Wednesday, July 18, 2012

So I Am Told...

I am told quite frequently that I talk more than most vets.

How do I give advice and help a pet and a family if there isn't talking involved?

Isn't it my job to give a voice to my patients?

Isn't that why people bring their pets to me? To help them understand what they need?

I take the "chattiness" quality as a compliment. It's not like I am going to change this late in the game, and I think asking me to talk less is asking me to care less.

My job is a mix of appointments, some are routine annual physical examinations with shots and others are emergencies, (or some degree of such), or I am in surgery,( these too run the gamut of routine spays and neuters to emergencies).

Tuesday nights are my usual weekly exam appointment times. It is one of the best parts of my job. Every room is another story, another pet, and another chance to meet a new case, a new challenge, and make a new or even re-meet an old friend. As I walked into what appeared to be a "normal annual exam" a few weeks ago I was met by a high spirited, frenetic black lab-ish dog, which appeared older than his demeanor was making him out to be.

I expect that over the age of 6 most dogs will have been through the veterinary examination process enough times to have learned one of two ways to manage getting through without incident. They either decide to just embrace and enjoy the change of scenery and make friends with everyone in the building, or they just sit and wait for the fate to befall them and then make for the exit door as soon as possible. I don't tend to see 8 year old middle sized dogs that dart back and forth like a newly caged captive wild animal. This exam was for Beau, a 60 pound male neutered Lab-ish boy. He was owned by a laid back placid couple who apologized for his lack of polite salutations and sputtered their disbelief that "he has never grown out of his fear of everything."

They went on to explain to me that Beau had just lost his lifelong Beagle companion who kept his fears grounded and chaperoned him every moment of his every day. Beau's only coping mechanism was his beagle brother, and since his passing Beau had unleashed his fears and anxieties onto every other being in the home. He was unmanageable to the point that his parents feared for his safety.

As they described his outbursts I was reminded of the ads for Clomicalm when it first was released to the veterinary industry. The ad featured a sad looking dog sitting dejected next to a room in shambles.

Beau's dad pulled his phone out to present me with Exhibit A and B in the Prosecution’s evidence file. Exhibit A and B were irrefutable evidence to a dog in a dark desperate place.

Exhibit A. Day 1 in the laundry room.

Exhibit B. Day 2 in the laundry room.

"Lordy! Beau! You are stressed out!" I said after closing my gaping disbelief mouth. Beau's destruction wave had led them to trying every method of containment, restraint, training, and counseling. They had failed at every intervention.

When I see a dog who destroys a home, or living area, or when I hear about a dog that is constantly whining, crying, barking, or mis-behaving I start to ask questions. I live by the adage "a barking dog is a dog who needs something." Trying to figure out what they are pleading for requires a bit of a detective work, but if you keep listening, keep asking yourself questions, and most of all if you can be patient, (and ask for help if you can't seem to make sense of their pleas) you can figure out the root of their problems and then fix them. In an act of frustration and have known people resort to yelling, scolding, or banishing their pet instead of trying to address the underlying causes.

Lucky for Beau his parents understood how the change in the household was affecting him. He was grieving the loss of both his best friend and his entire support system. He needed help immediately.

OK, here's where the great veterinary debate begins. Drugs or no drugs?

I will admit that I am not a big "drugs cure everything" practitioner. I think they have great benefit in many, many, cases, and I prescribe lots and lots of them, but Beau's problem stems from his loneliness, and not a chemical imbalance in his brain.

As Beau's owners talked about his outbursts they collectively agreed that although they weren't quite ready for a new dog, they recognized Beau's mental health, (and theirs too), were going to have to accept that a trip to the shelter was looming and inevitable.

(It is such an incredible relief to be a spectator in a pet behavior session where the answer is concluded without your having to coerce, beg, or plea for the life of a pet).

We then discussed Beau’s options for immediate peace of mind. The list included things like;

1. Thundershirt. I have many clients using them and testifying to its "miraculous" calming effect.

2. DAP, (Dog Appeasing Pheromone). This resembles a plug-in room scent, but it releases calming dog pheromones. I have had very mixed reviews on this product because it isn’t a drug I offer it as something to try. There are published studies to testify to its benefit, but my clients have mixed mediocre reviews.

3. Drugs. These include TCA's (Tricyclic Antidepressants) like clomipramine and SSRI's (Serotonin Reuptake Inhibitors) like fluoxetine (generic for Prozac). I heard a statistic not too long ago that 1 in 3 women over 40 are on one of these drugs. Goodness, we all need more dogs! The concern with these for me is that they take about 30 days to work, if they work, and then you are on them for life. So I don't want to start someone unless I think we have exhausted all other options. I also think that in general many of us aren't so great at remembering to give medications everyday. So don't start down a path you can't follow through on.

Just a few last points to mention; I think a huge number of the behavioral problems we see are plain old boredom. If you are not keeping your pet active and mentally stimulated (some breeds literally cannot function without a job, for example, have you ever met a bored Border collie? They go crazy). I also think that in general we underuse the SSRI's and TCA's medications. I have started to prescribe them to some of my patients over the last few years and had the most incredibly beneficial results. There are patients out there that benefit from anti-depressants, they should be offered, and we shouldn't be afraid to try them. Ask your vet about them if you think your pet's quality of life might benefit from a trial.

I finished Beau's exam (he is the perfect picture of physical health) and wished them all well in their pet finder endeavor.

More on Beau's story next time..


  1. I have to say that a chatty vet is better than a quite type. There are still many vets out there who just "do things" without saying a word. I would have a problem with that. There are even some who refuse to discuss things and share information even when asked. I have a serious problem with that. So chat away! :-)

  2. Good information, but something is wrong with the formatting and there are a number of repeat paragraphs. Just wanted you to know so you could fix it, you don't have to post my comment, hahameow.