June 19th, 2011 by ChristopherChangMD in Health Tips, Research
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There have been a number of studies in the past investigating whether it is healthy for a baby to be around pets and whether such exposure increases or decreases risk of becoming allergic to them later in life.
In a recent study (published online June 2011), the researchers found that among males, those with an indoor dog during the first year of life had half the risk of becoming allergic to dogs at age 18 compared with those who did not have an indoor dog in the first year of life regardless whether born by C-section or vaginally. Also, teens with an indoor cat in the first year of life also had a decreased risk of becoming allergic to cats. Neither cumulative exposure nor exposure at any other particular age was associated with either outcome. So it appears that Read more »
*This blog post was originally published at Fauquier ENT Blog*
May 23rd, 2011 by Paul Auerbach, M.D. in Health Tips
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The Combat Application Tourniquet Dr. Brad Bennett provided an excellent workshop at the 2010 Wilderness Medical Society annual meeting in Snowmass, Colorado on how to manage severe bleeding, based on his work with the Committee on Tactical Combat Casualty Care. From time to time,
wilderness medicine practitioners encounter situations of severe bleeding, so this information is essential for anyone responsible for the health and safety of outdoor explorers and adventurers.
In a simple algorithm, we learned that the first attempt to control bleeding is almost always direct hand pressure. This is followed by application of a pressure bandage. If that is successful, the victim then is evacuated. If the pressure bandage does not adequately control bleeding on the torso of the victim, then a hemostatic (stops bleeding) substance is applied prior to evacuation. If bleeding from an arm or leg threatens the victim’s life, a tourniquet may be required. A hemostatic agent that is being used with increasing frequency is QuikClot Combat Gauze. Tourniquets include the Combat
Application Tourniquet (“C-A-T”). Using any of these modalities requires instruction and preparation. Read more »
This post, How To Stop Bleeding: The Combat Application Tourniquet And QuikClot, was originally published on
Healthine.com by Paul Auerbach, M.D..
March 17th, 2009 by Dr. Val Jones in Humor, True Stories
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As some of my Twitter friends already know, I had a bit of a scare a few days ago with my cat. I know that I more-or-less promised not to let this blog degenerate into cat talk (and for the record I love dogs too), but please indulge me because I think there’s a larger lesson to be learned.
A few days ago I was emailing away on my computer when I heard an odd thud behind me. I turned around to find my cat lying on her back with one leg fully extended, her pupils dilated, and a fine tremor in all four legs. This lasted for about 10 seconds and then she jumped back onto her feet and walked away as if nothing had happened.
My husband denied giving her any catnip, and since I hadn’t seen this odd behavior in her before I decided to keep a close eye on her. About an hour later she was walking across the floor when she suddenly raised her back rear leg, hopped a few steps, flopped onto her back and did the same weird leg extension, trembling, and let out a bizarre yowl.
That buys her a trip to the vet – and I started running my differential diagnosis through my head. It seemed to me that she was having some kind of focal seizures – and I wondered if she could be in renal failure (she had had a UTI earlier in the year) with metabolic encephalopathy, or perhaps a small tumor that had started to trigger some seizure activity. The episodes seemed to resolve completely in between episodes so I didn’t think she was having a stroke, she also wasn’t continuing to limp and when I pressed on her bones she didn’t flinch so I didn’t think she had broken anything. I called the vet and when asked for the “chief complaint” I was just as helpful as many ER patients:
Dr. Val: My cat’s ‘acting weird.
Receptionist: Could you be more specific?
Dr. Val: Well, she’s acting like she’s had catnip, but she hasn’t.
Receptionist: Uh huh… And what do you mean by that?
Dr. Val: She keeps falling on the floor and stiffening her rear leg. Then she gets up as if everything’s fine. This seems to be happening every hour or so.
Receptionist: I see. And is it possible that she could have eaten something toxic? Do you have poison lying around the house?
Dr. Val: Not that I’m aware of.
Receptionist: Well it sounds like you should bring her in. Can you be here in 15 minutes?
Dr. Val: Wow, that’s not much time. But I can try! I think she might be having seizures…
And so with the vet’s office being 15 minutes away, you can imagine the frenzied efforts that ensued – I managed (single handedly) to put together a cat carrier and stuff the “seizing” feline into it and hoist her onto a cart and push her down the city sidewalks, much to the amusement of onlookers, who probably fully believed that I was a cat-abuser, hearing the pitiful cries coming from inside the cage.
To make a long story short, I explained to the vet-on-call what I’d witnessed, and suggested that my cat might have a brain tumor. Luckily for me, the vet did not blindly take my diagnosis for granted, but performed her own physical exam.
The conclusion?
Vet: Dr. Jones I don’t believe your cat is having seizures. She has a subluxing patella.
Dr. Val: Um, so you’re saying that her knee cap popped out of place?
Vet: Pretty much, yes. That’s why she flops on the floor and stiffens her leg. She’s trying to get the knee cap to slide back into place. It’s a grade 3 subluxation, which means it pops out easily, but still goes back into place on its own.
Dr. Val: How do we fix it?
Vet: She’s a surgical candidate. We can create a divot in her femur to help keep the knee cap in the right groove.
Dr. Val: Wow, we don’t do that for humans. Are you sure that will work?
Vet: Well, you can try glucosamine. It will reduce the inflammation.
Dr. Val: Glucosamine doesn’t reduce inflammation in humans – and there’s no conclusive evidence that it improves joint health either. Isn’t this more of a mechanical problem that needs a mechanical solution?
Vet: [Becoming irritated] Yes, well you can see our orthopedic specialist. She’s not board certified though – but she has a lot of experience with these kinds of things.
Dr. Val: Well, is there a board-certified orthopedic veterinary surgeon that we could consult with? How much do you think that would cost?
Vet: There’s an animal hospital in Friendship Heights. I’m sure their surgeons are all equally well qualified. I guess the procedure would cost around $2000.
Dr. Val: Wow, $2000 to put a divot in a cat’s femur? Gee… I don’t know…
Vet: You should also know that your cat needs her rabies shot.
Dr. Val: She needs another one?
Vet: Yes, they need one every year.
Dr. Val: How likely is a house cat to get rabies? Are there rabid mice that could get into our condo?
Vet: [Scowling] It’s the law. All cats must get a rabies shot every year. There is one rabies shot that can be given every three years, but it’s been associated with osteosarcomas in cats. Would you like to give her that vaccine?
Dr. Val: Uh, no. But seriously, where is my cat going to catch rabies?
Vet: Maybe she’ll catch it from the other pets at the animal hospital when she goes for surgery?
Dr. Val: [Visions of Cujo dancing in her head] Well, that doesn’t sound like a very safe place to take her.
Vet: Would you like to buy some glucosamine?
Dr. Val: No thanks, I think I’ll go now.
***
I learned a few things from this amusing interaction:
1. People should try not to make diagnoses beyond their level of expertise. (Brain tumor versus subluxing patella? Yikes.)
2. Vets do not necessarily practice evidence-based medicine. (Glucosamine for a subluxing patella?)
3. There’s a lot of money in cat vaccines.
4. Cash-only practices are quite lucrative. My little visit cost $300.
What do you think I should do with/for my poor cat?
