Seraphina. Lip Avulsion in a Hit By Car Cat. How to, why it is so imperative to do early, and cost of care. Warning surgery photos!

Serafina

This is Serafina. Serafina was brought to me one afternoon by a client who witnessed her, minutes before, dragging herself across the road as numerous other drivers passed her by. That single act by this brave woman to stop her car, pull over, and go out into the road to get to her saved Serafina's life.  

Seraphina was a wisp of a kitten. Barely three pounds in all, mostly fluff and wide green eyes. When she came to me, just a few minutes after being the victim of a hit and run, (although this wasn't witnessed by the finder I deduced it by the severity of her injuries), she was being cradled in a towel. Her face was obviously injured. Her chin had been detached from the bottom row of teeth and lay flapping midway down her mandible. Her pupils were different sizes, (indicating head trauma), and a left back leg just sort of lifelessly dangling. She was adorably and unabashedly obviously cute, but, also crunchy. Crunching is broken bones. She was crunching from the bottom of her sacrum, because her tail was pulled off of her pelvis, which, by the way was broken in multiple places, and there was a long list of worries I had just on my very quick preliminary over view of her. 

The first few hours were about assessment, observation and pain management. She didn't have much going for her. She didn't seem to be able to feel or recognize her broken left leg. We weren't sure that the head trauma wouldn't cause hemorrhage in her brain which could kill her. With little more than a warm bed, food, an opioid to place inside her cheek she was left for 12 hours to see if she would survive overnight. I wouldn't have suspected that she would have survived her injuries. Life is like that. Chance, fate, luck, it is often little more than this. 

It is important to pause the story here. There is a knee jerk reaction to protest the black and whiteness of this particular case at this specific moment in time. There are spectators among the readers who wanted me to start fixing her. On. The. Spot. Life in medicine in the world of severe trauma isn't like this. In many cases we have to wait to collect information before attempting to repair the obvious that is not life threatening. Serafina's injuries; skull fracture, leg fracture, tail avulsion and lip avulsion are not life threatening unless severe hemorrhage or nerve loss is occurring concurrent with them. She also did not have a parent to provide consent to our care so we have to be careful about what we can and cannot do for her. Many (too many I fear) would see this list of injuries, no discernible home to provide financial assistance or care for. The list of all of the "worst case scenarios" is long, ominous, and foreboding. Many just shrug that they are sparing her further suffering and would have put her down right here, right now. My personal plea is to not give up. These are almost always savable. Maybe not "perfect" anatomically, but perfectly happy and functional, able to live a long happy, healthy life.

When she first arrived at the clinic we tried to find her home. We hope each and every time an unknown pet is brought to us that there is some worried parent out searching for them that we can locate and notify for a tear filled reunion. Some small semblance of extending the compassion we inherently feel when we see some little thing so fragile hurting yet alone and at the mercy of the world. We spent days searching to see if she belonged to someone near where she was found. She was so young, only about 3 months old, but she was affectionate and trusting. She knew people and she wasn't afraid of them. She had no microchip, and no person came forward to claim her even after her finder canvassed the area where she had been found. She was one of the too many who gets overlooked, forgotten especially when trauma with a big price tag presents. She is one of too many unwanted, which makes her disposable and easily replaceable. 

The next morning she was still brightly enthusiastic to see her breakfast and made herself very quickly yet sheepishly at home. The first 12 hours are critical. The first two days reveal almost everything you need to know from where you are and how far is needed to get to fly the coop. 

It was two days before I was convinced that she had any nerve function to her broken leg. This was the first hope to save it. She also was beginning to drag herself to the litter box to go to the bathroom. 

For cats, in my opinion, for a trauma patient to be able to survive they need to be able to do the most basic of things, this includes; eat, drink, pee, poop and ambulate. These things must be intact to allow them a reasonable chance at being adopted and cared for adequately to allow them a safe and comfortable life for many years to come. (This is a general rule. Not a hard and fast rule.. ask me about Dora someday).

Within a week Seraphina was beating all the odds. She was alive. She was improving miraculously and at an alarming speed. The injuries that might have been life ending were being crossed out like a bucket list to live.

The last item to resolve, the only one I really felt compelled to correct, the one that would get worse over time, (unlike all the others who were correcting themselves on their own), was her lip. It needed to be reattached to her mandible. It had come in damaged and ripped off the chin of her face, but it was contracting with scar tissue and pulling the chin off of her face at an alarm quick pace daily. Scar tissue is designed by the body to close wounds, pull tissue together, but if the anchor is released the pulling of the tissue can worsen an injury. 

The edge of the front of her lip was being pulled down her chin. Food, hair, and debris was collecting in this pocket. She was uncomfortable with her non-functional chin in the wrong place. 

Lip avulsions happen most commonly, (I have seen it twice, both times with a cat, both times when they had been hit by a car), because the skin of the chin is pulled off the bone of the  mandible when the face is pushed into the ground as the body is pushed forward. Serafina was very, very lucky. Her mandible was not broken, just the skin torn away.

There are reasons I waited a week to do this surgery. She had worse injuries to heal from. Possible internal trauma that would have  made surgery more dangerous and tenuous. The lip had to wait for her to be well enough to survive anesthesia. 

Serafina is lying on her back. Her jaw is clipped,
scrubbed and draped out of the surgery field. 

Serafina went under anesthesia to have the lip replaced and secured to her jaw. This is not a surgery we do every year. Maybe once in a decade. 

Cleaning the tissue, (there was an immense amount of hair, food, debris stuck between her lip and jaw was done under anesthesia. It was the only way it could be done. This is delicate sensitive tissue. You can't clean it well with her awake.

Once the tissue is cleaned it was loosened. We call it undermining. The tissue, her jaw and lower lip was shortening as it was being pulled toward her neck. It is scar tissue contracting. To relieve the tension you have to break down this fibrotic tissue and pull the flap back into place.

Stents (small pieces of surgical i.v. tubing) are used to go through the mandible skin and then looped around her canine teeth. It was the most exciting, aesthetically transforming surgery, (and quickest meets easiest), I have done in a long time. If I could do this surgery every day I would! It was that fulfilling.

A better close up of the closure and stents.

 Waking up her new chin,, just as it is supposed to be.

Serafina was lucky. Incredibly lucky. This case will have a happy ending because someone intervened immediately. She also had her internal organs intact. Bones will heal, especially in young animals. They need time, patience, containment, and monitoring from someone who knows what to look for and what to worry about. 

The cost of the surgery to repair her lip was about $200. It was that quick and easy. Our internal Good Samaritan Fund will cover it.

I have read posts where veterinarians are too afraid, tentative, reluctant to do this surgery. I want to send out a personal plea to all of you looking at a kitten, cat, dog, puppy who has this injury; if the mandible is intact, the canine teeth are anchored, then please try. It is so simple and easy. I'll help in anyway I can.

If you are a pet lover, pet parent, or pet expert I hope that you will join me on Pawbly.com to lend a helping hand for others who need us. If you are interested in more informative cases you can follow me on YouTube, or you can follow our amazing Jarrettsville Vet Facebook page.

Here is another blog about Serafina. The WHY In Who I Am.

Serafina. The WHY In Who I Am.

I have been a veterinarian for about 15 years. The best moments of these years are those I call 'dwelling within my calling'. The cases that remind of the WHY I am here. WHY I worked so doggedly and determinedly hard, for over a decade, just to get into vet school. Never mind the hard work it was to actually get through those 4 years. I was never blessed with blissfully finding, or even fortunately stumbling, upon the road to professional salvation to that destined path toward my perfect future. I could not ever find it among the tangled brush of my day to day life. I suppose I would have been better served by looking toward the horizon in place of the daily clutter that clouds all good decisions. The WHY of me within my little veterinary life exists in the moments of the day that prove to serve my purpose. These minutes of veterinary medicine that mean so much to me are the ones no one else has time for. The cast away felines to be specific. It has become increasingly more imperative for me to look for, recognize, and live within the WHY.

Serafina. Our first meeting.

There are more cats in U.S. homes than dogs. Felines are smaller, require less effort to care for. Less walking with leashes and poop baggies on those cold early mornings. Cats can eliminate in a small box hidden in some remote corner of the home. Cats are just easier; less time, energy and even expense. Cats may be in homes across the USA in greater numbers, but they visit the vet in minuscule proportions when it comes to their canine counterparts. Cats, in our current society, are provided a fraction of the investment in both time and financial resources than their canine cohorts get.

Life is not fair, we all know this, but, life for a cat is exceptionally more complicated, difficult, and cumbersome when compared to a dog.

How many stray dogs do we routinely see roaming my area of the country? Almost none, ever. We are conditioned from the love of our own bedroom occupant pups to stop, call for them, try to recapture them with the leashes we all always have awaiting in our cars. We will take the time to call the authorities as a last act to intervene on their behalf when we see a pup running loose without a leashed parent attached to them. A cat, we all pass by cats trying to survive on the most primitive and basic levels, routinely. Cats get a call to intervene as considered more "pest removal" than missing persons. Cats are omnipresent, replaceable, disposable. It is tragic that so many humans will never know the immense intelligence, kindness, adoring affection and abundant joy that they inherently inhabit. Cats are just as, (if not more so), wonderful than dogs. If you don't know this it is simply because you haven't opened your heart enough to see their magic. Why, (back to the WHY?), why, don't more people extend the same compassion to cats as they do to dogs? I have an answer; it is the failing of humans. Cats make you earn their trust. They take effort. People are inherently impatient and too many have convinced themselves that they are allergic. Milk, milk they will push themselves through tolerating milk in tiny sips, eaten in small icy spoonful quantities of Ben loves Jerry, until the body accepts it as permissible. (Did you know the huge majority of people are born allergic to milk?). Cats, they are wily, coy, cunning, and people dismiss the effort from initial rejection with excuses to dismiss their magic preemptively. "I'm allergic." People you don't know what you are missing.

Cats need help, and I always root for the underdog. It is the badge of honor for considering yourself an advocate. It is also the one species that I can make the most impactful and meaningful difference for. This is important in a profession ripe and replete with immense emotional turmoil. It is important to protect your soul as you try to navigate in the black through the business of hocking your service bespoken wares. I have had to learn this. I have had to figure out how to be a veterinarian who cares and wants to keep trying to care, in a world with tenuous intentions seeming to force you into caring less as the best option to lifelong soul preserving survival.

Serafina, pre-surgical chin repair prep.

Kittens, the ones no one wants, those that everyone else overlooks, the ones with deficiencies, disfigurements, the ones so easily removed as so many others who meet the standard of "perfect" can replace them. Not sure what I am talking about, ask a shelter employee in the middle of March who they feed and care for when there are dozens in need of round the clock feeding every 2 hours. Which ones get the best chance? Which ones do you try to save when you fear that you cannot save them all? You save the ones people will adopt. It is that simple, that linear. There are too many cats. This isn't my opinion, it isn't even my belief, it is the numbers of those who are set to fend for themselves. Those cats who are labeled "feral" are not descendants of cougars or lions, they are the children of humans who gave up on them.

I am going to be honest about my reasons and intentions for defending and publicizing my why. The motivation to intervening on these cases. It is a vulnerability that most won't confess to and never would embrace. It leaves you open to eating your words. Made especially poignant when the world of pets, the business of pet care, and the current environment of hiding that compassion as it leaves you open to dumping (even more) problems on your lap if you admit to caring when no one else either does, or, wants to be financially responsible for, if they do. It's a predicament. Price over empathy. It is a web of disaster I navigate daily. It is the reason many people just close their doors to appearing as if they care about anybody or anything when those lives appear at your doorstep without a checkbook attached to them.

It is also a place of opportunity with little liability. It is where I have found my purpose again and again. These unwanted, unowned, broken, needy felines are the best place to fulfill my WHY.

Serafina is a perfect example. She is the why behind the longing I have to maintain a desire to keep practicing. She is the fuel to burn my continual passion for caring. For reasons beyond her control, she just doesn't have a mom. Well, she has me. That's all either of us need. I am lucky in that way. I have isolated myself so that this is the reality of my veterinary practice. She isn't about being profitable. She is more important to me than that. She is about my safe place.

Serafina was brought into my clinic by a client. This is the only way we will receive them in almost all cases. She has to be assumed to be an owned cat, before she is assumed to be an unwanted cat. Even though the later is far more likely than the former. It may sound that I am pessimistic about so many unwanted cats living among us, but people will feign and deny ownership if a fee for services is looming. We always scan for a microchip when an unknown pet lands at our doorstep. A tiny clue to help find a worried mom. Some small token of adoration the huge majority of pets are denied. In cases of emergencies I have some leverage due to my credentials to provide care to the injured, albeit unknown, pet. Many vets would just send her to the ER, or, the shelter (who without a veterinarian on staff is woefully inept to manage even the mildly sick pets of our community), or, they would just tell the finder to act as the owner and assume financial responsibility for this patient as it is not uncommon for a pet parent to claim the pet "isn't theirs" to avoid having to pay the tab. You can begin to see the landmine of pitfalls we walk among. There is no human equivalent to this. You walk yourself, or someone else, into a human ER, broken and bleeding due to skull, pelvis, leg, and tail fractures and they start helping immediately as someone else starts asking the questions. There is not an internal pause of delay to figure out who is paying first as someone is possibly dying next to them.

In veterinary medicine helping/intervening/providing even basic care isn't so compulsory. In fact it isn't even marginally compulsory. Pets are considered "property". The whole single solitary reason injustice, cruelty, and blind eyes are commonplace. I took Serafina and offered to help her, based on a few things: I knew the person who brought her in. The person who found Serafina, a speck at two pounds, dragging herself across the road, smashed from the waist down, as many other cars passed her by, wasn't lying about her story. This wasn't her cat. Serafina in the first minutes that I examined her had a chance of surviving. It was a slim, tiny chance. But enough for me to know she was best off here, and better off  trying to stay alive instead of giving up on her with a small pink needle of fluid into her vein. This is a little bit of skill and just as much gut. I could eat the cost of her care because I have had cases like hers before. The first time you jump into pro bono is scary. The tenth-plus is not.

Serafina's finder also offered to help. This is a key component. Being a savior for another life is a step into unknown waters. Having someone else to help you through the journey empowers you immeasurably. It helps immensely to not want to feel alone. It's a way to share the load even if the ending is tragic. It takes a village to save both sides. We are all victims to the pressure and chillness of society. I have learned this too. Serafina's finder canvassed the area she was picked up in to see if she had a home. Nothing. Someone knew her, no one would claim her. She also reported her as found to the local authorities. I waited as Serafina got better in my clinic and no one came, or even came to check to see if she was possibly theirs. I was not in the least surprised.

Serafina has been a many months long journey. She has resilience. She is gentle and affectionate, and she is the example to why I am vocal in being proudly compassionate. Even if all I end up is a good story. There enough of the others to need washing and leveraging. I will stick to Serafina for as long as I need to. She completes my why. Fulfills my ever emptying internal soul sucking public pleas for taking everyone else's problems as my own. At least for today she is the WHY. She is the who I am. She is also the reason I don't feel alone, or even oddly vulnerable, lost in a profession with so many others struggling every single day to remember, and maybe even re-embrace their own WHY?

Serafina is a small piece of my tortuous and twisted journey. She is currently residing at my clinic, Jarrettsville Veterinary Center, in bucolic Harford County. She is looking for a home. A home where her love for people can be mirrored by someone's love for her. She deserves this. We all deserve this.

Serafina's recovery story is my next blog.

Thank you to all who help me, the staff, the people who aren't afraid, nor ridiculed, when they care. We take care of each other, two, four legged, furred and skin alike.

For more information on me, the clinic, and our WHY please follow this blog, our Facebook page, and my YouTube channel.

Drugs, Drink, Or Die? The shitty shady side of my last 48 hours as a veterinarian.

This is glaringly obvious...

I need a full time shrink. You know like other rich white entitled women have assistants, or glam squads. I just need full access to a therapist at all moments of the day.

How else am I supposed to deal with the shit that I do?

I have considered excessive exercise. Some cathartic attempt to tone my temple to a place of self absorbed elevation. Dump all my time and energy (the tired dog has no bad habits model) into spin classes, Zoomba, Ironmans. But alas, I can't, or rather, don't want to. It's a little excessive and selfish. Especially when you think about how much time that's going to require.

Or, I start to drink excessively.. No, not this either. No path to enlightenment here.. Watch too many of your relatives die from the bottle.. Not interested.

Drugs, Nope.. I lack the stomach for this. End up another number on the police billboard for the class of 2019. And, I'm too old. (Vices, addictions are age dependent I think? Aren't they?).

So, I am left with creative license to try to deal with the shit I can't compartmentalize quickly and quietly into lock boxes.

I deal with too much shit. Vets, those of us who still show up and give a damned (pun intended people), and those of us still trying to manage getting through the shit without it eating us alive. (I could go off on a whole tangent of suicide in this profession. How pervasive it is. How abysmal our stats on suicide vs the rest of the population are. All the little reasons it happens. The chipping away of your fragile psyche as the world tries to break your compassion with fatigue that has no end and any healthy outlet. But that is already widely publicized,,,,, I hope?)

I have resorted to blogging instead. (Slightly cathartic and even minimally effective), and, cutting back my work schedule. The tactic of minimizing exposure in the hopes the stats of the one absolute awful humans walking amongst us in society between the hundred of amazing humans I see daily. (There is always one psychopathic serial murder in a pack. Stay small. Be quiet. Hope some other victim is met sparing you the slaughter).

Blogging is great, (i.e. here I am,) but, there is still something lacking with it. My coping mechanism to handling the shit I get dumped on me isn't absolved via a blog. (hard as I hope and try)...

Getting my shit sorted out effectively AND in a healthy manner requires more than sitting down and vomiting my complaints to the world wide web. It requires an outlet bigger than that.

Here's how shitty my shit can get.. and why I need more places to put stuff. Hide it so I can try to resolve it, not let it eat me into oblivion, later.. You'll understand.

Here's a few examples of my shitty life as a vet... And to shorten my list to something people will actually try to plow through I am just reviewing my last 2 days.

The Lying, Thieving Neighbor:

The setting; new client with dog is here for exam and vaccines.

The protocol; every new client is asked to provide information on themselves, basic stuff like address, phone number, and email address for the purpose of notifications and legal criteria. We aren't like human hospitals where we must meet and provide HIPPA, but close. And we are every so often to provide proof of vaccination status to law enforcement in the cases of bite injuries. We take protecting our patients and clients info very seriously. We never provide info without scrutiny first. And even then we still never do.

The case; Quiet, reserved, somewhat shady looking arrives with jubilant compact tan dog in tow. The guy makes a point to tell you within the first sentence that you meet him that "he is a lawyer." The adorable pittie pup at the end of his leash is jumping around the room elated to be in public with lots of people who love pitties. Her name tag says "Olivia," the gem of a girl who is loved. He is a new client, a guy noir neuvo. He wants us to have her examined and update her vaccines. Olivia is not a puppy, obviously. She is a full fledged adult and she has probably been to the vet before. But, upon initial questioning he has no medical records and no clear idea of when she might have last been seen by a vet or vaccinated. My savvy technician takes her to the back treatment area and scan her for a microchip. Guess what? Yep! She has one! And guess what else? This guy still isn't a client, BUT Olivia IS!.

We go back into the room to discuss our findings and he says, "I haven't been completely honest." (shocker).

We call Olivia's mom. She has been looking for her for days. Has been filing missing dog reports and now her missing Olivia is here. With us. Great lucky joy she is safe and found.

It goes on.... She (Olivia's mom) calls back minutes later to say she doesn't want her back... she is after all running away often she admits.

She calls back again minutes later and says she does. Starting to see the problem here yet?

We are confused... We are torn. All we really care about is the best interest of this dog. Where is that in this mess? Whose side are we now rooting for?

We call Animal Control, which, thank goodness, is a part of the Sherriff's Department. We walk away wondering.... why do people steal pets?.. Well, they are either shady and use them as bait dogs, or sell them, OR, they think they are a better parent than the original parent which means they know them, they are neighbors and how you gonna hide that body?

The shit we deal with.... we save a lost dog... we have an angry lawyer because we stuck our noses in his shit,,, (oddly he confessed he already had three other dogs and didn't need anymore,, and he went to a different vet. Why did he come here? Maybe his original vet would have stuck their noses in his shit? Or, maybe not? Please just go away... like forever Mr. Lawyer-shady-guy).

And we have a client with an unfulfilled dog in need of more exercise, more supervision and more people to love and take care of her.

And people wonder why vets kill themselves? Clearly this is beyond my vet degree, AND, we are now scanning every pet with a microchip and scrutinizing those who decline them. (yes, we do stick our noses in other people's shit,,, I go back to dilemma of giving a damn).

(PS Olivia is not her name.. Mr Lawyer had changed it, gotten a new name tag, and did he really want her? Is he just a guy who cares and maybe went about it the wrong way? and how do I sleep at night?).

Case Number Two. Angry "Kill My Dog ASAP!" woman.

The cast; New client, new patient.

The stats on the cast; New client states that she just moved here, can't remember where her previous vet was, and the dog is a 14 year old lab.

The setting is ripe for disaster in my eyes already. I can see this emotionally devastating tsunami coming. Had I been the receptionist I would have found some creative way to discourage her from coming here. It is a vibe we get. Not concrete. Just a feeling. Thwart destructive people before they enter the front door in every case possible.

The next example of fried burnt out vet meets "I can't handle this shit" is the never met before woman, with the equally never met you before patient who makes an appointment to euthanize her dog and goes ballistic because she isn't seen immediately for her appointment. (This is not a proud moment for us. We get behind because we invest our whole heart and soul into every patient and these cause poor time management). She gets impatient. Really, really impatient. She then gets even more heated and ticked when we inquire about this never seen before dog who is here to be killed,,, We call it "euthanasia" because it is prettier, but let's not cloud the issue,, it is death,, no going back from that. She goes to a place that is irreparable. She starts screaming and charging through the clinic. She puts her dog in the car, yelling foul things, like a two year old without the toy she wanted, but didn't get in Wal-Mart, and then upon the intervention as I try to smooth things over I foolishly say "We don't know you, or your dog and we need to insure proof of ownership and rabies status." (And, I want to say, and who gets defensive about that?)

The worst part of this whole thing is how happy her dog is.. How much he has no idea about what is going to happen and how sick we all are to witness it.

Is this about us? Jeez, I hope not. It is not a dog we can see as being suffering. It is a dog who is older, ( reason enough for many), and she is ALL ABOUT HER. We are her servants. We aren't supposed to have a heart or a soul, We don't know her story. We don't. But his, this sweet dogs, seems apparent.

Shitty online review from her follows.

Once again soul crushing disgust in lacking humanity ensues.

So I sit here. Dilemma of the day; drink, drugs, therapist, exercise. VENT!

Get out alive people.. Pets you are at the mercy of these humans I hope to be able to hide in the pack from.

P.S. New JVC protocol; Don't call us and request a euthanasia if we don't know you. Sorry, not sorry..

Shit like this. People like this, cases like this, happen every single day at every single vet clinic. No one talks about them. We may joke internally. Share each others beaten empathetic complex. Share the burden of the pets we feel got cheated by the people who they relied on most. But most of us just internalize the frustration. Let it chip away at our fragile souls until we give up. We kill ourselves because of the shit we can no longer swallow healthily. We die internally as we comply. Find utter indifference. Abandon caring because it just hurts too much to do it anymore.

Me, single me, I am getting out alive. Protecting my heart and soul running for the goal post cradling it like a gladiator in the arena of compassion fatigue.

Those two pups in this story, I also carry them. The impact of their stories. One now deceased and one without a happily ever after ending.

Here's to praying the meek inherit the earth and do a better job than humans did.

For more information on everything and everything veterinary medicine related please follow me at my other social media places;

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If you have a pet and want free help or advice about them please ask us on Pawbly.com. If you are a pet parent, enthusiast, or expert in any field, please join our little community to help others.

This Time Around. Coming To Terms With The Death of My Beloved Pup..

Veteran territory. I have been here before. The wound is soo deep it seems fresh, draining, life threatening. Death has been to visit me before. We haven't come to terms with each others presence, nor purpose. IT is still an unwelcome intruder. Albeit, ominous and undeniable, still IT calls, I collude, and yet, IT always wins, as I feign fractured and defeated. Again, and, again.

Our pets never live long enough. You can try to push the limits of pet-mortality with purchasing a parrot,, get yourself a good chance at a millennia, but dogs, if you stay mainstream canine, are lucky to see their teenage years, incredibly blessed if they hit two decades, and if you like to go big, or even "giant" you may not ever see double digits together.

I have learned that my heart can barely handle this pain every 10 years. I need, want, choose, hope, pray, beg, for a decade of longevity. Turns out my track record reflects this. "The older I get, the smaller my pets get." It is a hard-learned trade secret to try to spare me the loss every 5 years, or so, and it allows me to be able to carry them when their winter starts to wither and their bones can no longer support their ambulatory requirements.

The last few years has marred me with the loss of two beagles; Jekyll (just last month), and Savannah, a few years ago.

It took me weeks to get out of the grey fog I was flailing in with Savannah's loss. I just couldn't get out of the programmed repetitive daily motion I had become so accustomed to. The getting up at all times of the night. The managing her hysteria, messes, and failing functions. Undoing the habitual duties she set into my daily life took time. All the while desperate to go back to that place of interrupted sleep that her deprived mania brought just to have her back with me. But her loss was explainable, excusable, sensible. She had made it to 16. A ripe old age. A respectable age for any dog. She could be grieved but not denied a silver lining sentiment for surpassing the acceptable tenure. I could complain that her loss hurt, but I couldn't expect sympathy that she hadn't been afforded a long loving life.

Savannah

Jekyll, my most recent loss, another beagle, passed away at 8. He got cheated. I have anger lining that grief. Bitter shards to embalm him in. Seething pain to intern him with. Dust to damnation. A cursed cruel loss.

jek

The pit of my grief with his death lies here. The time frame cut too tragically short. The agony of desperate attempts to buy another "good" day for him. The exhaustion in losing the big battle. The responsibility I feel as having been the ultimate master of his destiny and purveyor of his curtain call. It is a terribly painful place to be. The ultimate responsibility can leave you with the lifetime of despair in second guessing and brow beating every previous decision. Sad couldn't begin to capture my angry bitterness. Except to mar it with also feeling responsible. That little fact made it crushing to swallow, impossible to move on, and fraught with such self doubting so that no piece of me was big enough to reassemble.

The days after his passing were simply about getting up, getting dressed, crying in the car to work, choking on grief and visible despair , all the while attempting to trudge into a day I dreaded facing. It also brought me back to why. The why of this profession? The immense magnitude of the responsibility we carry. The joy and the pain and the immeasurable grief it brings when you build a life around another.

The why we let them into our homes and hearts? The why we incorporate them into all parts of our lives? The why it is so easy to love them and yet so impossibly hard to lose them?
The why is the reason for everything we do as a parent and a veterinarian. It is important to always remember the WHY's?

I can love this pup, let him go knowing life too often works in its unfair ways, and not be ashamed, embarrassed or surprised when it repeats itself in my clients lives. If you can't feel a loss you cannot love. They are inseparable. It is what makes a vet a real person in the right profession for the right reasons.

I know this. I believe this. The tough part is living this when my own heart is shattered after losing the little one I loved so completely. It is grieving. Understandably. Grieving without withdrawal from ever opening your heart again is what I believe to be the most devastating part of pet loss. This is where I spend time talking to clients. It is normal to grieve. Grieve, however you need to, for you. Take time for yourself. Make a place to memorialize your pets life. A place to know you can go to to tell them how much you miss and love them. Live in the memories of your time together. But, try to not blame yourself. Try not to get stuck here. I know it is hard. I spent weeks here feeling like I, me the great powerful veterinary healer, could surely have saved my beloved boy. I had time, financial resources, access to the best specialists. Every tool to make him survive even the worst disease. It didn't happen, He left too soon. I lost him. I failed him.

Me and Jek at the oncologist's office.

That was exactly how I felt. Can you imagine how everyone else who doesn't have a decade of being a doctor, a clinic at their disposal, an Army of specialists, a bank account dedicated to dog care feels?

We will all lose a love because life always meets death. But giving up on loving again, ever having a pet again, that's where the real tragedy for me is.

So many clients give up after their pet dies. I think they feel it is too painful to go through again, or, like me they feel as if they will never find another pet who fills the shoes, measures up to the caliber of loyal/obedient/dedicated/wonderful there pet did. It is natural to not want to feel awful again. But not feel again? That's a loss that costs more than any heart should endure.

You cannot go through life living it if you try to not feel it,, good, bad and everything in between.

We all write the chapters of our own book. My book, each deep rich chapter of it has always been delineated and defined by the four legged family who made the tapestry the vivid, meaningful experience it was. The many homes, the varied geography, assorted jobs, were all the background that set my stage for each chapter whose central characters were always the dogs, cats, and pigs who made this life colorful and rich. They were, and are, the most important and meaningful pieces of the life I created and treasure. Some took up hundreds of pages. Some saw me through decades of questions trying to create the adult the kid was dreaming of. Some were short poems, a life too little, too fragile and too small to last past a haiku on an abbreviated page. But I am a richer, wiser, more content and accomplished thanks to their acceptance, love and wisdom.

You would think that with all of these chapters, all of the times I have been through loving and losing them that I would be better at grieving? My previous practice would make perfect assembly line efficiency of recovery? Yeah, not so much. I still invest whole heart immersed, drown in despair with loss, and trudge ugly through getting over it. Practice has not made perfect, unless that perfect implies pitiful.

The loss of Jekyll and Savannah took me weeks, months, longer/forever, to come to terms with. I will never "get over them." They were too monumental for that. All I wanted from myself when getting through their loss was to not give up. It was all I could hope for. They were loved. (I can say that with total conviction). There are millions (millions) of equally deserving (I can say that with complete honesty also) who never know a kind hand. I still have that to give. I may be broken and hurt, but I can still be kind to a furry face. I have to think beyond me. Society, civilization rests on this. It does transcend past human to human. Anyone who has ever loved a pet knows that. The world is better for all of us because we can love each other, regardless of size, shape, color, claws, fur, or fins. Love that is compassion is the key to life. All life and all living. This is what I believe, and remind myself of when reeling in loss.

Here's what happened to me after Jekyll passed away. I cried a lot, for days, weeks.  I told the people around me that while I appreciated their sympathy I couldn't talk about it at work. I had to stay busy and focused around the grief.

After two weeks I started trying to put my toes back in the water. I started looking at the pets in the shelters and at the local rescues. None of them were Jekyll. None of them pulled me into compulsion to step forward for them to come home with me. None of them were Jekyll. I was looking for that face. That smile. Those ears. Some tiny resemblance to jar me into adoption and out of affliction. I realized that obviously I wasn't really ready. I wanted to be ready. I just wasn't. I started spending loads of time with Charleston, my other dog. The left behind dog while we were all so focused on Jekyll. He had been neglected while Jek took so much of my time to monitor, treat, and obsess on. I owed him help in his grieving to. He was as heart broken as I was. We went on lots of walks, changed the room around. Got new toys. A little distracting helps pets adjust to a different routine and life. He got quiet and withdrawn. He missed his instigator and boisterous beagle brother. He was always the shadow behind that dynamic personality. He never saw his own sunshine  without Jekyll pointing the way.

Charlie was depressed.. But, he seemed more than withdrawn. He seemed deflated.. Vet mode mom kicked in (although it felt like paranoid vet mom). What would I do if he was dying too? Charlie's blood work revealed a low thyroid. I put him on medication to see if this would help resolve his lethargy, depression and sadness. It helped quite a lot. He started to wag again.

The next set of events changed everything. It added a new chapter and pulled me out of isolation and despair. A hurricane hit. Storm landed. (more on him soon). Hurricane Florence lands.

I added two very sick puppies within 3 weeks. We needed each other. I remembered I had a purpose outside sadness. I am alive again with them. I can go on. Being needed and loved helped me remember to start writing the next chapter, again. I was pulled out of grief by two sick puppies. I reinvested my energy into them, constructive caring, versus my grief soaked couch. Charlie, well it took about a week to realize they were residents, but when he could no longer ignore their incesant chew-bite instigation, he started to play. Within two weeks we stopped his thyroid meds (there is no medical study to back this, but its true). Charlie, and I, were back with the living.

I wasn't ready. I have no idea how long we will get together. But the time with them is far better than the wallowing in despair. We need each other, all of us. Loneliness is the gateway to despair and my puppies are waiting for me at home.

To all of those out there drowning in grief I hear you. I know. There is a way out. Reinvest your whole self in a pet. They need you as much as you need them. You can help each other to the shore. I send you all love and support.

For more information on who Jarrettsville Veterinary Center is please visit our Facebook page, or our website.

If you have a pet question or a story about your pet to share so we can start to help others who might be in the same situation you are (or were), please visit us at Pawbly.com. It is free to use and open to everyone.

If you want to learn more about pet care visit my YouTube channel here. 

One Year Later. The Impact Of A Rant

It has been one year. My life, almost everything about how I see and live it, has changed over this past 365 days. It has been one year since the video I made about a pet who had not been given enough options to help them found me and we saved her life for a fraction of what had been offered a few hours earlier at the ER. It is a story I hear daily. People being told they have three options; fork up the deposit immediately (often 2 am), euthanize (always, as I hear it from these clients, too strongly encouraged if the deposit can't be produced), or, go home to let your dog suffer. My video opened the dirty secret of how limited the options given often are, and people were angry.

I struck a nerve. A painful, deep, resonating nerve. It followed full circle. It came to haunt me, humble me, and cause we to seriously reconsider the path I had spent my whole life, over 4 decades, building.

The consideration to bail on everything vet related, was on the table more than once. You can live life, hard already by any measure, and consciously decide to try to make it easier. At some place, affectionately (hopefully) before you slam into the bottom, it helps to try to make your life easier, or, at least not create your own landmines and road blocks.

I considered hiding, running, bailing, abandoning my calling, repeatedly. I told myself over and over again "that this job wasn't worth dying for." I live in a profession that has grown almost immune and indifferent to bailing. suicide-risk-highest-among-small-animal-female-veterinarians. I was blamed by numerous people for being part of the cause of this abysmal fact. I was even removed from the groups dedicated to helping vets in danger of hurting themselves. The profession took my voice as an attack when its intention (who everyone outside of medicine saw as it was), was a plea for a pet to be given more than she was.

Turns out the reality is that this being a veterinarian gig isn't just a job, and the problem doesn't go away because you hide or kill yourself because you got lost in the pain of feeling helpless and hurt.

Never was I the one to take the road less traveled. Me, no, i will jump into the poison ivy to make a point. The message can get lost in the delivery if your too battered to enunciate or stand at the podium.

Here's what I have learned, and how my plea for help to those we rely on and serve changed me;

• Don't make a point out of anger. Nothing good comes from that place.. it's cathartic, but not constructive. That is my only regret. A voice of passion is more powerful and lasting than anger. I was met by anger and I contributed to it. I have learned that lesson.. (the hard way of course,.,).

• Let the lunatics hang themselves.. don't feed them. I stopped responding to the hateful diatribe early on in the 4,000 plus comments left on that video post. It turns out the other side of the angry mob (the distraught pet parents) did a better job than I could.

• Keep records,,, screenshots are important. Karma is King. And, nasty people live nasty lives. Let them live them. I, and they, know who you are. You can only kill so many animals for all of the awful inexcusable reasons that you do and before you know it you have built your own legacy. Maybe indifference will help ease the burden? Maybe blaming others will? Maybe your cost of living needs to be reassessed instead of the clients standard of care? There is a #MeToo movement on the horizon in vet med. I'll be one of those women pointing the finger and reciting my experience to those some of the men and women who bully to intimidate and threaten to coerce. 

• Take the high road. Even if you have to gag yourself to do it.

• Be ready to stand by what you believe in, but always be prepared for sacrifice when you do. Remember at the end of this journey you will only have to face yourself. No one else's opinion matters. You die alone, you might as well like the person you share your grave with.

Sacrifice became a consistent theme over the last year. I repeatedly had to ask myself what I was willing to sacrifice. It was made more apparent when ER's, private practitioners, (some of them I used to believe were friends), and a few of the angry online mob all sent the cases they could have taken care of to me,,, some just showed up to say, "my dog needs a pyo surgery, my vet down the road, said you do it cheap." I did A LOT of surgeries last year. I made a real difference in peoples lives, and best of all saved a boat load of pets who would have otherwise been relieved humanely of their suffering economically. There is more to this profession, to the lives entwined in it than a simple linear mathematical equation dictated by an economist. There is more to every life than DISEASE + FINANCIAL ABILITY = OUTCOME. There is a pet, a person, and an emotional tie that far outweigh the scales ability to measure "equals."

Me and my pup Storm.

To all of the squawkers who proclaimed that the video was a "marketing ploy" I have to admit that I wasn't that calculating, nor, divisive. But, I also have to admit it worked. Business has never been better. But business doesn't last because of a catchy ad. There has to be substance to that client experience. Truth is that video, that message, was honest and compassionate. If you are trying to run a business, most importantly, a service based business, people can see through the bull, the sales pitches, the fake motto's. Don't tell people that you "treat their pets life family" and then send them packing to find help because they aren't profitable, convenient or as prepared as you expected them to be. Your family must really have their shit together, unlike all of the rest of us.

There were days of phone calls. All of them set-ups from "fake clients" trying to get us on tape declining to help them "for free." When we began to question them, like "please let us have your number so we can call you back to discuss," click. Or, yelling, screaming, cursing at us on the phone.

It seems to me after this year of questioning who I am, what kind of vet I want to be, and what my veterinary legacy will be, I have come to understand that I am really not afraid anymore. No matter what you threaten me with, no matter how long I feel that I am walking alone, no matter how tired I get from doing the pyo's everyone else wants to send my way to teach me my lesson, I am who I am. I am not for sale, I cannot be shamed, silenced, beaten, abandoned, or castigated to a quiet place. This is a profession who kills themselves at unprecedented numbers, I won't be sent there, I won't retreat there, and I won't feel lost in the finding of a place of peace. Its there inside me. ranting.

There is a peaceful resignation to knowing what you are capable of, how you can survive feeling so alone. A sense of  transcendent maturity.

I accepted months into this bashing quest to ruin me (three letters sent to the Board, multiple calls from "veterinary groups" to fuel their fires, shutting down all social media outlets, and numerous private warnings from people I didn't even know to "be careful" people are "out to get you." that if someone wants to get you they will. You can't walk through life always afraid. It just isn't sustainable if you are trying to live in and through it.

I would rather walk away from veterinary medicine proud that I never euthanized a treatable pet, gave every option imaginable and faced the wrath of a profession set out to destroy me, than let the ghosts of the voiceless steal my soul.

We all pick sides. It is the nature of conscious awakening. I picked a side a long, long time ago. I went to vet school to take care of animals. I will continue to do so. I stand with them.

There is more to come. Promise.

Here is the original Veterinary rant video,,, after being chastised by almost every veterinary group and organization to "Take It Down!" it stands. Perhaps simply as a voice for those who have been wounded by us, this profession, perhaps, as a small symbol of freedom of speech (after being challenged by the State Board to be removed/and have me punished for an ethical violation), and maybe perhaps to be a rallying cry for change?

Side note for those of you paying attention. It has been longer than a year since the video went viral. When the anniversary came around I was grieving (terribly) over the loss of my beagle pup Jekyll. It consumed me, and, the thought of trying to put words on paper about anything other than him was impossible. I took time to grieve him, and I took time to reckon this subject. It really comes down to deciding what you can and can't live without. I had to live without him (two very sick puppies to refocus on have helped me more than I can measure), and, knowing that there were people who wouldn't let me feel alone.

My slogan for 2019 exists in two parts; #transparency #getoutalive

For more information about our veterinary clinic, Jarrettsville Veterinary Center,  please visit our Facebook page, or, our website.

If you have a pet question or a story about your pet to share so we can start to help others who might be in the same situation you are (or were), please visit us at Pawbly.com. It is free to use and open to everyone.

If you want to learn more about pet care visit my YouTube channel here. 

Cole's Second Chance. Your Pets CAN Live On Without You.

Cole came to us one evening in the middle of Summer, 2018. It was the end of another long day. I work primarily nights; week nights 3 pm to 8 pm. I often see the appointments we couldn't fit in earlier, or, the cases that are attached to special scenarios that require a degree of liability in both the financial and 'out of the box' maneuverability. I wouldn't put these cases on the other vets who work at the clinic. It wouldn't be fair to.

These cases are a long story, meets pivot point bordering on euthanasia and deaths door, AND, an owner who cannot find any other option. It is essentially ALWAYS the same. Person in dire straights (often homeless, addicted, evicted, always desperately spewing emotionally garble) and a million excuses, and a pet in the cross hairs of a balance between if I don't do it the shelter (or the pink euthanasia juice) will. I, due to my poorly trained patience, have gotten better at being the listening forgiving humanitarian with these.  I'm not shy about the reasons. I am in these for these pets. The people, well, I am not so forgiving with them. I can't help most of them. They don't want it, they just want help for their pets.

Cole last week,

I walked into examination Room number two. First room on the right. The one with a bench seat, lots of room, and the most updated within my humble 1950's rural little veterinary clinic. There stood an aged black shabby, overweight wagging dog. He was entertained by the chaotic clutter and bustling revolving door of patients and their chauffeurs.

His mom, a woman shrouded in clothes trying to be very small hid her face sat on the bench ignoring him within her own grieving.

Cole was a mess of energy pent up in a body that should have been tired a long time ago. He was bright, happy, active, and yet obviously rather elderly. He smelled bad. He was matted, lumpy, had a fleshy marble bag hanging from some part of his belly. Attraction and affection for him would be a little deeper than the average onlooker would find at first glance. He was a soul in dire need of looking past a lot of deficiencies. He was also here because all other options had been emptied. Almost as desperate as his mom who was seated, sobbing, and almost incoherent.

Cole at his mass removal surgery.

This was one of those moments that suspends time. Removes you from the chatter of cluttered pesky dilemmas of daily life. It was one of those defining moments. The moments I don’t think lots of other vets deal with. I understand why, although it doesn't change the needs nor the consequences of turning a blind eye.

Quietly and spontaneously his mom started reciting her plight. She was a woman who started out like we all do. She once had dreams, hopes, plans for a life full of possibilities and potential. She wasn't any older, or younger than me, but, she was broken beyond repair from an intervention. She looked doomed. She couldn't stop crying. It was difficult to understand her story on a timeline. She was at this moment simply a person who needed to stop living in and out of her car every day. She wanted to be in a shelter where she could rest safely. Her dog, who I barely articulated as having been purchased as a puppy at 8 weeks old, was her soul source of companionship through all of her losses. She repeatedly told me that he had never know another mom. She was so insistent that I know this that I feared she would chose to put him to sleep rather than rehome him. This, this one incomprehensible statement, is one I have heard so many times I have almost lost faith in people being anything other than so self absorbed they will kill their best friend to prove the point.

“I am homeless. I live in my car. He needs more than I can give him but I have had him since he was a puppy. He only knows me.”

It was a moment in time, I have had too many times before. It was one of the many situations of feeling like my stethoscopes duties were extending well beyond my medical practice’s primary purpose.

This dog, Cole, looked like a marketing ad for some animal sanctuary pamphlet. He was big, shaggy, matted, filthy, had some odd bald black skin sac-looking mass swinging to-and-fro from his midsection, and for as bad as he looked he smelled equally unwantable. He was a tough sell unless you already possessed the eyes of adoration years together build. All of his discouraging selling points weren’t going to change his current predicament. He had a car for his only home. He was a dog who had energy and needed more than he had.

I have learned that in moments like these a few things really matter. First, I cannot undo what has walked in my door. Being cold, indifferent, and ambivalent isn’t going to change this pups fate. It also isn’t going to stop haunting me. Yes, I have to identify and embrace that I “feel” for my patients, even when they are just off the street and ownership has been only 5 minutes.

Next, many of these situations seem impossible. Impossible is a place where nothing happens. Novices make predictions, the rest of us, those who have learned that amazing happens when you invest yourself, offer hope, extend a hand of compassion and support, those of us who have gotten here know that life will surprise you if you aren’t afraid to let it.

What happened next was what ended up making all the difference in Cole’s story. I took a breath. I decided to not concoct an excuse to walk away. Send him and his mom to a place they didn’t have left to go. I asked Coles' mom if I could interview him and her. To tell his story to the world (at least our Facebook world). This is what made a difference. See Coles video here.

The last, and probably most important part of this meeting was having a staff who understands who we are, why we are this way, and what the world has room for. I had one person, my very dear friend, vet tech extraordinaire, who looked at me and said; “We can do this. I want to help.” It just takes one more person who believes and a spark happens. That glimmer of maybe?, turns into the beginning of a movement. Hiring her wasn’t an accident. Like the rest of the staff who I am so lucky to work with, it has been a long, (many years long), process of finding like minded people who believe and want to do something. Me, all by myself, that’s (almost) impossible. But a community of people like me, well, that is where fairy tale endings meet real-life.

Cole went home with that technician who believed in miracles that night. He stayed with her, as the newest member to her 5 dog flock for a few weeks. She gave him a new perspective and excitement to a life unfinished. He was caught on film in their back yard playing with her other dogs. It brought me to tears, (it still does). His joy was undeniable in that little snippet of yard play. I so wish his mom could have seen it. How happy she would have been. How relieved to know he was ok without her, and in spite of how alone they had been once.

After about 3 weeks, another video or two, Cole found his home. I can call it his 'next' but it has become his 'perfect' home. He is what they call him "the best dog we have ever had." Who knew 'best' could reside in this old package? (I guess we all did?, didn't we?).

Cole 2018 Pets With Santa. His family photo.

Cole was adopted by a wonderful family who also goes above and beyond what a little challenge might require. They take the hardest, most needy cases, and from their hands of love an kindness second chances become more than these little souls could have ever hoped for.

What I have come to believe as true, even though I dread each repeat episode, it is the time I love my job the most. Being a veterinarian can't, shouldn't be about finding the easy cases, the easy people, it is about helping the worst cases in the  most dire circumstances. It is the fulfilling place to build a lifetime of stories from.

For more information on who Jarrettsville Veterinary Center is please visit our Facebook page, or our website.

If you have a pet question or a story about your pet to share so we can start to help others who might be in the same situation you are (or were), please visit us at Pawbly.com. It is free to use and open to everyone.

If you want to learn more about pet care visit my YouTube channel here.