A Vet’s Guide To Life

Did you know that I was a professional wrestler?  Seriously.  And I get to practice it pretty much every day.  Some days I think I might be able to take on Hulk Hogan or The Rock (yeah, dating myself a bit on my knowledge of wrestlers).

You see, many of my patients don’t want me to examine them, inject them with vaccines, or collect blood and fecal samples.  Go fig.  Unfortunately, they really don’t have much of a choice, and these things do get done one way or another.  Many times that involves physical restraint, and sometimes that restraint can get pretty strong.

Veterinarians and veterinary staff are trained in various ways to safely and effectively handle pets.  Most pets won’t simply stand there as you poke them in various uncomfortable ways.  We need to be able to keep them still to allow us to do necessary procedures, keep them from getting injured, and keep the humans from getting bit or scratched.  It’s also important to be able to “read” the pet and know when physical restraint isn’t going to work, and we have to use injectable sedatives.  The longer someone works in the field, the better they get at being able to restrain dogs and cats.  After 24 years at this, I’d consider myself pretty darn good.

We had two patients today that required a bit of a “lock-down”.  One was an extremely happy but uncontrolled 80-pound pit bull.  We needed to do some pretty simple things, but he just didn’t know how to control himself.  And even though I’m double his weight, it’s still very hard to hold a dog this size still.  I had one arm under his belly, while my other arm circled his neck around the top and came back to grab one of his front legs.  Kind of a pretzel hold.  The other pet was a 105 pound Burmese mountain dog that really didn’t want his eyes looked at.  Holding a dog’s head still is actually harder than holding the rest of him still, and this dog wasn’t an exception.  These kinds of pets are far stronger than you would think, and it can be tricky to get them briefly still without anyone getting hurt.

Because I’m the only male in the place and because of my experience, I often hold large dogs for my techs to collect samples or do other simple services.  And sometimes I do have to get the equivalent of professional wrestling moves on the patients.  Now, when I’m talking professional wrestling, I’m not really talking about Olympic-style, Greco-Roman wrestling.  I’m talking about the decidedly American “rasslin’” that you see on late-night TV and Pay Per View.  I’ve often had to get very creative in how I grab legs, paws, heads, and bodies.  I’ve sometimes had to practically lay on top of them and put most of my body weight on them.

Don’t get me wrong.  I definitely don’t want to do anything to hurt the pets, and am very ready to use chemical restraint when necessary.  I just hate having to do something like that for a procedure as simple as collecting blood for a heartworm test.

So think about this if you ever get into an argument with a veterinarian or their staff.  These folks are very experienced in rasslin’, and aren’t the kind of people you want to pick a fight with!

I’ve been in the veterinary field for about 25 years now, and during that time I have known countless thousands of pets.  Most of them have had relatively common names, and honestly not much originality.  If you look at the most common or popular pet names in the USA, it breaks down like this (listed in order beginning with the most popular).

Dogs:  Max, Jake, Buddy, Maggie, Bear, Molly, Bailey, Shadow, Sam, Lady
Cats:  Tigger, Tiger, Max, Smokey, Sam, Kitty, Sassy, Shadow, Simba, Patch

Now, depending on which resource you use, the list may vary a little, but most of these names will show up in the top 5 on any list.  Do any of your pets have these names?  Then you’re in very good company.  And I’m sure many people have good reasons for giving these names to their pets.  However, as a veterinarian, I find them lacking in originality.  Sure, there’s nothing wrong with them, and they make great names.  But the ones I enjoy are the truly unique ones that you may not immediately know the significance of.  These often stick in my memory, sometimes for years.

One of my favorite examples was a cat I saw when I was in vet school.  Honestly, I don’t even remember why he was being seen, since pets normally only end up at veterinary colleges if it’s a difficult case.  But I definitely remember his name….Bird Dog.  Yes, a cat with this name.  Of course, it was a bit of an unusual name, so we asked the owner about it’s significance.  He said that when Bird Dog was a kitten, he would look out the window and see something that caught his attention.  When he did, he would go stiff, hold up one front leg, and point with his nose.  Just like a pointer, or bird dog.

In my own family, I try to do unique names.  The first pet I ever named myself I called Galahad, a gray and white cat.  I love mythology, and wanted something Arthurian.  I was going to use Merlin, but his personality didn’t seem to fit.  My second cat I named Perceval, to keep the theme going.  After being married, my wife got a cat of her own, and named him Pooka, after the dog in the animated movie Anastasia (one of her favorite movies).  When we got our lab, we mulled over many names, but ended up back in the Arthurian names with Guinevere.  A year ago we got a new kitten, and let our kids name it.  They wanted Pikachu, since they are fans of Pokemon, but I couldn’t bring myself to call a cat that.  I talked them into Ash, which is the name of the main character, and the kitten was all black.  I’ve already picked out the name Gimli (from Lord of the Rings) for the English bulldog that I will eventually own.

Clients often have difficulty picking names, and I’ve had many that will go through different names for the first several visits.  When it comes time to your own pets, give it some thought, and don’t be afraid to really branch out.  If nothing else, your vet will really enjoy the story.

Speaking of that, I’d love to hear yours!  Readers, post a comment with your own pets, and how you chose them.  Any of you who happen to be in the veterinary profession, feel free to add any names that have really stuck in your mind (like Bird Dog did with me).  I’m looking forward to seeing them!

I’m old enough to remember a time before the Internet, rotary dial phones, and home computers being a luxury rather than a commonplace item.  Anyone remember computer programs on cassettes?  And before you go thinking that I’m ready to retire, I’m 39.  These changes in our society have come on very quickly, and I don’t think that people born after MTV really understand just how much things have changed.

One of the things that has most impressed and amazed me is how much smaller the world now seems.  My father is Swedish, and I remember what a big deal it was for him to talk to his family back in Sweden.  Now it’s a simple matter of a quick and free email, and you can make international calls practically for free via internet phone services.  We as fans of the Net have found ways to come together in ways that would never have been imagined 20 years ago.  I’ve been using email and internet-like services for about 15 years now (remember BBS’s? Newsgroups being more common than web sites?), and have gotten to know many people around the world through various forums and sites that I’ve belonged to.

Over the last few years I have developed acquaintances and friendships with people in England, Australia, Japan, Germany, France, Canada, and all over the US.  With most of those people, I have no idea what they look or sound like, and may not have ever learned their real name.  Yet I have gotten to know them rather well, and have even helped them over the computer like I would any friend by phone.  I’ve also been able to keep in touch with “real” friends by computer easier than by phone.  This blog has been viewed by people in the UK and New Zealand, and maybe others that haven’t made their presence known.

The internet isn’t just a cool place to meet new people.  As a medical professional I can look at articles and consult with specialists around the world, something I wouldn’t be able to do with local resources.  I can research things professionally and for personal use without ever getting out of bed.

So look at how our world has shrunk, and we can now interact and communicate in mere seconds to people in virtually every corner of the globe.

There was a bit of a rough morning for me today.  My second patient of the day was a schnauzer that I had diagnosed with a heart murmur four months ago, but had not come in for an evaluation.  He came in with congestive heart failure, and the owners decided to put him to sleep.  While I was preparing to do that, a young cat who had been hit by a car suddenly came in.  She was in shock, and had severely fractured her left hind leg with bone poking through the skin.  Additionally, she didn’t have any feeling or movement in her hind legs, apparently having suffered a broken back and spinal damage.  Her owners also decided to euthanize.  So I went from one to the other, trying to end the suffering of these two pets.

As a vet, euthanasia is one of the hardest things we have to do.  Yes, it does help to end the pain and suffering that a seriously ill or injured pet is feeling, and knowing that allows us to be able to give the injection.  However, we are knowingly ending a pet’s life, and that is a very serious decision.  I never take it or recommend it lightly, even though I think there are definitely circumstances where it’s necessary.  Today, I told the clients of the schnauzer that treatment might be possible, but without it euthanasia was the best option.  To the cat’s owner, I told them that there really wasn’t another option given the severity of the injuries.  In both cases, I was helping severely and even terminally sick patients.

As hard as it is to actually be the one doing the injection, the harder part is knowing how to relate to the clients.  I’ll admit that I don’t feel comfortable with human grief, and often feel at a loss when dealing with clients whose pets I am putting to sleep.  However, I also know what they’re feeling, as I’ve had to watch it happen to my own pets, and even had to personally euthanize one of my own cats.  Everyone handles it differently, so it’s hard to know how to prepare.  I’ve had some people simply say a quick goodbye and leave.  Others have broken down until they couldn’t stand and grabbed onto me.  Most of them simply cry.  Many times I’ve thought that it’s harder to see a grown man cry than a woman.  But however it happens, I have to be there with them when they say goodbye.

Goodbyes are never easy.  Many of these people have had the pet for years, and it’s a valuable member of the family.  Some want to be there with them when the light leaves the eyes and the pet breathes their last, while some find it too hard to see these final moments.  Unfortunately, this is not something they really teach us in veterinary school, and some doctors learn it better than others.  I’d like to think that I’ve learned some ways to help comfort people during this time, though I also feel like I still struggle.  No matter what I say or do, it often seems inadequate.  Putting an arm around someone, telling them they made the right decision, and allowing them to lean on me when they cry is about all that I can do, and I know that it doesn’t completely make up for the fact that they now no longer have their friend and companion.

For any who have lost a pet, my heart goes out to you.

We have a little puppy clinging to life in our hospital.  He’s critically ill, and has about a 50% chance of surviving.  For the last three days he has been lingering, not really getting much better or even worse.  There’s no way for us to be able to predict what will happen at this point.  All we can do is treat him, take it day by day, and hope for the best.  The worst part about it is that this was completely preventable.  He has parvo.

Parvo virus is a very serious intestinal disease, and highly contagious.  Puppies are most susceptible, though dogs of any age can potentially get it.  Interestingly, this virus (which affects only dogs) mutated from the feline panleukopenia virus in the 1970s.  It was first recognized in 1978 and had spread world-wide within two years.  Over the years very effective vaccines were developed, and nowadays it’s one of the most common ones given to dogs.  The vaccine is very effective, and is a major reason to make sure your dog receives all of his or her immunizations.

The virus has devestating effects on a dog’s body.  It first attacks the lining of the intestine, causing the villi (small projections where food is absorbed) to die and slough off.  Several bad things happen because of this infection.  The dog becomes very nauseous, not wanting to eat or drink.  Even if they try, they often cannot hold down food or water.  If anything makes it past the stomach, the absorptive areas of the intestine are gone, so almost nothing is absorbed or retained by the dog.  The lack of an intestinal lining means that the dog also looses much water through the intestines, causing severe diarrhea.  The combination of fluid loss and an inability to take in more leads to rapid and often severe dehydration.  Bacteria in the intestinal tract can get into the dog’s blood stream through the weakened barriers in the intestine, leading to severe systemic infection.  Dogs that are infected in the uterus or before about 8 weeks old can have the virus also infect the heart, though this is much les common.

This combination of effects become evident very quickly.  A dog can be fine one day and critically ill in less than 48 hours.  Most puppies who contract parvo will die without treatment.  Even with treatment we can’t save all of them.  Truthfully, there is no cure for parvo.  We give them intravenous fluids and antibiotics, and try to control their symptoms as best as possible.  Then we have to just wait until they die or their body is able to clear the virus and recover.  Basically, treatment involves trying to keep the dog alive until it heals on its own.  And that can take anywhere from a few days to a week or more.  During that time, they can be seriously sick and in pain.  It’s definitely not a very pleasant way to struggle with life.

Luckily, the parvo vaccine is very effective.  However, it does no good if it’s not given.  Puppies should start receiving vaccines around 6 weeks old, and every three weeks or so after that.  The puppy we’re treating didn’t receive the immunization before becoming infected.  And because of that, he might die.  I see many people who don’t get their puppies in for vaccines until they are several months old, and some not even then.  Later in the day I saw an 8 month-old poodle that was having bloody diarrhea, not eating, acting lethargic, and starting to vomit.  All of the classic signs of parvo, and it had never received vaccines.  The owners couldn’t afford any tests or treatment, so we’re not sure if that was the problem.  But it well could have been.

So please make sure your dogs receive their vaccines as recommended by a veterinarian.  It truly is a matter of life and death.

In today’s society it’s common to talk to people who learned English as a second language.  Sometimes their grasp of English is minimal, which makes communication difficult, especially if you’re having to discuss potentially complicated medical issues.  Now, I could go on a rant about how you should learn basic communication in the language of whichever country you’re living in (this goes for Americans living abroad also), but that’s not my reason for writing.  Several years ago I had a rather awkward situation involving a translation, and one that I can now laugh about.

A Hispanic woman came to see me with her cocker spaniel for routine vaccines and preventative care.  She didn’t speak or understand much English (if really any), so she brought her daughter with her to help translate.  I guessed that her daughter was about 9 or 10 years old, and did have full fluency in English.  The visit was pretty routine, and I went through the vaccines, heartworm testing, and so on.  The dog was overall healthy, so there weren’t any complicated issues to discuss.  Or so I thought.

You see, the dog wasn’t neutered.  And I felt that I couldn’t overlook the recommendation to neuter him, as I feel that this is an important surgery that can prevent health problems.  Realize that “neuter” is the polite and commonly used term.  What we’re really doing is more properly called castration, since we’re completely removing the testicles.  And remember that the mother didn’t speak English.

So there I was, needing to recommend that the dog be neutered (castrated).  The mom couldn’t understand me, and the little girl was translating.  Somehow I had to tell the girl that the dog should have surgery so she could tell her mother.  This was a bit awkward (to say the least!), as I didn’t know what the girl might or might not know about “the birds and the bees”.  Yet I had to get her to tell her mother to have the dog’s testicles removed!  Sheesh!  I think I finally stumbled around and said something about having surgery so he couldn’t make any babies.  I’m not sure how much the girl or the mother really understood, but not speaking a lick of Spanish myself I did the best I could.

If anyone has friends who don’t speak English well, please recommend that they learn the language before going to the vet.  Not only will they be able to understand more about their pet’s health, but they might just save their vet a ton of embarassment!

There are many abbreviations used in medicine, most very confusing to average people.  Just look at your prescription some time before you give it to the pharmacist.  Something given by mouth is abbreviated “PO”, meaning “Per Os” (Latin for “By Mouth”).  A medicine given twice daily is listed as BID.  If you look on a medical record and see TPR, this stands for Temperature, Pulse, and Respiration.  A problem with the right eye might be listed as OD, or “occular dextrans”.  The list could go on.

Which brings us to an abbreviation that I have seen used in official records while I was in veterinary college.  This is surprising because of what it stands for.  Keep in mind that medical abbreviations are normally based on Latin or sometimes Greek, and are considered official and proper designations.  These abbreviations are not taken lightly.  And that brings us to the abbreviation of “ADR”.

Most of the time when a patient comes in, the client can list the problem.  It might be vomiting or diarrhea, limping, acting lethargic, not eating, or a number of things.  However, sometimes the client can’t say exactly what’s wrong, only that there is something wrong.  I’m sure those of you with pets know your own pets very well, and can tell when they’re not feeling well.  It might be kind of subtle, and you might not be able to put your finger on the exact problem, but you know there’s an issue that needs to be examined.  When your pet is sick with ambiguous or even indefinable symptoms, your vet might list him or her as “ADR”.  So what does it mean?

Imagine a farmer bringing his dog into the vet.  He doesn’t know what the problem is, but he knows that his prized hunting dog isn’t feeling well, and he’s worried.  The doctor asks him what’s going on, and what problems he’s seeing.  The farmer replies, “I don’t know, doc.  He just ain’t doin’ right.”

Yes, that’s correct.  “ADR” stands for “Ain’t Doing Right”.  And I’ve seen it in official veterinary college medical records.  I’ve always enjoyed this abbreviation, and find it very amusing that something like this has persisted among veterinarians for who knows how long.  So the next time your pet has a mysterious problem, tell the vet that they are ADR.  I’ll bet that your vet will understand.

This is perhaps a subset of Pet Peeve #1 (go back and find it at the very beginning of my blog).  I talk to people who have a pet and sometimes hear “it’s only a (dog/cat/hamster/parakeet/etc.).”  I have clients who put their dog or cat outside, and pretty much let it fend for itself.  Sure, they provide food for it, and maybe get vaccines done, and if I’m very lucky they will make sure it’s on heartworm and flea preventions.  But they don’t spend time with it, don’t train it, don’t interact with it, and don’t really make it a part of their family.  The pet just kind of exists as something they have.

We have come a long way in Western Civilization in our attitudes towards pets.  One hundred years ago they were largely there to help around the farm, kill mice, and protect us.  However, there have always been dogs and cats raised purely for companionship.  Look at the history of some of the breeds, and look at pictures of royalty.  There were often ornamental dogs, bred to be small and exotic-looking, and bred to have behaviors that make them good companions with no ability to hunt or otherwise provide a useful skill.  In the last century, we have progressed to where the “working” dogs are the big minority, and most people have them as family pets.  It’s also gotten to the point that we now have monogrammed dog beds, sweaters, Halloween costumes, and other things that make them into little people.  The bond between pets and people has grown closer, until now they sleep in our beds and we treat them as our children.  And I am of the opinion that this is a good thing.

Having a pet is a big responsibility.  You are their sole provider, and it’s your duty to provide them with good shelter, adequate medical care, proper nutrition, and see to their well-being.  But many people forget about their mental well-being, and this is just as important.  These are not wild animals, and have been specifically bred for millenia to be close companions to us.   Do you keep your dog outside in a pen or on a leash and only see it when you dump some food in its bowl?  Do you cringe when the dog tries to play with you or jump on you out of love and seeking attention?  Does your dog have some behavioral issues because it’s been left by itself and you never really gave it proper training and socialization?  Is your pet becoming an inconvenience and a frustration because caring for it hampers your lifestyle?  If you answered yes, then I have to be blunt….why do you have a pet at all?

Many people get dogs and cats (and other pets) because they think it will be fun, and don’t really think about the responsibility.  When the pet turns out to need care and attention, it bothers the people.  Basically abandoning that pet and ignoring it is actually potentially cruel.  And it really frustrates people who strongly care for pets and have close bonds with their own.  Those readers who are in the pet care or veterinary fields know exactly the people I’m talking about.

If you’re one of the people these people that I’m talking about, please stop, look outside, and look at your pet.  Is what you’re doing really fair to them?  Do they have a good life?  Is ignoring them really being a responsibile pet owner?  Starting today, make a promise to me and yourself that you will embrace that pet, give them the care and training they need, and make them a member of your family.  If that dog or cat is really an inconvenience to you, then please consider giving it to someone who really wants to care for it properly, and will give it a better home…because I promise you that if you see it as an inconvenience and are mostly ignoring it, then you are not the right person to be caring for it.  And if you end up giving this pet up, please, please, PLEASE think long and hard before getting another pet, and make sure you’re fully 100% ready for what it takes.

Winter is coming, and that means we need to be aware of the weather changes with our pets.  Here in the US there are huge differences in weather, from Maine to the Dakotas, Florida to Oregon, California to Georgia.  But regardless of where you live there are some guidelines to remember.  Most of our pets, especially dogs, aren’t really well designed for living outside.  We’ve bred them to be dependent on us, and often have bred coats that don’t do well in cold weather.  Smaller breeds are especially at risk for this.

Most dogs can do well outside, though long-haired breeds are much more likely to have problems with matted fur.  However, dogs that aren’t arctic breeds shouldn’t be outside in cold weather.  A dog house with fresh straw or hay is needed to help keep them warm and well-insulated.  The bedding should be changed regularly to keep it clean and hygenic and to prevent insects and parasites from growing.  Outside dogs should also have shelter from rain or other precipitation.  Don’t use heaters in dog houses, as they are a potential fire risk, and we definitely don’t want that to happen!

As a rule of thumb, I tell my clients that if the weather is going to dip to freezing or below, pets should be brought inside.  Certain breeds, such as huskies, malamutes, St. Bernards, and other thick-furred dogs can do well outside in cold weather with appropriate bedding and insulation.  But most breeds cannot tolerate these temperatures, especially small dogs or breeds with short hair.  I know that many people have kept dogs outside year-round, so I can’t completely argue that.  But often that is in warmer climates, or they have very well insulated dog enclosures.  The average pet owner likely isn’t going to have good preparations for that.

What if your dog is large, or messy, or particularly rowdy and you simply cannot or are not willing to bring it inside your house?  Well, a garage is always an option, and is going to be warmer and have better conditions than being outside.  If you still can’t or won’t do that, I’d have to be blunt and ask why you have a dog (again, I can be more direct here than with my own clients).  As a pet owner, you have a responsibility to provide them with proper care.  Pets can also be extremely rewarding, and bring a lot of joy, fun, comfort, and companionship.  If a dog is simply going to be outside all of the time, you might want to seriously think about why you have it.

Now, those of you who have kennels with many dogs for breeding or hunting, I’m not really talking about you.  I know plenty of people with these circumstances that interact with and train their dogs daily, and give them excellent care.  Admittedly some people simply have so many dogs that it’s impossible to bring them all inside.  In that situation, make sure they have appropriate places to stay when outside.

The weather is getting colder, and we need to think about our little fuzzy friends.  Take care of them and think about whether or not you would want to sleep outside during the winter.

The last week’s blogs have been a bit heavy, so let’s close out the week on a lighter note.  Today I had a situation presented to me that I’ve never been faced with in 11 years of practice.  Sure, I’ve heard of it happening, but how it was put before me was very unique.

A client had dropped off their dog, a shih-tzu, and their cat for routine preventative care services.  When the came later in the afternoon to pick them up, one of my receptionists came back to me and had a strange look on her face.  “Dr. Bern,” she said “Mimi’s owner wants to know why she gets ‘frisky’ when they get ‘frisky’.”  I just had to stare and blink for a few seconds.  Mimi was a very sweet little 3 year-old spayed female, and I couldn’t figure out the connection.  My receptionist was also uncertain if she heard it right.  So, knowing this might be a private conversation that shouldn’t be discussed at a very public front desk, I had her put the clients in a room.

I walk in the room, and there is the couple, being warmly greeted by their little dog.  I took a breath and gently try to broach the subject.  “Now, correct me if I’m wrong,” I started, “But I’ve been told that Mimi reacts when you get…’frisky’…and you’re wondering why she might be doing this.  Is this right?”  The gentleman nodded.  Now realize that he was the one who used the word “frisky” to my receptionist, so I’m just repeating his phrasing.  And I think all of you readers probably realize the true meaning of that word in this context.  Now I was left with trying to delicately get more details in order to hopefully solve the situation.

After a little more questioning, I learned that when the husband got “frisky” with his wife, Mimi would start to get very excited.  She would bark, run around, and jump on the bed.  The wife even said that Mimi would get one of her toys and bring it to them.  As you can imagine, such canine behavior is not exactly an enhancement for people in this kind of a “mood”.  My interpretation was that Mimi could sense the…*ahem* “excitement” of the owners, and became excited herself.  However, as she is spayed, and isn’t keyed into human sexuality, she only perceived it as a form of “play”.  If her people were playing, then why shouldn’t she get to play?  So, perceiving the “excitement”, “activity”, and “enhanced vocalizations” of the owners (hey, trying to keep this blog family-friendly), she started showing behaviors designed to join in the fun and engage the owners in play.  As I mentioned, this was a bit…distracting….to the clients.  My only suggestion was to keep her out of the room.  If this was a “planned encounter”, they could put her in another part of the house until they…finished.  Unfortunately, it would be hard to correct her otherwise, as she was reacting in a way that she perceived as perfectly normal.

I’ve often said that you can never know what to expect in veterinary medicine.  Today I proved myself right, and in the most interesting way possible.  What a conversation to end the work-week on!