Diary of a Real-Life Veterinarian: January 2013

Wednesday, January 30, 2013

Pivotal Parvo

There is nothing more heart breaking in veterinary medicine than parvovirus.

Parvo is the reason I am in veterinary medicine. It is the disease that has tested my sense of purpose and conviction. I hate this disease, and I hate the path of death it leaves. I have made it my personal mission to never ever give up on a pup with parvo, and to try to educate the rest of the world about the death, destruction, and devastation this killer deals.

I was working as a second mate on a cable ship in Baltimore Maryland. It was the late 1990's. I was so crazy bored on the ship that I happily agreed to house sit for a friend for a few days. Her row home was completely rehabbed, and decked out. It was a girls pad and I was giddy to have a few days away from the ship full of men I lived with 24/7 for four months at a time.

I spent the early evenings and nights at her house lounging and basking in the quiet, and I got up to drive the few blocks away to the ship docked in her home port of Baltimore MD each morning. One spring morning I got up, headed out the door and was shocked to see a small round puppy marching down the sidewalk. I grabbed that little brindled 6 week old pit bull puppy before I could look around to see if anyone was attached to him. Not the smartest move for downtown Baltimore. I was so sure that his owner would come running around the corner screaming in despair, sick with worry, and professing their gratitude for my rescue.
I waited...
I waited..
I realized I was going to be late for work.
But still I waited...

After about 45 minutes I made an executive decision to hide him in the bathroom. I left food, (Yeah, it wasn't dog food, I was improvising) and water, and I went to work.
I rushed home at four o'clock. That little love missed me!

We went for a walk, and debated how to notify the public of our status. This was a rough neighborhood and lord only knew what was going to come knocking at my friends house if I posted signs all over the block. To be safe, for the both of us, of course. I decided to notify the shelter. "Small approximately 6 week old male brindle colored pit bull puppy found in Canton area of Baltimore." The staff at the shelter snickered at me as I left. But I had hopes of finding this puppies loving parents and needed to be a responsible good citizen.

On day three the diarrhea arrived. It started as a few small piles over a six hour period. Twelve hours later it was 4am and I was at the ER. A very nice veterinarian broke the news to me. My little pit bull puppy had parvo.

I was so upset that I had to have her remind me how bad this might be.

Twenty minutes later I left the ER without him. To this day it remains the single deepest regret of my life.

I had given up on him and I had not even tried to save him.

Those twenty minutes were spent trying to figure out how I could take care of a puppy when I was assigned to a ship on 12 hour call out. How I could care for him when I lived 300 miles away and didn't know when I would be home again? How I could pay for a $1000 to $2000 vet bill to save him? I had no way to take care of him.

I left the ER that day determined to never walk away from a pet that needed me, and never to be at the mercy of anyone or anything else. To this day I stand by my word.

I have saved a few puppies in the process and found myself in the cross hairs of a country and a state that define a pet as property and expect that I will put those pieces of property to their death if their owner requests it.

My first dog, Ambrose. I will always have a brindled pit bull.

Charleston. My second generation of brindled pit.

Sunday, January 20, 2013

Finding the Right Kitten

Adopting a kitten is quite an undertaking and absolutely one of the greatest joys imaginable. Nothing brings a smile to your heart and joy to your soul faster than a bouncing ball of fur popping up and rolling over. To be able to share the pure joy of that spirit is one of the most endearing qualities of pet ownership. That bubbly spirit and those inquisitive curious stares bind our hearts to their adorableness and are the foundation to the many years of love and companionship to come.

There is nothing more precious than the round face, those big soft eyes and the whiskers and fluff of a tiny body full of energy.

With all of the chaos that a kitten can bring into your life there will come the responsibility of a life that may live for another 20 years. Those twenty years will be full of love, affection, purring, companionship, but also potential illness, disease, behavioral conditions, moves to other homes, additional members of the family, and some twists and turns in the road of life. To be prepared for all of them at the time of adoption is inconceivable, but to have a plan and basic understanding of the path ahead is the best way to make a solid decision for everyone involved.

Most kittens are adopted. Many of these are from shelters, some from friends with unexpected litters, but a few are purchased from breeders.

There are many breeds of cats. They, like dogs, have breed specific personalities, characteristics and even diseases and medical afflictions. Also, like purebred dogs, there is an over representation of some diseases due to their purebred status. Most veterinarians agree that the ‘muttier’ mixed pets seem to live longer healthier lives and not need veterinary intervention as often. If you decide to purchase a pure bred cat ask the breeder very specific questions based on the research done online, with your veterinarian, and with the breeder.

There are many helpful hints to picking the perfect kitten for your home.

The best place to start is making sure that this addition to your home is what everyone in the household wants. Don’t get a pet as a gift for a child without adult parental approval, and don’t make this decision without a thorough understanding of the ups and downs and costs associated with this lifelong decision. Do you have a safe and appropriate environment for a new kitten? Is there room to run, play, eat and be safe from any other members of the household that might be scary to a new kitten?

Here is the challenging part of adopting a new kitten? With the kaleidoscope of colors playing in front of you how do you know which kitten is right for you?

It is best to decide first what pet will fit best into your life. (see our how to pick the right pet guide).

Once you have decided a kitten is the best fit for you and your family then the task of trying to decide which kitten to choose from arises? If you are adopting from a shelter or rescue ask the adoption center staff to help you. Ask about which kittens are best for you based on the personality qualities you are looking for. Also ask about the kittens and cats that they recommend? Maybe a kitten that is already spayed, neutered, and vetted is a better fit for you than a 6 week old rambunctious baby who still needs multiple vet visits ahead of them?

A good tip for deciding which kitten to choose from a group is to stand back and just observe them for a while, at least 10 to 20 minutes. Observe which kitten is the ring leader, which is the most vocal, the most outgoing, the shy one, the bubbly one, in essence which kitten will be the most like your household, or the most comfortable fit for your environment. We humans each have our own unique personality and the same goes for each feline. If you are looking for a lap cat then pick up each cat or kitten and see if they settle into your arms gently and calmly. If you are looking for calm and reserved then perhaps the kitten that is quietly playing in the corner is a better choice than the kittens climbing the walls?

As a veterinarian I think that for many of my clients debating adopting a kitten I also discuss the advantages of adopting two. They don’t have to be siblings, or even the same age, but having two kittens, or cats, or about the same age or activity level tends to be easier than one. I know this might sounds crazy, but think about how much time you have to spend with your cats. If you want a companion to lie on your lap for much of the day, well then you probably need a cat, an older cat. If you are adopting a kitten to have a fun-loving addition to your already busy life then maybe having a kitten to keep your kitten tired at night so you can sleep, and entertained so they don’t attack your feet with every step you take is a good idea? I see far fewer behavioral problems and frustrated families with two happily co-existing kittens keeping each other company than with the one kitten households. After all, we all need companions don’t we?

After practicing veterinary medicine for many years, and having many cats of my own, I have figured out which kitten works well in my home. I love the sweet cuddliness of a warm purring cat or kitten in my arms. So when it came time to bring a new cat into my home that’s what I looked for. The bright, happy, cat that turned into a puddle of purring when picked up. I also took great time in making sure that the original family members got along with the new family members. It is imperative that every member of the house feel safe, and happy.

If you find a timid reluctant kitten and fall in love, don’t dismay. Kittens, like all other living beings, have the ability to learn and adapt. But there will be a longer, more challenging road ahead. Time, patience, and determination are sometimes all that is needed to turn a shy kitten into a trusting loving member of a new family.

Ask many questions, seek lots of advice, and make a sound decision for a happy long lifetime together.

Friday, January 18, 2013

Tips Before Adopting a Pet

There are as many reasons for having a pet in our lives as there are types of pets to fill that place in our hearts. Some people are looking for a companion to spend their days with, some are looking for a companion to help protect and safeguard their family, others are looking for a pet that doesn’t take much room, effort, or expense.

Many of us have grown up with a family pet and don’t need any outside help to figure out who will be our next companion. For the new pet parents out there we thought it would be helpful to provide some pointers and guidelines to make the big leap into pet adoption successful.

The leap into pet parenthood should only be made after very careful consideration and deliberation with everyone who will be a part of this pets life.

Important points to consider before adopting any pet are;

· Do you have the time for a pet?

· Do you have a place suitable for this pet

· Do you have the resources?

· Do you have the ability to make a life-long commitment to them?

· Do you have the ability to train and accept that there will be challenges to adopting a pet?

· Have you done your homework to learn about the pet? Their lifespan, lifestyle, nutritional and health care needs, housing requirements, personality, and behaviors?

After careful scrutiny of these questions, they can be used to help you narrow down which potential pet will fit best into your home and heart.

Today we can pick from all sorts of pets.

Dogs, cats, horses, birds, fish, rabbits, guinea pigs, mice, rats, spiders, snakes, hermit crabs, goats, cows, pigs, turtles, and the more exotic choices.

Pets come in every size shape and personality. There is a perfect pet match out there for everyone. Miniature cows, horses, pigs and dogs from 1 pound to two hundred. But please, before you fall in love with a tea-cup piglet ask yourself if you can take care of them in three years? And if you care to have a litter box in your kitchen, or rooting in your dining room carpet?

Elton.

There are a multitude of places to find out information about the pet you are thinking about adopting. Ask questions of everyone involved in the decision making process. The more information that you gather the happier you will all be in the long run.

Lady. A sweet gentle happy girl.

As a final note I always recommend that following;

· Take tons of pictures. Mark every momentous occasion with a snapshot. Build your relationship around the positive aspects of the pet experience.

Be very patient. The mark of happiness is built on love, respect, and kindness. Let these always be your guide.

· Get help if you have a question or concern. Help can be found for every problem and every experience. Build a network of support to help your pet parenting experience be as fulfilling as it can be.

· Try to always make choices with the health and well-being of your pet placed first. There will likely be hard choices in your future but if you can make them based on what is best for your pet, and be true to that, you will be at peace with them.

· Every relationship in life is a reflection of what you put into it.

Stitch

All of the pets above are available for adoption through No Kill Harford, at petfinder.com. Please visit NoKillHarford.org for more information.

For more helpful advice please also visit;

http://www.aspca.org/adoption/adoption-tips/questions-to-ask-before-adopting.aspx

Thursday, January 17, 2013

Your Cat in the Winter

Cats and the Outdoors

We know that cats live longer healthier lives if they are inside your home. Cats that live indoors can live to about 20 years old. But cats that are outdoors live to be about 3-5. That’s a big difference!

Outdoor cats are exposed to weather extremes, hardships, and face many potential threats and dangers. They have to try to keep themselves fed, and thwart the ever present dangers of other predators, never mind the accidents and injuries.

Cats have incredibly acute senses to protect them, like vision, hearing, and their sense of smell but they are a domesticated species and are our collective responsibility. Providing food shelter and warmth is of paramount importance. Cats that are not able to stay indoors will appreciate and utilize a dog house, or other enclosed small structure, especially if that structure is kept in another larger shelter. The smaller shelter should be filled with blankets, straw and be weather and wind proof. If you have more than one outside cat have multiple shelters so that each cat can seek their own shelter. Keeping the small shelter off of the ground, or at varying levels so the older cats don’t have to jump, and the younger ones can get away from the older ones.

An outdoor cat should be monitored very closely. Cats that are outdoors are susceptible and will get fleas, intestinal worms, ear mites, wounds that turn into abscesses, and can suffer from diseases that are very difficult to identify because their clinical signs can be missed. If an outside cat is only observed for short periods of time the subtle changes in their demeanor can be easily missed.

The many potential dangers that an outside cat faces are so diverse and varied that they are impossible to list completely.

The common dangers that are seen at the veterinary hospital are as follows;

· Antifreeze. Some brands of antifreeze have a very sweet taste. Pets that ingest even a very small amount can die from it. There are commercially available antifreezes which are sold as more pet friendly, but all toxins of every kind should be kept in closed containers and locked away safely from pets. Also any vehicles or equipment should be inspected to insure that they are not leaking any fluids.

· Cars. Cats seek warmth and shelter in cars. Honking or banging on the hood will scare them away so that when the car is started they will not get caught in the motor.

· Frostbite. Just like people frostbite tends to affect the extremities first. Fingers, toes, ears are usually the first affected parts bitten. Frostbite usually looks like shiny, grey, pale or white skin.

· Cleanliness. If your cat is dirty or matted, itchy, smelly, or sparse. Please see your veterinarian as soon as possible.

If your cat is not eating normally, not acting normally, not looking normally, or in any way appearing as if they need attention please bring them to your veterinarian as soon as possible. It’s a rough world out there for a little feline alone. We are their advocates and they are our responsibility.

Sunday, January 13, 2013

The Heart of a First Grader

My Sunday exam schedule had a bit of a change of pace today.

My very good friend asked if I would give a tour to her daughter’s Girl Scout troop of the veterinary hospital. I said yes about two months ago. It was one of those requests you agree to, don’t really want to do, and figure that it is far enough in the future that everyone will forget about it.

I have to remind people that I don’t have children, and I went into veterinary medicine for the same reason most vets don’t go into human medicine, we like dogs and cats better than kids and people. I love kids, other peoples’ kids, but I am just a four legged lover person. I can’t help it, but I’m being honest. Those dogs and cats are easy for me to understand. I don’t get asked questions; I don’t have to try to figure out politically correct, anatomically appropriate answers. But, I love my friends, and I was a kid at one time, long, long ago, so it’s my turn to give back.

So off I headed to work an hour early to face my demons, (of course I am referring to my own internal insecurities, and there is no pun intended).

I got a call from my good friend on the way to work and somewhere in the conversation I said something like “I’d take ten maggots to pull from a dog in exchange for one kid.” He laughed, who would take maggots over children? I have more experience with maggots. I didn't see the lack of logic with this scenario? He reminded me I was a good vet and an inexperienced parent.

At arrival I was met by a dozen over excited first through third graders. Perhaps I should have reviewed Girl Scout age children before I volunteered? I thought for sure they would be older?

I introduced myself and was quickly given a beautifully colored dog picture by two of the Girl Scouts, Grace and Natalie.

I then took a quick poll of my audience. When I asked how many had pets? I was elated to see every hand go up.

“Ok,” I thought I can relate to these guys, and we were in business.

I had many good questions, some were very obvious and some gave me a good moment of self reflection on why I am who I am, and do what I do.

"How many years of school do you need to be a vet?”

“Well, in general most veterinarians go through four years of college and then four years of veterinary school. Me, well I never do things the easy way, I have eight years of college, and then four years at vet school. I was determined to go, it took me awhile.”

"Do we treat fish?”

Many of the girls had fish which made it a good question, except the question was being asked by an adult, who just as quickly as they asked it said, “Oh, they are disposable.”

“Umm, I’m not ever going to say a pet is disposable.”

OK, stick to the kids questions.

After about 20 minutes of me talking the bored girls decided petting a cat and dog was more fun. See we share a lot in common.

In first grade all you should want to do is pet a cat or a dog. Follow your heart, do what you love, and if you can spend every day of your working and personal life petting a kitten, puppy, dog, or cat, or even a fish, do it! I love my job, and damn right my favorite part is still sitting on the floor and smothering a pet with kisses.

In my heart I am still, and always will be, one of those first graders.

Saturday, January 12, 2013

The Battle of Cancer, Leroy's Tale

There are the stories of the pets and the people that you meet that nestle their way deep into your heart and capture your spirit. They define who you are they shape who you want to become and they remind you that the beauty of life is sharing the love that surrounds us all.

For me, and many of my clients, these stories are centered around our pets. Those creatures who stand beside us, lay by our feet, follow our wanderings, and gaze up at us with adoring eyes. For us our pets do not merely provide companionship, they are the truest form of devotion, respect, and love that we know.

To be a part of that relationship and to be able to assist in keeping those pets healthy, or comfortable, and sharing all aspects of that families joy, pain, and sorrow is a humbling, deeply meaningful duty.

There are few dogs and few people who will mark my heart with more memories and sense of devotion than Leroy.

Leroy was a Bassett Hound whose spirit was evident in every piece of his being. The long droopy apathetic ears, the sagging soft eyes, the sway-backed sorry Eeyored back, and the low slung cowboy tail, with just enough sway to notify you that “Yes, I am a very nice boy.”

Leroy’s tale spans many years at our clinic. There were many years of routine visits of varying importance where he was always a willing patient and a friendly face. Leroy could always be found at the feet of his parents, attached to them by a leash but seeking security at the safety of the tops of their shoes. He was ever faithful, ever calm, and ever present. Although he was a shy and timid boy when you knelt to see him and gave him a soft “Hello” he would always respond with a slow low wag. He, like so many other Bassett’s, always portrayed the peaceful charm of a man secure in his own down trodden excessive skin.

When his parents arrived to notify us that fateful day that his demeanor had dampened a bit, we quickly discovered that he had cancer. It was a painfully difficult realization for his parents but they persistently and faithfully brought him to every appointment with every specialist and followed every path with any promise of recovery and return to wellness. They were a steadfast two person army charging forward regardless of any roadblock set before them. Through every visit, every blood check, every i.v. fluid therapy, and every step and stumble along the way they remained determined to make Leroy better.

I have seen enough cancer to know a few things;

First, it is a crap shoot. There are statistics, and options and twists and turns in a mine field of uncertainty. The more people you invite into your disease discovery and treatment process the more opinions you get and the more confusing it is to know which way to go.

Second, your chance of success in beating the odds and surviving to see a remission is better if you go to a specialist. I know it is more expensive, and incredibly time consuming, but I have seen successes with their help in pets that far exceeded even my optimistic spirit.

Leroy was one such dog. His diagnosis of cancer led to weekly trips to the veterinary oncologist for months on end. The repeated i.v. infusions, chemotherapy drugs, anti-nausea medications, endless blood checks, and many days of rescheduled treatments were an ever constant fight to beat the disease that raged inside of him. Even when his body didn’t appear to be strong enough for another chemotherapy knock-down he would waddle into the front door, give a little wag, and settle on the floor by the door.

Through the ups and downs Leroy’s tale wagged, granted, it slowed and it lowered but his sweetness persisted.

There were many days that his blood count was too low to withstand another dose of chemo, or days when he wouldn't eat, or stubbornly protested the placement on yet another i.v. catheter. But there were periods of his smile and joy that let us all believe that the treatments were worth the efforts of everyone involved.

The treatments gave him months that he would have otherwise likely not had. And in the end his spirit was diminished by the anemia and exhaustion brought his parents to us for that final visit.

I have had my own long, sad, frustrating, and emotionally draining voyage down the road of cancer. I meet with clients facing the same road I had been down with a different perspective because of this. I remind them that every disease has its own path, its own enemies, and its own destiny. Be aggressive if you can, fight for every day you can give them, be hopeful, and in the end, for however long it may be from today, love them enough to let them go peacefully.

Third, remember they are not afraid. I think they understand what our human higher consciousness has lost, that we are all a part of a life with many shapes, and forms, and our spirit is always with those we leave behind.

I see and talk to Leroy’s family often via the pages of Facebook. They are and always will be a part of our family. They don’t have any pets now, but I know in time Leroy will lead them to another hound to make a place in their heart and home.

I got a call from an old dear friend just the other day. He called to tell me that his 3 1/2 year old Corgi was diagnosed with stage 5 b lymphoma. He was undergoing chemotherapy but having a very difficult time getting him to eat. I gave a few recommendations based on having my own dying pup who was refusing food more and more as his days grew shorter and shorter. He texted me back to say his appetite was improving slightly and that his chemo treatments seemed to be slowing the progression of the disease a bit. He is in my thoughts and prayers.

Thursday, January 3, 2013

Important Resources for Veterinarians

This list was put together to help veterinarians, but I think much of this is helpful to all of you pet lovers out there..

So just FYI,, To keep at your fingertips.

It's a New Year! And we are all trying to get organized!

Adverse Event Reporting

Submit reports of adverse events associated with animal foods or health products, as well as suspected failures of animal health products to the manufacturer and/or one of the following:

Drugs and devices

FDA Center for Veterinary Medicine
888-FDA-VETS (888-332-8387)

FDA Consumer Complaint Coordinator
(Find your Consumer Complaint Coordinator)

Topical insecticides

National Pesticide Information Center
(sponsored by EPA)
800-858-7378

Vaccines/biologics

USDA Center for Veterinary Biologics
800-752-6255

Animal Drugs

FDA Center for Veterinary Medicine
Report shortages of medically necessary veterinary drugs
240-276-9300 or askcvm@fda.hhs.gov

Food Animal Residue Avoidance Databank (FARAD)
Information on animal drugs and chemicals with the potential to cause foodborne residues. (sponsored by the USDA Cooperative State Research, Education and Extension Service).
888-USFARAD (888-873-2723)

Blood Bank Resources

Animal Blood Resources International
A 24-hour hotline focusing on transfusion medicine (particularly blood component therapy), recommended dosages and infusion rates for canines and felines. No cost to caller.
800-243-5759

Blue Ridge Veterinary Blood Bank
A 24-hour commercial blood bank that focuses on transfusion medicine.
800-949-EVBB (3822)

HEMOPET
A 24-hour national, full service, nonprofit blood bank and educational network for animals.
714-891-2022

Veterinarians Blood Bank
A commercial blood bank for canines and felines.
877-838-8553

American Association of Blood Banks
301-907-6977

Association of Veterinary Hematology & Transfusion Medicine (AVHTM)
Additional resources and links

Controlled Drugs

DEA, Office of Diversion Control; registration
800-882-9539

Disaster and emergency response

FEMA Disaster Assistance
800-621-FEMA (3362)

Disease outbreaks

USDA-APHIS Emergency Operations Center
Report suspected animal disease outbreaks.
301-436-3110

CDC Emergency Operations Center
24-hour hotline only for use by health care professionals or government officials in the event of a public health disaster.
770-488-7100

State Veterinarian
(Find your state veterinarian)

State Public Health Veterinarian
(Find your state public health veterinarian)

Food Safety

Food & Drug Administration
888-SAFEFOOD (888-723-3366)

USDA Food Safety & Inspection Service (FSIS)
202-720-9113

USDA Meat & Poultry Hotline
888-MPHotline (888-674-6854)

Insurance

AVMA Group Health & Life Insurance Trust (GHLIT)
800-621-6360

AVMA Professional Liability Insurance Trust (PLIT)
800-228-7548

Other

Impaired Veterinarians & Veterinary Technicians

Impaired Veterinarians Information Line
(sponsored by the AVMA) 800-248-2862 ext 6738

Pet Loss Support – Grief Counseling

Chicago VMA
630-325-1600

Colorado State University, Argus Institute
970-297-1242

Cornell University
607-253-3932

University of Illinois
217-244-CARE (2273) or 877-394-CARE (2273)

Michigan State University
517-432-2696

P&G Pet Care, Pet Loss Support Hotline
888-332-7738

University of Tennessee
865-755-8839

Tufts University
508-839-7966

Virginia-Maryland Regional College of Veterinary Medicine
540-231-8038

Washington State University
509-335-5704 or 866-266-8635

Poison Control

ASPCA National Animal Poison Control Center
Small fee per case and an additional discount for veterinarians enrolled in the Veterinary Life Line Partner Program. No charge for calls covered by ASPCA Animal Product Safety Service. 888-426-4435