The Beauty and Failure In Seeking Quietude. Doing Good AND Doing Well.

It is time to slow down.

Truth be told, if I don't I will break. I am too tired to be any other way. Maybe it is midlife meets maybe too late?

I built a few key things on the way to tired, things I am immensely proud of and equally exhausted because of.

I built a veterinary empire (albeit rural and quaint) based on compassion. It is the key ingredient to my success in veterinary medicine. BUT, I also built a business centered on it as our core concept. Having such a strong emotional purpose makes daily life challenging. It also wears down your engine and psyche.

A letter came to me a few months ago inquiring about the recipe to our success for "doing good and doing well". We do both. I cannot see living, or even attempting to live this life, any other way. It was a wonderful opportunity to remind myself who we are as a vet hospital, what I am consciously creating, and how we can be profitable while doing "good" for our community. These two things, especially when you are a caregiver based profession, are intimately and vitally entwined. I cannot give up one for the other. I would rather walk away broke, then abandon the core of what we are and what we are here to do. I know others might argue this point. That we aren't expected, nor should we feel compelled to have to help everyone. But that is a shallow excuse to the start of a slippery slope on the way to blind and indifferent. Little steps can still lead you to the same destination.

I cannot imagine exiting this profession without a soulful of stories and a legacy to be proud of. It is the subject matter of every moment of my day. Trying, (sometimes failing), to live up to a persona of the character I carved long before I got the white coat and the accolades of graduation.

I get tired. Lately I am very tired of being sent the cases no one takes the time out of their day to try to manage. Lately we have had some happy endings for some very needy patients get some attention. It has caused a flurry of equally needy patients to find, or be sent, to us.

On a personal level this is hard to come to terms with in any sort of healthy, optimistic, peaceful fashion. It is difficult to understand how other clinics clients get sent (literally told to show up at our clinic) because they cannot, or will not, take care of them. How does this happen? Where does personal responsibility come in? I am not sure if it exists in many places any longer? I think it is the code of ethics that the private established practitioners once regaled as being expected and honored. If a client called you in a bind you made time. I know that when my families dog, cat, sheep, horse, whomever found themselves in a predicament we called our little small town vet. He always came to help. Weekends, night times, rain, shine, he was counted on and accountable. The humble roots of that mantra seem sorely lacking these days. Sure, there are lots of excuses, and lots of reasons, but an emergency and a patient in need are timeless. How does the whole integral commiserative collaborative community coexist if we don't help each other?

Where did the relationships go? Why are they no longer valid? Or valuable? Why, and when did neighbors start sending their patients elsewhere when they had the means to assist them?

I am human. I get tired. I get frustrated. I have to ask myself a lot of questions, and even face the ugly answers occassionally. But the most important part of my human-ness is still getting up to try, and never abandoning caring to someone else to manage.

I refuse to give up, pass the buck and turn my back on the people who need us. I damned sure don't send the cases that are sticky down the road to my colleagues. Maybe they snicker? Take pleasure in being selective? I honestly don't know? If you are a client of ours we take care of you. Through sunny puppy days as much as the dark days of dying.

This is why I am so tired.

The time under the guise of being compassionate comes at a cost. Maybe that's why it is so ubiquitously abandoned?

Taking time away to regroup, redistribute the wear and tear and remember what I can do and how I can continue to contribute to my little community is vital.

We do so much. I have to remind myself what we are doing and how we are giving back even on the days that wrench your gut and break your heart into shreds.

Here's a sampling of the requests we get. These are from this last week alone;

Situation Number 1;
The emails start at 9 pm on a Sunday night. They find me. (Desperate people in dire circumstances with a little bit of digging find me).

Help! Our 7m old pit, Tracy has eaten something foreign. X-ray shows it is stuck in small intestine. Tracy started showing symptoms of distress 2 days ago. We came back from vacation where he stayed with my mother in law on her farm. The morning after picking Tracy up, he began vomiting to the extent of a close 30x in a few short hours. What started as bile and mucus slowly turned into a color resembling blood. Tracy began to look pale and his attitude was that of a lethargic pained animal. All of the red flags promoted our first trip to the animal hospital. $1000 later he underwent blood work, fecal sample, urine test, and X-ray. All results were normal except for the X-ray which showed the foreign body. The vet told us it appeared that the object was trying to make its way out but could be lodged. Clinically Tracy appears to be near death. Doc says object could possibly be removed with an endoscope or surgery which would cost anywhere from 2k to 3k. Our family just cannot afford the bill, however we also cannot afford the heartbreak. In a short 7 months Tracy has become my child’s keeper, my boyfriends companion, and my best friend. I cannot live with myself knowing a fatal outcome could have been avoided if the money was right. I am asking in desperation for anyone who reads this to open their hearts to us and to Tracy in helping us give him the treatment he needs to survive and live out the life he deserves. I will be applying for care credit first thing in the morning but a recent home purchase along with other things tell me that a denial could be in my hand. Even with an approval we desperately need the financial help to pay it back. I am begging all of you to look at gods plan for Tracy and see that it is not his time to leave this world especially not like this. Thank you all for reading and God bless. 

I was denied care credit I copied that into the email from our gofundme where we were only able to raise $500. Delaware specialty wants 75% upfront and 25% at pick up. They won’t take donations from any organization that I have reached out to. I have 2 places willing to help. Krista it is an emergency tonight Tracy has a fever. I’m so concerned and idk what I’d do without him!

What do I do with this? Better yet, what would you?

Tracy

Situation Number 2;

Client shows up with a cat with an injury to its ear. It is not her cat, she does not want to pay for care. She expects we will take it and care for it, and be the person she is not. Uncomfortable, awkward conversation ensues that we cannot take the cat. She isn't ours to take. She isn't hers to give. And we are not the shelter designated for such pets. Further, while there is an injury a torn ear is left torn. Cat is scanned for microchip, none found, and we post her photo on our Facebook page to notify the owners (hopefully part of our large FB following) that she is headed to the shelter. There she will be vaccinated, treated and held for the owners to come (hopefully) claim her. Finders are always given the option to adopt them back if the owner does not come forward. She calls us later to explain "how disappointed she is with us." (Like that river don't run both ways). Side note: we have 8 clinic cats already. All were cats brought in to be euthanized for peeing the house, or just not wanted any longer. They remain all are looking for homes. Cat anyone? P.S. I will keep an eye on her at the shelter and make sure she is kept safe. I do this with all of the shelter animals. For those clients seeking help we are happy to help. 'Help' is a term that infers giving assistance. It has to be a mutually agreed upon proposition. There are, of course, also legal parameters to comply with, like; "Not your cat" is not your cat to abandon on someone else. Her cat got a free exam,, and she never showed up at the shelter.

Situation Number 3;
Dog fight dog limping, unable to use leg. Caller has "no money". They NEED to come up with the price of an examination ($50) if they are not a client to be seen. It is the only way we can insure some basic degree of responsibility to the care of these pets. If you cannot come up with the $50 we try to offer surrender to one of the shelters/rescues we work with. Know how many people "with no money" surrender? None. Why? Well, they would rather be "theirs" and neglected than rehomed and treated. The story of the Judgement of Solomon is referred to commonly in my head for these cases. We ask that people come to us willing to put their pets life before everything else. We will meet you there on how to proceed forward. I, we, everyone at Jarrettsville Vet has witnessed the power of making what seems like the impossible possible. But everyone gives and contributes. The dog from this week had been attacked by another dog (the other dog was not on a leash, theirs was). The victim had not seen a vet ever in their hands. Was not neutered, and was an injured pit bull. They couldn't come up with the $50 and they didn't have a way to get the dog to us if they could. These, these are the cases that drive me to,, well,, blog... lets leave it there. We stood firm on two points. They had to drive to us. They had to come up with $50.

At the moments that seem most bleak, take a breath. Have, find, and resurrect faith.

Jax showed up a day later, lucky. He was limping. He had a very swollen, painful and infected leg, and a few minor lacerations. He was gimping around on the other three legs, but eating, happy, and otherwise unscathed.

He needed three things I could give him;
1. Antibiotics
2. Pain medications, (NSAID)
3. A rabies vaccine.

Total bill incurred; the $50 they borrowed from family, and the $16 bucks I loaned them for the rabies. The rest of the meds were generics and donated/trial size.

His family also got a lecture.. most of it off the record.

• file a police report. Maybe the owner of the other dog will take responsibility? (prob not, but I divert back to the faith statement).
• start a Pet Savings Plan with us to get the vaccines updated and him neutered. An estimate and budget plan was also provided.
• I know you love this boy. He is a lovely dog, but he needs more than love. We will help but it takes both of us to make his life safe and healthy.

I hope they heard me. I did fall in love with that dog...

That's my problem. I invest myself for these animals.. It is who we are. It is also why I get tired,, too often. I'm looking for safe boundaries while trying to not lose faith in mankind.. The animals, well, I am still doggedly determined to save every single one of them.

Every week it is at least one phone call, one person who shows up, and a pet stuck in the middle. We, collectively, all of us, can do this. We can "do good while doing well". We can save the huge majority of pets who need help. Maybe not at "Gold Standard" but this is life and death. I rarely think death (our coined "economic euthanasia") is the best option.

More information on me, this blog, and who we are at Jarrettsville Vet can be found here:

Pawbly.com is about saving lives, and providing options with data. Let the data set the standard of care and integrity via transparency be the guide.

If you care about pets, believe in making happy endings happen, and want to help others please join me on our Jarrettsville Vet Facebook page, our Pawbly Facebook page,and also on Twitter and YouTube.

The Road of Radiation. Veterinary Radiation Therapy. My Jekyll's experience

It is Tuesday, the designated cancer day in our family.

Jekyll has retired from the chemo circuit. It has been a long run, and I have to say my little boy looks pretty darned good for the barrage of poisons we have forced into his athletic beagle body. If pets are a reflection of their owners, this boys determination and stamina have me set for almost anything life wants to toss at me. That boy wagged and winked through every round we gave him. Four doses of Gemzar, and before that three other drug trials to cover 9 rounds in total.

Today is round one of radiation therapy. Today is also the first day that I am tentative about the steps I am taking. I am not even sure why? It is my gut talking. The longer you live in vet medicine the more you listen to your gut. I don't know what's with this unsettling gnawing, but, this is more than new therapy jitters.

This is fear. Unadulterated, massively apprehensive fear.

This is our last shot. I suppose most of my guarding and clutching him today is about whether this will work. I have to leave him with strangers for this last step in the hope of beating the demons residing in his belly. The fear is also my not wanting to accept that there isn't a plan of attack after this.

Now I should clarify my current state;

The fear of medical care is universal. There isn't one person who hasn't been troubled with a medical decision about what to do, or, not do. If only we all had that crystal ball to tell us what was lying around the corner of every decision so we could pick a path to travel.

The access to radiation oncology therapy, now ubiquitous in the human healthcare circles, is still limited in the veterinary world. For us, stuck half way between Baltimore and Philadelphia there are three places to pick from. All are about 2 hours away, each with its Pandora's box of traffic snafus. You pick based on availability, ties to your oncologist, and (in my case) my total lack of scheduling flexibility.

I was here almost a decade ago with my last cancer dog: Ambrose. His radiation schedule was daily for three weeks. I was unable to bring him everyday so I hired a chauffeur to help make the schedule for him the reality he needed for his cancer. Ambrose's treatments cost us about $10,000 when all was as fate had it. He got about 6 months that I wouldn't have gotten without it. But even as he passed away from the cancer and the wear and tear that the surgeries, radiation and drugs delivered I was left with a feeling of unrest. I expected more time. I had been led to believe that was the price for the calendars prognosis. I went into radiation being told that his type of tumor had an 80% recovery rate with radiation. I mean who wouldn't take those odds? He was 10, I wanted two years. I placed him on his hospice care a few months later promising myself I wouldn't do radiation again.

And yet, a decade later,,,

Here we are. The desperate souls seeking to rewrite our own destiny. Jekyll is 8. He looks like a million bucks. He has an insidious cluster of cells that every human man would be told is 'treatable/manageable/curable' and yet I have to designate him as "terminal." (What a fucking awful blasphemous word.. Can't vet med give us some good decades left ahead too for the common place condition of every middle aged man)?

The two hour drive to the radiation center took us through highways, traffic jams, and interstate construction zones. Jekyll slept passenger seat shotgun. You put him in a car and he snoozes. He is so used to traveling that he prefers to save his energy for the destination and just recharges for the rides.

At our arrival to the little old (in need of serious remodeling as its 'quaintness' starts to overly patina), I was met by a disheveled anxious man. "Hello?" he said quietly and submissively. I was trying to clean Jek's butt after his scant confetti poop session in the parking lot. I looked up so hoping he wasn't talking to me, or about to chastise us for the shrapnel poo mess we were trying to clean. "Does your dog have cancer?"

"Yes," we are after all in the parking lot of the dog cancer radiation center.. and I do have a dog with me.

"Do you trust this place?" He was quiet, withdrawn, emotional, and empty handed.

"Yes." Oh god I didn't want to have this discussion this morning. And, here I was. Angel of unkempt hair in the otherwise empty parking lot, seconds before we could no longer make our clean get away. The fear mounts to struggling almost paralysis.

We clean up, replace his colon after it slipped it mark from aggressive straining to sit in the reception area,, and we wait. We wait, and wait. Second chance to run,, we are already an hour behind schedule.. fingers crossed, gut in floor. The saddest beagle eyes calling me to just stop being so stubbornly dogged. Jekyll is panting. He is anxious. He is afraid. I get it buddy, I do.

For everyone who loves their pet and can't live life without them the slope to terminal death is tragically looming in its inevitability. It is that part: the knowing, the watching, the scrutinizing and the fear of every bump, twist and turn in the road that eats you.

I sit with a lot of my clients who all grapple with the grief and  trauma of the inevitability that the end of life decisions bring. The more I participate in their journey's the more I question and renegotiate my own. I feel their pain. Their not understanding the options. The costs of those options and the incredible resiliency of the pets who elect to try the best medicine has to offer. I hope to write blogs about how well Jekyll has done so far. How he has not lost himself in the process of killing the parts of him that aren't welcomed nor wanted. Those little parts that are killing him.

I have a wonderfully gentle client who is a practitioner of alternative human health care. She is dealing with her own aggressive cancer and she also has two older, failing dogs. She isn't seeking traditional chemotherapy for herself, she also isn't electing it for her dogs.

She asked me recently, "Do you think he is sick because I am sick?" Inferring the transference of her illness to him because they are so connected to each other. I couldn't even answer her with anything reassuring or merciful. I was caught so off guard. I didn't want to discourage either of them from not enjoying every second they have left, but the medical hardness of the reality was that he was dying. I knew that. The suffering, the burden, the weight of the responsibility for her, who already needs optimism and focus, was daunting. In times like this all I can offer is to reduce the current place to the joy they have at this moment to still be alive.

I ask myself every single day how much I am willing to pay for this one single day?

I walked out of the radiation office without my Jekyll. He is going to die.. someday.. I am trying to come to terms with that. I am buying my reluctance to accepting this ending today with leaving him in someone else's hands. Trying to go down swinging. Giving his cancer the hell I want to banish it to. It is the price I am willing to pay to walk away without him one day.

I can walk away feeling like I am afraid for him, afraid for life without him, and even feeling a little bit of solace in the statement I tell too many clients. "I would rather have him die trying to save his life, then dying because I was paralyzed and let it be taken away by his cancer." Truth be told if I got that call, that one that says "Jekyll didn't make it through anesthesia, or radiation, or the procedure, etc." I would be ok with any of these. I might even be better with that ending. As the more likely scenario is that he will be put to his end at my hand. For every client who wishes that their pet "die peacefully in their sleep" so they didn't have to come to my office and make this last impossible decision, I only wish that it didn't have to be me. I don't know how I am going to do this. And I don't know how I can let anyone else do it? For me, the single greatest cross to bear is this act. This impossible goodbye all on me..

Monday April 23, 2018

Maybe the fear grows a coward? And the coward who wants the easy way out of goodbye. The goodbye while he is still happy, functional, and himself. Where is the mercy? How much do I let fear guide us?

Three more radiations to go. If this one goes ok. But all I can do is hope for today,, again.

Tuesday evening, day of radiation treatment number 1

More  on Jekyll here;

Jekyll Arrives

Jekyll Loses His Tail Mo-Jo. Tail Droop.

The Things Only A Mom Knows. Planning for our pets lives beyond our own.

A Tribute To A Beagle, Jekyll.

Slowing Down Without Giving Up.

How Do You Say Goodbye When You Can't Let Go?

P.S. It is Wednesday morning.. The day after his first round of radiation. He is doing very well. Better than I expected. He slept the night comfortably at my feet on the bed. Pee pad in place as he is now almost urinary incontinent, and ate breakfast with bravado. He is a trooper. He  is a beagle. He  isn't checking out yet, it isn't rabbit census season, yet.

Weds 25 April 2018

If you have a pet story that you would like to share, or an experience with this condition please add it to our Storyline page at  Pawbly.com.

Please also follow me on Pawbly.com, our my vet clinic website Jarrettsville Vet, or our Jarrettsville Vet Facebook page. 

I am also on Twitter @FreePetAdvice, and YouTube. 

Breaking Through. The Good Days That Chemotherapy Delivers and the Life We Enjoy Around Them

For 48 hours every week I have him back.

The youth, the joyful expression and the wanderlust spirit of the boy I yearn to preserve.

For those few blissful days everything is as it should be once again.

We are free, we are happy and we are explorers in a world with adventures yet to be discovered.

He is back with me again and I live in the moment alone - abandoning the painful yesterday of excruciating moments of death hovering around us.

For these few days there are walks, and wags and jubilant reunions.

We are as we were. Time has lost its grip on us and fate looms for another.

There are mornings of wiggle dancing on the bed.

Kingdoms to perch over and protect and beasts yet to face and foil.

There are barking bellows to beg a meal. couches to claim and companionship to solidify and cement. We are each others best friend and no fate awaits us.

Footnote;

Jekyll has prostate canner and urethral transitional carcinoma. This is a show stopper. A final act. You aren't cured of this. You, me, I am buying him as many "good days" as I can.

For everyone who thinks that chemotherapy is beyond what dogs deserve, you won't understand my grief. For those of you who think that dogs lose their hair, will to live, or are "miserable" while undergoing chemo I will testify that after 9 rounds (weekly) he is alive and functional, because of the chemotherapy. He has good and bad days. We have great days, and days where pain meds are his elixir of bearability. The idea that we give up when "terminal" is assigned is like trying to get through life with just the good days being acceptable. You don't/shouldn't get to chose one without expecting (and maybe even trying to embrace) the flip side. Life isn't a lesson on navigating the shore. It is about the greatness that lies in the depths of magic of beauty. There isn't more in the sunshine, there is equal luminescence in the darkness.

I am here to stand beside him through the joy of his sweet puppyhood as much as his dying oldness. It is a path together. For as long as we have. I will always let him decide, as I try to see the grace in every shade of the spectrum and make his journey full of love and life for as long as we have left.

If you have a pet story that you would like to share, or an experience with this condition please add it to our Storyline page at  Pawbly.com.

Please also follow me on Pawbly.com, our my vet clinic website Jarrettsville Vet, or our Jarrettsville Vet Facebook page. 

I am also on Twitter @FreePetAdvice, and YouTube. 

The Threats To Impending Death and A Vet Moms Promise

For the first time in my long pet mom life I am consciously taking a radical new approach to the impending death of my beloved pet.

Jekyll is dying. In little excruciating tiny steps and failing pieces. He is doing it with his beautiful velvety ears, bright shiny coat, and soft youthful muzzle all suspended and preserved with his outward beauty and youth still intact. His dying is so subtle that no passerbyer would recognize it. But he is slipping and being ratcheted into deaths grip with his soulful yearning eyes eclipsing into subtle tiredness. It is killing me. I cannot lie, nor belittle its impact upon me.

It is the hard jagged robbery of a life lived with effervescent jubilant joy meeting its final curtain call.

I feel cheated. He is being robbed.

AND, I won't stand still, nor quiet, for it! So, I do what I am trained to do. The whole reason I stepped into vet school. I fight with targeted tools and obvious intentions. The passionate, determined, unyielding sleuth who is ready to fight longer, harder, and dirtier than the microscopic thief holed up and harbored inside my pup. It is the lifeblood of being a fierce hot headed Italian determined to shape the world until it conforms to your pleading tantrums. The truth of diseases elusive lure belongs to everyone else. I, I spent decades learning in tutelage so that my pups fate could be altered, detoured, and selected. Or, so I convinced myself to believe. Surrender is for the other side to chose.

When medicine fails, faith is offered refuse.

Jekyll was always the affable, charming spirit who loves everyone he meets. Always the warm glowing light of the gathering. The star of the party, the beagle with a celebrity charisma to draw the entire crowd to him. He is a people pleaser. Everyone who meets him loves him. He has always been this way from the first moment he came to me those many years ago broken and unwanted.

Jekyll's life has been a long list of challenges. As I reviewed his medical record for his last specialist appointment I was reminded how bumpy our road together has been.

Brought to me to be euthanized at 8 weeks old as it was the cheapest option available, I refused. At the time I was a new practice owner in a rural farming community and I said "no" to a client request. It was a taboo, defiant gesture for the new girl to even consider uttering. Had I been working for someone I would have been reprimanded harshly. Clients decide, because clients are our paycheck. He was one of my first defining vet moments. The real life scenario to decide who I would become. I lost a client that day and gained my dearest friend. He was irresistable from the beginning. He was also in very dire need of multiple surgeries; a prolapsed rectum from too much cow dewormer left him straining to poo so hard he pushed his colon out of his body. He was adorable from the front and heartbreaking to look at from the back. Three surgeries over two weeks and a he graduated from pediatric patient to permanent resident at both the clinic and my side of the bed.

The next few years yielded even more bumps in our road. Bilateral cruciates left him hobbling and crippled after a long rabbit foray to the edges of his farmland horizon. He would obsessively drive his body into the grave to let a rabbit know his masterative prowess. At five he had a mast cell scare. This took one hellaciously aggressive surgery to remove them. The last surgery was a year ago to eradicate some funky foot tumor that was a total pain to both manage and remove. This adorable boy of mine has been a short medical text book of his own making. Thank goodness he landed in a vets hands if he couldn't find Daddy Warbucks front door.

This one, this last diagnosis to his current dilemma is to a disease we hardly see. This one might be the undoing of me.

When I said goodbye to Savannah it was after a long many year long decline due to old age and dementia. She was ready to go. Her body was spent. She had cashed in every last chance, and I was able to accept her passing as a life well-lived and a journey at its end. Saying goodbye is never easy, but acceptance is a gift. I could grieve and forgive and move on in time. Savannah had made it to 17. There is an easier gracious acceptance when the expected lifespan has been exceeded by many months. I could grieve her loss and be grateful for our time together. Jek's saga just has me angry and determined to cheat death's unrelenting shadowed hands. He is only 8! He is at his half way point. Who said its ok to steal half his life? I have, (are you listening?), beaten you at this game before.

We are going to exhaust each option to keep him happy and functional. After all, this disease of his, a tumor on his urethra and an overzealous prostate, makes it difficult for him to urinate and defecate. Life, for pets at least, is four basic functions; eat, drink, pee and poo. Ambulating and being happy are second tier preferences. Jek has half of his most basic functions up for grabs.

We are also keeping an internal daily bucket list. It is his list. Not some ridiculous crusade to make expensive trips to the ocean or 4 star hotels. He is all beagle. He seeks acrid excrement, purview over his kingdom, and trips in the gator and truck to fuel his King of the Jungle self designation. We are giving him his favorite things everyday; runs in the parks, chicken and delifresh dinners, belly rubs, long walks to see the wildlife, and lots of re-affirming accolades. He loves a few things and he will get them every single day.

Jekyll is an adventuring spirit. He loves to survey his domain from his front porch. We designed it, the whole front of our home, for him to have this vantage point. Dog bed, custom cushion and best view around. His preference is to stand guard on his front porch, post in command and barking should any critter muster his purview. He could spend the whole day there. He wouldn't let a soul pass without warning. It is his calling. His purpose. The genetic code of a long legacy of invaluable guardians he serves. He is unsurpassed in this single skill. He has earned his keep ten-thousand times over. His contribution to a deep commitment we both have for each other.

He is the pup who digs succulent gummy grubs in late Spring. The mole hunter gatherer meets praying mantis appetite. He was also the only dog I ever knew who would seek his own snacks from the labors of others work. He can be seen propelling himself off of his perch to march directly to the corn field across the drive, sniff the largest juiciest kernels where he sniffs, selects, and snaps! The corn ear is twisted twice and ripped from its stalk. The confident thief then saunters back to his perch to enjoy the spoils of his plantation. When the first ear filled him he would select a few to bury in the yard for a darker day with leaner choices. He is the self-reliant MVP should the zombie apocalypse hit. Grab him and run, he will keep you fed amongst any seemingly barren wasteland.

Each Summer a few randomly placed stalks erupt in various places of the yard. An ear here and there he forgot about, or never got around to needing. I know those volunteer kernels will live on for many years to come after he has gone from me. The remnants of the time capsule to remind me he is always here with me.

This time he is dying in front of me, mind still sharp, will still focused on adventures in the woods, and failing to respond to anything I try to cease the aberrant alien cells within him.

I won't get a neat package of decay this time. I will get failure of viable options, inability to provide human standards of intervention and fury to become, and will myself into providing mercy. I am not sure I can do this for him this time. I am not sure I can push him into another place without me.

Veterinarians are trained to say goodbye. To accept that life will not play by a fair hand. That you cannot pick the fate it delivers on your terms. That acceptance is how you define it and how you resolve the unimaginable.

This time I am going to try to get through this without the anger of disappointment and the heartbreak of feeling cheated. This time I am going to just see the good, dismiss the unchangeable the battle already won on a scale only he can feel and I can see. We will live each day on our own terms, without judgement, without guilt and without fear.

Beagles are built this way. To only see the good, to only look back if it helps get through today. Beagles are not built to be brave, just beautiful.

More  on Jekyll here;

Jekyll Arrives

Jekyll Loses His Tail Mo-Jo. Tail Droop.

The Things Only A Mom Knows. Planning for our pets lives beyond our own.

A Tribute To A Beagle, Jekyll.

Slowing Down Without Giving Up.

There are pieces that I write that serve a singular selfish purpose. A cathartic way of putting the shit out to dry and letting the world take care of it in for some hopeful wish I can get a bit of an emotional respite. I also feel that my adoration for my pets is felt similarly by so many others. Others who sit quietly at home struggling with how to say goodbye, and how to process a grief they fear others might mock at. To all of you who feel that the loss of your companion is one of the most painful things in life I understand. I also empathize. It is impossible. I know it. I feel it too.

Be who you are. The most precious and beautiful parts of everything are fleeting. Savor and celebrate them even if they hurt later. The hurt will fade and the joyful memories live forever. Protect your compassion with everything that you are for it is your most valuable asset.

If you have a pet story that you would like to share, or an experience with this condition please add it to our Storyline page at  Pawbly.com.

Please also follow me on Pawbly.com, our my vet clinic website Jarrettsville Vet, or our Jarrettsville Vet Facebook page. 

I am also on Twitter @FreePetAdvice, and YouTube. 

The Problem In Veterinary Medicine Exists In ONE Place, While The Answer Resides Everywhere.

The problem is the divide.

The divide can exist in education and intellect, a matter of resources, privileges and perspective. Or, it can exist in accessibility and willingness to assist.

Vet medicine is drifting to many of these divisions as the infrastructure for our services becomes more coldly organized, corporatized, and managed. Somewhere not too long ago we veterinarians needed help to become increasingly solvent in our business, (or lack there of), decisions. We were a profession of talented 'make-do' surgeons and 'Jack-of-all trades' practitioners and never the pencil pusher accountants everyone told us we should/needed to be. We lacked the business-infused intellect to help us grow out of our fledgling single owner practices into the shiny-gleaming white marbled fish tanked towers of our vision of what "successful" looked like. We were valuable, but, we just weren't bragging rights "profitable." Things changed. We surrendered the management of our practices to the suits to make easier money with less hard feelings and started to sacrifice those who we knew couldn't afford us to pay off our loans and increase our standards of care. The divide began.

Veterinary medicine is a profession built on trust. We are too poorly regulated and overseen to be anything else. The trust is never going to be present in any sort of guiding magnitude if it is built consistently and singularly on financial gain. They are inherently polar opposites. As the desire/need/cost increases and the inability to meet them rises, the trust decreases. It is the nature of humanities basis being neglected intentionally for profit.

There are endless days I spend stuck in the dilemma of "unmet need" meets "unwilling ability." It is what the experts would call 'ethical dilemmas' and trying to carry the weight of the increasingly indifferent world on your shoulders. I get asked, advised, and notified on a daily basis about the dangers of this predicament and my unwillingness to not walk away from them. Desperation breeds innovation and/or despair. I am stuck here trying to solve this great divide and looking into the desperate AND treatable eyes of the forgotten/unprofitable as I do so.

Me and Dimples.
Rescued by me from the local shelter, heartworm positive and a pit bull.
Needs love, care, and someone to vouch for her deserving a second chance.
She is one of the many faces we dispose of too easily.
She is one of the many reasons we lose our souls when we make excuses to forget these lives matter.

Every single day I am asked to provide some veterinary need or service to a client who has been turned away elsewhere. It is the second opinion for affordable options that someone else can provide but won't, usually because of inability to meet a standard of care that makes the cost inaccessible (or so they say?). Every day I am asked to help. Everyday I am faced with unwillingness and unmet need. Too often at life threatening crisis status state. The degree of unmet need is overwhelming. The depth of emotional ties that people have to their pets is also undeniable.

People LOVE their pets. Why are we ALL not starting here? Why are we starting at "ability to pay" as the measure of acceptable pet parent worth?

Henry. The face of cerebellar hypoplasia.
His devoted mom is fighting to bring awareness and compassion to these kittens.

When did the veterinary medicine goal become anything else other than providing assistance to save lives? Can't we all agree on this being the seat of the veterinarians soul?

I often feel stuck, tortured, and tormented by need versus ability and this great divide. I know I am not alone. There are others out there who love and care for pets, animals, and feel burdened and compelled to help them. We are being pulled emotionally, physically and ethically as the rest push them away.

Jasmine, our second PB heartworm positive rescue.
Both looking for a home and a sponsor.

The divide is also polarizing the ends of the spectrum. Caught in the middle are those of us, (overwhelmingly women, does anyone ask why this is?), who feel alone, abandoned and asking themselves where to go? We have to chose a side. Too often this act of inner reflection feels as if it will cost us our livelihood, or, our community. Too often we instead chose to give up on ourselves as we cannot chose.

Innovation is the child of conflict and this divide is ripe, ready, and in desperate need for disruption.

What if we fractured the system so significantly it forced the current managed systems to meet the pleas of the divide instead of growing it? What if the part of the equation that limits public social assistance is the key to the answer of the problem? What if we leveraged the worst part of the animal care equation to be the tipping point for revolutionary change?

Luna

What if obsession to solve a problem allows innovation that pushes boundaries, redefines public access, and empowers the person as a being and not a "thing"? They are all related. They are all the keys to the problem and the keys to the solution.

Luna, shelter rescue, learning to trust again even after humans have failed her.

Radical change is coming. The forces, the polarity, and the divide will collide and the demand, the integrity and the ultimate survival will become mandatory as it becomes transparent. The meek will inherit the destiny that compassion and trust inhabit. It is where this profession came from, and it is the place we will go back to. Less death lives there.

Related blogs;

Find What Breaks Your Heart and Change It.

Gratitude; The Grace That Hardship Brings. 

Mobbing and Lobbying, The Backlash to the Video Rant.

Ethical Fatigue and the Crossroad of Vet Med and the Public Conscious Awakening

Affordable Options Are Everyone's Right.

More information on me, my YouTube channel, my company Pawbly.com, and my vet clinic Jarrettsville Veterinary Center, and my clinics Facebook page, are all available to you and your pets needs anytime. Almost all of this is FREE! We are an Army of activists set on saving lives, our own included. Join us. You are all welcome and all pets are loved here.

Get Out Alive Blocked Cat Episode.

The cases that move me are not the easy quick ones.

Life works that way. Your greatest rewards often lie in the trenches during the greatest conflicts. It is our version of the battlefield stories that bond us in our darkest hours.

Yesterday was one of those days. (I seem to live in these days these days).

We get a call that goes something like this; (I only heard one side of the conversation. My receptionists side).

"I'm sorry to hear about your cat. You say that you found a clinic that would give your cat a free examination, (clearly a corporate marketing tool to drum up new clients I thought?), and, they say your cat is blocked? (A blocked cat is a cat who cannot pee and this is ALWAYS an emergency!)." long pause.. "I'm sorry did you say that you have seven (7????) dollars?" Her voice took a tragic upturn on the dollar sign part.

...short pause.....

"Ok, well,,, umm,,   (pause)      ummm,,, (deep swallow),,, let me get your information and I will call you right back." My receptionists are seasoned pros. They hardly get flustered. But, then again, who calls with $7?

At this point everyone within ear shot was huddling around her desk with muffled giggling. This is the giggle of the great battles. The first shot has been fired, the troops are gathering and a plan is about to be hatched. These are the stories of the place Jarrettsville Vet has become. These are the stories other vets get, most sarcastically laugh at and dismiss, disregard, or decide to just be bitter about. I was/am/try very hard NOT to be this person. I pay for electricity, wages (waaay above minimum btw) and blah, blah, blah, (excuses to not care), but it doesn't change the fact that there is still this guy, AND, there is still this cat.... so we listen to the stories. We gather the troops, and we devise a plan. The plan is always a conversation, a compromise and a quest. The goal however is always mutually consistent in the most critical component: We have to act fast AND we feel compelled to get help. We place phone calls. We are a place that listens and lives by our motto 24/7/365.

After a round table discussion we formulated a preliminary plan. The first phone call was back to the cats dad. We have a team dedicated to returning these phone calls. We have a shield for them in our first line of defense, our receptionists, then the team takes over. No one should be the single troop in a militia. The first test is in assessing the pet parents intention and integrity. He has to be able to compromise. Turns out he also has to be one other thing.. completely dedicated to his pet and follow through with our advice so we don't perpetuate another terrible predicament. Vitally important to the success of these cases is that he has to participate in this cats treatment, recovery and long term care. Thankfully we discover that he loves his cat and he is willing to do whatever he needs to keep him healthy. I can do just about anything as long as we start here. Everyone has to invest in CARING. Nothing of merit lives outside of caring.

Next step in the plan of attack;

We called our friends at the rescue. Circle the wagons, build momentum by uniting the troops. They have the ability to manage this cats care after we get him unblocked. They can manage the nursing care for the next few days while he gets his bladder and kidneys diuresed. It is nothing more than a medically induced flushing of his urinary system. "The solution to pollution is dilution."

They offered to pay for his after care. We would get him unblocked. Two phone calls and we are on our way to saving this cats life. Go Team GO!

An hour later we met Socks.. As always (ok,, truly always), the ones who need you the most are the ones who are the sweetest souls. This cat was pure love. Young, adorable, and desperate to pee. He purred the entire time we squeezed his rock hard massively overfilled bladder.

Here is his story in synoptic detail, video style.

There are articles and discussions of this condition listed below. While I am not here to argue that there are absolute benefits to maintaining ideal standards of care I firmly beleive that the biggest failure we provide is not offering assistance regardless of clients financial abilities. When we as a profession decide collectively to support our patients first I will with hold posting prices and offering cost saving options. Get Out Alive series is coming. Blocked Cats is first on my list. Next, pyometras.

The typical cost of a blocked cat at my clinic is;
Exam; $50 to $75
Radiograph $100 *
Intravenous catheter $40
Intravenous fluids $40
Intravenous fluid pump $40
Anesthesia $100
Urinary catheter placement $75
Hospitalization care about $100 per day. Usually stays for 3-5 days.
Bloodwork $150 *
Urinalysis $50 *

* optional if client cannot afford it.

For more information please see these articles;

Urinary Obstruction in Male Cats, ACVS article. One of the best on this condition. Please read this one!

Feline Urethral Obstruction: Diagnosis and Management. By Today's Veterinary Practice. A very thorough description of how, why and what happens to these cats along with detailed description of treatment options. I recommend taking this article and discussing each step with your veterinarian as they provide an estimate for the cost of care. Know how much each step costs, know where your cat falls within the spectrum of the disease process and know that one size does not fit all! You may be able to cut some costs with the use of this step by step guide. Get everything in writing and GET OUT ALIVE!

A protocol for managing urethral obstruction in male cats without urethral catheterization. Cats were treated in a hospital but not catheterized (which I feel is the most important part of the treatment plan). Read carefully and understand this protocol cannot, and should not, be  accomplished at home.

Controversies in the management of feline urethral obstruction. Journal of veterinary emergency medicine. 2015, PubMed. Please read the prognosis section; "Feline urethral obstruction is associated with 90-95% survival, with reported recurrence rates of 15-40%." How many people cannot afford to treat their cat when the survival rate is this high? I would guess that there is not a single other emergency condition that pets get that has this high of a survival rate when compared to the number of economic euthanasia's due to cost. What is the rate of economic euthanasia for this condition? At my clinic it is zero. What is it elsewhere? (Good question? Anyone want to share their numbers? Speculative numbers?)?

Can these cases be managed at home? Without a veterinarians intervention or assistance? I would strongly discourage this. I feel the prognosis is far better with a urinary catheter placed and intravenous fluid therapy to flush the bladder, kidneys and remove the toxins and systemic imbalances, but here is a widely cited article on managing these cases at home. Which is better than nothing (although I would still argue it isn't enough!).

If you have questions about your cats care, the cost associated with this diagnosis and most importantly ever feel pressured to euthanize based on economics please ask/beg/insist on options and please seek a second, third, or even fourth opinion so that your treatable cat can GET OUT ALIVE!.

I am here for you. Find me on Pawbly.com and remember "never go quietly into the night."

Free pet advice is available on Pawbly.com.

Parting thoughts;
1. Get Out Alive. Ask about options. Insist on care. Document everything. There is help available even if you have to be insistent on it. This is an emergency condition and your cats life depends on your actions. Be kind. Always be kind. You can't ask someone to be someone you are not.
2. If you do not have any  financial constraints almost every vet and emergency facility can care for your cat with this condition.
3. If you do have financial constraints ask for a written estimate. Go over each line item. Ask which is most imperative at the immediate time. Ask the vet to rank these. Start at number one. Stay at the clinic as each line item is addressed. Once your cat can be transferred to your vet it might be more affordable to get their care with them.
4. Ask about the incidence of recurrence for this condition? Ask how you might be able to avoid this? My advice is a diet and lifestyle change. Less dry food, less poor quality dry food, more exercise, less stress. (Ask about cat stressors? Often clients cannot, and do not see the world the way their cats do).
5. Ask about a PU surgery. Start planning and saving for it. The second, and definitely the third time a cat blocks we put this surgery on the table. This is about GETTING OUT ALIVE! remember. PU surgery info here. Perineal Urethostomy by Michigan Animal Hospital. Cost is between $1,000 and $3,500.

If you have a pet story that you would like to share, or an experience with this condition please add it to our Storyline page at  Pawbly.com.

Please also follow us on Pawbly.com, our Jarrettsville Vet, or our Jarrettsville Vet Facebook page, Twitter @FreePetAdvice, and YouTube. 

The Power Of NO. The culture of vet med and how we cannot utter nor accept "NO".

There is a culture in veterinary medicine. It is pervasive, overarching and in many cases detrimental. We cannot say "No". We are taught not to, conditioned against it, and therefore it persists and cripples us. Inside the profession of veterinary medicine there is never a welcomed voice of dissent. There is also not a culture of open acceptance that others have different goals nor sense of purpose. And, with all of that truth we still cannot say "No". Would any of us want to teach our children to be so passive and prejudiced to not question what intrinsically does not feel right? And, yet, we are these parents. You do as your profession has dictated. You accept the reality as it is laid out for you. There is not a line between species outside of human and non-human. It is confusing, painful and nonsensical to admit outside of our own ranks.

Luna. Rescued from the Humane Society.
Looking for a second chance and perfect in every way already.

Spend a few minutes explaining to outsiders how and why the way we practice medicine is so different and disparate within the separation of the type and/or species you practice on and it becomes apparent. There is a huge difference in the ethics and laws within our profession. Say, for example, if you are a food animal practitioner versus a small animal specialist. What about a feline exclusive practitioner versus a poultry practitioner? After all they exist on the same pieces of real estate. Do you think that any boarded feline specialist is paid to practice "herd food production management" by calculating acceptable losses for cost savings versus medical need based interventions? The spectrum is wide and the rules to play vary so significantly we cannot put them into words and rules without species delineation to qualify them as "just" and/or "appropriate" when in fact they are much more likely to be simply based on "archaic practices" and/or "profit margins." Within this large spectrum of diversity there is a lack of oversight, accountability and an almost complete abandonment of enforceable laws based on compassion at the end of the 'less than canine' spectrum. Ask the USDA slaughterhouse vets how differently humane euthanasia resembles the in home euthanasia's that are franchised and marketed to be the "peaceful passage" we would all want for our beloved pets. They aren't even remotely similar. Why is that?

Dimples. Rescued from the local Humane Society.
"Dimples lives her truth everyday.
She is kind, gentle, and longs for human companionship.
Living in the present and full of second chances -
please help us help us find Dimples her happily ever after." Laura 

How do we get to a point where vets assault patients in their clinic? Or shoot their neighbors dog? Or euthanize themselves with Euthasol? We are a fragment of society without a consistent code of ethics and the nuances to allow transparent public perception with the derivation from them. We are also an old, humble, gritty profession. We don't adopt change quickly enough even when the death rates and discord dictate the critical nature of the current time. We are a profession who says "Yes" to financial incentive more than "No" to the ethical divisions, or our obligation to all species to unite us. It is the power of being trained to not question abandonment of our own internal "No" response meets simple basic greed with an unwillingness to permit the other side into our discussions for "best practice" management.

I have found that I far more regret the "Yeses" than the "Nos". Maybe because it took me a long time to find my voice, assert an opinion and start to protect my own soul? It has become a matter of life: professional and personal, and death: personal and professional. How much does "Yes" versus "No" cost you? It is a question I would like to ask every veterinarian. I would also like to know how so many got to this pervasive place of indifference basking in shaming blame that seems so pervasive in general society today? Was it when you started to accept not saying "No" more often?

It is the nature of being a student to not question authority when your purpose is to absorb first. Every person in medicine remains a life long student. We veterinarians are all students our entire lives, UNTIL at some point you get to be in charge. Once you reach that pinnacled place you have to learn the word "No" as a matter of survival. In the end, (and there is always an end), it is all about survival. Not the financial kind, nor the status, popular, nor celebrity kind. It is about the little voice who guides your ability to even like yourself when the crowds leave you for the next new enlightened thing.

I was interviewing a new vet grad a few weeks ago. I was telling her about our clinic. How hard I work to protect the emotional toll being a veterinarian can take on you. How we are a practice that protects our patients and staff and the ethical crossroads that living the life of a veterinarian that can often present. "We are a safe place for our patients and staff first." She went on to tell me how this had already become a point of inner conflict for her. "I was at a practice where a chihuahua came in with a puppy who had been stuck in the birth canal for two days and the people had no money. We sent them away without anything to die at home. I will never forget her." It is a scenario that plays out every day, in every practice and I reassured her that here, under our roof, no person will ever leave without feeling like we hadn't offered every single option to make a happy ending possible."

That night I couldn't sleep feeling that we failed so many. We failed this new grad who is feeling and being taught to be powerless, voiceless and being conditioned to remain this way. We are failing our clients who were brave enough to seek help. And worst we perpetuate cruelty we blame the owner for without taking a moment to reflect upon ourselves as being complicit to it. Did that vet who turned them away ever follow up? Did they at least call Animal Control, (as awful as that ending might be?), at least the dog would be humanely (?) ceased in her suffering with a dead puppy stuck inside her? I would venture the answer is again "No". We don't speak up often enough, (even if we are now bound by law to do so. More on the Mandatory Reporting of Animal Cruelty here).

Our conversation resonated so hard with me that later that night I sent her this text message; "Hello. I wanted to say how nice it was to talk to you. I hope that you have a wonderful trip back to school, and most of all I really hope that you never lose your sense of compassion for even those it seems that you cannot help. (That last part of that sentence I also hope proves to be your most treasured asset as you leave vet school). I keep thinking about your chihuahua case. Indifference is learned and conditioned in vets. It is shameful so many vets abandon it for reasons I do not understand nor accept. You never have to walk away feeling helpless. I hope that you always remember that. Even 40 years from now when you have seen everything. Enjoy your last weeks at school. They are precious and life is never the same (which is definitely both good and bad ;-) ). "

I have learned to say "No" because I had an accelerated path of defining where my loyalties and ethics were rooted. I am not here to perpetuate outdated selfish practices and ethos. I am not here, in the trenches to believe the outdated, unmarketable internal dialogue we still cling to. We should not be a profession serving ourselves first. Protecting outdated cruel practices to protect profits, "property" designation, and disfigurement to our patients. I am here to serve my patients. Not only the patients who can afford me, but all of the patients who need me. (Where and why did the debate about pain management, declawing, debarking, and factory farming ag-gag laws take precedence over our obligation to be our patients advocate?).

There needs to be a reminder to all among us what the indifference, silence and bullying culture costs both us and the society we live in.

Questioning is the advancement of science. The innovation of professions. And most importantly the protection of liberty that every soul deserves.

We need to start pulling back the veils, dismantling the incestuous relationships with producers, manufacturers, lobbyists, and put our patients and our people first. Please start to question, and even mutter "No" to the slaughterhouse practice of overpopulation herd management (this includes, cows, horses, pigs, cats AND dogs).. "No" to toxic people.. "No" to clients who hit their dogs, threaten, deny basic care, neglect, harm, hurt, perpetuate disease via their neglect, and allow pets to die horrible suffering deaths. We see it, we don't do enough (or anything?) about it, and it undermines our ability to recognize it even in our exam rooms. It also makes us complicit. We are just as responsible, (perhaps even more so?), and we are part of the indifference that makes killing in society "ok". I may be a single solitary voice in a profession of pleasing paying people but the core of why and who I am is preserved and protected. It is also the influence I have every intention of fostering and perpetuating in my practice for my staff, my clients, and most importantly for my patients. It is time to have a voice other than the lobbyists hushed threats about what we will lose if we stand up and demand a kinder approach to serve the animals first. It is this internal conflict that each vet sees, feels, and knows that is the greatest consequence to our work-life inner peace.

Stuart and Falcon. rescued from the Humane Society.
A long story of their own and now ready for a home of their own.
Call me, email me, ask me about them, or any of our rescues.
They are all proof positive of the power of "NO!"

The profession is at a cross roads. Societies views of pets as members of the family, the financial incentive for us to acknowledge this, and the power of social media when we forget these are all testament to this. We are acting like we are making huge efforts to curb the suicide rate, job dissatisfaction, dwindling numbers of vets seeking ownership, and stagnant pay when compared to rising costs of our educations, but, we are still promoting, permitting and accepting a culture of exclusion and complacency. We are trying to empower, encourage and inspire each other while at the same time not acknowledging the most obvious reason we feel so trapped. Yet among all of this we don't have our own voice. We are sheep in a pack of masses huddling to stay alive while the wolves hover. I will attest to the pain found outside the pack. It might be better to follow the school and avoid the sharks but the inability to exercise your second amendment power is more than I can bear.

The profession has become a lobbying firm. You either adhere to the pervasive culture or get (forced) out. In most cases they won't really mind if it is at your own hand. It is stifling to live here. I hate it. I will come out and say I hate living here. I am losing hope. It is the fundamental lifeblood to a passionate person borne into a profession that alienates and destroys life on whims, economics and opinion. It is a reflection of the bullying that society does not adequately address nor protect.

There is a storm brewing. Maybe I will be some part of it? Maybe I will be yet another vet deemed collateral damage to a profession that doesn't say "No", doesn't have a voice of its own, and doesn't care enough about anyone or anything outside of its bottom line? We are far too worried about preservation of our power, our influence over lives without voices, and our lack of oversight from the human sides restrictive, profit driven corporate controlled medicine practices. The cruelty in vet med is alive top to bottom, across all species lines. The culture of accepting it is crumbling too slowly. And the death is both inside the pack and around us. Start to question who you are? Why you are here? And why hope for change is so elusive? Say "No" to being unkind, unwilling, and unable. We aren't sheep, and we aren't replaceable. I'm here to say "NO!" to being a part of  death of compassion of this new grad. I am also here to say "NO!" to sending a chihuahua home to die because we think we can't afford to care anymore.

There is liberation in having a voice that is your own to guide you. Being even more than who your white coat and oath asks you to be. There is the place where trust, integrity, innovation, inspiration peace, and purpose lives. If you can't learn "no" you will pay for the assumed "yes" whether it be in inconsistent drama based business, sleep deprivation, bankruptcy, or collapse. At some point something gives and you learn to say "No".

Where is your "NO!" living? What is your silence costing you?

Me and my Jekyll. Another "No", one of the best ones I ever muttered and stood up to.

More information on chihuahuas and dystocia here. Coco's Story.

More on Compassion Fatigue here

Get Out Alive blog here.

Gratitude. The Grace That Hardship Gifts blog here.

More on Fate versus Indifference In Vet Med here.

More on Ag-Gag Laws here.

AVMA Euthanasia Guidelines here.

More information on me, this blog, and who we are at Jarrettsville Vet can be found here:

Pawbly.com is about saving lives, and providing options with data. Let the data set the standard of care and integrity via transparency be the guide.

If you care about pets, believe in making happy endings happen, and want to help others please join me on our Jarrettsville Vet Facebook page, our Pawbly Facebook page,and also on Twitter and YouTube.