Thursday, March 29, 2012

Doctor Old School

Dear Dr. Old School,

I have seen cases of yours before, so I guess I should have been prepared for the experience of working in your clinic. The first thing I noted was that there were no computers. At all. Not even for the books. This is the 21st century. How can you not have a computer that at least manages your books? Does your accountant hate you?

And though handwritten notes are still common, writing records on 5 x 7 note cards is a little 1970's. And one line per visit does not help me out. When Fluffy got here for shots and I looked back to see what shots Fluffy had, all it said was "vaccines." That doesn't help me. It also doesn't help your patients.

Further more, leaving the vaccinations (which are supposed to be kept refrigerated) on the counter all day is a good practice builder: when all of those puppies come down with parvo, you will get paid to treat them. And why is the staff telling me that I am supposed to use a steroid rather than the sterile diluent to mix the vaccines? Do you really do that shit? Seriously? How have you not been sued yet?

The 10 AM kitty "allergy shot" did not get a shot from me. Why you ask? Because you have given her a long acting steroid shot (one that lasts 4-6 weeks) once a week for the last month. And frankly, she looks a little cushingoid at this point. And judging from the clear foul smelling urine, I am thinking that she might be a diabetic with a urinary tract infection as well. At least the owner is pretty adamant that she is not paying for "any of those newfangled tests." Awesome. I am trying to save her cats life and not throw you under the bus and I am the bad guy.

When 2 PM rolled around, and a dachshund in full status epilepticus was rushed in, your staff had no idea where the valium was located. I think I almost had a sympathetic seizure when they told me that. Even more fun is that the staff does not know how to use the x-ray machine. Seriously? You do that yourself? Well, I guess I could try to use your technique chart to coax a decent picture out of it? What, no technique chart? Oh, well I guess it doesn't matter because I don't know how to use the dip tanks to develop the radiograph anyway. The first clinic I worked at in 1995 even had a machine that developed them.

At the end of the day, when it was time to get paid, I was happy to receive cash. That way there is no official record of me being here, besides my scribbled signature on those antiquated records. You are a super nice guy and I always enjoy talking to you, but your clinic is a mess. You are one board complaint away from being fined out the yin yang and possibly handed a reason to retire. I have no idea how you pass inspection each year. You don't have to have expensive toys to be a great vet, but you do need to keep decent records and practice good medicine.

Mixing steroids with a vaccine.... When I saw that, I knew I had to blog that shit. I might be worried about you reading it, but since you have no computer, I am not too worried.

Saturday, March 24, 2012

Requiem for Gryffin (guest post)

One of our readers, a colleague, submits this essay at a time of great personal loss, remarking that perhaps clients need to recognize that we have these feelings, too.


He heard the voice as from a distance. It was the voice he heard every day, the voice of the one who scratched under his chin and behind his ears. The voice who controlled that damn red dot that somehow always vanished just when he was about to catch it. The voice who fed the yummy mushy food, and, when he used That Look, dispensed the tasty tuna treats.
The voice was soothing, and choked with emotion. He could feel the hand stroking his head and chin. He purred, enjoying the touch.
It wasn’t that he was in pain. He just ached all over. He was so tired all the time now, and so very thirsty. He couldn’t seem to get enough to drink. Sometimes he almost fell asleep while drinking. And today he just could not get out of bed.
The tiredness began to overwhelm him. He purred once more (he knew it made the voice happy), then took a deep breath and closed his eyes...

When he opened his eyes again,  something was…different. He felt different. He stretched an experimental paw out, and realized there was no ache. He reached out with the other leg and reveled in the sensation. No aches, no kinks or creaks or pops. He leaned forward and stretched his back and hind legs. They felt loosed than they had in ages.
He sat down and took another deep breath. The air smelled clean. Pure. And  a little… ‘nippy? His nose twitched. He moved his head as he breathed in the scent, homing in on the source. He stood and paced over to a small garden. He nosed through several less interesting plants (making mental note to come back later and investigate them) until he found the Catnip. He inhaled the sweet smell, letting it tickle the inside of his nose. Then he chomped hard on a leaf, the flavor exploding on his taste buds and swirling within his senses.
He came to a while later. He looked down to find himself sprawled on the grass next to the garden, a handy sunbeam warming his fur. He rose and shook himself, then settled back into the sunbeam to wash. He hated feeling dirty.
Once finished, he chose a direction at random and casually strolled through the grass. A light breeze tickled the fur inside his ears and countered the warmth of the sun overhead. He found a large tree with a cool shady spot underneath. He sniffed the tree, taking note of several scents he hadn’t come across in quite a long time. One of those might even be his brother…
He rubbed against the tree to leave his own message, and then stood tall and stretched his body against the rough bark. His claws dug into the bark, and he delighted in the feel of ripping his nails out, then sinking them back in, then ripping them out again. For several minutes he simply indulged his primal instinct to sharpen, mark, and destroy.
Afterwards, he contemplated the tree. He could easily make the jump to the lower branches, and there might be something interesting up there. He was preparing to leap when a splash nearby sounded. He turned and spied a small pond, ripples spreading across the surface. The tree forgotten, he moved to the side of the water and gazed down.

He could see a small school of fish (FISH!) moving just below the surface. Every now and then, a fish (FISH!) would jump from the water and splash back. He dangled a paw in the water in contemplation, slightly disappointed as the fish darted away. When he removed his paw, the fish returned, and he began to plan his attack. He waited for another jumper, then grabbed at the air. Unfortunately he only caught air. But he refined his calculations and planned for the next jump. That was when the movement caught his eye.
He turned quickly, searching for the source of the darting motion. He saw it – a squirrel (SQUIRREL!) digging near the base of the tree. He immediately crouched low in the grass. If the enemy (SQUIRREL!) hadn’t seen him yet, he had a chance to make the first move. He waited motionless. The squirrel (SQUIRREL!) continued to search the ground for food. He inched forward at a glacial pace. Carefully he calculated the distance he needed for the perfect attack. He neared the ideal spot when… he heard the voice. It was very faint, as if from a very long distance. He turned his head and looked, but saw only the rolling meadow, swaying trees, and ponds dotting the vista. In the far distance he could make out others like himself (he made mental note to investigate later). But no sign of the voice. He almost stood to search, when he felt a gentle breeze, almost like a final touch, caress his head and chin. He closed his eyes and purred once more to the voice.
Then he turned back to his prey. Almost there…

"I've already spent SO MUCH MONEY..." - guest post

Today, a guest post from Emily, who writes:

I have been working in ER/Critical Care for more than 10 years.  And wow, today I read in the news that the owner/trainer of "Uggie" who was in Artist and Water For Elephants was suffering from some mysterious shaking disease and had spent thousands of dollars on trying to figure out what it was, I got a little miffed.  Now you might think that I would be happy that they were spending money on the dog that they earn money off of, but no.  Why does the amount spent have to be at the forefront of the conversation?  Do parents always preface their quest for diagnosis on a illness in a child with a dollar amount that they are spending after insurance?  No, not really!!!!
Does spending money on your pets make the owners saints?  Some owners think so, but really come on people.  Having a pet is a responsibility wether or not the pets are for companionship, breeding, show or other.  It is very frustrating to go into a room and the first words from the client are "I've already spent 200 dollars on Fluffy and I she is not better and I really do not want to spend much more."
Well, had the owner got their pet vaccinated appropriately, you would not be here with the dreaded Parvo virus!!!  Had the owner spayed or neutered their pet they would not be here with ulcerated mammary tumors, or a testicular torsion.  Had the owner properly provided flea, tick and heart worm preventative, they would not be here for flea anemia, immune mediated joint disease or right sided heart enlargement.  Had the owner actually paid for regular grooming, or bathed and brushed their pet regularly, they would not be here for skin laceration from trying to cut matts off their pet.
I have known clients to obtain a second mortgage to pay their vet bills. Their pets were family.  I have had clients call family and friends to collect money to treat appropriately.  It can be done!!!
So, when people brag on how much they have spent on their pets for sympathy or attention, I find it repulsive and insulting.  We are doctors, we studies hard, we love medicine and prefer treating those who do not have a voice!!  Veterinarians are here to provide a voice for the patients.
The owner/trainer of Uggie certainly have it in their budget for pet health insurance as well as most others. It saves in the long run just like it does in people.  Imagine if you had to pay for your annual physical exam and blood work, mammogram or colonoscopy, or any ER visit or UTI or sinus infection.
We are doctors and not taking advantage of people or their pets.  We want to practice excellent medicine and improve quality of life for pets.  It is not amount the money. 
I tend to agree - investing in preventive care up front can save a lot down the road. Too many owners are penny-wise and pound-foolish. But then, that's not a behavior limited to pet-owners. Emily, I feel your pain. I hope the economy turns around and fewer people are put into the position of making healthcare decisions with their wallets.

Wednesday, March 21, 2012


A few days ago, I had the opportunity to ease the passing of a long-time patient of mine. I'd been seeing this dog for >10 years in my practice, and we got along pretty well. In the past six months or so he'd been in a decline, and for multiple reasons his owner chose this past weekend to end it.

These occasions always make me think.

I think about death. What does it mean to die? Is it really true that sometimes, dying is better than living? I think so, but can I really be sure? It just about kills me (no pun intended) that I can't be sure. No one can show me the evidence. I have to take it on faith. I am not a person for whom that comes easily. I don't really believe in faith.

I think about my part in the process. Do I have "the right" to end anyone's life? Is there any person, group of people, or supernatural power that can grant me that right, or am I allowed to grant it to myself? Regardless, I feel a responsibility to end suffering when possible. Sometimes any continued life will mean continued suffering. So.

I think about the impact my patient's death will have on the people in his or her life. The owner. The extended family. Me. My staff. Sometimes it is very very hard. Other times, not so much. I'll come out and say it: given the opportunity to euthanize a particularly nasty-tempered animal, I have sometimes felt pretty good about never having to see that animal alive again. I believe the phrase "don't let the freezer door hit your ass on the way in" may have been uttered, in jest, even. More often it's sad, though. Sometimes devastatingly so, as when octagenarian or even nonagenarian pet owners have to say goodbye to their companions, and feel it would be unethical or inhumane of them to get a new pet, if they have no trusted friend or family who agrees to take it in should they, the owner, predecease the new pet. Those people always seem so terribly lonely - sometimes, we call them every few weeks just to say hi... sometimes, they just slip away and are never heard from again.

Anyway, all of this is just an aside. This past weekend, my patient was accompanied by his owner, a man of about 35 or 40 years old. The patient was quite large and we elected not to put him on a table, but to spread a blanket on the floor and let him lie down comfortably before I injected the euthanasia solution. Afterwards, the man laid down next to him and hugged him and cried, in a way that generally men of this age in this society do not do in public, unless experiencing overwhelming tragedy. I put the tissue box near them both, told him how very sorry I was, and left them to have a private goodbye.

The man ended up leaving the building while I was occupied in the other exam room, before I could come back in and say anything else. Not that I had any great prepared words of wisdom, but usually I'll offer a final "I'm so sorry," a handshake or hand on the shoulder, a "please let me know if there's anything else we can do for you," that kind of thing. For a long-time client like this, we'll follow up by sending flowers or a charitable donation or something in memory of the pet, depending on what we think would be best appreciated. I flagged the patient's chart to make sure the staff would have me personally sign whatever card might be sent. I'm not always around when they are preparing those to go out.

My very next patient was an adorable so-cute-it-hurt puppy. On the one hand - yay, puppy! Cycle of life, to everything there is a season, yada yada yada. On the other hand - pet store puppy. Fake/made-up pseudo-designer "breed." Entropion. Luxating patellae. HUGE inguinal hernia. No vaccine history. No deworming history. Serious case of craniorectal inversion in the owners! So, essentially, no heartwarming take-home message here. Just another day at the office.

Friday, March 16, 2012

Don't Judge Me

A few of us here at the VBB have fielded more than a few critical comments about our blog posts, some downright calling us names.  I feel they are just jealous that they are not as awesomesauce as we are, but I digress.  :)

I had to share a story about a situation that came up this week at my clinic that was so appalling, I had to write a blog about it so that I don't kill the person who did this.

So we're doing our normal routine right before lunch - working on a dental while the staff sees tech appts, etc.  Right about then a car drives up in our parking lot and sits there.  We notice, but no one has come in yet, so we just sort of wait.

Then one of my staff noticed that a woman with a small child got out of the car, brought a dog that was wrapped in duct tape to our light pole, and proceeded to tie the dog's leash to the light pole.  Staff ran out to the car to see if we could help, and this person had the nerve to tell us that "the dog needs to be euthanized but I can't afford it."   That was it.  No explanation, just made it clear she was gonna dump her poor dog off on us and leave.

The dog had some sort of extremely large tumor on its side, and this idiot had wrapped duct tape around the dog in some feeble attempt to control the fluid leakage.  Never mind that she hadn't taken the dog to a vet for ANY form of care.  Do I really have to say that this person had no business owning a pet?  But I digress again.

My staff caught her in time to shame her into admitting what she was gonna do.   She told us she could not even afford euthanasia.  Normally I would try to help if possible, but this person was so unbelievable in her trashy attempt to dump her suffering animal off on us, that I told her to take her pet to the low cost place and have him euthanized.  It broke my heart for the pet.  It made me want to kill her dumb ass. 

But she was not a client of mine, and other than paying for it all out of my own pocket, there was nothing I was going to be able to do to help.  And believe me - I pay out of my pocket every single day helping people and their pets.  I'm much more apt to give a lot more when I'm being met in the middle for the most part.  But come in as a non-client, offer ZERO money and just expect me to take care of your responsibility?  Um.  No.

So when people get mouthy with us and accuse us of being heartless or cruel or that we are being overly hard on clients...  understand that it is because of situations just like this that we suffer from a condition called Compassion Fatigue - a very real syndrome that vets (and other healthcare professionals) suffer from, because of the constant struggle of caring for animals a hell of a lot more than a significant amount of the general public cares for them. 

It simply wears us down with time.

10 years into this career, I can tell you that my used-to-be bubbly self looks at the newer generations entering the profession and I feel badly for them, because I know that they too will suffer from compassion fatigue at some point in this career. 

Because you just can't fix stupid.

The Day Can't Get Much Worse

My clients love to tell me all about their pets and their personal lives. Most stories communicated are mundane daily happenings; my mind tends to wander while I smile at proffered tales but I listen to them all.

Several years ago, one client had me giggling at his horrible morning: he had been sitting on the toilet while a horrible storm was raging outside. Lightening struck his house outside of his bathroom and blew him off of the toilet. Then he found out his girlfriend was pregnant…pregnant with triplets. He said the fateful words: “the day can’t get much worse.”

Several hours later his girlfriend rushed in his dying pet. Half an hour later, another of their pets presented, also dying. Both pets passed away and in our efforts to discover the horrible cause, I happened to mention the possibility of anthrax. Both pets had symptoms of possible anthrax poisoning or other intoxication. The girlfriend told us that there was no possible toxin available to these pets. She had remembered that her ex husband threatened to kill their pets and she had seen some suspicious white powder in their driveway. She collected some of the powder and brought it in to us. I packed it up with the two pet corpses and took it all to our state veterinary school for a necropsy. The state school immediately contacted the FBI regarding the possibility of anthrax.

The next day, this poor man, his girlfriend and her ex husband were answering questions from the FBI and Homeland Security. Their homes were searched as was my clinic. My staff and I spent a day being interviewed about how this potential bioterrorism had occurred and what we had done with all of the evidence. We were all in fear of the men in black and the potential death awaiting us. The first to die would surely be my technician who had stuck her nose in the bag of white powder (suspected anthrax) and smelled it. She is blonde. But after her, we knew that we would quickly join her in the next life.

It turned out that there was no anthrax. The pets had eaten a human medication and the powder was just the bleach from someone’s swimming pool. We all resumed with our normal lives and on one specific day shortly after this, I was thumbing through outgoing mail and found a “Welcome to our practice” card to this poor man and his girlfriend. I tore it up and threw it in the trash can. Never did see these people again, I hope their lives are peacefully happy and that they are not scarred for life.

Thursday, March 15, 2012

Doc, he's been --dum dum dum- poisoned.

How many times do I hear that someone's dog has been poisoned? Well, it happens enough that it is a common joke among veterinarians. Dog has been eating sausage biscuits and pizza, not's not pancreatitis, it's POISON! Dog hit by a car, trouble breathing, not able to walk or's not a diaphragmatic hernia, it's poison!

When it is poison, it can be hard to convince people of that. Uremic breath, lingual ulcers, seizures, not urinating, hypocalcemia... Has your dog been around any cars? Was it acting drunk yesterday or the day before? Any anti-freeze? Any green-yellow puddles around? Any enemies? Are you sure that there is no anti-freeze around? No? Ok.

Finally get some urine and there are the crystals typical of EG toxicity. Oh, you have been working on your car. And the puppy ate the paper you used to soak up the anti-freeze. Well, if you had told me this, I could have saved you a metric ton of money at the outset.

Another case: bloody urine and bruising. Go through the questions, any aspirin? Any one on blood thinners? Any sago palm? History of liver failure? What about rat poison? Has anyone put any out? Are you sure? Are you really sure? Yes? Ok. Elevated PT, PTT and finally someone admits that the dog had bright green diarrhea a few days ago. Ok, now someone remembers that the pest guy brought around some packages last week.

Well, these two scenarios play out daily in the veterinary world. Very seldom is a pet actually poisoned on purpose. However, it does happen. We had a case in vet school where the owner told us point blank that her boyfriend poisoned the dog. It took some time and a store bought urine drug screen, but we found out she was telling the truth.

Two lab mixed sisters presented on the emergency service as a transfer from a day vet. Both were comatose and alternated being bradycardic and exhibiting tachycardia. The history was that the woman had broken up with her cheating beau. He happened to be a pharmacist. The dogs became suddenly, and similarly, ill and she thought that he might have poisoned them. It turned out that she was right. There was no source in the woman's house.

We treated both dogs with gastric lavage (flushing) and activated charcoal along with supportive care. One of the dogs did fine, but the other aspirated the charcoal and ended up dying. The police were called and the woman talked of bring charges. I am not sure that she did, but the thought of this person running around, giving out medications to humans skeeves me out.

Sunday, March 11, 2012

White Lightning

In the record of humanity’s past on this world, one of the earliest known uses of written language was to preserve the recipe for making beer. Shortly thereafter, writing stuff down was applied to commerce, to keep track of the talents, shekels, and such. Only much later did penning religion, history, philosophy, poetry, and sports scores use up of most of the words. Clearly, as a species we valued getting loaded and figuring how to pay for this took precedence over a lot of that other extraneous stuff.

With luck, we can return to getting loaded in a moment, but I wanted to briefly talk about commerce, the paying for things that we want or need. You may have noticed that we will be having an election soon, and those old arguments concerning whether we are better off by being victimized by the greed and criminality of banks, insurance companies, and big business, or instead by the incompetence, inefficiency, and criminality of government seem to dominate the whole process. And in the middle of all this sausage making, the yelling over who should pay for health care seems to fit right in.

I hope you aren’t holding your breath waiting for my solution to the health care issues in America, because I don’t have the answer for that. Most of the solutions folks are proposing will cost me more and deliver to me less, so I don’t know…maybe I don’t see these as solutions. 

So I simply look instead at the little picture, the one on one exchanges that take place in the exam rooms of veterinary hospitals every day, as the doctors negotiate diagnostic and treatment costs with the clients, and some decision is reached that ultimately helps, or doesn’t help, our patients. Our thinking is not muddled much by governments, insurance companies, unions, organized crime, Marx or Rush, or any of the other influences that come into play in the big picture. It’s just us and you all, with Fido in the middle.

I once had a middle aged couple as clients. They had no children. They did have an older Yorkshire terrier. When the time came to purchase a new motorhome, they let the little dog chose the model. They wanted him to be happy with the decision. Needless to say, they never hesitated to authorize whatever it took to assure their little pooch the best in medical care. When the time came that they had to decide whether or not to spring for the brain surgery up at the university for his nasty tumor, they simply said “do what it takes” to try to save the little guy. Sadly, money was not the answer for that particular problem.

For every client like this, I’ve had hundreds who would neglect or even kill their pet rather than dig into the cigarette money, or that weekend in Vegas.

In the middle between these extremes live all those folks with the common realities: budgets, sick kids, fixed retirement incomes, bad luck, bad jobs, bad bosses, layoffs, repossessions, asshole spouses, and all those other reasons why they cannot simply write a check to cover whatever expense Fido might require. Each and every time I’ve stood on my side of the exam room table as they stood on their side, and we’ve tried to find a way to help. This, from time to time, has led to some interesting stories….

Every young doctor mentored by the wise old one has heard the suggestion that you cannot judge what a client can and will do to help their animals by the way they look. Never have I seen this to be more true than when a character direct from central casting arrived with poodle in hand. This man walked right out of an optimistic young doctor’s worst nightmare. Long stringy oily hair, full untrimmed beard with some of breakfast still aboard, filthy denim bib overalls with no shirt and only one shoulder strap fastened, and bare feet that looked like they had never met a shoe. Oh, and the subtle odor of man. No way was this guy going to grasp the concept of paying for the medical care of a dog. He didn’t look like he could afford a nail trim, much less a significant problem.  And the dog he held had two broken front legs. 

I began formulating a plan to try explaining to this guy the ramifications of this dog’s injuries, when he interrupted me. He pulled out a ROLL of $100 bills, and just flat OK’ed the entire treatment, without even hearing about it. No questions asked. And despite the presence of Murphy in the world, the dog healed perfectly.

Then there was the day the young lady showed up with her version of the dog with broken leg. She opened the discussion across the table with the statement that she didn’t have any money, but that she was good for it. I had fallen off the turnip truck quite some time earlier, so I was a mite suspicious of this promise, but she proved me wrong. I had asked for a $100 deposit to begin treatment, for in those days that got you halfway through the care needed. Five times that afternoon she came back to the hospital with $20 each trip. I didn’t ask, and she didn’t tell. This dog also healed up just fine. 

But the strangest experience of my career involved a very distant house call, and a very different owner. It was three plus hours up the interstate, then turn left into the mountains for another two hours and 40 miles along narrow, winding, clinging to the cliff above the river, mostly unpaved road, dodging logging trucks and trying to stay on the track while gawking at the scenery. 

My friend lived in a dilapidated ancient trailer house haphazardly sited on a flat shelf above the white water river. The nearest veterinary hospital was two hours away, so she often lined up a few of her neighbors’ animals for me to treat while I was there visitin’. The town, if you could call it that, was a few cabins spread along five miles of river, and some dirt floored hand built log homes set up the mountain in the trees by various creeks. Most folks got their electrical power from Pelton wheels set in those streams. The area and its people were just a tad bit behind the times. 

On an earlier trip, I had arrived with the notion that we might be trimming the overgrown hooves of a local deer. The old man and woman who lived in one of those log cabins were in the habit of feeding the deer, so their neighborhood was filled with the lovely things. The locals all hunted deer, but they knew the unwritten law…ya didn’t hunt around their place.

Anyway, there was this old doe with hooves so overgrown that they curled up like a genie’s slipper. So I brought the drugs that would induce cooperation, and the old lady would lure in the doe, who she could pet, and I’d poke her and when the drugs kicked in, trim her hooves. It was an optimistic plan, doomed to failure, so when the doe didn’t show that day, no doubt psychically warned away, we weren’t surprised. 

The old woman was an artist, and to thank me for taking the time to try to help, she gave me a product of her genius. It was a tree fungus, those shelves that growth off the side of dead trees, with a curved side on top and a flat bottom. On that flat bottom she had painted a snow scene, with trees and rocks, and a doe standing there, just looking through you like they can do. Nearly forty years later, I still have that painting. It is far more precious to me than any talent or shekel I’ve ever earned in this deal.  

Picture my friend’s trailer kitchen, vinyl sheet covered floor tilting slightly toward the river, an old table centered in the room, and the young cat anesthetized on said table. It was time for him to be neutered, and that was my job. Oh, and the owner wanted to watch. She was not the type to take no for an answer. A woman of indeterminate age, somewhere between thirty and sixty, she wore a dress that would have done the madam of a nineteenth century French brothel proud. Silver studded high top leather boots, long ribbons in her hair, and a hand tooled western style belt and double holster, with two pearl handled Colt single action army revolvers, loaded, completed her ensemble. She was thrilled when I finished and her kitty was just fine. And yes, I made a point to take special care of the little tyke, standard of practice notwithstanding.

For services rendered, the kitty’s owner offered up some local favorite, a fifth of triple distilled moonshine whiskey, in a used booze bottle. What could I say? A few years later the local currency become more herbal, but that is yet another story.

So see, I did get back to getting loaded, and I tied it in with commerce, too. Not bad for a Sunday.

Saturday, March 10, 2012

2 Live Crew: A lesson in female anatomy.

This is not a veterinary story in any way, though it does reference an alternative word for cat and well as the word “vagina.” I wish I could tell the story in person, because the pronunciation is key.

I used to work for a very funny man…. He often said wildly inappropriate things and I think he even made a joke and rubbed his nipples at my job interview. But as he reminded me of Baloo the bear and when he said “I love you” to his staff (and meant it), I never took offense.

His recounting of stories was amazing, often including spot on imitations as well as bursting out into operatic song. This is one of his stories.

While he was in vet school, his wife was a teacher at an inner city school in the late 1980’s. This was about the time the group 2 Live Crew was pumping out songs destined to be banned. If you know 2 Live Crew, you know where this story is heading.

A kindergartener was skipping along the halls of the school singing, “Hey, hey, we want some puuussssy….” (click for full lyrics)

Said kindergartener was promptly tagged and bagged by his teacher and he was taken into the principal’s office. There the principal demanded if he knew what “a pussy is.”

The kid looked down and shuffled his feet, “I dunno, something you eat?”

Fo rizzal, to quote someone slightly more contemporary Luther Campbell. He said that. Well, at least he was getting some sexual education.

The icing on the cake was when the principal, a rather buttoned up woman shouted, “It’s not pussy, the word is VAG-in- A, VAG-in-A.”

Life, it is real and it is weird.

Thursday, March 8, 2012

A few things they never taught in Vet school.

This was given to a colleague in a day practice by a client who bought a wolf hybrid from a breeder & I thought I'd pass it on for interested parties. These are things I was never taught in Vet school & am sorely disappointed in said school.  All the time & money I spent there....wasted. :P

Here are some helpful tips when one of our clients brings in their wolves for check ups or with problems:

They have a very high metabolism.

Parvo shots could kill them or make them ill.
Wolves are prone to have diarrhea because of their metabolism.
Can be caused by drinking too much water or not getting filtered water (as we always recommend)
Too much moisture in their system. Wolves absorb moisture through their skin.
Too much food, they should be eating one time per day.
Eating the wrong types of food. They need a high protein diet, 27% or higher. Should not be eating any fruits or vegetables, can not digest them, it make rake the colon and make them bleed.
Require dirt in their diet. This comes from years of eating a kill that gets dirty on the ground. It makes their stool solid. Food should be fed on the ground or a small amount of dirt/pebbles added to it.

They do not get parvo or heartworm.

Diarrhea is more than likely caused by the above mentioned items.

No flea products. These products are made for hair not fur. It can burn the fur and cause their skin to be irritated.

They are from the feline family, non the canine as taught. This is why they have a high metabolism. the same as lions, bears and tigers.

So no dog shots, feline shots only.

The skin is about 1 inch thick and so a mosquito can not lay larva under the skin so they do not get heartworm. Because of this they also do not get fleas or ticks because they can not penetrate it. Meds for heartworm could cause them to become sick.

Because of their fur coats they tend to get hotter faster than dogs. They can easily get heat stronke so if it is hot outside they need a cool area they can get to.

Please feel free to contact us with any questions

Wednesday, March 7, 2012

When Did I Know?

Most of us knew that we wanted to be a vet when we were children. I did not. I dreamt of being 1. a shepherd in New Zealand 2. a stripper, and then 3. a radiologist. I have since realized that I became a veterinarian as reparations for my family’s sins against animals.

My parents were not responsible with any pet they had and they collected several dogs, snakes and even a raccoon. None of the animals were properly vaccinated, neutered or on any heartworm prevention (obviously snakes need none of this). Their pets ran loose and were frequently killed by cars. I was repeatedly traumatized by my pets’ horrible deaths.

The real trauma was due to my baby sister. She was not a psychopath-in-training but she had a very “experimental” mind. This did not end well for our pets. At six, she made parachutes out of napkins, attached them to her hamsters and threw them from the second story to their deaths. None of their napkins opened. I couldn’t sleep for many nights.

In earlier years, she had tried to lower a dog from the second story by his leash. Leashes didn’t reach from the second story in the ’70s. The poor dog did not survive.

She once caught about four anoles. She has always been fascinated by lizards. I have a weakness for them, myself. She cut all of the blonde synthetic hair from her Barbie dolls, glued the hair to the heads of the anoles and made clothes for them. I later found them dead in a change purse with pieces of hotdog interspersed amongst them; they were all blonde and wearing the latest in lizard fashion.

I am still haunted by the unnecessary suffering that all of these animals endured because of my family. I think about them frequently and hope that they would forgive our ignorance had they survived.

I have to say that my sister developed into one of nicest people that ever lived. She owns a dog and she is a very responsible owner. She even brushes her dog’s teeth daily. I hope that I have been able to educate my family on how to make a pet’s life better.

We've Been Robbed!

Let me tell you a little about Sally.  Sally is a 2 year old Labrador Retriever who has the energy of 10 dogs.  She can't focus, she has ADD and she is just all-around naughty.  But she's a sweetheart, a marshmallow to the core, and we love her.

She had parvo as a pup and we barely saved her.  It took nearly 10 days in the hospital to do it, but she came through with flying colors. 

She ate a battery once and ended up in the ER.  Survived that.

She ate plastic once and survived that.

She ate a plastic pencil sharpener once.  Survived that.

Yesterday her owner called and said, "Sally ate a quarter!  She picked it up and before the owner could get it back, down it went.  So they called us, and we had her come down.

She also grabbed a whole bunch of dog food right before leaving the house.  Vacuum cleaner, I tell ya.

Anyway, we induced emesis (vomiting) when she arrived.  Given her history, we weren't even sure it was JUST a quarter.    Sally's owner waited in the lobby for us to tell him what we found, and whether or not we needed to do xrays.

Up came the vomit.  My techs had the wonderful job of digging through the warm pile of frothy dog food, looking for foreign bodies and quarters.

We found a nickel.  A nickel amidst a smelly pile of partially digested dog food.  Yay!

So I went up to the lobby to tell the owner that it was actually a nickel she'd eaten, not a quarter.   But she would be fine and could go home.

The owner laughed and said, "Oh my!  We've been robbed!  It was a nickel, not a quarter!"

Damned dog.

Tuesday, March 6, 2012

The Geico Panther. IRL

A member vet of the ER used to do the local Zoo, and heavy exotics. Had a client in about an hour out of town with a dehydrated panther. I tried to get out of it, but no go. So in it came. All I had to do was place a catheter and run IV's overnight. I asked the RDVM how I'd know if it was improving. "Easy", he said. "When it wants to kill you." Fucking swell. The panther was calm when we placed the cath. I rigged the IV lines so they could be disconnected with just a tug. If the panther pulled them out, too bad. We put the panther back into it's own crate, since I didn't want to handle it any more than necessary.

Unfortunately that night we had also hospitalized a very young pup, first time away from mom. The pup was feeling better, and developed a bad case of the lonely's. And cried. and cried. And cried.

My tech, trying to convince the pup to sleep, turned out the lights in the ward. And the light switch was on the tech's side of the room, not the side of the Dr.'s room. And by now the panther was feeling better.

A brief time later I came out check on the patients. Now an irritated panther has a growl that will make your blood run backward and make you want to shit food you haven't even eaten yet. And it was growling. I had to cross a dark room with an agitated 90 lb. predator that had been in a flimsy airline crate. Was it still there?

I claim courage for very few incidents in my life. This is one of them. The walk across the room was one of the longest walks of my life.

Fortunately, all was well. But I never, ever wanted to do anything with a big cat again. And now you know why there's grey hair in my beard.

When you take them out, but leave them in.

I had an interesting conversation today.

Actually, I had a lot of interesting conversations today, for the definitions of “interesting” that include “seriously unpleasant, yet necessary,” “horribly painful and depressing,” “same old family drama, different day,” and “you can’t make this shit up.” The one I want to discuss right now, though, was interesting to me because it reminded me yet again how perception differs between individuals, and how the most obvious fact to me can be completely non-obvious to someone else.

Today I saw the new puppy of a long-time client. The puppy was adorable, as puppies generally are. He did take issue with the whole temperature-taking thing, but I’m not 100% sure it was an inappropriate response. We’ll see how he does over the next few weeks. So, I did my exam, and chatted with his people, and was basically wrapping things up as I tend to do by explaining what had been done in the past, what I had found on my exam today, what other things I’d done today, and what needed to be done in the future and when, and I mentioned that generally speaking, I like to neuter male pups at about 6 months old.

Well, that led to a discussion of the fact that the breeder wanted them to neuter the puppy at one year old or later. For the first time ever, y’all, I replied brightly “Oh! The breeder’s a vet? Where did she go to vet school?” They looked at me blankly for a moment and then started laughing. “No, doc. She’s no vet. She wants to breed him is the thing.” “Oh, ok. I didn’t realize he was such a fine genetic specimen. I’m not an expert in the miniature schnoodlehunden breed standard, or anything. I had thought your breeder was one of those breeders who just prefers to neuter everyone really late because they think neutering sooner causes cancer, or growth problems, or whatever it is that they think it causes. You know, there are a couple of issues that have been looked at that may be influenced by pre-pubertal neutering, but generally having reviewed the available data, I think neutering males at 6 months is reasonable and results in a healthy pet with appropriate pet behaviors.” The other owner then said “actually, you’re right. She IS one of those breeders.” I just smiled and said “well, regardless, you have plenty of time to think about it and decide. I’ll have the front desk print you a handout about neutering to take with you.” And THAT is when it got interesting.

The man said “by the way doc, our last dog, you know, Cheeksie - we had him neutered, but they left the testicles in. Can we do that again?” I looked at him blankly this time. “I’m sorry, there must be some misunderstanding. The point of neutering is to remove that hormone source. The testicles are not left in.” He said “well, it was more like a vasectomy then. You know.” I said “I do know what a vasectomy is, but most vets don’t do them.” He tried to tell me we’d done it at our hospital and I told him there was no way that happened. Then a lightbulb went off over my head. “Is it possible that you were simply seeing the empty scrotum, without the testes in place?” and he said “yes! that’s what it was! So, you don’t take that part off then, just the inside?” and I explained that yes, generally speaking, we don’t remove the scrotum. He asked me what made it hang down like it was full, and after a couple of failed attempts to explain I said “forgive me for being crass, but - imagine a breast, after the removal of a breast implant. Wouldn’t there just be an empty breast hanging down, kinda flat?” And then his lightbulb went off and he nodded yes. “That’s great!” he said. “Because I was afraid, you know, you were gonna mutilate him.”

I just laughed and said that generally speaking, we preferred to avoid mutilation at our hospital. He laughed too and everyone was happy.

**Please note: my choice of breast implant as teaching model should in no way suggest any dislike of, disdain for, or other negative attitude directed at any woman who may have had or considered having placement or removal of breast implants at any time. No breasts were harmed in the writing of this blog post.**

Monday, March 5, 2012


Warning: this is not a strictly veterinary post

My mom and my dad both graduated from college. My dad and uncle were the first people in their family to do this while my mom and her siblings followed my maternal grandfather in getting a college education. My dad died suddenly when I was a teenager, so my mom raised my sister and me once it got to the pretty complicated stage (13 and 16, respectively). Education beyond high school, and even beyond college, was expected in our family.

When my mom, a very medically savvy and medically educated woman, married into a family of people with a pretty low educational background, it created a new job for her. I am in no way discounting intelligence: my step father does not have a college education but I consider him to be someone that is a genius in his own right. However, her in laws (my step grandparents) have an education that tops out at 8th grade. I think they had to drop step dad's mom because she had to take care of the other kids in the family and my step dad's father because he had to go to work to help with his family's bills. I don't think that the initial education was any great shakes either: think of a place where "You gotta a pretty mouth, boy" might be uttered. That is the kind of place I am talking about. My step grandmother can create a meal that will make you cry with joy. And Papaw is the kind of guy that can take parts from 20 different cars and build a vehicle that would make most people clap their hands with delight.

However, my step grandparents have a distinct lack of understanding of biology. And a lack of ability to read with comprehension much better than my 6 year old daughter. So, my mother has become the person that reads everything from warranties for appliances to information about health. Which is fine with her...that is part of being a family.

A couple of days ago, Mamaw told my mom that her doctor told her she had "Flea-bite-us" but she had no idea how this could happen: she couldn't find any fleas. The answer was of course she doesn't have fleas...she has phlebitis. Now, since neither my mother nor I was there, I have no idea if the doctor explained what he meant. I don't know if he gave handouts (though my mom usually interprets this for the inlaws). However, I do think that it illustrates things that we can all take home.

As a vet, I always make sure that my clients have oral and written information on disease processes. I give actual handouts, I give internet addresses where clients can find "vetted" information. I have given out my phone number to some clients if I know we are going into a weekend and the patient has a serious problem. And other vets that follow this site, likely do similar things. If you are a vet and you are reading this and you don't do this, start. It is not very hard to link a diagnosis in your computer system to a blurb on something....hell, take it straight from Veterinary (please cite it). The Homeless Parrot in our side bar also has great information on diseases and terms.

If you are a non-vet reader, please ASK for an explanation from your MD/DO or DVM. Please ask for the spelling of the problem. And while you can google the information, please take all information with a grain of salt. The initial exam can often feel rushed...but if you approach your health care provider with real questions....real interest without agenda, you should be welcomed...even if they tell you they will need to look into it (NOT a sign of weakness...a sign of strength). If you are not taken seriously, find a new doctor/NP/DVM. As a doctor, I want to CURE my patients. I assume my clients will research something online. Fine... I will evaluate this and I might find it FOS or I might take it seriously...and some will be a combination of the two.

Don't be a passive doctor or nurse/tech: every question is a chance to critically evaluate why you believe and advise the things that you do. And others, don't be a passive consumer of your health. The only way for a health system to work is to be honest about the things that you don't understand. The health care providers will do a better job if you tell them what you don't understand.

As much as I initially wanted to snicker at the word "flea-bite-us," it really just makes me mad. Someone failed. And I don't think it was the woman with an 8th grade education.

Friday, March 2, 2012

Or, we could not do that...

Because life doesn't put itself on hold in troubled times, even though VBB central is under a lot of stress today, I still had to walk the puppy. We walked up the street through the neighborhood for about 40 minutes this morning. Oh neighborhood. Why hast thou forsaken me?

Believe it or not, I expect people to be nice. I expect polite, intelligent, kind people to populate my world. I am constantly disappointed, by the way.

The guy with the obstructed dog wasn't out, though I saw his dog pee yesterday, so there's that. But a few homes past him is "my dog wants to play with your dog" man. This man drives me to drink. His dog is a land shark and shouldn't be allowed in polite society. But today his dog was not home (it's at the groomer! Yay!) so instead he just wanted to chat about his new "invention." He insisted that he was going to create a dog food system that involved feeding the dog a capsule and then 20 minutes later, dog food. The capsule dissolves to reveal a baggie that waits in the rectum to be filled with stool. Then the dog poops out a bag of stool. Honestly I was LMAO but he became quite put out & insisted he was "extremely not kidding." Then he said "you know I hadn't thought of it but we'd make a great team. We could market this in your clinic." I just looked at him, & raised one eyebrow, and left. He's probably blogging now about his bitchy-ass neighbor, the vet who blew off his big business idea.


Yesterday we had to call the plumber out to our house to rooter the pipe that drains the washing machine. Apparently it was full of gunk, a.k.a. dog fur. The plumber spent about 15 or 20 minutes and charged us $350, which I didn’t have. I thought about all the things my clients have said to me over the years when presented with treatment bills for their pets:

  • “If you really cared about animals you wouldn’t charge so much.”
  • “You should name a wing of this hospital after me, for all the money I’ve spent.”
  • “I don’t get paid until next Friday. Can you hold a check?”
  • “Is that the lowest you can go?”
  • “You vets are only in it for the money.”
  • “I bet you drive a Porsche.”

For about a tenth of a second I thought about trying out one of those lines on the plumber: “If you really cared about washers you wouldn’t charge me,” or, “Think of my poor children! They won’t have clean clothes to wear to school!” But I didn’t, because I’m a decent person. Instead, I handed over the credit card.

For most people who claim they “can’t” afford veterinary care, it’s really that they choose not to spend money on veterinary care. It’s all a matter of priorities. If your priorities are an iPhone, shiny new SUV, and cigarettes, don’t try to make me feel guilty. I feel sorry for your pet that he is stuck with you as an owner, but I don’t feel sorry for you and your poor decisions.

And for the record, I drive a ’99 Subaru with 209,000 miles on it, having upgraded from an ’88 Blazer with 180,000 miles that couldn’t turn left in the cold without stalling.