The Acceptable Liability, Coot and Loon

I was forced unwillingly to participate in 15 hours of a lecture on Veterinary Law and Ethics. Truth be told I thoroughly enjoy the subject, I am only bitter about the mandate. It was a wealth of information and worth the time and effort, but there were a few points that I remain unwilling to comply with.

At the top of the list was the ‘immense liability that clinic pets, especially cats, creates.”

What the heck is a veterinary clinic without clinic cats?

If asked to compile a list of things that a client should bring when interviewing for a veterinarian, or veterinary clinic, I would place “free roaming pets in the reception area” at the top. After all, if a clinic doesn't have free roaming pets wandering quietly, inconspicuously lurking on the counter, in the bags of food or in the examination rooms? What does it tell you about the clinic?

Here’s what it tells me. That they have forgotten where their heart is.

Now I know that I push the boundaries of my peers often. I know that I too freely state my opinion without regard to the fact that there are multiple ways to own and operate a clinic. I could sit here and try to manage a way to deliver my words so that my footsteps avoid anyone else’s, but my intended message would still be the same. I have never been the best delivery person. I get you there, bruised and battered, but it’s a quicker path to the same place. Eloquence is an art for those who run for office, are British, or harboring ill will.

Cats are a liability because cats don’t follow a script. They possess an opinion, free will, and they know when you are not a fellow cat person. You can't bluff or bullshit them. They put all the cards on the table, never hold, and are content with the idea of the house being at an advantage. Another words, they will dope slap you without warning or provocation. Luck and liability lie with the house. 

You see a veterinarian can be sued if any animal under our roof or on our premises inflicts harm on anyone. Therefore, vets have to think about the areas of our hospital that pose significant risk of liability and decide whether the reward is worth the risk.

Seems pretty simple, doesn't it? Just avoid responsibility (the single greatest act to drive me to furor), and keep the pets in the carriers, cages and other peoples name.

But, here is where I argue the veterinarians oath. We are asked to help pets and we don’t follow the example we expect others to. There are literally millions of pets out there dying, or being killed, because there are not enough homes for them. There isn't a week of the year that a pet doesn't enter our clinics looking for salvation and a kind heart. What example do we set? Are we silly enough to think that our clients don’t notice that our offices look like a dentists? All shiny bright white and smelling like “gargle and spit?”

My office, well, my office smells like the air freshener of the day. We use a ton of disinfectant, air spray fresheners, and plug–ins. And thanks to a company called Scentsy we now have candles candles to add aroma and ambiance. The clinic is impeccably clean (it is after all a hospital), and homey feeling. Perhaps my kind of homey feeling, which is four cats, and a slight pinch of chaos, but it smells, looks, and is clean.

Every feline resident of our clinic has some sad tail of misfortune and impending doom.

Every cat was brought in to be put down unless we saved them. Every single one. Even the apparently young normal healthy looking cats.

Jarrettsville Vet has over the last 9 years that I have owned it housed and adopted out dozen and dozens of last and only chance felines. They are a big part of the reason I own a vet clinic and one of the most important missions of our hospital.

Coot and Loon came to us from a farm of over twenty black and white cats, or what we call “tuxedos.” The man who owned the farm loved his cats, and I am not sure if it was because they were all black and white, or if he just wasn't paying attention, but one day he looked around and realized that the few Tuxedos he was feeding had turned into a small pre-technicolor army.  He came to me asking for help in getting the troops under control. Every Monday he would show up with about a half dozen cat carriers or humane traps filled with white spotted black cats. There was no way to identify them other than to start spaying/neutering, vaccinating, microchipping and ear tipping them. At the end of every Monday we would turn over the daily catch to return to his farm. After about a half dozen of these trips I sat down with him and asked if he could really handle so many of them?

My concern was that these cats were so young and so many in number that we were essentially managing a colony of cats that started out friendly and ended up as feral just due to their vast numbers. They were getting lost in their own crowd and regressing to feral status. He loved his cats but there are only so many cats that one man can care for. Coot and Loon were the last two he captured and the first two to reside with us. They were placed in two homes but never acclimated well enough to be kept. And so they came back to us.

Like every pet they posses their own spirit, their own wants, needs, desires, and abilities. Somehow in our loud revolving dog/cat door dysfunctional family they work out perfectly.

Coot can often be found hogging a whole bench in the waiting area. Asleep and oblivious to the barking, lunging dog in the adjacent seat. Or the angry cat hissing in its paddy wagon only inches away. He can sleep upside down in a packed waiting room. Or he will barge into a closed exam room to jump on the lap of a client waiting for their pet in x-ray. He is bold and presumptuous and unapologetic. Often the clients who are sobbing as they say goodbye to their pets are found cuddling him as a longtime friend separated from you by years and miles that only death bring together. He knows which client to seek, which one needs a lap to lie on, and who needs the quiet understanding that only a pet can provide.

He and his sister Loon are what I call “the bosses of the place.” They are our daily reminders that pets bring more to us than companionship, they bring a sense of purpose to a place that was created to serve others.

Loon, is the quieter, timid one. She is sweet, gentle, and a reflection of admiration if you take a moment to cuddle her in your arms.

I  am asked every so often if they are "available for adoption," and each time I have to pause, reflect, and sigh an answer, "I haven't quite made up my mind?"

They deserve a home of their own. A place to roost and rule, where they don't have to share a place with wayward souls and a bustle of activity. But I have tried to let them go before, and  they are always returned. They even came to my house for a few months. But they weren't happy there and so they returned to the most permanent home they have ever known, Jarrettsville Vet. So I think they prefer it here, and I think we need them as much as they need us. And isn't that what a family and a home are all about?

If you would like to see Coot and Loon in person please pop into the clinic, Jarrettsville Vet, and give them a "hello!"

Or if you have a cat story to share please join me on Pawbly.com. Pawbly is free to use, visit and ask questions. You can pop in there anytime too, and it's always free!

Or find me on Twitter @FreePetAdvice.

And as always, Thank you for being so kind to the cats in need.

Happy Mother's Day! Just a few of the amazing moms I know..

Happy Mother's Day to you all!

Limbs Are Accessories, Until It's Yours.

This is Oscar. 

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

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

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

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

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

Here's why;

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

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

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

Here's why;

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Oscar is expected to have his femur repaired on Tuesday. 

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

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

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

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

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

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

Is Your Cat Safe In Your Own Home?

The most common toxicity we see at the clinic is the inadvertent application of a dog flea and tick product on to a cat. It is the accidental poisoning of the Spring and Summer season.

It happens by accident in most of the cases, as a neglectful oversight of an owner who shares their home with both a dog and a cat. Or, the simple doubtful advice of a product manufacturer who the owner believes is just trying to sell a smaller size for a wider profit margin.

Turns out those warning labels are real warnings.

Those big red letters that state "DO NOT USE ON CATS" doesn't seem to be enough to dissuade people from using it.

Granted, in many cases the drugs and products that we use for people are also used in veterinary medicine. Unfortunately there are a few very very important exceptions.

I get the phone call routinely, it always starts something like this, "Hey Doc, I think that Fluffy is _____,(fill in the blank, truly, the blank isn't the important part), and I gave her some ______, (again fill in the blank, also probably not important I specify the product). Do you think she will be alright?I can't come in until tomorrow."

To which I almost always have to gasp and roll my eyes silently as I try to muffle the screaming "NO!" into a more calm and less threatening voice of, "No, that is not safe for cats."

Unfortunately, in the huge number of cases the cat was given the drug hours, or even days, ago and my heeded warning is too late. 

In the hopes of saving another cat I am going to violate one of the covenants of medicine. I am going to provide broad sweeping generalization guidelines. (Disclaimer provided; Always ask your vet before giving your pets anything! Please?).

1. Charlatans: If it didn't come from your vet don't give it. This includes drugs of any and every type, supplements, vitamins, food, treats, chews, toys, etc. etc. Sound too broad, and slightly paranoid? OK, it might be, but I have seen cats die from every crazy thing imaginable. Like, a supplement recommended by a feed store, a drug store, a big box store, the list goes on. I have seen cats be injured by toys, treats, chews, leashes and clothing. Not to mention urinary tract infections, calculi, strictures, and inflammation from over zealous supplements and inappropriate diets. 
2. Accessories: When you are purchasing something for your cat ask your vet. Collars, although cute, can be functional in alerting an unsuspecting bird of your cats presence and providing a name should they wander. But they can also get stuck around a leg and become a tourniquet or a noose around their neck should your cat get caught in something. Use a microchip, it is far safer.
3. Drugs. If it didn't come from your vet for that specific pet don't give it. This includes every pain reliever, antibiotic, cream of every type. Did  I ever tell you about the client who used hemorrhoid cream for a rectal mass? No, in  fact the cat did not have a hemorrhoid..and  boy did that stuff burn his butt bad!. (People are obsessed with laxatives and hemorrhoid cream. I guess its a big human problem?)
4. Cats and Drugs: I cannot over emphasize how fragile cats are when it comes to drugs. One human sized pain reliever can kill your cat! Don't give them anything without your vets blessing. And, if the box says to "Not Use On Cats" they really do mean it. We had a client  who almost killed both of her cats last year because she thought it was a "suggestion." After spending almost $500 she was angry at us for having to pay for three days of hospitalization, emergency supportive care and all of the numerous drugs it took to save their lives. She was lucky to have been able to walk out with two cats. It was an expensive lesson to learn.

This is a good time to remind us all about the Top Ten Toxins for dogs and cats in 2013, from the Pet Poison Helpline;

Cats: Top 10 Toxins of 2013

1. Lilies: Plants in the Lilium species, such as Easter, Tiger, and Asiatic lilies, cause kidney failure in cats. All cat owners must be aware of these highly toxic plants!
2. Household cleaners: Most general purpose cleaners (e.g., Windex, Formula 409) are fairly safe, but concentrated products like toilet bowl or drain cleaners can cause chemical burns.
3. Flea and tick spot-on products for dogs: Those that are pyrethroid based (e.g., Zodiac, K9 Advantix, Sergeant’s, etc.) cause tremors and seizures and can be deadly to cats.
4. Antidepressants: Cymbalta and Effexor topped our antidepressant list in 2013. Cats seem strangely drawn to these medications. Beware – ingestion can cause severe neurologic and cardiac effects.
5. NSAIDs: Cats are even more sensitive than dogs to drugs like ibuprofen and naproxen. Even veterinary specific NSAIDs like Rimadyl and Meloxicam should be used with caution.
6. Prescription ADD/ADHD medications: These amphetamines such as Adderall, Concerta, Dexedrine, and Vyvanse can cause tremors, seizures, cardiac problems and death.
7. Over the counter cough, cold and allergy medications: Those that contain acetaminophen (e.g., Tylenol) are particularly toxic, as they damage red blood cells and cause liver failure.
8. Plants containing insoluble calcium oxalate crystals: Common houseplants like the peace lily, philodendron, and pothos can cause oral/upper GI irritation, foaming at the mouth, and inflammation when ingested, but severe symptoms are uncommon.
9. Household insecticides: Thankfully, most household sprays and powders are fairly safe, but it’s best to keep curious kitties away until the products have dried or settled.
10. Glow sticks and glow jewelry: These irresistible “toys” contain a chemical called dibutyl phthalate. When it contacts the mouth, pain and excessive foaming occurs, but the signs quickly resolve when the cat eats food or drinks water.

“Every January, we examine our records to see what toxins contributed to the most emergency calls from pet owners and veterinarians the previous 12 months,” said Ahna Brutlag, DVM, MS, DABT, DABVT and associate director of veterinary services at Pet Poison Helpline. “We hope that by sharing these lists, more pet owners will become educated about how to avoid problems and protect their pets in 2014.”

The best thing concerned pet owners can do is get educated on the most common pet toxins, which are listed above, and then pet-proof their homes. However, accidents happen and if a pet may have ingested something toxic, Pet Poison Helpline recommends taking action immediately. Contact a veterinarian or Pet Poison Helpline at 1-800-213-6680. Pet Poison Helpline also has a helpful iPhone application with an extensive database of over 200 poisons dangerous to cats and dogs. “Pet Poison Help” is available on iTunes for $1.99.

Pet Poison Helpline

If you have a pet question or want to share any of your cat photos, antics, or even a cute little story about how precious your cat is to your life you can find me and a bunch of other cat-enthusiasts at Pawbly.com. Pawbly is dedicated to the love of pets and provides free help to any pet in need. Please join us today. Maybe you can save a pet's life with your knowledge and lifetime experience?

Or you can find me on Twitter @FreePetAdvice. Or at the clinic Jarrettsville Vet, in Jarrettsville Maryland.