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Posts Tagged ‘Veterinary medicine’

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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This is a condition seen most commonly in tall, long necked horses and large breeds of dogs, particularly Great Danes and Dobermans. The disease is characterized by an abnormal gait in the front and/or the hind legs. The animal seems to “wobble” when walking or exercising. Some animals seem to have a stiff neck, may appear to be weak or lazy, that is reluctant to move, stumble more than normal or seem to misstep. There may be a generalized unsteadiness, hindquarter weakness or knuckling over in the lower leg joints, particularly in the hind limbs.

The term is frequently applied to several different abnormalities resulting in ataxia, defined as a proprioceptive deficit (loss of sense of where the animal places his or her feet). In advanced cases, the animal may fall as it struggles to ambulate. In horses, it includes a specific condition known as Equine wobbles anemia. There is considerable controversy about the potential genetic nature of Equine wobbles anemia. Other specific conditions that can result in the same set of signs include at least three different malformations of the cervical (neck) vertebrae; protrusion of an intervertebral disc, disease of the interspinal ligaments or of the articular facets (the joints) of the vertebrae in the neck. Other names for this condition are; cervical vertebral instability, cervical spondylomyelopathy and cervical vertebral malformation. The condition can also be the result of a brain lesion.

The most common cause in both dogs and horses is spinal cord compression from one of the various cervical vertebral malformations, which, again, may or may not, be inherited. Spinal cord compression can be either dynamic, occurring only when the animal bends or extends its neck, or static, present all the time.

To make a definitive diagnosis your veterinarian will have to do a complete neurological exam and then radiographs (X-rays) of the spinal canal including a contrast study (myelogram). The radiographic studies will have to be conducted with the animal under general anesthetic. While conducting these tests your veterinarian will also rule out the possibility of an infectious agent or a traumatic injury by examining the cerebrospinal fluid.

Some wobblers treated with nutritional and medical management have shown improvement, but the results are not impressive. If the cause is compression of the spinal cord a veterinary surgeon, with the proper training and experience, can decompress the spinal cord and fuse the problem vertebrae, usually by using Titanium baskets and bone marrow transplants. This is similar to the recent surgery done to the professional football quarterback Peyton Manning. It ain’t cheap folks!

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