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The Everything in Nothing

I know I’ve been remiss in posting, and I wish very much I could say it’s because I’ve been so busy creating amazing and exciting book campaigns and creating a plan to hit the NY Times Bestseller List in July. I still want to, don’t get me wrong, and I still plan to at least give it ago. But that’s not why I’ve been quiet.

I guess you could say I’ve been doing nothing. Nothing. Let me explain.

I’ve said to many people when I started working with Paws into Grace two years ago it was like my career and work finally made sense. I liked working in a clinic, I liked the day-to-day stuff, but only two jobs in life ever touched my soul and felt as close as one could come to a calling: writing, and veterinary hospice. Stepping into hospice work was like buying a new pair of leather shoes and finding them already perfectly worn in.

If you recall, I took it a step further when I began speaking on the topic at various Ignite talks, the first one being in January this year at NAVC:

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Then later, in San Diego in February:

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Putting those two talks together forced me to really dig into why I thought this work was so important- first, I realized, we can do a lot to help people understand the process of grieving a pet.

Then, I realized losing a pet is in itself a really important lesson in how to lose a person, or more importantly, how to help them gracefully experience the end-of-life process. I really, really wanted to share that message.

I remember a lot of things about that night at Ignite San Diego, namely about how I said that all people should hire me so their kids wouldn’t stick them in a nursing home later in life because they were too scared to deal with them. I pointed at my parents and said, “See? Aren’t you glad I made this promise to you guys in front of like, 200 people?” And they laughed, because we knew that was all a long time away.

It all happened very suddenly: the fall, the seizure, the diagnosis of an inoperable brain tumor. One day, my life was filled with the usual concerns, getting annoyed with pseudoscience on the net, figuring out Teacher Appreciation Week. The next day, I forgot everything except this: My mom, still young, beautiful, and full of life, looking at the same diagnosis that made Brittany Maynard a household name last November. It is perhaps one of my worst fears, this particular beast, and now it has invaded someone I love more than words can adequately express. The person who, in other circumstances, would be the one I called for support.

Now she was looking to me, and then it all made sense, this need to understand the importance of hospice and advocacy and learning to let go gracefully. I wasn’t meant to help other people understand the difference between living poorly and dying well. I was doing all of this preparation, whether I knew it or not at the time, for my own mother.

In the space of two weeks, I moved my parents into my house, earned frequent parking points at the hospital, and had to dig deep into everything I ever stood up for and ask myself if I really meant it when I said I thought people should change how they dealt with illness and end of life in their families:

  • Would I help someone honor their own wishes to say no when everyone in an authority position was pushing for treatment? It seems like oftentimes it is easier to do all the treatment than to say no and risk upsetting loved ones who want you to try it.
  • Would I be honest with my children in an age-appropriate way or just kind of try to avoid it for a while? Use the old la-la-la-everything’s-fine approach our family has relied on for generations?
  • Could I bring this whole experience into my house, ask my husband and my children to take on this really intense experience, when it would be a lot easier on them- in the short term at least- to keep my parents at arm’s distance, in their own home, in skilled care?

The two weeks during the diagnosis phase was an unending slog up and down the linoelum floors of the hospital, trudging from one cramped waiting area to another: CT. Neurooncology. Neuroradiology. Neurosurgery. Each appointment took an emotional toll that far compounded the physical one, leaving mom too pooped by the end of the day to do more than go to sleep. Waiting rooms filled with other seriously ill people nervously picking at the fraying vinyl upholstery, doctors too aware of the gravity of the diagnosis to be able to offer a smile.

My mother was so upset at the prospect of poorly effective radiotherapy she didn’t want that she could barely speak after the appointment with the radiologist.  He had recommended six weeks of daily radiation and chemo, tied to those halls and the stale air. Glioblastoma, a poorly researched and dreaded cancer- even in the world of oncology, it’s a bad one- has had few treatment advancements in 25 years. Treatment doesn’t cure the disease, just kind of kicks it down the line a little.

“And if we choose not to do the radiation?” I asked.

“You could do nothing,” he said, “But I don’t recommend it.” No one did, but nonetheless that was exactly what Mom wanted.

So we did it anyway, leaving through the doors of the hospital one last time into the cool evening breeze of the evening marine layer rolling over, before calling in the ‘Nothing’ that is hospice. So far, Nothing has included the following:

p1

  • Watching hot air balloons fly by in their sunset flights
  • Getting through all the Harry Potter movies
  • A comprehensive plan for managing every symptom, every discomfort
  • Greeting the children every morning and tucking them in every night
  • Trying every flavor of macaron at the local French bakery (lemon = best)
  • Getting our nails done
  • Going through old photo albums
  • Driving to the beach

Brody, exhibiting that strange instinct most dogs seem to possess, hasn’t left my parents’ side. He’s been so protective, in fact, that he came barreling out of their room last night to bark at me when I got up at 2 am for some water.

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My mother has chosen to die well instead of living poorly. But really, I can’t call what she’s doing right now dying. The walls of the hospital, filled with fear and extended wait times and the ever-looming spectre of illness, feels more about dying. She is living. Each moment, each breath of spring air, each hug, is imbued with a gratitude and a joy it wouldn’t have had in a different situation.

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I don’t believe one person’s tragedy is any greater or less than anyone else’s, no story more worthy of being told. But I do hope that in sharing this one I might reach someone who is struggling with a similar situation or just looking to understand why a loved one may have made the same choice.

We’re terrified, but we’re ok. We’re devastated, but happy. I have an incredibly high tolerance for stress right now but Rubio’s running out of pico de gallo leaves me in tears. We are doing what we can and continuing what routines we are able to do. We are together, and that matters most.

We are doing nothing but living, and that is enough. It is, in fact, everything. And this Mother’s Day, we’re having a hell of a celebration.

 

Filed: Be The Change, Blog, Cancer sucks, Daily Life, Featured Posts, Musings Tagged: ,

Do No Harm

I always assumed my experience as a veterinarian would serve me at some point when I needed to navigate the human healthcare system. The similarities between veterinary training and medical training, after all, lend themselves to a good number of similarities: how to read scientific articles critically. How to read an MRI. When to call the office and say, this prescription doesn’t seem quite right, is this what you wanted?

The similarities are all well and good, but I never understood, in the marrow of my bones, until recently that what would serve me best was our differences.

We MDs and DVMs are both given an ethical mandate to ‘do no harm’, which we as communities hold dear. Our duties to our patients are guided by this overarching principle; we look to it for direction in complicated cases, fall back on it when we feel conflicted about a request, and hold it like a flashlight when we shine a light into the cave of an uncertain future, looking for direction.

But oh, do those lights shine in very different spectrums.

Recently, a man in Russia volunteered to become the subject of the very first head transplant, an idea that leaves most of the world recoiling in horror. “There are some things worse than death,” said many of the neurosurgeons commenting on the piece.

As a veterinarian, I agree. We veterinarians occupy a strange place in the medical field in that most of us view it as not only an option but often a moral imperative to ease the pain of a traumatic death process through pharmacologic means. We are precise in our process, with the goal of minimizing stress and pain. We view it not as causing death, but as easing an uncurable pain. In this, we view our fulfillment to do no harm.

But in the human medical field, the prevailing attitude is by and large that hastening death is, indeed, harm, and anything we do to prolong a life is conversely fulfilling their requirement to do no harm, no matter what it does to a person or family in the process.

Even if it is multiple craniotomies.

Months of chemotherapy.

Daily radiation therapy with a bevy of ill effects. And you have to get screwed down to the table wearing one of these while they shoot brain shrivelling radiation beams at your head:

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Not to cure a disease, but to make a patient breathe one more day, for better or for worse. It is the second most common utterance to me in my hospice work: we do better with our pets than we do our people when it comes to end-of-life decisions, and truly, friends, we really do.

I was recently-by invitation- listening to a doctor outline just such a series of events and possibilities to a patient who didn’t want to partake in them, who has been looking- without success- for someone to say, it’s ok to say no to months of hospital visits and yes to fewer days filled with this:

Ha

Plenty of people do want everything we have to throw at disease, and more power to them all. Thank God for modern medicine. But when did it become not only an unthinkable mistake, but an outright affront to the medical community to say, “thanks but no thanks”?

Searching for information on hospice and palliative care has been as challenging as getting bootleg rum during prohibition, furtive conversations in hallways and whispered hints at such necessary things as family support and respite care, secondary concerns far down the to-do list after scheduling yet another CT. I never knew how much of an afterthought the emotional wellbeing of the patient truly is in many medical decision making processes.

“So what if they don’t want to do this?” I asked.

“Well, this is the standard of care,” the resident responded.

“And if they choose not to do this?” I asked again.

“Why wouldn’t you?” he said, dumbfounded. He never did give me an answer.

Do no harm.

 

Filed: Be The Change, Blog, Cancer sucks, Daily Life, Featured Posts, Musings Tagged: , ,

Wisdom Panel 3.0- the next gen DNA test has arrived

Disclosure: This post is sponsored by Mars Veterinary Wisdom 3.0 Panel. Opinions are those of the author.

 

So, if I showed you a picture of a dog, you may be able to tell me a little about him or her.

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You would often be able to make some generalizations about temperament-

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Or adult size-

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Or medical concerns, such as whether or not a dog can tolerate ivermectin.

But what about when it’s not entirely obvious, as is the case with my friend Karen’s adorable dog Ramone?

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He’s been labelled everything from shar-pei to Bernese Mountain Dog to pit bull. Karen doesn’t care, because she evaluated him on an individual basis before deciding he was just perfect, which is what groups with extensive adoption experience like the ASPCA recommend anyway.

On the other hand, there are some good reasons to know the genetic history of a dog beyond the simple novelty of it all. Shelters who have used DNA testing such as the Wisdom panel have found potential adopters really like having a bit of extra information in front of them. For example, my friend adopted a pup about a year ago with a projected weight of 30 pounds who looked pretty similar to these guys:

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As of his first birthday, he just topped 50 strapping pounds and still growing.

Or what if you have a dog who might be part Australian shepherd but you’re not sure and he has Demodex? It would be nice to know if he has the MDR1 mutation before taking your chances on a course of ivermectin treatment.

 

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When Mars Veterinary Wisdom panels first came out a while back, people (myself included) had mixed reactions. What started out as a novelty has grown to have some real use. As our knowledge of the canine genome has evolved, so too has the role of DNA testing in dogs, everything from keeping dogs in homes when a misinformed landlord says, “but he LOOKS like a pit bull!” to increasing shelter adoption rates to helping HOAs bust the person who isn’t picking up after their dog’s business in the common area.

The latest version, Wisdom Panel 3.0, has the added benefit of screening for the MDR1 mutation, a test licensed for home use for the first time to Mars Veterinary  by Washington State University. The MDR1 mutation is known to affect particular breeds and results in some very specific drug sensitivities.

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Over the next six months, the Wisdom Panel Swab-a-thon Tour will be partnering with communities and shelters to swab the DNA of a number of their dogs, with the reports showcased to help match the pets to compatible homes. (I am really excited about the way this is helping shelter pets!) They will also be offering the product to consumers at the events.

The regular test runs $84.99, but the Swab-a-thons will offer discounts to pet owners during the events. On April 10, 11, & 12th Wisdom Panel will be hosting the first Swab-a-thon at the America’s Family Pet Expo in Costa Mesa, California. Visitors to the Wisdom Panel booth can take home a discounted kit for $49.99. 3 weeks later, you get a report and the results of the MDR1 test for you to discuss with your vet.

For more information about the Wisdom Panel or to see if there’s a Swab-a-thon coming to your area, you can check them out at: Wisdom Panel,  Facebook , Twitter, Pinterest, and on Instagram.

Happy sleuthing! Isn’t science neat?

 

 

Filed: Blog, Daily Life, Dogs, Featured Posts, Health, Lifestyle Tagged: , , ,

Jerky Problems AGAIN: an infographic

Are you kidding me? After years of pressure, people finally get pet stores to agree to stop carrying treats from China only to have a new crop of cases of illness emerge in pets who ate jerky with a “Made in the USA” label.

Is it sourcing? Is it weird contamination from aliens? Who cares! Just don’t buy it. It’s not worth the risk. Feed your pet an apple, or some of their regular food, or follow the link to where I show you how to make it yourself.

Or watch the video:

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Any questions?

 

Filed: Blog, Cooking, Daily Life, Featured Posts, Health, Pawcurean Tagged: , ,

How to be happy in 4 simple steps

This month’s JAVMA features confirmation of what those of us in the profession for more than a year or two already suspected: veterinarians are a sad bunch, compared to the general population. Consider these stats from the CDC’s first-ever survey of the veterinary population:

  • 1 in 6 have considered suicide;
  • 25% of men and 37% of women in the profession report depressive episodes;
  • 1.1% of men and 1.4% of women have attempted suicide;

That last stat is the only one where vets figure in below the national mean, but before you cheer consider this: it’s because more veterinarians successfully complete suicide.

This preliminary data doesn’t delve into the causes or the proposed solutions, though those are currently hotly debated. Nonetheless, it’s good to see on paper what so many who are struggling have needed to hear: You’re not alone.

Stayin’ Alive

After watching my Ignite talk on being a Death Fairy, a veterinarian asked me how I avoided compassion fatigue in my work. I told her I would answer that, but first I have to admit this:

For a long time, I didn’t avoid it at all. I didn’t just float out of vet school and find an amazing job and love every second and plan to be a hospice vet because I knew that was the right thing for me to be. I wish I could tell you I was that organized and thoughtful, but the truth be told I did what most people I know in this field do when they’re stressed: power through bad situations until they became untenable, taking on more responsibility every other second.

So no, I didn’t avoid compassion fatigue. In fact, I burned out and quit. But then I reincarnated, I guess you could say, with a lot more perspective and a healthy understanding of what I’m really supposed to be doing here. But not until after I got really sick, like going to specialists and talking about scary tests sick, did I decide to get my priorities in order. Once that got sorted out, life got really good!

How to be a zen vet in a Prozac profession

 

1. Don’t underestimate the importance of your co-workers

 

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I think there is no greater indicator of how happy you will be at work than how well your team works together. They will prop you up when you’re down, have your back when things get nuts, and inspire you to do better every day. Unfortunately, the converse is also true. The saying “turd in the punchbowl” exists for a reason.

2. Don’t settle for a toxic environment.

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Temporary Like Sadness by Dominic Alves on Flickr

 

Sometimes you think you’re starting in at the best place on the earth, but something happens. The office manager is stealing. Your mentor turns out to be Voldemort. You get pregnant and can’t work overnights anymore. So many people stick it out in a bad situation because 1) we’re taught not to whine and 2) we’re scared there’s nothing better out there.

There’s always something better out there, but you won’t find it if you don’t look. If you are in an office that is causing you physical symptoms of anxiety, it’s time to start looking for a new job. Living in modern day American comes with certain advantages, like the whole “no indentured servitude” thing.

3. Don’t be afraid to explore. 

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I had no intention of being a veterinary writer. Blogs didn’t exist when I started vet school, nor did hospice veterinarians. Sometimes you just have to strike out in a direction that looks good and see what’s out there. Because guess what? I don’t care what anyone else has told you, you’re allowed to come back and be a vet if you leave. Taking time off to explore another career, take care of family, get another degree, none of it is a one way valve- unless you want it to be.

4. Set boundaries. Mean it.

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Out of every rule I laid out, this is seriously the number one important one. With the exception of the rare shining star who really does want this to be their life, most of us want a life of which veterinary medicine is only a part. This is a profession where it is very easy for it to take over your life, because there will always be more asked of you than you are able to give. Always. It is not a failing to recognize that.

Set boundaries with your clients, your co-workers, and yourself. Take vacations. Exercise. Enjoy your family. Do not let work intrude on this or else you will begin to resent it, and that is the seed of burnout. You can (and should) work your butt off, then go home and play your butt off.

Set those boundaries, and enforce them like your life depends on it.

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It was an ironic realization to figure out that point of diminishing returns in terms of giving of yourself. You cannot truly understand compassion unless you’re willing to extend it to everyone, including yourself.

Resources

AVMA list of Wellness Resources

National Suicide Prevention Hotline

A place to talk to other vets- I am aware of several online and Facebook groups for vets to talk and support one another. Feel free to reach out to me if you would like more information.

Filed: Blog, Daily Life, Featured Posts, Fit Life, Health, Lifestyle, Musings Tagged: , , ,

The Salem Shill Trials

1692

In the early days of the Puritan settlements, colonial Massachusetts was gripped by fear. Between the British and French warring over colonial dominance, smallpox, and potential attacks from Native American tribes, the residents of Salem Village lived in a constant state of anxiety and worry for their safety. In addition to these real concerns, an overlying and persistent worry that some people possessed supernatural powers tickled away in their psyche.

When two young girls began exhibiting strange symptoms of fits and screaming (now believed to be caused by fungal contamination of grain stores), the local doctor diagnosed ‘bewitchment’, because why not. The first to be accused were a family slave, a homeless beggar, and an elderly woman- but they weren’t to be the last.

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As the hysteria spread and some of the accused confessed in an attempt to save their own skins, others took note: accusing someone you don’t like of witchcraft is an effective way to get them out of your hair while also setting yourself apart as someone virtuous enough to be worthy of bewitchment. Rivalry, desire for power, fear and suspicion, ego- pretty much everything except reality itself seemed to play a role in the accusations.

 

WondersoftheInvisibleWorld-1693All you had to do was point your finger and yell “witch!” and out came the pitchforks.

It was quite effective- after all, how can you prove you aren’t a witch? After all was said and done, 19 people were hanged that year before everyone came to their senses.

The evidence that sent them to the gallows? Dreams and visions; and of course, some very self-assured charlatans.

Nowadays, we scratch our heads at how this could happen, how people could go so easily down the road of hysteria and gullibility. Or do we?

 

1998

In 1998, a medical researcher named Andrew Wakefield published a now discredited study linking the MMR vaccine and autism. Young parents, petrified at the increasing incidence of autism in children and worrying that their own choices could play a role, began delaying or declining vaccines altogether.

In first world countries where preventable diseases were being, well, prevented, parents felt the risk of a vaccine injury was now greater than the risk of the disease itself. There’s only one problem: it wasn’t true.

As the research proved Wakefield a fraud and everyone came to their senses, the medical community assumed that people would go back to business as usual. But, people are funny creatures, and sometimes we don’t really evolve. It only took the people of Salem a year to come around, but a strange thing happened at the turn of the millennium.

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The “all natural lifestyle” turned out to be a very lucrative phenomenon, tapping into all our current fears: corporate conglomerates controlling the food chain. Large pharmaceutical companies more interested in lining their pockets than curing disease. Money over health. Go back to nature, they proclaim, and the world will be a better place.

2015

The era of social media. There was a time where in order to be heard, you had to earn a spot at the podium through having something worthwhile to say. Now, you just have to get there first and have the loudest megaphone. Also: be a babe.

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On the sidelines of the ‘nature vs chemicals’ battleground, people with no stake in either the pharmaceutical industry or the coconut oil industry shook their heads. “But look!” they said, holding up science papers. “That’s not how it works! GMOs aren’t causing cancer, vaccines aren’t causing autism, and pet food doesn’t contain dead cats!

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“I appreciate your desire for transparency in consumer goods,” they continued, completely misconstruing the authenticity of those with the pitchforks, “but do we have to say things like airplanes should contain 100% oxygen and a bleach enemas cure autism? Surely we can be reasonable here.”

They smiled, holding their papers in front of them with their palms up, waiting for the coconut salesmen to welcome them with open arms.

The coconut salesmen, who had just celebrated their millionth Facebook fan and launched a new website selling crystals, lowered their pitchforks. They looked at the people with the papers, pointed their fingers, and in a clear, loud, voice they yelled-

“SHILL!”

And the pitchforks came out, because how can you prove you aren’t?

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A word from the stake

Whenever I speak on the worrisome outcomes of the current trend of science illiteracy, people say to me, “but don’t you agree that pet food should be transparently sourced? And that companies should tell you where their food comes from?” I imagine them saying this as they hold a match to the pile of wood underneath my feet, shaking their heads sadly.

And to those well-meaning but nonetheless about to burn me people I say, “Yes, but I don’t understand how you can make the leap from ‘I’d like more information about my food’ to ‘Subway contains yoga mats’ and ‘vanilla ice cream contains beaver butts.’ ”

Industrialized society is a double-edged sword. There are great benefits and some pitfalls, worthy of trying to improve. But why bother with such nuanced debates? It’s much easier and faster to call someone a shill. Next!

Toxins are today’s sorcery. Shills are the modern day witch. I take pride in being put to the stake, because I know history will vindicate me. And the only reason I’m not laughing at the absurdity is because while we sit here and have these nonsensical fights, children are dying. And there’s nothing funny about that.

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Filed: Be The Change, Blog, Health, Musings Tagged: , , ,

Grand Opening: The Pawcurious Surgical Training Centre

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So, every year I attempt some form of creative teaching enterprise at the kids’ school, and some years go better than others. This year, in a school I really like, I think things went well. I was asked to do a “veterinary science station” for the annual Science Fair, and I thought back to what I was excited about when I was a kid:


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Playing with guts! And I thought to myself, I bet I could create a dog version of this anatomical model. So I went to Joann’s, bought a bunch of random attachments and fabric bits, and commandeered one of my daughter’s stuffed animals to volunteer to be my surgical model.

Step one: preparing the abdominal cavity

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I chose a mottled red fabric for the interior of the dog, and sewed a pouch to contain the abdominal organs. After cutting open a midline incision, I removed a bit of stuffing then sewed in a zipper. (Do this before sewing the pouch in, or you’ll end up with the zipper seam showing.) Then you can sew the top ends of the pouch to the edges of your incision and voila!

Step two: making organs

You can go kind of crazy with this stuff, but I tried to hold myself back to the main parts (no spleen, pancreas, etc). All of the organs were secured to the abdominal wall with Velcro so they would remain in the right place but they could be removed if the kids really wanted to see what was in there.

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I tried to keep the organs moderately accurate, but I was limited by my own sewing experience and what I had on hand, which is how I wound up with lavender sparkly kidneys and a two-lobed liver. For the bladder we filled a white balloon with rice. The kids don’t care too much about accuracy.

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The intestines were a long tube of velour that I sewed and then had to turn inside-out. I didn’t think that one through ahead of time. I debated leaving it a giant intussusception but I eventually got it figured out with actual surgical tools. Next time, forget it.

In the interest of simplicity, the loop represented both the large and small intestine. I had some nubby yarn that I really, really wanted to throw in there as omentum but I held myself back.

The stomach needed to be fairly correct as a gastrotomy was going to be one of the two surgeries the kids could do. It’s a fleecy material with the nubby side on the inside (rugae! yaay!). I ended up using ribbon “stitches” sewn into the sides of the incision, which was a smart choice once the fifth graders started yanking on them full-force.

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For the uterus, I sewed two red socks together at the toe (worked like a charm!) and bought a handful of small puppy toys. The ovaries were little white yarn pom-poms.

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I sewed a snap into the tip of both socks to keep the “uterus” closed. I also put in a piece of stretchy rubber ribbon on both sides of the abdomen that the uterus held to with velcro but that was overkill with these kids so I didn’t use it. Feel free to use it for the vet student in your life, though- they’ll have to get used to wrestling with that thing.

By the time everything got stuffed in there it was actually a shockingly decent approximation for the surgical experience- you look in and think, what the heck am I looking at? So I made a legend as well.

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With all of that in hand, as well as a bunch of gloves and masks we didn’t end up using, we headed off to the science fair.

Step 3: The actual test

We had a lot of competition at the science fair. Computer programming, dry ice, slime, rockets, frogs. Since the kids didn’t know they were going to be doing surgery until they came up and asked what was going on, they all freaked out a little and then said, let’s do it!

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I used some of the radiographs readers shared with me. The pregnancy one was a big hit!

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A small cardboard tube served as a trachea and the kids intubated with a See’s candy stick.

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An old pillowcase with a rectangle cutout in the middle served as a surgical drape.

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For the case where the dog was vomiting, we used our legend to try and determine what we were looking for (something big and pink.)

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The kids got to pull out the assortment of items our patient ingested: a ball, a sock, a rock, and to see how they would lodge in the pylorus as there was no way they’d fit into the intestines.

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I could easily have had two dogs going, but as I had to re-stuff the dog after every surgery I had my assistant prepare the surgery table while the next group waited.

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Unsurprisingly, the c-section was a big crowd pleaser. We had only one person run off in horror when they figured out what was going on, and it was a dad.

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I wrapped the puppies in saran wrap “membranes”. For the little kids who weren’t quite up to delivering a puppy, the bigger kids could hand them a puppy to wrap in a towel, remove the membrane, and stimulate them to breathe (you see one in the lower left corner). Worked like a charm.

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Even the moms learned something, as in, “dang, that’s a big uterus.” Yes, it is.

The kids were all very concerned after to make sure the dog was closed and “woken up” after surgery was completed, all except the older boys who wanted to pull all the organs out and play with them. There’s something for everyone here at the clinic.

And the best part of the night were the kids who realized there were two surgeries and came back for more. Mission Minion recruitment accomplished!

Filed: Blog, Daily Life, Goofball Antics, Lifestyle, Mother of the Year Tagged: , ,

Two things people always say when a pet dies at home and other DeathLord lessons

Life is weird in lots of way. Things happen for a reason, and you have to kind of be open to what life’s going to throw at you because you certainly aren’t going to expect most of it. Even the good stuff. Especially the good stuff, which is often hidden in bad stuff.

When I go to a house for a euthanasia, people invariably say one of two things:

1. This must be so hard.

2. I wish we had this for people.

The answer to both is “I agree.” The interesting part is that they co-exist.

Lots of things we deal with in life are rotten: losing an eyeball, I imagine, would be hard. Crawling through the Amazonian rainforest naked and afraid with no water. Chaperoning a group of fifth graders on an overnight field trip on a boat you can’t escape from. All of them hard, and none of them leading me to say, “gee, I wish I could replicate this experience for my family and loved ones.”

Death is hard. It can also, in certain circumstances, be good. Not always. Sometimes deaths are horrible and tragic and cruel, and when we see that we fear it, and forget that many times it can also be meaningful and loving and bittersweet. We need to cherish those experiences to give us the strength for the times it is not. We need to learn that we can talk about it and lean on each other and be there, really be there, in every way we can.

This is what I do as a hospice vet, and while it is very true that this is in my opinion the best way for a pet to experience death, I have found the ones who benefit the most from the experience are the people, not only for their pet but for their whole idea of what death is about.

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Pets don’t know what death is or that it is coming. The fear they exhibit in the clinic euthanasia appointment is fear of the clinic thermometer, because when I go into a home to euthanize a pet I cannot tell you how many very ill pets look up, give me a wag and a lick, and in essence signal to their families that they are ready. It’s quite stunning to see.

When I submitted a talk for Ignite San Diego titled “I’m the Angel of Death, Now Gimme Your Kids” I think I freaked out a good 95% of the attending audience who had no idea who I was or why I wanted to steal their dumplings. By the end, though, I think they all realized that no, really- it’s a good thing to learn to move forward without fear. Pets teach us so much, from the moment they arrive to the moment they leave us. Yes, even then, if we are open to seeing it.

If you want to hear me sum it up in 5 minutes on the nose, here’s the link:

Filed: Blog, Daily Life, Features, Musings Tagged: , , , , ,

Panic in the Aisles: The Beneful Lawsuit and You

As you may or may not have heard, the internet was abuzz last week with a series of alarming headlines, such as:

PURINA IS KILLING DOGS

or

CLASS ACTION LAWSUIT AGAINST DOG-KILLING BENEFUL POISON

etc, etc.

And as these things tend to do in today’s internet age, the story has taken on a life and momentum of its own, just like last year’s “Eukanuba is killing dogs” story that ended up fizzling out and the “New parvo strain is killing dogs” story that also ended up fizzling out. Remember those? No? They were huge at the time, until they realized there was no actual evidence to support the claim and WHOOSH gone, not that it seems to matter these days.

1-800-BetterCallSaul

I take lawsuits with a big huge salt-lick sized grain of salt, because once you’ve seen what people do in court rooms you gain a grim view of human nature. One veterinarian I know of lost a court case alleging intentional infliction of emotional distress for a phone call that never happened, because the plaintiff was able to bring in several family members to perjure themselves and say they heard the harassing call that never took place.

The veterinarian was able to prove the call never occurred using phone records, and the case was overturned on appeal, but not before the plaintiff called in the local consumer advocate, got the clinic on TV, and had to endure months of people coming into the clinic and yelling at the staff. The damage was done.

CC by MikeMccaffrey on Flickr

CC by MikeMccaffrey on Flickr

Filing a lawsuit is easy. Anyone can do it. I can sue the guy across the street tomorrow if I want to. I’ve never met him or interacted with him, but I could, just because. Winning one, proving damage- that’s another story.

Here’s a hard truth: a lot of dogs die every day, and much of the time we don’t know why because people don’t have the money to spend getting a definitive diagnosis on a 15 year old dog who has been vomiting. So they look to the obvious thing: the food! and never actually learn that the dog’s had a percolating abscess in the liver, or a hemangiosarcoma that metastasized, or any one of a number of things that happen. If 1.5 billion bowls of Beneful got eaten last year, it’s a given some of those dogs will die because that happens in life not because their food killed them; but they’re the easy target.

Here are my own FAQs based on the questions I’ve been getting this past week:

1. Is it possible that Beneful has a problem?

Sure. It is possible the case has merit, but until we see the actual proof I can’t say much about it. Given the fact that the suit mentions “propylene glycol” as an antifreeze analogue (it’s not), it seems to be one more tired rehashing of the whole ‘I can’t pronounce it so it’s bad’ argument people like the Food Babe have made so popular recently. Possible? Yes. Likely? I can’t say I have seen any evidence of it. Dr. Weeth has an excellent analysis here.

Were you to believe every “this kills dogs” claim on the net in the last 10 years, you’d have to have given up the following entirely:

Febreze, Swiffer, Iams, Eukanuba, Purina, any commercial dog food, Trifexis, ice water, vaccines, corn, anything with toxins, preservatives, moldy food resulting from lack of preservatives, veterinary care, Advantage, life as we know it.

2. Don’t you believe this poor man?

I believe that the man who filed this lawsuit believes in his heart that this is what killed his dogs. My heart goes out to him for his losses, it truly does. People want accountability for sad events and that is understandable. That still doesn’t prove that the food had anything to do with it.

3. What about melamine? Is your memory so short that you think pet food companies are flawless?

Here’s the thing about the melamine incident I want everyone to remember: Do you know how that story was discovered?

-It was not one person with a Google account and a phone book opened to “law offices.”

-It was not the FDA or companies testing dog food (melamine isn’t something normally tested for.)

-It was individual veterinarians who noticed a pattern, did some digging, talked to each other, and pursued an answer. I watched it happen, and it was incredible. There are some smart vets out there.

I can list about 3 major food problems off the top of my head that veterinarians figured out, and based on their experiences I would agree that not all pet food companies are forthcoming or proactive when it comes to potential issues (none of those companies I am thinking of, by the way, is Purina or any of the other big name companies. They were boutique ‘premium’ brands.) Yes, it happens, but the answers come with careful analysis by trained scientists, not lawyers.

4. If I feed Beneful, should I change my food?

Purina-Beneful

Food is kind of like religion: people get really worked up about it. Each food has its place in the market, and if you’re the type to obsess over food labels and ingredients (nothing wrong with that! I do!) you’re probably purchasing a different category of dog food anyway, right? But this food has its place too, even if it’s not in your house. For plenty of people it’s been working fine.

I say the same thing about this that I do any food: if your personal individual pet is doing fine on their food, I wouldn’t change a thing. If he isn’t? Well, let’s talk. So yes, you should always report weird symptoms to your vet and tell them what the dog is eating (it is one of many, many data points.) Most of the time it is not the food. On occasion, it is.

Any questions? Then carry on. I have to catch up on Walking Dead.

Disclaimer: This post was NOT sponsored by Purina, Nestle, Big Pharma, or Corporate Shills. In fact I’m losing money writing this because I could be working on another project I actually get paid for. Information in this blog post is for informational purposes only and should not substitute for mass hysteria generated by your regular inflammatory website.

Filed: Ask Dr. V, Blog, Daily Life, Health Tagged: , ,

Giveaway: Halo Night at the Oscars Goodies Grab Bag!

When I was in college, I volunteered one night at a Grammys gifting suite. As a peon, I wore my one nice dress and handed bags full of ridiculously extravagant presents to celebrities and/or celebrity assistants. In return, I got….well, to say that I did it, I guess. Swag has gotten even more crazy in the ensuing years. Out of control, even.

Compared to the Grammys, the Oscars are even more insane- the “Everybody Wins at the Oscars” bag given to the non winning nominees in the top 5 categories is valued this year at $160,000. Included: glamping trips, “adult massagers”, cars, wine, jewelry, and- for real- mind control lessons. All the things a needy star could desire. Ah, Hollywood, you’re so crazy.

To balance out the scales of ridiculousness, Halo and Freekibble.com are donating something to the bag that everyone will love: 10,000 meals to the shelter of the nominee’s choice (that’s $6K in food!) So when they sort through the bottles of moisturizer and tooth care items, they will also find this:

Halo Oscars 2015 certificate

 

So you don’t have to give up on humanity entirely. Some good will come of this bacchanalia.

In honor of this event, Halo is helping me out by offering something to you as well: two goody bag items, one dog and one cat. While I can’t give you guys any adult items (this is a family blog!) or 10,000 meals (though I promise if I’m ever an Academy Award bag recipient I totally will donate my prize), I can offer the following:

redcarpetdog

redcarpetcat

 

The dog and cat prize will each contain:

1 bag of Halo food (dog or cat depending on the prize)

1 container of Halo Liv-a-Littles treats

1 autographed copy of All Dogs Go to Kevin (to be sent after release on July 14)

At least 2 additional surprises such as a Gentle Leader, K9 Cakery kit, Yeoww! catnip cigar, Blinking Buddy cat toy, Through a Cat’s Ear CD, Groom Genie brushes, Hidey Hole cat bed!

Estimated retail value: $125

 

Terms: This giveaway starts NOW and ends at midnight PST Tuesday, Feb 24 2015- so enter now before you forget in your haste to watch Fashion Police on Monday! All you need to do is click here and enter your email address. One winner for each prize will be selected randomly and notified by email. US only (There’s weird laws about international food shipping, sorry.)

enter-now-button

As for the Oscars themselves? I’m rooting for Grand Budapest Hotel, personally, but that might be because it’s the only Best Picture nominee I’ve seen. Who cares? It’s all about the dresses anyway!

Filed: Blog, Daily Life, Giveaways, Lifestyle Tagged: , ,

An open letter to Kevin Smith and his dog Mulder

Dear Kevin,

I’m sure you get fan letters all the time, from people who love your art: Clerks, Dogma, Chasing Amy. I think Chasing Amy was one of the first movies I watched with my boyfriend, who is now my husband. He thinks you’re the cheese.

I think you are a great writer, and like all great writers you have an amazing willingness to share things that other people hold close. Painful things, like a humiliating experience with an airline or, in this case, the terribly personal loss of a beloved dog. I am so very sorry Mulder died. I hope it is OK I am sharing the photo you posted because the love and the bond you share in this shot is there in a way I think others would be very comforted by.

kevin and Mulder

To everyone: I encourage you to read Kevin’s words about Mulder here: They are beautiful.

I’m writing you today to thank you because I don’t know if you know just how special this is- not only your bond with Mulder but the fact that you are open to sharing this with the world. As a hospice veterinarian, I see people every day who are torn to shreds to have to say goodbye to their beloved companion. All kinds of people: women, kids, men, even big burly Marines and wrinkly faced Charlton Heston types. I worry about those men the most, because they have so often been taught not to express grief and sadness that they are as worried about my own reaction as they are just letting themselves experience the moment and admit, yes, I love this creature. Of course I am grieved.

I can speak all I want and tell people that they have permission to feel this way and let themselves cry and share and ask for camaraderie in a time that often feels incredibly isolating and lonely, but until more people like you- people with influence, whose words matter to so many- do what you’ve just done, it will continue to be a struggle for many more.

The conversation you opened up on your Facebook page- that matters. That’s huge. There are so many people starved for the opportunity to reach out and know it’s OK to drop your basket over this kind of loss, it’s like a dam breaking every time. What a testament to Mulder to have so many share in kind. It doesn’t lessen the pain, but I think the sharing the burden does help cushion the blow.

He was a beautiful dog and I know your heart must be broken into bits right now. For every idiot out there who called you an ‘attention whore’ for this, there are hundreds more moved to empathetic tears by your loss. You have fans who have your back. The average person out there who doesn’t have that support needs to see that.

And in the spirit of sharing, I’ll post a picture I never planned to share for all the reasons I just mentioned: I look horrible and tear streaked. It was a private moment. It is my dog Kekoa kissing me on the day she died. I was really annoyed with my husband for pulling out the camera that day, but in retrospect, I’m glad he did. You’d be surprised- at least I was- at how many people do the same when I am there to help them say goodbye. Maybe this will help others feel more permission to do the same.

20koa2 copy

I guess now I’m attention whore too. It’s all good.

Sincerely,

Dr. V, your newest fangirl

P.S. Will have a pint to toast Mulder’s long and storied life tonight.

Filed: Blog, Daily Life, Dogs, Euthanasia/Hospice, Health, Musings Tagged: , , ,

Vaccine vs Disease, Parvo Edition: an Infographic

Vaccines are a complicated topic, let’s start with that. It’s impossible to break down the conversation into something so simplistic as “Vaccines: yes or no”. Some are more effective than others, some prevent more severe diseases than others. There are some vaccines I did not recommend (hello, FIP) and others I was adamant about (parvo!) when I was in general practice. This is why you should have a good relationship with a vet you trust, who is willing to have a dialogue.

On the other hand, when people are wading into the quagmire of what to vaccinate for and when to boost it versus titer it, one thing stands: ALL puppies should have ALL the core vaccines: parvo, distemper, adenovirus-2, and rabies. What you do after the one year booster is between you and your vet, but basic risk/benefit is indisputably on the side of vaccinating young dogs for the above vaccines on schedule.

I think sometimes people forget how awful some of these vaccine preventable illnesses are. If you’ve ever seen a puppy dying of parvo, you would never miss that vaccine for your pet again.

vaccine vs parvo

Filed: Blog, Daily Life, Dogs, Features, Health Tagged: , , ,
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