VMDiva

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Archive for the ‘General’

Ch-ch-ch-ch-changes.

September 27, 2012 By: Dr. K Category: General, Just For Fun

Tumultuous. That’s how I describe the last 6 months in the VMDiva family. We’ve experienced so much change since the turn of the year and nearly all of it is exciting and wonderful!

As a general rule, I loathe change. Even good change scares me and exacerbates my ongoing neurosis and worry. But alas, the only sure thing in life is change and it really is better just to embrace it because just when you get comfortable…Bam! Huge changes. Huge changes usually reduce me to a wilted, blithering pile of nerves. But not this time. This Diva has stayed strong!

Bring on the Emergencies

I made the decision this summer to leave my veterinary practice in search for more mental stimulation and job fulfillment. Burnout is very common in my profession and I am not exempt. General practices daily doldrums lulled me into boredom and restlessness. I needed a jolt!

I’ve gotten my jolt with the pursuit of emergency medicine! Emergency practice always brings excitement even if it’s an emergency case of fleas at 2am. (Yes, seriously.)  I am thrilled to have finally pulled the trigger and pursued a dream. I suspect some very interesting case studies are on the horizon for you readers.

More Career Changes

Not only have I changed jobs, but my husband has begun a fabulous new position with room for personal growth and expansion. Two new jobs in 3 months? And I still didn’t melt into a puddle of uncertainty! We couldn’t be more thrilled with where our careers are taking us.

Saying Goodbye

One of the sad notes of the VMDiva family has been saying goodbye to some beloved pets. My dear Winston succumb to his many ailments and is sorely missed. I held him in my lap as he took his last breath. His neurotic, sneezing, snuffling persona endeared him to the soft spot in my heart for unthrifty animals.

In addition, my parents have lost two pets who held large pieces of my heart. The most loving, entertaining, and dopey black labradors you could ask for crossed their rainbow bridges this summer. These siblings, Jake and Rachel, passed within three months of each other leaving a void that may never fill.

Saying Hello

The biggest change of all: The VMDiva family is expanding! My wonderful husband and I are expecting our first child in January! We are excited, nervous, and going through all the emotions expectant parents experience. We can’t wait to introduce you to the newest addition of our family.

 

In Memory

Ten Signs It’s Time To Leave Your Veterinary Practice: Part II

July 17, 2011 By: Dr. K Category: For Vets, General, Practice Management

Ten Signs It’s Time To Leave Your Veterinary Practice: Part I

I’ve listed  the first 5 signs it’s time to leave your veterinary practice in Part 1. The remaining 5 signs below are equally important. Feel free to list more signs or relate personal experiences!

6. Compromised Patient Care

Do patients sit in their filthy cages all day? Tipped over water dish never filled? If your practice fails at basic care for patients, it will never excel at advanced medical care. Practices that competently complete the basics are easy to find; Finding practices that excel at advanced care proves more challenging.

A dear friend told me about a nightmare hospital where they put on the facade of a referral hospital, even providing blood products. Of course, not one of the support staff members knew how to perform a blood transfusion. Couple that with their lack of transfusion supplies and you’ve dialed up a situation for poor patient care.

Compromised patient care, at any level, is a deal breaker. Clients entrust their beloved pets to veterinary hospitals and believe we will rightly care for them. We are obligated to peak performance. If a practice does not have its focus on patient care, refuse to compromise.

7. The Practice Is Chronically Understaffed

The formula for stress at work:

Stress = Too many tasks + Too few employees – Patient care (see #6).

If your practice is always hiring, firing, or losing employees, you can bet that turn-over rate is an indicator of severe dysfunction traceable to the leadership. Practices with high churn rates find themselves in a perpetual cycle of being understaffed. High churn also means new employees in need of training. But without staff who trains them? Too few and untrained employees results in one big problem: Poor patient care!

8. Lies, Lies, Lies

Whether it’s lying to employees or lying to clients, businesses built on lies are dangerous. Evacuate now.

9. Inability to Effect Change

The ability to effect change is integral to feeling like a contributing member of a practice. Having ideas for improvement embraced and implemented rewards free-thinking employees. Movers and shakers become frustrated when their repeated attempts at correcting problems are thwarted by ineffectual leadership.

If you’re ideas and offerings are met with cold stares, or worse, promises of compromise that never come to fruition, perhaps it’s time leave for fertile ground.

10. Life Has Changed

The fluidity of life can alter your needs so that jobs that formerly fit well then may not fit now. Marriage, children, illness, and family struggles all may change your employment needs. It’s never wrong to seek a job that fulfills your financial needs, provides better benefits, or offers the hours compatible with your life.

 

If you are in the market for a new job in the poor economy, perseverance and ingenuity are key. Make yourself more marketable by filling niches. Create job opportunities instead of just pouring over the classifieds. Thinking outside the box just may open doors for job fulfillment!

Ten Signs It’s Time To Leave Your Veterinary Practice: Part I

July 16, 2011 By: Dr. K Category: For Vets, General, Practice Management

Deciding to quit requires great consideration and, in many cases, should only occur following exhaustive attempts at improving your workplace. For tips on how to cope and avoid quitting, check out the first half of this article from US News and World Report!  If you think you are at the end of your rope, quitting your job may be the only option you have left.

Leaving your job during a down economy carries enormous weight.  Frequently the idea is abandoned because of fear of the unknown. Too often we accept mediocrity in exchange for comfort. Our griping, stress, and stagnancy linger because we don’t want to sacrifice a sure thing.

Some of the best advice I ever heard came from Mr. Vernon Hill, past-CEO of Commerce Bank. When asked what to do when management refused to budge he said pointedly, “Something’s gotta change. Either they change or you change.”

I offer you 10 signs it’s time to leave your practice. Many of the signs are interrelated, a consequence of compounded dysfunction.

Ten Signs It’s Time To Leave Your Veterinary Practice

1. Lack of Leadership

Having a definitive leader in a practice is key to maintaining balance and unity between personnel. A practice is only as strong as its leaders. The discord from lack of leadership trickles down the ranks from associates all the way to kennel staff. Leadership failures include ignoring conflict, refusing to address employee concerns, and an inability to accept feedback and criticism. If business owners and managers refuse to establish and adhere to set practices and guidelines, the practice quickly morphs into an every-man-for-himself mentality.

The strongest practice leaders seek input from their employees and strive to improve work relationships. Without that direction inconsistent policies, unresolved conflict, and disgruntled employees contribute to an even bigger problem: Poor patient and client care.

2. You No Longer Enjoy Your Job

This one seems like a no-brainer but it deserves a closer look.  Only about half of Americans report they actual enjoy their jobs. Yikes! Money, interpersonal relationships, long hours, and the job itself comprise many of the reasons for job dissatisfaction.

Burnout is one of the biggest factors affecting a veterinarian’s job satisfaction. There is a big difference between physical burnout secondary to long hours and emotional burnout secondary to chronic stress. Physical burnout can sometimes be remedied with vacations or sabbaticals. Emotionally burnt out employees may have no other choice but to leave their current position in order to reestablish balance.

We will all experience bad days, weeks, or months at work. Overall job dissatisfaction comes from chronic, systemic dysfunction resulting in more bad days than good over an extended time.

As an aside, I don’t know many veterinarians who, at one point or another, haven’t doubted their calling into the profession. The long hours, chronic stress, and interference with personal life take a toll. It leaves us second guessing. Determining whether you are unsatisfied with your job or your career is critical.

3. Work Interferes With Family Life

Veterinary professionals expect long hours and late nights. Those unfortunate enough to have the plague of  “on-call” carry a tether to the veterinary practice making maintaining your family and social life difficult.  Long hours make veterinary medicine challenging enough, throw in a chronically stressful work environment and you’ve got big trouble.

Overworked on a soft tissue rotation during my fourth year of veterinary school, the only thing I could think of on my 20-minute drive home was a hot sausage sandwich. It waited for me, an ample leftover certain to squelch my starvation. I arrived home to find my husband had eaten all of the sandwich rolls and all but three inches of coveted porky goodness. The consequences of fatigue, stress, and an 80-hr work week played into the epic at-home work-induced meltdown that ensued.

Rational thought escaped as I went on a tirade about how it was clear my husband didn’t love or respect me since he ate my long fantasized about dinner. I heated the measly morsel and continued to accost my poor husband. I stormed to the office, my husband in slow chase behind, and to my dismay my sausage rolled off of my plate and across the floor. I bawled. A lot. Work stress weaved its way into my home life and my attitude suffered for it. In retrospect, this proves another hysterical moment among many in our relationship, but a lesser man may not have been so tolerant of work-related meltdowns.

Ideals, however noble, are rarely upheld when serious long-term stress hits. Our families are the first affected by sour moods. Sometimes our work situation is so miserable no amount of positive thinking and affirmations contain the emotion of job dissatisfaction. Don’t let your family suffer.

4. Ouch! You’ve Run Into The Ceiling

Positions with little or no room for growth are frustrating. Stagnant minds rot. Stagnant paychecks are rotten.

5.  Any Other Job Is More Appealing

Find yourself thinking waiting tables looks better than your current job? Willing to take a significant pay cut just to escape? See those road workers dripping in sweat on a summer day and jealously think ‘Hey, they look so tan!’? You are not alone but it’s time to seriously rethink your current situation.

Remember the expression “The grass is always greener on the other side of the fence?” It’s true. It’s greener because it’s fertilized with bulls**t. We’ve neatly concocted scenarios in our minds as to how much better it is over there. If the only reason for leaving is  you think it’s better on the other side, think again. Perhaps you just need a vacation. But if you find yourself nodding in agreement with some other signs, this may contribute to your decision to leave.

 

Ten Signs It’s Time To Leave Your Veterinary Practice: Part II

Is it broken? Nah, it’s just fractured.

April 02, 2011 By: Dr. K Category: For Vets, General, Opinion

A colleague’s recent appointment went hysterically awry when the owner misunderstood the explanation of the dog’s illness.  Upon presenting to our clinic with a “swollen nipple”, my colleague diagnosed the dog with mastitis, a painful infection of mammary tissue.  Her owners recounted the treatment plan, consented to labwork, and waited while the diagnostics were performed. When the veterinarian and dog arrived back in the exam room, one owner said, “What’d you call that problem again? Mass tits?”

Mispronunciations and misunderstandings are a staple of veterinary medicine and I rarely fault my clients for them. Refills of subscriptions, ascriptions, and scriptions fill the prescription inbox. Eyedrops treat cadillacs. Elbows are knees, wrists are ankles, their left is my right. This list goes on and on. I usually chuckle and note I should keep a list (yes, I should definitely keep a list) but a few pet peeves still get to me.

Spaded

Every veterinarian has been there.  A client requests to have her puppy “spaded” and you fight the cringe. I’ve tried gentle coaxing with, “We can certainly set up an appointment to have your dog spayed; The receptionist can set that spay up for you.” This rarely works though I find myself trudging forward on a fruitless journey. It seems as though this term is firmly rooted in the client vernacular.

If gentle guidance doesn’t fix the misnomer, this is one better left alone. The correct term for removing the ovaries and uterus is an ovariohysterectomy. The general term for the procedure is a spay. It turns out spay is an English term derived from the French term espee, the early derivative of the sharp blade used in fencing called the épée.  A spade is a tool used to dig, cut, or remove. Maybe spayed and spaded aren’t so far apart afterall?

It’s Just Fractured, Not Broke

Somewhere in the history of medicine someone decided broken and fractured were both recognized medical terms for varying degrees of bone injuries. The idea spawned faster than mosquitoes in an abandoned tire. The misconception that fractures are minor injuries with minimal bone separation and “broken” applies to bone fragments in different counties is simply…false. Fracture is the only professional term describing the traumatic separation of contiguous bone. If it’s broken, it’s fractured. Separated bone ends are called displaced fractures. Bone fragments jutting through the skin are called compound fractures. Comminuted fractures refer to bones in multiple pieces.

This one is easy to remedy. Most clients are eager to learn about things relatable to humans. They describe the fracture in detail to friends and family and some even want copies of the radiographs to wave in people’s faces. (Much like me, many people can’t refuse the opportunity to show bruises, wounds, and other injuries in a attempt to either shock or one-up people. Some time I’ll tell you about the worst blood draw I’ve ever received. We’re talking full arm bruising. I digress.) Use this opportunity to correct wayward clients.

Lyme’s Disease

I tolerate client misinformation fairly well, but the term “Lyme’s Disease” is one I am seeing crop up on paperwork from other veterinary practices.  My skin crawls and my ears buzz when I hear a veterinary professional say “Lyme’s Disease”  further propagating misinformation and general ignorance to a highly endemic disease. If a professional can’t bother to use the correct name, how confident are you these veterinarians know the most up-to-date treatment and monitoring protocols for it?

Lyme disease is named after Lyme, Connecticut, ground zero for Lyme Disease. Perhaps I am particularly sensitive to this issue because I practice on the east coast where 9 out of 10 dogs will test positive for exposure to Lyme. Perhaps it’s because every time I turn around there is another consensus report on proper diagnostics, treatment, and follow-up on cases of Lyme disease popping up from researchers at my Alma Mater.  Or perhaps I expect the same level of attention to detail as I would give. Either way, straighten up. It’s Lyme, not Lyme’s. Read your JAVMA.

Your Dog Ate What? The Top Eats of 2010

January 02, 2011 By: Dr. K Category: General, Just For Fun

Dietary indiscretion can make for some good blog fodder. This year’s more memorable consumptions weren’t too hard to remember. I’ve left out the non-descript fetid balls of fabric, the shredded toys, bones, and rawhides due to their predictability and opted to let you in on some of the more ludicrous, dangerous, and enormous meals my client’s dogs have enjoyed.

Note: Labradors are overrepresented in this top ten.

10. One M&M

A panicked chocolate toxicity call always spices up an evening at work. But no, a solitary M&M is not anywhere close to a toxic-dose for Fido. For toxic doses of chocolate, check out this old Chocolate Toxicity Post.

9. Silica Gel Packets

The Animal Poison Control Center reports a large number of calls about dogs consuming these tiny desiccating packets. These little delicacies that come with your new shoes must taste great. Relax, this little nosh is non-toxic but can cause GI upset.

8. 50+ Pieces of Orbit Xylitol-Containing gum

This little Yorkie had a hankering for spearmint. What she didn’t count on was the dangerous hypoglycemia and potential liver damage from this outrageously high toxic dose of Xylitol. She lived to tell the tale and her owner has vowed to never have gum in the house again.

7. Feces

One of the most common complaints I get revolve around a dog’s proclivity to eat its own feces, other dog’s feces, any feces. Does it indicate a nutritional deficiency like some speculate? Maybe. Consumption an innate way to camouflage the dog’s presence in the environment? Could be. Does it taste good? Definitely. Another reason not to let Jake lick your face!

6. A Full Bottle of MultiVitamins

This proud pooch didn’t have a vitamin deficiency, just an apomorphine deficiency. We happily obliged, induced emesis, and Fluffy went home without complication.

5. Transmission Fluid

Perhaps the foulest smelling diarrhea I have ever smelled (yes, worse than parvo) came from a Labrador who consumed the remnants of a bottle of transmission fluid while exploring the garage. The mixture of feces and lubricant smelled like the tar used on telephone poles. Despite the cathartic effect, this guy didn’t miss a meal.

4. A bag of Cat Nip, Reese’s Peanut Butter Trees, and Styrofoam

If I told you this dog had no diarrhea, would you believe me? I suggest not putting your Christmas presents under the tree until it’s time to open them. While large amounts of styrofoam can cause an obstruction, this lucky dog simply enjoyed opening everyone’s gifts a few days early.

3. Tampons (Twice In One Year)

You’d think the first foreign body surgery to remove a tampon from your dog’s intestines would be enough of an incentive to buy a garbage can with a lid or close the door. I guess not.

2. Two boxes of Andes mints, 2 bags of Lindor Peanut Butter Truffles, 2 boxes of Pop-Tarts, and the box for a creme brulee baking kit.

This one goes to my parents’ three labradors, who diligently found their way through a closed door and consumed all of the above without consequence. A chronicle of all of their indiscretions is the subject of it’s own blog.

1. One bulk box of Cheese Its, one bulk box of Pepperidge Farm Goldfish, 16oz of Almond Slivers, 16oz  of Raisins

Both of these labradors can’t seem to stop eating their owners out of house and home. These repeat offenders raided the pantry after their owners came home with purchases from a wholesale club. They pranced into our office thrilled to have their dietary indiscretions rewarded with a trip to the vet. They were more than eager to eat up wet food laced with hydrogen peroxide and savored their spoils – for about 5 minutes. Waves of nausea hit the ladies but neither would…errr…cough up the goods. Good old Labrador iron gilded skulls and stomachs. Activated charcoal treatments, IV fluids, lab work, and two days of hospitalization later I decided to crown these two with Top Digestive Honors for 2010!

VMD vs. MD: How Far Apart Are We?

September 29, 2010 By: Dr. K Category: General, Opinion

I received one of the best compliments of my professional career this week when a client said he “wished his doctor was as good” as me. Wow.  His comment got me thinking: What makes me so different from his MD? Did his MD fail to engage him, encourage him to speak, make eye contact? I certainly am not that fabulous. I wondered where his MD fell short. I thanked him and told him my motto to veterinary medicine is to “Laugh so you don’t cry.” It’s important to keep it light when you can or you’ll end up crushed by the burden of the profession.

My quantum leap in thought took me back to college when I began as a biology major and a pre-medical student. That’s right. I coveted an emergency room physician position.  I had done work in an emergency room as a senior in high school and knew medicine was my destiny. Medicine was my destiny, just not human medicine. As a person who has seen both sides of the coin, I can draw some informed comparisons and contrasts.

I think the greatest agreement between the two fields comes in our education. Both veterinarians and doctors are taught how to diagnose and treat diseases all over the spectrum. From simple skin diseases to complex endocrine diseases, we learn them all. Veterinarians are problem-solvers most like ER Physicians. We must be prepared for anything that walks in the door and see a variety of cases throughout the day. Both vets and doctors (at least the good ones) must possess terrific “people skills” as medicine serves the public.

The biggest contrast between the two professions is probably directed by litigation and finances. A veterinarian’s pursuit of diagnostics and treatment is frequently limited due to cost.  I often find myself saying, “If we only can do one test, then I pick this one because….” I fantasize what my job could be like if I had unlimited access to blood tests and imaging. Bliss! Fear of litigation and the financial ability to perform diagnostics drives physicians to order a battery of tests. This is no indictment of MDs, on the contrary, I would find myself in the same situation had my career aspirations not done an about face in college!

Additionally, the high specialization in human medicine greatly contrasts with the average small animal general practitioner’s position. A specialist has a depth of knowledge in their niche that cannot be rivaled. In the span of a day, an endocrinologist may see five diabetics, two patients with thyroid disease, and several patients with obesity. My day consists of surgery, dental extractions, diagnosing heart disease, kidney disease, thyroid disease, and dermatologic disease all while managing a dog hit by a car and a rabies suspect. My breadth of knowledge adds spice to my career and keeps me fresh. The surge in veterinary specialists is slowly changing the profession’s focus but the vast majority of veterinarians still engage in the many facets of veterinary medicine.

Despite the differences one thing rings true: Good veterinarians and physicians care deeply about their patients’ health.

The Shortest Distance Between Two Owners Is a Straight Talk

June 09, 2010 By: Dr. K Category: For Vets, General

The diversity of my appointment schedule never ceases to amaze me. From the blissfully smooth to the guilt-inducing no-money client, I fluctuate between joy and stress throughout my day. One hair-pulling situation involves the disabled pet owner of two small fluffy dogs who routinely appoints her caregiver the task of bringing the aging beasts to me for exams. Following the visit, I then call the owner to discuss my findings, diagnosis, and plan. I’m struck with minor annoyance by having to repeat the entire appointment over the phone but can understand the owner’s absence.

The real trouble arose when I realized the owner and caregiver have a palpable distrust of each other. The caregiver revealed the owner doesn’t want her present at the exams. The owner called before an appointment to ask that I not tell the caregiver too much. The caregiver tells me the owner fails to give medications as prescribed and refuses to follow recommendations. The owner assured me she gave the medication and the dog is still no better. I’ve found myself in the middle of a owner/caregiver/dog triangle and needed to find the fastest way to the best outcome for my patients.

I’m tasked with placing the dogs’ health at the forefront while still adhering to the wishes of their owner. Now, I’m no fool and realize owners lie to me about giving medications, diets, and who knows what else on a regular basis. I rarely have foreknowledge of the impending lie. I tend to believe the caregiver’s story  because there is no rational reason for her to lie about the owner lying. The owner, with her impaired faculties, probably believes admitting to her lack of compliance will result in relinquishment of her pets. Despite this, I refused to cut some back-exam-room-deal with the caregiver to reach the treatment plan these dogs need. The owner has exclusive right to chose as long as she adheres to anti-cruelty statutes. So instead, I’ve employed my straight talker tactic.

I asked the owner pointed questions about completing courses of antibiotics and reasons she wished to pursue XYZ courses of action. We spoke candidly about quality of life and her ability to provide adequate medical care to her pets. I built trust and after we had a rapport, I reiterated the importance of all the things we discussed and planned. I cannot control whether she does them or not which is a lesson in patience and understanding only time teaches.

And I haven’t forgotten to document, document, document!

Anyone else out there find themselves in a similar situation? How did you handle it?

The Crutch: Internships vs. Employment for New Veterinary Graduates

June 02, 2010 By: Dr. K Category: For Vets, General, Opinion, Veterinary School

It’s internship season which always makes me wonder: Is life after an internship so radically different from spending your first year in private practice? I decided to forgo an internship, mostly for financial and marital reasons. Kudos to my husband who tolerated my indebtedness for four years of vet school. This year’s new veterinary graduates are faced with a decision that has educational, financial, and personal implications: Pursue an internship or full-time employment? About 40% of new veterinarians are entering internships upon graduation, leaving the remainder to *fingers-crossed* find strong mentorship at a private practice. New graduates have the base knowledge needed to develop a list of differential diagnosis but have yet to learn the the art of recognizing nuances of disease in practice, delivering bad news, and having confidence in their abilities.

In an academic setting, influences from specialists and the constant inundation of “ivory tower” medicine can easily persuade students to pursue additional training after graduation. Many of my classmates pursued an internship with knowledge they would never pursue a residency. But why? I argue many new graduates lack confidence in their knowledge and instead find themselves leaning on an internship as a crutch, that stepping stone between student and independent veterinarian. It’s not wrong to feel insecure but it warrants recognition for what it is. I’ve heard many reasons for pursuing an internship from: inexperienced, not ready, want more emergency training, not sure about specialization. Most of these reasons boil down to fear.

I felt fear and, admittedly nausea, on my first day of work as a veterinarian in private practice. I don’t regret my decision to forgo an internship. Within months I felt at home, climbed the steep learning curve, and blossomed into the veterinarian I am today. Interns earn a pittance, work double the hours of a private practitioner, and defer loan payments for one more year all the while accruing interest. I challenge new graduates to honestly explore the reason for pursuit of an internship because that path is wrought with challenges.  If the pursuit is for more education and career advancement – go for it! If it is fear of primary case responsibility and decision making – take the brave step, find a mentor in private practice, and jump!

In the Line of Duty

April 28, 2010 By: Dr. K Category: General

You certainly don’t think of the veterinary profession as one where performance of duties risks loss of life. Police, fireman, and men and women in our armed forces certainly face the prospect of death daily, but veterinarians rarely need to worry. Sadly, a small animal veterinary colleague died this month after she was struck by a vehicle while attending to two dogs who laid in the road outside her home. The driver fled the scene but has since been arrested and jailed.

Dr. Kathryn Gilpatrick, 37, died assisting her neighbor’s dogs who strayed into the road near Knoxville, Tennessee. We animal lovers put ourselves in harm’s way treating these animals. I know the emotional trauma of seeing pets in the road struck repeatedly by traffic. As a teenager, I stopped in the middle of the night to carry a wayward snapping turtle across a darkened road to ensure its safety with disregard for my own. I’ve even pulled over on the side of the highway to help fearful dogs who’ve found themselves in the middle of traffic. I won’t say these traits are innate but they come pretty close. Veterinarians share the passion to preserve animal life and alleviate suffering. I am sure Dr. Gilpatrick died doing what she loved.

Like Dr. Gilpatrick, I find myself unable to sit idly by during times of crisis. It’s humbling to view the fragility of life and to know the call of duty, however great or small, comes with great implications.

Hope for Cats with Snots, Snuffles, and Snorks

April 14, 2010 By: Dr. K Category: For Vets, General

How do you remove dried snot from painted walls without damaging the paint? You can’t. At least that’s my experience with my chronic snotting, snuffling, sneezing, snorking cat. Winston has successfully plastered my walls with copious amounts of mucous with a holding power rivaling the largest tube of gorilla glue. If you have one of these snorkers in your house, there is hope!

I recently attended a veterinary conference lecture that focused on these cats by Cynthia Stubbs, DVM, DACVIM. We all know snot-nosed cats can prove difficult to manage for both veterinarians and pet owners. Once the appropriate diagnostics are performed to rule out some of the more easy to treat issues, many pet owners are faced with the choice of advanced and often expensive diagnostics. While I still strongly recommend performing a vast array of diagnostics to get to the heart of the disease, many times cats suffer from difficult to diagnose rhinitis and sinusitis that can be exacerbated by respiratory infections. There is a probable association between chronic snorkers and chronic infections with herpes and calicivirus. Both herpes and calicivirus attack nasal and upper airway mucosa, causing chronic inflammation that can lead to nasal discharge and destruction of the delicate nasal bones that sit inside the nasal passages. This correlation has lead Dr. Stubbs to pursue both palliative and curative treatments.

Dr. Stubbs suggested one such treatment involves giving affected cats intranasal bivalent vaccinations against herpes and calicivirus. The intranasal delivery is purported to increase local mucosal immunity and therefore decrease the inflammation in the nose. Dr. Stubbs reported some cats needed only the vaccine on an every 3-6 month basis for near complete relief. The off-label use of the vaccine does not confer any immunity to panleukopenia, so Dr. Stubbs recommended also giving the traditional subcutaneous trivalent FVRCP vaccine. In addition, Dr. Stubbs bravely uses the anti-inflammatory antibiotic doxycycline along with the NSAID piroxicam to provide additional symptomatic support. Word to the wise: Non-liquid forms of doxycycline are known to cause esophageal stricture in cats and piroxicam should not be used in cats with kidney disease.

I am planning on trialing the intranasal vaccine in my own snorker. We’ve tried multiple antibiotics – no small feat given Winston is a perceptive, neurotic, inflammatory bowel disease cat. Nothing has alleviated his six years of nasal congestion. I will certainly follow-up in future postings.

Diagnostics Performed in Nasal Discharge in Cats

  • Complete physical exam
  • Complete bloodwork, urinalysis, Felv/FIV testing, +/- coagulation testing
  • Blood pressures, particularly if nasal discharge is hemorrhagic
  • Nasal cytology, culture, and biopsy
  • Viral detection tests
  • X-rays, CT scans, Rhinoscopy
  • Nasal Flushes

Common Diagnoses In Nasal Discharge in Cats

  • Dental disease – very common
  • Rhinitis/Sinusitis – very common
  • Nasal foreign bodies
  • Cancer
  • Nasopharyngeal Polyps
  • Infection: Bacterial, Viral, Fungal, Parasites – common either as primary or secondary diseases
  • Trauma
  • Hypertension or bleeding disorders