March 16, 2008 -39 animals sterilized
 on this day by only one veterinarian!
  (This included two very time-consuming surgeries:
 the removal of a dog's eye and the removal
of a 4-lb. tumor from a 25-lb. dog.)

I am so excited! On March 16, 2008 we held our first sterilization clinic in the building I have rented as a permanent location. Now we will have a clinic every month with just one veterinarian, Dr. Tello from Costa Rica. He is VERY fast - and he is also one of the best vets I have ever known. Now we can help more animals by having a clinic every month than we did by having clinics with multiple vets approximately every four months....and now with a permanent building, there is much less work and stress for me and everyone else.

The stress and work of the large clinics became more than I could handle. For example, the last two clinics were at the bi-lingual school "Paulletino." Our clinics are always held on a Sunday. We use only the most professional and knowledgeable vets. As always, Dr. Tello came from Costa Rica. In the past I also paid for transportation for two vets from/to Panama City and arranged for food and lodging for them on Saturday and Sunday nights, plus paid them twice as much for the surgeries as I now pay Dr. Tello. We also had to bring them from the airport in David on Saturday and take them back on Monday morning. We had to move all the equipment and supplies to the site on Saturday, and then take everything back to my house after finishing the clinic on Sunday evening, including lots of bulky, heavy things. We also had to clean all of the class rooms that night and replace the desks so the classrooms would be ready for the students early Monday morning. All the medicines and supplies were thrown into plastic crates in chaotic order, which I then had to unpack at my house, organize, do an inventory, determine what to buy for the next clinic, sterilize the instruments, repack the boxes in the proper manner, do numerous loads of laundry to wash the blankets used in recovery, etc. The work after the clinics, plus doing the web page, always took me at least three weeks - and by that time I was totally burned out. This was far too much work and hassle for the number of animals that we could help.

As a comparison to what we will be able to accomplish now, on August 12, 2007, we sterilized 73 animals, with two veterinarians. (Of the 73, Dr. Tello sterilized 46 of the animals himself, plus removed several venereal tumors, performed abortions, etc.) On December 2, 2007, with three veterinarians we sterilized 66 animals. 

Because Dr. Tello can sterilize at least 35 animals in one day himself, that means by having a clinic every month we will now be able to sterilize 140 or more animals in a four-month period....with much less stress, work, and chaos that we had in previous clinics! With our small group and our one excellent veterinarian, we can sterilize 420 dogs and cats (or more) each and every year!

Also, Dr. Tello drives to/from Volcan from Costa Rica in the same day. I pay him for his gasoline, but there is no hassle with his transportation. He is Panamanian, but he lives and works in Costa Rica. He is a licensed vet in both Panama and Costa Rica. 

In addition to spaying/neutering the dogs and cats, Dr. Tello helps the animals by performing any other surgeries that he is able to do away from his own clinic. For example, in our recent clinic in Volcan, he removed an eye from a dog that was in terrible condition. (Two clinics ago, Dr. Tello removed a serious venereal tumor from this same male dog. These are very time-consuming surgeries.) 

At our March 16th clinic Dr. Tello also removed a huge tumor from a very skinny, dehydrated dog. My first thought was that the dog should be put down; but Dr. Tello said he wanted to try to help her. We scheduled her as the last surgery of the day, and the operation took two hours. After the surgery, we gave her a large bag of IV fluids. After a 12-hour day, we finally closed the doors to the clinic at 7:30 p.m. Jose and Fariza and I went back Monday morning to clean the tables, floor, and equipment, and take the very full trash bags to the dump.

The experience with this dog with the tumor was another good lesson to me about not  judging people. When I first saw this skinny dog with the huge tumor, I was very angry at the dog's owner. He said she was so skinny because she wouldn't eat. I thought (but didn't say), "yeah, right - you just don't feed her." Well, Monday, the day after her surgery, Jose (my employee) and I went to check on the dog. We saw that her owners have other dogs that look perfectly healthy and are not underfed. This one dog already looked better but they said she was (and had been) constipated. The next day, Tuesday, Jose and I took them a mixture of yogurt and olive oil, gave her some with a syringe, and left more with the owners to give to her. We went back on Thursday, and they said she was eating, drinking, and pooping normally. There were three little boys who live there, and I told them that giving love to the dog would help her heal. I kind of jokingly gently scratched each of their heads and behind their ears and asked "doesn't that feel good?" They all gave big grins. When Jose and I left, the three little boys were all lavishing lots of love and attention to the dog. Very heart warming! (As we were leaving on Thursday, I pointed to their chickens and asked if they had all been sterilized...we all had a big laugh about that!)

I also discovered that these people had done the best they could to help this dog. They are obviously of very limited means, but they had previously taken her to a local veterinarian establishment near my house (when the tumor was much smaller) and the "vet" wanted  $50 to remove it. No way in hell could they afford to pay that. In addition, I'm glad they COULDN'T afford it, because that "vet" would have probably killed the dog. They also had her "spayed" at that particular place, and I'm sure that cost them a pretty penny...but the dog was not actually spayed. That local "vet" does not spay (which means removing the uterus and the ovaries) but merely ties the tubes - so the females still go into heat, still have sex, and still are vulnerable to venereal disease that is rampant in Panama. Dr. Tello could not find this dog's ovaries (unheard of for him), so maybe they have simply atrophied from her being so sick. I told the owners that if she goes into heat again, we will have Dr. Tello take another look. These owners could afford to pay nothing at our clinic, not even one dollar, for the two-hour surgery and the treatment of their dog, much less any after care products or food we delivered to them. They have very limited means and don't even have a telephone, cellular or otherwise. But I am so happy that they brought their sweet dog to our clinic. They obviously care about their animals and they do manage to feed them. I am so happy this dog will be okay. 

At the March 16th clinic, people had already signed up more than 20 animals for the April clinic. Then Thursday after talking with with the neighbors in the immediate area of this particular female dog, we now have more dogs/cats signed up so that the April clinic is already completely booked! The need is so great here, and I'm glad that peoples' consciousness is being raised toward their animals as a result of the clinics....and I am excited that we will be having the clinics every month.

Again, thanks to our caring volunteers who contribute funds, food, their time, and/or all three. This work could not be done without you wonderful people! After listing the volunteers and contributions below, I will post pictures taken during the clinic. Some of the pictures may be disturbing to some people. For those who object to seeing what is real life for many of the animals here in Panama, please do not look at the pictures. 

MANY thanks to our wonderful volunteers and contributors:

Ray Valdes, who served as registrar and did an excellent job!
Yina Ortiz, who is responsible for mixing and giving the anesthesia.
Jose Espinosa, who helps weigh and tag the animals and give the anesthesia; Jose also uses my car to bring animals to the clinic when necessary and to take them home after surgery.
Fariza Castillo, who gave the pre-op injections of antibiotics and pain prevention - and also helped train other volunteers to do the same. (Fariza is a dedicated volunteer who also helped install insulation in the roof prior to the clinic, etc. She helped for three days in installing insulation, setting up the clinic, and cleaning up the next day.)
TJ Stephens who did shaving and pre-op cleaning of the animals;
Bob Wald, who also did shaving and pre-op cleaning of the animals;
Wally Ewen, who helped with post-op treatment and injections;
Lynn Longbons, a surgical nurse from the US. She did post-op treatment and injections  - such as anti-parasite, vitamin B-12, and Rabies vaccinations plus treatment for fleas and ticks; and she also trained Wally Ewen regarding post-op procedures and injections. (We definitely need cross-training because there will times that certain volunteers will be unable to attend a particular clinic.)
Richard Kongable, who is very interested in helping the animals in Panama - and who came all the way from the Colon area on his motorcycle to volunteer for the day. He stayed at my house for two nights and he was a very welcome guest. My doggie family liked him right away, and naturally, he had a few of them sleeping with him. (Richard also helps dogs where he lives.)
Yimel Caballero and Eymi Pitti Arcia, high school students, who cleaned and sterilized the instruments. Yimel also received training in giving pre-op care and injections.
Nina Stephens, as always, did a super job in after care, checking the temperature and vital signs of the animals as they recovered from anesthesia.
Sharon Borgman helped in after care, and she also received training from Nina Stephens, who is our "head" after-care volunteer. (Nina will be in the US for the April clinic, so Sharon will need to take over, plus train other volunteers.)
Various male volunteers took turns tattooing the ears of the dogs, which indicates they have been sterilized. The incisions are so small that they are soon invisible. There has been more than one occasion that a dog has been anesthetized and surgery begun (not at our clinics alone) only to find out they have already been sterilized. So along the way we keep learning and getting the equipment (like the tattoo machine) that is beneficial.

Also, thanks to to Dra. Laura Kieswetter of Volcan. Laura has a full-time job with the government and her expertise is mainly with large animals. But Laura has had some training by Dr. Escrucias of the McKee Foundation with the sterilization of dogs and cats, and Laura volunteers to have people call her after the clinics if they have any problems or questions about their animals post-surgery.

---

My next one-time large expense will be for a digital floor scale (for determining the precise weight of the animals). These scales cost $400 and up. I've had a person volunteer to bring mine in May as part of his luggage so we can avoid the exorbitant shipping and customs charges. In the meantime, Ruby McKenzie (who holds the sterilization clinics in Boquete and surrounding areas) very graciously allows me to borrow her 65-lb scale whenever I need it. Thank you, Ruby!

Please forgive me if I have neglected to mention any volunteers or contributors!

Other contributions:
**Gail Hockberger donated a crockpot of sloppy Joes for our group.
**Lydia and David Dell donated 8 two-liter bottles of soft drinks.

Income and financial donations:

 It's impossible to compute the exact cost for each animal at a clinic. Until I became involved with this, I had no idea what is required to hold a safe and successful clinic. For example, each pair of sterile gloves for the vet (and/or his helper) costs 40 cents. The cost of the non-sterile gloves for the volunteers who perform the pre-op, post-op, and recovery work are slightly less but are still costly. The sterile  drapes used on each animal cost about 50 cents each. We use the best, safest (and most expensive) anesthesia. We use at least 8 needles/syringes for each animal, and they cost approximately 7 cents each. There's no way can we compute the exact cost of the injections for antibiotics, pain medication, anti-inflammation, anti-parasite, vitamin B-12, etc., because these injections are based on the weight of the animal. We also keep on hand drugs and equipment that are not necessarily used at any particular clinic, but are there for emergencies....Vitamin K to stop excessive bleeding, a "reversal" drug that's given to an animal that has trouble waking up, resuscitator tubes and bags, etc. Then we have the cost of the gauze - both sterile and non-sterile. How much will be needed for each animal? It varies. We also have the cost of alcohol (about $40 per gallon) and iodine (again about $40 per gallon. The distilled water for the autoclave costs $4.25 per gallon. I just bought a gallon of body wash/sterilizer for $40. There's really no way to compute the cost for each animal. Also, there are one-time expenses: For example, I bought plastic stackable chairs for the new location, $149.52.  I and two others donated insulation and our employees' time to install it on the tin roof ceiling, plus the volunteer help of Fariza Castillo. (Although she didn't ask to be paid, I gave her $25 for her three days of help before and after the clinic.)

Now, although we don't have the transportation costs and fees for the vets from Panama City, I pay $100 per month rent for the permanent building - which is very reasonable!

At the end of the day, I gave Dr. Tello a total of $400. $345 of that was for the surgeries, which averaged $8.85 per animal and  included two very time-consuming surgeries: removing the eye from one dog, and the two-hour surgery to remove the 4-lb. plus tumor from another dog. The additional $55 was for reimbursement for supplies he brought (needles, sutures, etc.) that I did not have on hand, plus his gasoline expenses to Volcan from Costa Rica and return. We are so fortunate that Dr. Tello is willing to come to Volcan every month and work a very long day for so little pay. He does it because he truly loves the animals and wants to help them. (He would probably come and work for no pay at all, but no way could I take advantage of his expertise and his generosity even more than we already do!)

Costs for the clinics: I still estimate an actual cost of $20 per dog and $10 per cat, not including one-time extra-ordinary expenses. (However, we have long ago bought the most expensive permanent supplies and equipment - stainless steel operating tables, stainless steel positioners, numerous six-foot tables, lots of blankets for the recovery area, surgical instruments, etc.) We also had an autoclave donated by Pat Chan at Spay/Panama. Pat is a wonderful person, very dedicated to the welfare of the animals, and she is responsible for creating my desire to begin our clinics in Volcan. 

The per-animal estimate is probably low. I can't give an exact amount of income versus expenses, but I do guarantee that every penny that anyone contributes is spent for the dogs and cats.  Including the new scale that will be delivered in May ($395.00), and stackable chairs for the clinic ($149.52), I spent $544.52 for those two items. Added to the $100 rent, that is a total of $644.52.  With a cost of $20 per dog (x 23 dogs) and $10 per cat (x 16) cost per animal was $620. Total expenses were approximately $1,264.52. Therefore, with income of $1,050.12, the deficit is $214.40.

A happy note: The dog of two of our volunteers had a problem with impacted anal glands. They were unable to express the glands completely themselves. They recently had a local Volcan vet come to their house, who refused to touch the dog's anus and announced "no problem." At the end of the clinic, they brought their dog for Dr. Tello to look at. He immediately expressed three huge, stinky portions from the anal glands into gauzes. Boy, does this dog feel good now! We love you, Dr. Tello!

Following are a few pictures taken during the March 16, 2008 clinic:

Jose and I unlock the doors at 7:30 a.m. Jose is carrying a big vase of roses that I brought from my garden.

Ray Valdes, our excellent registrar.	The eye that was removed from this poor suffering dog.	During surgery of the eye removal.
Here Fari Castillo, who assisted Dr. Tello, holds the eye and tumor that was removed.	Eymi Pitti Arcia and Yimel Caballero, who wash the instruments and then sterilize them in our autoclave.	This female dog also had a venereal tumor and was pregnant.
Fari Castillo and Yimel Caballero	Sharon Borgman works in recovery.	Wally Ewen works in post-op.
Bob Wald putting mineral oil in a dog's eyes. (With the anesthesia, the animals' eyes stay open and tend to dry out. We lubricate their eyes with mineral oil.)	Richard Kongable, who came all the way from Colon to help.	Yina Ortiz assists Dr. Tello.
Animals in recovery.	A  precious doggie waits his turn.	Performing an abortion  before spaying.
Wally Ewen and Lynn Longbons taking a break toward the end of the day - like the rest of us, they are very tired! (But their work is still not finished!)	This is the skinny 25-lb dog  with the huge tumor.  We scheduled her as the last surgery of the day.	A closer shot of this horrible tumor!
During surgical removal of the tumor.	Fari Castillo holds the huge  tumor after it  has been removed.	This is the LONG incision after the tumor was removed.

Darn! I did not get pictures of either Nina or TJ Stephens, two of our most dedicated volunteers and supporters!

My heartfelt thanks to all of our wonderful volunteers and everyone who participates in the sterilization process for these dogs and cats. We simply could not provide this vital service without you!  We love you all - and so do these fortunate animals! Together we are making a difference!

Here in Volcan, our group has been responsible for sterilizing 378 animals to date. Added to the 129 animals that Spay/Panama (from Panama City) sterilized in in Volcan in February of 2005, we have sterilized 507 dogs and cats! There are many more to go, but we are making progress! Now that we are able to hold the clinics once every month, we will progress even faster. Our goal is to sterilize at least 75% of the dogs and cats in the Volcan area, and thus almost completely solve the problem of homeless dogs and cats, and the terrible venereal disease suffered by so many dogs.

Dorothy Atwater - 771-5883 or 6780-2565 or viajar2566@yahoo.com

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