Wednesday, February 11, 2009

Know Your Anatomy

One of the entertaining things about being a vet is that you have the opportunity to learn some new and interesting things about animals, on nearly a daily basis. I have learned, for instance, that when people mention that their dog "has his lipstick out", they most decidedly are NOT talking about cosmetics (despite the fact that there is every possibility that said "lipstick" may in fact at some point come into close proximity to the dog's lips.) I've also learned that when someone refers to the "yayhoo" they are not discussing some rube they saw on the road or at a grocery store. They're referring to some body part for which they either don't know the anatomical name, or else know it but don't feel comfortable mentioning it in front of a doctor. Ditto with "doodydads", "marbles", "jewels" and "boys" (testicles); "ninnies", "teetees", "tatas" and "boobies" (nipples or teats, depending on the species, plus or minus the actual mammary gland); "hoohoo", "cooch", "purse" (?!), "twink" and "her - um...." (vulva); "down there" and "you know" (penis or vulva, depending on the gender referred to); "manhood", "thing" (always tempting me to ask with a cheerful grin, "What thing is that, specifically?"), "peepee" and "wiener" (penis.)

Okay, I get that. People are either trying to be polite by being euphemistic, or are actually embarrassed to say certain words in public, much less in front of (gasp!) a doctor - who in reality might be expected to be less dismayed by such terms than the general public, after all - or, worst of all: in front of a female doctor. So I firmly suppress any evidence of hilarity and pretend that yes, I DO daily use the term "doodydads" when speaking to my colleagues about testes, and of course "purse" is commonly understood always to mean "vulva" in medical circles. Most of the time I can pull this off with a strait face and nary a twitch. Luckily I have mastered a thoughtful expression involving me biting my lower lip whilst nodding and going "Hmmm..." which passes for careful consideration of the medical conundrum at hand, rather than an attempt not to either grin widely or burst out laughing. ("Purse"?!? I ask you!) If I fail in this - which occasionally I do - people are generally mollified by me saying (so long as I can do it with a friendly smile and a twinkle), "I understand exactly what you are referring to - I've just never heard that particular term before. Good one!"

Then there are the other oddities. For some reason, about 30% of people tell me about problems they've observed with their dog's "back hips" (as if there were "front hips" to compare to). Likewise, we often get requests to examine the "front shoulder" (as if there were back shoulders) or the "back rear leg" (is there a front rear leg no one told me about in vet school?) I kind of get this too. For instance, my techs are constantly tweaking me for referring to the "back leg" of birds. They patiently remind me that birds have WINGS in front, not legs, so there are only TWO legs to choose from, not four. I DO actually know this - promise! - but habits die hard. I'm thinking "pelvic limb", for which my usual and owner-friendly term is "back leg"; sometimes I just reach in the "pelvic limb" box in my head and pull out "back leg" even when talking about birds. My bad.

So those all make a certain amount of sense to me, even if they do amuse me at times (especially that thing where I say "back leg" about birds. I don't know why this cracks me up when I forget and say that, but it does.) Not everything makes as much sense to me, though.

One time a dog was in for a surgical procedure, and it was noted to have a very large mat behind each ear. We shaved them off - these pull mercilessly at the underlying skin, and create infections by trapping moisture and bacteria against the skin, so it's a big favor to the dog. The owner was enraged. They thought that the mats were extra ears, and that their dog had a unique mutation that made for four ears. I ask you. Did they not notice that in its original form the dog only had the normal number of ears? Did they think their dog just suddenly decided, as an adult, to grow more ears? It's not a starfish. It's a dog, and dogs don't spontaneously grow extra ears. And worst of all, did they never LOOK at the mats and recognize them for what they were?

Yesterday Dr. G had a client come in asking him to examine their cat's dew claw. If you didn't know, the dew claw is the thumb, the pollux, the first toe, the little claw on the inside of the foot, the one above the other four toes (always assuming a normal number of toes.) Some dogs have this removed in the first week of life; this is very common in sled dogs, for instance, since booties rub on them and make a giant mess out of them. It is also not uncommon on hunting dogs that work in rough terrain where the dews can get caught or torn, injuring the dog. Some people who breed show dogs or pet dogs also routinely remove the front dews (and in nearly all breeds the back ones are taken off, if present, even if the fronts are left alone; the rear dew claw is generally not a normal toe and unless the breed standard requires its presence - as in Pyrenees, for example - the dog is generally better off without them, as they very often create a problem by getting caught on things or being a nail-trimming pain in the rump.) My personal opinion is that unless the front dew is likely to cause the dog a problem - as in deformity of the toe, or in sled dogs or other working dogs where the dew would be an issue - it should be left alone. It is a functional toe, and in dogs that do a lot of lateral movement (like Border collies or any agility dog) or dogs who make turns at speed (like any sight hound, and many "other breed" dogs who love to run and do it fast) it engages the ground and stabilizes the foot, minimizing the risk of toe dislocation. But I digress.

At any rate, the clients come in and ask Dr. G to examine their cat's dewclaw. Obligingly, he has a look at it. It seems perfectly normal, as he remarks to the client.

"No, no - it's on the OTHER side of the foot," the client says.

Well, no. It's not. The dew claw is always on the medial side, toward the midline of the cat. If there's something on the outside of the foot, it might be any number of things, many of which would be cause for concern - but one thing it unequivocally is NOT, is a dew claw. It turns out it's an abscess, already ruptured, with the fur cemented to the skin in a hard carapace, including two small spiky projections, stiff as paper mache`, that the owner (not understanding the anatomy) has mistaken for a dew claw.

The same day I have a dog in that the owner says needs a wire removed from its mouth. The dog got its foot caught in the chain link fence and commenced to trying to chew himself free. The owners, discovering this an unknown span of time after the onset, cut the dog loose from the mangled chain link. But the dog's mouth was making a strange clinking noise, as from metal chiming against teeth.

I examine the dog - a cheerful, strongly-built Labrador - who is remarkably cooperative about me prying around in his mouth.

"Hmmm, let me borrow him to the back for a minute, where I have some instruments that might help," I say, having ascertained the source of the problem. The dog happily trots to the treatment area with me, where he is persuaded to plunk his muscular hindquarters (that would be the back hind legs, if you're confused) onto the floor. I grab a tissue clamp and, with the redoubtable J holding the dog's mouth open for me, extract a large slab fracture off the surface of the carnasial tooth. Inspecting it, I learn two things: One, the tooth is fractured into the root. Two, this is an old fracture, as the root is already discolored, indicating that it is many many days from the time of the original fracture. The fence-chewing has just displaced it.

About then, Dr. S comes in. "Is that the wire-in-mouth dog?" she asks. I nod. "What kind of wire was it?" she asks.

"Wire made of tooth," I tell her, holding up my slab of carnasial. She gives me an incredulous look.

"Why did they think that was a wire?" she asks.
"Probably didn't look at it; it was making a sort of metallic chiming noise," I say, demonstrating by tapping the slab against the counter. For whatever reason, the tooth slab does make a musical ching that sounds exactly like a bit of metal pinging on the counter.

I go show this to the owner, advising them that the dog needs the rest of the carnasial tooth extracted; the open root canals are a source for infection, which means an abscess is pretty much guaranteed. Marvelling, the owner takes the musical tooth fragment, making an appointment on their way out for the tooth extraction (for which they do not show up.) Oh, well. Guess I'll see them during the next year or so, when the tooth abscesses. Poor dog.

On Monday, Dr. G gets to see a dog who is being brought in because it has a ball stuck in its throat. Really? And it hasn't suffocated? Reasonably enough, my receptionist SS asks if they're sure there's a ball stuck in the throat. Oh, yes, she is assured. The owner can see it. However, the dog is perfectly happy, in no distress, and wandering around under its own steam. SS is even less convinced that it is a ball in the throat, as this is likely to be life-threatening in short order, if not fatal. But the owner insists that they can see the ball. Okay, then. Bring it on in.

Two hours later, Dr. G brings back a dog who has a large swelling on its jaw. I can tell at a glance that it's a nice big juicy abscess.

"Ooooh, nice abscess! You lucky brat," I tell him, because I love abscesses.

"This is the ball-stuck-in-throat dog," he tells me. I goggle at him.

"Didn't the owner say they could SEE the ball stuck in its throat?" I ask.

"Yes," says Dr. G. "It was the owner's sister who looked at it and swore she could see the ball in its throat. The owner didn't even look, just took her word for it. She's pretty mad now, because she thinks here sister made her look like an idiot." Dr. G looks as though he thinks the owner has a valid point.

I look at the dog. It has short hair. There's absolutely no question that the swelling is NOT in the mouth, it's on the outside of the jaw. I can't figure out how anyone could even begin to mistake that for the back of the throat. After all, the owner AND her sister both themselves posses a throat. I'm virtually certain that both of them have at least once in life swallowed something - say, food. Now, maybe I'm wrong, but I'd just about bet that on its course down the throat, their food did NOT suddenly form a large round swelling on the outside of their jawbones. Of course, I didn't watch them eat, so I could be wrong. I'm just basing my assumption on several decades of swallowing food and drink (and once, accidentally, a marble) and never once having a baseball-sized swelling - or any other sized swelling - appear on the side of my jaw. Now, I know you'll think I'm bragging, but I'm fairly certain I was aware of this even before I went to vet school. I know! Amazing!

Sigh. Just another reason why it pays to know your anatomy.

26 comments:

Karl Katzke said...

Pffbt. Obviously, you missed the elective seminar in cartoon animal anatomy. If you had, you'd see all kinds of items clearly outlined in the outside of the throat.

Oh, and you won't see any of those nasty doodads or purses. Of course animals come without those nasty parts. CHILDREN watch those cartoons! Think of the CHILDREN!

(*sigh* I wish we were both kidding.)

MaskedMan said...

*sigh*

Yet another point of evidence that I'd have made a terrible vet - I'd have had a terrible time controlling my outbursts in many of those situations - Either laughter, or disgust.

Oh, and abscesses? You're not well, sis. ;-)

AKDD said...

KK, I think you're right: I must have missed that seminar, becasue (strangely enough) I expect to find genitalia on pretty much everything, and I'm mightily concerned if I don't.

MM - but... but... it's pus. Good, laudable pus. Who wouldn't see the appeal in that? :D

Seriously, abscesses are one of my favorite things. You know it needs done, you know the animal will feel better right away, and the vast majority of the time, you treat it and you're done. Occasionally they recur, but it's uncommon. Plus, you get the enormous satisfaction of getting the pus into the sink and down the drain where it belongs, instead of being inside the animal.

You know what I always say: A day without an abscess is like a day without sunshine! Or something like that. :D

Ria said...

You forgot about the front knees. If they're part of the leg they must be knees. Under no circumstances will we call them elbows.

Ark Lady said...

And I thought I was the only behavior consultant that had to listen to some really bizarre descriptions of body parts--or bodily functions.

Funny post. I've actually NOT heard of some of those layman terms...lucky me because I would probably be ROF/LMAO.

Beth said...

Purse is now my favorite new one. I like to point out to my husband when the mares are *winking!* I also like red rocket.

I thought you were going to tie in the dog with the ball in the throat abscess - to the one that was going to get an abcess that didn't come back.

Dianna said...

As a pet groomer who has worked in a vet clinic for 20 years, I too have heard it all. (except "purse"??!) My favorites have been the male dogs that have extremely feminine names(Princess) due to the fact the owner actually thought they were female. These people really think that dogs are as difficult to sex as cats, apparently they just never looked "down there". LOL. Boy are they suprised when they come in to be spayed.

In grooming, our strange anatomy stories tend to be people that think a dog's feet start at the shoulder and end at the toes. They tell us "leave the feet long" when I look at them incredulously, and explain that this would look odd, to just leave hair on the feet, they then admit (with MUCH prodding), they meant the whole leg. Sometimes I am tempted to give them exactly what they asked for...but so far I have been able to hold back.

AKDD said...

Ah, yes. The front knees. I DO have to inspect those sometimes, you are completely correct. I can't believe I forgot to mention them.

AL, now you have me wondering what ones YOU'VE heard....!

Beth, I'm sure we'll be seeing the tooth dog for an abscess sooner or later. Just not today.

Dianna, we quite often get mis-identified cat genders, and some of them really DO have ambiguous genitalia. But dogs...? That's a pretty obvious difference, even in newborns. I can't believe people actually get that wrong. Man. I don't think I've EVER seen a client who was shocked to learn what gender their dog was... I did once see one who wandered into the clinic (cuddling a Rottie pup) to ask us what geneder it was (female), but I'm guessing from her demeanor she'd never had a dog before... she was completely thrilled with the puppy and more than besotted, but she seemed entirely unacquainted with anything about it other than that it was a puppy. That part, she had right.... and at least she knew she was ignorant of dog genitalia and had the sense to ask!

Dianna said...

AKDD: I know...it's hard to believe, try to keep the "look" off your face when explaining how you can "tell" Princess is a boy. Glad to hear in Alaska your clientele is a bit more educated on anatomy than here in MN! I had to comment on this post, as the last said canine with a sexual identity problem happened just the other day, and I just had to share. I am very hopeful that they had not been previous dog owners.

By the way, I can't believe you shaved off that dog's extra ears! They could've been on Ripley's Believe it or Not or something..now it's over.

AKDD said...

I know! My bad. Shaving away their chance at fame and fortune. What was I thinking?

Della said...

Oh my! I am a master at prevarications, and replacement words, but "purse?!?" LOL I was raised in a household where even the word "fart" wasn't used, but we knew the difference between the practical use of a word and the unnecessary.

Della said...

Again, truly, Thanks for the laughs!!

Dragon43 said...

I have been fighting computers all day and loosing..... I needed your new story really bad. You saved my day...

Oh, was also have another half grown kitten at the fox buffet tonight making the possum nervous. Will see if it hangs around. We actually put up a "No Vacancy" sign under our welcome flag. I guess they did not see it.

Be well & warm.

Gus

da sign

AKDD said...

[This is a comment from Hedra which got hiccuped out of existance during the moderation process, so I'm re-posting it]:

I'm always amazed when the squeamish person in question is a mom, too. I mean, um, you're a MOM, you've got to have been puked on, pooped on, and peed on many dozens of times... if these dogs are your 'babies' your reaction would be 'oh, you poor thing' and helping, yes? I mean, I realized I was definiately a mom when Mr G puked all over me and my reaction wasn't to puke back on him, but to say 'oh you poor thing, do you feel better now?' I have mom-friends who count themselves as having acheived peace with motherhood when they've caught puke in their hands. (Because, you know, that rug is harder to clean than your hands... heh.)

Maybe I just know all the wrong kinds of moms. Or rather, the right kind?

AKDD said...

I admit I wondered how the client in question could be so freaked out about an ear infection (particularly a realtively minor and non-disgusting one) when she had a child (and presumably had changed diapers at some point in the past, not to mention all the snot and vomit that sort of comes with the territory). Maybe she wore gloves for that, too. And a decontamination suit. Maybe she had a nanny. Maybe her husband did it. Maybe the gross-out thing was all an act to be more girly - in which case I lose some respect, since - come on. Why put on an act to appear more whiny and incapable and helpless than you really are? There's that whole "fake it til you make it" thing... Cary Grant (nee Archie Leech) once said something to the effect of that he became Cary Grant by acting the way he thought Cary Grant SHOULD act, until he became that in real life. So if you put on a good enough "I'm a helpless whiny 12 year old and can't deal with the slightest unpleasantness even to help my pet, who I claim to love and have vonluntarily taken responsibilty for" act, well.... you're certainly not going to become LESS that way, and you're likely to become MORE that way. Why would you pick something like THAT to become?

For the record, I used to have long nails, too, but found them inconvenient for the job, so that was the end of that; I wasn't willing to cause my patients any discomfort for the sake of fashion. But even when they were long I never let them keep me from getting my hands dirty.

Gus, sorry about the computer fights.... but bless you for helping kitties (even if they do ignore the "no vacancy" sign... dang cats!) :)

patty said...

hey - here in alabama we call the vaginal area 'veronica'. at least that we what we call my dog's purse area. :) and yes, my male has a 'lipstick' (which stays in most of the time, thank god) and my other dog (a low class redneck sort) has a 'cooch' that she likes to show everyone.

seriously though, thanks for sharing. i love to read your blog.

AKColleen said...

When I read your title, I thought, "That was last term, do I really have to remember it all?" Of course, I'm pretty sure I could tell the difference between a dew claw and an abscess. And that wasn't even covered in anatomy...

Teri said...

Well, you're supposed to learn something new every day, and I did today, as well as laugh my "back there" off!

Two occasions come to mind, one happened at the mixed animal practice in Oregon I worked at, and one at the cat hospital in Virginia where I am now...

A woman called about her ewe (sheep) that had a vaginal prolapse (sort of like hemorroids of the "ladyparts"). She told me that her ewe's "twat" was swollen and I just wondered what anatomical term she used when describing same part to her gynecologist!

And, a new client (male) made an appointment for his cat to be examined for some growths on it's abdomen that he just noticed. When he came in wit the cat, guess what...the growths were nipples. Ok, that's not too hilarious. But then he said "But it's a boy cat" like, um, they don't have nipples? I wanted to say "Well, don't you have them" but I wasn't sure I wanted to know the answer...maybe he was an alien or not of a nursing species...

Teri and the cats of Furrydance

Bill Fosher said...

Euphemisms -- how I love 'em. Consider this, from the masters of euphemism, the British: "Front bottom."

smartdogs said...

I'll never be able to talk about lipstick in my purse without snickering or blushing...

Anne said...

I'm surprised you didn't mention "goolies," which is what we've always called a dog's testicles or the general area between his hind legs. You made me curious, so I Googled the word "goolies" and found out that (a) it's also considered street slang; and (b) that it comes from the Hindi word "goli," which means "small sphere." It's been my experience that dogs like to be scratched in the goolies as much as they like to be scratched behind the ears. Even if they've been neutered and don't technically have them any more, a good goolie scratching can be part of the usual belly scratching activities.

Laura Carson said...

Doesn't everyone know that the "lipstick" is really a "pecker"??? What's wrong with people? I will say that Nick flashes his at me on a regular basis. "Purse" really is a new one on me!!

AKDD said...

Just catching up on comments here....

Patty, I have now started the entire office on using the term "veronica"... much to our mutual hilarity. The funny thing is that I bet $100 that if I said that to a client who was hesitating for a term (as in: Client: "Her... ummm..." Me: "Her 'veronica'?") the client would gratefully sieze upon the term and understand immediately what I meant.

Teri, your client is a bit earthier than I usually get to see (although there are the occasional clients who are much more "direct", shall we say!)...mine tend more toward the kinds of euphamisms (or maybe "Brittishisms") that Bill notes... maybe we're a bit prudish up here. After all, (given the bundling up for weather conditions), there are several months a year you can't tell anyone's gender whilst outdoors, short of a close inspection of facial features (although if they're sporting a big bushy beard, it's USUALLY going to be a man).

Laura, thanks for cutting to the heart of the matter; that's what I like about southern women: Ladylike and sweet, but with a willingness to cut through the crap to get at the essentials of a matter! :-D Anyway, I laughed my "goolies" off - or would have, if I had any.

Colleen, I'm pretty sure if you weren't able to tell the diff between an abscess and a dew claw, you'd have to give up your Wildwood Farm Smart Chicks membership card. Cuz I think they expect you to have some common sense if you're gonna be a member! (Which means you're pretty much a lifer, IMO). ;-)

Anne said...

OK, so I'm not a vit'nery or a technician or a groomer, or even employed in a vet's office. I've simply been owned by a series of dogs over a long-ish, happy life. So which are they on your dog: nipples or teats? I always assumed nipples. The current dog, a male beagle, has a pair that seem to be on the outside of his prepuce, or whatever you call that hairy part where dogs stash their lipsticks, or penises, or whatever, when not in use. I'm assuming that's what they are since they're identical, symmetrical, and in line with the rest of his whatever they are.

AKDD said...

Anne, you are correct: they're generally referred to (anatomically, I mean, not euphemsitically) as nipples when on a dog. That's correct for any animal, really, though by convention we often refer to "teats" on livestock. You are also correct about identifying the prepuce on your beagle, and his nipples (which on male dogs are usually less well-developed than on females, and sometimes rather subtle.)

Valerie said...

I just came across your funny, funny blog! I was trying to read this posting out loud to my husband, and was laughing SO hard I was choking.

Thanks for the entertainment,
Valerie