Dr. Luttinen’s first week on the job as a veterinarian in 2001: pink nail polish, a corneal ulcer, and Marley!

While carrying a dozen veterinary journals and a surgery textbook in my right hand and my laptop bag in my left, I entered the back of Snohomish Veterinary Hospital (SVH) to begin my 4th day as a licensed veterinarian.  I was so excited about this new job and finally felt like I was at a point where I could start to use all of these cool things I’ve been learning about medicine, surgery, and dentistry for dogs and cats over the previous 8 years.

While plugging in my laptop and digital camera, Dr. Miller came into the upstairs library and walked over to my desk.  I still dream of this library at SVH.  It was spectacular, with a huge amount of really great textbooks and journals, along with a huge conference table, and a small kitchenette.  The table was so big and there were so many books & journals, that they could only fit one desk in there.  The other five doctors were in a large common room.  I preferred my desk alone because it allowed me to read and study alone.  I kept photos of all of my interesting cases and a case log so that I could follow through with each case.  I also wanted to be able to keep track of my treatments, the responses to those treatments (both positive and even not so positive),  and just maybe write my own journal articles someday.

Dr. Gail Miller was our medical director and an extremely gifted veterinarian.  I am so grateful for her mentorship my first year of practice.  She gestured to my desk and said, “hey, when you’re all settled in here, I’d like for you to take a look at a case with me downstairs in Room #2.”  I replied promptly, “Sounds good.  I’ll be right down.”

Marley 1A few minutes later I made my way down the two flights of stairs and down into the pharmacy hallway right outside the exam rooms.  Dr. Miller was standing over the pharmacy counter with her hand on her chin reviewing an open chart.  She was really thinking through something and kept shuffling back and forth through the various pages.  Once she collected her thoughts, she said to me,  “let me give you a little history on this patient before we look at her. ”  She then proceeded to tell me about the last several weeks of Marley’s eye problem and treatments.

We then entered slowly into Room 2 to see a very large Boxer dog with cropped ears.  If I didn’t immediately notice her pink toe nail polish, I would’ve been frightened by her look, but it was immediately obvious she was a total sweetheart.  Her right eye was really painful and nearly squinted closed.  The other very noticeable thing was her cornea had a large neon green patch.  From my last rotation at Northwest Veterinary Specialists in Portland, OR with Dr. Paul Scherlie, a veterinary ophthalmologist, I knew that neon green was from a fluoroscein stain, a special stain used to identify corneal ulcers on the surface of the eye.

According to Dr. Miller’s earlier history, she had been struggling to get this corneal ulcer to heal over a several week period, despite standard therapy to treat such a condition.  We saw alot of these in Portland and I remembered these were called Non-healing corneal ulcers, or Boxer ulcers, since Boxers have a predisposition for them.  They can be very challenging to treat and especially because it takes a pretty scary procedure to get them to heal.  You have to numb the eye and scratch the surface with either a blade or needle to get them to heal.  Most veterinarians, rightfully so as it’s pretty scary to do, are not inclined to jump into scratching up the surface of a dog’s eyeball.
Marley 3

 

Since Dr. Miller was asking my thoughts, I had the chance to share something Dr, Scherlie had just taught me, called the anterior stromal puncture (ASP).  Instead of using a blade, you numb the eye and take a needle bent at a 90 degree angle to gently poke microscopic holes in the cornea.  Since the dogs tolerate this “slight pressure” and it has a much lower chance of rupturing the eye than the blade, the patient doesn’t need general anesthesia.

After sharing the idea with Dr. Miller and Marley’s mom, we sedated her a bit with pain medication and a very small amount of sedative, numbed the eye, and within minutes, I was doing the ASP on Marley’s eye.  What a bizarre moment for me in the very early days of my career.  Marley was a really great patient for it, which added to my excitement that the procedure went just as well as I had saw Dr. Scherlie doing it as a very experienced board-certified ophthalmologist just a few weeks prior.  The best part was that Marley and her mom returned just 2 weeks later with a fully recovered eye and a fresh coat of pink nail polish.

Marley 2

Comments are closed.