A Passel Of Puppies

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

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

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

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

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

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

Would You Do It Over?

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

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

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

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

The Impact of Friends

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

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

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

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

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

New Kitten Blues

Here's a question from Christopher...

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

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

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

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

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

Just what in the heck do they do at conventions?

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

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

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

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

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

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

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

Spaying and Neutering....Not About Reproduction

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

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

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

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

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

The Best Pet Foods

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

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

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

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

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

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

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