Today I did something that I have put off for over eight months- I finally forged ahead with a dentistry procedure on my oldest dachshund, Anya. I have always been very proactive taking care of Anya, especially with her teeth because I know first hand that untreated dental disease can shorten their lives, usually by damaging the kidneys.
I cleaned her teeth (yes with anesthesia) every year until she was around seven years, then every six months. I made sure I took dental xrays yearly and took every precaution to protect her from periodontal disease. In 2010, when she was fifteen, her dental xrays still looked like those of a young dog, her bone support around her teeth still healthy. As a result of all my good work, her labwork, her kidney values are still perfect normal. So why was I such a procrastinator?
Like many people, life got in the way. We have a baby, Anya had a bout of gall bladder disease, and of course work, work , work. But I still did her labwork regulary- every 3-6 months. I still brought her to work everyday. I am a veterinarian, I own my practice, and dentistry is one of my special interests, but still I delayed her anesthesia and dentistry. Why- fear of the unknown.
Like many clients, I began to convince myself that a sixteen/seventeen year old dog was so elderly that, as my husband put it, every day is a gift. It didn't matter that she was healthy, it didn't matter that I anesthetize elderly dogs and cats every day with a high success rate. It didn't matter that I knew that by not treating her teeth, I risked her kidneys. Her teeth were dirty, but looked normal on the outside. She was my baby and professional sense and yes, common sense went out the door.
It wasn't until she started loosing weight that I noticed that she was hungry but not picking up her food well. She was painful with her mouth, and I , a veterinarian, was too blinded by my own fear to pick up on it. I then snapped out of my denial, and made a treatment plan for her as I would any patient. Her dental xrays today showed that Anya had an abscessed tooth. It looked perfectly normal on the outside, but the abscess was clearly visible on the xray film. I tell clients every day that we cannot treat what we cannot see. I extractd her tooth today and she is doing wonderful. This little seventeen year old girl came through her anesthesia with flying colors and continues to have a bright future.
Fear of anesthesia prevents many pet owners from getting their babies needed care. This fear leads people into postponing dentistries and other procedures until it is too late for me to help their pets. Anesthesia is what I do for a living. I am trained, experienced, and our team does things the right way. Very few pets die under anethesia, and when they do, it is usually an unknown heart problem or other disease. Yes, every anesthesia procedure has some risk, but proper work ups to detect preexisting problems before anesthesia help us decrease that risk.
There is much more risk in doing nothing, more certainty that doing nothing will result in your pet being in pain or dying from a treatable problem. I understand the fear, but I overcame it when I saw that my fear was hurting my precious doxie. I know now that I gave my old girl a gift of not one day, but maybe a few more years if I can keep her healthy. I saw a twenty one year old poodle this week, so anything is possible.
Tuesday, February 14, 2012
Thursday, January 26, 2012
Attack of the Crazies
Being a veterinarian is the most wonderful and the most awful job in the world. No where else can you experience true joy and saving a life of animal and later read about yourself in an online review about how much someone hates you.
Years ago, the only real way to find out about a business or professional was word of mouth. You would ask someone or hear a story and it would help you form an opinion about them, their services, and whether or not to use them. At the same time, you could see the person, converse with them, read their body language etc. This was always helpful to filter out the crazies
We all know who they are- the crazies who always complain. They complain about their steak and get it for free- never mind the poor waitress who gets to pay for it later. They always argue about their bill and keep the line at the store held up forever. Everyone has ripped them off and they never make mistakes. In person, they can be seen for who they are, but online they are invisible.
We vets hate online reviews because the sane people never write them. Good clients for whom we have treated their pets for years do not go online and write reviews- unless people love you because you are cheap. But, the crazies, they love reviews. No where else can they omit part of the story, forget that they declined recommended services, ignore that they called my technician a bad word, not mention that they bounced a check and best of all, just make stuff up. Trying to answer one of these just draws more attention to it, so it makes you feel so frustrated and wondering why be a vet at all.
My latest experience involved a dog with a perforated intestine from eating sticks. My team and I saved his life against all efforts of his owners who did not follow instructions, walked him a mile after being discharged from the hospital, and no showed his rechecks. Much to our surprise when three weeks later, he ate stuff again, we were told how terrible we were that we refused to use test results from the first surgery to diagnose the problem today. Yes, people, we cannot use x-rays from three weeks ago to figure out what your dog ate today. Not surprisingly the clients got mad and sure enough, wrote a scathing online review.
There is a saying that you can't fix stupid. This is what I try to tell myself when we encounter these situations, but I can't say it isn't extremely hard. I just hope that most reasonable people can read through the hate, pick out the bad grammar, run on sentences and recognize the crazie hidden in cyberspace. I devote my life to helping animals and if I say so myself, do a bang up job with a bang up crew. It would just be nice to have some recourse without making myself look like a crazie. Maybe I need to enroll some of our favorite patients and their baby boomer owners in some online classes; better yet, just go home and enjoy a nice evening with the doxies- they make all bad things go away.
Years ago, the only real way to find out about a business or professional was word of mouth. You would ask someone or hear a story and it would help you form an opinion about them, their services, and whether or not to use them. At the same time, you could see the person, converse with them, read their body language etc. This was always helpful to filter out the crazies
We all know who they are- the crazies who always complain. They complain about their steak and get it for free- never mind the poor waitress who gets to pay for it later. They always argue about their bill and keep the line at the store held up forever. Everyone has ripped them off and they never make mistakes. In person, they can be seen for who they are, but online they are invisible.
We vets hate online reviews because the sane people never write them. Good clients for whom we have treated their pets for years do not go online and write reviews- unless people love you because you are cheap. But, the crazies, they love reviews. No where else can they omit part of the story, forget that they declined recommended services, ignore that they called my technician a bad word, not mention that they bounced a check and best of all, just make stuff up. Trying to answer one of these just draws more attention to it, so it makes you feel so frustrated and wondering why be a vet at all.
My latest experience involved a dog with a perforated intestine from eating sticks. My team and I saved his life against all efforts of his owners who did not follow instructions, walked him a mile after being discharged from the hospital, and no showed his rechecks. Much to our surprise when three weeks later, he ate stuff again, we were told how terrible we were that we refused to use test results from the first surgery to diagnose the problem today. Yes, people, we cannot use x-rays from three weeks ago to figure out what your dog ate today. Not surprisingly the clients got mad and sure enough, wrote a scathing online review.
There is a saying that you can't fix stupid. This is what I try to tell myself when we encounter these situations, but I can't say it isn't extremely hard. I just hope that most reasonable people can read through the hate, pick out the bad grammar, run on sentences and recognize the crazie hidden in cyberspace. I devote my life to helping animals and if I say so myself, do a bang up job with a bang up crew. It would just be nice to have some recourse without making myself look like a crazie. Maybe I need to enroll some of our favorite patients and their baby boomer owners in some online classes; better yet, just go home and enjoy a nice evening with the doxies- they make all bad things go away.
Monday, January 16, 2012
Doxies versus Babies- Who knew?
In case you haven't noticed, I have taken quite a leave of absence from the blogging universe. My husband and I welcomed a new baby boy into our family in June and to be honest, time has literally flown away. While being a new mother brings with it a wealth of new experiences and joy, watching my baby boy forge a bond with my dogs has been a wonderful experience.
With two elderly dachshunds in the household, certainly we were concerned about acceptance, jealousy, and safety of our son, Jack. Especially when one of my girls has little dog napoleon complex and rules the house with an iron fist. Daisy, our happy go lucky mix, was expected to get along. Anya, on the other hand, was sixteen years old and yes, a bit nippy. Let the games begin.
Like most things, what we expected to happen turned in to the exact opposite. Daisy immediately pouted, changed couches, and was thoroughly disgusted that we brought a baby home. Anya was curious, but initially- thank goodness- uninterested. Soon though, we found that Anya liked to lay next to the baby, she liked his blankets, she was curious about the bottles. Over the next few months as Daisy continued to ignore him, Anya loved him, snuggled him, and lately has tolerated grabbing and kicking with the patience of a saint. Jack has always been enthralled with Anya; he smiles when he sees her and likes to touch her soft coat. He seems to already like dogs and is fascinated with the cats at the hospital when he spends his days at work with me.
Anya, now seventeen, continues to welcome Jack into our family and even Daisy has come around a little bit. People ask how we did it, how we "trained" the dogs. I think it was because we were able to genuinely show love for the doxi girls and Jack at the same time- combined with a little bit of luck. As responsible parents, we always supervise all dachshund/baby interactions but by allowing the relationship between baby and dog to blossom, we have facilitated a friendship that can last forever. I think as we teach Jack how to love animals, treat them kindly, and view them as part of our family, we gave Anya an opportunity to welcome a new member of the pack and show her true colors as the best dachshund in the world!
With two elderly dachshunds in the household, certainly we were concerned about acceptance, jealousy, and safety of our son, Jack. Especially when one of my girls has little dog napoleon complex and rules the house with an iron fist. Daisy, our happy go lucky mix, was expected to get along. Anya, on the other hand, was sixteen years old and yes, a bit nippy. Let the games begin.
Like most things, what we expected to happen turned in to the exact opposite. Daisy immediately pouted, changed couches, and was thoroughly disgusted that we brought a baby home. Anya was curious, but initially- thank goodness- uninterested. Soon though, we found that Anya liked to lay next to the baby, she liked his blankets, she was curious about the bottles. Over the next few months as Daisy continued to ignore him, Anya loved him, snuggled him, and lately has tolerated grabbing and kicking with the patience of a saint. Jack has always been enthralled with Anya; he smiles when he sees her and likes to touch her soft coat. He seems to already like dogs and is fascinated with the cats at the hospital when he spends his days at work with me.
Anya, now seventeen, continues to welcome Jack into our family and even Daisy has come around a little bit. People ask how we did it, how we "trained" the dogs. I think it was because we were able to genuinely show love for the doxi girls and Jack at the same time- combined with a little bit of luck. As responsible parents, we always supervise all dachshund/baby interactions but by allowing the relationship between baby and dog to blossom, we have facilitated a friendship that can last forever. I think as we teach Jack how to love animals, treat them kindly, and view them as part of our family, we gave Anya an opportunity to welcome a new member of the pack and show her true colors as the best dachshund in the world!
Monday, January 2, 2012
Why Vets Hate the Holidays
Once again I ask myself what is it about the holidays that make people want to put their pets to sleep? Every year, veterinarians around the country experience an influx of last minute euthanasia appointments in the 4 weeks in between Thanksgiving and Christmas. I have seen it happen at every place I have worked and see it now in my own practice.
The stories vary. Some have old pets that have not seen a vet in years, that suddenly fall ill and require a trip to the rainbow bridge preferably before the Christmas guests arrive. Others have grumpy cats that hide and like to bite Grandma, so a trip to the vet to let her go peacefully and not suffer. The saddest are the families that acquire a new puppy or have a new baby and decide that the old dog has just gotta go. Some are honest and need to get rid of their family pet because they can not handle the "smell" when family arrives to visit. Others are going to travel at Christmas and feel that death is preferable to boarding for their cat; living in a kennel for a week would upset her so much you know. These folks usually have a regular vet, but feel guilty and try and find someone new to do the deed. No one wants to do a medical work up and try and help their pet or make a decision based on facts- they just know it is time to let them go.
Most good vets can smell these a mile away, but far too many just do what the client wants and perform euthanasia upon request. I worked for many a vet that just did what the clients wanted, no questions asked. When I finally acquired my own practice, I swore to myself that I would never perform what we call a convenience euthanasia. We require at least an examination and often a work up to determine what, if anything is wrong with a new patient presented for euthanasia. If the problem is complicated with a poor prognosis then certainly euthanasia is a valid option. If the problem is treatable (within reason) then we absolutely do not do it- Period!
It is so different when we have a relationship with the client and pet, are working with their problems and we come to a decision together that is time. Those euthanasias I can perform with compassion regardless of the time of year. Men who show up at our office shouting at the girls and demanding we put his perfectly healthy 12 year old cat to sleep because he is sick of dealing with "it"- I say too bad, because my staff and I still have to be able to sleep at night knowing that we did the right thing by our patients. I have to be an advocate for them as they cannot speak for themselves- but I am pretty sure they would choose life if given a chance.
The stories vary. Some have old pets that have not seen a vet in years, that suddenly fall ill and require a trip to the rainbow bridge preferably before the Christmas guests arrive. Others have grumpy cats that hide and like to bite Grandma, so a trip to the vet to let her go peacefully and not suffer. The saddest are the families that acquire a new puppy or have a new baby and decide that the old dog has just gotta go. Some are honest and need to get rid of their family pet because they can not handle the "smell" when family arrives to visit. Others are going to travel at Christmas and feel that death is preferable to boarding for their cat; living in a kennel for a week would upset her so much you know. These folks usually have a regular vet, but feel guilty and try and find someone new to do the deed. No one wants to do a medical work up and try and help their pet or make a decision based on facts- they just know it is time to let them go.
Most good vets can smell these a mile away, but far too many just do what the client wants and perform euthanasia upon request. I worked for many a vet that just did what the clients wanted, no questions asked. When I finally acquired my own practice, I swore to myself that I would never perform what we call a convenience euthanasia. We require at least an examination and often a work up to determine what, if anything is wrong with a new patient presented for euthanasia. If the problem is complicated with a poor prognosis then certainly euthanasia is a valid option. If the problem is treatable (within reason) then we absolutely do not do it- Period!
It is so different when we have a relationship with the client and pet, are working with their problems and we come to a decision together that is time. Those euthanasias I can perform with compassion regardless of the time of year. Men who show up at our office shouting at the girls and demanding we put his perfectly healthy 12 year old cat to sleep because he is sick of dealing with "it"- I say too bad, because my staff and I still have to be able to sleep at night knowing that we did the right thing by our patients. I have to be an advocate for them as they cannot speak for themselves- but I am pretty sure they would choose life if given a chance.
Monday, May 16, 2011
Have I become my Dad?
As I gaze around my office this morning, I note an odd quiet, lack of chittty-chat, and alot of on hold phone calls. While I hope that this is the product of my staff working with sheer efficiency, I realize instead that this is simply a result of fewer girls (techs) per square foot. Welcome to small business America, where, sick employees stay home and tired bosses continue to show up for work.
My Dad was a product of a WW2 work ethic, going to the law office every day- never out sick. As a girl I occasionally heard him complain about sick secretaries or no show assistants, but he always went into work- rain or shine. Until I was married, I had never heard of sick leave or personal time. I had always been taught that the first part of work meant "show up". As an associate vet, I mostly followed my Dad's example- as a practice owner, I live it every day.
It is part of the American dream to be your own boss- set your own hours, take time off when you want, and make the big bucks. Unfortunately, being the owner of a vet practice means I work longer than anyone else, I have to be there or we cannot make money, and I am responsibile not only for my actions, but of my employees. If I want time off, I have to pay a veterinarian to take my place. The big bucks?- Well, maybe someday once the practice is paid off, for now the bank is the one sitting pretty.
What this means is when I am sick, I still have to come in to work. As a workaholic dinosaur, am I jealous of my stay at home sick employees- sometimes, but I know they work hard for me and really care about our practice. Hiring the right people includes taking care of them when they need it. My Dad would just say this is the price we pay for owning a business. I say it is part of being a modern boss and being able to see the big picture. Too bad my big picture can't include some sick stay at home couch time with the doxies!
My Dad was a product of a WW2 work ethic, going to the law office every day- never out sick. As a girl I occasionally heard him complain about sick secretaries or no show assistants, but he always went into work- rain or shine. Until I was married, I had never heard of sick leave or personal time. I had always been taught that the first part of work meant "show up". As an associate vet, I mostly followed my Dad's example- as a practice owner, I live it every day.
It is part of the American dream to be your own boss- set your own hours, take time off when you want, and make the big bucks. Unfortunately, being the owner of a vet practice means I work longer than anyone else, I have to be there or we cannot make money, and I am responsibile not only for my actions, but of my employees. If I want time off, I have to pay a veterinarian to take my place. The big bucks?- Well, maybe someday once the practice is paid off, for now the bank is the one sitting pretty.
What this means is when I am sick, I still have to come in to work. As a workaholic dinosaur, am I jealous of my stay at home sick employees- sometimes, but I know they work hard for me and really care about our practice. Hiring the right people includes taking care of them when they need it. My Dad would just say this is the price we pay for owning a business. I say it is part of being a modern boss and being able to see the big picture. Too bad my big picture can't include some sick stay at home couch time with the doxies!
Wednesday, May 11, 2011
Too Bad I am not a Yes Vet
"What is right is not always popular and what is popular is not always right."
— Albert Einstein
I suppose most folks have heard that quote somewhere before in one form or another. In veterinary medicine today, there is no statement more true, or more difficult to accomplish. As a vet, doing what is right often involves being an advocate for my patient. It means discussing all the options, and recommending the best solution to treat your pet's condition based on current medical knowledge, research and my experience. What is right is not necessarily the most expensive; it is not always the easiest on the pet owner's pocketbook. So, if doing what is right is my job, why do Yes Vets seem to garner all the glory?
Every city or town has one. Yes Vets are known for always bending rules for clients and waiving fees. Yes Vets don't need to perform those expensive lab tests or x-rays to find out what is wrong with your pet- they just know. Owners that always want a cortisone shot for their itchy pet- Sure and no questions asked says a Yes Vet.
A Yes Vet is usually very charismatic. He has learned that Vet Med is a people pleasing business and that you just need to read people, figure out what they really want, and say YES. Now while that sounds well and good, often the poor animal gets caught in the middle. That cortisone shot given to a diabetic or pet with cushings can cause severe harm or even death. Cancer patients that may have a future, are put to sleep without even discussing available options. Patients are diagnosed with heart failure without even an X-ray. Surgery is performed without sterile attire, without pain medication, and the high school kid monitoring your pet under anesthesia. And the list goes on and on.
Today I learned that a patient of mine with a ruptured ACL had a second opinion at a local Yes Vet. Although it is commonly accepted in Vet Med that ruptured ACL or cruciate ligaments need surgery, my client was told that she didn't need to do anything as ACLs heal on their own in small dogs. She of course was happy with this advice because it meant that she did not have to spend any money. Yes Vet is a hero but unfortunately her little dog will suffer the result.
What clients do not realize is saying yes is much easier than saying no. How beloved I would be if I could tell my clients with a radiant smile that YES, you don't need to give your cat pain medication after her surgery, why that lump is probably just a fatty tumor, YES we'll just watch it, allergies?- YES, here is some predisone and call me in the morning. Thing is- I like to sleep at night knowing I did the right thing for your pet. Ask yourself if your vet is a Yes Vet, then look at your pet and decide if he deserves better.
— Albert Einstein
I suppose most folks have heard that quote somewhere before in one form or another. In veterinary medicine today, there is no statement more true, or more difficult to accomplish. As a vet, doing what is right often involves being an advocate for my patient. It means discussing all the options, and recommending the best solution to treat your pet's condition based on current medical knowledge, research and my experience. What is right is not necessarily the most expensive; it is not always the easiest on the pet owner's pocketbook. So, if doing what is right is my job, why do Yes Vets seem to garner all the glory?
Every city or town has one. Yes Vets are known for always bending rules for clients and waiving fees. Yes Vets don't need to perform those expensive lab tests or x-rays to find out what is wrong with your pet- they just know. Owners that always want a cortisone shot for their itchy pet- Sure and no questions asked says a Yes Vet.
A Yes Vet is usually very charismatic. He has learned that Vet Med is a people pleasing business and that you just need to read people, figure out what they really want, and say YES. Now while that sounds well and good, often the poor animal gets caught in the middle. That cortisone shot given to a diabetic or pet with cushings can cause severe harm or even death. Cancer patients that may have a future, are put to sleep without even discussing available options. Patients are diagnosed with heart failure without even an X-ray. Surgery is performed without sterile attire, without pain medication, and the high school kid monitoring your pet under anesthesia. And the list goes on and on.
Today I learned that a patient of mine with a ruptured ACL had a second opinion at a local Yes Vet. Although it is commonly accepted in Vet Med that ruptured ACL or cruciate ligaments need surgery, my client was told that she didn't need to do anything as ACLs heal on their own in small dogs. She of course was happy with this advice because it meant that she did not have to spend any money. Yes Vet is a hero but unfortunately her little dog will suffer the result.
What clients do not realize is saying yes is much easier than saying no. How beloved I would be if I could tell my clients with a radiant smile that YES, you don't need to give your cat pain medication after her surgery, why that lump is probably just a fatty tumor, YES we'll just watch it, allergies?- YES, here is some predisone and call me in the morning. Thing is- I like to sleep at night knowing I did the right thing for your pet. Ask yourself if your vet is a Yes Vet, then look at your pet and decide if he deserves better.
Monday, May 9, 2011
I put my own cat to sleep yesterday
So often when people find out I am a veterinarian, the first thing they say is "I always wanted to be a vet, but I just couldn't handle putting animals to sleep". Euthanasia is a daily presence in veterinary practice- sometimes due to tragedy, sometimes economic. The most difficult ones are the pets that we have known for years or even their entire lives. These patients become part of our extended family and when we have to let go to relieve their suffering, it hurts us inside and reminds us of each of our own we have sent to the rainbow bridge.
My Katie, a chubby yet active Maine Coon, was part of our family for almost eleven years. A week old labor day weekend kitten, she was brought into the clinic by a good Samaritan. Cold and soaking wet, I agreed to foster her for the weekend then give her to the Humane Society to find a home. My husband and I had just lost our cat, Bugs, to kidney failure and were struggling to keep our Great Dane, Uli, afloat after his leg amputation and chemotherapy due to bone cancer. Another cat we did not need.
Fast forward to a weekend of bottle feeding, cuddling and purring- and as Stephen predicted we had a new cat. Katie grew into a big Maine Coon- she loved our dogs and acted just like them. She was very social- greeting us at the door and inserting herself into our daily lives. Katie was absolutely the best cat we have ever had.
Ten years later, Katie developed severe asthma. Treatments to help her included a daily inhaler that she took in stride allowing us to do what was necessary to help her. As her breathing became more difficult, her activity diminished, she kept her distance, and her appetite waned. Even as we could hear her gurgle, I tried to convince myself that she was just having a bad day, that I could still help her. Sensibility came when I realized that as her veterinarian, I had to make a decision that was best for her, not me.
Sunday, we let her spend the morning on the porch. I gave her some pain medication, then a sedative. We held her and stroked her head while she fell asleep. My husband carried her to our table for the final injection. I asked him to walk away while I gave it to her and felt her life slip away. This procedure I have performed many times, but the emotion and responsibility surrounding this time was deep, painful, and filled with guilt.
With each patient euthanasia I perform, I relive my own pet's love, life, and death. It is a necessary, but difficult task to take a life, to relive suffering. But I would be lying if I said it was easy or without regret.
My Katie, a chubby yet active Maine Coon, was part of our family for almost eleven years. A week old labor day weekend kitten, she was brought into the clinic by a good Samaritan. Cold and soaking wet, I agreed to foster her for the weekend then give her to the Humane Society to find a home. My husband and I had just lost our cat, Bugs, to kidney failure and were struggling to keep our Great Dane, Uli, afloat after his leg amputation and chemotherapy due to bone cancer. Another cat we did not need.
Fast forward to a weekend of bottle feeding, cuddling and purring- and as Stephen predicted we had a new cat. Katie grew into a big Maine Coon- she loved our dogs and acted just like them. She was very social- greeting us at the door and inserting herself into our daily lives. Katie was absolutely the best cat we have ever had.
Ten years later, Katie developed severe asthma. Treatments to help her included a daily inhaler that she took in stride allowing us to do what was necessary to help her. As her breathing became more difficult, her activity diminished, she kept her distance, and her appetite waned. Even as we could hear her gurgle, I tried to convince myself that she was just having a bad day, that I could still help her. Sensibility came when I realized that as her veterinarian, I had to make a decision that was best for her, not me.
Sunday, we let her spend the morning on the porch. I gave her some pain medication, then a sedative. We held her and stroked her head while she fell asleep. My husband carried her to our table for the final injection. I asked him to walk away while I gave it to her and felt her life slip away. This procedure I have performed many times, but the emotion and responsibility surrounding this time was deep, painful, and filled with guilt.
With each patient euthanasia I perform, I relive my own pet's love, life, and death. It is a necessary, but difficult task to take a life, to relive suffering. But I would be lying if I said it was easy or without regret.
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