One part of being a medical professional that no one really prepares you for is how to deliver bad news. If you watch those who have done it long enough (read: emergency doc) you’ll see the professional approach: sterile, blunt, quick. You have to do it that way, because you have a bunch of patients still alive to attend to. OK, not this blunt:
This approach is frowned upon in veterinary medicine
But that’s a learned skill. Those who haven’t done it as frequently have obvious tells: the grimace when your hopeful face meets their eyes, the sympathetic tilt of the head: I’m not going to tell you what you want to hear. It’s the same in human medicine as it is in veterinary medicine- humans are humans after all- so I’ve become extra sensitive to the way people talk in the confines of the exam room.
Last week I was fortunate enough to experience that singular medical test known as the mammogram, a tool developed by someone who I can say with absolute certainty never actually had to have one himself. If you’re not familiar with the process, fill a Ziploc with jello, place it on the concrete, and drop an anatomy textbook on top of it. That is kind of what it is like. Then do it in the other direction. Anything that has a knob dedicated to “Newtons of pressure” is never something that should be applied to one’s boneless bits outside the confines of the torture chamber. What sicko looked at a trash compactor and said, hmmm, I wonder what would happen if I put someone’s chest in that thing?
Nonetheless, we do it because it’s the best we got right now, and after the first time I went through this and they found all sorts of things they decided to biopsy, one by one, before saying, “No worries, it’s fine” I’m a bit jumpy about these things. Like I said in my post about preventive care, when in doubt, slice some out. So I go through this every year.
Seriously, we can endure this without having to pretend it was a joy. Do you ever see anyone leaving their colonoscopy making this face?
This time around, I had an ultrasound technician and someone else- maybe a trainee- in the room with me, casually discussing the whorls and swirls of my hyperechoic lesions like I was an earless blob of flesh attached to a lump of interest. They took photos of whatever it was they saw and sent me on my way. As I was in the dressing room, I heard a discussion in very hushed tones, the sort you use when you absolutely do not want someone to know you are talking. So I froze, turned on my mom ears, and listened.
brllb lrb whoosh she might have cancer brlb shhhhh
I’m not 100% certain that is what they said, but it sure sounded like it. I mean, what else would one be discussing in a mammogram office? Horoscopes? She seemed kind of moody, she might be a cancer….Or lunch? She might have a Casear but be quiet, they might be hungry out there in ultrasound… It’s not like the office was busy. I was the only patient there when I walked in. Who else were they trying to hide the discussion from?
I pulled back the curtain, and there, two feet away, was a woman probably the same age as me, holding the ubiquitous pink crop top medical shawl thingie tight to her chest as she waited her turn for the dressing room. We gave each other the tight smile of comrades in arms, comammrades, before heading our separate ways.
I looked up, and saw the technician standing in the hallway. She avoided my eyes, the trained response of one who gets asked questions she can’t answer on a daily basis, and said, “The doctor will have the results tomorrow.”
“Thanks,” I said. “Have a good day.”
“You too,” she said. “Good luck.” (note: not the best verbiage in this situation.)
So I spent the next 24 hours jumping at every ring of the phone, certain I was fine at the same time I was certain something bad was going to happen. And then, right at 9:30, my doctor’s office called. I grabbed it on the first ring.
“Hello,” said the nurse, and I immediately breathed a sigh of relief, because no one ever makes the nurse (or in my case tech) call when it’s bad news. “Your test results were fine. Have a great weekend.”
And yaay, now I would, except now I started thinking about the other woman in the waiting area. I can’t say I was hoping they were talking about her and not about me. I actually hope they were talking about me, because in that case they were simply wrong and everyone’s fine. But if they were talking about her, all I can say is, I hope she had the Caesar.
I usually spend this time of year making up wishlists for dogs and cats, and with a new kitten in the house, there’s plenty she could be interested in finding under the tree (though for her, the tree itself is present enough). But then I saw a few things that I just had to stick on my Amazon Wishlist, and because I thought they were awesome I thought some of you out there might find them awesome too. If you want to get that special vet in your life something that blows the lid off a “I love dogs” keychain, here you go.
For the Glamourpuss: The Feline Hermes Scarf
OK, I don’t actually know any veterinarians who can afford a $600 scarf, or if they could would spend it on that as opposed to, say, one of those nifty electronic stethoscopes, but nonetheless it is beautiful and so I will put it here. Because you never know, lottery wins happen.
Tendresse Feline at Hermes.
Not that I would bring this anywhere near a vet clinic filled with claws and anal glands, but it would make a heck of a statement as a surgery cap, wouldn’t it?
For the Shoe Fiend: Give your feet a bone
I’ve made no secret of it that I love fancy shoes. Do I get to wear them very much? Well, no, I actually wear Keens 99% of the time. Perhaps it is for this very reason that I so covet designer shoes, because they are as practical to my profession as, say, a Hermes surgical cap. But look, these Charlotte Olympias have BONES on them. BONES!
Charlotte Olympia Skeleton shoes, $785 at Net a Porter.
OK, I realize these are the veterinary equivalent of the Victoria’s Secret 10 million dollar bra, so let’s bring this on down to reality and share a couple of things mere mortals might actually buy:
For the Christmas Nut: Veterinarian Nutcracker
Come on. COME ON. I need this like the desert needs the rain.
I’m sure I could find a coach and a painter to foist the other two in the set off on. $44.97 at World Market.
For the Art Lover: The Most Adorable Sculpture Ever
It really is. Anthropologie, I just can’t quit you. Wire sculpture here:
Art not your thing? How about the perfect coffee table book?
Old dogs ARE the best dogs.
For the Person Who Can’t Resist Nativity Sets: Dachshund Nativity
I don’t care that dog nativity sets routinely round out top ten lists of worst nativity sets ever, I would put this out on my mantel every year with absolute glee. And given this Etsy lady’s shop is backordered, I don’t think I am the only one.
Custom breed nativity set, $106 on Etsy. I can request a Golden nativity set? Why do I never figure this stuff out until late December?
For the Vet with the Huge Tree in the Lobby: The Ornament that Says it all
This one, perhaps:
Or maybe this one:
For anyone, anytime: The Freebie
The holidays are rough, tensions are high, tempers are low. When the vet or the tech comes out to meet you in the lobby covered in scratches, fur, and the apologetic cup of Nosorb indicating that, in fact, she was unable to obtain that urine sample after all, consider the wise words of Shel Silverstein and hug it out:
While I don’t advocate tackling your vet to the ground for a kissing and rolling match- it doesn’t generally go over well, so leave that part to the dog- a hug can sometimes be the best gift of all.
Hoo boy, that 20/20 piece sure stirred up some emotions, didn’t it? And it’s Thanksgiving, a week of gratitude, so I’m going to take a step back and say thank you to all the wonderful readers and colleagues who make writing this worthwhile. In honor of that, I’m going to take a moment and also share with you some of my own veterinary secrets. For the low low price of nothing, I want to explain to you what I believe, based on over a decade now in the field, is the best way to save money at the vet. No sarcasm here.
The best way to save money at the vet is….are you ready?
To spend more time at the vet. No, really.
Preventive Care is where it’s At
If one wants to know some of the best ways to save money on medical care, we need look no further than the group that has gotten the cost/benefit analysis down to an exact science: the human medical profession. It’s taken a long time for the field to come away from the model of medical firefighting: wait until something gets bad- CANCER! KILL IT WITH RADIATION! and more towards preventive care: MAMMOGRAM ALL THE LADIES! Firefight when you have to, but how much better is it to catch things early? For us, of course, it’s lives on the line, but guess what? It’s better for the bottom line too. Win-win.
Interestingly, the three situations described in the 20/20 bit as potential money grabs by the veterinary profession are perfect illustrations of why preventive care is so very important. Had we seen the extent of Marty Becker’s 90 minute interview for the piece in context, this would have all been part of the piece, by the by.
50% of dogs over the age of 10 will develop cancer. I see it every day. It stinks, and once it’s diagnosed in advanced stages the treatment options are difficult and expensive. When your veterinarian finds a lump on a dog during a routine exam, for the love of everything, check it out! Trust me, I would make more money resecting it in a messy surgery a year from now when it’s huge as opposed to doing a little biopsy or fine needle aspirate here and now, but I don’t recommend that because I don’t want that to happen to your pet.
Here’s just a few examples of things I have diagnosed on a check of a lump the owner was on the fence about doing anything about:
-mast cell tumor
Kekoa had a sarcoma hiding under a lump of fatty tissue that, to my fingers, felt like a lipoma (benign fatty tumor.) It wasn’t.
Early detection saves lives.
People often go to those weekend vaccine clinics to save money instead of getting it done in the office. Then what happens? They hand you a pamphlet and you have to decipher which package, A, B, or C you want like it’s ordering your kid’s school photographs. It’s confusing. Often, you overbuy. It’s a lot of work to try and stay on top of these things, and I certainly don’t expect pet owners to be reading up on current best practices for vaccines each and every time the dog’s getting boarded and you need a Bordetella vaccine.
I take vaccines very seriously. I keep up on the latest AAHA guidelines- based on research, science, and the best our field has to offer in terms of what constitutes duration of immunity and core versus non-core vaccines. I use that to tailor a vaccination protocol for each pet who comes through the door. I can’t tell you what I recommend across the board because there is no such thing as ‘one size fits all’. I’ve done the full complement, I’ve done titers, I’ve written letters asking the county to exempt an elderly pet with a history of vaccine reactions from a rabies vaccine. This is what we do. If your veterinarian isn’t open to that conversation, I agree 100% that you may want to find someone else.
That being said, the majority of my patients do stay on schedule with vaccines, because once you’ve seen dogs dying of parvo while a little child weeps, you kind of get invested in doing all you can to prevent that.
Bottom line: It’s worth it to find a veterinarian you trust. We’re not unicorns, at least in my experience; we usually can be found hanging around.
Vaccines save lives.
Here’s the one that caused the most discussion. Our profession is in the middle of some real change in terms of recognizing the importance of dental care. Since I am not a boarded veterinary dentist, I defer to their vast reservoirs of knowledge and the evidence is clear: 85% of pets have periodontal disease by the age of 4. Most of it is invisible to the naked eye. Can you imagine if we waited until our teeth looked brown and grungy with recessed red gums before going to the dentist? There is real, actual value in getting professional care even if a mouth “looks” OK.
The *best* way to keep your pets’ teeth healthy at home is incidentally also the cheapest: brush their teeth daily. The other best thing is to get regular, anesthetized dental cleanings to prevent disease from developing/worsening. If you choose not to anesthetize a healthy pet at 3 years old for routine maintenance, the end result is often a 12 year old with impaired organ function and a mouth full of horrifically painful teeth that need to be removed, at great expense. I can address the anesthesia component in another post, because it’s worth a discussion all its own, but suffice to say, anesthesia performed to excellent standards of care- that’s the key- while not risk-free, is actually very safe in healthy pets.
The three issues presented above are life-savers for pets. I am not saying this hyperbolically. Done early and with forethought, they are also money-savers, because they stave off much more significant, and expensive, disease down the road. There’s a reason my own insurance has a $0 co-pay for preventive care: it works. Same goes for our pets.
And happy Thanksgiving, everyone.
Did you see this bit on 20/20 this weekend? Ah, media. Titled “Veterinary Confessions,” the piece follows a couple of dogs through a series of veterinary visits where different vets offer different services based on their clinical experience, interspersed with the contrite admonitions of a former veterinarian who says that he was, before he relinquished his license (more on that later), the medical equivalent of a used car salesman.
Look, I’m not going to tell you that every vet in the world is equal and that everyone follows the same recommendations every time, but if you think that was the real point of this piece, you’ve been duped. Citizens of Oz, let me show you the Wizard.
“The vast majority of vets are ethical” and don’t recommend what’s not needed, says Dr. Andrew Jones, who then goes on to admit he regularly practiced the most unethical practice of recommending what wasn’t needed, just to make more money, hence confessing that he personally was worse than the vast majority of vets. Sounds like a legit guy to speak on behalf of the profession.
Why is he a former vet, you may ask? Well, the excellent blog SkeptVet profiled him a couple of years ago, if you’re interested. Rather than stop his continued practice of talking smack about, well, pretty much any vet except for himself- he was great, you see, unlike the rest of us slobs- he voluntarily gave up his license to practice in Canada.
And what is the good Dr. Jones doing now? Championing the cause of the poor and underserved, fighting the good fight to educate consumers about the latest AAHA vaccination recommendations or raising money for all those people getting soaked by the rest of us unethical greedy vets?
Um, not quite. He has a website. On it, he offers a
which sounds nice and altruistic. Oh look, he’s pre-prepared for the website traffic he’ll get tomorrow:
So, if you continue to scroll down for 5 or 600 feet, you’ll see that yes! it’s FREE!
(save the $6 shipping and handling)
Hey man, sign me up! Only $6 for all this info! I’m going to CLICK!
Wait, what? In order to get the free $6 DVD I have to also sign up for the $10 monthly service in perpetuity? Isn’t that the Naughty Video Site approach?
So, in return for tossing me, and my friends, and the vet you hopefully like and trust, under the bus, the good doctor is already planning for the side bennie of all those new subscriptions (note the date on the website, and the date I’m posting this.) All in the name of altruism, you see. Behold the Wizard.
You know me, I don’t normally get this upset, but MAN, my hide’s a little chapped right now. Greedy vets? When’s the last time I’ve asked you for a credit card in order to peruse my website?
I will leave you with one last thought. In this piece, Dr. Jones called dental cleanings the “would you like fries with that” of veterinary medicine, a very often unnecessary bit of work. To illustrate the point, he used a little pit bull who was seen by several vets who said she was fine and didn’t need any dental work. Anesthetized dental cleanings, by the way, often allow you to do a closer examination than you can do on an awake pet and might let you discover something like
Yes, that’s the same dog.
But by all means, continue to compare me to a kid at McDonald’s. In the meantime, may want to get that looked at.
Hardened criminal. Swimsuit model. New media revolutionary. NPR host. Animator. What do they all have in common?
Their lives have been made better by having a pet. And we’re not talking oh, I have a cute cat and I sometimes feed it and it makes me chuckle, I’m talking about people whose lives have been profoundly affected by the animals in their lives.
I assume if you’re here reading this blog, you feel it too. Something about the bond between ourselves and our pets goes way beyond the mildly symbiotic relationship developed millennia ago when cavemen tossed scraps to the wolves on the outskirts of the clan; it is an uncomplicated, pure type of love, and those of us who are fortunate enough to have experienced it spend most of our lives trying to come up with ways to pay our animals back for what they give to us.
This Tuesday, I attended the Purina Better With Pets Summit in New York City. As it was the inaugural event, I didn’t know what to expect. No one did, really. 16 speakers in a Ted Talk-ish sort of format, 20 minutes each to share their stories of how pets have enriched their lives. It was, to put it mildly, fantastic.
Some speakers were enlightening, like Dr. Brian Hare from Dognition who is learning some amazing things about dog breeds and different measures of ‘intelligence’:
Some were funny, like Alex Ohanian from reddit- who talked about how putting a cat on your head and taking a picture creates an experience that allows people to connect with all of humanity:
Some moved us in entirely unexpected ways, like Black Label Dance Company’s exploration of a man’s relationship with his aging dogs:
And some just reduced me to a slobbering mess of OMG-can’t-deal, like Judy Finnegan of Puppies for Parole. Missouri’s program has rescued over 2,000 dogs from euthanasia at high kill shelters, placed them with prisoners for 8-12 weeks, and ended up transforming the lives not only of the saved dogs, but the deeply hardened men who found, through these dogs, how to learn compassion.
These are just a couple of samples, but the other previews are available here, including the inimitable Dr. Marty Becker ending us on a lovely note. When the full videos are up I’ll share again because there were some powerful messages in there that bear repeating, like Dr. Robin Downing’s assertion that reducing pain saves pets’ lives, and Dr. Arleigh Reynold’s touching discussion of moving to Alaska to live and breathe life with his dogs. Doesn’t that sound cool?
I left the event much more affected than I thought I would. As someone who has made my life’s work about animals, I forget that just because someone else hasn’t, doesn’t mean their pets aren’t just as important to them as mine are to me. I forget why I do what I do- not because I love pets, but because so many other people do as well, and I can provide something that helps make that even better. In our human world of strict social order, etiquette, and rules of conduct, pets are one of the rare things that can transcend that artifice and bring us all to the same level.
Group hug, everyone. Life really is better with pets.
*disclaimer: Purina invited me to the Better with Pets Summit and generously covered my travel expenses. They did not pay me or require any posts about the Summit- all opinions and musings are entirely my own.
This week my Facebook newsfeed has been filled with friends listing, day by day, those things they are thankful for. Health. Family. Security. All good and wonderful things, and what a lovely sentiment to take a moment out to acknowledge how fortunate we are to have what we do. I like that.
I think it’s safe for people to assume I am thankful for my family and their health and the nice things I am lucky to have, absolutely. But I think a more interesting question is this: What are you thankful for that you might not have seen as a blessing at the time?
I am thankful for an unpleasant woman who did something horrible to me once, years ago. It took me a very long time to come to that place, because the immediate effect of her action was to make me question what I do and why I do it. It made my unhappy with my work. And ultimately, it gave me the push I needed to get away from a position I was unhappy with for reasons having nothing to do with her and take a big risk making a go at writing. I don’t know if she had never wandered into my life, if I would be emailing my agent to discuss meeting up for coffee in a couple of weeks. That is my ultimate dream, and to think it all might be tied to what I have long thought of as the worst experience of my career. It’s funny how life works, isn’t it?
I am thankful for Kekoa’s death. Don’t get me wrong, I am not thankful that she died, but I am thankful for the manner in which it happened. She had to die at some point, as do we all, and my feelings about that are neutral. But it was a quirk of time and circumstance that I was in need of a home visit veterinarian, and I happened to remember a friend of mine ran such a service. That reconnection gave me a chance to do work I didn’t know I wanted to do, and it has to date been the most emotionally gratifying service of my career. I am also thankful Betsy did not hire me based on my first stab (no pun intended) at placing a butterfly catheter. I got it now.
Grateful for dogs who steal other dogs’ beds, because they give me something to laugh about after they are gone.
I am thankful for everyone who trusts me to come into their home and, in essence, end their pet’s life. That is a massive trust and responsibility. I hope I make that experience just a bit easier for them. I hope that when I leave, they are glad they asked me to help.
I am thankful for weird things, holes and shadows and grudges that provide us the counterpoint we need to see the shine and light and vistas that make life beautiful. Thankful for those occasional moments of clarity that pull me out of my daily haze and strike: needlelike and sharp realizations of a truth, soft and melting warmth of an interconnectedness.
Most of all, I am thankful for my irresponsible neighbor who didn’t spay her dog, because without that there would be no childhood dog Taffy and no Dr. V and I might very well be a moderately satisfied podiatrist who, as far as she knows, isn’t a pet person. And if that isn’t a big stretch, I don’t know what is.
It’s one of my earliest memories: kneeling on the soil next to my grandmother in her lush front yard just to the left of her Mary on the half shell, her hair tied back with her ever present babushka. She clips a dead marigold and hands it to me. I look at it, brown and crinkly in my hand, then look up at her in askance.
“Look,” she says, and peels back the dead leaves. Inside, a pocket of seeds spills into my hands. Mary- I called her Babcia, because in her native Polish that is how you say grandmother- dug a hole into the ground next to the area where the marigolds had blossomed and planted the seeds in the dirt. “The flower gives you what you need to make more flowers.”
My mind was blown. My four year old brain didn’t know if things just kind of appeared on Earth or were all bought at the store, but the idea that a crinkly dead marigold was the key to making more marigolds was a kind of magic I wasn’t prepared to handle. I never forgot that afternoon, many summer afternoons spent pouring seeds into a baggie for later. To me, marigolds represented magic. They represented Babcia, nature in its glory, and the eternal nature of life even in death.
This afternoon, I was walking out of the grocery store when my eye caught a pot of marigolds. They aren’t common here in San Diego, so I stopped and looked more closely: “Dia de los Muertos marigolds”, the sign proclaimed. The Day of the Dead. How could I have lived here for so long and not known of the association between marigolds and a holiday honoring our loved ones who have passed on?
This is not a popular holiday in the New England I grew up in, where death comes with the most somber of attendances and sneaking a bag of Dunkin Donuts munchkins into a grandfather’s coffin for the long ride home requires special dispensation from the funeral director. But it’s big here in San Diego, and despite being born out of the same Catholic roots the manifestation couldn’t be any more different: a color explosion replaces the black and white palette, the music is loud and joyous, and marigolds replace funereal white mums. Life continues, even after death.
We’re all marigolds in our own way, all of us leaving something of value to those we’ve left behind, a mark on the world that persists long after we have ceased to. For me, Babcia taught me reverence for all living things, right down to the trees, to be thankful for what they have to give us and to be kind in our stewardship of the earth. Those were the seeds she planted in me.
It’s even more apropos when we think of our pets, who like flowers have such a short season here on Earth, but whose beauty and brightness in life compels us to continue bringing them in the house despite knowing our time with them is all too short. I have so many little blossoms in my heart now, from Taffy and Nuke, Mulan, Emmett, Apollo, Calypso, lessons they have gifted me on patience and love.
The most common question people ask me, in my current work providing home euthanasia services, is “Wow, isn’t this so hard?” And it’s hard to answer, because watching people in pain is hard, and not enjoyable, but the ability to provide them a service that means so much is immensely rewarding. To a one, in their grief, when I ask clients about their pet, they smile through their tears as they tell me, “Neil loved to chase lizards, but he’d never hurt one. So we had a house full of lizards running around.” That sort of thing. My Babcia is now in me, helping me crack the seal of their sadness and shake out the memories and love within, which over time will take root and remain in bloom when the grief has faded to dust.
And that is a beautiful thing.
Those of you who watch The Walking Dead know about Michonne, arguably one of the most kick-booty characters on television today. When we first meet her, on her own after the zombie apocalpyse, she is holding her own thanks to her katana and a pair of neutered (as it were) zombies she has put on a leash and uses to avoid detection by other zombies.
Even though we are now on Season 4 and Michonne has long since lost her zombies, it remains the only instance in which zombie power was harnessed and used for a good cause. Really, they are losing out on a good opportunity here. Yes, zombies do a lot of bad things like try to eat you and the like, but on the other hand, they aren’t that smart, being brainless for the most part. With a little careful handling, they could be of some use. I’m picturing a big hamsterwheel or the like, just stick ‘em on with a pile of meat hanging out front and use it to power a generator. At least one engineer must have survived the apocalypse who could figure out how to rig one.
My point is, even when you are faced with a very bad behavior, there is the chance to manipulate it for your own benefit.
Take tonight, for example. Both of my children declared they wanted to be zombies this year, for reasons I find both charming and alarming. My daughter chose to be a generic zombie child survivalist type, while my son went for a more specialized “Football Zombie” prototype. I had bought my daughter some horrifying purse accessory shaped like a severed limb, but didn’t come up with an accessory for my son. He came downstairs this morning with a Nerf football that he said could be distressed and turned into a prop.
We rubbed it in the dirt. It looked mildly dirty.
I sprayed it with fake blood. It melted into the ball and turned fuschia.
I stabbed it with a butter knife. It just bounced right off.
All this time, Brody has been following us around the house with a mixture of curiosity and lust. You could say he’s drawn to balls like….a zombie to brains.
Like a zombie to brains.
I don’t know why I didn’t think of that one sooner.
“Go play with Brody for a little while so I can think this over,” I told my son, tossing the ball down the hall.
Five minutes later, mission accomplished. My son set off this evening with a well mangled Nerfball, Brody got a little extra playtime, and all was right with the world.
Let’s imagine, for a moment, that there is a serial killer loose in your town. One by one, he picks little kids off from the local playground, and it’s horrible and awful. The police are working around the clock, but the killer remains elusive.
But he only ever chooses his victims from that one playground.
You wouldn’t take your kids there, right? Even if *most* of the kids who play there end up ok, even if the police chief says, well, it might be OK now? Why take that chance, when there are plenty of safe alternatives?
That’s kind of how I feel about this jerky thing. From the latest FDA update:
The agency has repeatedly issued alerts to consumers about reports it has received concerning jerky pet treat-related illnesses involving 3,600 dogs and 10 cats in the U.S. since 2007. Approximately 580 of those pets have died.
Since 2007, guys. Keep in mind that the FDA is usually all over dog foods when there is potential human illness involved as well, but the wheels turn a little more slowly when there is no indication people are also getting sick. Regardless, I’m glad they are becoming involved- and the level in which they are asking for veterinarians and consumers to participate is much higher than I’ve seen before- but there’s no indication when we might have some answers.
There’s really only three things I’m reminding people of here:
1. It’s not just chicken
Everyone keeps focusing on chicken jerky as the culprit, but some sickened dogs have eaten duck, fruit, or sweet potato jerkies as well. Most of the treats have come from China (they aren’t saying it outright in the fact sheet, but we can read between the lines here.)
2. The symptoms are diffuse
Not every dog has the same symptoms. Some have GI signs, some have liver issues, others have renal disease. There may be one cause but it is possible we are dealing with multiple contaminants, drugs, or toxins. Which is really frightening.
3. This is 100% entirely preventable
Now that we know it’s a problem, there’s an easy solution. Don’t feed jerky treats from China. They are not a necessary part of anyone’s daily nutrition. It won’t find the culprit, but it will keep your pet safe until they do. Here are some alternatives:
- Make your own. No special equipment required.
- Use fresh alternatives like baby carrots or apples
- Become obsessive about label-reading. Even some products that appear to be from the US or distributed from the US have ingredients made in China. If you’re not sure, don’t buy it.
I made this video almost two years ago, and we STILL don’t know what is going on with those jerky treats.
Do you know anyone whose pet was sickened from jerky?
I had a moment. I admit it. A moment of just sheer utter sad, thinking on the amount of death and loss and unpleasantness that’s been floating about lately.
I thought of my daughter’s poetry book, which she started after Kekoa died to work through her grief. Just as she was finishing up with it, now she writes about Apollo.
I thought about the little shadow in the background that used to flit about.
I thought about the happiness certain things bring me and the kids.
I thought about the things that my life center around, my life’s work, and before you knew it I had driven somewhere I wasn’t planning on going, and walked somewhere I wasn’t planning on walking, and signed something I wasn’t planning on signing.
I thought I wouldn’t do this, but I did.
This is Penelope. She is outgoing and awesome and I love her very much already.
I thought that might happen.
I used to work in a clinic that offered twice a week vaccine clinics. During those times, we would waive our customary exam fee (at the time it was $45), as long as the client was coming in solely for vaccines and had no health questions.
We did this to provide a service to those clients who would go to the weekend vaccine clinic at the pet store instead of coming to us. I know how those weekend clinics work. They are much like the flu clinic I took my kids to last week. You go, you get your shots, you leave. If you ask about your kid’s ear infections you’d be given a blank stare as they ushered you out the door. Poke, pay, push off.
And you know, it works as long as that is truly all you need. But you would be shocked, or maybe you wouldn’t, I don’t know, at how many times that was not at all the only thing clients need. Especially in the vet clinic. I love questions! That is what I am here for, to educate nervous new pet owners and also say, hey, look at this tooth or this mass or this ear. To say, hey, I see Rover is 14 and has never had bloodwork and you said his appetite is low; perhaps we should postpone these vaccines and make sure he’s OK. But all of that stuff? That’s an office exam. And we have 15 people in the lobby waiting for a bordetella vaccine.
I hated those vaccine clinics with a passion, because at least once a clinic I would get a client who said, “no concerns! Just rabies!” to the technician, waited until I came into the room, and asked me for an allergy consult. And I would either do it because I felt a professional obligation, even though it meant everyone else outside had to wait, or risk being called a (insert choice insult here.)
With the exception of rabies vaccine, our local feed store carries all the other regular canine vaccines. Yes, it’s less than coming to me. Anyone can learn how to give a shot to a dog in about 5 minutes, that’s not the hard part. When you come to me for an exam and vaccines, you are paying for all the other intangibles, captured here so nicely by a colleague with better graphic design skills than me:
I understand why people go to those clinics- it’s inexpensive and it’s convenient. It is not, however, a replacement for an office call. Give us a chance. You might be pleasantly surprised at what our staff can do for you, and most importantly, your pet.
I’m getting Apollo’s ashes back this week. I still haven’t quite processed it yet, because his death lacked that months long painful preparation/ agonizing over a pet in the process of dying: The Infinite Hovering of the Big Hanging Clock. He woke up Wednesday morning, meowed for his food like always, and was dead 12 hours later.
Whenever you learn of a terminal diagnosis, that invisible countdown clock that all living beings share suddenly appears. And we know that it’s winding down, sooner rather than later, but we don’t know quite how long it will take. No matter how long it takes it always feels like no time at all, while also taking forever. In Kekoa’s case, 2 long months. In Apollo’s case, one unending afternoon. That hovering space between a good life and a good death is a painful, lonely place when you’re a loving pet owner trying to decide what is best for your pet.
It is, however, part of living with a pet, right? We know it happens, and with as much precision as science allows how a body winds down, so why aren’t we doing a better job of working through it?
It’s the way doctors- MDs and DVMs alike- are trained: here is how you cure. Here is how you preserve, prevent, delay, at all costs and to the last breath, we go down fighting. Play as long as you want, but the house always wins, in the end.
What are we fighting for again?
My grandfather wanted to die for at least a year before he actually did. He was very clear about this. He was done, his wife was gone, he had no interest in this world any more. I understood this. I respected it. The last day of his life, he lost consciousness and was rushed to the ER (which he never would have agreed to when conscious.) When he woke up, the doctors said they couldn’t find anything wrong with him so they were going to have him stick around for a while and be observed. He was so annoyed at this that, by what I can only assume is sheer force of will, he said, “NO!” and died. Sometimes, it’s ok to not want to fight.
Sometimes we want to, and we should fight. And in that regard, veterinary medicine has a dizzying array of weapons at its disposal, chemo and surgeons and radiation therapy. Here’s the truth from the trenches, though: most people don’t go that far. Good owners, loving owners, many people stop far short of doing everything, for a variety of excellent reasons. When looking at the inevitable certainty of death, the pendulum is swinging away from quantity of life to quality of life. Instead of preserving life at all costs, we preserve good life as long as possible, and then we accept the end. I like this. I am glad more vets are open to this approach.
I will support whatever decision you make
When I took Apollo to the specialty hospital after finding him down in the back end, I was almost certain of his diagnosis. Once I had confirmation from one other vet, I was 100% set that letting him go was the proper option. That is an educated decision based on my history with saddle thrombus and my personal beliefs, but if I were a non-vet client, I’d have been overwhelmed.
Apollo’s clock stood at 00:00:01. I knew this. I had no desire to fight for two extra minutes. The specialty hospital, doing what specialty hospitals do, assumed I was more of the “let’s throw the whole arsenal at him” camp because that is what most people who seek out a specialist want to do. I don’t blame them for that, but I did have to clarify “Nope, that’s not what I want.” As soon as the cardiologist confirmed my suspicions and also told me Apollo’s heart was enlarged, I knew all I needed to know.
I have worked with some exceptional veterinarians in my time; a couple who stand out to me tonight are an oncology resident in vet school and the cardiologist I met this month with Apollo.
They lay things out, clearly and precisely. “Your pet has this. Our options for treatment are A (everything), B (somethings), or C (nothing/palliative care.) The survival rates are this. I will support whatever decision you make.” Even though most vets really do feel this way, I wish we did a better job of letting clients know this, that A-B-C does not stand for ‘great owner- OK owner- awful owner.’
It’s actually a terrible choice of words; ’doing nothing’ often really means “choosing not to pursue therapy and instead focusing on minimizing suffering.” That’s something. That’s huge. And clients shouldn’t feel guilty asking for that.
The Hospice Vet
If your pet has a terminal diagnosis, you have options. My friend Edie has written eloquently about her recent experience with a hospice veterinarian, and it outlines an experience I hope more people become aware of: The preparation visit. We do a great job of outlining a treatment plan for life, for managing kidney failure and cancer and liver disease, but when it comes to outlining a plan for death? Not so much. I have done these visits as part of my current work and it does so much to reduce the fear and anxiety of the unknown surrounding death.
Even if you don’t specifically use the services of a hospice veterinarian, most veterinarians can help you come up with a long-term plan if you ask for them to help. A hospice plan will help you determine several things:
- What to expect as your pet’s disease progresses.
- What quality of life means to you and your pet, which may be different than it is for someone else.
- What very specific occurrences are your signal that it is time.
- What tools are at your disposal for managing pain and keeping your pet comfortable.
Knowledge is power. Knowledge is peace. To all of you facing a tough decision, I wish you all three.
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