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21 Jul 16:12

Age Adjusted D-Dimer Testing

by Salim Rezaie

ThromboembolismD-dimer testing is sensitive for thrombus formation, and in patients who are not high risk, this test is used to rule-out venous thromboembolism. D-dimer has been shown to increase with age, which can cause a lower specificity (i.e. more false positive tests) in older patients.  Specificity can range from 49 – 67% in patients ≤ 50 years of age, but in older patients (i.e. ≥ 80 years of age) the specificity is quoted as 0 – 18%. The result of this is, older patients often have more diagnostic imaging, but a higher cut-off may lead to increased false negative cases (i.e. missed VTE) and make this strategy less safe. So could age adjusted d-dimer testing increase specificity without affecting sensitivity?

It is important to know what type of d-dimer assay you have at your institution and make sure that it correlates to the studies below.  Broadly, d-dimer testing can be described as quantitative tests (i.e. results expressed as a number), semi-quantitative, or qualitative (i.e. results expressed as positive or negative). More specifically there are 5 major types of d-dimer assays:

  1. DVT and PEEnzyme-Linked Immuosorbent Assay (ELISA)
  2. Latex Agglutination Assay
  3. Whole Blood assay (Simplired)
  4. Turbidimetric Assay
  5. Immunofiltration Assay

A nice review of some of the newer d-dimer tests can be found by Schutgens RE et al from 2003. Realize for the purpose of this post, we are specifically discussing quantitative d-dimer tests.

How do you perform age adjusted d-dimer testing?

  • The formula is: Age (years) x 10 ug/L for patients > 50 years of age
  • Example: Patient age 88 = age adjusted d-dimer of 880 ug/L

Where was age adjusted d-dimer testing derived and validated?

  • PE Derivation: [1]
    • Conclusion: Age adjusted d-dimer combined with clinical probability, greatly increased the proportion of older patients in whom PE could be safely excluded
  • PE Validation: [2]
    • Conclusion: Age-adjusted cut-off increased clinical usefulness of D-dimer in older patients
  • PE Validation: [3]
    • Conclusion: Irrespective of which clinical decision rule is used, age-adjusted d-dimer increases the number of patients > 50 years in whom PE can be safely excluded.
  • DVT Validation: [4]
    • Conclusion: Combination of low clinical probability of DVT, use of age dependent d-dimer cut-off value for patients > 50 years, DVT can be safely excluded, compared with the conventional cut-off value of 500 μg/L
  • DVT Validation: [5]
    • Conclusion: Age-adjusted d-dimer in combination with clinical probability greatly increases the proportion of older patients in whom DVT can be safely excluded 

Summary of Studies:  Age adjusted d-dimer testing appears to increase specificity in patients age >50 years, without affecting sensitivity

There has also been a systematic review [6] that looked to review the diagnostic accuracy of d-dimer testing in older patients (> 50 years) with suspected venous thromboembolism comparing conventional d-dimer testing with age adjusted d-dimer testing.

What they did:

  • Systematic review and meta-analysis
  • 12, 497 patients with non-high clinical probability for venous thromboembolism included
  • Comparison of conventional d-dimer vs age adjusted d-dimer

Results:

Type of D-Dimer
Age (years)
Pooled Sensitivity
Pooled Specificity
Conventional 51 - 60 100% 57.6%
Conventional 61 - 70 99.0% 39.4%
Conventional 71 - 80 98.7% 24.5%
Conventional >80 99.6% 14.7%
Age Adjusted 51 - 60 99.4% 62.3%
Age Adjusted 61 - 70 97.3% 49.5%
Age Adjusted 71 - 80 97.3% 44.2%
Age Adjusted >80 97.0% 35.2%

Conclusion: Age adjusted d-dimer testing increases specificity without modifying sensitivity in patients > 50 years of age.

What is the newest study to evaluate age adjusted d-dimer testing? [7] 

ThromboembolismThe ADJUST-PE Study

What they did:

  • Multicenter, prospective validation of diagnostic yield of age-adjusted d-dimer cutoffs
  • 19 centers in Belgium, France, the Netherlands, and Switzerland
  • 3346 Consecutive patients presenting to ED with clinically suspected PE
  • Applied either a revised Geneva score or a 2-level Wells score for PE followed by a high-sensitivity D-Dimer in non-high risk patients

Outcomes:

  • Failure rate of diagnostic strategy (i.e. Thromboembolic events during 3 month follow up)

Results:

  • Prevalence of PE was 19% (Higher than North American studies)
  • 2898 patients had a low or unlikely clinical probability of PE
  • 3 month failure rate in patients with a d-dimer level < 500ug/L was 1/810 patients (0.1%)
  • 3 month failure rate in patients with a d-dimer level > 500 ug/L but below age-adjusted cutoff was 1/331 patients (0.3%)
  • 3 month failure rate in patients with a d-dimer level > age-adjusted cutoff was 7/1481 (0.5%)
  • In patients > 75 years with age-adjusted d-dimer level vs a 500 ug/L conventional cutoff, PE exclusion went from 6.4% to 29.7%, without additional false negatives…this is a 5-fold increase.
  • 1 in 16 would have PE ruled out with a conventional d-dimer cutoff, but 1 in 3.4 would have PE ruled out with age-adjusted d-dimer cutoffs, with no increase in missed VTE

Limitations:

  • 2 different pretest probability scores and 6 different d-dimer assays were used…cutoffs for different d-dimer assays vary from 200 – 500 ug/L
  • Not a randomized clinical control study, so there was no control group
  • 7 patients were deceased in the > 500 ug/L and < age adjusted cutoff d-dimer, but only one had an autopsy to confirm diagnosis, therefore hard to exclude PE as the cause of death
  • Prevalence of PE was higher than what is cited in most North American studies, but the same rate as European studies
  • Patient follow up was not with the gold standard CTPA

Conclusion: Compared to a fixed d-dimer cutoff of 500 ug/L, the combination of pretest probability assessment with age-adjusted D-dimer is associated with a larger number of patients in whom PE can be ruled out, without a decrease in missed PE

Important MessageTake Home Message

In patients > 50 years of age, using a clinical probability assessment plus an age adjusted d-dimer cutoff increases the number of patients that can be safely ruled out for PE/DVT. It is important to note that different hospitals will use different assays of d-dimer and so the age adjusted cutoff used in the above studies may not be the same as your institution.

Other people have also written about age adjusted d-dimer cutoffs, and for their thoughts checkout:

 

References

  1. R.A. Douma, G. le Gal, M. Söhne, M. Righini, P.W. Kamphuisen, A. Perrier, M.J.H.A. Kruip, H. Bounameaux, H.R. Büller, and P. Roy, "Potential of an age adjusted D-dimer cut-off value to improve the exclusion of pulmonary embolism in older patients: a retrospective analysis of three large cohorts.", BMJ (Clinical research ed.), 2010. http://www.ncbi.nlm.nih.gov/pubmed/20354012
  2. A. Penaloza, P. Roy, J. Kline, F. Verschuren, G. LE Gal, S. Quentin-Georget, N. Delvau, and F. Thys, "Performance of age-adjusted D-dimer cut-off to rule out pulmonary embolism.", Journal of thrombosis and haemostasis : JTH, 2012. http://www.ncbi.nlm.nih.gov/pubmed/22568451
  3. J. van Es, I. Mos, R. Douma, P. Erkens, M. Durian, T. Nizet, A. van Houten, H. Hofstee, H. ten Cate, E. Ullmann, H. Büller, M. Huisman, and P.W. Kamphuisen, "The combination of four different clinical decision rules and an age-adjusted D-dimer cut-off increases the number of patients in whom acute pulmonary embolism can safely be excluded.", Thrombosis and haemostasis, 2011. http://www.ncbi.nlm.nih.gov/pubmed/22072293
  4. H.J. Schouten, H.L.D. Koek, R. Oudega, G. Geersing, K.J.M. Janssen, J.J.M. van Delden, and K.G.M. Moons, "Validation of two age dependent D-dimer cut-off values for exclusion of deep vein thrombosis in suspected elderly patients in primary care: retrospective, cross sectional, diagnostic analysis.", BMJ (Clinical research ed.), 2012. http://www.ncbi.nlm.nih.gov/pubmed/22674922
  5. R.A. Douma, M. Tan, R.E.G. Schutgens, S.M. Bates, A. Perrier, C. Legnani, D.H. Biesma, J.S. Ginsberg, H. Bounameaux, G. Palareti, M. Carrier, G.C. Mol, G. Le Gal, P.W. Kamphuisen, and M. Righini, "Using an age-dependent D-dimer cut-off value increases the number of older patients in whom deep vein thrombosis can be safely excluded.", Haematologica, 2012. http://www.ncbi.nlm.nih.gov/pubmed/22511491
  6. H.J. Schouten, G.J. Geersing, H.L. Koek, N.P.A. Zuithoff, K.J.M. Janssen, R.A. Douma, J.J.M. van Delden, K.G.M. Moons, and J.B. Reitsma, "Diagnostic accuracy of conventional or age adjusted D-dimer cut-off values in older patients with suspected venous thromboembolism: systematic review and meta-analysis.", BMJ (Clinical research ed.), 2013. http://www.ncbi.nlm.nih.gov/pubmed/23645857
  7. M. Righini, J. Van Es, P.L. Den Exter, P. Roy, F. Verschuren, A. Ghuysen, O.T. Rutschmann, O. Sanchez, M. Jaffrelot, A. Trinh-Duc, C. Le Gall, F. Moustafa, A. Principe, A.A. Van Houten, M. Ten Wolde, R.A. Douma, G. Hazelaar, P.M.G. Erkens, K.W. Van Kralingen, M.J.J.H. Grootenboers, M.F. Durian, Y.W. Cheung, G. Meyer, H. Bounameaux, M.V. Huisman, P.W. Kamphuisen, and G. Le Gal, "Age-adjusted D-dimer cutoff levels to rule out pulmonary embolism: the ADJUST-PE study.", JAMA : the journal of the American Medical Association, 2014. http://www.ncbi.nlm.nih.gov/pubmed/24643601

The post Age Adjusted D-Dimer Testing appeared first on R.E.B.E.L. EM - Emergency Medicine Blog.

01 Jun 22:42

Fantastic Coral Reef Sculptures Made out of Household Objects

by EDW Lynch

Coral Reef Sculptures by Lynn Aldrich

Artist Lynn Aldrich has created a fantastic series of coral reef sculptures out of household objects like plungers, mop heads, and sponges. She has more sculpture work, much of which is made from found objects, on her website.

Coral Reef Sculptures by Lynn Aldrich

Coral Reef Sculptures by Lynn Aldrich

Coral Reef Sculptures by Lynn Aldrich

photos via Lynn Aldrich

via Junk Culture

31 May 00:24

Finnish Man Has An Incredibly Close Relationship With the Fully Grown Black Bears He Raised

by Lori Dorn

Sulo Karjalainen, the proprietor of Kuusamo Large Carnivore Centre in Kuusamo, Finland, has become locally famous as the “bearman” due to the incredibly close bond he has with the fully grown black bears that he raised from tiny cubs.

The 73-year-old runs Kuusamo Large Carnivore Centre with his brother Jalo, which has been home to more than 20 orphaned brown bears. After working on a research project studying Finnish carnivores, Sulo was asked if he would mind taking in some cubs. And over the years a deep bond has grown up between Sulo and his furry companions.

31 May 00:20

Bodyscapes, Black Light Body Art by John Poppleton

by EDW Lynch

Bodyscapes by John Poppleton

“Bodyscapes” is a body art series by artist John Poppleton that uses fluorescent pigment to paint landscapes on female models. He then photographs the models under UV light for the final fluorescent effect.

Bodyscapes by John Poppleton

Bodyscapes by John Poppleton

Bodyscapes by John Poppleton

Bodyscapes by John Poppleton

photos by John Poppleton

via Distractify, My Modern Metropolis

31 May 00:20

An Incredible Glowing Dress That Is Covered in Fiber Optic Filaments

by EDW Lynch

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Instructables designer Natalie Walsh has created a stunning fiber optic dress that is covered in a free-flowing array of fiber optic filaments. She’s posted detailed instructions on how to make the dress on Instructables. We previously posted about her Disco Ball Helmet.

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F7DI29QHTHKFLIK.LARGE

FHLW6XQHTHKFLJ9.LARGE

photos by audreyobscura

submitted via Laughing Squid Tips

31 May 00:19

Colorful City Landmark Silhouette Illustrations by Yoni Alter

by EDW Lynch

Colorful City Landmark Silhouette Illustrations by Yoni Alter

Designer Yoni Alter has created a delightful print series in which he represents different cities around the world with overlapping silhouettes of their most famous landmarks. The illustrations are part of his series “Shapes of Cities.” Prints are available for purchase.

Colorful City Landmark Silhouette Illustrations by Yoni Alter

Colorful City Landmark Silhouette Illustrations by Yoni Alter

Colorful City Landmark Silhouette Illustrations by Yoni Alter

Colorful City Landmark Silhouette Illustrations by Yoni Alter

images by Yoni Alter

via Colossal

30 May 00:38

Inventor Shoots 12-Foot Flames From His Wrists with a Homemade X-Men Pyro Flamethrower

by Justin Page

British inventor Colin Furze heats things up as he shoots 12-foot flames from his wrists with a homemade X-Men Pyro flamethrower. Colin also made a 9-minute video tutorial that shows how he created the wrist-mounted flamethrower. We previously wrote about Colin’s homemade Wolverine claws and magnetic Magneto shoes.

music by March to the Grave – “BMX Haircut

30 May 00:36

An Interactive Infographic Showing the Global Migration of People Between 1990 and 2010

by EDW Lynch

The Global Flow of People
2005-2010. Image via Wittgenstein Centre

“The Global Flow of People” is a fascinating interactive infographic that visualizes human migration between world regions from 1990 to 2010. The visualization can be viewed in five year increments, which gives a sense of how population flows have changed in recent decades. The infographic was created by Nikola Sander, Guy J. Abel, and Ramon Bauer at the Wittgenstein Centre for Demography and Global Human Capital and was published back in March in Science magazine.

The Global Flow of People
1990-1995. Image via Wittgenstein Centre

via Boing Boing

30 May 00:35

An Adorable Plush Octopus Backpack

by EDW Lynch

An Adorable Plush Octopus Backpack

Artist Jennifer Mones recently made an adorable plush octopus backpack. Mones is also an illustrator in addition to her design work — her illustration work (some of which is also octopus-themed) is available for purchase.

An Adorable Plush Octopus Backpack

photos via Jennifer Mones

via Dragons, Doodles, and Doodads, Boing Boing

30 May 00:30

So Majestic

Ray tries to fly - AnimalsBeingDicks.com

C’mon Benny, it’s your time to FLYYYYY…SHIT!

28 May 21:23

Lomo’Instant, An Instant Camera Featuring a Variety of Lenses

by Rollin Bishop

Lomo’Instant is an instant camera by Lomography featuring a built-in wide-angle lens with a fisheye lens and a portrait lens both available as attachments. The camera can take multiple exposures, long exposures, and can use color gels to infuse photos with color.

Lomography is currently raising funds via a Kickstarter crowdfunding campaign for the design and production of the Lomo’Instant.

Lomo'Instant Camera

Lomo'Instant Camera

Lomo'Instant Photo

http://kck.st/TPKqIM

photos via Lomography

via Lomography

28 May 21:08

Great Little Backyard Coop

by Ivory Soap

IMG_1001
We’ve learned the hard way, that a “free range” chicken is pretty much a “dead” chicken.  Out of 15 chickens we’ve owned.  We have 4 left.  Four were predator deaths.  One was old age.  Six were killed by their own stupidity: hanging themselves on fences they couldn’t quite jump, ramming themselves under fences they couldn’t escape, chasing dogs, fighting goats for domination of the yard, etc.  So that, and the constant splats on the back porch convinced us to get a Precision Pet Products Hen House Chicken Coop.  We actually got ours on sale at Tractor Supply for under $200.

It assembled in under an hour.  However, don’t drag it across the concrete after you build it; the wood is soft.  See below.

IMG_1002Also notice the bricks under the coop.  The wood is SOFT, y’all.  So unless you’re yard is bone dry year round, you will need to put it up on something.   We built two brick outlines so we can hop it to the next square for scratching variety.  If you don’t toss straw in there, though, you would need to move it every few days.

Totally unnecessary is the Retractable Wheel Kit.  The whole thing is so light, my 8 and 10 year old can put it anywhere I want.  However, be it known that the ramp WILL pull away from the screws when you lift it (or roll it on that wheel set).  If you plan to move it often, do secure that ramp, bottom and top.  In the top picture, you can see that our ramp is gone.  We gave up reattaching it when we realized the chickens could just jump up there anyway.

Below you can see there are an assortment of doors on this contraption.  To the right is the “big door” that you can almost crawl into.  The window door is almost never used by us.  Under the window door is a tray that pulls out for easy cleaning.  The next box in the back has it’s own door and there’s a little door on the opposite end.  All that is super-convenient for cleaning and feeding.
IMG_1003
Overall, we’ve been very pleased with the coop.  We’ve had it for months.  I would like to add on the Chicken Coop Extension Pen some day to give the girls more room.  (It seems too cramped in there for four chicks, but I’m sure they much prefer being ALIVE to having unlimited elbow room.)  That and there’s no ROOST.  Chickens want to sleep in tree branches.  This coop doesn’t come with a roost, but you can buy a Roosting Bar or just wedge a dowel in there.

27 May 23:02

Baby Elephant Gleefully Rolls In the Dirt Under His Mother’s Watchful Eye

by Lori Dorn

A baby elephant named Kyan, who lives at the Amersfoort Zoo in the Netherlands, gleefully rolls around in the dirt while remaining very much under his mother’s very watchful eye as shown in this 2013 video posted by elfje999.

via wykop, Daily Picks and Flicks

26 May 17:00

Soy Braised Onion

by Beyond Kimchee

This Soy Braised Onion was one of my childhood favorite side dishes. My mother often made it whenever she had too much onions in the kitchen.

You will only need onions, soy sauce and olive oil. I added a little Korean style corn syrup and sesame seeds for extra lust and nuttiness, but you can omit them. It is extremely simple to make and delicious to top a bowl of rice. Perfectly vegetarian and vegan worthy.

Soy-Braised-Onion

Soy Braised Onion

26 May 03:05

Morgan Freeman On Helium For Science [Video]

by Geek Girl Diva

morgan freeman helium

Morgan Freeman has an iconic voice, which is why this new season 5 promo for the Science Channel’s Through The Wormhole is so much fun.

Morgan Freeman on helium. Day = made.

Check it out after the break.

(via Laughing Squid)








19 May 04:43

Brannigan's Funklehorn

by Carl Turner

Brannigan's Funklehorn; horns to be added after firing.

08 May 22:48

This Geeky Woodblock Art Features Everyone From Darth Vader To Lemongrab

by Amy Ratcliffe

geeky woodcut print 1

Carving out a woodblock to make prints isn’t a simple task, but artist Brian Reedy has mastered the skill. In his Etsy shop Woodcut Emporium, he offers incredibly detailed prints made from his woodblocks and they feature the likes of Darth Vader, Thor, Godzilla, and Lemongrab. The images are stamped onto rice paper, and they look unbelievably cool!

See more of the neat art after the break.

geeky woodcut print 2

geeky woodcut print 3

geeky woodcut print 4

geeky woodcut print 5

geeky woodcut print 8

geeky woodcut print 7

geeky woodcut print 6

geeky woodcut print 9

geeky woodcut print 10

Product Page ($10 and up via Geek Tyrant and Technabob)








07 May 22:44

More Awesome Nerdy Carved Crayons By Hoang Tran

by Amy Ratcliffe

carved crayons 1

Many people use crayons to color art, but Hoang Tran turns the tools into art. We’ve seen his incredible crayon carvings of the house sigils from Game of Thrones, but he’s posted plenty of other colorful art online. His latest batch of crayon sculptures features the Teenage Mutant Ninja Turtles, Han Solo, Hello Kitty, Captain America, and more.

You can buy crayons and glass tubes for displaying them in his Etsy shop, Wax Nostalgic. The miniature pieces of art start at $32.

See more of Tran’s work after the break.

carved crayons 2

carved crayons 6

carved crayons 3

carved crayons 4

carved crayons 5

carved crayons 7

carved crayons 8

(MMM via GoA)








30 Apr 20:29

April Tidbits

by Cake 'n' Knife

photo 2

1. Vegas still overwhelms me… So many lights!! Oh and I got to drink soup from a chicken foot cup!

2. I secretly wish I was an amazing guitarist at times. After watching this, I know that will never happen…

3. I would eat every single one of these chicken and waffle concoctions. Every. Single. One.

4. Ummmmm this pavlova?? GAH, someone please deliver me one right now.

5. I just love Ellen. She rocks and this is only 1 of the thousands of examples.

6. This read on how Wikipedia could be so much more fun is SO TRUE. Conference calls? LOL yes, every single time yes.

The post April Tidbits appeared first on Cake 'n' Knife.

29 Apr 16:28

Well, It Has To Be A Squnk

by Brinke

(Squirrel + Skunk = Squnk. Isn’t that the right spelling? Who knows, we’re makin’ this stuff up as we go.)

Ever seen anyone like thees? This little girl/guy was spotted in San Jose CA., and she’s/he’s called a “Piebald” sqwerl. Ah, let’s trot out The Big W for that one.

A Piebald or Pied Animal is one that has a spotting pattern of large unpigmented, usually white, areas of hair, feathers, or scales and normally pigmented patches, generally black. The colour of the animal’s skin underneath its coat is also pigmented under the dark patches and unpigmented under the white patches. Animals with this pattern may include horses, dogs, birds, cats, pigs, and cattle, as well as snakes such as the ball python. [+ SQUIRRELS. -Ed.]

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Photos by the San Francisco Globe.


Filed under: Uncategorized Tagged: Squirrels, WHAT! IS! THAT?
22 Apr 20:29

Well, U Don’t Have To Be So Piggy About It

by Brinke

These little guys can really pack it in. But where are the little tiny Hamster Napkins to wipe off their lil’ Hamster Moufs? Just sayin.’

From DP&F.


Filed under: Uncategorized Tagged: Hamsters, Prolly an Encore Presentayshe but I can't find it
22 Apr 20:14

Science Makes Balloons Do Crazy Things In A Minivan [Video]

by Nicole Wakelin

balloon_Upload

It’s something special when a guy can use the most mundane of everyday objects to effectively explain something as complex as fluid dynamics. That’s exactly what Destin does in his Smarter Every Day series, and in this video he uses a minivan, a balloon, and his adorable kids in his demonstration.

It seems like a simple question. Which direction will the balloon tethered to the floor of the minivan move when Destin accelerates? You likely have an answer in your head and that answer is likely wrong. Watch as Destin explains the science behind it all in the video after the break…

(via io9)








18 Apr 16:54

Friday Haiku: Snails

by Brinke

Most underrated
The Snail just creeps right along…
Minding his/her biz

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Photos by Vyacheslav Mishchenko, as seen on 123 Inspiration. Sent in by LOTZ O’ Cuteporters, thank U!


Filed under: Uncategorized Tagged: creepy crawlies, Friday Haiku, snails
18 Apr 16:37

Surreal Dog Photography by Sarolta Ban

by Capree Kimball

Surreal Dog Photography by Sarolta Ban

“A picture is worth a thousand words.” The saying couldn’t be more apt than in the case of shelter animals looking for forever homes: it has been repeatedly proven that good photos greatly increase their chances of being adopted. Inspired by this fact, Hungarian artist Sarolta Bán launched the “Help Dogs with Images” project in March.

Surreal Dog Photography by Sarolta Ban in other

Surreal Dog Photography by Sarolta Ban in other

Putting her incredible skills to work, she takes ordinary photographs of adoptable animals from across the globe and creates fantastical images with the hopes of increasing their visibility and, ultimately, getting them placed in loving new homes.

Surreal Dog Photography by Sarolta Ban in other

Surreal Dog Photography by Sarolta Ban in other

Surreal Dog Photography by Sarolta Ban in other

Currently, anyone can submit a photo of a homeless animal in need through Bán’s Facebook page to be considered for the project. Photos will be accepted through June 30th, 2014. Check out Sarolta’s site and fan page for more info and images.

Surreal Dog Photography by Sarolta Ban in other

Surreal Dog Photography by Sarolta Ban in other

Surreal Dog Photography by Sarolta Ban in other


Share This: Twitter | Facebook | Don't forget that you can follow Dog Milk on Twitter and Facebook.
© 2014 Dog Milk | Posted by capree in Other | Permalink | 2 comments
17 Apr 18:40

Before the Rainbow Bridge

by noreply@blogger.com (Guide Dogs for the Blind (GDB))
By: GDB Foster Care Coordinator Rebecca Hornick

We’ve all been through it; if you own animals, there is a tearful time when we have to say goodbye.  If you haven’t heard the term “Rainbow Bridge” it refers to the animal version of Heaven. It’s a nice thought to imagine our animals finding peace when they leave this life, but it is also a relief to know that they experience love and comforts here before they go. Some of us even feel privileged to be there for them in the most difficult time of all; the end of life.

This is why I want to sing the praises for the special foster care providers who are willing to take in hospice dogs.  Most of our dogs are lucky enough to find themselves living out their final days in the loving homes they already know: with their raisers, graduates or adoptive families.  But a few come to us in need of a new home and they happen to have the added challenge of a serious medical condition.  Our stellar veterinary staff continues to care for these animals and local volunteer foster care providers agree to house them until the end of their lives.  It is a huge gift they give these dogs and to their raisers and to the grads who had these dogs as guides.  After all, it’s not always possible for previous caretakers to continue to care for these dogs when they face some of the most challenging times of their lives.

Below are some thoughts from several California campus Foster Care Volunteers as well as comments from the graduate whose guide dog is in hospice care.

From Foster Care Provider, Edith Allgood and Philip Farmer:

There is no question that it really hurts to lose a dog, especially a particularly beloved one like Wilma. Death is inevitable, and there’s never a good time for it.  Very often people say, when they learn what we are doing, “I could never do that because I wouldn’t be able to deal with losing him or her.”  I don’t really understand that. When you decide to share your life with a perfectly healthy dog, you are accepting the inevitability of their death by virtue of the fact of their naturally short life span.
Because it is going to die somewhere, sometime, we think the dog should be with us, because we will love him or her and do everything we can to insure he or she has the best life possible while it lasts. As hospice care providers, we place the animal’s well-being and quality of life before our desire to keep the animal with us. This makes it less difficult to help make the decision for euthanasia when the end of the dog’s life is near. What motivates us to do foster care, as well as hospice care for GDB in particular, is that we feel that since the dogs have been bred to be service dogs, we owe them service when they are unable to do their jobs for us.

Doing this work with GDB is about as easy as it could be. Everyone wants the very best for the dogs and they work hard to insure that they get the best. The staff at GDB is tremendously supportive of all of its volunteers; we always feel appreciated and supported by the veterinary staff, the kennel staff, the foster care coordinator, the adoption folks and other foster care volunteers. If we had not taken Wilma into hospice care, we would not have had the pleasure of knowing and loving one of the best dogs ever.
Black Lab Wilma with her pal, yellow Lab Storm

Wilma

Wilma


From GDB Graduate, Rosalyn Butt:

Last October I had one of the scariest experiences of my life. Bryant, my eight-year-old Yellow Labrador guide, dog, became very sick one October evening. He had to have emergency surgery to remove his spleen and lab results confirmed that Bryant had hemangisarcoma, a particularly virulent cancer.  A few days later, he came home, where he began to heal from the surgery. I knew I couldn't take care of him permanently myself and nobody I knew was in a position to give him the care he needed and deserved. So after considerable discussion with GDB staff, it was decided that Bryant must retire and return to San Rafael to find a new home.

After being medically examined at GDB, Bryant met his new family and entered his new foster home. Bryant gives and receives all the love and affection he can handle. He goes to work often with his new Mom, Rebecca, and receives care at GDB's state-of-the-art veterinary clinic. He is pain-free and loves his retirement. Rebecca, her husband Mike, and their three sons enjoy the love of a wonderful dog. If Bryant becomes sick again, he will leave this world peacefully. Until then, he's having fun.

Yellow Lab Bryant smiles while wearing a blue soft cone color around his head.

Yellow Lab Bryant sits under an umbrella with Rebecca's young son wearing a red hooded sweatshirt.

Yellow Lab Bryant sits on a mat with his front legs crossed.

Yellow Lab Bryant sits on the beach with Rebecca's young son and dog friend.

Yellow Lab Bryant walks along the beach towards the water.


From Bryant’s Foster Care Provider Rebecca Hornick:

My family and I took in Bryant six months ago and as of right now, his cancer shows no outward signs. This beautiful dog shows only happiness and joy to everyone he meets, so it’s impossible to imagine he has any illness at all when he acts like Mr. Sunshine, wagging and smiling all the time. Dogs are like that – they can teach us how to embrace each moment and that every day can be a great day if we focus on all the good that surrounds us.

When I first told people I was fostering this terminally ill dog, a heartbreak waiting to happen, some wondered if it was fair to my kids (I have three boys, youngest is 10).  But I have always been the kind of parent who feels this can be one of life’s many lessons that teaches compassion. We know it will be hard to say goodbye, but we make the most of our limited time together and I can honestly say, having Bryant has been a joy for all of us. This experience has been so intrinsically rewarding, not only giving Bryant all the love he deserves, but also to give peace of mind to the graduate and puppy raiser who were unable to take on his end-of-life care.  Every time I share with his graduate the new funny nick names he has or about his latest adventures or new fans, I feel I am comforting her and myself. 

Obviously, hospice care is different, but somehow similar to the loss the puppy raisers must feel when they send their pups back for formal training. But I hope that once they sort through their pain, they feel, like me; so happy to have helped another person and a precious dog, through the gift of their time and love. 

Bryant has changed my family forever because he taught us that illness and future heartache doesn’t have to destroy all happiness. We have shared the greatest time together and treasure all of the happy little moments. Even though we know it won’t last forever, we still feel lucky because we have walked this path with this amazing animal and experienced the joys of unconditional love.
09 Apr 18:21

Teenage Mutant Ninja Turtles Break Through Your Walls With These Lights

by Nicole Wakelin

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These Teenage Mutant Ninja Turtle lights will make it look like the boys are breaking through your walls with their faces. The lights feature the 3D faces of Donatello, Raphael, Michelangelo, and Leonardo. Preorder now for delivery in May.

See the rest of the turtles after the break…

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tmnt light

Product Page ($44.99)








05 Apr 23:32

Workouts Inspired By All Of Your Favorite Fandoms

by Geek Girl Diva

batman work out

I’d like to call Neila Rey a fitness guru or something encapsulating, but she eschews any kind of label on her site and the closest thing I could find was “Accessible Fitness & Active Lifestyle” on her twitter.

Whatever you call her, I call her a genius when it comes to making workouts geeky and easy to understand thanks to her poster series.

You can see more of her posters after the break.

lannister-workout

hulk work out

jedi work out

matrix work out

worlverine work out

avengers work out

terminator work out

From The Avengers to Game Of Thrones, she’s designed themed workout posters for just about everything. She also offers nutritional advice and some great recipes. I’d definitely suggest stopping by her site and checking out more.

(via Incredible Things)








05 Apr 22:44

Stamping Out Stamp Fraud

Drugstore | NC, USA

(A customer and his two teenage children come into the store at the beginning of every month, when they get their food stamps. We don’t sell a lot of food – being a drugstore – but we have basic essentials like bread and milk, and also candy. Every month, they would spend their food stamps on the most expensive candy we have. A few days later, they would return it, without the receipt, which rewards them with a store gift card. They would then use the gift card to get things they really wanted. It takes several months of the same cashier/manager combination to figure this scam out, because they try to buy and return from different cashiers at different times of the day. When we finally catch on, the next time they try to return items for a gift card, they were informed that we would NOT be giving them a gift card, nor accepting the return.)

Customer: “Why not!? I return things here all the time! I’m a regular customer!”

Manager: “You are returning food items that you bought with food stamps in order to get non-food items for free. That is a violation of the terms of the food stamp program. Goodbye.”

Customer: *as he and his children are stomping off* “Well, we are NEVER coming here again!”

(It was only three weeks until they were in the store again! Way to teach your children, Dad!)

19 Mar 16:45

Wooden Figures Featuring Superheroes And Disney Villains

by Amy Ratcliffe

wood figure 1

Toys don’t have to be made from LEGO bricks in order to be attractively blocky. Artist Amanda Visell does a fine job making angles with her wood idols. We’ve featured her Star Wars figurines in the past, and now she’s added superheroes and Disney villains to her portfolio. The unique figures aren’t quite like anything I’ve seen, and I love the take on the characters and the fact that Visell also makes the boxes. Her newest designs feature Wolverine, Batman, Wonder Woman, Captain Hook, and more.

See more of the cool toys after the break.

wood figure 2

wood figure 3

wood figure 4

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wood figure 6

wood figure 7

wood figure 8

wood figure 9

(Comics Alliance via TMS)


    






08 Mar 03:02

The Art In Disney’s Mondo Art Show At SXSW Will Make You Drool

by Amy Ratcliffe

disney mondo 6

South by Southwest takes place in Austin, and that puts the festival in the same town as Mondo Gallery. It’s a match made in art heaven. This year Oh My Disney is taking over the space with their “Nothing’s Impossible” show. The list of artists is impressive and so is their work. I’m head over heels for these takes on Disney and Pixar films and wish I could seem them in person. They’ll be on display from March 7-March 11. Hopefully we’ll be able to buy prints from Mondo one day.

The gorgeous Beauty and the Beast art pictured above is by Martin Ansin.

See more art after the break.

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by Tom Whalen

disney mondo 7

by Rich Kelly

disney mondo 3

by JC Richard

disney mondo 5

by Anne Benjamin

disney mondo 10

by Kevin Tong

WinniePooh

by Dave Perillo

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by Tom Whalen

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by Billy Baumann

disney mondo 1

by Tom Whalen

(via io9, pieces originally shared on EWWiredOh My DisneyNew York Times, and /film)