Sunday, January 29, 2012

The Pet Expo 2012

I just got home from the 3 long day Pet Expo in Timonium MD.

I have to admit that it was much more fun than I had imagines it to be on Thursday night as I was setting up. But I will admit that it was a ton of work. Thankfully I had many of my staff there to help. In all I had 3 Vets come to help on Sat, 6 technicians, and I saw many of our clients. It was a very busy three days and there were crowds of people from open to close on all three days.

I also want to express my sincere amazement at how many rescue groups were present. I saw rabbit rescue, cat rescues, many breed specific dog rescue groups (I was situated next to the Brittany groups who had the cuddliest dogs of them all), but I have to mention the dachshund, german shepherd, westie, shiloh, bird, animal rescue, and 2 groups that just take anyone who they think they can re-home. There are so many people who dedicate their lives to helping pets in need. I was humbled and awe struck by the compassion and dedication I saw. We are so lucky to have so many people who are willing to sacrifice so much personal time and expense to help an animal.

At our booth we offered microchips for $25.00 each. We seemed to be placing microchips all day today. I am so encouraged to see how many owners took advantage of us microchipping today and provided their pets with the best form of permanent identification we have to offer.

I also got to meet many owners who had great questions and were seeking additional advice to keep their pets in optimal health.

I really want to Thank my sister Diedra for taking two days put of her incredibly busy life to help us out. Her husband John for taking over the kid care for the 2 days she spent here. My dear friend Linda who spent all day with us and is the "best salesperson" EVER! My friends kate and Cindy and Haley who busted their butts today, and helped with the dreaded clean-up. My inspiring staff of Melissa, Rose, Amanda, Laura, and Dr.'s Hubbard, Breen, and Morgan. I really really appreciate your help.

I am so grateful to be so blessed by such good friends and family!

Thursday, January 26, 2012

Signs Of A Bad Economy?

I hope that I can someday look back and talk about this time in my professional life the same way that my mentors talked about what being a vet was like 25 years ago.

I worked with one vet who would always talk about flea & ticks with the same opening lines. He would say, "25 years ago we only had powders and toxic smelly dips to use to treat flea infestations. Now we have these convenient monthly topicals. Boy veterinary medicine has changed! We may pay a little extra, but gone are the days of pets having to die of flea infestation because we didn't have anything effective to treat them with." He sold a whole lot of flea and tick preventatives when he recalled the "old days" with his clients.

I hope that someday I will be looking back, and talking about this terrible economy from an "I learned about blank because I lived through that time."

Here's how I am seeing the effects of a terrible economy.

People are dumping their problem pets at the shelters like I have never seen before. Any sign of a problem and they bail. It is disheartening to put it mildly. Somehow humanity has been lost because we are worried about our bank accounts. Now, I know this is a gross generalization, and I know that many people are truly struggling, but the people I see dumping their pets still have cable, iphones, and manicures. I just don't get it. I would sacrifice almost everything, (I mean this) to keep my pets. My pets are my salvation. My sanity, and my life companions. Maybe I just see the world differently? I don't know, I just don't understand it.

I am also seeing the number of positive heartworm cases escalating like I have never seen before. Fewer people are buying the preventative and giving it monthly, and more dogs are testing positive because of this. Subsequently more dogs are carrying the disease, more dogs are spreading the disease.

We are lucky that Northern Maryland is not a prevalent heartworm disease area. I used to see maybe 1 case a year, and these were usually rescue dogs that had come from down south, (heartworm disease is carried by mosquito's and it is much more common down south because of this), but in the last few months we have seen 4 cases.

Heartworm disease is spread by mosquito's infecting your dog (and cat) with microfilaria for a heartworm positive animal. The microfilaria are killed by heartworm preventatives that are available in chewable treat form, topical liquid form and even a 6 month injectable is available. In many cases the preventative costs a few dollars a month for each pet. It is safe, incredibly effective and as I say everyday, "one of the most important parts of pet care. because you get a lot of bang for your buck with heartworm preventatives. many of the available preventatives on the market today not only prevent this potentially life-threatening disease but they also treat and protect your pet against some of the most common intestinal worms your pet is susceptible to. For a few dollars a month you prevent disease, treat your pet or worms, and help insure that you and your children don't get one of these worms yourself." It is an easy sell no-brainer for me.

To make matters worse the treatment for this disease has become almost impossible, (I am using "almost" although it is more honest if I just omit it), to get the treatment for this disease. So what are we to do? More pets are getting the disease, and now we can't treat it. It is a preventative disease that is now becoming more and more common place. And dogs are being dumped at the shelters because a preventable disease is now harder (and very expensive) to treat.

Am I going to look back on this time in history and say, "I lived, and practiced through a time in history where a completely preventable life-threatening disease that I rarely ever saw became an epidemic because people chose to not use the preventative and then couldn't treat their dog when they became positive with heartworms?"

Gosh, I really hope not.

Wednesday, January 25, 2012

The Finish Line

I think that I have shared with you all already that one of the things I love most about this job is learning why people name their pets what they name them. I get some funny names and some even funnier explanations. (For those of you new vets out there, this is a great "ice-breaker" for a new client, or a new pet, and it's also a great way to help you remember a client and your patient).

One day I received a call from a very good vet friend of mine who doesn't particularly enjoy surgery. Her clinic is very close to my home and we have been very good friends for as long as I have lived in my home. She has a beautiful clinic on her in-laws farm and it is the quintessential picture perfect rural small animal practice. But not all vets love surgery, so for those that work in a 1 doctor practice they have to "farm" out some of the things that they cannot do in-house. For her it is the big surgeries. She called me and said that there was a very nice family who had an older lab mix dog who had a bone cancer and that the dog needed her right hind leg amputated.

Dogs with advanced bone cancers most often are recommended to have their affected leg amputated to prevent the cancer from spreading and also to stop the chronic terrible pain associated with a bone tumor. Bone tumors are aggressive bone eating cancers that will spread to other organs and other places in the body if not excised completely. I have seen many bone tumors over the years and seen many owners try many different kinds of treatments for them. Veterinary oncologists and surgeons have tried many kinds of operations, radiation, and chemotherapy's to try to treat this devastating kind of tumor. I will say that for the bone tumors I have seen I still stand by the choice of amputating that chronically uncontrollably painful leg and the care of a vet oncologist. The difference in a pet when you take off that broken bone that never heals, is like light and day. I actually have discussions with owners and say to them "I am happy to give you the numbers of some of my clients who have done this surgery and actually said "Thank-you," after we amputate the leg. These dogs are soo much happier because they are finally pain free." I fully understand how hard it is to decide to amputate a leg, but in all cases these dogs aren't using the leg anymore. They are just dragging around a broken crumbled bone that hurts them every second of everyday.

When I met the owners that my friend was referring to me I knew I did not have to convince them that doing this surgery was the right thing to do. When I met this dog I had to ask if her name was correct as it was written on her chart. "Finish Line? Is that correct?" "Yes," was returned with a smile and a bob of blonde Shirley Temple curls. Finish Line's mom is a cheerful, always smiling kind, thoughtful, gentle woman. She never speaks without a smile and direct eye contact. She has the aura of pure sunshine. I liked her from the starting line. She explained to me that her husband is a race car driver, (we live in the middle of nowhere between Baltimore MD and Philadelphia PA, so I can't imagine where he is a race car driver at, but I am sure it is a drive to get there. Someday I will ask). She has two dogs, Finish Line and Checkered Flag. (Maybe I will move from naming my dogs after southern cities, what I currently do, to veterinary instruments? "Here hemostat," "Heel thumb forceps," "Sic needle driver," Umm? I guess I'll stick to southern cities.

It was grossly apparent that Finish needed her right leg to go away. She would barely walk at all, because even placing her toe on the ground sent shooting pains up her leg. So she would just lay still and growl or threaten to bite if you even thought of approaching her to touch her. We checked her blood work, (all normal), took x-rays of her body, (we check the lungs to make sure we don't see any evidence of metastatic lesions) and decided that everything looked very normal except for that wretched leg.

Finish Line was scheduled for surgery on the next day and successfully had her right rear leg amputated. Within 2 days she was up, walking, and feeling like the dog she hadn't been in months. Her mom and dad were thrilled by how happy she was, and how good she felt. At 13 she was playing, jumping, running, taking the stairs to spend the night in the kids room, and in general doing things that they had not seen her do in a long time.

Two weeks later I got a phone call that haunts me to this day. I was at the front desk when the phone rang and I saw the receptionist answer and then heard nothing but blood curdling screams. I immediatley took the phone from the receptionist and tried to understand what was happening on the other end of the line. It took me a few times to understand who I was talking to, and what they were talking about. I clearly remember hearing "SHE'S BLEEDING OUT!"

"What? How can that be, it's been 2 weeks?" I said to her.

She replied, "I heard a yelp from her in the kitchen, and I ran in, and there was blood squirting out of her leg. It's everywhere! So I just took a towel and put pressure on the incison where her leg was."

"Ummmm, OK,,,,Umm, well,,,keep pressure on it." I sounded like a fool as my brain tried to digest, comprehend and process what she was telling me. And my heart was breaking hearing her sound so desperate and so scared. She said to me, "I called **** (the vet who had referred her to me, and lived much closer to her than my practice was) and they told me if I brought her there they could only euthanize her." I knew that that clinic was equipped to do an exploratory on poor Finish Line.

I said "can you get her here?"

"It's only me here, with the kids, and if I take my hand off of her leg it starts gushing blood again."

Damn It! I thought, "I will send someone to get you."

"No, I can drive 1 handed I will get there faster if I go." She hung up and I waited the longest 15 minutes ever. I was certain that Finish would arrive at our clinic dead. And I grappled with the thought of "How can this have happened? Because I couldn't imagine how this could have happened.

I am so careful with my surgeries. I dissect out everything. I put ligatures on every vessel, and the big ones I put at least four ligatures on. I thought that she must have fallen or bumped something and punctured an artery? Or avulsed (pulled the blood vessel away from its attachment) the artery. Any scenario I could come up with were all very very bad based on her owners description of how much blood was coming out of Finish.

Finish's mom arrived covered in blood and clutching a black mass of frantic fur. Sometimes (actually quite often) owners significantly exxagerate how much blood they are seeing. But in this case she was right on. It was an incredible volume of blood. And she was right by saying that if you took your hand off of the gusher it would pump out blood like a geyser. I took one look at her, and one look at Finish, and took her hand off of the place where her right rear leg used to be and I knew I was going into surgery NOW! The clients in the waiting room also took one look at her and her dog and they all volunteered to come back another day. Within minutes Finish was on the OR table and I was dissecting out a huge hematoma to try to find the tiny coffee stirrer sized straw that was the remnent of her femoral artery. Only this little monster could produce this much blood at this fast of a pace. I was determined to find it before it pumped its last remaining drop of her blood.

What an incredible mess that almost completely healed leg was. Within 5 minutes I had found a tiny nubbin' of the femoral artery and I was lassoing to save her life. Where my first surgery was pretty and precise, this one was sloppy, immediate and vengeful. I didn't care about how it was going to look when I was done (which is how I approach every other surgery, I think about how I am going to finish before I start), I just tied and tied and tied again. I didn't have much rope to strangulate but I was going to put as much suture as I could around that artery to get it to stop spewing, and I was serious about how angry I was at it.

It was the quickest life-saving surgery I have ever done. I got in, got my revenge, and got out.

Finish walked out of our hospital from her second leg surgery the next day. I spent the next three weeks as worried as her parents were. But she did great. I don't know what slipped, or how it could have slipped, but I am sure that it was her femoral artery and I am also sure she is one lucky pup.

It has been 23 months since that day. I saw Finish last night. She has a recurrence of the melanoma tumor that we surgically removed 2-1/2 months ago. She is now 15.5 years old. She is every bit the happy, playful, companion to her family that she has always been.

But we know her time is near, and this tumor is too aggressive and invasive to treat. Her parents are trying a new melanoma vaccine, because it is all we have left to offer.

We will all hold out for one last miracle, if anyone can catch one it is Finish Line.

"Fini," as her mom called her, was euthanized tonight. She had some moments of running and playing with the kids, but yesterday and today was unable to stand and refused to eat or drink. When she arrived at JVC it was evident to us all that it was her time. She was unable to move and her eyes were all any of us needed to know that her struggle was too  much to bear for anyone anymore. Her mom cried and told me that Fini had been with her for 16 years, long before her children were born. And that she had never had to have a pet put down before. Fini passed gently, quietly, and peacefully. We send her family our deepest sympathies, and hope that they always remember how much she loved all of them.

Monday, January 23, 2012

We ALL Need Options!

There are many times I see a client and their pet when I curse myself for not being able to clone myself.

How do I keep myself available to all of my clients and their pets and still try to have a life with my own pets and my own family?

I grew up in a small town with a vet who lived over his practice, (Dr. Barsanti) and was available 24/7 to his clients. Now in my own defense I will say that he didn't have the luxury of an emergency clinic for his clients and patients to go to after hours, and he didn't have as many clients as I am serving. But the point is, his clients knew he was there for them at anytime they needed him and he was able to save many pets because people called him for help as soon as they needed it. They didn't wait until Monday when their dog has been vomiting profusely since Saturday afternoon, and they didn't go to the emergency clinic to be given an estimate they couldn't afford and therefore "elected euthanasia" because they had no other options. He was an Vet, a shoulder to lean on, a friend, and always available. His clients loved him, trusted him, stayed very faithful to him, and he built a respected and cherished practice because of these.

I know that there are many vets out there who need to be able to "turn off the clinic" and focus on their family, and I have not worked for a clinic that puts you "on call" so that you never get a full nights sleep. I understand and empathize with trying to wear every hat at every minute, it is an impossible task.

But I feel incredibly guilty leaving my clients to fend for themselves and be at the mercy of a new place, a new face, and a new set of hospital policies when my door isn't open. I am lucky to have two emergency clinics available to my clients within a 20 minute drive. The problem lies in the inherent nature of an emergency clinic. In most cases the emergency clinics are going to be more expensive than your local vet, and they have to provide you with a wide ranged estimate to cover all of the possible diagnosis. This wide range estimate means that you, the client, need to be able to provide a deposit for the mid to high range of their estimate.

I have many clients go to the emergency clinic and either leave without their pet because they could not afford to treat them, or left because they could not afford the deposit. Either way those patients don't get the care they need.

I use the saying "you do the best you can in life, and that's the best you can do." But medicine needs to be about treatment options..OPTIONS, you all always have options. Here is a story of a dog who needed lots of options.

On Wednesday morning while I was back in surgery sweating nervously over Wrens eyelid surgery a very very sick young Rottie walked in. I will call her DiDi. She had a sweet gentle face and was unable to move more than just picking up her head to look around. She was what we call "flat out." You could see the misery in her young beautiful face. She remained on the surgery floor while the vet and techs on her case gathered her medical information.

She had been found by the people who brought her in 4 months ago. She had not been to the vet since they found her, and they had no history on her. This is a very tough place for the vet to try to build a case when we have a very ill patient. We have no idea of vaccine status, age, history, etc etc. It makes your possible list of diagnosis long and difficult to dissect through.

As Dr. E came back to the surgery area I asked "what the deal with DiDi was?" She filled me in on the scant history and said that the people, (I will call them her owners, because at this point they are), said that "they had brought her in because they noticed blood on her backside." Sure enough she had a butt covered in dried blood. We spent a few minutes making sure that the blood was indeed coming from the rectum and not the urinary or reproductive organs. (Very important to know where the source of your bleeding is!) A digital rectal exam revealed a gloved finger covered in frank blood. She was definitely bleeding from her butt. But why?

Our first bit of detective work told us that we had a very sick young female dog in front of us. She appeared to have lost a significant amount of blood. She was depressed, dehydrated, and had more unanswered unattainable questions than we were going to find answers. So we started collecting any information that we could. Her blood work looked terrible, (honestly it usually does if you are dehydrated and you look terrible). She had a very high PCV (packed cell volume) and TP (total protein), so, OK even her blood knew that she was dehydrated. She had elevated kidney values, (dehydrated), and her temperature was low.

We took x-rays and found no additional clues to help here. By the time we had covered our basic diagnostics it was closing time. Our presumptive diagnosis was HGE (hemorrhagic gastroenteritis) so the i.v fluids that we had started a few hours ago were hopefully going to start to treat both the dehydration and assist her body in its own healing process. Because she was still so ill, needed to stay on i.v. fluids and needed 24 care we sent her to the local emergency clinic for overnight care. Her owners came to JVC to pick her up at 7 pm and headed with her to the ER. When they arrived there the attending vet gave her an exam and repeated the x-ray. She then reported to the owners that she believed there was blood in the abdomen and told the owners they needed to put down a $1500 deposit for her overnight care JIC she needed surgery. The owners called us back immediately and said that they couldn't afford to keep her at the ER overnight. So back to JVC she came. Certainly not ideal because we are not 24 hour and she couldn't be monitored overnight. But she needed her i.v. fluids and she needed a break.

The next morning DiDi looked worse. We knew she needed immediate intervention and she couldn't wait any longer. With a sad phone call to her owners we told them that her only two options were to euthanize her or go in to her belly and take a look. 20 minutes later she was on our OR table and we saw for ourselves what had her feeling so terrible. Her intestines were black from her stomach to her anus. She had been dying from the inside for at least 3 or 4 days.

She was put to sleep on our operating table and her owners were called with the terrible news.

She is a sad story with an unhappy ending but I am glad that we could give her owners some answers even if I still don't know exactly what happened to her or why.

She could have found a poison somewhere. She could have torsed (twisted) her stomach and the rest of the intestines that follow it, or she could have had some disease that just ravaged her entire gi tract.

I think of how many owners bring their pets in to us in search of treatment and options and how many of them never get either. It is heart-breaking to think that we can't at least offer some small answers and some hand of compassion without an estimate and a deposit.

Sunday, January 15, 2012


There are many challenges that a veterinarian faces. It is a job that most of us come to because we feel compelled to do it. It is our calling. For some of us it is because we have a strong sense of caring for something that has no voice to ask for help. In my opinion, this "mothering instinct" is one of the biggest reasons women are beginning to dominate this career choice. For others it is a way to help people, practice medicine, and be "out on the farm" with a truck, a dog, and a schedule that changes with every call, every case and everyday. Not many of us veterinarians could ever go back to or choose to embrace the 9 to 5 cubicle life.

Some of us come from families of veterinarians. Others grew up on a farm, where the arrival of the vet was the equivalent of Christmas morning. But most came into veterinary medicine simply because we love animals and want to spend our whole lives surrounded by them. I fall into this later category. I was lucky enough to have spent elementary, middle, and high school in rural N.H. My parents moved to Alton N.H. from Oyster Bay, Long Island, N.Y. just to be able to own some land, a horse, a dog, and a cat. (Although to be honest there was also a random sheep my mom spontaneously bought on a trip to the state fair). Ours was a small farm, but it was enough for three little kids who never needed, or had, any neighboring kids to play with.

When I started middle school I got a babysitting job watching the town veterinarians 6 month old little boy. They had just moved to our little town and the new vet needed his wife in the afternoons to help out answering the phone. Theirs was a three person veterinary clinic. The vet, (Dr. Barsanti), his wife, (aka the receptionist), and one vet tech. And then there was me, half babysitter, and half veterinarian-wanna-be at age 13. They quickly became my after school family. I loved their little boy, loved being in their home, and I especially loved to watch Dr. Barsanti practice.

I would rush out of the double glass school doors at 3 pm sharp! Run the one block north towards Main Street, where his practice, the white clapboard sided 2 story cape, was at the intersection of School and Main Streets. They all lived in the tiny 2 bedroom second story of the house because he had converted the main floor into his 1 and 1/2 exam room, reception area, and laboratory space. It was a very small house, that bulged with pulling double, triple, quadruple duty of; house, hospital, surgery, and boarding facility. Only two people could fit in the largest of the examination rooms, and that was only if that other person did not have a large dog. The surgery suite had an enormous floor to ceiling 6 foot wide picture window that was adjacent to the walkway that led into the clinics front door.

The most consistent source of chatter in that little town was who was at the barber shop, the post office or Dr. Barsanti's surgery table. His surgery window could be seen from Main St, School St, and the grocery store. For me, (and I know I wasn't alone), it was impossible NOT to rubber neck whenever you were at any of those three places if his surgery lights were on. For the critical cases, or especially gory surgeries, he would pull up the shade so that they blocked him from the shoulders down so that you could only see his surgical cap and the surgery lights tentacles escaping from the surgery rooms' ceiling. 

I, to this day, have no idea why they hired me. As I recall it, and I dare think that my father can't argue this, Dr. Barsanti, and my dad were not close friends. To put it nicely, out of respect for my father, I will say that I think that my dad was probably not one of his "favorite clients" I am not even sure we were "good clients." I know that on at least two separate occasions my dad called him in the middle of the night because our obsessive Border Collie had come home covered in porcupine quills. Our dog, Bonnie, had porcupine quills embedded in her face to the point that she could not close her mouth. Those quills were stuck in every square inch of her face, neck, front feet, and worst of all her tongue and mouth. She was the canine version of pin head. I know my dad was infuriated that she came back in that state (definitely more infuriated on the second assault), and I know my mom pleaded with him to call Dr. Barsanti. For reasons that still escape me Dr. Barsanti told my dad that he could bring her over to the hospital so she could stay there overnight, sedated, so his three kids didn't have to listen to her cry all night in the laundry room.

Bonnie also got pregnant twice. Two litters of 9 and 13 puppies. We never did figure out who Bonnie shacked up with. For my 15 years of living up there in the freezing cold Arctic tundra, where the snow only melts long enough to let the massive swarming mosquito and black fly population suck the last tiny remnants of vitamin D any living creature has left coursing through their vasoconstricted veins, it was a lonely life. Where she met a lover when I could never even meet a friend is a true testament to her OCD. She must have traveled miles, at least to the next county, where there was actually entertainment (a roller skating rink). I went back to visit after I graduated from vet school and like many of us have had to do at some point in our lives, I apologized for my parents. I think that my youth must have distorted my memory, or in typical veterinary fashion, (which I now understand, acknowledge, and own) he told me that he had no recollection of any of that. He just said that he remembered me growing up in their house, playing with their son, watching every patient, every surgery, and riding his coattails through every corner of their clinic. It is a valuable life lesson to learn to see and only remember the world through rose colored glasses and a half-full glass.

As I left for college, and my siblings followed, my parents started to fill their emptying nest with dogs. In particular Jack Russell dogs. 4 years of veterinary college and they never thought to ask me about their dog preferences, purchases, or pet care. Jack Russell's are best singly, unless you have horses and they have something else to focus on, than each other. My parents went from a terribly OCD breed to the worst OCD breed. Jacks, like paranah are best if they have their sights focused on a kill. If they don't have a target in their sights they can turn on each other. Many a client has walked into our clinic with one of their dogs sporting war wounds inflicted upon them by a sibling. To this day, my parents run their home like a penitentiary. The dogs are let out in shifts and only with certain other dogs, or a brawl will begin and everyone is put in lock down.

Many of my parents generation also still believe that spaying and neutering will change the personality of their dog. It is a fight I have conceded to stop losing sleep over. It is a small attempt to tolerate rose lens. It is a discussion I hear myself saying all to often. My speech goes like this; "If you got your dog to be your pet then spaying or neutering is the best way to keep your pet safe and healthy. An unneutered dog has a different agenda then staying at home where he is safe and sound. His hormones will encourage him to roam to find a mate. The huge majority of hit by car animals that I see are unneutered males. Ontop of roaming they will likely mark their territory by lifting their leg to urinate all over your property. This may include the inside of your home. Spaying will protect your dog from unwanted pregnancies, (which trust me do happen), and uterine infections, also known as, a pyometra. I tell my clients that if you don't spay your dog, and your dog lives long enough, there is a very high likelihood that I will be spaying her at some point in the future because of mammary tumors, unwanted litters, or worse of all a pyometra. I would estimate that 95% of the dogs we see at the clinic are spayed. Of those remaining 5% that live past age 10, 85% of them need an emergency spay surgery because they have developed a uterine infection. It is far more dangerous and expensive to spay them when they are sick and dying of a uterine infection. Also, in the US alone, we euthanize 2 plus million animals a year because there aren't enough homes for all of the dogs and cats in the US. SO help save a life, and  please, spay and neuter your pet, because you love them, at age 6 months old."

My parents never took my advice with this either.

One Sunday a few months ago my dad brought Cait, their 14 year old female Jack Russell, in to see me because she was not eating and was lethargic. An x-ray,  blood work panel, and ultrasound few minutes later and it was discovered that she had a severe uterine infection.

I vividly remember telling him that "If I didn't do her spay surgery right now, she would likely be dead by morning, and even if I did do the surgery right now, I couldn't guarantee she would live through it." 20 minutes later Cait was belly up on the surgery table.

Thankfully, her surgery went well. And she is a new dog now.

Surgically removing a dilated, pus-filled rotten uterus is a surgical procedure that most dogs should not have to go through. Most dogs present just like Cait did. Painful bellies, lethargic, not eating, and dying of internal infection. There is no reason not to spay your female pet. The old wives tale about "them getting fat, or changing their personality" is ridiculous. It is as silly as saying that "40 is old." (Remember being 10 and thinking that 40 was approaching the grave? 40 is the new 20. Isn't that what I am telling myself? Aren't you all telling yourself that too?) Your dog will get fat if you overfeed and under exercise. In fact, that's the same for all of us. And if a change in personality means that they choose to stay home with you, then your pet is probably living up to the expectations that you had for them in the beginning.

I will however note that I have had more than 1 male client react to the discussion of neutering their pet as a deeply painful personal insult. To them I remind them that "I am proposing to remove their dogs testicles and not their own."

This is NOT what your uterus should look like. This is a swollen dilated, full of pus, uterus. It is engorged with blood because the body is trying with all its might to fight the infection. It is also very fragile. We take great care in being very gentle so that the uterus doesn't rupture and spill its contents into the abdomen.
Cait recovering post-op

Thursday, January 12, 2012

Lost Little Lucy

I know that every veterinarian has those days where things go wrong to the point of actually watching to see if you are stepping on the cracks in the floor, pacing around the hospital and obsessively knocking on any wooden structure available, and trying to not pass the path of Kiki, or resident black cat.

Yesterday was one of those days. I will add that in light of some of our more recent events, namely one of our little boarders being attacked by one of our much bigger boarders (thankfully everyone is fine). Yesterday was more comical than tragic.

I was busy doing my little Wren's spay and corrective eye surgery and completely consumed in her, to the point that I lost all track of time and space. i know that I was in surgery with her for more than an hour, but I couldn't tell you if it was 20 minutes or four hours longer than that. I was so worried about her and trying to not worry about her, so I could stay focused on her surgery and not on the fact that it was "her" under my scalpel that I just got lost in the void. On top of that, my technician, who is my constant surgical technician and knows me to well to be able to bluff in front of her anymore called me out on it.

"I don't know how can you do surgery on your own pet?" A very valid question. I replied, "Well, I sort of feel stuck." "I actually thought about not doing it, because I have gotten soo attached to her, but I feel like I can't ask my associates to do it. I mean, how would they feel if anything happened and they killed the bosses cat?" I wouldn't want to be put in that position, so I can't put them in that position." "And she also needs her eyelids corrected and what if she comes out looking all lop-sided, crazy-eyed? I don't want to feel like maybe if I had done it they would have come out better." So, I was going to do it and that was that.

I did remind her that when Ambrose, my old pit bull, needed what we expected might be a very difficult and involved surgery I took him 2 hours away to a very good surgeon that I knew would do a great job, but also not see again because he is four other surgical specialists further away, JIC Ambroses surgery went terribly wrong. But i told her it did cross my mind to repeat this. Then i thought, "ok, my colleagues are going to think that I am completely nuts if I bring a boarded surgeon my cat to spay." I am not sure they even would remember how to spay a cat?" No, I was stuck with Wren again.

Wren's surgery went fine. It took me a long time, (I guess), but she did great under anesthesia, and I had no complications. She was not happy when she woke up, and I spent abut another hour carrying her around and apologizing to her cursing whines.

Wren. Waking up from surgery, and not happy.

At about early-afternoonish I came back into the surgery area and saw all of my techs huddled together and whispering. I could tell by their faces that this wasn't the routine gossip looks, this was the "OMG, what do we do know, and how do we try to keep this one from our boss?" look. "OK, what's wrong?" I asked. One of them pointed to a cat cage that still had its litter box, cat bed, and food in it, but had it's door open and no cat inside.

"Yeah? SO?"

She replied, "The new owners are here to pick Lucy up, but she's not in her cage." "We are trying to figure out if anyone has seen her today, or if she was picked up last night by the person who is giving her away."

That's where all of the whispering was coming from. Everyone trying to ask each other if she was in the cage last night? Was she sent back home last night with the woman who brought her from her farm? Was the fed this morning and then we forgot to close the cage door? Did anyone see her roaming around the clinic? What doors were open this morning when the first tech arrived? Could she have possibly slipped through one of our many exit doors? Was she hiding somewhere? What do we tell the new owners who are sitting out in the reception area? whisper, whisper, whisper...

"OK, let's get some facts." I said.
1. She couldn't have slipped out, because all of us know better than to open a door with a cat around, and one of us would have seen her if she tried to dart out.
2. the doors surrounding the surgical area, (because that's where she was last night), ( of course, she was in a cage 3 feet away from me the whole time I was doing Wren's surgery and I never even noticed an open, set-up, but empty cage, I was totally oblivious), were all closed last night. So she couldn't have escaped out of the surgery area.
3. The pm kennel person was SURE she was in her cage last night when we all left.
4. I am VERY SURE, that every possible cat hiding spot has already been identified and sealed shut. (there was a loose cat about four years ago that got behind the files, found a very small hole, and somehow Houdinied his way into the wall, then 4 feet from the hole in the wall and then got stuck. When I called my husband to tell him that we had finally found where the cat was (three days later) and told him that I needed him to come bust a hole in the wall so we could pull him out, he replied to me, "He'll come out when he is hungry, and I am not making another hole in the wall." "I reminded him that he was stuck, hungry, and that I wasn't really asking for permission." I told him that I was just asking him because "I thought that the hole might be easier to fix if he made it, but I was happy to do some renovations if needed." He cut the wall, got mauled by the now very scared cat while trying to extract him, and then we made sure every possible hole, regardless of size, was closed from that day forward. (P.S. the cat was fine, Joe was too), But, sorry, and thanks honey.  ;-)
5. We were going to go out and tell the new owners, who had by now been waiting about 20 minutes and realized something was up. the truth. "We hadn't really lost, but never the less couldn't find their new cat."

As I left the huddled the gang dispersed to comb the cluttered hospital. This isn't the first cat who has gotten out of our hands and we had some "favorite" first hiding spots to check. Behind the x-ray unit, under the dental sink, behind the oxygen tanks. I felt pretty sure Lucy wasn't going to find a spot we didn't already know about.

As the staff went to turn over every stone I headed to the reception area to meet the new owners.

There they sat, two women, with blankets, new food, and happy expectant smiles on their faces. "Oh, this is just perfect." I said to myself, we finally get a cat adopted, (albeit not one of ours, but still a big day for all of us!) "And I get to disappoint these new moms." "Crap!" I thought again. As I approached them you could hear all of the furniture being moved around upstairs, people calling, and walking, and staff members with flashlights came to search the waiting area. It wasn't too difficult to figure out what I was about to tell them.

Thankfully they are very good clients of ours, and we all laughed, and then even offered to help tear the place apart looking for her. (Gosh we are so lucky to have great clients).

I told the new owners that somehow she had gotten out of a cage that required apposable thumbs to open. When I said this they got worried about how to contain their new bundle of joy in their big cavernous labyrinth of a basement. We all decided that a small bathroom might be a better first stop to put her, (less places to hide).

after an hour of looking we decided she was in a better spot than her prior "at large escapees." I told the owners, who were now late in picking up their kids, that we would put out a humane trap with food and hope to catch her over night.

Two hours later we found her behind the surgical drapes sleeping.

We sent her to her new home and I will keep you posted on how she does.

Lucy is a sweet cat with some hidden talents, good luck.

Wren recovering at home, day of surgery. Lying on the warmest place in the house.

Wren sleeping on a heating pad, next to me, night of surgery. Still feeling a little crummy.

Sunday, January 8, 2012

Chewie's Case of Mistaken Identity

Not so happy to be at the vets office
My first visit with Chewie was rather uneventful. She was a newly adopted beagle pup from the local shelter. I remember that she was shy, scared, and very bashful. I also remember that her new parents were the exact opposite. They were outgoing, talkative, excited, and just a little nervous about their new responsibility. It seemed that all of their personal traits were exactly what this beagle needed. I thought it was a great match from the onset.

I am sure that we talked abbout all of my routine new puppy things.

The appointment for a new puppy with me is one of my longest examinations. We spend A LOT of time talking. It is a whole lot of information to talk about. I tell owners to bring a pad and a pen, and a list of questions. I want to make sure their new pup starts out on the right foot (paw), and I want the owners to leave this appointment with an armload of documents on proper pet care, goodies from our vendors with free stuff including heartworm prevention, flea & tick preventative, a brochure that tells them what we are doing at each visit and why, our clinic information, (JIC of any emergency), a picture of their new pup, microchip registration form (we microchip at the first visit, did you know dog-napping is up 43% because of the recession? microchip now! And we do it for free!), and lots and lots of advice.

I don't recall any odd discussions at Chewies first visit. It seemed to go well. I gave Chewie a kiss for being such a good dog and said goodbye. I also made sure Chewies owners made a return appointment in three weeks for their next set of puppy shots.

Chewie made it to the next appointment without any problems and things seemed to be going swimmingly. I checked Chewie's weight,(perfect, very important to monitor closely with beagles), we talked about the diet they had chosen, I checked to see potty training was going well, and we discussed the difficulty of trimming nails, (also esp. difficult with beagles). But I wondered through the entire exam why they kept calling Chewie a "him." So I finally asked? "Becuase Chewie is a boy!" they exclaimed, with a pause, a hint of criticism, and a dash of frustration. I picked her up and exposed her belly to the world. "No," I replied, "He is a She." Without pointing I flashed her belly toward them. "No, thats a penis!" (long puase and glances back and forth to each other, with some finger poiting at the area in question). Another pause, "Isn't it?" pause, this was getting a little embarrassing. "Umm," (much softer response, another uncomfortable long pause on my part. Think to myself "Try to be delicate, and don't embarass anyone!)" "No, that is definately a vagina." one more point at said anatomy.

Long pause again, more looking back and forth at each other....

Then full blown laughter! Around the room.

Now I totally understand that many normal people do not routinely look at genitalia. I understand that vet school trains us in all aspects of pet care and anatomy. We spend a whole half of a semester going over all of the species genitalia. Let me tell you, there are some interesting, (and very bizarre) genitalia out there. (For giggles look into a rams penis, freaky stuff, I tell you, then imagine being 20-something year old, in a dark formaldehyde smelling lab in the basement at 2:30 in the morning cramming for your anatomy exam and throwing that thing on your stainless steel lunch tray. Talk about contagious giggles...Ah, the crazy delirious days of vet school, fun to remember, but I assure you that I don't want to relive them).

From that moment on that day, we have become fast friends. And thankfully for Chewie no name change was necessary.

"I think I'll stay close to mom."

Saturday, January 7, 2012

Cora-Belle, The lucky Beagle

CoraBelle being carried, as always, with me.
There are those days in history that all of can recall exactly where we were and what we were doing when we got the news about a certain event. You know what I mean, the death of JFK, (although many of us these days are too young to use this anymore), the verdict for OJ, the tragedy of the twin towers, etc. For me, I remember exactly the date, time and place of meeting Cora. (Although I call her CoraBelle, because I found her, and I name all of my dogs after my favorite Southern cities; so, Corolla was her name with me.)
It was that way for me on May 8th 2011 when I was driving home from Washington D.C. I had just finished the five day long CVC Veterinary Conference. I had thought that 5 days at a “local” conference would be a great idea because I could immerse myself in all of the conferences activities and go to as many wet labs as my voracious heart wanted. In retrospect 5 days is 4 too many if I am going to stay there alone. I was bored to tears. I actually went to class from 7:30 am to 11 pm every day because there was nothing else to do. (Note to self; next time I stay a shorter time or find a partner in crime to go visit all of the local restaurants). Ok, once again I need to get back to my point. I was excited to be heading home after 5 long days and as I approached my driveway I saw a small timid looking beagle standing in the middle of the road right in front of my driveway. When I say standing I mean standing, frozen in fear standing.  I was happy it was “ME” behind the wheel because anyone else (almost) would have kept going expecting that she would move out of the way. I came to a dead stop and I assure you she did not budge. So I did what anyone else would do and I stopped my car dead in the middle of the road. Now thankfully I live on a very quiet road because I positioned my car to blocked the entire road so that no impatient passer-by’s could even think about sneaking around me, my car, and the frozen Beagle.
I got out of the car and slowly approached her, for fear that the frozen, would transform into fleeting, and gently said, “Hello little beagle.” She immediately lowered her head and gave a barely recognizable wag. I took a breath and said to myself, “Oh, thank god you aren’t running.” I whispered to her, “come here little beagle.” She lowered her head more and I approached her with my hand extended. She lowered her nose to the pavement and braced herself. “Oh dear,” I thought, “She is soo afraid that she thinks I am going to scold her.”
As soon as I was close enough I grabbed her collar and scooped her into my arms. I am very proficient in handling animals in all situations and I know that once you get a hold of an animal you better be prepared for a big change in their demeanor. Some pets react to restraint with a surge of fear and aggression (aka snarling, biting, and aggression) and some just give up. Either way I was not letting go of her. once you lose a grip on a pet you will not likely get them back. Because she was only about 20pounds I picked her up easily and kept her face away from my body so I could keep control of the fear weapon, the mouth. As I picked her up she went limp. She seemed to be the saddest case of absent self-esteem that I had ever met. She was the classic abuse victim. She had been afraid and neglected from any form of kindness for so long that she now expected to be abused so she didn’t fight. I think the saddest creatures are always the ones who have lost the ability to show any emotion short of “frozen fear.”
As soon as she was in my arms she relaxed and surrendered completely. She seemed relieved and almost expectant to be put in the car.
Putting an animal in a car is another dangerous scenario. Some pets have never been in a car, so for them it’s the equivalent of a space ship hijacking you. Would you go willingly? Would you be afraid of an intergalactic transport? Cora didn’t seem to be bothered by the car, the claustrophobia, the noise, or the vibration of the motors engine. But I have heard of owners putting their pets in the car and half way down the road the pet freaks out, jumps on their head, scratches their face, or dives under the brake pedal and then you can’t use your brakes. I ALWAYS tell my clients to NEVER transport anything without a protective carrier, for both you and your pet’s sake. If they are going to flip out let them do it safely in a cage. And don’t try to plea with your pet about staying calm in their carrier. Be prepared for a freak out session and put a towel, blanket, or sheet over the cage. Most pets feel safer with a closed, dark quiet place to hide. Whatever you do, don’t open the cage! A whole lot of worse things can happen to a freaking out pet lose in your car, then them just being stressed out. I also recommend that you line the carrier with newspaper, have some extra towels, newspaper and cleaning wipes available JIC you arrive at your destination and need to do a cleanup. This means that if you stop at a rest area in between you Point A and Point B and you need to open their cage do it inside your parked car, and don’t open any doors or windows until your pet is safely back in their now clean cage. Vomiting and diarrhea are very normal responses to most pets going in a car ride, so expect it and be prepared for it.
Cora made the short trip down the driveway sitting calmly and quietly in the passenger seat. As I parked the car she didn’t even lift an eyelash as to where we were. Her whole demeanor reflected nothing but absent minded Alzheimer’s. I opened the door to let her out on the leash and kept my dogs from scaring her with their overwhelming jumps of jubilation at the arrival of a new visitor. She looked right through them. She had no interest in them at all. Not fear, joy, or curiosity. I put her feet on the ground. She gave a few perfunctory whiffs and sat. she also refused to budge one step. That foreign thing around her neck was in no way tolerated and she had no idea what purpose it served. Many many attempts of leash walking, to avoid straying off, yielded fruitless tugs of war. If you have ever tried to convince an adult beagle of anything then you understand where the saying “old dogs and new tricks” comes from. That leash was not happening. The rest of her time with us meant that she needed a constant chaperone if outside. There was no directing her movements short of carrying her.  she was carried in and out every single time. Her new home list needed a fenced in yard for sure.
 She didn’t seem to have enough courage or will to be able to observe, contemplate, calculate, or form any sort of opinion at all. She didn’t even seem to have any semblance of innate survivor instincts. It was as if all of her natural god given ability to maintain any degree of self preservation had been lobotomized. She was like no creature I had ever witnessed. She threw me off guard at every turn. I kept trying to out think her, and thwart her at every intersection but I had no opponent at all.
I carried her to the house and once again put her down outside the front door. I opened the door and saw her first and only sigh of emotion. She was reluctant to cross the front door threshold. So I picked her up again and brought her inside. It was very apparent that “inside” was a completely foreign place to her. she was back to frozen in fear mode. She wouldn’t walk on the hardwood floors. So I picked her up again and put her on a dog bed and gave her, and my dogs, a few minutes to decide how they were all going to react to each other. Within a few minutes my dogs had given up on her being anything of interest, and she was walking around, nose to the ground, sizing up her new digs.

I called around to all of the rescues, neighbors, and veterinary clinics to try to find her original home. I knew it would be very unlikely that anyone would make much of an effort to find her. Beagles like her, (so prejudiced of  me to talk like that, but if you saw her you would agree) do not have “loving homes.” She came from a breeder, and she was just a number, a disposable $1.00 scratch off ticket.
My initial exam of her revealed an underweight, undermuscled, dirty, middle aged dog. She had a significant limp on her back right leg, terrible teeth that made her look older than she was, (I estimated 4, but she could be 2 to 6, estimates for dogs are difficult, think of them as ball park, then add or subtract 4 years from that ballpark). She was also covered in ticks.
The next day she came with the regular caravan to the clinic with me. No microchip, SHOCKER!, no signs or messages anywhere reporting her as “missing,” and 2 actual snickers when I called to report her as “found.” Yep, I was pretty sure on day 2 that she was staying with us for a while.

The first round of diagnostics revealed very strongly Lyme positive on the SNAP test, (a quick (8 minutes) in-house 3 drops of blood test that looks much like an in-home pregnancy test). Another big shocker there; a tick covered stray that’s Lyme positive! These dogs all have Lyme’s disease. When we get an in-house positive Lyme dog we recommend that a Lyme titer test be done to quantitate the degree of the Lyme disease. Our test only gives positive and negative, but some of these dogs have a very high titer and are at a significantly higher risk of clinical disease, so we run a titer to see how much of those little Lyme guys are swimming around. Cora’s titer came back very high, (I know, another shocker!) That meant 30 days of oral Doxycycline for Cora. The rest of her abnormalities would be corrected with time, a good food, and TLC.
As for her personality she was very slowly coming out of her shell. She started to figure out the routine. And I quickly learned that three beagles and feeding time is like a carcass in piranha infested waters. You had to be careful of infighting and protect your own limbs, and wear protective hearing devices. If my husband had any fears of me getting attached to Cora all I had to do was remind him how dangerous meal times were, and he rested easier.
Within a week Cora had discovered the joys of couch sleeping, decided that I was not like any person she had met before, and was adjusted to the routine at the household and clinic. After that first week with us I started to look for a permanent home for her. (After 30 days on the “found” lists at the shelters she is considered abandoned and allowed to be placed). I left her at the clinic for Friday and Saturday so she could be up front with the receptionists and give her some “client exposure” time. That Saturday one of our very long term second generation clients walked in with their beagle “goofy”. Goofy was a regular because he had multiple medical issues that required almost monthly visits. He was a big sweet boy who despite being a frequent flyer was still gentle. Every person at JVC could pick Goofey out of a 10,000 beagle line up. they saw her that Saturday and they called me right away to ask me all I knew about her. They loved her from the start but because of  Goofy they felt they may not be able to handle another beagle with long term medical problems. I assured them that I would help them with any problems that arose and that I would make sure she was treated for all of her pre-existing conditions. Which in essence meant she needed a full dental and to figure out that lame right leg. I asked them if they would like to foster her for the three weeks she had left to be “claimed” and then after that we would decide when she would be formally adopted. That would give all of us time to sort out her needs, and reassure them that she wouldn’t need long term, expensive care. 

Cora and her new mom, this time she's on a leash.

The dental was scheduled for a week later and a few extractions later her estimated age went from a possible 6, back to a more likely 4, years old. And the idea of her giving you a kiss, not that she would ever be so bold, was not so offensive anymore.
The limp I suspected was most likely due to the Lyme disease, and since we got her titer down to an “acceptable level” she has not been lame at all.
Within those few weeks Cora’s visits to the clinic became outings to show her off. She walked in on a leash like a Westminster pro, pranced around to say hello to everyone, and begged for treats in the jar she knew lived on the front desk. Her new family also told me that she refused to not be a part of the social gatherings at their house. They had closed her in a bedroom while company was over and she dug her way out, by way of removing the door frame) to join the party. She also decided she liked their sons bed best out of everyone else’s.

The foster period for Cora was officially over on June 8th. That morning her family woke up to find Goofey had passed in his sleep. None of us had any indication that he was in any way this ill. He had not given his family or us any reason to suspect he would not live another 4 plus years. All of his medical concerns were in no way life threatening, and his passing caught everyone off guard. To Cora’s new family they feel as if Goofey knew that Cora was theirs and he could leave them in safe hands. For Cora’s family they are grateful to have a beagle to share their life with who got to know their first beagle Goofey.
Life works in mysterious and sometimes magical ways.

Cora with Santa, 2011

Cora and her new family, at Pets With Santa, 2011