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Manuel Monteiro de Castro
|His Eminence
Manuel Monteiro de Castro
|Major Penitentiary emeritus of the Apostolic Penitentiary
|5 January 2012
|Term ended
|21 September 2013
|Fortunato Baldelli
|Mauro Piacenza
|Other posts
|9 July 1961
23 March 1985
by Agostino Casaroli
|Created cardinal
18 February 2012
by Benedict XVI
|Personal details
|Birth name
|Manuel Monteiro de Castro
29 March 1938
S. Eufemia, Portugal
|Roman Catholic
|Previous post
|mane nobiscum domine
|Coat of arms
|Styles of
Manuel Monteiro de Castro
|Reference style
|The Most Reverend
|Spoken style
|Your Eminence
|Informal style
Manuel Monteiro de Castro (born 29 March 1938) is a Portuguese cardinal, He was the Major Penitentiary of the Apostolic Penitentiary from 5 January 2012 until his retirement on 21 September 2013.[1] He had previously served as Secretary of the Congregation for Bishops.
Monteiro de Castro studied humanities, philosophy and theology in the Archdiocese of Braga. He was ordained to the priesthood by Archbishop António Bento Júnior on 9 July 1961 after which he studied at the Pontifical Gregorian University in Rome, where he earned a doctorate in canon law in June 1967. During this time he received practical training and obtained a diploma in diplomacy from the elite Pontifical Ecclesiastical Academy. In February 1969, he became advocate in the Sacred Roman Rota.
Career in Church diplomacy[edit]
He entered the diplomatic service of the Holy See in 1967. He was created Chaplain of His Holiness on 1 July 1968. He served as secretary of the nunciatures in Panamá from 1967 to 1969, Guatemala from 1969 until 1972, Việt Nam and Cambodia from 1972 until 1975, Australia from 1975 to 1978 and México from 1978 to June 1981. He was upgraded to Prelate of honour of His Holiness on 1 July 1981. He returned to Rome where he worked in the Second Section of the Secretariat of State from June to November 1981. The decision was taken to appoint him counselor of the nunciature in Belgium in 1981 where he served until 1985. In 1985 he was awarded Knight Grand Cross of the Order of Infante Dom Henrique, granted by Prime Minister Mário Soares.[2]
In 1985 he was appointed archbishop and pro-nuncio to the countries in the West Indies that have diplomatic relations with the Holy See, including The Bahamas, Barbados, Belize, Dominica, Grenada, Jamaica, Saint Lucia and Trinidad and Tobago, and apostolic delegate for the other territories, such as the Turks and Caicos Islands and the Netherlands Antilles. He was consecrated by Cardinal Secretary of State Agostino Casaroli. Two years later, when Antigua and Barbuda had established diplomatic relations with the Holy See, he became pro-nuncio there too instead of apostolic delegate. In 1998 he was transferred to South Africa, with responsibility also for some neighbouring countries. And in 2000 he became Apostolic Nuncio to Spain and Andorra. As such, he met with José Luis Rodríguez Zapatero, to reduce the tension between the Spanish Government and the Church.
In 2003 he was decorated with the Knight Grand Cross of the Military Order of Christ, granted by the minister of Foreign Affairs.[3]
Secretary of the Congregation for Bishops[edit]
On 3 July 2009, Pope Benedict appointed him secretary of the Congregation for Bishops,[4] replacing Archbishop Francesco Monterisi who was the same day appointed as archpriest of the Papal Basilica of Saint Paul Outside the Walls. The Congregation that considers candidates for appointing bishops for Latin Rite non-missionary dioceses, except in cases that fall within the competence the Section for Public Affairs of the Secretariat of State (appointments that require some form of consultation with governments) or the Congregation for the Oriental Churches (in the Middle East and Greece).
Traditionally the Secretary of the Congregation for Bishops is also Secretary of the College of Cardinals, and Monteiro de Castro was formally appointed to this role on 21 October 2009.[5] He is also one of the consultors of the Congregation for the Doctrine of the Faith.[2][permanent dead link]
Major Penitentiary[edit]
On 5 January 2012 Archbishop Monteiro de Castro was appointed Major Penitentiary of the Apostolic Penitentiary, replacing Cardinal Baldelli, who had reached the retirement age of 75 in 2010. It was his job as major penitentiary to ensure the absolution of excommunications latæ sententiæ reserved to the Holy See, the dispensation of sacramental impediments reserved to the Holy See, and the issuance and governance of indulgences.
It was announced on 6 January 2012 that Archbishop Monteiro de Castro would be created a cardinal on 18 February by Pope Benedict XVI. He was duly created Cardinal-Deacon of San Domenico di Guzman on that day. On 21 April 2012 Cardinal Monteiro de Castro was appointed a member of the Pontifical Council for the Pastoral Care of Migrants and Itinerants, Congregation for the Causes of Saints and the Congregation for Bishops. He held these memberships before reaching the age of 80.[6]
He was one of the cardinal electors who participated in the 2013 papal conclave that elected Pope Francis.
He lost the rights to vote in any further papal conclave upon reaching his 80th birthday, on 29 March 2018.
Homosexual relationships[edit]
Monsignor Monteiro de Castro has been cited in the press for his views on homosexual relationships. He insisted that same-sex unions could not be regarded as marriages, but he implied that they were at least worthy of compassion.[7]
- ^ RINUNCIA DEL PENITENZIERE MAGGIORE E NOMINA DEL SUCCESSORE Archived 22 September 2013 at the Wayback Machine.
- ^ Cardinals of the Holy Roman Church
- ^ Cardinals of the Holy Roman Church
- ^ NOMINA DEL SEGRETARIO DELLA CONGREGAZIONE PER I VESCOVI[permanent dead link]
- ^ Press Office of the Holy See 21.10.09[permanent dead link]
- ^ [1]
- ^ Papal envoy breaks ranks on gay couples
External links[edit]
- "Monteiro de Castro Card. Manuel". Holy See Press Office. Archived from the original on 19 September 2016. Retrieved 6 December 2017.
- Living people
- 1938 births
- Pontifical Gregorian University alumni
- Pontifical Ecclesiastical Academy alumni
- Roman Catholic titular archbishops
- Apostolic Nuncios to Honduras
- Apostolic Nuncios to El Salvador
- Apostolic Nuncios to South Africa
- Apostolic Nuncios to Lesotho
- Apostolic Nuncios to Swaziland
- Apostolic Nuncios to Spain
- Diplomats of the Holy See
- Portuguese Roman Catholics
- Members of the Congregation for Bishops
- Members of the Congregation for the Causes of Saints
- 20th-century Roman Catholics
- 21st-century Roman Catholics
- Commanders of the Order of Merit of the Grand Duchy of Luxembourg
- Knights Grand Cross of the Order of Isabella the Catholic
- Recipients of the Order of the Star of Italian Solidarity
- Grand Crosses of the Order of Prince Henry
- Grand Crosses of the Order of Christ (Portugal)
- Major Penitentiaries of the Apostolic Penitentiary
- Cardinals created by Pope Benedict XVI
- Portuguese cardinals
- Apostolic Nuncios to Antigua and Barbuda


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We have many strays turned in and we may have your Lost friend!
If you submit an ad to our website Lost & Found Listings, it is your responsibility that it is posted correctly.
Lost & Found Online Form Lost & Found Listings
NOTE: The ad system is a public service and is NOT a substitute for reporting your pet to the GMSPCA in person.
We check all incoming animals for identification (tags, microchip, tattoo, etc) to try and locate their owner through these means. An animal arriving with no current ID will be impossible for us to reunite to their family. This is why you need to be actively looking for your pet. For example, you can check/post on Kijiji, local lost pet sites on Facebook, your local animal control department and your local veterinarians.
It is your responsibility to look for your lost pet. Come in to the GMSPCA daily to look as tomorrow may be too late.
Kennel fees are charged for each day a stray animal remains in the care of the GMSPCA and must be paid in full before they will be returned to their owner. The associated impound fee will need to be paid in full. Dogs will be required to have a current license. Any outstanding veterinary bills must be paid in full prior to claiming your animal.
If you believe your pet may be in the custody of the NBSPCA, please call 1-877-722-1522.
Please call us if you have found an animal at (506) 857-8698. You have two options:
Did you know that the City of Moncton bylaw (H202) requires that any dog residing within city limits must wear a current tag.
Purchase your dog tags online quickly and easily by filling out the form below. Dog licenses are also available for purchase at the shelter, from the animal control officers directly, at Moncton City Hall and most local veterinarians. The GMSPCA and Animal Control Officers also do an annual door-to-door dog tag campaign at the beginning of the year.
City of Moncton Residents ONLY - For areas outside of the City of Moncton please inquire with your veterinarian or city hall for locations where you can purchase dog licenses for your specific area.
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This program matches some of our much older animals or animals with special needs to loving homes. These animals may be adopted at a lesser rate at the discretion of Greater Moncton SPCA management.
For more information on our Seniors for Seniors Program, please contact the GMSPCA at (506) 857-8698.
Approved foster homes are used to take some of our animals in need in order to care for them until they are ready for adoption. Often, this includes unweaned young animals, pregnant and/or nursing mothers, animals recovering from extensive surgery or animals that need socializing.
For more information on fostering, please contact the Greater Moncton SPCA at (506) 857-8698.
The Greater Moncton SPCA offers educational tours for schools, youth groups and adults. We have a large room where people can gather, ask questions and learn a little about animal care. We then take the group on a tour through the shelter.
Tours are given free of charge, however donations are gratefully accepted.
For more information on booking a tour, please contact the GMSPCA at (506) 857-8698.
Animal Control Officers are responsible for enforcing the City of Moncton's animal control bylaws (H202).
They answer calls for issues such as stray animals, complaints from the public about barking dogs, dogs that are defecating off their property, dogs being walked off their leash and dangerous animals, to name a few.
Part of their responsibility is also the sale of annual dog tags. It is part of the City's bylaw that all dogs residing within city limits wear a City of Moncton dog tag.
Another large part of their job is public education. These officers take any opportunity they can to answer questions from the public regarding animals, the shelter itself and the City of Moncton bylaws related to animals.
If you have any questions or concerns about animal control, please contact the appropriate officer for your area:
Please visit our Emergency/Other Contact page for other emergency and/or animal-related information phone numbers.
Sadly, in time, we all lose our pets to age or illness.
The Greater Moncton SPCA offers two services to those in need. We offer general cremation and private cremation. Many people opt for the private as it allows them to take home the ashes of their dear friend and have their memories close. If you choose private, you will receive the ashes of your pet back in an urn container, a bronze "Beloved Pet" plaque and a card. Please contact us regarding fees for these services.
We also sell an exclusive line of beautiful urns for your consideration. Please contact the shelter for further details.
If your pet passes away at home within the Metro Moncton area, for a small fee we will pick up your pet and bring them to shelter for the cremation service of your choice.
The Greater Moncton SPCA can provide the use of a trap cage for the purpose of capturing feral and/or stray cats.
These cages will not be given out for the purpose of capturing wildlife. We refer nuisance wildlife calls to a nuisance wildlife officer.
For more information, please contact the GMSPCA at (506) 857-8698.

subset: commoncrawl


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"Des paysages nouveaux à chaque tournant de route: Henri Vever et son monde"
Une rencontre-conférence avec Prof. Willa Silverman
Spring Awards Ceremony and Reception
Apr 27, 2018
from 03:00 PM to 04:30 PM
|Garden Room, Pasquerilla Center
|Contact Name
|Heather McCoy
|Add event to calendar
Please join us in honoring Department of French and Francophone Studies student accomplishments at the undergraduate and graduate level! We look forward to hearing about our graduating seniors' plans for the future as we look back on all they have achieved here at Penn State. All current students and members of the department are invited. Light refreshments will be served.
Graduate Student Vieux Touré to give talk "The Writing of Negritude"
Table ronde: Prof. Kumari Issur, "Mapping Ocean-State Mauritius and its Unlaid Ghosts: Hydropolitics and Literature in the Indian Ocean".
French Film Series: Fatima
French Film Series: Examen d'état
Film Series: Frantz
Table ronde: Dr. Caroline Ferraris-Besso, "Postcarding the Other: Nineteenth Century Voyages to Polynesia"
Table ronde: Dr. Catherine Clark, "Picturing China for the World".
Film Series: Ma vie de courgette
Please join us for our first film in our annual French Film Series. Admission is free to the public!


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Regular Shipping Charges (Continental 48 States) Ground shipping within the continental United States is done via the United States Postal Service and usually takes 2-6 working days for delivery depending on location. Shipments via USPS require street address. PO Boxes can not be accepted.
Orders are processed within two days of submitting the order on the web Monday - Friday.
Your shipping charges are determined by the amount of your purchase according to the table below. Purchase Total Shipping Rate *SHIPMENTS Add 0 to 50.00 $6.95 50.01 to 75.00 $9.9575.01 to 100.00 $10.95 100.01 to 150.00 $11.95 150.01 to 199.99 $13.95 *200.00 up *FREE SHIPPING
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Sad news that legendary author Gabriel García Márquez has gone to the Great Library in the sky.
"The best friend a person has is one who has just died."
One Hundred Years of Solitude – Gabriel García Márquez
Yes, he was an avowed Leftist. Yes, he was buddies with Fidel Castro, the tinpot dictator of Cuba. None of that diminishes the fact that he created magical literature. One Hundred Years of Solitude, Love in the Time of Cholera, Autumn of the Patriarch, The General in His Labyrinth. Each of these magnificent books and others carried me away to another place, another time, another life. The Columbian wordsmith's ease with language was maddening, and I spent as much time with a dictionary as with his prose and poetry. No other author has ever commanded as much respect from me, and his tomes occupied the top shelf in my library.
Goodbye, Gabo.


text:
You are likely overpaying for your prescriptions even if you have a low insurance copay. (See Free Prescription Discount Card Below)
Let's Lose – Advanced Weight Loss Clinics offers you the opportunity to purchase any of your prescriptions at the guaranteed lowest price by comparing your insurance copay price to a negotiated discount price through the Discount Drug Network (DDN).
You are eligible to participate in this free program simply by presenting the card below to your pharmacist. There is no enrollment or fee to participate.
This program is accepted at almost every pharmacy in the U.S.
There is no cost to the patient and there is no patient information required to participate.
Discounts are available to all participants regardless of current insurance status. (Insured, Uninsured, Medicare) All FDA approved brand name drugs and generics are covered by the plan and is HIPAA compliant requiring no patient data for participation.
Generic drugs offer substantial savings over their brand equivalent. Ask your doctor if there is a generic drug alternative that provides you with the same medical benefit of the brand drug.
Search for the pharmacy with the lowest price for your prescription in your zip code at www.discountdrugnetwork.com or call 877.537.5537 (No Patient Information Required)
Guarantee yourself the lowest price by contacting us at:
Customer Service – 877.537.5537
Pharmacy Help Line – 877.459.8474


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Abby is a Roswell native and an alumna of the University of Georgia with Broadcast Journalism and Digital Marketing degrees. If you ask her, she sings just as well as Carrie Underwood. (She doesn't, which is why Abby is just a country music radio jock and not a Nashville star). In her free time, you can catch her watching Georgia sports teams, Tweeting way too much, and pretending to be a foodie because she can't actually cook.


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14 Photos Home Decor Stores Near MeOn
14 Photos Home Decor Stores Near Me – home titivation is an valuable element of contemporary living spaces. The full of beans spaces and architectures request careful selection of furniture, rugs, lighting and supplementary decor items to convert the comprehensible tune into dynamic areas. But, transforming house interiors into an fascinating atmosphere is a costly


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Ron Weasley sat by her side, his face screwed up in a half-concerned, half-angry look, his emotions utterly tangled. Concern, because one of his best friends was lying next to him, completely frozen, and anger at himself for feeling this much concern. He didn't really know why he was so upset about her. He knew that Hermione would be better as soon as Professor Sprout could produce the antidote from the mature mandrakes. He knew she would not be stuck like this forever, her eyes glassy, her lips parted in an interrupted gasp. He knew she'd be okay.
But really, this was an improvement on her usual attitude: know-it-all, smug, bossy Hermione. The fact that she couldn't speak or give him that disapproving look was somewhat of a blessing right now. But then again...
He looked around the infirmary. He was all alone. Well, alone if you didn't count the petrified victims lying in the beds surrounding him, and that Madam Pomfrey was standing in the doorway, waiting for him. Ron tried to tell himself that he was simply concerned about passing his final exams-he couldn't do it without Hermione, after all. They couldn't do a lot of things without her, like figure out who was behind all these attacks. Maybe she had found something out that afternoon that she had been attacked.
"Ahem," Madam Pomfrey cleared her throat from across the room. "I think you ought to be getting back to your common room now, Mr Weasley."
"Coming," Ron replied. He looked at Hermione one more time, that same look on his face. He certainly didn't miss the bickering, he thought, as he took her hand in his, stroking it with his thumb. Slowly, the look of anger at himself melted away, leaving only concern. "See you when you wake up."


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Kaplan Insurance Agency is located in Wappingers Falls and has many Auto, Home, and Commercial insurance clients from Fishkill and the surrounding Hudson Valley towns.
We are located on Barrister's Row, if traveling to us from the North on Route 9 we are about a quarter mile south of The Bake Shop. If traveling from the South on route 9, we are located half mile North of Hudson Volkswagen on the opposite side of the road. Many people that live and work in the area work with us because of our convenient location and friendly agents.
Kaplan Insurance Agency Location and Contact Information:
12 Barrister's Row
Wappingers Falls, 12590
Our goal is to insure that your coverage meets your needs at the best possible price. Kaplan Insurance provides Home, Life, Auto and Commercial insurance to the communities in the Hudson Valley including Fishkill, NY.
Kaplan Insurance provides Home, Life, Auto and Commercial insurance to the communities of Fishkill New York.
Homeowners Insurance | Auto Insurance | Business Insurance
Photo Credit: Flickr


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David Tennant had THIS to say about Jodie Whitaker being the new Doctor Who
Jodie Whittaker has been cast as Peter Capaldi's replacement as The Doctor in the BBC's hit sci-fi series, Doctor Who and David Tennant agrees that it's "brilliant".
The former Doctor, David Tennant explained, "Sure, Jodie is from a different gender than anyone who's gone before, but that will be irrelevant almost immediately when she takes the part. The Doctor can be whatever he needs to be."
The star who took on the role from 2005 to 2010 continued, "It's about finding the right performer at the right time, and that's Jodie without a doubt."
We couldn't agree more.
The Scottish actor also addressed the backlash that the 46-year old new female Doctor received from the loyal fans of the show who were disappointed by the casting.
David said: "Whenever the Doctor changes, there's a backlash because that's a character people love. So people get very affectionate about the Doctor they knew."
We happen to think it's great. Could a female James Bond be next? Jane Bond?
The BBC revealed the new Doctor shortly after the men's Wimbledon final; a joke that is only now beginning to dawn on people.
Whittaker, whose Broadchurch co-star Olivia Colman was a favourite to take over in the TARDIS, will be the 13th official Doctor, and the first woman to play the role.
Doctor Who's new head writer, Chris Chibnall, who also created Broadchurch, said he had been clear about the direction he wanted to take the show.
"I always knew I wanted the 13th Doctor to be a woman and we're thrilled to have secured our number one choice," he said. "Her audition for the Doctor simply blew us all away.
Whittaker said she couldn't wait to begin a journey "with every Whovian on the planet".
"It's more than an honour to play the Doctor. It means remembering everyone I used to be, while stepping forward to embrace everything the Doctor stands for: hope. I can't wait."
Inevitably, disgruntled male fans of the show have started ballaching about the casting decision, but this has simply led to some charming smackdowns on Twitter.
The BBC had been criticised this year after the Doctor's popular companion Bill Potts, played by Pearl Mackie, was killed off at the end of the series, despite being the first major gay character on the show.
Many fans had hoped that the 13th Doctor would be a woman, after Peter Capaldi announced his departure from the programme in January this year.
Fleabag and Star Wars actress Phoebe Waller-Bridge, and Tilda Swinton, had also been rumoured to be contenders for the role.
Guys...we've got a female Doctor! THIS IS THE BEST!


text:
Gwitchyaa Zhee Corp
7th Ave., Fort Yukon, AK 99740
(907) 662-2933
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7th Ave.
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Fort Yukon
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(907) 662-2933
Contact name:
James Kelly
Contact title:
(907) 662-3056
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According to our records, this business is located at 7th Ave. in Fort Yukon (in Yukon-Koyukuk County), Alaska 99740, the location GPS coordinates are: 66.5656833 (latitude), -145.2404878 (longitude). Gwitchyaa Zhee Corp is categorized under Community Development Groups (SIC code 8399). Known organization manager is James Kelly. The company employs approximately 3 people. You can contact the company by phone at (907) 662-2933; the following fax number is also provided: (907) 662-3056.
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Last Updated: May 10, 2011
Known Bugs
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tag:blogger.com,1999:blog-18174378380594278362018-08-21T23:24:52.397-04:00My DVM VacationA Ross vet student blog.Julie Ladahttp://email@example.com:blogger.com,1999:blog-1817437838059427836.post-47459205333122860022014-08-21T09:45:00.001-04:002014-08-21T09:45:21.278-04:00My FeLV experience.As if new grads don't have enough to deal with, I got the added bonus of very nearly euthanizing my healthy cat!

When my husband and I moved back in together in May, we combined our cats for the first time. I had Mama and Cas, and he had Roosevelt. He adopted Roosevelt from a shelter in Spokane, Washington in December 2012 and had kept him as an indoor only, single kitty in his apartment for a year and a half. In mid-August, my benefits kicked in and through Banfield as a part of my contract I get three of our Owner Wellness Plans. I brought Roosevelt in as the first of the three to booster his vaccines, run blood work, and do a dental cleaning. I received a nasty shock when he turned up weakly FeLV+ on an ELISA snap test. I thought it was probably a false positive, so I ran it again. Same result.

I panicked, raced home to grab my two cats, brought them in and tested them. Both tested negative, and I vaccinated them right away.

Don and I had a serious conversation that night about the risk Roosevelt posed to my cats, even with them vaccinated, and how very bad FeLV was. I told him that even vaccinated, I wasn't prepared to risk losing Mama or Cas to this disease. He was ready to euthanize Roosevelt right then, but I asked him to let me submit an IFA as a confirmatory test, because Roosevelt's history just didn't fit with this disease.

Feline leukemia virus stats are a bit all over the place, but the general gist is this: 30% of cats will obtain the virus, get sick with what is called the "primary viremia" stage of the disease, and mount a sufficient immune response so that they completely clear it and are immune for life. The rest of the 70% either die outright of infection (usually the kittens that are infected young before their immune systems are very good) or they become persistently infected with the "secondary viremia" stage of the disease because they didn't clear the virus. This stage occurs when the virus is present in the bone marrow and associated with white blood cells. These cats typically die within 1-3 years of suppressed immune system diseases like chronic respiratory infections, or lymphosarcoma.

Roosevelt's IFA was negative. This didn't fit with his history at all. There was no way Roosevelt could've been infected within the last year and a half as a single, indoor-only cat. The only way he could've been recently infected was if Cas or Mama had done so within the last couple of months, but both of them are negative. The reason this is odd is because a positive ELISA, which tests for the primary viremia stage, and a negative IFA, which tests for the secondary, white blood cell-associated stage, is only possible with recent infection. Which in Roosevelt's case was impossible.

With this confusing, discordant result, I submitted a PCR on whole blood. This test is the grand-daddy test that would determine if he had any circulating virus in his system at all. It was negative. That settled it; Roosevelt does not have FeLV. Curious, I took the second blood sample we drew for the PCR that I had saved part of, which was taken about a week later from the first sample I ran the first two ELISAs on, and ran a 3rd ELISA. It came back positive.

I've since spoken with two internal medicine specialists about this case - one of the phone consultant clinicians from Antech, the lab I submitted the tests to, and Dr. Gillespie who I externed with at IndyVet this past spring. Both feel that even with three positive ELISAs ran on two different blood samples taken on different days, this is a case of a false positive ELISA. Something in Roosevelt's blood is cross-reacting with the test as similar to the p27 protein FeLV antigen that the test screens for.

I submit this as a case for any of my vet school or fellow clinician readers. If you get a cat whose history does not fit with the clinical progression of FeLV, yet tests positive on ELISA, always submit a confirmatory test before euthanizing!Julie Ladahttp://firstname.lastname@example.com:blogger.com,1999:blog-1817437838059427836.post-42031265579538934682014-07-27T09:23:00.000-04:002014-07-27T09:39:26.771-04:00Just vet stuff.So if any of you are wondering what real life is like after vet school, here's my breakdown so far.

We all have our strengths and weaknesses. A common problem many new grads have is communicating with owners. It's intimidating telling someone you want their money, no matter how justified the reason is. Due to having been a tech for a number of years prior to vet school, and just my own shameless personality, I have zero problem talking to owners. Even difficult owners aren't really a big issue for me. My biggest hurdle right now is time managment.

Speaking of time management, here's the deal. You go from a teaching hospital with every drug known to man, the latest diagnostic tools like ultrasound, a CT, an MRI, the latest nutroceutical therapeutics like cold laser and hydrotherapy, to a tiny clinic with a limited pharmacy and if you're lucky digital radiology. Maybe not, if you're doing an internship or you happen to work at a really awesome clinic. But for most of you, it's going to take you forever to discharge your first few dozen or so appointments because you have to decide what you want to do (which you won't have your protocols down in your head yet for skin, eyes, cough, etc) then decide what you CAN do with what you have to work with, then okay it with the owner which will usually modify it further due to cost. It's gonna take awhile.

Also, my first few spays have taken me an hour. No one's there to hold your instruments for you, or follow your suture line by keeping your tag out of your way. I'm primarily spaying 4 lb chihuahuas and whatever-poo puppies, which by the time I've placed my clamps gives me no space to work in. Also, I freaking hate those needle drivers with the scissors in the handle. I've cut my suture line unintentionally THREE times! And then had to start over. Not to mention, the scissors are so far down the handle that it's next to impossible to clip your tags short enough without craning your neck so far you're practically resting your cheek on the patient. So. Much. HATE.

Other than that, things have been fairly decent. I'm an okay doctor, I can generally keep up with appointments with a good tech team keeping me on track. I'm frustrated sometimes that I'm not accomplishing things as quickly as the other doctors, which I recognize is silly and I need to stop being so hard on myself. I get frustrated when I don't have access to drugs I want and my boss won't buy them, or when techs who are used to the way the other doctors do things get a little passive aggressive with me when I want to do things another way. Just micro-struggles that you'll all deal with once you're out in practice.

So that's it. That's the reality of a new grad in practice. It's not very glamorous, but it isn't hellish, either. It's a lot like having a job, oddly enough. ;) Julie Ladahttp://email@example.com:blogger.com,1999:blog-1817437838059427836.post-61095056211621112982014-06-29T13:54:00.001-04:002015-12-01T10:20:00.220-04:00I'm alive!So if anyone is still reading this, hello! I am writing my first post as Julie Lada, DVM! I locked down my blog while applying for jobs. It's just a good idea to minimize your non-professional social media presence during that time.

Externships were a mixed bag for me. My first one, at the emergency/internal medicine specialty clinic was fantastic. I learned so, so much so quickly. I got to play with an endoscope, and take biopsies (bone core, and endoscopic). I saw a few splenectomies, one of which weighed 15.5 lbs! And a ton of pyometras, most of which were septic and required 3-4 days of 24 hour care. Spay your pets, people!

The second internship was very informative in many regards, and also very frustrating. The first thing I learned was that the avian specialist, a large part of the reason I chose that clinic, would be gone for 2/3 of the time I was there and I wasn't told this prior to scheduling. That was a huge let down, particularly since I really enjoyed working with him my first day. The second half of the problem was that I don't know if they aren't accustomed to hosting students so near the end of their schooling, but I was basically treated like a technician to a large degree. Instead of going into exotics appointments, I was being asked to scale and polish dog teeth, or even restrain for anal gland expressions. If I mentioned that I was already comfortable with my skills doing a routine scale & polish, but if they had any extractions to please let me know as I needed more experience with those, I was told that I was "there to learn" and to stop turning down opportunities I was given. I was also asked not to assist with taking a history in the room, just to stand against the wall until I was asked to do something. Compare this with at the previous externship, I was going into rooms on my own to take a history, do a physical, and report back to the internal medicine specialist with my differential list and plan. And at this clinic, I wasn't even allowed to ask a single question.

Like I said, frustrating. Probably the nail in the coffin was a neuter gone horribly wrong, where I was told, "It's all you, I'm just your assistant!" and then everything I wanted to do was second-guessed and micromanaged. Many of the things that the vet "assisting" me wanted me to do are outdated and now regarded as incorrect technique. For example, I was told to place eight throws on each spermatic cord. Eight! And I was also told that you cannot place a transfixing ligature in a neuter. I was really uncomfortable, and then told later that I made her feel uncomfortable. So both of us were unhappy with the way it went. (FYI, my new employer watched me do a dog neuter two days ago. I used a one clamp technique, two ligatures - one modified Millers and one transfixing. All of my ligatures held beautifully, and I was done inside of 20 minutes start to finish. She called me a "rock star" and said I didn't require any further instruction in routine surgeries. I'm just saying, surgery is one of my strong suits and it really, really bothered me to have my skills brought into question.)

So yeah, I ended that externship early and came home to take an in-house rotation at Illinois because we were just a horrible fit. For that reason, Rossies, I recommend not taking a 4 week externship unless you really know the clinic well. I could've been stuck there for another 2 weeks of misery.

In other news, I have a job! I interviewed at four clinics, and was offered 3 out of 4 of the positions. The one I was turned down for smarted a bit, as it was a great salary working with very talented people with lots of the latest diagnostic toys. But I made it from the initial 17 new grads interviewing to the final 5, so I can be proud of that, at least. And I'm happy with where I wound up. The team and I seem like a really great fit, we joke around a lot, and it's a comfortable atmosphere. I'm the newest addition at the Banfield clinic in NW Indianapolis, going from a 3 to a 4 doctor clinic. So far I've been really impressed with the company; patient care, client satisfaction, diagnostics, employee benefits, etc. I think I can really be happy here. And my clinic just got a digital dental radiograph unit, so yaaaay! Now if I can just talk my boss into letting me get an ultrasound. ;)

So there you have it. I completed my goal of writing a Ross vet student blog from start to finish. Now you guys know it's possible to survive without failing out or being eaten alive by a giant centipede. Good luck, Rossies! And now and always, GO GREEN!Julie Ladahttp://email@example.com:blogger.com,1999:blog-1817437838059427836.post-22159216372954695682014-03-18T12:24:00.002-04:002014-03-18T12:28:33.509-04:00Sprint to the finish!The end is in sight, I can see the blue ribbon waiting for me! I just finished up my last rotation at the University of Illinois on Friday. Now I head off on 8 weeks of externships, and then I'm done! This last rotation, soft tissue surgery, was hands down my favorite so far.

I never expected to love surgery. I just had an interview recently where I was asked to name a couple of my favorite rotations/fields within veterinary medicine. I told my interviewer that I think there are common experiences in vet school that everyone goes through; when you try something you were dreading/thought you'd be terrible at and find you actually love and excel at it, and when you stumble upon something that you're randomly great at. For me, surgery was the thing that I expected to be awful at. The reason why is that I used to get quite faint while working as a tech and watching surgeries. It happened again at Ross in 3rd semester while watching a necropsy. I was terrified that I'd be unable to complete my live animal surgeries in 7th semester, so I volunteered for the feral cat spay/neuter days to get as much table time as possible before I had to do it for a grade. Turns out, I just have to be the one holding the scalpel! Once my mind is focused on a task, I'm able to shut out the part that gets woozy (usually, sometimes I still get a little light-headed and have to yawn, dance around a bit, bite my cheek, and then I can power through it). But it turns out, the same quality that drew me to culinary arts and pushing myself to achieve more and more adeptness at cooking, also applies to surgery. The perfect chocolate hazelnut tarte vs. the perfect gastropexy. Both require attention to detail and a delicate touch.

The thing I stumbled upon and just happened to be good at is radiographic imaging interpretation. The first day of class our professor said that in order to become good at reading radiographs we'd have to "learn how to see." And that it could take years for clinicians to develop this skill. For some reason, I can just see things intuitively. Pathological changes in radiographic images can be incredibly subtle, but for some reason they stand out to me. I'm able to create a 3D map in my mind of how structures sit within the body and overlay that with what I'm seeing on the 2D image in front of me, keeping a visual reference image of what "normal" would look like in comparison. I don't know why I can do this, and it was certainly unexpected. But now I really enjoy diagnostic imaging and want to pursue a continuing education and certification in the use of ultrasound, since I feel that's a weak area for me at the moment but it's such a profoundly useful tool in private practice if you know how to use it.

Speaking of interviews, I have potentially exciting news that I have to sit on until I know for sure. However, things appear to be falling into place, for both myself and my husband. Right now the future looks bright and we're both cautiously ecstatic. After 3+ years of living apart, and the fear that we wouldn't find work in the same city right away after I graduate and we'd have to continue to live separately for some time, our lives finally seem to be moving in the right direction. I'll post as soon as I know more!Julie Ladahttp://email@example.com:blogger.com,1999:blog-1817437838059427836.post-28517786014880407812014-03-13T09:34:00.001-04:002014-03-17T11:55:14.833-04:00"Rub their nose in it!" And other such myths.Dog training is a hot button issue right now. Dozens of TV, magazine and book personalities are dying to tell you the best way to get your dog to stop jumping up on your guests or going through your trash. In some ways, that is a great thing. Traditionally, dog training consisted of a rolled up newspaper. Getting the issue of dog behavior and training into the public awareness is a huge step for behaviorists and people who are passionate about pet welfare. However, as usual, anytime a topic becomes popular and a profit can be made off of claiming to be an expert, you get bad ideas and bad information being promoted just as heavily as the good. Television shows in particular focus on which host is the most charismatic rather than the most knowledgeable or accurate.

Part of the challenge for me personally, being a vet student and passionate animal behavior geek as well as a firm believer in evidence-based medicine, is the pervasiveness of bad ideas in my field of study. Witnessing a colleague perform an "alpha roll" right in front of me, it's a struggle to balance my desire to address the issue with the need to still maintain good relationships and not become known as the token naysayer.

Dog training is one of those topics that must be handled with a delicate touch. A method isn't purely a method anymore when you're talking about its application toward an animal that a person feels a strong emotional connection with. The method becomes the person employing it, and its effectiveness becomes intrinsically tied to their value as a pet owner. Like it or not, as any trainer or behaviorist will tell you, the moment you say something like, "Dominance-based training is not as effective as we previously thought and can actually have detrimental effects on an animal" it becomes translated by the person you're talking to as, "You're a bad owner and you abuse your dog."

The problem with any topic in medicine is that bad arguments can be made to sound very persuasive and convincing by using the lingo. The argument behind dominance-based training methods is an excellent example of this (BARF diets are another good example). Advocates such as Cesar Millan point to wolf pack hierarchy models as an example of "natural" applications of dominance-based behavioral conditioning. They tell dog owners to be their dog's "alpha" by using techniques employed by wolves such as throat holds and alpha rolls. They also attempt to shame owners by telling them that disobedience is a form of dominance which proves that their dog doesn't respect their status as "pack leader." The appeal to nature fallacy is something we skeptics are well aware of but it is unfortunately remarkably persuasive with the general public.

A huge, glaring problem with the dominance hierarchy argument is that it makes the assumption that behavior models which we have obtained based on the study of captive wolf packs are reflective of natural behavior in the wild. This is patently false. Firstly, the dominance-based hierarchy suggested by Millan only occurs in captive wolf packs. Wolf packs in the wild consist of genetically related members with the breeding pair being the "alphas." The frequent displays of aggression and dominance seen in captivity do not occur in a natural setting. Secondly, feral dog "packs" - the aggregates formed by stray dogs - do not display this hierarchy model, so even if it were true of wolves in the wild this model does not appear applicable for domestic canines. (Mech, 1999; Taylor & Francis, 2004)

And then there's the problem with the word "dominance" itself. Common usage would lead most people to believe that dominance is a personality trait; something a dog just is. A common thing we hear from our clients is, "She's just so dominant!" Or claim that their dog is trying to be dominant over them. Dominance has a very specific meaning within the context of animal behavior and it isn't something an animal just is. This is a common misunderstanding and something I've even seen my colleagues use. Dr. Sophia Yin, a DVM with a Master's in animal behavior and a widely renowned expert in dog behavior does a pretty good job of summing it up here. She has written extensively on the topics of dominance, aggression and training and I highly encourage anyone with a dog to spend several hours reading her articles. The American Veterinary Society of Animal Behavior reinforces Dr. Yin's position with their official statement on dominance theory:

"Dominance is defined as a relationship between individual animals that is established by force/aggression and submission, to determine who has priority access to multiple resources such as food, preferred resting spots, and mates (Bernstein 1981; Drews 1993)... In our relationship with our pets, priority access to resources is not the major concern. The majority of behaviors owners want to modify, such as excessive vocalization, unruly greetings, and failure to come when called, are not related to valued resources and may not even involve aggression. Rather, these behaviors occur because they have been inadvertently rewarded and because alternate appropriate behaviors have not been trained instead."

But beyond the implausibility of the theory behind the use of dominance and physically aversive stimuli in dog training, as well as the misuse of the term "dominance", there is the added factor that it just doesn't have a wide range of practical use. Meaning in the majority of cases, it doesn't work. Several recent studies have confirmed that dominance/positive punishment training methods have a number of negative effects on dogs (including physical injury and death in cases of choke chains and prong collars being used incorrectly) and can actually impair learning ability. These methods also cause fear and escalate aggression in terms of frequency, magnitude and situational aggression - meaning a dog that wasn't previously aggressive becomes aggressive, or a conditionally aggressive dog begins to display aggression in situations where it previously did not (Husson et al, 2009; Hiby et al, 2004; AVSAB, 2008). This is particularly worrisome for vets and shelter workers. An owner employing dominance-based techniques toward their dog who is aggressive toward other dogs can actually cause that dog to not only be more aggressive toward other dogs, due to the added negative association with pain and fear, but also cause the dog to redirect its aggression toward its owner. In which case the problem goes from being something that could possibly be solved via proper training to what is a probable euthanasia case.

Positive reinforcement techniques such as clicker training are gaining momentum, and it's got behaviorists cheering in the streets (or rather, their offices). These techniques avoid the negative associations with pain and fear seen with dominance-based techniques and thus the ramping-up effect on aggression.

Finally, I know that this is a contentious topic and I anticipate anecdotes from those who have used Cesar Millan's or other dominance-based techniques successfully. A few words on that.

First of all, there are always outliers. I saw something recently that I quite liked and determined to borrow that said that between 80-90% of smokers will develop lung cancer, which means that 10-20 out of every 100 smokers will not develop lung cancer. So you will often hear claims such as, "My father smoked two packs a day for forty years and died in his sleep at 85 years old!" And while true, it does not disprove the fact that overall smoking is highly associated with lung cancer.

Also consider that the effect of fear on the cessation of all forms of behavior is fairly well documented. Simply put, a fearful animal will stop doing anything, including what you wanted them to stop doing. A dog that is fearful of inviting a painful punishment can appear to an owner to be "cured" of the unwanted behavior. But in fact, the underlying issue of why this dog was exhibiting the unwanted behavior is still unaddressed. A dog that is fear aggressive toward strangers, for example, is still terrified of strangers but simply stops reacting. Don't confuse this with being a happy, healthy, well-adjusted dog. An animal that has stopping displaying observable fear signals is still fearful, and the use of punishment can contribute to a more unpredictable animal that will give no warning before attacking (AVSAB, 2007)Julie Ladahttp://firstname.lastname@example.com:blogger.com,1999:blog-1817437838059427836.post-69748929279532580442014-01-22T17:01:00.003-04:002014-01-24T20:14:59.202-04:00I'm a doctah!NAVLE scores were just posted! I PASSED!!!!!!!!!!!!!

Julie Ladahttp://email@example.com:blogger.com,1999:blog-1817437838059427836.post-53971207220948670032014-01-19T11:08:00.002-04:002014-03-13T06:48:38.574-04:00Long overdue update.I guess when someone other than my mom is nagging me to update, that's how I know it's been far too long. So I've got today off, and I'm warm in bed with lots of coffee and the kitties. I had just gotten back into town from a primary care rotation in Chicago and decided to stop in on a small gathering of friends. I walked up behind a friend I hadn't seen in months and gave her a hug, and she suddenly went completely limp. I wasn't expecting it, so I'm sorry to say I didn't control her fall as well as I should have, but I managed to prevent her from hitting her head. We're still not sure if it was the corset she was wearing, or locking her knees, or a combination of both, but she just passed out for a second. Her corset was really tightly laced. Luckily my handy instrument pack Ross gave us when we transitioned from 7th semester to clinics was in my purse, and I used my hemostats to get the laces undone. I checked her pulse rate and quality, and she was fine. Paramedics showed up and got a blood pressure and pulse ox reading. She declined to go to the hospital. Anyway... Interesting night, definitely. I never expected to undress a woman in public with medical instruments, but hey! Life is full of surprises.

So, yeah. My primary care rotation was at Furnetic. Great clinic, lots of awesome people. It definitely helped me realize what really gets me excited about general practice and what leaves me feeling a little bored. I really love surgery. The one day I spent all day in the OR with animals rotating on and off the table was my favorite. Diagnostics are also super fun. Putting together a puzzle and knowing how to help an animal is such a great feeling.

I got my first negative evaluation in clinics so far from orthopedic surgery. I passed, but it was pretty harsh. Part of that was earned, but part of it I feel really wasn't. But, oh well. Orthopedics is and always has been by far my least favorite subject. My heart wasn't really in the rotation from the get-go, and having it for three weeks instead of the usual two (hooray for the holidays!), as well as the timing right after I took the NAVLE and was experiencing a bit of a depression funk, pretty much ensured that I was miserable the entire time. I'm sure that influenced my usual level of participation.

Speaking of NAVLE, we've all heard that we're getting scores back this week. I'm impatient and just want to rip the bandaid off. I've never been very good at waiting for potentially bad news. Fingers crossed I won't be retaking it in April!Julie Ladahttp://firstname.lastname@example.com:blogger.com,1999:blog-1817437838059427836.post-50555518365408612802013-11-20T14:34:00.001-04:002013-11-20T14:53:15.778-04:00Tattoo.Ever since I learned that I could cover old tattoos with new ones that I like more when I got my leopard gecko over an old, faded rose on my foot back in May, I've been obsessed with covering the other old, faded rose on my back. It's a tiny little lower back tattoo, about the size of a silver dollar. It used to be very pretty, but now the colors are dull and the detail is blurry and I just really dislike it.

So I've been designing a rat to go over it. I used Shutterstock free images as my base, and then took bits and pieces from different ones to create the final image. I'd steal the whiskers from one, the hind leg from another, the tail from another, and then use Paint to piece them together and the drawing tool to fill in or erase parts. I'm very happy with the results!

The text will be more flowy and script-like. This is the closest font I could find to one I liked. And it will curve around the tail instead of being straight like that. The saying is the one that my closest friends and I chose to have on our necklaces that we made in 7th semester. It means, "I'll find a way or I'll make one." Not only does it have special meaning to me because of those girls, but also because I really identify with it. What Rossie wouldn't? We couldn't get into the state schools, so we went on an adventure instead and did what it took to become vets.

Now just to find a tattoo parlor in Chicago or Indy so I can get it done while I'm on externships. I think I'll email Nic, the guy who did my gecko in San Francisco and see if he knows anyone he trusts in those areas.

Julie Ladahttp://firstname.lastname@example.com:blogger.com,1999:blog-1817437838059427836.post-82659278909943080312013-11-19T13:51:00.002-04:002013-11-19T13:59:02.839-04:00Horsies!!!I'm on large animal emergency right now. I love it so far. The hours are a little annoying (7pm-midnight or later, usually). But I love the one-on-one time with the animals. It's quiet, the lights are dimmed, they're sleepy and cuddly. We do walk-bys every hour and any treatments that need done throughout the night. Last night I spent 10 minutes holding a hot pack against a sweet little Arabian mare's shoulder, and feeding her treats and scratching her neck.

While I was in Nashville camping with Don a few weeks ago, I picked up some apple molasses horse treats at a dog treat bakery there. I used to buy treats from them all the time for my rats. They were crazy for the peanut butter blueberry cookies and the cheese sticks. But these apple molasses treats smell *heavenly*. The other brands I've ever given to horses, although the horses love them, smell like Milk Bones. Just bland and uninteresting. These smell like oatmeal cookies fresh from grandma's kitchen. Every horse I've ever given one to has started nickering and bobbing their head enthusiastically.

I just love horses. The sweet, musky smell of a horse barn is one of my strongest olfactory triggers for a feeling of calm and well being. When I was working at Purdue, one of my responsibilities was husbandry for the horses. I'd clean out anywhere from 6-23 stalls every day. I got really comfortable shoving horses around in a cramped stall without fear. I had those horses trained well, too. They didn't get hay until they backed into the far corner of their stall. Anyone trying to crowd me or bump the hay out of my hands got the stall door closed in their face. I don't tolerate bratty behavior from an animal that can kill me with one kick. Most of them would move to the back corner if they saw me coming with hay. The rest would usually only take one, firm "Back!" and they'd move. Occasionally I got a butthead or two who needed work. Then, after I was done cleaning, everyone got a quick scratch and a cuddle before I moved to the next stall. And afterward, if there was time, I'd brush them out, pick their hooves, feed them treats and love on them. Those were my babies. They were research horses, usually a terminal study, so they were euthanized at the end of their time. But I did my best to make sure their remaining days were happy, and all of my coworkers did, too.

And I swear, if I'd had the money or the ability to board him, I'd have adopted Bo. He was undoubtedly *my* horse. Bit a few other people, because he was a stall sour jerk. But we had one day where he tried to bite me, and I yanked his head down by his halter and made it very clear that I was not afraid of him, and from that moment on that horse loved me. He'd poke his head out and follow my every move in the barn, and lean against me for cuddles while I cleaned his stall. I still miss him.

But I don't want to go into equine practice. I've seen enough of my classmates who started out with a strong equine focus and switched to small animal to know that I'd burn out fast if I even considered it. They all say the same thing; they love to ride, have loved horses all their lives, but equine medicine made them hate horses because all you ever see is horses close to death, in pain, aggressive or scared. So I'll stick to cuddles and kisses and treats. Julie Ladahttp://email@example.com:blogger.com,1999:blog-1817437838059427836.post-45559322732755660842013-11-09T14:11:00.000-04:002014-03-13T06:54:17.868-04:00Compassion fatigue.It's something every vet student hears about, has lectures on, awareness raising on social media about it... Compassion fatigue is, if anything, overly-emphasized in vet med. And for good reason. Our profession has an alarmingly high burn out rate, and suicide rate. My own professor, when lecturing on the topic, brought up a vet who she went to Ross with who had committed suicide with Fatal Plus euthanasia solution and an injection pump machine from her own clinic.

Today, Dr. Wallace, my beloved large animal medicine professor, linked to this article on Facebook. I'll quote the portion that made my heart clench in empathy:

"Veterinarians are determined, driven, type A people. We as a species hate to give up, we loathe defeat, and we give until the bank is empty. Our ability to maintain a level of empathy for every client, every incident and every patient is unrealistic. How does a normal rational empathetic person put a pet that they have watched grow from infancy to geriatric to sleep in one room and then walk ten feet away to another patient who you are expected to be jubilant and clear headed to examine, diagnose, and treat? Somewhere along the way we learn to mask, shelter, or disregard our emotions. Somewhere it became expected, and we learned to push feelings aside and press on. It is a recipe for a psychopath and a schizophrenic. And we do it every single day."

She goes on to say that we need to take better care of ourselves. Pay attention, stay clued in to what our bodies and our minds are telling us. Look for patterns of substance abuse or coping mechanisms in our own behavior that are red flags. And set boundaries. Learn to say no to clients.

It reminds me of a conversation I had with a clinician when my septic, failure of passive transfer calf was dying. I was watching him lying on his die, struggling to breathe, groaning with every breath, and just clearly in abject misery. He was receiving excellent care. He was on pain medication. But he was still suffering, because he was just continuing to get worse with no hope of cure. We were playing catch-up with his suffering as he continued to plummet.

I asked the clinician, "Have you ever reached a point where you fired a client because they wanted to keep going, but for your own sake of mind and your personal, ethical considerations you felt it was wrong to do so?"

He said no. He said we can control suffering with pain medication, or even induced comas if necessary. He said the owner had to reach the conclusion to end life on their own.

I agree, to an extent. I understand his position. But I disagree on one basis, and that is the sake of my own mental health. Yes, ideally the owner should decide to euthanize without you pressuring them to do so. Saying, "Euthanize or find another vet." definitely falls under the realm of pressuring a client. But if I am treating a patient past my comfort level, and I am upset, and do not want to continue, and feel it is wrong to keep going, and I do this often enough, I feel that I will burn out.

I had this exact conversation again with the anesthesia technicians when we had a particularly nasty case come in and everyone in the room felt that elective surgery in an animal that old and that ill was probably not in the animal's best interest. The technicians agreed with me, and said that they would be more apt to work with a veterinarian who set firm personal boundaries regarding quality of life than one who kept going in the face of suffering.

It helped re-establish my gut feeling that I am not being selfish, or a bad person, or a bad doctor, if I establish boundaries with my clients regarding end of life decisions. I'm pretty confident in my decision now that I will reserve the right to gently, but firmly, show them the door if need be.Julie Ladahttp://firstname.lastname@example.com:blogger.com,1999:blog-1817437838059427836.post-45910919804692618502013-10-15T11:43:00.001-04:002013-10-15T11:48:42.887-04:00Go to sleep, little kitty!I'm on anesthesia rotation right now. Ax scares the crap out of me. The drugs we use to induce and maintain anesthesia have some profound systemic effects. They slow the heart, drop blood pressure, make them stop breathing... It's scary. When you think about the fact that the Illinois teaching hospital is a referral hospital, and we don't get average, every day, healthy pets for the most part, but difficult, involved cases, often with multiple combined illnesses, it's terrifying.

Usually, an Ax protocol goes like this:

Premedication: This is to make the animal sedate and relieve anxiety before placing an IV catheter and and inducing anesthesia. Usually a combination of an alpha-2 agonist or benzodiazepine with an opioid.

Induction: After you've placed an IV catheter, you induce anesthesia with propofol, thiopental, alfaxalone, etc. These agents usually induce apnea (no breathing). You've got about a minute from the time you induce until you need to have an endotracheal tube in that animal so you can hook them up to oxygen and ventilate them if necessary. It can be very scary. Cats in particular are difficult to intubate, because their largyngeal muscles spasm with stimulation and can cause a dry choke where their airway closes and then you cannot get a tube in. We often use a lidocaine splash block on the arytenoids to desensitize them and then use a thin wire stylet to guide the ET tube to avoid that.

Maintenance: You can use a TIVA (total intravenous anesthesia) of a combination of drugs to maintain sedation, but more often we use inhalants. Inhalants like isofluorane are extremely cardiovascular depressive. They cause hypotension and bradycardia.

That's all pretty intense, in and of itself. If you also have a bunch of complications that make you have to be very selective in your choice of drugs, and have to add CRIs (constant rate infusions) intra-op to correct the things that the anesthetic causes (dopamine to improve blood pressure, diuretics to improve blood flow to the kidneys in renal failure patients, dextrose for hypoglycemic patients)... Shit gets complicated and intimidating.

Two of my anesthesias wound up being cancelled because it wasn't safe to anesthetize them. Both were very involved, with bad systemic illnesses, and I was scared. I'm glad they were cancelled, not just because it was very unsafe for them and likely could've killed them, but also because it was a relief that I didn't have to go through with it. I am very happy, though, that I spent a long time researching for each case, carefully putting together what I thought was the safest anesthetic protocol uniquely crafted to that patient, and each time the faculty or resident anesthesiologist barely altered it at all. And my protocols were REALLY involved. Each of them involved 2-4 premeds, a co-induction with propofol and fentanyl, and at least two intra-op CRIs. Both had hypotension concerns, so I needed to keep my inhalant down as low as possible while still keeping them under.

It's nice when a board-certified specialist looks at your work and says, "I'm happy with this. Tweak this a bit, lower the dose of that, and we're good to go." And those changes were based on experience with those drugs in the specific conditions my patients had that I don't possess yet. So I'm pretty pleased with my performance so far.Julie Ladahttp://firstname.lastname@example.com:blogger.com,1999:blog-1817437838059427836.post-49851674795105208152013-10-05T14:53:00.006-04:002013-10-05T14:55:18.649-04:00Long distance vet.Recently a friend of mine in Australia messaged me about a lump on his cat's jaw. He had an appointment with his regular vet in a few days, but he wanted my take on it. The cat was older, and a few differentials popped into my mind, some of them not very good. I asked a few questions that would help me narrow it down:

Where exactly is it located?
Is it hard or soft?
Can you move it around in the tissue, or is it fairly fixed in place?
Is there pain associated with it?

The answers did narrow down the possibilities, unfortunately not in a direction I liked. I had to tell my friend that I was highly suspicious that this was an aggressive form of cancer seen in older cats, particularly in the location he was describing on the mandible, called squamous cell carcinoma. I told him I really hoped I was wrong, as I had not seen the cat myself, but given the description that if I were to work up this case SCC would be at the top of the list.

It's really, really hard delivering that kind of news. Particularly when someone isn't expecting it. I knew my friend well enough to know that he wouldn't want me to bullshit him. He'd want the facts, no matter how hard they were to hear. So I warned him that this does not have a good prognosis, as even with the most aggressive treatment (surgery to remove part of the jaw, chemotherapy, radiation therapy), most of the time the cancer has already metastasized by the time it's detected and the cat will die within a few months.

Turns out that SCC was confirmed with more tests. My friend opted for palliative therapy with pain killers and soft foods to make her comfortable for as long as possible, until the other day when he had her humanely euthanized at home. He's since written me a couple of times thanking me for my help and support. I was kind of taken away by his gratitude, because from my perspective I hadn't done much other than deliver some really bad news. His vet was the one deciding course of treatment and administering those treatments to make his old girl feel better.

It's a reminder that in this career your bedside manner, empathy, and a shoulder to cry on are equally if not more important as your skills as a diagnostician and clinician.Julie Ladahttp://firstname.lastname@example.com:blogger.com,1999:blog-1817437838059427836.post-84367464521326486602013-10-03T22:42:00.003-04:002013-10-03T22:44:30.267-04:00Graduation date.For the last 3 years, we've all been looking forward to graduating in New York City. It seemed so glamorous, so romantic, so thrilling! We'd wear fancy clothes and pretend we're fancy New Yorkers for an evening. It made it more special somehow, for a lot of us.

Well, screw all that, because we're graduating in Florida. Hot, sweaty, sticky Florida. Graduation has been announced. We'll be graduating at the Bank United Center in Coral Gables, Florida on June 13th, 2014. No one in my class is happy, except perhaps the people who already live in Florida. The rest of us are bitching about frizzy hair, melting makeup, sweaty clothes, and the decidedly less glamorous location taking away from our romantic, multi-year-long fantasy of New York.

I'm happy to be graduating. I'm not happy about looking shiny in all of my graduation photos.Julie Ladahttp://email@example.com:blogger.com,1999:blog-1817437838059427836.post-35581074706105974702013-09-29T10:45:00.004-04:002013-09-29T10:56:29.693-04:00Amazeballs.I'm sure at some point in vet school everyone has a case that just takes them on an emotional rollercoaster, makes them exhausted and grumpy at times, and elated and walking on clouds at others. I just had my first one.

On Tuesday at around 3:30pm we got a call that a 4-day-old downer calf was coming in. When he arrived he was "flat out" meaning on his side, unresponsive, kind of comatose but awake. The history I got from the owner was that the calf had been at the teat constantly, and crying through the night. It sounded like he wasn't getting enough to eat. My top differential was failure of passive transfer. Either mom wasn't producing enough milk or her teats were blocked or something was causing this calf to not get enough colostrum in his first day of life and he wound up immune compromised.

His serum total protein was 5.0g/dL, which was a good indicator of inadequate maternal immunity transfer. A value of 5.5 or above indicates adequate transfer. Normal serum total protein is around 7.0 with half being albumin and half being globulin (antibodies). 5.0 - 3.5 = 1.5. So he got something, just not enough. Unfortunately his blood glucose was 38 and he had a fever of 103.7. So that steered my differentials away from purely failure of passive transfer and into FPT and a secondary septicemia. He had an expiratory grunt and when I listened to his lung sounds they were harsh on expiration, leading me to believe he had a lung infection. We stuck an ultrasound probe on his chest and saw thickening of his pleural membranes and some consolidation.

So at that point my problem list was:
- Hypoproteinemia
- Hypoglycemia
- High lactate (4.9 yikes!)
- pleuritis
- dull mentation/weakness/ataxia

We gave him a fluid bolus of 1L of saline and then started him on an 8% dextrose drip to help with the lactate and hypoglycemia. We gave him some anti-inflammatories and antibiotics for the infection. And we gave him a unit of plasma for the low protein and lowered immunity.

Over the next two days he got a little bit better, started drinking from a bottle again. Then on Friday he crashed and burned. We'd corrected his lactate and his glucose, both were within normal range again. But his ataxia suddenly got worse, his mentation plummeted, and he started head pressing. So what had originally been our secondary neurological signs became suspected primary. We did a CSF tap and sent it to clinical pathology. I was sitting in the breakroom typing my SOAP when I saw the clin path people walking down the hallway toward the in house large animal ward and I thought, "Oh no..." Because clin path people don't belong down there. They stay in their offices and lab upstairs. If they came down for this, it's bad. I ran out the door to catch up with them.

Sure enough, Dr. Russell greeted me with a print out and he said, "This should make your skin crawl." The protein in his cerebrospinal fluid was 5.2g/dL. That's higher than in his blood. Normal CSF has a total protein of around 0.5g/dL. The total white cell count was 113,000/mL. Normal is 10-20/mL. Translation: Calf has an infection in his brain. The fluid was analyzed and showed high numbers of intracellular and free short, thick rods. So we added bacterial meningitis to the problem list.

We switched his antibiotic, since clearly the first one was not working, and over the next 48 hours changed his fluid rate, dextrose concentration, and fluid type half a dozen times based on seesawing blood work results. We added a nasogastric tube and feedings every 4 hours. And we also administered mannitol three times, which has to be given slowly over a period of hours and the patient has to be monitored the entire time for respiratory distress because if it's given too fast it can cause pulmonary edema. Basically, I lived at the clinic Friday and Saturday. And Saturday I was on call for ambulatory service and had to go on three farm calls as well as keeping up with his treatments. Thankfully another Rossie was on RAHMs with me who was helping me out with the calf when I was away on a call.

It was very touch and go, but then I got news that he had finally passed some feces. I came in and he was standing, alert, and hungry! He sucked down a bottle last night on his own and again three times for the overnight students. He ate very well this morning and is much more "with it" mentally. Things are looking very optimistic for him.

This is the first time I have personally been responsible for the care of a patient who has gone from completely unresponsive and mere hours from death, to making a full recovery (almost there, give it another couple of days). I did that. And it feels incredible. Pulling 12-14 hour days five days in a row, sitting in a stall with a comatose calf for hours at a time, not seeing sunlight because I'm there before it comes up and leave after it goes down.

When I was serving tables as a waitress, if I had a long night or a bad night, I hated the world. I was miserable. Even at my most exhausted and sore and disappointed this week, I was never in a foul mood. I guess that's how you know you're in the right field. Julie Ladahttp://email@example.com:blogger.com,1999:blog-1817437838059427836.post-78358284286249297502013-09-24T10:59:00.002-04:002013-09-24T10:59:41.221-04:00NAVLE.My exam is scheduled. Tuesday, December 10th at 8am I'll be taking my veterinary licensing exam. I pretty much want to vomit.Julie Ladahttp://email@example.com:blogger.com,1999:blog-1817437838059427836.post-12428121453739044412013-09-21T10:25:00.001-04:002014-03-13T07:05:02.017-04:00Making a decision.These past two weeks I've been on lab animal rotation. And I have to admit, I was bored stiff most of the time. The sad part is, I was following around an actual, board-certified vet the entire time, so it's not as though my experience wasn't an accurate reflection of what her day to day is like. And her day to day is spending most of her time behind a desk, or in meetings. Clinically, there was very little going on.

I think this has solidified in my mind what path I want my career to take. And it kind of breaks my heart a little. For the last four years, I've had my mind set on a career in lab animal medicine. And the primary drive for that was because I care deeply about rodents used in lab animal medicine, and want to make beneficial changes in their housing and care. And let's face it, there just aren't that many people who deeply, genuinely care about mice and rats. Being one of those people, I feel a responsibility to go into LAM.

Unfortunately, I no longer think it would make me very happy. I love the hands on stuff. Surgery, especially. And you just don't get to do that much surgery as a lab animal vet. Or many treatments, for that matter. The researcher does most of their own surgeries, and the technicians do most of the treatments. I would hate being stuck behind a mountain of paperwork, and in meetings, all day, every day, with very little practical work with the animals.

The thing that sucks is that while a boarded lab animal vet can hope to make anywhere from $90-120K, an average small animal vet makes about half of that. The hit in salary is a hard pill to swallow. Also, the knowledge that my professional life will be harder in private practice. Clients will get angry at me, they'll be heartbroken when I can't save their pet, I'll be heartbroken when I can't save their pet. Emotionally, the toll private practice will take on me will be much, much worse. The hours will be longer and less predictable. All in all, private practice is a less cushy, comfortable job than lab animal, any way you slice it.

But I can't ignore my gut. And these last two weeks my gut has been telling me, "This is awful. You'd be bored, frustrated, and miserable. You're itching to get your hands on an animal after two WEEKS. Imagine two years. Or twenty."

So I think I'm going to pursue small animal private practice. Which terrifies me, to be honest. Changing my plans in such a huge way, the financial hit, the unpredictability and drama of private practice. It scares me to be leaving my comfy lab animal bubble. And there's a part of me that feels like I'm betraying and turning my back on the rodents that need me to be their advocate, and that hurts a lot. But I think I'll be happier in the end.Julie Ladahttp://firstname.lastname@example.com:blogger.com,1999:blog-1817437838059427836.post-21893328732308259962013-09-16T11:24:00.000-04:002013-09-16T11:27:25.668-04:00Left my heart...Lately I feel more and more like a child of two worlds.

The weather is getting cooler here in Illinois. Fall is almost here and I'm loving it. I grew up in the midwest, and autumn is absolutely my favorite season. I can't describe the perfection of a beautiful fall day to someone who grew up somewhere without a true autumn season. The sun is warm, but the breeze is crisp and cold and makes your cheeks pink. The sunlight filtering through leaves so brightly jewel-colored red, orange and yellow makes you feel like you're standing in a kaleidoscope. The air smells like woodsmoke and baking spices. It's been my own personal Nirvana since I was a kid.

Then I moved to St. Kitts. At first I hated the heat and humidity, but soon I grew accustomed to it. I fell in love with the coqui frogs at night, and the serenity I felt floating face down watching brightly colored fish darting around me. Now when someone still at Ross posts a photo of themselves on the beach, I feel a pang of longing to be there. I miss the ocean and eating barbecue chicken with my feet buried in the sand. I miss my friends. The island got under my skin in a big, bad way and I miss it so, so much at times.Julie Ladahttp://email@example.com:blogger.com,1999:blog-1817437838059427836.post-68239409449294582682013-09-14T19:46:00.000-04:002013-09-15T00:26:55.886-04:00Apologies.I know I've been really lax in updating lately. It's a combination of being busy and tired and just not having too terribly much to say.

I finished my diagnostic medicine rotation last week. Necropsy was rough. Large animals like horses and cows are a serious work out to necropsy. I was so sore I could barely move some days. I went home with dried blood still on my elbows a couple of times. I'm not a fan, basically. It can be cool to see lesions and find the cause of death, but overall, it's a lot of bloody, nasty, hard work. But I got a good evaluation from the faculty, so that's nice.

I just finished my first week of my lab animal rotation this past Friday. So far it's been pretty slow. There were three first year students rotating through before they began classes last week. I mean, before they've had a single day of vet school yet they're on these rotations with fourth year students. It's kind of cool, I guess, for them, but I don't see that they get much out of it. The students on my rotation didn't seem all that enthusiastic. And it certainly bogs down the fourth years' experience. I don't really get it.

One really cool thing we did get to do on Thursday was head up to Chicago to get some experience with non-human primates used in animal research. I won't say much about that, because animal rights groups tend to go insane at the mention of research monkeys. I can assure you that all of the ones I saw were socially-housed, got lots of enrichment through music, toys, food, etc. and were in good health. Getting to pet monkeys for a day was pretty awesome.

It's finally getting cool here. Down in the 70s today. It was lovely. It's cool enough to sleep with my A/C off and the windows cracked tonight. I'm looking forward to my apartment smelling like the outdoors again.

I've been dieting, trying to lose some weight before graduation. I'm down six pounds so far!Julie Ladahttp://firstname.lastname@example.com:blogger.com,1999:blog-1817437838059427836.post-5233882244610619702013-08-17T12:05:00.004-04:002013-08-17T12:08:14.199-04:00Boo do doobie doo.Not much to say. The Ross summer semester officially ended on Thursday, so I have officially completed one semester of clinics (OHMYGODholycrap!).

I'm on Diagnostic Medicine right now, which actually takes up two blocks for a total of four weeks. I'm spending the first two weeks on cytology, and the last two weeks on necropsy. I really enjoy pathology, it's another aspect of medicine that feels like a treasure hunt to find the answer. Unfortunately, I'm not as good at it as I feel I am with imaging. My eyes don't pick up things as easily when they're microscopic on a slide, or surrounded by a puddle of gelatinous blood on a necrotic piece of tissue. But so far my skills in ctyology seem comparable/slightly above those on rotation with me, so I don't feel too bad.

I do remember being much, much better at recognizing cells in 3rd semester during my Clinical Pathology class, though. However, we were looking at slides several times a day every week, so that likely has something to do with it. And I have gotten better over the course of the week. Yesterday I successfully diagnosed 11 out of the 21 cases we looked at, and of the 10 I missed I had recognized elements that were right but I didn't arrive at the correct conclusion (i.e. saw a pyogranulomatous inflammation, didn't find the fungal agent responsible).

Anywho... Not much going on. Castiel is getting bigger. He's been neutered, and he's flipping crazy. I miss my calm, sleepy kitten when he first came to me (anemic and with gastritis, yeah, I know). But hopefully he'll grow out of this uncontrollable phase of climbing curtains and destroying anything remotely resembling plastic.

Okay, not as cute as a cat, but still. I like giant millipedes.

I bought brand new brushes a few months ago, and hadn't had the opportunity to try out the eyeliner brush yet. I love it! Using the brush and gel eyeliner makes drawing vintage cateyes a la Audry Hepburn super simple!

Julie Ladahttp://firstname.lastname@example.com:blogger.com,1999:blog-1817437838059427836.post-85006395405264926522013-08-06T20:22:00.002-04:002013-08-11T23:59:35.436-04:00Winner!I actually really like reading radiographs most of the time. Sometimes it's tricky and frustrating, but most of the time it feels like a treasure hunt for me that ends in an animal going home less sick than it came in. And I'm kind of good at it, too.

Back in 5th semester (I'm ashamed to admit this) I really slacked off on my DI - that's Diagnostic Imaging - midterm. There was a Pharmacology midterm right before it, and we were leaving for Puerto Rico a day after it. So, yeah, I wasn't my most focused. I didn't study hardly at all. Of 20 powerpoints on the exam, I had reviewed 11 the night before the test. I woke up at 4am the morning of the exam and rushed through the remaining 9 just hours before the exam. I was so afraid I was going to fail the midterm and have to catch up on the final exam. I walked away from that midterm with a 95%! Something about radiology just clicks in my head. Maybe I'm a visual thinker, I don't know.

So I was pretty confident going into my Imaging rotation. What I wasn't expecting was to find out that the Univeristy of Illinois students hadn't ever had a class on imaging. They had gotten it in bits and pieces spread out throughout their various coursework, but never a class devoted to imaging.

Suffice to say, I'm doing well on this rotation, and we'll leave it at that.

Today I had a pretty awesome little moment of victory. We are assigned three cases: bone, thorax, and abdomen. We are asked to study the case based only on a brief signalment and history (Ex: 9-year-old, male rottweiler, vomiting for two days), and interpret what we see on radiographs, and present the case along with our differentials to the class.

My thorax case threw me because some of the findings were contradictory. On lateral view, there was a HUGE soft tissue opacity centered around the base of the heart and dorsally elevating the trachea. The mass was more visible in right lateral than left lateral, indicating it was in the left lung. But on ventrodorsal view, it wasn't there. My first thought was a mediastinal mass, probably the tracheobronchial lymph nodes given its location, that would explain those findings. But then, the mediastinum was deviated to the left. Masses in the chest deviate structures away from them, not toward them. It made me start second guessing my diagnosis. I considered atelectasis, but couldn't explain why I couldn't see a retracted lung lobe on VD or why I could still see blood vessels in the lung extending out to the periphery of the thorax if there was a collapsed lung lobe. I ended up sticking with my diagnosis of a mediastinal lung mass.

The clinician specifically said that it was a challenging and confusing case. He said that the deviation of the mediastinum was odd and made you second guess yourself. Basically, I was given a deliberately difficult assignment and knocked it out of the park!Julie Ladahttp://firstname.lastname@example.com:blogger.com,1999:blog-1817437838059427836.post-24558897566554038682013-07-27T11:38:00.004-04:002013-07-27T14:20:49.234-04:00The little things.One thing I am very grateful for inheriting from my mother is her positivity. My mom is just a naturally happy person. There are people in this world who I just don't understand how they function being as angry and miserable as they constantly seem to be. People who say, "Ugh, I hate ____" every other sentence just confuse me and make me sad. That isn't a statement against clinically depressed people. I've been there twice in my life, and I know it's different than just being a moody jerk. Plus most of the clinically depressed people I know, you would never guess it talking to them. I'm talking about people who are just negative all the time and unpleasant to be around.

The great thing about being a positive person is you can be having the crappiest day ever, and it only takes something small to bring your spirits right back up again. A nice day, a good cup of tea, and suddenly all of the stress and negativity is gone. And I truly do love that I'm one of those people, because it makes life easier.

Today I had a really hard time getting out of bed. I've spent the last six days in and out of our small animal isolation ward caring for a very sick dog with Parvo. I was exhausted and sore and did not want to get up to go do 7am treatments. I went, and left school around 9am and decided to stop at the Market at the Square, Urbana's farmer's market, on my way home. The sun was warm, the breeze was cool, the sky was blue with big fluffy white clouds, and the air smelled like summer in the Midwest. After a few minutes of walking through isle after isle of fresh produce and baked goods, I was in my happy place. I bought apple butter, cheese, sweet corn, and shortbread cookies. Now I'm in bed, cuddling with Castiel, sipping a cup of mint tea, and completely and utterly content.

Here's some pics from the market. It's truly one of the biggest and best farmer's markets I've ever been to.

I love it when there's a vendor that does this! They basically take every fresh lettuce and herb in their garden and combine it to make a salad mix. It's seasonal, so it's always changing, and delicious. I love to have it with goat cheese fritters, dried cranberries and sunflower seeds.

A shuck your own corn truck! My favorite of all the vendors there.

Julie Ladahttp://email@example.com:blogger.com,1999:blog-1817437838059427836.post-10352002506866798312013-07-16T13:27:00.000-04:002013-08-19T07:58:54.683-04:00Money woes.Sorry for the big gaps between posts. The wildlife and exotic rotation was crazy busy. I got to do a lot of really cool stuff, though, including two zoo visits where I anesthetized and did physical exams on zoo animals. There was also a big wildlife component, so I got to restrain owls, snip off some necrotic bone and sew up a goose's leg, and put a nasogastric tube in a box turtle.

Right now I'm on small animal critical care. There are three students on the rotation right now (three Rossies of different generations - HOLLA!) and so it's actually pretty laid back and we have a lot of time to round on cases, or common clinical presentations, topics like fluids or specific diseases... It's nice.

One thing I will say about the first clinical semester is that you blow through money fast. Between a deposit on your apartment, furnishing a new apartment from nothing (sofa, bed, dishes, silverware, cleaning supplies, etc.), my parking pass for Illinois was $660, the NAVLE was $570 for the national exam fee plus another $225 for state licensure, $230 for VetPrep NAVLE study materials, etc. almost every Rossie I know that just started clinics this semester is almost broke. Some of them have to live on less than $1,000 for the next month and a half, including rent. It's insane that in clinics we actually get about $2,000 less on our refund check than we did in semesters 1-7.Julie Ladahttp://email@example.com:blogger.com,1999:blog-1817437838059427836.post-12266632656278018752013-07-04T11:46:00.001-04:002013-07-04T11:52:46.428-04:00The good with the bad.I had a hard day on Tuesday. I took over a patient staying in the ICU from another student when I started on the wildlife and exotic rotation. She was an intestinal resection and anastomosis post-op that wasn't doing well. She wasn't passing feces and had hard masses of impacted fecal material in her bowels that weren't moving. On Tuesday her owners came to visit and she passed away in the room with them. It wasn't a very pleasant situation, her owners were very upset, and I took the brunt of it.

Later that day I was drained and moody and just wanted to go home. My last appointment was a snake with a persistent respiratory infection that we'd been trying to treat for over two months. Even with a culture and sensitivity, the antibiotics weren't clearing it up. We resorted to an antibiotic that can have some serious side effects, but would get some of the nastier bugs that won't show up on culture and the antibiotics we'd tried previously did not cover. The owner was understandably upset and reluctant, and for some reason was having a personality conflict with the clinician. Things got heated and he refused the treatment. I asked the clinician if I could go try and talk to him, because I felt like we'd developed a rapport earlier and maybe I could get him to come around. We felt this was kind of our last shot at getting this snake better, so she told me I could try. I went up front and sat with him and told him I was sorry that things got so heated. I explained again why we wanted to proceed with this treatment, despite its risks. I told him it was ultimately up to him, and I'd understand if he still didn't want to, but that I didn't want him to walk out angry and to not at least try the treatment because of a personality conflict and tempers getting out of control.

Well, he agreed to the treatment. He also told me that he's working on a Master's in counseling, and that I am very good at conflict resolution and empathizing with people. It kind of made my whole day.Julie Ladahttp://email@example.com:blogger.com,1999:blog-1817437838059427836.post-19342884097360626832013-06-30T23:14:00.001-04:002013-06-30T23:14:52.882-04:00Second rotation down.I just finished with my small animal ER rotation today. Basically, I don't like emergency medicine. It's just not my bag. I hate the heartbreak of it, I hate feeling helpless, and most of all, I hate having the money conversation. ER fees are hefty. Most 24-hour clinics charge a $100 exam fee, and that's just to get the animal seen, not including any diagnostics or treatments. After the emergency fee, bloodwork, radiographs, ultrasound, and ICU hospitalization fees, I was quoting owners $1,000-$2,000 routinely during this rotation. Many, many people don't have that kind of money these days. It was exhausting and sad and I really didn't enjoy it at all.

I am looking forward to tomorrow and the start of my exotic and wildlife rotation, though!Julie Ladahttp://firstname.lastname@example.com:blogger.com,1999:blog-1817437838059427836.post-67386953482721140862013-06-25T20:02:00.001-04:002013-06-25T20:04:40.901-04:00Hot dog.An important message this time of year.

http://www.ebaumsworld.com/video/watch/82689781/

And just in case you're ever arguing with someone who thinks it's okay on a "cool" day: http://caninecollegemi.com/1758/pets-in-vehicles/temperature-inside-car-chart-2/

It only takes 20 minutes to reach 100 degrees in a parked car with the windows cracked on a 70 degree day. That's easily an, "I'm just going to run in and pick up a few things." amount of time.Julie Ladahttp://firstname.lastname@example.com


text:
(Bloomberg Gadfly) -- Something still doesn't add up at Toshiba Corp.
The Japanese conglomerate on Thursday pledged to speed up investments in its memory-chip unit as first-half financials revealed the business's profit quadrupled on strong demand. Toshiba's semiconductor unit now accounts for 88 percent of total operating profit, Pavel Alpeyev of Bloomberg News notes.
Toshiba second-quarter operating profit - 135.1 billion yen.
The move to spend 600 billion yen ($5.3 billion) on the chip business (50 percent more than previously planned) underscores just how much of Toshiba's value is wrapped up in an arm that's supposed to be sold to a Bain Capital LP-led consortium for $18 billion as soon as antitrust approvals are obtained. Toshiba will retain a stake in the operations.
Bain and Toshiba both say a deal is imminent. But if the chip business is really out the door, why are so many investors piling in to buy stock?
Shares in Toshiba fell Thursday amid broader market softness but are up 24 percent over the past six months. Japan's benchmark Topix Index has risen 15 percent.
While short interest as a percentage of stock outstanding has risen in recent weeks to 5.3 percent, that's nowhere near the 13 percent level reached in April 2016 and again in August of this year, when investors got whiplash from the roller coaster of deal negotiations and questions over whether Toshiba would be delisted. Toshiba has since been removed from the Tokyo exchange's watch list, a curious move for a bourse that's pledged to help improve corporate governance.
Take a look at the makeup of sellers and buyers now. The percentage of Toshiba shares held in Japan, a country where company ownership tends to be concentrated among domestic players, fell to 33 percent this month versus more than 50 percent 12 months ago, Bloomberg-compiled data show. The percentage of publicly reported holdings in the U.S., meanwhile, rose to 35 percent, from 29 percent a year earlier. Why are foreigners getting behind a company local players are backing away from?
Perhaps some fund managers believe there's a chance Toshiba can find a way to keep its chip unit, as Gadfly's Tim Culpan suggested back in August. Or that a windfall could be coming Toshiba's way in the form of tax loss carry forwards, a policy that lets companies use realized losses from, oh, a giant bankruptcy of its U.S. nuclear business, to offset tax on future gains. Toshiba has said the hole could be as big as 1.01 trillion yen.
President Satoshi Tsunakawa left the door open in October when he said that even though he believes the chip-unit sale will go through, Toshiba is considering alternative options in case it doesn't.
That coy remark, coupled with all the buzz in Toshiba's shares, suggests a story some had thought was nearing its conclusion remains alive for the telling.
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