Health

Confessions of an Agnawstic

A few weeks ago, while my publicist was asking online dog lovers if they might be interested in reviewing my book, he came back with a question:

“Do you recommend Science Diet or raw?” he asked.

“It’s really not an either/or thing,” I said. “The book doesn’t talk about nutrition at all.”

“Well, one of the people we approached said they only write about things from a raw food perspective,” he said.

“Oh, then they don’t want my book,” I said. “It’s just from a dog lover’s perspective.” And that was that. Because here’s the truth, which is going to probably cause a few people’s heads to explode: when it comes to my belief about the omnipotent power of food, I’m an agnawstic.
 

agnawstic_edited-1

 

This belief started, as many things do, with my own experiences with food evangelism: Atkins, paleo, etc, wash, repeat. For one brief, terrifying month my husband dropped down the rabbit hole known as “extreme diets.” Now, I can’t blame him for trying- I’ve tried them too over the years, but he’s never been on board. After years of ignoring my attempts at zoodles, banana “ice cream” and other current food trends on the paleo circuit, he announced one day he was “going keto.”

“What does that mean?” I asked.

“Less that 20 net grams of carbs a day,” he said. “I heard it’s great for detoxing.”

“Did you find this on reddit?” I asked. He didn’t answer.

For the next 30 days, I learned what it is like for someone to be discovering enlightenment. He would follow the kids around the house asking them if they had any idea how much sugar was in their ketchup, pouring verboten salad dressings down the drain, and meaningfully wait until we were all in the room at the same time before turning on “Food Inc” on Netflix.

He preached fire and sugarstone, swallowing almonds with one hand while tossing pretzels in the trash with the other. He was flush with the light, or maybe just a little zany from ketotic acidosis, who knows. He says he felt great. He was online talking to people who gave up dairy, sugar, alcohol, gluten, fruit, potatoes, and on life in general and were now convinced their nuts were causing inflammation when he finally broke and had a fudgesicle. Now we are living a life of moderation together, and it is wonderful.

abyss

 

Now, don’t get me wrong. I think the idea of knowing what you are eating, and preparing it yourself, is a mighty fine thing. I try to avoid bread and pasta and sugar in favor of veggies, water instead of soda, but the last two months it was ALL CHOCOLATE AND CHEESE AND WINE and I didn’t feel bad about it at all. I have permission to meander in my choices. Good nutrition matters, but it isn’t the only thing that matters.

Life is balance, right? I eat well mostly and exercise a lot and don’t smoke and try to get enough sleep. Know who else did that? My mom. All my grandparents lived to 90 and she got brain cancer when she was 67 and she did everything right. It doesn’t mean I’m going to start lighting up. The CFO of Rady Children’s Hospital was killed a mile from my house during my mother’s memorial service while he was out riding his bicycle, being healthy. Sometimes shizz happens, and while diet matters, it’s no more a guard against bad luck than any of those other multitude of things in your life like genetics and a careless woman in a Range Rover.

Which brings me to what I refer to as “blog chum,” the words I always hesitate to type lest it attract a group of angry club wielding acolytes the way blood draws a Great White: Dog Food. I don’t care what you do with it. There. I said it.

  • You can feed a crappy kibble and your dog might live to 20 or he might look like he got run through a wood chopper.
  • You can feed a high quality kibble and your dog might live to 20 or he might get cancer when he’s 2.
  • You can feed raw poorly done and your dog might live to 20 or he might look like Casper when he’s 4 months old because he got nutritional hyperparathyroidism.
  • You can feed raw that someone balanced for you and your dog might live to 20 or he might get kidney failure when he’s 7.

That’s the way it works. Food is one piece of a really complicated puzzle, and anyone who tells you otherwise is selling something. (Probably dog food, magazines, or coconut oil.)

Now clearly, my education (paid for without the aid of Big Pet Food, by the by) and my experience lead me to recommend that with which I am familiar- that would be commercial dog food- but if you want to feed your dog raw and you swear it’s the most amazeballs choice ever and your dog is the healthiest dog who ever walked the face of the earth, go forth and be happy, because I really don’t have the energy to fight over any of the following:

  • who taught me
  • who bought me
  • who sends me places
  • how much I make off selling food

If you want my opinion, I’ll give it, and I think it’s an educated one. I’ll listen to what you have to say, though I may not agree. If you have decided that my views on that one topic mean my years of experience and knowledge about all things animal health related are bunk, well, we might as well enjoy a lively discussion about the upcoming primaries while we’re at it because might as well go out with a bang.

And then I will go make a healthy chicken salad and wash it down with a glass of wine, because that’s what agnawstics do.

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

The vet will see you now- for entertainment purposes only

A year ago, my husband gave me a telephone number and said his insurance company now had phone consults available. 24/7, from the privacy of my own home, I could call in and get “seen” for ear infections, get a prescription for Ambien for travel, even get marriage counseling, should I desire it. I only used it once, but I was amazed that at 10 pm I could just call and talk to some random person and 15 minutes later pick up a prescription at the 24/7 Rite-Aid. I’m not going to lie, I think it was pretty cool.

For the past five years, I have said the same thing over and over to people in the veterinary profession: telemedicine is coming. How are we going to handle it? And over and over the response has been the same: no it’s not. This is only half true: it’s not coming from inside the vet profession.

But it is coming, as this piece from dvm360 goes into. And not just Vet on Demand. I’ve been approached about 10 times in the past year to sign up to be a telemedicine/internet consultation vet, and I always say the same thing: I am bound by my state practice act’s definition of valid client-patient relationship, which says that I must examine an animal in person to establish that. Anything outside of that and I’m breaking the practice act, which is why my FAQs are so clear on the topic.

Veterinarians make excellent points as to why telemedicine for us differs so much from telemedicine for people:

  • Doctors get a lot more out of history than we do. People can describe symptoms they are experiencing; pets cannot say, “I have chest pain radiating down my arm”. Veterinarians rely much more heavily on physical examinations.
  • Human medicine is incentivized to keep people out of the clinic to keep costs down, since general practitioners are already in short demand. Vets aren’t that slammed. Come on in.

And while we are perfectly content to say “This is a terrible idea,” others are not, and are trying to reap the benefits of it. People with background in restaurateurism see a chance to make a few bucks and throw an app together, paying a vet some pittance like $5 to put their license on the line. Why not? They don’t have anything to lose. They get around it by saying things like, “oh, we’re offering general advice, not specific diagnoses,” or take the old Miss Cleo approach:

psychic

For entertainment purposes only. Riiiiight.

vetondemand.com-

This is from the VetonDemand website. I dunno guys, sure sounds like diagnosing to me. (By the way, my favorite saying is a lump is a lump is a lump. No biopsy, no diagnosis, unless the lump was a tick or a piece of sticky kibble.) That’s wasted $$ right there.

To sum up: individual veterinarians are bound by their state practice acts in terms of whether or not diagnosing over the net is legal, and it’s all over the place in terms of who can do what. This is reason enough for people to fold their hands together and say, “See, it’s not going to work.” I disagree.

My husband called the human telemedicine line to ask about a cough, and they refused him antibiotics and told him to get a chest x-ray. They were clear in their limitations. I think there are opportunities for veterinarians to use telemedicine to our advantage in responsible ways:

  • consults for pre-existing clients
  • Online ER consultations in coordination with local clinics for things like post-op questions: “My pet’s incision looks puffy, can it wait or should I come in?”
  • With clearly defined limitations and expectations, it has its place. Truth is, most of the time the answer is, “It could be x, y, z…you should be seen,” but that’s still better than what I see happening now.

I don’t have all the answers, certainly, but I think it’s a huge mistake and a missed opportunity for the veterinary profession to not take this on proactively. It’s not a matter of if, it’s when, and if we pass up our ability to drive the bus then two restaurant entrepreneurs from Nashville are going to take the wheel instead, and we probably won’t like where they take us.

I love technology. I think we can use it, we just need to be a little creative and stop digging in our heels like those old guys who still- STILL- insist on fax over email for sending records over. Give up, man, the world is moving on.

What do you think? Would you use a service like this if you could?

Filed: Ask Dr. V, Blog, Daily Life, Featured Posts, Health, Lifestyle 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.

dog1

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

dog2

Or adult size-

dog5
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?

ramone

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:

dog6

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.

 

wisdom

 

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.

mommy

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, 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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JERKY4

Any questions?

 

Filed: Blog, Cooking, Daily Life, Health, Pawcurean, Picks of the Litter 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

 

team

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.

temporary

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. 

ROAD

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.

boundaries

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.

you-shall-not-pass-o
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, Fit Life, Health, Lifestyle, Musings, Picks of the Litter 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.

800px-Witchcraft_at_Salem_Village

 

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.

scumbag-jenny-mccarthy

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.

vani

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!

bill

“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?

shill

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: , , ,

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: , ,

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: , , ,

The SHOCKING TRUTH about cancer they don’t want you to know

Cancer. It’s scary stuff. Every day, I hear another story of an elderly dog and cat diagnosed with neoplasia, and my heart hurts for those dealing with it. Without a doubt, cancer sucks, and every new breakthrough is a gift.

There’s lots of theories and evidence pointing to different causes of cancer. Food, say some. Chemicals, say others. Vets peddling food and chemical-laden vaccines, say many. And I’m here to tell you this: They’re right.

What? Say it ain’t so!

It’s true. I’ve been giving it a lot of thought and going back through my years of work in the veterinary field, and I’m here to tell you this: In the United States, the leading causes of cancer in dogs and cats are:

bigbads

Vets Lead to Cancer. There, I said it.

The epiphany came to me a couple of years ago, when I was in Granada, Nicaragua. Life is simpler there, freed of the constraints and interferences from big companies typical of our American lifestyle. The dogs down there? They are free.

free2

Down in many of the places I’ve visited such as Granada, Iquitos, and Turks and Caicos, the dogs aren’t exposed to commercial pet foods. They eat like their ancestors, from what they can scavenge.

They don’t get injected with toxins/vaccines/anything.

And they certainly don’t have their reproductive organs rudely removed. They live and die the way God intended, without Big Corporate Interference.

And when you compare the causes of death in these areas to the causes of death here in the States, one thing is for sure:

When Vets, Pet Foods, and Medicine Stay out of the Picture, Cancer Does Too.

(Well, except for that nasty transmissible venereal tumor that is rampant in stray populations in tropical and subtropical climates and leads to a premature agonizing death, but let’s look past that all-natural death for a minute.)

Here’s the thing that has had researchers and doctors and scientists scratching their heads for years: No one can predict when cancer will strike. Sure, there are certainly things that can predispose one to tumorigenesis, such as genetics (sorry, Golden Retriever lovers), or the feline leukemia virus (sorry, 2-3% of all cats in the US with this vaccine preventable illness), but the truth is cancer is a capricious, heartless bastard.

Sometimes it strikes young people or pets who have eaten nothing but organic kale salad and free range chicken their entire lives. Sometimes it skips that old person who’s been pumping themselves full of tobacco and GMOs and grain-fed beef, or the dog who’s been swimming in toxic waste on a daily basis.

The Number One Cause of Cancer Is This

There are plenty of known risk factors for the development of cancer in certain populations, but only one that without a doubt spans all species in all countries: AGE. Age causes cancer.

If only you had died before you were thirteen, Kekoa, this bone cancer thing never would have happened. Can I ever forgive myself?

If only you had died before you were thirteen, Kekoa, this bone cancer thing never would have happened. Can I ever forgive myself?

When I was in Granada, what was the main reason I saw so few dogs with cancer? Was it their diet of plastic wrappers and banana peels? (No.) Their lack of vaccines? (No.) It was because until World Vets showed up with their evil boxes of toxins and Frankenkibble and neuter packs, the average lifespan of a dog down there was four years old.

Big Pharma, Big Pet Food, and Big Vet Med directly correlate with the number one cause of cancer: living long enough to get it.

That horrible Nationwide ad from the SuperBowl has nothing on us.

puppy2

Just kidding! World Vets got him set up with vaccines and dewormers. He’s one of the lucky ones.

The cocoon of health

If you want to keep your pet from dying of cancer, get suspicious bumps checked out asap, don’t let your pet pick up smoking, and cross your fingers. Or kill them off early by letting them get so fat they develop diabetes or die of heat stroke the first warm summer day you try to go for a walk. I guess that works too.

Living as we do in a comfortable place with reliable access to medical care, we’ve forgotten about the realities of all-natural living, for us and for our pets. Measles. Polio. Rabies. Organic, GMO free viruses that will kill you.

Vaccine preventable diseases suck, which is why the vaccines were developed in the first place. They are far preferable to the disease itself, and if you say otherwise (some people have), I invite you to the streets of India where rabies kills lots of children, every day. 55,000 people a year worldwide-mostly children, and 20 MILLION dogs culled in an attempt to control it.

Pet food is a reliable and affordable way to feed pets for 95% of the population here in the States. If you want to cook for your pet, more power to you, but remember this: Even the gnarliest brand you can think of is better than starving, and if you say otherwise (some people have!) I invite you to Iquitos to decide which dogs are healthy enough to save and which we have to euthanize out of kindness.

Number of people who turned down free vaccines, vet care, and food in Granada: Zero, because they were sick of seeing dead dogs in the street. Pets finally living to ten years, the age at which cancer becomes the leading cause of death, is pretty priceless.

The Four Horsemen of the Dogpocalypse

Apocalypse_vasnetsov

The four horsemen of the apocalypse are, if I recall correctly, Vaccines, Pet Food, Rational Debate, and Veterinarians. Oh wait, I got that backwards. It’s Pestilence, Famine, War, and Death- the stuff the first four are trying to prevent.

How easily we forget that in our armchair indignation.

Filed: Blog, Health, Musings, Picks of the Litter Tagged: , , , , ,

The Truth About Pet Food Research

About one year after I graduated vet school, I took routine screening chest radiographs of my senior Golden, Mulan. I looked them over, frowning at a small, mottled spot near her sternum.

“She has cancer,” I thought. It’s not an unreasonable conclusion to come to with Golden Retrievers. Before I panicked, I asked my colleague to look at the x-ray, and she agreed it looked suspicious. I was devastated.

I took Mulan to the local specialty hospital, where an intern I knew from vet school patted me on the back while the resident internal medicine specialist pursed his lips sympathetically. He grabbed his ultrasound machine to prepare for a guided biopsy. Before starting, he asked the radiologist to stop by to give his thoughts as to what this strange radiographic feature might be.

“What are you looking at? That? That’s normal sternum,” he said, sipping his coffee with the mildest of eye rolls before strolling out of the now-silent room.

I knew just enough to be dangerous but not enough to actually come to the correct conclusion. Along the way I dragged two other very educated colleagues with me through sheer force of conviction. Mulan lived another 4 years, by the way.

Data and Interpretation

Lots of people have asked me about the controversial results from the Truth about Pet Food’s crowdsourced food safety study. I haven’t said anything, because I couldn’t think of anything to say. It’s the same response I have when people send me this picture over email and ask me what this lump is:

dog

The correct answer is, “I need a lot more information before I can tell you that.” Which is about how I feel about the significance of this study.

As veterinary nutritionist Dr. Weeth points out in her excellent response, scientists kind of live to nitpick and poke holes in one another’s work. It’s necessary to allow criticism because there are so many ways one can go wrong with a project- from the way the study was designed, to the implementation, to the data interpretation. It was the persistent nagging of the science community that led to the eventual discrediting of Wakefield’s autism/vaccine research paper, the public health implications of which we are still dealing today, up to and including 19 people who were sickened with measles at The Happiest Place on Earth.

Without being allowed to evaluate the entire research process, we have no way of knowing how valid the results are. A pretty infographic does not science make. Nor does protesting “it’s not junk science” mean that it isn’t.

What We Know

I’m hopeful that the full set of data will be made public, including methodology. Until then, all we can do is go by what we have been told.

Dr. Gary Pusillo of INTI services, who has the misfortune of being out of the country while all of this debate is going down, was in charge of the testing process. Thixton writes that he is a board certified veterinary nutritionist, which in theory is fantastic because it means that he would have the background in both veterinary medicine and nutrition to not only perform the studies, but interpret the results. There’s only one problem: he’s not. (Nor does he in any way present himself as one, by the way.) A board certified veterinary nutritionist is a veterinarian who is also a diplomate of the American College of Veterinary Nutrition. You may think that’s irrelevant, it’s just semantics, but it’s not.

Credentials are a big deal, as I’m sure Dr. Pusillo himself would tell you were he around. I would really love for Dr. Pusillo and Dr. Purejav to have been available to answer questions while we’re all begging to know what the heck they did, and I’d love to hear more about how they determined “risk.” They may be the most qualified people in the world, but for right now, all I have is an infographic and a consumer advocate’s word that they’re the best.

jerrymaguire

Dr. Pusillo is a PhD who provides forensic science services, which actually sounds really cool and I would love to hear more about it. I have no reason to doubt that he is an excellent scientist. He probably knows tons and tons about how to test a food for specific substances. What he may or may not know is whether or not those substances matter clinically.

Data Collection vs. Interpretation

Let’s assume that the data collection was carried out perfectly. Data collection is only half of the equation- you still have to know what to do with it. You can have all the answers in front of you and still not know the question. The scientists Thixton contracted with are out of town at the moment, so who are we going to ask to help us interpret things?

carmen copy

Given who’s around right now, who could interpret the limited data we have through the filter of what matters?

A microbiologist with a background in food safety would be a good start, as someone who can tell you whether or not particular pathogens are actually of concern.

Or a board certified veterinary nutritionist, who can tell you about nutrient analyses and why dry matter comparisons without calorie content is useless. Both of them have some big reservations about this project.

They know more than I do about such things, which is why I defer to their interpretation. Little things mean a lot- for example, when you say “bacteria are present” what do you mean? Does that mean live bacteria were cultured using sterile handling procedures to eliminate environmental contamination? Or did the test just look for bacterial RNA, which could come from dead bacteria that were killed during processing and therefore prove that production works as advertised? I don’t know, but that would sure make a difference.

When the company you contract with to run your tests asks for their name to be dissociated from any press surrounding you, there’s one of two conclusions: 1. They were not happy about how their data was manipulated in the interpretation stage and didn’t want to be associated with bad science; 2. Big Pet Food Cabal. We may never know. *shrug*

A victory for food safety

I like to look at the bright side of things, and for reasons I can’t fathom, what I’ve found to be the biggest findings of the study are barely mentioned.

What are the three most common concerns I hear about pet food safety?

  1. melamine
  2. pathogens of most dire human significance, specifically Salmonella and Campylobacter
  3. pentobarbital contamination (implying euthanized rendered carcasses in pet food.)

Why were these not mentioned in the risk report?

Because they weren’t found. They did look for all of these products. All twelve tested foods were clear of the three biggest worries in recent memory to pet food safety. That’s something, don’t you think?

I’m an optimist. Let’s look at the bright side of things, what do you say!

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So let’s review here: I like asking questions. I have no problem questioning consumers, colleagues, my own professional leadership. I think concerned consumers are good consumers, and I applaud anyone who is invested enough to care about what goes into their pet, be it food, drug, or plant. I have chosen not to work in the employ of companies in the field specifically so I can feel free to say what I want without worry about my job or advertisers.

That being said, I think we also have to take the Occam’s razor approach to life and assume at some point that companies are telling the truth when they tell us they aren’t actively attempting to kill our pets. There are problems, some big and some small, and those are worthy of being addressed, but if you can’t accept at the end of the day that they are generally trying to do the right thing, then we may not ever be able to come to an understanding. As part of a profession that deals with this type of distrust on a regular basis, there comes a point where you have to say, “If you’re going to insist I’m out to harm you no matter what I say then I probably should just leave now.”

So let’s end on a high note: a toast, to those who care. I think everyone’s here arguing for that reason even if the conclusions are different. Salmonella free appetizers for all.

quotes

 

 

Filed: Ask Dr. V, Blog, Daily Life, Health, Musings, Picks of the Litter Tagged: , ,

How to find your Special Snowflake Vet

“But I don’t want to go among mad people,” Alice remarked.

“Oh, you can’t help that,” said the Cat: “We’re all mad here. I’m mad. You’re mad.”

“How do you know I’m mad?” said Alice.

“You must be,” said the Cat, “otherwise you wouldn’t have come here.”

cheshire-cat-alic

Every time I come across a “how to choose the best veterinary hospital” article, I read it, because it’s fascinating to me to see how different authors choose to guide you in this task. The articles exist, presumably, because not all hospitals are the same, therefore some are great and some, not so much. I think we can all agree this is probably the case. It’s like dating- lots of choices, but not all are a match.

Of course, the recommendations are pretty disparate, depending on how you define “good hospital.” Are you the holistic vet, the guy who’s dedicated his career to evidence based medicine and refutes anything without a journal article to back it up, the disgruntled owner who’s displeased with one bad experience and parlayed it into a major website, or the practice owner who’s looking to attract new clients? They all have different ideas of what makes a “good clinic,” to the point that one person’s perfect place is another person’s house of quacks and vice versa.

We've all had those "what are you smoking?" moments.

We’ve all had those “what are you smoking?” moments.

 

Clinic Dating

It’s good to know what your needs are, and good to know what a clinic provides. A client/vet mismatch is unpleasant for everyone. Like that girl in college who insisted that her jerk of a boyfriend who left his dirty socks in your living room was just misunderstood and refused to believe the stories of his drunken overtures to every girl on the dorm floor, some poor souls really have a hard time believing that most people just don’t change simply because you want them to.

Yes, we all know at least one vet who had a major epiphany mid-career and did a complete 180, but most don’t. And if you know one who did, it’s probably not due to you and the article you clipped out of a dog magazine you picked up at Whole Foods. I’ll be happy to look at it- heck, I probably already read it myself, I love Whole Foods- but please don’t be disappointed that I don’t change my entire medical perspective based on our 30 minute visit.

You’re paying me to give you my opinion, but if you don’t like it, well, we have decisions to make. While I’m happy to discuss my approach and how we might adjust it to your needs, it’s unlikely I’m going to completely change my medical perspective, because, well, I’m old enough now to be at least a little set in my ways. They’ve worked out pretty well for me. And if that thing I’m not into is that important to you, rather than getting really irritated with me for not changing, it’s probably easier for everyone if you cut your losses and find someone who’s a better match.

tinder

I like to make people happy. I will do everything I reasonably can to accommodate that. But at the end of the day, sometimes you and I- we just aren’t meant to be. And that’s OK. No matter what you’re into, from crystals and aromatherapy to a $30,000 kidney transplant assisted by a human nephrologist, there’s someone who can provide what you want.

Your Compatibility Score

There’s no match.com for vets (though hey, what an idea! who wants to help me develop that?) so you’re on your own for screening your vet for a potential match. You’re going to have to figure out your top couple of priorities and go from there. Here’s some things to consider:

  • If you want an office open until 8 at night every day because you work, don’t go to a solo doctor office.
  • If you want to see the same vet every time, don’t go to a huge office with enough staff to be open every day until 8 at night.
  • If you harbor some deep down issue with blondes/men with mustaches/people with tattoos/some other random thing, don’t go to that vet out of some weird sense of guilt. They’d probably prefer you didn’t anyway. Life’s too short to spend it explaining to a relative stranger why you don’t like them. I can tell when someone doesn’t like me. I’ll survive.
  • If you want a holistic vet, go to AHVMA and find one. Acupuncture is becoming very common, and a lot of places that practice mostly western medicine offer it, but if you want homeopathy or chiropractic, you’re going to have to look a little more. Most vets offer western medicine because that’s what most vet schools teach, that’s all.
  • If you want a place with the best prices in town, don’t be mad when the doctor won’t answer your midnight emergency. If you want a doctor to answer your midnight emergency, don’t be mad when they don’t have the best prices in town. Same goes for fancy stuff like lasers and endoscopy.
frustration

Nobody likes to be frustrated.

If you ask me about Chinese herbs, I will tell you honestly I don’t know anything about them. You can go with what I do know, or I can help you find the guy down the street who studied them (I have one doctor in mind, and he’s great.) Forcing me to prescribe those unfamiliar drugs for you is not an option.

So here’s my one sole bit of advice for how to pick the best veterinary hospital:

Find the vet who’s already your own special brand of crazy, whatever that is.

“You are old, Father William,” the young man said,
“And your hair has become very white;
And yet you incessantly stand on your head—
Do you think, at your age, it is right?”

“In my youth,” Father William replied to his son,
“I feared it might injure the brain;
But now that I’m perfectly sure I have none,
Why, I do it again and again.”

fatherwilliam

After a decade trying to be all things to all clients, I have finally embraced my own brand of crazy. While I am not your doc for orthopedic surgeries, just the other day I wore a client’s bathrobe and smeared cat food on my hands to help a nervous cat feel more comfortable. If I’m not that one for you, let’s break up so you can find your One True Vet Love.

“Would you tell me, please, which way I ought to go from here?”
“That depends a good deal on where you want to get to.” 

Filed: Blog, Health, Musings Tagged: , ,
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