Welcome to 2017! Let's Hope It's better Than 2016....

It is now officially 2017.  Happy New Year!

As I look back and reflect on 2016, I can say that it has been successful and good for me and my family.  However, that hasn't been the case for the USA or the world. 

An incredible number of celebrities and musicians passed away last year, some of them particularly tragic whether due to their young age or because they were so beloved.  We had the most divisive, contentious, and horrible presidential election that I can ever remember, and most people are unhappy with the final result (and would have been even if Clinton had won).  Many of my clients lost old, cherished pets over year, including ones I've been seeing for many years.  For many people 2016 was pretty tough, and anyone on Facebook has surely seen the complaints and memes going around.

But 2017 is a new year.  Even though January 1st really isn't that different from December 31st and the days go on as normal, psychologically we look at the date as a turning of the page and a new beginning.

Let's hope that 2017 is better than 2016 was!  And if you had a great year, I hope that the new one is even better!

Reflecting On Great Clients

As 2016 winds down to a close I've been thinking about some of my really great clients.  I've been at my current clinic for almost 6 years, and some clients followed me over from my previous one.  This means I have a few clients whose pets I've been seeing for nearly a decade.  During that time you can really get to know people and develop a close relationship.  

Many small animal vets thrive on these relationships. It's certainly something that I enjoy, and it helps when I know not just the pets but the human family members as well.  While I can't say that I really like every single one of my clients (nobody can say that), there are many that with whom I have a special relationship.  For example I had one of my long-term clients invite me and my wife to a Christmas party at their home.  Unfortunately I couldn't attend due to other commitments, but it meant a lot to me that they thought to consider us.  Because I've moved around a lot during my career I haven't had these lengthy relationships with clients until now.

This time of year we typically have clients bring us Christmas cards and cookies, and they are always very much appreciated.  It really means a lot to me and my staff when somebody takes the time to stop by and deliver a card and food just to let us know that they appreciate us and what we do.  These kinds of clients really help make up for the difficult ones and are a large part of the reason why we as vets tolerate long hours, difficult work, and comparably low pay.  

When I was younger I said that I didn't like people, and for the most part I still don't.  People as a whole are rather difficult, and being an introvert I want to minimize interactions.  However, when I was in vet school I realized that I did like "good" clients and enjoyed helping them and their pets.  I am very nice and outgoing to all of my clients, even ones I'd rather not see, because my responsibility is to care for their pets and I believe in treating people as I want to be treated, not how they treat me.  But there are some clients that I look forward to seeing because I've known them for so long, they take good care of their pets, and they're fun to be around.  It's these clients that give me the motivation to come to work every day and make the effort in my job worthwhile.

So a big "THANKS" to all of my great clients that I've met and had over the year (and previous years).  You make my job easier and keep me smiling.

Merry Christmas!

I hope that everyone has a very joyous Christmas season, however you may celebrate it.  Spend time with family, enjoy some gift-giving, and don't leave your pets out of the fun (though limit any treats to those specifically for pets).  But remember that the main reason we recognize this holiday is because of the birth of Jesus Christ, and what He has done for the world.

Merry Christmas, everyone!

Yes, We Really Do Need To See Your Pet For Prescriptions

One of my favorite websites is NotAlwaysRight.com, and I've shared things from there before.  I came across the following post and it mirrors something that I see far too frequently.

(One of my coworkers is relatively new and often sounds unsure when repeating information or instructions. Clients tend to try to take advantage of that, and my coworker isn’t confident enough to know when to put her foot down.)

Coworker: “Can you help me with this call? [Client] wants a prescription refill for [Patient]. I checked with [Doctor] and she said we need to do an exam since we haven’t seen [Patient] in so long, but [Client] isn’t liking that answer.”

Me: “Yeah, sure.” *picking up phone, to [Client]:* “Hi there, this is [My Name]. [Coworker] said you had some questions about a prescription refill for [Patient]?”

Client: “Yes! I need a refill of [medication] for [Patient], but the other girl said that [Patient] needs to be seen first! She HAS been seen!”

Me: “According to our records, we haven’t seen [Patient] in almost 18 months.”

Client: “No, no! I took her to a vet in [State]! She HAS been seen!”

Me: “Well, ma’am, pharmacy law states that in order to write a prescription we have to have physically seen a patient within the last 12 months.”

Client: “That’s ridiculous. I can’t believe that!”

Me: “I apologize, but the law is the law.”

Client: “Well, what am I supposed to do, then?!”

Me: “I can either set up an appointment to get [Patient] seen–”

Client: “But she HAS been seen!”

Me: “—or you can contact the vet in [State] that saw [Patient] to see if they will send over a prescription.”

Client: “Can’t you call them and get the visit history?”

Me: “I could, but that doesn’t change that we need to physically see [Patient], here, in the office, for an examination, before one of our doctors would even consider writing a prescription.”

Client: “I just don’t understand why you won’t write a prescription!”

Me: “Because it is illegal. You are asking us to break the law.”

Client: “Well, you’re useless, aren’t you!?” *hangs up*

When Good Companies Promote Bad Ideas

Recently a reader joined in a discussion from a couple of years ago, and asked a very good question.

As per your responses it makes me think of two additional things. I have read the replies from you and even others that grains are not bad for our dogs and you seem to imply that the brands you mentioned do more research and would be better but have you noticed that even Purina Pro Plan and Iams and Hills Science Diet are getting into the grain free or limited grain dog foods? I do not mean this as a gotcha question but rather it all confuses me.

This very thing is something that has been bothering me lately.  I consider Purina, Iams, Hills, and Royal Canin to be good food companies who have put a lot of money into nutritional research and the development of good quality foods.  So why are we seeing them make diets that nutritional specialists routinely say are unnecessary or misinformed?  Why are they making foods similar to those produced by companies that perpetuate false nutritional information?

I hate to say it, but it comes down to money and market share.

A few years ago somebody started saying that dogs and cats shouldn't have grains in their diets.  The idea started spreading and soon people were thinking that "grains are bad" and we need to eliminate them from pet foods.  Some manufacturers made a big deal about this idea and people on the internet started writing about it and spreading it.  Yet there has never been any legitimate scientific basis for these claims and board-certified specialists and nutritional researchers have disputed the information.  While there is strong evidence that grains are perfectly fine and readily digestible for most dogs and cats, somehow people started buying into the idea that grain-free diets were somehow better.

People mistakenly thought that they were buying good food for their dogs and certain food companies heavily marketed this aspect of their diets, disparaging other brands in the process.  Poorly informed consumers started buying these foods in larger amounts and the companies who promoted grain-free diets prospered and gained larger shares of the market.

Now the following is speculation on my part, but I think I have some very valid points and with some knowledge of the various companies and the real science behind pet foods I think I'm right on the mark.

Even though Purina, Iams, Hills, and Royal Canin are all good companies and produce good foods, they exist to make a profit.  Their boards of directors and presidents were probably looking at the expansion of grain-free foods in the market and seeing their own sales decrease.  So what do you do if you're a large company?  Do you spend time and money to try and correct the misinformation and have campaigns that talk about how ridiculous grain-free diets are?

Well, that would be the right thing to do.  But when do we see companies do this?  And if they do, how successful are they?  

So these companies did what pretty much every company does.  They make products to meet consumer demand.

The same thing has happened with gluten-free foods for humans.  For the vast majority of people there is no problem with gluten in foods.  Even many of the people who think they have a gluten sensitivity really don't.  But we now see a large number of products manufactured "gluten free", and even existing products that have never contained gluten changing their packaging to say "gluten free".

The large companies aren't saying that grain-free diets are better.  If you notice, they're still making plenty of foods that contain grains.  What they're doing is recognizing a demand and interest from pet owners, then making foods that cater to those people.  By doing so they are regaining some market share and selling more foods.

This drives me absolutely crazy because now we have even good companies who are upholding the myth that these kinds of foods are somehow better.  But the only way to fix it is for people to start sharing the correct information and bust those myths.  

As I am trying to do. 

Well informed pet owners will stop buying these foods, which will decrease demand and will result in fewer products and less misinformation.

Holiday Safety Tips

This time of the year I worry about my patients almost more than any other time.  With all of the holidays and decorations there are some significant risks for chewing on or eat things that dogs and cats should really avoid.  Pet owners need to be especially vigilant for the next several weeks.  Here are some good tips and hints to make the holidays safe and happy for everyone.

Rubber Band Tail Docks.....How To P*** Off A Vet

I've seen a lot of bad things in my 30+ years in veterinary medicine.  Plenty of neglect, some malpractice, carelessness, stupidity, and lots of things that aren't the fault of an owner.  I've become used to handling situations like these, and even perhaps a little jaded from so many years of seeing them.  We've come a long way in pet care just in my lifetime, let alone within the last century, so it somewhat surprises me when I see people still doing things that were a bad idea 50 years ago.

Recently a client brought in their brand new puppy.  They had picked her up just a few hours before and noticed that something wasn't normal with the tail.  They were told by the breeder that they had "docked" the tail themselves.

Let me pause for a moment to describe exactly what tail docking is.  Typically this is done in certain breeds when a dog is three to five days old.  There is no medical benefit for doing so, and it's only because people have come to expect a breed to look a certain way.  If done appropriately a vet will see the puppy, do a surgical scrub to disinfect the tail, and then use a sharp scalpel blade to cut through the skin and muscle and between the bones in the tail.  This hurts very briefly and there is minimal bleeding.  Either some surgical skin glue/adhesive or a quick stich are used to close the wound, and the puppy is put back with the mother.  The procedure takes no more than a minute or two in skilled hands, and within a few minutes afterwards the puppy is acting normal. 

But there are older "country" or "redneck" ways to dock a tail.  The most common is to tie a rubber band tightly around the tail at the desired level and just leave it there.  The idea is that blood flow stops and the end of the tail past the band simply falls off.

How idiotic!

Let's evaluate this method for a bit.  First, it's often done on older puppies who have thicker tails with more tissue.  The larger tail makes it more difficult to achieve the desired results.  But even so, stop and think for a minute.  Doing this is exactly the same as if you tied a rubber band around your pinkie finger and it eventually fell off.  How long would this take?  How much would it hurt?  How much risk of infection would there be?  I don't think any sensible, rational person would ever think that amputating a finger should be done with a rubber band.

The band constricts blood flow.  Without blood supply the tissues die.  With enough time they will deteriorate and fall off.  But the nerves aren't initially damaged so it will hurt quite a bit.  It's not natural for tissues to die in that amount, and restricted blood flow is not healthy.  You are not getting closure of the skin so a combination of dead/dying tissue and open wounds results in a high risk of infection.  If the tail is particularly thick you may not even get complete destruction of all tissue, leaving some muscle and the bone while the skin falls off.

Can you see how cruel and ridiculous this is? 

Now back to the puppy.  And as I'm sure you can guess, what I described above is what happened.  She was about six or seven weeks old and when I saw her this is what the tail looked like.

That white tip on the end?  That's bone sticking out.  And the whole thing looked worse than how it appears in the picture.

Immediately upon seeing it I knew what had happened, and this was confirmed when I found this elastic band around the base where the viable skin stopped. 

I'm a very even-tempered, good-natured person, and it really takes a lot for me to get angry or lose my temper.  When I do get upset, I tend to get very quiet and stern.  One of my techs noticed this as I was describing to some of the staff what I was seeing and what had happened.  She said "Uh, oh.  Dr. Bern is quiet.  He has his mad face on."  And she was right.  I was royally ticked off at the breeder for having done this, and was working on how to remain professional yet honest when I told the new owners what was going on.  In fact, I can't remember the last time I was that pi**ed off at work, especially over a client situation.  My staff has rarely ever seen me get like that so they knew something big was going on.

The puppy had been left with us for a little while so when the owners came back I went into the room with them.  They confirmed that the breeder had told them that they had been the ones to "dock" the tail, and the clients knew something wasn't right when they saw it, which is why they brought the puppy to me.  I started to explain to them exactly what had happened and showed them the elastic band.  I was polite but very firm and blunt.  I could see the husband's face becoming like mine had been just a few minutes before, and the wife looked ready to cry.  He had suspected something like this but couldn't believe that anyone could actually do it.  I told them that I had heard many times of this being done, but this was the first time I had seen it in person. 

Then I had to drop the other shoe.  A problem like that won't heal with just antibiotics and a bandage (if a bandage will even stay on a tail like that, which it likely won't).  She is going to need to have the tip of the tail surgically amputated and the skin closed over it.  We really can't save the tail tip and if surgery isn't done soon she risks worse infection.  So not only had they spent money to purchase this dog, but they were now going to have to spend $600-800 or more to have the tail fixed.  All because some dip-wad jerk thought they could shorten a tail by cutting off the blood supply with a rubber band.

This upset them even more, but not at me.  And I could tell that they honestly felt bad about what happened and that it wasn't their fault.  The husband said that he thought she might need surgery so while my comments bothered him they didn't surprise him.

The three of us shared several moments of being furious over what the breeder did to this poor puppy.  They were in a tough situation because they had only had her for a few hours and were now faced with expensive surgery.  At the same time they couldn't bring themselves to take her back because of fear of what would happen to her then.  So they made the decision to keep her and fix the tail.  I was really impressed with their commitment and compassion for this little pup.

Part of our discussion was around the cruelty of this breeder.  And I'll be very, very blunt.  I consider this animal cruelty without any doubt.  I don't see how any reasonable, compassionate person could think otherwise.  If anyone reading this is one of the breeders who does such things, I would say the same thing to your face.  This is inexcusable, intolerable, and unnecessary.  That puppy was put through pain and developed an infection because a human wanted their tail to look a certain way and took it upon themselves do try and cause physical change in a way that would make cavemen cringe.  It's one thing if a veterinarian performs surgery in a sterile way and manages pain.  It's another thing to simply tie a rubber band and wait for the tissues to die and fall off.

We did discuss contacting the local police department animal control division to report the breeder for animal cruelty.  The clients seemed very ready to do this, and I hope that they did.  The breeder needs to never have dogs around them again, and absolutely should never be allowed to breed anymore.  There needs to be consequences for such inhumane actions.

I haven't seen the puppy for a follow-up because they have a different vet they normally see and we just happened to be close by and open on a Saturday.  But the clients said that they knew she'd be just as upset.  With proper care this puppy should end up being fine in the long run, and I think she has the kind of people who will do whatever it takes.

I'm glad that there are people like those clients.