Fasting versus non-fasting versus the A1c, a summary
The Creator is efficient. Evidence or testimony of this is found in any number of ways, whether in ones day to day work or in other more common ways. Truly, there is nothing so uncommon as the common place, and, to quote Conan Doyle; "when all possibilities have been eliminated, whatever remains, however improbable, must be the truth." My job is ultrasound, and I find the efficiency and brilliance in creation daily.
Few engineers (or more accurately, no engineer) could have conceived or implemented as brilliant and ruggedly beautiful design that is the organic pump, the heart. An echocardiogram is what is commonly used to image the human heart in the interest of defining some sort of clinical suspicion the doctor may have. Heart murmur, abnormal electrocardiogram, chest pain, abnormal blood enzymes, unusual shortness of breath are some common reasons to employ an echocardiogram to find the cause of the aforementioned issues. This is true in human medicine, and is also true in the veterinary medicine. In my case, I enjoy an uncommon freedom in owning a state-of-the-art medical ultrasound imager capable of imaging just about any organ or system in the human, and turns out, other animal bodies.
After 20 years of clinical imaging in just about every sort of environment, I launched a business offering cardiac, vascular, and abdominal imaging as an independent contractor for physicians and hospitals. Some 3 years into that (year 23), it occurred to me that surely veterinarians must encounter complex medical problems that ultrasound may lend itself in solving. I resolved to 'cold call' a veterinarians office near my home. Thus, 3 years later (year 26) and hundreds of dog and cat ultrasounds later, I am amazed at the cross species similarities in the physiologic design of humans and dogs.
Except for being a somewhat more spherical object than the human heart, the canine heart is exactly the same as a humans heart. In deed, I am hard pressed to find any key differences. The same chambers, the same inlets and outlets, the same 4 abnormal and normal valves. Some hearts work well, and others do not. The size of the heart is a bit smaller, but all in all, the pump is the same. How remarkable that I can appreciate the rudiments of E=mc squared, while my adult Australian Cattle dog can not add 1 and 1, and still our moment to moment circulatory pumps are virtually identical! My kidney and my cattle dogs kidney are the same! When I image a healthy 50 year old man and a healthy 10 year old German Shepherd, the kidney in each is virtually the same. The same placement in the body flanks, the same 'kidney' shape, the same darker and light areas, the same collecting system. The same. Liver? The same. The same right, left, and middle lobes. The same portal veins, the same ebb and flow of blood.
Engaged as I am in working with so many intelligent and amazing physicians, I am equally impressed and amazed at the multi-talented, creative, and highly skilled veterinary physician. A truer detective, engineer, and diagnostician there never was. Not only must they try to diagnose from a patient who has nothing to say....ever, they may in many cases end up doing the surgery to save their lives. As wonderful and skilled as human medical practitioners are, how many do you know that see their patient for an office call, take the blood sample themselves, diagnose the blood test themselves, and when required, operate on the patient? The body of a dog is just as amazingly complex and confounding as a persons. In many years of clinical diagnostic imaging in critical care and operative environments, I have never encountered such a ubiquitous physician as the veterinarian.
Creation, therefore, is no accident. The canine heart I image is equally as brilliant in its form and function as mine. Perhaps I am one of the few cross species sonographers in the area, maybe in the United States. This is no conceit, but just a simple fact. The way and means of treating an adult man or woman and an adult dog are virtually the same. Concerns about abnormal heart rhythm, abnormal cardiac enzymes levels, abnormal renal function, abnormal x-rays....all the same. The salient difference that I see is the sheer speed of the development of complex disease is dogs.
In 20 years of imaging neo-nates, children, men, and women in every clinical environment, I have not ONCE seen a hemangio sarcoma on a human heart causing a pericardial effusion with subsequent heart failure. Yet, in imaging dogs and cats in the past 3 years, I have seen it at least 20 times. A tumor that seems to develop in the canine spleen will often times make its way to the heart. There, it manifests as a mass most ofter on or near the right atrium or right ventricle. A subsequent inflammatory response ensues that leads to fluid accumulation and eventual failure of the heart to pump in the face of hemodynamic compromise. This is called cardiac tamponade. The treatments for a dog and a human are the same. Drain the fluid, excise the tumor, treat the cancer. However, the difference is that more often the dog is given something to make it comfortable while it dies, while the human enjoys virtually unlimited resources to diagnose, correct, and prevent the problem from redeveloping. One is insured, one is not.
From puppy to hemangio sarcoma in 10 years. A 90 year old human never gets its. In that the dog life span is barely 15 years or less, most with this sort of disease condition are treated conservatively. It is entirely proper that this should be so. But why does it happen? What in creation makes it so? Why so often in dogs (usually, pure breds), but almost never in humans? Why? This question is one I lay before any person reading this and offering their thoughts.
I find no lack of design in creation. Cross species form and function are remarkable, and beautiful, and I am privileged to work with human and veterinary physicians that see this as I do. God does what God chooses to do. Blessings are rendered upon the subjects of Gods creation at the whim of God. The same heart in different bodies. Who could ever make something like that work?
Time for wine.
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