Leave them here

I  have learned  few important lessons the hard way. I have regrets and scars to show for a few of them. Life is a list of stories we dictate to our own souls scribe. A long narrative with an endless list of extras and a few consistent lead characters. When your profession leaves you under one roof with a revolving door of 'next mystery guest stars' you learn to make quick assessments of the characters. I don't intend to sound judgmental, but I have learned that I can only help a pet if I can understand my clients description of the problem and the pet parents ability to manage them through the diagnosis or treatment process regardless of the difficulty or degree of illness.

I have also learned that the spectrum of abilities to articulate the problem, weed out the insignificant information, (for instance, "I think that he was the runt and once upon a time when he was 3 months old he vomited" etc.) is another whole ballgame to which vet school does not adequately prepare you for. Medicine is science put into practice, but psychology is principle to a veterinarians art and marriage between two disparate species. Magic, miracles, and mystery are ethereal figments that play somewhere in between.

There was a sweet, gentle pit bull who came to see us at the clinic for two months of devastating anorexia. This dog would show up at each re-check weighing even less than the previous visit. He was at the last few visits a depressed walking skeleton. Every appointment was a long discussion of foods offered, foods refused, and a client who seemed as flustered as we were at the death creeeping into his prognosis. At every single appointment we offered food and he readily ate it. At every appointment we would be more and more heart broken. We all knew he was dying. 

He died a few weeks later. A month after the second dog in the house was left at the local shelter in the same condition. It wasn't until we recieved the call from the shelter that a skeleton dog was dumped with our microchip in it. It wasn't until then that the light bulb blew up! This owner had starved one dog to death and dumped the second before she died. I called the authorities immediately. That family had a baby in the house and another dog. I sent letters to the states attorneys office, animal control, child protective services and the sheriff's office. A month later I had a very angry former client and a whole pile of letters telling me to pretty much shut up and go away. 

We adopted that second dog from the shelter. She lived a long healthy life with a wonderful family. We also became scarred so deeply that we all promised each other that the next case that didn't seem right we would remind ourselves that humans can be awful sick, despicable, or suffering from a mental illness such as Munchausen Syndrome By Proxy. We also decided that we would beg, plead, interrupt, and not walk away so naively the next time, or any other time  thereafter. 

This case is a perfect example of what so many vets do. When we have a case that doesn't make sense.. we offer up a stay at the lodge for observation. I have wished a million times over that I had insisted on that starving dog stay with us.. Maybe, just maybe we could have changed the tide and the ending to read "happily ever  after?"

This is Willy. He has his own story soon to follow. He is currently under residence at Jarrettsville Vet for his recurrent rectal prolapse. His mom, who is a heroine in this particular story, can't manage his sporadic, always inconveniently erupting gophering colon, so we keep him with us. He will have his fourth (and please pray for last) surgery on Monday.

We are keeping him at no charge to his mom with the help of the many wonderful friends of JVC who contribute to our Good Samaritan Fund.

There are always more stories to tell. More lessons to learn, and God willing less regrets to bear to the grave.

I am available for questions anytime, and always free, at Pawbly.com.

I am available for personal pet consultations at Jarrettsville Vet in Jarrettsville, Maryland.

I can also be found on Twitter @FreePetAdvice.

Rotten Cat Tails. What are your treatment options and the costs?

We all live on a budget even though none of us want to. It is a reality and obstacle we must recognize and accept. When it comes to pet care I will be the first to challenge the notion that there is only one way to do things and that this one way is going to cost you and arm and a leg. The whole idea that vet care isn't accessible or affordable to everyone is the single greatest reason pets are having to do without all of the incredible advances and options modern medicine allows. Technology has provided access, it is time for us to provide affordable options and transparency.

As much as I believe this to be true there are still a few conditions that don't allow many options.

Here is one such case.

This is Haley.

Haley is a stray cat that a very kind client of ours has seen lurking around the neighborhood for awhile. She had been seen chewing and biting at her abnormally shortened tail and she smelled awful. When they investigated her tail they found that it was severed off at the end, bleeding, and terribly damaged.

I strongly believe that people want to take care of the pets that they love. I also believe that too many pets, cats in particular, are left without care because they do not hold a position of importance amongst enough of society. I don't believe in the rest of the paltry arguments about.. "cats are able to care for themselves," or, "I don't like them," (to which I always reply "you don't like them because you don't know them"), or "I cannot afford care." I truly believe that almost every aspect of pet care is affordable if you deem it to be important enough. One of my goals is to help make care transparent, offer affordable options, and provide ways to pay for those options.

When it comes to tail trauma to this degree of tissue destruction there is only one option; Surgery.

There is not another effective treatment option to thwart the constant pain and infection then amputation, or removing the end of the tail.

Haley is under general anesthesia and the tail has been clipped and is soaking in our surgical solution.

The end of the tail after being cleaned and prepped for surgery.

I cut to the closest healthy vertebral body and amputate the tail there. Remember a pets tail is an extension of the spine, so the little pieces of bone that compromise the vertebrae extend to the tip of the tail. They house the spinal cord, nerves, small lengths of muscles, tendons and blood vessels.

Here is what doing nothing might have caused;

• Haley could have either continued to bleed until she became anemic, which would have led to her death as an outside cat.
• Gotten an infection that penetrated her spinal cord. Very bad!
• Kept traumatizing (biting and licking at her very painful tail) until it was a stub and then they keep on chewing until they jeopardize their nervous system and musculoskeletal systems ability to walk, urinate, and defecate. Very, very bad. Absolutely life threatening.

So, as much as I believe that it is imperative to provide multiple options with a range of prices..in these cases I just feel that there is no other option than to amputate.

Now I might not be able to provide good treatment options other than surgery to correct this, BUT, I can offer a few options with respect to how and who does this.

Typically we recommend pre-operative blood work ($40 - $250), FeLV/FIV testing ($50), and all vaccines ($16- $80). For Haley her mom opted for the FeLV/FIV test (I think this is the most important test to do), and her vaccines. She also opted for a microchip ($10) as she is an outside cat and now has a home.

Haley's surgery cost was about $200. She went home with antibiotics ($25), pain medication (Oh, how she loved the pain medication at about $30) and an e-collar ($12).

She is a wonderful affectionate girl and will make a great addition to their family.

This is Haley's tail at her 2 week post-op re-check.

It has healed beautifully. It looks nice, has no open wound, signs of infection and skin and fur cover the blunt end of the spine appropriately. She is also comfortable and not bothering it.

A happy healthy tail gives the "thank-you" salute.

If you have a pet question, or love animals ad want to help others, please join us at Pawbly.com. We are a free community centered around helping more pets live longer, happier and healthier lives. Pawbly is free to use and open to anyone who loves animals.

If you would like to ask me a question about your pet and you live in the northern Maryland area find me at Jarrettsville Vet in Jarrettsville, Maryland.

I am also on Twitter @FreePetAdvice.

The Profitability of Drive-Thru Euthanasia Clinics

Let me be perfectly clear; I am happy to talk to you about your pet because I am here to help your pet. But, let me also be perfectly clear that my job is to take care of your pet and be their advocate.

Except for the rare cases of human health safety, I am your pets healthcare advisor, I am not yours. So, if you are seeking get rid of your pet to unleash some burden due to the difficulty they cause you find a psychiatrist. I am not a psychiatrist. I am a veterinarian.

If you want to dispose of your pet, for whatever reason, find a lynch man. I am not a lynch man. I went to vet school with the hopes and expectations of helping pets.

I do not run a drive thru euthanasia clinic. I do not get up in the morning to try to find a way to earn a quick buck or bond with my fellow man. I get up to help the defenseless, powerless, voiceless souls live to see another day. This is a conscious choice to make a life without a voice better. I am not here to make your life more convenient.

Yes, it is true, this veterinarian sometimes detests people. Hard as I try, I do. Sure, I could choose to abandon my calling and my purpose to cash your check, but I must always choose an option that benefits your pet, not you.

Such is how I feel when there are days like today....

Two clients stand in the clinic, pets in tow, demanding euthanasia as their “God Given Right.” As if my veterinary services, my profession, and yes, my establishment are at their beckoned pet disposal call. After all, why would anyone else care about a pet that they don't want? And yet there is me, the vet on the other end of the euthanasia syringe, stuck between that chasm of being the killer of your pet and the murderer of my own soul. Which would you choose?

I don’t go to work every day to be demanded that I sacrifice who I strive to be, worked hard to become, and who I can live with being, for a pet to stand before me alive, treatable, and trying to survive while a client spews some indignation self-proclaimed power to decide who lives and who dies. It just doesn't work that way.

There are many alongside me who have lost their voice. Lost or suppressed their conscious compassionate voice and made a decision to cash a check, kill a pet, and not make a ripple in the pond. There are many a vet who care far more about whether you like them and therefore are willing to provide almost any service to what society deems "a piece of property". We are all stuck until the public asks for their service dog, war hero, and life line to get a title worth their love and devotion. I know and understand the reality of the world I live in and the pathetic state most other species fight to survive in. I also own my own veterinary clinic. I have an obligation to keep my employees employed. If I piss off too many clients I can no longer provide a paycheck for them. I also understand that they don't come to work to hold down a fearful struggling pet to be killed either. It is a difficult awful choice.

And so it was again, another client, with another treatable and trying to survive pet and their a apparent lack of caring about the situation their own pet was in.

I suppose the dilemma is that I see these patients as treatable, or in the least, manageable. Whereas their own guardians see them as finished. There are defined diseases and treatment options and it is hard for me to accept that people don't want to try to make their pets feel better.

Showing up at the clinic with your pet after being absent from care for years and telling me that they need to put their pet down because they are,, "old",, "sick" ,, "struggling",, whatever, without any mention of even trying to help them is heartbreaking and difficult to accept.

Tonight there was a woman who sat before me with a cat we had not seen in years. That cat sat there on the exam table looking up at me bright, responsive, and on high alert, (as all cats are at the clinic when they only go once every five years). She sobbed incoherently about “the cat urinating in the house and the weight of this decision and her inability to know what to do?” It is a dance where you sit, listen, try to understand and are still left not knowing whether to lead or follow. It is a dance of trying to pick details from a history you have no access to and a story that is being written before you. It is a nightmare that haunts you and the reason you do not sleep. It is the cause of your skeletons and a closet that you can no longer close. I agree with her that her cat needs help, and that I am happy to help. But, I have an obligation to inform clients of their options, to stay true to my belief that I am the advocate for this pet, and consent must be found on where to go from here. This act of finality has to be CONSENTUAL... There is a legal consent form that both parties have to agree upon. But she, of course (as is so common with these cases), "loves her pet" but doesn’t want to pay for an examination, or any diagnostics. Because, after all, her cat is "peeing in the house." She remains clear on the financial aspect of her decision. She will not pay for anything. She also remains hysterical and incoherent when it comes to signing a euthanasia consent form. I have to remind her that she must be clear in what she wants and that I cannot go back and revive her dead cat if she changes her mind. She needs a psychiatrist and her cat needs a vet.

Enter flabbergasted husband who knows clearly that he wants this cat euthanized. My life is further complicated by the fact that my new staff member has allowed him to pay for this service already. Oh, yes, of course, I am booked all night and 45 minutes behind. I have always liked pets more than people, and too often, I down right hate people. Animals are rational and predictable. Who in the world thinks that a walk-in euthanasia is any way to end a lifetime with your pet? I need a new policy that says “all euthanasia’s must be authorized before being scheduled.”

In the end, and there is always an end, I can sleep at night if you do not like me. I cannot however sleep at night if your cat doesn't.

I don't know how many veterinary clinics provide euthanasia's to anyone who books the appointment and pays the bill? I also don't know why we care so much about whether our clients like us? I don't believe that being compliant to every demand is a successful way to run a practice or live your life. If your patients don't have a voice and you aren't a voice for them then where were you when you were reciting the veterinarians oath?

If you choose to walk the easy path you may get richer and you may avoid the land mines of the State Board who only cares if the public is happy,, but you will be left as a shell of the champion you were intended to become.

I used to believe that veterinary medicine was about working hard to make a difference and that after I had accomplished this I could earn a decent living. Four years into practicing I realized that I only had to keep myself from growing indifferent. I had to hold sacred my creed of still wanting to get emotionally involved even if it meant I cared more than the owner did. To tread in those treacherous waters of trying to stay true to the 12 year old veterinarian I always dreamed of being.

Now, I realize that all I have to do is get out alive, and that hating people won’t help.

Your pet’s life is not about you. And my job is not about you either. Humans are the enemy to every other species free will. And, lastly, to every single person who thinks that euthanasia is a treatment option I ask "who they think they are treating?"

I am a Doctor of Veterinary Medicine.

If you are a veterinarian just trying to make people happy your title should read 'Doctor of Psychiatry', and, I have a former client, or two, I am happy to send along your way.

Related Blogs;

Compassion Fatigue. When the candle you are burning at both ends consumes you.

The Pieces of Me

Working and Living in the Land of Liability

Taking A Stand and Facing Consequences

There Has To Be Mercy Before Money

What Are You Building? My Advice For Vet Practice Ownership and the Women Who Lead Them

Photos; A few of the 19 kittens and 18 adults that the staff, clients, and friends of Jarrettsville Veterinary Center worked together to save this year. With thanks to all who support the JVC Good Samaritan Fund. JVC is a place where lives are spared, saved, and protected.

Along with my animal advocacy and welfare work, I can be found at Pawbly.com. Pawbly was founded on the belief that together we can solve any and every pet problem and build a place where every pet person can become educated, inspired and empowered to help every pet live a longer, fuller, and happier life. Pawbly is free to use and open to anyone who cares about animals.

I am also on Twitter @FreePetAdvice.

Outdoor Water Safety Tips

Written for Everyday Health.

Every fun-loving, adventure-seeking pup loves to make a splash in the endless vacation of summertime. But keep a few hidden dangers in mind as your pet stays refreshed and enjoys the long warm days. Many pet risks lurk in the same waterways that your pet needs to stay hydrated and cool — and wants to play in.

Every water source has its own inherent dangers, including toxins, bacteria, and other pathogens (bugs). Exposure to these bugs — the most basic, prolific forms of life — is inescapable given the high-density areas many of us share with wildlife, farms, and other people (bugs thrive in all of these). But even with the ubiquitous nature of dangerous bugs out there, the good news is that the majority of pets are built to thwart most of them without incident or injury.

Most bugs will pass through your pet without ever providing a clue they were even there.

Nature has built all of us to live fairly well together. For the few bugs and toxins we do need to worry about, here are tips to keeping your pet safe through frolics in outdoor waters.

5 Tips to Keep Water Safe for Your Pets 

How about a little trip through the dangers of outside waters, starting from your front door and heading all the way to the ocean shores of your summer beach trip.

1. The rain bucket. Outside your front door, the first potential water toxin is the galvanized bucket holding rain water. Galvanized containers leak zinc, which is toxic to most animal species in high-enough concentrations. When providing water for pets, choose stainless steel, ceramic, or glass.

2. The pool. As far as more modern water sources like pools go, as long as they’re maintained and monitored to meet human health standards, they will pose little threat to most healthy dogs. I don’t recommend pool water for drinking, but small amounts swallowed while playing or swimming are unlikely to harm your pet.

3. Puddles. Microscopic bugs like Giardia, Campylobacter, cryptosporidium, E.coli, andLeptospira all primarily find our pets through still water reservoirs like puddles and ponds. Your driveway might be pocketed with them, and dogs — just like kids — love to play in them. For whatever reason (it’s still unexplained by modern advances in medicine), the more foul-looking and -smelling something may be, the more our dogs want to roll, eat, and play in it.

Dogs find it nearly impossible to resist the occasional lap of dirty water. The vet’s answer to this: If your dog has any bouts of vomiting or diarrhea, see your vet and check your dog’s fecal sample. This costs about $30 to $50, and most veterinarians recommend it be done at least annually, or more often if your pups love gross stuff as much as mine do. It’s important to mention that some of these bugs, like Leptospirosis, are also transmissible to us, so careful clean-up is always required.

Keeping your pets vaccinated will help protect your family.

4. Ponds and lakes. In ponds, lakes, bogs, or brackish waters, blue-green algae has been prominent in the recent news for sickening, and even causing death, to dogs in some areas. In fact any shade of algae, from red, brown, green, to purple, is also a potential toxin. This sudden algae growth is most severe in hot weather, but can also be found through the warmer spring into fall.

It’s best to prohibit your dog from swimming in water with floating plant-like material that resembles pea-soup.

If your dog swims in anything resembling pond scum, then rinse her well and go to the vet at the first sign of any abnormality. Ponds treated with heavy metals like copper sulfate, which is used to prevent algae overgrowth, should also be avoided for four to seven days after treatment. These treatments can be extremely irritating to your dog’s skin. If your dog encounters treated water, bathe her immediately to remove any residues, and call your vet.

5. The ocean. The lure of the sea is a magnet to many a dog. Don’t let your pet drink saltwater, since it can cause salt intoxication. Too much salt in a pet’s diet can cause a dangerous shift in the delicate balance of internal electrolytes. A dog with salt intoxication typically experiences vomiting, diarrhea, lethargy, and depression.

Ingesting too much salt can lead to fatal consequences. Hard as it is to imagine, a saltwater-soaked toy, or a few gulps — whether because of thirst or accidental swallowing — is all it takes to start this intoxication.

If your dog is playing in or around the ocean:

• Offer lots of fresh water.
• Force rest periods.
• Try to avoid the overexertion and excitement that leads to saltwater poisoning.

Jellyfish can cause painful stings and toxins if touched. If your dog encounters a jellyfish and has a tentacle embedded, remove it immediately with a gloved hand or tools, and seek veterinary care.

When to Go to the Vet After Water Play

Any dog that has been playing, drinking, or living around potentially dangerous water sources and experiencing any signs of gastrointestinal distress like vomiting or diarrhea, or who is reluctant to eat or play, should go to the veterinarian immediately.

In many cases, the sooner your pet is diagnosed, the more effective the treatment plan, and the better the prognosis.

Most importantly, remember to have safe fun this summer!

Krista Magnifico, DVM, is the founder and chief creative officer of Pawbly.com, overseeing creative vision and user experience for the site. She earned her veterinary degree from the Virginia-Maryland Regional College of Veterinary Medicine in 2005, and has her own practice in northern Maryland. She has a strong interest in animal welfare, educating and inspiring people to take better care of their companions. Follow her on Twitter @FreePetAdvice.