If you’re a cat lover and enjoy dry humor, you’ll chuckle at this article from one of my favorite satire news sites! Have a Silly Saturday!
WASHINGTON—The current session of the 111th Cat Congress was once again suspended Tuesday following the sudden introduction of a sunbeam onto the Senate floor, a development that has left a majority of transfixed lawmakers unable to move forward. Read the full article here at The Onion News.com!
Here’s a little public grievance for my friends at Pfizer Animal Health: Stop jacking up the cost of veterinary medications on a quarterly basis and pricing my clients out of treatment! There, I said it. Pfizer, creator of wonderful drugs like Convenia and Zeniquin, has been increasing the cost of its medications exponentially since early last year. I grimace as I prep owners for the financial shock when these medications are indicated. Don’t even get me started on the price of Rimadyl and Clavamox.
Perhaps the recession hit the drug giant hard and their financial loss is being passed along to distributors and veterinarians. This is capitalism in action and money makes the world go round, yada yada. My problem is not with profit, but the repetitive precipitous increases in cost that get passed on to my clients. It’s not that the price is rising, it’s how fast and how much the price is rising each time. In some instances, the price rises nearly $0.10/pill every quarter. That sounds like small potatoes until you take into account that’s $10/quarter and $40/year on every bottle of medication we dispense. I recently wanted to prescribe 10 days of Zeniquin to a large German Shepherd for an ascending infection arising from a nail bed. Cost to owner would have been about $150. Yikes! Talk about seeking an alternative drug therapy!
Rising prices mean changing treatment plans to accommodate an owner who doesn’t have $150 to spend on medications. I will write a prescription for antibiotics so owners can get them for a better price at a local pharmacy. However, there are only a finite number of medications, particularly broad spectrum antibiotics, available to treat these common conditions so options are limited for a serious infection. I lament providing the “suboptimal” treatment because, quite frankly, drug companies like Pfizer can’t put a cap on their prices for more than four months.
This one’s for the girls. Recent discussions on my friend Dr. Khuly’s blog, Dolittler, have compelled me to beg, plead, and grovel for you to please have your female cat or dog spayed. A recent discussion about a pregnancy gone awry topped with an article released from USA today about attitudes toward sterilization of pets have burdened my heart with the age old problem of pet overpopulation and unnecessary suffering. Despite advocacy to have pets spayed or neutered in a push to curb pet overpopulation, a staggering number of animals acquired last year have NOT gone under the knife! Granted, some animals were too young for surgery at the time of the survey but 24% of respondents who hadn’t altered their pets stated they “hadn’t gotten around to it” while another 14% stated they “didn’t feel it was necessary.” Irksome at best, but potentially a red flag for a bigger problem: Lack of proper communication and education between the veterinary profession and pet owners.
Top Five Reason to Spay
1. Pet overpopulation
An estimated 4 to 6 million unwanted and stray animals are euthanized in shelters every year. The world, quite honestly, doesn’t need anymore dogs and cats to add to the mix. There will always be pet overpopulation (I’m not so naive to believe the problem will ever go away) but every person can do his/her part by making sure the cycle ends with their pets. This is NOT to say responsible breeding should be outlawed or discouraged. I guesstimate responsible breeders (AKA not puppy mills, not backyard breeders, not accidental breeders) minimally affect the overall pet population.
2. Pyometra
An all too common affliction of older dogs is a condition known as pyometra, or an infected uterus. This is a life threatening condition that can lead to sepsis and death if untreated. A uterus filled with infection can rupture in the abdomen leading to peritonitis. This condition is 100% preventable with a spay. Spaying your pet as a youngster is significantly less expensive than emergency surgery years down the road, so you’ve got no room to complain about cost.
3. Mammary Cancer
Mammary cancer develops commonly in unspayed females later in life. About 45% of mammary tumors are malignant in dogs, whereas around 90% are malignant in cats, and dogs have a much higher number of complex and mixed tumors than do cats. Spaying dramatically reduces the risk of mammary cancer in both dogs and cats. In dogs the risk has been reported as 0.5% when spayed before the first heat, 8% if spayed before the second heat, and 26% if spayed after the second heat. For a listing of scientific findings check out SkeptVet.com’s summary of research regarding companion animal mammary tumors.
4. Unwanted/Unplanned/Poorly Planned Pregnancy
I’ve heard the “I just want her to have one litter” line too many times. She doesn’t need to have a litter. Period. In addition, accidental breeding can result in a size mismatch and a possible dystocia (read: stuck puppies) during labor. Raising a litter of puppies or kittens is expensive when you consider all the time, effort, or finance that goes into caring for them for 8 weeks. The bitch or queen should be examined following labor. The puppies or kittens will need to be examined, dewormed, and vaccinated prior to being sold or adopted. Lack of planning or foresight can set the unsuspecting owner back a pretty penny.
Dolittler describes a case of at best, egregious ignorance in pet owners who “married” two dogs, missed all the signs of pregnancy and labor, and allowed their poor Maltese to have a dead puppy in her uterus for 24 hours – a move that may have ultimately lead to the dog’s death. “Back yard breeders” must be discouraged. Back yard breeders are folks who decide they want to breed their dog, know little about doing it properly, and typically do it with dreams of profit. It seems as though those breeders always seem to find the sickliest, poorest-doing dog with multiple congenital and genetic problems and breed her. And don’t even dream of those dogs having been vaccinated. I actually had one couple ask if a puppy would come out of their Chihuahua’s “who who”. That’s biology 101 folks. If you don’t know where babies come from perhaps you should avoiding breeding. That applies to both dogs and people.
Proper breeders will have their dogs or cats tested for contagious diseases, examined for general health, radiographed to see the approximate number of puppies/kittens, and are prepared for whelping/queening. They will follow-up with a veterinarian and have all puppies/kittens examined, dewormed, and vaccinated prior to placing them in appropriate homes.
5. Stop that Heat Cycle
Blood, howling, nervousness, lingering males. Need I say more.
Cold weather means snow, hot chocolate, and car problems. That puddle of antifreeze in the driveway could mean more than car trouble. Dogs can’t resist the sugary taste of antifreeze and consumption can lead to big problems for your pooch. Cats are less likely to lap up antifreeze but, if they do, the same fate awaits.
The main ingredient in antifreeze is ethylene glycol, an alcohol. Once ingested, ethylene glycol is rapidly absorbed in the GI tract, typically within 1-3 hours. The first 12 hours after ingestion pets will be intoxicated by the alcohol and therefore, may behave like they’re drunk. Ataxia (stumbling and falling), seizures, stupor, and coma can occur. Ethylene glycol is then broken down to glycoaldehyde → glycolic acid→ glyoxylic acid → oxalic acid, with different stages of disease occurring with the different metabolites.
Glycolic acid is highly toxic as it inhibits cellular energy metabolism and causes a severe metabolic acidosis. This can lead to cardiovascular collapse evidenced by high heart rate, pulmonary edema, and heart failure. If your pet survives these first two stages, it will contend with kidney failure caused by the end product of ethylene glycol metabolism, oxalic acid. Kidney failure typically occurs 24-72 hours following ingestion in dogs and 12-24 hours in cats. Oxalic acid causes kidney necrosis, or death, along with swelling. All three stages of toxicity can overlap making it difficult for the veterinarian to determine exactly where the pet is in the disease process.
If you suspect your pet has consumed antifreeze, you need to contact your veterinarian immediately. Diagnosis of ethylene glycol ingestion is made largely based on history and clinical signs as well as laboratory abnormalities. Metabolic acidosis, low blood calcium, and calcium oxalate crystals in the urine are typically diagnostic. These urine crystals can be present in the urine of nonaffected dogs and cats but should be held in high suspicion in animals with other symptoms. A blood or urine test exists for ethylene glycol, but is only available at certain laboratories and results may not be timely. Additionally, these levels are only detectable for up to 76 hours post ingestion.
Aggressive medical therapy is required. Aggressive diuresis with intravenous fluids is indicated. If ingestion recently occurred, the metabolism of ethylene glycol should be prevented by using compounds like 4-methylpyrazole (more widely used) or ethanol. Both compounds inhibit alcohol dehydrogenase, the main enzyme that begins the breakdown of ethylene glycol. In addition, drugs like thiamine and pyridoxine are used to prevent oxalate crystal formation. Urine output must be monitored closely. Some patients require hemodialysis or peritoneal dialysis.
Prognosis for animals treated in the early stage of ethylene glycol intoxication is guarded to good when appropriate treatment is instituted. Prognosis is poor for animals who have already developed kidney failure.
I have followed through with one of my New Year’s resolutions! And yes, I am proud of it!
You can now follow me on Twitter: @VMDiva. New blog posts will be listed on my Twitter page. Follow along for more personal updates and get to know your VMDiva!
Recent comments on my posts have touched on one of the most pervasive yet least talked about subjects in veterinary medicine: Burnout. There were no courses in vet school on how to deal with this topic. I suppose we are expected to suck it up and deal with it. That doesn’t sit well with me as I see excellent veterinarians bail on their careers, families, or worse, lives, in response to the stress this profession brings.
Burnout has many causes. Veterinarians typically work long hours. Very long hours. Those hours are changing, fortunately, for small animal veterinarians and a small subset of large animal veterinarians. Long hours alone can lead to mental fatigue but then take into consideration emergency care. The long hours topped off with calls in the middle of the night lead to physical fatigue. Yawn. For the practice owner, life is even more harried. Owners are balancing veterinary medicine with business decisions. In their “down time” they are making financial decisions for the practice, handling upset clients, and managing personnel. It can easily consume all of an owner’s waking hours. Maintaining a proper work to life balance is critical in keeping your sanity.
Next is the issue of stress. Every veterinarian has different stressors. For some it is dealing with difficult clientele who demand so much of your time you fall behind schedule or sit on the phone for what seems like hours waiting to leave at the end of the night. For others it is dealing with compassion fatigue. As acclimated to pain, suffering, and death vets become, we are never quite comfortable with it. The mental toll this takes is not always apparent until you find yourself lying awake at night thinking about a case. I still have patients who break my heart and I admit to tearing up over them. Compassion fatigue alone can be enough to lead a veterinarian to burnout. This phenomenon is common in all medical professions. And for other vets, stress comes from balancing the desire to provide optimal care with an owner’s financial considerations. Rare is the vet who hasn’t heard, “I can’t afford any of that. You’re going to let my pet die. If you cared you’d give it to me for free.” These difficult situations are only magnified by the aforementioned physical and mental fatigue.
Any job can cause burnout if the work environment is toxic. Viral personalities, unyielding bosses, unreasonable hours all lead to discontentment. As stress and angst grow at work, small issues become magnified and soon become large issues. In these cases, if the practice is stagnant and unwilling to change, you’ve got to make the change yourself. Quitting your job is no flippant recommendation. It should always be considered carefully as the grass is always greener.
So what do we do about it? More vacation, less hours? That will certainly help. Do we leave our jobs? For some that’s feasible, for others it’s not. But what are some creative ways to lessen the daily stress that tends to accumulate over time?
Our feline friend from A Complicated Matter: Locating a Rogue Testicle had exploratory surgery today. He was not amendable to a thorough physical exam prior to surgery but once he was under anesthesia, the usual locations for a rogue testicle were inspected before making an abdominal incision. The likelihood the testicle had arrived in the scrotum was slim to none and, as expected, the scrotal sac was empty. However, another common location called the inguinal ring yielded a full-sized testicle!
When the testicle descends during development, it travels from the caudal pole of the kidney, down a ligamentous pathway called the gubernaculum, through a pelvic and muscular channel called the inguinal canal or ring, and into the scrotum. In our friend, the cryptorchid testicle was most likely trapped in the canal and could not be palpated externally or internally during the original abdominal explore. With time, growth, and a little luck, the testicle emerged from the canal and could be removed via a relatively non-invasive skin incision.
The story doesn’t end with surgery. Tackling the inappropriate elimination issue is key! I’m looking forward to a happy ending.
Last night I may have gotten a taste of what it’s like to be a mother who has to let her baby cry himself to sleep. But let’s start two weeks ago, when my cat Winston decided to urinate outside the litterbox. It was not urinary “accident”. Oh no, it was a protest. He protested the delay in breakfast and, in true attention seeking fashion, urinated on the carpet at the entrance to my bedroom. I cleaned the stain, chalked it up to a one time event, and went along my way. About a week later I noticed the undeniable odor of cat urine wafting down the hallway. A nose to the carpet revealed the pungent odor of urine along the wall outside my bedroom. Despite all my veterinary behavior knowledge, I was ticked but decided to fight the urinary demon full force.
This wasn’t the first time we’ve had urinary accidents in the house. In 2006, when my new husband moved into our new home, Winston began urinating in the dining room and bedroom. After performing a medical work-up to rule out some of the common causes of inappropriate elimination (see below), I determined the stress of the move and a new family member shook his world. We scrubbed carpet, added another litterbox (actually, an underbed sterilite container filled with litter), removed lids from the other 2 boxes, and changed to unscented litter. We purchased a cat tree, toys, Feliway diffuser, and locked him out of the bedroom. And when that wasn’t enough, he even received a six month stint of Prozac. He finally began using the litterbox again, was taken off of Prozac, and the carpet in the dining room was removed. All was well until two weeks ago.
Back to last night when I decided to lock the two cats in the basement in an attempt to curb the inappropriate urination. The crying, howling, and gnashing of teeth began in protest of their new imprisonment. It killed me to hear them pawing at the door and meowing their melancholic sorrow. Alas, it had to be done. I am hoping a couple of weeks of confinement will yield a mental reprogramming of sorts. My husband’s office is in the basement so I have eyes watching Winston use the litterbox, which I am proud to report he has been doing.
Tips for Dealing with Feline Inappropriate Elimination
I will be sure to keep you posted!
I was recently awarded the opportunity to diagnose and correct a gastric foreign body. I had a phone call from a concerned owner who reported her young Samoyed, who I’ll call Hoover, was caught with a spool of thread in her mouth. According to the owner, Hoover had a propensity to consume anything and everything in sight. The owner was concerned with a threaded needle that was missing. I recommended monitoring Hoover’s feces in the coming days for any evidence of a needle and thread. Five days later, no needle. The dog remained asymptomatic.
The dog was admitted for radiographs which revealed a needle in the cranial midline abdomen. Discussion with the owner touched on the risk of needle migration within the abdomen or even though the diaphragm and into the chest. We also agreed about the unlikelihood the needle would pass through the GI tract given how much time had passed. We decided to take Hoover to surgery for an abdominal exploratory. We were prepared to find the needle in the stomach, intestines, liver, or free floating in the abdomen.
The abdominal explore began by observing the liver and abdominal cavity for evidence of a threaded needle. Then the stomach was exteriorized and I palpated significant amounts of firm material and digesta. The length of intestines were examined. Once I determined no foreign material was present elsewhere in the GI tract, a gastrotomy was performed. Two stay sutures were placed in the oral and aboral portions of the fundus. An incision was made near the greater curvature of the stomach.
Initial digital exam revealed large amounts of foreign material in both the pyloric and esophageal regions. Two large pieces of soft plastic material, resembling snack cake wrappers, were removed from the fundic and esophageal regions. A large firm glom of material was palpable in the pyloric region. Steady traction yielded a large baseball-sized orb of chewed pieces of white plastic, undiscernible foreign material, and, in the dead center, a needle with dark thread wrapped around the entire mass.
The prognoses for the dog’s recovery and future repeat offenses are both excellent. Hoover will most likely return to my care for a foreign body in years to come.
The name Michael Vick tends to incite inflammatory conversations about the man’s widely publicized exploits in dog fighting rings. Pet owners nationwide were largely aghast that the Philadelphia Eagles would extend a contract to a man who was convicted of brutalizing pit bulls in 2009. Now, I don’t believe Michael Vick is any different from Baltimore Ravens infamous bad boy Ray Lewis, who’s rap sheet could circle the equator, just because his crime is against animals. They are both criminals who don’t deserve NFL contracts. I don’t believe either one of these men should be given the privilege of million dollar contracts, public notoriety, and a position as a role model for children. But that’s another conversation.
What I find more disturbing is that the Philadelphia Eagles awarded Vick the Ed Block Courage Award. Are you serious, Philadelphia!? The Ed Block Courage Award is “given annually to a player who exemplifies commitment to the principles of sportsmanship and courage.” Vick is anything but courageous. Courage implies choice to persevere despite adversity. The only choice Vick made in this situation was to abuse and mutilate dogs. The law caught up with him and placed him behind bars for 18 months. There is nothing respectable nor courageous about serving your prison term.
“I’ve had to overcome a lot, more than probably one single individual can bear,” Vick said. “Take a look at what I’ve been through. You ask certain people to walk in my shoes, they probably couldn’t do it — probably 95 percent of the people in this world. Because nobody had to endure what I’ve been through — situations I’ve been put in, situations I’ve placed myself in, decisions that I’ve made — whether they were good or bad. There are always consequences behind certain things and there are repercussions behind them, too. Then you have to wake up every day and face the world, whether they perceive you in the right perspective or it’s a totally different outlook on you.”
Michael, you’re missing the point here entirely. People would not walk in your shoes let alone try them on! They would not beat, electrocute, and mutilate dogs for entertainment. I couldn’t walk in your shoes, not because I couldn’t endure prison, but because I could never have exhibited such blatant disrespect for life! And Michael, you don’t deserve to have a “right” public perception. I perceive you as a heartless, money hungry athlete who was willing to brutally sacrifice animals for cash and amusement.
And where does personal accountability come into play? He shows a glint of personal accountability but loses any credibility when he bookends his speech with his sob story about the challenge of living the life of a convicted felon. He wouldn’t have had nearly as much to overcome had he not continually recommitted himself to his dog fighting ring. Vick should never have gotten another opportunity to play professional sports, let alone an award for pulling himself out of the hole he dug with his own hands.
Philadelphia Eagles, you look like a bunch of Dodos.
Dr. Jennifer Koehl offers a unique perspective on all things veterinary medicine.
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