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Wednesday
Jan072015

The Nacho Deer

Kate Connell - Penn

Foot in Mouth Disease - Winner

Best Overall Submission - Winner

 

         I’ve often found that the most interesting cases in the veterinary field appear on the necropsy table. Unlike human medicine, we can’t always afford to run all of the necessary diagnostics to find our disease. So the most baffling cases literally open up for exploration once the patient is deceased.

            The case that I’ll lay out for you today features a deer that was brought in to a wildlife clinic in Guatemala (yes, there are deer in in Central America). At first glance, he took your breath away. Magnificent twelve point buck, glistening coat, bright eyes, and…morbidly obese. We might be used to seeing overweight cats and dogs coming to our offices, but let me tell you, seeing a fat deer is something that makes you scratch your head. 

            The police confiscated the deer from a man keeping it in his backyard, where it had been raised on a diet of Frito Lays and Pringles (how the name “Nacho Deer” came about). Once he was with us, Nacho Deer acted like a typical only child that had been allowed to eat cookies for breakfast and stay up late watching TV in his room. When given his vegetables, he kicked them around his pen in a bitter rampage, and volunteers weren’t allowed in the enclosure with him after too many charging incidents. 

            Needless to say, no one shed a tear when Nacho Deer was found suddenly dead one evening. Because it was too late to investigate cause of death, we locked him in the office (no deer-sized refrigerator in the facility) so that scavengers wouldn’t pick at him overnight. We returned to do the necropsy the next morning, and I’ve never seen such a bizarre combination of pathologies.

            The first oddity: our primary incision down the ventral midline bled. A lot. I glanced at the vet, but as usual he wore his poker face. Reasons for a bleeding corpse flashed through my mind.

It is dead, right? Yes, rigor mortis and cold clammy skin confirmed my first paranoia. I’ve only done necropsies with refrigerated specimens. Maybe in the heat it takes over twelve hours for blood coagulation. Corpses normally have clotted blood, right? For a moment my inexperienced brain froze. Then I shook it off. I had never been bled on before during a necropsy. Is this a Central American thing? Is it like sickle cell in Africa to avoid some kind of tropical disease?

Finally I realized that the others were moving forward with the dissection. The organ systems were divvied up between the three interns. I was told to find the kidneys. Child’s play. Or so I thought, until I realized how much thick, hard fat there was in the viscera. It took force to peel the layers of intestines back, with a sick sticky sound like duct tape being coaxed from the roll. Pellets of lard flaked off of the beast as we sweated and grunted our way through.

“I think I figured out what happened,” the intern with the stomach said. We paused to watch her pull a large plastic bag from the organ as a magician would pull a colorful handkerchief from his sleeve.

The vet bent down to examine it with quiet concentration. After a moment he stood and said, “It wasn’t caught in the sphincter, was it?” When the intern shook her head, he stated with a cool degree of confidence, “No, that’s been in his stomach for a few weeks. If it wasn’t blocking the passage of food, I doubt that it would have killed him so suddenly.”

(As a side note, I don’t know what year of vet school we learn the rate of plastic decomposition in deer bile, but I do look forward to the day when I sound so freaking omnipotent about everything.)

We continued working, and much to my embarrassment, I had to admit that I was unable to find the kidneys. My favorite organ, lost in the midst of fat and shameful lack of experience.  

The vet sidled over to the table, and after a few seconds of sifting, he jerked a soccer ball –sized lump of fat from the abdomen. (I truly wish that I had a picture of this to prove that I’m not exaggerating about the size. But considering I wanted to burn all of my clothes after the necropsy, I’m not sad that I didn’t have my camera around that tsunami of deer fluids). I took my already-dull scalpel and sawed through the fat.

When the two halves of fat cracked apart, all that I could see in the center was about three tablespoons of scarlet jelly.

“What is that?” I asked.

“That would be a kidney,” he nodded.

According to him, more Americans would be inclined to lose weight if the FDA could show images of what dense abdominal fat does to your organs. As I stared at the strangled kidneys, I made a promise to myself to lay off the stress eating around finals season.

This deer would have had next to no kidney function, but the vet shook his head when we asked if that was cause of death. “Too sudden,” he argued.

Obviously he had solved the case long before we had become sweat-drenched and unspeakable-fluid-drenched. Sensing his interns at a frustrated loss, he borrowed a scalpel and made a decisive nick in the caudal vena cava. Blood pooled out into the abdominal cavity.

“Should that happen?” he asked. After a chorus of no’s, he proceeded. “So why did it?”

Realizing that the mystery would never be solved at this rate, he provided the missing information. The venom in many tropical snakes could take down even large prey by setting off whole-body hemolysis. No blood cells, no gas delivery system. Put under a microscope, the red blood cells look like they had been through a blender, thus why our deer had such a bizarre looking clotting disorder.  

As we started shoving deer parts into the wheelbarrow, he tried to cheer us up. “If it hadn’t been for the snake, the problems you had found would have surely killed him in the next week or so!” 

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