Watch us take a boulder out of a Chihuahua!
***Surgery shown*** blood and stuff.
Is this an Emergency?! Common Over- and Under Reactions
Veterinary offices everywhere are struggling to keep up with the demand of the needs of pets lately and some folks are having to wait a couple of weeks to months to get things addressed. This is causing excessive spill over into the Emergency Clinic world. Suddenly, a place that was designed for the super severe, complicated, or tragic cases that happen in the middle of the night are now clogged up with ear infections and dogs that have been limping for 2 hours. Then, they are getting horrible reviews and dragged through the mud on social media for owners having to wait 8 hours and having to pay hundreds of dollars more than they would at their regular vet (if they have one). People sometimes forget how much money it costs to keep a top tier facility like that open 24 hours a day and fully staffed to be able to drop everything and take your dog to surgery for a bleeding abdominal mass. They also forget that a non-emergency is going to continue to get bumped by the actual emergencies that may not live through the night. So, I decided to come up with a list of things that are absolutely not an emergency to save numerous angry owners from the long waits and heavy fees of going to a place that is currently doing CPR on a dying dog. Then, I will have a list of things that are absolute emergencies that some owners might wait a little too long to address which could lead to more money spent, but more importantly, a poorer outcome for your pet. Also, please read my previous post “5 ridiculously easy ways to avoid pet emergencies and BIG bills that your vet doesn’t want you to know… oh, wait.”
Things that often present as emergency, but are not.
- Ear infections. Yes, these can be painful and itchy, but save your trip to the ER. It can wait until regular business hours. Ear infections in dogs and (lesser) cats are not like infant/child ear infections in that they typically don’t cause fever and significant internal pain. The vast majority of ear infections in dogs and cats are external to the ear drum and therefore, not as serious. Most ear infections can be prevented with diligent observation of the dog’s ears every now and then – are they red? Do they smell bad? Is your dog shaking/scratching ears more often? Your vet has some amazing ear cleaners that can prevent the infections to begin with if your dog produces excessive ear wax. Most infections are caused by breed (Here’s looking at you, Cockers) and allergies. Dogs can be kept on allergy meds (talk to your vet for recommendations) to prevent the excessive wax production that the little buggers (bacteria and yeast) love to thrive on. Your dog suddenly have fire-red ears on a Saturday night and won’t stop digging/shaking? Give 1mg/lb benadryl (So, 50lb dog will get 50mg benadryl – DON’T Give children’s liquid if it has xylitol in it) every 8 hours and wait for Monday morning to call your vet.
- Limping. Ugh, so many. Unless you feel like the leg is broken ie. dangling, bent in unnatural way, bleeding, largely swollen, or dog screams if you touch the leg (30min after injury) it can probably wait until normal business hours or may even resolve by that time. Yes, occasionally we will get a broken leg, more often, a torn cruciate (ACL tear) – big dog playing hard, screams, holding back leg up – but more often than not, it’s a sprain or strain and will not show up on an x-ray and will get better with rest.
- Bleeding toe nail. There’s a saying in medicine “the farther from the heart, the more likely to live”. Your dog is MORE than likely not going to exsanguinate from a bleeding toenail. If your dog will let you, elevate the leg, apply pressure with your fingers to either side of the toe involved, apply cornstarch or flour (all purpose, cake, self rising, I don’t care) until you get the bleeding to stop. If he won’t let you, send him out in the yard and forget about him for an hour.
- Vomiting…. once. We see it all the time. Client rushes into the clinic on emergency for vomiting dog. We’re all geared up for the next train wreck foreign body surgery, blocking off appointments to make sure we have enough time, and when we get into the room, we find out the dog vomited once last night – but ate breakfast this morning. Or vomiting three times 10 days ago. Or had diarrhea once. Would you rush yourself to the ER if you had diarrhea last night, but felt fine today? Or if you vomited three times last week, but have been fine since? Now, if a patient has been vomiting several times in a day, absolutely it could be an emergency, especially if they can’t keep anything, including water, down.
- Any skin issues. When I was working shifts at the ER, we would get someone waiting 8 hours to be seen for skin issues and end up paying 10x the amount they would at their regular vet due to increased costs of running a 24/7 clinic. Flea prevention goes a REALLY long way in preventing these, but even then, likely it can wait until normal business hours. Hot, inflamed skin that pops up all of the sudden and is oozing and terribly itchy? Trim the hair away from it, clean it with mild soap (Dog oatmeal shampoo if you have it, baby shampoo if not), give 1mg/lb benadryl every 8 hours until you can get to your regular vet.
Things that ARE an emergency but people don’t always take seriously
- Eyes! Eyes are always an emergency. Even when they’re not, you should still treat them like one until proven otherwise. One eye squinty? Redness, swelling? Drainage with squinting? Bluish color or cloudiness to the eyes? Any wound involving eyelids? Take to the vet NOW. Could it be something simple like conjunctivitis? Sure! But it could also be an ulcer or scratch or hole in the cornea that causes your pet’s eye to rupture and have to have their eye removed. Lacerated eyelids need to be repaired ASAP to make sure they are aligned correctly without too much “shrinkage”. If the repaired lids do not line up pretty perfectly, it will lead to problems in the future – like increased risk of corneal ulcers. Sometimes animals get foreign bodies in their eye that need to be either flushed out, or the eye needs to be numbed and the vet will look behind the third eyelid for sticks, grass, bugs, etc that will continue to scratch the eye every time the animal blinks. Eyes will either heal up like nothing ever happened or can turn into a train wreck in just a matter of hours.
- A male cat (neutered or not) that is straining or vocalizing in the litterbox. Male cats, as you can imagine, have VERY tiny penises with even tinier urethras. Any amount of crystals can get caught in that very tiny urethra as it twists and turns around the pelvis to get to the end of the penis. Once the crystals get backed up to the point of blocking the flow of urine, the bladder starts to fill like a water balloon left on the spigot. Not only will this put extraordinary pressure on the kidneys, but if the bladder eventually pops, your kitty is pretty much done.
- Bloated dog that is not eating or is vomiting/retching or is really really sad looking. Especially deep chested dogs. You can even thump on the belly and if it sounds like an empty drum, it’s gas. Big belly, happy, wagging tail, jumping around? Likely just got into something and ate too much (food bloat) but still, take in for radiographs to just make sure. Gastric dilatation volvulus GDV is a condition where the stomach bloats with gas, then flips over, cutting off the blood supply to itself and the spleen. This means you have mere minutes to jump in the car and get to a facility capable of dealing with these. You will likely need to get to a 24 hour emergency clinic as the dog will need surgery, then intensive hospitalization care as the dog can literally just drop dead hours to days after the surgery due to toxins released when the stomach is righted and the effects of those toxins on the heart. It will be vital to have your dog at a facility that can constantly monitor electrolytes and the heart to prevent this. Most small clinics likely will not be able to handle this entire procedure correctly. Ask your regular veterinarian if they are capable of performing a GDV after hours before it ever happens so that you don’t have to waste time calling them only to have them tell you to get to the ER. Get your dog in the car, start driving, have someone call the ER to give them a heads up on the way. This way they will be set up and prepared to properly treat your dog in an expedited fashion.
- Vomiting and unable to keep anything down. Sure, dogs sometimes throw up and it’s no big deal. They go out, eat some grass, vomit, but later, will eat a whole bowl of food and never look back. But if the dog has vomited multiple times, seems lethargic, and/or anytime he eats or drinks anything, it comes back up – DO NOT wait to bring these in. These could be a multitude of issues, but all need to be taken care of ASAP. It could be a foreign body, intestinal blockage, intussusception, intestinal torsion, pancreatitis, etc. Some are surgical, some need intensive hospitalization, but one thing is for sure: the longer you wait, the much much worse it will be. Waiting could result in severe dehydration with multiple organ damage, intestines dying or rupturing, causing deadly infection of the abdomen and body, and a general rapid regression in the overall prognosis of your pet. Foreign body caught right away – simple incision into intestines, suture back up, go home that night. Foreign body after three days: possible inches to feet of intestines removed, infection, days in the hospital, possible death. You may expect to pay a bit more for an emergency visit, but the longer you wait, the more exponential the bill will increase.
- Intact female dog doing almost anything. Vomiting? Drinking and peeing a lot? Lethargic? Vaginal discharge? Swollen abdomen? Any or all of the above? Not currently in heat or knowingly pregnant? Intact female dog (and sometimes cat – but more rare) coming in sick for almost ANY reason is a pyometra until proven otherwise. I discussed this a little before on how to save big bucks on major vet bills (spay and neuter), but a pyometra is where the uterus gets an infection and because it’s just a huge sack of pus hanging out in your dog’s abdomen, it causes grave sickness and if it leaks or ruptures, likely death. It’s easy to diagnose and easy(ish) to treat. Notice your intact female sick and take her in right away, if she is diagnosed with a pyometra, they will take her straight to surgery, remove the entire sack of pus without leakage and she will be a new dog when she wakes up. Wait a few days or try to nurse her at home, she will quickly become septic (whole body infection) and require prolonged hospitalization and a much greater risk the sack of pus will leak or rupture during surgery (all that bacteria, inflammation, and stretching of the uterus makes it super weak and friable) and that will lead to an even poorer prognosis.
In the end, if you aren’t sure, try calling the ER and finding out how emergent your pet’s issue is.
How do you get through the hard days?
Yesterday, I had a hard day. I had an emergency animal come in on death’s door from possible trauma, thought I could save him, but after an hour of fluids, meds to bring down brain swelling, warming bair huggers, oxygen, and all the meds to keep his heart going when he stopped breathing on his own, we had to finally throw in the towel. Calling and giving the owner that news was heart wrenching to say the least. Later that day, another patient came in for what I thought would be a pretty simple, but long term treatment plan for a young animal with chronic issues. The owner, understandably, after having pours thousands of dollars into a very young animal without ending the suffering, was already ready to throw in the towel. I knew it was the right answer, but it just felt like I was murdering this beautiful baby soul. I know what my job is and the practicality and humanity of stopping the fight, but it was still, literally, gut wrenching to push that pink fluid into that sweet, loving animal’s vein, even while those eyes trusted me not to hurt her, I stopped her heart.
I’m the worst when it comes to looking on the bright side – when it comes to myself. I’m fantastic at trying to get others to see the light in things and keeping humor interjected in almost every situation to keep others out of the black hole that is my mentality sometimes. I’m cynical, I’m doubtful, I lose faith in the existence of God on a regular basis, I lose faith in people (just read the news, like, ever), I lose faith in myself and wonder if anyone who really knows me actually loves me, I have bad days, bad weeks, etc. (If I haven’t posted in a while, I’m probably in a dark place) How have I even survived this long? Well, medication, therapy, and trying to think of things in a MUCH broader view.
Stay away from the news! Any news about the nation or world. You can’t change any of it, you literally just read it and get paranoid, angry, sad, or otherwise negatively emotional. I used to (and still slip into it every now and then) go looking for news that would make me says “OMG! I can’t believe that!” or look for something to talk with someone else about “did you see where.. ” or “can you believe what *** did??”. It’s addicting – somehow reading something that makes you feel an emotion – there has to be a hormone similar to dopamine that is released when you read stuff like that. I still find myself falling into rabbit holes, but if I can stay away from the news, I can typically control my emotions better because, guess what! —> see next point
The people around you and in your community are generally good people. We may all have very different opinions about subjects and topics, but for the most part, most of the people around you are courteous, polite, and trying to do the best that they can. Remember, all the crazies that make you crazy on the internet or social media are the loud ones. The majority of people who are normal, reasonably balanced human beings are not out there touting far one-sided crap. I truly believe that there are enough (probably plenty) of intelligent, wise, level-headed humans in this country who could actually take the issues (social and economic) and come to a reasonable conclusion. If you talk to a *rational* person about politics, you may find that y’all can agree on a lot when solutions are trying to be found. But the whole “my team says this, so you’re stupid” thing will never work. We all have more in common and can agree on WAY more than the news, social media, or your crazy polar friends will let on.
At the end of the day, most everything will be the same. Horrible clients? A dog that tried to die on the table? A horribly complicated case that had you dragging your eyeballs over the gravel while jumping through fiery hoops? When I get home, my kids will be energetic, they will be safe, my dog will greet me like she hasn’t seen me in a year, my cats will greet me like they literally saw me two seconds ago, and after the kids go to bed, I will sit down and have a cup of cheese balls and maybe a glass of wine sitting on my couch watching the next episode on Netflix with Tony. That is pretty much a constant and when I’m stuck smack dab in the middle of the weeds wishing whatever horribly stressful event to be over with, I will stop, go into my mind and imagine sipping that glass of wine thinking about how all of those stressors are behind me. When I can picture myself being done with the stress, I can calm down and muggle through it.
Exercise is always good – you can’t worry about piddly little things when you’re gasping for air!
Find a friend or therapist. Believe it or not, voicing your concerns and even crazy paranoias can release them. Sometimes you just need someone to listen (not necessarily give advice – guys) and tell you you’re not crazy (unless you are – then they may call the police =D) and sympathize with you. Sometimes, even though it’s super hard, actually talking about your issues with the person who is bothering you (esp if family or close friends) clears the air and you both find out you were worried about completely different things.
Try seeing the positives in whatever situation you’re in. Horrible client, but super cute dog? Focus on the fluffy fur. Can’t figure out a case and have never seen anything like this to even know where to start? Try to think “even though this is super painful and stressful and I want to crawl in a corner, after it’s all said and done, I will have learned something new and can apply it next time” – hard times lead to broader knowledge.
Stressful days suck, sometimes they pile up for a bad week or month, but if you can stay strong and keep yourself as an example to others, then the general atmosphere of your workplace, home, community will have a brighter outlook. And when you make others brighter, you will feel brighter and will have a more solid ground to keep yourself going. Everything will pass, eventually. As my favorite quote says “Do your best and leave the rest, for it will all come right one day or night” – Black Beauty, Anna Sewell.
Vet Medicine: the greatest career on Earth
So, you read about all my whining and complaining in the last blog. Being a vet is TOUGH. Understanding that you can treat an animal without having the exact diagnosis and without choosing the same treatment as any other vet (there will never be full consensus on treatments for any disease, ever) takes a long time of feeling like a failure, staying up nights worrying that you didn’t treat something right, wondering if you should have gone with the high dose, short therapy or the lower dose long therapy. Are you causing antibiotic resistance? If you don’t send an antibiotic home, will the owners hate you? Will you get a bad review because, even though you spent hours researching and worrying, the animal didn’t get better, or another vet threw you under the bus? So, why even try? Why enter this field?
Because it’s FREAKING AMAZING!! That’s why!
Reasons it’s FA (freaking amazing): The animals, obviously. Granted, you LOVE animals, but must accept that they hate you. You must just understand that you’re doing it for your love for them, and not to win their love (though I handily try with multiple treats and a slow approach). It’s much like being a mom or a religious leader. You care for and are responsible for others, but they might not like what you have to say or do. Occasionally you get the adorable puppy/kitten, but sometimes you have to deal with the jack-wad pet. If you are companion animal, most of your patients will be middle to older aged animals with skin, ear, endocrine issues. If you are large animal, most will be reproductive, preventative health, and emergency. Most of the animals are happy with you anyway, especially if you keep pushing the treats.
The SCIENCE – if you love science and seeing things work like you read about, you will love vet med. It doesn’t always work out, but when it does, it feels MAGICAL – and it works out most of the time. You get a rush of dopamine (this is not proven, just theorized) when you hear back from a patient you’d been working on and hear that they’re SO much better! Even when it’s just an older dog with probable arthritis and the owner didn’t think it was pain but was willing to do a trial of pain meds. They call back and go on and on about how much like a puppy their old Bella has become. It makes my insides smile.
You can FIX things! Sometimes this feeling is amazing! Female intact dog walks in, sick as, well, a dog, you find it’s a pyometra (uterus is huge and full of pus). The dog looks like death, but with a 30 minute surgery (spay), the dog is back to almost 100% overnight! Laceration repair can be tedious, but is like creating a work of art. Indoor/outdoor cat comes in with a swelling and a fever – cat bite abscess – super rewarding to drain the abscess and the cat is back to normal by the next day. There’s nothing like the feeling “hey, your animal has this problem, but don’t worry, I’ll fix it!” The feeling only gets super frustrating when the owner chooses not to treat for one reason or another (finances, chronic issues that require multiple rechecks, long-term medication). Then, this leaves you totally frustrated – “but I can fix it…”
Learning all the time. You may think this sounds tedious and awful, but it’s not. Again, learning something new that you can immediately apply to a case, whether it’s researching for a current case and finding an actual answer or going to continuing education conferences and learning a new fabulous (and low cost) new treatment regimen, actually gives you a rush. As a vet you are (or should be) CONSTANTLY learning, researching, RE-learning and it’s actually fun. There are always new things to learn and ways to check your pride and try a different methods and while you’ll find yourself frustrated in the moment, and may take awhile to institute the change, you’ll be elated when it all falls into place. Because – science.
The clients! (okay, there are some sour lemons, but with the current demand for vets and long waiting list to get an appointment, we have the luxury to “rehome” clients who are naughty) Are you a people pleaser? Do you get a physical giddy sensation when you make someone happy? Vet med *can be* for YOU! For the most part, clients are extremely polite, understanding, and grateful for what you do. I think it helped my client communication skills to be a large animal vet for awhile. When you’re stuck standing over a newly gelded colt, waiting for him to get up, you learn how to chat with people and not feel awkward. Depending on the client’s attitude toward me (the more positive, they more they get), I will go to all sorts of lengths to make sure they and their animal are getting free samples, internet sources, brochures, under the table treatments (slip in a free nail trim), etc. If a client is cold and dismissive, they will get what they ask for and that is it.
Then there’s the not so obvious perks to being a vet; Comradery – Everyone in the vet world is stressed and many take it out with a twisted sense of humor. When you find the right clinic, it’s like getting together with your friends every day – joking, griping together, getting excited over gross things, inappropriate humor. Everyone working in your field (or at least the vast majority) love animals and share the common goal to help people and their animals. I’m sure there are others, but how many other work places do you have where everyone in the company has the same interest? Want to talk about your cat’s cute way she chirps to you? So does your co-worker!
Something for everyone. You like working with your hands? Large animal is perfect for you, prefer indoors with more meticulous skill? Surgery is for you! Like both? Do both!! Don’t like working with your hands? Medicine. Pathology. Teaching. Like people? General or referral practice. Don’t like people? Pathology, lab animal medicine. Want to practice medicine everyday, great! Don’t? Government work! Like people, but only your kind, and not general public? Become a drug representative, traveling to clinics telling them about all the new products coming out! Want to work all day everyday, and be on call – don’t worry, there’s plenty for you! Only want to work 3 days a week? Pick up relief shifts! Night owl? Work emergency overnight shifts. ***These examples are all highly generalized, and I’m 100% sure vets working in all of these fields will have something to say, but my point is there’s a job out there for anyone with a Veterinary degree, don’t just envision working at a clinic***
So, you want to be a vet?
I was driving to work yesterday morning, feeling COMPLETELY miserable. Flu-like symptoms, my body ached like it had been beaten and rolled down a hill. I was freezing, then two seconds later, sweating. My head was pounding and I had a very painful baseball sized lymph node under my right armpit. Don’t worry, though, I wasn’t going to spread a horrible sickness among co-workers (this time), but instead, I had gotten vaccinated two days prior – my third COVID-19 vaccine (a booster) and it hit me like a truck. I kept thinking to myself “Ugh! I just want to go home. This is going to be a long day. I can’t call in sick though because I already have a completely full schedule and can’t just leave my co-workers to take all of my cases.” Such is the life of a vet. Don’t worry, there’s awesome parts too (just not in this blog).
Training to be a vet is sort of like boot camp for a marine (but not at all the same). Once you enter vet school, they start the mental and physical conditioning. Not only is there no rest for the weary, but if you’re weary, there’s extra work. They start with a grueling schedule of 8 hours of advanced science/medicine classes per day – 8am-5pm, then expect you to go home and review the material (they approximate an hour per hour of class). Then, the testing starts. This means studying night after late night into the early morning, internally debating whether more review or sleep will be better for you (psst! Get the sleep). One professor described the onslaught of information vs retention as throwing a giant pile of horse crap at a wall and hoping some of it sticks.
After three and a half years of dragging your brain across a cactus field, the clinical rotations start. Vet school clinicians (drill sergeants) are notoriously miserable themselves, and therefore, feel the need to make sure everyone else is also miserable. I can’t blame them, necessarily, they are dealing with the hardest cases (most animals don’t come to the vet school unless there’s a super complicated issue that a general practitioner can’t deal with), they are doing it on very little income, and they are having to “babysit” over eager students who, despite having studied for 3.5 years, don’t know squat. **side note: some of the senior clinician are absolute SAINTS – made to teach AND a master of their field. And some are literally trying to drag you down to hell with their miserable selves – none shall be pictured.**
While a student, you are expected not to complain about not sleeping because someone always has to comment how they’ve been up for 32 hours straight (to which I guess you are supposed to bow down to that person?). You are expected not to complain about being hungry – you may, I don’t know, end up eating some horse or dog food because you are so hungry and it doesn’t look too bad when you’re holding a horse for the 90th hour and haven’t been allowed to move. You are not to use the bathroom while people are around – thou shalt not flaunt your excessive time allotment by urinating when others cannot.
You are expected to show up NO MATTER WHAT is going on. Snow storm? In Georgia, where snow plows are a thing of fairy tales? Better start hiking or you won’t hear the end of it when you finally manage to drag yourself (and wreckage of a car) into the hospital. Have the flu? Might as well resign vet school before calling in. I mean, technically, they’ll have to allow you to stay home, but you may be excommunicated for showing an ounce of self care. Also, you’d be so much cooler if you just took some ibuprofen and pushed on. Vomiting? Just bring a bucket and you can empty it during your bathroom breaks which don’t exist. Pregnant? Just get out. (There were actually a few classmates who were brave enough to have kids during vet school and they are all amazing women and vets to this day).
You made it to graduation, yay!! You somehow also survived the SIX HOUR test you have to take to apply for a license. Some will go on to start their career, while some will choose to get internships with the idea that this will ease them better into the work field (because when you graduate, despite the physical and mental torture and water boarding of information, you still know nothing, but are happy to be alive). Some internships are AMAZING (I’ve been told), but some are just a way to get you to do the crap work, while getting crapped on (pun intended), further breaking you down (because now it’s about breaking your soul) all with the exciting wage of $25,000/year – with the ($100K+ with 6-12% interest) student loans lapping at your heels.
You can then, enter a residency if you choose to be specialized in a certain discipline (surgery, medicine, oncology, ophthalmology, etc) – typically you will need to be at the top of your class (I was NOT) and even more into self torture than most. This option is three years of more intensity than anything previously experienced, with, again, little pay – but from what I’ve heard, you won’t need the money anyway – sleep at the hospital, never eat, etc.
Finally, it’s time to start your career. Due to the mental, physical, and spiritual beating you have endured, you’re perfectly happy and, in fact, eternally grateful for your first job offer. $42,000/yr? YES!! That’s almost twice as much as you were making as an intern, living on literal beans and rice!! You’re going to be rich!! (you might even be able to add some CHEESE to your beans and rice). From here, it may be a good 2-3 years before you don’t think you’ve made a huge mistake and that you’re a failure and imposter, and then 7-10 years before you realize your worth – as a vet, but mostly as a person.
So, now, you’re finally comfortable in your own skin, you work hard, contribute your all, but also expect respect from your boss, co-workers, and, especially, clients. Finally, it’s time to start realizing what there is to love about veterinary medicine. *See next blog*
5 ridiculously easy ways to avoid pet emergencies and BIG bills that your vet doesn’t want you to know… oh, wait.
***Warning: graphic content – pictures depicting emergencies discussed will be held until the end of the blog***
If you haven’t heard or experienced it, here in the US, we are having an onslaught of new patients and cases in veterinary medicine and people are experiencing extremely long wait times or even being rejected from places because there is simply no room/time to see the animals. I work at a general practice full time, and pick up emergency shifts at the local ER, as well as have access to tens of thousands of other vets’ perspectives on my groups on Facebook. One night, when I got to my shift at the ER – after working a full day at my regular job – by 6pm, I was pickup up cases that had been waiting since noon. In the first hour that I was there, FIFTEEN more cases showed up. We were telling people that wait times could be 8-12 hours! There were only three doctors there with one about to clock out. There were also very few assistants/techs to help us – I counted 5 total – 2 techs, 3 assistants and two of those had to come in on their day off.
This was absolutely insane! How could they mess up this scheduling? How could they be so careless with hiring staff that we get to this point?? In frustration, I finally asked someone what on earth was going on?? That’s when they informed me that everyone was getting so burned out that they were all quitting. They were also having trouble hiring anyone because of the workload and hours. This COVID pandemic has somehow increased pet ownership exponentially and, in doing so, has run the vet industry ragged. That is a whole other discussion, but today, I want to talk about the most common “emergencies” we see and explain how to avoid them so that you are not only not having to wait at the ER for 8 hours to spend $1500, but you are also not taking up staff and doctors’ time when they could be seeing other emergencies that were not so avoidable.
- Spay/neuter you dog (unless you are a very careful and meticulous breeder)before the age of 12 months.
- Pyometra – during heat cycles, female dogs can produce a lot of mucus in their uterus, then, when they don’t get bred and go quiet for the next 6 months. If ANY bacteria gets introduced into the system (including bacteria swimming up the blood trail from their heat) this excess fluid/mucus accumulation provides an optimum breeding ground for that bacteria. As most cervixes close up tight after the heat cycle, this can lead to a sealed sack of purulent material (Pus) and infection. This causes the dog to get VERY sick and can lead to systemic infection and/or death if not treated immediately. Surgery being the treatment of choice, there is WAY more risk to this spay than a routine spay as typically the dogs are dehydrated, toxic, feverish, some can be septic, and then when you get into surgery some of these uteruses literally look like a giant summer sausage in the abdomen – just hugely distended with pus – and if any of that pus escapes during surgery or is already leaking, the dog’s chances of survival will fall even more and much more expensive aftercare will be needed. Literally any non-spayed female dog on the schedule that is sick, lethargic, or vomiting is assumed to be a pyometra until proven otherwise. – Cost of routine spay (depending on town) – $150-500 Cost of emergency pyometra surgery – $800-$5000
- Dystocia – So you thought Princess Fiona was the perfect dog and you just wanted one litter from her to show your kids the miracle of life – or , like others on the Doodle mania wagon, you thought you’d make some cash by slapping a cute “breed” name along with a hefty price tag on the puppies. When the time comes, she has two healthy, beautiful puppies and then nothing for 7 hours. You didn’t have her radiographed to do a puppy count whether out of ignorance or to save money, so you have no idea how many she’s supposed to have, but she still looks pregnant. You decide to take her into the emergency clinic. Now, you find out there’s 5 more puppies and she needs emergency C-section, and the 5 remaining puppies are dead. Estimated profits before the C-section at $1500/puppy – $10,500. Profits after emergency surgery and spay because most places give you a discount to spay at the same time: $-2000.
- Conclusion: if you absolutely insist on puppies, get patient checked by a vet before her due date – ensure the puppies are alive, and get an estimated count. Save money and prepare for a C-section just in case. Don’t breed for profit – you’re not helping the breed become better. Evaluate your breeding stock before you breed to check for genetic diseases. Good breeders will tell you they don’t make much money (if any) breeding dogs – they do it to better the breed and ensure physically and mentally healthy animals.
- Neuter – okay, this doesn’t necessarily cause too many emergencies.. as long as the dog is kept in a fence. Intact males will wander if they smell a bitch in heat and can get into all sorts of other trouble as discussed next.
- Keep. Your. Dog. In. A. Fence! (or otherwise contained)
- HBC – vet lingo for hit by car – could be anything from some bruising to instant death and everywhere in between. Broken bones (legs, ribs, spine), internal bleeding – come to us coughing up blood, abdomen full of blood, ruptured diaphragm – abdominal organs floating around in the chest.
- Dog/animal attacks – your dog wanders, gets into fights or gets attacked by other animals – I’ve literally had to sew a dog’s throat back together.
- Gunshots – dogs wander into a hunter’s territory, chases away their deer, gets shot. Dog goes onto a farm, chases some sheep/goats/other livestock (it is completely legal and encouraged in most states to shoot a dog chasing livestock). Dog goes onto someone else’s property even, if someone feels threatened or is just a jerk, shoots your dog.
- Diarrhea/vomiting/foreign bodies – you swear your dog couldn’t have gotten into anything because you keep your trash locked up, but the dog is not in an enclosure. So, they could have wandered to find a rotting carcass, someone else’s trash, compost pile, animal feces, discarded drugs, rat poison, antifreeze, etc.
- Traps – I have seen dogs and cats get lost and when they are finally found, their leg is crushed or strangulated, and rotting in a small game trap.
- Porcupine quills – yes, it’s possible for a porcupine to wander into your yard, especially if you have invisible fencing, but it’s far more likely that your dog (or cat) wandered into the woods and found this prickly friend.
- Vaccinate your animals –
- Parvo is a horrible virus that attacks the small intestines, stripping tissue off and causing horrible bloody diarrhea and vomiting and is 100% preventable with vaccines. And yet we see numerous puppies a year that need to be hospitalized and can take 5-10 days to fully recover – if they recover. They will be hooked up to IV fluids and medications while we try to get on top of their intestines melting and prevent infection traveling to all the organs and causing a horrible septic death – all because vaccines were too expensive or inconvenient, or whatever ridiculous reason we are given. And we have all seen numerous parvo cases where the owner bought vaccine at a farm supply store. Just go to the vet. Just do it. Vaccine $30 (with 1-3 boosters depending on age of presentation) Parvo treatment $1000-5000 depending on length of stay
- Distemper – more rare now, but severe neurologic (can’t walk, breathe, etc) symptoms – very rarely recover.
- Lyme – very big in parts of the country and getting worse – mostly tired acting sore/painful animals, but sometimes they go into kidney failure – grave prognosis
- Lepto – a bacteria spread by urine from other animals – your pet picks it up from drinking from water on the ground – rivers/lakes/streams/puddles. Causes severe renal and liver failure – poor prognosis.
- Rabies – 100% FATAL!! and 100% preventable. That is all.
- Look at/touch your animals occasionally. No, you are not a vet, but you can certainly keep track of something not looking right about your pet before it gets to the point of a 1am emergency. I can’t tell you how many “this 7lb tumor just grew over night and is now open and bleeding” or “I don’t know how his collar got embedded 2 inches into his neck” or “we just noticed his ear melting off his head” etc.
- Get established at a veterinary office – so many ER clients end up there because they have a semi-urgent problem, but they don’t have a primary DVM so they are stuck going to pay for a $1000 visit (usually they decide to do this at 9:30pm for some ungodly reason).
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Kidercise!!
No time to workout? Conventual exercises too boring? We have the workout video for you!!
We hope you enjoyed the video. And, as always, thanks for watching!!
Movie Magic – Life on a Reality TV Show
I know Tony has done a post about working with the film crew, but I was just remembering some fun antics and thought you guys might want to read a little about what it was like to work on a reality show.
The film crew was fantastic! They loved their jobs, loved the long term nature of the show (most of their life had been going from one gig to the next), and loved working on a “real” reality show. I got to hear stories of some of them working for other shows where it was encouraged to set up disagreements or fights to get more viewership. Despite the long-term nature of the show, however, it still seemed as though we would make friends with them, then they would be let go and new ones would be hired. That was not my business, but still sad to see good friends go.
One bit of “movie magic” was the episode that was supposed to be my first day on the job. This was certainly NOT my first day, it was just a day they picked a few weeks into my employment to pretend that it was the first day. I had to pull into the parking lot several times, get out of my car and walk to the clinic a few times, all while clients were there, wondering what on earth I was doing. It was, frankly, embarrassing, but the best part was when I was introduced to the office and Charles greets me to show me around. The first clip done, he comes up to me, all excited acting and says “alright, so just go ahead and take off all of your clothes and I’ll show you around.” We had to re-shoot that one after all of us fell out laughing.
Early on, they got an idea to make a character out of me. They tried at first to get me to fully embrace my southern roots and the producer, Jon, asked me if I could say things with more of a southern drawl and more stereotypically southern phrasing like “I was happier than a pig in shit!” I flatly said no. I understood the risks that were going to come with putting my professional skills on national television to be assessed and critiqued by vets all over the world, I was not about to make a caricature of myself.
When they found out I was pregnant shortly after I arrived, they decided to make it their center of every thing that I did. I would do a case and get asked the question “Are you afraid this could hurt your pregnancy” or “Weren’t you worried about your baby while doing this”? I was very patient (I think) for a very long time, but after becoming more friends with them, having a late night emergency with them involving maggots, and getting the ridiculous question asked for the 97th time that day “Are you afraid that the maggots are going to affect you or the baby and why?” My smart-ellic side came out and I got very quiet and serious, looked dead into the camera and said “yes, actually, there’s a condition where the maggots will burrow in through your belly button and infect the baby, which then pupates and eventually bursts from your abdomen and eats everyone”. The field producer just said “Cut” and we were done. I apologized for my antics, but he said that he was also tired of the questions from DC (headquarters).
One thing you will get tired of with cameras following you around all the time is definitely cameras following you around all the time. It was one thing when they were there for the cases you were seeing, but sometimes, you just wanted to research a case in a book or online or even just stare into space without having to worry about being filmed. One of the times I rebelled against the cameraman filming me do EVERYTHING ended up being a pretty good clip. I was hungry and trying to eat without having to worry about smacking or crumbs on my face in front of national TV, but Mikus, a very good friend, but also stuck to a camera would not leave me alone, so I intentionally went over, grabbed an obscenely large handful of animal crackers and ate them as sloppily and ridiculously as I could. I don’t actually think Dr. Pol was there watching, I’m pretty sure that was just an edited-in clip.
Everyone had to be mic’ed (microphone attached to them) before a scene could begin. Sometimes, if I arrived too early to an emergency or a farm call, the crew would ask me to wait in the driveway so they could get to the client and get a microphone on them before I arrived or you wouldn’t be able to hear what was said. This always gets me in reality shows when they are going to “surprise” someone, but when they get there, the surprised person is already Mic’ed up and ready to go.
There were also numerous… upon NUMEROUS times where I was asked to re-enter a room or driveway so they could get different angles, or get the jeep going through a large puddle just so. The best was when it was after a farm call and doing multiple shots of the same scene was keeping me from returning to work. The worst were when I entered a room and gave bad news but the crew wasn’t ready for it and asked me to give bad news again – to real people about real medical issues with their pets.
The interviews you see with the doctor on a chair with a barn scene background were all filmed in the garage at the clinic with a projector putting up the image that you see behind us. This was the time that the field producers would ask us questions about the cases they shot with us. There would be a multitude of cases all piled up on one day for us to remember. They would be like “you remember Buddy, the beagle?” No. Then, they would have to show me the transcript of what was done and said, sometimes weeks before the interview. Sometimes I would be like “Oh, yeah, of course I remember Buddy!” and sometimes we would go over the entire transcript and I would just say “Whatever, it was a pyoderma, I’ll just answer general questions about pyoderma”. It was interesting though, the producers definitely wanted a certain answer from you and so they would word questions to get you to answer like they wanted. It was a dance; sometimes we were in sync, sometimes I just said “just tell me what you want me to say!” when I was really tired.
Working on a TV show has certainly changed by perception of watching any “reality” show. Now, Tony and I will watch one and chide back and forth about what questions the producers asked to get that specific answer from a character or how they may have trimmed the clip to make it look like someone was angry with someone else when maybe they were just bored and sighed, but the clip was then inserted as a reaction to someone else.
Overall, I had a blast working with the film crew. I got to know most of them and even became good friends with some of them. They came from all over and had all different stories. Some were local, some were from Los Angeles, or even the Virgin Islands. Some were party happy in their early 20s, some were older family men. Some were a shoulder to cry on or an ear to complain to, some took me under their wing and helped me along. All of them were fantastic people and I miss them dearly and hope nothing but the best for every single one of them.
*** Disclaimer – all the medical things you see on the show were real – patients, clients, problems. ***
Goodbye to Merlin (Merman, Schmermles, Myrtle, Schmermilator) and I love you
I never in my life thought about owning a Saint Bernard. They just weren’t on my radar, just like Michigan was never there for me to live.
One day, while working at my first job in South Carolina, a local dairy farmer brought in a new born puppy. She owned a dairy and had a very small Saint Bernard breeding kennel on the side. Her bitch had just whelped and had killed all but two of the puppies and had mangled one of those puppies’ back legs. At first, it appeared as just a puncture on the out side of the hind leg. We cleaned it and sent home antibiotics.
The next day, the farmer brought the puppy back in. The leg wound was now bigger, draining pus, and the foot was stiff and cold. We gave the puppy a guarded to poor prognosis with infection set in and a dead leg in a newborn, frail baby. The farmer, with all of her responsibilities as a dairy woman, did not have the time to dedicate to this sickly puppy. She decided it would be best for him to euthanize as he was not getting better.
I looked down at this beautiful, perfect except for a mangled rear leg, and could not picture myself sticking his tiny heart with a needle and then tossing him in the freezer where we kept dead animals. Now, at this point, I was just exiting my first trimester of my very first pregnancy (with India). We had just moved to this town, not 5 months ago, we were renting, and already had 2 dogs, 2 cats, and 2 horses. I was absolutely not in the right place to even think about taking on a new dog, let alone one that would need intensive care for 5 weeks and would grow to over 100lb. I talked it over with my best friend working there with me, Kim, and she encouraged me to take on this (currently) 1lb project.
I talked to the farmer about surrendering him and letting us try to amputate the leg and save him. She was in tears. She was a tough woman, running a dairy farm, but she had a fantastic heart. She was so upset that she was going to put him to sleep, but was thankful that we would at least give him a chance. I had him signed over and was now the owner of a very sickly infant St. Bernard. What had I done? What was Tony going to say when I came home? I knew he would understand. He knows who he married, but he would likely shake his head a little.
I brought him home, honestly under the impression that even if he survived to, and then through surgery, that he would likely die sometime after from infection, or fading puppy syndrome. I had 0-0.5 hope of his survival (#naturalpessimist), but I had to try.
The next day, we were to do the surgery. I had to meet my boss at a dairy to continue to learn how to efficiently palpate cattle for pregnancy. I went over and over the surgery in my head. Finally, we were done palpating cows and I would drive to the clinic to cut on this three day old puppy. We put him under with just some valium and then masked with gas. There were three people gathered around this 1 lb patient. Kim, our assistant, the other Dr. at the clinic running/monitoring anesthesia, and me, carving on what felt like a chicken wing from KFC. I dissected down to the femur, at some point severing the femoral artery that was so small, it never bled. I used a heavy pair of surgical scissors called Mayo scissors to score a shallow cut around the bone, like a glass cutter, then the bone broke easily in half.
I, then filed the end of the bone so it wouldn’t be rough on the muscles, closed the muscles around the tip of the bone, and finally, closed the skin over the muscle. Whew! We were done! We took him off of gas, and put him on oxygen only and waited for him to wake up. And we waited. And waited. He wasn’t waking up. That’s it, I knew this was stupid, but at least we tried, right? Then, the doctor helping me got some injectable dextrose and just put a couple of drops in his mouth. He woke up! Thankfully, she was able to keep her calm and remembered that neonatal patients will get hypoglycemic under anesthesia.
We took the puppy home, now named “Doomed puppy” because of my pessimism and superstition all rolled into one. We had to bottle feed him. The little bottle that came with the formula had a nipple that was way too small for his mouth. We ended up having to get a soda bottle and put the smallest goat nipple we could find on it. We also had to stimulate him to pee and poop until he was a certain age. He slept in a cardboard box on a heating pad in our bathroom for the first few days of his life and came with me everyday to work. We had to set alarms to get up every few hours to feed him.
One weekend we were travelling back to Georgia to announce my pregnancy to the families. We would take our dogs with us when we travelled and had the two big dogs in the backseat with the box of puppy in the back as well. He was about 2lbs at this point. Along the way, we stopped at Subway to get dinner but didn’t want to leave the puppy in the car alone with the two dog aggressive dogs, so I picked him up and placed him in an inside pocket in my coat and carried him inside. The workers there never knew I had a Saint Bernard in my coat pocket.
Eventually, we settled on a name “Merlin” and he continued to live in our bathroom, he particularly loved the bath tub. Every night, when it was bed time, he would just shuffle into the bathroom and lop himself into the bathtub to sleep. Having only had three legs his whole life, we always just figured that he would have no trouble learning to walk with three legs. Just like four-legged dogs who get an amputation later in life seem to do just fine, and to “not miss a step,” we thought that he would have even less trouble learning the ways. We were wrong.
Having basically been born with just the three legs and having never learned to walk properly, he would just scramble. He would pull his body along with his front legs and kind of paddle with his one hind leg. Thanks to the advice from my friend, Kim, we sought a Veterinary specialist in rehabilitation in Columbia, SC. She was able to make some chiropractic adjustments, and fit him for a cart for us to borrow. He hated that cart. We would harness him up and he would freak out and run around the room, getting caught on furniture and knocking over everything. We were finally able to harness him up and take him on walks in the neighborhood. It took a lot of practice, and he grew quickly and eventually had to return the cart, but by then, he had learned better how to get up on that back leg.
He eventually got along on that back leg like it was nothing. We couldn’t take him on long hikes and I could only take him on a 1 mile “warm up walk” before my run so that he got to feel like he was part of the pack too, but he also loved to play tug-of-war – which is typically not recommended for pets because it can make them think everything is a game when you’re trying to take things from them – but this was his main method of exercising, and I could just tell him to drop it and it was over.
He loved vegetables, fruit, tissues, and baby socks. He would wait in the kitchen while I cooked, waiting eagerly for kale stems, carrot ends, strawberry leaves; would follow the kids around or sit next to me while strings of drool hung at his lips if we dared to eat an apple around him. He EXPECTED the core. He would run outside and help the horses eat watermelon rinds or try to find the scattered sweet potato skins I had just thrown out for the deer. If you left a paper towel or tissue within reach, he would stalk it because he knew he would get into trouble for eating it and the moment we weren’t paying attention, he would suck that thing down like it was a piece of cotton candy. Even when the kids were babies and we were in a complete state of chaos, if we forgot to close the baby wipes when we were done, you would catch him sucking each one down as it pulled up the next – like his own tissue Pez dispenser. His love of baby/kids socks got him in trouble too. We would constantly have to go out and buy more to make up for his dietary needs. Our kids were so trained not to leave their socks on the floor downstairs that if we went and visited another person’s house, our kids would come up to us and ask us where they could safely put their socks. Between the tissue diet and socks he consumed, once spring rolled around and we mowed the lawn for the first time the mower would spray our yard with confetti of tissue pieces and colorful sock remnants.
As Merlin got older, he would go through phases where he couldn’t walk as well anymore. Most of the time, he responded to pain medication, time, or a chiropractor adjustment. I took an x-ray of his hips to see the horror that I was afraid of. His only hind leg he had was suffering from horrible hip dysplasia. I knew, even though we were very diligent about keeping his weight down, at 120lb, it was still only a matter of time before he completely tore his cruciate ligaments in his only knee and then it would be done. He was definitely MY dog. Tony would tell me that if I wasn’t home, Merlin would just lay in the corner of the dining room all day, not moving even to go outside. He did NOT appreciate the kids and as he got older, he only became more cranky with them, especially when they got crazy silly.
This past fall, he started having trouble walking again. We knew, at almost 9 years old, anytime could be his last. He was no longer getting up on his back leg anymore and would just scramble along the wooden floors. We would assist him outside and, at first, he would get up on the leg to go to the bathroom. We had him on three different pain medications, joint supplements he had been on his whole life plus a few more, got him some fancy Dr. Buzby’s toe grips, a Help ’em up harness, but still he dragged that stump around. Eventually, he stopped eating as much and the stump became raw and bloody. We had smears of bloody trails across our floors where he had needed to be with me. I altered his harness to pad the stump, but it wouldn’t stay where it needed to. I brought home an “After surgery wear” from work and altered that to pad his stump. That seemed to work better.
I had been avoiding it. I was in denial. When he would use every last bit of energy in his painful body to get to where ever I was in the house, I just knew he depended on me, how could I let him down? But finally, I stayed outside to watch him go to the bathroom, because now he was soaking his after-surgery wear every time he peed. To my horror, and with tears running down my face, I saw him drag himself to a spot and just sit and pee all over himself. Then, he dragged himself to another spot and pooped while sitting, only swinging his rear away to keep the poop from sticking to him. I knew it was time.
The final day, he was so excited to get to go in the car with us, as that was a rare occurrence for him. We were feeding him Milkbones like he was starving and he just thought that was the best. My mother even met us at the clinic and brought him a porkchop wrapped in a paper towel. He chomped that down too, paper towel and all. He was just having the best day! Of course, it took me and Tony to get him out of the car and into the clinic to our euthanasia room. He required a sling to hold his hind end up. But he just dragged us in, found the few people working after-hours, his tail just flagging like the happiest pup. We finally got him to the euth room and he stumbled and collapsed on the floor. Tired, from all his happiness. I gave him the sedation, then cuddled his giant bear head in my lap as the final injection was given. He was only 3 days old when I decided it wasn’t his time to go to the freezer and even though I had given him 3,200 more days of pure love, it still felt like I had abandoned him as we gently lowered his body, finally, into the freezer.
Bye buddy.
First Snow of the Year!!
We’ve had our first good snow of the year, and the Thomas family made the most out of it!! Hope you enjoy the video