Wrestling For A Living

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!

What's In A Name?

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!

A Shrinking World

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.

Goodbyes

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.

The Perils of Parvo

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.

Translation Troubles

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!

Is Your Pet ADR?

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.

Why Do You Have A Pet (a.k.a. Pet Peeve #4)?

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.

The Weather Outside Is Frightful

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.

Your Dog Interrupts WHAT?

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!

Cropping--The Ears Have It

Here is another controversial issue (never say I stay away from these topics). Ear cropping. For those who aren't familiar with the term, this is the surgical removal of part of the ear flap (pinna) on dogs. Most of you know the results of this. Look at the slim, pointed, upright ears of boxers, doberman pinschers, schnauzers, pit bulls, and many other breeds. These are not naturally occurring ears, but achieve this shape only through surgical alteration. Many countries have outlawed this surgery, and the US is one of the few where it's still legal. Even here there are many vets who refuse to do the surgery, and that number is increasing.

I'm one of those. As a vet, I totally and completely am opposed to ear cropping, and do wish that it would be removed as a breed standard in the US and be outlawed. Why do I feel this way since I'm willing to do declaws? It's because of what goes into the surgery.

Ear cropping has no medical value whatsoever. If ear cropping was medically necessary, then we would probably crop every cocker spaniel. The breeds that are commonly cropped have no health benefit from the procedure. This was originally done to help protect the ears of dogs who would fight, removing the floppy pinna that could be grabbed by another animal. This reason is irrelevant anymore, as fighting dogs against other animals is no longer morally acceptable in the Western world. In modern times, ear cropping is performed only because people have grown to expect it as a breed standard. It is done for human preference only, and is purely a cosmetic surgery.

Cropping requires general anesthesia. During the surgery, part of the pinna is removed, the amount depending on the breed. This is more art than science, as the surgeon is basically reshaping the ear into a different shape and size. Afterwards, the ear must be glued or taped in an upright position to cones or boxes. As the pinnas heal, they should scar in a way that the ears will remain upright. On the surface, this sounds pretty straightforward. However, there are many problems. This is not a surgery taught in vet school, so the doctor must find someone in practice who knows how to do it and will teach him or her. This means that there are rather loose standards of how the cropping is done, and again is more art than anything else, similar to plastic surgery in humans. The ears must be taped or glued for anywhere from several weeks to several months. This is not a quick and easy surgery. A declawed cat is usually fully recovered in a few weeks. For a spay or neuter the recovery time is less than a week. But ear crops can take months. Even then, there is no guarantee that the ears will stand up as intended. I've seen ear crops done properly, and the ears flop over at some point.

So basically, we're taking a beloved pet and forcing them into a medically unnecessary surgery that can take months to recover and may not even work. All because of how we as humans have decided that we prefer their appearance. Spaying and neutering have health benefits, as well as keep stray populations down. Declawing could be argued to have a limited set of circumstances where it may be indicated due to behavioral problems that some people can't control. Ear cropping never, ever has any merits or benefits beyond physical appearance.

That's why I have never learned this surgery, and always strongly try to talk clients out of doing it. Now, I'll admit that doberman pinschers look a bit goofy with natural ears, but all other breeds look better to me uncropped. And even in dobies I disagree with it. I realize that there are still some vets who support it, but they are in the minority and their numbers are shrinking every year. Hopefully enough breeders will pressure the AKC to disallow cropped ears in shows, especially as they find fewer vets to do the surgery. Only in this way will we move permanently away from doing this to our pets.

Declaw Or Not?

The question of whether or not to declaw a cat is filled with debate and controversy. I talk to clients about this a lot, including a couple of times today. Here's what I talk about with them, and hopefully it will give you some insight if you have to make such a decision with your own pets.

Many people oppose declawing because of the pain and type of surgery. Those are some admittedly good points. Regardless of the method used to declaw, it is a painful procedure. We usually have to remove the last bone in the toe in order to remove the claw, which is a form of amputation. Even if proper pain control is used, the procedure produces more long-term pain than a spay or a neuter. It also has a higher risk of complication and infection because the patient is walking on the surgery sites. Recovery isn't as quick and simple as with most surgeries, even with all proper precautions. Because of these concerns, I don't think declawing should be a routine, standard, and expected procedure in cats.

Scratching and clawing is normal behavior in cats. It helps them remove the old nail sheath and is involved in scent marking. Even declawed cats will sometimes scratch at surfaces because of this natural instinct. This behavior can be directed in an appropriate direction by use of scratching posts and pads. Some cats will prefer one surface over another, so you may have to try several different ones. Trimming the nails every month can also reduce the need to claw, and will reduce any damage when the do.

However, sometimes there is a time and place for declawing surgery. If you have tried all other options and your cat is still being destructive, then consider it. In my opinion, declawing should be a last option, not a first one. However, it can come down to a decision between having the surgery done and giving the cat up for adoption. In cases like that I think it's a clear decision to have the declaw performed.

This isn't an easy decision for many people and shouldn't be done lightly. However, there are good reasons for doing it. Talk to your vet about the pros and cons before making the decision.

The Dangers of Outdoor Living

I once saw a statistic that showed that cats who lived primarily outside have an average life-span of 11-12 years, while indoor-only cats lived about 15-16 years. I can definitely believe this. Over the years I have seen numerous situations of cats who went outside getting injuries and illnesses that you would never see if they had stayed inside. Many of these injuries are repeated ones, as cats get into fights again and again. Bite wounds, fractures, poisonings, and similar problems are relatively common in outside cats, as well as serious and incurable infections such as feline leukemia and feline AIDS.

Today was another example of it. The cat was allowed outside whenever he wanted. Earlier this year we had treated him for an infection on his leg, and this wasn't even the first time. Today we saw him again, with another bad wound. Most of his left front leg was affected, requiring sedation, disinfecting, and removal of the dead tissue. The skin was completely gone over the infected area, and there was a lot of brusing and damage. This was likely caused by a bite from another cat that abscessed and then ruptured. Here is a picture of what it looked like after being cleaned up. Sorry that it's slightly unfocused, but I didn't have my camera at work and had one of my nurses take a picture with her cell phone.



I bandaged the wound, and we will have to change the bandage every other day for a few weeks. With proper treatment this should heal well, though it's going to take a while and will likely leave a sizeable scar. If the owner isn't compliant with coming back in for rechecks, this could turn much worse and not only take longer to heal, but potentially spread the diseased tissue and require surgery to correct. This kind of problem is common with cat bites. The cat's teeth penetrate the skin, and usually pull out through the same hole. This is a rather small hole that heals closed quickly. However, a cat's mouth is full of bacteria, so this is kind of like injecting a load of bacteria under the skin and then keeping it from draining out. Infection builds and festers until it suddenly ruptures. Often the initial wound goes unnoticed by the owner, only becoming obvious when it opens like in the photo.

So those of you with cats who go outside, keep this in mind and remember this picture. This is not an unusual occurrence. Cats who stay inside aren't mentally harmed, are exposed to fewer health risks, and on average live longer lives.

A Passel Of Puppies

Here's one of those great stories that sticks with you for a lifetime. It's the kind of thing that we vets will try and reflect on when things aren't going as well as we want.

I had been practicing for a little less than a year and was the only doctor on duty that day. In came a medium-sized very pregnant mixed-breed dog in some obvious distress. She had been in labor for a long time, yet had not given birth to any puppies. She was obviously having a lot of difficulty and was very uncomfortable, so the owner agreed to a caesarian section.

A c-section isn't something to go into lightly. Whatever anesthesia you give to the mother will also go to the babies still in the womb. Those babies aren't able to handle it as well, and you run the risk of losing them as the anesthesia gets too deep. It's a balancing act to give the mother enough anesthesia to do the surgery, yet keep the anesthesia light enough to have a minimal effect on the puppies. This is different than in human c-sections, which are done as a local nerve block rather than a general anesthesia.

So I went into the surgery, not completely knowing what I would find. I made it into the abdomen quickly, and pulled out a very large uterus. I cut into the uterus and started pulling puppies out. Now, for those of you who don't know, puppies (and kittens for that matter) are each in their own amniotic sac, and have separate placentas. To do a c-section you have to gently pull the puppy out and tear off the sack without hurting the puppy. Then you have a little bit of a race against time. The act of birth helps to stimulate the puppy's senses, and then the mother cleans off the fluids and tissues. During a c-section this doesn't happen. So the surgeon has to hand over the puppy to an assistant and then dive back in for the next puppy (remember that time is of the essence here). The assistant vigorously rubs the puppy to stimulate it, and slings it head-down to help force fluid out of the lungs and nose. It can take several minutes to get the puppy in good condition.

As I continued the surgery, I realized that there were more puppies than I expected. I kept pulling puppies out and handing them off. I was removing puppies faster than the staff could keep up! We even pulled the receptionists from the front to help, essentially shutting down the hospital. By the time I was finished, I had removed 12 puppies. Twelve! That is a very large litter for just about any dog.

Now here's the best part. Every single puppy lived! And the mom did great! We spayed her while I was in there so this wouldn't happen again. To give you an idea of how big of a surgery this was, she was about 40 pounds before the surgery and about 30 pounds afterwards! And best of all, every single one of those puppies found a home. Our staff was amazed by the whole experience, and the owner was very happy about the outcome. And that gave me a great story to share with people.

Would You Do It Over?

It's an age-old question. If you had a chance to make different choices in your life, would you change things? If you knew then what you know now, would you do things the same way? It's interesting to ponder these things, and it's probably a difficult decision. After all, we wouldn't be who we are now if it wasn't for the events that shaped us.

I think about this at times. There are many, many times when I regret my decision to become a veterinarian. Over my years of practice, I have found it harder rather than easier to handle the serious or life-and-death decisions. I get very tired of dogs and cats trying to bite and scratch me. Things that were once fun are now tedious. I've also discovered other interests and abilities. I've learned that I have great natural skill as a public speaker and teacher. I've grown a great interest in history and religion. And I've even stated that if I could do it over again I would become a college history professor instead.

But would I really? As much as I hate my job and even profession sometimes, I wouldn't be the same person without it. I wouldn't have had a reason to move to where I met my wife, and wouldn't have my perfect partner and two beautiful children. For all I know, I'd be writing a blog about how much I hated history and wished I had pursued my interest in veterinary medicine. In the end, though it's speculation, and a bit of a fruitless excercise since we can't do anything about our past.

What about you? What would you do differently if you could? And looking on how it impacted on how you turned out today, would you really change it? It's said that those who don't learn from the past are destined to repeat it. What can we learn about what went on in our personal past to help guide us into the future?

The Impact of Friends

I'm not a very social person. This will come as a surprise to some who know me, and will be completely expected by the rest. I do consider myself to be an introvert, and have tested as such, even though I can be extremely extroverted when the situation calls for it. I'm also the kind of person who doesn't keep many long-term friends. I have no idea what any of my high school friends are doing or what has happened in their lives. Most of the friends I've had over the years have gone separate ways. Really, I only maintain contact with about 4-5 people out of all of the people I've known in my life, and of those, probably only 2-3 with any regularity. I'm enough of a loner that I just don't feel the need to have lots of people to hang out with, and generally prefer doing things on my own.

So it has come as a surprise to me in the last couple of days that I have enjoyed seeing old friends again. While at my veterinary conference my wife and I took the time to visit the church we used to attend when we lived in the Raleigh area. We moved away about 2 1/2 years ago and have only visited a few times since then. We showed up unexpectedly at an event they were holding, and it was really amazing to see how many people were excited to get to see us again. We didn't realize the impact we had had, and were a bit taken aback by everyone wanting to talk to us. Then today on our way home, we stopped and met with someone we know from Fans For Christ (see my links) for lunch. We had interacted with him online, and had hung out with him a bit at Dragon*Con (see my links once again), but this was the first time we had gotten together in a "normal" setting. It was really fun, and a pleasure to get to know him better.

All of this started me thinking (on our very long drive home) about how we impact people in our lives. You may not notice your interactions with others, but it's a sure bet that some of them notice. We all have effects on those around us, often without realizing it. Sometimes we don't get to see just how strong those effects are until years later. Each of us can think about someone we've known or even just briefly met who made an impression on us. Something they said or did, or who they are, or what they did for/to us really stuck in our memory. Years later, or even for the rest of our lives, we will be marked by our experience with them. The same holds true for people that we interact with. Sometimes it's humbling to realize this, especially when it happens without our knowing.

It can be a bit frightening as well, since we're not always at our best. The effects we have can be for good or for bad. Here are examples of each....My parents have a next-door neighbor who is a real problem in the neighborhood. The wife has caused numerous problems with other neighbors because of her attitude, including calling the city when leaves from a house across the street blew into her gutter during a windy period. She has alienated all of the neighbors, and has been very hateful. Her husband is a Baptist minister. Because of her attitude, my father has grown a dim and rather cynical view of people who profess to be very religious. Now, on the positive side, I was mentored by a veterinarian for most of my childhood, and though I haven't worked for him in about 12 years, hardly a week goes by without him coming to my mind. He gave me much advice and many examples that I use to this day.

We should think about these things as we go about our lives. We are going to interact with countless people, sometimes briefly, and others ongoing for a lifetime. We will have a chance to make a difference in their lives for better or for worse, often without even realizing it. So what kind of an impact will we have? What kind of a legacy will we leave? What can we do to affect people for their and our good? Think about your friends and acquaintances, and how you will both change them and be changed by them.

New Kitten Blues

Here's a question from Christopher...

I just got my kitten from someone and now that she's (i think it's a girl) here, She keeps hiding. She will come out and play but will hide more then not. Is this bad???

Dogs and cats have personalities as individual as humans', which means that they won't always behave in the same way as other pets you may have had. I have known many perfectly healthy and normal dogs and cats that aren't very playful and are shy. Your kitten may be one of these. There are also some very important aspects of feline behavior to keep in mind.

First, you have just brought her home, so think about her situation from her perspective. There she was, in a home that she was used to, likely with her siblings and mother, and likely the only place she's ever known in her young life. Suddenly, someone she doesn't know comes and takes her away from her home and family, putting her in a place she's never seen before, with all kinds of strange sights, sounds, and smells. It's really not surprising that the first few days that a kitten or puppy comes to a new home they are somewhat quiet and withdrawn. It takes them a while to get adjusted to their new surroundings, and that's perfectly normal. Give her some time and she'll start coming out of her shell. Make sure she is eating, drinking, using the litterbox normally, and growing normally. If these things aren't happening, make sure to have a veterinarian check her out.

Cats are also very nocturnal by nature, and so tend to be more active at night than during the day. This is a big reason why so many cat owners get annoyed when the cat decides that it's play time while the people are sleeping. Your kitten will make some adjustments and get used to your schedule, but will always have some activity during the night. You may be trying to interact with her when she thinks it's nap time. Cats also like enclosed places when they're nervous, so hiding to sleep or simply wait is very normal.

If you have any concerns about her, make sure to take her to a vet. You'll want to go ahead and plan on this soon anyway, as it's important to have her tested for intestinal parasites, feline leukemia, and feline AIDS, and make sure she receives her first vaccines on time. Have fun with the new kitten! And when she is having a "kitty spaz" around the house at 10:30 at night and literally bouncing from the walls, think back to when she was nice and quiet. :)

Just what in the heck do they do at conventions?

Here's another insight into the life of veterinarians. Really, this is probably applicable to most industries and many professions regulated by the state.

Veterinarians spend a lot of time in college and graduate school learning about animal medicine. However, once we graduate, the education doesn't end. Medicine is constantly changing as new research is done, more is understood about diseases and parasites, and new medicines and technologies are created. That means that we have to be life-long students. In each state there is a licensing board that approves veterinarians for practice. Part of maintaining a license is a requirement to perform a certain number of hours of continuing education ("CE") each year. The exact amount varies from state to state. For example, in North Carolina we have to attend 20 hours of CE annually. In Georgia, the veterinary board requires 30 hours every two years. The most common way to acquire these hours is by attending conventions. Other professions that must obtain a state license have their own CE requirements, so it's not just us vets. And that's where I am right now....at the North Carolina Veterinary Conference.

So just what goes on at these conferences? Well, most of it is lectures. There are speakers from the veterinary college, respected specialists from across the country, researchers, and various other experts. Generally each lecture lasts around an hour, and therefore we get an hour of credit per lecture attended. The content of the lectures can vary from surgery to dermatology, pharmacology to toxicology, internal medicine, behavior, and parasitology. Usually the lectures are relatively narrow, such as gastrointestinal surgical techniques, or the latest methods of managing diabetes in pets, or diagnosing and treating renal disease in cats. The lectures include a lot of review of each topic, as it's hard to remember every tiny detail from school. Now, that doesn't mean that we don't know how to diagnose and treat problems. Like everyone, it never hurts to have a review of the basics. Usually the lectures include updates that may have happened since we were in school, such as new drugs that had not been developed when we graduated.

Though the lion's share of the conferences are lectures, and these are the primary reasons for attending, there are other events. For extra fees we have the option of attending "wet labs", where we can do hands-on practice of various surgical or medical techniques. There is always a large hall or room reserved for industry retailers, such as pharmaceutical companies, equipment manufacturers, product distributors, general contractors, and so on. During breaks we wander this exhibitors' hall. They are all there to convince us to use their products or services, but we can also learn about new drugs, vaccines, or equipment that we may not have had any experience with. A fun part of this is the "swag" they usually have. Most often the free things are pens (I haven't had to buy a pen in years!), though it can include t-shirts, note pads, yo-yos, stress balls, and all kids of other things.

And at the big conventions they will usually have a night or two with some entertainment. The largest ones can get concerts from big-name performers such as Alabama. The smaller ones can sometimes only afford a local performer, if at all. I attended one that had a local ventriloquist and stage magician.

None of this is free. I paid $495 to attend this conference, which is a pretty average price. That's only to attend, and doesn't include food, travel, lodging, or any other costs. And this is something we're required to do every year.

So that's another behind-the-scenes look at life as a vet!

Spaying and Neutering....Not About Reproduction

Spay and neuter your pets. You've heard that a million times or more. Many people do it simply because it's what the vet recommends. But do you really know why? And if you chose not to, do you really understand the risks you're taking? I'll try and help. Because reproductive issues are the least compelling reasons to have the surgery done.

First let me make one thing clear. Dogs and cats have no awareness of their own sexuality. They don't have a conscious perception of what those reproductive organs are really for. They don't judge themselves by whether or not they have testicles or ovaries. I want this to be known, because a large reason why many men oppose neutering is because they don't want to "take away his manhood." I hate to break it to you guys, but your dog or cat doesn't know what his "manhood" is, and isn't aware of what has happened when they're gone.

Neutering helps lower the risks of behavioral problems in males. Intact males are more likely to "mount" inappropriately, urinate to mark their behavior (including inside the house), roam, be territorial, and be aggressive. Neutering them before puberty (7-9 months old) dramatically lowers risks of these unwanted behaviors. Neutering also eliminates the risk of testicular cancer and lowers the risk of certain kinds of prostate disease.

Behavioral problems aren't as common in females, but can happen. The biggest reason in females is risk of disease. Mammary gland cancer is equivalent to breast cancer, and is just as bad. If a female dog or cat is spayed before their first heat cycle, they have less than a 0.1% chance of developing this cancer. If spayed between the first and second heat cycles, the chance jumps to 10%. After the second heat, the risk is about 25%. Ovarian cancer is also a possibility, though not as common as mammary. Within the last few months I have had to remove three mammary tumors from unspayed dogs, one of them highly malignant. And if you have never had a female in heat, it can be very messy.

So hopefully you can see that there are very valid reasons for surgically altering your pets. If done properly, any health risks are very low, and these are very routine surgeries. If you haven't done this, talk to your vet right away. There are no good reasons NOT to spay or neuter.

The Best Pet Foods

We're spoiled in Western society. C'mon, you have to admit that. And that's especially obvious when you walk into a pet specialty store like PETsMART or PetCo. There are aisles and aisles of pet foods of every kind and price. Many countries in the world don't have this much variety for the people, let alone the dogs and cats! And while this plethora of food choices allows people to find just the right food, it can also be confusing and intimidating. What food is really best for your pet? Are the expensive foods worth it? Do pets really like having bone- or fish-shaped pieces?

I have to admit that even as a veterinarian this can be a very confusing topic. We get only a little training in pet nutrition during vet school, and it's not easy to piece together the information once we graduate. There really is very little consistently published in the veterinary journals on this subject, so this can be a hard topic for vets to learn about and discuss with clients. For this reason, I've recently tried to get down to the bottom of what the ingredients mean and which ones are good or bad.

I consulted with a board-certified veterinary nutrition specialist. This is a vet who has done specialized training and research purely in animal nutrition. I asked him about the various ingredients, types, and so on. And believe it or not, I can't say that my confusion was dramatically ended. I discovered that much of what I had believed about good pet foods wasn't necessarilly true. And I also discovered that the subject is more complicated than I thought. But I know that clients don't want a long discussion or disertation on the subtleties of pet nutrition. They (and you readers) just want to know which foods to feed, short and simple. So I broke it down and asked this specialist what foods veterinary nutritionists feed their own pets.

Now before I give you the list, remember that all of the food companies are in the business to sell their products. They are going to do everythign they can to promote their food and convince you that it's the best. Everything from the commercials to the packaging, and even color and shape of the food are all directed at the people, not the dogs and cats. There is also a general rule that you get what you pay for. The reason why some foods are cheaper is because they have lower quality ingredients. The converse is true about the premium foods.

Okay, so which ones are the best? The following list is what veterinary nutritional specialists feed their own pets. Remember that these are the doctors that know more about pet nutrition than anyone else, and with that knowledge they have chosen these foods as the best nutritional quality for their own pets. The choices are based on overall quality of the manufacturing and ingredients, as well as knowledge of the companies' quality control.

In no particular order: Science Diet, Iams (especially the Eukanuba line), Royal Canin, Purina (just the ProPlan and ONE lines), and Nutro. Personally I lean towards Royal Canin and Nutro, but do recommend the others based on my discussion with the specialist.

So there you go! Nutrition does matter in your pet's health, and this has been shown in several studies. Choose one of these foods, and you'll be doing the right thing.

Why Not People Food?

People food. Table scraps. Call it what you want to, but it's something that people commonly give their pets, especially dogs. You look down and see those big brown eyes and the pitiful expression, and you can't help yourself. Your little pup looks so cute and adorable that they can't be resisted. So you give in and give them some of your supper or a few potato chips. And since they enjoy it so much, you give in again another time. Pretty soon it's a regular habit. And since nothing bad seems to happen, you keep doing it. Then you wonder why your vet gets on your case about you doing this. Well, I'm going to try and help try and explain it.

Remember yesterday's discussion of how dogs and cats are different than their wild ancestors (if not, go back and read it)? Well, the differences are even greater between humans and our pets. What might be good for us may not be as good for dogs and cats, and can even be toxic. For example, onions are very toxic to cats, and even onion powder in foods can cause serious illness or even death. It also means that pets may have difficulties digesting our foods. This can cause vomiting, diarrhea, or pancreatitis (remember that I mentioned this two days ago). I have treated numerous cases of pancreatitis after pets have gotten a plate of table scraps or gotten into the garbage to eat human leftovers. One of my patients, a shih-tzu, died from pancreatitis after eating a plate of stir-fry.

Besides digestibility issues, human foods are not nutritionally balanced for pets. Feeding your pet a large amount of your food means that he or she may not be hungry for regular dog food. Eating less dog or cat food can lead to nutritional imbalances. Large amounts of human snacks and foods can also lead to obesity.

Another problem comes in the form of picky eating. Many dogs, especially small breeds, can be very finicky eaters. If you start feeding a little human food, they start to get a preference for it. Then they realize that their dog food isn't as good as that bowl of hamburger. So they turn their nose up a their pet food. Now people usually start to panic because their little doggie has just skipped a meal. They don't want little fluffy to starve, and since the only thing the dog will eat is people food, that's what they give. Congratulations, you've just been trained by your dog. And the more you allow this, the harder it will be to switch them back to regular pet food. Sound familiar to anyone?

Commercially available dog and cat food is always the best way to go. Yes, many people are still scared after the problems with toxins in pet foods two years ago, but that was still in a minority of pets and many of the recalls were as a precation and not because toxicities were found. Regardless of that, human food is never a good idea to give. It's nutritionally imbalanced, can lead to a picky eater, makes health problems more likely, and can even cause serious illness or be toxic. Simply put....don't do it!

So with all of these discussions about feeding and nutritional issues, what pet foods are really the best? Tune in tomorrow for the answer!

The Truth About BARF

Mary's question from yesterday actually had a second part that I'm discussing today.

My dog is mostly Boxer, and I have been reading a lot about the breed. I have been reading some about something called "the raw diet." Do you know much about it, and would you recommend this diet to your patients if it were done correctly?

Sometimes called the "BARF" (Bones And Raw Food) diet, this is something gaining a little popularity in the last few years. You can go online and find many sites promoting the wonders of feeding raw foods. They talk about the great benefits of no processed and manufactured foods, no artificial ingredients and preservatives, and how these diets more closely duplicate a wild canine's natural diet. By reading these sources, you could easily get the feel that anyone feeding commercial pet foods is doing their pet more harm than good, and only by feeding a BARF diet will your pet live long and healthy to its full potential.

Hogwash. Complete and utter hogwash. I could be more blunt, but there may be youngsters reading. But if I may be blunt....."male bovine excrement".

Proponents of raw foods are on the fringes of veterinary medicine and animal care, and are far from being mainstream. You will be hard-pressed to find any veterinary college faculty who are big proponents of this kind of diet. And I have never heard of any board-certified veterinary nutritionists that are fans of raw diets. Though I don't have hard numbers, I would venture to say that well over 90% of veterinarians would be against raw diets. And there are some very good reasons for this.

Saying that this is closer to a canine's natural diet is completely true. However, this ignores many important facts. A dog's digestive tract is not the same as a wolf's or wild dog's. Dogs have been domesticated for about 15,000 years, and have been selectively bred by humans during this time. Our modern species do have some significant differences from their wild ancestors. Even among dog breeds, there are subtle differences in the digestive systems of certain breeds, as well as their nutritional needs. Visit a pet specialty store such as PETsMART or PetCo some time and look at the breed-specialized diets of many manufacturers. What this means is that you can't assume that a wolf's natural diet would be beneficial for your shih tzu, lab, or boxer.

Second, wild canines live far shorter lives than pet dogs, sometimes as much as half the life-span. Part of this is due to the improved nutrition and health of pet dogs. There has been considerable research and studies about dog and cat nutrition. Modern foods, especially high-quality ones, have a lot of scientific data behind them. The quality of this nutrition is far superior to putting together a raw diet.

Third, think about whether or not you would eat raw food yourself. Forgetting the fact that raw chicken would be a bit disgusting to most people, consider why we cook our food, and why some states have laws preventing beef from being cooked rare. Raw foods have the potential of having hidden microscopic parasites in the meat. There can also be considerable amounts of bacteria contaminating the meat. Eating these foods raw leaves your pet at risk for serious diseases such as salmonella or trichinosis. These diseases can be fatal, or at a minimum cause very serious illness that can be expensive to treat (if even possible). Even handling the meat could put yourself or your human family at risk for contracting these diseases. That's why physicians tell us to avoid using cutting boards after putting raw meat on them until we have washed the board.

I can't deny that the proponents of BARF diets can point to certain benefits of their recommended diets. However, in my professional medical opinion, and having read discussions about this topic in veterinary journals by nutritional specialists, I strongly believe that the risks and problems far outweigh any benefits.

So to answer the last part of your question, Mary....I would never recommend these diets to any of my clients under any circumstances, and would never feed them to my own pets.