2014, Central America

South America – Ecuador

Feels great to have two feet back on home and native land. Bring on the cool green grass, Swiss Chalet quarter chicken dinners and of course, Timmies coffee!

After leaving Canada on May 26, our Global Vets journey has come to an end. It’s time to gear up for school, and prepare to grind said gears for year #3 at the Ontario Veterinary College. Three countries in 3 months; Belize, Guatemala and finally Ecuador, I can’t wait to share some experiences from the last leg of our journey.

Ambato, Ecuador

We quickly got to work with Dr. Diego Barrera, spending the days at the municipality shelter, where we would work till about 4pm, then hop in the bed of a truck and head to the local clinic, PAE (Protección Animal Ecuador), till about 7pm.
The municipality clinic services consists largely of sterilization, where 15-20 animals are spayed and neutered every day. The clinic also welcomes members of the public to bring their pet in for other medical issues, where the veterinarians will treat the animal, providing they agree to sterilize the animal after treatment in order to control the animal population.

Animals are presented with various ailments, falling on a large spectrum anywhere between mildly injured and severely diseased. From kennel cough –  a respiratory infection caused by bacteria, to traumatic injuries and mass removals, the Ambato municipality clinic treats many cases each day, each dog or cat requiring different medications and treatments. Here’s a few examples of cases Laura and I saw at the municipality shelter:

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Oral growths, caused by papillomavirus
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Giant bladder stone removed from this cat who was urinating blood. The clamp on the tongue monitors heart rate, blood pressure and oxygen saturation during anesthesia.
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Dr. Diego removing a severely infected uterus. This is a common risk to female dogs who are left unspayed into adulthood – Pyometra.

After the first week in Ambato, word spread through the communities about a few Puma attacks on livestock animals in a nearby village. The town brought in the wildlife organization to trap and release the cat to prevent more animals from being attacked and to provide peace of mind and safety to the members of the village. We were called in to treat the livestock attacked by the Puma, we didn’t really know what to expect…. FYI here’s a puma:

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WARNING. I know I’ve had a few “Graphic image warnings”  in these blogs, but this one is the most graphic of them all. Below are the actual pictures of the animals we were called to treat after being attacked by the puma. Cruise right on by this next paragraph if you don’t wish to see them.

We drove up to a house on top of the mountains above the clouds. After locating the donkey in the forest we noticed green material flowing from the side of her face. No, this was not necrotic gangrenous tissue like I had thought, rather it was chewed grass that had leaked out of the hole in the donkeys face that had been slashed away by the puma. The cat had also taken a large chunk out of the donkeys back leg – I was blown away to see the donkey walking effortlessly.
I was also amazed at how this animal still had a large appetite! These are truly hearty animals and prove the theory of survival of the fittest. For years these animals have been forced to withstand many of natures challenges, including harsh climate, predation and food shortage. The weak ones die and the strong survive.

First survivor of the puma attacks. This donkey did great with a good cleaning, a few sutures, and two needles; one an antibiotic shot and one to control pain.

The next day after work we traveled to another village, not too far from where the donkey was attacked, this time to treat a calf that had been attacked overnight. Again, I was surprised at our clinical findings: No fever and eating fine, literally no significant findings besides the gaping wounds caused by the giant cat. The wildlife folks told us that they think the mother cat is trying to teach the baby how to hunt, explaining why the victims were injured as opposed to killed and eaten – we later found several cattle carcasses throughout our walk through the mountains.
This was not a safe place to be.

Calf Puma
Screenshot of a video I took while examining the damage to the Holstein calf. Scratched on the leg and back, a chunk missing out of her face. Tough little girl.
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The dart that is used to sedate the Puma once trapped in the cage in the background. They will then drive the cat far away from people and release it.

 

This last story was my most memorable case of the entire time working in Central and South America, and came from the final day of our 3-month Global Vets trip.

It had been an uneventful day of surgeries up until this point. I heard a voice ask if someone could come and take a look at one of the dogs on the surgery table. It was scheduled to be a routine spay, but when I rushed over and looked at the animal being operated on, it’s mucous membrane colour was far from routine. Very pale, almost white. The dog was in shock, meaning it was not pumping blood to all of its tissues properly. I listened for the heartbeat, it was there, but barely. Pulse was very weak and the dogs blood pressure was extremely low.

She was not breathing.

The surgery had just finished, and we began ventilations, holding the mouth shut to make a seal, and breathing through her nostrils to fill her lungs, immediately transitioning into emergency CPR measures. I had my stethoscope on the heart and could hear it continue to slow down. Emergency drugs were administered to increase heart rate and beat quality and the heartbeat raced upwards for a short period of time then began to fall again until I could no longer hear it. Manual ventilations continued and I listened to the lungs inflate through the stethoscope I had placed over her chest.

More compressions, more ventilations. The heart and lungs were not functioning, so we were manually operating the organs. Breathing into the lungs of the dog, and compressing the heart to generate pressure allowing blood to pump from the heart to the body. We removed the dog from the surgery table and took her to the recovery area, where a warm blanket and a heat lamp were stationed. She felt cold and surely her temperature had dropped to very dangerous hypothermic ranges.

We were losing her.

I put a catheter into her arm, ran intravenous fluids to increase her blood pressure and respiratory stimulants were given, all while chest compressions and ventilations were being continued. Dr. Diego then placed a needle between the upper lip and nose of the dog, an acupuncture technique very commonly used in emergency CPR. This is an act of desperation, an attempt to cause a release of adrenaline in the animal in order to shock the body and stimulate the nervous system to trigger heart contraction and lung ventilation. Didn’t work. Try again. Try again. Continue compressions and ventilations.

Suddenly a little gasp. Not even close to an adequate breath, but it was a sign of hope. I could feel a great heartbeat and it was not slowing down. We rubbed and rubbed in order to quickly generate as much heat as possible, she was 4 degrees too cold, in extreme risk of death. the body cannot function at temperatures even a few degrees below normal.

The little gasps stopped, then continued, my steth still locked in place, listening as the gasps grew in size, feeling her shivering as she inhaled.
We need to warm this dog up, now. She’s not out of the woods yet, her breathing can stop again at any minute.
I checked her temperature and she was climbing, 0.3 degrees Celsius every few minutes. She was getting warmer. Heart beating rapidly, little gasps turning into bigger breaths. It was working.

Every minute her breathing improved, all on her own, we could now stop breathing into her nose for her.

She was back to life after dying 3 times throughout the 35 minutes of CPR. She didn’t give up, and neither did we. It was an incredible day.

 

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The shot one of the shelter employees took of me after she had come back to life after 35-40 minutes of CPR. Mentally and physically exhausted, but relieved.

Dr. Diego,
your dedication to the animals and the sacrifices you make for them are inspiring. Thank you for allowing us into your clinic and especially into your home. I can’t say enough about the experience you provided us with. See you next year for the spay and neuter clinic!

I would like to sincerely thank all of our sponsors, Global Vets would not exist without donations and sponsorships. It is with your help that we are able to travel outside of the country and experience the way veterinary medicine is practiced around the world. Each one of our 16 students this year have all come home with different experiences that will help shape them as they develop into young veterinarians, thanks for your support.

And finally, to the millions of readers of this blog, I hope you were able to somewhat vicariously experience what it was like to work in animal shelters in Central and South America. It was an experience we will never forget. Thanks very much for reading.

yours,

Dan Katz and Laura Tindal

Global Vets 2014

 

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Laura and I with the staff at the municipality shelter in Ambato, Ecuador. Missing – Dr. Diego Barrera
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Outside puppy pen, vaccines all around. Everyone’s dewormed and ready for adoption.
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Alright, one more puppy picture. These two sisters were inseparable.
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