Limbs Are Accessories, Until It's Yours.

This is Oscar. 

He is a Rottweiler mix who was found by Harford County Animal Control and brought to the Harford County Humane Society on May 6, 2014. He is about 8 months old, unneutered, unmicrochipped and had an obvious swollen and poorly functional right hind leg. 

There are a few dedicated veterinarians who generously give their time to help the unwanted, forgotten, and lost dogs and cats at the shelter. It is a difficult, often depressing, and sad task to see all  of those sad, anxious, afraid, or desperate for a moment of your time pets. I will be the first to admit that I cannot do it. I cannot face the pets housed there. I will only go to take a pet home, help on a fundraiser day, or to aid in a specific pets care. And, there is a small matter about how I think things should  be done, and my inability to keep my mouth shut. If there is a sick, injured, emotionally suffering pet I demand attention for them. I am not interested in logistics, lack of available funds, overcrowding, or any other encumberence or reality about the difficult predicament and situation that a shelter must exist in.

Upon delivery to the shelter Oscar was processed which  includes scanning for a microchip, assessing for injuries, behavioral problems, and any evidence of where he might belong. Pets are  also vaccinated, de-wormed, given a flea preventative and placed in a cage with an arrival date. Pets that are found as strays have 5 business days to  be claimed or they become the property of the shelter and can be either placed in general adoption or euthanized. Pets are euthanized for a large variety of reasons;

1. Not adoptable. (Definition defined by organization, labeled by staff who may or may not be trained adequately to do so).
2. Not enough room. Most shelters have contracts with the local community to keep open spaces for incoming animals. If they do not adopt out enough pets as new ones come in they have to make room by removing the less adoptable, or longest resident, or whatever the staff decides.
3. Behavioral concerns. Any pet who might be deemed a threat to people is euthanized.

With the small amount of information we have already I am afraid. 

Here's why;

1. A young dog in a shelter is at considerable risk of contracting a contagious disease. Of greatest concern is parvovirus, distemper, kennel cough, respiratory infection and the cascade of complications any one of them can cause.
2. Unneutered and concerned about this being synonymous with unvaccinated. Add number 2 to number 1 = recipe for disaster.
3. Obvious injury makes likelihood of happy ending more elusive.
4. Broken bones are expensive to treat, and shelters have mouths to feed and already very difficult decisions to make about the healthy uninjured pets.

Oscar is a young sweet gentle boy so he was sent to a local veterinary clinic for an examination to assess his leg.

Even with his gentle nature and the small amount of information we have already I am afraid for him. 

Here's why;

Oscar's radiograph quickly revealed the source of his lameness and swelling.

Oscar has what we classify as a distal diaphyseal fracture of the right femur. A radiograph can give us some answers to a few questions, but Oscar still holds a few. We don't know how long he has been injured, and we don't know if there are other injuries that we can't see so easily. For instance bruising of the lungs, tears or bleeding of internal organs, etc. 

On the lateral (side) view there is a concern about the bottom (distal) part of the femur bone having been pulled up (towards the pelvis) and back due to the muscles that run along the femur. When the bone is no longer rigidly intact the big thick muscles of the leg and thigh will contract or pull the end of the femur up.

Oscar's life was being determined by the vet who saw him initially and the staff at the Humane Society, until Dr. Hubbard saw him.

Dr. Hubbard, our resident Humane Society savior was at the shelter and inquiring about Oscar. She called me to say that the Humane Society was looking for a surgeon to help Oscar or they were going to take the advice of the original vet who stated that it would be cheaper and easier to amputate his broken leg. I have been down this road before. There are very very few instances when cheaper and easier is the right decision. This is an 8 month old dog, and this is a Rottweiler. There is a terrible chance that this boy will need an extra leg by the time he is 8 years old and has osteosarcoma on the left rear leg. Save his right leg as a spare. Rotties need spare legs. (Related article; Kelso's Christmas Wish).

Cheaper? Well, I am going to argue that one too. Seems the estimate the other vet gave was $1,000 to amputate. Someone hand me a paddle. I'll take your $1000 to give this dog fewer options, a longer recovery and I'll fix it for half. I got a little heated. Why are we seriously debating taking a leg off of a puppy without trying our damnedest to fix him? 

Dr. Hubbard and I were on a two woman mission to save Oscar's leg. Dr. Hubbard wanted me to fix it, (in whatever pathetic haphazard way I could). But, I know Oscar needs a bone plate which I do not have, and I leave for a weeks long vacation in one day..Oh, and in that one day I have to pack and celebrate Mothers Day, AND,,, still..I feel obligated, and stressed...very very stressed!!..(oh, yeah, that's why no one else volunteers for these).

Here is where the flood of anxiety, frustration, and feeling of "oh, god, what am I getting myself into this time begins?" For some reason I have yet to understand, I feel as if I am the only vet who is willing to throw my hat in the ring and help. To work for the simple satisfaction of trying to do the right thing for a pet. When did that become such a scarce commodity? I have the same training as my peers, I have had to learn by jumping in the ring. By being comfortable with uncomfortable surgeries. and still, no one else will even try??!! It's incredibly frustrating. 

Dr. Hubbard and I called every surgeon we knew to get Oscar's leg fixed. The  best we got was 10% off the standard surgeon cost of $3,000. Did I forget to mention that this dog is not owned? And is a resident of the Humane Society? UGH!

Now I know I am ranting. Vets get asked every single day to work for free. It sucks, and it is unrelenting. (See previous rant on Compassion Fatigue). 

After numerous frantic calls back and forth, Dr. Hubbard and I decided that, no matter what we were going to;

1. Try to save Oscar's leg. 
2. We were going to try to find someone to plate the leg and give him the best possible chance at healing. 
3. We were going to get him out of the shelter ASAP.
4. We were going to find this boy a forever home after.

I called a dear friend, client, a fellow Rottie fan. In that one phone call the myth of feeling like Dr. Hubbard and I are the only ones who cares was shattered into tiny pieces. 

I explained Oscars plight and our quest. He said to me, "I just saw Dr W (our local orthopedic surgeon) yesterday with Heidi. He has done surgery on both of her knees and was the surgeon for her sister too. Call him and tell him that Oscar needs this surgery and that I am helping to pay for it. It's only money and this dog needs help."

I cried, I seriously cried. All of the stress, the guilt, the terrible turmoil about going on vacation when there was a dog at the cshelter who needed help slipped away. 

"Oh, Mr. H, that's so incredibly generous of you. We are going to do our very best to help you with this. Jarrettsville Vet will donate, and No Kill Harford will pitch in too. And we will keep asking for help from everyone." I said, trying so desperately to get a clear Thank-You out as I choked down tears.

And then I went back to joyful tears and called Dr. Hubbard to share the news.

Oscar is expected to have his femur repaired on Tuesday. 

We will keep you all posted on his saga and hopefully there will be a happy ending to his tumultuous beginning.

And, just for the record again, amputation is not an option for quick and cheap.

If you would like to help Oscar you can send a donation, or even a Thank-you card care of "Oscar's Fund to Jarrettsville Veterinary Center, or No Kill Harford. Any funds received will go to help a pet in need to help them live a long, happy and healthy life.

May the memory of those we leave behind inspire us to do better for those we have yet to serve..

If you have a pet question, a story to share, an inspiration to help another pet and another person please meet me on Pawbly.com. Pawbly is all about pet people helping other pet people, and Pawbly is free to use.

Or find me at the clinic, Jarrettsville Vet, or on Twitter @FreePetAdvice.

When Trying Is All That Matters

This is a story about Daisy Mae.

A small dog with a big gleeful smile and a disposition as sunny as a spring day's dress. She is pure joy on short crooked legs. To her the world is rose colored glasses and a pinch of tentativeness. I loved her from the moment she lowered her head and threw her ears forward at my "Hello."

But my first introduction to Daisy was with a blackened film on a window pane.

The x-ray film came to me from the clinic down the road who had neither the time nor the inclination to address her misfortune. On our first meeting Daisy was just a film and a paragraph. "Daisy, corgi, 8 months old, broken femur, unspayed, unvaccinated, owner has no money."

They had sent the film to us and wanted to know "If we could help her?"

A film and a question. It starts out this simply. 

I looked at that film longer than I needed to. I was volleying back and forth between knowing what I knew and wanting my head to tell my heart that this broken bone was beyond my ability. 

Isn't it easier to have a solid stern excuse? Isn't that how vet number 1 got off the hook?

I did what we all do when we are reluctant to put our necks out for a stranger. 

I called my friends with adept skilled surgical hands and I asked for advice. 

If you don't know what to do you get a second opinion. Two second opinions later I was on the hook. I merely had a few details to resolve.

I called Daisy's mom. We had some important things to discuss.

Here's where my dilemma begins; Daisy Mae needs her leg fixed. I can help but her owner is not my client, and she has not been what we would call a "model parent." She cannot afford my services, and I feel guilty.

I asked Daisy Mae's mom to come in the next day and talk to me. 

The dichotomy of being able to help is being responsible for the after. It is not just the quick fix and goodbye, it is the obligation to that pet to catch them up, get them mended and put them on the path to a healthy rest of their life.

But that little piece of advice I learned the hard way.

I have helped so many pets simply because I knew I could, believed no one else would, and felt I wouldn't be able to live with the guilt of turning away. And those little acts of kindness, those good deeds, well, they often led to owners who for a short time made you feel as if you were their hero. Until some time later when another disaster strikes, and then they come knocking again. An unplanned pregnancy, a pyometra, a bloat, severe ___ anything, and that good deed does not go unpunished. Medicine is about looking at the problem in front of you, the path to get out of your problem, and an exit strategy.

I met Daisy and I met her mom. As my pessimistic attitude proved me wrong, Daisy's mom was a dream. She had rescued Daisy, had multiple other pets, and all were all spayed/neutered, vaccinated, and loved by a responsible mom. First bullet dodged.

I discussed my concerns with getting Daisy caught up on her needed puppy items. And how she was going to be able to afford those after the surgery? She had plausible feasible plan, and I felt more comfortable assisting her despite the first set back. We laid out a short term plan; get broken leg fixed. A catch-up plan; for vaccines and a life long plan; for spaying, heartworm prevention, and the incidentals of being an active young pup. Second bullet dodged, guilty conscious acquiesced, and onto surgery we went.

There are quite a few secrets that every compassionate veterinary clinic has. For us at Jarrettsville Vet we have a network of people who we can call and both ask, and receive help, from. I also have a JVC donation fund that clients, friends, and angels from afar help to keep funds available. After I met Daisy's mom I offered to place a few calls and in total we raised almost half of Daisy's surgery with just one phone call. I also offered to do her surgery at the barest bones possible.

Now I know that many people would argue about this last offer. But when you walk a mile in my shoes you can criticize my judgement calls. It is physically impossible for me to look a pet in the eyes that needs my help and for me to not try to help. If that means cutting some corners, then I cut corners. BUT, I tell that pet parent what I am doing, and what those corners mean. Those cheaper options ALWAYS place the burden on the pet parents. You may have to give more pills, drive back and forth more times to the clinic, and talk to me a whole bunch. Is it easier and safer to leave your pet in the emergency clinic for three days so they can be closely monitored by a professional? Yes. But if you are a parent who wants help for your pet we will make it happen, regardless of your budget. Medicine is a little bit skill, ability, equipment, resources, miracles/magic, and a whole heartful of determination always helps to tip the scale in your favor.

The next surgery day Daisy Mae had her femur pinned in two places. It was not a fun, easy, or routine surgery for me but thankfully, she did very well and woke up with the same little tail wag and bowed ears she went to sleep with. Her bones were soft and young and the grace of youth will bless them with a forgiveness that can make even a novice surgeon look like a super hero.

I called her mom to deliver the surgery report. It was an open and honest discourse. Her surgical repair had taken longer, been more difficult, and hadn't been as quick or easy as I had hoped for. But I was fairly certain it would hold long enough for the bone to fuse and give her a normal return to her short stubby shuffle.

Daisy was ready to go home the next day. When her mom arrived to pick her up I when out to meet her to go over the post operative instructions. I explained to her that Daisy's leg was much worse than I had hoped it would be, and that the bone wasn't as aligned as I wanted it to be. I also explained that we had to keep Daisy quiet, calm, and on a leash or in a crate for about 8 weeks. As I explained all of this Daisy's mom looked at me and with tears in her eyes, "I'm just grateful that you tried."

I stopped talking, looked at her, and said, "You have no idea how much I needed to hear that."

Update;

It has been a month since Daisy's surgery. She is running, jumping, and playing (all against strict doctors orders, but try explaining that to a puppy). She is bright, energetic, and unstoppable.

Here are her one month post-op radiographs. 

If you have any pet related questions you can find me at Pawbly. We answer any pet question and we are always free. Come join us! It is all about helping pets.

When the Price Tag is the Show Stopper

There are not too many Pawbly questions that I carry over into my blog. But every once in a while I get hit by a question that reminds me that my primary duty is to help pet parents. Whether they be near, far, wide, rich, or unfortunately, in many cases, those people trying to take care of their pets and live within  budget.

Here is the question that Damion asked us today on Pawbly:

We adopted a kitten about 3 months ago. She is now about 5 1/2 months old. Normally she is VERY playful cat, jumping and running all over the place. Yesterday when I got home she was laying down and instead of her usual come up and greet me, she continued to lay there so I knew something was wrong. When she attempted to get up she was not putting any pressure on her back leg. She did this about a month ago as well but was fine after a couple of days so I figured it was a simple injury. As bad as it seemed this time, I knew it was more serious. We took her to the animal hospital last night to find out she has severe hip displasia and bad knees. Her one hip is now disclocated and would not stay back in after sedating her and attempting to relocate it. At his point we are told the socket joints are too shallow to hold the femur bone in. The surgeon said the one side is dislocated and the other MAY dislocate in the future as well. He suggested we do a femorial head resection surgery (or FHO) on the disclocated hip and we can do the patella luxation surgery on the knees, but the total cost is around $4,000. This doesn't even include surgery on the other hip. We don't have the money for the surgery and we don't want to take her to a shelter where they will put her down. The shelter where we took her from said they can do an evaluation to see if she could be surrendered but that would only place us on a waiting list and more than likely she would need too much attention and care to be able to take her back. We want to keep her and nurse her back to health but we don't know what to do. She is on pain meds now and doesn't seem to be in pain but is walking very little. She is eating and drinking but is not really using the litter as she really can't climb in. Please let us know if there is anything we can do, some financial assistance possibly? Thank you.

Here is my answer;

Hello Damion,

I am so sorry to hear of your kittens mis-fortune. What a terrible set of diagnoses.

It sounds as if your kitten may have some congenital rear leg deformities which left her susceptible to luxation of the hip(s). If the surgeon said that both hip sockets were shallow then she certainly may be at risk for dislocation of the contralateral (other) hip.

Without having the x-rays, and performing a physical examination (and because this is the internet, and I couldn't diagnose without seeing your kitten and discussing all of the concerns with you), I would strongly suggest that you ask for and seek out a second opinion. Maybe from a general practitioner who is comfortable and proficient in orthopedic surgeries in kittens? (A good hint here is to call ALL of your local rescues and ask them who they go to, or recommend, AND ask ALL of your local veterinarians too).

Many general practitioners are able to do this surgery and often they are significantly less expensive than a surgeon.

I have also seen some success in people starting a Facebook page, or local petition to ask for funds to help subsidize their own veterinary expenses.

For example I know of a client who had 2 kittens with fractured rear legs. After some networking and searching he was able to get both of them fixed for $500, (after receiving estimates for over $4,000) so it is possible.

As a last mention. There are many kittens and cats with limited mobility who live happy lives by their parents making adjustments to their home environment. Think about significantly reducing the size of your kittens living area so that she does not have to walk a great distance for any of her routine needs, i.e., litter box, bed, food, water, scratching mat, etc. If her rear legs get too weak there are carts available to help support their weight and assist in mobility. (See (http://www.handicappedpets.com/).

If you are anywhere around my neck of the woods I would be happy to help your kitten with an examination and discussion, or maybe even surgery?

I wish you the very best of luck and hope that you can find some help for your kitten. I also hope that she can stay with you, and that you can help her regardless of her current, or future handicaps.

Sincerely,
Krista

For those of you who don't know which kittens I am referring to see; Elliotts story. Or Kits story.

Is It Possible To Save A Life AND A Limb For Pennies?

There are a few patients, clients, and cases that become indelibly etched in your heart and soul. Some of them are disastrous, heart breaking, and cause you to question why the heck you ever decided to care so much, invest so much, and even try to help people in the first place?

BUT,

there, thankfully, are more of the good cases to keep your spirit fulfilled and to carry you through the train wrecks.

This is Elliott. He is a two month old, never been seen before by a veterinarian, grey and white kitten. He is a sweet gentle boy,

BUT,

he, unlike so many of the other kittens that I see, is healthy, bright, purring, and calm.

His dad is an older man with a story about Elliott. It went as follows; He and his wife had recently bought a home here in rural Harford County Maryland. Unbeknownst to them when they bought the home they also acquired a few cats. Those few cats did what all cats do, they populated.

When they realized they had more mouths to feed, they started a proactive approach to getting the felines under control.

As I listened to his story I relaxed. He was trying and I was beginning to think that maybe for the first time in a long time I wasn't going to have to try to figure out how to convince a person to take care of their pet.
First challenge appears to be diverted.

Elliott was here today because as his dad reported "he has a bum back leg. That bad leg is a mystery as to how it happened. But Elliott won't use it and so he has come to visit us."

The right side is normal, the left has three fractures.
Can you see them all?

An x-ray later we had our answer. Elliott had a broken femur, a broken tibia, and a broken fibula. No wonder he won't use that leg. There aren't any intact bones of his back leg to hold him up.

Second challenge, paying for surgery.

The challenge is all too often the same: 1. Trying to coerce a person to step up to the plate and do both steps; and 2. take responsibility and follow through with a treatment plan.

Today, the gods were smiling on Elliott. His dad loved him, he cared about his injury, he wanted to treat it, BUT, he had a herd to manage and a budget.

In the area of Elliotts injury he has a laceration over his hip.

Here is where I put my BIG disclaimer!!
I did what I hate to admit in public, on record, and in reality do all too often. I sat down and negotiated.

Why do I hate it? Because it sets a terrible precedence. It de-values what I do, it makes it harder to hold future expectations on par, and it further drives my profession into scrambling to make ends meet. It perpetuates the same problems that we vets have been plagued with forever. Why should I work for free? Who else but vets get asked daily for free services AND then are made to feel guilty when they decline? Think about it, how would you feel if everyday at your place of work your boss came to you and asked you to work an hour (or more) later for nothing? And then gave you some guilt trip about why you should after you reluctantly tried to discuss why you didn't want to work late.

In typical never-confess-this-exchange to my husband mode I offered to "try" fix the leg for $300.

To put this in perspective, at a boarded surgeons I would expect they would start the opening bid at $1,000 US dollars.

Me, heck no, I will not only significantly undercut my own services I will also add a mountain of stress onto myslef. Why? because damn it I still can't learn my lesson. I still can't turn a blind eye, and say "not my problem." And, mostly, I liked this kitten and this guy. If he's willing and committed to taking care of his feral cat population I'm willing to throw my best pitch.

We 'hang' the broken leg in the hopes of straightening the broken bones.

Holding both parts of the femur together with thumb forceps (you know them as tweezers) to pin the leg.

There are two stainless steel pins in the hollow part of the bone.
They will stay in for about 4-8 weeks.
Elliott is a kitten and they heal fast!
I am so proud of this that I beam every time I see this x-ray!

Elliott was walking on his leg by the end of his surgery day. He was given pain medications for the first few days and very very strict cage rest. NO running, jumping, or playing!

Elliott will have his pins removed in about two months. When I remove them we will also neuter him.

I saw Elliott tonight for his first re-check post op. He is happy and he is walking on his leg!!

go Elliott!

Best of luck Elliott and family!

Update:

Elliott had his pins pulled on Monday the 9th of September. They came out easily and his bones are all healing splendidly!

In a matter of minutes Elliotts pins were removed.

Elliott has a few more weeks of rest ahead of him, but I expect a fully functional leg in spite of his three fractures.

If you have a question about Elliott, or fracture repair in a kitten please find me at Pawbly.com