Friday, May 31, 2013

My First Mistake

I was asked a question via my twitter friend OnTheFloor @Dove, who hosts a FABULOUS veterinary site to provide training to all veterinary professionals on almost every veterinary topic, the following question;

(Boy, how I remember that exam like it was just yesterday).

How long did it take you to make your first big mistake at your FIRST veterinary job? Comment and tell us what it was!

My first mistake when I was a new grad and it was on my first day practicing. Unfortunately the practice I started at left me alone day one minute one..(P.S. my first HUGE red flag that this wasn't the place for me). I remember being in the exam room and a very sweet middle aged Golden Retriever with an elderly woman came in. 

She said to me "Doc, I think Daisy's ears are bothering her. Can you take a look?" 

I carefully looked in both ears with the otoscope and said, "We'll Mrs. Jones they are......ummm...I think they might be infected. Could I bring her in the back for a closer look?"  

Thankfully she said "yes."

When I brought Daisy back I had to ask the techs to look at the ears for see the problem was that I knew they were bad, I just didn't have an internal reference range to assign them as far as being "not so bad" from "atrocious."

Thank goodness the techs knew.  Turns out to this day they were the worst ears I have ever seen.

You can learn about veterinary medicine in school but its an acquired skill, not a book skill.

I left that practice 7 weeks later.

On the Floor @Dove gives your entire veterinary team on-demand training that’s real, useful and never boring.

Wednesday, May 29, 2013

Veterinarians Are People First

A guest post from fellow Pawbly advisor, Dawg Business writer, founder, and dog lover Jana Rade. 

Veterinarians Are People First

I am working on a guest post about choosing a veterinarian. It made me reflect on all the veterinarians we've worked with—and it had been quite a few.

There are some important objective criteria to consider when choosing a veterinarian for your dog.

However, veterinarians are not machines—they are people. Each of them is a unique individual. Michelangelo, Einstein … it was not their education or their affiliations what made them who they were.

Every veterinarian is a person first, then a veterinarian.

What kind of person is your veterinarian?

Their education might be the same, the information out there is available equally to all of them—it is what they do with it what makes the difference.

Do you prefer an experienced old-timer or a young vet who won't have that much experience but is more likely to be up to date with all the new treatments and techniques?

Well, I can tell you that it is not as simple as that. 

Jasmine's present vet is an old-timer and he is on top of all the latest research and treatments. I haven't stumped him yet, and, believe me, I ask all kinds of questions.

Jasmine's earlier vet was a young one and couldn't care less. He was the type who believed that since he's made it through the vet school he now knows everything.

Jasmine's first vet was an experienced practitioner, working in a reputable clinic. 

He seemed to know his stuff. Yet he failed to recognize Jasmine's food allergies.

We started looking for a new one because we felt that our frequent vet visits were fruitless. More importantly, we felt that it became just business for him; there was no indication that he actually cared about his patients.

The vet we switched to came with great recommendation from our friends.

As we heard all the stories about how wonderful he was, we were very excited to get him as Jasmine's new vet.

He did seem to care about Jasmine and was very nice. And yet he became a source of great disappointment.

Our friends thought he was as amazing as they come.

At the beginning we did too. But he didn't listen to what we were telling him and his effort to keep things price-friendly for the clients led to cutting corners where they shouldn't have been cut.

Priorities are important.

What is your prospective vets' main priority? Is it an academic interest? Is it personal success and image? Is it their ego? Is it looking good in front of the clients? Is it just business? Or is it well-being of their patient? We've met them all.

It all comes down to attitude.

Intellect, education, those are all important things. Experience is great, but it can work both for or against your dog. Attitude, however, is what will make the difference when it really matters.

If your vet really cares about his patients, they will keep up with newest research and treatments. They will listen to what you're saying. They will take your dog's symptoms seriously. They will discuss things with you. They will consider what you came up with during your research. They will seek a second opinion when unsure.

They will have the drive to do everything that needs to be done to make your dog well.

We dealt with vets who lost the motivation to work their way to a diagnosis in a complicated case and were satisfied merely dealing with the symptom(s). We dealt with vets who made up their minds about things before hearing out what we observed in our dog. We dealt with vets who knew it all and nobody, particularly not dumb owners, could tell them anything. We dealt with vets to whom their professional pride meant more than their patient. We dealt with vets who'd jump out of their skin at the notion of looking for a second opinion.

At the end, attitude is what can make it or break it.

We love and cherish Jasmine's present vet. Do we agree on everything? No, we don't. Is he infallible? No, he isn't. But I know he will bend over backward for Jasmine's benefit.

Aptitude is important. But aptitude without attitude is useless.

When looking for a vet for you dog, consider all the objective criteria. But don't forget to look for attitude.

It's your dog's health!

If you would like to read Jana's other articles you can find them at the following links;

Dawg Business

dvm's daily

If you would like to ask Jana a question about dogs, dog health, or any other dog issue please visit Jana at pawbly

Monday, May 27, 2013

Hit By My Own Car

Being a veterinarian means you wear a lot of hats, everyday.

Most of us vets are what we call "general practitioners."  A quaint little way of saying "jack of all trades, master of none."

Truth be told, I enjoy having a broad spectrum of basic knowledge. But every vet has their own particular strengths, weaknesses and areas of interest. I am lucky to work with 5 other veterinarians who all have their own honed skills and resume of experiences. We often work together collectively and will tackle the cases that require multiple brains with our multiple own perspectives and this ultimately always benefits our patients.

At Jarrettsville Vet I am the surgeon. It suits me just fine. I enjoy the tedious challenge, the never-the-same-problem twice individuality of every case, and the cosmetic aspect. I like to take the puzzle pieces and put them back neatly, and prettily in order, not losing site of function, of course.

Sometimes the surgeries are what we term "routine." A spay, neuter, or a small skin mass removal, these are the daily bread and butter. The surgeries we don't think much about, get too excited about, or fret over.

The once in a while trauma cases, those are the toughies.

Trauma, when I talk about this in veterinary medicine I separate them into two categories;

1. Motor vehicle meets pet. 


2. Mammal meets mammal. Whether it be BDLD, (our acronym for big dog vs little dog), or wildlife meets pet, or human being is abusive to pet.

Let's discuss category number one today.

Twenty years ago HBC (hit by car) was a more frequent, more likely to be fatal event. 

In my opinion a few things have happened to change the once grim statistics.

  • More people spay and neuter, and therefore, fewer pets wander.
  • More people use home containment devices (invisible fence, etc) to keep their pet within their own property.
  • Almost every municipality have shelters and actively pick up roaming pets.
  • Many people will stop and try to help a wandering or injured pet.
  • Veterinarians who specialize in surgery and can correct almost every broken bone in the body.
But here's the trauma that I do see happening now more often these days.

Household-induced trauma.Specifically, I see more and more pets being injured by automobiles that belong to the pets own family. These are tough cases on many levels. The family feels guilty, they feel terrible about inflicting pain and suffering on their own pet, and they have to be clear headed enough to be able to make decisions about their pets care.

If there is one wish I could make with today's blog it would be to be diligent and careful and not to assume that your pet understands that a moving car, or lawn mower, or piece of farm equipment, or anything that moves, or has moving parts, is a threat. No matter how slow or how fast it moves your pet is curious and unable to comprehend circumstances, I don't care if they have "been hit before, and you think they have learned their lesson." They haven't and they will be hurt again, or worse yet, maimed or killed.

This is the story of Mac. He was seen lying on the driveway as his family started the car and began to back out. They heard him yelp! and they stopped the car to find they they had run over his tail and ankle.

Abrasion wound to the inside of the ankle.
Mac was brought in immediately after his family injured him. He was examined, x-rays were taken and he was started on pain medications and antibiotics. Luckily nothing was broken. He had a few abrasions, some with open wounds, a moderate amount of soft tissue damage, which included bruising and a few small areas of bleeding. All of his wounds were cleaned and dressed and he was scheduled for surgery the next morning.

The end of the tail is filleted open and there is damage to the fibers that surround the tail vertebrae.
There was some concern that we would have to amputate the end of Mac's tail. We would have had to do this if the end of the tail was necrotic (not viable or dead tissue). Thankfully, Mac's tail tip was still pink and he had feeling when you pinched it.

I have had many discussions over the years about how best to treat tail tip problems. There is a condition in dogs that we call "happy tail." This happens when a dog wags their tail so much, and in close enough proximity to a hard wall, that they break the blood vessels in the end of their tail. Or they hit it hard enough and often enough to cause the skin on the end of the tail to open. It can be a very frustrating ordeal to treat. Try asking a happy dog to stop wagging? Or try affixing anything that can, or will, stay on to the end of a wagging tail..not easy tasks.

Every vet has had to deal with this problem, and just about every one of us has had to amputate a tail or two because we either can't get that tail to heal, or the client loses the ability to try any longer.

The first vet Mac saw on the day of his trauma thought that maybe his tail would need to be amputated. She had forewarned his parents. It has been my experience to always try to keep from amputating a tail because I know how hard it is to manage them long term. If you ever think that this is the easier option please have a long talk with your vet before cutting..any happy dog with happy tail will keep wagging and keep busting open those sutures. Not only do you have to think about dehiscence of a suture, you also have to try to figure out a way to keep it bandaged..

When Mac came in the next day we removed his bandages to see how things were progressing.

The first big clue that Mac needed surgery was the smell that removing the ankle bandage produced. The bouquet of a simmering infection is a definable as the pus that it emits. Sometimes you only smell infection and Mac smelled of infection. Oddly I didn't see a wound that made sense with the putrid pungent aroma I smelled.

I knew right then that Mac would need surgery to find the source of the smell.

Mac's wound was very small..About half an inch long, and there wasn't any signs of bleeding, or the ever easy to identify pus. To an untrained eye (and nose) the ankle wound was small and unimpressive. But when Mac was placed under anesthesia we were able to make a very large pocket of fluid, about 6 inches long with the surgical scrub. The pocket was infection and it lay not beneath the skin where the small wound was obvious, but rather below the layer of muscle that appeared to be wound free.

Half of the drain has been placed. The drain must enter and exit at an area outside of the pocket of infection, but be in communication with it.The drains function is to keep the infection from remaining walled off under the muscle and allow a tunnel for both draining and flushing of an antibiotic solution.

Under general anesthesia as we prep his wounds for surgery.

The drain in above and below the infection.
His tail looked jagged and swollen but it was healthy tissue and I thought that a few simple sutures to keep the edges opposed were the first step. The next was just to keep it clean, protected, and watch and wait to see if it would heal on its own.

After surgery. 
Mac's tail stayed bandaged for a week. We checked it daily for the first four days, and then the owners changed it at home for the remainder of the week. The tail healed quickly and looks like brand new.

The ankle was flushed twice daily with a chlorhexidine solution. It is important to remind clients that we are flushing around the drain and not through it. The drain is a flexible latex material that keeps an opening around the infection. We want to keep the entry and exit hole open so that the wound can drain, and so that you can flush a cleaner around the drain and into the infections pocket.

A few last notes on drains;

  • Drains need to be removed within 7 to 10 days or the latex starts to break down.
  • Be very diligent in keeping your pet away from the drain, and never cut it on your own. Every once in a while the ends get cut, or chewed off and I have to go back into that wound that we have worked so hard to get to heal and fish out a piece of shrunken latex..frustrating and annoying, for everyone.

If you have any questions, or any story to share please share them.

For any pet question you can find me, and many other helpful people with many other skills, at Pawbly

If you are a pet person please visit us at pawbly and share your skills, thoughts, and help other pets and their people. We are a place for all things pet, always free. Or visit us on facebook, Many thanks for reading.


Sunday, May 26, 2013

A Client and A Blogger

Life has an odd way of presenting you with insurmountable obstacles and then testing you to see if you turn, run, detour, defer, or face them head on..I swear I think that life will keep handing you the same challenges until you figure out a way to face them, address them, and tackle them. It my self-made version of Ouroboros. I keep facing the challenge of not being able to give up on a task, I drive myself in circles, wanting, yet not quite expecting a different outcome, and still chasing my tail..Oddly, I can correct my dogs, and my cats grow bored of the game, and yet I still run the gerbil wheel, headstrong, determined, and optimistic.

I expect to be able to build a monumental platform to reach billions, (literally every single soul on the planet with access to a computer), because my experience in my little small town practice has me hearing whisperings of tiny voices about "not doing enough" not being there "for the meek and the voiceless" and this unshakable feeling of not being able to put my finger on the answer of why I am so compelled to help every last little critter. I seek to build Pawbly because I know there is a need, I know there are people seeking it now, and I know I can help them. Why, then do I chase my own tail, trying to bite off more than I can chew, (or is it biting it off at the expense of myself?), I do not know?

But I do know that I am not alone. I know that for as many folks that are out there with questions there are as many out there with answers..Simple equation, simple answer, just "build it an they will come."

And so we have, and so it starts, and so the beast grows fatter..

And then fate, chance, and luck come my way...

I was in an examination with a timid sheltie last week..I opened the door, entered the room, smiled and gave a "hello." As I waited for the answer a pause settled,..

"You don't remember me do you?" The client said sitting with his shy, trying to disappear dog.

OK, longer pause..because there is no way to formulate an answer to this nicely...None..

I took one last long hard studying look at him.

He had a gentle face, a quiet demeanor, and a serious air about him..and yet, I had no ideas of who he was, or why I should remember him.

So I did what my default is, and answered honestly.."Ummmmmmm, nooooooo." I tried to lower my voice, and cower my answer..both his sheltie and myself were now in the same boat.

He lifted his hand and showed me his wrist. A long jagged very prominent scar was revealed..
My face instantly changed from shyness to aghast!

"OH! YES! I remember!" I blurted out.

A few years ago on a cold snowy wet day he had come to the clinic to drop his dogs off for boarding. When he opened the door to let his dogs out they had so excitedly bolted out of the car that he had slipped on the wet driveway and broken his wrist. I had heard about the ice sipping incident and wrist breaking accident from a few of the staff later that day.

I had not seen him that day, but I had spoken to him for many days after as he underwent his surgeries and recovery..

We began catching up on each others hobbies, activities and lives. I, of course, started talking about Pawbly and he very inquisitively listened on.

As my luck would have it, he too is a blogger. He is also a well versed accomplished writer and has written many articles on his love for shelties. He started quizzing me on their specific diseases and afflictions and impressed me with his incredible passion, prolific writings, and diverse skill set.

Before I could contain myself I was pleading with him to join us on Pawbly in our quest to help pets.

And a new member was added to our ever expanding list of people who want to help pets..

Mr. Stewarts muse.

Mr. Stewart's article links can be found below, and if anyone has any sheltie questions. he can now be found at,-Costs-and-Considerations&id=7020335

We are so excited to be able to share his articles, his knowledge, and his love for this docile breed.

As for me, I can't stop chasing my tail, and I can't give up the hope that someday there will be a place for anyone, anywhere, with any pet need to be able to go to get help for them..I am determined to do it, I am determined to provide it for free, and I KNOW it can be can't it? We are surrounded by pets and the people who love them.

I will be sharing his articles on shelties soon, and interviewing him on his dogs, their lives, and sharing all of that with you all too, soon..

Thanks Again! Mr Stewart!! and Welcome! 

Friday, May 24, 2013

DawgBlogger Interview. The Dog Health Advocate Speaks

Pawbly, the collaborative effort of myself and my dear friend and Adam, (president of No Kill Harford,, is a place to ask questions, learn, and build relationships to strengthen peoples ability to take care of their pets. Our motto is "Ask --> Connect --> Learn. And that's what we are here to do. We are actively building a community of pet experts to help pet loving people across the globe. It is a very simple mission that we are all passionately devoted to providing. We have been so fortunate to find others as passionately devoted as we are.

Pawbly is thrilled and honored to have Jana Rade with us as a  guest blogger, contributing her years of research,writing and sharing her experiences with us. She is also answering questions pertaining to dog health. She is a true dog (or as she would say 'dawg') lover. Her beloved dog Jasmine, (her self described, "dog of her life") lead a long battle with many medical challenges along the way. Jasmine sadly lost her battle this past spring. Ms. Rade was diligent and devoted in meeting every obstacle head on and researched every disease, illness, and stumbling block that Jasmine faced. Jasmine was Ms. Rades inspiration to learning, writing, and informing others of the plights and challenges a sick dog faces. Her body of work continues to shed light on emerging veterinary medicine, alternative options, and provides a network of resources to assist other pet lovers in trying to find longevity, health, and happiness for those dogs Jasmines legacy leaves behind.

Although I was never fortunate enough to meet Jasmine in person I feel as if I knew her. Jasmine's tale, her ups and downs, every illness, every side effect to every treatment option, and clinical sign were documented by Jana. Jasmine's life has helped countless others because of the intense dedication of her mom. She is missed by many of us who never got to kiss her face but always knew who she was.

As our first guest blogger we wanted to introduce Jana to you with our first guest blogger interview;

Pawbly; I just want to ask you very basic questions like;

1. What started you writing?

Short answer? Jasmine. All the things we didn't know and realized we should have. Such as not all vets were created equal, that simply taking a dog to the vet should be enough but often isn't, and that one should trust their instinct if they feel things aren't right. Also all the things we learned along the way. I came to believe that Jasmine's rough journey could help other dogs and started writing about it.
2. Where did you see your writing when you started versus where you are now?

My mission remains the same and I don't expect my writing to change, just, hopefully, keep evolving.
3. What is your hope in writing and publishing?

My hope is to help dog owners to become true, educated health advocates for their dogs. I do hope to put together a book about Jasmine's journey eventually.
4. What have been some of your favorite aspects of blogging and writing?

Hearing about dogs whose lives are better because of Jasmine's journey and legacy.
5. What are the topics you enjoy writing about

Dog health advocacy topics
6. How much time do you dedicate to your blog, your DVMs Daily, and other online publications, or social media?

Too much and not enough both at the same time. I hope to be able to devote more time to my writing so I can put out more well researched articles on dog health issues. I'm hoping to land a sponsor one of these days.
7. How can Pawbly help you achieve some of these goals?

I don't know, actually ...? I signed up with the intention to help, not expecting getting help.

Anything else you would like to mention to help us get to know you better and understand how to help you with your purpose.

As I mentioned above, my mission, and Jasmine's legacy, is that other dogs would benefit from her journey and our experiences. I also encourage other people to share theirs, for the same reason. One can always learn things as they go, but there can be quite a high price for that. Learning from experience of others is a gift that can help avoid mistakes, help understand problems better, help knowing that one is not alone, help making better decisions. At the begging, I said, that if Jasmine's struggles can save just one dog from suffering, than my mission was fulfilled.

Q. what pet related blogs do you follow?

A. I follow and read about all veterinary blogs that are out there. I read some blogs on training and behavior. I follow a whole bunch of other blogs  but, frankly, don't have time left to read them. I skim through the content and read posts related to dog health topics only.

Jana Rade publishes a daily on-line publication "the dvms daily",

a blog, Dawg Business,,

and can be found on twitter @DawgBlogger.

She is an amazing dog advocate and we are so fortunate to have her on board helping us help pets everywhere.

You can find us 24/7/365 at We are always here to you and your pets and we are always free!


Thursday, May 23, 2013

Picture Homage to BlogPaws 2013

The complete Pawbly delegation. Joe, me, and Adam. 
My beloved husband and my brainy-geeky-genius (and I mean that in the most loving way possible). 

As a "newbie," (the term of adoration assigned to a first-time BlogPaws attendee), I came to BlogPaws with no expectations and a list of attendees that I was determined to say "hello" to and to tell them how much I admired their work, their message, and their passion..

Within minutes of arriving I knew I was sure of a few things.
1. There were a lot of other "crazy pet people" just like me in this world.
2. I was going to have to be diligent in reading the small print (note to BlogPaws staff PLEASE print the badges bigger,,I looked ridiculous staring at peoples chests trying to read their names and blogs), to find my list of blogger-idols.
3. I would not be able to type fast enough to be able to blog while I was attending. So I resigned to taking lots of pictures and type later.
4. That I was at my mecca. I was home where my heart is, where my fellow devoted pet colleagues are, and I was going to savor every single second.

Steve Dale, and his pups, who gave a rocking keynote address!

Catching a quick wink between two other bloggers.

What a face!

Chilly, the mascot for the Helping Hands. A referral only dental and surgical hospital in Richmond VA.
They are helping to make surgery more accessible to clients in the greater DC area.

Someone is super excited to be here!
Lots of dogs and even more pet-loving , loving to pet pets people.

A captured audience.

Steven May, How to build a fan base on Facebook.

Me, and my blogging AND veterinarian idol, Lorie Huston,  DVM.
She participated as a blogger and a pet expert, two hats she wears effortlessly.

Dr. Brunt and Adam, and her beautiful poodle.

Jane Brunt, DVM, CATalyst Council Executive Director, 
and American Association of Feline Practitioners Past President, 
brings a somewhat reluctant attendee to a lecture.

Really adorable peeps, who were the mascots for a food vendor selling beef, pork, and chicken parts to bloggers.
A hand-written notebook page posted on their cage read "free to good home."
I don't know if it was just me but I thought it was a bit sad to see cutie-pies being sent home in suitcases of ?appropriate homes? (AND, still we have so far to go..sigh).

The ferret parade. And yes, she has purple hair, very purple.
No purple ferrets that I saw.

Cold hard reality.
PLEASE microchip your pets!

Now that's a ride!
This is Brighton the Cornish Rex, whose mom was at her 4th BlogPaws!
She has three Cornish Rex's that attend, and she says
"and yes, they brought more outfits that I did."

Oh, goodness, I apologixe, I forgot this little loves name, I know it started with  a P?
I love me a pig, guinea or pot-bellied, I don't discriminate.

Two smiling faces!

I posted this kitty on Facebook. The best guess I got was Shaun White.
This sphinx was as animated and adorable as they come.

What a face!
Although not at all interested in Steve Dales talk ( I however was).

"Pleased to meet you too."

My favorite photo of the whole lecture.
Only at BlogPaws.
Pet expert, trainer, and media personality, Harrison Forbes.

Author and pet behaviorist, Darlene Arden speaking with Adam about working with shelter pets.
Two of Ms. Dardens books.

Molly, the Fire Safety dog. She was my buddy at one of the classes. She kept nudging my butt as I sat on the floor. So her mom gave her a chewie to keep her quiet. But I didn't mind the nudging. I am used to being forcefully persuaded to give belly rubs. It makes me feel like I am at home.

Pete The Vet, facebooking, interviewing us, and a copy of his books.
Pete was the most charming and altruistic person I met all weekend.
When I hear a vet say, "if someone asks me for help I help them."
I knew he was my kind of vet.

Dino Dogan of Triberr

And just a few of the many adorable pets I met.

And goodies from sponsors!
And some of their products to tell my clients about.

Thanks to everyone for making BlogPaws such a memorable time!!

We had a blast and we are
looking forward to seeing you all again next year!