Wednesday, July 6, 2011

Dealing With Ducks


Today I may have learned to actually hate an animal… No, ok that word is way too strong but I have definitely developed an extreme dislike of fishers.

What is a fisher? Well it is a mammal, carnivora to be exact and part of the mustelid (weasel) family. And, it ate my duck.

Not just ate it, eviscerated it!

I suppose now would be the time to give some back ground to the situation. We have 5, or had 5 muscovy ducks. In the summer they move to their palatial summer accommodation. It consists of boxed nesting boxes, patio, feeding and roosting areas. It is also fenced, on all sides. Well, each morning we start opening the farm by letting them out of their outdoor enclosure and feeding them breakfast. Usually, the ducks come waddling towards us quaking and wagging their tail feathers. This morning it was different. My Dad must have spotted something wrong from a distance because he shouted back across the yard to where I was eating breakfast that he needed my help quickly. As I rushed to the yard, quite a few scenarios of why he needed me went through my head, finally settling on the idea that a duck must be stuck behind a nesting box somehow.  However, I quickly saw that this wasn’t the case. Our favourite (mainly because she’s incredibly affectionate) duck, Buttercup, was bloody and looked like she was missing an eye. As I crouched down by her to check out the amount of damage Dad looked in the nest boxes for the others. Three were in the newest box and were completely unharmed. Then Dad opened the last nest box and with a bit of a gasp, said “oh my God”. Now, Dad’s not squeamish and neither am I, but my God did it ever look like we were visited by Jack the Ripper during the night. I’ll spare the goriest details, but basically Anne’s body was basically half a shell of what she used to be.

So now we knew the damage, we went into recovery mode. We let everyone out and grabbed Buttercup and took her into our backyard where the clean up began immediately after placing a call to our large animal vet for a consult.

She was surprisingly good for what we did with her!

 So here’s a breakdown of what I did first aid wise for a duck… Duck first aid 101 if you will.

Not surprisingly a lot of the concepts for wound care in animals are the same as those in humans. Number one priority was to assess the damage. This I achieved by the judicious use of warm water, soft cloths and a gentle touch. Basically I rinsed the blood off to see where it was coming from. Buttercup had one gash on the underside of her neck just below her bill. She also had scratches above the carbuncling around her eyes, on the top of her head and lower down on her neck on the left hand side. The worst were the puncture wounds. Basically theses were what gave me a good idea of what had gotten into the pen. The punctures on her neck and side of her head on the right hand side were roughly an inch and a half apart (one set of canines) and the exact opposite side of her head was where the other two punctures were. One below the mandible, right where it meets the maxilla and the other was basically in her eye.

We gave her a break and waited for the vet to call back. Giving her some water and access to food (I even brought out the lettuce, usually a treat of theirs). While I went into the house my Mom went to grab Henrietta to bring her in our yard along with Buttercup (as those two usually wander together). I was relieved to see Buttercup preening and essentially acting normal but was still really concerned about the damage.

As I could see it there was really only one course of action. I was going to re open the punctures to allow them to drain, flush the wounds with warm water (no saline on hand sadly) and apply some sort of topical antibiotic (which I was waiting to hear from the Vets about). As for her eye, I could tell that she had a little bit of vision left in the injured one by the way she’d move from my hand towards her head. However, the eye had definitely lost a lot of aqueous humour. At this point I know that the cornea has been punctured. I’m almost certain there is damage to the lens, but the retina is intact. So what to do now?

Well all I could think of was, enucleation (on a duck?)….. or wait and see what happens, hoping that it heals up without infection and she regains some of the sight.

It was on that thought that the vet called… and I discovered you can use polysporin on a duck. So polysporin it was to the wounds, oral Tetracycline in her water and BNP to the eye…… and hope for the best. Basically the eye can heal up, refill and hopefully she has some residual sight…. Or…. She could develop a corneal abscess and then we’ll have to revaluate the situation. It was at this point I asked about enucleation, which could be done, theoretically. Just not with them (best to go to an exotics vet here as mine had no idea even where to start with anesthesia on a duck… sentiments I can fully appreciate).

So Buttercup was doctored up and released. She definitely has been quieter than usual today. We have moved their nesting boxes into the barn, so tonight they will all be bunking up with the goats and alpaca. At least they will be extra safe… We aren’t going to risk ever using that outdoor pen again as there is no way for them to escape and we’re certain the fisher now has a good idea of where to get an easy meal.

As for her prognosis?…. To be honest I’m not really sure. She wasn’t as gung ho for her food like she usually is. I know she must be very sore so I’m hoping that is it. I just really hope that no further internal structures have been damaged and that no raging infection sets in. I’m hopeful but I’m also aware that carnivores mouths are dirty, dirty, dirty.

Soooooo, at the end of it all… I can’t say that fishers are very quickly going to become my favourite animal and I know that with time my dislike will fade. It’s not that I begrudge any animal a meal and I do fully respect its right to behave within its nature.. I just really wish it wouldn’t enact those rights on my ducks.


Pictures will follow of the invalid… However dial-up is not exactly conducive to image loading.. So, they may have to wait.

Saturday, May 21, 2011

After a very long delay.......

I'm back... well rather.. My computer is.

Well not back per se... but rather brand spanking new.. It only took how many months? Essentially what happened was my laptop was stolen the day after my last post and insurance really didn't want to give me the money to replace it right away.... but now I'm back on board!

So an update... I'm in exams at the moment so I will get back to my musings as soon as I have some free brain space. Sorry for the massive delay but hopefully I will have something to add (or rather, review) shortly.

Cheers
-P

Wednesday, February 9, 2011

Beautiful Joe


Well, I could be doing some actual schoolwork at this point in time but instead I strongly felt the need to share with you one of my favourite books.

Perhaps it’s due to the fact that I’m away from home and it’s a Canadian author. Or perhaps it’s because I’m missing my own dogs. But for whatever the reason I’ve started to read one of my favourite childhood books over again.

Now I’ve read this one many times as a child/teen/young adult (whatever the PC terms may be). But until today I haven’t yet read it as an adult. Funny that.

The book is called Beautiful Joe. Written in 1893 by a Canadian woman (yes woman) author. Margaret Marshall Saunders (better known as Marshall Saunders) wrote this story of a medium sized ‘cur’ that not only contributed to a worldwide awareness of animal cruelty but my own.

Beautiful Joe was a real dog. A medium sized terrier cross dog, he was often times described as a mongrel, cur or mutt. Originally, Joe had been owned by a Meaford man. This man greatly abused him, starving him and cutting off his ears and tail. At one point after being nearly beaten to death in 1809, Joe was rescued by a relative of Marshall Saunders. Saunders met Joe not too long after on a visit to her brother and was apparently so touched by his story that she wrote a novel. Joe’s fictionalized autobiography. The book was submitted to a literary contest sponsored by the American Humane Education Society and went on to win. By the 1900’s over 800 000 copies had been sold in the United States, 40 000 in Canada and 100 000 in the United Kingdom. Today he is honoured with a statue and park dedicated to his name in Meaford, Ontario. A society, The Beautiful Joe Heritage Society in Meaford, has been established in his name not only to ensure that this part of our cultural heritage lives on but to ensure the continued awareness of animal cruelty and the humane treatment of animals. I’m certain that both Saunders and Joe would be proud.
 
In the story, Joe after his rescue goes to live with the Morris family. From his experience with both the people in his new family and the animals he shares his life with he gives the reader a good overview of how animals were treated in the late 1800’s, both good and bad. Through Joe’s eyes we see good people and bad, we see ignorance and enlightenment and ultimately we gain a respect for other lives and creatures… no matter how great or small.

I love this story, not only because it was told from Joe’s own viewpoint, but because it greatly humanized the idea of animal cruelty. Somehow, Saunders managed to write from the viewpoint of an animal without fully anthropomorphizing it. Joe does “speak” to the reader, but still seems to be very much a dog.

Now when I read the story, I am struck by many things that I would not have been aware of as a child. The story is set in the late 1800’s which does account for many instances of what would be appreciated as cruelty today, yet would have been the standard then. Yet at the same time, I am blown away by just how much it does to bring forward the notion of animal cruelty and it’s condemnation without seeming preachy. (Which is funny considering that the father of the Morris family in the story happens to be a pastor). You can’t avoid comparison with Anna Sewell and Black Beauty. The author herself makes reference to it early in the novel as Joe describes his mistress “laughing and crying over a little book that she says is a story of a horse’s life”. Yet this is a different story with again a different though similarly powerful impact. Saunders has not only managed to discuss animal cruelty in terms that made it easy to understand, but also in a way that opened my eyes to the fact that cruelty does not always stem from brute barbarity but also from ignorance.

I have to say that even when reading it as an adult, though I am now aware of some of it’s faults, I still love this book. And in hindsight I now begin to wonder if having read it as a child managed to change not only the way I look at the world and the species we share the planet with, but also how I look at human society and the idea of cruelty.

I do think that cruelty is not just a byproduct of an “evil” person but is a symptom of greater problems in society. It’s a byproduct of ignorance and of cultural standards usually developed out of poverty and more ignorance. I do think that there can be some people out there who are just plain cruel, but at the same time I think that most can be redeemed. That if they could be brought to understand what they are doing and its actual effect on other living beings (human, feathered and four legged) the world would be a better place overall. A bit of ‘head in the clouds’ idealism there? Yes, possibly but I feel that it is always better to think something good of a situation or of a person than to believe otherwise.

I think Joe himself would agree.

Sunday, January 16, 2011

Back to school.... and Exams.... ugh

Alrighty, sorry for the delay in posting, thoughts will be coming fast and furious once I get some of these exams under my belt. I can't say I'm a huge fan of the 100% final.
However at least this blog provides me one way of procrastinating and studying at the same time, so much more productive than facebook.

This term will provide some comparative anatomy for the more rare species treated in practice (re: exotics), neuroanatomy (yay?), animal maintenance (essentially how to feed your animals/pets), introductory epidemiology and something called integrated and applied veterinary biology which I am certain is just a nice way of saying "yet more microbiology that you probably won't use unless you become a lab specialist".

Hope I can continue to make things interesting..

Mostly on topic and rambling-ly yours
-Phil

Thursday, November 11, 2010

Food for thought


So this post will be a little off topic. As I’m sure you’ve noticed by now most of my posts at the moment are rehashes of what I’m learning (anatomy of the head, just incase it wasn’t obvious enough!)

However some recent reading has brought up something that I felt like sharing.

I’ve always been interested in animal welfare. Not surprising for someone who wants to be a vet you might say. Well perhaps, but it wasn’t until I started on this course that I realized just how difficult it is to establish what is good welfare is, how to measure it and how to ensure that it is protected.

In class we learned a good basic way of measuring the welfare of an animal species. The Five Freedoms (which can be found on almost every animal welfare site) were established by the Brambell report for the UK governments Farm Animal Welfare Advisory Committee in 1967.  They have been elaborated upon since then and are defined as.

1.  Freedom from thirst and hunger - by ready access to fresh water and a diet to maintain full health and vigour.
2. Freedom from discomfort - by providing an appropriate environment including shelter and a comfortable resting area.
3. Freedom from pain, injury, and disease - by prevention or rapid diagnosis and treatment.
4. Freedom to express normal behavior - by providing sufficient space, proper facilities and company of the animal's own kind.
5. Freedom from fear and distress - by ensuring conditions and treatment which avoid mental suffering.

These are a great way to establish basic standards by which to measure whether or not a welfare standard has been met. As well it actually actively describes a standard that can be recognized and in many cases measured.

However welfare is expensive……. Very expensive.
And we like our food affordable (read: cheap).

In a recent conversation with an animal welfare scientist she had this to say on the matter:
“Cattle are so large that consecutive doses of analgesics may be a substantial cost, and then there are concerns re withdrawal periods and the cost of maintaining a now healthy animal during this period. In the case of sheep and footrot, the problem may also be their low market value. In both cases, one can argue that being pain-free improves recovery, weight gain and incidence of respiratory disease (in the case of calves and dehorning, as I recall--I'm not up to date with literature now). Yet, despite that, our obsession with money and having cheap food creates cashflow problems for many farmers e.g. in 2006, a farmer told me that he was paid 17p per litre for his milk and it cost him 21p per litre to produce...”
This is just a little depressing. Essentially our desire for accessible foods has created a welfare (crisis?) issue in our farming industry. Can we really take our meals at another beings cost?

Recent changes to animal welfare law bringing standards up have cost the industry greatly. For instance the changing over to enriched cages in the poultry industry by 2012 has cost the industry around 16 million euro to support the changes for the farms affected by the change. One poultry farmer I had the chance to work with told me that the changes were cost him £100 000.00. That's on top of the cost of running the business, marketing and general production related costs. What's more is this is a cost that he will not really recoup through his product as the change is mandated but the price will not increase (necessarily) as a result.

There is some good news on this front however, in the same conversation she went on to say that a colleague of hers who works in farm animal practice had told her that the farms in that practice who supplied Waitrose and Marks and Spencers were content, paid and treated fairly.

Why do the other national supermarket chains not follow suit. I will do some more reading up on this but I feel that they could learn something here.

The question now becomes, what matters more? How we feel about what we eat, or how much it costs?
" In 2010, my impression from the sidelines is that the economics of the survival of the farm animal may trump questions of their being pain-free, largely because, as consumers, we are beguiled by the idea of cheap food (cheap everything, in fact... We seem to know the price of everything, and to have forgotten the value of having nothing). "
Perhaps we need to focus more on the value of what we have, rather than what it costs.

Perhaps this is easier to say than to do….. but I sincerely hope not.



Tuesday, November 9, 2010

Getting down to the bare bones of it all...

WELLLLLL today (as I was at a loss of where to go to next) we're going to hit some of the basics (well structurally that is). Today's discussion is the skull.

As I'm sure you know (in humans that is) the skull is made up of many bones. Well, it is the same for animals. The rough anatomical regions of the skull are the face, mandible and cranium (or "brain box", though that term sounds somewhat unprofessional at the best of times).

The skull is formed from two kinds of bones (embryologically speaking). The bones of the skull are endochondral bones (from cartilaginous structures and are usually unpaired) and intramembronous (From mesenchyme of the embryo (I'm sure I'll get around to discussing what that is at one point but basically it's a type of embryological tissue). The intramembranous bones are usually paired and are usually plate like.

Each of the bones shown in the picture of the cat skull are paired (each have a partner of the same shape on the opposite side of the skull).

Now bones, though solid also have quite a few holes in them (to allow for the passage of different nerves and sometimes blood supply). Not shown here but usually found in the maxilla near the orbit (eye socket) is a hole called the infraorbital foramen. Through this hole a nerve leaves the skull to innervate the upper lip and the whiskers of the animal.

Also not shown here but perhaps in another image...

Ah, here we are.. in the mandible there are some more holes. The ones shown here (the mental foramen) is where the mental nerve (a branch of the inferior alveolar nerve of Cranial Nerve V, The trigeminal nerve... sorry for that mouthful) leaves the skull. It enters the mandible (or lower jaw) on the inside of the mandibular body (about opposite and just below where the marker is pointing to the masseteric fossa). Nerves, when running through the bone do not only innervate the tissues, but also gives some sensation within the bone. This nerve here, the inferior alveolar nerve, sensitizes the lower teeth. It's partner the maxillary alveolar nerve sensitizes the upper teeth (this is why tooth
infections or chips can hurt!).

The bones of the palate (hard palate which underlies the softer tissue you can feel with your tongue (in your mouth that is) are also part of the skull. There are all sorts of bones in the head as I'm sure you can now appreciate.  Issues that can happen in this area is a failure of the secondary palate to close (the bony palate) it is called an oronasal fistula or cleft palate and leaves an open connection to the nasal cavity from the roof of the mouth. This is usually first picked up in puppies or kittens as milk comes out of their noses when they try to feed. Cleft palate is both serious (great risk of them breathing in milk) and hard to fix. Surgery here is the only option though ay not always be successful. If the primary palate fails to close it is called a cleft lip (which is more cosmetic than damaging though there is a possible increase in nasal infections). Both of these need a surgical fix.


Also visible on this skull is the incisive foramen (or palatine fissure). This is where the vomeronasal organ (or Jacobson's organ) sits. That gland is a really neat sensory gland (you've probably seen horses flip their lips upwards and make a funny face, this is called Flehmen and it's them utilizing their vomeronasal organs to scent pheromones or something new). Usually this is described in stallions "smelling" a mare in heat but both sexes do this when they smell something new, or something interesting. Flehmen forces air into the nasal cavity through slits in the hard palate forcing it through the vomeronasal organ.
Other animals (ie cats) have this ability as well.



The back of the skull also comes into play. It's where the spinal cord leave the brain to be covered with, well, spine. It too has some clinical implications. Most recently issues with the bones around the foramen magnum (big hole where the spinal cord leaves through) have been implicated in a disease recognized in the dog breed the Cavalier King Charles Spaniel.  In this breed, due to selective breeding to create a smaller dome shaped head the occipital bone is too reduced and compresses the cerebellum against the foramen magnum, as a result the trapped fluid creates lesions in the brain, neuralgia (nerve pain) and can result in the dog being in a great amount of pain. The disease itself is called syringomyelia.

There are also small little bones (associated with the skull.. well sort of) in the area of the throat. This is called the hyoid apparatus and is what allows great movement of the tongue (important to vocalization... especially in human language). It's a good idea to know both what this is and where it is so that when you radiograph a dog (or cat) you don't go "oh look at the size of that bone they've swallowed". Or alternately... it's not a great idea to stick your finger down it's throat and try to pull it out ("that's not a stick, that's suppose to be there!")

Finally.... Head shapes.. Just like ears they come in all shapes and sizes. In dogs and cats they are most commonly described as Dolicocephalic (long pointy noses like greyhounds and siamese cats), Mesocephalic (like the german shepherd and the common domestic shorthair cat) and Brachycephalic (bulldogs and persian cats). As with everything else, there can be clinical implications here too.

Brachycephalic dogs (those cute squishy faced things) tend to have multiple problems associated with the reduced skull shape. They can have breathing difficulties, popping out eyes, bad teeth and bad skin. Essentially, those skin folds are not due to excess or "just plain wrinkly skin" but due to such a reduced skull shape. They have the regular amount of skin for a dog, just not enough skull to go underneath it. They have such issues as stenotic nares (closed up nostrils) because of too much cartilage or soft tissue in this area for the underlying skeleton and therefore have trouble breathing through their noses. They have trouble breathing period due to an overlong soft palate (again for the size of their skull) which then overlies the larynx causing them to make that snorting snuffling nose as they try to breathe properly. They have issues with their bite (mallocusion) an extreme underbite that usually results in an increase in incidences of dental disease. The have popping out eyes (exopthalmic eyes) due to the reduced bone around the eye socket that can then lead to increased ulceration or even proptosis (eyes popping out!). and also they tend to have an increased risk of skin disease due to all those wrinkles trapping dirt and bacteria (definitely have to wash these little faces at night).

Riiiight, so it may not be a dog ... 
but I felt that Pacman deserved at least a nod in the reduced skeleton department


So in conclusion, there is quite a lot going on in the head and it's only going to get busier as you add on those layers (muscle, nerves and other tissues). But that said, going down to the bare bones of it all is a good way to start.

Monday, November 8, 2010

I can't hear you!

How about ears... Shall we start on the inside and work our way out?

There are essentially 3 major parts to the ear. The inner, the middle and the outer. Wow, crazy naming there eh? Lets start at the middle. This is where all the good stuff is (the tiniest bits of your ear, the microscopic bits that actually allow you to hear). The inner ear is essentially formed from the semicircular canals, the vestibule (saccule and utricle) and the cochlea.
\
The cochlea looks like a snail shell and holds the cochlear duct (in which the organs of sound, the organ of corti are contained). 
 If you cross section this area you get many round windows (with scala vestibuli and scala tympani both holding perilymph separated by the scala media that has endolymph and houses the organ of corti). 
The organ of corti house hair cells lightly covered by a tectoral membrane. Vibration of this membrane deflects the hairs and the electrical impulses created by this deflection are passed along Cranial Nerve VIII (CN VIII = vestibulocochlear, or cochlear nerve) to the brain. This is what we and other animals "hear".

Moving outwards from this section is the vestibule of the inner ear, which forms the Vestibular system (imagine that!). This is made of the saccule and utricle respectively. This area houses the macula and otoliths ("ear stones") which are calcium carbonate crystals (not stones at all which I found a little disappointing). The macula and otoliths allow for recognition of static balance (balance when the head is still). The macula/ otoliths in the saccule recognize balance when the head is positioned horizontally and the ones in the utricle recognize balance when the head is held upright. So when the head is moved forwards and backwards (in respect to upright position with gravity) the Utricle recognizes what's going on, alternately when the head moves from side to side in the same situation the Saccule "knows" where you are. Together they can also recognize linear acceleration and deceleration (if you start to run or leap up and down).

Basically this works by the otoliths pulling on the hair cell = a nervous signal is created and a pulse is sent down CN VIII and your brain does the rest. If there is no pull there is no signal sent. So essentially the movement of the head is what creates the deflection of the hair cells and results in a signal being sent to the brain to let it know what's going on. Move your head = move your hair (cells) = lets your brain know you're moving!

Also in this area is the cristae and cupola. This apparatus allows for recognition of circular movement of the head (rotational acceleration and deceleration). It works just like the macula and otoliths (minus the stones which weight the gelatinous mass (so to speak). These cupola are found in all ampullae (where the semicircular canals meet the utricle) and in these positions allow for recognition in all planes of orientation (granted, being in the presence of 1g gravity is key here). Again movement of the head results in the cupola bending the hair projections from the hair cells and yet more information is sent down the CN VIII about your movements. This is the best sort of big brother there is.

Here's a cool cover of what Nasa says about your (inner) ear in space http://www.nasa.gov/audience/forstudents/9-12/features/F_Human_Vestibular_System_in_Space.html

So now for the Semicircular canals. What do those do? Well along with the Utricle they house the endolymph and cupola that allow for recognition of circular movements (housed in the ampulla of the semicircular canals where it meets the utricle).

Now for the clinical aspect.. Basically if something goes wrong here, you're deaf..... permanently.

Moving on: the mechanics of hearing. This involves the middle ear, tympanic membrane and covers the transmission of sound waves to the inner ear (the actual sense organ).

Mechanics of Hearing
  1. Ear Drum vibrates,
  2. Ossicles vibrate
  3. The stirrup pushes the oval window in and out
  4. Perilymph moves
  5. Pressure waves transmit from scala vestibula and scala tympani to the endolymph of scala media
  6. The basilar membrane deflects (hair bundles bend and hair cells convert the mechanic vibration stimulus to an electrochemical signal
  7. This signal travels to the brain via CNVIII (auditory nerve in this image)
Now this breakdown of the mechanics of how you hear included some structures not yet mentioned. So here they are.
First: the Ear Drum (or tympanic membrane), now depending on who you talk to this is part of the middle ear or the outer ear (basically it's the marker of the boundary between them). It's where the sound transmits from the outside of an animals body to the processes that allow them to "hear".

The bones (ear bones or ossicles) that allow this process to happen are as follows: Malleus (the hammer), Incus (the anvil) and Stapes (the stirrup). These bones are linked together by synovial joints and transmit the movement of the ear drum to the inner ear.

Also in this area are the spaces (which as our anatomy professor is fond of pointing out, all have names). The tympanic bulla is the round space (can be seen as is housed by a round projection off the base of the skull) and houses... well... apparently nothing. It is just the space. However if it does get something in it (like infection) it can drain via the Eustachian tube to your pharynx. Yummy. It also allows for air to be equalized on either side of the tympanic membrane (or ear drum) which would explain that "popping of your ears" during pressure changes.

A few things can happen clinically here.
1) Otitis media: a middle ear inflammation or infection. Pus can collect in the bulla (shows up on radiographs). You'll also see your dog or cat tilting their heads towards the affected side. This can happen because of viruses or perforation of the ear drum amongst many other possibilities. It can happen to anyone.

2) Horner's syndrome: This is a neat one (at least I think so). It usually stems (in relation to this position of the anatomy) from prolonged middle ear infections. Essentially the inflammation and build up of pus put pressure on a nerve that is completely unrelated to hearing -> The Facial nerve (CNVII) or the sympathetic fibres of the cervical ganglion. Basically you can get the symptoms from damage to the facial nerve in other areas as well but we are talking about the middle ear here!
The damage to CNVII results in facial paralysis, constriction of the iris, drooping of the upper eyelid and the displacement of the nicitating membrane over the eye on the affected side.

Sooooo finally the OUTER EAR!!! This is the bit that we all see (and that dogs usually love to have itched for them). This includes the Pinna (outer ear/auricular/chondral cartilage) to funnel sound towards the external auditory meatus (the ear canal) which carries sound through the annular cartilage (a ring that links the cartilaginous parts to the internal bony meatus of the external ear).... now if that's not a mouthful I don't know what is!.... 

All of this ends on the tympanic membrane (see I told you it's either inner or outer ear depending on which direction you come from).

The pinna is the cute part of the ear... Well maybe not in Lulu's case here.... But usually it's considered the cute bit!






And they come in all shapes and sizes....