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Sunday, January 30, 2011

All About Veterinary Technicians

Today we have a first on my blog.  A guest post!  I thought this was a very worthwhile topic, and I hope you find it informative.

Veterinary technicians are not exactly veterinarians, but they’re the next best thing to them. They’re involved in the provision of medical care to animals, and they’re qualified professionals who have had academic and on-the-job training in looking after animals and birds. In general, the tasks and responsibilities of a vet tech include:
·       *   Assisting veterinarians in all that they do.
·       *  Helping with surgeries and routine examinations.
·       *  Administering medication, intravenously or otherwise.
·       * Conducting lab tests and knowing how to read the results of these tests.
·       * Providing overnight care for animals that have had surgeries and need to be kept in the hospital for observation.
·       * Working X-ray machines to diagnose animals with broken bones.
·       * Talking to clients and explaining surgeries and other medical procedures to them.
·       * Teaching clients how best to care for and cope with their animals.
·       * Helping with training animals – they teach obedience classes for pets.
·       * Some vet techs specialize in animal behavior and are involved with behavioral testing at veterinary practices.
·       * Some vet techs treat minor injuries and small wounds in the absence of a veterinarian and in emergencies.

If you want to become a veterinary technician, you must be prepared to:
·         * Enroll in and complete a two or four-year degree program. It could be an associate’s or bachelor’s degree, but it is necessary that you attend college before you’re allowed to take the certification examination.
·         * Apply for and pass the Veterinary Technician National Exam (VTNE). This exam spans four hours and will test your abilities in prepping animals for surgery, nursing, animal pharmacology, lab procedures and other topics pertinent to veterinary science.
·         * Apply for an internship position at a veterinary practice or hospital.
·         * Apply for a job with a veterinarian who practices independently or with a larger hospital, depending on your location and options. 

Most vet techs go on to specialize in one particular field of care – you could choose to study critical care, internal medicine, dentistry, equine care or anesthesia to extend your repertoire, boost your chances of success, and earn a higher salary. If you’re looking for jobs and hoping to reach out to other vet techs, joining the National Association of Veterinary Technicians is your best bet. This association helps not just with jobs, but also with continuing education and career development.  

According the BLS, the median salary of vet techs is around $29,000. Vet techs in research earn more than their counterparts who choose to stay on in general practice. 

This guest post is contributed by Tina Marconi, she writes on the topic of vet tech online . She welcomes your comments at her email id: tinamarconi85[@]gmail[.]com.

Saturday, January 29, 2011

Questions From A Prospective Vet Student, Part 3

Here are the last set of Jasmine's questions.

If I was able to become a practicing vet, I would like to own my own private practice. Would you be able to give me a general idea as to what that would be like and what are the odds of really being able to "be my own boss" and direct my own clinic? 

Owning your veterinary practice is a lot of very hard work, and you don't get any training in this as a veterinary student.  You will need to secure business loans of around $300,000-500,000 (US) or more for even a small practice. Having strong business skills and training is important to being a business owner, as many private practices go bankrupt because the owner isn't a good businessperson.  You will spend a large portion of your day and week managing aspects of the business and not being a doctor, and this may not be enjoyable for you. Another downside is that veterinary practices are no longer a good retirement plan, as many older vets are finding it very difficult to sell their practice and retire.

All of that being said, being a practice owner can be satisfying.  Doing so gives you the best opportunity to make a high salary (though it requires good business skills), and certainly more than an associate vet.  You can also have the freedom to pick your methods of practice, products, medications, designs and so on.  All aspects of it are completely in your control.  And odds of starting a practice are good if you have good credit.  Odds of maintaining profitability and staying open are another story.

Also, was your ability to handle the bloody and gory aspects of surgery acquired over time or were you already able to stomach that sort of thing? I'm not too squirmish about the sight of blood, but a few of the pictures in your blog were a little disturbing (like the protruding eye on the poor pup that ended up needing to be removed)... 

I actually used to have a weak stomach before I started working for a veterinarian.  When I first started seeing surgery and blood, I passed out a couple of times.  But I knew that I wanted to be a vet and would have to get over it.  So I just stuck with it and eventually I started being able to handle it.  This tolerance didn't happen overnight, and it took a few years to really get used to it. Some people never develop that ability, and it's pretty important for a vet.  You have to be able to handle blood, pus, maggots crawling through skin, broken bones poking through flesh, ruptured eyes, draining abscesses, and many other disgusting things.  The variety of gross sights is one of the reasons why you should work for a veterinarian before considering a career in the field. If you find that you can't handle seeing these things or handle dealing with a pet in pain, then this isn't the right career choice for ou.

Jasmine, thanks for all of the questions!

Friday, January 28, 2011

Questions From A Prospective Vet Student, Part 2

Continuing the answers to Jasmine's questions, here are the next ones....

Also, I am undeclared in regards to what my major and minor are at the moment, and I was wondering what would be the preferred major in order to benefit me most if I did pursue becoming a vet? I have a strong love for English as well, I might take English as my minor, but I'm not sure if that is recommended for this type of career... Are there many areas where a minor in English would be useful? 

I can only really speak from experience with US veterinary schools, but I would imagine that in other countries it would be the same or similar.  Honestly, your major doesn't completely matter.  In the US the admissions office looks at whether or not you have taken and passed specific courses, and don't look at your overall major.  Each veterinary school will have slightly different entry requirements, so you should check with each one you plan to apply to.  Since most of the required courses are in the fields of biology, chemistry, and mathematics,certain majors definitely make it easier to take these courses.  The most common majors are Biology and Animal Science, as the requirements for these majors will already have you taking most or all of the courses you need for entry into vet school.  However, I've known vets who majored in non-science disciplines in college, and even some who didn't receive a final undergraduate degree.  Even if you had an English major, as long as you took the required courses it wouldn't negatively affect your application to vet school, though it would take longer to make it through college since you would be taking so many courses outside of your major.

If you have a strong interest in English, you could consider trying to drive your career towards the veterinary publishing industry.  There are dozens of veterinary journals on the market, some strictly research-based and others intended more for general practice and as veterinary-specific news magazines.  Many of the editors are also veterinarians, as are the reporters and especially the consultants.  Moving in this direction would potentially take you out of daily practice, especially if you ended up as an editor, but would rely heavily on your English skills and may be something you would enjoy.  Even if you don't end up in publishing, good written and oral communication skills will benefit you greatly in daily practice and should never be underestimated.  If you really love English, I would encourage you to pursue at least a minor, simply for your personal satisfaction and enjoyment.

Tomorrow we finish Jasmine's questions.

Thursday, January 27, 2011

Questions From A Prospective Vet Student, Part 1

Jasmine recently emailed me with quite a lot of questions.  Over the next few days I'll try and address them.  Here's the first part!

I am currently a first year student at the University of Alberta, enrolled in the faculty of science. All my life I have had a strong love for the well-being of animals of all shapes and sizes, and have a firm belief in the proper ethical treatment of animals. The past year I have been wondering what type of road I would take to the career that would have major involvement with the proper treatment and health of all animals. I have established some sort of path for myself where I'd like to get into the 4 year DVM program at the University of Calgary to become a practicing veterinarian, as well as take part in a project such as PETA for the ethical part of how animals are treated. Would something like this be possible? Or would the workload of being a veterinarian be too much to juggle without the extra curricular?

Let's start here.  First, just be aware that there are many vets who have poor opinions of PETA because of the often questionable practices of this group.  There's also a difference between "animal rights" and "animal welfare", so be aware of the distinction and where you stand.  As part of veterinary training you'll be dealing with livestock and production facilities for farm animals.  There are some debates on treatment of various aspects of poultry, swine, and beef production and you'll have to deal with this yet still make it through these aspects of veterinary college.

Attending veterinary school is a full-time job by itself, and leaves little time for anything else if you really want to put your full effort into it.  That being said, you can't be in school or studying 24/7. Depending on what kind of project or activity you're involved in, you do have time to do other things, as long as school is still your priority.  Also, there are often extra projects and reports you will be required to do as part of class, and you can do a project like this for credit.

And are there any activities I can participate in such as volunteering at a clinic to better prepare myself for what's to come? Or any courses I should consider taking this early on in my university experience that would greatly benefit my decision as to whether I would choose to become a veterinarian or not?

First and foremost I would recommend finding a job at a local veterinary practice. If you want to find out what day-to-day life as a veterinarian is like, there simply is no other way.  You'll get to see the hard cases, the gross and disgusting things, and the long hours required.  Courses in anatomy and physiology will help get you into the medical mindset, as well as see if you can handle the degree and detail of knowledge that you will learn in vet school.  But above everything else, you should learn about the daily life and trials of a vet, and this can only really come from working for one.  Some veterinary schools also require experience working in the field prior to acceptance in vet school, so check the requirements of where you'll b applying.  You can also consider volunteering at an animal shelter, though this isn't always directly related to veterinary medicine.

Tomorrow, more of Jasmine's questions.

Tuesday, January 25, 2011

Puppy Graduation

One of my regular readers posted this comment on my entry about Training Techniques...

I would really urge you to find a good trainer rather than rely on books.
The reason for this is because it takes allot of time and patients to really help a dog learn. A good trainer creates a plan and then re-enforces your training again and again and again. ( notice I said your training)Most of this is about training you and you pass that onto the dog.

I think that's an excellent point, and one I also believe in.  In my own practice I always recommend group training classes rather than books.  First, socialization is vitally important to a dog's development.  You need to do this in a controlled setting with proper guidance and training.  Failure to socialize your puppy by four months old (yes, studies have shown it needs to be by this young) then you could risk behavioral issues for the rest of the dog's life.  Also, as Rockjdog pointed out, learning proper training can take a lot of time and the classes are as much about training the owner as about training the dog.  So yes, I firmly believe that if given a choice someone should pick a class rather than a book.

And I try to practice what I preach.  My own puppy, Yvaine, has been in a group puppy class for the last eight weeks.  I started her at 10 weeks old, and this past weekend she graduated.

My wife went to the classes with her and continued the training at home.  Yes, I know the basics of dog training and could do much of it myself.  But we really wanted to give Yvaine the best chance for great behavior, and knowing what I know of mental development in dogs we decided to enroll her.  It's been a great bonding experience for Yvaine and my wife and a great start in good behavior.

Saturday, January 22, 2011

Fleaces And Other Random Things

Today is just a few quick and simple comments and answers.  The first one is probably only going to be found amusing by my veterinary colleagues.

Today one of my associate doctors was talking about looking for "flea dirt" with one of our techs.  For those who don't know, flea dirt is the little black specks you will see on the skin in pets who have active fleas.  These specks are the feces of the fleas and is pretty distinctive.  Since it's flea feces, we know that the fleas are actively feeding.  As she was discussing this, I mentioned something about flea season and she heard "flea seas..."  Her mind immediately related this to flea feces, and she coined a new term...FLEACES.  So in our clinic from now on we're going to call flea dirt fleaces.  Anyone else can feel free to use this term, as she's hoping it will catch on.

Now a couple of quick questions from reader Cindi...

In a current blog post, you mention about vetting hamsters.
Do you charge the same for a hamster, as you do a dog?

Yes, I do.  The office visit charges cover the basic costs of an exam and the vet's initial time and knowledge.  Since a hamster visit takes the same time as an average dog visit and I'm doing the same basic exam, I charge the same.  My skills and expertise are worth the same regardless of which species I'm seeing on a given visit.

Second, do you pay yourself/clinic for you personal animal care?

I manage my location but don't own it.  Part of the employment agreement with the practice owners is that we get basic preventative care (vaccines, blood tests, fecal exams, and so on) completely covered for up to three pets.  For any further pets or for any services beyond the basics, we pay out-of-pocket with a 15% discount.  So yes, I do pay for much of my own personal pet care, including heartworm and flea prevention.

What many people don't realize is that most veterinary practices are incorporated.  Because the practice is a corporation (even if it is a single location with a single owner), the business is financially separate from the owner's finances.  If the owner or an employee doesn't provide for care or services, then in effect they are denying the corporation it's rightful revenue.  Practice consultants recommend that the practice owner pay themselves a set salary rather than just relying on pure profits. 

Hope this answers your questions, Cindi.

And don't forget everyone...fleaces!

Thursday, January 20, 2011

Pushing The Boundaries Of What We Can Do

Back in December, The News & Observer (based out of Raleigh, North Carolina) published an article describing bone marrow transplants in dogs.  I found it interesting for many reasons.  First, I hadn't heard of this being done in dogs.  Second, it was being done at the North Carolina State University College of Veterinary Medicine, my alma mater.  Here are a few quotes.

Dr. Steven Suter of the N.C. State University College of Veterinary Medicine is scheduled to perform the surgery Feb. 2 in Raleigh. Suter started the canine bone marrow transplant program about two years ago with machines donated by the Mayo Clinic.
Since then, 36 lymphoma-afflicted dogs have gone through the procedure. The survival rate for dogs that undergo traditional chemotherapy treatments for lymphoma is less than 2 percent.

Although some dogs relapse within months of the surgery, 60 percent of dogs that have left the hospital have survived so far. The longest surviving N.C. State dog had the surgery 22 months ago. There haven't been enough transplants or enough time to pinpoint a cure rate, Suter said.
Although N.C. State was the first vet school in the nation to provide the transplants in a clinical setting, dogs have undergone bone marrow transplants for decades. If not for canine research, human bone marrow transplants would not be as commonplace as they are today.
"The dog has been the transplant model for close to 35 years," Suter said.

It's the last part that really got my mind thinking.  When dealing with my exotic patients I run into the problem that we often can't run lab tests because of the size of the patient.  For example, it's hard to safely collect a sufficient blood sample from a hamster.  We have normal lab ranges for the various common values, but it's difficult to get enough blood to run.  So we have the capability to do it, but are limited by our patients.

Really, that's true of many things in veterinary medicine.  We have capabilities that go beyond what we commonly see.  And that make sense, because any surgical or medical procedure is performed on animals before humans are ever involved.  So virtually regardless of what human doctors and surgeons do, theoretically vets can do these things because they were first done on animals.  For example, we commonly know about kidney transplants in humans.  Did you know that this can also be done in cats?  Here's an article on the surgery with some great and detailed pictures.

So why don't we do these procedures more commonly?  In my opinion it simply comes down to money.  In human medicine most of the costs of such therapy is covered by insurance.  People pay only a fraction of what it actually costs.  But in veterinary medicine very few people have pet insurance so the entire cost of the procedure must be paid out-of-pocket, and this can be substantial.  Bone marrow transplants in dogs?  It runs around $20,000.  And the vast majority of pet owners simply can't afford this kind of money.  Of the rare ones who could, few of them would spend it for a pet.  However, there are certainly those who will, and I admire them.

From the above article:
Gibson and his wife, Rebecca, are planning for Potter's medical care to cost about $20,000, including pre-surgery treatments and travel costs. Working with a website that raises money to help pay for canine cancer treatments, they have set up a fund to collect money to help with the cost.
Gibson, 30, a lawyer, figures about 10 percent of what they need will be donated. "We're just going to put the rest together," he said.
Potter, who received his diagnosis in October, seemed healthy one day and was stricken with terribly swollen lymph nodes the next. Doing nothing was never an option.
Gibson realizes that some people will not understand the couple's financial dedication to their dog. If Potter were older, they might make a different decision.
But with a successful transplant, he said, "we could have Potter for another 10 years." 

But even though this seems like a lot of money, it's still a fraction of the cost of the same procedure in humans, which can run $100,000-200,000. Veterinary medicine is still a huge bargain compared to human medicine.  And veterinarians are just as capable of performing complicated and extensive treatments and surgeries as their human colleagues are.  So really there should be no more limits on what we can do medically and surgically with animals than there are on humans.  Hopefully we will reach a point in the near future where pet insurance will be more common and viable, and we can start seeing these treatments performed more commonly.  Such care can significantly improve the health and lifespan of our furry, feathered, and scaled friends.

Wednesday, January 19, 2011

Training Techniques

Stefanie has written before and sent this to me...

You may remember me as having a 14 year old Queensland Heeler/Australian Shepherd mix (Shadow) that had a squamous cell carcinoma on her left tonsil and soft palate. Just days ago I had to have her put down. While her spirit and mind were willing - she was having more frequent episodes of gagging on her tumor - so I made the most humane decision I could for her and rather than have her choke to death on it, I took her to the vet and had them euthanize her. Very difficult to say the least. The silence at my house is deafening. The pain of losing her - physical and emotional in a way I didn't expect.

As I am not ready financially for another dog (not emotionally either - but do want to do something productive rather than wallow in the loss) - I was looking into fostering dogs through a rescue group as these organizations generally cover vet costs so I would be helping out a dog in need without the financial burden I am not quite able to take on again just yet. My question is how best to train any dogs that are in my care so that they are more adoptable. I have to admit that with Shadow - I was definitely a novice in the art of raising a dog. I probably did most things incorrectly - let her sleep on the bed, jump up on the couch, lead in our walks, counter surf, just to mention a few. Now, while I didn't mind these behaviors and we got along really well - I realize that these things are not readily acceptable to most people. Any recommendations on training techniques? There are just so many different books and authors on the subject and they all have widely differing opinions on how to train a dog. Since you have an interest in animal behavior - I thought you might be able to offer some valuable advice.

First, Stefanie, let me express my sincere condolences.  Having been there myself, I know how hard this can be.

There are indeed many different training techniques, and it can be difficult to figure out which ones to use.  Honestly, most of them have at least some validity.  Personally and professionally I recommend techniques that rely on positive reinforcement.  I do not believe in the various methods of dominance training, such as alpha-rolls or similar tricks, and the opinion of most behavioral specialists is the same.  Negative reinforcement techniques are more difficult to use than methods that rely on rewarding good behavior.  These positive reinforcement techniques have been shown to be much more effective and faster in guiding desired behavior.

Also, some people may feel personally more comfortable with the tricks outline in some methods versus others.  Techniques that may be uncomfortable or difficult for you to use aren't going to be effective.  Especially with fostering pets, you want something simple and easy for you to do.  Also, you'll want methods that are easy for new pet owners to learn, as they will need to continue the training.  Pets won't retain good behavior unless it continues to be reinforced.  You can't train a pet and expect them to be forever properly behaved without continued work.

You'll also want to concentrate on basic training, such as housebreaking, simple commands, not jumping on people, and so on.  These are really the behaviors people want, and it's not necessary to worry about more specialized tricks.  So find books and methods that will give you good tricks for these types of behaviors.

All of that being said, I don't have a specific book or trainer that I recommend. You will have to look through the resources you have available and see which works best for you with the guidelines I've given.  Best of luck to you, Stefanie.

Thursday, January 13, 2011

Born To Be A Teacher

I received this email from Krissy today...

First off I really enjoy reading your blog. I'm a first year vet student at UC Davis. I'm pursing small/equine track (leaning more towards equine) but want to keep my options open. I've tutored college chemistry in the past and really feel I have a passion for teaching. I was wondering how you got involved in teaching college biology and if you were still a practicing vet? Please direct me to your blog if you have already written about this, but I would find any information interesting because I've been considering teaching while also being a part time vet. (maybe a couple years after graduation after I have had the chance to be a full time vet and practice my skills in the field. I've also considered pursuing a PhD and teaching vetmed, but we'll see how much school one can possibly handle :)

Thanks for reading, Krissy!  I hope this is giving you some insight into the real-life situations you'll face in a few years when you've graduated.

My route to teaching was a bit different than most.  Prior to college I would have never considered it as a career choice.  When I was getting my Master's degree I took a job as a Teaching Assistant, basically in charge of running the labs for the intro Biology classes.  I did this just for the extra money, but started liking it.  To find out more about graduate school life and a masters education visit this site that does a decent job of covering some of the specific of pursuing a masters degree program in college.  One semester I had the opportunity to teach an evening lecture course, basically being the full-time instructor with complete control over the class.  I found that I loved teaching, and received good reviews from the students. After that I went to vet school and began volunteering with some other students to go to classrooms and talk about animals, pet care, and being a vet.  Those opportunities were with kids from kindergarten through about 4th grade, and I enjoyed them more than I expected.  However, I still never considered going into teaching full time.  Once I graduated I continued to make myself open to going to local school classes while I was practicing.

The longer I practiced the more I realized that it wasn't everything that I had wanted it to be, and I started looking for other options to do with my degree.  One thing that I kept coming back to was teaching, because I realized more and more that this was my passion.  I loved teaching my clients and staff, but it wasn't quite the same as teaching full-time.  I looked into teaching at a veterinary school, but that would have required me getting a PhD or a specialty certification.  Either choice would have required me to go back to school, making a pittance, and taking another 4-5 years out of my life; none of those options have been appealing to me.  I also looked into teaching at a veterinary technician college, but salaries for that run around $40,000 annually at the most, which is considerably less than a practicing vet can make.  With all of these things in mind, I thought I would have to give up my dream of being a teacher.

Several years ago I was working at a location where I had to commute 2-3 hours round-trip each day.  That became very tiring and very old.  Every day I passed a small local college that was about 5 miles from my house.  One day I started thinking about how much nicer the commute would be if I worked there.  That sparked my teaching interest, and I looked online for any available positions.  They did have a full-time Biology instructor opening, and long story a little shorter, I applied and was accepted.

For nine months I taught there and loved it. It was truly the best job that I've ever had.  At the time my wife was also working full-time, and we began to realize that this made it hard for us to be with the kids enough.  We realized that babysitters and family were watching them more that we would like, and with them getting older we wanted to be more directly involved.  My wife was also tired of her job, so together we decided that she would stop working and be a stay-at-home mom.  Unfortunately, as a teacher I was making half of what I made as a vet, and with me being he sole income again, I couldn't afford to support a family of four.  So I quit the college and went back to practicing veterinary medicine.  I still miss teaching, and hope to one day be able to go back to it.

So, Krissy, that's my pathway.  Because of the scheduling of classes, it might be a little difficult to find just the right job where you can teach and practice part-time. Also, your class schedule will vary from one semester to another, which might be a little difficult with a part-time employer.  But if you can arrange it, you'd have the best of both worlds!  If you wanted to teach full-time and get paid enough to justify your veterinary degree and pay back your student loans, you'll want to get into a veterinary college.  But this will require a PhD or board-certification, and that will take much more time and money.  Frankly, I can't blame you if you don't want to go this route, as I was also tired of school by the time I received my DVM.

Good luck with your studies, Krissy!

Wednesday, January 12, 2011

Work/Life Balance

Erin asks a great question...

Hi, I have been interested in being a vet since I can remember but I just wanted to ask, how do you fit you family life/ love life around your work if you have to work so hard all the time till your about 30 before you've become a proper vet?

If someone finds the ultimate answer to this they can make a living writing books and giving seminars.  Honestly, this is something that is really hard to do.  In my opinion it's about priorities and what you want at any given point in your life.  Also remember that there are very few things you have a "right" to.  I believe in a strong family and know that it's hard to be alone and not have a good love-life.  However, you may have to sacrifice part of this to get what you want and shouldn't feel like you are entitled to such luxuries.  Acquiring an advanced degree is very difficult and takes a great investment of time, money, and effort.  When you're in veterinary school this needs to be your single priority if you want to do well.  You will spend the huge majority of your time attending classes, labs, or studying.  If you shirk these you may not make it through school and therefore may not reach your goals. Thankfully your schedule gets more reasonable once you're a practicing vet.

Now this doesn't mean that you can't have friends, relationships, or any kind of social life.  It just makes it more difficult.  Break-ups and divorces are not uncommon during medical schools because of the immense strains on time and emotion, often leaving little for a significant other.  But with a little balance, you can have life outside of school.

First, always keep in mind that your education is your priority, and make sure your family and potential relationships are aware of this also.  Keep up with your studies (always easy to say and hard to do) so you're not having to cram at the last minute.  Schedule at least an evening of "personal time" every week.  You can't have this time every night, so don't expect it, but you'll go crazy if you don't have some each week.  This personal time can be used for dates, family dinners, social events, or a quiet evening at home.  Keep a calendar and schedule so you can keep everything straight and know when you do and do not have free time.  Thankfully you'll have holidays and summers to get caught up on relationships and rest.  You can also find books that will help with general work/life balance and those can be applied to veterinarians.

One big hint though.  As hard as it is to think about, I advise against trying to start a family and have kids while in veterinary school.  It's hard enough if you already have kids, but if you're dealing with pregnancy and an infant it can make it nearly impossible.  After having stated that I'm fully expecting to get strongly worded comments from female readers and vets.  Note that I'm saying it's not impossible, just very difficult.

Once you're a vet you won't have as much to tie you up after hours since you won't be studying and preparing for exams.  So even though you're working often long hours, it is easier than being in school.  So even as a new vet it's simply the challenges of having a life while working, something that everyone faces.

Erin, this may not have helped much, as this is something I've struggled with myself.  If any readers have any other hints and suggestions, I'm sure there are plenty of people who would love to hear how you've managed to have a life while being a vet.

Tuesday, January 11, 2011

The Cost Of Snow Days

Remember my rant about winter weather?  Well, it looks like the weather reports were correct and some of the worry was a little justified.  It's still nowhere close to what northern and mountainous parts of the country get, but in this area they're calling it "Snowpocalypse".  It's the most snow in Georgia since the early 1990s, and many of the interstates have been completely shut down due to accidents and jackknifed big-rigs.  Much of this is due to the ice rather than snow, as parts of the area received up to a quarter-inch of sleet and freezing rain. Even Wal-Mart closed early yesterday, which is pretty much unheard-of.

This is more snow than my kids ever remember seeing, and it's been great to share it with them.  My wife made snow cream, we had a snowball fight, and the they got to go sledding with some of their neighborhood friends.  Personally I love snow and winter weather and don't get enough of it for my taste.  So all-in-all, this has been a nice little vacation for my family.

However, as a business manager I have a different perspective on things.  We were closed yesterday because of the extreme weather and the risk of staff getting to the clinic safely.  Since officials were telling people to stay off the roads except for extreme need, this was a pretty easy decision.  Today we contemplated opening late since the snow and ice had stopped coming down and road conditions had improved a little.  At the same time we would likely close early since the roads would re-freeze after dark.  However, my receptionist and tech couldn't get out of their neighborhoods safely, and our other staff lived even farther away. Even if I could have gotten in, I wouldn't have had anyone there.  We don't board pets and don't have any hospitalized patients right now, so there wasn't an imperative need for someone to have to be there.  In all likelihood we would have few to no clients since everyone else would be staying home also, so I erred on the side of safety for my staff and closed today as well.

All of that sounds nice and logical, and I do feel that it was the right decision to make.  However, part of my purpose for this blog is to give people a look "behind the curtain" of being a vet and running a business.  Our gross revenues this time of the year run around $2000-3000 per day, with some days being higher (we'll push $5000 on a really busy day).  So by closing for two days we've effectively lost $4000-6000 compared to normal weather conditions.  We do save in paying staff, which will offset the losses slightly.  But insurance costs, employee benefits, and many other costs stay the same regardless of whether or not we're open.  Our landlord also doesn't give us a break on our rent just because we can't make it in for a few days.  So there are plenty of costs that we're paying out even when we're not there and not bringing in revenues.

Don't get me wrong, I don't regret closing for a few days.  Besides just looking at the numbers and money I have to realize that my staff are real people with families and I need to consider their safety also.  Running a business involves making tough decisions like this.  In order to stay profitable (and therefore stay open) we will have to make up these losses at some point.  Thankfully it's early in the year, so that is a very reasonable goal. 

There is soooo much more to running a veterinary practice than simply practicing medicine!

Sunday, January 9, 2011

Winter Weather Rant

Here in northern Georgia we are expecting a major winter storm to hit tonight and into tomorrow.  There will be several inches of snow and up to a quarter inch of ice.  For our part of the country this is a pretty big event.  For those not familiar with US geography, our region doesn't get snow very often, so it doesn't take much winter weather to cause panic and shut things down.  People in this area simply don't know how to handle snow and ice, so they freak out a little (or a lot) when it happens.

Even though I've grown up in the South and have lived most of my life here, I simply don't understand the panic.  I remember several years ago when 1/2 inch of snow shut down Raleigh, North Carolina and ended up in some children having to spend the night at their schools because the buses couldn't get out.  Last year my kids' school was closed for a day because there was a threat of flurries!  Not even confirmed real snow!  Northern parts of the US will get several inches in a day and still function normally.  You'd think that would be the case everywhere.

However, that's not the part of all of this that frustrates me the most.  I realize that the state and city transportation departments have more limited resources than their northern counterparts because of the infrequency of truly bad winter weather here.  I also know that people live here in part because they don't like severe winter weather.  Safely driving in snow and ice requires experience, and people here really don't have any.  If you're not safe driving in such weather, it's safer for everyone if you stay home.  So I do somewhat understand a little of the fear that hits some people.

What really gets to me is the rush on grocery stores.  People buy food like they're going to be locked in for a week or more during an apocalyptic winter.  Yet even in the absolute worst blizzard I've experienced I was trapped in my apartment for only three days.  The items that get sold out quickest?  Bread and milk.  Why those two?  First, like I just mentioned there is little chance of being stuck in your home for long.  But even if I was, I'd rather have chips, soda, and pizza.  If I'm isolated in my house for a few days, I'm going to want to relax, have fun, and maybe have a little party with the family.  I'm going to want food other than bread and milk.  So why do those two things get sold out?  It never makes sense to me, and I think people do it because that's what everyone else does.

So the bad weather starts tonight and continues through Monday and into early Tuesday morning.  By Wednesday the highs for the rest of the week are scheduled to be above freezing.  All kidding aside I really do pray that nobody gets hurt or killed.  And there's a very good chance that I won't be able to make it into work on Monday, so I may get to have that little party with my family.  Soda?  Check.  Chips?  Check.  I'm set!

Saturday, January 8, 2011

Microchips & Tumors

In 2007 a press report stated that there was a direct relationship between microchips and certain tumors in mice, rats, and dogs. Depending on the studies reviewed, tumors happened in anywhere from 1-10% of the animals who had chips implanted. This article has caused an uproar and concern in those who have read it. Now there are people who are extremely concerned that microchips will cause tumors in their pets.

However, I haven't seen any good evidence that this is a true risk. Here are some quotes from the original article, which I think are overlooked in the discussion.

Dr. Cheryl London, a veterinarian oncologist at Ohio State University, noted: "It's much easier to cause cancer in mice than it is in people. So it may be that what you're seeing in mice represents an exaggerated phenomenon of what may occur in people."

Tens of thousands of dogs have been chipped, she said, and veterinary pathologists haven't reported outbreaks of related sarcomas in the area of the neck, where canine implants are often done. (Published reports detailing malignant tumors in two chipped dogs turned up in AP's four-month examination of research on chips and health. In one dog, the researchers said cancer appeared linked to the presence of the embedded chip; in the other, the cancer's cause was uncertain.)

A Time article had more interesting quotes.

In an exclusive interview with TIME, Silverman provided a list of 34 studies the company included in its FDA application, including one of the three mentioned in the AP article, which showed that less than 1% of 4,279 chipped mice developed tumors "clearly due to the implanted microchips" but were otherwise healthy, and that "no clinical symptoms except the nodule on their backs were shown." The second study, conducted in France in 2006, two years after VeriChip's FDA application was approved, found that while 4% of the 1,260 mice in the study developed tumors, none of them were malignant. As for the third study, Silverman says it was conducted in mice specifically bred to produce tumors, and was therefore omitted from the sheaf of studies included in the FDA application.

Dr. Lawrence D. McGill, a veterinarian and leading expert in animal pathology says the tumor development in rodents is unsurprising. "Even if you put in a bland piece of plastic, it will produce tumors in rats and mice," says McGill, who assessed the studies on behalf of VeriChip. He says it would be a leap to apply the findings of studies in mice to cats or dogs — or to humans, for that matter — which are much more complex animals. Few official scientific studies have been conducted on the effects of microchip implants on house pets, but none have found a link between the chips and cancer, says McGill. If there were a problem, he says, we would have already seen lots of cancer among the approximately 10 million pets that have been chipped over the past 15 years. Says Silverman, "There are no reported incidents to the FDA of any cancer formation around that."

The American Veterinary Medical Association did release a position statement shortly after the original article came out.

In a Sept. 13 statement posted online, the AVMA said staff and member veterinarians are actively looking into the potential for electronic identification implants to induce tumors in dogs, cats, or people but must await more definitive data and test results before taking further action.

Considering how a large number of pets have been implanted with microchips with a relatively small number of confirmed cases of tumors associated with microchips, the AVMA advises against a rush to judgment on the technology.

In fact, there is a concern among veterinary medical researchers that some of the research into supposed chip-induced tumors may be flawed, because the animals used were genetically predisposed to cancer. In addition, removal of the chip is a more invasive procedure and not without potential complications.

The Time article further quotes a representative of the AVMA.

The AVMA officially counsels against removing the chip, while assuring pet owners it will continue to monitor the situation. "At this point we do not recommend that people should stop microchipping," says Dr. Rosemary LoGiudice, a veterinarian and assistant director with the AVMA. "We are actively watching. For the number of animals that are said to actually have microchips, when you consider the number of animals that have been microchipped and returned to their owners, the benefits are huge compared to the few and suspect cases that have been reported to have tumor formation."

Personally, I don't think there is a large enough risk of tumors to be concerned.  Is the potential there?  Quite possibly.  However, there really is nothing out there without any risk at all.  Vaccines, routine surgeries, antibiotics...they all carry some risk.  Some time read the warnings and side-effects on a label of ibuprofen or aspirin, and you may be surprised and scared.  No matter what medicine we take or procedure we undergo, there will be various degrees of risk.  Thankfully, most of the time nothing adverse happens.  So there could be minor risk in some patients, but I see no evidence that it's a worry for the majority of pet owners.

In my years of practice I have never seen any tumor associated with a microchip or talked to any other vet who has seen it.  Millions of pets and livestock world-wide have received microchips, yet there are no reports of wide-spread tumors.  In fact, this one 2007 article is the only I've ever heard of that has looked into the issue, and if it was really a true concern, I would think that more data would have come out in the three years since it was published.

I know that there are some people who are vehemently opposed to microchips, and I'm sure that I won't convince them otherwise.  But based on the available data I think that microchips are overall safe.  I recommend them to my own clients, and believe in them enough to implant them in my own pets.

Friday, January 7, 2011

Tattoo or Not Tattoo

"De plane, boss!  De plane!"

Sorry, I couldn't resist.  And my younger readers probably have no clue what the heck that means.

Yesterday I talked about microchips.  In the discussion about identifying pets, tattooing usually comes up.  In fact, many people are strong advocates of tattoos over microchips.  Tattoos cannot fail, and short of cosmetic surgery to remove the skin, they can't be lost.  However, I think they are less than ideal methods of identification, and I don't recommend them.  Here are some reasons.

1.  In my experience few veterinarians have tattoo equipment.  The tattoos normally used for livestock are the ones most commonly seen in veterinary offices, and even then usually only with large animal vets.  So finding someone who can tattoo a pet may be a bit tricky.
2.  Tattoos can be altered or covered over by anyone with tattoo equipment.  This may even be done by non-vets with human tattoo equipment.
3. Placing a microchip is very quick, taking a couple of seconds.  Giving a tattoo is a lengthier procedure, and may require heavy sedation.
4.  My biggest objection to tattoos is that there is no standard.  Some will put their dog's AKC registration number.  However, many or most non-vets probably won't know what the numbers are.  And what about mixed-breed dogs?  They don't have an AKC identification number.  Tattoo your phone number?  There's a good chance that you will not have that number for the rest of your pet's life, and then what do you do?  Use your Social Security number (in the US)?  First, that's a huge risk for identity theft.  Second, there's no way to get in touch with you through that number.  Tattoo a pattern or a string of random numbers?  Sure, you could tell that a pet is yours pretty quickly, but when someone finds your pet how are they supposed to get in contact with you?  All-in-all, tattoos provide a pretty poor way to find the lost pet's owner, in my opinion.

If you're one of the ones who are big supporters of tattooing as a method of identifying your pet, I'm sorry if I've ruffled your feathers.  But based on the reasons above I can't recommend it to my clients.

Tomorrow I'll close out this latest discussion on pet identification by discussing whether or not there is a risk of tumors associated with microchips.

Thursday, January 6, 2011

Microchip Failures?

Recently I received a question from Cindi, who is part of a poodle flickr group.  A discussion came up because several members of the group had found that the microchips implanted in their dogs could not be read.  I won't copy the entire discussion here, but this is a basic summary:  Several chips from different manufacturers in different pets and different geographical locations could not be read by multiple scanners.  Within a veterinary practice 2-3 different scanners were used and none of them could find the chip.  So obviously people are concerned about the microchips in their pets.  And this is a good and valid topic for discussion!

First, let me point you to a post I made in 2009 about the basics of microchips:  read this and then come back.  I won't repeat information from that post here, and it will give you good basic information about some of the current microchipping issues (which haven't changed since I wrote it).

Microchips function as passive transmitters.  The microchip itself has no battery or other power source.  Until activated it's basically an inert object that simply sits under the skin and does nothing.  The scanners broadcast a radio frequency over a short distance. Some scanners broadcast a specific frequency while most newer ones will broadcast multiple frequencies to cover different types of chips.  Each chip responds to only one specific frequency of radio wave.  When that frequency hits the chip, it gives it enough power to broadcast a small amount of data (its number) over a short distance.

Now there is a problem with microchips in the US because there are a couple of different competing frequencies (see my previous post).  Modern universal scanners should be able to read all frequencies.  However, there is one company, Avid, that has encoded their chips so only an Avid-brand scanner will read them.  There was even a controversy because all other microchip manufacturers agreed to unencode their chips so all scanners could read them, but in the US Avid refused to do so (even though they have different frequencies and open-read microchips outside of the US).  Some scanner companies found ways to "crack" the code and can now read Avid chips.  However, this isn't consistent or reliable, so in some cases an Avid microchip can only be read by an Avid scanner.  I'll be nice and not give my personal feelings about Avid because of this issue (though you can probably guess that I'm not a fan of them).

In my opinion, microchip failure is very rare, and overall they are one of the best ways of identifying your pet if lost.  I believe in them enough that I have microchipped all of my own pets, and will continue to do so.  However, a microchip is an electronic device, and any such device does have a chance of failing.  It's a fact of the laws of entropy that any mechanical or electronic object has the potential of breaking down.  You can manufacture an object to be very reliable and have a low chance of failure, but it's impossible to make something that will never stop working.

Personally I haven't seen or read any reports of wide-spread microchip failures.  There has been nothing reported in any of the US veterinary journals that I receive, and I haven't personally seen this as a wide-spread issue.  I can think of a couple of cases over my career where the client said they had a microchip and I couldn't find it with my universal scanner.  In those cases I recommended going back to the shelter or vet who implanted the chip and have them scan it with one of their scanners.  I can't say that I ever heard back from those clients to see if the chip was found.

In my own practice I'm a big advocate of microchips, and we use the 134 kHz chips.  We routinely scan new pets, especially any that are brought in as strays.  I can think of at least a half dozen stray pets over my career that I have personally found microchips in and been able to track down the owner.  I can also say that when a client says their pet has a chip and I scan it, I'll find at least 99% of them even if we didn't implant them.  So I believe that as a whole, microchips are very reliable.  Are they perfect and immune to failure?  No.  That's why I tell my clients to still use collars and ID tags, and both of my dogs have this form of identification on them.  But when a collar or tag is lost and the pet gets away, a microchip is still your best chance of having that pet found.

Cindi, I hope this answers the questions your group had on this topic.  There were some comments regarding tattoos as a method of identification, and I'm going to talk about that tomorrow.

Tuesday, January 4, 2011

Where Does Obligation End? Part 2

Back in November I started the most recent poll, asking if veterinarians had an obligation to provide treatment for a pet even if the owner couldn't afford it.  The question was based on a situation with a client, and though it was one of the more extreme situations I've seen, it wasn't the first one on this subject.  The results of the poll surprised me somewhat, as I didn't expect such a large percentage to say a vet has an obligation to treat.

I'm Not Sure--12%

I think that many people don't realize how much money it takes to run a veterinary practice.  Most vets run on a slim profit margin, and it's not uncommon for veterinary clinics to go out of business.  The most common reasons for such failure usually revolve around the vets not charging for services, giving away services, or having too low prices.  While it may seem nice to a client to have low veterinary prices, these low prices often come at the cost of the veterinarian.  Not charging and keeping prices too low are key reasons for vets to end up in a failed business, and ending up having to close their doors.

Veterinary practices are expensive.  Routine in-house blood analyzers can cost over $20,000.  An electronic tonopen, used for measuring eye pressure during glaucoma screens, runs around $3000.  My practice usually spends $2000-3000 per week ordering routine supplies, vaccines, and medications (and we're an average practice, not a really big one). About 40-45% of our monthly budget goes into meeting our payroll.  Each month we have to pay rent, utilities, unemployment insurance, liability insurance, benefits for the staff, data and phone lines, and a long list of other expenses that most people don't think about.  We are a profitable practice, but there isn't a lot of wiggle room.

So let's say that we took the obligation to treat all pets, even if the owner couldn't afford it.  When we're using medications, bandaging, surgical supplies, and so on to treat pets for free, it still costs our business to order them.  We still have to pay all of our obligations.  I can't call the phone company and say "We gave away about $1000 in services to needy pets this month. We're a little short on our phone bill.  Can you give us a break this month?"  I'm not sure my staff would stick around long if I told them I couldn't pay them for their hours worked because we did a lot of charity services this week.  And I wouldn't get far with our suppliers if I wanted to order more things but hadn't brought in enough money to do so. We have expenses and bills regardless of how much money comes in.  When we lose more money than we make we have to close he business.  And who can we help in those situations?

It's really nice to wish that we could see any pet and treat it.  But the reality is that this is not sustainable. I know that many of the people who voted were likely thinking of their own pets, and looking at themselves as the exception.  "Well, the vet makes enough money I'm sure he could afford to absorb a few hundred dollars for my pet."  Once in a while this may be the case, and I don't have a problem with vets who do occasionally help out clients by writing off costs or allowing payments.  But this can't be maintained by any vet.  And remember that there are many people who want the same consideration.  If the poll numbers are representative, 30% of the clients are expecting the other 70% to help pay for their medical care.   Or looking at it another way, veterinarians are being expected to keep their high level of medical quality and services, but doing so with 30% less income.  It simply can't be done.

So here's my question for anyone who voted "Yes" to the question "Do veterinarians have an obligation to treat a pet even if the owner can't afford it?"  How are the veterinarians supposed to pay their bills and stay open if they treat every pet without regards for payment or compensation?