One Big Hot Spot

 D. E. Larsen, DVM

The early morning air was warm and unusually humid as I loaded into my truck to head to the clinic. This was going to be a hot day, and I just hoped I wouldn’t have some dog with a heat stroke today.

“The good news is there isn’t much going on this afternoon,” Judy said when I leaned over the front counter to look at the appointment book. “We should be able to leave early before the day warms up.”

When Dixie came through the front door, her immediate concern was the daily schedule.

“I’m hoping we have an easy afternoon,” Dixie said to Judy.

“I am trying to keep things open,” Judy said. “They say it will be a hot day, and you know how hot it gets in this clinic.”

“Yes, I am going to get the backdoor open and start the sprinkler on the roof,” Dixie said. “That will keep things cool until two or three this afternoon.”

Dixie opened the garage door in the back of the clinic. With the front door open, it provided a nice cool breeze through the clinic. The sprinkle on the roof kept the clinic from heating up until later in the afternoon. The water running off the roof was hot already.

“I didn’t schedule any surgeries today,” Judy said. “That way, we won’t be stuck here recovering a patient in this hot weather, and we can fill those hours with any clients that call this morning.”

The morning was busy, and Judy did a good job fitting the entire day into the morning.

“I think we will be out of here at one if we work through the lunch hour,” Dixie said. “That will be great. I have plenty to do this afternoon.”

I was finishing the last appointment at twelve-thirty when Georgia came through the door with her Saint Bernard, Nana.

“I know I don’t have an appointment, but something is terribly wrong with Nana,” Georgia said. “I am hoping you can see her.

“We are just finishing up for the day, but I think the doctor has time to look at her,” Judy said.

Dixie showed Georgia and Nana into an exam room. “Something doesn’t smell good with Nana,” Dixie said. “How long has she had a problem?”

“I noticed her smelling this morning,” Georgia said. “I was so hot yesterday, and she suffers in the heat anyway. I just assumed she was just hot when she was scratching yesterday.”

Nana’s odor had filled the room by the time I stepped into the exam room. I took a deep breath.

“Nana is an interesting name,” I said. “Where did you come up with it?” 

“Nana was the family Saint Bernard in the Peter Pan movies,” Georgia said.

“Let’s see if we can find where this odor is coming from,” I said. “How long has she had a problem?”

“I noticed her scratching a little yesterday,” Georgia said. “I just figured it was the heat, but this morning she really smells.”

I knelt down to look at Nana. She was far too large to lift onto the exam table for just an exam. I ran my hands down her back, and her skin was moist over her shoulder blades. 

“I think I have found the problem,” I said as I parted her hair to look at the skin. A large area of infected skin was on the middle of her back. “I think we need to clip some hair to get a better look at things.”

“I hate to have her hair clipped,” Georgia said. “Are you sure that needs to be done?”

“What is going on with Nana is a moist skin infection,” I said. “The hair mats down a little, and the infection just grows. We need to remove the hair and clean up the area. Then with some antibiotics and other medication, things heal up pretty fast in most cases.”

We started clipping Nana’s hair in the middle of her back. The skin was painful, sore, and covered by a thick layer of yellow pus. We extended the area of the clip, looking for the edge infection. Nana was an excellent patient. She never complained through the whole process.

“Look at the size of this hot spot,” Dixie said as she finally reached the edge of the infection, almost up to Nana’s neck and back to the middle of her back. “I don’t think I have seen anything this large.”

“And it looks like it extends down her sides,” I said. “It looks like someone poured a bucket of pus on the middle of her back.”

When we finally finished clipping hair, the area covered looked like the area that a saddle would cover. Several strips of infection extended Nana’s sides, almost to the bottom of her rib cage and down the sides of her legs.

We scrubbed the area with Betadine Scrub. Then after a rinse, we applied some Furacin Ointment and hydrocortisone cream. 

“We are going to send you home with some antibiotics and prednisone. I expect this to heal rapidly, although there are a few spots where the infection is pretty deep, and they might scab over.”

“What caused all of this, Doctor?” Georgia asked. “Was it something that she ate?”

“I could be a food allergy, but the dermatologists say that food allergies are real rather rare, unlike what the dog food companies try to say,” I said. This often starts from a reaction to something, and maybe just a flea bite. Controlling fleas this time of the year is just about impossible. I hear new medications are on the horizon that will help with flea control.”

“How can a flea bite cause something like this?” Georgia asked.

“It is not just a simple flea bite. It is the allergic reaction to the bite,” I said. “Or the reaction to some other allergen, the dog scratches a bite, the skin oozes some moisture, that mats the hair down. A skin infection quickly follows in this heat, and the lesion just grows. This is by far the largest hot spot I have ever seen.”

“So she is going to be okay,” Georgia asked.

“Yes, I think she will feel much better in the morning,” I said. “We should plan to check Nana on Monday, just to make sure everything is coming along okay. Then it is just growing some hair back.”

Nana’s tail was wagging as she went out the door.

“I was so glad we didn’t have to sedate her,” Dixie said. “I could just see our free afternoon melting away.”

“I turned the phone over to the answering service,” Judy said. “I hope everyone has a good weekend. It is supposed to be cooler by Monday.”

***

Nana was a different dog when she came through on Monday afternoon. Bouncing in the door, tail wagging and nuzzling Dixie, she led her and Georgia back to the exam room.

“I think she knows you guys helped her,” Georgia said. “She feels so much better, and there is only one small scab on her back.”

“Looks like we are home free,” I said as I looked at Nana’s skin. “The inflammation is mostly resolved. There is nothing more to do now except finish the medication, and then Nana can grow some hair.”

Photo by Olga Dudareva on Unsplash. 

Brucellosis Vaccination 

D. E. Larsen, DVM

I was up early and got to the clinic well before eight. I was hoping to get out to Bill’s place and finish his heifers before the day heated up too much.

“We have a call this morning to vaccinate some heifer calves,” I said to Dixie as soon as she came through the door. “It is going to be a hot day. We need to get out there right away, so we can be done before it really heats up.”

“Well, the good news is there isn’t much going on this afternoon,” Judy said. “We should be able to leave early before the day warms up.”

Dixie and I double-checked the truck to make sure we had everything. We will give a brucellosis vaccine to about twenty heifer calves this morning.

Brucellosis is a disease that is contagious to man, a zoonosis. There has been a federal program to eradicate the disease since 1934. The incidence is much reduced from those early years. 

In the 1930s, brucellosis, or undulant fever, was a disease in women and children. The disease has become rare with the widespread use of pasteurization of dairy products and the federal eradication program. Now it is mainly a disease of veterinarians and slaughterhouse workers.

The eradication program uses calfhood vaccination of all breeding heifers before they are a year of age and testing of adults. Infected cattle, and sometimes entire herds, are slaughtered.

Vaccinated heifers are identified with a vaccination tattoo in their right ear and either an official ear tag or, in the case of registered cattle, their registration tattoo is satisfactory. An official record of vaccination is made and submitted to the state veterinarian’s office. The identification process and the paperwork cause the process to be a little time-consuming.

Bill was waiting at the barn when we pulled into the breezeway.

“This is sort early for you, ain’t it, Doc,” Bill said as we stepped out of the truck.

“I was worried about your black cows. You know they suffer more in the heat,” I said with a smile.

“These cows are not bothered by the hot weather,” Bill said.

“Well, we need to get started,” I said. “Dixie wants to be out of here before it gets hot.”

“I’m still not understanding why we have to vaccinate these heifers for a disease that we don’t have in this state anymore,” Bill said. “I mean, Oregon is supposed to be brucellosis-free. I would think that we could stop this expensive vaccination.”

“Cattle move around a lot more these days than they did twenty years ago,” I said. “They did a study some years back, where they took four hundred head of cattle and put them through a sale. Then they followed them for the next week. It was sort of an eye-opener. In the week following the sale, those cattle spread across five states and were exposed to thousands of cattle as they went from one sale barn to another.”

“Well, I don’t go to a sale barn to buy cattle,” Bill said.

“No, but your neighbor probably does,” I said. “Actually, the only real source of brucellosis in this country today is the bison and elk in and around Yellowstone National Park. And, the experts think there is probably no way that we will get control of that situation.”

“So we have to pay extra, just so a bunch of city folk can go get gored by a wild buffalo,” Bill said.

I mixed the vaccine, and Bill ran the first heifer into the chute. I gave the heifer a dose of vaccine under her skin on her right shoulder and then placed an official tattoo in her right ear.

The tattoo had a number for the quarter, followed by an official shield, and then the last digit of the year. I used green ink because it would show up better on the black skin of these ears.

“Why is it that you have to do these vaccines?” Bill asked. “I mean, we can do the other vaccines. Why can’t we do this one?”

“This vaccine is called Strain 19,” I said. “If it is a live strain of the brucellosis bacteria. If it is not handled correctly, it can make a person sick. The book says that usually happens to young veterinarians who don’t have their safe practices established yet.”

“Do you know anyone who has ever had Brucellosis?” Bill asked.

“Oh, yes,” I said. “My grandmother, for one, she probably got it from raw milk. For that reason, my mother quit drinking milk when she was ten or twelve. The first veterinarian who I worked for in Enumclaw had it. His case was pretty severe and eventually resulted in him losing his colon. Then Dr. Haug from Myrtle Point had it. He told me he was sure he had caught it from a cow that he worked on way out in a pasture, and he didn’t have enough water to wash up with until he got back to his truck.”

“Okay, you convinced me. Let’s just get to work and get these heifers vaccinated,” Bill said.

With Dixie keeping track of the paperwork, I was able to get through this bunch of twenty heifers in less than two hours. The temperature inside the barn was already starting to warm up. It was hotter in the breezeway when we washed up and put everything away in the truck.

“I hope Judy has kept the book open,” Dixie said. “That clinic, without air-conditioning, gets hot on these days.”

“Yes, when we were building it, Jim said we would only need air conditioning for a few days out of the year,” I said. “I guess he was right, as far as the numbers go, but on these hot days, we just have to close down.”

When we returned to the clinic, Judy had the appointment book emptied out, and it was hot enough to call it a day.

“Give the answering service the phone and tell them the clinic is too hot for us to work,” I said. “I think I will get Sandy to gather up the kids and head up the river to soak our toes and wait for the evening breeze.”

“Give us a call before you go,” Judy said. “We will join you as soon as Kenny is off work.”

“That will be good. Maybe we can cook some hot dogs for dinner,” I said as I headed out the door.

Photo by Kat Smith from Pexels.

Rambo and the Eagle, From the Archives

D. E. Larsen, DVM

Walking down the fifth fairway at Pineway, I was relieved that I could see ball. 

“At least I am not in the ditch,” I said to Jim as we parted toward our respective balls.

Dr. French had always told me that the if you are paying attention to your practice, you will never have the time to be a good golfer. I could see his point, I took Thursday afternoon off to play with the Pineway Men’s Club and most of the time with a group or two once on the weekend. But I really felt that athletes are born, not made. Of course, with work and coaching, we could improve and reach our potential, but some guys are just born with a ball in their hands. We all knew them, they were stars in little league, and they excelled on the basket ball court. They are the ones who didn’t go out for football until they were seniors, and they made all league. The coach always tries to take the credit, but it is just the way it is.

And my slice was a good illustration. I could beat just about anyone on any one hole. But I could never hold my concentration for the next hole.

I got to my ball, it was in the short rough, about a foot from the ditch that ran down the right side of the fairway. It was a position I knew well. I could reach the green from this position on this short 5 par hole. This position actually set me up well with my ball flight. There was a slight dogleg to the the left, with my slice, I liked to call it a fade, I could start my ball left of the hole and it would run up the front apron to the green. I just needed to fade the ball, not slice it.

As I addressed the ball, I caught sight of Jack Wright’s cart starting down the eighth fairway. Rambo, his little poodle mix, always rode on the back of the seat in Jack’s cart. Rambo had already spotted me. I could hear him throwing a fit from two fairways over. 

Jack loved it, and here he came in his cart with Rambo barking up a storm over his shoulder. Just what I needed to hold my concentration on this shot.

“Good morning, Doc,” Jack said over Rambo constant barking, louder now that they were parked just across the ditch. “How is your game this morning?”

“It has been pretty good so far,” I said. “With a little luck, I will reach this green in two.”

“Rambo spotted you and wanted to say hi,” Jack said with laugh. “I think you are the only person he knows on this entire course.”

“Yes, I notice that almost every Thursday,” I said. “I don’t know what the problem is, I have never done anything to him other than his shots and stuff.”

Jack chuckled again, “He just wants you to know what he thinks of you.”

“Well, I guess it is good to be loved by my patients,” I said.

“I’ll let you get back to your game, good luck, and fly that ball right at the stick for a change,” Jack said as he turned the cart and headed back to his fairway. Rambo on the back of the cart, facing me and barking as loud as he could.

I addressed the ball again, trying to think what it was that I had done to Rambo to make dislike me so much. Then trying to brush that thought away, I took a deep breath and started my back swing.

I swung with all my strength, and caught the ball perfectly. The ball seemed to hang on the club face briefly, then sprang into a high flight. This was my Ping 5 wood, my favorite club. Probably because I could hit the ball straighter with it than any of my other woods.

The ball started out on a line about 10 yards left of the green and then started to fade to the right. Then the fade became a slice and it was struck hard enough that distance was going to be more than usual for this club. I held my breath and leaned to the left, as if to guide the ball a little.

The green ran on a diagonal left to right and the hole was cut in the far back corner. I had hoped to land in the fairway and run the ball up on the green but this ball was going much more to the right than I had hoped. Then it came down, and stuck on back edge of the green, maybe 10 feet from the hole.

I perfect shot and it surprised everyone, including myself. “Maybe I should talk with Rambo more often,” I said to myself as I picked up my bag and started toward the green.

Bruce West was coming down the sixth fairway. He pointed at the ball near the pin and asked, “Whose ball is that?”

Jim pointed at me, “Larsen’s, good shot, don’t you think?”

“If he makes the putt,” Bruce replied.

I could still hear Rambo barking as I walked up on the green. He was out of the cart and standing under the trees over by the eighth green, only thirty yards away. He pounded his front feet with each bark in a little bounce, just to add emphasis to his distaste.

Jack had loaded him up and headed to the ninth tee box just as I addressed my putt. I was relieved that the barking was fading off in the distance. 

One small breath, and I stroked the putt, straight putt, right to the bottom of the hole. “Take that Bruce,” I said as I stepped quickly to hole to retrieve the ball.

Eagles were rare birds for me on the golf course.

Photo Credit: Photo by Markus Spiske from Pexels