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I leased my practice in Phoenix and moved my family to Mexico City after accepting a one-year appointment with the Food and Agricultural Organization of the United Nations. FAO was operating a project with the veterinary school at the National Autonomous University of Mexico. The purpose of the project was to aid the college in upgrading their programs. My job was to help establish an ambulatory clinic to give the students hands-on experience diagnosing and treating animals on the farm.

While visiting a small community a group of students and I diagnosed a mule with tetanus. It was a textbook case and I decided that as many students as possible should be able to have the experience of observing and treating the animal. I explained to the owner, in my rudimentary Spanish, that the prognosis was very poor but that I would like to arrange to move the mule to the veterinary hospital to give as many students as possible experience with this kind of case. I was careful to explain that since the case was valuable as a teaching tool he would only be responsible for the cost of the drugs used and then only if the animal recovered enough to work again.

He agreed to the arrangement and I arranged transport for the mule to the veterinary teaching hospital at the university. Various groups of students assigned to the case treated it under my supervision for over three weeks. At one point, we had to put him in a sling because he was unable to stand on his own, but he made a miraculous recovery. It was extremely unusual for an animal with tetanus to recover in 1967. I arranged to transport the mule back to the owner the next time we went to the village where he lived.

I explained to the owner how to care for the mule until he fully recovered and handed him a bill for five-hundred pesos, about forty dollars, a small fraction of the cost of all the drugs we used in the treatment. I explained that I had substantially reduced the bill by charging for only a fraction of the drugs we had used because so many students had benefited by working on the case.

“But Senor Medico you say me I would not have to pay if the mule could not work. You see he is very weak, he cannot work.” He was speaking in elementary school Spanish so I could understand.

“I understand,” I said. “He will recover and when he does you will accept this obligation, true?” I fully understood that the poor farmer probably only earned twenty-five pesos a day, maybe less and five-hundred pesos was a fortune to him, but the mule was worth at least a thousand or more pesos.

Two months passed and we visited that village three or four times. Each time the farmer took pains to seek me out and explain that the mule was still too weak to work. I told him I understood and smiled to myself.

Three new students were with me in the truck a few weeks after my last conversation with the mule’s owner. As we drove past the village, I saw my man out in a field plowing with the mule. I stopped the truck.

“Now you will experience the practical side of veterinary medicine,” I told them and related the story. All of them knew about the mule and were amused that I had been unable to collect the bill, interested to see how I would handle the situation.

“Buenos dias,” I greeted my client.

“Muy buenos dias Sr. Medico,” he replied.

“I see the mule is fully recovered and working well.”

“Si senor, but it was not your medicine.”

“Oh?”

“You see the leather thong on his left front fetlock?”

“Yes.”

“A curer in the market at San Angel sold me that. It is treated with many special cures (mostly urine my students explained later) and the curer said me it would make the mule completely recover if I tied it around his left front fetlock.”

“What if you tied it around his right fetlock?” I asked.

“He said me it would only function if I did it properly and with the correct knot he showed me.”

“And it obviously worked,” I smiled.

“As you see, the very next morning he was cured.”

I turned to the students.

“Today’s lesson is to never believe you are smarter than your clients.”

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There is some evidence that Polybrominate Diphenyl Ethers (PBDEs) may be involved in hyperthyroidism in cats. Feline hyperthyroidism may be the most common endocrine disorder in cats. It is associated with benign tumor(s) of the thyroid gland and usually appears in middle-aged to older cats, without preference to breed or gender. The signs of hyperthyroidism are weight loss, hyperactivity accompanied by a voracious appetite. Cats can also demonstrate increased water intake, more frequent urination, along with intermittent vomiting and/or diarrhea. Cats with severe hyperthyroidism suffer from increased heart rates, arrhythmias (irregular beats) and congestive heart failure. About 10% of cats with hyperthyroidism develop a condition known as apathetic hyperthyroidism. These animals show depression and lack of appetite with fast weight loss.

The diagnosis of hyperthyroidism is by measuring increased circulating levels of the two thyroid hormones. Your veterinarian can verify the diagnosis by the use of special thyroid imaging called planar thyroid scintigraphy. Hyperthyroidism can be treated successfully with anti-thyroid drugs, surgery or the administration of radioactive iodine, the latter is currently the most commonly employed and probably the most successful.

There are three different types of PBDE compounds commonly used as flame retardants. They can migrate out of the flame retardant products then accumulate in indoor air and house dust and eventually contaminate the environment. Since the PBSEs do not break down quickly in the environment they accumulate in air, soils, sediments, fish, marine mammals, birds and other wildlife and well as in meat, poultry and dairy products. We should expect a decrease in these contaminants in this country since two of the most commonly used types were discontinued in 2004 and the third will be phased out in 2013. However, exposure from existing building materials, furnishings and consumer products, especially those imported from countries still using these products will continue.

A paper recently published in the Journal of Toxicology and Environmental Health suggested a link between PBDEs and hyperthyroidism. The researchers studied 21 normal cats, 41 cats diagnosed as hyperthyroid and 10 normal feral cats with no exposure to household dust. Although the total PBDE concentrations in the serum of normal and hyperthyroid cats were not significantly different, the total PBDE in dust from homes of hyperthyroid cats was significantly higher than the dust from homes of normal cats. The levels of PBDE in dust and one of the thyroid hormones (T4) were significantly correlated. Although this study does not prove a cause and effect between PBDE levels in household dust and hyperthyroidism in cats it is another indication that household pets could serve as sentinels for environmental toxicants that could affect humans. A major problem with most toxicology studies is that the effects of low levels of toxicants, over long periods of time, are too expensive to conduct and therefore are almost never done.

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