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Monday, September 1, 2014

Does Homeopathic Therapy Work?

A reader recently asked me my thoughts about "quack" treatments (their words) such as homeopathy, accupuncture, and so on.  This is another very polarizing subject, but as long-time readers know by now (and new readers find out quickly) that doesn't make me be quiet.  Polite discourse and debate is good for the mind!
As should be pretty clear, I am a trained in and practice traditional Western medicine.  I fully support traditional methods of diagnosis and treatment, using them myself on a daily basis.  For example, I would much rather use antibiotics than colloidal silver to treat an infection.  I also only have limited knowledge of many homeopathic/holistic treatments as that was never part of my education and I tend to think that there isn't a lot of evidence for many treatments.  That being said, I don't think that all homeopathy is "quack" medicine.
The hallmark of Western science is scentific study and peer reviews.  If we say that a prevention, test, or treatment is effective, we had better be able to support that with properly conducted scientific studies.  No, not all of them are 100% accurate and over time opinions can change.  But those opinions often change based on new evidence and data or new studies.  The duration of immunity ascribed to certain vaccines has increased over the years based on trials rather than merely thought and anecdote.  From what I've seen there is a lack of rigorous, independent, double-blind studies with many homeopathic treatments.  And really, that's the biggest complaint that most scientists and vets have about these therapies.  Show us the studies!  Show us the proof!  Don't say "well, it's worked well for me"!
Let me give a recent example that I came across.  I had a client tell me that she had started using black walnut extract to prevent heartworm disease based on things she had seen on the internet.  I had never heard of this so I started looking into it.  I found many websites, blogs, and articles from naturopaths on the benefits of black walnut, on how toxic traditional heartworm preventions are, and how safe and effective this extract was.  Do you know what I didn't find?  Proof.  Studies.  Sure, plenty of proponents of this method of prevention talked about what the mechanism of action should be, and I read a website from a vet about how he only recommended it and had never seen a case of heartworm disease in a dog using black walnut.  But all of these were opinions.  There wasn't a single scientific study, or even a report by parasitologists, immunologists, or toxicologists.  Some of the articles were by vets but most were by laypeople or people with an interest in homeopathy rather than a degree in a related field.  I even found articles and opinion pieces written by advocates of homeopathic therapy who had looked for direct proof or studies and found none.  Those same people were very honest in cautioning people about quickly jumping on black walnut extract because it really hadn't been appropriately studied for safety and efficacy.
"But it works!  And I know it does because I haven't seen a case of it!"  Really?  Okay, by the same logic when I see a dog who has never been on heartworm prevention and they test negative, it means that it's okay to not give preventative to that dog.  Right?  And in the same vein if I run back and forth across the interstate and never get hit by a car it must mean that doing so is safe.  Right? 
Not seeing a case does not constitute proof.  There is a difference between correlation and causation.  For example, I can see a graph that shows as temperature goes up the number of pirates also increases (yes, this is from the Wikipedia article I linked above).  Does this mean that an increase in temperature causes pirates to multiply?  That would be causation.  And that's the same kind of thinking that we often see with people advocating homeopathic treatment.  "I give A and I haven't seen a problem with B, so A must be working."  "My dog had X so I gave it Y and X went away.  Therefore Y works."  This is directly attributing causation when you may actually have correlation.  Using this method of determining efficacy contains a huge logical fallacy.  Scientific analysis and study through hypothesis testing and experimentation is supposed to differentiate between correlation and causation, allowing us to make a proper conclusion.  That has historically been missing in homeopathy.
I know that anyone reading this who is very much into holistic or homeopathic medicine is likely becoming very red-faced about now. But bear with me, as I'm not done. Because using the same logic we must keep in mind that just because there are no studies doesn't mean that a given treatment won't work.  If we say "Medicine P probably doesn't work because there haven't been rigid studies" we make the same mistakes of logic and once again place causation as a direct result when it may not be.  I do think that there are several homeopathic treatments that do work.

SAM-e has been studied quite a bit as a supplement to help liver function in animals, and has been attributed to improvement in osteoarthritis and even Alzheimer's in humans.  Glucosamine, chondroitin, and green-lipped mussel are all well known to help reduce joint pain and improve arthritis.  Omega fatty acids and fish oils have considerable benefit in certain kinds of skin and joint disorders.  All of these were at one point (and to many still are) considered "alternative" or "natural" therapies.  But because of scientific studies and considerable use we have been able to document true effects instead of simply anecdotes and personal reports.  Because of the scientific analysis they have become accepted by maintream medicine.

There is a form of "Western" accupuncture that seems to also have a legitimate basis in physiology.  I knew a vet in my area, a colleague whom I knew well and trusted, who had been trained in this form of accupuncture.  She said that it worked with known nerves and nerve clusters, stimulating them with the puncture of the needle.  It had also been studied and accepted at several veterinary colleges.  This particular method of accupuncture is different from the Eastern philosophies which tend to lean more towards energy clusters and similar mechanisms of action (as I understand them). 

There is much of homeopathic medicine and therapy that I do think is entering the realm of "quackery" and for which you won't find true scientific support.  However, I don't think that we should throw the baby out with the bath water and automatically eliminate all natural or holistic therapy.  More and more we are seeing proper studies done on these methods, many of which are showing real results and supporting the idea of a given treatment as being effective and safe.  As these studies build in number and are more widely known I would not be surprised to start seeing other formerly homeopathic-only treatments become commonly accepted in traditional Western medicine.  It's certainly happened before.

If you are interested in finding a vet who practices these methods of pet care, here are a few links.  And for now I'll continue to support my own methods and practice as I was taught in school.

American Holistic Veterinary Medical Association
Academy of Veterinary Homeopathy
British Association of Homeopathic Veterinary Surgeons

Wednesday, August 27, 2014

Even Furry Pets Get Mosquito Bites

I received this comment on a recent post about mosquito-borne diseases.  It was from a spammer, so I didn't publish it, but it brings up a very important point that is worth discussing.
 
My dog is a Pomeranian and he (like most dogs) is covered in a thick coat of fur. He always looks healthy and this fur is probably one of the reasons. Mosquitoes cannot penetrate the thick fur to get to his skin, if we were covered in hair I think it would be the same situation.
 
Unfortunately this is a misconception that many people have.  They assume that because their pet's body is covered in dense, thick fur a mosquito can't bite them.  And if a mosquito can't bite them, it can't transmit disease such as heartworms.  Sounds like it makes sense, right? 

This idea is absolutely, 100% false!  There is no such thing as fur too dense or skin too thick for a mosquito to get through.  These insects are quite persistent, and will find any area of exposed skin.  If the body fur is extremely dense, they will be happy to go for the face and ears where fur is naturally thinner and the skin more easily reached.  No matter how thick the rest of the coat, it is always at least a little thinner around the muzzle and eyes, regardless of the breed.  It's also not impossible for mosquitoes to burrow through a thick area of the coat.

It really comes down to this....If you live in an area that has mosquitoes your pet can and probably will get bitten.  You need to care for your pet accordingly with good preventative medicine.  First and foremost this is proper and consistent use of heartworm preventative in all dogs, cats, and ferrets (yes, all of these species can be infected), no matter where you live or the condition of their coat.  Since there are a few other diseases besides heartworms that can be carried by these insects, I recommend using a topical flea/tick preventative that also repels mosquitoes (you'll see that on the package label), especially if you live in a high risk area.

Whether your pet is an Alaskan Malamute or a Mexican hairless, they ARE at risk for mosquito bites.  Don't fall into a false sense of security that might result in your pet contracting a serious or fatal disease.

Sunday, August 24, 2014

Strong Desire To Be A Vet......It's Not Enough.

Recently I read an article about the opening of two new veterinary colleges in the us, one in Tennessee and one in Arizona.  Dr. Kathleen Goeppinger, the president and CEO of the Arizona school, Midwestern University, was quoted as saying, "I know the world says, 'Hey, vets don't get paid enough' and 'Vet school is expensive,' but I also know that the desire to be a vet is very strong in many people."
 
This statement really bothered me, and it should bother anyone who is thinking of attending vet school, especially these new ones.  Dr. Goeppinger is essentially saying "I know that the financial outlook for vets is pretty bad, but that doesn't matter because so many people want to be a vet."  It seems to me that she is saying that we shouldn't care about the employment prospects or debt load that new graudates face, because so many people are simply determined to be vets.  Unfortunately, the strength of desire to be a vet isn't enough to make someone successful and financially stable.  The attitude of the quote may not be what she intended, but she seems to come across as only caring about the desire and not the reality.
 
I'm also possibly a bit cynical at her motivation when I see what the tuition will be.  Midwestern University is enrolling 102 students at an annual tuition of $52,400.  The Tennessee school, Lincoln Memorial, is enrolling 95 students with a $40,241 tuition each.  This is a lot of money, around double the in-state rate for most veterinary colleges, and is a bit higher than most out-of-state rates.  Is the motivation for starting these private colleges based on improving the veterinary profession, or making a lot of revenue?  Even if I'm off base on my thoughts, students from these schools will graduate with $160,00-$200,000 in debt based on tuition alone.  That doesn't include living expenses, books, supplies, and so on.  My own school loans were needed for costs other than just tuition, and I'm sure the case is as true now as it was then.
 
Dr. Goeppinger's statement seems to imply that she cares about students' desire to become a vet.  But in that desire is she considering that her students will be graduating with a far higher debt than the national average?  And that her students will have well over $200,000 in debt to start in a job paying around $65,000 per year?  I realize that the article may have missed numerous other quotes, but there is nothing in the description of the new schools that addresses the great debt crisis that new veterinarians face.
 
Veterinarians have a very low unemployment rate, but it has been gradually increasing for several years.  The majority of new graduates find jobs, but the percentage is slightly lower than just a few years ago and the jobs are harder to come by.  Recent data from an AVMA study shows that there is approximately a 12.5% excess capacity in the profession, meaning that we have more vets than are currently needed.  Every year for the past three years in a row the average debt load has increased while the average starting salary has decreased.  The amount of debt most new graduates have make it difficult to even survive, let alone have families and get ahead financially. Yet despite these facts two colleges felt the need to add around 200 new vets per year to an already burdened profession, and will be doing so at high tuition rates.
 
I really wish that everyone who wanted to be a vet and could qualify for admission could go through school and be successful.  Unfortunately the reality says otherwise.  I don't want to completely dissuade everyone from applying to vet school, but I do think there should be a healthy dose of cold water thrown on the hot desire.  Be realistic when you consider this profession and have a good handle on the finances.
 
I certainly hope that there aren't other vet schools that will be opening in the near future.  That's the last thing our profession needs.

Thursday, August 21, 2014

Can Pets Get Sick From Mosquitoes?

Recently I was emailed a simple question, "can mosquitoes make dogs sick?"  The short answer is "yes".  Thankfully there aren't too many diseases to worry about.
 
Of course the biggest concern is heartworm disease.  Mosquitoes are the only vector of this disease and part of their larval development is in the mosquito.  A single mosquito bite can infect a dog with heartworms and lead to a potentially fatal disease.  Most vets talk a lot about this disorder, especially in the southeastern quarter of the US, so this is probably not a huge surprise.  However, some people aren't aware of how dogs can get the disease so it's important to review it.
 
There is another disease that dogs and cats can get from moquitoes, but we're still trying to understand it.  West Nile virus mostly affects humans, horses, and birds, sometimes with fatal effects.  But there have been cases reported in pet dogs and cats, though thankfully it doesn't seem to cause as serious illness in these species and isn't as much of a concern.
 
Lastly, some cats can develop an extreme allergic reaction to a mosquito bite, resulting in severe inflammation and ulceration.  Though it looks bad this is usually limited to the area of the bite and can be treated with antihistamines and antiinflammatories.  It should still be seen by a vet but shouldn't be considered life-threatening.
 
For a little more information, the US Food and Drug Administration has some details on their website

Monday, August 18, 2014

Here's Blood In Your Eye

I recently saw a king snake for a prolapsed hemipene and a swelling on the underside of his tail.  One of the interesting things about this case is that I had seen him for the exact same problem almost a year ago to the day.  Thankfully this time wasn't as bad and the swelling didn't have dead and decaying skin over it like it did in 2013.  Last year there was a large amoung of clotted blood under the skin, and between that and the hemipene I had to do minor surgery.  He recovered well and had no problems until this year.
 
As I was examining him I started to palpate the swollen area.  I had seen some blood on his bedding and wanted to get an idea of how extensive the swelling is.  Unfortunately I didn't realize how much pressure was inside the swelling and how the small opening could act as a nozzle.  I put some mild pressure on the area and all of a sudden found myself sprayed with blood along the front of my clothing and on the right side of my face, including near my eye.
 
So here's the picture for your mind....I'm in the exam room with the clients and with no assistants.  I've been talking to them and examining their snake.  Now I have managed to cover my lab coat, face, table, and counter with a fine spray of blood from some sort of lesion near his cloaca.  What to do in a situation like this?  I need to take care of the blood, especially that on my face, but I don't want to panic the owners, don't want to fling the snake away and risk injuring it, and don't want to totally freak out. 
 
This is where experience comes in.  Though I've never sprayed my face with blood, I've had other things hit me there.  When my son was an infant I was home alone changing his diaper.  While I had the diaper in one hand and his legs in another he suddenly defecated with a little gas behind it, quite accurately projecting poop into my beard.  Not much I could do then other than finish cleaning him up, put a new diaper on, and then go thoroughly scrub my face.  Last year I was expressing the anal sacs of a cat when a plug dislodged and all of the thick secretions coated my face and beard.  I still had one finger in his rectum and was half-way done, so I didn't want to pull out and have to go again.  I quickly finished, keeping my mouth tightly closed, and then went to scrub the smelly mess from my skin and facial hair.
 
I handled things similarly with the snake.  I transferred him over to one hand while I grabbed a wet paper towel and started wiping my face off.  I then pointed him into the skin and finished expressing the blood and clot, this time into the sink instead of on me.  Once he was cleaned up I put him back in his carrier and proceeded to clean and disinfect the table and counter.  The whole time I continued talking to the owner, trying to act as if nothing had bothered me. 
 
Thankfully things like this are rare and hopefully will never happen again.  But it also shows some of the risks of the job and how this is most certainly not a glamorous profession.  Anyone who can't stand the idea of getting feces, blood, urine, or pus on them every day should avoid a career in veterinary medicine.

Saturday, August 16, 2014

Winding Path Filled With Regrets

I'm going to take a stab at this one, but there is more psychology needed than veterinary training.  I'm sharing it because I think there are others out there who feel similarly.  Here's the email I received....
 
I'm desperate. It's 1 AM, finals week, and I am bawling my eyes out because I wasn't realistic in my career/school goals 10 years ago and desperately trying to find some guidance.

I went to college and got a useless Bachelor's degree in Criminal Justice because I wanted to work for the DEA. I honestly can't tell you any good reason why I wanted to do this, except that I thought it would be intense/busy/not a desk job, etc. I dated a sh**ty guy who I ended up having to put into rehab for shooting up heroin, as well as just being a general drug addict.

This lead me to wanting to work with drug addicts. My senior year in college, I had considered going to law school, but had already been accepted to NYU where I got a Master's degree in psychology. Another useless degree because it has a low salary and without a doctorate in psych (hate research, don't want a PhD), it's essentially worthless. It also required 1.5 years of supervised hours after my Master's just to qualify for full licensure, something I never pursued. During my time in school, I had an interest in working with sexually trafficked children, and thought I could use the degree with that. Turns out, non-profits pay s**t and are exceptionally hard to get into it.

At the same time, the economy went to hell and the job market fell dramatically. I decided I wanted to go to law school, as it looked better than "counselor", but I wanted to work in the advocacy/policy non-profit realm in regards to sexually trafficked children. I took the LSATS, applied to a million schools, and went off traveling the world for a year. I got into law school in NYC and after one semester, I dropped out. I didn't want to be a lawyer, law school was difficult and I was struggling, and I realized the salary for non-profit lawyer as well as being able to get that job sucked just as much as counselor.

I got extremely depressed, sought counseling for 9 months, and somehow managed to survive with sh**ty promotional jobs for the next year in NYC as I tried to figure out what the hell I was going to do with my life. During that time, I got a puppy. He changed my life. He saved my life. He is literally the best thing that has happened to me. I had two dogs growing up, who were beaten (not by me), and as a young child, I tried to "save" them whenever I heard them getting beaten. I will always regret not calling the cops and ASPCA, but I was young (middle school?) and I was getting beaten as well. Those dogs lived in hell and although I didn't want them to be beaten, I didn't love or care for them, really. They lived outside and I would occasionally pet them on my way in or out of the house. I never walked them or played with them. My guilt lives on...

When I got my dog, I grew a passion I never knew existed. This went beyond just "that sounds like such a cool job!" (which, at this point, had been my driving force-- I looked into toxicology or other "cool or unique jobs"-- never anything fulfilling). I wanted to save dogs. I never wanted to be a companion pet vet or own my own practice. My passion was for helping those dogs saved from fighting rings or severely abused/neglected. Now that I have personally owned and been loved for and cared for by a dog, I feel so committed to this passion. I owe them, I owe my previous dogs, and an abused dog is the one thing that will bring me to my knees.

I apply for ASPCA jobs (anti-cruelty non-vet positions)-- no response. I work with local rescue groups as a volunteer, but want to do more. I get my s**t together and I am accepted to the vet school in Sydney, Australia (No pre-reqs as it was included in their program and I had no ties to NYC, yet I'm able to use that degree to get licensed in the US if I want to come back later). Greencard is expiring, can't get loans in time, I defer for a year.

I continue to pursue going to Australia the next year (renewed greencard--defaulted on law school loans--consolidated--able to get new loans) but during this time, I start getting a more realistic outlook on vet school tuition, loans, future job opportunities, and salaries. Looks bleak, and I'm already in debt from law school (I worked during my Masters and paid off all of those loans on the day it was due). I also meet an amazing guy. I decide it's not worth going to vet school because of the reasons listed above and the fact that I'd have to specialize (adding a cool 5 more years) just to get a decent salary. And even longer to actually get to a position where I'm working at an organization like ASPCA to help rescued animals (because you know they're not hiring fresh vet school grads).

I have no idea what I'm doing with my life, so I google degrees I can get in a short amount of time that are somewhat relevant to my previous degrees and can give me some sort of security in life. I find nurse practioner in psychiatric mental health (starting salary 100k, desperate shortage in NYC-- with per diem jobs, I can make 150k a year first year). I need pre-reqs, so I decide to get another Master's in neuroscience (from Columbia) to fulfill that (if i'm taking the classes anyway, I might as well get a degree out of it-- that was my logic). I load up and get this done in 1 year. Debt rises. I apply to Columbia's accelerated nursing program that gives me a BSN, a master's in nursing, and a doctorate in nursing in 4 years. Off I go. Debt rises further.

First semester-- I hate nursing. I hate people. I don't have empathy for people like I do with animals. It is difficult material, lots of material, little time. I sacrifice my sleep, my health, etc, to get through school. This might be worth it if I loved the job. I do not. This may change for the NP/DNP part (as it's not bedside nursing), but nevertheless, I have to get through the RN part (1 year).

I am 30. If I was 20, I'd go to vet school (although, my grades back then may not have gotten me in anywhere in the US. My grades now are unbelieveable). I'm struggling because I think I'm going to regret not going but I have a boyfriend I live with (path to marriage) and 75k in debt so far (quickly rising with interest), plus the fact that it would take me at least 10 more years of school. There comes a point where I'm either a lifetime student or I'm creating a reasonable life with someone.

I was undecisive and unrealistic and naive. I will survive nursing school. I should be able to get a job. I will make a decent salary. My path so far has been erratic and I somehow bull***t the connectivity of the degrees when I apply for schools/jobs.

How do I get over my regret? I've read your posts and I can't imagine you telling me to follow my passion to vet school. Am I finally rational in thinking that pursuing vet school now is unrealistic and obviously a stupid and risky path? How do I suck it up and just get over this?

Any guidance is appreciated.
 
I definitely have many sympathies for this person and it makes me sad to see the frustration and pain she is going through.  I'm not a psychologist by any stretch of the imagination, and that's probably what is needed here.  In fact, I'd recommend that she find a good counselor, psycologist, or psychiatrist that can professionally help with the anxiety and confusion.  As someone with a degree in psychology I'm sure you can understand the benefits of this advice.  There are a few things that stand out to me, though.
 
First of all, stop getting more degrees!  At least for the time being.  The very first step is to really sit down and figure out why none of these jobs have been satisfying.  What about each one makes you unhappy?  There is a consistent pattern here of multiple attempts at widely varying fields, each with more education and more cost necessary.  You need to really stop and analyze exactly and minutely why you have been unhappy and what it will take to make you happy.  This is probably best handled through a mental health professional, as this stems from mindset rather than circumstances.  But you're never going to be happy until you figure out what has made you unhappy.
 
Is it because of dealing with people and having to show empathy?  If that's the case then veterinary medicine isn't the career for you.  Every single day I have to deal with people, many of them difficult or upset, and if I couldn't handle that I'd quickly go crazy.  If you're only in it to help the animals then you're going to be quickly dissatisfied as a vet because you'll see situations every day where the client can't or won't do what is best and necessary.  You'll get frustrated at these "stupid" people and wish you could take their pet away.  Yet they have control over the situation, not you, and you can't force them to do something.  You also can't continually discount or give away services or you will go bankrupt.    You can't save or rescue all of them, and if this is going to be difficult to handle mentally then you should avoid the profession.
 
Have the previous jobs been unsatisfying because of the pay?  Again, don't go into veterinary medicine.  Using current statistics you'd acquire another $150,000 in debt on top of the existing $75,000, all in order to make $65,000 per year.  You're not doing yourself any financial favors by pursuing it until your debt is paid off.
 
I'm going to go out on a limb and share some things that I've personally learned.  And before I start I want to pause and share some of my own struggles.  Often I've hated my job and regretted ever getting into the profession.  I've desperately desired to do anything except veterinary medicine.  I've dealt with clinical depression for most of my adult life, worsening once I was in my 30s.  I've had multiple times that I've been suicidal, the most recent being just a few years ago.  I've seen counselors, psychologists, and psychiatrists in my attempts to get a handle on it.  I've been on antidepressant medications for about 10 years now.  I'm not saying any of these things to gain any sympathy or have someone feel sorry for me.  I mention it because I've had many emotional and mental struggles over the years and have found myself in very dark places many times.  The following advice and "wisdom" comes from experience and personal struggles. 
 
First, some of my favorite quotes.
 
"Success doesn't mean happiness.  Happines means success."  Garth Brooks
 
"The remarkable thing is, we have a choice every day regarding the attitude we will embrace for the day."  Charles Swindoll
 
"Our attitudes control our lives.  Attitudes are a secret power working twenty-four hours a day, for good or bad.  It is of paramount importance that we know how to harness and control this great force."  Irving Berlin
 
"If you don't like something, change it; if you can't change it, change the way you think about it."  Mary Engelbreit
 
"A man is but the product of his thoughts, and what he thinks, he becomes."  Mahatma Gandhi
 
Your circumstances may put you in situations that influence your thoughts, but ultimately you are responsible for your response to these circumstances. One of the methods that I learned to help overcome depression is "cognitive therapy".  This is where you become consciously aware of a change in your thoughts and emotions, stop to analyze them, and make a sincere change in them.  You make a concscious decision to NOT have a bad attitude.  Believe me, this does work, and has even helped my children.  If you don't like aspects about your job, stop and analyze why.  Then say "I WILL have a good attidue."  Like any muscle it takes excersise and practice to hone.  It's hard at first, but the more you do it the better you will become.  And if you work with a psychology professional it will be easier, even with your background.
 
There's also another very big part of what helped me control my depression and my feelings about life or my job.  Faith.  My believe in God and my reliance on Him is a huge part of who I am and how I handle life.  When I get depressed or frustrated, I pray.  When I need guidance I go to the Bible and find passages relevant to my struggles.  But it goes even beyond belief and prayer.  All of my life I've learned to be independent and self-sufficient.  Since I started following Jesus closely I've struggled with the whole idea of "let go and let God".  We are told to turn our cares and worries over to Him, rely on Him, and He will help take care of us.  Yeah, easier said that done.  I struggled with that for many years, before I reached the depths of my depression and finally just turned it all over to God.  Since then I've been much happier and have had less stress.  My wife even commented last year on how well I took some challenges that would have sunk me into despair the previous year.  It's been hard and it's still something with which I struggle, but a large part of my happiness and peace is because of my faith and reliance on God.  I don't know where your heart and faith lie, but I'd like to make a suggestion....if you don't already, pick up the Bible, read it closely, and get closer to God.  If you already do, start doing it more.  I'm rarely this direct, but at the same time I know that I didn't really conquer my depression and anxiety until I added this piece to the puzzle.  Therapy and medicaion have helped, but not to the degree that deeper faith did.
 
Okay, now some of the good parts.  Being 30 shouldn't stop you from going into vet school.  Some of my classmates were older than that and I've known plenty of people in their 30s and even 40s starting vet school.  But you need to first get your fiances and mental status under control.  And you need to really figure out what you want out of life.
 
Definitely don't feel any regrets.  In fact, you may be as unhappy going through vet school as you have been in every other area.  Belive me, it's much harder than law school or nursing school.  But you don't have to be a vet in order to help!  Find a good paying job with which you can be satisfied, then spend time volunteering for rescue groups or donate money to great causes.  You can still be fulfilled and help animals without being a doctor.  In fact, we need people like that involved in animal care and rescue.  There is no way that vets can do it all.
 
This may not be helpful enough, but hopefully you can find a few bits of advice to take from my response.  Again I would recommend seeking the help locally of someone who can help you work through the psychology of your frustrations and unhappiness. 

Wednesday, August 13, 2014

Pure Breeds, Diagnoses, And Vets

Paul sent me this email in response to a recent blog I posted.  

love your blog.  just wanted to comment on your most recent post about messed up breeds.  You have answered, almost in the post a question I have always had about vets - but you might just comment to clarify.

I have always believed that as a vet, knowing more about animals than we, non animal doctors could ever know about species and breeds, I have always thought that it must be difficult for you (by you, I mean vets) not to look at your clients when they bring in their breed dogs and cats and immediately think - oh X breed - probably will get cancer, arthritis etc depending on the breed.  For example I love Bernese Mountain dogs but I would never own one because being such a large breed they will be old by the time they are 7 and dead by the time they are 10, likely to get cancer and arthritis.  King Charles - could have that awful brain condition where the brain is too big for the skull.  I could go on and on.  Most vets I know own mongrels or sturdy crossbreeds or small terrier dogs - is this why? because they won't be as prone to diseases and conditions.  I guess sometimes too much knowledge can have its down sides.  When I was young - all of 40 years ago, german shepherd dogs and alsations had straight backs but we humans have created a terrible situation where these beautiful dogs now have hind legs that are very bent causing the dog to have curved spine and develop arthritis - certainly from a visual perspective this development is not an enhancement, and from a health perspective its not an improvement either though I understand it enables the dog to jump higher and scale walls etc useful if these dogs are guard dogs or keeping intruders out - great police and drug sniffing dogs but the legs going under the dog in the back and curved spine look awful and spell pain and discomfort and shorter life for this breed as result.

Paul brings up some great points and questions.  As I blogged before, we have messed up most of the modern dogs in our pursuit of a certain "ideal".  And vets know this better than anyone.  Paul is right that when I see a certain breed, especially a puppy or kitten, I'm immediately thinking about what problems that breed has.  If it's a young pet I will spend time talking to the owner about the potential health problems they could face during that pet's life.  If I see a sick pet I definitely take their breed into account when I'm trying to figure out what is wrong with them.

This is one of the reasons why it's typically harder being a vet than a human doctor.  And please understand that this is not meant to disparage my human colleagues!  Most of the physicians I've known are very skilled, knowledgeable people.  They have to know one single species while vets have to know many.  You'd be surprised at how many anatomical and physiological differences there are just between dogs and cats, let alone the other kinds of animals we see.  There is simply no equivalent differences in humans.  Then when you throw in the dozens of different breeds and the incredible anatomy variations and health tendencies it becomes even more complicated.  In human medicine there are several racial differences, but you won't find as many between blacks, Asians, and Caucasians as you will between Yorkies, bulldogs, and Great Danes.  I have incredible respect for my human medicine counterparts, but by comparison they have it easy.

Paul also asks about vets having mostly mixed breed dogs.  I have to say that this isn't necessarily the case.  The vet that I grew up working for bred English bulldogs and Labrador retrievers.  I have a pure-bred Lab myself.  A tech I worked with bred cocker spaniels.  One of my current staff has several pure-bred Pomeranians.  I've known a lot of vets and veterinary staff who have had pure-bred dogs, and while many of us also have mutts, I would say that it's pretty evenly distributed rather than being predominantly towards mixes.  

You would think we should know better, but that's not always the case.  I absolutely adore English bulldogs, while at the same time being all too aware of their multitude of health problems.  While I've never personally owned one I definitely will do so.  I grew up around the breed and have since gotten to know many of them as a doctor to the point where some clients think I specialize in them (which I don't...I just love them).  Seeing the numerous allergies, skin disorders, eye problems, respiratory issues, joint problems, and so many other serious health disorders you'd think that I'd avoid them like the plague.  Instead it just makes me want to be extra careful when finding a good breeder.

While I generally recommend mixes based on average health problems I have also seen plenty of these multi-breed pets have serious problems.  "Hybrid vigor" is real but doesn't eliminate the risks completely.  If you are considering a pure-bred dog or cat, please research the breed's typical health problems ahead of time so you can know how to prevent some of them and be aware of the others.