The Common Goal

There is no argument that the focus of everyone's immense efforts here is the animals. 

Me, and the compound kitty, Mitsi.. I do LOVE her!

To have such a strong common goal is the only way this many craggy, crazy people, all deprived of sleep, food, warm comfortable beds and all of the amenities associated with running water, AND, being from all corners of the UK, (and me the single American), could coexist together for weeks on end. Life here is complicated, and full of tragedies. People are trying to live normal lives, but, it is obvious that isn't possible here. Because of the poor living conditions, the overarching fear of air raids, bombs, and all of the insecurities war can present it is difficult to lose your way if you don't have a common goal and purpose. It is the glue that keeps us cohesive. If we didn't have this I am sure all of the ragged edges of all of the hardships would crack us. I am also sure that I am the person who fits in the least here. (I think I am proud of that.)

The depth and width of the pet dilemma that is here is oceanic. Mind boggling. This is a country that has very few frivolities. Dogs roam. Cats roam. People trudge in ratty clothes, and everyone sweeps bent over, scoliosis, kyphosis, nose to the dirt, sweep, sweep, sweep. An old country, old people, old stories of war, a country of tales of having been claimed by others, broken away from them, the castaway step-child and the weight of the world with whom you never know who you will saluting to lives here. These people have so much to manage already that the pets, the kind animals, are stepped over and passed by. To be honest there is probably no way to even begin to suggest an end to this mess. As the war drags on the problems deepen, intensify and coalesce. The lesion this began as has become a metastatic cancer of a wound that never received adequate treatment to begin with. How do we try to end the plight of these animals when we started at accepted indifference?

The animals here, at the compound I stay at, were all extracted (the term they all use) from the streets and abandoned shelters after they lost their residencies to the bombs that their homes became Russian targets of. They are all scarred. Some with obvious wounds, others with anxiety based fear so deeply embedded you don't want to know the source, or, excise the reason. You just assess, be kind, exude confident optimism and take small steps one heartbeat at a time. I am a fixer. I am wired to examine, dissect, treat, cure, and claim victory. here, each of these must be set aside. Reduced, and simplified to simply what I can do in the right here, presently, now. I will go mad, abandon the cause if I try to practice medicine like I do in my well controlled, everything accessible home. There are almost no spayed or neutered animals here. I assume with every tragic life threatening ailment that they come to me with they are also passing it forward to the half dozen offspring within them. Great, the problem multiples as I gaze upon it. There is no end. No finishing point.

The dogs here at the compound came from a shelter in Alexandria Ukraine. The shelter before the war used to run with a capacity of about 40 dogs and cats. When the war hit the numbers surged to 400. When the staff could no longer manage the animals and the war they reduced the care to feeding alone. No cleaning and no exercising. When the threat of further invasions and insecurities presented the shelter staff had to make an even more perilous decision. They opened the cage doors so the pets would not be left to starve. The group when in weeks ago to find many of the animals set free from their cages. The scene they came upon was about 150 animals alive the rest in some form of eaten. It is what we would all be faced with if 5 weeks went by without food or water. The weak, gentle and submissive were not who were left to rescue. Most of these dogs are German Shepherds. All are thin, matted, and apprehensive of humans. this is what war looks like. The war of abandoning human kindness and compassion. It is the face of people we should never be reduced to become. It is also why I am here.

I wonder if as the days pass that I won’t grow more indifferent to this place then desiring to stay and help? It is the same dilemma I face at home as a veterinarian. Do I give up as others have to save my fragile soul, or provide it with barricades shrouded in tattered clothes and fight on?

Why the Spay Price Isn't Fixed.

Three reproductive tracts of the three spays I did a few days ago. They are an excellent explanation as to why there is not a flat fee for spay surgeries (at least at my clinic).

Could you guess which reproductive tract belong to which patient?

Patient Number 1;

A 7 month old domestic short haired cat.

Patient Number 2;
An 8 month old 38 pound Cattle Dog.

Patient Number 3;
An 8 month old Labradoodle who is 55 pounds.

At my clinic I try to do everything I can to treat every case independently and be fair to each. Therefore, providing a "one  size fits all" approach doesn't work in many surgery cases. With the exception of routine cat and dog neuters, every other surgery has a price range and every other surgery is based on the patient. 

Historically vets have put themselves in the predicament of dismissing spays as a "basic" surgery done so often that it has been diminished to "routine" status. This perception has understandably caused clients to price shop and balk at spay costs of anything over $100. High volume low cost spay and neuter clinics have popped up to meet demand and only reinforced the perception.

For all of the knee surgeries that I do weekly with a $1200 price tag, that clients are more than happy to pay based on the specialists average going rate of upwards of $3,000, I have to argue and justify a spay price of $200 plus. Ridiculously that spay has a much higher chance of causing a life threatening post operative complication than my knee surgery does. I will take a bad knee to correct over a fat dog in heat to spay any day of the week.. and I make 5 times the amount of money doing it. 

Why does "one size not fit all"? Because some dog spays are ridiculously difficult to do. And some patients need more time, more pre-op consideration and more peri-op care, not to mention post-op goods and services. All of these cost more time and more money. Wouldn't you want your vet to tailor and customize your pets care to their needs. Isn't it fair to pay for that?

The three uteruses (probably grammatically correct to say 'uteri' but that just sounds snooty scholarly, which I am not, so I'll move on).. belong to the pets above and listed in their perspective order. (Note; I did not use the actual patients for this,, they are in fact my cat Wren, and my dear friends Madeleine and Maizie.. but they represent the actual patients very well.). The top uterus is an early pregnancy in a feral cat. Middle is an 8 month old who is 38 pounds and in heat, and the last is also an 8 month old who is 55 pounds and not in heat.

The costs of a spay should vary based on the patient. If your dog is in heat, pregnant, or has a uterine infection it is going to be more difficult to perform the procedure. It will take more anesthetic time, require more equipment and suture and should also be followed up with post operative medications to include analgesics and antibiotics.

As I  discuss why spay surgeries are each entitled to their own charges I will admit that I never charge a different price for cats. A pyometra cat is the same cost as a pregnant cat is the same cost as a regular cat spay. In truth there is not enough of an additional degree of difficulty to warrant the extra fee. The only exception to this is the post operative care and medications. I challenge other vets to argue differently. I especially challenge the emergency clinics who give estimates of cat pyometras in the thousands of dollars. 

The cat below is also pregnant. Although no one wants to be stuck in the middle of this moral and ethical argument it is Spring here and the kittens are blooming as fast as the flowers. Sadly, many of the cats in our rural area are also feral. Feral cats having kittens perpetuates more feral cats having kittens and many of these are eaten, killed, or die of infection. When a feral cat  is caught and brought to us for a spay or neuter we can't touch them, examine them, or even know if they are pregnant. Once they are sedated they are all spayed and neutered regardless of their condition. It is the only way the cats can be released responsibly and spared their life. But a cat is a cat and a cat uterus is easily surgically removed regardless of uterus size. If your cat is given a thousand dollar estimate (or anything near close to that call me. I will do it for a fraction of that.

If you asked me to spay your dog as I would my own dog here's what I would do;

1. Have the vet who is performing the spay on your dog do a physical examination while you are present. Can you imagine going in for surgery and never meeting your surgeon, OR, having never met them and they never examined you? That's plain neglectful.

2. Every human patient has pre-operative blood work done to check basic organ function. I now want to check clotting function too.

3. Your pet should be free of internal and external parasites. Having fleas walk through the surgery site is not maintaining an acceptable sterile field. People with invasive surgeries these days have to use a special surgical soap and shower with it every day.

4. Every spay should be intubated and maintained on inhalant general anesthesia. The best way to maintain an open airway is to have one. The best way to maintain an acceptable anesthetic plane is to use gas.

5. Intravenous fluids via an indwelling iv catheter. I use it for every spay these days. Why risk it for $80?

6. Every spay gets and goes home with analgesics. For the cats most of these are injectable. or the dogs a 24 hour dose of an NSAID is given pre-op and oral meds go home for the next 4 days.

7. Suture material. The glue that holds the tissue together and keeps your pet from bleeding internally or opening up their incision. You get what you pay for in this department and no one ever asks what this vital material is. There is still debate in the veterinary field about what  is and is not considered acceptable standard of care. For many experienced vets I will not argue that using what works for you is fine, but, the rules of engagement are shifting and clients have the right to know what we use and why we use it. If a surgery fails they also have the right to their pets records and challenge us on our choices.

There is a terribly fragile line between low cost and affordable and borderline substandard care.

Chloe who needed an emergency pyometra surgery and couldn't afford the ER price.
Her story below.

We all like to have an idea of what something will cost. It allows us to plan, budget, and bargain shop. Medicine allows for only so much planning and presuming.. the rest is decided on luck, fate and preparedness for worst case scenario.

If you are price shopping for a spay you are asking for more cut corners than I would ever be comfortable with. If your pet has a problem while being spayed or neutered your vet has a much better chance at your pets survival if they are intubated, under inhalant anesthesia, with iv  fluids, and a full sterile surgical suite. Wouldn't you expect the same for yourself?

There are a few brave clinics who provide set prices for a service and rely on the law of averages to make the bad cases dilute out the overwhelmingly easy cases. It allows for clients to not be side swiped by sticker shock when those inevitable outlier surgeries are their pets surgery.

I much prefer the open and honest approach. I treat each case as their own and each is priced fairly based on their own merit. I also care far more about every pet walking out of surgery happy, comfortable and safe. If you cannot provide optimal care due to financial struggles we will work with you,, it is the reason we maintain a fund for hardship cases at the clinic. Good patient care should not be  about bottom lines, budgets, and unacceptable risks.

Related Blogs;
The Ode of My Obligation. Why does the ER charge so much?

Chloe's Emergency Pyometra. Saving Your Pets Life When Optimal Options Aren't Possible.

Jarrettsville Vet Price List 2016 Edition.

Pyometra. Finding a Happy Ending With A Preventable Disease.

If you would like to discuss your pets medical or behavioral condition with me you can find me on Pawbly.com. Pawbly is a free online community dedicated to helping people who love their pets. If you are a pet lover please join us in and share your experience and expertise. Together we can shape the destiny to provide more happy endings to those who need them.

If you would like help and you are in the northern Maryland area come visit me at the clinic, Jarrettsville Veterinary Center in Harford County.

Or find me on Twitter @FreePetAdvice.

Pawbly Question."Based on the latest research, at what age would you recommend to spay a German Shepherd?"

This is CC, who was spayed last week.
She is a 6 month old shepherd (and lots of other stuff) mix.

Pawbly has been aflutter with questions lately..here's one I haven't talked much about.. 

"at what age do I recommend spaying?"

Always a smile..

Ready for surgery.

 Here is my answer;

There have been a few studies done that have altered our old perceptions of "ideal time to spay."

Certainly some breeds of dogs seem to be predisposed to some diseases, so we looked for ways to alter the statistics of incidence to see if anything (other than diluting out the gene pool,,a subject for another debate), might influence the incidence of disease. Of note is the study done on Golden Retrievers and a lower incidence of many diseases like hip dysplasia, cranial cruciate ligament tears, and even cancer IF the age of neutering was delayed. This study sent shock waves through the veterinary community who is now re-thinking our previously held belief that ALL dogs should be spayed/neutered at 6 months old.

Unfortunately, the decision is not so simple. As awful as watching a pet suffer from one of these diseases is, it is even more awful to deal with the other end of the spectrum of this debate. It has been decades of trying to convince pet parents to spay and neuter their pets in an effort to curb the unwanted pet population. In this country alone we euthanize upwards of 10 million pets a year. And we are sometimes forced to euthanize puppies and kittens because we do not have homes for them.

If my clients did not spay/neuter this number would be larger. Most of my clients do not want to have an unwanted pregnancy, or deal with a pet that goes into heat so they spay at about 6 months old.

The other thing I have seen all too often is aggression. I see more anxiety, fear, and aggression related problems in un-spayed/neutered dogs than those that are fixed. Of all of the breeds of dogs that have the worst fear aggression and most devastating consequences German Shepherds have been the most horrible cases.

No one wants to admit it but medicine is all about statistics. I know that statistically as a population GSD suffer from aggression, fear, hip dysplasia, allergies, and immune mediated diseases. Whatever I can do to help avoid these I will do..But starting your dog on the best path can only be done by understanding the client, their abilities, restrictions, lifestyle, the pets bloodlines, genetic markers, parental diagnostics, and then deciding with as much information as possible what age is best to spay.

If I have to give an age without knowing any of these I say 6 months old, (before the first heat cycle).

I hope this helps..As always every pet is a unique individual who should be treated as such. After that the rest of the guidelines are based on statistics, they are the best guide we have to go on for now.

Surgery is done,, cleaning up the incision.

Waking up.

To find the Golden Retriever study please visit;
AVMA JAVMA News.

A little snack before heading home with dad.

If you have a question about anything pet related you can ask the community on Pawbly.com. Pawbly is dedicated to providing a safe, credible place to help people and pets the wide world over. Pawbly is free for everyone to use. We are also on Facebook..

You can also find me at the clinic, Jarrettsville Vet, or on Twitter @FreePetAdvice.

Thanks to Jana Rade for this question. Jana is the amazing woman behind Dawg Business, a blog to help people take care of their dogs, dedicated to the memory of her Rottweiler, Jasmine. 

Happy Spring Everyone!

Von Willebrand's Factor. How To Understand What It Is, and What To Do About It.

Greta.
Looking a bit perplexed.

Greta is a six month old blue Doberman puppy. She was purchased by an older couple who wanted a doberman. Seems simple enough? BUT, there are so many things pet parents need to know before you go jumping into a life long relationship. 

Here's what her parents didn't know;

1. Dobermans are most common breed at risk for the most common inherited bleeding disorder in dogs, Von Willebrand's disease. They had never heard of this disease.

2. Greta has no paperwork. Therefore, we have no idea what her parents Von Willebrands status was? Were they ever tested? What were their results? Have any of Greta's siblings been tested, or had a bleeding disorder? History is such an important and over looked part of every case.

3. Without knowing the answers to number 2 her vet opted to address her spay as cautious as possible. So, Dr. Morgan called the referral hospital to inquire about having Greta spayed there? They quoted over $1,000 to do it. (At our clinic it is about $250). Big difference! Yes, her parents thought so too, and decided to forego the referral.

With a limited budget, a scant history, and her parents desire to have her spayed Dr. Morgan did her due diligence to fill in some of the blanks and help her parents make a safe, educated decision about how to proceed with Greta's elective surgery.

What an adorable face.

Here's what Dr. Morgan did:

1. Performed a through physical examination.

2. Based on Greta's dilute color, (she is what we call 'blue' an the perceived and tested links between autosomal recessive traits and incidence of disease) she performed a Von Willebrand's assay the week before her spay was scheduled.

3. Called for a consult about how to prepare for her surgery.

4. Gave Greta's parents lots of options and then helped them decide which were best for them.

Von Willebrand's disease is inherited. Dogs affected get it from their parents. Both males and females can have the disease or pass it along to offspring. The disorder occurs because of a deficiency or disorder of von Willebrand factor (vWF). Von Willebrand's factor is a plasma protein essential for the platelets in the blood to allow a clot to form and stop bleeding. If you have a breed commonly affected, like the Doberman pinscher, Scottish terrier, Shetland sheepdog, golden retriever, Pembroke Welsh Corgi, or standard poodle it is wise to suspect vWF if they ever have abnormal bleeding events. This can include nail trims, trauma, or problems with surgeries.

Greta's Von Willebrand's assay results were 22 (low).

• The normal values for canines are 70-180% (weird I know you can get a better score than 100%, but yes, you can). 
• 50-69% is considered "borderline normal" (reassuring isn't it? How do you interpret that when the lab notes it as " indeterminate range"
• <50 % abnormal carrier for vWF:AG

To make the testing more confusing, many experts will add that many dogs in the <20% range never show any signs of bleeding abnormalities. They also will tell you that the level of the vWF does not always correspond to the likelihood that they will bleed. OK, a little reassuring if you have a dog with say <20 %, but isn't the opposite true? Yes, you can have a dog previously tested and found to be "normal" who bleeds uncontrollably and life-threateningly. Terrific!

Good Girl!

DDAVP  (desmopressin) can be used pre-operatively (before surgery, just in case you do have a bleeding problem, you need to have this in the patient BEFORE surgery) as a prophylaxis. BUT it is not effective for severe Type 2 or 3 Von Willebrand dogs. (YIKES!! so confusing!) BUT, desmopressin is not commonly used in veterinary general practice clinics and it is very expensive. SO, when you mention it to a client, that MIGHT, or MIGHT NOT need it, OR MIGHT OR MIGHT NOT even benefit from it, it is a tough call. SO, there you are back at square one. Not really knowing what to advise OR what to do.

For Greta's spay her family opted to have her spayed with Dr. Morgan. Dr Morgan placed an i.v. catheter, paid very close attention to minimizing tissue trauma and maintained a high degree of surgical precision to minimize bleeding. IF the patients don't bleed significantly they don't need as many clotting factors. There are many cases of vWF pets doing very well under the most traumatic accidents and surgeries. For vWF pets they should have a physical exam, buccal mucosal bleeding time (BMBT), and careful precision in surgery. If the BMBT is abnormal they should be pre-treated with DDAVP and have fresh frozen plasma standing by should bleeding become a concern.

 

Thankfully, Greta had no surgical concerns or complications. But her family knows that any future surgeries need to be met with care and concern and any traumatic events monitored very closely.

I spoke to Dr. Morgan about Greta's case and we corroborated each others previous experiences with having doberman's with this disease, and the prevalence of seeing vWF positive dogs who are dilute blue's. If you have one of the breeds mentioned, or a dog with a dilute blue/silver coat thinking about this disease might be prudent to help avoid a medical emergency down the bumpy road of life. 

Dr. Morgan has a blue Cane Corso. He was tested, based on her color superstition and found 'normal' but has bled abnormally with each knee surgery he has had. 

That's disease for you, does what it wants and leaves you guessing in spite of 'being an expert."

Dr. Morgan and her boy, Cletus.
Recovering after his cruciate repair surgery.

If you have a question about this, or any other pet related item, you can find me chatting away, helping other people with their pets at Pawbly.com, or on Twitter @FreePetAdvice.

Surgery Monday, Aug 28, 2013

I'm too tired to fill in the blanks tonight..

But here's what my day looked like:

Three sphinx kittens to neuter..and their mom standing by as the recovery ward.

And for our local rescue we did three kitten neuters, and two kitten spays..

And lastly, a laceration repair on a lower eyelid.

And at the end of every day I get to head back home to be with my own bunch.

My Savannah, at 17 1/2 and still happy to see me at every single occasion and happy for a thick lawn of grass to stick her nose in to breathe in a life she remembers not too long ago.

My husband and our Jekyll,,,two peas in a pod

For many people the idea of working with animals everyday is a dream.

For me it is my real-life, and my purpose..

Happy end of Monday everyone!

Do You Believe In Second Chances?

Do you believe in second chances?

Do you give them? Do you wish for one, or two, or more for yourself?

What would you do if you could have a "do-over?"

I think about this. And as much as I would go back and do things differently inside I am glad I can't. It reminds me to not screw up the here and now. I would waste lots and lots of time if I knew I had a free pass to just do it over.

This is the story of Diamond. Her life is a three-peat of do-overs. And if I had to place a chip on the table I would bet the house on there being a four-peat.

Diamond was brought to our clinic about four months ago. She was a card on a carrier in a long list of cat carriers. It was a spay-and-neuter-athon day at the clinic. The sort of day where names where irrelevant and the goal was just to draw a line through the list in as short a time as possible.

I vaguely remember the first time I met her. A pure black young girl who only stood out because one of the handlers felt a small round ball under her skin behind her ear.

"Doc, what do you think this is?" she asked.

Half ignoring her I felt the bump her finger lay upon, "BB." I half consciously replied.

BB's are unfortunately not an uncommon finding. We live in the country and people are despicable sometimes.

"Hey, I feel another," the girl chirped again. This time the BB was on the other side of Diamonds face.

"Can we take an x-ray?" a whole cackle of volunteers asked in unison.

"Yes,,," I quietly replied. I was in surgery and I say yes to almost everything. It allows me to stay focused and quiets the storm for a few minutes.

There were seven small metal pellets strewn about Diamond's body. Left, right, front, back. She was a graffitied buckshot canvas. And a miracle to be standing before us.

Attempt Number 1;
Her spay began like every other spay. She arrived at my surgery table belly up, clipped, washed, and spread eagle machines providing her dreams with quiet calm oblivion.

Scalpel, cut, dissect, enter abdomen, scoop uterus, clamp left ovary, ligate, cut, follow back to uterus to other ovary.....umm,,,hello? other ovary?

There was no other ovary. Diamond was seemingly missing her right ovary. Her uterine horn led to a dead end of scarred, clumped unidentifiable, somewhat familiar mass of stuff that looked like it was at one point a loop of intestine, a kidney, and omentum.

I stop plucking for pieces of tissues that my hands recognize. This cat is a mess, she's going to blow my pace. I look for a volunteer, a volunteer who can make a decision.

"Close her up, and move on to the next."

Needle drivers, suture, thumb forceps, sew, sew, sew, close up the belly, make it look pretty and the lifeless body goes to the next station in the assembly line.

Four months pass, and a call is placed to the rescue.

"We adopted Diamond from you a few months ago, she has been acting like she is in pain, yelling, screaming, meowing, there is something wrong with her."

They relay the message to me. "Crap, I guess that right ovary is still in there?"

Tell them to bring her back we will go in and take a look for it.

Attempt Number 2;
Diamond arrived a few days later. She had been out of heat for as many days. We re-scheduled her surgery. I explained that I was already going fishing for a needle in a haystack, the needle is a lot bigger if she is in heat. So we will wait for her needle to amplify.

Attempt Number 3;
Diamond sat in the surgery cage waiting for her number to be called. When it was her time on deck we opened her cage and the devil erupted out at us.

Talk about hormonal, this girl was ANGRY! I now knew why her parents were a little worried about her erratic behavior.

Once again Diamond lay on the stainless steel table. Once again I went on a fishing expedition in her belly.

There it was again a conglomeration of coagulated curiosity. All jumbled and jelled together.

I picked, parted, fumbled,,,, I opened the incision larger, I pulled out anything not tied to something else..

Finally there it was a tiny cystic bubbly thing about half the size of a pencil eraser buried in tissue that it shouldn't be. All nestled by itself in the bottom of an intricate network of tissue.

How had she been shot so many times and not been injured? One of those BB's had penetrated her abdomen, severed the ovary from its stem and caused it to adhere to everything else surrounding it.

As I held her presumed ovary in my fingertips I debated. How could she be so lucky to survive gunfire, and me be facing not being able to fix her?

"Crap," of course it was a Friday, we close early, and this mess needed about three hours more than I had to dedicate to it.

I gloved out of surgery and placed a call to her parents. I was worried about jeopardizing the glued pieces of colon, intestines, pancreas and omentum.

We agreed that the difficulty of Diamonds surgery wasn't worth the cost of losing her. They felt that as long as she "wasn't in pain they could live with the hormonal outbursts."

I closed her up again.

A few days later Diamond was back at the office.

Her family was concerned about her incision. I was losing sleep about her attitude.

I had spent the last days thinking that I had made a mistake, I should have spent the three hours in surgery. I should have helped make her life better, her house quieter, and her family love her more?

Oh, the guilt.

I called my friend to ask his advice.

I had done the surgery for free, both times. He told me I had done enough. It was their decision now. I should refer her surgery, I should walk away with a light heart.

I wasn't and I couldn't.

"If she was my cat i would remove the ovary." I said to her family.

"But? Isn't it risky?" they worriedly replied.

"Well, it might be, but if you don't she will be going into heat, and I am worried about your sanity with a screaming cat who hisses and might even lash out at you, and you have small children,,," My mind had been racing with every sort of worst case scenario. I was afraid that Diamond would be back on the street, or abandoned at the shelter. I had seen her, she was vicious.

Her mom paused. "No, we love her, she is a part of our family. We will never abandon her, and we love her just the way she is."

I can be found @FreePetAdvice, @pawbly, or if you have any pet questions you can ask away Pawbly. Please feel free to comment. And as always, Thank You for reading.

Problematic Peeing Puppy, Is It Behavioral Or Medical?

Today's Pawbly question..

I have an unneutered 7 month old aussie-poo mix who wont quit peeing and spraying every where. The last week he has hiked his leg on people's faces, legs, my tv, and all over my walls. We take him outside every hour, but nothing works. He just does it even worse outside. I have run out of ideas for what to do that might actually work. Any advice?

Barks and Blooms replied;

http://www.barksandblooms.com/

Hi Christie--An Aussie-Poo! What's his name?
My first thought is neutering help with this issue.
It sounds like it may be more of a territorial behavior rather than a potty training issue.
Here is a great article with information on why this is happening and what to do about it. It suggests neutering an intact male to reduce the spraying, but also offers solutions if you choose not to neuter. Please let us know how he progresses!

http://pets.webmd.com/dogs/urine-marking-in-dogs

Barks and Blooms gave great advice! Many Thanks to them for helping Christie,

I added a few thoughts just from the DVM point of view, 

Hello!! Everyone!!

Certainly in a 7 mo old puppy I would ask your vet about neutering. Lots of boys like to "mark their territory" with urine, BUT, the other concern is a urinary tract infection. It is not as common in younger puppies but it is a possibility, and the longer you wait to treat a urinary infection the more difficult it can be. Also, an untreated urinary tract infection can lead to a kidney infection which is VERY VERY bad.

The ASPCA has a wonderful blog on spaying and neutering, it is included below. It can help you talk about and think about neutering. If your puppy is marking then neutering ASAP is the best way to curb the unwanted behavior.

http://www.aspca.org/pet-care/spayneuter/spay-neuter-top-ten.aspx

There are some pee pad diapers available commercially, but if your goal is to stop the peeing then you need to identify and treat the underlying cause. Pee collection diapers just help collect all of the pee, and that means changing a lot of diapers.

If you need any help discussing any of these I would be happy to help.

We are all so excited to be able to provide a platform for so many viewpoints and we hope to be able to provide lots of resources for people and their pets world wide!

http://www.pawbly.com/

Here is why I recommend spaying and neutering;

Many new pet parents wonder about spaying and neutering. It is one of the most common questions I am asked at a new puppy and kitten examination.

At every new puppy/kitten exam I discuss the timeline for care of their new addition.

In general puppies and kittens visit the veterinarian every three weeks between 8 and 16 weeks. At six months old we recommend spaying and neutering.

Here are some of the reasons why we recommend spaying and neutering.

In case you aren’t familiar with the terms, spay a female, neuter a male.

Spaying is removal of the female reproductive organs. This is usually the removal of the uterus and ovaries via an abdominal incision.

Spaying a female before their first heat cycle will significantly reduce their chances of ever having mammary (breast) cancer. (It is reduced to almost zero). Mammary tumors affect both dogs and cats but is often aggressive and life-threatening in cats. If you ever feel bumps or abnormal tissue around your pets nipples please see a veterinarian.

Spaying will help your pet live longer.

Spaying will help your cat be a better pet. An unspayed cat will go into heat, usually for 4-5 days about every three weeks, during breeding season. When they do they often call loudly, usually at all hours of the day and night, and act erratically. Some will even spray urine to attract a male. This is very annoying and drives some pet parents a little crazy.

Spaying your pet will help prevent pet over population. There are millions of unwanted pets who cannot find a home. By spaying your pet you will be helping prevent another unwanted pet from being the victim of a society that euthanizes unwanted or un-owned pets.

Your pet does not benefit from having a litter, neither does allowing your pet to have a litter help your family understand responsibility or biology. A pet that is allowed to have a litter is allowing a nation of over populated pets to be burdened further. Teaching responsibility starts with teaching to be kind and compassionate. Do you know where those babies will go? Can you afford to care for all of them in case you cannot find a forever loving home for them?

Not spaying your pet can lead to the additional expenses. This includes veterinary care, vaccinations, de-worming and spaying and neutering if you cannot find them a home.

Neutering is the removal of the testes from the scrotum.

Neutering removes the chance of testicular cancer and significantly reduces the chance of prostate problems in dogs.

Neutering also reduces the roaming of your dog. They will not be driven to stray to find a mate and it will help keep your pet safely in your yard or home. Unfortunately, many dogs are involved in traffic accidents or hit by a car because they are driven to roam to find a female in heat.

Behavior issues may be curbed or avoided by neutering. Aggressiveness and marking with urine are more common in intact males. If you wanted a pet to be your companion then it is in both your and their best interest to spay and neuter.

An unneutered cat will often mark or spray your home and your belongings. The urine is very strong smelling and can be difficult to remove. Neutering your cat before 7 months old will help prevent this behavior from being displayed. If your cat starts to spray see your veterinarian and have him neutered as soon as possible to try to stop this.

Spaying and neutering requires veterinary assistance. There are affordable, low cost spay and neuter clinics available in almost all cities in the U.S. The anesthetics and procedure are routine and very safe. Anesthesia has inherent risk but there are many ways to diminish the risks to your pet. Ask your veterinarian for information and recommendations about these surgeries.

If you decided a pet was something you wanted to share your life with then you decided to have a pet for the love and happiness they bring. By spaying and neutering you are helping to prevent disease, provide a safer home, save other pets from pet overpopulation and provide for a happier longer life with your pet.

Cait

There are many challenges that a veterinarian faces. It is a job that most of us come to because we feel compelled to do it. It is our calling. For some of us it is because we have a strong sense of caring for something that has no voice to ask for help. In my opinion, this "mothering instinct" is one of the biggest reasons women are beginning to dominate this career choice. For others it is a way to help people, practice medicine, and be "out on the farm" with a truck, a dog, and a schedule that changes with every call, every case and everyday. Not many of us veterinarians could ever go back to or choose to embrace the 9 to 5 cubicle life.

Some of us come from families of veterinarians. Others grew up on a farm, where the arrival of the vet was the equivalent of Christmas morning. But most came into veterinary medicine simply because we love animals and want to spend our whole lives surrounded by them. I fall into this later category. I was lucky enough to have spent elementary, middle, and high school in rural N.H. My parents moved to Alton N.H. from Oyster Bay, Long Island, N.Y. just to be able to own some land, a horse, a dog, and a cat. (Although to be honest there was also a random sheep my mom spontaneously bought on a trip to the state fair). Ours was a small farm, but it was enough for three little kids who never needed, or had, any neighboring kids to play with.

When I started middle school I got a babysitting job watching the town veterinarians 6 month old little boy. They had just moved to our little town and the new vet needed his wife in the afternoons to help out answering the phone. Theirs was a three person veterinary clinic. The vet, (Dr. Barsanti), his wife, (aka the receptionist), and one vet tech. And then there was me, half babysitter, and half veterinarian-wanna-be at age 13. They quickly became my after school family. I loved their little boy, loved being in their home, and I especially loved to watch Dr. Barsanti practice.

I would rush out of the double glass school doors at 3 pm sharp! Run the one block north towards Main Street, where his practice, the white clapboard sided 2 story cape, was at the intersection of School and Main Streets. They all lived in the tiny 2 bedroom second story of the house because he had converted the main floor into his 1 and 1/2 exam room, reception area, and laboratory space. It was a very small house, that bulged with pulling double, triple, quadruple duty of; house, hospital, surgery, and boarding facility. Only two people could fit in the largest of the examination rooms, and that was only if that other person did not have a large dog. The surgery suite had an enormous floor to ceiling 6 foot wide picture window that was adjacent to the walkway that led into the clinics front door.

The most consistent source of chatter in that little town was who was at the barber shop, the post office or Dr. Barsanti's surgery table. His surgery window could be seen from Main St, School St, and the grocery store. For me, (and I know I wasn't alone), it was impossible NOT to rubber neck whenever you were at any of those three places if his surgery lights were on. For the critical cases, or especially gory surgeries, he would pull up the shade so that they blocked him from the shoulders down so that you could only see his surgical cap and the surgery lights tentacles escaping from the surgery rooms' ceiling. 

I, to this day, have no idea why they hired me. As I recall it, and I dare think that my father can't argue this, Dr. Barsanti, and my dad were not close friends. To put it nicely, out of respect for my father, I will say that I think that my dad was probably not one of his "favorite clients" I am not even sure we were "good clients." I know that on at least two separate occasions my dad called him in the middle of the night because our obsessive Border Collie had come home covered in porcupine quills. Our dog, Bonnie, had porcupine quills embedded in her face to the point that she could not close her mouth. Those quills were stuck in every square inch of her face, neck, front feet, and worst of all her tongue and mouth. She was the canine version of pin head. I know my dad was infuriated that she came back in that state (definitely more infuriated on the second assault), and I know my mom pleaded with him to call Dr. Barsanti. For reasons that still escape me Dr. Barsanti told my dad that he could bring her over to the hospital so she could stay there overnight, sedated, so his three kids didn't have to listen to her cry all night in the laundry room.

Bonnie also got pregnant twice. Two litters of 9 and 13 puppies. We never did figure out who Bonnie shacked up with. For my 15 years of living up there in the freezing cold Arctic tundra, where the snow only melts long enough to let the massive swarming mosquito and black fly population suck the last tiny remnants of vitamin D any living creature has left coursing through their vasoconstricted veins, it was a lonely life. Where she met a lover when I could never even meet a friend is a true testament to her OCD. She must have traveled miles, at least to the next county, where there was actually entertainment (a roller skating rink). I went back to visit after I graduated from vet school and like many of us have had to do at some point in our lives, I apologized for my parents. I think that my youth must have distorted my memory, or in typical veterinary fashion, (which I now understand, acknowledge, and own) he told me that he had no recollection of any of that. He just said that he remembered me growing up in their house, playing with their son, watching every patient, every surgery, and riding his coattails through every corner of their clinic. It is a valuable life lesson to learn to see and only remember the world through rose colored glasses and a half-full glass.

As I left for college, and my siblings followed, my parents started to fill their emptying nest with dogs. In particular Jack Russell dogs. 4 years of veterinary college and they never thought to ask me about their dog preferences, purchases, or pet care. Jack Russell's are best singly, unless you have horses and they have something else to focus on, than each other. My parents went from a terribly OCD breed to the worst OCD breed. Jacks, like paranah are best if they have their sights focused on a kill. If they don't have a target in their sights they can turn on each other. Many a client has walked into our clinic with one of their dogs sporting war wounds inflicted upon them by a sibling. To this day, my parents run their home like a penitentiary. The dogs are let out in shifts and only with certain other dogs, or a brawl will begin and everyone is put in lock down.

Many of my parents generation also still believe that spaying and neutering will change the personality of their dog. It is a fight I have conceded to stop losing sleep over. It is a small attempt to tolerate rose lens. It is a discussion I hear myself saying all to often. My speech goes like this; "If you got your dog to be your pet then spaying or neutering is the best way to keep your pet safe and healthy. An unneutered dog has a different agenda then staying at home where he is safe and sound. His hormones will encourage him to roam to find a mate. The huge majority of hit by car animals that I see are unneutered males. Ontop of roaming they will likely mark their territory by lifting their leg to urinate all over your property. This may include the inside of your home. Spaying will protect your dog from unwanted pregnancies, (which trust me do happen), and uterine infections, also known as, a pyometra. I tell my clients that if you don't spay your dog, and your dog lives long enough, there is a very high likelihood that I will be spaying her at some point in the future because of mammary tumors, unwanted litters, or worse of all a pyometra. I would estimate that 95% of the dogs we see at the clinic are spayed. Of those remaining 5% that live past age 10, 85% of them need an emergency spay surgery because they have developed a uterine infection. It is far more dangerous and expensive to spay them when they are sick and dying of a uterine infection. Also, in the US alone, we euthanize 2 plus million animals a year because there aren't enough homes for all of the dogs and cats in the US. SO help save a life, and  please, spay and neuter your pet, because you love them, at age 6 months old."

My parents never took my advice with this either.

One Sunday a few months ago my dad brought Cait, their 14 year old female Jack Russell, in to see me because she was not eating and was lethargic. An x-ray,  blood work panel, and ultrasound few minutes later and it was discovered that she had a severe uterine infection.

I vividly remember telling him that "If I didn't do her spay surgery right now, she would likely be dead by morning, and even if I did do the surgery right now, I couldn't guarantee she would live through it." 20 minutes later Cait was belly up on the surgery table.

Thankfully, her surgery went well. And she is a new dog now.

Surgically removing a dilated, pus-filled rotten uterus is a surgical procedure that most dogs should not have to go through. Most dogs present just like Cait did. Painful bellies, lethargic, not eating, and dying of internal infection. There is no reason not to spay your female pet. The old wives tale about "them getting fat, or changing their personality" is ridiculous. It is as silly as saying that "40 is old." (Remember being 10 and thinking that 40 was approaching the grave? 40 is the new 20. Isn't that what I am telling myself? Aren't you all telling yourself that too?) Your dog will get fat if you overfeed and under exercise. In fact, that's the same for all of us. And if a change in personality means that they choose to stay home with you, then your pet is probably living up to the expectations that you had for them in the beginning.

I will however note that I have had more than 1 male client react to the discussion of neutering their pet as a deeply painful personal insult. To them I remind them that "I am proposing to remove their dogs testicles and not their own."




This is NOT what your uterus should look like. This is a swollen dilated, full of pus, uterus. It is engorged with blood because the body is trying with all its might to fight the infection. It is also very fragile. We take great care in being very gentle so that the uterus doesn't rupture and spill its contents into the abdomen.

 

Cait recovering post-op