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Wednesday, August 27, 2014

Even Furry Pets Get Mosquito Bites

I received this comment on a recent post about mosquito-borne diseases.  It was from a spammer, so I didn't publish it, but it brings up a very important point that is worth discussing.
My dog is a Pomeranian and he (like most dogs) is covered in a thick coat of fur. He always looks healthy and this fur is probably one of the reasons. Mosquitoes cannot penetrate the thick fur to get to his skin, if we were covered in hair I think it would be the same situation.
Unfortunately this is a misconception that many people have.  They assume that because their pet's body is covered in dense, thick fur a mosquito can't bite them.  And if a mosquito can't bite them, it can't transmit disease such as heartworms.  Sounds like it makes sense, right? 

This idea is absolutely, 100% false!  There is no such thing as fur too dense or skin too thick for a mosquito to get through.  These insects are quite persistent, and will find any area of exposed skin.  If the body fur is extremely dense, they will be happy to go for the face and ears where fur is naturally thinner and the skin more easily reached.  No matter how thick the rest of the coat, it is always at least a little thinner around the muzzle and eyes, regardless of the breed.  It's also not impossible for mosquitoes to burrow through a thick area of the coat.

It really comes down to this....If you live in an area that has mosquitoes your pet can and probably will get bitten.  You need to care for your pet accordingly with good preventative medicine.  First and foremost this is proper and consistent use of heartworm preventative in all dogs, cats, and ferrets (yes, all of these species can be infected), no matter where you live or the condition of their coat.  Since there are a few other diseases besides heartworms that can be carried by these insects, I recommend using a topical flea/tick preventative that also repels mosquitoes (you'll see that on the package label), especially if you live in a high risk area.

Whether your pet is an Alaskan Malamute or a Mexican hairless, they ARE at risk for mosquito bites.  Don't fall into a false sense of security that might result in your pet contracting a serious or fatal disease.

Sunday, August 24, 2014

Strong Desire To Be A Vet......It's Not Enough.

Recently I read an article about the opening of two new veterinary colleges in the us, one in Tennessee and one in Arizona.  Dr. Kathleen Goeppinger, the president and CEO of the Arizona school, Midwestern University, was quoted as saying, "I know the world says, 'Hey, vets don't get paid enough' and 'Vet school is expensive,' but I also know that the desire to be a vet is very strong in many people."
This statement really bothered me, and it should bother anyone who is thinking of attending vet school, especially these new ones.  Dr. Goeppinger is essentially saying "I know that the financial outlook for vets is pretty bad, but that doesn't matter because so many people want to be a vet."  It seems to me that she is saying that we shouldn't care about the employment prospects or debt load that new graudates face, because so many people are simply determined to be vets.  Unfortunately, the strength of desire to be a vet isn't enough to make someone successful and financially stable.  The attitude of the quote may not be what she intended, but she seems to come across as only caring about the desire and not the reality.
I'm also possibly a bit cynical at her motivation when I see what the tuition will be.  Midwestern University is enrolling 102 students at an annual tuition of $52,400.  The Tennessee school, Lincoln Memorial, is enrolling 95 students with a $40,241 tuition each.  This is a lot of money, around double the in-state rate for most veterinary colleges, and is a bit higher than most out-of-state rates.  Is the motivation for starting these private colleges based on improving the veterinary profession, or making a lot of revenue?  Even if I'm off base on my thoughts, students from these schools will graduate with $160,00-$200,000 in debt based on tuition alone.  That doesn't include living expenses, books, supplies, and so on.  My own school loans were needed for costs other than just tuition, and I'm sure the case is as true now as it was then.
Dr. Goeppinger's statement seems to imply that she cares about students' desire to become a vet.  But in that desire is she considering that her students will be graduating with a far higher debt than the national average?  And that her students will have well over $200,000 in debt to start in a job paying around $65,000 per year?  I realize that the article may have missed numerous other quotes, but there is nothing in the description of the new schools that addresses the great debt crisis that new veterinarians face.
Veterinarians have a very low unemployment rate, but it has been gradually increasing for several years.  The majority of new graduates find jobs, but the percentage is slightly lower than just a few years ago and the jobs are harder to come by.  Recent data from an AVMA study shows that there is approximately a 12.5% excess capacity in the profession, meaning that we have more vets than are currently needed.  Every year for the past three years in a row the average debt load has increased while the average starting salary has decreased.  The amount of debt most new graduates have make it difficult to even survive, let alone have families and get ahead financially. Yet despite these facts two colleges felt the need to add around 200 new vets per year to an already burdened profession, and will be doing so at high tuition rates.
I really wish that everyone who wanted to be a vet and could qualify for admission could go through school and be successful.  Unfortunately the reality says otherwise.  I don't want to completely dissuade everyone from applying to vet school, but I do think there should be a healthy dose of cold water thrown on the hot desire.  Be realistic when you consider this profession and have a good handle on the finances.
I certainly hope that there aren't other vet schools that will be opening in the near future.  That's the last thing our profession needs.

Thursday, August 21, 2014

Can Pets Get Sick From Mosquitoes?

Recently I was emailed a simple question, "can mosquitoes make dogs sick?"  The short answer is "yes".  Thankfully there aren't too many diseases to worry about.
Of course the biggest concern is heartworm disease.  Mosquitoes are the only vector of this disease and part of their larval development is in the mosquito.  A single mosquito bite can infect a dog with heartworms and lead to a potentially fatal disease.  Most vets talk a lot about this disorder, especially in the southeastern quarter of the US, so this is probably not a huge surprise.  However, some people aren't aware of how dogs can get the disease so it's important to review it.
There is another disease that dogs and cats can get from moquitoes, but we're still trying to understand it.  West Nile virus mostly affects humans, horses, and birds, sometimes with fatal effects.  But there have been cases reported in pet dogs and cats, though thankfully it doesn't seem to cause as serious illness in these species and isn't as much of a concern.
Lastly, some cats can develop an extreme allergic reaction to a mosquito bite, resulting in severe inflammation and ulceration.  Though it looks bad this is usually limited to the area of the bite and can be treated with antihistamines and antiinflammatories.  It should still be seen by a vet but shouldn't be considered life-threatening.
For a little more information, the US Food and Drug Administration has some details on their website

Monday, August 18, 2014

Here's Blood In Your Eye

I recently saw a king snake for a prolapsed hemipene and a swelling on the underside of his tail.  One of the interesting things about this case is that I had seen him for the exact same problem almost a year ago to the day.  Thankfully this time wasn't as bad and the swelling didn't have dead and decaying skin over it like it did in 2013.  Last year there was a large amoung of clotted blood under the skin, and between that and the hemipene I had to do minor surgery.  He recovered well and had no problems until this year.
As I was examining him I started to palpate the swollen area.  I had seen some blood on his bedding and wanted to get an idea of how extensive the swelling is.  Unfortunately I didn't realize how much pressure was inside the swelling and how the small opening could act as a nozzle.  I put some mild pressure on the area and all of a sudden found myself sprayed with blood along the front of my clothing and on the right side of my face, including near my eye.
So here's the picture for your mind....I'm in the exam room with the clients and with no assistants.  I've been talking to them and examining their snake.  Now I have managed to cover my lab coat, face, table, and counter with a fine spray of blood from some sort of lesion near his cloaca.  What to do in a situation like this?  I need to take care of the blood, especially that on my face, but I don't want to panic the owners, don't want to fling the snake away and risk injuring it, and don't want to totally freak out. 
This is where experience comes in.  Though I've never sprayed my face with blood, I've had other things hit me there.  When my son was an infant I was home alone changing his diaper.  While I had the diaper in one hand and his legs in another he suddenly defecated with a little gas behind it, quite accurately projecting poop into my beard.  Not much I could do then other than finish cleaning him up, put a new diaper on, and then go thoroughly scrub my face.  Last year I was expressing the anal sacs of a cat when a plug dislodged and all of the thick secretions coated my face and beard.  I still had one finger in his rectum and was half-way done, so I didn't want to pull out and have to go again.  I quickly finished, keeping my mouth tightly closed, and then went to scrub the smelly mess from my skin and facial hair.
I handled things similarly with the snake.  I transferred him over to one hand while I grabbed a wet paper towel and started wiping my face off.  I then pointed him into the skin and finished expressing the blood and clot, this time into the sink instead of on me.  Once he was cleaned up I put him back in his carrier and proceeded to clean and disinfect the table and counter.  The whole time I continued talking to the owner, trying to act as if nothing had bothered me. 
Thankfully things like this are rare and hopefully will never happen again.  But it also shows some of the risks of the job and how this is most certainly not a glamorous profession.  Anyone who can't stand the idea of getting feces, blood, urine, or pus on them every day should avoid a career in veterinary medicine.

Saturday, August 16, 2014

Winding Path Filled With Regrets

I'm going to take a stab at this one, but there is more psychology needed than veterinary training.  I'm sharing it because I think there are others out there who feel similarly.  Here's the email I received....
I'm desperate. It's 1 AM, finals week, and I am bawling my eyes out because I wasn't realistic in my career/school goals 10 years ago and desperately trying to find some guidance.

I went to college and got a useless Bachelor's degree in Criminal Justice because I wanted to work for the DEA. I honestly can't tell you any good reason why I wanted to do this, except that I thought it would be intense/busy/not a desk job, etc. I dated a sh**ty guy who I ended up having to put into rehab for shooting up heroin, as well as just being a general drug addict.

This lead me to wanting to work with drug addicts. My senior year in college, I had considered going to law school, but had already been accepted to NYU where I got a Master's degree in psychology. Another useless degree because it has a low salary and without a doctorate in psych (hate research, don't want a PhD), it's essentially worthless. It also required 1.5 years of supervised hours after my Master's just to qualify for full licensure, something I never pursued. During my time in school, I had an interest in working with sexually trafficked children, and thought I could use the degree with that. Turns out, non-profits pay s**t and are exceptionally hard to get into it.

At the same time, the economy went to hell and the job market fell dramatically. I decided I wanted to go to law school, as it looked better than "counselor", but I wanted to work in the advocacy/policy non-profit realm in regards to sexually trafficked children. I took the LSATS, applied to a million schools, and went off traveling the world for a year. I got into law school in NYC and after one semester, I dropped out. I didn't want to be a lawyer, law school was difficult and I was struggling, and I realized the salary for non-profit lawyer as well as being able to get that job sucked just as much as counselor.

I got extremely depressed, sought counseling for 9 months, and somehow managed to survive with sh**ty promotional jobs for the next year in NYC as I tried to figure out what the hell I was going to do with my life. During that time, I got a puppy. He changed my life. He saved my life. He is literally the best thing that has happened to me. I had two dogs growing up, who were beaten (not by me), and as a young child, I tried to "save" them whenever I heard them getting beaten. I will always regret not calling the cops and ASPCA, but I was young (middle school?) and I was getting beaten as well. Those dogs lived in hell and although I didn't want them to be beaten, I didn't love or care for them, really. They lived outside and I would occasionally pet them on my way in or out of the house. I never walked them or played with them. My guilt lives on...

When I got my dog, I grew a passion I never knew existed. This went beyond just "that sounds like such a cool job!" (which, at this point, had been my driving force-- I looked into toxicology or other "cool or unique jobs"-- never anything fulfilling). I wanted to save dogs. I never wanted to be a companion pet vet or own my own practice. My passion was for helping those dogs saved from fighting rings or severely abused/neglected. Now that I have personally owned and been loved for and cared for by a dog, I feel so committed to this passion. I owe them, I owe my previous dogs, and an abused dog is the one thing that will bring me to my knees.

I apply for ASPCA jobs (anti-cruelty non-vet positions)-- no response. I work with local rescue groups as a volunteer, but want to do more. I get my s**t together and I am accepted to the vet school in Sydney, Australia (No pre-reqs as it was included in their program and I had no ties to NYC, yet I'm able to use that degree to get licensed in the US if I want to come back later). Greencard is expiring, can't get loans in time, I defer for a year.

I continue to pursue going to Australia the next year (renewed greencard--defaulted on law school loans--consolidated--able to get new loans) but during this time, I start getting a more realistic outlook on vet school tuition, loans, future job opportunities, and salaries. Looks bleak, and I'm already in debt from law school (I worked during my Masters and paid off all of those loans on the day it was due). I also meet an amazing guy. I decide it's not worth going to vet school because of the reasons listed above and the fact that I'd have to specialize (adding a cool 5 more years) just to get a decent salary. And even longer to actually get to a position where I'm working at an organization like ASPCA to help rescued animals (because you know they're not hiring fresh vet school grads).

I have no idea what I'm doing with my life, so I google degrees I can get in a short amount of time that are somewhat relevant to my previous degrees and can give me some sort of security in life. I find nurse practioner in psychiatric mental health (starting salary 100k, desperate shortage in NYC-- with per diem jobs, I can make 150k a year first year). I need pre-reqs, so I decide to get another Master's in neuroscience (from Columbia) to fulfill that (if i'm taking the classes anyway, I might as well get a degree out of it-- that was my logic). I load up and get this done in 1 year. Debt rises. I apply to Columbia's accelerated nursing program that gives me a BSN, a master's in nursing, and a doctorate in nursing in 4 years. Off I go. Debt rises further.

First semester-- I hate nursing. I hate people. I don't have empathy for people like I do with animals. It is difficult material, lots of material, little time. I sacrifice my sleep, my health, etc, to get through school. This might be worth it if I loved the job. I do not. This may change for the NP/DNP part (as it's not bedside nursing), but nevertheless, I have to get through the RN part (1 year).

I am 30. If I was 20, I'd go to vet school (although, my grades back then may not have gotten me in anywhere in the US. My grades now are unbelieveable). I'm struggling because I think I'm going to regret not going but I have a boyfriend I live with (path to marriage) and 75k in debt so far (quickly rising with interest), plus the fact that it would take me at least 10 more years of school. There comes a point where I'm either a lifetime student or I'm creating a reasonable life with someone.

I was undecisive and unrealistic and naive. I will survive nursing school. I should be able to get a job. I will make a decent salary. My path so far has been erratic and I somehow bull***t the connectivity of the degrees when I apply for schools/jobs.

How do I get over my regret? I've read your posts and I can't imagine you telling me to follow my passion to vet school. Am I finally rational in thinking that pursuing vet school now is unrealistic and obviously a stupid and risky path? How do I suck it up and just get over this?

Any guidance is appreciated.
I definitely have many sympathies for this person and it makes me sad to see the frustration and pain she is going through.  I'm not a psychologist by any stretch of the imagination, and that's probably what is needed here.  In fact, I'd recommend that she find a good counselor, psycologist, or psychiatrist that can professionally help with the anxiety and confusion.  As someone with a degree in psychology I'm sure you can understand the benefits of this advice.  There are a few things that stand out to me, though.
First of all, stop getting more degrees!  At least for the time being.  The very first step is to really sit down and figure out why none of these jobs have been satisfying.  What about each one makes you unhappy?  There is a consistent pattern here of multiple attempts at widely varying fields, each with more education and more cost necessary.  You need to really stop and analyze exactly and minutely why you have been unhappy and what it will take to make you happy.  This is probably best handled through a mental health professional, as this stems from mindset rather than circumstances.  But you're never going to be happy until you figure out what has made you unhappy.
Is it because of dealing with people and having to show empathy?  If that's the case then veterinary medicine isn't the career for you.  Every single day I have to deal with people, many of them difficult or upset, and if I couldn't handle that I'd quickly go crazy.  If you're only in it to help the animals then you're going to be quickly dissatisfied as a vet because you'll see situations every day where the client can't or won't do what is best and necessary.  You'll get frustrated at these "stupid" people and wish you could take their pet away.  Yet they have control over the situation, not you, and you can't force them to do something.  You also can't continually discount or give away services or you will go bankrupt.    You can't save or rescue all of them, and if this is going to be difficult to handle mentally then you should avoid the profession.
Have the previous jobs been unsatisfying because of the pay?  Again, don't go into veterinary medicine.  Using current statistics you'd acquire another $150,000 in debt on top of the existing $75,000, all in order to make $65,000 per year.  You're not doing yourself any financial favors by pursuing it until your debt is paid off.
I'm going to go out on a limb and share some things that I've personally learned.  And before I start I want to pause and share some of my own struggles.  Often I've hated my job and regretted ever getting into the profession.  I've desperately desired to do anything except veterinary medicine.  I've dealt with clinical depression for most of my adult life, worsening once I was in my 30s.  I've had multiple times that I've been suicidal, the most recent being just a few years ago.  I've seen counselors, psychologists, and psychiatrists in my attempts to get a handle on it.  I've been on antidepressant medications for about 10 years now.  I'm not saying any of these things to gain any sympathy or have someone feel sorry for me.  I mention it because I've had many emotional and mental struggles over the years and have found myself in very dark places many times.  The following advice and "wisdom" comes from experience and personal struggles. 
First, some of my favorite quotes.
"Success doesn't mean happiness.  Happines means success."  Garth Brooks
"The remarkable thing is, we have a choice every day regarding the attitude we will embrace for the day."  Charles Swindoll
"Our attitudes control our lives.  Attitudes are a secret power working twenty-four hours a day, for good or bad.  It is of paramount importance that we know how to harness and control this great force."  Irving Berlin
"If you don't like something, change it; if you can't change it, change the way you think about it."  Mary Engelbreit
"A man is but the product of his thoughts, and what he thinks, he becomes."  Mahatma Gandhi
Your circumstances may put you in situations that influence your thoughts, but ultimately you are responsible for your response to these circumstances. One of the methods that I learned to help overcome depression is "cognitive therapy".  This is where you become consciously aware of a change in your thoughts and emotions, stop to analyze them, and make a sincere change in them.  You make a concscious decision to NOT have a bad attitude.  Believe me, this does work, and has even helped my children.  If you don't like aspects about your job, stop and analyze why.  Then say "I WILL have a good attidue."  Like any muscle it takes excersise and practice to hone.  It's hard at first, but the more you do it the better you will become.  And if you work with a psychology professional it will be easier, even with your background.
There's also another very big part of what helped me control my depression and my feelings about life or my job.  Faith.  My believe in God and my reliance on Him is a huge part of who I am and how I handle life.  When I get depressed or frustrated, I pray.  When I need guidance I go to the Bible and find passages relevant to my struggles.  But it goes even beyond belief and prayer.  All of my life I've learned to be independent and self-sufficient.  Since I started following Jesus closely I've struggled with the whole idea of "let go and let God".  We are told to turn our cares and worries over to Him, rely on Him, and He will help take care of us.  Yeah, easier said that done.  I struggled with that for many years, before I reached the depths of my depression and finally just turned it all over to God.  Since then I've been much happier and have had less stress.  My wife even commented last year on how well I took some challenges that would have sunk me into despair the previous year.  It's been hard and it's still something with which I struggle, but a large part of my happiness and peace is because of my faith and reliance on God.  I don't know where your heart and faith lie, but I'd like to make a suggestion....if you don't already, pick up the Bible, read it closely, and get closer to God.  If you already do, start doing it more.  I'm rarely this direct, but at the same time I know that I didn't really conquer my depression and anxiety until I added this piece to the puzzle.  Therapy and medicaion have helped, but not to the degree that deeper faith did.
Okay, now some of the good parts.  Being 30 shouldn't stop you from going into vet school.  Some of my classmates were older than that and I've known plenty of people in their 30s and even 40s starting vet school.  But you need to first get your fiances and mental status under control.  And you need to really figure out what you want out of life.
Definitely don't feel any regrets.  In fact, you may be as unhappy going through vet school as you have been in every other area.  Belive me, it's much harder than law school or nursing school.  But you don't have to be a vet in order to help!  Find a good paying job with which you can be satisfied, then spend time volunteering for rescue groups or donate money to great causes.  You can still be fulfilled and help animals without being a doctor.  In fact, we need people like that involved in animal care and rescue.  There is no way that vets can do it all.
This may not be helpful enough, but hopefully you can find a few bits of advice to take from my response.  Again I would recommend seeking the help locally of someone who can help you work through the psychology of your frustrations and unhappiness. 

Wednesday, August 13, 2014

Pure Breeds, Diagnoses, And Vets

Paul sent me this email in response to a recent blog I posted.  

love your blog.  just wanted to comment on your most recent post about messed up breeds.  You have answered, almost in the post a question I have always had about vets - but you might just comment to clarify.

I have always believed that as a vet, knowing more about animals than we, non animal doctors could ever know about species and breeds, I have always thought that it must be difficult for you (by you, I mean vets) not to look at your clients when they bring in their breed dogs and cats and immediately think - oh X breed - probably will get cancer, arthritis etc depending on the breed.  For example I love Bernese Mountain dogs but I would never own one because being such a large breed they will be old by the time they are 7 and dead by the time they are 10, likely to get cancer and arthritis.  King Charles - could have that awful brain condition where the brain is too big for the skull.  I could go on and on.  Most vets I know own mongrels or sturdy crossbreeds or small terrier dogs - is this why? because they won't be as prone to diseases and conditions.  I guess sometimes too much knowledge can have its down sides.  When I was young - all of 40 years ago, german shepherd dogs and alsations had straight backs but we humans have created a terrible situation where these beautiful dogs now have hind legs that are very bent causing the dog to have curved spine and develop arthritis - certainly from a visual perspective this development is not an enhancement, and from a health perspective its not an improvement either though I understand it enables the dog to jump higher and scale walls etc useful if these dogs are guard dogs or keeping intruders out - great police and drug sniffing dogs but the legs going under the dog in the back and curved spine look awful and spell pain and discomfort and shorter life for this breed as result.

Paul brings up some great points and questions.  As I blogged before, we have messed up most of the modern dogs in our pursuit of a certain "ideal".  And vets know this better than anyone.  Paul is right that when I see a certain breed, especially a puppy or kitten, I'm immediately thinking about what problems that breed has.  If it's a young pet I will spend time talking to the owner about the potential health problems they could face during that pet's life.  If I see a sick pet I definitely take their breed into account when I'm trying to figure out what is wrong with them.

This is one of the reasons why it's typically harder being a vet than a human doctor.  And please understand that this is not meant to disparage my human colleagues!  Most of the physicians I've known are very skilled, knowledgeable people.  They have to know one single species while vets have to know many.  You'd be surprised at how many anatomical and physiological differences there are just between dogs and cats, let alone the other kinds of animals we see.  There is simply no equivalent differences in humans.  Then when you throw in the dozens of different breeds and the incredible anatomy variations and health tendencies it becomes even more complicated.  In human medicine there are several racial differences, but you won't find as many between blacks, Asians, and Caucasians as you will between Yorkies, bulldogs, and Great Danes.  I have incredible respect for my human medicine counterparts, but by comparison they have it easy.

Paul also asks about vets having mostly mixed breed dogs.  I have to say that this isn't necessarily the case.  The vet that I grew up working for bred English bulldogs and Labrador retrievers.  I have a pure-bred Lab myself.  A tech I worked with bred cocker spaniels.  One of my current staff has several pure-bred Pomeranians.  I've known a lot of vets and veterinary staff who have had pure-bred dogs, and while many of us also have mutts, I would say that it's pretty evenly distributed rather than being predominantly towards mixes.  

You would think we should know better, but that's not always the case.  I absolutely adore English bulldogs, while at the same time being all too aware of their multitude of health problems.  While I've never personally owned one I definitely will do so.  I grew up around the breed and have since gotten to know many of them as a doctor to the point where some clients think I specialize in them (which I don't...I just love them).  Seeing the numerous allergies, skin disorders, eye problems, respiratory issues, joint problems, and so many other serious health disorders you'd think that I'd avoid them like the plague.  Instead it just makes me want to be extra careful when finding a good breeder.

While I generally recommend mixes based on average health problems I have also seen plenty of these multi-breed pets have serious problems.  "Hybrid vigor" is real but doesn't eliminate the risks completely.  If you are considering a pure-bred dog or cat, please research the breed's typical health problems ahead of time so you can know how to prevent some of them and be aware of the others.

Monday, August 11, 2014

Cat Food: Dry Vs. Wet

A question recently was asked of me as to what kind of food cats should be fed.  The person said "some people say that it is really bad to feed a cat dry food and you should only ever feed them wet food, is this true?"  I thought that was a great question and worthy of more than just a quick email.
For those who just want the quick bullet point, here is the summarized answer:  canned/wet food is better but dry food isn't bad.
Why is that?  Several reasons, actually.
Cats are obligate carnivores.  In the wild they eat small, frequent meals of small prey such as mice, voles, birds, and lizards.  Yes, you may see cats occasionally nibbling on grass but that is not a good source of nutrition for them.  They need the high protein, low carbohydrate diet comparable to the prey they would eat if they weren't our pets.  Studies have shown that this protein/carb balance (sometimes referred to tongue-in-cheek as the "Catkins" diet) manages weight and blood sugar much better than a dry food that has a higher comparative carbohydrate percentage.  Underweight cats tend to gain weight and overweight cats more easily lose weight.  I've personally had borderline diabetic cats with blood glucose successfully managed with only this kind of diet.
Our domesticated cats originated from small desert cats in the Middle East, particularly Egypt.  Their physiology is still very much like a desert animal, as they have very efficient kidneys that resorb water well, and they tend not to drink a lot of water.  The downside to such a system is that their urine concentrates so well that they can be prone to kidney disease, urinary tract infections, and urinary blockages.  The best way to prevent these problems is to ensure a high level of fluid intake, thus keeping a constant flow of fluid through the kidneys and promoting more frequent urination.  Since cats don't drink much we can aid good renal and urinary health with canned/wet foods.  By their very nature these foods contain 3-4 times the amount of water per volume as dry foods.  There are a few urinary disorders in cats that can only be consistently treated by using specialized canned foods.
All of this sounds pretty compelling, right?  And indeed it is.  Growing evidence shows that wet foods really are better for a cat's overall health.  So why feed dry food?
Convenience and cost.  That's really what it comes down to.  It is far less expensive to feed dry food than to feed canned food, and that can add up over time.  Dry food also stores well and doesn't start to dry out and look nasty if it sits in the bowl.  Really we feed dry food for our sake, not our cats'. 
But that doesn't mean that dry food is automatically bad and that you should never feed it.  The average cat does perfectly fine on dry food and can live their entire lives without any weight problems or issues with their urinary system.  Modern commercial cat foods have been carefully formulated over several decades of use and research to be the best they possibly can for our feline friends.
Several years ago after reading the recent research I started switching my cats over to an exclusively canned diet.  I quickly discovered the difference in cost, and that was the number one reason I switched back to dry food. The cats I currently have only eat dry kibble and have done so all of their lives.  As I mentioned above, cost and convenience were the reasons I chose to feed dry.
So what should you do for your cat?  If you can afford it and don't mind the smell or mess, I do recommend using canned/wet foods.  If that isn't really feasible for you I wouldn't lose sleep over feeding a dry food or worry that you're automatically killing your cat.  In the end it comes down to a personal choice and a necessary balance between your cat's health and the practical realities of life.

Saturday, August 9, 2014

I'm A Dying Breed

This weekend I'm attending a veterinary conference, something I've done every year for nearly two decades.  I've been to so many that I don't typically think much about it, other than which lecture I'm going to attend, how many free pens I can get, and how much my butt starts to hurt from sitting so much.  But this year something struck me as rather different.

There were hardly any young men.

It's been years since it was announced that the profession had hit the tipping point at there were at least as many female vets in practice as males.  And for 20 or more years veterinary classes have been 75-80% women.  While I knew all of that in principle, it was a bit shocking to see it play out so clearly.  As I looked around the conference and started paying attention I noticed women of all ages, from late 20s on up to nearing retirement.  But I was having a hard time finding any men under 40!  Seriously, almost every male vet I saw was anywhere from 40s to 60s.  For a while I just stood and watched people pass through the vendor hall and it was several minutes before I finally saw a man that I pegged as in his 30s.  While the overall distribution of males to females seemed pretty even, the age difference really stood out.

And it's going to get worse.  Men dominated the profession up until the last 20-30 years, so it makes sense that these older vets will be retiring with greater frequency, leaving younger vets to continue the profession.  And those younger folks are overwhelmingly female.  At current graduation rates it's pretty obvious that as a man I'm a bit of a dying breed, and by the time I retire I'll be in a demographic that makes up around 25% or less of the profession.

Now please don't get me wrong and think I'm sexist.  I have absolutely no problem with women, I think they can be just as good as men in this profession, and both of my associate doctors are female.  I've also worked in this profession for around 30 years, the majority of that time surrounded by women (veterinary paraprofessionals are closer to 90% female).  Being a rare male doesn't bother me in the least.  I just find it interesting to start seeing this shift in the profession so clearly.

Thursday, August 7, 2014

Messed-Up Breeds....We're Responsible

My favorite dog breed is the English bulldog. Yes, I know that I'm crazy.  They are prone to so many health problems that I often say that you just about have to be a vet in order to own one.  They have problems with elongated soft palates, narrow nostrils, allergies and skin disorders, eyelid issues, tear gland disorders, hip dysplasia and so many other things it's really pretty ridiculous.  They also can't breed or give birth without human intervention.  But I love they way they look, their personalities, and I grew up working for a vet who bred them, so they're close to my heart.
The original English bulldogs weren't as bad as this.  Their faces weren't as short and they had longer legs. When bull baiting was outlawed some people wanted to preserve the breed and slectively bred to make them into companion pets.  In doing so they deliberately selected for a somewhat different physical appearance, and that ended up leading to predispositions for a number of different disorders.  Because of their health problems and difficulties in breeding, English bulldogs would die out within one or two generations if humans suddenly disappeared.  While we may love them and continue to desire a certain appearance, we have also caused the health problems that lead to so much discomfort.

Bulldogs aren't the only breed that has suffered from humans tinkering with breeding and genetics.  Cocker spaniels are prone to ear infections because we wanted large, floppy, hair ears.  Westhighland white terriers are one of the worst breeds for chronic skin allergies.  Breeds such as German sheperds and Great Danes have a high risk of bloat.  Boxers and cavalier King Charles spaniels are prone to heart disease.  Just about every pure breed has its own set of health problems and tendencies towards certain disorders.  Sometimes this is because we have bred for a specific appearance that ends up increasing risks for diseases.  Other times it is because a particular genetic predisposition happens to go along with the genes for appearance or behavior.  Historically people have bred dogs for appearance and behavior, not for health.  The issue is exacerbated by breeders who are careless and don't care about the quality of the parents, thus leading to higher risks of problems in their puppies.

It doesn't have to be this way.  There are people who are deliberately trying to breed out health problems, leading to Old English bulldogs and king shepherds.  I knew a vet who was working with a geneticist friend to identify genetic markers in Westies, allowing them to pre-screen potentially breeding dogs for allergy tendencies and only breed those who don't have that gene.  Responsible breeders try to screen for common health disorders in the dams and sires, and won't breed dogs that show signs of chronic illness or abnormalities typical for a breed.  There are definitely right ways to breed dogs and allow them to pass on good quality genetics, rather than the mess we have made in many breeds.

If you are considering buying a pure-bred dogs, I would encourage a few things.  First, check with local shelters and breed-specific rescue groups.  You'd be surprised how many pure-bred dogs are in desperate need of homes.  If you do go to a breeder be sure to ask them about health problems in the parents and how they screen for potential problems common to the breed.  And please do NOT purchase dogs or cats from pet stores (that's a rant for another time).  If people adopting or buying dogs are careful about where they get them, we can put more pressure on peole to be more responsible in breeding.  This will never eliminate problems, but it can certainly reduce them.

Tuesday, August 5, 2014

US Vet Job Market For Foreigners

Here is a recent email from a veterinary student in South Korea.
I am studying veterinary medicine in s. korea. I was googling about forign veterinarian and found your blog. I saw your answers from emails. And i have something curious and hard to get an answer. My letter can look akward but hope you feedback . Short one is surely okay
I am personally want to work and live in USA . So i am preparing to get an american vet license. Actually i've never been usa .
If i get a license it can be hard for me to get a job? Though AVMA's course requires certain level of english skill, clinical service sometime needs more than medical profession.
The good news is that unemployment among veterinarians in the US is very low.  The bad news is that it's increasing.  While almost all US graduates find jobs, it is becoming harder to do so and you don't have as many options.  After I graduated I sent out several dozen resumes and got job offers from three different practices.  I had my pick of the three.  Nowadays that is a very rare situation and new vets often end up taking the first offer because there aren't a lot of other choices.  And remember that this is for US veterinary students who know the language and culture well.
Coming to a new country can be a big change.  Not only is there a language difference but an often big cultural one as well.  Because the US is so large and includes over 300 million people, there are also significant geographic differences.  Anyone who has lived in Los Angeles, Chicago, Boston, Houston, and Atlanta can tell you that there are big differences in how people act and interact.  Even among Americans there can be a culture shock going from one region to another!
People tend to react best to other people who look, act, and sound like them.  That doesn't mean that foreign graduates can't be successful.  I've worked with several in my area that are from South America, the Caribbean, and other places who are extremely well-liked, successful, and respected.  But I've also worked with vets who are difficult to understand because they are not as fluent in English or don't seem to relate well to American culture.  These folks seem to struggle in the profession and clients don't take to them as well.
My first recommendation to anyone considering living and working in another country (not just the US) is to first visit it.  Take a long vacation to that country or area of the country and spend some time simply looking around and interacting with people.  You will get a good sense of your language skills when speaking to natives who may have a regional accent, and will also start to learn how well you can adapt to the culture.  If the country doesn't seem like a good fit for you, you've lost nothing more than time and money on an interestnig vacaton.  If you are indeed intrigued and want to do more, I would recommend getting a work visa and doing some temporary work.  In this case it doesn't have to be as a veterinarian.  Having friends or contacts in the country is always a huge help, as they can ease your transition and provide you a place to stay or work.
Getting a veterinary license in the US when you are coming from a foreign country is a very long, often difficult process which costs a lot of money.  I wouldn't recommend investing the time and finances unless you have visited the US and are sure that you want to make a career here.  And if you do decide to stay (really, we're a great place to live and work!) realize that jobs are out there but may not be easy to find right away.  Being flexible about where you live is the best way to find a job.

Monday, August 4, 2014

Cats And Dogs

Time to lighten things up a little bit.  I've been interested in animal behavior since my undergraduate years and one of the most interesting dynamics is between different species.  The relationships between dogs and cats can be particularly fascinating and amusing because their basic natures are so different.  While both can be social and affectionate each species shows these traits differently.  Watch these videos and enjoy your laughs for today.


Friday, August 1, 2014

The "Best" Training Method

Clients sometimes ask me what the best method is to train a dog.  I don't think they realize just how complicated that issue can be.  First of all, what are we training the dog to do?  Fetch a Frisbee?  Roll over?  Stop chewing on the furniture?  Become housebroken?  Each modification of behavior requires a different process and steps.  Also, some dogs will respond better to one form of training than another, meaning that there is rarely a catch-all "best" method.
That being said, there are some general rules that we can make.  First of all, yelling at or hitting a dog is never appropriate.  Sure, this may sometimes correct the behavior, but you're also teaching the dog to be afraid of you and can create or worsen anxiety issues.  Punishment is actually the least effective method of training.  And dogs don't feel "guilty" about actions as many people may think.  If you come in to find your favorite bunny slippers chewed up and you see your little dog slinking away holding her head down, you may immediately think that they are "guilty" about what they have done.  Not true!  And studies have proven this.  What is really happening is that your dog has learned that when you see torn up slippers you become upset and raise your voice.  So they associate "mess" with "angry owner", and start acting submissive in anticipation of punishment.  The dog actually cannot associate their behavior with punishment unless the correction happens within 20 seconds of the behavior.  Punishing a dog minutes or hours later does not help fix the problem. 
The same time limit applies to rewards.  Let's say that you're trying to housebreak your puppy.  You let the puppy into the yard, where they start sniffing around and exploring.  After a minute or two they go to the bathroom.  Then they sniff around more and finally come to the back door.  At that moment you give them a treat and tell them what a good boy/girl they are.  In our mind we're saying "Good dog for going potty!"  But the dog has essentially forgotten about using the bathroom and the behavior most closely associated with the reward is coming to the door.  So in their mind it is "Good dog for coming to the door!" 
Positive reinforcement has been repeatedly shown to be the best form of training.  Behavior that gets rewarded gets repeated.  Wait until your dog is doing what you want them to do, or acting in the way you want them to, and reward that behavior immediately (remember, 20 seconds) with praise, attention, or treats.  If you train this way they will continue to seek out whatever it takes to get that reward and should eventually become consistently successful with doing what you want.
Put yourself in your dog's shoes and think about it as if you were an employee and you were dealing with your boss.  If your boss yelled at you whenever you did something wrong, and even threw things at you or hit you, how would you feel?  Would you have learned what to do right?  There is a difference between knowing what not to do and knowing how to do something correctly.  Now switch it around.  What if your boss didn't talk to you much when you messed up, but every time you did something right they personally congratulated you and gave you a candy bar?  Would you want to do the same thing again in the future?
Training dogs, raising children, or managing staff are all surprisingly similar.  I've been able to apply the same principles to each of them, and in all cases rewards and positive reinforcement gives the best results.