The culture, ups, and downs of Guatemala

We wanted to take a break from posting about vet work to tell you about our journey of adjusting to Guatemalan culture and customs. We have been fortunate enough to witness some of the most breathtaking landscapes and meet the most generous people.

Lake Atitlan 

It is difficult to describe the feeling you get while walking the streets of Guatemala: Hearing the sound of tortillas being sculpted by hand or howler monkey roars echoing through the trees, seeing volcanoes in the distance or Mayan descendents in colourful traditional clothing, hearing the waves crashing against a lancha or the local pharmacy blasting Eminem featuring 50 cent songs (with no censors).

Volcan Agua in Antigua

It hasn't been all fun and games here though, there has been a lot adjusting to: The smell of black exhaust billowing out of chicken buses, the sight of deceased dogs on the side of the road as a result of car collisions, and flying down bumpy streets in a tuk tuk with no seat belts or doors.

A chicken bus in Panajachel

During our first night in Panajachel, we were woken up several times by the sound of loud bombs going off in all directions. The next day we found out that Guatemalans will set off bombs at 3 or 4 am to celebrate mothers day, birthdays, and religious occasions. The louder the bombs, the better the spirits can hear them in heaven and appreciate the celebration. This would have been nice to know before we thought there was a war going on in the middle of the night.

Another interesting sight is the local newspaper. We looked through about 5 pages and saw 6 pictures of dead bodies on the street. Newspapers here do not sugar coat their stories at all! Locals aren't phased by the sight of dead bodies and use the pictures to identify the deceased.

If a person is caught stealing or trying to murder someone, vigilante justice can occur. We heard stories about a man who was caught robbing several tuk tuk drivers and killed by Mayan descendants for his crimes. Mayan law is to leave the deceased body in the streets for 72 hours so everyone can see the consequences if you choose to steal.  We were told about another story of a man who tried robbing a chicken bus and shot at 2 Mayan descendant women. The rest of the women charged at the man and successfully caught him for the police. However, once in jail, Mayan descendants protested outside the doors for the man to be released so he could face the consequences of his actions. The mob grew larger and larger to the point where police had no choice but to release him. To make a long story short, he spent his 72 hours in the street as well.

During our last lancha boat ride home in Panajachel, the water was choppy and the driver loaded the boat to double capacity. We were sinking and tipping side to side so much that we thought the boat was going to flip over or water would rush in through the sides. Michelle, Terri, Mike and I were shooting each other looks of extreme fear while everyone else seemed to not even notice! The most reasurring part was when a few Guatemalan men at the back of the boat started laughing and grabbing life jackets from the roof. We heard them counting in Spanish, "17 life jackets for 31 people." They seemed to think it was pretty hilarious.

Michelle on a lancha at normal capacity

Michelle on a lancha at double capacity

Way too many people...

After 1 hour of stress and planning various escape routes should a capsize occur, we made it to the dock safe and sound. We'll NEVER forget that boat ride...

On a brighter note, something else we will not forget is the stunning clothing worn by Mayan descendants. Women wear intricately  hand woven skirts, belts, and shirts that differ in colour depending on the region in which they live. They are also able to balance just about anything on their head with ease. We have yet to figure out how they walk around so casually with 20 or 30 lbs of items on their heads.





















As our 5 weeks of hard work comes to an end, we are already starting to miss the country we so quickly fell in love with. Stay tuned for our last blog posts about the sterilization clinic we are helping to organize and run on July 28th.

Adios!

Sabrina

More from AWARE and Dr. Linares

Hello again!

I hope that everyone has been enjoying our blog posts so far! We apologize for the delay in uploading a lot of pictures as we have not always had reliable internet. Right now we are staying with a volunteer at AWARE, Darvy, who is an amazing host-- allowing us both the access to fast internet (:O) and a laundry machine (:O!!!!). I feel like I am in the 20th century again! Darvy is essential to the team at AWARE, driving animals to and from Dr. Linares' clinic at least once a week for treatment. He has also rescued many animals from AWARE, and has a collection of adorable dogs and cats. Here is one of our favourites Nina.

Nina enjoys both acting as foot rest (while getting a belly rub) and stealing Sabrina's bed.

So basically this blog is just a follow up to the one Michelle did the other day. I just wanted to touch on what Mike and I have been up to, as well as expand on Michelle's post.

I wanted to start by talking a bit about AWARE and how we are making a difference there. When we arrived at AWARE, the individual who ran the clinic had recently left without training a replacement. This meant that a lot of the treatments and clinic duties were left to spontaneous volunteer members and Xenii, who is very busy trying to run the shelter. We quickly realized that a major improvement we could make was the sanitation of the clinic environment. Since it is often so busy in the clinic, sick animals were let out of their cages while they were cleaned. Unfortunately, this meant that many sick animals were running around on the floor at one time. We quickly realized how big of a problem this was since many of the animals had fecal parasites or even had pneumonia, which was presumably caused by kennel cough (or something similar). We have drastically improved these protocols by ensuring that sick animals are walked alone and that if animals are switched cages, the cage must be well cleaned with bleach. We also noticed that a lot of their dosages for drugs were done somewhat spontaneously, meaning that most animals were getting a lower dose than they required. Using (as Michelle mentioned) the vet bible--Plumb's-- we were able to work out dosages for commonly used antibiotics and treatments and leave this with the employee Deanna. We are also helping Deanna learn to diagnose different problems and how to recognize when an animal needs treatments so they can be brought to the local veterinarian.

This is Michelle teaching Deanna how to do a physical exam, with a special appearance by Dexter!

A lot of time at AWARE is also spent looking around the shelter for animals that may be in need of treatment. Since there are so many dogs, sometimes problems can go unnoticed. Our goal while we are here is to get every dog that needs help the help they deserve. A lot of times these problems are skin conditions, as Michelle mentioned, Sarcoptic and Demodectic mange are very common here in Guatemala. Unfortunately, the treatment for these in Guatemala is not always as simple as Revolution. Revolution is very expensive and impossible to get for every animal here at the shelter, so we are forced to use more difficult treatments including Amitraz baths and Ivermectin which require repetition. We are hoping to make a sustainable difference through training employees at AWARE, including both Deanna and a new employee who arrives on Friday.

Now for what Mike and I have been up to at Dr. Linares'! WARNING THERE ARE GRAPHIC PICTURES IN THIS PART OF THE BLOG!
On our first clinic day we got to help with a C-section! It was a Schnauzer who had been bred to something much larger than herself so she was unable to pass the puppies on her own. Dr. Linares had us help with the C-section and with the puppies.

Me helping one of the puppies begin its life :). When they are first out, Dr. Linares has us insert a finger into the mouth and rub the stomach in order to make the puppy cough and gag. When they are doing this reliably, we set them in a box to keep warm.

Mike closing the incision. This lucky lady was spayed, no more puppies for her!

Even though the dog was spayed, Dr. Linares showed us how we would close a C-section which was really interesting to learn.
Mike was also able to help with closing another spay incision, and I was able to do a dog neuter.

Bye testicles!

Mike also got to do a dog neuter and a penile correction surgery.... yes, a penile correction surgery. We are not sure what happened to this poor guy, but he came in with a tear in his penis and an awful infection. I can practically hear all the men going "OOOOOWWWWW".

Mike working on his masterpiece

At the very end of the day, a cat came in to the clinic on an emergency. It had a massive abscess on the top of its head from a cat bite. As the cat had not yet been neutered, the owners decided to go for a two for one deal and get an abscess drain and a neuter. Dr. Linares allowed me to perform the neuter and the abscess drain and flush. I realized how twisted vet students are when I got really excited about the abscess drain, it was awesome.

Today Mike and I were at the clinic again. It was a much quieter day, but we enjoyed the break!

This little guy had a corneal puncture wound. Dr. Linares was able to suture it and he is currently on optic antibiotics.

We also saw one more case of sarcoptic and demodectic mange, as well as a dog with hypothyroidism.

On a sad note, I performed my first euthanasia today under Dr. Linares' supervision. A dog came in this morning which was suffering from a horrible skin condition and was emaciated. The doctor believes it was Pemphigus Foliaceus which is an autoimmune disorder in which the body attacks the cement that holds skin cells together. This means the dog often has blisters and crusty erosions which become infected. There are treatments available for the disorder, but unfortunately, the owners were unable to afford them. He was well sedated before the euthanasia was performed and he passed peacefully.

As I'd rather not end the blog on this note, I would like to mention that Dexter is doing much better. He has been living with us at Darvy´s for the past few nights, and has been quite spoiled! He is the best puppy ever, already learning to whine when he needs to go out to do his business!

Hope you all keep following along for the last couple days of our journey! Can't believe it is already coming to a close.

Terri

Busy days with AWARE and Dr. Linares!

Why hello again,

AWARE clinic

Sorry we haven't blogged in a while, but we have had our hands full every day. We have been alternating days working at the shelter AWARE in Sumpango and Dr. Linares' small animal clinic in Antigua. Every morning, two of us head to work at the shelter while two of us head to the city to work with the vet in Antigua. The days have been long but the work is very rewarding. Here’s a short look into what we have been up to:

 AWARE

Some clinic dogs and Sabrina hard at work

At the clinic we help every morning with changing the cages, feeding and walking the dogs. We then start all of the treatments for the dogs and cats in the clinic and the ones in outdoor enclosures. Right now we are treating some puppies that have upper respiratory infections. They are all getting cephalexin. One of the puppies (Dexter) had a respiratory infection that has progressed to pneumonia. He was really in rough shape. The vet gave him enrofloxacin which is a strong antibiotic. Unfortunately, this antibiotic also has a side effect which causes cartilage damage, so it really not good to give to puppies. However, there was no other choice at the time as Dexter could hardly even breathe. We put him on IV fluids and took him home with us to monitor him overnight. He was switched over to another antibiotic as of yesterday because you could tell that his joints were already stressed, and we are happy to say that he is doing much better. 

The two major problems that we have seen at the clinic are diarrhea and skin conditions (for example, mange and flea allergy dermatitis). Since so many dogs have diarrhea, we decided to do giardia and fecal tests. We decided it was best to deworm and treat all the puppies/sick dogs since we think that they were not dewormed properly upon their arrival to the clinic. One of the big things that we are doing at AWARE is teaching the new employee Diana as much as we can before we leave. We taught her about the different intestinal parasites and what to do if you see them.  We taught her how to put in an IV catheter and how to take vitals on the dogs. She is a very quick learner and we really hope we can help improve the clinic and treatments through leaving as much knowledge as we can with her. We have been teaching Diana about the 'vet bible'- Plumb's drug handbook- to teach her how to properly calculate doses and make sure that the dogs are getting the proper treatment

 Other than diarrhea, skin problems are another huge problem at the shelter. Since many families in Guatemala have limited financial income, many of the dogs are not fed proper diets. In addition fleas are normal for almost every single dog here so we see a lot of flea allergy dermatitis. Here is a picture of Loki who has severe allergies. It's really sad to see so many dogs with skin issues. 

We see a lot of Demodectic and Sarcoptic mange in Guatemala (which are caused by skin parasites). The dogs have massive hair loss and inflamed infected skin. We've learned that skin with Sarcoptic mange looks more pink, while demodex is more pigmented. We’ve put our skin scraping and microscope skills to the test numerous times during this trip. We are currently treating three dogs with bad mange at the shelter. This is Patriota who has Demodex. He was found tied to the fence at the entry of the shelter, emaciated and with barely any fur.  He gets an Amitraz bath every 5 days, Ivermectin injection every week and Cephalexin (antibiotic) for the secondary staph infection. We have seen a huge improvement with this dog over the time that we have been here.

    In addition to the huge amount of regular treatments at the shelter we also have many people from the community coming to the gate of the shelter with their animals who need to be looked at. Yesterday, morning we had a man bring a dog in a box to the front gate. In the box was a poor Chow Chow who lost his eye as a result of a sling shot to the face. Since the closest vet is 40 minutes away we were able to put the dog on fluids, give him pain medication and antibiotics for the infection. The next day, we took him to the clinic to be treated by the veterinarian. Unfortunately, the vet was unable to perform surgery on him because the infection was too severe. Therefore, he has been put on antibiotics and will be treated for the week at the AWARE clinic, and will return next week for his surgery. It is so sad that many of these dogs go through so much living on the streets. However, the dogs here are very tough. It was amazing to see this dog walking around and still eating and drinking even when he was in so much pain.

Dr. Linares

Surgery room

Exam/treatment room

Working with Dr. Linares has been amazing. Everyday we help him with his regular appointments and with his surgeries, all while putting our Spanish skills to the test as he speaks limited English. 

 Some of the things that we have seen with him is skin conditions again-Sarcoptes (we could actually see a living parasite on the microscope from a boxer). See the picutures below left-dog with sarcoptic mange and right-the actual parasite.

Its really hard to take pictures through a microscope, so we know it sort of looks like a blob... but beleive us, its sarcoptes!

Sarcoptic mange

We've also helped with the chemotherapy for a precious shelter dog 'Blanco Neuve'. She has a very common and contagious type of venereal cancer here in Guatemala nick names 'Sticker' or Transmissable Venereal Tumour (TVT). The treatment is with Vincristine IV after anesthesia. The treatment was fully donated from a generous sponsor of the shelter. The little pooch has finished her final treatment and is doing just great. Sabrina and I also got to help with a spay on a female boxer with pyometra, which is progesterone driven infection of the uterus that can happen in intact females. It was really cool to see the surgery. The uterus was filled with pus a great thing to see right before lunch.  

Transmissble Veneral Tumour at the time of the fourth treatment. When they first come in it is much larger.

Overall we have been having a great time working at both places. The days have been long but the experience and the care that we have been able to provide for the animals is more than worth it. Stay tuned from more updates from Mike and Terri.

Shaving a huge abscess on a dog

Little kitten in a little sweater

Cute Husky in heat at Dr. Linares' clinic

Until next time,

Michelle

Farewell AYUDA, beginning AWARE

Hola!

The supplies we brough for AYUDA

Our last morning with AYUDA was action packed. We tracked down two females in heat which we had been monitoring all week, both were surrounded by potentially aggressive males. We knew it was our last chance to save the females since we were catching our shuttle at noon. One female was desperately trying to escape the males underneath a car while the other was exhausted with bloodshot eyes, barely able to walk. During a females heat cycle, all of the male dogs from the streets and from pet owners that house them outdoors surround her day and night. Unfortunately, males are rarely castrated while more females are spayed so when one comes into heat, the males bombard her. Luckily we managed to capture 2 females and bring them to Selaines house to be spayed that afternoon. Both were exhausted and starving but will live the rest of their lives in peace! At noon we said our goodbyes to Selaine and were sad to leave the extraordinary beauty that is Panajachel. Working with Selaine was an eye opening experience to the lives lead by street dogs. She made us feel at home in Panajachel and we could not be more grateful!

After another shuttle and a tuk tuk, we made it to AWARE. It is the largest no kill shelter in Guatemala and is home to 300 dogs and 80 cats! During our first couple days we assisted with daily feedings, cleanings, and treatments of the animals. Michelle and I dewormed about 50 cats one afternoon which was really intense, there were cats flying through the air at us, trying to grab the delicious wet cat food we hid the pills in! We also are working with Dr. Linares in Sumpango.

Dexter recovering from bronchopneumonia. He is living with us during his antibiotic treatment for extra monitoring.

This is Debora (Dexters sister=, our favorite puppy at AWARE

AWARE regularly sends ill animals for treatment or surgery to Dr. Linares so we assist him at his clinic as well. We witnessed treatment for Transmissible Venereal Tumor in a female dog, something we rarely ever see in Canada. After a long day of treatments and surgery, Dr. Linares invited us into his house. We were snacking on our boring granola bars when his lovely wife brought us all plates and cups. We thought she was just giving us plates to catch the crumbs, but next thing we knew, she filled the table with home made guacamole, tortillas, rice, chicken, and other delicious things I cannot pronounce. His family, like many other families here in Guatemala, are incredibly friendly and inviting.

After this an amazing volunteer drove us back to AWARE, where we helped with some afternoon treatments and then to the internet cafe so we could write this very blog. So after a long and tiring day, we will leave it at that. Keep checking as there will definitely be a lot more to come from AWARE!

Sabrina with closing remarks from Terri

San Pedro Clinic

Hello again from AYUDA!

We woke up this morning bright and early to walk down to the dock and meet Selaine. Today we are running another sterilization and vaccination clinic, but this time in San Pedro. San Pedro is directly across the lake from Panajachel, and has some wonderful community coordinators that contact Selaine when they have animals which need sterilization or treatment.

We first arrived to San Pedro to the news that there were two females in heat that needed to be caught in order to prevent further breeding. Even though in Canada it is usually advised against to spay a dog in heat, here it is very common because it is important to prevent new litters of pups. Unfortunately, when one of the dogs was found it was surrounded by a pack of males. As we blogged about earlier, it can be very dangerous to attempt to remove a female when she is surrounded by unsterilized males. This meant that we would have to leave her until she was through her heat, at which time Selaine and Dr. Estrada would return to spay her.

When we started the clinic in the morning we had only 4 dogs. We thought it might be a pretty quick day.  Boy were we wrong! As the day continued the clinic filled up. Dr. Estrada was kept extremely busy with both dog and cat spays and neuters (completing 14 by the time the day was through!). It was also an amazing day for all four of us as we got to assist in a surgery each! Under the supervision of Dr. Estrada, Michelle assisted in a dog spay, Mike and Sabrina assisted in dog castrations, and I assisted with a cat spay. We were all extremely excited!

We also were allowed to practice placing catheters, drawing blood for SNAP tests, and giving anesthesia with the help from Dr. Estrada's amazing assistant Charlie.We are happy to say that all the SNAP tests we have performed here in Lake Atitlan have been negative! We were also able to collaborate with Charlie and Dr. Estrada on different restraint and anesthesia techniques. They were very interested in the kitty burrito technique, es muy fascile! Dr. Estrada was also very interested in discussing the spay and neuter techniques we use in Canada, asking how they were different from what he performed here.

Puppies recovering after their neuter surgery

It was another great day of communicating with locals as well. With the help of Selaine we are able to communicate results of SNAP tests, instructions for home care after surgery, and possible health risks for local dogs. The locals are all very receptive, and seem extremely grateful to have our assistance.

Waiting for their dogs to recieve annual vaccinations.

I would like to make a special mention at the end of this blog to how awesome it was to have the opportunity to work with Dr. Estrada. He was an enthusiastic and patient teacher, and each of us felt very comfortable under his instruction. As vet students, it is so important to have a teacher who is just as excited about your successes as you are. He was definitely this kind of teacher, cheering excitedly when I was able to find the uterus on my first try with the gancho (spay hook).

Overall, these two clinics have definitely enhanced our knowledge and experience. We are very happy that we could be involved in AYUDA's initiatives, and we feel that our presence was definitely appreciated.

Terri

 

 

Clinic in Jaibalito 10 July 2013

Hola!

Today we packed up a boat and made our way to a small village called Jaibalito on the lake. We held a vaccine and sterilization clinic. We sterilized 11 animals and vaccinated/dewormed approximately 20 dogs. We were set up in a small house in a house that was donated by someone in the community. We quickly shuffled some things around and set up for the surgeries. Soon enough people from the community started coming with their animals. It was so great to see the families coming in with their pets and their health records from the previous year. There were many kids and adults dropping by to watch. Sometimes there would be a big group of people surrounding us as we vaccinated their dogs.
 

      We saw a lot of dogs with ticks, some with at least 3-4 in each ear, however all of the 4DX tests donated to AYUDA were negative which was great to see. We used Advantix donated from St. Lawrence Valley Animal hospital and the dewormer from Pfizer. The supplies that we got as donations were quickly put to use during the clinic. We would like to sincerely thank all of our sponsors as the items were drastically needed!

      We saw a lot of dogs with mange. There was a group of 3 dogs from the same home who were all in really rough shape. The youngest one either had demodex or sarcaoptic mange or microsporum caninum. In order to properly diagnose we would need to look at a skin scraping under a microscope. However, we didn't have this luxury. We treated the dog with Ivermectin, long lasting antibiotic for the folliculitis and Advantix. The vet said if he came back and saw he dog was still ill than we would know if was ring worm.

For the surgeries the vet uses Ketamine and Xylazine. The 1st top up dose was 1/2 the amount of both Xylazine and Ketamine. On the second top up is 1/2 the amount of ketamine only. We recovered the animals outside and sometimes got the owners to sit with their dogs as the recovered so that they were involved i the whole process. During recovery we would give them antibiotics (Pen B), flea/tick prevention, remove the ticks if we saw some (Mike was great at this), trim nails and remove dreadlocks if necessary. We talked to the owners about keeping their animals quiet and off the streets.

During the clinic we noticed a female in heat being harrassed  by a male (if you know what I mean). We found the owners and got the ok to fix both of them. It was done right away since many males will stay around a female in heat forming dangerous heat packs. During their recoveries the male hopped up when he saw the female walking by; little did he know she was no longer the same dog.

Overall it was a wonderful experience working with so many dedicated people. It was great to see the community getting involved, however it is still evident that more improvement can be made. Many people won't sterilize their animals, more specifically the males, because they feel it makes them less of a "man" hence less useful as a guard dog.

We're off to do another clinic tomorrow in San Pedro!

Michelle