Musings of a Veterinarian

What Keeps Me Up At Night

April 30, 2015 By: Dr. K Category: Just For Fun

A few days ago I spayed a large pit bull who decided to give me ajada by excessively bleeding during and after surgery. Her owner, a rescuer, opted to monitor her at home with the knowledge she may bleed internally. I fought back the knot in my stomach for 16 hours while I sat by my phone waiting for the update: She made it through the night! I, however, lost countless hours of sleep over it.

As a veterinarian, wife, and mother, I lose lots of sleep over lots of things! Here’s a non-exhaustive list:

1. The On-call Phone

Hate is a strong word. One I reserve for things like creepy-crawlers, the sound of a fork on someone’s teeth, and the ring of the on-call phone. I loathed carrying that anchor everywhere I went years ago when I had a position that required it. I am convinced I have PTSD that is triggered by merely hearing the ring-tone.

Nights on-call went like nights as a new mother: Waiting for the wailing when I should have been sleeping. Anticipation is as powerful as a midnight latte.

2. The Angry Client

Who likes beratement? Deserved or not, an angry and often times hurtful client keeps the lump in my throat for days. The vast majority of angry interactions are forged in the exam room during times of client stress over sick animals and low finances. That does little to blunt the blow of hurtful words that are replayed over and over in my restless mind.

3. My Toddler

If  you haven’t had the joys of putting a two year old to bed six times a night, move on to #4.

If you are not familiar with the term “mommy guilt”, move on to #4 or share your secret in the comments section.

4. The Sick Patient

Sick patients, in particular the ones with the potential for cure but hanging by a thread, are the ones I worry about most. I research, I hope, I pray. Sometimes they make it; Sometimes they don’t. You can’t know with certainty which ones will pull through, making successes feel like winning the lottery and failures feel like your heart is in a vice grip.

5. My Lovely Stupid Annoying Amazing Cats

These dingdongs are locked from my bedroom at night given their proven propensity for every 30-minute bed readjustments and spontaneous facial biscuit sessions. It doesn’t stop my Maine Coon-mix from deftly using his paddle paws to pull door knobs and handles, sometimes wiggling them free and barging in our room announcing his greatness and great hunger.

6. Money

Like every other human, I feel the pinch of finances. Who doesn’t worry about retirement and putting their kid through college? I’m nearly 10 years in to paying off my student loans. Every spring around April 15th I have to force myself to look at my student loan balance. This result: Lost sleep and a run on Tums.

7. Late Afternoon Caffeine Jolt

A 12-hour day at the office after #1-6 and I find myself dragging around 3pm. I promptly reach for the cup o’ joe. Come 11pm I am wide awake watching some derivation of Bigfoot hunting on TV and lamenting my poor decision making once again. But my late night gives me plenty of time to think about angry clients, sick patients, ruining my daughter, my aging cats, and my bills. At least I don’t have to hear the bleat of the on-call phone.

VMDiva named to Top 25 Animal Care Blogs

April 30, 2015 By: Dr. K Category: Opinion

I am proud to say VMDiva  has been appointed to the Top 25 Animal Care Blogs by VetTechColleges.com for it’s useful and informative care! The blogs included in this list are updated regularly with news, tips, and useful information about animal care, and all are worth a look, and a follow.

Check out the list HERE!

Angels for Animals Foundation Launches Guardian Angels K9 Fund for Police and Military Service Dogs

March 27, 2015 By: Dr. K Category: For Vets, General, Opinion

A couple of years ago I had the pleasure of working for Dr. Mark Magazu at his practice, Saint Francis Veterinary Center, in New Jersey. His son and close business partner, Mark Magazu II, recently launched the Guardian Angels K9 Fund following the recent news coverage highlighted the final walk for a canine officer, Judge, as he entered their building. It’s worth sharing the press release for the new fund and remembering those four-legged officers who give their lives to service.




Fund seeks to raise money to ensure service dogs receive life-saving medical care

Woolwich Township, NJ (March 13, 2015) – In recognition of K9 Veterans Day, the Angels for Animals Foundation is launching the Guardian Angels K9 Fund, which will raise money to ensure that service animals such as police and military dogs receive life-saving medical care while on active duty and in retirement.

“Our K9 officers and veterans serve our communities and risk their lives in the same way that our bravest service men and women do,” said Mark F. Magazu, II, Founder and Chairman of the Angels for Animals Foundation. “Like our human protectors, K9 officers are subjected to gunshot wounds, shrapnel from explosive devices, bone fractures and life‑threatening internal trauma resulting from perpetrator physical assaults. The costs for this type of care can reach into the tens of thousands of dollars range, often exceeding the funding capabilities of handlers and departments. The Guardian Angels K9 Fund, if successful, will help ensure these canine heroes receive the medical care they need to return to health.”

The Guardian Angels K9 Fund was started in honor of a K9 hero named Judge, who served his community with the West Deptford Police Department in New Jersey for seven years. When K9 Judge was diagnosed with Cushing’s disease, his medical bills exceeded $12,000 in specialist medical care, the cost of which required his handler, Corporal Mike Franks, to ask his community for fundraising help. The Guardian Angels K9 Fund is meant to assist service men and women, like Corporal Franks, and K9 heroes, like Judge, during these kinds of urgent, unexpected times of need. K9 Judge was laid to rest on February 20, 2015, surrounded by nearly 100 fellow human and K9 officers, who lined the road to honor Judge with a final salute. The Angels for Animals Foundation honors his memory today on K9 Veterans Day.

To donate to the Fund, simply text the word “GuardianK9” to the number 41444, followed by a space and then the amount you would like to donate. Donations can also be made online at www.BeMyAngel.com/Guardian.

For additional information, visit the Angels for Animals Foundation at www.BeMyAngel.com or on Facebook at www.facebook.com/angelsforanimalsfoundation.

About Guardian Angels K9 fund

The Guardian Angels K9 Fund is a dedicated fund of the Angels for Animals Foundation solely focused on raising money to provide life-saving medical care to police and military service dogs on active duty and in retirement.  More information can be found at


About Angels for Animals Foundation

The Angels for Animals Foundation is a 501c3 not-for-profit organization that raises money to help pet owners suffering from extreme financial hardship to provide veterinary care for animals facing serious medical challenges. Each year, thousands of family pets are euthanized because their owners simply cannot afford life-saving medical treatments and procedures. The Angels for Animals Foundation has facilitated nearly $500,000 in services of either cash raised or negotiated free or discounted services for all types of animals since it was founded in 2011. Donations to the Angels for Animals Foundation can be made online or via text message. More information can be found at www.BeMyAngel.com.

February is National Pet Dental Health Month

February 05, 2015 By: Dr. K Category: Opinion

HealthyPet Magazine Provides Top Tips for Keeping Your Pet’s Teeth Healthy

February Marks National Pet Dental Health Month

YARDLEY, PA (January 26, 2015)HealthyPet Magazine, a seasonal publication dedicated to delivering relevant and educational pet wellness content to pet owners through their veterinarians, has released its top dental tips to help pet owners keep their pets’ smiles healthy in advance of National Pet Dental Health Month in February. Dental disease ranks as the most common disease in adult cats and dogs.

“By the time dogs and cats are three years of age, most have dental disease. So, it’s critical to your pet’s health to make dental care a priority,” said Dottie Normile, VMD, an Advisory Board Member of HealthyPet Magazine. “As National Pet Dental Health Month approaches we remind pet owners of the importance of regular dental care for their pets. Just like humans, cats and dogs need regular brushing and professional teeth cleaning. Our winter issue of HealthyPet highlights the best dental practices for pets and provides pet owners with tips to help keep their pet’s teeth healthy.”

HealthyPet Magazine provides pet owners with some top dental tips to help ensure their pets do not suffer from the harmful effects of dental disease:

1. Which toothbrush and toothpaste you select matters: Pet owners should identify the proper toothbrush for their pets, paying close attention to the size of the toothbrush. Pets should NEVER be given human toothpaste, as pet toothpaste is made to be ingested and human toothpaste will likely make your pet sick. Pet owners can ask their veterinarian for tips on how to brush or can learn more in the latest issue of HealthyPet Magazine.

2. What pets eat can affect their dental health: Some companies  offer pet food specifically for controlling plaque and tartar in dogs and cats. These foods should have the Veterinary Oral Health Council (VOHC) Seal of Acceptance.

3. Help fight dental disease with treats: Choose treats and toys that help to control plaque and tartar. Some will include sodium hexametaphosphate (SHMP), which reduces tartar formation, or chlorhexidine gluconate, which targets bacteria and will continue to work for 24 hours.

4. Consider adding oral rinses and sprays to your pet’s at-home dental routine: These “point-and-spray” products can be used after meals in order to maintain your pet’s oral hygiene and health. Consult with your veterinarian to see which ones might be right for your pet.

5. Schedule a professional teeth cleaning for your pet at your veterinarian’s suggestion.

HealthyPet Magazine is committed to reducing the number of pets who suffer from dental disease. For more information on how to properly brush your pet’s teeth or to learn some of the other great pet wellness tips that HealthyPet provides its readers, please ask you veterinarian to provide HealthyPet Magazine.

Stay connected and like HealthyPet Magazine on Facebook at www.facebook.com/HealthyPetMagazine and follow HealthyPet on Twitter at @HealthyPetMag.


About HealthyPet Magazine

HealthyPet Magazine is a seasonal magazine that is dedicated to bringing relevant and educational pet wellness content to pet owners. Available exclusively through your veterinarian, HealthyPet Magazine is distributed to over 8 million pet owners every year, reinforcing the bond between the pet owner and his or her veterinarian. HealthyPet Magazine believes that improving communication between veterinarians and their clients leads to healthier pets. HealthyPet Magazine is published by Vetstreet®. To learn more about HealthyPet Magazine, please visit vetstreetpro.com.

What I Wish My Clients Knew

January 23, 2015 By: Dr. K Category: Opinion

Publishing this post has weighed on my shoulders. I’ve made the mistake of perusing the web, dangerously reading the opinions of lay people who lambast modern medicine and veterinarians. It’s crushing – but mostly – really irritating. Time to say what’s on my mind.

1. I am not rich.

I am in debt. Yep. That’s right. Like nearly all veterinary graduates who completed school circa the millennium or after, I carry a heavy student loan burden. Every month I have the equivalent of a big mortgage direct-debited from my checking account. It’s best this way so I don’t have to look at the money rapidly draining out of my funds. And with tax season upon us, I just received the balances remaining on my loans. It’s nauseating.

I am not sure where the misconception that veterinarians are rich comes from but suspect it’s from a lack of understanding of business practice and the laws of overhead and employment cost. Clients sometimes only see the “big” bill at the end of the visit and must erroneously believe the veterinarian pockets that money. By the time operational, supply, and staff costs are covered there’s not a lot leftover. Believe me.

2. While I may not be monetarily rich, I am rich in spirit…most days.

Veterinary medicine is fun, engaging, and ever-changing. There’s rarely a dull moment and that’s one of the things I love most about my career. A successful case keeps me walking on clouds for the day.  It’s a passion, a lifestyle, and a way to make a living. But it has a dark side the general public does not see. This career sucks the life out of you. Not in a boring-sitting-in-a-cubicle way. No.

It’s far more insidious.

Death, suffering, long hours, and high expectations are an elephant sitting on our chests. Clients can be demanding and demeaning without being compliant or trusting. In the height of stress, grief, and guilt, owners can say some of the unkindest things you can imagine. My shoulders are broad and most days I handle it well. But occasionally I bring it home with me and the queasy feeling lingers for weeks.

On the most challenging days I may come to your exam room after euthanizing a favorite patient and getting berated on the phone by a disgruntled client. Perhaps I’ve just been accused of “stealing food from a child’s mouth” or preventing someone from buying his ailing spouse’s prescriptions with my “high costs” of treatments and medications. Maybe I just found out a colleague committed suicide, succumbing to the depression that creeps in over years of burnout.

I walk in to your appointment with a smile, hiding the sorrow and the hurt from the previous appointments. While you may be my 15th appointment of the day, your 20 minutes with me is your only impression and I have to put a smile on my face. I need to make you feel like your cat is the most special cat in the world and answer questions I have answered a million times before without bleating like a broken record. If you walk out of your appointment knowing I love your pet, I have done my job well. I take pride in that.

3. Your opinion matters…most times.

Veterinarians share the basic need of feeling “liked”. I want you to like and respect me both as a person and a veterinarian. I want you to appreciate how much I care about the well-being of your pet. Please come again. Perhaps that sounds trite, but I strive to please my clients by being kind, accommodating, and understanding.


When you get angry with me because I won’t authorize a refill of your animal’s prescription when we haven’t seen your pet for three years and you’ve refused to keep up with the required lab work? No – at that point your opinion of me does NOT matter.

As my head hits my pillow at night, I need to rest assured I made decisions that upheld the standard of care I have set for your dogs. I need to know I have advocated for your cat. I need to know I’m not killing your dog with Rimadyl or Heartgard. If a client is angry I won’t practice below the standard of care to accommodate their demands, I will happily agree to provide a copy of her records and challenge her to find another veterinarian.

Side Note: The fastest way to get fired from my veterinary practice is to treat my staff with disrespect. Clients will never get away with name-calling, screaming, and stomping their feet.

4. I am not perfect and I hate it.

Most veterinarians are Type-A personalities. Perfectionists by nature, we push ourselves and oftentimes become our own worst critics.  Like any other medical professional, I cannot get the answer right every time. It kills me. I want to be able to streamline the diagnostic and treatment process for my clients. I don’t want to spend clients’ money and not get answers.

It’s called the “practice of medicine” for a reason. We’re always fine-tuning and perfecting our craft. That means missed diagnoses. It means imperfect surgeries and complications. It might mean more serious errors that could even lead to an animal’s death.  The terrifying stakes make me neurotic about preventing errors.

I’m not a perfect vet. I can never be perfect. And that keeps me up at night.

5. Euthanasia is NOT the hardest thing I do.

So many times, in the saddest moments of ending an animal’s life, my clients tearfully utter that this – this act of euthanizing dear pets – must be the hardest thing I ever have to do. I offer a conciliatory agreement to a grieving owner but the truth is it’s not even remotely the most difficult thing I do in the scope of my job.

Ninety-nine percent of the time the animal presented for euthanasia is suffering. Cancer, organ failure, or debilitating arthritis all lead to a confident decision euthanasia is the best course. Perhaps I have compartmentalized and protected my heart with this approach, but I truly believe I make the biggest difference by relieving suffering. Euthanasia is less a burden and more a gift to my patient.

The hardest thing I deal with is client finances. So often I am forced to make economic medical decisions because clients cannot afford the prescribed work-up and treatment plan. I loathe discussing estimates because so many times I receive negative reactions to the cost of diagnostics, treatments, and follow-up. I am stuck between two difficult spots: Providing the optimal treatment for my patient versus practicing within the financial limitations of my client. I cannot give away services routinely and stay in business. I must pay my overhead, staff, and myself. Yet, the compassion and drive to heal that provoked me to pursue veterinary medicine make me feel angst over allowing economics to play a role in my practice.

There’s no solution to this problem. Rare is the vet who doesn’t give away services. But if I gave away services to every case that needed charity, I would quickly be out of business. See #1.

6. I don’t want my child to become a vet.

Most parents would be flattered if they discovered their child wanted to follow in their footsteps. I’d get a knot in my stomach.

I want better for my daughter. She doesn’t need the physical abuse veterinary medicine rages on our bodies. She must live without a lifetime of debt. I don’t want anyone to question her integrity because they mistakenly believe she’s greedy. She doesn’t need to stay up at night worrying about her cases. Why enter a field where the public’s respect and trust is declining? And I cannot stand idly while she joins colleagues with one of the highest suicide rates of all professionals.

Please, dear child, get a business degree.

The Humble Feline

November 26, 2014 By: Dr. K Category: Opinion

A few weeks ago I examined a friendly indoor only cat for a several day history of not eating and vomiting. My examination didn’t reveal much of what might be causing her maladies, so I recommended we start with some laboratory work. Her owner’s reply left me speechless.

“This might make me sound like a jerk….” Uh oh. Experience told me that “might” is a great qualifier for “will” and I waited to hear what came next. “Well, you see, she’s a cat. I just don’t want to spend a lot of money on her, you know? I mean, if it were my dogs I would spend anything but, you know. Boy, you must think I sound like a jerk.”

Well, yes, kinda definitely.

So why the disconnect? Why is it that time and time again it seems dogs owners are much more willing to pursue veterinary care than cat owners? It’s not that Americans don’t love their cats – quite the opposite when you look at overall pet numbers and spending. Cats outnumber dogs in the United States by about 5,000,000 but are seen at the veterinarian about half as frequently. In addition, in 2012 the mean household veterinary expenditure per animal was $90/cat and $227/dog. Is feline veterinary care less expensive? Of course not.  Perception of dogs as “man’s best friend” and cats as “independent” definitely plays a role.

Below are a few myths surrounding felines. Feel free to add others in the comment section!

Myth #1. Cats are aloof and uncaring

My cats show me they care by saving intimate moments like bath time and anus exposure to quiet times on my lap while I am engaging in a desirable television watching activity. Nothing says they care more than the way like crush my cooking magazines under their fuzzy butts to prevent me from making that award winning chocolate lava mountain fountain cake and wrecking my diet. And believe me, the way they make sure to find the area rug with their projectile pica-driven dirt-ridden vomit is the definition of “I don’t want you to have to mop the hardwood because you just did it yesterday.” They care.

Ok, ok. I can attest my cats do not behave like Retrievers. While Miss Pigglesworth certainly eats like a Labrador, neither of my cats are people pleasers. They snuggle, use me for their grooming and petting needs, even mooch body heat on cold nights. Mine, like most cats, aren’t wired with the desire to please the way dogs are and, thus, the perception cold calculating murderers was born.

The truth is, cats do show affection through slow blinks, rubbing against your legs, cuddling, and playing. They don’t tend to fawn all over their owners. For me, that’s a plus. With a toddler tugging at my leg and the daily routine bogging me down, the last thing I need is an attention grubbing never-satiated dog under foot, or worse, tugging at my other leg.

Myth #2: Cats have superpowers

My cats think they have superpowers. Any self-respecting feline does. This is evident when a poorly executed furniture leap results in paw licking and coolness like it never even happened. But you know what power they don’t have? The power to keep themselves healthy and lick their wounds clean. C’Mon people! Do you REALLY believe cats have clean mouths and that licking wounds is the way a cat can “take care of itself?” I suppose if I cut my finger badly and it abscessed, I would just spit in the wound and gimp around for weeks until it scarred or I died from sepsis – whatever came first. Afterall, denial and deliberation makes more sense than seeking medical care, right?

For intelligent minds, the idea that any animal can care for itself when it is seriously ill is absurd and they seek veterinary care when kitty gets sick. Others really believe cats do not need veterinary care because…well…errrr…I have no idea why they think that. Cats are not self-healing magicians. If cat owners sought veterinary care when it was warranted, the mean annual expenditure would more closely match dogs.

(Aside: Many cats are part of multi-cat households. Some are part of multi-multi cat households – if you get me, crazy cat people.  Finances come into play when cat owner’s have to spread the care over multiple cats. My experience is when more than 3 cats live in a house at once: A cat is going to have lower urinary tract problems, another cat is peeing on the carpet somewhere, and someone always has upper respiratory tract signs. Crazy cat folk have a hard time keeping up with maintenance of the clowder, so many stop seeking veterinary care regularly to cut costs.)

Myth #3: Indoor Cats Don’t Need Vaccinated

1. Cats are the most common domestic animal in the United States diagnosed with Rabies.  An unvaccinated indoor cat that either escapes outside or is exposed to a rabid bat in the home is at risk and puts the owner’s life at risk. A cat or a human can be bitten by a bat and you may not be able to tell! Why risk it? Rabies kills!

2. The “Distemper” vaccine for cats, more accurately known at the FVRCP vaccine, prevents a fatal virus called Panleukopenia. In addition, even for cats who never go outside, the vaccine suppresses feline herpes virus infections from the 99.99% of cats who have been exposed and possibly carry the virus in a chronic state.

You might be wondering about that cat from the beginning of the post. Her owner consented to lab work and declined radiographs. The labs were normal and I sent her home on a cocktail of gastroprotective medications. I’ve received no updates and can only assume she tapped into her superpowers.

Another Veterinary Suicide Shines Light Into Dark Corner

October 06, 2014 By: Dr. K Category: Opinion

In the past week, the veterinary world lost another colleague to a brilliant mind, Dr. Sophia Yin, to suicide. Another high profile death shines the light in to the dark corner of the veterinary field the public knows little about; This profession can chew you and spit you out without flinching. Constant suffering, acting as the angel of death, and dealing with the owner economics in caring for a living being all press down firmly on our souls. Those more prone to depression can sink to the depths easily, without hope of rising above the clouds.

This article from Claws Carefully Sheathed highlights that weight we vets feel on a daily basis.


Other Useful Links:

Veterinary Suicide Rates

Burnout and Depression in the veterinary profession

Check out my previous post about Burnout that was published in Veterinary Economics.


I don’t have the answers, but I sure have a lot of questions and concerns.

Guest Column: Helping Your Veterinary Practice Navigate the ACA

September 13, 2014 By: Dr. K Category: For Vets, Practice Management

The Affordable Care Act affects many veterinary practice owners and it’s vitally important to stay abreast of new laws. In particular, mandates for insurance coverage and the advent of the health insurance exchanges have muddied the waters of understanding. Below a guest columnist, Monica Maxwell, SPHR, discusses the appropriate steps in navigating the ACA mandates.

Overcoming the uncertainty: Implementing a health care plan in a veterinary clinic
By Monica Maxwell, SPHR

Many veterinary practice managers, like managers in other industries, are looking at the changes brought about by health care reform and are uncertain about how best to implement a health plan for their employees. You probably didn’t enter the veterinary business because you are particularly interested in learning about health insurance, but you do care about your employees’ well-being, and you no doubt also know that health benefits are a great recruiting and retention tool.

So how do you go about finding a plan that meets the needs of both your employees and your business?

First, talk to your staff members and find out what is important to them. What if they don’t want healthcare? Or they prefer an option that will allow them to gain access to alternative care (like acupuncture). You cannot please everyone, but at least you’ll get an idea of people’s actual priorities rather than simply making assumptions. Also, if you have fewer than 50 employees, note that sometimes individuals can find less expensive or better-value plans on a health insurance exchange than a small clinic can offer its employees. The Affordable Care Act allows for companies with fewer than 50 employees to offer insurance on the health insurance exchange without penalty. It is a viable option for many, so you might want to consider referring them to an exchange if that makes the most sense.

After you have a clear idea of your employees’ needs, you’ll want to find a good health insurance broker. Chances are you don’t have the time or expertise to dig into the details of all the plan options and keep track of changing regulations. Choosing a broker is an important decision, so take the time to conduct a thorough search and interview process. Trust and rapport are critical. Ask potential brokers about trends they’re seeing in the industry and how those trends might affect a business of your size. Talk about the renewal process, communication styles, what you need from each other and how you see each other’s roles. Make sure your broker understands your needs and is willing to have a strategic discussion when it’s time to change your plan. They should be knowledgeable and flexible with you on the changing trends.

Once you choose a health care plan, make sure the company provides the service you require and expect. The network of health care providers (and the quality of care, of course) is important, but don’t underestimate the value of customer service. Quick answers to questions and timely payment of claims reduce administrative headaches and save everyone time and money. Benefits are important and ensuring your staff feels good about the quality and service they receive is absolutely critical.

Choosing a health care plan may feel daunting, but it doesn’t need to be overwhelming, and it’s not just a bureaucratic chore. A health benefit that helps keep your employees healthy and happy will contribute to your ability to attract and retain the best staff members, thus furthering your practice’s goal of providing exceptional care and service.

Porter & MM

Monica Maxwell is the program director for On the Floor @Dove, DoveLewis’s online, on-demand training website for veterinary professionals. Maxwell graduated from Sam Houston State University with a Bachelor of Science in psychology, and she has nearly 15 years of experience at both for-profit and nonprofit organizations. She shares her expertise with other veterinary practices through On the Floor @Dove.

Why Does My Vet Do That?

September 05, 2014 By: Dr. K Category: Opinion

As the years tick it’s easy to become a slave to routine. We do our jobs daily and soon a routine is formed. Over time I’ve become more engrained in my practice, adhere to the routine, and forget that many clients don’t understand why we vets do what we do during the course of an appointment! Wonder no more! I’ve compiled an explanation of some of the actions that may stupefy pet owners.

If I tell my vet my dog’s paw hurts, why does she look in his mouth?

Our critical listening skills are attuned, trust us! A thorough examination of every pet presenting with a problem is necessary to achieve a proper diagnosis. Did you know that a lethargic dog could have pale gums from internal bleeding or even red speckled gums from a platelet issue? Did you know we can look for jaundice in the gums and the whites of the eyes? I often reserve the “sore” limb for last so as to not develop a bias in my physical exam findings.

Why do they take my pet to the back for blood draws?

While some practitioners are comfortable and willing to draw blood in the examination room, oftentimes technicians and veterinarians will take your pet to the central treatment area for lab work. There are a few reasons for this. First, spare staff is typically roaming about and are readily available to provide an extra hand. Second, supplies and lighting are oftentimes better in the treatment area. Last, the techniques used to draw blood from domestic pets are not for the faint of heart. Typically, blood is drawn from the jugular vein when a larger sample is needed. I’ve been on the receiving end of a line-backer-sized man slumping down the wall in the examination room just from a peek at the syringe.

Why do they restrain my cat or dog even when he’s behaving?

For the safety of everyone in the room! My general rule of thumb is that if the animal has teeth he can bite, regardless of previous behavior. Pets in pain function on instinct and act accordingly. Proper animal restraint techniques can be misunderstood as being too “rough” or “hurting” the pet when in actuality handling techniques keep pets and staff safe during exams, vaccines, and blood draws.

Why does my vet require an examination for vaccinations?

Best medical practice means ensuring our patients are the healthiest they can be prior to receiving a vaccination. For vaccinations to reach full effect, the animal must be systemically healthy. We assess animals for signs of infection, disease, and fever. Giving a vaccination to a sick animal could be immunologically like not giving a vaccination at all. In addition, vaccinating a sick animal has the potential of exacerbating the disease – something none of us wants to see!

Why does my vet care so much about poop?

Your veterinary practice asks you to bring a stool sample to every annual examination but is it really necessary? YES! Dogs and cats, even indoor ones, can pick up intestinal parasites from a variety of locations including dog parks, walking trails, wild animals, consumption of wild animals, and insects. And did you know that tapeworms and roundworms can infect people? Hookworms can burrow in your skin! Veterinarians represent the front lines of public health and checking your animal for parasites protects both him and you!

Cutaneous Larval Migrans from Hookworms

Have wonderings? Ask in the comment section.

Is Your Vet Any Good?

July 13, 2014 By: Dr. K Category: Opinion

You’ve found a veterinarian who jives with your personality but wonder – Is she competent at providing the best care possible for your pet? There’s more than one way to practice veterinary medicine and provide good care. Then there are some practices that fail at the basics. I’ve assembled a non-exclusive list of what to look for to assure your practice meets the standard of care and a few red flags that tell you to take your business elsewhere.

Standard of Care

Cleanliness. All veterinary practices can have that odor from time to time, but it should not look dirty. If they can’t keep the waiting room clean, what do you think the surgery suite looks like?

Vaccinations. The widely accepted core vaccinations for dogs include Rabies and Distemper/Adenovirus/Parainfluenza/Parvovirus. Leptospirosis vaccines are part of the core dependent on where you live. Lyme and Bordetella vaccines are dependent on the individual’s risk factor and should not be administered to every patient. Core cat vaccinations include Rabies, Feline Viral Rhinotracheitis/Calicivirus/Panleukopenia, and for kittens, Feline Leukemia vaccine. The leukemia vaccine is only given to adult cats who go outdoors. Vaccination schedules are variable based on the individual states law regarding Rabies vaccination. Is your vet offering a Giardia vaccine? Coronavirus vaccine? FIV vaccine? Think again as these vaccines are recommended against by the AVMA and AAHA.

Stool samples, Heartworm, and Flea/Tick prevention. Your veterinary hospital’s job is to ensure you and your pet stay healthy. Proper parasite prevention is crucial, as a number of intestinal parasites are communicable to humans and disease carrying ticks can hitch a ride indoors on your pet. All pets should have routine screenings and preventatives they protect the pet and public health.

Pain management. If your new practice does not offer pain management with surgical procedures you need to find a new practice. The absence of pain management is barbaric and antiquated and shows the veterinary office is not following current guidelines and recommendations from governing bodies such as the AVMA and AAHA.

In-house diagnostics. Well functioning veterinary hospitals can perform radiographs and basic blood work and can easily acquire needle samples of lumps and bumps. I heard of one veterinary practice that does not perform fine needle aspirates of lumps and instead refers all of them. It takes very little skill to collect a sample, therefore even if your vet doesn’t read them herself, submitting the sample to the pathologist is the only other reasonable approach.  In addition, ear cytologies, skin cytologies, and urinalysis round out the list of diagnostics I expect all veterinary practices to perform.

Referral. Will your vet refer you to a specialist when it’s warranted? Referring complex cases for a more comprehensive work-up after you have exhausted their diagnostics is always in the patient’s best interest. Lack of referral reveals either an ego or financial issue.

Red Flags

Mean or disgruntled front-desk staff. My experience has shown that the receptionist staff is the canary in the coalmine for the temperature of the practice. If the front desk is unwelcoming and unaccommodating when you come in, it spells T-R-O-U-B-L-E with the rest of the staff.

Mean or disgruntled veterinarian. Sometimes we have a bad day but part of our job is to turn on our happy face with every appointment. If a vet can’t fake it for a 15 minute appointment block, we don’t deserve your business.

Hospitalization of patients overnight without supervision. This is tricky if you’re live in a rural area with no other options. However, I can attest  animals hospitalized overnight for “medical care” with no staff frequently experience the following complications: laying in urine/feces overnight, occlusion of intravenous fluids, and chewing out incisions and IV catheters with subsequent bleeding. Rarely animals with IV fluid lines can strangle themselves. If there is a referral or emergency hospital nearby, your pet will have more comfort and safety with a transfer to a 24 hour care facility.  If your pet will stay at a hospital that is unsupervised overnight, it is a veterinary hospital’s duty to alert you to the risks associated with doing so.

None of the exam is performed in an exam room. This goes two ways for me: 1. I know of a practice where all exams and conversations are performed in the waiting room while you are surrounded by other clients with their animals. 2. I know of multiple practices that take the pet to “the back” and return the pet when finished. Both of these scenarios are wrong. A thorough examination should be performed in front of the owner in a private exam room. This allows for conversation, follow-up questions, and peace of mind. The rare exception are dogs and cats who are so scared and aggressive that separation from their owner helps calm them.  All of this said, it is important to note that it is very normal for pets to be taken to “the back” for blood draws and, sometimes, nail trims. Frankly, our extra supplies and staff are there if needed.

Frequent misdiagnosis. We all miss a diagnosis from time to time. We have surgeries that don’t heal properly, swellings that shouldn’t be there, and treatments that don’t work. But if your veterinarian has repeatedly incorrectly diagnosed a common disease process you can rest assured the quality of medicine she is practicing is poor. Reference material, continuing education, and other veterinarians are great resources for any veterinarian. There are plenty of ways to reach an appropriate diagnosis even including the aforementioned referral to the specialist.

If your veterinarian meets the basics and no red flags have alerted, feel confident that you can have a good relationship with your veterinary hospital.