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Auggie just slobbers. Wallace and Hurt, however, are launched on some gentle verbal jousting. The surgeon insists the dog is suffering from garden-variety arthritis in both the knee and in the toes on that foot. The last time Hurt made the trek up from Eau Claire, Wallace diagnosed arthritis and prescribed Rimadyl, an anti-inflammatory drug. But Hurt says the pills didn't help, adding that Auggie's limp is much worse at home. Nylon jogging pants crinkling audibly, she slides down to the floor and the dog immediately backs up and leans against her. "See, he's taking the weight off that leg," Hurt says.
Wallace stifles a giggle. "I don't doubt that it hurts," he replies. "I just think it's arthritis."
The two examine a lump on one of Auggie's toes (run over in an accident several months earlier) and then agree to have it X-rayed at a cost of $70. Auggie bounds off toward the radiology department without any sign of a limp.
When the films show nothing except arthritis, Hurt questions Wallace about what else might be causing the limp. Really the only other possibility, he says, would be a tear in the meniscus, the cartilage in the center of the knee that cushions the bones. He could diagnose that via an arthrogram, a kind of X-ray in which dye is injected into the joint. Wallace again says he suspects arthritis and recommends drugs. Perhaps something else would work better for Auggie than the Rimadyl.
Hurt listens, but opts to spend the $200 for the arthrogram anyhow.
Again, the only thing visible in the images is arthritis--persistent and painful after a workout, but nothing Wallace can fix with a scalpel.
As the field has become more sophisticated, people's expectations have skyrocketed, says Wallace. Like Auggie Doggie's doting human, his two-legged clients are adamant about definitive resolutions for their animals' ailments. "Take my back patients," he says. "Say a disk ruptures and they're down and they can't walk. I do surgery and explain to their folks that it's going to take a while before the dog feels better. After a couple of weeks, they call saying they don't understand why the animal isn't up and around--while a human would still be in a wheelchair or on crutches."
When Hurt returns to pick up Auggie Doggie, Wallace is immersed in an emergency. A technician wanders back to the surgical wing where the vet is preparing to repair a cocker spaniel's pelvis, crushed the night before by a car. "Auggie's owner has a lot of questions," the technician says. "She's wondering if you have time to talk to her."
Wallace shakes his head. "You tell her for me that she doesn't have to do what I say," he tells the tech. "You tell her that's what I said." The tech is back a few minutes later, asking for another Rimadyl prescription.
Like most students, Wallace started vet school thinking he'd like to own a small-animal clinic. He was inspired to become a surgeon by a Michigan State University professor who is considered one of the fathers of veterinary orthopedics. When Wallace graduated in 1962, the first surgical procedure to correct hip dysplasia in dogs had just been developed. Aspiring surgeons didn't have many choices.
Outside academia, some of the best opportunities for veterinary specialists back then were in human medical research. Companies that manufacture products like sutures or bone cement often hire vets to conduct tests on research animals. Years later, after the product in question becomes commonplace in human medicine and its cost falls, it often trickles back down to the veterinary market. Wallace himself spent seven years consulting on the pacemaker, which was refined by testing in dogs even after it went into use in humans. Today, the vet hospital implants pacemakers in pets.
After graduating from veterinary school, Wallace studied human medicine to learn more about orthopedic conditions that affect both humans and animals. But veterinary orthopedics--with its then-limited job opportunities--kept tugging at him. One of his first veterinary achievements was to perfect the second surgical treatment for hip dysplasia.
The procedure doesn't correct the arthritis that accompanies the disorder, explains Wallace, but does give dogs an extra five to seven pain-free years. At a cost of about $500, it's still used by vets in private practice when a pet owner can't afford the superior, but much more complicated, triple pelvic osteotomy. The hospital staff know of only two private practices in Minnesota that routinely perform the latter procedure, which Wallace has been teaching at the UM since he arrived in 1972.
The number is one indication of the complex financial picture facing new vets. Most students leave school deep in debt and can't afford to spend four years completing a residency--even though developing a specialty is one way budding vets can assure themselves of a decent income after graduation. In her last year of vet school, Jen Roberts has her postgraduation finances worked out down to the last nickel: An out-of-state student, she anticipates leaving school with about $90,000 in debt, or loan payments just under $1,000 a month. (Even at $17,000 a year for nonresidents, tuition in the UM's veterinary program is a relative bargain for a school ranked in the top 10 nationally: At Tufts University, for instance, the bill hovers near $25,000 a year.) Veterinary medicine "has become a luxury degree," she opines.