Which Kind Of Vet Would You Be?

Madeline cuddle time.

We are all some kind of vet, just as we are all some kind of person, spouse, friend, and pet parent.

Some call it labels, which skews it as some sort of personally offensive connotation, but how else would we describe it?

I have been asking myself which kind of veterinarian I am? I realized when I first bought this clinic that my decisions from the very beginning were going to shape who we were. It is reflected in our color scheme, our motto, our hospital lay out, our pricing, and every word we speak or print. It is omnipresent. These in turn influence the kind of clients we see and serve. I would take this one step further and say that it even influenced what practice I bought, where I bought it, and who I bought it from.

This is what we call marketing and it is present in almost every facet or our personal and professional life.

From the very first baby steps of practicing medicine our words, our acts, and our ability to help both animals and humans is governed by our ability to sell who we are and what we believe to be warranted in the expression of our profession.

A client left us the other day because she felt that she would be better served at a clinic that was more in line with her personal perceptions of herself which she labeled as "old fashioned." At the heart of my veterinary soul I would have used this exact term to describe myself. I think that the disconnect between her definition and mine were not in how we treat people, but rather how we believe we should be practicing medicine.

Loverboy, up for adoption now at the clinic.
His name is 100% appropriate.
I am secretly scheming to add him to my herd.
He is the best therapy in the world. 

The example that she gave was that she felt pressured every time she came in to have procedures done. Here is an excerpt of her letter.

"Thank you for your note. I felt pressured every time I came there for the last couple of years to have procedures (e.g. stool samples at $30 a pop for dogs that are already protected against worms by their flea -- or maybe heartworm medication -- and who are very closely monitored by me) that were unnecessary, and as I am a widow who works as a church secretary, money is an issue. I am committed to my dogs health but must balance that against my budget. As I have  had dogs for about 40 years and keep a very close eye on them, brush their teeth and clean their eyes daily, look at and pick up every poop, I feel my position and choices should have been better respected. I felt as if some of it was pressure to add procedures that would raise the cost, though I certainly could have a misperception there. I have found a vet who is closer to my home and is I suppose more old fashioned in that he takes into consideration what I as the dog owner want to have done and does not argue with me and pressure me into having additional items done. Thanks so much."

My reply;

Hello Mrs. XXX,

I called yesterday and left a message on your phone about your departing email. I also wanted to clarify a few things that should have been explained to you at your visits so that you wouldn't be feeling as if we were doing any procedures unnecessarily or without your willing participation. I apologize for that failure on our part. If you would like to discuss why we recommend what we do I would be happy to clarify. For the record I do not believe we have ever made one single decision while I have owned JVC in an effort to make money or pad a bill. In the 9 years I have owned JVC we have never taken a profit (which is absurd when you own a business). Every decision and recommendation is done with the pet first, and the parents safety second. I also believe that we are incredibly understanding and absolutely committed to tailoring a treatment plan and wellness plan to the individual. Any item that the owner is uncomfortable with or unable to afford is discussed and compromised. But, we must adhere to a high standard of care and adjust down. It cannot and absolutely should not be the other way. This is never about the money, it is only and always about the health of the pet and their family.

I would consider myself an old fashioned vet. I grew up in the office of one and I remain committed to being one. Almost every one of my clients has my email, and or my cell phone and I am available 24/7 to them. Last week I did 3 emergency pro bono surgeries to clients whose pets would have died without our intervention. I did it for them for free (or at cost) because the were long time clients in a terrible desperate position. This does not happen at the majority of the larger clinics, or many clinics anywhere. 

Three weeks ago I helped a client who had been going to a small one dr clinic just south of us who was told to put her dog to sleep instead of removing the mass that was so large he could not walk. He received his life saving surgery here with us after his vet gave up on him. (His story can be found at my blog, Tucker's Story). She believed that he was old fashioned in that he saw her pet as replaceable and not worth the time or effort to treat.

I tell every single client that their decision about their vets care is a personal choice that should be based on trust. We have failed you in this regard and I certainly understand that you should be at a place that you feel comfortable in. But please do not confuse old fashioned with substandard. Fecals are part of the basic standard of care and should you or your family get one of the intestinal worms that dogs often carry, and become blind or disfigured you can sue your vet and you will win, IF they have not been recommending a yearly fecal. We live in a litigious society and doctors are liable and culpable.

Lastly, I write a veterinary blog and I would like your permission to use your letter as a way to publish how important it is that we talk to our clients so they understand what we are doing and why we are recommending it.

Thanks for your time, and I would appreciate your permission in using your letter. I can be reached here for any questions or concerns you might have,

Sincerely, 
Krista"

Her reply;

"Well, obviously I have hurt your feelings. Not my intent, and I am sorry for that. I purposely said that it could have been my misperception that testing and procedures were pushed to increase income, because I believed it could in fact be my perception, not fact. It is fact, though, that I often felt pressured, and it was uncomfortable. My current vet does recommend fecals but when I decline I am not subjected to a long dissertation on why the medications they are already on are not always effective, etc. if I may be totally blunt with you, fecals for my two tiny dogs are more than I earn in a day, after taxes. TMI, I'm sure, but there you have it. As a 62year old widow, not much chance of moving upward financially. 

I have no doubt you are an outstanding vet. If you can meet XXX's standards, there's no question. I'm so sorry that I didn't just say that I'd moved and let it go. I so don't want to hurt you. I just was trying to be honest, not hurtful. 

You may use my letter. Perhaps the overarching problem was pride in that I  should have shared my financial limitations. The logical question after that, though, is why do you have pets you can't afford. I can afford them, I feed them well and care for them in every other way, but there are limitations. Not to harp, but this annual fecal thing is a relatively new vet care idea. As I mentioned, I've had dogs over 40 years. Dr. XXX (the previous owner of my clinic) commented one time about how closely I monitor my dogs when I picked up on one tiny thing (I forget what it was) that evidently he thought was usually missed. I'm proud of how I care for my girls and don't want to feel as if I'm giving them less than adequate care if I choose not to do something recommended by my vet. You all have the education but I know my girls intimately. 

Again, I am truly sorry to have hurt you. It was not my intent in any way."

My reply;

"Many thanks for the reply.. and I am sure that my personal involvement with my patients and my clients allows me to have my feelings hurt,, a price I pay for my stubborn resolve to not become indifferent no matter how long I stay in medicine..

I understand and empathize with your financial limitations, and I would never even hint at the idea that income is relevant or required to be a wonderful pet parent. The discussion should never come across as us badgering you to do anything, but I don't know where that fine line between concern and coercion exists. Fecals are not a new recommended basic standard of care, they are only new to us discussing them. In the near future veterinarians will be required to have you sign a waiver of liability if you decline them. The healthcare standards will become reality as the lawyers and medical boards provide us with tighter and tighter oversight. This is the world we live in. I never judge a persons commitment to their pet, and love for their pet by the amount  of money they have or spend on them.

I sincerely appreciate your honesty and I do appreciate that you were open about it. If we aren't open and honest we can't ever be true to who we are and what value other people have in our lives. So I am glad you didn't just say that you were moving on..those little white lies have a way of finding you again..

Being a vet is being a part of a team..and you have to be comfortable with your team, so I wish you well.

Sincerely,
Krista"

Mallard the chihuahua puppy.

So, what kind of vet are you? OR, What kind of vet would you want to be?

How would you describe yourself?

And, how do you think that your clients would describe you?

And, would you talk to an exiting client?

Are you leaving your fate to perception, and how do you insure that that perception is what you intend it to be? Or, are you the ostrich with your head in the sand?

Related articles:
Paw and Order, Limiting Legal Liability, by James Wilson, DVM, JD.

If you have questions or comments on this blog you can find me in the clinic, Jarrettsville Vet, on Twitter @FreePetAdvice, or on Pawbly.com, where I am still fighting the battle between caring about other peoples pets in spite of the slow monotonous whittling down of my spirit steering me towards indifference, still talking to people, and still trying to save the world one wet nose at a time.

Thomas, the receptionists kitten.
A world class purring machine!

Who am I kidding? I couldn't go a day without my pets, and the best part of my job; everyone else's! If I am at the clinic you can bet that I am snuggling some pet somewhere. So be warned, if you arrive with a pet that will let me hug them I will be taking selfie's with them...

Suggestions For The Cash Growing On Your Trees.

These two lucky kittens walked from the negligent cat breeding farm across the road
into the arms of this savior.
Hard as she tries to convince her neighbors to care about their cats,
they don't, so she takes up the lifelong responsibility.

There are millions of ways and billions of dollars spent on the sheer adoration and healthcare of our pets. As a veterinarian I take great delight in seeing the pet costumes of Halloween, the parkas of winter, the slickers of April showers, and the year round blinged out leashes, collars, scarves, booties, and yes, it has even crept into our clinic (we now use only decorated Vetrap). But when I read the latest memorial offer I wanted to scream.

Coming soon you can send your pets remains into space.

What the hell? What purpose does this serve? I swear I can't even begin to understand.

Dead is dead. No going back, no do over, no bucket list items to cross off  after that last minute. Kaput.

So why would anyone spend $995 to send their pets remains into orbit?

If you have so much cash burning in your pocket that you think this is a great idea give me a call. I would be happy to introduce you to a few of my clients who struggle day in and day out to keep their pets fed, (usually at the expense of themselves), or keep them warm, even when they lack the funds to pay for heat, or watch their cat companions die of something as simple as fleas.

This last week I donated my time, my surgical skills and the clinics resources to save about a dozen pets. These included the weekly parade of unappreciated cats, Charlie, Eve, and Poe, (their stories to follow).

For more information on this service please visit; BigStory.AP.org
For more information on Celestis Pets please visit here.

For more information on the local rescues who support pets in need please see;
No Kill Harford
Animal Rescue Inc
Jarrettsville Veterinary Center Donation Fund

This summer Jarrettsville Vet is sponsoring the spaying and neutering of one of our long time clients, very good friends, and devoted cat clients. We estimate that we will spay and neuter about 40 cats. We do this with the generous donations of our staff, corporate sponsor Zoetis and community volunteers who trap and transport these cats.

Coot one of our resident cats stands watch over the feral kitties.

Zoetis has donated Revolution to treat the fleas, ear mites and intestinal worms that these feral cats struggle with. Many BIG! BIG! thanks to them. (Revolution is my first choice for outdoor cats).

Thank You Zoetis for your help!

The other pets in need that Jarrettsville Vet met this week are;

Charlie, Taking A Stand And Facing The Consequences blog

Eve's post-op pyometra smile.

Poe, deathly ill due to his second obstruction (in 3 weeks).

All of these cases were special exceptions and all would have likely died had they not found us. If you would like to help in their care you can send your $995 to the Jarrettsville Vet Donation Fund and we will help a dying animal live.

Thanks,

If you need me outside of Jarrettsville Vet please send me question at Pawbly.com.

Beagle Freedom Project. Minnesota Saves Lab Dogs.

Our gang.
Jekyll, Cora (vacationing with us for the week), and Charlie.

Few of us escaped the journey of childhood without a few close calls from the boogieman/monster that lurked patiently under our bed waiting for us to close our eyes before they would stealthily slither up to consume us by muffling out our cries, suffocating us, and then swallowing us whole. We had good reason to worry, these fellas were ominous and omnipotent.

A few decades of sleepless nights later our haunting's morph into real life worries. Those real-life experiences that shape our idea's of frightening and cause us to shy away from things like roller coasters, sky diving, and bungee jumping. My real-life adult haunting's all oddly involve those places I know exist, feel helpless against and chew away at my sense of injustice.

Jekyll's morning ritual.
A little wiggle dance to get the day started.

There is no shortage of horror stories in this world we live in. You don't have to look any further than the newspaper, the news, or the internet, all crying out with obvious injustices, immoralities, and atrocities. But few things seem to change even as the public spotlight gains more exposure to places once shrouded in secrecy due to distance and denial.

The greatest haunting of my four years at vet school were the cinder blocked windowless impenetrable locked steel door buildings hidden in the very outskirts of campus. Save for the endless puling barks you would think they were simply warehouses for farm equipment. But the volume and spectacular range of voices gave the great number of inhabitants away. They were beagle houses. They were my modern Auschwitz.

The vet school beagles were a sporadic visitor to the student side of the vet school. They were always clean, always in good body condition, and always shyly hopeful to have a gentle hand. They loved attention and when they saw us they were showered with it. For us they were a fleeting reminder of what we were there for. We were there because we were still 10  year old's at heart who understood that these were our calling and our purpose. Some of the beagles were housed near the anatomy lab section. We were allowed to take them out for lunch break in the small double fenced wire enclosure. I spent almost every lunch of my freshman year with them. They were my therapy, my refueling, and my daily reminder that I had good reason to keep my nose in the books.

There were faculty who justified these studies based on research to benefit others. But to every person who took a moment to look into those beagles eyes I would ask, "Isn't there a piece of you that sees this as sad, cruel, and bothersome? Could you truthfully and honestly explain this life to your four year old and not feel that these dogs deserve better?"

Keeping guard at the front door.

There was a poster that hung beside the staff break room of a beautiful "Best In Show" worthy beagle. It read "Our beagles are the finest quality. Obedient, quiet, compliant." It was a poster from a company that sells beagles in bulk for research.

That poster still haunts me. It haunts me because those places still exist. We still breed animals to live appalling lives. It is one of the reasons I will always have a rescue beagle. I will spend my whole life saving beagles who would otherwise have little chance of survival, and for every one I do I will spend every living day making it up to the brethren left behind. My small protest and penance.

You can add your own caption..

I am grateful to the vet school for providing me with a first rate veterinary education but there were pets there who suffered, who assisted unwillingly with research and no one talked about it. It was kept quiet to protect research grants. This practice will end someday. It will end because humanity can do better and will refuse to accept otherwise.

Letting dinner settle in the belly.

The Beagle Freedom Project had another victory in helping research pets in the state of Minnesota. In Minnesota any dog used in state funded experiments must now be put up for adoption instead of euthanized. The numbers in the US are staggering. Nearly 65,000 dogs a year are used for research and close to 96% are beagles. To find out more about the Beagle Freedom Project please go to their website here or Facebook page. And please also join me in using their app so that you can put your dollars where your heart is and refrain from buying products that are still tested on dogs.

Update; February 2016. Open letter to beagle breeding facilities and labs;

Jekyll says "Thanks!"

Jekyll loves his dad.

If you are a pet lover I would like to invite you to come visit a whole bunch of other pet fanatics at Pawbly.com. We are dedicated to helping pets the whole wide world over by providing a free credible place to meet and exchange pet information, support, guidance, and friendship. Pawbly is free to use and open to anyone who cares about animals. You can ask a question, create or follow a topic, and share your pets photos, stories, and experiences.

You can also find me on Twitter @FreePetAdvice, or in the clinic Jarrettsville Vet. Stop in and say "Hello," or just visit Jekyll beagle. He's always there with me, and always eager to meet a new friend.

Freedom Beagle Project Media Report about Minnesota lab dogs law here.

Related Blogs;
Jekyll Arrives

Taking A Stand And Facing Consequences.

How many veterinarians work at a hospital that give them the latitude to express their own voice?

A place where they can stand up and say "NO!," when they don't feel right about what they are being asked to do?

I often wonder this?

The biggest reason that I decided I needed to own my own clinic after I graduated veterinary school was that I knew I would have some hard cases that required a decision to be made between the business and the patient. I did not enter veterinary medicine to get rich. Not that some can't but there are compromises every wealthy person makes. Some spend less time with their family in an effort to make a living, or sacrifice personal time to develop stronger business practices, and some sacrifice the reason they went into veterinary school. History and revenue sheets all indicate that to be successful in the veterinary business world you must treat the business like a business. You charge for what you do, you do what the customer asks, and you don't get emotionally or personally involved. Almost all successful big veterinary practices have established protocols, business plans, and spread sheets to maximize their revenues. It is exceptionally difficult to run a person to person to patient business based on a spread sheet. The intimacy gets lost in the numbers. There is lost revenue in time spent with clients talking, and there are muddy treacherous waters in having your own opinion and your own barriers. Then, should you still decide to side with the pet and stand in opposition to the owner there is the whole big messy ball of wax about what the hell to do with a pet that the owners no longer want? This is the place where associates get crucified. This is the place that your heart gets broken, your soul gets sacrificed, and the burn out and fatigue gnaw on you until you either break or become indifferent.

I have had to learn that my ability to care for other peoples pets is a tenuous complicated road of where my beliefs stand and, often, the great divide, of others. I have to remind myself every single day that I am the vet who worked a lifetime to be a healer and not anything else.

It is never an easy answer; the reasons that people make the decisions that they do about their pets, especially when it relates to end of life decisions.

Veterinarians are asked every day to be the person who will;

• end a life due to financial constraints
• end a life due to necessity
• end a life due to lack of perceived value
• end a life due to many reasons that are beyond my ability to justify..like moving, death, unmanageable medical needs, lifestyle changes, and such.

Last night was a repeat of a situation I find myself in every so often. Hard as I try to avoid it, it still happens.

I have told the staff repeatedly that we do not take appointment requests for new clients seeking to euthanize their pet. All requests should be booked as an 'examination'. IF the veterinarian examines the patient AND agrees that the condition warrants euthanasia the pet will be humanely euthanized. IF NOT, the client has been notified that the request must be consensual and cannot be expected. There are those who disagree with this position. I remind those veterinarians that there is a divide between the law and the beliefs of our desired clientele. Not one single small animal vet desires to work for clients who regards their pet as simply 'property'. If we did our average client transaction would never pay our mortgages. Don't ask for one, "patients = property and therefore protect against liability", and hope for the other, "client spends thousands to treat life threatening disease." We market our goods and services, encourage diagnostics, allow walk-ins, emergencies, provide surgical treatments always in excess of "replacement value" and then euthanize at whim. It is a contradictory incongruous hypocritical business model. 

And so I arrived at the exam room paperwork in hand for tonight's euthanasia. The clients had never been to see us before, I did not know this case, and I had no history to accompany the file. And there stood before me a happy, bright, inquisitive, young dog. If he was sick someone had forgotten to tell him. He had an obvious limp but he was happy to be here and anxiously awaiting a "Hello" from me. The night froze and I knew the story was about to get sticky. 

I am not sure how many vets would have stopped their incredibly busy night to talk to this couple? but I spent the next 30 minutes talking and trying to understand to their story, their concerns, and what my role in helping this pet was? In the end I stood between a husband who was unwilling to spend any more money on a case that he believed was not treatable, a wife who loved her dog desperately, and a dog who was happy, maybe not perfect, maybe not going to live another half decade, but today, at this moment happy and functional.

In this appointment debacle the husband and wife were at odds about what to do. The husband wanted to let the pet go. The wife stood quietly sobbing. The dog was running around the room wagging, jumping, playing, and soo happy to be round new people. And there I was thinking that I should have gone to floral design school. How do I pick a side on this one? It was a perfect example of the worst cases to be a part of. Where the hell do I go? What do I do? Who loses here? 

I had to walk away and get out of the room for 15 minutes to think about what I was about to do.

I found my associate and asked her. Her words of encouragement and advice put the wind back in my sails. "Screw them! Say NO! and get rid of them!" Now, I didn't go back and use this language, but damn it felt good to hear it! I needed her support and I knew then that my guts decision to refuse was the right one. 

This is the point where judgments are made. This was the point where I knew I was about to enter a landmine of emotions and risk my neck for a dog I didn't know. This is where the sick feeling in my soul reminds me that I better have a backup plan because the Board of Veterinary Medicine was going to get another letter with my name on it. This is where I had to decide if I could really stand behind my words, my thoughts, my beliefs, and my desire to elevate veterinary medicine to the place my clients believe it exists.

I refused to euthanize that dog. I offered every single option imaginable. If I am going to duck out of what my client wants I better be able to offer assistance to that pet and the only way that pet is going to get assistance is with some options. It is the luxury of my position, my lack of debt, and my compromise to sleeping at night with a clear conscious. When the husband told me that he preferred the dog dead versus in someone else's home I knew this was an examination and euthanasia to absolve myself of. How could dead be better than elsewhere? 

As the appointment ended I made one last desperate move. I secretly handed the wife my cell phone number. 

For those of us who live a life as a female I know that husbands often dictate the financial decisions. I know that there are millenia of women told to keep quiet while the husband decides where resources can be spent. I hear it every day. The women love and adore a pet that the husband does not. I know this sounds terribly sexist, generally broad sweeping and that there are some men who love their pets as much as any woman does. But in 10 years of practice here is what I have seen: In general men make financial decisions over emotional decisions (perhaps the reason of my clinics financial back seat?). Whereas women live by a more maternal guidance. We are programmed to nurture and men are more pragmatic. An expense is calculated and assigned a priority. Your pet doesn't drive you to work, pay the rent, or keep food on the table. BUT a pet is the center of many a woman's heart. I would give up a car, a trip, an expensive meal for the companionship and unconditional love of my pet. I cannot take every pet, and I cannot work pro bono consistently, but every time I have offered to help I knew it was the right decision for me. I would regret making a different choice. 

I often torture myself over the afterward.. What will happen? Where will that pet end up? To try to alleviate this I offer those clients lots of options. I keep talking even after I refuse to help them with their request. 

• "You can take your pet elsewhere if you are still electing to euthanize." I understand there will likely be a backlash from other vets about this. 
• "You can find or look for financial assistance through private companies. Like a credit card, bank, etc."
• "I can ask for help from my network of rescues, friends, etc."
• "We find some way to compromise to get your pet care." I think and behave outside of the box. I find a way to build a bridge between caring for their pet and avoiding shouldering the entire responsibility of a pet. In some cases the clinic will take responsibility for the care of a pet and then assist in finding that pet a new home. These cases remind my staff that there is a heart here. Our primary mission is to help pets AND people. We do not sacrifice one for the other.

Clearly, I understand that people have different feelings about their pets. Clearly, there are very few veterinarians in the world who do not understand that pets have moved into peoples homes and hearts and that this is very unlikely to change. But, there is still a great divide on who a veterinarian is at the seat of their soul and the tasks that they are asked to participate in.

I know that there are many veterinarians out there who are told to do as the client asks. If the client pays the veterinarian participates. If the client cannot pay the patient is left to...?? 

There is no doubt that compassion fatigue exists, that there is an over represented number of suicides in our profession, but there is a reason for these. A deep cumulative reason. A small incessant chipping away of the soul of the people we wanted to be, thought we were, and make excuses as to why we have become who we are. 

Our clients know who we are. They know where we stand, where our obligation lies and they support us. The days of clients asking and expecting services that are inconsistent with our mission are few. The clients that remain are our foundation, our support, and our cheering squad.

If, at this point in time veterinarians do not embrace that segment of society who loves and treats their pets as children we will lose our ability to be the provide both exemplary care and care with purpose. 

Update;

Two days later the wife called me. We scheduled a treatment plan for her dog. I will help her with costs, use some of our donation fund for him, and hope that we can find him a palliative care. Shoot, I am hoping for a miracle, and who knows? Sometimes there is salvation in trying.

A week later Charlie had surgery.. The end to his story can be found here.

Related blogs;

Compassion Fatigue

How Many Sides Does Your Equation Have?

When Trying Is All That Matters.

The Cat And The Line In The Sand.

If you have a pet question you can find me on Pawbly.com. Pawbly is free for everyone and created to help people find answers to their pet concerns. We are a platform full of dedicated caring people. 

You can also find me Twitter @FreePetAdvice. Or at the clinic, Jarrettsville Vet, where I get to hug, kiss, and enjoy the 99% of the wonderful things that being a veterinarian brings. 

Clones, Cat Nappers, and Cadavers

My muse, Wren.

There is not another human being on the planet that loves their pets more than I do, (OK, there might be a few of you out there, but you understand me)..add to that that I don't have any children other than my four cats, two dogs, and pet potbellied pig, and my pet-fanaticism is over the normal socially acceptable limit. (Yes, I do have a "crazy cat lady" coffee cup that I use proudly). I identify with the labels, I embrace the snickering, and there is nothing anyone can say or do to shame me into hiding it!

Oriole. In charge.

If I had to pick sides I would say that for as long as my feet are planted on this earth and my lungs draw breath I will have a cat beside me. They were my first pet and they will be my last.

Playing with Wren.

Because of my devotion to my kitties I read the latest press release from the University Of Georgia's Veterinary School about their second kidney transplant with great interest and contemplation.The University of Georgia continues to forge a path into the relatively new field of companion animal organ transplants. They  are now incorporating the use of stem cells to help the recipients body from rejecting the new kidney. This surgery was different from previous feline kidney transplants because it incorporated the pioneering approach of using harvested stem cells to help the recipient,  Arthur, the most recent kidney transplant patient, is a four year old Siamese cat who was dying of kidney failure. He had been diagnosed at age 3 and his only chance for long term survival was to find a donor and receive a new kidney via transplant. Stem cells were used because his body had not responded well to the more traditional anti-rejection medications used to help a donor accept a new organ. Arthur had been turned down for the surgery at two other teaching hospitals because of this. Without the use of stem cells Arthur would not have been a candidate for the surgery and he would have died from his kidney disease.

There are a few areas of Arthur's story that I find incredibly compelling and warranting further discussion.

First is the concept of organ transplant for pets. Next to cloning there isn't anything left that proves our affinity for our pets. Extending their lives with human equivalent medical and surgical options is a testament to our desire and ability to keep our pets with us for as long as possible.

The question has shifted from the impossible to obtain the service to the ethical of who is eligible?

This is how I watch tv every night;
Sharing the couch with a relaxed Magpie.

How close do our human medical and surgical options mirror our pets options? The line gets blurry and seems that the options are only now limited by our wallets.

Of comfort to my moral conscious is the fact that all kidney transplant donors are shelter cats. Those cats need to meet certain criteria to be donor eligible, but they must also be adopted into the family whose cat is receiving the kidney and remain a lifelong pet. The prince and the pauper are expected to be on equal footing after they share a kidney of the same origin.

Is every cat kidney transplant worthy? Yes, of course in my eyes. Every cat is capable of eliciting and demonstrating as much affection, improving the quality of their owners and families lives, and for that there is no dollar amount to prove a pet's worth and value.

Do I think that the majority of the public scoffs at the idea that I share my home with 4 cats who are given access to as much of my home as every other human inhabitant is? Yes.

Do I think that many people  lack the ability to understand why I am so crazy about my cats? Yes.

And, do I think that I would transplant an organ from one cat that I do not know, but would inevitably love as much as my others, to one of my resident kids? Well, yes, perhaps I would. I see my pets as my kids and it is my job and my responsibility to care for, protect, and provide what they need to live a happy healthy life.

Jitterbug, in a rare frozen pose state.

Here is where I hear my internal voice quibbling.

Where is my line?

Where is that point where I say this is too much? Having had a dog who underwent radiation therapy for a tumor that extended his life 6 months at considerable cost, I believe I would do that again. And for all of the difficulty Savannah's last year was, I would happily do that again. My dear old kitties had wonderful lives, even though saying goodbye was so terribly hard. For me, maybe there is truth in the knowing what the sadness for without that I would not know what the joy is. And for all of the many many pets whose lives I have been a part of, each pet and each story, whether they be long and thriving, or short and tragic there is always another chapter and often a sense of being a small part of a greater force in a mysterious universe.

Let me try to explain this.

Let's start with an easier topic to debate; Cloning. I have written about this before.

At some point there needs to be a long thought out discussion on not what is possible, but what is ethical.

Life isn't about cheating and stealing a way to live forever. Life is about learning to live and enjoy this time that you have. Don't wait until you are dying to realize that life was a precious gift. You get one shot, you know the old saying "life isn't a dress rehearsal," and the advice about doing the things on your bucket list now..well, there's truth in those words of wisdom.

Veterinarians know all to well that life is not fair. We watch puppies die of treatable and even avoidable disease and illness, (often because of just pure neglect and  poorly educated parents). We see 2 year olds die of cancer. Cats die from fleas, lack of resources, or just because they serve no perceived purpose to their owner. Many vets are asked, and required to euthanize routinely.

Cloning doesn't get you your pet back. It gets you a close representation of them. Your loss still needs to be addressed like everyone else's. Losing a pet that you love is really, really hard. But the memories are yours forever, and the difference that you made in taking care of them changes the world in which you live in, forever. Getting through grief is possible, and loving another pet is also possible. They will bring new joy to your life if you can open your heart and let them.

For as hard as it was to lose my dear cat DC and my Savannah, and all of the rest of them, I have a new set of rescues who are happily living a life of pampering and bliss in our home. I miss my departed pets, as I miss my departed friends. But I wouldn't ask to go back and re-incarnate them into the shell of what they used to be. What I miss is the spirit and the soul of who they were, that never can be replicated, duplicated, or re-born. That is the gift of life.

Life isn't fair, but it does go on.

My days at the clinic always include cat naps.

Find Arthur's Story Here.

Find more information on the University of Georgia's transplant program here.

For more information on stem cell use, research, and future use in medicine please see, Huffington Post here.

Or, See Pet Health Gazette and Jana Rade's blog here.

Previous blogs relating to this one;
Charlie Arrives
Pete The Vet, Blog On Cloning.
Savannah's Saga
How Many Sides Does Your Equation Have?

If you have a question about anything pet related you can ask a whole community of pet loving and dedicated professionals on Pawbly.com. Pawbly is free to use and open to everyone who loves pets.

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

Gassy Pets. What To Do With Those Dogs That Blast You Out Of The Living Room?

My two puppies,,,and Jitterbug, the cat, who thinks he's a dog.
Can you guess which has the gas problem?

I get some great questions on Pawbly. They run the gamut from life-threatening, to which I simply answer; "Get off the computer and get to the ER now!" to the funny and fairly common pet stuff, like today's from Elizabeth; "What can I do for an 8 month old puppy with terrible, smelly gas?"

All of us suffer from this from time to time, and pets are no exception. We all have the same biology so we share many of the same conditions.

A gassy dog is especially difficult when they sleep in your bed,,
but it does give you a convenient excuse.

Here is my answer;

Hello,
Gas, or flatulence, occurs for a few reasons. It is a normal part of digesting and processing food, so it will be impossible to stop all of it.

BUT, It can also be associated with poor diet, poor ability to digest food, and intestinal problems like worms, etc. so talk to all of these with your vet before dismissing  it as a normal puppy thing.

The more plant based your diet is the more likely you are to suffer from gas. The gas is a by-product of the guts bacteria breaking down the food we eat so that it can be converted into energy. Foods like beans, legumes, etc. are notorious for making us gassy, but they are excellent sources of protein and fuel for our body. Add to this that puppies have an incredibly efficient and over active metabolism (especially those large and giant breeds) and you can get a gassy puppy.

So, if we can't avoid farting puppies what can you do to minimize it? Well, you can see if a different diet will be easier on the digestive system? Some diets that are lower in fiber and filler can reduce the gas, BUT, I am always far more concerned that you stay on a very good, veterinary recommended, age and breed appropriate food. Ask your vet for their recommendations and then you can do your own in home food trial to see which food(s) might be easiest on his system. BUT, remember that each diet change should be done slowly and gradually (over a week or more) and then do a few weeks on the new food while you collect your data/observations.

I have a Great Dane patient who at 4 years old had recurrent bouts of bloat and terrible burping problems, so he is on a daily gas reducer..but I would never recommend a long term medication until the easier and safer to change stuff was eliminated.

I hope this helps,

Let me know if anything works, or if you identify what he is sensitive to.

Sincerely,
Krista Magnifico, DVM

The fumigator in our house is Charlie, on the right.
Why? Because he is a poop eater, and that gives him gas.
I know, so gross.

Dr. Chambreau is a holistic veterinarian who contributes many answers to Pawbly and offers a fresh perspective to the traditional veterinary protocols and treatment options. To read more about her please visit her here, or on Pawbly.

Here is Dr. Chambreau's answer:

Could you tell me what you are feeding, what supplements you give and how long the gas has been going on?  How are his/her stools - firm, soft?  When does the gas occur - anytime, or only after meals? If the stools are soft it would be good to have the stool checked for parasites by your local veterinarian.

The quick and easy answer is to begin using probiotics. My favorite is Mitomax, a super probiotic. I have had many animals' smelly gas clear up while using this, though sometimes they need to stay on it. Unlike other probiotics, it is very stable and is ok at the low stomach pH.There is an icon on my home page for it (www.MyHealthyAnimals.com). You could also get other pet probiotics if near a pet health store. (by the way, if you put in your city, we can be more specific in our answers)

The longer answer is to generally improve health. There are 7 keys that can help you do this, with a link on my home page.

Please let me know a little more and if you have questions about the holistic approach (7 keys to health). 

So, you see there is a wealth of information and interesting pet things to learn at Pawbly.com. Please stop in and say hello, ask a question, or even add some information of your own! Pawbly is all about helping people take better care of their pets.

If you want to see me in person, you can find me at the clinic, Jarrettsville Vet, or on Twitter @FreePetAdvice.

Top Ten Pet Wive's Tales

Madeline and I take a little work break.

If there is a trade that has been around since the dawn of time we adopt and accept a few of the old wive's tales as gospel and continue to use them as a foundation for making decisions for generations to come. Sadly, almost all of the most common wives tales have no basis as fact, and worse, almost all of them are completely wrong.

I seem to have a client a day who sites them as a reference for their medical knowledge, diagnosis, assumption of disease, lack of disease, reason for waiting to get help, etc. etc. Those wive's tales always seem to do much more harm than help, and always at the pets expense.

So, I decided that it's time to start dispelling those old wive's tales for good!

Here are my TOP TEN VETERINARY MEDICINE WIVE'S TALES. 

NUMBER 1. "A dog licks it's wounds to clean the infection."
OK, before the advent of modern medicine when we all lived in our own sewer this might have had a shred of efficacy to it. But with the invention of soap this became a true wives tale. Your mouth, your dogs mouth, every ones mouth, is full of bacteria. That's why a dog bite on your arm will cause infection. Saliva is not an antibiotic. Soap and water are. And just because we are on the topic of cleaning a wound, I will add my 2 cents on hydrogen peroxide. Hydrogen peroxide is best when used only on a "dirty" wound. A dirty wound is one where there are pieces of dirt embedded in your wound, like when you fall off of your bike and skin your knee in the dirt/asphalt. Think of the bubbles in hydrogen peroxide as those scrubbing bubbles in the toilet bowl cleaner commercials. After your wound is clean you need an antibiotic or soap. Don't use hydrogen peroxide after you have gotten the wound clean because those same bubbles are killers to your newly forming cells that are trying to heal your wound. Using hydrogen peroxide after the wound is clean will delay healing.

Most of the dogs that I see who are cleaning their own wounds, are self traumatizing them to the point of causing more damage than they would have if they could just leave the wound alone. Think of it as a scab that you keep picking. Your wound will never heal if you don't let it scab over and heal. And think of your tongue as a wet bath towel you have left on the floor for weeks. Yuck and Yuck.

If your pet has a wound it should to be cleaned by flushing copious amounts of water and soap to clean out any dirt, debris, and bacteria. After the wound is clean and dry we usually place protect bandages and antibiotics over the wound. There are exceptions to this! So if your pets wound is deep, and/or extensive you need to see your vet. Many deep wounds should be closed surgically after they are explored for pockets and deeper tissue damage. We also usually start oral antibiotics and a put an e-collar on. An e-collar will keep your pet from licking their wound and/or removing their bandage.

Many people are very reluctant to use an e-collar. But I really think that they are the only effective means of keeping your pet from causing any more damage to their wound then they already have. Also please know that there are many types of e-collars available. So if your pet isn't tolerating the one you have been given there are some other options. I really like the Jor-Vet soft e-collar. It is easy to clean, easy to sleep in, and goes out 90 degrees from the neck so dogs don't feel so claustrophobic with them.

NUMBER 2. Letting your dog have a litter to improve their emotional health. 
Your dog doesn't need to have a litter  for any reason, and the likelihood of things like mammary tumors (breast cancer) is almost 0% if you spay before their first heat cycle. They run the risk of unwanted, unplanned pregnancies, or uterine infections. These can be life-threatening, expensive, and cause emotional and financial hardship. The thought that female dogs need to have a litter or experience motherhood is silly. You are responsible for your dog, their mental health and their offspring. Providing a safe place full of love and exercise is what your pet needs mentally. See Coco's story.

NUMBER 3. "A mother bird won't take care of her babies if you touch them or the nest."
If you find a baby bird and you know which nest they belong in, you can put them back. But maybe the baby is out of the nest because it is learning to fly, in which case it will just plummet out of its nest again. A mother bird does a better job at raising their babies than you or I do so leave the baby alone and let it's mom resume her duties. In just about all cases she is watching you eyeing up her baby, she just thinks that you are too big to fight. (Oh, last thing to mention. Keep your inquisitive predatory pets in the house while the babies are learning how to fly).

NUMBER 4. "A dog won't lift its leg if you neuter him before 6 months old."
OK, lets differentiate between peeing (urinating), marking (territorial), and lifting a leg. Some dogs pee on four legs, some pee on 3 legs, regardless when they were neutered. But a dog that is allowed to become sexually mature will usually "mark their territory" by placing a small amount of urine as high as they can on a vertical surface. This might be a tree, a shrub, or your couch arm. Once a dog starts marking they may not stop even if you do neuter them. We recommend neutering at 6 months old so that your dog doesn't start marking your property because he thinks it is his.

This is my five year old mix, who usually pees on all fours, but will "mark" should the mood strike him.
He was neutered at 6 months old.

This is my other pup, Jekyll.
He was also neutered at 6 months old.
He usually pees on three legs, but rarely urinates to mark anything.

NUMBER 5. A wet cold nose is a sign that your  pet is adequately hydrated and doesn't have a fever, OR, a dry warm nose is a sign of a fever, OR, a pet that feels warm has a fever.
The only way to know if a pet has a fever is to take their temperature. A digital rectal thermometer should be used with proper lubrication and inserted deep enough to get an accurate internal temp. Dogs and cats have a normal resting temperature of about 100-102 degrees. The rest of your pet is just what it feels like at the time. How often are your feet warm, your hands cold and your temperature is still normal? Your pets nose can change from warm to cool, moist to dry, and any variation in between based on humidity, temperature, activity, metabolism, etc.. If your pet feels warm take a temperature, or make a visit to your vet.

Madeline's nose in our selfie.

NUMBER 6. Garlic and onions can be used to treat fleas, ticks, and heartworms. 
Ugh, these are not safe nor effective options. I have seen pets almost die from these. There are many affordable and safe options available, just ask your vet. And please, please, don't use garlic, onions, or any other crazy thing that you read might ward off parasites. (I once had a client soak his kitten in fuel oil..it almost killed the kitten. It was horrible and heartbreaking). See Top Ten Kitchen Toxins here.

NUMBER 7. One year of life for a dog/cat year is equivalent to seven human years.
Cat's can live to their late teens. All of my last generation of cats lived to see 18-20 years old. In fact I just read about a 32 year old kitty. Small breed dogs can also live to see their 16 or 17th birthday. Giant breed dogs live to about 7 to 8 years old. So, you see there isn't a linear conversion equation.

Taking care of your older dog. Savannah's story.

NUMBER 8. Dogs with black tongues are dangerous. 
Sounds a little bit like profiling based on color, or prejudiced opinion. Certainly dogs of all breeds have a few consistent traits, like Golden Retrievers tend to be silly and happy, Labs outgoing and playful, Jack Russell's driven and determined, and Chow Chows often have a black tongue. Every single dog has the capability of inflicting harm, and every pet should assessed independently by a person who can understand the subtle clues a pet gives. If you approach a pet always ask the parent if the pet is able to be touched or approached. Or be respectful and give a safe distance. Don't assume a pink tongue is a friend, nor is a black one dangerous.

This is Bismark, who would take great offense to being told that he was dangerous.
He is indeed a fine well-behaved sweet boy.

NUMBER 9. Dogs scoot their butts because they have worms.
Dogs that scoot usually have either anal sacs that are full, distended, impacted or infected. If the anal sacs are normal then check for itchy skin. For more information on anal sacs please see The Scoot Story.

NUMBER 10. Feeding soup bones helps keep teeth clean. 
Feeding, watering, adding, etc..all of those advertisements for products that promise to keep your pets teeth clean are full of malarkey. Your pets teeth will only stay clean if you brush them. A few minutes daily will help protect your pets mouth from dental disease, bad breath, dental infection, a painful mouth, difficulty eating, and even heart disease. Offering dry soup bones can lead to broken teeth (which should be extracted if the pulp is exposed) bone shards causing gastrointestinal upset, obstruction and sepsis. I know that no one wants to hear it, but the only safe and effective way to keep your pets mouth and teeth clean and healthy is the same way you keep your own, brush daily.

Lower canine is worn and fractured due to chewing.

OK, there are more out there, toss them to me. Let's see if we can think of any that might have one shred of credibility.

If you have a wive's tale to share please tell me!

If you have a pet question you can find me anytime at Pawbly.com. Pawbly is the place for all things pet! Pawbly is a community driven pet focused social media platform. It is free to use and everyone is welcome.

You can also find me on Twitter @FreePetAdvice, or on the Jarrettsville Vet Facebook page.