FOOT IN MOUTH DISEASE

Submitted by Reilly Scheppers, Louisiana State University

STUDENT EXPERIENCE: GALAPAGOS ISLANDS

Submitted by Isabel Correia, University of Tennessee

"In January, I traveled to the Galapagos Islands for a study abroad experience as part of an “Applied One Health” elective course through my veterinary college. As a dual degree DVM-MPH student, I am passionate about one health approaches to wildlife conservation. From my previous education, I don’t think a realistic solution to conservation issues involves insufficient efforts to remove human influence from wild areas. This effort no longer seems practical in our current earth system and in light of the rate of climate change and globalization. Rather, I think a more promising direction to pursue lies in embracing these new human-animal-environment interactions and finding healthy, sustainable ways to move forward.

As much as I read and write about one health and value its importance, there is no replacement for real-world application of the principles I have come to value. There are few opportunities for applied one health that currently exist for veterinary students, and I am very grateful that this opportunity arose at my university during my time here. Working with Galapagos Animal Doctors (GAD) through Worldwide Veterinary Services (WVS) provided me with great insight into this field. This experience was also a great opportunity to improve my cultural competency, cultural humility, and Spanish-language proficiency. I gained confidence in my Spanish speaking skills, helping to break down language as a barrier to my career and ability to communicate.

One major takeaway from this experience was the complexity of establishing and growing a successful one health project starting as an ‘outsider’ to the community. GAD’s primary objective at this time is to perform sterilizations of dogs and cats in an effort to reduce the burden of introduced domestic species on the native wildlife. Following their one health goals, future objectives include vaccinations of dogs and cats as well as eventually providing care for wildlife. Coming from the United States, vaccination sounds like a very basic, fundamental part of veterinary practice. This is supported by the awareness that so many animals on the islands suffer from diseases that core vaccines and preventatives can help prevent, such as parvovirus, distemper, and ehrlichiosis. However, I learned that starting a vaccine program in a place like the Galapagos is not as straightforward as it may seem to someone with my background. Additionally, public perception is something to be taken very seriously, and outreach is vital to advocate for responsible pet ownership and the efficacy (and safety) of vaccinations once GAD has the ability to administer them.

I also found it very valuable to learn about conservative medicine. In our classes, we are used to learning about the ‘gold standard’ of veterinary care and often have a wide array of resources at our disposal. At the GAD clinic, I learned how the veterinarians still practiced high quality medicine in spite of limited resources, often empirically treating cases. My takeaway from this is not that we should never use the diagnostic equipment at our disposal, but rather that we may find ourselves in situations where the most blood work we can do is a smear and PCV, imaging is limited to an ultrasound (if that), and the surgeries you can do are limited to what can be done with a basic spay pack under total intravenous anesthesia. It is essential we learn to be resourceful in this profession; this is a quality that I think one gets better at with experience, and it will be very important in my future career. 

In addition to practicing my clinical and surgical skills, I gained incredible insight into the increasingly necessary role that veterinarians play in the anthropocene on the one health stage. While the Galapagos Animal Doctors clinic currently works with domestic species (mainly dogs and cats), it is clear that there is a great need for veterinary care of these animals. Introduced and invasive species have a massive detrimental impact on the endemic wildlife that the islands are known for. Seeing the impact that a single clinic can have on greater conservation efforts was very eye-opening and inspiring as I move forward with my career. I am so grateful to IVEC for supporting this experience that has allowed me to grow personally and professionally, giving me more confidence for a career in one health."

PHOTOGRAPHY

Submitted by Christine Wright, North Carolina State University

"Glacial" 

DVM Loading... Podcast

Submitted by Katlyn Marr and Karling Hemstreet, Texas Tech University SVM

Veterinary school can be daunting from a lot of aspects. From getting admitted to your dream school to graduating with the coveted DVM behind your name, it can be difficult to navigate life as a veterinary professional. During lunch one day, two first year veterinary students decided to take the leap and discuss the relevant issues that many young professional students face. Thus, DVM Loading… Podcast was born. With your hosts, Katlyn Marr and Karling Hemstreet, DVM Loading… serves as a platform for pre-vet students, current veterinary students, practicing veterinarians, and their families to discuss the real world highs and lows of being in veterinary school. As first year veterinary students at Texas Tech University School of Veterinary Medicine, Katlyn and Karling wanted to unite future, current, and past veterinary students to the practicing veterinary industry to leave a mark on those that need encouragement, advice, or support. When listeners tune into weekly episodes of DVM Loading… they will get discussions about advice on applying to vet school, how to handle rejections, imposter syndrome, finding friends and mentors, how to get involved in the community and clubs, life in general as a vet student, and SO MUCH MORE! The ladies of DVM Loading… plan to pass the torch to fellow classmates once they reach graduation, so the podcast can continue to serve as a platform for information and advice as veterinary medicine will most definitely look different from how it did when they started the podcast! While Katlyn and Karling are from Texas, DVM Loading… is for everyone, from other states as well as countries around the world, with the goal of having guests from other veterinary schools for additional insight. DVM Loading… is the place for future and current veterinary professionals to gain knowledge and camaraderie from others experiencing similar life events. So if you’re looking for advice or just wanting to reminisce on life as a veterinary student, tune in every Monday for new episodes! DVM Loading… is available on Apple Podcasts and Spotify. Questions or comments can be sent to Katlyn and Karling via our email: dvmloadingpodcast@gmail.com. We’d love to hear suggestions for future podcast topics too, so if you have any burning questions or experiences please reach out to us!

Below is a direct link to DVM Loading... on either Apple Podcasts or Spotify:

https://podcasts.apple.com/us/podcast/dvm-loading/id1670111309?i=1000607059919

https://open.spotify.com/show/4cE1zRKnC9wSSTM4BjJvoJ

With love,

Katlyn Marr and Karling Hemstreet

Case Report

Submitted by Olivia Obringer, Michigan State University

My personal pet, Merlin, an 8mo old MN DSH presented to MSU VMC for inability to urinate. He was adopted by myself 29 days prior and had no history of urinary issues. His bladder was firm and painful upon palpation. An IV catheter was placed, and Merlin was sedated and unblocked. This procedure was uneventful, and urinary catheter positioning was successful. A urinalysis was submitted and was positive for crystals and negative for bacteria and casts. An abdominal radiograph of the bladder revealed 2-3 mildly radiolucent stones in the bladder. Ultrasound of the bladder confirmed the stones (see image below).

A cystotomy was performed and the stones were removed and submitted to the Minnesota Urolith Center. Merlin recovered well from surgery and began a diet of Hill’s c/d. 

A few weeks later, the results of the stone submission confirmed Merlin had ammonium urate stones. Because of this result, bile acids were run, and the results were as followed:

Bile Acids Fasting (Enzyme cycling): 8.6H [Range: 0.5-7.9] umol/L

Bile Acid 2 Hour (Enzyme cycling): 88.5 H [Range: 1.9-11.3] umol/L

Two weeks later, Merlin was sedated for a CT with angiogram and bloodwork. His bloodwork results revealed:

Urea Nitrogen: 7 L [19-36] mg/dL
Total Bili 0.1 [0.1-0.3] mg/dL
Direct Bili 0.0 [0.0-0.1] mg/dL
Indirect Bili 0.1 [0.1-0.3] mg/dL
ALP 104 H [13-48] U/L
ALT 71 [25-76] U/L
AST 22 [14-36] U/L

His CT report revealed a “single extrahepatic splenophrenic portosystemic shunt”.

Merlin never had any neurological signs (ataxia, seizures, dysphoria) and only ever had a history of chronic diarrhea. Due to the blood’s diversion of the liver, Merlin accumulated ammonium in his body which promoted the stone formation in his bladder.

Merlin had a good prognosis with surgery, and that option was pursued. An ameroid constrictor was placed around the shunt, and he did well during surgery and post-operatively. He was discharged the day after. Unfortunately, Merlin developed post-attenuation neurological signs (PANS) a few hours after returning home. He was disoriented, ataxic, and experiencing central blindness. Despite proactive treatment, Merlin continued to decline and developed cluster seizures. He was humanely euthanized.

I will miss him dearly.