Ever-Growing Teeth

Clearing out my inbox before I take a week off to go to Dragon*Con in Atlanta.  Here's an email from Teng.

My prairie dog's teeth keep growing. I have trimmed it for 2 times, everytime the vet need to inject narcosis to make him sleep.

But after a week his teeth grown, after 2 weeks it's amost reach his throat. By the way he has stop chewing, and his neck has disease, the wound never closed, and bleeding. Not sure it's this cause by the teeth. 

I can't think of any solution, can you help on this?

Rodents have rather interesting teeth.  They continually chew on hard and abrasive materials, which would wear down the teeth of most other mammals.  To counter this constant wear-and-tear rodents have open roots and their teeth grow continually throughout their lifetime.  Normally this isn't a problem as the upper and lower teeth will rub against each other and the animal will chew on things that will keep the teeth worn down.  

Problems can and do occur.  Often this happens after a tooth breaks off, resulting in the opposite tooth not having anything to grind against.  Misaligned teeth or jaws can result in the same problem, allowing teeth to grow longer than is normal and natural.  It is also possible to have abnormal wear due to chewing habits, resulting in points, elongated teeth, and so on.  Regardless of the cause, overgrown teeth are potentially a serious problem.  Molars can rub against or even trap the tongue, causing pain and an inability to eat.  Abscesses can result due to infection in a broken tooth or an overgrown tooth pushing into the gums.

It is impossible to stop a rodent's tooth from growing, regardless of whether it is a hamster, rat, prairie dog, guinea pig, or rabbit (and before I get comments, yes, I am fully aware that technically rabbits are lagomorphs and not rodents).  When you have overgrown teeth you have very limited options.  Initially the best option is to keep the teeth trimmed, which can be done by any vet with proper skills in these species.  For the incisors you may be able to trim the teeth while they are awake, depending on the animal's behavior. For molars you always have to fully sedate them because it's nearly impossible to get that far back in the mouth while they are awake.

Other than trimming the other solution is to have the affected teeth extracted.  This is much more difficult than removing them in a dog or a cat due to the tooth structure, and so it should only be attempted by vets who know what they are doing.  You also have a problem in that you'll often have to remove teeth on the opposite jaw to prevent them from overgrowing.  And you can't remove all of their teeth since they need to be able to chew and grind their food for proper digestion.

Yes, this can become burdensome.  Yesterday I saw a guinea pig that is a regular patient of mine.  The owner got her from Craigslist, and on her first examination I discovered that she was completely missing her lower incisors, the upper ones were growing back into her mouth, and her tongue was split and had healed.  I suspect that she had some sort of injury that caused the lower teeth to become damaged and fall out, cutting the tongue at the same time.  We see her every six to eight weeks to trim the upper teeth and keep them at a proper length.  I have another patient, a rabbit, who has a misaligned jaw which causes her teeth not to properly contact each other.  I have to trim her incisors at about the same intervals.  Both owners know why and how this has to be done and have accepted that responsibility.

Teng, I wish I had better answer for you.  If this is as serious as it sounds you may need to contact an exotics  specialist, as many general practitioner vets don't have the experience or equipment to treat these cases.  Talk to your vet about the various options and get their opinion.

Cat Dental Care

Rebecca sent me this question....

I came across your blog recently and have enjoyed reading it very much. I'm wondering if you have any advice regarding maintaining my cat's oral health, particularly as I was told she has slight gingivitis. My vet recommended that I add a powder called Perio Support to her dry food, but I've found she won't touch the food if I do that. I am uncomfortable brushing her teeth with my finger, especially since I got her as an adult stray and so wasn't able to acclimate her to brushing as a kitten. Please let me know if you have any other suggestions. Thanks!

Great topic!  Many people seem to forget that cats can get dental tartar and periodontal disease just like dogs.  I've seen far too many cases of severe gingivitis and infection in cats that are obviously painful and having difficulty eating.  It's a disorder that can be prevented or at least improved.

When there is significant tartar and gingivitis the only solution is to have a professional dental cleaning performed.  Once the calculus is hard enough nothing will get it off other than scaling and cleaning, similar to what we have done at our dentists.  However, there are things that can be used to prevent such accumulation  either when the pet is young or after a dental cleaning.

Cats are especially tricky because they tend to be far less tolerant of brushing and generally being messed with than dogs are.  They fight us more and can potentially even do more damage if they really get upset.  However, even adult cats can be acclimated to having their teeth brushed, which is the gold standard of dental care.  Start with just gently lifting her lips and looking at her teeth a little every day, getting her used to this kind of exam.  Give her the taste of a cat-safe toothpaste and let her lick it off our finger.  Once she sees this as a treat, start to smear it on her lips and teeth.  Gradually you should be able to work up to full brushing.

There are numerous products on the market that claim to help with dental tartar, but not all of them live up to the claim.  I try to direct people to the Veterinary Oral Health Council, which helps educate pet owners about dental care.  There is great information on that site, but my favorite section is the list of products that carry the VOHC seal of approval.  This seal means that independent veterinary dental specialists have evaluated the claims of a product and found them to be effective.  There are several diets, treats, sprays, and water additives on their list.  While this is not necessarily an all-inclusive list, it certainly covers enough variety of products that anyone should be able to find something they can use for their cat (or dog!).

So Rebecca, I'd recommend checking out the link and see if you can use one of these products to make dental care easier.

List of VOHC approved dental products.

Name That Dog!

Pet names are always interesting to me, and I've blogged about it before.  I see so many "Bella"s nowadays that it's rather insane, and I've had days when we have 3-4 pets dropped off who all have the same name.  It makes us have to be rather careful not to treat the wrong "Max".  I really enjoy unique names, which is why our pets are Inara, Yvaine, Ash, Tristan, Pippin, Falcor, Adara, and Silvermist.

I've posted infographics from this site before, but this one is really interesting to me.  Hope you find it interesting also!


Dog names graphic produced by Matt Beswick for Pet365. Click here to view the original post.

Who Do You Believe? Part 2: Vet vs. ?

Yesterday I talked about the medical aspect of Laura's post and today I want to talk about the rest of it.  Here's a repeat of her email to me.

I recently rescued a 9 year old chihuahua. He only has 2 bottom fang teeth remaining and they are rotten and loose. He has been to several vets with varying opinions of treatment. I was told to leave the teeth because the jaw will completely breakdown without the teeth there to anchor the jaw. I was told by another vet that if I leave the teeth they will make the jaw infected. The rescue group I adopted the dog from says leave the teeth in because the jaw will break if the teeth are pulled. I'm not sure if this is a question futon website but I would really like some feedback, option and/or experiences with this type of situation.

People come to a vet because they want help and advice for their pets.  You might be surprised how many times they DON'T believe us.  Breeders, groomers, pet store employees, shelter workers, and just about anyone who works with animals will have an opinion.  But you have to look at the education, background, and training of the people you listen to.  

A veterinarian has many years of intense, comprehensive training in anatomy, physiology, pharmacology, parasitology, infectious disease, and surgery.  In order to keep our license we are required to do continuing education training every year, keeping up to date on the latest developments in the field.  Most vets read several professional journals every month.  We see things every day that most people won't see in a year, or even in their lifetime.

So please tell me how all of that pales in comparison to someone who's main qualification is having bred dogs for a few decades.

Yes, it's a fact that many people will believe their dog's breeder over the vet.  Or in Laura's case possibly the shelter worker.  I've seen people ignore a vet's advice because the clerk in the pet store told them something different.  In many of these cases there is no arrogance or ill-intent on the part of the person giving the advice.  They are saying what they honestly believe.  But I've also seen many people (and breeders are a high percentage of this) who honestly believe that they know better than a doctor.  They try to convince you that the vet is full of crap and is only trying to make money, yet they have no training or education whatsoever in immunology, medicine, or anything else.  They may have read something on a web site or forum from like-minded people and don't actually have any real evidence.

So please, when you have conflicting opinions look not only at the motivation of the person giving advice, but their background and experience as well.  In 9 out of 10 cases the vet is going to be the one with the more solid facts.

Now all of this becomes more difficult when you have vets who differ in opinion, as Laura had happen.  I've often said that if you put five vets in a room and ask about a specific topic you'll get at least six different opinions.  There is rarely a 100% consensus in medicine.  Our opinions are going to be based on where we received our training, which lectures we've attended after graduating, which articles we have read, and so on.  It's sometimes difficult even for us to make sense of what we should do and recommend when specialists differ on a diagnosis or treatment. This can be confusing to clients and I've been in the position of giving different advice than the last vet they saw.  This is never intentional on my part and I'm very careful to never disparage my colleagues to a client.  Rather it's simply a difference of opinion.  I even have differences with my associate doctor!  Thankfully they are minor and we otherwise have similar practice philosophies.

So what does a client do?  If you're uncertain, ask for details and reasons.  I've always felt that if I'm going to have an opinion I should be able to justify it.  I don't like hearing "because" as an answer to my questions, and I don't like giving it as an answer.  Have your doctor explain in as much detail as you can understand and need, and if they can't give adequate answers you should consider getting another opinion.  In the end, though, you'll have to make up your own mind.  I feel that a vet's job is not to make a decision for you, but to give you the information so that you can make your own decision.

Laura, I hope some of this may have helped your situation!

Who Do You Believe? Part 1: Bad Teeth

Is it "who" or "whom"?  I always get confused on that particular grammar rule.

Laura recently left a comment on a post I did last year about a case of severe periodontal disease in a dachshund.

I recently rescued a 9 year old chihuahua. He only has 2 bottom fang teeth remaining and they are rotten and loose. He has been to several vets with varying opinions of treatment. I was told to leave the teeth because the jaw will completely breakdown without the teeth there to anchor the jaw. I was told by another vet that if I leave the teeth they will make the jaw infected. The rescue group I adopted the dog from says leave the teeth in because the jaw will break if the teeth are pulled. I'm not sure if this is a question futon website but I would really like some feedback, option and/or experiences with this type of situation.

There are two things to address here.  First, what to do in this particular case.  Second, looking at who you believe and get advice from.

The "fang" teeth, properly called canine teeth (even in non-canine species!) have extremely long, curved roots that go back much further than people realize.  In the front part of the lower jaw the roots of these teeth take up a considerable amount of space.  Removing the teeth can be tricky, especially if there is considerable periodontal disease.  If the infection is severe, you do indeed have a risk of accidentally fracturing the jaw during the extraction process.

Let's take a moment and look at what periodontal disease is.  As tartar and calculus remains in contact with the teeth and gums it causes inflammation.  This inflammation allows easier access of bacteria to the tissues, as well as the bacteria spreading on their own.  When teeth become loose it's not normally due to just the tooth itself.  In these cases the infection is bad enough that it is spread into the bone of the jaw leading to erosion and deterioration.  As the bone erodes its hold on the teeth is reduced, leading to loose teeth.  So by the time the teeth are loose we already have breakdown of the bone in the upper or lower jaw due to infection, which is why the teeth are loose.  The teeth don't anchor the jaw.  The jaw anchors the teeth.  Yes, the teeth do give some stability to the lower jaw, but healthy bone isn't going to break or deteriorate by being worked on.  So if we have a case where the tooth has to be removed due to an injury rather than infection, the chance of breaking the jaw is very low.  With periodontal disease the risk of fracture is because the jaw is already weak and infected, not because you're extracting a tooth. 

In my opinion and in the opinion of every dental specialist I've heard talk, these teeth need to come out.  They are helping to keep the infection persistent and as long as the bad teeth are there the problem won't completely go away.  The vet doing it will have to be very careful during the procedure, but it still needs to be done.  I normally put such a patient on antibiotics for a few days prior to the extraction and then for 7-10 days afterwards.

So what about the second part of this discussion?  I'll get into that tomorrow.

Dry, Cracked Paws?

Stefanie emailed me this a while back and I'm finally getting to it.

I would like to know how to care for my dog's paws in the dry heat and winters here in Arizona. Are a dog's paws even supposed to be smooth and soft? Are the cracks and dryness that I see "normal"? And if not - what would you recommend I use to help those rough patches?
I do feed her a high-quality dog food and also give her a supplement provided by my vet for her hip dysplasia and also is supposed to have something in it to help her skin and coat (Phycox).

 

My first recommendation is to have your vet look at the paws.  While a puppy's paws are soft and smooth, it's very common for an adult dog's paw pads to become rough and thick.  Such changes are a normal response of the body to walking on rough or abrasive surfaces.  A little thickening will happen merely with age, but the harsher the surface a dog spends much of its time the rougher the pads will get.  That's exactly what the pads are designed to do.  Some cracks and dryness are normal, but you can have situations where there is a medical problem causing excessive cracking.  That's where your vet can determine if what you're seeing is normal.

There are several products that can help.  A basic vitamin E lotion often will do the trick.  There is also a lotion called Bag Balm that was originally used to help cows' udders but can be used to soften skin and relieve minor irritation on any species.  If a dog is going to be on rough ground for a very short period of time a little petroleum jelly can be a temporary protectant.  But if the harsh ground (rocks, sand, extreme heat or cold, etc.) is going to be more than a couple of minutes you should consider getting protective booties.

A Preventable Dilemma

Today I ran into a rather unfortunate situation.  A couple brought in a six year-old unspayed female pit bull that hadn't had any veterinary care since it was a puppy  The dog was very sweet, which makes the problems we discovered more unfortunate.

The "minor" problems were some worn and broken teeth, dirty ears, and about 15 pounds of extra weight.  During the exam we found a small (about 1cm) firm mass in one of the mammary glands.  With her being a middle-aged unspayed dog I immediately began worry about cancer.  Part of our discussion at that point was about doing chest x-rays to look for metastasis, spaying her, and doing a partial mastectomy to remove the mass and send it for biopsy.  Because these kinds of tumors can grow and spread rapidly, it was important to try and remove it and make a diagnosis as soon as possible.  So this was problem number one.

Since she didn't have any preventative care so we began with with heartworm and fecal testing.  This revealed problem number two as the heartworm test came up positive.  A quick look at a blood smear showed more microfilaria (heartworm larvae) than I've seen in a long time.  So now we had two serious problems going on at the same time, both potentially life-threatening.

The real dilemma came in trying to fix both.  Because of her mammary mass she needed surgery pretty quickly to prevent possible spread.  However, heartworms can severely compromise the heart, making anesthesia very risky.  So should we treat the heartworms, possibly letting the tumor grow?  Or would we risk her in surgery to get the mass off?

In the end we elected to treat the heartworms first.  It will probably be about four months until we can get to a point where it's safer to do anesthesia, but the surgical risk of a heavy heartworm infection was too great in my mind.  Thankfully the owners are ready to do treatment and we're starting this week.

But what really got me was that both of these situations were preventable.  If they had her on preventative medicine she wouldn't have had heartworms and we could have done surgery quickly.  If they had spayed her when she was young it would have dramatically lowered the risk of her getting this kind of cancer (if it's what I think it might be).  So with proper preventative care started at a young age we wouldn't be in this situation.  And the owner wouldn't have to be paying almost $2000  for treatment and eventual surgery.

When a vet talks about preventative care, please listen to him or her.  We are honestly looking out for your pet's best health and are trying to keep them from having serious illnesses.

Pain In Animals Is Real

Last week I did a routine spay on two little kittens.  Everything went well, the kittens recovered normally, and they were getting lots of attention before they left because they were so cute.  When the owner came to pick them up our receptionist offered pain medication for them to go home with.

The owner said "Do they really need it?"

Okay, stop and think here for a minute.  We just took two young cats, each about five pounds, cut through their skin and abdominal muscle with a sharp knife, pushed around their internal organs with a probe, pulled out their uterus, tied off the appropriate areas, cut away the uterus and ovaries, and then put in several layers of sutures to close everything up.  After all that we are asked "do they need something for pain"?

Unfortunately there is a perception among many people that animals don't feel pain, or don't feel it in the same way that we do.  There are even some vets who don't feel convinced that pain control is necessary, and that pain can help a patient by forcing them to restrict their activity.  Both of these viewpoints are severely flawed.

Quite a lot of research has been done on pain in animals over the last 15-20 years, and the overwhelming conclusion is that they feel pain as acutely as we do.  Just like some people can push past it while others are a bit wimpy (raising my own hand, here), some animals show more obvious symptoms than others.  But they certainly do have pain receptors just like we do.

Why does this matter?  So what if they hurt a little bit?  It doesn't really bother them, does it?

Pain is the result of stimulating certain nerves and those signals begin a cascade of chemicals released into the body.  Pain increases stress hormones which have been shown to slow healing.  Pain also causes significant mental stress and can lead to long-term trauma and aversion of events or locations where the pain occurred. All of this can have tremendous effects on a pet.

Let's put it very simply.  Painful animals suffer mentally and physically and heal slower.  Pain-free animals have a much faster recovery and healing process with less stress and trauma.  Whenever  an illness, injury, or surgery causes pain, it is absolutely in the pet's best interest to do everything we can to control that pain.

Think about yourself.  If you had surgery how would you feel?  What would you think of a doctor that didn't worry about controlling your pain?  Extend that attitude towards your pets and you're in the right direction.

Veterinary Medicine In Comics

Anyone who reads this blog long enough, or just looks at my favorite links, will quickly learn that I am a geek.  I have been reading comic books since I can remember reading anything at all, and have continued to keep up with current comic plots and lore.

One of my favorite characters is Hawkeye in Marvel Comics.  I've been following him since he was a secondary character in Iron Man and of course enjoyed his appearances in the Thor and Avengers movies.  Though he has made his appearance throughout Avengers titles and even some solo mini-series, it has been a long time since we've seen stories about him on his own.  So it was with great excitement that I picked up his brand new series.  

What I didn't know until reading it was that a vet clinic plays a central role as a key location!  I was surprised and pleased to see that Clint (Hawkeye's real name) taking care of a dog that gets hurt during his battle with some gangsters.  However, as I read I started to see some flaws.  I hate to say it but that annoyed me a little, as I doubt the artist or writer talked to a vet before creating the issue.  Here are the pages I'm talking about.

Doesn't look bad, does it?  But I have never seen a front desk that is large enough to put a full grown dog on it!  That kind of counter would be extremely difficult for any client to work on and reach across.  I've never seen a vet clinic that has anything other than standard width desks and counters.  Still, a nice little introduction.

The good points here are how the vet talks to Clint.  I've had similar conversations myself and agree with the vet's approach to the case.  I also understand Hawkeye's stress and applaud the writers for having him apologize after the outburst.  The bad point?  Do you see how much blood he has on his lab coat?!?!  No matter the case I would NEVER walk into my lobby looking that bloody.  How hard is it to switch coats or just take it off?  There is always time to look professional, or at least not look like you stepped out of a butcher's shop, before talking to a client.

Yay, the vet saved the dog!  But he still has on that bloody, gory coat.  Really?  After surgery and recovery he is still wearing that coat?  In order to do surgery he would have had to take it off, so he willingly put it back on again!  I tell you, that stain is never coming out at this point.  And what's up with the care?  A broken pelvis, yet he's lying awake on a surgery table?  I can't see any signs of surgery on the pelvis, though perhaps it's on the right side where we can't see.  It could be the same situation with the broken leg, because those bandages aren't sufficient to stabilize such an injury.  Lastly, check out that eye patch and bandage.  Yes, that's how they do it on humans, but if we have to remove an eye we don't put any bandage on at all.  The lid will be sewn closed but the surgery area will be exposed.  The artist may have the basics of dog anatomy down, but he obviously didn't think out how the heck that bandage is supposed to go around the head.  Let me tell you from experience that such a bandage would be quite difficult as the anatomy of a dog's head doesn't really allow such a wrap.  In any case I can't think of any circumstance where I'd try to place something like this.

Over-critique?  Absolutely!  I should just be glad that they had a vet in there.  But when it's your profession that is portrayed it's hard not to see flaws in the details like this.  Still, I'll certainly continue to pick up this title.

Depressing Facts For New Graduates

Normally I have a veterinary student that works the summers with us, learning the ropes of being a small animal veterinarian.  Every year or two we have a new student as the previous ones enter senior clinics and graduate.  So I've gotten to keep up with the life of a vet student even after graduating myself.  Yesterday I was going over the recent article on the veterinary job prospects with my current student, and I think that I depressed her.

This isn't a good time going into veterinary medicine, as hard as that may be to say.  Many people grow up wanting to be vets and put their whole hearts into it.  They work hard, get good grades, and beat out the competition to make it into school.  Then they go through absolute misery for four years to get their degree.  Once they graduate, they have so much hope and excitement.  They finally did it!  They finally achieved their dream!  And suddenly reality hits.  They have a hard time finding a job and have a hard time making enough to pay their student loans and other bills.

Katie made the following comment on yesterday's blog (just in case people don't read the comments): 

I am a 2011 graduate and pursued an equine internship right out of school thinking that I would do a surgical residency. There are even less equine jobs than small animal jobs and I am still looking for work in either small or large. It'd be nice to have a job, not even to mention a job that pays well;-P Most of my classmates have over $140,000 in debt from vet school alone. It's a mortgage. I don't know what the answer is to the rising dilemma, but it disheartens me to think that there are new veterinarians coming out every year that will be in my same situation, if not worse.

This is the harsh reality facing newly graduated veterinarians.  And unfortunately all of the trends seem to show that it will be getting worse.  While my current student will have significant challenges when she graduates in 2013, I can't imagine what the class of 2017 will face, let alone beyond that.  Burdensome and overwhelming debt is racked up for very low pay and not even a guarantee of a job.

It is downright depressing.  And it will kill the dreams of many people as well as affect the profession as a whole.  Many people are discussing the issue and I have seen many suggestions made, but nobody seems to be doing anything about the problem.  I think that the leaders in our profession are spending too much time talking and not enough time acting.  They are letting down our current students, people considering a career, and even the clients.

It makes me glad that I graduated 15 years ago and have established myself successfully.  It is much harder to do so nowadays.

Veterinary Shortage? Not So Much. And That's A Problem.

For many years there has been a debate in the veterinary profession in the US as to whether or not there is a "shortage" of veterinarians.  I have seen the pendulum swing to both extremes, from "OMG, we're not going to have enough to provide for clients!" to "Yeah, you're going to have a hard time finding a job."  Recently an extensive study was published that looked into the subject, which I read in the July issue of DVM Newsmagazine.

Is there a shortage of veterinarians?  The study clearly says "no".  But even with that simple of an answer it doesn't give all of the details.  We have seen signs for years that the food animal industry is lacking in vets as fewer people pursue this as a career (in fact, I've blogged about it a few times).  The recent study indicates that there are unfilled positions in research and public sector jobs (epidemiology, food safety, public health, etc.).  The main area where there is an over-supply of vets is in the companion animal field, and even that can be regional.  But it's pretty clear that the evidence is building that we are graduating more veterinarians than are needed, especially those working with pets.

Depite this fact vet schools are looking to increase their class sizes, hoping to offset funding deficits due to a decline in state funding.  There are also states looking to open new vet schools with the idea of meeting the needs in the under-supported areas.  These philosopies will assuredly lead to even more of a disparity between supply and demand for vets.

So why does this matter?  The study reached the conclusion that the cost of becoming a vet is at a "crisis point", with the ratio of debt to starting salaries over 2 to 1.  Newly graduating vets are facing a huge challenge in simply surviving and paying back their loans, and the problem is only getting worse.  We're not talking about whether someone has to choose between a Toyota versus a Lexus...we're talking day-to-day existence.  Nobody should be surprised at this trend, as we've been following it for more than a decade.  The study predicts that as people see a horrible return on investment for their veterinary education the quality of applicants will decline.  No matter how much someone loves animals, if they can barely pay their bills in a job they will likely look elsewhere for a career.  The combination of these facts and this trend means that we may see less qualified vets (though I do have my own doubts about this) and an increase in the costs of veterinary care (have to pay back the bills somehow).

So what is the solution?  The study gives many suggestions, which for brevity's sake I won't repeat here.  Personally I don't think we need to be expanding class sizes or opening new schools with news like this.  In fact, I would venture to say that it is utterly irresponsible of universities and state governments to do so.  We should consider "tracking", guiding people down one aspect of medicine or another, therefore allowing us to have a certain number of applicants in a given field.  And there should be strong incentives to practice in under-served areas of the profession through loan forgiveness programs like we see in professions such as teaching and human medicine.

All of this should be a wake-up call for anyone considering becoming a veterinarian, at least here in the US.  We're seeing debt rise many times faster than salaries while jobs are becoming harder to find.  You need to think very long and hard about going into the profession at this time and look very realistically at the financial prospects.  For the sake of my colleagues and the profession I really hope that the leaders in the industry and universities will look hard at the data and come up with real solutions.

Is There An App For That?

I have a confession to make.  Though I love technology I'm usually late to embrace new gadgets.  I didn't get my first MP3 player until about two years ago.  My first digital camera was only a few years before that.  We bought an XBox 360 about six months ago; before that we had a PlayStation 2, and the game console before that was an Atari 2600.  I don't have a smartphone and don't plan on getting one any time soon.  So even though I have a fair bit of knowledge about these things, I am far from an expert.  I'd love to have a new phone, iPad, and other cool devices, but I don't have a real need for them in my job and can't justify the extra cost for a cool toy.

Which brings me to an email I recently received from Sarah...

As you’ve said you’re a bit of a technological geek, I was wondering if there are any smart phone apps that you use in your practice and could recommend.  Currently I own an iPhone, but I would be interested in any recommendations for other platforms as well, as I am purchasing something else in a few months. 

Technology can be a great tool in a veterinary practice.  There are digital versions of text books and formularies.  Some large practices and hospitals use laptops or tablets in the rooms that communicate with the clinic's computers via wi-fi.  My associate has an iPad that she uses for drug calculations, having created a spread-sheet where she plugs in the patient's weight and it calculates all anesthetic dosages. I know that there are plenty of other programs and apps out there, but I don't have a lot of experience with them.  Heck, I really don't have any personal experience with them!

So unfotunately I can't answer Sarah's question.  However, I'm sure some of my readers could! So I'm putting the shout out for any reader in the veterinary profession to chime in on this issue and make their best recommendations.  I also know that journals like Veterinary Economics have published articles on this topic in the past, so people may be able to search archives online.

A Vet's Other Life

Don't send out the bloodhounds, it isn't the "Case of the Missing Blogger".  I realized that I haven't posted anything new in almost a week, and no, I haven't dropped off the planet.  This is a great time to talk about what else veterinarians do.

I've mentioned this before, but many people seem to think that vets do nothing but play doctor.  It's sometimes hard to imagine professionals having a life outside of their office.  But in fact we have quite an active life that takes up quite a bit of our time.  Let me give you an example of things that I'm involved with.

* I'm co-director of a Christian fan group, Fans For Christ, and we're preparing for our biggest event of each year at Dragon*Con.  Besides this con, we attend other events and I help arrange these gatherings.

*  I was just elected as treasurer of our community theater group, The Pumphouse Players.

*  I act in the theater and was recently cast in a supporting role in the play Wit.

*  I manage the financial and marketing side of my wife's custom costuming business, A Touch Of Magic Costumes.

*  I have two kids and don't want to completely abandon them.  I want to be an active father, spending quality family time when I can.

*  We home-school our kids and I try to help teach and supervise on my days off.

*  I'm very much in love with my wife and actually want to spend time with her.  That gets a bit difficult when there are so many other things taking up my time!

And somewhere among all of that I have to sleep!  Needless to say, I have a somewhat busy life.  In fact, I could make a full-time job out of the things I do outside of my paying job!

Vets really are down-to-earth real people with dreams, goals, and interests outside of veterinary medicine.  We put 40-50 hours per week practicing medicine, but we also do things once we leave the clinic.  Our weeks can get pretty full, not always leaving a lot of extra time.

Yep, it's a life!

Back To School Blues

I'm bored.

Like many businesses, veterinary medicine is sometimes at the whim of seasonal changes, weather, and so on.  Summer is our busy season while things really drop off during the winter.  We'll also see that rainy days tend to bring out fewer people, though beautiful weekend days are also slow because of people taking advantage of the nice weather to do outdoor activities.  Another influence is kids and school.

Today is the first day of school in our county, and Monday kids go back in a neighboring county.  Parents are spending their time and money getting their children back into school, which means less time and money to bring pets in.  While the first part of the week was steady to busy we really dropped off today.  As much as I hate being slow I shouldn't be surprised becuase this happens every single year.  I can always count on the fact that for a week or two around the time that school begins and again when it ends for the Summer we will see a drop in business.

But I don't have to like it.

First and foremost we are a business and have to take in revenue.  If clients don't come in, we have less revenue and if it continues for too long we're in trouble of surviving.  Many veterinary clinics in the US have closed because of a significant drop in business during the current economy.  My problem today is merely an expected seasonal variation and we're actually growing quite well, so I don't see this as a reason to worry.  If it continued at this rate for the next three or four weeks I would indeed worry!  But I have years of data to show that this is typical for this week of the year.  As I've mentioned frequently in the past, there are aspects to operating a veterinary practice that many people never realize, even veterinary students or newly graduated vets.  For better or for worse we have to pay attention to business trends and anticipate the slower periods by doing well in the busier ones.  We have to maintain profitability in order to stay open and continue to serve our clients and patients.

But today I sit here bored.  Blogging. 

*sigh*