pet care - This Little Light

July 27, 2020July 27, 2020

What’s coming into the clinic?

I’ve decided to compile a collection of expected diagnosis based solely on judging a book by its cover. Basically, what we, as vets see coming in and go ahead and make large assumptions (normally we assume the worst or most obnoxious). So, here are some presentations and the expected problem.

Basset hound/Cocker spaniels: Ears. Always ears. Even if they’re just coming in for a rabies vaccine only and refuse to pay an exam fee, they will want you to check out their ears…. and a nail trim.

Red/white/blue pit bull: skin – allergies and or mange. Dilute colors = skin issues – also nail trim.

Labrador (any age, any color) not eating/vomiting – foreign body – ate toy, golf balls, raw hides, rocks, dry wall, socks, underwear, etc.

Any female dog over the age of 1 year and not spayed – WILL ALWAYS BE PYOMETRA until proven otherwise – and owner will give you a guilt trip about the expense of the emergency surgery “So you’re just going to let my dog die then?!?” even though you told them from the beginning to get the dog spayed “No, sir, I did not tell you to NOT spay your dog” (avoid a $800-$4000 emergency bill)

Puppy (any breed) under 1 year of age presenting with diarrhea, inappetence, and/or vomiting: Parvo until proven otherwise.

English bulldog: this one is wide open but can include some or all of the following: skin issues – (allergies, hair loss, ear infections, skin infections), respiratory failure due to nonexistent nostrils, too long of a soft palate, heart failure, or obesity. Inability to use hind end due to hemivertebrae, spinal bifida, obesity. Eye issues due to entropion (eyelid curling inward causing eyelashes to scrape the eye), cherry eye (gland of third eyelid popping out), dry eye (eye is dry.. and covered in thick green mucus and crust). Infection of skin around butt hole due to tail corkscrewing around and stabbing them in their own butt, also obesity. C-section: they literally cannot have puppies naturally due to large heads, small pelvis, and, well, often obesity (most also have to be artificially inseminated due to their poor conformation). *** hint – if you want an english bulldog, go ahead and save for $1500-2500 PER year in vet bills.

Old chihuahua/toy poodle – coughing – heart failure – will want nail trim – dog will turn blue trying to bite us

Young chihuahua/toy poodle – broken leg from getting sneezed on

Great Dane – vomiting/retching/bloated – GDV or twisted stomach bloated. Get to the emergency clinic NOW – the stomach is likely dying as you drive.

Cat (outdoor) swollen leg/lump/lethargic – cat bite abscess – sometimes caused by just a friendly cat fight gone wrong, but much more often by a neighborhood Tom – they will try to breed anything with a cat shape – male, female, spayed, neutered, it doesn’t matter and the fights that ensue end up with someone getting a serious bite wound. Cats have a particularly nasty bacteria in their mouth similar to the bacteria in a komodo dragon’s mouth and the bite wound will fester and cause fever, lethargy, limping until it breaks open and drains. Antibiotics are very helpful.

Male cat – vocalizing in the litterbox/posturing to urinate, but nothing or very little coming out – blocked urethra – right now emergency! Don’t wait until morning. The urine backs up to the kidneys and causes serious, sometimes irreparable damage.

Same thing goes for castrated, male goats – looks like stretching, urine dribbling, loud vocalization, sometimes looks like constipated – it’s not constipated – get to vet immediately! Some studies have shown that if you wait to castrate until 6 months of age and avoid feeding grain altogether, you can avoid this fatal issue.

Older Dachshund/chihuahua/other tiny breed dogs: “trench mouth” – the teeth are rotting out of mouth – will also want a nail trim.

Dachshund of any age, unable to walk/stumbling: Intervertebral disk disease – the same gene that makes them short legged and long backed also makes their connective tissue crap and they will often “slip a disk” and without surgery +/- major anti-inflammatories, will be paralyzed – will definitely request a nail trim.

Coughing dog anywhere in the southeast – Heartworm until proven otherwise

Dog constipated: diarrhea – almost every time. Diarrhea causes straining, straining looks like constipation. Most owners, including myself don’t necessarily pay attention to their dog every time they go out, but will notice when the dog is going out all the time and straining.

Dog stares off into space, stumbles, or collapses when not walking, urinated on self – marijuana – just admit it and save us all a big “told you so” and, like, $400 in diagnostics. We won’t call the cops.

Any animal with the history of “I think my neighbor poisoned him” = anything except poisoning by the neighbor – just doesn’t happen.

Lump on boxer : mast cell tumor until proven otherwise

Dog with episodes of choking or “something stuck in throat” – allergies with reverse sneezing or kennel cough

Dog with lameness/stiffness/lethargy in certain areas of the country: lyme disease until proven otherwise

Small breed dog with hind limb lameness: luxating patella (knee cap slipping out of place)

Large breed dog with sudden hind limb lameness: ruptured cruciate ligament (like the ACL tear in athletes)

Goldens: especially the super sweet ones that belong to a special needs child: Cancer. Every F***ing time.

German Shepherd: will rush the door viciously barking as soon as you open the exam room door. Everyone in the clinic will hear and will assume you saw the shepherd. Will not let you touch it the whole time without heavy restraint, muzzle, sedation. Absolutely will request nail trim.

Cat with scabs all over body: fleas/flea allergy (even one bite from a flea can trigger the allergy in some cats)

Obese draft/quarter horse/donkey/pony that is stiff, doesn’t want to walk: founder/laminitis

Anything that is scratching and not on veterinary prescribed flea meds: fleas. Always fleas. Especially if the owner preaches essential oils and says there are absolutely not fleas and uses a natural remedy for flea control – fleas all day.

Cat with significant weight loss: and drinking a lot/not eating: kidney failure. Eating a ton/personality change: hyperthyroidism

Anything named “Lucky” or “Miracle” = doomed.

Anything named “Angel” will bite, unprovoked – owner will definitely want a nail trim.

Again, these are things vets just assume when they see it on the schedule. It doesn’t mean every patient every time and we all certainly go into the exam room with an open mind.

January 19, 2020January 20, 2020

How to Lose Your Large Animal Vet in 3, 2…..

I hear the statement all the time: “Nobody wants to be a large animal vet anymore! They all just want to work 9-5 and sit in an office.” Having been a large animal vet myself and having access to thousands of vet moms online, I have heard all the reasons for leaving and they’re all about the same. Are we lazy and just don’t like getting dirty? No! We love throwing on muck boots and being armpit deep in a cow (as odd as that sounds). Is it because we don’t like the odd hours of on call? Sometimes, but with enough vets to share the call and with responsible owners, it’s really not that bad – and, no, we don’t mind getting up at 3am for an emergency… as long as the emergency was first noticed at 3am (that same day). Is it that young folks these days don’t know an honest day’s work? Stop it, silly, we love working, we love helping people, we love getting dirty, but we also respect ourselves and know how to keep our job from becoming our entire life.

***Warning: all examples provided, as crazy as they sound, have actually been experienced by me or another vet***

*****Warning #2: some gruesome pictures at the very end. All animals pictured are alive and completely healed from the picture thanks to fast acting clients*****

1. Complain about the bill. I’ve already written a piece on how little money vets make so I won’t be long winded, but large animal vets already make less money than small animal vets as a general rule, but when you add in the number of extra hours, the drive time between calls (loss of production time), it can be even harder on their pockets and lives. Unfortunately for the vet and for the farmer, many times a 2am call 30 miles down the road costs the vet more to perform than the farmer is willing to pay. So, when the farmer gets the $400 bill for his cow, he may get upset at the cost – it’s just a cow and she only got 2 injections! Large animal vets know it’s a fine balance, but when you’re out for 3 hours in the middle of the night and have to show back up to work at 8 am and work another full day, it can also detract from your production for days to come. Not to mention the fact that most large animal clients are billed and when we sometimes don’t receive payments in a timely manner, we have to withhold paying our bills or even employees. – This is also the reason most vets won’t do payment plans even in small animal. I believe in my Disney movie loving heart that people ABSOLUTELY intend on paying every cent of that bill, but things come up, electric bills, hospital bills, and dare I say, some people never intend to pay. I would estimate we never see 80% of the payment plan money – thousands of dollars a month vets don’t get for believing in people has slowly soured us.

2. Only call us when you’ve tried everything else including what your neighbor’s cousin’s beet farmer friend suggested. You’ve been walking this colicky horse since 10Am, have given it 3 injections of banamine (in the muscle *cringe – see picture below*, have tried your neighbor’s recommendations of sticking an onion up the horse’s rectum, coating the tongue in a bottle of cayenne pepper, and now you and the horse are soaked in mineral oil you tried to get the horse to swallow and has perhaps aspirated. It’s now 11Pm and you call the vet – the one that you haven’t called since 4 years ago on Christmas morning when you had a foundering horse that you’d already bled 3 gallons of blood from because your friend said it would work – but it didn’t cause that’s not how any of this works. Or, you saw that your cow that was due to calve had her tail up and some membranes hanging out three days ago and now she’s down in the mud (likely rotting from the inside), or you and all your friends have already been inside the cow and despite only having a head and one leg for presentation, you went ahead and tied her head to a tree and chained the calf’s one leg and head to a tractor and had the cow suspended in the air before you gave up and called me (because now she’s down – likely a broken pelvis). As the entire veterinary community, we want you to know something – We would MUCH rather you call when you think there might be a problem and we can ask you questions and decide if it’s an emergency (and go see your colic at noon when there’s light out and the horse isn’t 90% dehydrated now from walking) than wait until the animal is practically unsalvageable. Also, your bill will be much more reasonable the earlier we see the problem. As much as you think we cost to use, we stay alive with regular visits, the “bread and butter” as one boss called it – vaccines, coggins, heard health, etc and we are much more likely to jump out of bed to help you if we have a good working relationship with you and your farm.

**Success! Smart client called as SOON as they noticed a problem – no legs presenting, only a head. Saved calf and mom!!**

3. Try to save costs by compromising good husbandry and only calling us when you have an epidemic. We don’t like getting called out to clean up a disaster situation that could have been prevented with a little more money, forethought, and elbow grease. Why are all of your calves getting sick and dying?

3a. Are they kept in clean, dry bedding out of the wind, rain, snow, heat, sun? Access to clean water, non moldy/spoiled food? Pens cleaned and sanitized between animals? Animals kept far enough apart to not lick or touch each other (so they can’t spread diseases)? You would not believe how much of an impact good husbandry can have on the health and production of your animals.

3b. Are you vaccinating? No? Do it – vaccines are amazing tools we have that can be given as early as birth to EASILY prevent deadly diseases that *gasp* can’t be fixed with an antibiotic injection. Also, talk to your vet about a smart deworming protocol for your herd – deworming every 6 weeks is often not recommended anymore due to resistant worms (especially in goats/sheep).

3c. Are your animals being fed a diet that works best for their species? Spoiler: even though grain makes them gain weight faster, they need roughage (ie. hay) to keep their bellies happy (yes, even pigs). In fact most ruminants (cows, goats, sheep, etc) would have better health with little to no grain (think bloat, rumen acidosis leading to founder, liver abscesses, urinary blockages in male goats, etc) Good quality hay too, NOT straw or that hay that’s been sitting in the pasture for 5 years, is mostly black, and will likely cause respiratory issues for you and the animals when you break it open.

3d. Water, water everywhere! Clean water, water that doesn’t have 2 inches of ice on top of it – buy a deicer – water in multiple places if you have numerous animals and the bullies are guarding it, water that doesn’t have an electric current going through it (check that 10 year-old deicer)

4. Don’t have your animals caught when the vet arrives. I cannot tell you the number of times, after I ask them to get a halter on the cow and at least tie her to a truck or tractor before I get there and the farmer will absolutely INSIST the cow is down and “she ain’t going anywhere”. Then, as soon as my vet truck pulls up to the farm, that pet cow that was bottle raised and loves you and is so sick now she cannot even lift her head will reach down deep into her soul, grab what’s left of her water buffalo ancestry, jump up and scramble away. She will then lead an hour long chase across pastures, through woods, and briars before finally falling into a creek, losing her will to live and attempting to drown. Don’t expect us to rope or dart her. Unfortunately, they have dropped Rodeo Clown 101 and Rhino darting from the veterinary curriculum, at least since I went to school. Basically, if you have large animals, have the equipment needed to handle them – gates, corrals, chutes or head catches would be amazing, trailers that work. Make sure your horse will load in a trailer if needed. Have halters, ropes, etc. Don’t expect us to halter break your 2 yo stud colt when it has a laceration and you haven’t touched it since it was born. It’s stressful and inefficient if we get there and you’re chasing animals around when we already have 3 more emergencies waiting on us and you may get charged for the time.

**See this client just now rounding up the patients? Just kidding, it’s Tony moving minis out of the pasture – just a cute picture.**

5. Get annoyed when we can’t be to your place immediately. There is often only one vet working after hours calls and if we’re at someone’s farm, soaked in birthing fluids and wallowing around in the straw trying to pull a calf when you call and we don’t call you back for another 30-45 minutes and THEN won’t be to your place for another hour because you’re on the opposite pole of our practice range, please be understanding – we’re trying.

And, here are other requests from a group of 12,000 vet moms:

1) Just give me your address – GPS works great in most areas – no, I don’t know where the old Hamilton place used to be or that oak tree that was cut down a few weeks ago – also have easily visible, large reflective numbers or name on both sides of your mailbox.

2) Don’t leave the bull in the herd up until pregnancy checks. It’s much easier to estimate a breeding date when the cows are 30-90 days bred and there’s not a bull currently trying to breed the cow behind you in the chute.

3) Don’t call your vet after hours for non-emergency questions that can wait until regular business hours; scheduling appointments, etc. We have families and a life outside of vet medicine, please allow us to live as much of it as possible.

4) Please don’t call us after hours for advice on how to treat something you have no intention of having us come out for because we’re expensive. Also don’t ask us to teach you how to do something you see us doing like passing a nasogastric tube on a horse (please, for the love of God, don’t try to tube your own horse or stick a hose down their throat to “wash out the choke”) just to save money next time – bringing me to my next point

5) Animals are expensive. Please carefully consider this and basic husbandry for the animal you are about to buy or rescue. Rescue animals are often even more expensive because of all the health issues they come with. If you can’t provide it the care it needs, you haven’t rescued it, you’ve just relocated it – there, I said it.

6) Don’t call us out for an emergency that could wait until normal business hours just because it’s more convenient to you. A 5-day duration lameness in a horse at 11pm because you have to work tomorrow and don’t have time? Me too! No thanks.

7) Colicky horses (can sometimes looks like straining to urinate as well) – A) call as soon as you suspect – 5% dehydrated animal much easier to correct than 50% and with colic, hydration is 90% of the problem. B) Don’t walk the horse more than 30-60 minutes before calling – walking/trotting/even a short trailer ride can help immensely, but not to excess; the more they walk, the more tired and dehydrated they get. C) Let a laying horse lay. If they start rolling (and not getting up with a big ole’ shake off) then get concerned. Even a colicky horse can be allowed to lay quietly – think of how you would feel if you went to the doctor with a stomach ache and they put you on a treadmill for 4 hours.

8) Don’t comment on my size as a woman. You, sir, also cannot body slam a 1500lb steer, so lets let the drugs I brought do the talking.

9) Please admit to any and all treatments already given before I arrived. This goes for small animals as well – think he got into weed? just say it *big, tired sigh here*, we’re not calling the cops, but knowing that can save you $500 in bloodwork/diagnostics/referral to a neurologist.

10) Don’t ask us to look at your other horse who has had a weird, flakey skin condition for the past 2 years and also needs a coggins while we’re out treating a laceration on another animal at 2am.

Bonus: Please don’t pull a nail out of an animal’s hoof before we get the chance to shoot x-rays to see how deep it penetrated and whether it got the bone or joint.

We love our jobs and we want to help. Call as soon as you think you have an emergency. Please, the easier you make it on us and the more we can help you, the better our doctor/client relationship will be and the longer we will stay with the large animal work. Be nice to your vet. Please.

**Good forethought by this client saved mom from pregnancy toxemia (too much baby, not enough mom) and saved all three giant babies!**

**Have horse, will have lacerations – client called as soon as it happened and got it all fixed up. Client stuffed burdock leaves in wound – he said for pain – I dunno.**

**What it can look like when intramuscular banamine goes awry – give it orally, please.**

**Repeat picture just to buffer the gross pictures. And it’s cute.**

January 9, 2020January 20, 2020

Vets are just in it for the money!

This particular blog is set out to let you see us and hopefully answer some common misconceptions about us. Vets are people pleasers; they are hard workers who like to fix things. We will go out of our way to make sure you are getting the care your animal deserves. We hate to not know what is wrong with your animal and we hate more not being able to make it better. Sure, there will be bad eggs out there, vets that just want to shuffle you along in the line of patients they have, some that want to make the most money off of you that they can, but, for the vast majority of us, we just want to help. We all worked REALLY hard in vet school and are still working just as hard to better our techniques, better our medicine, learn what is working better. We have entire social networks dedicated to sharing information and sharing what works for us and asking for help with cases. Tens of thousands of veterinarians constantly reaching out for help from vets all over the country and even the world, with tens of thousands open to helping and giving advice. Even board certified surgeons, internists, etc are answering some of our questions on some of these hard cases. I’m no 100% certain, but have asked human doctors and, to my knowledge, they don’t have this.

“Vets are just in it for the money, if they cared about animals, they would do it for free/less.” – Other than world famous veterinarians, the vast majority of us make much less than you would think. Modern veterinary school tuition is anywhere from $20,000/year to $60,000/year (tuition and fees ONLY – not rent/living expenses/food) for 4 years. So, at best, we are paying approximately $150,000 for the degree alone, including undergrad (4 years). Then, you have to factor in at least 4 years of lost financial gain where you couldn’t work enough to pay for rent/food – we had class from 8am to 5pm then ate something non-nutritional, started our IV drip of cowboy coffee and studied from 6pm to 12am/6am depending on if there was an exam (or 3) the next day- so add another $50,000 (depending on the state you lived). So, graduate with $200,000 in the hole. Unless you or your parents are independently wealthy (and they don’t hate you), you will have to take out a loan for this. In our country, interest rates can vary between 5% and 8+%, meaning that some of us pay upwards of $1200/month just to cover interest. One vet I know has paid $50,000 over 5 years toward her loan, but owes $80,000 more than when she graduated. One tells me she earns an extra $41/day in interest. Per. Day.

So, fresh out of school, with a $200,000 hole in your bank account. You get your first job, like I did, making $42,000/yr. , then, after 3 years, upgrade to $65,000. Now, you have a family, a mortgage, and other expenses to pay such as daycare so you and your spouse can actually go to work. So, you make $4000/month after taxes. You have costs of ~ $4200/month to live (these are figures from a time in my own life including only mortgage in a really low cost area, car payment, electric, daycare, gas, health insurance for the family – mine was covered by the company – and food – does not cover medical bills, car repair, other random bills) plus your $1200 interest-only payment. Your monthly costs are now at a minimum of $5400 meaning you make -$1400/month (that’s negative $1400) for being a DOCTOR. For having studied for 8 years, for continuing to upgrade and improve your knowledge as fast as you can, for bending over backwards, staying extra hours to work on a case, personally taking animals home to make sure they get the right care, crying in frustration or tragedy if the animal is not improving or dies. For storing every single one of those losses in our memory, but never seeming to remember the successes.

Some older vets may throw their younger colleagues under the bus and say that vets charge too much these days. Vet school tuition in the 60s was approximately $350 PER. YEAR, in the 80s; $1600/yr and calculated with inflation that translates to 60s: $2800/yr and 80s: $3900/yr compared to $50,000/yr now (that’s almost an 1,800% increase). I’ve had people argue with me and say “well, if you can’t afford vet school, you shouldn’t attend it.” My question is “would you rather have the best and the brightest working on you or your animal, or do you just want the rare rich folks who actually want to be a vet doing it?” – just like a larger country or state is more likely to get good athletes, a larger field of people to pull from will get better vets.

So, we don’t make a ton. Let’s talk costs of veterinary medicine. Every piece of equipment we use in a vet hospital – blood analyzers, ultrasound, x-ray, surgical instruments, gloves, syringes – all of it – is the same equipment used in human medicine and they all cost a pretty penny. Granted, they probably cost a human hospital as much as they do us, but a human hospital can charge you 10-100x what we charge for the same procedure because of insurance (*cough* “SCAM” *cough*). These are the same procedures we do with the same amount of training that goes into performing and interpreting them, but often with less wait time.

Another difference between human medicine and veterinary medicine is the way we look at our patients. In a human hospital (I imagine for the most part), patients are priceless family members and the best treatment is often not a question. In veterinary medicine, there are two very different views of the patients and a full spectrum in between. On one side, we have the pets that are considered family members, that go everywhere and do everything with their owners. Some are the only children our clients will ever have. Some are the last remaining piece the owner has of a deceased child or spouse to whom the pet belonged. Even mentioning cost of care could be insulting to them, because, obviously, this is their child and money is not a concern (though, sometimes “money is not a problem” means they don’t have any money =) and OF COURSE they will do whatever is the absolute best.

On the other side of the spectrum (which is not wrong) is people who view animals as animals. As possessions with monetary value. Some may be farm animals or hunting dogs, or barn cats and the idea of spending any amount of money above the animal’s perceived economic value is completely absurd. So, you had better discuss costs with these people before doing anything because if they walk out with a $200 bill for a barn cat, they will have a conniption.

Without a client making it perfectly clear to us where on the spectrum they stand, we offer all the options from the most ideal to the most conservative. This can make people mad. If the client is on the “my dog is my child” side they may get offended that you would even offer something that’s not the absolute best and, therefore, question your credibility as a doctor. If they are on the “it’s just a dog” side they may feel that you are pushing them to feel guilty to spend more money because you are just money hungry. Even if a client agrees to the most economic route, even if you explain all the potential risks of not doing the ideal option (again, not necessarily to push guilt, but to cover our butts) and the client signs a waiver, this still does not guarantee they will not or cannot come back at you later and sue or go for your license.

So, yes, vets are in it for the money… but mostly the love of animals, science, and fixing things. We love animals, but we must make money to live, to support our children. I’ve never heard of someone telling a car mechanic they shouldn’t charge money and just fix the car because they love it. (but perhaps they have heard that) We want to help you and your animal. That’s all we want. Please consider all of this next time you are upset with a vet bill. Consider the area that you live. The same procedure in Boulder, CO is going to be much more expensive than in Clare, MI – the same size house is about 7x the cost.

Can’t wait to see you and your animal next time!!

Pictures of my pets: 3 out of 4 of them are hazards of the job that I love!