How to manage epidemics and a better deal for greyhounds

Hero teases me from a height. Who says three legged cats can't somersault in the air and land in places you can't reach them?!

We’ve made it to the weekend folks, although it promises to be a busy one.

If you’ve not yet enrolled in the Coursera epidemics course, this might tempt you: the organisers have updated the course to include information about current infectious disease outbreaks including Ebola and MERS (Middle Eastern Respiratory Syndrome). You don’t have to be a vet or doctor to enrol – just willing to learn. (Why am I spruiking it? I think the more people are informed, the less they will react out of fear and the less the threat of infectious diseases = better world).

To enrol in the course (which is free), click here.

A better deal for greyhounds

Jeroen van Kernebeek, Australian Director of Grey2K USA Worldwide, this week delivered a petition to end greyhound racing to MP John Kaye. The petition, with 6,340 signatures, will be presented to NSW Premier Mike Baird.

Mr Baird is due to respond to the recommendations of a parliamentary inquiry this coming week.

Accompanying Jeroen was Nora from Greyhound Rescue and rescued Greyhound Millie (you can see photos of their visit here). Millie has a prosthesis

You can read the news story about Millie’s prosthesis here.

And for the ladies...

On another less serious note, for those of you into themed clothing (and in my view there is not enough of it), Black Milk Clothing is on the verge of releasing these outbreakleggings (perfect to wear whilst doing the epidemics MOOC).

I confess that I succumbed to temptation and purchased their puppy dress last month.

Animal intelligence, dolphin medicine and fish surgery

Nope, I don't have a pic of a dolphin, but I can't promise there aren't one or two hiding in this frame either...

In my day to day work in Sydney I don’t encounter too many dolphins (okay, so I think the number stands at zero). But they are fascinating creatures and often discussed in debates about animal intelligence and sentience.

SAT reader Jess sent this link about the comparative intelligence of dogs versus dolphins, which raises some interesting points about the way we measure and assess intelligence of non-human animals (but remember there are also controversies about the way we measure and assess the intelligence of humans – more on that in a later post).

Are dogs smarter than dolphins - or is this question a dumb question, reflecting our own predjudice?

You can read the article here.

If you’ve like to learn more about disease conditions of dolphins, the World Aquatic Veterinary Medical Association (WAVMA) is hosting a free webinar on September 24, 2014 at 8pm Australian WESTERN Standard Time (i.e. it will be a late night for East Coasters!).

Speaker Nahiid Stephens (BVMS, MANZCVS (Pathobiology) and PhD candidate) will discuss the pathology of select disease conditions affecting dolphins, the multifactorial nature of disease, risks and predisposing factors, common vacterial, mycotic, viral, protozoal and metazoan diseases of dolphins, clinical signs and gross pathology (as in, not “ewwww gross” but visible to the naked eye).

For registration visit here.

Note that the webinar will be made available to all registrants to view after the date, so you don’t have to stay up late or alienate your spouse/flatmate/dog etc, but you have to register first for this access.

Would you consent to surgery on your fish if it could improve quality of life?

Finally, on a smaller but no less fascinating scale, reader Kerry sent this link documenting the removal of a tumour on a gold fish at the Lort Smith Animal Hospital. The surgery of course is fascinating but fish anaesthesia is so different from mammalian anaesthesia, it’s worth a peak. Have a great Friday folks!

Mourning animals: headstones

Simple, tiny, and a very good place for other reptiles to bask: Sutcliffe's headstone.

I recently lost a foster bearded dragon Sutcliffe to metabolic bone disease. He was such a magnificent creature and I wanted to acknowledge his brief but spectacular existence. Mourning animals is a personal thing. Its been called "disenfranchised grief" because many people feel like they can't mourn the loss publicly. Studies suggest that this sort of disenfranchised grief occurs on cases of perinatal loss, and up to half of animal owners feel that grief is not really accepted by society. And I admit, grief is not an easy subject to discuss, particularly with people who aren't animal lovers - probably for fear of judgement. But that is exactly why I think it needs to be discussed.

I've always relied on photographs to remember my pets, but a friend suggested that I order a headstone. To be honest I wasn’t sure how I felt about that, but I did it, and it now sits in the garden. I walked outside the other day and found a skink sunbathing on the stone, which was perfect [well, almost perfect: I didn't have a camera to capture the moment].

In the process of ordering Sutcliffe’s stone I got chatting with the team from TalkingStones who agreed to answer a few questions about what they actually do.

What do you do?

Talking Stones are stone engravers.  Talking Stones was “born” when the owners (James and Samantha Rae) lost their own dog, Lady, and they struggled to find a fitting, elegant tribute that didn’t make their garden look like a cemetery.

We create a range of high quality, personalised products which include people memorials, house name plaques, wedding bonbonerie and customised, one-off jobs, as well as our core range of pet memorials.  Everything we make is lovingly hand-engraved on the Central Coast of NSW and shipped Australia-wide (and sometimes even further afield).  We work with a range of materials including tumbled riverstones, granite, sandstone, clay pavers, glass and stainless steel.  

What species have you been asked to make memorials for?

The majority of our pet memorials are for dogs, cats, horses and rabbits.  But we’ve also created tributes for guinea-pigs, mice, budgies, cockatiels, bearded dragons, other lizards, snakes, and a duck!

What is the largest stone you have made for a pet?

A couple of years ago we were involved in a charity project “Following the Legend ofArcher” where Australian Olympian Ed Fernon rode his horse over 1100 kms from Braidwood, NSW to Melbourne (following the alleged route that Archer  took before going on to win the inaugural Melbourne Cup race in 1861). 

We created a stunning sandstone marker (measuring around 45x35x25cm and weighing approximately 50kgs!).  As well as traditional engraving, we also incorporated some very detailed custom engraving on recessed stainless steel plaques.  This was placed at the beginning of the trek, forever memorialising the Legend of Archer.

We are also involved with creating an ongoing memorial for service animals in the police service and armed forces for the Queensland Government.

What is the smallest?

Most of our business is done through our website or through our network of vet clinics and pet stores, but one day last year a lady knocked at the door of our workshop with two children in tow.  The daughter’s pet guinea pig has just died and she was very upset.  She wanted something that she could carry in her pocket or school bag.  We ended up engraving a tiny tumbled riverstone about 4cm in diameter, that the girl hand-picked from our collection.

Have you had any unusual requests?

We pride ourselves on being able to create exactly what our customers have in mind, and have replicated logos and even hand-drawings and hand-writing into stone.  Our most recent unusual job was a granite paw-shaped plaque engraved with the Japanese symbol for the pet’s name “Zen”. 

Does the extent of grief people feel for their pets ever surprise you?

In short, no!  We are pet lovers ourselves and have huge empathy for our customers – we understand what a gaping hole the death of a beloved family member can leave.  We often deal with customers who are very traumatised, and whilst we are always professional and efficient, it’s sometimes hard for us not to get upset ourselves!  Interestingly it’s the people with the toughest exterior that really get upset. For example builders and trades people can be devastated when their four legged workmate passes away. 

Thank you for your time, guys. Its really interesting to hear another perspective on mourning animals. I am currently working on a project about grief and pets at the moment, but vets encounter grief and loss regularly. I'm really interested to learn how others mourn their pets.

Asking the big philosophical questions about animals - AASG conference

Why is the human species so fascinated with non-human species?

The existence of animals, and our interactions with theme, raise huge philosophical questions that we frequently overlook as we go about our day to day business. In some respects that’s fair enough – as a card-carrying graduate of an arts degree with a philosophy major, I can attest that engaging some of the big questions head on can leave one paralysed or send one into a nihilistic whirlpool. But questions need to be asked.

Our assumptions about other species can have dire consequences, in terms of the way they are treated, housed, and killed.

The Australian Animal Studies Group (AASG) is co-convening a conference in July 2015 and looking for contributors.

The conference, titled “Animal Publics: Emotions, Empathy, Activism” is co-convened by the Australian Centre and the Human Rights & Animal Ethics Research Network (HRAE) and will be held at the University of Melbourne.

The human/nonhuman animal relationship is continually in flux. In the twenty-first century our relationship with other species is more complex than ever. Images of animals dominate advertising and the internet. Many people feel a profound connection with their companion animals, consider them part of the family, and grieve when they die. At the same time almost all the species we breed for consumption are processed through the animal industrial complex, and are neither seen, nor heard, nor touched in a living state. Animal exploitation and commodification is increasingly hidden from public view.   The predominance of some species, and the complete absence of others, in our relationships with animals, raises important questions about how we understand and empathise with others. Why do so many people have such an emotional response to animals? Why do children bond with animals? What have we lost by excluding so many animals from the public domain – from our cities and day-to-day lives?     New advances in science indicate that we are only beginning to understand the complex nature of the emotional and ethical lives of animals. Philosophers have begun to re-think the way in which they have theorised some form of ‘essential’ divide between human and nonhuman animals in order to define what it means to be ‘human’. Political scientists have begun to discuss the issue of social justice for animals. Artists, writers and filmmakers now question the validity of an anthropocentric viewpoint in their creative works.    In this interdisciplinary conference, Animal Publics, we ask: How can the lives of animals be made visible - brought into the public domain? How might they be transformed? What roles might direct engagement, academic discourse, bearing witness, the arts, or community debate take? What part do emotions play in the changes taking place across a range of key discourses and in our relationships with nonhuman ‘others’? How should we understand our emotional response to animals and how important should the emotional lives of animals be to us? How might the emotions, empathy and activism be brought to bear on making the lives of animals visible in the public domain?   

They are after abstracts that address the theme ‘Animal Publics: Emotions, Empathy, Activism’ in relation to humans and other species:
 

-     In what sense can we ‘know’ nonhuman animals? 
-     What role does empathy play in the human/nonhuman relationship?
-     How might the emotions help us to rethink the boundary between human and nonhuman?
-     How does anthropomorphism influence the human/nonhuman relationship?
-     Why is the human species so fascinated with nonhuman species?
-     How can the lives of animals be made visible – brought into the public domain?
-     How can we use the law to regulate the lives of animals when most animals are absent from our lives?
-     Why are some species rendered invisible to the public while others enjoy a privileged status?
-     Why are animals so frequently omitted from discussions about sustainability & the future of global food production?
-     Why does the human species ‘deny’ its animal origins?
-     What role should emotions play in ethical responses to animals?
-     How has science influenced the human nonhuman relationship?
-     What role do emotion and empathy play in response to species extinction and climate change?
-     Why do we care more about some creatures than others?
-     What impact do representations of animals have on the human/animal relationship?
-     Is ethical consumerism an adequate response to species with whom we do and do not empathise?
-     What can the ‘othering’ of animals teach us about ourselves? 
-     What role should animal welfare science play in teaching us about the needs of nonhuman animals and other species? 
-     What has the animal protection movement contributed to our understanding of nonhuman animals? 
-     How should we live ethically and emotionally with other species in the era of the Anthropocene?

If you feel like tackling any of the above questions, click here, or submit a 250 word abstract for a 20 minute paper by November 17, 2014 to aasg-conference@unimelb.edu.au

Avoiding Errors In Medicine

There's a difference between being cavalier and being a cavalier.

Over the last decade or so there has been a trend in medicine to discuss and disclose error. This has coincided somewhat with a cultural shift away from a person-centered approach (individuals – and their inattentiveness, forgetfulness and carelessness are to blame) towards a systems-based approach (starting from a position that to err is human, but systems can be designed in such a way to minimise the risk of error) and that makes sense.

Usually when errors are investigated, multiple contributing factors are identified. (It’s one reason why I enjoy watching Air Crash Investigations even though I hate flying – usually there are MULTIPLE things that go wrong – it’s not usually just a drunk pilot or a leaky fuel tank or a dodgy fuel indicator that brings the plane down…it’s when all three happen at once that disaster strikes). Moreover, people are hardly going to be open about error if they know they are going to be scapegoated or hauled over the coals.

Incident reporting, clinical audit, retrospective case note review and morbidity and mortality meetings are increasingly common in human teaching hospitals as a means of quality control but also to identify actual and potential errors and minimise the risk of these occurring. One reason these strategies are less common in the veterinary setting is that we have smaller, less complex systems. It can be much easier to trace the root cause of an error in a smaller system. That said, veterinarians are just as capable of erring as human doctors and we can learn a LOT from our human-treating counterparts.

The difference between a good doctor and a bad doctor is not that the latter makes errors whilst the former does not. Rather, a good clinician learns from errors [a quick aside here – The Bad Doctor is also the title of a very awesome graphic novel which puts paid to the notion of perfect doctors – read more here].

The Bad Doctor...is actually a really GOOD read.

Avoiding Errors in Adult Medicine(Wiley-Blackwell) is designed so that doctors and medical students can learn from the errors of others – but this is an excellent read for vets and vet students also.

Many errors, of course, do not result in poor outcomes (these are the “near misses”). But some are devastating. The authors estimate that one in ten patients admitted to hospital in the developed world are the victim of error, and 1 in 300 patients admitted to hospital dies as a result of such an error.

“Healthcare professionals tend to act in good faith and medical error has many victims – patients, families, those very medical professionals (and their families)…”ix

 The authors have done a brilliant job in researching a range of cases, commenting on the specific details of these (including medicolegal comment) but also drawing out general pearls of wisdom (these could equally apply to veterinary patients). Here are my favourites:

1. “It is easy to identify a severely unwell patient. The challenge is to spot the patient who is not yet severely unwell but who may deteriorate rapidly if he does not receive the right treatment. Such patients present alongside hundreds of other patients with self-limiting conditions.”p12
2. “When cases involving sick patients who were not correctly identified are reviewed, it is often found that the patient had a single abnormal parameter and that this was not acted upon.”p13
3. “…it can equally be that sometimes, when patients are seen very early in the course of a critical illness, that there are no early warning signs of a severe illness to identify. This only serves to reinforce the need to give patients very clear ‘safety net’ advice, when they are discharged from medical care: that is advice about when they should re-attend the ED or the GP, if the patient fails to get better. Such advice should be given no matter how trivial the presenting complaint may appear to be.”p12
4. “Practical procedures require good communication skills, manual dexterity, patience, a calm and gentle touch, and supervised practice…The objective should be to perform the correct procedure on the correct patient, on the correct side, competently and with appropriate consent.”p13
5. “The term ‘Units’ should be spelt out in full when prescribing (e.g. insulin or heparin) in order to reduce the chance of U being interpreted as ‘O’ leading to a tenfold error.”pp15
6. “…make sure you develop the competence before the confidence…have regard to your position on the spectrum from cavalier under-investigation [did make me think of a Cavalier King Charles Spaniel…] through to defensive medicine.”p59
7.  “Keep calm in all clinical interactions and step away from the situation where necessary…If you are upset defer practical procedures where possible. Seek advice from senior colleagues when you are in a situation you have not faced before.”p102
8.  “Whenever you propose a diagnosis or explanation ensure the facts fit the mechanism you propose. Be logical and analytical – it is why you spent years learning basic anatomy, physiology, biochemistry, pharmacology and pathology.”p116
9. “Doctors who make mistakes may become better at their jobs as a result. They can, and do, go on to have successful and productive careers. The key is to reflect on errors and pay heed to any lessons that can be learnt.”p164

It all sounds crystal clear and very obvious, but the retrospectoscope has 20:20 vision. When one reads about the challenges these health professionals faced at the time the errors were made, at least in some cases, one can understand why someone made a particular decision or assessment, or how easily an oversight was made. It’s a very good reminder of the kind of mistakes almost anyone can make – and the life-saving importance of learning from these.

If you like this book, you'll also enjoy The Bad Doctor (more here) and How Doctors Think (more here).

Reference

Ian Reckless, D. John Reynolds, Sally Newman, Joseph E. Raine, Kate Williams,Jonathan Bonser (2013) Avoiding Errors in Adult Medicine. Wiley-Blackwell. ISBN: 978-0-470-67438-3

A pit bull as therapy and Rookwood Cemetery open day

Christophe and Dennis on horses. They have participated in funerals before and, as we discovered, are partial to an apple or two (but definitely not three).

On Friday I posed an ethical question about breed identification and received a range of comments, mostly from people who didn’t want to post publicly which is fine. It is, like many animal welfare topics, fairly emotive.

A colleague sent this video (if it isn't showing on your device, click here). In places where pit bulls are banned it seems shocking to see a “dangerous breed” in a therapy role – but it certainly provides food for thought for those consequentialists contemplating the conundrum.

Speaking of pets as therapy, yesterday Phil and I popped over to the Rookwood Cemetery, aka Rookwood Necropolis, the largest Necropolis in the Southern Hemisphere. [There is something about the word Necropolis – its Greek for “city of the dead”, which to me conjures up thoughts of very industrious dead working away at their projects]. Naturally they were selling tea and scones and Phil tried his hardest to perform some quality assurance by taste-testing.

Tongue...doesn't...quite...reach. 

The cemetery was actually pretty stunning.

They had an open day so we got to take a little tour, and we met a remarkable Newfoundland called Mo, who is a trained therapy dog. Not only does Mo visit people in hospitals and nursing homes, he also attends funerals. His owners are funeral directors, hence his personalised Guardian Funerals bib.

Mo. He's big, he's beautiful, and he brings joy to people he visits in hospitals.

There is something very lovely about the idea of a calm dog at a funeral. I think people take great comfort in the presence of animals when grieving. 

This gorgeous cat was just hanging out at the florist, flirting with the customers and making a lot of people smile.

Interestingly there were also horses, which may be requested to lead a funeral march, and also a very friendly little cat at the florist. And on that note, if you missed our post on 50 reasons to adopt a cat, check it out here.