Top Seven Things To NEVER Say To Your Vet.

Beasely and family.

1. "What would you do if this was your pet?"

You are asking ME what I would do? Like, I, as in, imagine I am YOU? or, I, as in, ME?

While I admit that this is most often asked from a position of;
a. trusting in your vet,
b. confusion about what to do, and
c. humility in truly not knowing what to do,
I have to openly say that this is an answer fraught with slippery problems and impossible answers.

Here's why; Everyone sees their pet differently. Some are family members, others are guardians, service pets, lifelines, companions, and even alarm systems. There are also some cases where the disease/recovery/treatment, etc. is so labor intense or costly that some people are either physically or financially unable to provide it.

Let's be honest, I am not YOU.. My abilities as an able bodied trained veterinarian are not the same as yours.  Asking me to presume what you can do, are healthy enough to do, financially stable enough to manage, or mentally prepared for if the dice decide to change midway through the plan is impossible for me to gauge, guess, or presume? Life, medicine, and all of the requirements that need to align for best case scenario don't always happen. There is not a feasible answer to this question that I can provide for you. It has to be your decision. Coersion, dismissal, and whatever all of the rest of the possibilities may be are yours to pay for, live with, and decide. You know your pet best. You are their advocate and you are their whole entire world.

And as for ME? What do I DO? For my friends and clients who ask because they know and trust me I provide this personal answer; "I am crazy. I am. I am over protective, able bodied, and weathered. I will live on rice and beans so that I can take care of my pets. There was a time when I had no job, no income, no car, little food, and 12 cats. Yep 12! I am crazy. I would do anything it takes to keep my pets alive for one more day. I can let them go in the quiet privacy of my home at 1:30 am after the last seizure incapacitates them. I believe in hospice care, I believe in there being beauty in the preservation of life, and I feel deep responsibility to protect and provide beyond the point of "quality of life as based on pennies in a "good day" or "bad day" jar." And, you want me to make a decision of this magnitude for you?

Points to consider when you ask your vet our opinion on what to do with your pets care;

• Every vet has more access to more information to permit us to make easier decisions. It is the inherent nature of our profession.
• We have a breadth of previous experiences to permit us to make easier decisions with respect to our own pets health care decisions. We love our pets just as much as our clients do, but, we have accepted that life and death duel without established rules of conduct. 
• I also think that there are too many vets who feel that it is easier if "you elect to euthanize." There is no liability in you electing to euthanize. We provide the options; you make a decision. The fault and blame lies squarely on your shoulders. My fear is that euthanasia is the one option we face the least litigation and backlash for. In most cases vets have to guess and prognosticate and we often have to do so with little to no data to support it. We make too many diagnoses without confirmatory data to support them. We are scientists who deny anthropomorphism and simultaneously overuse the noun "suffering" as a way to mediate our patients status.  Our task is to relieve this suffering and we too often use euthanasia as our tool to assist. In many cases lack of fiances dictates this as the only available option. 
• You must be brave enough, love enough, and be selfless enough to make a hard decision. We cannot, nor should we ever, presume to know what kind of regret, pain, or suffering taking away your decision might cause you.

While I recognize that some ask us this question as a way to try to understand information they cannot adequately process it is not fair to you or your pet to have anyone else act as judge, jury, or executioner. Take the time you need to understand the information your vet is providing you. Seek a second opinion if it will help. But don't pass the buck.

Raven

2. "Wouldn't it be cheaper to get a new one?"

While there is no argument with the fact that some diseases and some conditions are expensive to treat, (and that some may not even be treatable), we veterinarians are here to help your pet live longer, healthier and happier lives. Pet care and your veterinarians devotion to all of the years it takes to understand, heal, and help provide these, and, replacement value is the basis for a decision? Loving anything is not an economic equation. Your vet is probably a vet because they love pets and asking us to make an economic decision on a patient that most of us see as a family member is tantamount to reminding us that the emotional tie to pets is negligible. Don't ask this! We probably already know you are heartless, don't provide us with quotes to place as a reference.

Lucy

3. "I don't want to pay for stuff (vaccines/diagnostics) that I don't need?" 

Does anyone? Ever? Veterinarians are not able to foretell your pets future. We have to use our experience and training to provide you all of the best advice and pearls of our practice to help you understand what is in the best interest of your pet. There are numerous professional advisory panels to help us provide these recommendations. If you are ever skeptical, or want to make your own informed pet care decisions, utilize them. They include; AAHA, AVMA, AAFP, AHS, and each of the veterinary specialty colleges.

Weasely and Thor

4. "They are this way because they were abused." 

They are "that way" because some human failed them: True. But they are also "this way" because you didn't train them to know otherwise. Behavior problems are ubiquitous. They often do not improve with age, time, or all of the small concessions to avoid eliciting them that protective pet parents provide. The first sign of any troublesome action or reaction should be discussed with your vet. Please don't wait until someone is bitten, or you are unable to care for them in a safe and calm environment. The excuse that someone else bears responsibility for poor behavior is not a justification to not resolving it.

Linus

5. I don't believe in heartworm prevention/flea & tick prevention/vaccines, etc.

"My reply, "I don't believe in not protecting your pet from treatable or preventable diseases."

Ultimately you, the pet parent, are responsible for your pets care and health. You are also legally responsible and will be held accountable if a required vaccine is not given and a human being suffers because of it. I am specifically talking about rabies. I will, and do, advocate others, including helping clients to understand their complacency and culpability if they refuse to vaccinate, fail to protect, and dismiss the consequences of breaking the laws in place to protect us all.

People often ask me if euthanizing an elderly pet dying of natural causes is the worst part or my job? No, it isn't. It is hard, sad, and difficult, yes, but, watching a pet die from a preventable disease, that's worse.

Kitten intake crew

6. "I don't want to put them through, XXXX procedure."

Treating your pets disease, infection, trauma, etc is only accomplished through the care given by your vet and support staff. Denying that is a conscious decision to let fate have the upper hand. It is complacency, who is the nemesis to medicine and science. Utilize the tools and resources of your pets medical professionals at every opportunity you can.

Why are we willing to fix a broken bone but not remove a cancerous lesion? It is important to educate clients on how our patients are different from ourselves in both response to care and recovery. Losing a leg to whatever does not change who your dog is, nor does it change their ability to get up the next day and seize the joy they find. There are so many important lessons our pets have to teach us; one of the most important ones is that they can recover, thrive, and often prove to be far more resilient than anyone imagines. The point is that it takes time, attention, medical care and intervention to get them there. Too often the excuse "I don't want to put them through, whatever, " is a shirk to deny a second chance. Fight and work to protect life it is our single greatest gift to each other. And, lastly remember, our goal is to get your pet back to being happy and well. We don't want to put them through anything that isn't beneficial either. Ask us if the short term treatment plan is worth the long term gain. We will be honest with you.

Mallard

7. "I got a new puppy and I don't want my old one anymore." 
What the hell? I can only dignify this question with that response,, (and a few expletives, finger gestures, and a reminder to try to not say or do any of them in public).

I am a small animal veterinarian at Jarrettsville Veterinary Center in Harford County Maryland. I can be reached at the clinic, on Facebook, on Twitter @FreePetAdvice, YouTube, and for free questions and pet advice on Pawbly.com. If you are a pet professional or advocate, please join me on Pawbly.com. We are a free online community dedicated to helping pets and their people thrive.

ISO New Vet. How To Find A Vet To Fit You, AND, Your Pets Needs.

At the advice of my friend who has been a member of my little community for decades I joined an online social network designed to act as the community message board for almost everything imaginable. It has been a lifesaver for the wayward lost pet, traveling salesman warnings,  and garage sale announcements. It is a neighborly way to share information relevant to our zip code. It also builds a sense of community as we all look out for each other.

Tommy

 The other day an "ISO Vet" post appeared. I have furtively been watching the responses fly in. Most are the predictable; "I love my vet at XXX. Been going there for years!" As a practice owner for about a dozen years the recommendations overwhelmingly reflect the long standing small practices, and well established vets, in my county.

Titan and his best friend

What I am finding somewhat perplexing is the lack of important details that I think picking a new vet should include.

I sat down with the some of the clinic staff to hear their thoughts on what makes a good vet or vet clinic? I also wondered if their selling pitch points for our little practice aligned with my own? It was a discussion that reflected previous practice experiences, and the poor understanding most clients have when it comes to making consumer choices within the veterinary sphere. Certainly most of us prefer to stay within a drive-able convenient distance from our vet.

Are you simply about location? Perhaps there is only one vet in town? If so, the decision is easy and the post on community message board irrelevant.

But what else matters?

There must be more to picking a vet, and vet practice than "likability" and "proximity"?

Chubby gets a radiograph

What I found lacking in the post was any indication of what picking "your ideal vet/vet practice" should include? Like every piece of advice I give a client this is a long term relationship best built on understanding who you, and your pet are, and what is important to you both.

Think about what part of your pets care is most important to you?

Spend a few moments jotting these down and thinking about;
1. What were some of the things you loved about your previous vets?
2. What were some of the things you thought needed improvement?

These are a good place to start as you head off to find a replacement.

Jax and his family

Here are the tips I would give you when looking for a new vet practice;

• How many days of the week are they open? 
• Can you get a same day appointment for something you are worried about/aren't sure is an emergency? 
• Can you see a particular veterinarian at your request? 
• Do all same day requests/emergencies get sent to the ER? Ex. my pet is vomiting or having diarrhea now!.
• Do they publish prices for their goods or services? 
• Do they provide generic drug requests? Are generics only provided by request? Many clinics do not allow you any prescription options and this will almost always cost you more money.
• Do they provide written vaccine or preventative guarantees? Do you know these exist?
• Do they provide day care?
• Do they provide boarding? 
• Do they provide grooming?
• What if you have a sick or elderly pet and you need help boarding? Ex. a diabetic dog? 
• How much do the "routine" surgeries cost? Ex. spay/neuter/mass removal, dental.
• What if your pet needs an emergency surgery? Ex GDV, pyometra, blocked cat, foreign body blockage? Which surgeries do they provide in the hospital and which do they refer? 
• How much do the emergencies, or emergency surgeries cost? If you have a dog ask about exploratory surgeries or a cranial cruciate injury. If you have a cat ask about urinary obstruction?
• What happens if you cannot afford to pay for an emergency up front? Do they have any third party billing options? You need to know this before your dog has an obstruction or needs emergency surgery (you really, really, do if you don't have access to $1,000 to $5,000 immediately).
• Ask your veterinarian about which surgeon in the clinic does the emergency surgeries. In many clinics there may only be one vet, or even in some cases, no one, who can provide in clinic surgery care.
• What happens if you need your vets help after hours?
• What community based activities do they participate in?
• Do they have any assistance for any behavioral issues? Most people need some help at some point with this and I believe that every vet clinic should provide help and direction before a little behavioral issue becomes a source for surrender or euthanasia.
• Do they work with any local rescues or shelters? 

Mumford, One of the rescues we helped find a happily ever after

Here are some specific patient care points to ask about;

• What vaccines are recommended for your pet? Your pets care should be tailored to their breed, age, lifestyle, environment.
• How much do these cost? A written estimate and schedule for the vaccines should be provided upon request.
• What parasite preventatives are recommended? Cost? Are there other options available outside the clinic? Ex. Where I live dogs should be on flea/tick prevention and heartworm preventatives year around. Prices for these can range from $4 a month to $18 a month.
• Price to spay/neuter? There should not be a single cost for every size, age and breed. If so, ask how this is possible? Who does this surgery and how is it done? Ask for a written protocol, or interview the vet as to how they perform these surgeries. Find the AAHA Surgery Standards here.
• Price for microchip? Every pet should be microchipped! 
• What is the price for an average dental cleaning (only)  dog or cat?
• What is the cost for euthanasia? I know it is a terrible thing to talk about, BUT, some clinics will not provide a protocol, price, or even see you if it is needed as an emergency.
• What are the protocols for euthanasia? Do I need to be a client? (If they say "NO" ask why? and then run!).
• Do they provide cosmetic surgeries? If so which ones and why? Ask about how they are done and then do your own research on what is considered best practice?
• What are the recommended healthy pet diagnostics? Ie. heartworm test? fecal? How often,? costs? Information on everything heartworm can be found at the American Heartworm Society page here.
• Be very careful price shopping. It is common practice for the exam fees, vaccines, and routine spay and neuter prices to be marketed and provided as "inexpensive" but hidden fees, or exorbitant extras are commonly used to supplement the advertised "bargain". 

Is it possible to find a good vet at a bad veterinary practice? Does anyone even think about the practice behind the person? I know of lots of wonderful vets working at practices that dictate what they can, and cannot do, based on liability and revenues (overwhelmingly revenues). They cannot offer options that might be more affordable, more convenient, or more personalized. Would you even know the difference? How can you tell what the often absent clinic motto, corporate conglomerate behemoth, or fine tuned patient care schematic is behind that white coat?

There is more to choosing a family care provider than location and likability. There has to be a deep level of trust, a provision of transparency, and these days a consistent level of care for how YOU SEE YOUR PETS VALUE IN YOUR HOME.

Rio

The idea that one size fits all, and, all vets are the same is not the reality. 

P.S. Just in case anyone is curious; here is what my clinic does for our patients;

1. Jarrettsville Veterinary Center is open 7 days a week. 

2. Walk-in appointments for clients are available everyday.

3. Most surgeries are done in house by our own vets. Beware clinics that offer specialty surgeries by surgeons who visit. There may not be adequate after care available if there is a problem. Also, referral surgeries (in my opinion) should be done at a referral practice.

4. All of our prices are published online. This is updated every year. 2016 Price Guide List here.

5. We do not provide cosmetic surgeries as a matter of placing patient care above client preference.

6. We do not provide declaw surgeries. See blog on declawing here.

7. We offer third party billing to our clients if credit is not available. Why? Because patient care should not be a matter of ability to pay up front. More on this here.

8. We do not provide euthanasia to anyone except our clients and patients we know, or pets with terminal untreatable disease. See The Success of Drive-Thru Euthanasia Clinics.

9. We are available on Facebook messenger at all times. We answer quickly, usually within minutes. 

10. Practice and personal emails are available to all clients for anything they need. Wouldn't everyone like to be able to reach their vet without being put on hold, taking a message, and waiting for a phone call back?

11. We provide our community with a pet food pantry, Good Sam Fund, free boarding if it is too hot or too cold for outside pets, and we do not euthanize based on lack of client finances.

12. We stand behind our motto to "always be kind" and we never deny care to a client in need. So much so that we have provided homes and second chances to any Jarrettsville Vet patient surrendered at any shelter or rescue. Once you are a part of the JVC family we are there to help you forever.

As a person who used to be a client I understand the difficulty in all of these open ended questions. As a practice owner and veterinarian it is why I built Jarrettsville Veterinary Center into the place that I would want to bring my pets to.. For those of you who aren't so happy with your vet or vet practice I would say, "keep looking. Your perfect vet, and vet practice, are out there!"

A much appreciated Thank You note from a client.

I am a small animal veterinarian in Harford County Maryland. You can find me at the clinic, Jarrettsville Veterinary Center, on YouTube, on Twitter @FreePetAdvice, and if you have a pet question, or, are a pet person please join us at Pawbly.com. 

The war between the veterinary profession and the passionate welfare advocates. The declaw debate.

Magpie, the editor..

My very good friend, Karen, called me yesterday to borrow some battery juice. She has found her second calling in life as a feral cat rescue lobbyist and welfare reform advocate. She wanted my thoughts on declawing and why it is so impossible to find affordable help from the veterinary community for the multitude of rescue organizations she is trying to assist? She has spent enough time entrenched in the horror reality of cat rescue to become bitter about how my side was crippling her efforts to get where she wanted cat welfare and their critical medical needs to be.

The conversation started as they always do... We reminded each other how much we needed each other. How hard we were working, and, how the road blocks never seem to lessen, soften, widen, or cease. We always start with gratitude for our friendship and commiseration on common ground.

Karen has made numerous trips around the country visiting rescues, organizations and other role models for feral cats in the hopes she can pick up some of the tips and tools of their successes to carry back home for the benefit of New Jerseys over whelming under served misplaced community cats. She is a woman on a mission and she has gumption, intelligence, and resources. I admire and adore her.

Her dilemma du jour was causing her ulcers to erupt. She was curious and reluctantly pessimistic to see what my opinion and stance on declawing was? I could hear the trepidation and despair in her voice as she muttered, "I cannot believe this ban might actually stall in NJ? The veterinary association and even my own vet, who I have known and trusted for years, is opposed to the ban. How could anyone be opposed to this ban?" (see more on NJ's proposed ban here)

I knew that the long pause at the end of her question was laden with despair should my title provide another disappointment in the current state of animal care humanity.

Her naive misplaced assumption was that NJ Vet Association, and, her own beloved vet who are sworn to the "protection of animal health and welfare, and the prevention and relief of animal suffering" love cats. How then could they oppose banning the removal of the end of these cats fingers? Anyone with any personal investment in animal care wouldn't accept this as appropriate form of animal husbandry?

Sad truth be told, it is the well affirmed time honored tradition for all of the Vet Med associations to oppose anything that might infringe on their ability to do anything they want to. We can speak out of one smiling side of our mouth passing out cartoon books to kids about the honor and pride in being a custodian of the livestock, food supply and bed fellow, but, the other side is desperate to maintain a veil of blind trust. This includes too many horrific antiquated realities like debarking, animal testing, and almost completely unregulated (wrt compassion seeking hidden cameras) protected slaughterhouse practices which are definitely not for the feint of heart. We also vehemently rationalize pets as property for every reason, including that we euthanize when owners cannot, will not, or do not want to pay for care, services, assistance or treatment. We want to do whatever we can to earn a living without any government interference, oversight, or laws, just like every other professional organization big enough to have a bank account, a lobbyist firm and eyes to monitor every animal related rule, law or proposal.

My Wren.. My heart fills with her near me.

What is declawing? It is, in very simple terms, the amputation of the last part of the digit of the fingers/toes. It either involves removing the piece of the toe that has the nail attached to it, or, surgical alteration of the toes that paralyzes the nails ability to extend or use the nails at all. This latter method, the tendonectomy, is not recommended by the AVMA (American Veterinary Medical Association), versus an onychectomy (surgical removal of the end of the toe) which is neither recommended nor disallowed. The AVMA position can be found here. 

I wrote a blog on this a long time ago, What You Need To Know Before You Declaw, about my feelings on amputating toes to save furniture.

I admitted to my dear friend that of all of the amazing things I am proud of at my clinic there was one subject that caused more dissension and resistance than anything else; my declaration of prohibition of declawing. It was the first, and subsequently only, time that I refused to allow the vets to do what they want to based on what they think is best practice. I would hate to work for someone who micromanaged me, and therefore, I don't, (or at least try very hard not to), do it to others. We had varying opinions on the practice, but my heart, our practice philosophy and how we look ourselves in the mirror when these declawed cats come back to us for euthanasia (after I feel responsible in some part for their current state) left me feeling like I just had to say no, for good, and forever.

I decided that I feel obligated to be true to our motto of being a "cruelty free safe haven" and this is will remain our first obligation. I also did not want to profit on something I did not support. The ban has been in effect for one year. It has been the right decision. My conscious is clear as I help the cats in our community find a better life and a more accepting attitude for them to be who they are.

Jitterbug full on cat nap on our bed.

Let me summarize some of the reasons I hear vets still supporting declawing;

1. We can provide it safer than the back yard do-it-your-selfers. My response; I cannot answer this other than to hold up a coat hanger and remind ourselves cats wouldn't choose to have their toes cut off regardless of the degree of expertise yielding the blade.

2. We provide pain management. Me; OK, isn't that ethically responsible for everything we do?

3. We only do it if the pet has no other options to stay in the home. Me; And those peeing cats? What do we remove to save from euthanizing them? We do not lower our standards of acceptable care because others lack them to begin with.

4. We do it to protect people who have bleeding disorders. Me; There are other ways to keep nails from being so sharp, like trimming, or even use glue on nail covers.

5. Economics. No one wants to say it out loud but we vets make money on declawing cats. At my clinic it was about $500. I know of other clinics who charge upwards of $1500 to declaw.  The surgery is quick, easy and lucrative.

The nephews start to socialize the newest clinic orphans

The overwhelming reason I have clients requesting declaws is two fold;

1. The cats are clawing their owners furniture. Protect the furniture by maiming the housemate?

2. It has been a practice vets have offered for decades. In the USA it is accepted as a matter of historical precedence. We vets have failed to provide the time to educate owners on why cats use their claws, and how to curb it. We fail to provide the needed network of support to save these cats from surgery, surrender, frustration when they inevitably try to evolve from a predator who hunts, climbs, and explores to a sedentary pet with as much inconvenience as a fish. Neither party has made a strong effort to evolve into a more compassionate caretaker.

Like every unwanted behavior intuitive to a species it takes time, training, and patience, and yes, some degree of acceptance that we can live together with each others undesirable ticks and compulsions.

Cats are compulsory stubborn persnickety unyielding souls with solid reasons for doing what their ancestors have seeded as a life preserving habit. For my kitties, who are in truth the children I will never have, I see their marks on the side of my side chair (worth all of about $200) as a calling card for their staking claim to our home as theirs. Magpie greets me every morning with a long stretch of worship and begging for a hug on the back of the chair I keep in her room. These cat calling cards are touchstones of anointment scattered around our home. The key to my acceptance is that this is OUR home. We share it. Cat hair, disposable upholstery, litter box scatter, and love. There is an unwritten mutually agreed upon acceptance as to what is off limits and what is cat Parvati territory.

Jitterbug photosynthesizing

The personal side of declawing runs deep and painfully pierces my gut. These cats suffer, they are subjected to a painful unnecessary procedure. Even with providing this surgery with the highest standards of pain management, careful dissection and after care, many of these cats become less inclined to being affectionate companions as we have removed their natural tendency to feel and interact with their own environment by touching and leaving their scent behind. Cats are furry graffiti artists intent on marking their world and tagging their friends as next at bat.

Where was my friend to go take her rescue organizations rallying for a bill everyone should be agreeing upon from here? Simple; to remember that if we can find our common ground, our common purpose, we can start the discussion and make meaningful change for the betterment of cats everywhere.

My personal advice for her dilemma given the lack of compassion she sees her vet possessing: Find someone else to care for your pets after telling her why you are leaving. In the end I would guess her position is based on the reasons I list above. Support the vets who you find common ground with. Ultimately your vet needs to be someone you trust and believe in.

Oriole

Here are my tips to providing resolution to scratching and clawing;

1. Learn how to trim your pets nails. I have YouTube videos to help with this. At my clinic we offer free demonstrations with the technicians to help get our clients comfortable with restraining and trimming.

2. Offer your cats options to be the tactile I love the corrugated scratching mats. I bait them with fresh dried organic catnip weekly. They are placed all over my home. They are the disposable demolishable offerings I provide to allow them to release their inner prowess. I vacuum them weekly and replace them about every 6 months.

3. I discourage clawing the furniture by providing acceptable options in the areas they choose to scratch. I either place a blanket over the corner of the chair, or place a scratching board or mat nearby.

4. I understand and acknowledge that my cats claw in my presence for attention. It is their non-verbal way of saying "HEY! I am here! What's up with you today?" I always reply with a "Good Morning!" and pick them up for an acknowledgement cuddle. Yelling at them when they are saying 'hello', looking for loving attention does not articulate to them that I am upset they are scratching. They DO NOT correlate the scratching to my disapproving discipline. They just hear "BLAH! BLAH! BLAH! Magpie!" Which translates to "I hate you Magpie!" She has no idea what she did or why I would be harsh to her. NEVER EVER EVER YELL AT A CAT! It is counterproductive and cruel.

It is up to us, the veterinary profession, to place patient care above all else. Not our wallets, not our clients furniture, and not the rest of  the excuses to not advocate for our patients welfare. Period. My gut tells me that this won't happen. We will remain stuck in old outdated unshared beliefs and actions and further grow the divide. I also believe that the masses demanding change will call us out on our hypocrisy.

Be on the first wave of turning the tides. Build your practice on compassion. I can attest to it being the most lucrative way to grow with a direction you aren't stuck killing an angry painful cat on.

I will stand on this soapbox alone as the single vet screaming at the rest of my profession and declare that we know better. We see the best of our clients affections for their companions. I will challenge us to never place personal or financial gain above the health, wellness, happiness, and personal protection we owe our patients. They should be who we serve to protect first. It will happen. One state at a time, one vet shaming at a time, one bold outspoken animal advocate at a time chipping away on tradition, fear to embrace the true side that builds our businesses and aligns with our own experiences and sad declaw stories. We do know better. We owe our cats better. We have an opportunity to really be the trusted advocate we portray ourselves as. I don't believe that many of us really still regurgitate the empty words that "just because we have been doing it for decades" is a valid excuse to keep on putting ourselves first.

If you have a pet question that you would like to ask me please go to Pawbly.com. Pawbly is free to use and open to all pet lovers. If you want to visit me at the clinic we are open 7 days a week. Also please follow us on Facebook, my YouTube channel ad on Twitter @FreePetAdvice.

Managing a Broken Toe Nail At Home

Blood, it's a scary thing when its all over your carpet, walls, and seems to be unstoppable. Many a pet parent has called in shaking hysteria recanting some bloody unexplaianble crime scene to find that the crimson spackle decor is simply due to a toenail.

Every time I explain the same thing;

• "Yes! I know it does look like a lot of blood. But it always looks worse than it is."
• "No, it isn't an emergency."
• "Yes, you can manage it at home."

If your pet is struggling with a bloody foot the first thing to do is calmly restrain your pet. Have someone hold the head and body gently. Many pets are adverse to having their feet held. Start at the body and head and then when you have a calm pet look at the foot.

Some pet parents will see their pet limping and not see blood. A toenail that is broken at the base can be painful as the sharp edge of the nail rubs on the tender tissue of the toe. For these cases I ask my clients to

Hello,

Clean the toe with warm soapy water and then use gentle direct gentle pressure for 10 to 15  minutes to stop the bleeding. Try to discourage your dog from licking the nail. For this reason I usually give either a local anesthetic or a day of an anti-inflammatory (never ever use a human OTC). Or you can try a loose fitting sock to cover it. Make sure that the other nails are kept trimmed so that they don't have the same thing happen to them.

If there are any signs of infection, persistent pain, or a limp see your vet.

No one ever wants to admit it, but a broken nail is not an emergency. It can look like a lot of blood, but if you can stay calm, get it clean, and keep your pet calm hile you apply direct pressure it will stop bleeding. After that just don't let you pet traumatize it any further.

hope this helps.

If your pets nail is almost completely broken off this is the source of the pain, and therefore the subsequent licking. I use a muzzle and tweezers and quickly pull the nail off. If it is hanging on by a small piece of nail it will come off quickly and easily.

If the nail is almost fully attached I cut the nail back as much as possible so it isn't acting as a fulcrum and annoying the delicate raw tissue underneath.

Regardless, none of these are emergencies. Use a sock to prevent licking. Use Quik Stop (or baking powder) to stop the bleeding. But most importantly be careful if your pet is painful, and especially if they are already a pet who hates to have their feet or nails touched. You don't want to be bitten because they are painful (that would be an emergency).

See your vet if the licking, pain, or lameness/limping persists for more than 12-24 hours.

Euthanasia. Why do we make it so convenient?

Let's boil it down to the simple one sentence conclusion: Life isn't easy, it isn't fair, and it shouldn't be convenient.

Don't we all agree on that?

I am at the point in my veterinary career where easy is not my primary job compulsion. To make it easy in some way seems to be diminishing the importance of that life. The reflection of what their time meant. The transient nature of a disposable, replaceable piece of property. There is beauty in all things, saying goodbye, watching life move to another place, and the peace of being in the last chapter included. We have tools to help with pain, and suffering but removing them because they are unpleasant seems a bit like cheating their value to the beauty of life's magnificent moments.

No doubt my most uncomfortable and difficult moments reside in assessment of "quality of life". I scrutinize every euthanasia appointment and debate whether this is appropriate and necessary. It is not what some clients want to hear. They expect I am there to comply without question or discussion. (So much for the healing hands BS you thought your life represented in that stupid white coat of compromise?)

There is this growing segment of our profession for in-home euthanasia veterinarians. I understand why so many have chosen this as their way to avoid the stress and pain of general practice. The old joke that vets receive the nicest cards, comments and adoration from our clients is when we euthanize their pets. How sad is that? They like us the most when we are the hands of death?

People euthanize their pets for a huge number of reasons. Granted the overwhelming number of people who seek in home euthanasia veterinarians are looking for a quiet peaceful way to bid their beloved pet a final farewell. We have painted this picture of these hospice angels who are a phone call away to help end suffering as harbingers of the best of our professional compassion. We also paint analogies between ourselves, the all compassionate vets, and our human counterparts who watch and prolong suffering because they are powerless to call it as it is and end human life humanely. We cannot, nor should not, make such parallels. Although the love is consistent in all of these relationship scenarios, pets are, and remain, at the mercy of society's classification that they are property. Any human being can walk into any veterinary practice or shelter and relinquish their pet. If this is a cat they will most likely be euthanized immediately. If this is a dog there is a chance, a small chance, they will not be killed and perhaps given a second chance with another family. We live in a consumer driven, quick, convenient, disposable world.

We are a profession of dichotomies. We do not practice what we preach and we do not support what we condone. We advise routinely that clients spend thousands of dollars on care and provide economic euthanasia when they cannot afford us. We have to decide who we are and stand as a profession behind the care we recommend from start to finish. It is time to start asking the hard questions, debating the grey area, and supporting each other simply because we all share a love for pets as a part of the family.

How does a vet handle this? We all handle it differently. Most are left to feel that if the owner won't provide care and support they should not feel guilty or obligated to do so themselves. In my opinion it is the biggest fracture in a vets ability to live at peace with themselves and one of the biggest reasons our suicide rate is so astronomical.

How can we compare ourselves to the medical profession if we can seek, and feel most appreciated by euthanasia?

These are open questions for me.

I know day to day general practice is demanding. It is stressful, anxiety-ridden, and fraught with having to always make sure your ass is covered and your client is happy. Euthanasia is free from all of this. Why is that? Well, sadly because as much as we advocate, commercialize and promote the notion of being "the other family doctor" we are not. We have no protocols, criteria, or restrictions on which cases are euthanized and by what criteria. This is a far cry from what our human counterparts have to adhere to. In a few states around the USA people can seek assistance to end their own lives. The stipulations and guidelines for this to be permitted require at least three doctors be in agreement and that the patient is coherent to understand their own disease and prognosis. A waiting period for permission to get access to the life ending medications is also required. In short it is never a quick, easy, or independent process.

Why so do we then promote one phone call to permit it on the veterinary side? Because pets are property. And we all know that the peaceful passage with a veterinarians assistance is better than the backyard and a bullet. Hard to make an argument when reality and a millennia are your precedence.

I don't spend much time in the delivery room, insemination collection or distribution arena anymore. It is not where I find a sense of purpose. The world of breeders has shifted to the pages of Craig's List, backyards, and tax aversion employment. The established breeders are increasingly doing more on their own, in their own breeder selected veterinary clinics. All of those that I know of are high volume, low price assembly lines. My time and focus has shifted to the middle and endings of the life spectrum.

While I would not be so bold to say that I am not a hypocrite I understand the desire to have my dear beloved pets laid to rest peacefully and quietly at my home. For every dying soul in my family they have met their light in my arms on the floor of our home with just myself and my husband bawling our eyes out, blurred in my ability to find a vein and delivery our goodbye. I too don't want them to be carted off  in our car to sit waiting for the vet to see us in our darkest and final hours. I embrace the empathy in this.

Where I have a very hard time providing a blessing is in the lack of professional courtesy between the lifelong general practitioner and the euthanasia practitioner. As the field of available on call euthanasia vets grows there has still yet to be one phone call, one request for medical records, or one questioning of whether there might be some palliative therapy, some provision of hospice, and some assistance to not make death easy and abrupt.

Why is it our mission to make life easy? Free from feeling? Why are we shortchanging our patients lives with a feeling of pride that we provide convenient options for end of life decisions?

As I add another notch of another year of practice to my veterinary belt I am changing my viewpoints on life, death, and my role in the continuum of these in the veterinary spectrum.

Life isn't easy, it isn't fair, and it shouldn't be convenient.

If you have a pet in need, or a pet question you would like to ask, please find the helpful people at Pawbly.com. It is a free and open community for anyone and everyone who loves pets.

I am also available via Facebook, Twitter @FreePetAdvice, and YouTube. 

Hank. Cervical Disc Disease Management When Surgical Treatment is NOT an Option. His journey and recovery blog.

Hank was a statistic no one wanted to happen.

He is a beagle who is middle aged, lazy and overweight. He also spends his time outdoors with a hyperactive over exuberant nut case of a brother, Moe. Moe has everything going for him. He is active, lean, muscular, and full of energy. This lifestyle has made him a powerhouse, it has also made him a liability to his brother, fat, old, slothy Hank.

Moe, Caleb, Hank

Hank was found laying on his side unable to stand, move, or walk on a Friday afternoon. He was shaking, trembling, and crying in pain. His family brought him to see me on a Sunday after it was apparent he was not recovering on his own.

Now I am just like you. I heard his story, looked at his pitiful pathetic desperate self and thought, "Oh God! why did they wait to bring him in?"

This is what I saw when I entered the exam room the first time I met Hank and Caleb.
I will never forget seeing them.
I feared the worst...

I have been wearing a white coat for a while. It has provided me some important life lessons. One is to not assume or rush to judgement. Hank's family was overwhelmed with caretaking for their son, Caleb, who has spina bifada. Caleb is 8 years old and preparing for his 6th surgery this year. It was very clear very quickly that this family was taxed beyond what many of us could handle on a routine basis and now Hank was down and out. When I discussed my concerns for Hank, how he needed to be transferred immediately to a neurologist and how the optimal care for his current condition would require an MRI and decompression surgery with its $8,000 to $10,000 price tag, his family went white with anguish.

Hank was Caleb's best friend. His lifeline, and his inspiration for all of his surgeries. At every surgery Caleb carried in a stuffed version of his beloved Hank to keep him company.

My bright idea of publicly posting Hank's condition in an effort to gain social media assistance to cover some, or all, of Hanks medical costs was abandoned when Caleb's mom quietly mentioned that they already had a GoFund me site set up to help pay for Caleb's next surgery. How could I ask for help with Hank's medical needs when Caleb's were in competition for those dollars? There was no way I was going to ask, or beg, for help and have it cost Caleb. So I did what I believed was the only option left. I took Hank's case on as my own. No advertising, no reimbursement, no discussion of anything except to say to his mom "You worry about Caleb and yourself, and I will worry about Hank."

And so it was. After two nights in the clinic Hank came home with me. I arrived at home late Wednesday evening with a paralyzed Hank and an almost absent ambivalent husband who now expects that I take the critical cases home with me. A few minutes of basic technician training and my husband was enlisted in Hank's care and understanding that verbal protests would only damage our relationship and fail at discouraging my maternal veterinary compulsions.

After 14 days with us, including a week of almost completely sleepless nights because Hank refused to sleep on a dog bed at the end of our bed, and would only stop crying, whining and bellowing when I put him in our bed. Which is a ridiculously dangerous place to be because who wants a paralyzed dog to fall out of bed? AND he is peeing and pooping at unforeseen intervals.

Hank required 24/7 care. Multiple baths at 2 am because had to go to the bathroom, multiple times getting up to try to figure out if the whimpering and discontent meant he needed something like, perhaps,, food?, water?, pain medication?, to go outside?, to sit up?, to get more attention?, to see the cat who believed she also belonged on the bed?, to cool him off?, warm him up?, etc. etc. There is no exception to these pups being an intensive amount of work with an unknown amount of recovery time.

There were days I went to work exhausted and cranky. There were nights my husband hated me for inflicting these restless nights upon our bedroom. And, there were the endless questions of whether this was all for naught? Would he ever get better? Would his family take him back? Would that be best for Hank? What would the rest of Hank's life look like? Would he relapse in a week? A month? A year? Would he recover the next time?

Here is Hank's YouTube diary.

There are a few critical things I hope that everyone leaves this blog with;

1. These cases are difficult.

2. There is no rule book for time and prognosis.

3. These cases need affordable options provided to clients,

4. Never surrender hope.

5. Or let anyone steal your faith.

6. These cases deserve an opportunity to provide and offer the fertile ground of miracles a chance. If any vet tells to you surrender your hope IF YOU DON'T have a couple grand available immediately walk out and find another vet. 

7. Managing pain is possible, and these cases have a chance at recovery. Hank was trembling and panting for a week in discomfort. It was hard to watch, and I tried very hard to keep him as comfortable as possible, BUT, I did not out him in a drug induced coma. 

8. We got through it together! Me, Hank, my husband, and the staff at the clinic. Provide a supportive network or encouraging helpful people. Death is not an option I considered. I understand this is on a case by case basis, BUT, I was prepared for a cart and a dog who needed help for as long as Hank needed help.

What does Hanks future hold? I am not sure. He is home with his family. We talk often and we will continue to do so. Caleb has his next surgery next week. Our best wishes and thoughts are with him. We have faith,,,, sometimes that is enough.

Caleb comes to visit Hank, day 3.

Hank and his family day 10

There is a whole lot more information on IVDD on my other blogs. Please visit them. I think they answer every question I have ever had on managing this disease.

Hank goes home, day 17

IVDD. The Days Immediately Following the Diagnosis.

IVDD. Dr Kelcourse's Advice.

IVDD. A Tale Of Two Outcomes.

If you have a pet in need, or a pet question you would like to ask, please find the helpful people at Pawbly.com. It is a free and open community for anyone and everyone who loves pets.

I am also available via Facebook, Twitter @FreePetAdvice, and YouTube. 

The Year Of Year Around Care, Transparency, and Accessibility. How Jarrettsville Vet Will Redefine Exceptional Patient Care.

2016 was a banner year for us at Jarrettsville Vet. It was really the first year we started to both think and act way outside of the traditional veterinary clinic box.

We were always a little different. Something I embraced a long time ago. I wasn't cut from the cloth of everyone else and I have learned the very hard and painful way that I could be exactly who I felt compelled to be without fear of castigation and shame as long as I stayed true to who I had always dreamt I wanted to be. At some point you grow out of the ability to force yourself into a mold you foolishly think others believe you should fit into. It is a combination of maturity meets exhaustion when you just cannot be at peace with yourself any longer. Last year was the year I really gave up trying to do anything else except help animals. Last year was a banner year because of this. All of that sweating the small stuff of being responsible for payroll, bills, and overhead gets, well,,, old. It inhibits your freedom to be creative, to live beyond possessions and when you are a dreamer at heart it is a parasite on your vision.

In 2016 we helped rescue, tame, care for, vaccinate, spay/neuter and find amazing homes for over 60 cats. We also helped about a dozen dogs. It was a sincere pleasure and delight to see emaciated, frightened parasite and disease ridden skeletons blossom into jubilant healthy joyful love bugs, and then head off into a life of their own. It happened over, and over, and over. So much so that many of us actually didn't recognize them when they returned to be spayed and neutered. 

We also opened the kennel up to any pet who needed shelter on the hottest, or, coldest days of the year. We helped feral cats in snow storms, homeless pets from freezing in cars, and even a chicken who forgot to shed feathers in the Spring versus the Fall. Did the pragmatic vet in me whisper about fear of staff being bitten by unknown pets? Yes. Did I worry about giving up paid tenant space to a poor homeless kid? Yes. Did I secretly fear that some random uncared for pet might cause a disease outbreak? Sure I did. But at the end of the day, and at the closure of 2016, I know that my heart, and the hearts of the staff who work so hard to help every pet we take care of, believe the purpose of JVC is to "always be kind." We live it.

This year also marked the beginning of our JVC Food Pantry. The simple extension of providing vet care and shelter without cost to those who need it, also now extends to feeding those who do not have the means to buy food. 

We also had a work shop day to make outdoor cat shelters. Thanks to the incredible generosity of our friends at Gemmill Plumbing, Heating and Air Conditioning we made a dozen  cat houses (that got snatched up in less than 24 hours) for the cats who do not have a warm inside bed to share with their humans. The shelters were offered to anyone who needed them for the suggested donation cost of $7.00. We provided them for free if this was not affordable. (PS please visit the Gemmill's and send a big Thank You!). It was such a resounding success that we are doing it again this Thursday.

This year our Spring Yard Sale was a huge success too! We raised about $2,000 from vendor donations and friends who donated every thing imaginable. Our Pets With Santa also raised about $2500 for the Good Sam Fund. Two fundraisers provided food, lodging, feral cat care, homeless pet assistance, and a litany of good deeds.

Did I ever imagine that every single pet need would be covered by our community pitching in to help? Well, it far surpassed my wildest dreams! I thought I would just end up doing a whole lot of pro bono work to fulfill the presumed endless need, but, it turned out the outpouring of support far outnumbered the need.

Simple things like posting our Price Guide. Putting our transparency where our mouth is provided proof that we have no hidden agenda other than to be the place that your pet is provided the best care at the most affordable prices. It is what I would want if I was the person sitting and waiting in the exam room. I would want to know that my worries would be treated with respect, fairness and dignity. There are endless options as long as the team approach remains focused on helping your pet. Where there is love there are options to help preserve and protect this bond.

So what is new for us in 2017? Well there is a lot!

We are going to be offering Pet Savings Plans to help spread out the yearly costs of pet care. We are going to provide options to preventatives. You can choose the "Easy Preventative Plan" the "Most Affordable Preventative Plan" or, the "Preferred Preventative Plan". We will even send you reminders for them, AND, we will show you what the online pharmacy charge for the same preventative is. (Look out Progressive Insurance,, Move over Flo!)

We are offering new services, new client options for goods and services and we are going to do it with credibility and integrity. The heart and soul are complimentary and always included.

Accessibility has been a key factor in our ability to help our clients. If you need us you can find us anytime via a Facebook message, a question on Pawbly.com (free!), or, coming in late Spring via our app. I also widely publish my email address for all clients. If you don't have it call me and ask for it. It is on every receipt and end of examination Pet Report Card.

What else is there to do? Well, I am going to move mountains, break ceilings, and shatter myths about veterinary medicine. If there is one veterinary demon left to slay it is that I am not going to stop until every pet has a home, every creature has a warm bed, a full belly and a loving hand to share their life with. How can I do this? I am going to keep finding ways to end the ridiculous practice of economic euthanasia. What is economic euthanasia? It is the veterinary profession's way of saying "the only option for you is to euthanize your pet because we can't offer you more affordable options." It is the sequela of abandonment of where this profession came from and legal sheltering of pets still only being considered as "property". We can do better. I am going to challenge the profession to see the shame and the betrayal in this term.

For anyone who might not be confident in the ability to have faith that the new year won't bring positive changes I invite you to stick close, find us, and watch what can happen when you don't care about anything else except building positive change. Is it possible? Yes, if you believe and you dare to be different. Here's to 2017!

Related blogs;

Price Guide 2016

Economic Euthanasia

What is Pawbly?

Pet Savings Plan, JVC Plan For Clients with Financial Constraints

Jarrettsville Vet Pet Food Pantry

Borrowing Battery Juice

Wellness Plans and Savings Plans, and Surprises

What do you think? Is change in veterinary care possible? Is it something you think needs to happen? If you have a voice for better pet care please share it.

If you can help a pet in need please find us at Pawbly.com. It is a free open online community dedicated to helping pets and their people.

I am also on Facebook, Twitter, YouTube and at the clinic helping every wet nose and furry friend.