Leave No Patient Behind

George is a 9 year old indoor domestic short haired cat who visited us about a month ago for straining to urinate in the litter box, and producing only small amounts of urine. 

He presented again to us yesterday; unable to urinate. George is now a "blocked cat" or, UO cat (for urinary obstructed) cat. 

He found us, like they all do, with a little bit of luck, and a parent with limited resources. 

When he arrived on Saturday morning at the vet clinic we suspected that he was blocked. We also hoped that his parents had a rainy day account of immediately accessible funds so we could send him where he needed to be; the ER. The ER these days require a $4,000 deposit for this. It is beyond my comprehension what they do with that $4k, but it seems ubiquitous enough amongst the lot of them so it must be accountable in some list of line items. 

Within 20 minutes of Georges arrival at my clinic my phone rang.

"Sorry to bother you, (I was away for the Thanksgiving holiday), but, we have a blocked cat here." 

"Is anyone there willing to unblock him?" I asked.

"Yes."

"Ok, then we will figure out how to pay for it later. Have the owner go through our emergency sheet. Have someone else in the room with them to serve as a witness. And, make sure she is ok with us sharing the story and photos. Call me if you need anything."

"Ok. What would happen if we didn't help these cats?"

"They would die at home a miserable death, or be euthanized. Just like all of the rest of the cats. You know that." I replied.

My office manager agreed to go over everything with George's mom. She was working from home, on her day off because that's what George needed from us. George is a perfect example of who we are. He is deserves to be cared for. He is why I went into veterinary school. He is my WHY as much as any of the regularly paying customers are. Maybe more so.

George, the morning he arrived at JVC.

Here is the Facebook post we put up that morning; Georges first FB post here

"This is George.  He has found himself in a hopeless situation today.  He is blocked, and his mom only has $400 available to help him.  At our practice unblocking runs $800 - $1,000.  Despite the lack of funds we’ve agreed to help him, because we know without help George will die.  George and his mom could use some help financially with the cost of his care and treatment over the next couple of days.  Donations can be called in or made in person directly to George’s account.   Donations can also be sent via PayPal to jarrettsvillevet@gmail.com, please note that your donation is for George.

A big thank you to our kind hearted Dr. Ahrens who agreed to stay late to help George today.  ❤️"

A few hours later we posted an update;

Waking up from surgery.

"George is out of surgery and resting!  Thank you to all who have donated.  Please know any funds raised in excess of what is needed for George will be used to help another pet in a predicament like George. 

We truly couldn’t do this without the kindness and generosity of those who support us in our mission to help pets like George."

Two hours after the first post was put up we had raised $1900 for George. 

I posted a video on his story. Find it here; Inspire an army to save lives video here.

George update

One day post op. Looking good George

He is feeling SO much better with the help of our rockstar Saturday staff. He is getting his sq fluids currently (he is awesome at it) & taking his meds like a good boy.

So, George is a miracle, right? I mean its an incredible thing to be able to be given the treatment you need at a price your client can afford? Why doesn't every veterinarian do what we do? 

Well, because they think they can't. I hope to set an example of how this can be done. And remind everyone how good it feels to help save these lives.

We take a can-do approach to these cases. We take a leap of faith that we can save these pets first of all. We only offer payment plans, pro bono, take a risk on non-payment for cases that we think will survive and have a good return to a quality of life. We do not offer this to patients used for breeding purposes, people who are abusive, unkind to the staff, and who we do not believe will continue to provide routine preventative future care. For all of the cases we do not offer pro bono, or potentially not pay us back, we do offer to have the pet parents the option of signing over their pets to us. We will find a home for them, or keep them as our own for the rest of their lives. While this might sound cruel or unkind there are situations where pet parents realize they cannot provide the care their pets need, and they put this above all else. These are the people we want to over extend ourselves for. Sadly, almost everyone would rather their pet suffer, remain without treatment, and ultimately die than give them up. There was a case of a 4 year old dog who swallowed a corn cob who died recently after the owners declined the offer to give lifesaving surgical intervention. They watched her die over 4 days while they tried to raise the $3500 the ER required as a deposit versus signing her over to the rescue who offered to take her and get her the surgery she needed. 

Here is the document we use for these cases. We ask the pet parent to initial each line and then give them a copy for their records. If people would come to me and say "I love my pet so much that I would rather have her treated and alive with someone else than dead with me." I would do everything to save them. I don't think I am alone with this. 

For more information on this please see our website; Jarrettsvillevet.com see the tabs for Financial Assistance and Immediate Help.

All clients who cannot afford the estimate for needed care at Jarrettsville Vet must agree to and sign the following;

___ I understand this is an emergency.

___ I understand my pet would be best served at an ER, ICU, referral center.

___ The only reason that I am NOT at the ER/referral center/ICU is that I cannot afford it.

____ I understand that my pets current condition is (we fill in our differential diagnosis here).

____ I understand that I may not fully understand the extent and severity of this condition without a referral or additional financial resources

____ I have been given an estimate for care;

I can   ______        or    _____       cannot afford this estimate.

____ I understand that the estimate may change as my pets status changes. We will offer a payment plan if we go over your estimate.

If I cannot pay the estimated deposit for care I will;

1.       Sign a letter of collateral. If the invoice is not paid in 90 days the collateral will be transferred to JVC at my cost and the item will be sold for payment. Collateral item is; ______________

2.       Allow my case to be shared on any social media platform of JVC’s choosing to try to raise funds for my pet and awareness for their condition. This will help pay knowledge forward and maybe spare another pet from this condition.

3.       Follow all suggestions to include full story write up, starting a Go-Fund Me, sharing the fundraising efforts of JVC, and assisting with future fund raising projects at JVC

4.       Volunteer at other non-profits to pay it forward.

____ I allow JVC to share photos, videos and pertinent patient info for an indefinite period of time at their choosing.

____ I allow JVC, Dr Magnifico have full access and rights to my pets story. Past, present, future,

___ I will provide updates as asked and allow JVC, Dr Magnifico, the GSF, TPGSF, to share my pets story.

___ I understand that JVC has offered to help me care for my pet as an extension of compassion, kindness and shared goals to help end suffering and provide care regardless of financial constraints. It is with this in mind that I will be kind, compassionate, and generous with the actions and comments about my pets care.

___ We reserve the right to refer care back to an ER/ICU/specialist at any time.

 

Our Immediate Need Policy and Expectations for Non Clients are as follows: 

· We strive to offer affordable options for pet owners.

We usually require a full deposit at the time of intake for any emergency services. Our team will go over an estimate for your pet’s care once your pet is assessed. 

Please visit our website for additional resources to help with paying the balance. 

CareCredit may be utilized. You can apply for CareCredit via their website - https://www.carecredit.com/applyo Payment plans will be offered only to existing clients who have applied for or exhausted CareCredit. Payment plans are provided via Vet Billing

· Any financial concerns must be discussed at the time of receiving an estimate. 

· If you cannot afford the exam fee, the estimate for diagnostics and the treatment plan we will ask what is feasible for you financially, emotionally and physically to care for your pet long term. You are asking us to put your pet above the cost of running a veterinary facility, paying our staff and the emotional burden we take on with these cases.  

You will receive a copy of our Client Rights and Responsibilities and be expected to abide by it. We will not tolerate abrasive behavior directed to our staff. We are here to help you and your pet and expect to be treated with kindness. 

We will work together as part of a team for what is in the best interest of your pet. 

In working within the confines of financial concerns we may discuss with you waiving some diagnostics to keep the estimate within your budget. 

If it is determined that it not feasible for you to care for your pet long term, or if you pet is in need of immediate emergency care and we can not come up with a reasonable financial plan we may discuss surrendering your pet to one of the rescues we work with so that may receive the lifesaving care they need. 

· Jarrettsville Vet is a small animal general practice, we do not have staff in the building overnight. In most cases you will be expected to pick your pet up before we close. 

· We are working your pet in as an emergency. This means that the veterinarian may defer update calls to the support staff. Please rest assured that if your pet’s condition worsens you will receive a call. 

· It is our policy that if your pet is in need of emergency surgery and is intact, they will be spayed or neutered at the time of surgery. This is non-negotiable, if you are not agreeable to this clause please seek services elsewhere. All patients will also be vaccinated for rabies and given a microchip with Jarrettsville Vet listed as the contact for the life of this pet.

· You will allow us to share your pet’s story on Pawbly.com and social media at the discretion of the veterinarian. 

· If you receive funds from our Good Samaritan Fund you will participate in JVC or Good Samaritan Fund fundraising or volunteering and agree to the terms and conditions of our Good Samaritan Fund Recipient Policy. By signing below, you are indicating that you have read and understand our Emergency Services Policy.

Hoarders, Surrender, and the Worst Fate of All

"I have such great news! .... My mom found a home for the cats!" 

It is a tough ask; pitching two adult cats to anyone. People adopt babies. Cute fluffy new babies. Teenagers, well, teenagers are a hard tough sell. And yet it happens; life, and it's unforeseeable twists and turns leaves us in a place with pets we are not sure we can care for any longer. None of us want to feel as if our own life is so fragile, so uncontrollable, or, so unpredictable that we are one bad decision, or, phone call away from bankruptcy, homelessness, etc.. But, these things can, and do, happen. People get a twist in the road of life that derails them. They find this place where they are no longer able, or willing (in some cases), to support their pets. What happens to them, our companions we brought into our lives, should we ever find ourselves here? In my life, and this line of work these stories end up as preludes to these dilemmas too often.

A few years ago a house fire threatened to leave a client and his 42 cats looking for new living arrangement options. (Yes, 42!). He began collecting cats as a rescue effort. One or two here or there, a litter became four litters, and 7 years later his 4 bedroom home included 10 to 20 cats in each bedroom. The litter box management alone left everyone smelling like sewage. The house couldn't be kept up. Random pieces of appliances began to fail and he feared letting anyone in to fix anything as the cats would literally be out of the bag. He began using a hot plate, and a kitchen fire happened. Thankfully no one was hurt, but he realized his cats were almost public knowledge, and if this happened he knew his whole life would come under county scrutiny.

This is a man who loves his cats.. Like many hoarders he has more than he can care for and he also believes that surrendering any of them places them at a far greater risk then their current situation where they are overcrowded, underfed, and lacking in basic medical care.

He fears the public more than he can see his participation in the denial of the affection and health to his cats that they so obviously needed. He always believed that his life was managing fine, and his cats are happy because he loved them.

After years of trying to help him and his cats with multiple attempts to spay and neuter everyone (which never happened because the few we couldn't catch were too feral to trap), I realized he didn't really want a population neutral home. He wanted more cats. Kittens to be precise. Kittens made him feel needed. They were so small, vulnerable and often so sick. They needed him to nurse them back to health (because they all were after all unhealthy and always sick), he had concoctions for every ailment. He began to resist spaying the girls because he wanted "to focus on the boys," and, "most were related and they wouldn't mate if they are related, so I didn't have to worry." I spent years begging and pleading him to start considering adopting out some by letting us find homes for the youngest, the friendliest, the ones we knew other families would adopt. But, he would never even consider letting even one go. Not one kitten. Not one feral adult. They all had names given to them as soon as they were born. He knew who was whose grandparents, siblings, aunts, and uncles, etc. This was his family. He loved them more than he could see what that love was costing them.

After 10 years of seeing bad decline into criminally negligent and mentally incompetent I was broken to resolve that I was merely a spectator watching his cats die more tragic deaths than the parents before them had. The problem over the years had gotten bigger, and more alarming and he just wasn't seeing it. A few timid cats turned into 40 plus (although I suspect the number is 70 plus) indoor cats with severe emaciation, respiratory failures, illnesses that can only be explained due to massive overcrowding, inability to manage basic sanitation, and starvation due to dental disease that left the cats unable to eat and dying to in the process. I gave up my ability to believe that I could make his cats lives better. I realized I was just flaming the fires of an inferno and watching cats die more excruciating deaths than I could intervene on. My last straw was a dozen plus cats who starved to death from stomatitis. A cat with stomatitis has inflamed gums that causes such severe mouth pain they can't eat although they are desperately hungry. One emaciated fire mouthed cat after another showed up. Each so sick they couldn't fight the stranger they knew everyone to be. So weak and yet afraid to eat they gave up and willingly died in a corner of a cage that offered no reprieve.

Any person who hoards is already a difficult person to relate to. There is always a lack of trust, there is always a degree of denial that often turns into defensive denial coated anger, and there is always a helpless life hanging in between.

I got to the point where I knew I wasn't helping anyone. I was just prolonging and participating in their and my own suffering. I didn't want to continue to be an accomplice to his feral cat breeding side show circus any longer. I explained that the conditions had gotten to a point where they were no longer manageable, that I felt as if I was complicit in this, all of  the death, the disease, the perpetual continuum of it all, and I couldn't live with it any longer. I tried again, and in vain, one last time to be the advocate for his cats who he dedicated every minute of his life to.

At the end of my attempt to open his eyes to the state of despair his cats were living in I landed the ultimatum. Either he got help, or I would report him to the county animal control officers.
Helpless is a place for the meek to hide in. Helpless and hog tied as a bystander is torture beyond forgiveness. I was the enabler watching disaster strike over and over again.

I never saw him again.

Over the next few months the local shelter received 5 hoarding cases. Each case had between 20 to 80 cats. All were thin, sick, and covered in fleas and feces. I would estimate that less than 5% of these ever found a home. Most were too wild to be adopted. Some ended up in barn colonies. Others just died of fear.

It is impossible for me to tell you the worst way to die? It is impossible for me to say there is anyway for a happy ending in these cases. It is also impossible for me to understand people. Veterinarians seek animals to fulfill our healing purpose, people we distrust amongst our dislike.

I grapple with the fact that I ever made anything better for these cats who deserved a life of so much more. I still ask myself if they were better off with quick death from someone who doesn't care about them, versus the slow death they got from someone who does? There was no happy ending, I just got out, and, even in this I wonder if it was the right thing to do?

"I have such great news! .... My mom found a home for the cats!" Jenn, my office manager, relayed the seconds ago phone call as she came bounding into my office.

The excitement in her face was obvious. The relief was inflected in her tearfully bubbly words.

We had spent much of that morning, and previous few mornings, discussing this dilemma of the impending eviction. The eminent need for a home for two older cats whose long time clients were moving to a smaller apartment and not taking them. We, the collective of us who manage the vet practice, had decided many many years ago that if we wanted to run a family-oriented veterinary clinic then we had to stick to our words. Be more than a trademark tag-line and actually stand by it. We aren't going to say that we "treat your pets like family" and then not really treat them like our family. So, we do. We offer payment options, free boarding, intervention care and emergency care to our patients when the pet parents need it. In the past this has included; emergency boarding for family emergencies, the automobile accidents heart attacks, deaths and even domestic abuse and inclement weather needs. If needed we even do it pro bono. We have never  put profits above compassion, nor, pitted purses against pet care. We stand by our patients at their best AND worst days and most dire times of need.

We had also learned the very hard learned lesson that if you give someone an easy out they never truly take responsibility, and they hardly ever follow through with their end of the bargain. People who abandon/surrender pets already have an emotional disconnect, or, they are so far removed from financial ability that follow through won't matter. In 15 years I have only had one surrender I ever felt right about. (See Cole's story here). The rest were clients who had a history of disposable lives the unloaded (often obviously un-remorsefully and un-apathetically onto anyone else who would take them. Once you surrender in (many places) you are forever blacklisted from adopting again. Shelters, rescues, and yes, even us, won't adopt out to you again. Ever. (How can we?)

This particular family were losing their home. It was something we had known was likely for months. We had been in constant contact with the family to get as much social media saturation as possible. Just that morning Jenn had told me that she was scheduled to visit the home to take an in home video of the cats (as one of them was very shy and wouldn't film well at the clinic). She had planned her weekend around this home visit. We all know how hard it is to place adult cats, especially shy reluctant cats. When I asked how the visit had gone she told me that they had cancelled it.

"Don't they understand how hard this is going to be? How we really need to find them homes before bringing them here to live at the clinic."

We have taken two other pairs of cats into the vet clinic over this last year. Our current number of in clinic cats stands at 6. All older, all tough sells to find homes for. One pair came from a family who had developed allergies. The other from a family who just didn't want them any longer then the 10 years they had already had them. One of these cats had gotten so depressed, fearful and withdrawn that we feared he would die from the stress and anxiety our busy chaotic clinic landed him within. I had almost gone as far as placing a feeding tube to force feed him. Cats bond very closely to their owners. Even if they aren't a lovey-dovey lap cat they know who their caretakers are and they adapt to their home with a dependence not seen in other species. When their world changes many of them cannot handle the insecurity. They withdraw, they stop eating, they stop grooming, their depression can kill them. Even when they don't appear to love and need human companionship they die without their people.

"No, she cancelled over the weekend, and that was before her mom had called her to say that she had found a home for them."

"Do you know her mom?" I asked.

"No,"

"Call the shelter. I will bet you a thousand dollars she is just going to bring them there."

...."WHAT! Are you kidding!!??" Jubilation transitioned into shocked perplexity and angered pause.

"No, I'm not. I have never known her mom to be a nice person. She had a sweet cat named Feather, the only time or attention she ever gave that cat was letting her follow her to the mailbox every day. She was never allowed inside and she was never more than a cat., and she also never says anything nice about anyone, her daughter especially. Call the shelter, give them a heads up."

The next day the shelter called to say the cats had been picked up by Animal Control. The mom had requested they be euthanized. She had expressed that they were better off dead, something about being concerned that they would be "abused if adopted to the wrong people."

Now, I have to pause here. I have to stop here because as hard as it is to believe I hear this a lot. Too often. It bleeds into this paranoia, the same paranoia that precludes a person from finding homes for his 42 cats who are dying slow deaths around him, in his home. He firmly believes that all of his cats, whom he loves and will admit to repeatedly loving, are better off with him than anywhere else. He is blind to their suffering. Distrustful of everyone else in the world. Which also included me, the one vet who would allow him to drop off any sick cat at any inconvenient time, AND, not force him to pay when clearly he had no ability to afford anything.. Even I was  threat so intense that I had to be cut out. The same paranoia that allows people to believe death is a better place than chance when you dump them into societies mercy.

The lack of trust in medicine, in compassion, in humanity has been one of the hardest pills to swallow.

The shelter called to ask for medical records to be transferred to them for these two adult cats that we had just been told Mom had found a home for. I interrupted. I have such great news! .... My mom found a home for the cats!

"Who dropped them off?"

"Mrs. MOM did" they replied.

"Well, she isn't the owner!" I exclaimed. I was excited to have caught them before the euthanasia filled needle did. Before they were lost in an overcrowded shelter. Maybe, I thought, if I could show that these weren't the MOMs cats we could get them into a better place for their second chance?

The rest of the day included multiple phone calls to the shelter staff to promise me that they wouldn't euthanize the cats, the Animal Control Officer to explain the whole situation and urge him to go and speak to the cats real mom in person, and the vet clinic staff, just in case someone came packing and angry. We have had to go on lock down before, get restraining orders, and do emergency shelter recons before. You put everyone on alert when shit like this happens.

When I was on the phone with the Animal Control Officer I begged him to go to the cats home in person. "I'm afraid her mom lied to her. We have offered to help to find homes for the cats, give them a foster home, all so they wouldn't have to be surrendered, which was what she told us all along she feared the most. That sending them to the shelter where they could be euthanized if they were too scared to be adopted might be their fate. Please go! I just can't imagine she would do this, or knowingly let her mom do this? And, please give her my cell phone number. She can call me anytime. We will help her and her cats."

The next day the shelter called back requesting records. She, the cats real pet parent mom we have known so well,, hugged thousands of times, cried with over the loss of her pets, shared holiday cards with, loved more than any other person/client/friend/and even more than family had signed them over to the shelter. Their fates, as the shelter will openly admit to, are open, can be decided to be terminated at any time (because surrendering allows immediate euthanasia), and I am devastated beyond words.

I do not understand people.

Why would you not trust us more than the shelter that can/will/might kill your unadoptable/stressedout/abandoned-and-petrified cat?

It is impossible for me to tell you whats the worst way to die? It is impossible for me to say there is anyway for a happy ending. It is also impossible for me to understand people.

It is increasingly more impossible for me to not judge people as I try to dissect into the comprehensible these non-sensible pieces. I live in a profession where people decide their companions fates. I live in a world that I still willingly invest my heart and soul in, and I live in a world where even those pet parents who I think/feel/believe will fight and die for their pets don't.

And I'll be damned maybe, but, I sure don't understand them. The hoarders are killing their cats with selfish abusive neglect they cannot see, and, the disposers pass on a problem to let their guilt succumb to freedom knowing full well they can be, and often times are, euthanized. Because in the world of shelter medicine surrender allows anyone to decide at anytime whatever fate they want to deliver.

The pets, these defenseless deeply emotionally attached to us regardless of how atrociously we treat them, well, they deserve better.

I spent the night trying to figure out how I could be so wrong about her? Her obvious love for them?

Do I call her and try to unravel this? Do I secretly go get them and hope that I never see her again?

The next day Jenn called. "The Humane Society called. They are full, they want to know if we will take them?"

This is where the soul of every vet/every rescuer/every humane is decided. The little pieces. The incremental stories that your life gets entwined in and the facing of the fact that you do care more, you always have, and that's what makes you who you are. For me, the little fired-up vet who looks at every one of her patients as HER patient, HER family. I will never abandon you, or fight for you, without or without your parents.

"yes."

Here is the video of us picking up the cats. Meet our new JVC kitties;

Here's my video of how these cases affect me;

If you would like to know more about the topics I discuss here please find me on Pawbly.com. It is free to use and open to everyone who loves pets. Please also consider joining if you have experiences to share and pet support to lend.

If you would like to learn more about me at the clinic please visit our Facebook page at Jarrettsville Vet.

For my YouTube channel please visit here.

For more information on my veterinary clinics services, including prices for care please see our Jarrettsville Vet website.

Thank you for being kind..

The Real Cost Of A Puppy

If you haven't had a puppy recently, gone through all of the ups and downs, sweaty nights of worry, long days of potty training, and messy clean ups when "they just came in from outside?" in the last few years, then I strongly recommend that you listen to my tale of Poe before you willingly and feverishly jump back into those puppy days again.

This is Poe,,, so impossibly cute, fluffy, small and adorable you can't contain yourself from scooping him up for a face dive smother. He is the epitome of everything that causes the heart to flutter. All puffy-fluffy rounded edges of irresistible and full of possibility. He is perfect just the way he was born... they all start out like this.

It's us, the humans, who keep having to relearn what we can't get right, over and over again....

Poe came from Craig's List. An ad online. Cheap and available at the touch of a cell phone text message. Ugh,,, the number of bad endings that start at Craig's List. I wish I could say that I have more happy endings than disastrous consequences from Craig but in truth I wish Craig took his List and shoved it, hard, and indefinitely. Craig has no business in the pet business.

Every person who has no business breeding hocks their unplanned pregnancies via Craig and that damned List. Get yourself a dog, or two, and POOF! you are in business! Lucrative, dog breeding, business. Everyone oogles over puppies. And,, your dog, your dog is of course the perfect specimen. No courses, credentials, signature clad paperwork, no accredited oversight, no business related taxes or license fees, ordinances, nothing. Put one dog with another, call it a "designer" breed (people pay BIG bucks for them,, sshh! don't call anything a mutt anymore,, no money in "mutt"). Go online buy some acronymed derivative of something with a K(ennel) and a C(lub) in any random order and now your puppies are "purebred with papers." (Probably the biggest sham around).

$80 bucks. That's what Poe cost. His new dad and old dad met at a nearby parking lot and exchanged cash (always cash) for a small being of mercies being. That's all it takes. No questions, no paperwork, no legitimate form of this being anything other than a casual exchange. Sounds like a great deal, doesn't it? $80 bucks for that face! I mean, who can say no to that?

ME! I will say NO! I will say it for about ten thousand more times over my vet career.  I will roll my eyes, swallow hard, sink into my shoes each and every time I hear this prelude. "I got him off Craig's List." Every time I meet a new pet for their first vet visit I ask. It is important for me to know. I need to heighten my degree of paranoia and understand how much more at risk to everything these guys usually are.  Why is that? Because, I know, I have learned first hand, how terribly awful these stories can end. You haven't heard about how disastrous Craig's goods can be? Have you? Well, sit back, hold on, and let me tell you how hard a happy ending from this beginning can be, and often is... Let me tell you about Poe.

The person who had no business with puppies dishes them out to anyone with the cash to exchange. Too often this is unknowing meets unprepared,, and too often I can't cast blame unequally on one side versus the other.

Puppies, kittens, I would venture to say every living being, listed needs a better chance than Craig can deliver. These are living, breathing, vulnerable beings. Let me highlight "vulnerable" again.

I could go on for days. Will it change? Or, ever stop? Not in our current climate. The want ads are the lazy mans answer to affordability meets accessibility. No contracts, no fenced in yard requirements, no questions asked. Me personally, I take Craig's List to be a puppy mill incognito.

Poe was purchased by a family with good intentions. A puppy is pure joy. Undeniably simply flat out ubiquitous joy. They all start out like this. Joyful. The dream of a lifelong companion to grow old with, but, as every vet and rescuer knows the first two weeks are fraught with worry that there is some lingering issue about to rear its ugly Sith yielding cypher.

Poe was as unplanned in birth as he was in purchase. Poe probably had a mom who wasn't vaccinated, and a dad who was most likely a transient fly by night passer-byer. No decision with any living thing should be based on these.

Within days of purchase Poe got sick. He wasn't playful, wasn't barking and was both vomiting and having diarrhea. All the classic signs of parvovirus which was the first thing he was tested for when he arrived at the vets office.

A parvo puppy is like a box of chocolate. (I stole that from one of my favorite movies,, but it holds). You never know what you are going to get. Medicine is also like this. There is no crystal ball to foretell the future. No play book to follow. And, our last best analogy is to try to give you "an average case" scenario, but, even this doesn't always readily apply. Parvo can be quick, cheap and transient, or, prolonged expensive and still deadly. Which puppy gets which? That is all guessing and hoping.

Veterinarians have to prepare clients for this. The complete Pandora's box a parvo puppy presents. Within a day or two of being placed in his new home Poe was a sick puppy with a treatment plan that started at a few hundred bucks and had the potential to end at thousands and still include death. Who, which of these  poorly pet-educated brand new parents can face this. They did just pay $80 bucks for him. Poe's first vet visit was crippling emotionally. His first visit also cost over $150 and he only had a diagnosis,,, there was no treatment included with this.

Stubborn determination is a valuable trait to possess when you are a doctor. I can tell you all straight up that I have saved more cases by my dogged determination than my decades of intellectual tutelage. My devotion to my patients, my sheer hatred for unhappy sad endings, and this infatuation with feeling like love conquers all is omnipresent. It is how I have decided I must live this veterinary life I am trying to live through and still like myself when I hang up my stethoscope. Happy endings happen if you let them.

I always (YES! always!) see parvo as treatable. I don't ever suggest giving up on treating them until they prove me otherwise. I firmly believe that this disease is our fault. That negligent, unknowing, or otherwise breeder, parent, transport person, well intentioned or not, exposed this puppy and medicine is available to treat. But, I also always have to be honest. I have to confess to people that I never know which puppy is going to go which way, and even with all of the money in the world, (for which I have yet to meet the person who can admit this), you might still lose your puppy. It just goes like that. It's a crap shoot. Surely treating earlier and aggressively increases your odds of winning, but even these guys can take tragic turns and succumb. It's a tough one to watch. A puppy dying slowly in front of you. The worst deaths are the deaths without empathy and advocacy. I say this because I have seen it. Its not fair, it's not right and it's not the path I take.

Every,, yes, every parvo puppy who meets my hands is offered treatment. I don't want to sound self-righteous, I am not. I want to sound determined. I am determined to give every treatable patient a chance. Screw the pessimists, the hardened, the pragmatic economists. That face! Do you remember that face? Try euthanizing it. Try to talk yourself in and out of all the excuses to make it justifiable. I'll give you a minute....

When Poe's story crossed my path it was a quick three sentence inquiry from a fellow veterinarian.

"We have a parvo puppy here. Can you take him? We don't have an isolation area."

Now this is a veterinarian I know well. She actually worked at my practice for many years. She knows how I feel about parvo. And puppies. She knows where my heart strings are anchored and how to make a serenade of them.

"We don't have an isolation area either." I reply. I know she already knows this.

"And the guy has no money."

Of course he doesn't. If he did she would have sent him to the ER, who is more than capable and versed in treating this.

I call her. The texts aren't going to shed enough light to make this case comprehensible or resolvable.

The story is always (always, always,,,) the same. New (brand spanking!) puppy just purchased, (no accountable breeder would have unvaccinated, unquarantined puppies to set out into the world... never mind the cash exchange in the parking lot and no accompanying paperwork), and almost immediately the puppy gets sick.. really, really sick. New pet parent has no idea what parvo is? No way to transfer to the ER (who requires a $1,000 deposit and forewarns the final cost might be a multiple of this), and now the client is calculating if it is easier and cheaper to just get a replacement? After all they have only had this puppy a few hours/days.

Do the math. This whole scenario started with simple math. $80 bucks off Craig's List versus almost (or up to) $1,000 through some breeder.

The conversation with the other vet goes a little like this..

"We want to transfer him to the ER. He is dehydrated. Can you use some of your Good Samaritan funds to help?"

This puppy will do best at the ER. They can provide 24/7 care. They are however, expensive. People don't go because they don't want to, or don't recognize their value, they don't go because they cannot afford to.

"Ummm, what the??,,, that money is money we raised. We internally feed into, for our clients.. the short answer is "no." I don't apologize for my audibly shock-filled curt reply. But, I cannot stop talking here. Remember that face? She has already, before the text messages even started, sent me that photo.

"I am happy to show you how to create your own internal clinic fund for your own clinic. Or show this owner how to set up a Go Fund Me page." I reply.

 ... crickets....

I speak again, "If the only options come down to euthanasia then call me. I will see if I can get one of the rescues to take him and I will provide the care pro bono." Like I said I always offer options. They may not be what the pet parent wants to hear, but I am not offering for them, I am offering to give this puppy a chance.

"Ok, I'll see what he (the owner) wants to do. I'll call you back." click.

I go back to work. There are other cases in front of me to worry about. Internally I feel that bubbling nausea of frustration meets vomit induced worry that another sick puppy will be biting the dust because another vet who wants to feel like they are offering empathy is merely shirking the guilt and another vet practice who is happy to let me do what they can for their own patient for free.. I have to admit it gets overwhelming feeling like I am the only one around willing to offer and provide empathy with meaningful service and care. Not just lip service and wash your hands.. (permit me a bit of bitterness in my verbal exasperation.. I have to harbor it and set it to sail as a sort of cleansing endeavor).

Poe arrived a few hours later. I documented his arrival the next day. He arrived quiet (always a bad sign), depressed, and dehydrated. He didn't interact with us, he just sat there cowering on his pee pad  in his bare wired easy to decontaminate cage.

So the story begins. Will he make it? Will it take weeks of no sleep? Wondering and worrying and trying to protect my heart as he tries to survive? This is also always the same. Invest yourself without killing yourself.

Miraculously Poe only got better. He never had one episode of vomiting or diarrhea with us. Within 2 days I was pretty sure he would be ok. We, the collective small group of us who had intervened on his behalf, all talked about how lucky he had been. How nice it was to have an easy case with our much sought after happy ending. At least the ending of parvo.

We also talked about what was the right thing to do next?

The real hard cost to us was a few hundred dollars. We all agreed to donate our time. It was a gift we were happy to give him. I suggested that we give Poe back to his family. We had heard that there were children who were crying and distraught with the surrender of their puppy. That was something we didn't want to be a part of. We wanted to remedy that, if we could.

I called the vet who knew the family and asked if it would be a good idea to at least offer Poe back to them? (in other words, I was asking her to vouch for them as I didn't know them at all).

"Yes, the kids would be so happy. He (the dad) seemed like an honest good guy,, he was crying too."

And so it was, a veritable happy ending would be had in totality! We were all conjuring up the reunion videos in our heads. The crying crowd as we delivered a healthy puppy back to 4 little kids. Move over Walt, we were about to have our own Disney moment.

Now I am a pragmatic seasoned vet. I have learned (always the hard way) that helping people isn't just about getting them across the land mines, it is about being to that glorious sunset with the rest of the sun filled days behind you safely. I owe Poe this too. We wanted to spell out in black and white what being a pet parent entailed; regular vet visits, vaccines, preventatives, neutering, training, time and money. Love, yes, love is imperative, but responsibility is what assists you in curtailing the remaining potential land mines ahead.

We all agreed to give Poe back without any incurred costs. I would use donations and we all donated our time. We all felt really good about being a part of the good in the world when there is already too much sadness.

I called Poe's dad to share the news. I confessed that we don't usually do this. We don't usually contact the original owners, but Poe had been such an easy success that we felt it was the right thing to do in his case. I discussed the plan to help identify future costs of care, and even told him that we could help him find low cost options. Poe would be given back to them healthy and happy and we would help them with whatever he needed to stay this way.

He told me his kids had been upset with Poe's departure. He also said he wanted to speak to his wife about it. I left him my cell phone number and he said he would call me back.

He never did. He also never said "thank you," or, "I'm glad/relieved/happy, etc, that Poe is ok."

And so the dream ended,,, the fairy tale was half fulfilled. Poe made it..

Poe is still with us. A week and a half later. We will do everything we can to be a part of his life. Indefinitely.

And maybe there is one less Craig's List customer out there? Maybe he feels like he dodged a bullet? Maybe he thought that $80 is all a pet needs for their whole life? Maybe he just didn't have the $500 bucks I estimated Poe would cost over the next 6 months, and he couldn't listen to the kids cry again? I really don't know?

Maybe being a dreamer is not as important as a doer? And just maybe I need to revel in my own happy endings, even when the world doesn't deliver them in packages as marvelous as a puppy.

I would like to Thank Jenn for always being ready to take another potential heart break on. For making as many sacrifices as she does and for hoping for "happily ever "after as often as I do. But mostly for making every case a purpose and for never asking or expecting anything in return. It  is always about the animals who need us, never about what it costs us.

If you have a question relating to your pets care you can ask me, the whole team of us at Pawbly, for free at Pawbly.com.

If you want to learn more about Poe please see my YouTube channel here. Or, follow our latest rescue endeavors at our Jarrettsville Vet Facebook page. 

Affordable Options Are Everyone's Right.

Heather
Harford County Humane Society surrender

For a huge part of the pet owning population the ability to find affordable care for many aspects of their pets health is unattainable. Many cannot afford to make good routine nutritional choices, attain routine veterinary care, provide little to no vaccines or preventatives, and even more cannot begin to find affordable options for complex disease(s) or emergency care. The size of the chasm of need increases significantly for people as the small choices for basic care grow into more complicated health concerns.

The reality of the intensive side of veterinary pet care, and by that I mean; emergencies, life threatening disease or conditions, or pet care that requires specialists, referrals or hospitalization, is that if you have deep pockets you can, and will, get state of the art unimaginable high quality specialized care. The state of veterinary medicine is at the point where amazing things are possible when clients have access to immediate funds.

In the real-world of this small animal general practitioner there are too many cases where the degree of assistance and the altering of prognosis with the likelihood of cure is directly proportional to the power to pay immediately.

Let me explain. Many difficult cases require more than one vet visit and more information than our eyes, ears and nose can identify at the initial visit. Running tests and making repeat visits to the vets office are needed to find the critical clues that help lead to the answers your pet needs to provide optimal care and prognosis. These can be expensive. As the wallet shrinks these key critical pieces for a best case outcome scenario fade.

In some cases I cannot even get close to a diagnosis. Without at least $500 I often can't get a narrowed down list of possible rule-outs to allow focused effective meaningful care. Seasoned trained well established vets dole out a boat load of convincing "educated guesses" when we are presented with pets who need answers and pet parents who don't or can't pursue diagnostics. It is sad and true that huge numbers of fates are decided on "guesses" educated or otherwise.

Even in the few cases that I can almost 100% definitively diagnose for less than $100 or $200 dollars, let's say for example DKA, fractures, blocked cat, obstructions, pyometra, GDV,  IVDD, neuromuscular disease, toxins, cancer, behavior cases, (the list is endless), I cannot provide cheap AND prognostically favorable answers for less than $500 (plus). It is always a dance of managing expectations, resources, and open honest communication, and always, always, trying to figure out a way to keep a pet in a home and happy on all sides. It is why so many vets learn to walk away indifferent.

I believe that vets are an integral part of a pets quality of life. We are their advocate for all facets of their care. Why then is it that we shirk away from guidance when there are financial constraints? How on earth can denying affordable options help maintain our credibility and integrity? If there is a pet care problem there are ALWAYS options. There are even affordable options. Perhaps they are not attainable under our roof but shouldn't we be obligated to provide them regardless? Is withholding affordable options a part of who we want to be? My clinic provides clients in need with resources of low cost spay/neuter clinics, vaccine clinics, surgical facilities and trainers, even though  we provide all of these services under our roof. Why do we do this? Because ultimately our patients shouldn't have to pay for our inabilities (vet AND parent included).

Our most recent endeavor is to curb the need for shelter surrenders of our patients.

Undoubtedly there are many sides to the problem of why people surrender to shelters. There are many sides that I cannot help. Of them I cannot convince a pet parent to love their pet. I cannot build a bond between a person who doesn't want to make a place in their heart or family to care about them. I cannot convince someone to not be evicted, or not rent an apartment that won't take pets, etc. BUT, I can help in behavior and health care issues that might cause some loving pet parent to consider surrender, abandonment or economic euthanasia because the cost of care is too great.

PetFinder.com's  Top 10 Reasons for Relinquishment*

Dogs:

1. Moving (7%)
2. Landlord not allowing pet (6%)
3. Too many animals in household (4%)
4. Cost of pet maintenance (5%)
5. Owner having personal problems (4%)
6. Inadequate facilities (4%)
7. No homes available for litter mates (3%)
8. Having no time for pet (4%)
9. Pet illness(es) (4%)
10. Biting (3%)

Cats:

1. Moving (8%)
2. Landlord not allowing pet (6%)
3. Too many animals in household (11%)
4. Cost of pet maintenance (6%)
5. Owner having personal problems (4%)
6. Inadequate facilities (2%)
7. No homes available for litter mates (6%)
8. Allergies in family (8%)
9. House soiling (5%)
10. Incompatibility with other pets (2%)

Jarrettsville Veterinary Center can help with some of these. Here is what we are doing to help the pets in our community;

• Providing shelter for pets from excessive heat or cold for free. 
• Providing payment options when care is denied elsewhere. 
• Providing care when euthanasia is the only affordable options given, or, even taking surrendered pets when our clients pass away. 

We will do it. We can help and we will. Coming soon we will offer a pet food pantry and Pet Savings Plan to help our clients prepare for the rainy days every pet will at some point face.

This is our latest offer of assistance;

Dear Local Shelters/Rescues,

At Jarrettsville Veterinary Center we have a deep desire to help animals in need.  We want to be part of the solution in keeping pets out of shelters.  According to the ASPCA approximately 7.6 million animals enter shelters nationwide every year.  This number is shocking and we would like to do something to help with the problem in our community.  We are reaching out to the shelters and rescues in our area and asking for your cooperation.  When a pet is surrendered due to the owner’s inability to pay for the pet’s veterinary care we ask that you ask one additional question.  Please ask who their veterinarian is.  If Jarrettsville Veterinary Center is mentioned or listed on a vaccine history as the center where the pet received care please contact us at 410-692-6171 and ask to speak to Jennifer Taylor.  We would like to see what we can do to assist the owner and their pet.

Thank you so much for your cooperation in this matter, as a team we hope to help our patients who may find themselves in unfortunate circumstances.

Warm regards,
The staff of JVC

This is Heather. She was surrendered by her family to our local shelter. She is 3 1/2 years old and has not been treated for her diabetes diagnosed over a year ago. She was very, very sick from her neglected diabetes. Without immediate care she would have likely died within a few days. She was 113 pounds at arrival. This is almost 30 pounds more than she should be. If it weren't for the shelter staff calling us and our ability to help her she would have been euthanized. Somewhere someone failed her. This disease is avoidable and treatable. A lot could have been done for her to keep her from being surrendered. She needed to be given dietary options. Affordable, over the counter, options. She needed to be shown to how to be treated for diabetes. Affordably. She needed more than her family could provide. She is one of those pets in our community we are responsible for. We owe her more than she has been given and we will help her find her second chance at a new and healthier life.

Our goal is to offer options to help people so surrender or economic euthanasia isn't a needed option. Pawbly and Jarrettsville Vet are here for this purpose. We hope that you will join us in helping pets in your community. Education and options are often all that are needed to change and better the lives of those in our communities.

More on Heather soon.

If you would like to help a pet please join us at Jarrettsville Vet for one of our fundraisers, like Pets With Santa. Always the first Sunday in December. Or visit us on our Facebook page. You can ask me questions about your pet on Pawbly.com. It is free to use and open to anyone. I am also on Twitter @FreePetAdvice and YouTube.

Coot, our resident clinic cat, and I steal a snuggle selfie

Related Blogs;

What Are You Building? Leadership in a Compassion Based Clinic.

Medical bill madness: what if human medicine was like veterinary medicine?

Economic Euthanasia.

Veterinary Rescue Shaming and The Frank-Starling Law.

Rescue Economics. When The Expense Costs You Your Ability to Care.

Wellness Plans, Savings Plans, and Surprises.

Jarrettsville Veterinary Center Protocol for Clients with Financial Constraints.

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

Open Admission Shelters are NOT Safe Houses

People should be told the truth. Regardless of whether they can face it, deal with it, or do something about it. We all deserve honesty and transparency. Wouldn't you want to know what was going to happen to your pet if you dropped it off at a shelter? Shouldn't this sign be the first notification that you see? 

I have a very deep troubling sense of despair over open admission shelters. I will also be the first person to admit that I do not know how resolve the problem. 

In too many places of this world you will find the face of poverty, struggle and suffering. There are millions of lives on the brink of death in every corner of the globe. Compassion in some places has manifested into "open admission shelters". Shelters to house and feed and provide the very basic of care so that these animals are not on the streets, in the elements and at the mercy of predators. It sounds like a good answer doesn't it? It shields us from seeing and facing the stark divide between the "haves" and "have-nots". Wouldn't you rather be in a room with a meal then on the merciless ground without? Seems sensible? But what happens when the line at the door is too long for the number of rooms available to lodgers? It is a dilemma faced daily at open admission shelters. The dilemma of what to do when you have a contractual obligation to be the safe house for the lost and the unwanted. If your room is needed and your contractual obligation time frame to hold and house you is up you are most likely going to be killed. In medicine we call it euthanasia. In reality euthanasia is a kinder, more compassionate description of terminating a life. In the shelters the majority of euthanized animals are healthy and killed due to lack of space or resources. 

Buster. Our newest JVC addition.
Owner unable to pay for the cost of his chronic dermatology care.
He is being treated by us and with the help of  the folks at Long Green Dermatology.
He is a happy engaging pup in foster and looking for a new home.

Let's talk about why people surrender pets. Here is the data from PetFinder.com

Dogs:

1. Moving (7%)
2. Landlord not allowing pet (6%)
3. Too many animals in household (4%)
4. Cost of pet maintenance (5%)
5. Owner having personal problems (4%)
6. Inadequate facilities (4%)
7. No homes available for litter mates (3%)
8. Having no time for pet (4%)
9. Pet illness(es) (4%)
10. Biting (3%)

Two of the 14 homeless kittens we placed so far this Summer

Cats:

1. Moving (8%)
2. Landlord not allowing pet (6%)
3. Too many animals in household (11%)
4. Cost of pet maintenance (6%)
5. Owner having personal problems (4%)
6. Inadequate facilities (2%)
7. No homes available for litter mates (6%)
8. Allergies in family (8%)
9. House soiling (5%)
10. Incompatibility with other pets (2%)

Does it seem odd to you that these numbers don't even come close to approximating 100 %? It does to me too. I can say that after a decade in practice I have seen too many people turn to a shelter when they can't face the other options. What are the other options? Abandonment or euthanasia. (Perhaps there are others but those are too awful to even contemplate). 

It is inconceivable to me that some of these are on any list.

• If you are moving you bring your pet. Period. 
• Landlord doesn't allow,, well, what are you doing there to begin with? 
• No homes for litter mates, no time, inadequate facilities, and too many pets all sound like lapses in good mature adult judgement.
• Cost, well, cost is  something we can do something about. Cost is a relative, manipulative entity. There are options when it comes to this. This is where rescues, vets, and society can make a dent in shelter admissions. 

The list of reasons cats and dogs are surrendered is fraught with pet parents who either weren't prepared, weren't making decisions that put their four legged kids first, or simply are irresponsible. This notion that pets are peripheral disposable replaceable accessories is part of the reason there are so many pets in need. This mind set has got to change. How do we do that? We teach respect for life, love for each other, and manifest, nurture and foster kindness to all others. 

Paisely needed a surgery that only JVC was willing to try.
She is Harford County shelter rescue who has since been adopted and is doing great!

There has to be a better way? Has to be! There needs to be a shelter to serve as a holding facility for lost pets where people can bring them. For the few pets who are found and need a place to stay while mom and dad remain frantically searching the neighborhood there needs to be a safe house available. Some sort of central location for reuniting pets and their parents. The only justifiable existence is as a halfway house, a sheltering holding facility for reunions.

Laura (JVC Rescue coordinator) and Sammy.
Cecil County Animal Shelter rescue.
They closed their doors and she would have been euthanized if we didn't rescue her.

The old adage holds true. "You are either a part of the solution OR you are a part of the problem." 

How does my clinic, Jarrettsville Vet, become a part of the solution, if we are, as I believe every clinic is, a part of the problem? We are not going to be the place that decides, influences, or confers that veterinary care and the cost of it is too excessive for parents to provide. There is a considerable amount of fluff in the medical estimates we provide to parents. We, the vets who have been taught by the hand of the specialists at the Ivory Tower should always offer the Gold Standard of care, and we too, need to remember that Gold Standard is not always attainable or financially feasible. We are forgetting that if our client walks out of our hospital without an affordable AND agreed upon treatment plan that some of these pets will be euthanized or surrendered. We are a big part of this problem, and we have to take responsibility in being the force of change that provides for a solution.  

Laura and Chico.
Owner surrendered whose only other options were euthanasia or shelter.
He is now also in a new home

In the last year Jarrettsville Vet has gone to every emergency clinic and shelter in our area and left them with a plea; If any of our patients end up in their lobby for any reason with their parents feeling like they have no options other than surrender or euthanasize call us. Have the person surrendering call us, give our name and number to any of our clients who thinks that there isn't another option. We will do whatever we can to help, and, we will help.

Petey and Dr Allen, his new mom.
Owner surrender or would have been euthanized.

How has this been received? Sadly with disbelief and a deaf ear in some cases. In others with a rapid phone call, Facebook message, or even a behind the scenes emergency hotline call to one of the staff. Jarrettsville Vet has helped many pets get out of a shelter and into a home. Some of these have even been the original home. The majority of the surrendering desperate pet parents just needed help and a shoulder to lean on. Sounds incredibly easy, and it really is just that easy. 

Tanner, Number 2 Cecil County Animal Shelter shut down rescue.
Currently in foster. Ready for a new home soon.

To all of my friends, colleagues, neighboring vet clinics and those of you who think that there has to be a better way and more options there are. Jump in, lend a hand, stick your neck out, and save your patients life. I know you are not a rescue, I am not either. BUT, these pets come through our doors. Their stories are ones we know. We feel and hear our clients frustrations. We see their despair, and often participate unquestioningly in their final decision. We can do better, and we owe our patients more.

Talking about other options can be a difficult task in a time of emotional turmoil. Have I lost clients because I have offered other options? Yes. Of course. What I see as offering their pet a second chance they see as a possession they are determined to decide for. I may never see them again, and I am OK with this. Their anger at me is their shame in being unable to see a different option exists. My obligation is to my patients. They are not disposable, replaceable, and dismissed. Other clients know and believe us when we say that we are here to help, especially even when there are lots of bumps and tears in the road.

Murray and  Diedra.
Owner surrender.

Each owner surrender has been a euthanasia request replaced by a second chance. Every client was offered financial assistance, veterinary services at no cost, and options to keep their pet in their home. Every pet, just like every one of us, deserves a second chance and a friend in your corner at your darkest hour.

Thank you to those clients who help us in offering options that aren't routine. Thank you to the clients who help in providing foster care, making donations, volunteering their time and reminding all of us that this village can care for its own.

If you are interested in learning about different options to running a vet hospital out of the corporate box find me at the clinic, Jarrettsville Vet, on Twitter @FreePetAdvice. Or on our Facebook page.

If you want to help a pet in need please join me on Pawbly.com. We are a village of volunteers to help provide guidance and assistance in the virtual space of pet lovers worldwide.