Pee Problems

Here is the second part to Diana's email...

When he was a puppy he was very well litter trained. However, after he was left at a family member's house whilst my mum and myself were away, he seemed to have been neglected in some ways (or so me have assumed) and certainly had not been taken out for a while and all the litter training was, well, "forgotten" by my dear best friend. He is now an 11 year old male (not castrated, no other pets or children at home), and has problems with urinating in the house since then. He is taken out for walks regularly (at least 4x a day and let out in the garden in between) and has no bladder problems, UTI infections etc. His bladder is thus never bursting! He tends to urinate objects that are not meant to be where they are placed (e.g. a plastic bad or coat on the floor). But generally also urinates chairs, armchairs and curtain corners. My mum has thoroughly washed the places where he has urinated (even using diluted bleach on the carpet) to try to kill the smell but to no avail. It is impossible to catch him in the act and punish him accordingly as he does this when no one is around. Positive reinforcement from doing it on walks has not helped either. This problem can be quite embarrassing and he cannot be taken to friend's houses as he will urinate everything there too and has caused us a lot of impossible hassle over the last 11 years. We can't keep him outside in the garden (he's a clingy indoor dog) and have no idea what to do. Obviously neutering him would not be ideal (he has a heart murmur and too old for that sort of thing). I also could not afford expensive behavioural classes either.

I've personally not spoken to the vet about this (it's embarrassing for me as an owner!). We have tried and given up on what on earth to do. Do you have any advice? Is it too late to change his ingrained behaviour? 

This is certainly a tough case, Diana.  As you mentioned, the obvious first step would be neutering.  Though I agree that his health may prohibit this surgery, there are also ways to do it safely.  If the murmur is mild and stable, there are anesthetic protocols that can be safely used.  However, another thing to consider is that at his age neutering alone may not be enough.  If the problem is largely influenced by hormones (specifically testosterone), then you won't have much success without neutering him.

One recommendation is to go back to basic housebreaking techniques, especially the "crate training" method.  You may already be familiar with this way of training, but if not you can easily find instructions on the Internet and in any good dog training book.  This method is more than simple positive reinforcement, though that is certainly part of it. 

If improper housebreaking when he was young and hormonal influences are the underlying cause, then the above recommendations are all that you can really do.  If there are other behavioral causes such as anxiety, stress, and other issues, then medicine may help.  Many cases of inappropriate elimination have been helped by pharmacotherapy, though you need to find a vet who is comfortable with this kind of behavioral treatment.  This kind of problem can be difficult to handle, so you want a doctor who has handled these situations before.

In the end, this isn't going to be easy to fix, in large part because it has gone on for so long and because he's not neutered.

Educating About Behavior

Diana wrote me some questions, and I'm going to answer them in two parts.  Here's part one...

Firstly, I'm interested to hear about whether you advise owners on behaviour problems very often. I'm a prospective vet student in the UK and have seen many consults (It's mandatory in the UK to carry out work experience if one wishes to pursue this career)  and have yet to see many owners come to their vets with sole behaviour problems, and I am unaware of many people seeking advice from behaviour specialists which seems to be less common than vets! Does your training as a vet in the US include behaviour issues to any extent (out of curiosity)? 

Since I've only visited the UK, and that was about 20 years ago, I honestly can't say how veterinary training may be outside of the US.  Here in America there is some behavioral training in veterinary school, but probably not as much as we really need. When I was in school in the late '90s we had part of a semester.  It was around that time that board certification in veterinary behavior first became available. 

Most vets end up picking up some behavior training simply through necessity.  I commonly get questions about basic behavior, such as housebreaking, barking, bringing new pets in the household, and so on.  However, the truly difficult behavioral cases are a different story and many vets aren't adequately trained to handle them.  Sure, some will, but effective behavioral therapy can be very complicated and requires much follow-up for the owner and the doctor.  This kind of treatment always involves extensive commitment from the owner to do appropriate training and conditioning, and is never solved merely by medication.  The length and difficulties of treatment can be overwhelming for both the vet and the client, so many vets aren't comfortable with it.

There are currently 50 members of the American College of Veterinary Behaviorists.  This is actually a very small number compared to the veterinarians in the US, and ends up being few enough that there isn't one in every state.  These behaviorists are highly trained vets, comparable to human psychiatrists.  For truly complicated behavioral cases general practitioners can refer to a behaviorist just like they can for complicated surgical or medical cases.  Diplomates of the ACVB have years of additional training beyond veterinary college and must pass rigorous training to receive the title.

I have a lot of respect for behaviorists, but not every problem needs to be sent to them.  I personally have a strong interest in animal behavior, and so have taken it upon myself to attend continuing education over the years specifically targeted at behavioral issues.  I feel very qualified to handle most behavioral problems, including separation anxiety, storm and noise phobias, and elimination disorders.  However, I will refer severe aggression cases to a behaviorist due to the severe risk of harm to people or other pets.  I would say that I have better than average skills in behavioral issues, though nothing beyond what a typical vet could have the opportunity to learn.

 So, Diana, I hope that answers your question about behavioral training for vets.  In a few days I'll respond to the other part of the email.

Ceiling Critter

A while back I had a small leak from my bathroom shower that dripped down into the ceiling of the laundry room underneath.  It was a very slow leak, but enough to drip on the ceiling tiles (it's a drop ceiling) and through them.  One of the tiles closest to the wall became soft enough to eventually crumble, leaving a small gap.  I finally figured out where the leak was coming from and fixed it, but still haven't gotten around to replacing that tile.

That's when I discovered that one of my cats, Tristan, decided to make the area in the ceiling his personal play place.  One day we heard him meowing but couldn't find him.  It took a while of searching before we heard him walking above our heads.  Lifting up a tile, we quickly found him looking down at us curiously.  It seemed like he was saying, "Hey, guys, look what I found!  Isn't it cool!"  To get up there he jumps on the washing machine, then onto a shelf just above that appliance which also happens to be just below the opening.  Since our discovery, whenever we wonder where he might be, he can inevitably be found hunting for who-knows-what in the ceiling.

Thankfully, there really isn't anything up there to hurt him, so I haven't worried about it.  I did buy a replacement tile, but haven't gotten around to putting it into place.  Tristan has had access to the ceiling space for a few months now, so I know that when I finally do fix the tile he's going to be surprised and probably a little miffed.  Until then, he gets to have his own private play-place.

The Yellow Season

In the northern hemisphere it's now spring, and that means it's also allergy season.  For some parts of the US this is simply a nice time when plants bloom and the weather starts to warm up.  But for other places, such as where I live, it means that we get to pay attention to daily pollen counts.  The worst part is the layer of yellow that coats everything:  cars, streets, porches, and pretty much anything that spends even a few moments outside. Thankfully my seasonal allergies aren't too bad.  But that pollen gets into some amazing places.

One of the most common tests we do is a fecal exam, looking at prepared fecal samples for parasite eggs or other microorganisms.  One of the routine findings during this time of year is pollen. These small particles have been swallowed by the dog or cat and made their way completely through the digestive tract.  They're easily identified, as the most common kinds look very similar to a Mickey Mouse head.

Today I actually found some pollen on a skin scraping.  This is a superficial scraping of the skin with a dulled scalpel blade to look for skin mites.  It was surprising to see such a large amount of pollen, though the dog had been outside during the day.  However, I shouldn't have been so amazed, as pollen contacting the skin is a common cause of allergy disorders in pets.  Contrary to most people's beliefs, most pollen allergies cause itchy, irritated skin rather than the sneezing and itchy eyes that people get.

So here we are, having to deal with the ubiquitous yellow powder over everything, including our pets.  It's an annual event that won't go away, no matter how much we complain about it.

Getting Adjusted

My little bearded dragon (who I still haven't named) is settling in well.  He's getting used to his tank and has been eating well, which is helping my anxiety a bit.  So I thought I would share some pictures of him.  You can see his missing left hind leg.

My daughter is especially gleeful about him joining our family.  Today she got to hold him by herself for the first time, and you can see the expression on her face.  She's the daring animal lover in the family.

Now, my wife is still not certain about him, even though she allowed me to bring him home.  She refuses to touch him at all. However, she has admitted that he looks cute perched on his branch, and was curious to watch him eat his crickets.  So I can see some glimmers of a possibility of her actually holding him at some point.  It may be a while, but I'm being patient.  Simply being allowed to have one is a big step for her.

Still looking for name suggestions!

Beardie Comes Home

Last week I posted about a recent surgery I did on a tiny bearded dragon.  Today he came in for his final post-operative recheck, and he was doing great.  He had been active for the last two weeks, and eating regularly every day.  The incision had healed well so I took the sutures out and cleared him for going to a new home.

Now one of the interesting things about this little beardie is that he was from a pet store.  With only three legs, they couldn't sell him, and knew that going into the surgery.  When things like this happen, they give the pet away to a good home for free. In this specific case the original adoptee turned him down for some reason.  I had mentioned that I might be interested in him, and the let me know he was available.  So, I brought him home with me today.

My kids were overjoyed, especially my seven year-old daughter.  After the surgery I had sent them a picture of the beardie from my cell phone and her first words were "can I have it?!?"  When she saw it all set up in the tank, she proudly said "See, it worked!"  They are so excited about having our new pet.

Now I'll let you in on a little secret.  This is actually my first pet reptile.  Sure, I know a lot about them and do treat them, but so far all of my knowledge is from books and not first-hand experience.  Believe it or not, I'm a little nervous.  I know all of the things that can go wrong and how sick they can get from improper care.  I know the proper care and information, but I've never had to put it into action before.  Since he's done so well after his surgery, his continued life and well-being is now up to my ability as a pet owner and not a vet.  It's important to me to do well and keep him healthy because I am a vet, as well as a good example to my kids.  Plus, I've wanted a bearded dragon for years, and my darling wife finally gave the okay.

Now I just have to come up with a good name!

Laying Down The Law?

It's hard being a vet and being in charge of a hospital.  There are numerous difficult decisions to make.  Which lab tests do I need to run?  What treatment do I use for a given disease?  What are the odds of survival in any case?  How many surgeries to I take each day? 

But I think that the hardest decisions involve running personnel.  At my current location I've been facing this problem off and on for a couple of years now, always with different people.  Part of it is that many people seem to enjoy gossiping and talking behind each others' backs.  I've had team meetings and tried to tell everyone that it had to stop, but I can't be there every time people talk. 

My latest problem involves two very skilled but very strong-willed people.  One has been there for around a year, and the other is a relative newcomer, but someone I've known for a few years and wanted to have join our team.  There is always some tension when a new person joins a group, especially in a leadership position.  But lately it has been beyond even that.  These two people are great at their jobs, but for whatever reason feel some hostility towards each other.  That tension is quite palpable and is affecting everyone's performance.

So today I had a talk with them.  My plan was to lay down the law, tell the two main people that I wasn't going to tolerate this anymore, and then force them into a situation where they would work it out.  It didn't take long for the discussion to deteriorate into raised voices and harsh words.  I let them try and talk it out, but when it became obvious there wasn't going to be a resolution, I stepped in and ended it, but I don't know that we solved anything.

Now we're at a crossroads.  Both people want to go on to be hospital leaders, and I made it clear that this was a test of their leadership.  The next step is to see how they work over the next couple of days and whether they will let their performance suffer because of the conflict.  Honestly, though, I 'm expecting to loose at least one person out of this situation, if not several.

Managing people is tough.  And certainly nothing we were taught about in vet school!  Give me a bladder surgery or a limb amputation instead of these problems any day of the week!