Hand Holding Anxiety. When You Love Too Much It Costs.

 Hand-holding vs. confident and competent?

Izzy takes a ride with Allie.

It occurred to me that as much as I hope to practice for the latter I see a lot of the former. Maybe I attract it?

Maybe I market it,,, albeit unknowingly.

Questions about intentions from the newest rescue we are helping.
This little one is about 10 weeks old and was rescued from a dump in deep Kentucky.
She had an ultrasound and some questions about the size of our position pillows.

The issue is not that one is better, or worse, than the other. The issue is that I am not as adaptive as I hope to be, or know others hope me to be. The issue is that I am too sensitive, too driven and too insanely compelled to practice for the benefit of the patient and forget to tailor my delivery to the client.

 The real issue is that I forget I am merely an extension of the leashes many avenues, and not the patients only resource to recovery. 

Teddy. TPLO surgery last Wednesday.
All sweetness and a pinch of Border Collie anticipation.

Yesterday was an example of this. Yesterday was Lilly. A bubbly, bouncy curly ginger girl who has had multiple trips to the ER and multiple trips to my clinic for her waxing waning intermittently, self-described as "violent" vomiting and diarrhea. She is owned by two doting millennials. The kind that the vet journals remind me to both recognize and cater to. They are the new generation of my bread and butter. They love their pets in place of having children and they will both spend for them and advocate for them. These are the couples with sets of pet outfits, all personally monogrammed with the family crest, one for each member. One for each holiday, each gathering and always captured in holiday post cards. They have vacations designed around "pet friendly" parameters. They are new parents who jump and take notice at the first sign of illness, discontent, or dismay. They are what I want every pet parent to be, not withstanding the narrow age bracket to remind me I still live in a rural place where people on farms still refer to all species with a prefix denoting "farm use." (The labels can literally kill you around here).

Skylar, also a TPLO surgery Wednesday.
The eyes, they always get me.
I spend a significant amount of my work day reassuring.

Lilly's mom arrived in her work clothes. A clean, dark, pet hair free, (I cannot remember the last time I had one of those outfits, likely never) pencil skirt, with mid-heeled black leather shoes,  and a tight fitting ruched shirt to match. She must work in an office where professional image matters, I think. I have yet to ever live that life,,, (and, yes, there is a side of me that is jealous about that). Compared to my professional attire which included; poorly matched scrubs, upper and lower hemispheres, and not-at-all comfortable, (nor supportive) sneakers with the laces untied dragging behind me swinging to and fro collecting hairball tumbleweeds as they traversed. I was reminded of the hazards by everyone I passed and still was too tired, too painfully arches in agony, to correct them. I have considered adding slippers, or Crocs, (I cannot believe I am here), to my wardrobe as the days get soo long I am reminded my body is decaying. Lilly's mom was intense, apologetic and fretful. Her dog is just over a year old and she has been to the vet a dozen times for the same thing. She is also, in quiet, subtle undertones, worried about the current place her vet bills lie and what the road ahead will look like to for retirement account if she stays on the current path for another decade.

It was 730 pm. We close at 8. I had fit her in after her call at 630 pm begging to be seen for her dogs "vomiting and diarrhea all over the place for the last 3 days." I had been in the clinic all day, 12 hours, and I was,,, done. Toast. And I know it.

I was exhausted. And now I have Lilly in front of me, with her worried mom,, and I am asking myself if I can see just one more case today? I remind myself silently that this, this profession, this day, and yes this moment,, is not about me. There are times, many times, and many days like this, where I am a bag of bones with untidy shoes, urine/fecal stained scrubs and a belly soo dehydrated and hungry I cannot adequately focus, nor separate myself from the clock calling me to close. I had arrived at the clinic at 8 am. I have not had a meal of any sort, nor sat down, nor taken a break to clear my cluttered head. There were 11 surgeries today. Two of which were my own pets. (Let's talk about how difficult that is). Then pile it on top of a day like this. I remind myself there won't be anything left of me to cremate when the burner expires within. I know this. I push my nose deeper into the ground and flex all fours to plow on. 

"Lilly's exam looks fairly normal." I reply. Lilly is now cowering behind her mom. She is drooling with anxiety and really wants me to go away. Pet hair free and upright on her kitten patent leather heels she asks me, "Why does this keep happening? And, how do we stop it?"

It's 745. That answer could take another 12 hours. 

Gunner, using the almost infallible tactic of,
"I'm too cute to ask to participate in an exam" ploy.

"Well, we have never gotten her a diagnosis. We are always treating the emergency and never investigating the in between times that might be leading her to this." I reply.

It's 750 pm. I sit down. I have to. I look up and meet her moms eyes. This was not the answer she wanted.

"Again, thank you for seeing me today. For fitting me in."

"You are welcome. I know you are worried." I suspect she is also worried about needing the ER, having to repeat an overnight stay. The x-rays, blood work, and ultrasound. Never mind the barium study. All of these have been done. And all were normal. 

"Maybe it would be helpful to keep a journal?" I suggest. Something for us to better understand what is happening between her visits? She is a normal weight. Normal size, normal coat. A picture of a healthy dog, but,,,, (bracing myself here),,, she is nervous. Mom is nervous. Is everyone in this household nervous? Stressed? How much exercise does she get? There is a direct correlation between dogs who play, act, and remain happy independent of their parents. I suspect she is a single pet in a perfectly doting home and maybe this isn't beneficial to her gi tract?

I suspect too much love is not what her inner self needs to grow up feeling confident, calm and content with the world she lives in. Good news is there is not an expensive diagnostic for that... just some difficult conversations and a few transitional anti-anxiety medications.. and,, "have you considered another dog?"

Pumpkin is waking up for a mega-dental extraction dental..
very common in older dachshunds.

Lilly is like so many cases I see everyday. I am never sure how problematic a medical problem is when I am not sure that the environment is influencing the clinical signs. Can you love a dog too much? Yes, when you complicate the problems with perception, actions and off setting the balance every life needs. That balance of allowing your pet to be who they are and not needing to live in the shadow of who you are and what you expect them to be. Feeding; the dilemma of feeling desperate to have your pet be happy with their meals, eat as much as you think they should be, and not buckling to offer them anything they find interesting,, too often poor quality, and too often ever changing as we chase the palatability compulsion. When I was in Ukraine rescuing dogs and cats I had a Romanian vet remind me that I needed to chill about the constant feeding concerns for the 12 animals we had transported in the car for the last 20 hours. He reminded me "that in the wild dogs might not eat for days." I wondered to my exhausted, cooked self if that included the stress of a tiny cage shoved in a tiny car running from wars? I loved those animals so much it will be the PTSD I never can shed about that broken place with all of its too many heartbreaking tales.

Mucous. The Gooey Lubricant that Helps the Poop Pass Through. When to worry about mucous in the stool.

I was asked to help contribute to this article for Care.com. It is not the most glamorous topic in veterinary medicine, but there are important clues to your pets health in the subtle characteristics of your pets feces.

Mucus in Dog Stool: The Common Causes

There are benign, normal reasons for mucus in dog stool but here's when you should alert your vet.

Amy Aitman, Contributor

Articles> Mucus in Dog Stool: The Common Causes

You'd do anything for your dog, even check his stool, especially if you thought
something could be wrong. Notice any differences in your dog's bowel movements
lately? Although mucus in dog stool is very common, and necessary, sometimes
it warrants a trip to the veterinarian.

What Is Mucus in Dog Stool?
Dog stool often has mucus. It's a slime-like substance made by the intestines to
keep the lining of the colon lubricated and moist and is perfectly healthy. "A little
bit of mucus is always  going to be normal and is actually a good part of the GI
[gastrointestinal] function. It's part of the normal cell turnover in the gut, and it's
part of the natural lubrication in the gut.

Without it, defecating is much more strained and difficult," says Dr. Krista Magnifico,
a veterinarian at Jarrettsville Veterinary Center and the founder of Pawbly.
Dr. Kimberly Hammer, a veterinarian at NorthStar VETS and a diplomat of the
American College of Veterinary Internal Medicine, agrees that mucus in stool is
normal. "Mucus is often either the dead cells being shed from the lining  from the
colon or secretion from the colon and is usually not a concern," she says.

When Is It a Problem for Your Dog?
"Part of being a really great and responsible pet parent means you really need to know
what is going into and out of your dog," says Dr. Magnifico. And that means knowing not
just what you are feeding him, but what he found to ingest all on his own. Think your dog's
mucus is problematic?

Here's when you should call the vet:

• Your Dog has Diarrhea
  Both vets say when mucus is accompanied by diarrhea, it's something that could warrant a trip to the vet. "When your dog has diarrhea that persists longer than 24 hours, and is accompanied by mucus in the stool, you should go see your vet," says Dr. Hammer.
   
• Any Part of the Stool is Changing
  "If you've suddenly got really, really soft stool and a lot of mucus, or a lot of mucus and not very much stool, that could indicate that there is a problem," says Dr. Magnifico.
   
• You Witness a Change of Color
  "The mucus will only change color when there is something else present in it. So, if there's excessive bile or blood, this will change the color of the mucus and could mean something is wrong," says Dr. Magnifico.
   
• You Dog is Only Producing Mucus
  When you see your dog overly straining, and nothing is coming out but mucus, this could mean something is wrong in the GI tract. Both veterinarians agree you need to see a pattern of this occurring before taking your dog to see a vet. "The cell turnover in the gut is so rapid and changes quickly, " says Dr. Magnifico. You should wait it out. Dr. Hammer agrees, "If your dog is only producing mucus in a 24-hour time period, it is time to call the vet."
   
• Your Dog isn't Eating or Drinking
  "A lot of times dogs will get better with conservative measures at home," explains Dr. Hammer. "Sometimes it can be a bland diet that helps, but if your pet is not eating or drinking, this can be another warning sign that something is wrong." Dr. Hammer warns that if your pet is not drinking anything, don't wait 24 hours to see improvements, especially if you notice other symptoms of lethargy. Just call your vet.

Talking to Your Dog Sitter
If you're worried about the state of your dog's GI tract and health, talk to your dog sitter or dog walker. Make sure he or she keeps track of everything your dog is ingesting, whether it's the food given to the dog directly or a piece of pizza he found on the sidewalk.

You're not with your dog all day and can't tell if she's been straining to poop and just getting mucus, but your pet sitter probably can. Tell your pet sitter or dog walker your concerns and make sure he or she watches your dog closely during the time with your pet. With these precautions, soon your only poo concern will be scooping it off the ground.

And read Dog Vomiting Bile: A Diet Plan for Getting Your Dog Back to Normal.

Amy Aitman is a freelance writer with a passion for the four-legged creatures in this world, especially her 13-year-old Westie, Buckles. Follow her on Twitter.

* This article is for general informational purposes only. It is not intended nor implied to be providing medical advice and is not a substitute for such advice. The reader should always consult a health care provider concerning any medical condition or treatment plan. NeitherCare.com nor the author assumes any responsibility or liability with respect to use of any information contained herein.

If you have a pet question of any kind you can find a whole community of pet loving people at Pawbly.com. Pawbly is free to use and open to anyone who cares about the wonderful pets we share our lives with. Meet pet people from all over the globe at Pawbly.

If you would like to talk to me about your pets mucus, or any other pet related topic find me at Jarrettsville Vet in Jarrettsville Maryland. Or, find me on Twitter @FreePetAdvice.

Diarrhea. The Very Basics, Canine Version

Most of my clients make appointments in hopes of my curing some clinical sign. They aren't so concerned on the disease that caused the clinical sign they would just,
"Very much like it if I could stop the diarrhea NOW!"

Diarrhea is always a consequence of something else.

"The good news," I tell my clients, "is that in most cases it is an acute self-limiting sign that will resolve with time."

Here's why:
The majority of cases that I see are caused by one of two things;

1. Dietary Indescretion. Anther words, "I ate something that I shouldn't have." Poop, trash, the Thanksgiving turkey leg, a tainted piece of food that probably smelled irresistible to your dog.  Why the dog brain says, "Smells rotten, Yumm! Let's eat!" I don't know, but it does.

Dude, You Are Stressing Me OUT!

Cooper

Stress.

I say this word frequently during my routine veterinary day. 

Every time I do I have to take pause and explain. 

Stress in medical terms is something that causes an upset or disturbance.

For people when we say the word "stress" and we think "bad," but a disturbance isn't always a bad thing. So I start throwing out examples, like, "remember when you got married, or you moved, or got excited for your birthday? Well, those weren't necessarily bad things but they got your body worked up. And you might have had cramps, diarrhea, or not been able to eat because you were nervous? Well, that was stress and your body reacted to it."

Cooper is a 4 month old effervescent dynamo puppy. He came to see me last week because he had had diarrhea for the last two or three days and his mom was worried. 

I listened to her tell me about Coopers routine and what changes had occurred over the last few days to weeks. She told me that Cooper was normally a very happy energetic puppy. He loved to play, he had a huge assortment of toys, he had been kept current on his vaccines, was on heartworm and flea & tick preventatives and except for the 2 or 3 daily episodes of abnormal loose stool was acting just fine. 

There are a few key points to Cooper's moms statement. In an effort to help educate you all I am going to take a moment to review them.

1. Cooper is acting normally. Always listen to your patient before anyone or anything else.
2. Cooper is current on heartworm medication prescribed by his vet. Dogs kept on heartworm medication are less likely to have intestinal worms. 
3. He was an acute case of diarrhea (clinical signs lasting less than 72 hours). It is so important to seek help inside of this window.

I asked Cooper's mom about his activities and home environment. Specifically I wanted to know if he was being given table food, or snacks, and what type they were, if he tended to eat things he shouldn't like garbage, things outside, etc., and if there had been any changes in his home life.

Here's why I asked. Many healthy young puppies (dogs under 1 year old) have episodes of acute diarrhea because of one of two things; they got into something that they shouldn't have (think garbage can raid or the delicacies of wild animal poop), or they got stressed about something.

In veterinary medicine we call the latter item "stress colitis."

Stress colitis causes large bowel diarrhea which is an increased frequency of having to defecate, straining to defecate (many people incorrectly think their dog is constipated because they are straining), soft to watery stool, sometimes with blood visible in it, and is most often affecting young dogs.

For all young dogs with diarrhea it is important to examine a fecal sample. Intestinal parasites are a common cause of diarrhea in dogs and can cause significant weight loss, anemia, and even death. 

For Cooper his stressor was re-visiting crate training.

Cooper, like many young, newly adopted puppies had been started on crate training when he first arrived at his new home. But over the last few weeks he was left out for longer and longer periods of time.

Then his mom had to go back to work and his daily routine changed from having not been in his cage for any measurable period of time, to in the cage for a work shift.

His mom said that she felt terrible leaving him alone all day. But she wanted him to be safe (CRUCIALLY IMPORTANT!!), so she was taking him for walks in the morning before she left and playing with him when she got back home. She wasn't sure that my presumption about Cooper being stressed in his cage so I recommended that she try to leave a video camera on him when she leaves to monitor him. 

She also had a few other clues that made me suspect that Cooper was having a hard time getting all of his needs met.

Cooper was a young very energetic puppy in a household with a couple who were past retirement age but still working. His mom admitted that she was having a very hard time keeping up with him and was unable to play with him to the point if him being tired. So Cooper was being put in a cage with extra energy left over and being left alone all day. His needs for exercise and social interaction were not being met fully.

Cooper is 4 months old and he is stressed already. Worse is that he doesn't have a clear way to start having his unmet needs resolved.

Coopers treatment plan was five fold.

1. Check a fecal and address any intestinal parasites. Remember some intestinal worms are what we call "intermittent shedders" so I will not declare a pet parasite free until we have three consecutive negative fecals.
2. A bland gi diet. This can be either boiled boneless, skinless chicken, or boiled ground beef and rice, OR a commercially available prescription food like Science Diets I/D for 5 to 7 days. A bland diet is designed to not only be easy to digest but also to not over work a body system that is trying to recover. This is done by offering small amounts of the bland diet with an increased frequency. So, instead of feeding a large meal twice a day feed four small meals every 6 hours.
3. Probiotics to help replace the good gut flora that aids in the bodies ability to remove excess water from the feces.
4. A plan to address his future stress.
5. A monitoring protocol to insure that his acute colitis did not evolve into the more difficult to treat and resolve chronic diarrhea.

My advice; Get Cooper a puppy, or something he can exhaust and that will in turn exhaust him.

If you have any questions about this, or any other pet related item, you can ask me at Pawbly.com, or find me on Twitter @pawbly, or FreePetAdvice, or Google+ +Krista Magnifico.

Thanks for reading!

And remember Always Be Kind.

Yesterday was Vomit Tues, Today was Diarrhea Weds

We all know that the crazy cases come in waves.

I remember one year where we saw 12 splenectomies in 12 weeks. It was incredible, and freaky! I was really beginning to think about sending a water sample into the the health department.

Well today we had three cases of diarrhea in a row.

Case 1 was Ruby, an 8 week old, just adopted 2 days ago, Boxer puppy. Ruby is quite possibly the cutest thing with two ears. She was so shy, and so kissable! Dr. C kept kissing her and telling us that she was pretty sure she was infecting herself with round worms every time she did. (That's typical Vet hosp humor). Ruby likely had diarrhea because she had just left the only place and the only family she ever known. This would be incredibly stressful to anyone, and it is especially stressful to a baby. She also is likely eating a new food, (hopefully a high quality large breed puppy brand), and having some "stress and dietary diarrhea" because of it. Dr. C. gave Ruby an oral de-wormer, and we sent her fecal to the lab for analysis. As long as Ruby's diarrhea is not profuse, she is eating and drinking well, on a good diet, and de-wormed, and monitored closely she will likely be fine in a day or two. Any puppy with diarrhea needs to be monitored very closely and needs a Vet immediately. I have seen puppies with Parvovirus die in 2 days.

I tell every new pet owner to expect some intestinal worms. It's part of the puppy/kitten package when you get a new pet. We check a fecal first thing, (and then yearly), and de-worm appropriately when the results come back positive. It's very important to bring your new pet, (and their poop sample), to your Vet within three days of getting your new pet. And make sure that you pick- up and dispose of all poop daily so you don't get your yard contaminated with the intestinal worms that might be making a home in your puppy or kittens belly.

Also, I recommend a follow-up fecal a month or so later to re-check that all of the worms are gone. And if your pet is having chronic or recurrent diarrhea we recommend that you check 3 consecutive fecals before we call your pet "intestinal worm-free." Some of the intestinal worms that pets can acquire are what we term "intermittent shedders." This means that we won't see them in the fecal exam at every fecal test we check. Three consecutive negative fecals and we usually call you negative.

Case number 2 was Maggie. A spayed 4 year old Papillon. Maggie's mom, Mrs. Kyrie, called us today to tell us that Maggie had woken them up at 2 am with bloody watery diarrhea. Maggie continued the projectile diarrhea sporadically throughout the night, and Mrs. Kyrie was very worried. The Kyrie's are very doting, watchful owners and they called us as soon as we opened to see if they could bring her to us.

When Maggie walked in the door she had her butt tucked under her and seemed to still be straining to defecate. Many owners incorrectly assume that their pet is constipated when they see this stance but in reality it is the complete opposite. Some owners have actually gone so far as to give their pets laxatives. Can you imagine anything worse than being given a laxative when you already have bloody, watery, poop dripping out of your butt? These guys are postured to poop because their over active intestines are full of watery diarrhea and their intestines are telling their brain to poop to get rid of it.

When Maggie was seen by Dr. C she thought that she looked nice and pink, (therefore indicating good circulation, good RBC count, and not septic) and not dehydrated. Dehydration is one of the things we are worried most about in pets, (and people) with diarrhea, especially with the small breed dogs. Everything in her examination looked normal and the fecal sample Mrs. Kyrie had brought in was loose but not discolored. Our plan was to send Maggie home with some SQ fluids, an anti-diarrheal, and a diet plan. She was in her mom's arms at the check-out counter when Mrs. Kyrie put Maggie on the floor to sign her check when Maggie tucked her butt, postured and produced what we call "raspberry jam" diarrhea in a Jackson Pollack application all over the reception area. This "raspberry jam" is a classic sign for HGE. Hemorrhagic Gastro Enteritis.

We diagnose HGE by a few factors. These include raspberry jam diarrhea, and  a high PCV. Maggies PCV was 63%. The normal reference range should be around 40%. Above 50% and we start you on i.v fluids to decrease the PVC. Maggie stayed the day with us to correct her PCV, monitor her diarrhea, and start her on antibiotics and anti-diarrheals.

Case #3 was Winston. Winston is a three year old wire haired fox terrier. He is owned by a couple who monitor his every move and love him like crazy. Winston's dad is retired so they are best buds that are inseparable. Winston's dad also spoils him terribly. I am usually not a stickler for feeding your pet some table scraps but I do not want you to feed them bacon, and fried eggs.

Winston sat begging by the dinner table on Friday evening as he has been trained to do by his parents. After they had eaten their portion of their stuffed shells that they had for dinner they handed him their plates to polish off. That evening Winston woke them up to notify them that he had just vomited and pooped in their bed. He had four other episodes Friday night. Saturday morning he refused his breakfast had 4 more episodes of diarrhea and was placed on plain white rice for dinner, which he readily ate. Sunday morning he seemed to be back to his normal self and sat begging again for their breakfast. Winston ate bacon and fried eggs Sunday morning. Winston's dad did mention that this was "his favorite Sunday breakfast foods."

I examined Winston on Monday and he seemed to be within normal limits for all of his physical exam parameters. I gave him some SQ fluids to maintain his hydration throughout the day and instructed them to not feed him anything else for the rest of the day. I told them to feed him boneless skinless boiled chicken or ground beef with plain white rice starting Tuesday morning. I instructed them to feed 1/4 cup servings every  4 hours as long as he wasn't vomiting. I asked them to do this for 4 days. I also sent them home with a gastro-protectanct and probiotic. I, as always, provided a written instruction sheet for dad to take home for mom to review. (I try very hard to document everything so that owners don't go home with questions, and because I know I talk fast).

I called this morning to check on him. His dad said that he had done great on Monday and Tuesday morning, but that his wife had started to add his normal food back into his food on Tuesday night's dinner. Winston's belly was apparently not ready for this and the diarrhea resumed. WInston and his dad came back to see me this afternoon. Winston still looked fine, but we all decided to stick with the chicken and rice for 4 days. Winston's dad asked me to write "No regular food for 4 days," in bold letters on his go home sheet. He was blaming his wife, and he wanted her to know that these were "Dr.'s orders!"

I will check on him again on Thursday.

Skunk's Sweet Tale

I have to admit it. I am a cat person. I mean I love dogs, A LOT! I have three, and they go everywhere with me, but my true love is a kitty, (you know, if I am forced to pick). I think it is the fact that a cat makes you earn their love, a dog is just an opportunist. Cats, they are a challenge that repays you with purring.

I understand that most people are dog fans. I sometimes blame it on experience, rather their lack of it, with cats. I think that if you get to know the love of a cat, especially on those cold snowy winter days bundled up on the couch with a cup of tea and a curled up ball of purring sumptuous fur on your lap, then you know what true joy and peace is. On the flip side, if you have ever watched a kitten tail all puffed up dancing on tip-toes playing with a scrap of paper jumping like a pogo stick Chinese fire cracker all sideways hopping, then you are witnessing pure bliss.

I met Skunk’s mom many years ago for the routine examination and vaccines. Skunk was a very important part of his mom’s life. She had had Skunk since she was a kitten, and they were very attached to one another. For the last few years of Skunk’s life she had intermittent bouts of gastro-intestinal upset. We had a difficult time trying to figure out what exactly would cause the episodes. I have a personal (I am a self-proclaimed cat-xpert, because I do have 6, and I dote on them like an over bearing mom) opinion that many cats have GI issues due to a few basic reasons. Here is my medical opinion for diarrhea in both dogs and cats. First check for intestinal worms, really we should ALL be doing this yearly, don’t skimp on this, your dog eats poop, your cat grooms profusely and catches and eats everything it kills. Check a fecal, save yourself those terrible pictures of what worms look like in YOU. Next, is a reminder that your pets eat things they shouldn’t.  If you drink water from the toilet, or a puddle, or lick your hands clean after you climb out of your litter-sand-poop-box then you shouldn’t be so shocked to have diarrhea every so often. In hind sight I do think that Skunk had a chronic GI issue probably related to diet (almost ALL cats get an inferior commercial cat food, “you get what you pay for, and you are what you eat”, and it is IMPOSSIBLE to get a good cat food from your grocery store). Please don’t underestimate how important a good diet is to your (yes, YOU and YOUR cat included) overall health. Try a bland diet (chicken and rice, or Hill’s Science Diet I/D) and a good probiotic (get it at your Vet’s office). Some pet’s, (and some people (see Crohns disease)) need a special diet lifelong.

With Skunk, she also had chronic persistent dental disease. I find that almost every cat over 5 years old needs a dental every 4 to 5 years. I also think it is almost impossible for the average human being to brush their cats teeth. I beg my Vets to check the molars of every cat at every visit, and I also break the Vet Laws by manually removing those huge hunks of tartar glued on the molars at every visit. Then I beg and plead with the owners to have their cats teeth cleaned. I wholeheartedly, fully admit, that 1 in 5 owners will actually pay for, and schedule, a dental for their cat. So for those other 4 of you I at least take some small solace in knowing that I at least removed some of the insulting tartar. (Ok, that’s a BIG can of worms, and I know many a Vet is now shaking their head, and pointer finger at me.) Skunk’s mom did have Skunk’s teeth cleaned, she did come in for every exam, and she did pay very close attention to her cat. She is a great example of how to do everything right, despite having a cat that seems to have everything wrong.

In the summer of this year Skunk came in with a mammary mass. Mammary masses in cats are notorious for being very invasive, fast growing, and have a terrible prognosis. We don’t see them very often but when we do it is a hard and sad discussion to have with an owner. There are surgical options, and there are Veterinary Oncologists who offer treatment plans, but I admit, based on personal experience most cats die within 6 months.

Skunk was euthanized 2 months after she came in and was given her poor prognosis. I know her mom was very concerned about her comfort level at the end. I spoke to her many times about the possible treatments available to try to alleviate her kitties discomfort. I always tell owners to keep me posted on every aspect of their pets life. I want to know if you think they are hurting or struggling, and I want you to know that there are many options available. Some are expensive, some are cheap, and some patients respond differently than others. So keep your healthcare team posted on how you are doing, and we are here to help you every step of the way.