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Tuesday, January 29, 2013

Testing the Test

Since we last talked I have finished the Onco block, started the Infectious Dz block, taken up snowboarding (shared activity with the boyfriend) and have watched Farley become almost 99.99% sound again. It was almost certainly not an abscess, "just" a softening of that old wire scar which caused some pain/discomfort. I say "just" because while I'm glad that she didn't have an abcess, I'm not exactly happy that the old injury raised its ugly head - I purchased her with it and have never had any problems with it.....but now I know that it is something I'll have to keep in mind and manage. At least it wasn't in the middle of my ride season!!!!!!

I'm in the middle of doing some final edits on a post that gives some pointers on how to evaluate literature, and while I was doing so I got on a bit of a tangent. There are 2 terms that I think you should be familiar with in literature, that is most likely to come up when looking at different tests that detect diseases or conditions. This isn't strictly evaluating literature.....but I do think it helps to understand some of the statistical background to some of the tests that you will run across in your everyday horsey world (like the Coggins test).

Sensitivity versus specificity

Sensitivity is the number of "True positives" (animal has the disease AND the test says they have the disease) divided by the total number of animals that actually have the disease, whether or not they tested positive or not (true positive + false negatives).

--> a test that is 100% sensitive means that there is zero false negatives. Every single animal that has the disease tested positive.

Specificity is the number of "True negatives" (animals without the disease that tested negative) divided by the total number of animals that are actually negative, whether or not they tested negative or not (true negative + false positives).

--> a test that is 100% specificity means that there are zero false positives. Every single animal that doesn't have the disease tests negative.

As you can imagine there is usually an inverse relationship between the two --> there is a trade off in specificity when there is high sensitivity and vice versa!

How does this apply to your horsey life?

Let's take the tests for Equine Infectious Anemia (EIA), which is most commonly tested with something called a "Coggins".

There is actually a second type of test that which is a type of ELISA that also tests for EIA.

The Elisa is faster - if the elisa is negative, than the horse is documented as EIA negative. HOWEVER, if the Elisa is positive, the standard coggins has to be positive too to call the horse positive. If the Coggins is negative, then the horse is certified as negative no matter what the Elisa says. If the Coggins is positive, than the horse is EIA positive.

Why might this be?

We are euthanizing horses based on these test results. A positive EIA horse is usually euthanized. We better be darn sure that the horse has it.

The Elisa test is highly sensitive. Remember as a test approaches 100% there are fewer and fewer false negatives - the Elisa test is going capture more diseased animals and call them diseased. But what about the false positives? Those horses without disease that the test mistakenly calls positive?

The Coggins test is very specific. As specificity approaches 100%, there are fewer and fewer false positives. ie - it is unlikely to call a healthy animal diseased.

Which test would you rather have deciding whether your horse lives and dies? A compromise has been reached. The Elisa is fast and if it's negative the animal IS negative and the paperwork is sent off and you get your Coggins cert...but if it's positive, the Coggins test is there as a back up, and we err on the side of not euthanizing a healthy horse, and perhaps missing a few infected animals.

The issue of specificity versus sensitivity is also why it doesn't work to get screened for a large amount of diseases in a shot gun approach - better to match testing with clinical signs and suspected disease because each test has it's own unique specificity and sensitivity.


Wednesday, January 23, 2013

Welcome to my life

I couldn't have said it better myself:


Studies, lameness, and other opportunities for critical thinking

Farley is lame.

At first I thought it was a hoof abscess. It was a reasonable conclusion - there is a ton of mud right now, combined with a relatively small pen, and not much riding or turn out, coupled with a sudden onset, acute, toe touching lameness.

However, now I think it's related to that old wire injury on the left hind. The hoof has gotten soft and the architecture of the split near the heel has changed (doesn't look like it did before we had all this mud), possibly combined with a current or historical (meaning that it has resolved) abscess that could have easily gained entrance through the compromised hoof at that point.

Within days Farley was moving much better and although today, running around in front of me in the arena she seems sound enough to ride, I'm taking it slow and easy since she still preferentially pivoting on the other hind foot.

Standing in the mud is not a recipe for a sound horse, especially one that isn't being ridden regularly.

As a nice change I didn't overreact and run around like a chicken with my head cut off when she presented dead lame that first evening. I evaluated my options and did some critical thinking and made a decision that both me and Farley could live with.

Here was/is my thought process.

1. Most probable "differential diagnosis" for a previously sound horse now "broken leg lame" with no actual sign of broken leg? Abscess.

2. Abscesses are not an emergency and general resolve.

3. How to treat an abscess? Get advice from horsey friends (the 2 legged kind), (my favorite "laymen's" site for reliable information), and from the literature.

4. Most friends recommended the conventional wisdom of soaking etc. had some older articles that referenced soaking, and newer ones that suggested that soaking wasn't part of the necessary treatment - this practice was mostly one of those things that probably didn't hurt, but probably doesn't substantially help or resolve the issue either. Another friend (endurance background) messaged me to say that last time one her horses had an abcess, the vet's recommendation was in the "non-soaking" camp and the managed it through pain meds, time off etc.

5. Fact: I do not have the time or energy in my life right now to spend time doing treatments that just make me feel good. I saw enough evidence that soaking may not help to investigate it further.

6. A quick dive into the literature told me that there is not enough evidence that soaking Farley's hoof was going to be helpful - thus I chose to go the route of bute (Edit: I'm being told that Bute may not be the best choice in an abscess situation - I used 1g once so I'm probably ok. One more example why you should be careful perscription drugs on hand!), rest, turnout/footing management, and a close eye on whether the issue was resolving.

7. Not soaking also fits nicely into my "belief" framework that minimal intervention for hooves is best, which includes soaking and/or putting substances on the hoof. There's no sign of thrush or anything else abnormal in Farley's hoof beyond the obvious immediate problem, so nothing is too out of whack --> and I don't want to disturb that delicate balance. Since I do tend to be drawn to the minimalist approach, this could also be an inherent form of "bias" when I read studies.

8. However, I did pick up an awesome soaking tip from a friend that sounds very doable for me if I ever do need to soak a horse hoof - baby diaper with epsom salts in it, put on hoof with one small opening on top, fill with water and then seal it on.

People throw around the word "studies" a lot --> especially in politics. I can't count the number of times I heard the phrase "studies show...." in speeches in the last presidential election. Not all studies are valid inherently, not all studies are relevant to the topic people apply them to, and it's wise to remember that PEOPLE design and write the studies, and studies are not infalliable or always entirely correct. Learning how to read and critically evaluate studies is very important - and once you have a few tricks up your sleeve, you won't be entirely dependent on your friends and random websites - you will have yet another tool that can help you make decisions.

I've run out of time and it's time to put Farley back in her pen and go to school, so "Mel's introduction to how to read and interpret literature" will have to wait until next time.


Thursday, January 17, 2013

Things more interesting than studying for the onco test tomorrow

Proving that I don't make this sh*t up


Playing with the cat

Doing house work. The house is by no means clean, but the dishwasher is at least running. And it distracted me from looking at onco for a whole 20 minutes.

Deciding to demonstrate how big Jonah actually is. You can see the pillow that Reed decided to destroy in the background. My new found interest in housecleaning did no extend to the living room. Only the kitchen. Because that's what is in front of me when I "study". Connor is in a cage to my right, in the dining room, where he can watch me study through the partial divider.

Making Conner foraging toys, watching him use them, and then watching him take a bath.

-Today he got paper packets filled with pellets and seeds strung on a bamboo skewer, a modified cat ball on a string with millet, a rice cake on a string, a "birdie vegge roll" with his fresh veggies and grains in an egg roll paper, and a foraging bowl with pellets in the bottom and dried pasta and toys on top.

Giving dogs big whole uncooked ribs. OUTSIDE.

Dentist appointment


Back to Onco. *sigh*.


Sunday, January 13, 2013

An update on Melinda! (Good)

Three days after the accident I'm feeling better! Just like the Urgent Care Doc said. :) How do I know I'm feeling better?

1. I started reading my Tahoe Rim Trail book last night and this morning started making a gear list for my trip this summer.

2. I made Connor a bunch of foraging toys and bowls for his food today instead of simply throwing his food into dishes and calling it good.

3. I didn't feel like sleeping all day and actually got out of bed before 8am and made coffee.

4. I'm actually bummed that there's no way that I'm going to be able to spend anytime in the saddle this afternoon. Doc said 7 days after I stopped showing symptoms like headache etc. so I figure that I shouldn't be riding any earlier than next weekend --> especially because Farley is likely to be a bit "naughty". >:)

5. I'm talking and laughing and singing again (generally being annoying to the other people in the household) and not conserving my words. My brain is starting to speed up until normal.

Before today thinking about complex ideas, the idea of typing or writing anything, or doing anything physical was a bit foreign to me. "WHY would anyone want to do anything but sit here and think simple thoughts such as 'ice cream is good and vanilla is better than I remember'?"

That isn't to say every is totally back to normal. I have a really hard time multitasking still and get distracted easily (it's like my shiny object disease on steroids, except instead of it being a delightful, fun distraction, it's more like a old person I-can't-remember-what-I-was-doing-or-why-my-ipad-is-in-the-laundry-basket type of distraction.....

Do you want to hear a Jonah Story?

Jonah has been living in the bathroom for the last 6 or 8 weeks until someone decides to foster him (I thought I had a foster home for him, but I think she is rethinking whether or not she can do it with her schedule). He's a bit.....fatter than he went in --> I guess that happens when you live in a mobile home bathroom and don't get any exercise.

A couple of days ago I found him out side. brother had his wisdom teeth out and his friend is taking care of him so maybe with the commotion he got out. Back into the bathroom he went. Tristan sweared innocence (rightly so since he at that point was horizontal only) and the friend claimed he was out when he got there. Hmmmm......

The next morning he was out side again. What the????????????

Started inspecting the bathroom, since I have not learned of a cats ability to walk through walls in school (maybe that comes in the next block?) and found out how he got out side.

"Dear Parents/Landlords/Property owners: The front bathroom no longer has a screen. Your 20 pound cat that I am kindly looking after for you somehow managed to get out the window that is located above the shower, near the ceiling by a yet unknown mechanism, since I have to get a stool and reach to my full height to reach this particular window. Once latched onto the 6" by 18" screen opening, he then managed to squeeze his fat out of the crank open window that was open no more than 3" for ventilation. Then, like a flying squirrel, I'm assuming he took a leap down to the ground, which is at least 12 feet down, using his enormous fat pads to cushion the fall with no ill effects. "

Anyone interested in fostering this cat need not contemplate the full situation too deeply. He's "inventive", "motivated", and "problem solving". Not, "destructive", "cunning", and "nothing-stops-me-from-getting-what-I-want".

Friday, January 11, 2013

Breaking news!


I managed to fall off my bike and give myself a concussion. No I wasn't wearing a helmet. My feet were all tangled up in my bike so down I went. One hand broke the fall and then I was sliding across the asphalt on my orbital ridge and cheekbone after making brief contact with the ground with my chin.

I'm lucky. My facial bones absorbed most of the impact instead of my skull, but since the brunt of of it came on my cheek bone, I didn't break my jaw. I think I came pretty close - the socket is sore. I had an instant headache which has continued to today. I definitely scrambled my brain a bit and while it is mild as concussions go (no vomiting, no blacking out) I'm definitely feeling the effects.

Foggy, slowness, headache, "deer in the headlights" look, dizziness etc all were present yesterday and continue today. I'm told that in about 3 days most of it should be resolved.

Yes I went to the doctor (urgent care) after it happened.

It's my first head injury and really it's rather unpleasant. I can't concentrate, although most of the visual stuff resolved itself by last night. I literally can't think --> and I'm not suppose to either. Beside the obvious no riding or running for 7 days after I am "normal" again, physical AND cognitive rest is prescribed.

This is a bit problematic since the only thing worse than sitting through this onco block would be sitting through it AGAIN, so after talking to the administrator, I'm going to attempt to take the 2 hour take home exam Sunday (due 8a Monday) and if I can muddle through it OK, I'm going to finish the block and take the final next Friday. If I find myself unable to complete the exam, then I'm going to suspend this block and complete it over the summer.

It's weird. I could literally look out into space drowsily for a couple of hours and be perfectly happy. And take naps. My brain just wants to check out for a while and let itself heal. Considering the next block after the next week is a HUGE fast paced, important, LONG block, I really want to make sure I give myself time to heal, and more importantly I WANT to heal.

Fortunately, this is mild enough that I'm feeling like myself by the end of the weekend and can get through this block. Today all sorts of other things hurt like ribs, a knee, and my neck.

I have a tendancy to take short cuts on wounds and healing, BUT even a mild head injury is not something I mess around with. Can't be a vet, go backpacking, or 100's as a vegetable!

Thursday, January 10, 2013


I'm sure that you came here looking for some wonderful "cliff notes" version of vetmed onco, similar to other blog posts that I've had in the past.

Sorry folks. I've never been so at risk for sleeping through an entire block at school. I can NOT make myself focus my eyes on the overhead or the instructor for more than 10 seconds. If I had to score my interest level on a scale of 1-10 I would be somewhere in the neighborhood of negative infinity. In fact, the only way I'll probably end up passing this block is because I have a friend that is THRILLED with the subject that sits me down in small rooms in regular intervals and forces me to do interactive study sessions where I'm not allowed electronics -- only pen and paper. And I'm within throwing distance of the dry erase marker if she catches me doodling.

So, instead of providing an entertaining looking into vetmed onco, I will instead direct you to a far more entertaining way to learn about onco --> through the book "The Emporer of All Maladies: A biography of Cancer". I'm listening to it as an audio book on my commute, and as I sit here another friend sitting in class is reading it on her computer during lecture after my recommendation yesterday.

And that is all I have to say on the subject of onco. Only Naps Can Occur.


Catching up on some Google Reader stuff and liked these post well enough that I briefly contemplated doing posts on them.....and then came to my senses and decided that I would just post the links here and let some one else post their thoughts if they wish.


a subject near and dear to my heart and one I saw published in magazines several times over 2012:


This could be a fun way to break up some of my runs:


Nice to know that even though I've read that the morning may be the best time to exercise, that there is some evidence that afternoon exercise has its place too.....


Funny how similar this article is to my "change one thing" post


Couldn't agree more with the thoughts here on reporting horses to SPCA. The unfortunate "law" of unintended consequences.





Wednesday, January 9, 2013

Just do one thing

Make one change. Not a dozen, not three, not an integration of your perfect plan. Just make one change today that will change your life for the better, and when it is second nature, make another change.

Also, no making a list of changes of choosing one and then another then another in a long line that stretches before you to infinity. Just one thing that matters right now.

Chose one thing, big or little, that is easy or a priority right now, and make that change today. And then, when you realize that you are ready for another change, think of another something in that moment and do it.

2012 was characterized by little changes that added up to a huge difference when I look back. I didn't have the energy or time for big changes or lots of changes, but because of those little changes, my life is now very different and I'm a different person.


Here's some of the little changes I made, one at a time, in 2012 that made a huge difference.


I started logging my food and activity into a program called my fittness pal - and lost 12 pounds and motivated many of my family members to join me. Its been a great group experience. At the end of the summer i was back to my "old weight" and over the holidays i only gained back five pounds - a number that was typical for me to gain over the winter and then lose ( until a few years ago when i only gained and didn't lose).I'm healthier, happier about my image, and dont feel helpless in the face of a scale that either won't budge or seems to be's simple cause and effect and it's very comforting to know that, even if I chose to splurge and undergo a "fattening" once in a while!

Do interval training - I ditched my tried and true running plan and did something radical. I based my running in high intensity intervals. As a result I did a ride and tie without dying, improved my mile time (which is a good indicator of overall health and my risk of dying of some heart or metabolic thingy in the near future) stayed injury free, and stayed motivated to run.

Sit less - my posture improved, back pain and foot pain is no more, and I just feel stronger and more balanced. The difference during my kinda- annual backpacking trip to Ohlone showed the difference of making an effort to stand and move slowly most of the day, rather than mold my butt and thighs to the shape of the chair.

Get rid of the todo list. I am one of those people that can't remember anything unless I write it down, but I realized that by keeping myself accountable to a todo list, it was creating stress and inflexibility in my life. So, inspite of spending actual money on a subscription to a todo list recently, I stopped cold turkey. No more lists. If it was important enough to remember, I remember it. If it was important to me right now, but I thought I might forget I did it right away. And if I did forget something, I either remembered it later when it was more urgent, or a I didn't - it got lost among more important things. Yep, I've missed some appointments, didn't follow through on some of my intentions, and overall feel more satisfied at the end of the day of what I have accomplished. I do utilize a priority matrix for big projects that are longer term so I can keep track of due dates, and things my mentor or boss have asked me to do, but they dont function like todo lists. Things that are reoccurring go on the calendar.

No more gifts at Christmas. Instead i give gifts throughout the year to friends and family and call them "birthday presents" even though they may be months early or late. Spreading the shopping throughout the year reduces my stress around the holidays and gives me the freedom to enjoy the process of finding that special something for someone. This last holiday season was the first one I truly enjoyed in a long time. And I feel more charitable throughout the year, constantly keeping in mind whether I just saw the perfect gift for someone that hasn't gotten a "2012" or "2013" gift instead of focusing on my wish list. I think that regularly buying or giving to others helps me from becoming too selfish with my money or needs. It just makes me feel like a better person, which increases my overall sense of happiness and well being.


What changes have I made in 2013 so far (counting one that I started the end of December here)?


Replace my banana a day with an apple - I love bananas and usually eat at least one a day. I read in readers digest that people who ate an apple a day lowered their cholesterol. I have high cholesterol, although none of the other risk factors that would cause me to reach for a pill bottle yet. I don't like apples as well as bananas, but it's a simple change that isn't too painful so I'll try it. I'm not swearing off bananas - ill just make sure I've had my apple for the day first, before reaching for that banana if I feel like another piece of fruit.

Give myself an allowance - its difficult for me to wrap my head around my money because I'm living off loan money and the generousity of my boyfriend. Should I be saving every cent because everything that I pay for that isn't an essential has to be paid back with interest? Theres going to be some descresionary spending - its not realistic that I'll be able to hold off buying treats or dog toys, or birdie stuff or horse stuff, or ride and tie events or endurance for four years. What I needed was a system that allowed me to feel like I had some freedom and control with money that didn't require me to exercise so much will power that I periodically just blew it and then felt guilty and/or tried to justify it. Matt suggested I give myself a weekly allowance. Ive always worked on a monthly budget but then it's a long time between pay checks so in a world where my "income" and "pay days" are irrelevant anyways, I've decided that sounded like an excellent idea. I have a weekly amount set, and a day that I pay myself. I can either save up for something or blow it on fast food. All together, per month, my allowance equals less than I was spending on discretionary stuff over a month before, but magically it feels so decadent to have this cash in my hand, I find myself using more self control knowing that if I wait until I get home to eat, I'll have five more dollars to spend on Connor, or Tess, or Farley, or the new backpacking gear I'm coveting.


In my spirit of "one thing at a time", I have no future goals or lists of what I'll decide to add to the changes this year. We will just have to see what comes up!


Guilty confessions

I let my bird, Conner, sleep with me the other night.

I didn't turn in a scholarship application this year because I was too tired and wanted to go to bed at 8pm.

I didn't write down the rather big spoonful of icecream I had in the myfittnesspal diary the other night

I'm secretly proud that Tess is a problem solving puppy and has learned how to open the vault food container, jumps on the counter to try and get her favorite toy, and can snarf an entire piece of pizza that is my entire lunch and not puke.

Anyone else have something they want to get off their chest?


Tuesday, January 8, 2013


Can you tell that I'm going through my different subject blocks and catching my readers up on those things in vet school that I think are cool are think you might want to know?

Today's post comes courtesy of the Dermatology block, which was the 2 weeks of class before my Christmas break started.

As I looked at more and more derm pics of really unhappy animals with miserable skin diseases, I was more and more convinced that repro and research is my calling.

Did you know that horses have sweat glands in their frogs? (thought they might function in trail marking!).

Did you know that the entire horse hoof is a derm structure? I think most of us are probably familiar with the inside and outside of a hoof from both working with our horses' feet and from various magazine articles on laminitis etc. but never before have I had such a whole picture view of the horses foot and thus such an appreciation for the beauty of its structure. Considering i go on and on about the incredible hoof, thats quite a statement, so I want to share with you the wonder of the hoof through understanding. Thus I introduce, Mel's dermatology short course (and of course the horse hoof is on the only important part of dermatology as far as I'm concerned....).

Using histo images from Colored Atlas of Veterinary Histology, 3rd Edition (highly recommend as a vet histo text book!). The cross section image is from Zachary's vet path text book. White board stuff is mine and the other pictures is stuff from off the internet.

Here's a picture of "normal"skin --> note the layers. 4 is the different layers of the epidermis (outerportion of the skin). Underneath 4 is the dermis. The dermis and epidermis interlock like little fingers in non-haired areas. This example comes from the pad of a dog (I think).

Here's a picture of a hoof epidermis. This entire thing is epidermis!!!!

Here is a picture of hoof dermis, which fits inside the epidermis hoof capsule. Do you see how the epidermis takes on the shape of the underlying dermis? It's hard to see in the picture above, but the epidermis capsule has little ridges in it on the inside.

Do you see how the epidermis and dermis might velcro together? The epidermis and dermis of the hoof have little fingers that tie it together just like in the first histo picture.

The hoof has folds because the dermis and epidermis must slide past eachother as the epidermis grows down to the ground and gets worn down, BUT the dermis and epidermis must stick together well enough that the force and concussion from the ground doesn't tear it apart. The more surface area that is in contact with 2 surfaces, the harder it is to slide past eachother. The function of the folds is to increase surface area. In addition to the folds are many itty bitty tiny projections, like velcro, that increase the surface area EVEN MORE, but doesn't interfere with the hoof epidermis being able to slide past the dermis.

Here's the hoof in a histo image. Can you see the same layers as the first picture? The epidermis looks a little different because instead of having a cell layer that flakes off the top, the epidermis has little tubes running through the "horn" of the epidermis that provide strength and flexibility to the epidermis much like rebar in concrete. But the layers and structures are still there!

In this picture below --> #3 is dermis, everything on top of that to the left is epidermis. 

In this picture below, number 6/8/7 is epidermis.  5 is dermis.

In this pic, 9/8 is epidermis

What's underneath the dermis? Fat, tendons, and bone. There's not much dermis in a horse hoof. Do you see how thin the epidermis is compared to the dermis? The arrows are showing the interface between one section of the dermis and epidermis.

Do you see the fat that is between the epidermis/dermis and the bone at the bottom/sole portion of the foot. That's a pad! It cushions the bone and tendons inside of the hoof capsule. I asked the professor whether that atrophies on a shod horse since the physiology rule is use it or lose and and a shod horse does not use their sole like a barefoot and she said although she hadn't seen any research on that specifically, that it was likely.

BTW - they covered just a few points about propery shoeing in the hoof portion of dermatology and made some points that I thought were really interesting --> mostly because I hadn't heard this in any of the shoeing articles I had read prior to going booted. If I could find a farrier that would shoe my horse with the following points, I probably wouldn't worry about going barefoot as much!

1. The nails shouldn't extend so far behind the toe/quarter that the heel and quarters can't expand --> the back part of the shoe that is in contact with the bottom of the hoof near the heel/quarters should be polished shiny by the movement/expansion of the hoof on top of the shoe.

2. The frog should have contact with the ground.

Unfortunately if there's a farrier out there that can do that, I haven't found them in my area, so I guess I'm barefoot in my renegades! (and honestly, the boots are easier than sticking to a regular shoeing schedule).

Not to mention, I have a strong suscepision that some of the soreness we see in horses that have just had their shoes pulled is from the atrophy of that internal cushion, which takes time to rebuild perhaps? Would love to see some studies on this......

Another RnT!

When my mentor announced the next ride and tie coming up in our area I knew I was in trouble.

It's early in the season - May. I haven't done any substantial running or riding since our last one in October. Not that my mentor knows that. I fact, I'm fairly confident that she's blissfully unaware of the amount of fattening and NOT running that her RnT partner has undergone in the last several months.

Want to hear my excuses. Of course you do.

1. I sprained my ankle in the middle of our first loop of our last RnT and I couldn't run for a month or so.

2. Then I got a really bad cold and was out for like three months (respiratory distress you know....)

3. I *always* gain five pounds in the winter (self fulfilling prophesy anyone?)

4. It's been cold. And wet.

5. Rest is the base of any training plan! I am preventing injury as I sit here on the couch and snack on m and ms and popcorn! (if you must know, this is my favorite excuse).

I told myself these were all really good excuses as I laced up my running shoes yesterday for my first run in what felt like a decade. I tried to console myself with the idea of how much fitness could someone really lose three months? And I've done this starting over thingy so many times that at some point my body would say "eh, you've given your dues. I can see you are really dedicated to this even though you are a bit spotty so let's just skip the pain and discomfort of those first couple of work outs shall we?". By all means yes.

Predictably, I looked (and felt) like every other new years resolution out there. I managed just five intervals (was up to ten comfortably) before deciding that I had too much pride to puke in front of everyone on the asphalt of the arboretum, that shoes DO suck (had to wear running shoes that I found in the depths of my locker being unable to locate my barefoot shoes at the moment) , and that running was clearly designed to kill people as there is nothing worse than nausea, wheezing for the afternoon afterward, and then having a massive allergy attack in the afternoon lab that had me begging for benedryl, which zonked me out spectacularly until I managed to crawl into bed at eight o'clock.

Oh yes. That was fun. Let's do that on a regular basis! *rolls eyes*.

I did wonder whether Farley felt like this on a ride after an extended break and judging from her attitude and sheer joy, I have to think that she does not.

And that folks, is the difference between an animal born to run, and one that was born to sit on the couch and eat popcorn.

Fortunately I know from vast experience of starting up running (and swearing that I will never ever put myself in the situation of having to do so again...) that this suckiness will last all of two or three runs and then I'll get sucked into the sheer joy of endorphins, power, speed, and movement. But if I didnt have that assurance, I dont know why ANYONE would stick with running after trying it for the first time.

I was rewarded for the pitiful five or ten minutes total that I spent running my muscle soreness this morning that reminded me of the following facts.

1. Biking is not running

2. Backpacking is not running

3. Tread desk is not running

4. A Fattening is not running

5. Walking the dog is not running

You may (rightly) judge that oncology is not my favorite subject based on the volume of posts occurring this block. Seriously folks. If there is one subject that I am NOT interested in, in any shape or form, it is oncology. I can do anything for two weeks right? Because the only thing worse than onco would be to spend my summer doing onco AGAIN.

Besides sitting in the classroom and (unsuccessfully) trying to convince myself that it is worth paying attention to onco because I am paying money to do so...and there's a one in three chance that onco will come very PERSONALLY relevant to me some day (at which point everything I'm learning will be obsolete anyways).....on the list for today is:

1. Attempt some strength training. If you hear sirens this afternoon, that's the medics trying to revive me at the bottom of some stairwell.

2. Turn out Farley and do some lunge exercises.

3. Practice my excited voice, so im believable when I agree with my mentor that yes, the 25 mile course at the may RnT is a WONDERFUL idea, and of course I've been keeping up my fitness..........

Monday, January 7, 2013

A Picture

Ever have the perfect photo that illustrates who you are? 

This photo was taken in 2008 and has been my facebook profile picture since early 2009.  I clicked on it today with the intention of finally updating it, and I can hardly bring myself to put in a more current one. It's me and Farley at the Death Valley ride, early in Farley's career. 

Every animal I've has had a picture that truly captured who they are. 

Sometimes it is taken at the autumn of relationship, like the photo that I consider "Minx"

Sometimes it isn't a picture at all.  Tess has told me since she was a puppy that she will be a commissioned watercolor. 

However I do know one thing --> the representation of the animal stands the test of time.  I don't get tired of looking at it, and when I hold the animal in my memory, or try to describe my relationship or feelings about a particular animal,  I often hold the image of the particular photo or representation of the animal in my mind as my "guide".  

I was complaining the other day that I didn't have an appropriate representation of Farley yet --> maybe I had it all the time, hiding in plain sight as my facebook profile picture?  The picture is unusual in that the picture is backlit with the shadow towards the photographer, and the background is much more colorful than the subjects.  I like how easy and casual the picture is, and how you tend to focus on the view of the ride than the horse.  Farley isn't bold and out in front like Minx.  Instead, she seems to fade into the background, not noticeable for her exceptional talent and ability until you take the time to notice.  I also like how the picture highlights her rather enormous ears (for an arab).  I'm convinced that horses hold their brains in their ears. 

Backpacking story

If you are interested in reading the story, looking at some pictures of my most recent backpacking trip to Ohlone over New Years, check out the following blogs:

1. My mother's food blog.  As of now, the first day is published. 

2.  Tess's blog

Not quite as good as an endurance ride or a ride and tie story for you horse junkies.....but it's trail and sunshine never the less and a good reminder of how good it feels to be outside on something besides concrete and asphalt. 

NSAIDs and dehydration

Excuse me for being presumptuous.....but I have a New Years resolution for you.

"I will not give my horse bute, or any other NSAID if there is even an hint of dehydration"

(repeat the previous line, as many times as it takes to imbed it into your consciousness)

Separating out the companion animals from the food animals and setting the horse into the companion animal category for a moment......
--> horse owners are unique among companion animal medicine in that we often take matters of vetmed into our own hands. To our credit, timely intervention of horse owners often lessens suffering and contributes to a speedy, complete recovery. Many horse vets of comfortable sending their horse clients home with all sorts of prescription drugs such as bute for use as needed.

Great! You have drugs that you might need! And being full of common sense and discernment, my bet is that you use those drugs appropriately 99 percent of the time.

But there's one risk that I don't think vets emphasize enough when they hand over the bute.


If you are like me, you've heard ride camp vets say that one danger of giving bute to a dehydrated horse is that it's unpredictable in dosage. A normal dose can act like a much bigger dose in a dehydrated horse, which can be hard on the kidneys.

That was the extent of my understanding until I went through my renal (kidney) block last semester.

What I learned will keep me from ever ever EVER casually dosing my endurance horse with bute after a ride, or even the morning after a ride.

Historically, if my horse looked a bit sore after a ride, but otherwise was eating and drinking, I'd often give some bute to reduce the amount of inflammation and soreness in the muscles to aid in recovery. Especially if I had a long trailer ride in the morning and I felt like my horse was eating and drinking appropriately, its very possible that I would give a dose of bute in the morning before the trip home.

With the research highlighting the dangers of inflammation, both in my life and my horses I felt motivated to limit inflammation and soreness as much as possible.

However I will NOT be utilizing bute at rides or the morning after since learning the following:

1. Horses seem to be very sensitive to the effects of NSAIDs (bute) when dehydrated compared to other animals. During hypovolemia (decease in blood volume) that occurs during dehydration, adding NSAIDs to the mix predisposes them to papillary necrosis. It rarely produces clinical signs.

Just in case using all those long words and tame sounding sentences doesn't quite produce the impact, let me put it a different way.

When you give your dehydrated horse bute, you cause parts of their kidneys to rot.

Necrosis doesn't reverse itself. The amount of kidney your horse is born with is the amount of kidney it has to last them for their entire life. Kidneys don't repair or replace themselves. Necrosis equals kidney that is lost forever,

You can lose a certain amount of kidney before you see any signs. it can be completely asymptomatic until one day your horse loses enough kidney that BAM! Kidney disease......

Considering that horses can be many percentage points dehydrated before there's ANY clinical signs, why would you risk giving bute after a ride? Since it is documented that there is a certain amount of dehydration that occurs for every hour that a horse spends in a trailer, why would you bute before trailering the horse home?

2. What about the muscle soreness and inflammation? The human research that is coming out in exercise physiology is the only way to prevent delayed onset muscle soreness (DOMS) is to properly condition for the activity. Once youve over done it, the only treatment is time. Massage, NSAIDs (before or after) ice baths etc DO NOT REDUCE THE DURATION OR DISCOMFORT ASSOCIATED WITH DOMS. In fact, NSAIDs may reduce the muscles ability to adapt to the work load.

So I ask again? Why would you give Bute to a potentially dehydrated horse after a hard ride? To risk kidney damage? To hinder the muscles ability to adapt to the work out?

Of course, if your horse has an issue that requires veterinary care and the alternative to not treating is worse than the treatment, than of course you work with your vet to take care of the horse. However, recognize that a horse coming off of a long trailer ride, or post endurance ride is a compromised horse.  I personally would seek the advice of a vet before treating with any medications if I wasn't at home, with a well-rested horse that I knew wasn't metabolically compromised, including hydration status.

Information came from the 20 minutes book, Zachary veterinary pathology book(which is where the image came from as well), information presented at the 2012 aerc convention, and lectures in my renal block at vet school.

Wednesday, January 2, 2013

The Best Things in Life

If you want to start your New Years by being grateful for the comforts of your life, ring in the New Year by going on a 3 night, 4 day backpacking trip.

This is the second time I've done this backpacking trip in January, with varying numbers of nights. It's beautiful, wonderful, hard, and satisfying.

I was more uncomfortable than I had to be, having packed as light as possible, because of the elevation changes in this particular hike. I knew that the result of my decisions to leave home some of my gear, if things didn't go perfectly would result in a rather uncomfortable trip, but wouldn't risk my health or life, and it was totally worth it not to have to lug any more than 30 pounds up the hills of the Ohlone trail (hiked from the Livermore to the Sunol end).

I think the best way to illustrate some lessons learned is by highlighting those things I appreciated the most upon my return to civilization last night.

1. A hot hot hot LONG shower. Unless the trip is in a warm spring or summer it is highly improbable that I will EVER utilize my backpacking shower. I view being wet on a winter trip as being one step closer to death. HOWEVER, having some wipes to do a bit of clean up at the end of the day probably would have been appreciated by my clothes, my sleeping bag, my hiking partners, and my dog..........

2. The ability to change into clean clothes. I had an errrrrr.....rather unfortunate accident on night 2 of the trip. One that left me soaking wet from the waist down, at night, with no spare changes of pant-like-things. The extra dry socks and underwear were appreciated. The micro weight towel was useful in extracting as much moisture as possible from my pants and smart wool bottoms. However, what I REALLY wished I had packed was my weight-nothing-take-up-no-room silk long underwear. They would have made a PERFECT pair of emergency bottoms while my other things dried out. As it was, I decided that damp smart wool pants were warmer than no bottoms at all, and decided that Tess would sleep IN the sleeping bag that night --> no easy feat considering I was wearing smart wool top + shirt + polortec sweat shirt + down jacket in a mummy bag.

3. The SOFT, WARM bed never felt so good last night. It was like a little piece of heaven. I can't even describe the simple JOY of snuggling on a good mattress under a down comforter, on the best pillow I could afford. Seriously, robbers could have broken in last night and as long as they left me and my bed alone they could have EVERY thing else in the house and I wouldn't have cared.

As part of my "pack lighter" attempt on this trip, I DELIBERATELY left my thermarest at home and relied on my crazy creek chair and a myler type tarp to keep me comfortable. I knew I would be a little colder and not sleep as well on the hard ground, but figured it was worth it for the weight and bringing the chair.

The result was I didn't sleep for 3 nights, was never really warm (and burned through a TON of calories keeping warm!) and "woke up" (we will use that term loosely as I'm not sure I ever really slept) from the dark 12 hour nights sore, cold, with a headache from neck cramps.

What I hadn't counted on was my 4 year old Marmot 15 degree sleeping bag being quite so worn out. It was never comfortable at those 30 degree temperatures (the temp rating is more like a "you won't die at 15 degrees), but at least I would eventually warm up. Considering that even through it's black interior fabric it's basically transparent, it might be time to retire this bag to summer trips only. I've used it hard and often during those 4 years, only washing it once, when it was obvious that the dirt was doing as much damage to the temperature rating that washing it would. The zipper doesn't go up and down well any more, the flap that keeps out the wind from rushing through the zipper has dissapeared, and I think I'm ready for a new bag.

The best way to determine the "right" price you are willing to spend on a piece of equipment that is going to be expensive, like a new bag is to lay there on a trip, uncomfortable and cold, and decide how much money you would give to your fairy godmother if she showed up to magically be warm and comfortable.

I decided that I would gladly spend between $200-250.

With a better bag, I think sleeping on the crazy creek chair would be fine. The crazy creek chair was SO WONDERFUL that if I'm concerned about weight I would gladly leave the thermarest at home, buy a new bag, and bring the chair. I used it at lunch, at dinner, in the tent to read. It insulated me from sitting on the cold ground and brought me a degree of comfort on this trip that it has become my new must-bring-piece-of-equipment that is more of a necessity and less of a luxury.


There is one thing that is better on the backpacking trail than in the comforts of home - food. Food never tasted so good as on a cold, windy evening. And my mouth waters even now as I think of the "blow out" feast we had our last night as we stuffed ourselves silly on everything we had left. There were no fewer than 4 courses and that doesn't include dessert.


If you are planning on a cold weather adventure of your own, here's a couple of things that did work REALLY well on this trip, that were "new" (ie, I didn't think of them or have them on my last winter backpacking trip 2 years ago). I have a feeling that many of you in other parts of the country that are NOT central CA are probably going to laugh at the commensense-ness of this list, but humor this sunny CA girl :)

1. A scarf or other neck covering makes a HUGE difference in staying warm.

2. Spring for the beanie hat with EAR flaps. You will be the envy of your camping partners.

3. Plan on eating almost double the amount of calories that you will in the summer (because I was eating dehydrated meals on this trip, I was actually able to quantify the number of calories on this trip as compared to my warm weather trips.

4. There is a perfect pair of gloves that will allow you the dexterity to do all sorts of things without removing them. Don't rest until you find them.

5. Don't be afraid to be a little uncomfortable for a couple of days. It won't kill you and it's good for your soul.

6. Good = down vest. Better = down jacket


Today is the end of my vacation! I have 3 important tasks to do before school starts on Monday and it's time to buckle down and get something accomplished. A book review for Aarene's Endurance 101 book, Scholarship application, and study guide for the reproduction block that will be shared with my friend and study partner. If I accomplish one a day starting tomorrow, I'll have one day of rest before it's time to start school again!!!!!!!!!