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Tuesday, December 30, 2014

Do Indoor Pets Need Rabies?

Connie asks this question:
How important is it for a small house to get a rabies vaccine. I know it's a law in Florida but since my dog is rarely outside alone except for walks, I feel it is not necessary.
In every US state rabies is required by law.  In every country I've ever had a client take their pet to, it is the one vaccine that must be given.  To enter some countries you have to be very specific in the timing of the rabies vaccine and even have titer levels run.  This is the one vaccine or preventative care that government officials don't joke about or give any leeway.
The reason for the strictness has to do with the very serious, incurable nature of the disease.  If a person is infected long enough and starts developing clinical symptoms, they will die.  It's that simple, as there is no treatment or cure.  Transmission requires direct contact, but the virus particles can go through the smallest opening.  For example, infected saliva contacting an abrasion or small cut is enough to transmit the disease.  It doesn't take a full bite wound.  People have been exposed by having a stray kitten lick them, or removing something from a horse's mouth.  Symptoms don't show up immediately, sometimes delayed by many months, so it may not be immediately obvious that an animal is rabid. 
This is a deadly, incurable disease.  And humans can easily catch it if exposed.  We have significantly reduced the number of human cases through wide-spred vaccination of pets and livestock, as well as control of animals entering certain countries.  There are even programs to leave vaccine-infused bait in endemic areas to help prevent transmission in wild carnivores.  If people stopped vaccinating, this disease could easily become much more wide-spread.
Now you hopefully understand why the laws were established and why the governments are so strict.  But what is the real risk of exposure? 
Certain parts of the country are definitely at higher risk than others.  There are also different wild animals that are typical carriers (reservoirs) of rabies in different areas, though any warm-blooded animal has the potential to carry it.  Here are some graphics from the Centers for Disease Control.
Most common reservoirs for rabies.
Number of rabies cases, 2009.
And since Connie lives in Florida, here is specific data for part of 2013.
As you can see, this is a wide-spread problem.  And just because a certain area doesn't have any "dots" doesn't mean rabies isn't there.  It just mean that specific cases weren't diagnosed, but can still be in the wild population.
So what about the dog who pretty much lives indoors and goes out only a leash?  That's where the situation gets tricky.  That particular pet indeed has an extremely low risk of being exposed to the disease.  But it's not impossible for a dead or dying bat to be found by the dog, giving exposure.  Rabid animals don't behave normally, so an infected raccoon could possibly attack the dog.  What about a dog wandering the neighborhood that attacks?  Sure, I'll admit that these things are pretty rare, but they're by no means impossible. I've seen plenty of dogs attacked by wild animals, or even stray dogs, and in those situations you have no way of telling the rabies status of the attacker without killing it and having the brain examined.  Do you want to take that risk?
There's also the bigger issue of legality.  When a pet bites someone or punctures the skin with their teeth, it gets reported to local animal control.  They then look into the case, and if the pet isn't current on the rabies vaccine it will be quarantined at the owner's expense and a fine charged.  After 31 years in this profession I can assure you that even the best, nicest dog or cat has the potential to bite, especially if they are scared, sick, or injured.  If that happens and the dog isn't current on rabies vaccine, the owner is in for a world of trouble from law enforcement.
I know this has been a long answer for a simple question, but I wanted to take the time to go into the details and "whys" of the situation.  The short answer is yes, it's important even for mostly indoor pets to get rabies vaccines.

Saturday, December 27, 2014

Big Dogs Mean Big Costs

Many of my clients have very large dogs.  Most of them are under 100 pounds (45kg), but some are quite a bit larger.  Dogs like Great Danes, mastiffs, Saint Bernards, and Great Pyrennes are really nice dogs and there is a differen kind of happiness when you have a "giant" breed that you won't find with a toy breed.  However, that joy can go away when something goes wrong and there are veterinary bills.
Owners of big dogs know that feeding costs are high because of the sheer volume of food the dogs eat.  But prospective owners don't always think about the medical costs.  In veterinary medicine we dose based on weight.  A 150 pound human is typically going to take the same dosage of antibiotics as a 300 pound human.  This is not the case with animals.  A 40 pound dog and an 80 pound dog are going to get radically different doses of pretty much everything.  This includes antibiotics, pain medications, heartworm preventative, flea preventative, anesthesia, and so on. 
Today a client came in with her 120 pound Great Dane.  As part of her annual physical we ran a routine urinalysis and discovered an infection that hadn't been obvious to the owner.  We talked and it did seem like there were some emerging clinical signs that supported our lab results.  The decision was made to put her on antibiotics.  The owner was fine with all of this until we added up the costs and the medications alone were nearly $200. 
Yes, that's a lot of money!  But because of her size and the nature of the infection there weren't a lot of other options.  A 15 pound poodle would have taken home the same medciations for less than $30 because it would have a much lower dosage to achieve the same result.  I've seen this time and time again, to the point where I actually cringe a little when I order up certain medications for these giant breeds.  Unfortunately, I have little control over it, as those higher doses of drugs cost us more to order and stock.  The mark-up is the same, but the larger dogs simply need more.  Believe me, we're not trying to gouge or penalize owners of these breeds.
When someone is considering getting a pet of a certain breed, I think it's always wise to research the pros and cons of the breed as well as the costs of medical care.  When you accept responsibility for caring for a pet you also have to shoulder the costs of that care, which are much greater for bigger dogs. Prepare for the inevitable greater costs, especially if that large pet gets sick. 

Wednesday, December 24, 2014

Merry Christmas

As a Christian this is one of the most special times of year for me.  We shouldn't forget about or ignore Christ the rest of the year, but around Christmas we get to celebrate His birth and what His coming into the world means to all of us.  I pray that all of you have a blessed holiday season and take to heart what the birth of that baby in Israel over 2000 years ago means to us now.  Enjoy your families and Merry Christmas!

Tuesday, December 23, 2014

The Very Real Dangers Of Tinsel

I don't have tinsel on my Christmas tree and haven't since I've had cats.  I know all too well the dangers of "linear foreign bodies" in cats, and tinsel is a big culprit.  This lesson was driven home this past weekend with one of my clients.
I'll call this cat Buzzsaw (not his real name....just his behavior).  He is a rather obese, quite unfriendly cat who came in for a few days of vomiting and not eating.  His exam (what I could get of it without sedation) was unremarkable.  The owner said that he did like to chew on plastic bags, but more importantly they did have tinsel on their Christmas tree.  The husband (let's call him Mr. Toldyaso) had been opposed to tinsel, having heard it was a bad combination with cats.  But his wife and children overruled him, and the tinsel went up. 
We sedated Buzzsaw and I took some abdominal radiographs.  With his rather corpulent nature there was great contrast with the fat in his abdomen and I could clearly see a very suspicious part of his intestines.  This confirmed my worries, and I called Mr. Toldyaso that we needed to get Buzzsaw into surgery right away.  Not doing so could prove to be fatal within a few days.
Linear foreign bodies are anything long, flexible, and thin within the intestinal tract.  This can include sewing thread, fishing line, ribbon, and yes, tinsel.  If a long section of the material goes into the digestive tract the movement of the intestines acts like a draw cord on curtains.  When your curtains are closed you can pull on a string, which causes them to open.  If you look at them you'll notice that as they close they develop pleats and bunch together.  The same thing happens with the intestines.  The contraction of the muscles moves the intestine but not the string, so the intestines bunch together along the object.  If this goes on long enough it can actually start to cut into the intestine causing severe and life-threatening damage.  The only way to fix it is to go in surgically as soon as possible.
We did the emergency surgery and Buzzsaw was very lucky.  I found the affected area quickly and the intestines were healthy with no obvious damage.  At that point it was a matter of making a few small incisions and carefully removing the tinsel.  Closing the intestine and abdomen was routine and he recovered well.  The surgery ended only two hours before we closed, so I sent him to the local emergency clinic for overnight observation.  That was four days ago and he's home and doing well.
I had a conversation with Mr. Toldyaso when he picked Buzzsaw up last Saturday night.  He said that he was trying not to be mean about it, but he hadn't wanted the tinsel to be put up in the first place.  I did save most of it and gave it to him in a plastic bag to take home and show his family as an object lesson.  Our charges were around $1000, and the emergeny clinic probably charged around $500 to hospitalize and observe Buzzsaw until he could go home.  Mr. Toldyaso was quite clear with his family.  "You wanted a computer for Christmas.  Instead, you have your cat."
While I have tried to instill a little humor in the story, it's one that is completely true and has serious consequences.  Cats have a very, very high tendency to want to chew on long, thin objects, and this can result in disastrous outcomes, including emergency surgery.  Buzzsaw was lucky because we caught it relatively early and there was no damage, but it could have been quite different.  If you have cats, you should NEVER use tinsel in decorating.

Sunday, December 21, 2014

Tightwads With Coach Bags

One of the things that frustrates us in the veterinary field is the life choices some pet owners make that puts their pets at risk.  I'm talking about the people who have enough money to buy luxuries but won't spend even a little money on their dog or cat.

Recently a client came in with her poodle, worried about her dog's nasal discharge and sneezing.  While the dog was in good spirits, she was running a low-grade fever and had slightly enlarged lymph nodes.  To me it was a very straightforward case....the dog had a sinus infection and needed antibiotics.  Because of the enlarged nodes and fever I wanted to treat for possible bacteria rather than just letting the case run its course.

To me this wasn't a big deal.  I ordered up the medications, which came to $18, and had my tech review the treatment.  The owner looked up at her and asked "Can I use something cheaper, like Benadryl?"

Several things bothered me about this comment.  First, antihistamines aren't going to treat an infection.  Second, $18 for antibiotics is really inexpensive.  And last, the client was carrying a Coach brand handbag.
I actually had to look up the costs of these bags, even though I knew they were expensive luxury items.  Looking on the Coach website when writing this blog, I saw that they start at around $300, and go up from there.  Some list for $1000 or more!  And the lady had one.  Sure, it's possible she got a really good deal or managed to pick one up at a yard sale for a steal.  Maybe it was a gift from someone else who had the money.  But it looks bad when you carry a brand known for its expensive price and then balk at necessary medicines that come out to less than $20.

I don't change recommendations based on a perception of the client's ability to pay.  I offer a treatment plan based on what is best for the pet, and then deal with whether or not the client can afford it.  I don't artificially inflate the price if I see a client driving a Lexus or wearing a Rolex, and I don't artificially discount the price if the come in wearing flip-flops and overalls.  What is the best treatment plan is relatively objective and whether or not a client can pay the costs doesn't change whether or not their pet needs it.

Every day I see people who want to treat their pet but can't afford to.  Many of them are sincere in their desire to help and legitimately can't come up with the funds.  But many others are tightwads are are simply looking for the cheapest way out rather than the best way.  Sure, I like a good bargain as much as the next person, but we shouldn't be dickering about the life of a pet. 

I'm sorry if this sounds harsh, but if you can't afford $20 worth of antibiotics for you pet, then you do not need to have a pet at all.  If you're that hard up for cash, put the Coach bag on eBay, make a couple of hundred dollars, and set that aside for your pet's care.

Yes, I'm ranting a bit, but it frustrates me and many others when we see clients buying costly handbags and carrying their iPhone 5 who complain about things that cost a fraction of their monthly cell phone or cable bill.  If someone is going to have a pet, then they have the responsibility to put that pet before luxuries.  Unfortunately many people have their priorities mixed up.

Thursday, December 18, 2014

The Emotional Toll Of Being A Vet

A lot of people seem to think that being a veterinarian or any other sort of doctor is fun and interesting.  Don't get me wrong, because it can be.  But I think some people don't think beyond the cool cases or the cute puppies to what can happen when things go bad. 
This was a bad week for me emotionally.  Two days ago we had an emergency come in, a young dog who had dug under the fence, got into the neighbor's yard, and was attacked by the neighbor's dogs.  When I saw him he didn't have obvious punctures, but was breathing hard and had some air leaking under the skin.  An x-ray of the chest showed some lung bruising but no air leaking into the chest yet.  We stabilized him with IV fluids, gave pain medicine, and planned to repeat xrays in a few hours to see if there were changes.  Over the next three hours he went downhill quickly and passed away despite our attempts to intervene.  That same day I found out that one of our good clients had to euthanize her dog at the emergency clinic, and another dog that we had been treating died at home (which in that case wasn't unexpected).
So that day I came home pretty bummed out by all of the death I had heard and seen.  The next day was only marginally better.  One of my earliest appointments was an obese cat who was in a diabetic crisis with liver damage, and the owner had to chose euthanasia because she couldn't afford the potentially thousands of dollars to stabilize the pet, let alone the long-term care.  I also had to tell a client that their Sheltie had complete kidney failure and wouldn't make it to Christmas.  This morning another long-term client brought in their very elderly dog for lethargy.  We had been monitoring him over the year as he became more severely anemic, and the owner didn't want to pursue specific diagnostics.  His anemia was worse and his white blood cells significantly increased.  Since he was nearly 15 years old the owner decided to euthanize.
So over the last three days I've euthanized two pets, lost one under treatment, lost two from other causes, and had to give terminal news to another one.  Not exactly the fun parts of the job.
This rapid-fire set of cases wears on a person mentally and emotionally.  We do the best we can to help pets, and we are very aware that we can't save all of them.  Everyone in a medical profession has to have a certain degree of emotional resilliency in order to keep performing on a daily basis.  But some days and some cases are worse than others.
This emotional toll isn't always talked about.  But it's a regular part of being in a medical field.  Over the years I've learned how to cope and handle things, but that doesn't make weeks like this one any more fun.  Anyone who wants to become a vet needs to keep this particular kind of challenge in mind, as it's not typically taught in school.  These are the times when the rose-colored glasses come off and the brutal reality of death hits you in the face rather forcefully. 
Thankfully most weeks aren't quite so dire and depressing, otherwise I don't think I could keep doing this job.  Now I just need a few days off and some healthy puppies and kittens to see!

Monday, December 15, 2014

How To Thank A Veterinarian

Peter asked me a very interesting question, one I've never had someone ask before....

My wife and I recently had to put down our cat Jessie.  She was diagnosed with CRF at the age of 4 during blood work taken as prep for a normal dental cleaning.  (Her kidneys were the size of plump raisins... I suspect she got hit with the whole Chinese Protein fiasco, even though she never had a brand of food that was recalled.)  She lived for 7 years after that with no more than every-other-day sub-q fluids and kidney food (after starting fluids her blood values never again left the normal range by much, if at all).  Her only complications were a couple of UTI's and a stone.  In the end, it wasn't her kidneys that got her, it was lymphoma that spread throughout her intestine.

Our vet and clinic staff took great care of her over the years, and I was wondering what would be an appropriate thank you gift would be.  I was hoping for something more meaningful than a gift basket...

First, Peter, on behalf of my colleagues let me say thanks for your appreciation.  Even the best vets tend to get more complaints than compliments, or at least it can seem that way.

Believe it or not, genuine, sincere thanks doesn't come as often as you may think.  In all of my years I've probably gotten about a dozen or so thank-you cards from clients.  And I've cherished and kept every one of them.  It may not seem like much, but a short, simple card where the client expresses their thanks and feelings means more than you can imagine.  We are in this profession to help people and pets, not to get rich.  Sometimes it feels like we aren't successful as we see pets go untreated, therapy fails, or clients are unhappy.  We crave those few times that a person takes the time to single us out to let us know how much they appreciate what we do.  Such thanks often come at the times when we most need them.

If you want to do more (and believe me, a card is thanks enough!), gift cards are a great option, especially to a nice restaurant.  I've gotten a few of those over the years, and it gives me an opportunity to go out to eat with my wife, something for which we don't always have the budget.  Gift cards to coffee houses such as Starbucks are also very nice, and have sometimes allowed me to grab something caffeinated on my way to work. gift cards are also nice because they allow us to splurge a little in ways we normally wouldn't.  If you want to do something more specific, make a gift basket with cookies, candy, and chips.  Nice pens are always a great gift, as we constantly lose the ones we have around the clinic.

In case you couldn't tell, those of us in the veterinary profession are very motivated by food!  We love the holidays because we will get clients bringing in cookies for the staff.  We'll often buy munchies to keep around the clinic so we can snack between patients.

I hope this gives you a little direction, Peter.  Really, the simplest thanks are more than sufficient and are greater than we usually get.  You don't have to do something extravagant in order for your appreciation to be recognized.

Friday, December 12, 2014

Fat Cats Aren't Just Fluffy

I hate seeing obese pets.  I really, really do.  It is something that in most cases is completely preventable and results from a combination of too much food and too little exercise.  Most of my clients don't seem as concerned about the health consequences as I am so it becomes frustrating to recommend weight loss and then they ignore my advice.
It shouldn't be a surprise that pet obesity is a rapidly growing problem in the US.  Our human population is one of the fattest in the world, so it's no shock that our pets resemble us in this way.  As with humans, there are consequences to obesity.  Cats are about six times as likely to become diabetic if they are obese, and this disease is particularly challenging to regulate in the species.  Being overweight also can lead to skin problems, liver disease, heart disease, joint issues, and increased risks of anesthesia.
My clinic recently saw one of the fattest cats I've personally examined.  Actually, one of my associate doctors had the case, but I got the chance to look at him too.  Here are some photos.

As you can see, the cat is morbidly obese.  When these pictures were taken he was 29 lbs (13kg), which was less than his previous visit weight of 33 lbs (15kg).  Considering that this cat should have weighed around 12 lbs (5.5kg) you can see the magnitude of the problem.  At his peak he was essentially carrying around three cats on his frame!  In human terms this is equivalent to someone who should weigh around 150 lbs (68kg) actually weighing over 360 lbs (163kg)!

This isn't cute.  This isn't fluffy.  This isn't something to ignore.  This is sad and should never have happened.  The cat is suffering because he really can't easily move around.  It requires a lot of strength and energy to move that much weight and his body isn't designed to do so.  And it puts him at a significant risk for serious disease.

Just a few days ago I saw a sick cat.  He was 13 years old and hadn't been to a vet in many years because he never acted sick.  This cat was obese, and when we ran lab tests we diagnosed severe diabetes with significant complications.  Due to the life-threatening nature of his condition and the costs involved in treating him, the client had to euthanize him.  If he wasn't obese, he may never have developed that disease.
The good news is that the client is taking this seriously.  It's impressive that they were able to get a 4 pound weight loss in a month or so, and they're continuing to work on further loss.  With proper treatment and diet, he has a good chance of losing the weight and becoming healthier.

Tuesday, December 9, 2014

Puppy Regurgitates Liquid

Today's question comes from Kathryn....
My 6 week old puppy regurgitates liquids, he doesn't have any problem with eating food. What should I do to begin testing to find out what his prognosis is? He is from a litter of puppies I have and has had the problem from birth, regurgitating some of his mothers milk.
I have had him to the vets, he suggested x-rays and is suspicious of Mega-esophagus, I have research this disease online but find it usually includes food reguritation.
First, this is definitely a case in which you should rely more on in-person vet visits than online comments and research.  I'll give my thoughts, but if you want a true second opinion find another vet to do the exam on your dog.
My first two concerns would be megaesophagus or some kind of hiatal hernia.  Megaesophagus in puppies is typically a birth defect where a fetal vessel around the esophagus doesn't go away, resulting in a stricture and difficulty passing food.  It builds up in the esophagus, stretching it out and leading to food regurgitation.  While Kathryn's puppy is certainly not a typical case, I wouldn't completely rule it out.  In megaesophagus cases liquids typically can pass through easier than solid foods, which is the opposite in this case.  Still, it's worth checking out.
A problem at the upper sphincter of the stomach (cardiac sphincter in the hiatal region) could result in the stomach opening into the esophagus more easily.  In this case liquids would be more likely to pass back out rather than solids.
If this was my case my first step would be x-rays and possibly and upper GI contrast study.  If this didn't give any answers and the problem persisted I would want to refer the case to a specialst to have an upper GI endoscopy procedure.
Kathryn, I would continue to follow your vet's advice and see if they can track down the cause of the problem.

Saturday, December 6, 2014

Nutrition Mythbusting....Current Pet Food Fads

Every time I write about pet nutrition I get people commenting about how I'm full of crap and obviously don't know a thing about pet foods and what goes into them.  Time to walk that path again.
This post comes from a question sent to me by Sharron....
Hi Dr Bern: lexee is a yorkie/chihuahua 5 yrs old - my problem is i don't what to feed her - she is SO fussy when it comes to dry dog food. Of all the dry foods i have tried i always go back to Royal Canin.
But of course i have gotten raked over the coals because so many people believe it's a horrible food. Today i was asked if i'm trying to kill her by feeding her RC. I try not to get wrapped up in the holistic, organic etc trend. I think RC is fine. Lexee likes it but i still wonder if she should be on grain free - she doesn't have allergies. She also likes Hills Healthy Advantage Small Bites. Can you set me straight on these foods. Are they good foods to feed. Thankyou.
Before I get into the meat of my post, let me first stated that my opinions are formed by listening to and reading articles from board-ceritified nutritional specialists and internal medicine specialists.  My sources are reputable and experts in their field.  Before you disparage and dismiss those folks, remember that these are veterinarians who have studied for 5-6 years after vet school in a very specific field and then have passed rigorous exams where the pass rate is around 40%.  If you ignore their opinions, you are throwing away the views and knowledge of the people doing the reasearch that everyone else follows.

Okay, that's out of the way.  I had to throw that in there because I inevitably get people who think what I say is uninformed hogwash and my sources obviously don't know what they're doing and are shills for the food companies.

Sharron, here's the simple version....the people who are giving you advice don't really understand what they're talking about and you shouldn't listen to them.  Keep doing what you're doing.

Now the long version. 

The whole "grain-free" diet trend we've seen in the last couple of years is purely a fad without any real scientific basis.  It's perpetuated by people who have incomplete understanding of the gentics and digestive physiology of dogs, and often by pet food companies trying to sell food by playing on client fears.  So why is this such a popular trend?  From my personal experience this trend started as a result of two things, both incorrect. 

First, there is a percpetion that because dogs are descended from wolves we need to feed them something similar to the diet of their wild anscestors.  Since wolves don't eat wheat, rice, and corn, we need to be feeding grain-free diets.  The problem with this idea is that it's completely wrong.  Dogs are not wolves.  Yes, they are very similar and have a nearly identical physiology, but there are also significant differences.  Dogs have been domesticated for 10,000-15, 000 years, and in that time have been exposed to diets much higher in grains than what wolves eat.  Scientists have identified differences in several key genes in dogs related to starch digestion and glucose uptake.  This means that dogs have developed so they have a much better ability to handle grain-based diets than do wolves.  It also means that there is no benefit to feeding a grain-free diet over one with grains.

Second, there is a misconception that grains cause food allergies.  This is blatantly untrue.  It's the same as saying that a bee sting causes someone to be allergic to bees.  In any of these allergies the person/animal is already genetically predisposed to the allergy, and exposure to the allergen can trigger the reaction.  The bee didn't cause the person to be allergic; the person was already allergic and the sting simply triggered a genetic tendency.  It's the same way with food allergies.  If a dog has allergies to grains, it means that they had genes already in their body which would trigger a reaction after repeated exposure to the allergen.  Grains will absolutely not cause an allergy in a dog with no genetic predisposition, just like a bee sting wouldn't result in anaphylaxis in a person without an allergy to it.  Additionally, not every food allergy is to grains, and even if it is, it is usually to specific grains.  Wheat is indeed a common allergen, but beef and chicken are even more likely to cause a problem.  A grain-free diet is only of benefit if the dog has an already documented allergy to the grain in question.  For your average dog there is no need to limit this ingredient.

Now let's talk about Royal Canin specifically.  I think it's an excellent food, as does every nutritional specialist with whom I've ever consulted.  It is what I chose to feed my own dogs and cats, and I don't work for the company or get any financial incentives for recommending it.  I just believe in it that much.  When ever I've talked to veterinary nutritionists and asked which foods they recommend. Royal Canin is always near or at the top of the list. 

Royal Canin is a great food for a number of reasons.  They use high quality ingredients and pay particular attention to the needs and eating habits of specific breeds.  They put a lot of attention on palatability, which is why they guarantee a dog or cat will eat it.  They are highly involved with quality control on their foods.  And they are supported by the Waltham Foundation, which has been one of the premiere animal nutrition research facilities in the world for several decades.  Besides being one of the leaders in nutritional research, the Waltham Centre has always impressed me by how they take animal welfare into account when conducting research.  I would really challenge anyone to be intellecually honest and find serious fault with the research and findings of this group.

Yes, I know like I sound like I'm trying to promote Royal Canin and Waltham and that I work for them.  I assure you that I don't, and that it just comes from carefully looking into pet foods and this company in particular for over 10 years.

Sharron, I'm curious as to why some of the people you talk to think that Royal Canin is so horrible and detrimental to dogs.  I can almost guarantee it is because of some passionately held misinformed beliefs.  Personally, I think you're feeding one of the best dog foods on the market, and wouldn't recommend changing anything that you are doing.

Now I wonder how long it will be before someone starts commenting on how horrible and ignorant I am.......

Wednesday, December 3, 2014

Concerns About Fostering Dogs

Jennifer asks the following....
I have been thinking for a while about becoming a foster home for a bichon rescue group in my area. I am at home during the day so I would have time to be with and work with the rescue dog, and I have a fenced in yard for the dogs to run around in. I am concerned about how Sparky will react to the rescue dog. He is very friendly and energetic when other dogs come over to visit, and wants to run and play chase games. I understand that it is important for these poor little dogs to go to a home where there is a dog who is well socialized and friendly who can show them that people can be trusted. I am wondering though how do the 'home dogs' react to the very frightened and abused newcomers? Is it difficult for home dogs to adjust to a scared newcomer? I would like to be able to help abused animals in this way, however I don't want to harm my own pet in the process.
First, I want to commend you on wanting to become a foster parent for dogs.  This is truly admirable and it sounds like you have the right situation for it.
The concerns you have are valid, but there are no general answers that can be made.  Really this is very much a "it depends" situation.  If Sparky is generally friendly and gentle around new and unknown dogs, he should be a great foster brother.  If he is friendly but too energetic, he might frighten a very nervous dog with his exuberance.

On the other side it also depends on the personality and behavior of the fostered dog.  Some of them will not have been socialized well and will be nervous around any other dog, regardless of the other dog's behavior.  This can potentially result in fights from a scared or dominant dog.  It may also confuse Sparky when he wants to play and the fostered dog cowers or snaps.  Some fosters will actually like the social interaction once they get used to it, and it may be hard for you to give those up if they form a bond with Sparky.

If Sparky is as good with other dogs as you say, I would take the plunge.  It will help many otherwise homeless dogs and can be very rewarding.  But keep in mind that every dog is an invididual, and no two dogs are going to react exactly the same to the same situation.  Some of the dogs you foster simply may not be good fits in your home, and you shouldn't take that personally or think that it reflects poorly on you as a foster parent.  Have lots of love and patience with Sparky and the newcomers, and partner with an experienced foster parent who can help you though any challenges.

Sunday, November 30, 2014

Christian Challenges In Veterinary Medicine?

Time to delve into religion again.  Being so open about my faith brings up questions from readers from time to time.  Here's one that I received from Marie.....
I've been following your blog for the last 2 years and truly enjoy it! I'm currently pursuing a Masters in Food Safety at Michigan State-CVM while working at the USDA-FSIS, and plan to pursue Veterinary School. However, its been quite the challenge as Im growing stronger in my walk with Christ, that Im getting more road blocks and challenges from those that don't believe.
When you were in Vet School, or even now practicing...did you face opposition on your belief and relationship with God when it came to this profession? If so (which I assume yes), how did you handle it? Do you face it as an educational moment? Agree to disagree? etc.

First I have to say that I wouldn't consider myself as having been a Christian when I was in veterinary school.  Yes, I gave lip service to a belief in God, but it wasn't the personal, heart-felt relationship I have now.  I certainly did not act in a very Christ-like manner!  Even though I was rasied Lutheran, I consider my true beginning as a "Christian" as happening in 1998.  That's when I had a life-changing event that focused me on God, and I haven't turned back since.
So personally I can't speak on challenges in vet school by being a Christian.  I do know that there was at least one Christian student group, though I wasn't part of it.  I wasn't aware of any challenges they had.
I did begin to follow Christ early in my career, and I think it helps me be a better vet.  I try to remember the compassion that He wants me to have, even while I have to balance the realities of business and profit.  I try to follow the example that Jesus set as a servant-leader, where I do what I can to help my staff rather than standing above them and dictating things.  I'll still sometimes get down and clean kennels or sweep the floor if everyone else is busy. 
I haven't run into any opposition in the profession so far, even though people quickly know my beliefs if they hang around me long enough or ask me.  I've never been mocked or belittled for my faith, but I have also spent most of my life in the "Bible belt" where church and God are part of most people's lives.  The only thing I've struggled with is working on Sundays, and it still bothers me.  No, I don't think I'm sinning and don't think God is going to condemn me for doing so.  I just want to be able to attend church every week, and with my schedule I can't always do that.  Our clinic is open seven days per week, so I do work some weekends. 
I have known some Christian veterinarians who have had struggles against unethical behavior or being asked to do something that violates their religious beliefs.  I also do know that there are people out there who will get upset at someone merely because they are Christian and conservative.  I've just been lucky enough to have never faced those situations myself.
I will sometimes talk to my clients about my Christianity and how I sometimes will teach or give sermons.  I've asked some if I could pray for them.  Many of my staff have asked me to pray for their needs, knowing my beliefs.  I'm never pushy about it and only bring it up if the conversation heads that way, so most clients never learn that side of me.  But I'm also proud to be a follower of Christ and am not going to hide it.
I am also particular about some of the phrasing I use, and it can be very subtle.  For example, I'm not a believer in Darwinian evolutionary theory.  Yes, I know that's very controversial!  And I'm sure to take flack from it from some readers who would think that I am not being scientific enough.  Sorry, I've both learned evolution and taught it in college, and I have some real problems with the ideas of it scientifically, especially on a molecular level.  My disagreement with evolution can be defended without ever bringing God into the discussion.  But my faith opens me up to other possibilities, which is why I believe in Intelligent Design.  Sometimes when a client asks me "why does X happen?" I might respond "Well, because that part is designed to do Y."  I deliberately and consciously never use the term "evolved".  And I've never had anyone challenge me on the phrasing.  Would some of my colleagues look down their noses at me for my beliefs?  Absolutely.  But that doesn't bother me in the least and I just move on.
If you're going to be a loud, "preachy" Christian who drops God and Jesus into every conversation, I do think you're going to run into problems.  But that's not the kind of Christian God wants us to be!  That's exactly what Jesus fought against when he condemend the Pharises for their open but empty worship.  Instead, we should live our lives in a Christ-like manner, showing our faith, rather then telling about it.  Sometimes we are the example of Christianity people look at, so we need to be the Bible we want people to read.
And when it comes to people who will oppose us no matter what we say or do or how we act, just remember the verses about forgiveness and loving our enemies.  As Christians we will be opposed.  Jesus even promised it as a "when" rather than "if".  In these situations stand firm in your faith and act as Jesus would, with love, compassion, patience, and understanding.
Marie, I'd be happy to continue this as a discussion in the comments if you have more specific situations that you want to ask about.

Friday, November 28, 2014

What Vets Think About The Day After Thanksgiving

I came across this meme on Facebook today, posted by a veterinarian friend of mine.

It's funny because it's true!  After major holidays that involve lots of food we almost always see cases related to pets eating things that they shouldn't have.  Typically this is mostly after Thanksgiving and Christmas, and to some degree after Independence Day.  At these times people sometimes will slip "goodies" from the table to the dogs and cats, not realizing the harm that it might do.  We also see lots of scraps in the trash, enticing pets to try and get into this forbidden food.  So vets often get cynical about holidays in ways that a "normal" person would never consider.  That's why I loved this meme so much.

I did work today and was surprised that I didn't see any cases like this.  But there's always tomorrow!

Thursday, November 27, 2014

Happy Thanksgiving

I know that this is an American holiday, but it's a great time of year to stop and look at what we are truly thankful for.  I have a wonderful family, great kids, a loving wife, a good job, more than enough food and "toys", and a ton of blessings.  I hope all of my readers have a great day and enjoy good food and family fun.
Happy Thanksgiving!

Monday, November 24, 2014

Getting Cursed Out By A Client

Some clients are difficult to deal with and some of those difficult ones are downright nasty.  It doesn't happen often, but sometimes I do get a client particularly irate and irrational.
One client, we'll call him Mr. P, has been bringing his pets to us for several years.  One of them is a very sweet but grossly obese mixed breed dog.  More than a year ago she developed a mass in her mammary gland and it has grown rather large since then.  In recent months it has begun opening up and draining due to tissue damage in the center.  The dog is 15 years old, has a heart murmur, and isn't in great health, so she isn't a good candidate for a radical mastectomy.  Unfortunately, surgery is the only way to resolve the problem.
Recently she was taken to a neighboring grooming salon that we work with.  They brought her over to me because the mass was open and nasty.  When I looked at her it was worse than when I had seen her two months before, with the center open larger and the surface skin eroding.  I cleaned it up as best as I could, called Mr. P, and told him what was going on.  As before, I had reiterated that there was nothing we could permanently do other than surgery.  However, we would try some antibiotics and antiinflammatories to help it a little.  He was okay with that, agreed to the treatment, and picked her up a little later in the day.
This day was particularly crazy for me.  I was the only doctor on staff and we had a ton of patients.  I ended up seeing 31 pets that day, when a typical schedule is for 18-20.  This meant that I never stopped, didn't take any breaks, and ate my lunch while putting in medical notes.  I was absolutely swamped and barely had time to take a breath. 
Mr. P calls and speaks to my receptionist, saying that his dog's mass was oozing.  He wanted to speak to me for just a few seconds to find out what to do.  I simply didn't have any time to spare as I had all exam rooms full and dropped-off patients I still hadn't seen.  I had them tell him that I'd call him back later, which wasn't good enough for him.  He got mad on the phone and said that he'd be right down with her.  When they told me this I sighed and prepared for a rough afternoon.
When Mr. P came in I had all four exam rooms full with appointments.  He saw me through the window of one and knocked on the door, which I ignored since I was in the middle of an exam on another pet.  As soon a room opened up my staff put him in there, but I had scheduled appointments and continued to see them.  By the time I was able to go into the room with Mr. P and his dog, he had been waiting about an hour.  Remember that he had just shown up, even though he had been told that we were very busy.
When I finally walked into the room Mr. P was quite mad.  As we started talking he became verbally abusive, talking about "g*dd**n" this and "f***ing" that.  He also said that he was being treated like a third class citizen.  I could see that we weren't going to get very far, so I stopped him and told him that if he continued to speak like that I was going to ask him to leave.
I'm a very patient guy and have learned to handle stress and frustrated clients.  But there is no reason for anyone to stand up and simply take cursing and abuse, no matter who is doing it to them.  I've always told my staff that they don't have to put up with people acting that way, and I'll back them up.  Over the years I've had clients get that abusive on the phone, but rarely in person.  In either case, it's not acceptable to me.  Having a conversation is one thing, but yelling back and forth is quite another.
For those new to the profession or customer service, here's a good tactic that has served me well.  If a client is cussing or being verbally abusive, I will give them a couple of warnings.  I'll tell them that if they continue to act that way I won't be able to talk to them.  If that doesn't work, I'll tell them that if they continlue to use that language I'll hang up on them.  After that I'll warn them one more time.  Almost every person will calm down when I threaten to hang up.  They seem to realize that they're saying the wrong things and aren't going to get anywhere.  There have been only a couple of times that a person has continued to rant and cuss, and yes, I did hang up on them.
Mr. P wasn't happy with me threatening to ask him to leave.  He got up and said that I'd be talking to his lawyer.
The whole "I'll sue" or "you'll be hearing from my lawyer" is a common thing to be thrown around, and it simply doesn't phase me.  In 99% of those cases I am absolutely certain that the client doesn't have a case, even though I have no legal background or training.  What lawyer is going to take a case where I was willing to see the pet and work him into my obviously busy day, yet I ask him to leave when he becomes abusive?  Yeah, not going to happen.  Unfortunately we have a very litiginous society and the "solution" that people want to jump to is involving lawyers.  I think part of it is an empty threat, hoping that the threat of a lawsuit scares someone into doing what the client wants.
I told Mr. P that I'd be happy to talk to him and help his dog, but we couldn't have a conversation if he was going to speak to me that way.  He blusted again about the "third class citizen" thing, but I stood my ground.  I again repeated with a serious expression that I can talk to him and work with him, but not if he was going to use that language.  He started calming down and eventually we worked out a solution.  I placed a bandage wrap around the dog's belly to prevent leaking on his furniture and clothing, and said to come back in a few days for me to recheck it. 
That was really all he wanted!  But because I didn't drop everything else that was going on and move him to the front of the line, he thought that I was somehow treating him poorly.  The dog was in no immediate danger, and it seemed to be more about the seepage onto his belongings than the dog's actual health, so to me it didn't merit pushing aside every other client who was patiently waiting at their appointed times.
I'm sorry, but the customer is NOT always right, and I have to prioritize my cases based on many factors.  When you blatantly ignore our instructions and comments, you do not have the right to use any language or attitude that suits you.  All it would have taken is him to have patiently waited, have a calm conversation with me, and we could have easily taken care of things.  To give Mr. P a little credit, he did tell my technician to apologize to me on his behalf for his anger and attitude. At least by the end he realized that he probably went too far.
Folks, these are the things they don't teach you in vet school.  These are the situations that we have little to no training in how to resolve.  I've been lucky enough to have gotten conflict resolution classes over the years, so combined with my 17 years of experience I feel confident handling most of these kinds of clients.  But it's still emotionally and mentally draining, and in almost every case is completely unnecessary.
If anyone wants to become a veterinarian because they don't like dealing with people....they are certainly going into the wrong profession!

Friday, November 21, 2014

How Small Is Too Small?

Here's a question I received from Ashley...
My question now is about the weight of my Newfoundland puppy, Olive. She was born 26 March and when I picked her up at 10 weeks, she only weighed 8kg (17.6lbs), a bit small for a Newfie of that age. Well, now at 22 weeks she weighs 21kg (46.3lbs), and people are commenting on how small she is for her age. Despite the fact that she has consistently been gaining 1kg/week since I picked her up, I am starting to worry that maybe her lighter weight is due to a deficiency or improper feeding. I know this may come across as a daft question (as she has always been on the smaller side), but do you feel my concerns are justified?
I wanted to answer this question because the basic principle can answer a lot of client concerns.  I will often have clients ask me if their dog is too big or too small.   The question then becomes "what is too small?  What is too big?"  And really it's not as simple as most people think.  Even within a breed there can be big differences in sizes of healthy, normal dogs.  Some individuals will be outside of the normal size range, yet still be healthy.
Think about human heights and sizes.  I stand about 5'7".  My wife is 2 inches smaller, and her sister is about 5'2".  Her father is around 6' tall, as is my best friend.  I'm sure all of you know people with similar differences in height.  Yet we wouldn't consider the 5' person to be extraordinarilly abnormal, any more than we would someone at 6'6".  yes, those are outside of the typical heights, but these people aren't likely to be unhealthy due to the size alone.
So what about dogs?  Yes, each breed has a certain typical weight and height range.  But this doesn't mean that every individual within the breed will be exactly in that range.  To me this is like a human couple who are both 6' tall having a child that grows to 5'4".  It's not expected, but it doesn't have to be bad.  That smaller person or dog can be just as healthy as the bigger one.
Most vets use body condition scoring (BCS) systems to determine proper weight.  These are systems where we look at certain physical characteristics to determine whether a pet is underweight, overweight, or at an ideal weight.  Because it deals in proportions and physical features, the height of the pet in comparison to others is irrelevant.  Personally I use a 5 point scale, where 3 is an ideal weight, 1 is severely underweight, and 5 is obese (as in this example on the Hill's website).  I've also seen 7 point and 9 point scales, but the prinicple is the same. 
If I was seeing Ashley's dog I'd look at her proportions and compare it to a BCS system.  If the dog was at an ideal score, I'd consider her healthy even if she was smaller than her littermates or others in the breed.  An unusually small dog like this may not meet breed standards and therefore shouldn't be bred, but she can certainly be healthy and normal.  Dramatic differences in size are typically due to genetic factors rather than nutrition, so as long as her BCS was normal, I wouldn't worry about changing the amount or kind of food she gets.

Tuesday, November 18, 2014

Disney's "Feast" Shouldn't Be One

The last time I went on a rant about animal/vet portrayal in popular entertainment was way back in 2009.  Unfortunately, I feel the need to do so again.  In this case it's especially bothersome to me because it's Disney, a company whose products and movies I love.
Recently my family went and saw the movie Big Hero 6.  It was a great movie that we all enjoyed, and really appealed to our geek side (stay until the end of the credits for a great cameo scene!!!!).  Disney has taken a lesson from Pixar and now shows animated short films before most of their feature films.  I've really liked a lot of them and one of them won an Academy Award.  The one before this movie, however, made me cringe and squirm, simply because I'm a vet.
The short film is called Feast.  It starts with a stray Boston terrier puppy in the rain being enticed by a man with a few french fries.  He takes the puppy home and begins to care for it, giving him a good home.  The puppy was obviously starving, so he gives it a big bowl of dog food.  Then he slides a plate of bacon and eggs on top of it.  Over the next several scenes we see the dog getting spaghetti and meatballs on the food, pizza, and lots of other food.  Eventually we see the dog only eating these sorts of things, with no dog food anywhere to be seen.  The man meets a woman, and when she comes into their lives the dog ends up getting brussel sprouts and a little sprig of parsley on the dog food.  The dog is disgusted by this change in events and the lack of "good stuff", obviously pining away for the pizza and fries while he only reluctantly eats his food.
The couple breaks up and the dog realizes that his master is miserable.  He goes running back to the woman and in a cute scene is able to make her realize that they need her in their lives.  The couple gets married and the dog is eatining only dog food.  You can see that he does it because he wants his master to be happy, but it's not his favorite thing.  Then the couple has a child and food drops onto the floor.  We see the dog getting cake and other things from the child, and everyone is happy again.
From the moment the bacon and eggs landed on the dog food in the early scene, I started cringing.  Then it got worse and worse.  I was wriggling in my seat and my wife immediately knew what was bothering me.  I even admitted to her that I was already formulating my blog post about it, which earned me a chuckle from her.  She knew why I was upset.
You never give human food to pets!
My medical training was silently screaming "pancreatitis" and "nutritional imbalances"!  I was seeing this man doing the exact opposite of what my clients are told.  He was the kind of guy that I want to sternly lecture and tell him how bad it is for his dog.  I know it's common in movies and TV shows to see people give their own food to the dog.  But this was one of the worst examples I've ever seen, because the joy of the human food was the entire point of the film!  The dog was happiest when he was being given things that would significantly and negatively impact his health.  And that was the point!  Kids watching this would take home the idea that loading a dog's bowl with steak, tacos, and ice cream is the best thing you can do for your pet.

Yes, I know it's just a cartoon, and an admittedly cute one.  Disney is still great at telling stories and I love how recent shorts don't seem to have much dialogue and just let the storry flow through the visuals.  I also know that kids won't automatically do what they see in cartoons.  I grew up on Looney Toons and I've never felt the need to strap myself to rocket-powered roller-skates or hit my friend with a frying pan.

I really think that Disney dropped the ball on this one and set one of the worst examples of pet care you can have.  I really hope I won't have to do damage control when people see this film.

Saturday, November 15, 2014

The News Gets Worse...New Veterinary Degrees May Not Pay Off

Yes it's time for more bad news for aspiring veterinarians.  However, I think it's more of a reality check.  An article was recently published through the Veterinary Information Network (VIN) about a current study on the economic prospects of a veterinary career.  It should come as no surprise to anyone familiar with the field, or anyone who has followed my blog for the last couple of years, that the news wasn't very encouraging.  Here are some choice quotes from the article (read the full article at the link above).

Michael Dicks, who heads AVMA's economics division, reported that based on projected lifetime earnings potential, the average college graduate may do better financially to take a job immediately after earning a Bachelor of Science degree rather than attend veterinary school and work a full career as a veterinary associate. That is, the increase in lifetime earnings conferred by the DVM degree for the average associate in a companion animal practice will not make up for the average cost (including the loss of potential earnings during veterinary school) of a veterinary education. [emphasis mine]

Despite increasingly prominent warnings about the economics of the profession, student enrollment has continued to grow. New schools as well as class size increases have raised the number of available seats domestically, while a growing number of U.S. students are attending veterinary colleges in other countries. In 2013, more than 25 percent of the 4,460 new U.S. veterinary students were attending foreign colleges, according to data from the Association of American Veterinary Medical Colleges.

The growth in student enrollment has not been accompanied by a proportional increase in applicants. Counting international seats, the ratio of applications to first-year enrollment has fallen to 1.64 to 1, according to figures presented Tuesday by Lisa Greenhill, AAVMC’s associate executive director for institutional research and diversity.

Greenhill also noted that veterinary school applications have in the past followed a strong cyclical pattern — peaking every 16 to 19 years — and that applicant numbers now appear poised to fall. As a result, she said, the applicant-to-seat ratio could fall below 1 to 1 within the next five years, meaning seats would go unfilled.

Yes, the outlook really is that bleak.  Anyone considering a career in veterinary medicine needs to know the reality of the situation. Unless things change soon, you are going to be spending more money on your education than you'll be able to recoup.  A great desire to be a vet is not enough.  Just because you really, really want to do something doesn't mean that it's a good idea to actually go through with it.  I recently hosted a veterinary student for an externship, and she will graduate with over $300,000 in student loan debt, with the prospect of making about $60,000 per year at graduation.  That's a 5:1 debt ratio, far greater than the typically recommended 2:1 ratio.  And it means that she's going to struggle to simply make ends meet with her monthly loan repayment.

This is not really news, as this trend has been happening for several years now.  I've been writing about it for at least three years, and each study only supports the previous data, making a veterinary career even less financially appealing.  Anyone in practice knows the reality of this situation.  However, those in academia seem oblivious to it, to the point of opening new vet schools despite strong data that there is a national oversupply of vets, a lowering demand, and growing difficulty in new graduates getting job offers.

What really frustrates me is that there are more studies being done and more analysis of the situation.  There are proposals thrown around and each subsequent study only strengthens the position that we are graduating too many vets at too high of a debt load for it to be sustainable.  Despite this data, I have yet to see anyone actually doing anything to solve the problem.  There is a lot of talk and a lot of debate, including some solutions, but nothing actually gets accomplished and the problem doesn't get fixed.

Those of us in practice can't change the reality of the economics of private practice.  We can't suddenly raise prices or cause more clients to magically flow through our doors.  I feel that the onus of the problem lies on the AVMA, veterinary colleges, and college presidents to lower educational costs, stop opening new schools, and lower class sizes.  By increasing the number of new graduates at higher debt than ever before, they are setting up their students for struggles and failures, without giving them proper warning about the harsh financial realities of life.

Wednesday, November 12, 2014

Leeches In 21st Century Veterinary Medicine

I've known about medicinal leeching for a long time, but mostly on the human side.  Even so it still seems a little like something out of the Dark Ages and most people wouldn't expect it to be part of modern medicine.  In the latest issue of one of my journals there was a good article on the practice, and it really got me thinking.  I'm only going to touch on a few points from the article rather than repeating it, so if you want more details click on the link above.  And this article isn't from some left-field pseudo-doctor.  The author is a diplomate of the American College of Veterinary Surgeons and the article was published in collaboration with that speciality group. 
In human medicine leeches are most commonly used to reduce complication in microvascular or reconstructive surgeries, reduce postoperative swelling from damaged veins, and to reduce bruises or hematomas.  The leeches are beneficial because they feed on the accumulated blood, reducing pressure in the capillaries thus giving damaged veins time to recover.  In veterinary medicine we sometimes face similar problems and leeches may be a good solution.
Truthfully I haven't really thought about it much in my own practice.  But just today I saw a dog who had a tumor removed from its elbow three days previously.  The limb was swelling a little and there was a lot of redness around the surgery site.  I knew it was probably a disruption in the flow of blood in the veins as a complication from the surgery.  Medically there really isn't much we can do other than observe it and give the body time to heal.  But having just read the leech article I realized that this would be a perfect case for such treatment.  Here is a photo from that article showing how a leech would be used.
Unfortunately we don't keep a supply of leeches on hand, otherwise I may have given it a try.  Heck, I'm not even sure how to easily get ahold of them and how to store them for the rare circumstance in which I'd need them.  And I definitely don't know if the practice owners would be supportive of this form of treatment!  Even so, it's really interesting to consider and there are very valid medical reasons for using leeches.  These small creatures actually do a better job in these cases than the most advanced medicine and procedures we have available!

Monday, November 10, 2014

Bringing Steampunk To Neverland

As I mentioned in the last post, my family and I made a set of costumes with steampunked versions of characters from Neverland:  Captain Hook, Tinker Bell, Peter Pan, and Wendy.  My wife had made her costume a few months ago, which inspired us to make complementary ones for the rest of the family.

We've been working on them for the last few months, and debuted them on the Disney Magic cruise ship during our vacation last week on a Halloween cruise.  

You can see the hook and jetpack that I made and posted about previously.  There are also lots of small details that aren't immediately evident in these photos, such as the star pattern on Wendy's vest, the gears on Hook's, Wendy's and Peter's hats, and Wendy's necklace.  

The costumes were a hit with the crowd, and even several crew/cast members were blown away by them and very admiring.  One guest commented that my wife's costume was "movie-quality".  We really enjoyed them and will be wearing them again in a local Toys For Tots Christmas parade.

Saturday, November 8, 2014

DIY Steampunk Jetpack

I'm very proud of this particular steampunk accessory, and decided to take photos along the way so I could make make my own "do it yourself" post.  I use these kinds of posts a lot when I make my various crafts and thought I might be able to help someone else out.  No, this has nothing to do with veterinary medicine....just the private life of a vet.

The idea behind all of this was to do steampunk versions of various characters from Peter Pan.  I had the idea to do a jetpack for Peter as a way for him to fly.  But how do you make one?  I started with a broken vacuum cleaner.  The motor went bad and my wife was going to throw it out, but I thought I could use it for something at some point.  

The main part I wanted was the canister.

Okay, that's a good start, but where to go from there?  So I opened it, planning on getting rid of the top.

I found the cyclone portion to be a particularly interesting piece, and as I stared at it I realized that it could make a good rocket funnel.  So I cut it apart, inverted some of the pieces, and looked at how it fit.

Okay, now that's the start of a jetpack!  But plastic isn't very "steampunk", so I used a couple of shades of metallic paint to get the proper look.

The larger pieces are put together with bolts that I spray painted a nice brass color.  They provide a sturdy connection and don't lose the right "feel" of the Victorian era.

But a simple canister or body isn't enough.  To really look good I needed extra parts.  I also had the idea that the pack would be powered by pixie dust as its fuel, which meant that I needed a way for the pixie dust to get in it.

As I mentioned before, thrift stores are great for steampunk crafting.  In this case the Habitat For Humanity store had some great pieces.

That's the light fixture for a ceiling fan on the left, a cool plastic ornament I found, toilet paper holders, a couple of pieces from a doorknob fixture, and the nozzle for a shower head.  I ended up not using this last piece as it stuck out farther than I wanted, but here is what things looked like as they were coming together.

The light fixture is screwed tightly into the top.  The toilet paper holders cover some molded printing on the sides of the plastic canister, and have some cheap brass sheeting from a hobby store to add to the look.  I ended up using a short plastic pipe, spray-painted to look like metal, in place of the shower head.  I had to use a Dremel tool to widen one of the openings on the light fixture, but then it fit perfectly.

I always imagined the fuel as coming from a bottle containing pixie dust, feeding into the nozzle on the top.  I started to use a glass bottle, but realized that might be fragile.  A cheap plastic Christmas ornament filled with glitter had the right look and wouldn't be as much of a problem if it broke during transit or being bumped.  I used a little glue around the "bottom" half so that some of the glitter would stick to it and make it look more full.

Then I added a few touches such as a tire pressure gauge on top, the handle on a fishing reel, and a few decorative pieces from the jewelry and scrapbooking sections of the hobby store.  I also added a simple light fixture to create an interesting "look", as well as gears in appropriate places to complete the steampunk theme.  Here is the finished piece.

But Peter has to wear it, so I found some great leather with brass studs in the fabric section of the craft store.  A few more bolts and some clips, and we have a jetpack harness with two buckles in front.

And there you have it!  A steampunk jetpack!  And it looked even better as part of the full costume.  But those pictures will be for the next post.