I love seeing pets with unique and original names, and have tried to keep my own pets from having common names. There's nothing wrong with frequently used names such as Buddy, Max, Bear, Precious, and so on, and I bet most pet owners don't realize how common some names are. But those of us in the veterinary field see certain names happen again and again. So it stands out to us when people pick uncommon names. However, sometimes people go too far.
Recently I've been having a discussion with some colleagues about some of the very inappropriate names people give their pets, none of which I can fully repeat here since I try to keep this blog family-friendly. But we're talking about names like Dam**t, Sh**head, Nig**r, B*tch, Dumba**, and so on. People sometimes use curse words, derogatory racial names, crude slang for genitalia, and so on. Frankly, it makes no sense to me, and usually indicates someone who is rude, crass, inconsiderate, and insensitive. And these people appear to be highly amused by their own perceived cleverness. "Hey, come here, Dam**t!" [snicker, snicker] "Did you kids feed Sh**head yet?" [goofy grin]
I think it's very sad that these people don't seem to realize how offensive these names are. And I can't imagine their kids growing up in such a household where language and attitudes like this are normal and accepted. Is it any wonder that our society is becoming increasingly morally degenerate? It boggles the mind that there are people who find these things completely appropriate in public situations. Over the years I've seen a few clients who have named their pets like this, and I can tell you that they're not people I would want to spend time with. And I've also refused to call these pets by their names since I don't use language like that myself.
Friday, May 28, 2010
Thursday, May 27, 2010
They Grow Up Fast
Summer is here and my kids are out of school. This year they've discovered that there are other kids in the neighborhood that are about their age, and have started playing with them. Since the other children live down the road and a neighboring street, it means that my kids are starting to spread their wings and explore on their own more. This has been an adjustment for me and my wife as we learn how to let go and give them freedom, yet balance this with the knowledge that child predators exist and we don't want our kids harmed.
Looking back I can't remember all of my milestones. I know that I learned how to ride a bike at six, but I don't know when I was allowed to go around the neighborhood on my own. I know that my parents looked out for me, but I also remember having pretty wide range of where I roamed. I'm trying to find that balance with my own children, realizing that the world isn't the same as it was 30 years ago.
It's also hard to see my kids learning and growing without us. A month or so ago we discovered that my daughter learned how to ride a bike on her own. That was a huge surprise, as a few months before that I had tried to show her and she couldn't do it. Then I walk out one day and she's riding her friend's bike without any problems. When did that happen?
At the same time, the kids are becoming more self-sufficient and responsible, which is nice. My son can easily make his own lunch and both kids put their own laundry away. So there are some pluses to them growing up. I'm looking forward to when he can mow the yard!
Looking back I can't remember all of my milestones. I know that I learned how to ride a bike at six, but I don't know when I was allowed to go around the neighborhood on my own. I know that my parents looked out for me, but I also remember having pretty wide range of where I roamed. I'm trying to find that balance with my own children, realizing that the world isn't the same as it was 30 years ago.
It's also hard to see my kids learning and growing without us. A month or so ago we discovered that my daughter learned how to ride a bike on her own. That was a huge surprise, as a few months before that I had tried to show her and she couldn't do it. Then I walk out one day and she's riding her friend's bike without any problems. When did that happen?
At the same time, the kids are becoming more self-sufficient and responsible, which is nice. My son can easily make his own lunch and both kids put their own laundry away. So there are some pluses to them growing up. I'm looking forward to when he can mow the yard!
Wednesday, May 26, 2010
Trying One's Patience
I'm a huge proponent of client service and really try to get everyone on my team to go the extra mile in little ways to show our clients how much we appreciate them. But there are limits to this. And I hate to break it to anyone who has illusions, but your physicians and vets don't like every client they see.
I have a particular client whom we'll call Ms. Howlett (not her real name). She can be a real trial to deal with in several ways. She can be demanding of my time and insists on always seeing me. She is reluctant to spend money and has legitimately limited funds, but also wants problems with her cats fixed. She doesn't seem to understand relatively simple things I tell her and I have to repeat myself several times whenever I talk to her. She gets copies of her medical notes and nit-picks every little thing I have in there and every slightly abnormal lab value.
One of her cats was diagnosed with diabetes last week and she came back in today for me to go over with her how to administer insulin. That took many tries of demonstrating the injection, having her try it with some saline, and going over the instructions several times. What should have taken me 10 minutes with an average person took me about three times that long. Another of her cats has had chronic diarrhea and we're trying to work through a possibility of inflammatory bowel disease. This has necessitated several rounds of testing and may including having to do intestinal biopsies. But it has also involved lots of discussions on diet and other therapy, which of course leads to repeating information unnecessarily.
This afternoon she was at our hospital for over two and a half hours, in what for an average person would have been less than an hour, even waiting for lab tests. At the end she wanted us to fax her insurance forms in, a total of 15 pages. We were already about 10 minutes past closing, so we declined to do so, which upset her a bit and caused her to spend even more time trying to convince us to do this. If it was just a page or two I wouldn't have minded, but this was her responsibility and I thought it was rude for her to insist on us doing it for her.
Now based on what I've put here there are probably many reading who wonder what the big deal is. Those of you who do veterinary work can certainly identify your own Ms. Howletts and know exactly what I'm talking about. We can't like everyone, and sometimes a certain personality rubs us the wrong way. However, we still have to treat them with respect, and this really isn't a business for professionals with poor people skills.
I have a particular client whom we'll call Ms. Howlett (not her real name). She can be a real trial to deal with in several ways. She can be demanding of my time and insists on always seeing me. She is reluctant to spend money and has legitimately limited funds, but also wants problems with her cats fixed. She doesn't seem to understand relatively simple things I tell her and I have to repeat myself several times whenever I talk to her. She gets copies of her medical notes and nit-picks every little thing I have in there and every slightly abnormal lab value.
One of her cats was diagnosed with diabetes last week and she came back in today for me to go over with her how to administer insulin. That took many tries of demonstrating the injection, having her try it with some saline, and going over the instructions several times. What should have taken me 10 minutes with an average person took me about three times that long. Another of her cats has had chronic diarrhea and we're trying to work through a possibility of inflammatory bowel disease. This has necessitated several rounds of testing and may including having to do intestinal biopsies. But it has also involved lots of discussions on diet and other therapy, which of course leads to repeating information unnecessarily.
This afternoon she was at our hospital for over two and a half hours, in what for an average person would have been less than an hour, even waiting for lab tests. At the end she wanted us to fax her insurance forms in, a total of 15 pages. We were already about 10 minutes past closing, so we declined to do so, which upset her a bit and caused her to spend even more time trying to convince us to do this. If it was just a page or two I wouldn't have minded, but this was her responsibility and I thought it was rude for her to insist on us doing it for her.
Now based on what I've put here there are probably many reading who wonder what the big deal is. Those of you who do veterinary work can certainly identify your own Ms. Howletts and know exactly what I'm talking about. We can't like everyone, and sometimes a certain personality rubs us the wrong way. However, we still have to treat them with respect, and this really isn't a business for professionals with poor people skills.
Tuesday, May 25, 2010
A Tragic Double-Whammy
The two c-sections in the last week where all puppies lived were great experiences, and very happy. Unfortunately, not all cases can end on such a high note.
Today we saw a pair of puppies that had been adopted from a shelter last Thursday. As soon as the client took them home, they started coughing. A few days later she took them to a vet who diagnosed kennel cough, and put them on antibiotics but was worried about the fact that one of them had a poor appetite. Two days later she was at the emergency clinic with that puppy who was diagnosed with pneumonia and a consolidated lung lobe. They switched antibiotics and hoped for the best.
When the two pups (black lab mixes about 3 months old) came in today there hadn't been any improvement. The most severely affected one was also having diarrhea and her sister had just started having diarrhea and a loss in appetite. Though not clinically very severe, both were lethargic and had coughs. After talking to the owner and examining them, there was something nagging at the back of my mind. These pups had been dewormed a few weeks previously, and had had two prior negative parvo tests. But the symptoms other than the cough were consistent with parvo virus or some intestinal parasite. Even though this was the third test for parvo, I convinced the owner to test for it. And I'm glad we did.
The test rapidly became strongly positive for parvo. So not only did both have kennel cough, but they also had a parvo infection and one had pneumonia. Any one of these diagnoses was potentially severe enough and parvo by itself is life-threatening. Having two diseases at the same time was a severe double blow to their chances of survival.
Under ideal circumstances with unlimited money, these puppies probably would have had a 50/50 chance of survival at best, and realistically probably much less than that, especially with pneumonia. They would have required intense hospitalization, easily totaling $1000 or more per puppy with no promise of survival. Because of the money and the chances, the client elected to euthanize both puppies. It was a very sad bookend to the successes of the two c-sections.
This case also reinforced a few lessons for me. First, experienced doctors should follow their instincts. Something abut this case made me suspicious of parvo, and though it wasn't my top likelihood I did consider it. Second, there is a big benefit to diagnostic testing rather than guessing. We could have assumed that the diarrhea was due to the liquid diet the owner was feeding and the inappetance was due to the respiratory disease and not ended up finding the real problem. Third, a previous negative test doesn't mean that you can't be positive in the future, so it's often worth repeating diagnostics.
Oh, and make sure your pets are vaccinated! In this case it wasn't the client's fault, but it's still important to remember.
Today we saw a pair of puppies that had been adopted from a shelter last Thursday. As soon as the client took them home, they started coughing. A few days later she took them to a vet who diagnosed kennel cough, and put them on antibiotics but was worried about the fact that one of them had a poor appetite. Two days later she was at the emergency clinic with that puppy who was diagnosed with pneumonia and a consolidated lung lobe. They switched antibiotics and hoped for the best.
When the two pups (black lab mixes about 3 months old) came in today there hadn't been any improvement. The most severely affected one was also having diarrhea and her sister had just started having diarrhea and a loss in appetite. Though not clinically very severe, both were lethargic and had coughs. After talking to the owner and examining them, there was something nagging at the back of my mind. These pups had been dewormed a few weeks previously, and had had two prior negative parvo tests. But the symptoms other than the cough were consistent with parvo virus or some intestinal parasite. Even though this was the third test for parvo, I convinced the owner to test for it. And I'm glad we did.
The test rapidly became strongly positive for parvo. So not only did both have kennel cough, but they also had a parvo infection and one had pneumonia. Any one of these diagnoses was potentially severe enough and parvo by itself is life-threatening. Having two diseases at the same time was a severe double blow to their chances of survival.
Under ideal circumstances with unlimited money, these puppies probably would have had a 50/50 chance of survival at best, and realistically probably much less than that, especially with pneumonia. They would have required intense hospitalization, easily totaling $1000 or more per puppy with no promise of survival. Because of the money and the chances, the client elected to euthanize both puppies. It was a very sad bookend to the successes of the two c-sections.
This case also reinforced a few lessons for me. First, experienced doctors should follow their instincts. Something abut this case made me suspicious of parvo, and though it wasn't my top likelihood I did consider it. Second, there is a big benefit to diagnostic testing rather than guessing. We could have assumed that the diarrhea was due to the liquid diet the owner was feeding and the inappetance was due to the respiratory disease and not ended up finding the real problem. Third, a previous negative test doesn't mean that you can't be positive in the future, so it's often worth repeating diagnostics.
Oh, and make sure your pets are vaccinated! In this case it wasn't the client's fault, but it's still important to remember.
Monday, May 24, 2010
Special on C-Sections
Cesarean sections are not a common occurrence in an average veterinary practice, especially emergency ones. I'll average one every year or two. Some breeds such as English bulldogs give birth through planned c-sections, but even those aren't common. This is why I was surprised today with a second emergency c-section.
This dog was a Maltese who started active labor around 10:15 and had part of the amniotic sac coming out of her. The owner called us about three hours later, worried because no puppies had come out yet. We told her to come in immediately, and once she arrive I was able to quickly see the intact sac protruding from her vagina. She was dilated enough that I could gently put my finger up her birth canal and feel a puppy likely in breech position. It only took an instant to tell that she need to get to surgery right away.
Within a couple of hours we had six new puppies and a recovering mother. These pups were harder to recover and it was touch-and-go for a while. But we did manage to save all six, including the one I found in breech. The surgery itself was a bit easier than the one last week because this was a much smaller dog. And like last time, mom and puppies left to head home and heal.
It's pretty strange to have two emergency c-sections in five days. Thankfully, everyone is doing well so far, and it looks like they will make complete recoveries. One of the biggest lessons to learn here is to HAVE YOUR DOGS SPAYED AND NEUTERED! With "fixed" dogs, neither client would have had to spend the money or have their pets at risk.
This dog was a Maltese who started active labor around 10:15 and had part of the amniotic sac coming out of her. The owner called us about three hours later, worried because no puppies had come out yet. We told her to come in immediately, and once she arrive I was able to quickly see the intact sac protruding from her vagina. She was dilated enough that I could gently put my finger up her birth canal and feel a puppy likely in breech position. It only took an instant to tell that she need to get to surgery right away.
Within a couple of hours we had six new puppies and a recovering mother. These pups were harder to recover and it was touch-and-go for a while. But we did manage to save all six, including the one I found in breech. The surgery itself was a bit easier than the one last week because this was a much smaller dog. And like last time, mom and puppies left to head home and heal.
It's pretty strange to have two emergency c-sections in five days. Thankfully, everyone is doing well so far, and it looks like they will make complete recoveries. One of the biggest lessons to learn here is to HAVE YOUR DOGS SPAYED AND NEUTERED! With "fixed" dogs, neither client would have had to spend the money or have their pets at risk.
Saturday, May 22, 2010
No Veterinary Hand Models
Today I was on the losing side of a run-in with a particularly evil cat. I ended up with numerous scratches over both hands and arms, though thankfully managed to avoid being bitten. Though not the worst I've ever had, it was the most scratches I've received in a few years. They're more annoying than really deep or dangerous but they're a reminder of what can happen in the business.
Injuries from animals are a known hazard of being in veterinary medicine. I've known large animal vets who have had limbs or backs broken by a kick from a horse or cow. I've personally been bitten by dogs, cats, snakes, lizards, birds, hamsters, rats, guinea pigs and just about every species I've ever worked with. Thankfully most of my injuries have been minor, but I've been to the emergency room in the past to have deep bites treated. My first battle wounds happened when I was only 14 years old and had been working for a vet for just a few months. When we're in this field, we are aware of the risks. Most of our patients aren't going to be a problem, but there is a reason for muzzles, cat bags, and bite-resistant gloves. We also learn to read behavior and body language and most of the time are able to tell when to push and when to back off.
Those of us who have been doing this for long enough have the marks to prove our profession. I can still see the small scars from my first cat bite 26 years ago. I've often said that there will never be any hand models among veterinary staff because of the wounds that we get. At any moment you can find someone on my staff that has welts, bruises, or scratches from some of the rougher patients.
In a way, I think we get jaded to the whole experience. When I was getting scratched today I didn't freak out or panic, instead concentrating on trying to handle the patient with minimal further trauma to me or the cat. After we decided that we couldn't do anything without sedation, I worked on cleaning and treating my wounds, followed by bandaging my arm. Within a few minutes I was making jokes and seeing my next patient. When you're in veterinary medicine you don't have time to be sidelined by a little thing like cat scratches.
Yes, more excitement in a day in the life of a vet.
Injuries from animals are a known hazard of being in veterinary medicine. I've known large animal vets who have had limbs or backs broken by a kick from a horse or cow. I've personally been bitten by dogs, cats, snakes, lizards, birds, hamsters, rats, guinea pigs and just about every species I've ever worked with. Thankfully most of my injuries have been minor, but I've been to the emergency room in the past to have deep bites treated. My first battle wounds happened when I was only 14 years old and had been working for a vet for just a few months. When we're in this field, we are aware of the risks. Most of our patients aren't going to be a problem, but there is a reason for muzzles, cat bags, and bite-resistant gloves. We also learn to read behavior and body language and most of the time are able to tell when to push and when to back off.
Those of us who have been doing this for long enough have the marks to prove our profession. I can still see the small scars from my first cat bite 26 years ago. I've often said that there will never be any hand models among veterinary staff because of the wounds that we get. At any moment you can find someone on my staff that has welts, bruises, or scratches from some of the rougher patients.
In a way, I think we get jaded to the whole experience. When I was getting scratched today I didn't freak out or panic, instead concentrating on trying to handle the patient with minimal further trauma to me or the cat. After we decided that we couldn't do anything without sedation, I worked on cleaning and treating my wounds, followed by bandaging my arm. Within a few minutes I was making jokes and seeing my next patient. When you're in veterinary medicine you don't have time to be sidelined by a little thing like cat scratches.
Yes, more excitement in a day in the life of a vet.
Wednesday, May 19, 2010
A Half-Dozen New Puppies
Today I had a very, very pregnant dog come in. We have been seeing her for a while, and had been watching her pregnancy for the last couple of weeks. The timing of the pregnancy was weird, as she either was bred a full month after she should have been fertile or she was over a month delayed in giving birth. Somewhere the timing didn't match, so we couldn't be sure how far along she was. However, it was obvious that she was near term simply by looking at her. Radiographs showed about a half-dozen puppies, so we knew it wasn't just fat. She was getting more and more uncomfortable, and today seemed in particularly bad shape. Yesterday she seemed to show behaviors consistent with nesting prior to labor, but was showing no signs of labor itself. After weighing the risks, we decided to do a c-section.
This kind of surgery always carries a fair degree of risk. When we anesthetize the mother, we're also anesthetizing the puppies, so we have to work quickly. It's not normally done with epidurals and local blocks like in human surgeries. It's also more complicated because we're delivering multiple babies at once rather than one or a few. The goal is to get into the abdomen as quickly as possible, remove the puppies individually, then pass them over to a technician who proceeds to stimulate the puppy, clear mucus and fluid from their mouth and nose, and generally make sure they start breathing. Getting the puppies out is very messy, as amniotic fluid and blood come out copiously and you have to try and prevent that from getting into the open abdomen. If the plan is to breed, you have to be careful not to damage the uterus and then close it up. It's much easier to simply spay the female and remove the parts normally. After all that you have a very large incision to close.
This dog had a total of six puppies that I removed, and then spayed her. We were lucky that all of the puppies responded and survived, and once the mother woke up from surgery they started to nurse. The mom left this evening in apparent good shape, though obviously tired and sedated (I gave her lots of pain medications). Even so, she walked out on her own. She's not out of the woods yet, but if she does good for the next few days should be perfectly fine.
There is something incredibly rewarding about bringing new life into the world. This is especially true when you're the one who pulls the babies from the womb and welcomes them into the realm of the living. My entire team was so excited and proud, especially with the puppies all doing well (five females and one male). Everyone had their phones out taking pictures and videos. And I was guilty of the same thing, wanting my daughter to see the new pups.
It will be exciting to see these puppies grow up and know how they first began.
This kind of surgery always carries a fair degree of risk. When we anesthetize the mother, we're also anesthetizing the puppies, so we have to work quickly. It's not normally done with epidurals and local blocks like in human surgeries. It's also more complicated because we're delivering multiple babies at once rather than one or a few. The goal is to get into the abdomen as quickly as possible, remove the puppies individually, then pass them over to a technician who proceeds to stimulate the puppy, clear mucus and fluid from their mouth and nose, and generally make sure they start breathing. Getting the puppies out is very messy, as amniotic fluid and blood come out copiously and you have to try and prevent that from getting into the open abdomen. If the plan is to breed, you have to be careful not to damage the uterus and then close it up. It's much easier to simply spay the female and remove the parts normally. After all that you have a very large incision to close.
This dog had a total of six puppies that I removed, and then spayed her. We were lucky that all of the puppies responded and survived, and once the mother woke up from surgery they started to nurse. The mom left this evening in apparent good shape, though obviously tired and sedated (I gave her lots of pain medications). Even so, she walked out on her own. She's not out of the woods yet, but if she does good for the next few days should be perfectly fine.
There is something incredibly rewarding about bringing new life into the world. This is especially true when you're the one who pulls the babies from the womb and welcomes them into the realm of the living. My entire team was so excited and proud, especially with the puppies all doing well (five females and one male). Everyone had their phones out taking pictures and videos. And I was guilty of the same thing, wanting my daughter to see the new pups.
It will be exciting to see these puppies grow up and know how they first began.
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