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Their Compassion ‘Went So Much Farther Than We Knew It Could Go’


Their compassion ‘went so much farther than we knew it could go’Memphis, tornado, tornadoes, Oklahoma State veterinarians, Oklahoma State UniversityReflecting on the array of scenarios she faced during disaster response work, Dr. Dugat remembers a greyhound named Memphis.Two dogs—one owned and one stray—presented with fluid and air in their chests. They showed no outward physical signs of trauma.http://www.veterinarypracticenews.com/images/article-images/Memphis400px.jpgnewslineTheir Compassion ‘Went so Much Farther than we Knew it Could Go’Working to help animals in the aftermath of record spring tornadoes deeply affected college and students, Oklahoma State veterinarians say.By Lou Anne Epperley, DVM For Veterinary Practice NewsPosted: December 3, 2013, 11:50 a.m. EDT

Caring for storm victims and witnessing reunions of heartbroken owners and their animals after Oklahoma’s epic EF5 tornadoes last spring affected the state’s veterinary college and students on many levels, say two veterinarians who were deeply involved.

Professors Danielle Dugat, DVM, and Todd Holbrook, DVM, recounted tales of curious medical conditions, answered prayers, rewarded hopes and undying gratitude plucked like treasure from the ugliness the tornadoes left behind.

Reflecting on the array of scenarios she faced during disaster response work, Dr. Dugat remembers a greyhound named Memphis. Dugat is assistant professor of small animal surgery at Oklahoma State University’s Center for Veterinary Health Sciences.

"Two dogs—one owned and one stray—presented with fluid and air in their chests. They showed no outward physical signs of trauma,” said Dugat. One of these was Memphis. "We thought maybe underlying disease was present, exacerbated by the stress of the storm. Then, on CT scans, a focal part of their lungs looked destroyed.

Ventrodorsal, above, and lateral, below, thoracic radiographs of Memphis, a greyhound who presented with fluid and air in his chest. His ultimate diagnosis: barotrauma from the tornado. Dr. Danielle Dugat

"I couldn’t figure this out. It wasn’t bulla, or neoplasia or even pneumonia,” she said. "One portion of the lungs appeared severely atelectatic, with no evidence of a lung lobe torsion or vascular insult. At surgery, it looked like their lungs just exploded from the inside out.”

Histopathology analysis was negative for underlying inflammatory condition, neoplasia or other cause for the lung’s gross appearance, said Dugat, a diplomate of the American College of Veterinary Surgeons-Small Animal.

"We concluded it must have been barotrauma  from atmospheric pressure changes during the tornado. One dog underwent lung lobectomy and the other had a partial lung lobectomy, and both are doing great.”

Memphis’s surgery and associated expenses cost nearly $5,000, covered entirely by Oklahoma State’s Animal Relief Fund, established by the college to cover the costs of veterinary medical care for animals injured during the tornadoes.

Other Issues
On the large-animal side, Holbrook and his colleagues were wrestling with bleeding problems in a pony mare with a foal at her side.

"The foal was totally fine,” he said, "but the mare succumbed to a severe coagulopathy. It began with intra-abdominal hemorrhage, then intra-pleural hemorrhage. She received transfusions amounting to 12 liters of blood. Yet, her blood work results, the appearance of her abdomen and gums did not look ‘sick enough’ for her to have DIC (disseminated intravascular coagulation) or that severe a coagulopathy.”

The episode began with signs of pulmonary disease and tachypnea, and progressed to transudate forming in the mare’s pleural cavity, which was drained prior to the blood transfusions, said Holbrook, associate professor of equine medicine.

A diplomate of the American College of Veterinary Internal Medicine and Veterinary Sports Medicine and Rehabilitation, Holbrook said endotoxic shock is the usual cause of DIC in horses.

Trauma-induced DIC was possibly what happened, the OSU team concluded.

The mare’s necropsy results failed to uncover neoplasia or other obvious explanations, Holbrook said, the lack of which would fit with DIC due to trauma. "The postmortem was 10-14 days from the event, and we didn’t find anything in the lungs.”

Similar to Memphis the greyhound, Holbrook mused that the mare’s injuries possibly could have stemmed from barotrauma.

Emotional Scars
Dugat and Holbrook said the tornadoes that hit Moore and other central Oklahoma communities on May 20 and May 31 tapped emotions like no others for veterinary faculty members and students.

"Egor was a geriatric cat whose owners would go to their destroyed property daily and call and search for him,” Dugat said. "He was finally pulled out six days later from where he’d been trapped. He was severely dehydrated, and spent four days at OSU recovering before he was stable enough to go home.”

A donkey that was at the wrong place at the wrong time found his way to the teaching hospital thanks to neighbors in Moore, Okla. His hindquarters were "shredded” and one of his superficial digital flexor tendons was severed, Holbrook said. Using Facebook, it took a week to locate his owner, who had lost her home in the storm.

"When the owner came to OSU to claim him, she said she hadn’t slept well on any night since the storm, but when she saw that he was safe and in good hands at the teaching hospital, she got a good night’s sleep for the first time,” Holbrook said.

Disaster response work engendered the satisfaction of helping people, and opportunities to see unusual, possibly unique medical cases, he said.

"I think it was both the emotional aspect of knowing that you’re helping owners whose animals have been through a lot, plus it’s a valuable learning experience, not just for the students, but for the residents. Especially the DIC case,” Holbrook said.

Like Lazarus in the Bible, animals that conventional logic would have left for dead continued to surface, Dugat said.

"One orange tabby cat was found in debris with a large wound on his head and his right ear nearly amputated from the injury. It was four days after the tornado, and they had just pulled him out of the rubble. His large head wound was full of maggots. We amputated his ear in the field and removed the gross contamination, and brought him back to OSU in the van with us.”

For veterinary students, it was a rare educational experience.

"The students learned a lot through medical treatment of tornado victims, but also, seeing those dogs get reunited with their owners, their tails wagging and bodies shaking. . . some of the owners would break down in tears,” Dugat said. "That little bit of compassion we could provide went so much farther than we knew it could go.”

Other pets salvaged from tornado debris included guinea pigs, birds and even a turtle that was saved from a destroyed school classroom. OSU Dean Jean Sander, DVM, later returned the turtle to the schoolteacher in a new tank with supplies, Dugat said. 

OSU veterinary school task force to develop disaster response plans

By Lou Anne Epperley, DVM
For Veterinary Practice News

Oklahoma’s record EF5 tornadoes last spring left Oklahoma State University veterinary school leaders and faculty with the resolve to build a university-based veterinary response team for future disasters.

In the hours following the storms, Dean Jean Sander, DVM, said she contacted her leadership team and told them, "We need to be on the front line of this.”

While members of the OSU Center for Veterinary Health Sciences were instinctively poised to dash to the disaster scene, they soon learned that emergency response unfolds in a sequence governed by federal and state guidelines, and rescue teams wait to be tapped for service.

Federal and state emergency response hierarchy notwithstanding, the way Dr. Sander saw it was, "We’re the veterinary school for the state and we need to be involved in this. It was a surprise to me that we weren’t already in that place.”

For Sander, last spring’s deadly storms—69 people were killed--clarified the gaps in the school’s ability to respond to disasters.

"We’re kind of an island out here,” she said. "But we’re a land-grant university, and we need to be involved in outreach, in education of the entire state and not just our students.”

Todd Holbrook, DVM, is heading a task force to work with federal and state officials on developing the college’s disaster response program, Sander said.

"When you consider that Oklahoma is among the top three states in the nation for horse population, and we have the third-highest number of tornadoes in the nation, I was just flabbergasted that we do not have an organized emergency response team focused on large animals,” said Dr. Holbrook. He is an associate professor of equine medicine and a diplomate of the American College of Veterinary Internal Medicine and Veterinary Sports Medicine and Rehabilitation.

Danielle Dugat, DVM, assistant professor of small animal surgery, also is working with the task force to develop an emergency response plan for OSU to qualify for the first-responder chain of command to provide triage, supplies, transportation and veterinary support.

"Being the state’s veterinary school, I think it is important for us to provide high-quality care in a time of need like that,” said Dugat, a diplomate of the American College of Veterinary Surgeons.




12/4/2013 9:55 AM

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