Tuesday, November 29, 2016

Tips To Avoid A Trip To The Vet.

Daily there is a call, an online request, a pet parent at the door who has found themselves in a perilous pet predicament that they were not prepared for. It is unrelenting and exhausting. Worst of all it is in so many cases; they are avoidable.

In an effort to ebb the tide I have assembled a short list of common avoidable pet health care issues.

As a small incentive I added associated costs for avoiding them and what you might expect to pay if you end up at the emergency clinic.

Brush teeth daily. Cost to client, FREE, cost to resolve when they are at stage 4 can range from $800 at my clinic to $2,000 (plus) at a specialists office. Not to mention the damage a diseased mouth does to the heart, kidneys, and overall health. 

Eat a good nutritious wholesome food. If your pet is predisposed to obesity, disease, and any other ailment by their breed or genetics then diet is a key element to avoiding the worsening or exacerbating an underlying predisposition or disease process. You are what you eat, and, you get what you pay for. These are inescapable. The expensive prescription diets are, well, of course, expensive, but so is intensive care for a diabetic coma, heart failure, kidney disease, and a multitude of other conditions. It is my firm belief that we make up for poor diversification in breeding by diet and exercise. We will willingly pay $2,000 for a giant round lab puppy, then balk at the joint prescription diet they need daily to preserve their ambulatory function after they blow both knees.

Get lots of sleep. Dogs and cats have this concept mastered. We have some important lessons to learn from them. Try to go to bed tired, clear headed and exchanging whispers of adoration. Stress does awful insidious unraveling of our core functions. Not to mention obsessive compulsive disorders, incessant chewing, and needful whining, pacing, or nocturnal activity. Free!

Lots of interesting nose grabbing exercise. What do I mean by this? Let your dog be a dog. Sniff, tug, play, hide, walks that are adventurous AND at their own pace and destination. Let them explore the world. The best exercise is the one that is fun. Stop walking the path everyone before you has forged. Go off leash! Get dirty! Embrace the flavors of the season. Heck, go ahead and roll in it! Free!
Charlie and Jekyl
Ideal body weight and muscle mass. Avoid lots of the diseases and disease processes that obesity predisposes your pet to. Indoor cats need exercise and I warn about poor quality free feeding of dry kibble. Few of us maintain healthy eating habits at the "all you can eat" buffet bar. Try feeding a high quality canned food for breakfast and dinner. For an average indoor cat this is about 3/4 of a 5 oz can twice a day with 1/4 cup of high quality dry kibble as a "scavenger hunt" snack. For dogs I recommend they be fed twice daily a vet recommended food. Again, make it fun, earned, palatable and intentioned. Make it part of your daily morning and evening regimen. Clean the bowl and monitor poor intake as a means of health status. Diabetes, thyroid issues, cancer, joint problems,, gosh the list is long and expensive. Crazy expensive and often debilitating to life threatening, if not, severely life impacting.

Basic parasite prevention. For my part of the world this includes fleas, ticks, heartworm, and intestinal parasite preventatives. For less than $20 a month you can protect and prevent a flurry of health insults that not only threaten your pets health and safety but also your own. Heartworm treatment costs up to $2500, intestinal parasites can lead to life threatening gi conditions, and more kittens die of fleas than almost anything else. Tragic and completely preventable.

Spay and neuter your dog by 1 year old (7 months for cats). For the few poorly bred, hyperinbred, cancer prominent breeds they may benefit from sterilization at 18 months. Most pets were acquired to be companions. Spay and neuter. Avoid unwanted pet over population and behavior issues. Cost of pyometra surgery at an emergency clinic can be > $2500. Pyometra blog.

Chloe and Cooper. Two divine miracles!
Obedience and socialization. What would happen to you if you were not able to care for your pet AND your pet refuses to allow anyone else near it? Obedience is NOT about submission to humans. Rather it is enjoyment with sharing life with them. Be kind, compassionate and teach those around you to enjoy and love life. Not fear it. Too many pets are euthanized due to behavior issues that stem from not being adequately socialized.

Microchips save lives every single day. If you want the most affordable way to get one see a vaccine clinic, shelter, or rescue. They are obtainable for about $25 in many places. The statistics on finding your pet (cats predominantly) after they are lost is abysmal.

Start a savings plan for the unforeseeable accidents ahead. Wellness plans are not in the consumers best interests. Avoid them. Purchase pet insurance instead. Or, best yet. Put away $40 a month in a pet emergency fund. You will thank yourself later. Average emergency visits for trauma alone are in the thousands of dollars. Accidents happen, be prepared. Many are treatable with the help of an emergency plan and resources in place.

Have a great vet who knows how much you love your pet and be there for each other. Here are my tips on how to get something for nothing from your vet. At our clinic there is an answer for every situation and dilemma. Find a vet who will help you in both the good times and bad. 

Stop smoking. It is killing everyone in your home. Your feline family first. Smoking shortens everyone's life. Please quit for your kids, two and four legged. 

Basic hygiene and grooming. This includes petting, brushing/combing/brushing teeth every single day. The most beautiful and luxuriously coated cats are those who are loved, caressed, and kept matt free, flea and tick free and groomed by their family. Your fingers can feel the grit of flea dirt, the hair bunched in the armpits, behind the ears, around the face, and base of tail, etc.. The simple act of petting your pet is the single best indicator of their overall health. Train your hands to be the best instrument a vet has. And, at the same time you are reinforcing the love and trust every pet longs for. A sore spot, a wet spot, a decrease in muscle mass are all vital clues in identifying a problem at its infancy.

Do you have any tips you think I forgot to mention? Please add them as a comment.  I look forward to hearing them.

If you have a pet question or concern please find me on Pawbly.com. I am also on Twitter @FreePetAdvice, YouTube, Facebook at Jarrettsville Vet, and in the clinic seeing appointments.

Please always be kind.

Sunday, November 27, 2016

Law Suits and Veterinary Medicine. What To Do When The Courtroom Comes Calling.

This blog was written with the help of a few friends. Two are lawyers, one a veterinary malpractice attorney.  These two dear friends also urged me to not publish this. It is "too personal and could  paint me in a precarious light." I have grappled with this for weeks. If you want to be anyone of merit you have to be true to who you are and go beyond what others will. I have had two brushes with the legal side of veterinary medical practice. Both were cases where I put my neck out to help a pet and their family and both were times that that family tried to make me responsible for their pets misfortune. 

**I must provide a disclaimer to remind everyone that I am NOT an attorney. Please seek an attorney  for assistance should you find yourself in the cross hairs of a legal dispute.

In an effort to help calm my nerves my husband reported that he had done a little research and the "average veterinary practice is served with a lawsuit once in every three years." Based on my 10 year veterinary tenure I would say that I am one lawsuit short of the average. Two suits in 10 years is two more than I would like to have faced. Both are behind me, and both have left me a little smarter, a little thicker skinned, and more determined than ever to help other vets when their 36 months run out.

Here is some of what I have learned when the suits meet the scrubs;
  • You cannot tip toe through life trying to remain unscathed and off the radar. Pets are, and continue to become, integral parts of the family. With emotional attachment comes the responsibility to provide for both our patients and our clients. That, and,,, 
  • We live in a crazy litigious society. No escaping it, but, please try not to become it.
  • Be prepared for stormy weather. There are many wonderful glorious days of slaying illness, thwarting cancer, and soothing disease ridden pets so that they can live to see another day and with each bucolic day break lurks a thunderstorm somewhere on the horizon. It is life. There is good and, therefore, there has to be bad. Embrace both, they are life in its entirety.
  • You will feel the problem cases coming. As soon as you do hit the medical record and start shoring up the records to cover your ass. If your handwriting is like the rest of us take a few moments away from the constant barrage of phone calls, barking dogs, and pestering people and sit down to read your record. Think about where the holes are. Fill in as much detail as possible.
  • Relive every single detail of every interaction about the case and write it down as soon as you remember it. I walked around everyday with a notebook to jot down things I had forgotten, or neglected to tell my lawyer. I then sat down and assembled the whole case from day 1 to the final blow over a weekend. I drafted a 10 page recount complete with timeline, thoughts, and perceptions. I also provided guidance to my lawyer about my clients that I thought might possibly be relevant.
  • Re-living and writing all of this was both painful and cathartic. I could put it on paper and walk away. Getting those interviews, meetings, documents, and thoughts out of my head and  in someone else's hands was the only time I could get some small degree of normalcy back.
  • Never ever lie. That's the stuff that will get your butt nailed. You will in all likelihood have to swear on it in court. Start with the truth the whole truth and stick with it.
  • Keep your trap shut. Once a client starts circling over head it is best to not try to minimize the damages by offering more fuel for their fodder. Shut up and get legal counsel.
  • When the State Medical Board comes knocking take the same advice. They, in my experience, are gathering information to use against you. They expect you to talk but they will use it against you and they have the unfortunate ability of taking it out of context when you have no way of proving otherwise. "Yes" and "No" answers will serve you best. Should I ever have to face this again I will be using technology to my advantage. Get your lawyer on Skype, use Meerkat, or video tape the entire proceeding. For my case there were gross egregious errors and the guy who took my interview mysteriously disappeared to never be seen, or held accountable, again. I know it sounds ridiculous, but that is exactly what happened.
  • Take the advice you give your new associates. When a challenge of a new unknown case raises the little hairs on the back of your neck, and you think that you cannot face the challenge, nor succeed, jump in anyway. Never let fear, doubt, or insecurity halt your ability to heal and help others. That is what we are trained to do. Do it, live it, and jump in!
  • Never back down from a case that needs you and has no other option. In the end tis better to have tried and failed than to have never tried at all.
  • Don't walk away and leave a patient to suffer because you allowed your fear and insecurities to govern your ability.
  • Be prepared. Expect every amazing, devoted client who you believe trusts and cares about you as you cared for their pet to stab you in the back. It happens, that's why lawyers make so much more money than we do.
  •  Don't be stupid enough to believe your demeanor and generous time provide compensation when a client gets pissed off. 
  • Do have an exit strategy. For the day, the week, the month, and this career. Sometimes a light at the end of any tunnel is enough to keep trucking ahead. Even through the worst of times.
  • Walk into every situation with a best and worse case scenario. Have a plan for each. We do this for every patient we see. Learn to do it for yourself.
  • Never surrender your voice or your purpose. The State Medical Boards, the courts, the community can beat you up and strip you of years of your blood, sweat and tears, but in the end you walk away alone. In the end it only matters that you walk away alive and proud of the little tiny moments no one saw, paid for, or wrote Thank-You cards for. There is not one veterinarian who hasn't made another life better. 
  • Protect yourself. Hire people who are versed, experienced, and prepared to go the distance. This includes your staff, your associates, your accountants, and your legal advisers.
  • Relinquish the reins to those you hire to protect you, and to those who will care for and protect you while you cannot stand alone. Only greed, arrogance, and grossly negligent immaturity will destroy a career. 
  • Go to sleep at night with a clear conscious, whatever that costs you. Write a check and settle when a court case looms ahead. 
  • Break it down to simple unbiased mathematics. Hard and soft costs accumulate quickly. Disease doesn't choose a one year old puppy as a personal vendetta to a life just begun. How many times have we seen that? Life isn't fair. Step out of your emotional anger and apply science and math to a problem. 
  • When the storm recedes and there is an the end, (there is always an end), you have to be able to face yourself tomorrow. 
  • There is a winner and a loser. Money can buy you better odds, but ultimately fate, luck, and timing decide the narrow margins. Just accept that. 
  • Don't undersell your day to day health and blood pressure. Try to take a few steps back, see both sides, and be the rational person in the room of people who lack both the desire to have a clear conscious and a moral compass. Somehow lawyers can be bipolar, vicious and blood sucking and still smile at both sides of the gallery with equal conviction and genuine probity. It is the antithesis of a veterinarian. If Themis holds a scale blindfolded there is a lawyer on one side and a vet on the other. Find a lawyer as opposite as you are to provide some semblance of balance. For my case it required a short bearded man with a devilish smile, witty sense of sarcasm, and a heavy hand delivered in a slow calm slicing hand shake.
  • Call the AVMA and have PLIT insurance. Notify them of every potential case. Get a team in place before the letters, lawyers, and subpoenas arrive. Remember that your PLIT appointed lawyer works for a company, not you. They are there to protect you but are paid and must remain employed by someone else. I  think that in 10 years I have called them 6 times to alert them of the potential of a suit. I am sure my folder isn't the thickest in their office, but I may be the most proactive client they have. Oddly, I still only pay $69 a year for them to answer my paranoid phone calls.
  • There are battles where no one wins. There are fights that cost you more than green backs. Lawyers will be paid, you will lose time and money and the case will close. Let go of being angry. Don't swap one bad emotional crutch for another. 
Get out alive. Preferably not bitter and hating your fellow man. We have a legacy of humility, generosity and compassion to live up to. Leave the ugly stuff to the lawyers. I recommend you find one who is the yin to your yang now. The clock is ticking. Have you had your 36 month case yet?

Related blogs;


It has been many months since I had my last brush with the long arm. I remain a bit bitter and biased and convinced the vets with  friends in influential and politically flirtatious positions avoid being placed in the spotlight, or questioned when complaints are filed. It is a seriously flawed secretive system. As with much of veterinary medicine is archaic and severely lacking jurisprudence legitimacy. Any legit constitutional lawyer would laugh at our Lord of the Flies self governed veterinary judicial circus. I take great comfort in being reprimanded for not offering euthanasia to a 5 month old puppy with treatable injuries who I had treated, was subsequently blackmailed (by both the MD State Board and owner) to return and refused to. Turns out you can kill a cat with an arrow and still keep your license. Laughable,  ridiculous, and inane.

Stand up for what you believe and never let fear of reprisal abandon your compassion.


Find me at the clinic, Jarrettsville Vet, on Facebook, Twitter, YouTube, or providing free vet advice on Pawbly.com

Sunday, November 13, 2016

Weasely. Being Kind and Being Genuine. How Your Clinic Can DO It ALL. How to correct deformed legs in a kitten.

There are enough sad stories in this world. No one needs, or wants any others....

And yet they still keep coming.

This is Weasely. He arrived in a tiny yellow carrier at the front desk of my veterinary clinic on October 10th 2016 via a chauffeur from the local Humane Society. 

"They want to drop him off?" I heard the receptionist announce rather casually and open-endedly toward no one. 

The clinic at this time of day is a bustling, chaotic mass of dogs, cats, children, parents and vet staff. We more closely resemble a subway station turned MASH unit then a small town veterinary clinic.

Like any seasoned parent I knew better than to blindly and dismissively shout out, "OK!" go on with my day to only be shell shocked by the sad case who needed my attention hours ago, that I had overlooked at intake.

I walked out of my busy backlog of waiting patients to peek into the carrier to see the hidden content. 

There sat a tiny speck of  orange fluff. Eyes small slivers of recognition. It was immediately apparent that he was sick, depressed, insignificant and crippled. He was mercy in a box.

These introductions take all of 10 seconds. He had some speckled sad story of misfortune and if I sent him back to try to survive in a shelter the odds were slim and already certainly against him. He simply needed too much and they had too many.

"Do you know anything about him?" I asked the driver.

"No." Short, oblivious, absent.

"OK, leave him here."

I went back to the pace of the sprint that is our normal over busy, over crazy, mildly chaotic veterinary life.

I scribbled a few notes of instructions and passed his carrier and his first treatment plan to the able kitten savior technicians JVC employs.

Laura met me in the treatment area a few minutes later. Without needing to explain she had taken charge. She had been through a case like this before. Her own dog, Bella, landed her second chance with us almost a decade ago. This is her dog's story. Bella's New Legs blog.

Weasely wasn't a mystery to us. I knew he would need a week or two to get over his upper respiratory infection. He also needed a month or two to get his deformed front legs back in straight working order.

Here is how a vet thinks about these cases; Triage. Immediate life saving care is directed to the infection and disease. Legs, well, legs are accessories. We will start to train them now, worry about their form and function later.
  • Respiratory infection plan for a 1/2 pound kitten;
    • Amoxicillin drops, a tenth of an ml every 12 hours. The most important part of this plan and the single reason sick kittens need a vet.
    • Erythromycin ophthalmic. A small strip over each eye twice a day. Save the eyes, the eyesight and treat immediately.
    • Deworm. Kittens come with worms. Please use a veterinary prescribed product. The over the counter stuff is dangerous and too often also deadly.
    • Feed! If they are eating on their own leave out food 24/7. Change it every 4 hours.
    • Keep warm! A heating pad on low under the towel or blanket. And keep them inside draft free and safe.
    • Remove all fleas! Immediately. See my videos on how to do this.
    • LOVE, LOVE, LOVE! 

Here is how we treated his legs;
  • Day 1-3 was tiny pieces of a tongue depressor wrapped in soft vetrap. One small circumferential piece of tape held the tongue depressor in place. Essentially Weasely needs something with some soft rigidity to help support his relaxed and bent wrists. 

By day 4 Weasely's eyes and respiratory infection have markedly improved. He also has a nice big round belly! He is gaining weight, muscle mass and becoming a healthy kitten!

  • Day 4-14. Laura made plastic braces by cutting a syringe cover in to two halves. She smoothed the plastic edges and then applied elastic tape to cover the edges.

He still has lots of laxity in his wrists but he is walking on his feet and not the side of his forearm.

It is vital to remember that we have to heal Weasely's body and spirit! Socialization is as important to his overall health and long term prognosis as his splints are.

That's a lot of toes! 22 in all!

With any type of splint, brace or cast, you are going to get pressure sores and wounds. For this reason and for the ever changing evolution of a tiny sick kitten growing so fast you cannot blink I wanted Weasely to stick close to the clinic.

We changed his bandages and splints daily. By about day 5 he started to have sores where the splints were touching his skin. This required daily antibiotic soaks and changing the splints, and/or, adding more padding.

By about day 8 we changed to soft padded splints.

He went into a foster home within a week. Because every pet heals on their own time we wanted him to be socialized, loved, and encouraged to get up and use his new legs. A foster home is a much better place than a busy clinic for this.

This is Weasely with his foster family.

Where he was LOVED.

And spoiled...

And discovered he was a cat..

Who loves people.

And slaying defenseless toys..

It has been a month of treating his legs.. and now they are perfect. 

He is back with us learning how to be a friend and looking for his forever home with his new friend Thor.

Miracles come in all sorts of obscure packages. You don't have to look far for them. You just have to accept them as a tiny opportunity to be bigger than the often overlooked. And, you have to remember to love.

Weasely happened because Jarrettsville Vet does a few things;
1. We advertise that we are here to help the pets of our community.
2. The local shelters and rescues know that they can swing by and drop off a little soul in need in a little carrier.. even on our busy days. We don't dismiss or disregard there is need even when there isn't a paying client.
3. We utilize all of our resources to make happy endings. There is a small army of people who help at every step. Our clients, families, friends and supporters make this happen.
4. We have staff who provide pro bono care generously and unselfishly.
5. We have a box at the front desk to collect donations. We call it the Good Samaritan Fund. It helps  cover the cost of these cases.

We never walk away and we don't give up. It is our credo and it is all you need to allow little miracles to happen.

Related blogs;

Bella's New Legs.

Borrowing Battery Juice.

If Wealth Were Measured In Good Deeds.

Open Admission Shelters Are NOT Safe Houses.

Leave Them Here.

If you are an animal expert, or pet lover, or have a question about your pets care please join me on Pawbly.com. We are a place for exchanging information to benefit pets lives globally.

I can also be found  at the clinic, Jarrettsville Veterinary Center in Jarrettsville Maryland, on Twitter @ FreePetAdvice, or on YouTube.

Saturday, November 12, 2016

The Jarrettsville Vet Pet Food Pantry

Our latest endeavor at the clinic addresses another of our community pets most basic needs.
We already provide shelter, vet care and now we are going to offer food.

Here is the letter sent to all local shelters, vet clinics, and rescues;

Dear Fellow Vets, Clinics, Shelters, Rescues and Pet Related Stores,

This is the time of year we are reminded that there are those less fortunate than ourselves in our communities. Last year in the USA 42.2 million people struggled with hunger. It is also estimated that between 37-42% of US households have a pet (most have more than one). There are also about half a million people that are homeless and many of these people care for their own pets. The numbers of hungry and in need of the most basic fundamental lifesaving assistance is staggering. Concurrently the holidays are the time of year that we are also inspired with the generosity and goodwill provided to all. As the stewards of care and compassion to all animals we are all in a position to help those in our areas struggling the most at the toughest time of the year.


Cooper and Chloe

At Jarrettsville Vet we offer free shelter at the boarding facility through the coldest nights of winter to encourage bringing pets indoors by offering them lifesaving warmth. This year we are also offering food from donations from our annual Pets with Santa fund raiser. The donations will go into boxes for the Food Pantry. Food and provisions will be free to anyone in need and remain in our lobby year around. We are asking for your help and participation in allowing us to place a donation box in your lobby or entrance. We hope that it will inspire your staff, clients, and customers to remember that we can all join together and have meaningful impact to those who need it most but are not able to find assistance elsewhere. One bag of food can be the difference between a meal for the coldest, darkest winter months and diseases associated with malnutrition. 


We are happy to help provide the collection boxes and social media posts to announce this to your clients and social media friends. 

We are reaching out and asking for help from all of you that provide care, goods, and services to those fortunate pets in our communities who can lend a helping hand.

Lucy and Max

Many Thanks for your consideration, we hope to hear from you soon,

Our latest bunch of sick, broken and 'not allowed to die' kittens.

Krista Magnifico, DVM
Owner Jarrettsville Vet and founder of Pawbly.comFor more information on any of our community assistance programs including shelter, food, and veterinary care assistance please call Diedra, Jenn, or Richard at the clinic 410-692-6171. Or email diedra@jvcvet.com.

If you have a pet related question, or pet related areas of expertise we hope that you will join us at Pawbly.com. Pawbly is free for everyone to use and open to anyone who loves pets. I am also at the clinic, Jarrettsville Vet in bucolic Harford County Maryland. Or try my video library at YouTube, or reference materials and content on Twitter @FreePetAdvice.

Please always be kind, and always remember those less fortunate.