope. The ranger and the young couple were gone.

Charlize found something to interest her.

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Wilma the Cat

Sidney, Montana, the summer of 1960. Ike Williams and Jon Wilkins were partners, the owners of Williams & Wilkins Blacksmiths and Mechanics. Their shop was large, chaotic and dirty. It occupied the entire frontage of their property hiding their small, immaculate, frame house. The shop and their considerable skills shielded them from the necessity of acknowledging their relationship, something the community had no real need or desire to hear or talk about. The partners were able to repair and, if necessary, fabricate parts for any type of motorized or pulled agricultural implement. That was what the community considered important. They had lived and worked together in Sidney for twenty-five years before my new bride and I arrived. I was a recent graduate and new associate veterinarian in the only veterinary practice within a fifty-mile radius.

Like an old married couple Ike and Jon finished each other’s thoughts, knew how to avoid conflict, were comfortable in their own skins, and with each other. All necessary accommodations had been made.

They both loved cats. I was never able to determine exactly, or even approximately, how many cats they had. There were shop cats, outside cats and house cats, all well cared for.

From time to time one or both of them would bring in a house or shop male for castration or a female to be spayed. All received annual vaccinations. I guess they had a method for deciding which cats would occupy which spaces. The outside cats were free to reproduce but each new litter of kittens was brought in for vaccinations and caring homes were found for them.

They were both sitting in the waiting room when I returned from doing rectal exams on twenty-five head of half-wild range cattle to check for pregnancy. I rubbed my sore left arm as I greeted them.

“Mr. Williams, Mr. Wilkins, what have you got for me today?”

They stood up as if joined at the hip. Wilkins held a huge tabby in his arms. The cat was whimpering obviously hurting.

“This is Wilma, she’s a house cat. Old Doc spayed her for us several years ago and she’s had all her shots every year. Today when we came in for lunch we found her, crying in pain. She’s paralyzed.”

As he talked tears welled up in Wilkins’ eyes. Ike put his arm over his partner’s shoulders.

“It will be OK Jon. Young Doc is good everyone says so. He’ll take care of Wilma for us, won’t you Doc?”

I held out my hands.

“Here, let me take her. Let’s go into the exam room and see what we can figure out.”

Wilma was too soft, too fat, and too lazy. Both hind limbs were flaccid. She meowed louder with Jon no longer holding her. She was also hyperventilating. I examined her carefully, noting that the white nails on her hind paws were tinged blue and the paws were cold to the touch. I was unable to palpate a pulse in either femoral artery.

“This is not good,” I told them. “I’m pretty certain she has what we call a saddle thrombus. It’s a blood clot blocking the two main arteries to her legs. I’ve never seen a case but I remember the description from vet school. All the signs are there. She is paralyzed in the hind legs, in obvious pain and there is no blood circulating to her hind legs.”

“Is there something you can do to fix her?” asked Ike.

“Well, theoretically I could operate and remove the clot. However, I’ve never done anything even remotely like that before, never actually opened an artery on purpose then tried to suture it closed afterwards. I don’t think we even have any suture material small enough to do that kind of thing. Also we have no idea what causes this and it could come right back. I’m sorry. I hate to say this. My job is to help animals not kill them. In this case I think the best thing I can do to help Wilma is to put her out of her misery.”

They were devastated.

“Are you sure you don’t want to even try?” pleaded Jon. “Cost is not a problem you know. We’ll pay whatever it costs,” he looked to his partner for confirmation. Ike nodded his agreement.

“OK, I’m willing to try anything, but I have to make certain you know this could be a disaster. I’ve never even seen anything like this done. First let me look to see if we have any suture material small enough to close an artery.”

I was apprehensive as I searched through the cabinet of surgical supplies. I found one packet of 4-0 silk, with needle attached. It looked to be several years old. I had no idea where it came from or for what my boss intended for it when he bought it. I came back into the exam room and held up the packet.

“This might work, but it’s old and I’ll need to sterilize it again, I have no idea how long it’s been around, the package says it expired two years ago. You guys are certain you want me to try this? I don’t really know what I’m doing. I’ll have to dissect down to the end of the aorta, that’s the main artery coming from the heart, where it branches to supply blood to both hind legs and the tail. Then I have to find the blockage, try to put a tourniquet around the artery above the obstruction, open the artery, remove the clot and suture the artery closed. Chances are very good Wilma will bleed to death while I’m fumbling around.”

“But she’ll be anesthetized, right Doc? She won’t feel anything? Ike asked.

“That’s correct,” I said. “As soon as I anesthetize her she’ll feel no more pain, until and unless we remove the clot and get everything repaired and let her wake up again. She could still be in a lot of pain after I’m done with the surgery, I don’t know.”

“But you can give her something for post-operative pain, right?” Jon pleaded.

“Sure, sure, we can treat post-op pain.”

“OK Doc. Go for it. Is it OK if we wait here? We already put a sign on the shop door saying we wouldn’t be back until tomorrow.”

“Sure, you’re welcome to wait here. It will take me some time to put a surgical pack together to sterilize with the suture material. I have to think about what I might need by way of instruments. I know we don’t have any specialized vascular surgical instruments or suction so I’ll have to improvise. I’ll let you know before I get started. Let me give her just a touch of tranquilizer to see if we can make her more comfortable. I’m afraid to give her anything like a full dose because her heart rate is so fast. The tranquilizer will slow her heart rate and the high heart rate may be the only thing keeping her alive.”

I got Wilma anesthetized, hooked up an intravenous drip, opened up her abdomen, packed off her abdominal organs and found the distal aorta. When I tried to dissect around the aorta I managed to break off some small branches and the abdomen quickly filled with arterial blood. The turkey baster I added to the pack was not an adequate suction device and Wilma bled out in short order. It was the unmitigated disaster I had feared.

Today we know that saddle thrombus is almost always associated with a disease called dilated cardiomyopathy. This is a condition, probably with genetic predisposition, that is uncommon but not rare in cats. The heart is enlarged and dilated and it doesn’t function properly. Normally blood is always moving inside the heart. This constant motion of the blood, even when the heart is resting between beats, helps prevent clots from forming. Because the heart is dilated and unable to beat strong enough areas of flow stasis develop within the heart chambers. Areas of flow stasis allow clots to develop. When the clot becomes large enough it is eventually washed out of the heart. It flows downstream until it lodges at a location too small for the size of the clot, usually at the terminal trifurcation of the aorta. Modern veterinary surgeons can deal with this, providing the underlying heart disease is treatable. Today, if diagnosed early enough and if the underlying heart disease is controlled, many of these animals can be saved and will go on to live a reasonably normal life. In 1960 my saving Wilma would have been a miracle.

Ike and Jon understood and were even appreciative that I tried.

I felt guilty and depressed, never acclimated to losing an animal, especially through my own clumsiness.

Excerpt from “Animals Don’t Blush”

5star-shiny-web-review sticker

 

 

 

 

 

 

“The purpose of this road trip was to try to figure out what I should do with my remaining years and how to do it. I’m seventy-six years old, and for more than fifty-two of those years, I was married to the only girl I ever truly loved. I’m not accustomed to making decisions on my own. Charlize is a good listener but doesn’t contribute much, except enthusiasm, to the decision-making process.” Travels with Charlize: In Search of Living Alone by David R. Gross is an open story of recovery.

 

Gross is on a mission to discover how to live without Rosalie, his late wife. Three-year-old Charlize is his third German shepherd, adopted less than two weeks after Rosalie’s passing. Charlize came with a different name, but, according to Gross who decided to mimic John Steinbeck’s Travels with Charley, he renamed her. Gross describes their bond as “two injured beings who need to support each other.” His travels with Charlize started with Old Blue, his 2012 Dodge Ram 1500 and The Frog, his camping trailer. Gross was pleased – “Frog pulled like a dream, sticking close to Old Blue’s tail.”

 

Travels with Charlize is truly engaging. Gross’s skill as a writer is evident. His narrative and thoughts not only focus on Rosalie and the travels, but also include his fond memories from his younger days, his sons, grandchildren and even his previous German shepherds. The pictures included in the book make the reading more appealing. The writing style is straightforward; I love the casual tone of the prose. Readers, whether or not travelling is their forte, should give this book a go and get to know Gross, and especially Charlize.

 

This is a photo of one of many small restaurants inside the Mercado del Puerto. All of the separated restaurants have an open, wood fueled, grill like this one where most of the cooking takes place.

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This is the chunk of loin I was served. Alexis had a rack of lamb with at least ten chops. The meat portions were gigantic, but tender and tasty, a carnivore’s kind of place.

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We saw several of these horse-drawn carts while out and about in the city. Although there is full employment in Uruguay, jobs for anyone who wants to work, one sees people going through dumpsters to salvage paper, cardboard, plastic bottles, and other recyclables. The horses are very calm amidst the heavy, fast moving, car, bus and truck traffic. Lane markers seem to be just a suggestion with two lanes accommodating at least three vehicles, more lanes more vehicles. Horns are used to let other drivers know where you are.

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Out in the countryside horse-drawn carts are even more common and are used to transport goods short distances. It is obviously much less expensive than gasoline that sells for about $8.00 a gallon. The high price of gasoline also accounts for the small size of the automobiles, although we did see plenty of Mercedes and other luxury vehicles. Protected parking space is also a premium and we saw many houses with just enough room to squeeze the car inside the security gate.

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Most but not all houses in the city were guarded by high security, walls topped with wire or broken glass, or tall spiked bars topped with electric fences, windows covered with bars and/or heavy shutters.

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The yellow sign warns of the charged wires above the ten-foot tall spiked fence.

We asked about all the security and received a variety of answers. It appears that violent crime, including home invasions, is rare. There is some breaking and entering and stealing from vacation homes when it is clear the owners are away. Mostly, we were told, the crime rates are quite low but when there is a crime the news media tend to sensationalize it and thus there is a high level of paranoia. This paranoia is fed and encouraged by a home security industry that seems quite robust. We talked to some home and business owners with lower levels of security and they seemed to be unafraid and unconcerned. Certain areas are considered to have higher crime rates than others, so that’s not unlike our own neighborhoods, but we did see a lot of security.

Click on this link to read the review:

<a href=”http://www.prlog.org/12440447-travels-with-charlize-in-search-of-living-alone.pdf”>Travels With Charlize; in search of living alone</a>

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