Free Advice part 1
His leg fell off, but I don’t think he’s in PAIN! W.T.F.
I recently had a case where an animal had all the skin stripped off it’s paws which were now red, bleeding, and swollen. I comforted the owner after they asked me if I was going to close the wounds and informed them we would be unable to close due to all the flesh being torn from the pads, but not to worry, we would get the animal on antibiotics and pain meds until it heals. The owner looked at me like I was crazy and said “well, I don’t think he’s in any pain, except where your assistant took his temperature in his butt”.
Unfortunately, this wasn’t the first time I’ve had an owner deny their pets’ pain. It wasn’t even, likely, the first time that day. I have made a Tiktok video about it:
So, let’s talk about pain for a second. Animals are different than us. Not in that they don’t feel pain, but that they are NOT going to show pain like we will. We live in a society where 1. we expect a fix for every ailment we have thanks to modern medicine and 2. others in our circle will take care of us if we are out of commission. Animals, on the other hand are 1. Not going to ask for help because they don’t even know help is an option (my eye fell out? oh, well, guess we’ll try to eat and not die from it) and 2. are fighting for survival, or, at least feel like they are, even with us. House cats, believe it or not, are actually prey for many animals – large birds, foxes, coyotes, wolves, etc. but aren’t the easiest prey, so showing pain could mean being more likely hunted or targeted by those predators. Dogs, going back to pack mentality, may be taken out of the pack if they show pain or at least taken down on the totem pole of hierarchy. If you’ve ever had multiple dogs in a household and seen what happens when one cries out or whimpers and the other dogs run up on him, not to see if he’s okay, but to hover over him intimidatingly and possibly attack depending on the personality.
So, animals have good reasons NOT to show pain. They don’t know if they show pain, you will help them. They may be thinking we’ll get rid of them if they do or they might not get fed, or who knows what they’re thinking. Animals will also, notoriously, get 99% better when they go out in public or come to the vet. We see it all the time, animals who are reportedly dying at home, show up to the clinic, running around, wagging their tail. I don’t automatically think the owner was lying, I just think the adrenaline and survival skills of the animal has kicked in and they animal doesn’t want to show weakness. Just like me and you when you’re not feeling well, but good enough to go to work and you pretend to be peppy and spry around your co-workers or clients. Why? I’m not sure. Am I afraid someone will send me home?? Please! Am I afraid people won’t like me if I’m not 100%? Maybe. But we all do it, so why not expect animals to do the same thing?
So, here’s a list of signs that your animal is sick or in pain. Some will seem simple and straight forward, but I wouldn’t be making this list if people didn’t have a hard time seeing it.
- Not using a body part. Limping but not whining? Still in pain. Squinting, or closing the eye. I’ve seen dogs walk into the clinic, tail wagging, with the obviously fractured leg just dangling in the wind and STILL not vocalizing.
- Change in behavior. Suddenly avoiding you or other animals in the household, more fearful or aggressive, not wanting to eat, play, not jumping up when you’re about to go for a walk. Going in and out of the house or litterbox several times (could indicate diarrhea or urinary issues)
- Change in posture. Hunching, lowered ears, head, tail, curled up tight in a ball, not wanting to lay down, pacing, trying to lay, then pacing again. Standing with chest on the ground and butt in the air – typical of stomach pain.
- Panting, pacing, trembling, shaking, wide “whale eye” where you can see the whites of their eyes like they’re worried.
- Overgrooming/licking an area. This is super common with cats who will groom their under bellies bald if they have abdominal or urinary pain. Also, allergy areas of the paws, a wound, swelling. Sometimes they will even aggressively bite at and rip hair out of a body part that is hurting or irritating them.
- Teeth grinding or bruxism – this horrible sound from their mouth can indicate stomach pain.
- Drooling, eyes tearing, or liquid generally seeping out when or where it’s not supposed to.
- Swelling, bleeding, redness, hot to the touch (make sure to compare both sides of the body to make sure it’s not just you – you’d be surprised how many perfectly normal fat pads over the hips I’ve diagnosed when the owner only noticed one side being big)
I’m sure there’s more signs that I’m not thinking of right now, but this is a good list for now. Basically, animals don’t show pain very much – always playing it cool – and if you ever notice anything different, take them to the vet and have them evaluate them. I’d much rather tell you you’re crazy, the animal is fine than have you wait until the leg is rotted off before you decide it might need attention.
**Side note** – a lot of orthopedic pain issues can be helped by having your animal at the ideal body weight – unlike this obese clinic cat who is likely contributing to orthopedic/musculoskeletal pain of the small child trying to hold him. #weloveyoudan
Here’s a picture of a very healthy, non-painful dog – happily just finished a 4 mile mountain trail run. Head, ears, tail up, back straight, wide based stance.
Also, for the love of all that is holy, DO NOT give your animal human pain medication unless under the direction of a veterinarian. Most of them cause significant and immediate liver and/or kidney failure. This goes for you, too, Dr. Human Orthopedic surgeon, NO Celebrex! Even if all your human patients are on it! No!
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*
Vlog: Vet Scenarios: #awkward
Covid for Christmas
We made a heart breaking decision last night to cancel our plans to visit family in Georgia for Christmas. It wasn’t responsible in the first place, but then with numbers surging recently, COVID-19 being the number one killer in the US a couple of weeks ago – even over the long-reigning heart disease, some Georgia hospitals being at 97% capacity with some having to bring in refrigerated trucks to hold the dead bodies, and with increasing numbers of people here in Virginia testing positive that are getting too close to home, we knew that it was beyond irresponsible to travel. Down right reckless. I knew, deep down, that even though this decision would break the hearts of young cousins who haven’t seen each other in over a year, and may even anger some family members, that it was the right thing to do. I mean, it would be like hosting a party for unvaccinated puppies at a public dog park in the middle of a parvo outbreak.
You may be thinking “what does a veterinarian know about this human disease?” The answer is “Not much”. BUT, I understand outbreaks and highly infectious diseases and how to manage them and keep them under control. In small animal, I have dealt outbreaks when anti-vaxxer breeding kennels broke out with parvo as well as the not uncommon kennel cough outbreaks when people take their dogs to groomers, dog parks, kennels, etc. As a large animal veterinarian, we don’t even wait for outbreaks to occur to start with careful preventative practices such as isolation of dairy calves so they cannot touch each other, quarantine of new animals to the herd, health checks before shipping animals to a new herd, isolation pens for the sick animals, and the obvious vaccinations.
Honestly, thinking like a large animal herd health veterinarian, the idea that people all mixed together all the time and all over the world without protective protocols before this outbreak is kind of mind boggling. Masks should have been instituted long ago for anyone with the sniffles. Temperature checks should be common when intermingling groups of people. These are all very common ideas in the animal/herd health world that we just take for granted in the human world. And, no, your immune system does not get weak by not being exposed to highly infectious things. It maintains its memory – literally in your bones (marrow). You wouldn’t lick a toilet seat splattered with diarrhea to help your e-coli or salmonella immunity, would you? Some dirt good, some will kill you dead.
When COVID was fresh in the US, there was much discussion on my vet moms’ group because veterinarians have been dealing with a coronavirus for decades with no good answers. There is a feline coronavirus that is very common in the cat population and causes a transient (goes away quickly) diarrhea for most cats, but for some cats, it can change the way the immune system reacts to it and can cause a horrible death months to, even, years later and there’s not way to test to see which individuals will react this way. COVID-19, even though it is the same type of virus as FIP, is a respiratory virus whereas FIP is intestinal. They, very well, may not have the same long term threats, but COVID has only been around 10 months. It may take another year to determine if there will be any long term effects. Unfortunately, there is no effective vaccination for the feline form. We are hoping that with the increased money and interest invested in saving our human families, that this vaccine will be much more effective.
Long story short, if we can prevent spread of the disease, it would be smart, careful, it would be showing love for our fellow man. The death toll in the US is currently at 1.8% – seems low, but as my brother, who works at a cement company, pointed out – if everyone at his plant got infected, they would lose 4 people. It doesn’t sound like a lot, but if you had to look those 4 people in the eye before they died and say “well, it’s only a small percentage”, would you be okay with it? If you knew that only the people over 55 were the ones that would die, would that make it better? I mean, they’re too old to enjoy life anyway, right?
I could go on and on. Please comment with more questions. On to the point!
So, we begrudgingly announced to the kids that we would not be going to Georgia for Christmas. They were shocked, their little faces, fallen with mouths agape. Then, like little Cindy Loo Who, India muttered “but why?” When we explained to them about how terrible COVID was getting, they had lots of questions about the virus and the masks they’d been wearing. We explained how many people are dying of COVID. We explained that masks help, but are not 100% and that masks are for protecting other people and not ourselves – giving them the respiratory droplet explanation. She asked if some people were not able to wear the masks – we answered that a very small minority of people physically or medically cannot wear them, but that was even more of a reason for those of us who can to wear them, to protect others.
Then, India, my 8 year-old little girl asked me the hardest question yet: “Why don’t some people not want to wear masks?”
Was I supposed to explain the “sheeple shaming”?
Was I supposed to explain the greater fear people have of appearing to follow the crowd or somehow being controlled by the scheming government than that of killing strangers with their irresponsibility and selfishness?
How could I explain to a loving child who is always worried about how other people are feeling or doing that some people just don’t consider their own actions and the repercussions they could have? Those who don’t look past their front door for people to care about? All while teaching her the ways of Jesus?
So, I just took a few moments, trying to gather just the right way to explain it to her and finally said;
“Baby, I don’t know”
