Friday, May 26, 2017

Believe in Me.

Being a veterinarian and most especially the practice owner, is essentially nothing more than asking people to believe in you.

True, I need to have studied, practiced, and display the fundamental skills associated with being a veterinary medical doctor, but, there is very little oversight and even less direction provided for us while we are out in the trenches. Leadership skills are not provided as one of the important tools to carry in your medical bag. Some of us are born with them, others fight gallantly to escape having to earn them, and still others flee with great fear at the idea of having to take charge of anything.

I have had the audacity to try to build something far outside of the normal parameters of a vet hospital. I have learned the hard way there is a price to pay for that.

I believed I could do more. I also believe I can do it honestly, transparently and with integrity. It presents its own set of challenges.

If I invest the majority of my heart and soul into my practice I run the risk, like in every other relationship, of being taken advantage of, dumped, and/or feeling heartbroken. I can confess that this happens. I don't know how else to trudge through? How do I possibly remain a "heart on my sleeve bleeding heart kind of person" and not maintain some degree of caring when I get rejected?

I don't know how to be any different? I don't even know if I even want to? Which leaves me sitting here staring at the stars wondering where my place in the world is? How do I remain the eternal optimist in humanity, reason, fate, and the tiny steps of this ethical minefield, full of precious pets and messed up humans that I have to navigate through? (OK, I am trying to remain optimistic,, in fact I am jaded and jilted, and maybe even a little paranoid about the next perpetrator of my vulnerability).

Believe in me? Do I still believe in me? There are days.. when,, I... just... don't... know?

The problem is that you have to keep convincing yourself that you still believe in you when it seems that no one else does.

At the intermission of this one lifetime I know I made some hard decisions, taken some leaps of faith and tried every single time to be kind instead of right. I leave my head and neck on the chopping block because I don't see a pet, an animal, any living thing as a piece of property. I vehemently disagree with my colleagues policy of euthanasia as an acceptable answer to every-damned thing. I also give a great deal and expect to be treated respectfully and honestly.

This week I said "no" to two requests. I dug my heels in, left myself vulnerable to whatever legal repercussions to follow and I stood up to protect a pet knowing that the client might just walk out the door, drive 0.2 miles up the road to the next nearest vet clinic, walk-in, pay the $50 bucks for euthanasia on request and walk out 10 minutes later free of the burden their pet became. (PS to my vet neighbor up the road who may, or may not, hate or love me? I know I am probably the biggest PIA neighbor-vet who ever lived).

I have also made business relationships that transitioned into personal friendships. I provided an expectation for special treatments to these 'friends' and then disappointed them. The example list is long with friends who have "unfriended" me because I drew a line. I cannot ever leave well enough alone...Why? Why do I over extend myself and then feel hurt when I get dumped? Why do I always muddy the waters between business and friendship? (OK, I do know the answer to this.. because I feel obligated and compelled to be there for my patients, like, always).

Let's review my jilted list and see if it is an exercise in cathartism, or, just a gross display of dirty laundry? (Please refrain from casting a vote).
  • The many decade long client with too many dogs who worries I will rat them out for not having a kennel license because they have too many dogs. (Did I ever mention I once had 12 cats?). They want special boarding prices because they cannot afford to board them all. They left the clinic when we didn't provide special pricing. (PS we are the cheapest place in town.. we know,, we checked). 
  • The client who calls screaming that her dog "isn't breathing! She is coming in right NOW!" We direct her to the ER. We are closing within minutes. She is a nurse and she is livid. I try to call her the next day to explain that if anyone of her patients called her general practitioners office with this condition the first thing that would be said is "If this is a life threatening emergency please hang up and dial 911." Apparently added fuel to the fire. Relationship extinguished. (PS an emergency should always be treated like an emergency).
  • The client who routinely calls demanding immediate appointments for whatever disaster-du-jour has occurred. If not provided an immediate appointment I get a personal cell phone call requesting such. All are always granted, and always seen within hours of the phone call. I am fairly certain the other vets at the clinic hate me for always insisting they see emergencies even when we are booked. Who do I try to make happy? (PS I still don't have the answer).
  • Financially capable client requests an extension on paying the latest emergency bill. This request turns into constantly carrying a multi hundred dollar account for months. We ask nicely for payment, we are met with hostility, until finally the account is paid and they move to a "better" clinic. Who knew there are "better clinics" that are free? (I will pass along the info when I get their name).
  • The client who has over 40 cats spayed/neutered/vaccinated and treated pro bono who accuses a popular widely used topical flea & tick preventative of killing their cats. Hysteria ensues at the clinic, adverse event report case is opened and then they refuse to answer any phone calls or provide any information because there is a "vet and vet manufacturer conspiracy" theory going on. They ended up getting away with over $3,000 worth of vet care and services and think I am the "corrupt" one.
  • The number of vets who have left for greener pastures and the promised land. This one breaks me.. (note to self,, stop getting attached.).
  • The client who is always reprehensibly nasty to the receptionists.. Why? Why would anyone be mean to them? I bid them adieu.. and I always call to tell them why. No one deserves to be spoken to with derogatory comments, profanities, and anger. (OK, I have no remorse here. But I find it sad that these clients are always nice to me. Like that's ok? If you have a boss who lets you get walked on, while they get treated like royalty call me,, anonymously., I will call your boss. What the hell do I have to lose? Doesn't everyone deserve a friend with a big mouth who has your back?).

I need healthy boundaries. I am not good at this..

Maybe I only need to believe in me? Maybe, if I am super lucky there will be others who stick with my vet clinic-pet crusade quest and we can change the world? Maybe one single pet at a time, and maybe only with my soul still inside my own heart.

No one ever said this life was easy.. at least I can bank on that.

(PS to those who think this is a personal note of defeat and submission I will leave a post script here to spare the phone tag inquiries.. I am OK. Promise. A diary, public as it may be, is still a one way vessel. You don't need to intervene. I m, learning, growing, and trying to spare my compassionate obsessive self along the way.. Maybe tomorrow? Maybe I can do it all better tomorrow?)

For those of you in vet med I know you understand this.. for those of you not in vet med please understand that all of us are human beings with big hearts (too often on our sleeves). To not care is to grow indifferent which is the death of the soul that fuels the heart of a caregiver.

Juice.. saved by JVC twice.

If you want to help pets please reach out to me. Leave a comment here, join me on Pawbly.com, or find me at the clinic Jarrettsville Veterinary CenterFacebook at Jarrettsville Vet, Twitter @FreePetAdvice, or YouTube.

Stop and Smell the Reflection.

"Please submit 5 stories for review and consideration."

A personal letter from a dear old veterinary friend came in the mail a few weeks ago. It was short, simple and inquiring about using my veterinary blog posts for submission to a compilation book about the stories that make the fabric of a veterinarians life.

"Sure! I would be happy to submit a few of my stories!" I replied eagerly and instantly... I mean, come on,, I write a blog! I have tons of stories. It will be easy to find five.

And thus began the stroll through the 900 stories I have written. Easy? Right? Well, not so much. Seems about three years ago I started writing cases, all cases. Cases to learn from. Cases to help others. Cases to provide transparency for pet parents to learn from,, and in the process I lost my fun. I became the rote routine pet care professional who was all business and no cute fluffy stories. I lost my ability to share what I love most about being a vet in an effort to help other pets..

I took a little break from writing. I had to. I had to remind myself about what my voice was and who I wanted to read about if I was the audience. There had to be balance. Truth be told the world is a mess and I felt lost and disheartened to be in it.

It seemed that I had to shed my joy to shoulder the ever burgeoning burden of need. I feel that Jarrettsville Vet needs to be the answer to all of the pet problems in my community. Jarrettsville Vet also has become the place I spend the biggest part of my life. I am not alone. I know many other practice owners of every other kind of business share this ideology and compulsion. It can take you over. There are many vets before me who have given up everything else to the point that they don't remember, recognize or even reflect on what life used to look like.

We call it our "work-life balance". The terminology the new grads throw around in interviews when they chart the 'pros' v 'cons' list. They have to feel like you aren't over loading them because they need to preserve their "work-life balance". To which I reply, "you just got out of vet school, you never had it and you shouldn't be protecting it now." But I am not that predecessor and these are millennials. They feign from intimidation and crumble under pressure. They don't want any advice that I have short of mentorship on a healthy, less than 40 hours a week.

For me the balance has not been re-calibrated and the work became the life. Hard as I tried to be savvy and see it coming.

The request asked for 5 stories and I had three Herriott-esque ones from my first year out,, none since then. The reflection in the blog mirror proved I had become what I saw coming, drove into, and plead no contest to. Sure, I could dismiss it, pardon it, or even refuse to believe it, but, it happened.

I lost the puppy in the exam of the search for congenital deformities. The purr in the auscultation of abnormal lung sounds. The wag in the assessment of neurological function. The joy in the patient that is more than the sum if its parts. The emotional had succumbed to the analytical.

I needed, I wanted, and I had better take a second to stop and smell the roses. I at least needed to take pause to check my own health status.  There has to be a funny, cute, happy ending story in my day?

Maybe I will try to find the comfort in the challenge of the situation?

Maybe I will just try to recognize my own reflection and ask her if she knows where I went? Or if I just temporarily misplaced her?

Maybe too many of us work harder to find the balance and can't stop the pendulum from swinging higher as we jump from side to side?

Maybe all of this is what makes the greatness within the greater good? Or, maybe I let the grindstone take my nose to spite my intentions otherwise?

Blackjack
A happy ending lives here
About me;
I am available to answer  pet questions for free if you visit Pawbly.com. Pawbly is an open online pet community dedicated to educating, empowering and inspiring pet parents around the globe. 

I can also be found at Jarrettsville Vet in Jarrettsville, Maryland for appointments, or visit us on Facebook

I am also on Twitter @FreePetAdvice. Or check out my YouTube channel.

Thursday, May 25, 2017

Lost In The Sea Of Need. When the Vet Needs the Advice.

Hello Everyone,

While my usual blog posts are about my veterinary life's stories and experiences in an effort to educate and inform the public about the pet needs I see as imperative to overall pet health and welfare this post is different.

In this post I am asking for YOUR advice. Hard as I have tried I don't seem to have figured out how to come to peace with how to not feel compelled to help those pets and their parents in need.

Weasely's Story

Here's the typical scenario...

The phone rings and someone on the other end of the line is desperately pleading for help for their pets condition that they cannot afford to treat elsewhere. We have gotten calls from across the country, the Big Apple (where everything is astronomically expensive), to around the globe (these are especially puzzling. How do I help you in South Africa?), to our own backyard.

Whenever possible we offer the following;

1. Come in for an exam and assessment. We will give you an honest opinion and reasonable prices. We are also full-service which implies we can do the work-up and surgery on premises. It is the whole reason we publish prices and cases.

2. We offer options. Options come in all sizes, shapes and scenarios. They can be life-saving and/or life changing.

3. A chance. Often we just offer a chance.

Some of these cases involve an ambiguous undefined disease process that after a quick exam are deemed "lost cause-leading to pro bono euthanasia". It may sound cold and cruel BUT life can be exactly that. We see cases that are so progressed and difficult the prognosis is grave and eminent. This is suffering without tangible hope to improve. These are the cases where mercy was overlooked at the last rest stop. These are the cases I feel compelled to intervene as the last option for empathy to provide peace. Even with these too-little-too-late cases; a client without resources, a pet dying in front of us, and no real way to provide even the most bare-boned plan for any chance at remission or cure, even then, SOME of these cases are not provided a consensual to euthanasia. If you think suffering is bad, dying without hope, or, hospice care, is worse. Despair is unavoidable, but, the crippling inability to relieve suffering is cruel and criminal. It is as unsettling as the suffering you know is occurring. It is where my words need to be concise, direct, and well-intentioned. For these cases clients have to step outside of their grief, their blame and their denial. These cases call for real-life intervention. They are not frequent but they do happen. I don't need advice for resolving these cases. I need advice for how to notify clients to avoid them in the first place.

One of the pets who needed us.

We, the whole lot of us in veterinary medicine, need help in providing guidance so that too late isn't when we are sought to begin. 

What is the most basic tidbit of advice I can give them?

Don't assume that you don't have any options, OR, wait so long that you don't have any left. 


I need help in spreading this message!

Tammy

Here is a real-life example.,,

We received an email asking to help a dog with a suspected pyometra who was living in the DC area. The dog belonged to an older woman who didn't realize how sick her dog was. Her daughter was visiting and on inquiry was told that the dog hadn't eaten or gotten up in days. She rushed the dog to the local vet to be told it was likely a pyo and the cost would be upwards of $2,000. They, like many of us, couldn't afford this. They went online looking for affordable help. They found me, via this blog, and called the clinic looking for help. This was on a Friday. We offered to see them but explained that we don't do surgeries on Saturday or Sunday and urged that they call every shelter, rescue, and vet they could asking for a quicker surgery and a way to afford it.

The next time we heard from them was Monday morning. We saw them on Monday night. By this time the dog was almost in a coma. She couldn't stand, walk, or lift her head. Her color was purple-blue knocking on deaths door. She was labored to just try to breathe. They had $300.

I made myself a promise many years ago to never walk away from a pyo or a parvo. Two savable conditions that never survive with a death syringe, but often surprise you with skill and time.

The conversation with the owners went like this...

"I'm sorry." Anything and everything that could be said after was irrelevant and shaded with unneeded character references.

The conversation with the staff and associate vet seeing them was that they couldn't afford even the most pared down treatment plan. Three hundred dollars wouldn't get us past anesthesia and antibiotics. They needed a $500 surgery on top of these to remove the rotting uterus festering inside of her. Even if we offered to use the Good Sam Fund (overlooking that fact that they aren't a client) this dog needed to go to the ER after and that was going to cost at least $500. The ER isn't going to admit a dog without a deposit. If I had to guess I gave her a less than 10% chance of making it through surgery even if they had enough money for the intensive care she needed to provide any real chance at survival. It is not about the money, it is about what is fair for everyone involved. I didn't even think she would survive surgery  and I felt that it wasn't right or fair to them to take the little money they did have for a patient who wouldn't survive.

When I explained this to the client she said she wanted to take her dog home.

While I had elected to withhold my previous chatter to spare the client from feeling any more sadness than they already did, it was time to be the advocate for the patient.

"What can you do for her at home? She needs medical and surgical help that you haven't been able to find elsewhere. I am afraid she will die on the way home, and even if she does make it home she will probably not make it through the night. How are you going to feel if that happens? What do you think you would want if you were in her position? She is dying and she is suffering."

After 30 minutes of deliberating they put her down. Everyone felt better after. It is something we don't often admit, but, peace can come after death.

Sweet Baby Rae.. mom needed in patient help Baby Rae needs a home.

I need help in figuring out how to not get cases at this point. 

The next scenario is the more common one...

The phone call goes like this...

"The shelter/the vet I go to/my friend told me to call you and that you could help my  pet...."

Nothing (yes, NOTHING!!) burns my butt like my neighboring vets referring cases to us that they can do, but don't want to do because the client lacks the money up front. These are YOUR clients and YOUR patients...  Shouldn't they be YOUR responsibility? Or, do you just help those who can pay upfront? Take a note from our play book. Use CareCredit! Offer third party billing! OR, ask for help from your compassionate clients who WILL HELP IF YOU ASK! Heck, you might even get more Facebook likes and more clients because you CARE.

Yes, these clients often have little to no available money, BUT, they all have desperate and dying pets. They all also have DEAD pets if someone who can help doesn't step in. 

When one of our patients is surrendered at a shelter we go and get them.
Beignette,, she needs a home too.
What might happen if you surrender your pet at a shelter.

So my friends,, 

WHAT SHOULD WE DO? How do we make an impactful, meaningful difference for these pets? 

For those of you who aren't familair with how we extend our help to our clients in need, here is a review of our policy;

1. We do not deny care to our patients when they are in need. Emergencies may need to be referred on a case by case basis, but, we will assist the pet if it is safe to do so. 

2. We do not offer "economic euthanasia" (euthanasia as a means of treating due to financial constraints).

3. We provide multiple ways to pay for needed care. 

4. We provide the option of signing over a pet to one of our affiliated rescues if the burden is more than the client can or will provide for.

5. The vet has the option of providing pro bono care IF they want to, IF the case has a reasonable chance of survival, and IF we believe the client can follow through with the after care needed to insure successful resolution.

6. We don't treat a good paying client's pet any differently than a struggling financially client. Their pets have exactly the same diseases, conditions, and needs. Financial profiling should be so distaseful and shameful that the profession should take a stand AND do something about it! WHAT ARE WE WAITING FOR? A MUTINY? A competitor to figure this out (P.S. It is my dream to have PAWBLY be that meaningful change for these animals).

Extension outreach foster family

Here's where I need help! 
  • What should we do so that we can provide meaningful timely help?
  • How do we extend that reach to people who aren't local?
  • Can we convince other animal care facilities to be both the business and the provider when the situation is complicated and resources are tight? If we haven't been able to do it on the human side can we do it on the veterinary side?
  • The rescues think the vets are the problem (we have priced ourselves out of accessibility AND we don't care), and the vets think it is the public's problem (after all if you cannot afford a pet you shouldn't have one). Meanwhile pet is sick and dying.. don't argue when the need is in front of your face.
  • What does your vet do? Have you ever asked "what would happen if your pet needed something that you couldn't afford?" Are you prepared for the answer?
Thanks everyone for reading and contemplating. I am all ears.. let the ideas fly!

One of our TNR friends.

Related Blogs;

Jarrettsville Veterinary Center For Clients With Financial Constraints blog.

Affordable Options Are Everyone's Right.

Rescue Economics. When The Expense Costs You Your Ability To Care.


If you want to help pets please reach out to me. Leave a comment here, join me on Pawbly.com, or find me at the clinic Jarrettsville Veterinary Center, Facebook at Jarrettsville Vet, Twitter @FreePetAdvice, or YouTube.


Together we can save lives! It is who we are and at the heart of every pet parent and animal lover.

Friday, April 21, 2017

Lock Down At The Veterinary Clinic.

Twice. This has happened twice in about 4 years. The vet clinic has gone into lock down over a client showing up enraged and threatening us..


There are safety and terrorist drills that every place of business, social meeting area, community gathering place and institution needs to practice. Sadly, this also includes the veterinary hospital.

Both cases of lock-down were eerily similar; an enraged client came in seeking immediate action after their phone calls to the clinic were not answered quickly enough. The phone calls were belligerent, accusatory, demanding, threatening and intimidating to the girls at the front desk. The front staff are not naive to difficult phone calls. They tried to explain that the messages had been delivered and that someone would get back to them. This wasn't an acceptable answer.

The phone calls start as short and frequent. They quickly (within hours) escalate to demanding and threatening. The avalanche has started and you should expect the rest of the catastrophic destruction to follow.

The next action was to show up at the clinic enraged. Their anger has turned into threats and demands in person and with immediate expectation of engagement.

There is nothing you can say or do at this point other than to call the police. You don't know what these people are capable of and you cannot diffuse this situation and concurrently take care of your business. From my perspective I am also responsible for the health and safety of the other clients, staff and patients in our care. I don't dare risk their emotional or physical safety, and my ego doesn't believe I am a superhero who can swoop in to save the day. I have learned to NOT ENGAGE.

There is a back story to the culmination of these lock downs, (of course), they all went a little like this;

New pet parents arrive with Amish puppy mill, OR, Craig's List, puppy a few weeks earlier. It is very apparent to everyone that they are unprepared and uninformed about the cost, care, and responsibility of owning a pet. All routine pet services are explained in detail, associated costs provided and many are dismissed as being "not needed" or "too expensive". It is not uncommon, nor unreasonable to space out vaccines, visits, services and instructions for new pet parents rather than try to overwhelm and scare them away. We take our time and break the whole process into little easily digestible pieces. These visits take a huge amount of time and energy. They are also vitally important for the safety, well fare and well-being of these clients and patients. As is customary for us we offered brochures on products (preventatives are often confusing and difficult to understand the value of with new parents), and vaccine schedules. Written personalized instructions go home with the owner along with pre-booked next appointments. In this particular case I also strongly encouraged enrolling in a puppy/new pet classes. Phone numbers and recommendations are also given for these. We go to great lengths to provide a safety net and support network to new parents.


There are vet visits where you feel like a pre-puppy/pet-selection process should be law. There should be a screening process, an application, a review of the home and a waiting period. This requires time and patience. You can buy an Amish/Craig's List puppy/pet cheap and get them quick.

The clients admit to their pet purchase because they had been turned down by all of the rescues. People may castigate the potential adoption process but it has its purpose and reason and is often correct in their assessment of adopters.


Not everyone should have a pet. They are not little neatly packaged ready to go inanimate creatures. They are the worst example of Ikea's "lots of assembly required" challenges. They have needs. Their needs have zero respect for yours. There is no ideal time for a broken bone, infection or acute diarrhea episode. When they happen (and they always do) the unprepared new parents with angst and disdain always behave the same.. Anger, yelling and excuses about a "defective pet." (I cannot even tell you how many times I have had this discussion).

What I have to politically say nicely is "All pets come with and will have medical and/or behavioral challenges." They are intelligent, intuitive, needful beings. They need help with the challenges of life like all of us do."

BUT,

What I want to say is; "What the hell were you expecting? A pre-programmed self sufficient robot? Of course they cry for attention. Of course they will poop and pee in your house if you haven't trained them. Of course they need love and exercise!"

The worst cases of new pet parent failures end in death. I have come to know this, fear this, and see this. If you don't put time and attention into your children they fail to adapt to society and are ill-equipped to live happily in it. The behavior issues turn from disappointment to cast away outside to surrendering at the shelter to euthanasia appointment. It is the awful reality of property that fails to serve its owners purpose. Or, it turns into an anxious pet who bites or lashes out, which turns into death by euthanasia, or, abandonment which in too many cases causes death by predation or designation of "unadoptable" which subsequently leads to euthanasia.

At some point in this timeline a frustrated owner starts providing clues that the relationship is not mutually reciprocating of adoration. The parent cannot understand and assist the pet and the pet is still desperate for love and attention but unable to articulate their needs and wants, IF the vet, or pet professional doesn't intercede at this point it will cause a shortened cheated life for the pet.

Here is where our lock down happened. The new pet parents told us on multiple occasions to multiple people that he didn't want this pet. It is not uncommon for vets, and vet staff, to hear clients disparage and complain about their pets care and cost of care in front of us. Perhaps they do it to try to complain indirectly about the bill? Perhaps it is poor coping skills? Regardless, I am not able to ignore it. I have been heartbroken too many times to not intervene.

After an odd peeing incident and a heated visit with the dreaded "defective" label being thrown out as a reason to not pay, and not wanting the pet. I called to offer help and try to explain that these things happen. I attempted to explain that "perhaps she needs more time, more training and help? We are here to help her, and them. We can't do one without the other." What I feared was that her "odd behaviors" were a direct result of the anger and angst they felt toward her?

The next day the client shows up unannounced to leave her. "She is too much work and too expensive." The client is in such a rush he doesn't want to wait to sign papers. (You cannot just drop off a dog at a vets office). To be honest we only take them to get them into a rescue to try to save their lives. At almost every shelter in the country a surrendered pet is a most often designated a "euthanizable" pet. These pets pay for their humans inadequacies and instabilities.

Three days later the phone is ringing, the messages are stacking up, and a few hours later a very angry guy is at the front desk making demands.

It was lunchtime and my sister (our hospital manager) and I were out to get a few minutes of much awaited spring time sunshine. What the client didn't know was that I, the practice owner, had just returned from hospice vigil and hadn't been at the clinic for a few days. It is not something I felt I needed to share, but, it is not outrageous for a phone call to take a day, or even two, to be answered when they do not include patient health care requests.

The client was so belligerent that my mom (cleaning the clinic that day) hid in an exam room and called my dad to come rescue her.

Texts to my sister and I quickly escalated to phone calls for help.

"Call the police NOW! And, lock all of the doors" imagining them fearing for their safety as they were unable to diffuse the demanding lunatic in the front office.

That's my advice for every out of control situation. You just call the police. Let them try to manage the person who is not willing to talk like a mature adult. Never escalate, never engage, and never allow anyone to make you feel threatened.

The police arrived as the client departed. There is now a record outside of yours to corroborate your concerns. If you are worried enough inquire about a restraining order. It is a the best way to protect your business, your self, and your staff while at work. You also will benefit from having a police officer present at the time of request.

"If they show up again call us. We are one mile away. We will send extra patrol cars to visit today and tomorrow. We can even post one to stay if you need us." It was the most consoling offer of protection and peace we could have gotten. It was the only thing that allowed us to stay open the rest of the day.

Where am I in all of this? I am back to being afraid of people who will harm you if they feel embarrassed and/or not in control and the collateral turmoil of not trying to save the pet in the middle. It is the world we live in. Where guns are prolific and temper tantrums happen in traffic, workplaces and even school yards.

A phone call from their lawyer followed. "They want their dog back. They have had a change of heart." Lawyers ALWAYS get involved. If you are lucky, they get involved early. Lawyers at least have boundaries and repercussions if the client is a psychopath. Any, and every, mediator should be welcomed. It is yet another barrier to becoming engaged with an unknown unpredictable person. It is a way to provide leverage and pressure. Every vet needs to have a lawyer on retainer, or at least PLIT insurance. Call your lawyer as quickly as the hairs on the back of your neck take notice. The point about "not engaging" also includes passing the buck when appropriate.

My reply; "My job is to take care of my patients. I am still here to take care of them. The pet is in a home with people who love her and they don't want to give her up. It was stated to us on multiple occasions to multiple staff members that your client did not want this pet. I also need to notify you that the police were called when your client threatened the staff would not leave after being asked to. The police were called to the clinic to remove him and are on alert to return if he does. The clinic went into lock down because the staff was so afraid."


Why am I posting this? Well, because we have been threatened before. Threatened with lawsuits, physical harm, and intense harassment. I have had to go so far as to get a restraining order, (it takes four visits to the police and courtroom to get), and I know what the consequences to my patients are if I don't offer to help. I also feel compelled to share this story with other vets and vet staff to try to encourage them to say something when a client states they don't want their pet, threatens abandonment, physical harm or personal injury. Do not ignore a threat, ever! Document and get backup corroboration to support the claim immediately. This case has multiple entries in the medical record to support the statements made in both our presence and in phone calls/email exchanges. I was granted a restraining order because I had emails and witnesses to support the threats made.

Do I think this is the end of this? NO, I don't. I think this man doesn't take "No" lightly. I think that in some cases standing up for your staff and protecting the people you care about makes you a target. I also think this blog allows me a place to post fears, concerns, and educate all of us about how behaviors influence outcomes.

How hard it is to stick your neck out with people who threaten and intimidate? How easy it is to turn a blind eye on your patients to spare your butt? Vets have to ask themselves this question every single day. It can break you. I have had to become comfortable with repercussions in order to stay true to my ethical code of my obligation to caring for my patients. It is not a code my profession shares publicly. I also think that veterinarians deal with the a ridiculously ambiguous fundamentally unfit status of pets being deemed "property". It denies us ability to intervene, advocate and make meaningful life saving pleas. At will on demand euthanasia is a viable option to every pet owner. If I push to hard every patient can be euthanized, and some clients will do so just to spite and hurt others. That is absurd and reality.



Here are my tips for preparing your staff for potential Lock Down scenarios;

1. Never engage. Ever. The minute you feel threatened or that the situation is out of control just pick up the phone and dial 911. You don't have to warn the client, you don't need to explain, and you should never apologize. Just pick up and dial. Every front desk employee has a phone at their fingertips.

2. Start recording the event. Any other staff member should discreetly pull their phone out and hit record. Evidence will save you time and money.

3. Have a protocol in place. Get people outside. Lock doors so others don't walk into the heated situation as it boils over. And, never call in more civilians. The police are your only call.

4. Get photos. I had to get a restraining order on a client under daily psychiatric care who was threatening to kill someone. Of course he didn't exist in any social media platforms and has never had a photo of himself taken (that I could find).. It is harder to alert the staff to call the cops if he shows up if only a few staff members know him by face. We were given make and model of the cars the owned to post for staff's attention.

5. Stay on the phone with the police dispatcher. They can help you to keep calm and be safe.



End note; I really never imagined that being a vet who cares so much about pets would leave me to having to decide whether to stand by protecting their lives would leave me sitting in the cross hairs of my own. We live in a dangerous and unpredictable world. It shouldn't be governed by so much pervasive fear and hate, that's not what our pets bring us, that's simply humans.

Where is JVC going to go to help deal with the ever increasingly hotheads who are making the job of an underpaid vet assistant question why they stay? We will be adding video surveillance to the hospital. They will be in every public space, including examination rooms, and parking areas. We are also recording telephone calls. Too often I have a receptionist find me frantically befuddled to notify me that a "very difficult, angry client" is on the phone. Many of these phone calls include threats, harassment, profanities and requests they cannot acquiesce to. I ALWAYS take these calls. Overwhelmingly the client is nice as pie to me. There is some unwritten excuse to being able to be rude to the staff and nice to the doctors. For every client who does so I ALWAYS ask the client if they were rude to the staff? I know that most clients are put off that I ask, but, I explain that we are never rude to clients and it is expected this is reciprocated in return. Every single client had provided a firm and disgusted "NO!" For the repeat offenders they are given a written letter of warning and at the third infraction; fired. Every practice owner needs to both protect their staff AND hold clients to a standard with consequences. No vet staff member is ever paid enough to allow or tolerate abuse.



Clues to Lock Down worthy clients; (Note; I am not a psychologist AND I am way out of my vet hat boundaries.,, But, these have been my experiences. I add them as personal reflections).

1. They are usually new clients. Never people you have seen and known for years.

2. They have seen multiple practices over multiple years.

3. They provide red flags at every single interaction. Pay attention to the little voice that tells you to be careful.

4. They do not provide small talk unless it is somewhat uncomfortable and moderately inappropriate. Like asking for your private information, or, disparaging others to find a common enemy.

5. They seem to exist on the ends of the spectrum. Either too nice, or, too angry. You never know which you are going to get?

6. The pet goes from happy and jubilant one visit, to afraid and shy the next. ALWAYS pay attention to the pets and the kids. They tell you what you need to know.

Here is a reference from Psychology Today on Dangerous Personality traits. The men of this blog possess many (or all of them). Please read this article if you are a woman, vet, vet staff, person, employee, anyone and everyone.


Footnote; None of the photos in this blog are of the pets involved in these cases. The situations and scenarios are collected experiences based on previous situations within the clinic. Names have been omitted and references to actual clients have been altered to protect the staff from further harassment and client instability and instigation.

About me;
I am a small animal veterinarian and the owner of Jarrettsville Veterinary Center in northern Harford County, Maryland. We are here to help you and your pet at every step of their lives. Please check out our amazing Facebook page JarrettsvilleVet. Or find our 2017 Jarrettsville Vet Price List here.

If you would like to learn more about pet care or ask a free pet related question please visit Pawbly.com. It is free to use and open to all of those who love pets.

If you want to help others and you have experience with pet care please join us on Pawbly.com. Pet care is about helping others and we are built on this alone. I also have educational videos on YouTube, or @FreePetAdvice.

And of course we hope that you will Please always Be Kind to every living creature.

Tuesday, April 11, 2017

Top 10 Mistakes New Pet Parents Make

If only we could learn from the mistakes of others...? How many of us would avoid painful life halting mistakes? There isn't a single one of us that hasn't sat shotgun watching a beloved family member, friend, or even marginal acquaintance make some tragic mistake that changes the trajectory of their lives indelibly for decades to follow.

Some of those mistakes even end up being fatal...
  • The text that had to be answered on the interstate while behind the wheel.
  • The late night celebratory ride home after a few too many that didn't include a taxi or Uber. 
  • The poorly socialized large breed dog who landed in the wrong house, with the wrong owner after being purchased on impulse because the photo online made them feel more "manly" about themselves, bites out of fear or anxiety,, and ends up getting a one way trip to the shelter.. This happens at least once a year at the clinic.
  • The cat who gets sentenced to solitary confinement because her pleas for help and/or peeing outside the box (which is after all always a plea for help) cause disdain to the already overburdened over stressed family who is hard pressed to find time to do anything other than add food to the bowl once a week. This happens weekly,, these poor misunderstood neglected cats! (Please, please call me,, or go to Pawbly.com, we can help)
The list is long, varied, and painful for every family member involved... but every single one could have?, might have? should have been able to be avoided.. with a little advice from your friends or the experts who want so desperately to never see another tragic mistake repeated.

For those of us in the exam room of the veterinary clinic for 8 hours of every day you learn that people are destined to repeat others mistakes. Perhaps it is the balance to keep nature from over populating? Some sick form of Darwin's Law maintaining a balance? It is still, however, frustrating to the point of feeling like you are caught in Groundhog Day meets Edge Of Tomorrow. It is a sickening cyclic chasm of repetition that causes you to either sit down and compile them into a list for the near futile desperate hope that someone will take pause, OR, you become blind, deaf, mute and indifferent. (God give me the strength to not become indifferent).

Madelaine,, one of my dearest friends
Here is my list of the Top Ten Mistakes That I See New Pet Parents Making,,, over and over again;

1. Not being prepared for your life to change. Your life is going to change. You have another life dependent on your ability to provide love, support, encouragement, training, and happiness. Adopting a pet requires time, patience, love, sharing of the care they need to thrive and financial resources. Your life is going to change for the better!! Be the parent your pet needs you to be.

Amanda, River and Rosie
2. Not understanding this is a living being who will need you, your wallet, and will have stumbles along the way. I am eternally perplexed by clients who happily spend many hundreds of dollars on that cute face in a window or internet ad then fly half a country away to pick up their 8 week old baby, and then tell me they don't have enough money left for preventatives, microchip, or spay/neuter? The adoption fee is often the cheapest part.

Ouch!
Not a quick or cheap fix here,, 

3. Not making a designated pet place and allocating enough time. Pets, especially puppies, need lots and lots of time. They need time before you leave for work, (I suggest at least an hour), time after you get home from work (I suggest at least two hours), and they need to get out of the house for training, socializing and general sticking their nose, face, feet and whole body in the dirt/grass (at least 6 hours on the weekends). They need to be a dog. Your cat needs emotional and intellectual stimuli outside of a couch and litter box. They need play, long naps on laps with constant petting, catnip toys, etc. AND both need a proportional allocation of your home to the amount of time they spend in it. For example; if you live in a 1,000 sq ft home with your dog/cat they should get at least 100 sq ft of dedicated space for what they want and need. For my home with two dogs and four felines this includes their own litter boxes in their own spaces. They each have their own room/area and their own stuff there (litter box, food, water, bed). Some like raised beds in windows, others like the bed in the flower boxes, and Jitterbug prefers the giant dog bed they are now unable to even get near. She has claimed it and the cats rule this roost (it is always safer for the cats to be in charge. The dogs are not allowed to challenge them). To all of the clients who tell me that they "don't want their cat on the tables or counter top, etc." I remind them that their cat is a little fierce predator under that purr. They want to be where we are. They want to perch from a vantage point and you NEVER, EVER, reprimand or discipline a cat. You can try to silently discourage by covering the area with things like tin foil or hard plastic (but, cats will pee on plastic, remember what the litter box is made of?), so you need to pick your battle carefully and provide a compromise. If you don't want them on the table/counter top you need to add cat shelves to these rooms. That's a compromise. Not banishing them to the areas you aren't in,, like a spare bedroom or scary gross basement.



Wren at the cat food bar
The long walk from food to heated bed

Arrival; heated bed

Magpie the sentinel

Coot gets the best seat in the house
4. Not knowing how to love on their terms. Having a companion is NOT ABOUT YOU! Don't get a pet to accessorize or complete your life. Too many "cute" pets are dressed, shoved into bags, smuggled as therapy pets to vacations far away, or asked to ride in a side car on a speeding motor cycle on the highway. They have their own needs and you have to understand, support and provide for this. Cats need to feel the world. They are compelled to give it a graffiti tag of ownership, and they need to be active. Most people don't get a cat and expect for them to be active.. Dogs need stuff that stinks of life.. dirt, sand, sticks, and to be the wolf of their forefathers,,, at least in their minds eye. That's loving a pet. Giving them (safely of course!) what they want and need, even if you don't want a dirty dog, a shredded chair and a life surrounded by organic materials.

Jitterbug gets what he wants,, Jekyll has to put up with him



5. Not being educated on your pets breed, needs, and behaviors. If you want to buy a car, shoes, house, or even vegetables based on how they look in the package that's fine. Don't buy, adopt, or steal a pet based on the way they "look". A German Shepherd, Border Collie, Cane Corso or Rottweiler (the list includes every single breed) can be a deadly weapon in the hands of the wrong (often well-intentioned) people. "Cute" and "designer" are not in your pets best interests. A brachycephalic dog or cat that can't breathe or maintain a healthy skin due to excessive folds, or is blind because we wanted a "cool, unique" color coat is not compatible with ideal health status IS irresponsible and a poor excuse to build your own self-esteem.
Attack!
6. Not seeing life from their vantage point or standing in their paws. Your cat is probably bored to tears (and perhaps subsequently peeing in inappropriate places) almost all of the time. Can you imagine sitting under the same roof day after day? The same food, the same expectations,, ugh.. bleck! spice up life. Add catnip, cat scratching mats, or start walking (have I expressed how much I love harness walking cats?). Your dog barks at strangers walking by because they live in their home and their job is to alert the family. (Never yell at them for doing their job). That's all they have; this little home to protect and serve. They dig, shred, play and get into stuff because they have excess energy (those dogs eating toys needing emergency foreign body surgery chew, and swallow, because they are bored) OR, you forgot to let others into their lives and now they cannot function without you. There is a happy medium between too much love and attention AND too much dependency on each other (separation anxiety starts here).
River keeps her eye on the treat




7. Not sharing the joy of being a parent. How do people who have never had a pet before learn about the joys of being a pet parent? Through friends and family. Share the joy that your pet brings. Where do I see the biggest obstacles? Men who are in relationships with cat women. (OK, I know not PC, but, you get honesty with this blog!) The number of relationships that come with "get rid of the cat" ultimatums is staggering. If your boyfriend makes you chose your family over them just dump them. Immediately. They aren't worth the sacrifice.. and what are you going to do if the list gets longer? What about when they dump you because their other girlfriend gave them an ultimatum to get rid of you? (Footnote; the only person who doesn't like a cat is the one who doesn't know AND understand a cat).


Happy snow day!

8. Not socializing early enough and thoroughly enough. Every puppy should be touched by at least a hundred people BEFORE 8 weeks of age. I have abandoned the old ideology that we don't encourage social interaction until your pet is fully vaccinated... we exchanged a protected pet for a happy well-balanced pet. Get out there and play with the world. (Please have your pet micro chipped at 8 weeks! and scrutinize the people you play with. No sick pets, no day care, and no dropping off at hospitals, shelters or rescues. Keep them in safe, clean, disease free places).



9. Not raising an independent responsible member of society. Those selfish paranoid doomsdayers who keep vicious guard dogs trained to display aggression, with beatings and harsh words have bred dogs who will be shot the moment they get loose, injure a human, or the junk yard closes. This might be an extreme example, but about 50% of the docile friendly 8 week old puppies that I see a year later have become cowering, fearful anxiety ridden beings. Now I realize that they haven't seen me in a while, (which I would love to change with more frequent "happy visits" just to get a treat and a snuggle), but it is much more difficult to retrain a fearful dog than to always keep them in your inside AND outside of the home life happily sharing all aspects of it. Take your pets everywhere you can (safely, NO LEAVING THEM IN CARS!). Your pet needs to exist within the confines of society. They have to be stable, confident and able to deal with life outside and away from you. That is your job; to raise a being able to move on and thrive without you. People die, things change, your pets life should never depend on these. They need constant exposure to help them understand the society we live in. Should you not be here to take care of them and they end up in a shelter the pets who love people are far more likely to get a second chance adoption. I love my pets more than almost anything in life. They have a back up plan for the time I can no longer care for them. I have a small army of people to take over (with written instructions ;-) about what they need and like). They will go on after I can no longer do so. They are a part of my life and legacy. To provide them the best chance of flourishing without me I have to expose them to life, other people and they need to know what love is so that they can provide it to their next family without fear, apprehension or contempt. Pets are far better at moving on than we give them credit for.

Rescue life
This idea of euthanizing them so that they can spend eternity with you is selfish. I have seen dozens of pets go on to new homes they love and are happy in. It happens all the time. I have never seen one be sad, upset or even unable to adapt to a new life. My family can go on without me.. I want them to with all of the life skills a good parent prepares us for.

Molly and her second chance

10 Not knowing who to get advice from and not getting help early enough. Feeding, vaccinating, and taking advice from the kid at the gourmet pet store, the tv commercials, the Facebook ads, the breeder, or the flyer from the feed store, all has enormous potential to be bad advice from a biased, partially knowledgeable person AND it can do more harm than good. All pet questions start at the vets office (OK I am biased), but, I get crazed by the gourmet dog food store owner giving medical advice for diet, ears, skin, and behavior.. etc, etc.. If they could be sued for practicing medicine without a license I would encourage my clients to do so.. Or at least submit their medical bills for reimbursement. A problem that sits, simmers, or grows and worsens is always harder to manage after months of bad and/or inappropriate advice. If your pet needs help you can find me, and a whole bunch of very credible pet experts for free at Pawbly.com. (Be prepared to be given advice about seeing your vet. They are your pets best advocate and adviser!).

Mack, minus the two foot long string toy I removed a few hours earlier.
As always JVC, and I, are here to help you and your pet. If you would like to meet the amazing staff and hear more about the ways that we can help you and your pet live longer happier and healthier lives we would be happy to show you how the face of veterinary medicine and the care we provide can ext end past the traditional options of hope and luck. Please also follow our amazing Facebook page JarrettsvilleVet. Or find our 2017 Jarrettsville Vet Price List here.

If you would like to learn more about pet care or ask a free pet related question please visit Pawbly.com. It is free to use and open to all of those who love pets.

If you want to help others and you have experience with pet care please join us on Pawbly.com. Pet care is about helping others and we are built on this alone. I also have educational videos on YouTube, or @FreePetAdvice.


And, of course, we hope that you will Please Always Be Kind.

Saturday, April 8, 2017

Veterinarian Rants. Our Failure To Take Responsibility or Compromise

Sweet Baby Rae, looking for a home now, come meet her at the clinic
 In general I get a bit miffed when I read many of the most popular current veterinary blogs these days. (I admit I have angst,, I'm working on it. Based on current affairs it is going to take a while).

Not to say that I am not equally guilty of self-sought pity parties, BUT, I am utterly sick of veterinarians claiming naive oversight to the huge pitfalls that plague our profession. My latest tirade is centered on Andy Roark's published article on "The Bad Economics Of Veterinary Medicine." Written by a surgical specialist (which is the absolute best way to make over $200,000 a year in vet med), it serves to explain that we are underpaid, in huge debt, and struggling "to practice the best quality medicine possible ... at the lowest possible cost."

Wylan,, lap dog
I went to vet school before the advent of outrageous school debts, (yes, these days did exist). They are the same days that students looking into colleges with published price tags made decisions based on what you could get into AND what you could afford.  I don't know if this rationale is still employed? Most of my friends with college age kids use the axiom "if they can get in I will find a way to pay for it" thinking. (HUH? Maybe that was the spawn of the economic dilemma? So much for "leading by example?"). Every single student knows what their school is going to cost. My parents were open and honest about this price tag. It was the single reason I attended a free and flipping hard painfully brutal school that began with the all caps "UNITED STATES",, and ended with .."ACADEMY". It was not fun, nor easy, but then neither was vet school. I had excellent pre-vet training. I also had no debt. While I agree with the premise that vet students get very little (or more aptly NO) business training, the field of medicine has not changed that much save for one BIG exception,, women (we are classes of primarily women) got empowered in the 80's. We were fed a steady diet of "you can do, and have, anything you want" and we believed it. This gender equality mantra remains strong and ingrained. We all wanted to be veterinarians with the same delusional dream-like perception of saving the fluffy critters we adored. That tiny simple equation led to personal quests that provided the market to supply and permit almost "anyone can get in" vet schools to feed the demand (at outrageous costs). These determined students didn't do their homework, didn't employ a better discipline than their equally over extended in debt parents (who not coincidentally also bought houses they and the mortgage companies knew they couldn't afford), got in to schools they couldn't afford, dismissed the price tag, and fed the off-shore pop-up vet school machine that doesn't have a conscious nor responsible soul.

Coot insists Loon make room.
When the motto is "vet school at any cost" the collateral damages include sensible debt loads, expected post graduation income, calculated debt to income ratios, a long term vision for a life to include other debt related items (house, car, kids, vacations), and, we also forgot to reflect on the pressures, realities and landscape we were stepping into once we got out of vet school.

We all trained with vets before we went to vet school (it is after all a pre-requisite). How many of those vets drove luxury cars? How many of them lived a lavish life? How many of them were arrogant outspoken advocates for anything? How many of them gently warned us about the pit falls of vet med? (OK, all of mine did, I just thought I would be different and knew better). They were, and remain, humble quiet hard working 'salt of the earth' people. They also rarely complained. Why was that? It wasn't that they worked less than we did. It also wasn't that they didn't have financial pressures, bad clients, or weren't ridiculously underpaid for their degree of expertise.

Quality control crew

Here's where we failed to stay in the firm footsteps of our veterinary forefathers. We forgot to think about our futures past our own graduation, OR, if we did we thought we would be different.

I have new vet school grads seeking employment with over $400,000 of school debt. I know they will never, (yes, never), pay them back. I also know I can't pay them enough to get out from under that rock. At some point their bad debt decision IS going to affect their professional decisions, my ability to provide a satisfactory workplace and something will give. Will it be theft? Or, adding diagnostics that aren't truly indicated? Or, self-medicating to avoid self-doubt/loathing/futility? The potential scenarios were all too bleak to warrant employment.

Dempsey
Too many vets want to blame the economic environment, plea for pity that they didn't know what they were getting into, didn't know how much they would make, AND THEN want to charge clients more to compensate for these, WHILE, arguing about how intelligent and skilled we are. It is an argument that sounds like it is based on a juvenile temper tantrum.

We are all consumers. Perhaps not all in the same market places, BUT, we vets balk about the cost of human healthcare, brag about how much more efficient and sensible we are, (where else can you get your exam, blood work, x-rays AND a diagnosis in the same building for less than a grand?), and then try to berate our customers for not understanding the value in our services. Why? Why do we show contempt for the exact things we disparage the MD's for?

Charlie

If my clients cannot afford, (yes, I do believe them because we have already shelved the pointing fingers and placing blame argument as fruitless, haven't we?), then we find affordable options. It is exactly what my mentor did all those decades ago. It is the cornerstone of the mercy AND accessibility we pride ourselves in being so much better at than our counterpart MD's. "Best medicine" is great IF your clients can afford it, and it is a death wish to your patients who cannot. Get off your soapbox pedestal and work with people to save your patients. How many of us don't offer options because there is not an incentive that is economically feasible for us to do so? And then why do we denigrate the vaccine/spay/neuter clinics? (Starting to look like a vicious avalanche on a merry-go-round yet?).

Lilly gets her ultrasound

Let's go back to the Bad Economic's article..  Let's discuss the only example cited; "The best example of this is the dilemma of overnight care in general practice". It isn't that over night care options have changed. What has changed is our perception of what makes us the most money, what our clients can manage, or want to do (many of mine do not want to go to the ER based on previous experiences there (shelter head from angry ER vets,, sorry,, truth)), what is considered "best medicine", and it is STILL (just like it was for the old timers) cost prohibitive to provide 24/7 care at my clinic. Nothing here has changed.

Except,, I follow the precedent set by the vet I learned from. I do not live in the vet clinic (the ultimate all access vet).. but I do provide help after hours to the best of my ability.

Pinkie
Here's my favorite example, I do orthopedic surgeries for the clients who cannot afford it elsewhere. I literally say this; "I only do the surgeries that you cannot afford to do where they should be done; at the referral center." My knee surgery is about $1500, referral is about $3500. They are the oranges, I am the apple. Go to the specialist, if at all possible. Your pet will stay and be provided with excellent 24/7 oversight for 3 days. Mine go home post-op 6 hours later for you to stay up all night next to them to monitor. We rarely keep pets overnight. Why? well, because there isn't any staff member who stays overnight and I don't want your pet here without supervision. I send my patients home with my email, phone number, and directions to the ER. How many post-op patients have gone to the ER overnight, NONE (knocking furiously on wood). That's best medicine based on the client economics... it is what we do with every patient in every situation.

My pup Jekyll


Where is the responsible ownership of acquiring bad debt?

My personal debt is not my clients problem. Nor is it my business to judge or scrutinize where they allocate their resources. My problem is their pets needs and figuring out a mutually agreeable compromise to getting to "better."

It is time to be fair, honest and transparent.. the finger pointing, self-pity and arguing for a landscape economic environment which has not changed save for our naive oversight and self-imposed debt.

Reference article; The Bad Economics Of Veterinary Medicine. by Sarah Boston, DVM, DVSC, Dipl ACVS.

My related blogs;

Ethical Fatigue. The Crossroads Of Vet Med and the Public Conscious Awakening.

Euthanasia. Why Do We Make It So Convenient?

Affordable Options Are Everyone's Right

The Jarrettsville Veterinary Center Policy For Clients With Financial Constraints

Rescue Economics, When The Expense Costs You Your Ability To Care.

We Don't See You. How Vet's Became Biased and Lost Our Clients in the Process.

Compassion Fatigue.

Rocky,, eye on the prize

As always JVC, and I, are here to help you and your pet. If you would like to meet the amazing staff and hear more about the ways that we can help you and your pet live longer happier and healthier lives we would be happy to show you how the face of veterinary medicine and the care we provide can ext end past the traditional options of hope and luck. Please also follow our amazing Facebook page JarrettsvilleVet. Or find our 2017 Jarrettsville Vet Price List here.

If you would like to learn more about pet care or ask a free pet related question please visit Pawbly.com. It is free to use and open to all of those who love pets.

If you want to help others and you have experience with pet care please join us on Pawbly.com. Pet care is about helping others and we are built on this alone. I also have educational videos on YouTube, or @FreePetAdvice.

And of course we hope that you will Please always Be Kind.