The cases that move me are not the easy quick ones.
Life works that way. Your greatest rewards often lie in the trenches during the greatest conflicts. It is our version of the battlefield stories that bond us in our darkest hours.
Yesterday was one of those days. (I seem to live in these days these days).
We get a call that goes something like this; (I only heard one side of the conversation. My receptionists side).
"I'm sorry to hear about your cat. You say that you found a clinic that would give your cat a free examination, (clearly a corporate marketing tool to drum up new clients I thought?), and, they say your cat is blocked? (A blocked cat is a cat who cannot pee and this is ALWAYS an emergency!)." long pause.. "I'm sorry did you say that you have seven (7????) dollars?" Her voice took a tragic upturn on the dollar sign part.
"Ok, well,,, umm,, (pause) ummm,,, (deep swallow),,, let me get your information and I will call you right back." My receptionists are seasoned pros. They hardly get flustered. But, then again, who calls with $7?
At this point everyone within ear shot was huddling around her desk with muffled giggling. This is the giggle of the great battles. The first shot has been fired, the troops are gathering and a plan is about to be hatched. These are the stories of the place Jarrettsville Vet has become. These are the stories other vets get, most sarcastically laugh at and dismiss, disregard, or decide to just be bitter about. I was/am/try very hard NOT to be this person. I pay for electricity, wages (waaay above minimum btw) and blah, blah, blah, (excuses to not care), but it doesn't change the fact that there is still this guy, AND, there is still this cat.... so we listen to the stories. We gather the troops, and we devise a plan. The plan is always a conversation, a compromise and a quest. The goal however is always mutually consistent in the most critical component: We have to act fast AND we feel compelled to get help. We place phone calls. We are a place that listens and lives by our motto 24/7/365.
After a round table discussion we formulated a preliminary plan. The first phone call was back to the cats dad. We have a team dedicated to returning these phone calls. We have a shield for them in our first line of defense, our receptionists, then the team takes over. No one should be the single troop in a militia. The first test is in assessing the pet parents intention and integrity. He has to be able to compromise. Turns out he also has to be one other thing.. completely dedicated to his pet and follow through with our advice so we don't perpetuate another terrible predicament. Vitally important to the success of these cases is that he has to participate in this cats treatment, recovery and long term care. Thankfully we discover that he loves his cat and he is willing to do whatever he needs to keep him healthy. I can do just about anything as long as we start here. Everyone has to invest in CARING. Nothing of merit lives outside of caring.
Next step in the plan of attack;
We called our friends at the rescue. Circle the wagons, build momentum by uniting the troops. They have the ability to manage this cats care after we get him unblocked. They can manage the nursing care for the next few days while he gets his bladder and kidneys diuresed. It is nothing more than a medically induced flushing of his urinary system. "The solution to pollution is dilution."
They offered to pay for his after care. We would get him unblocked. Two phone calls and we are on our way to saving this cats life. Go Team GO!
An hour later we met Socks.. As always (ok,, truly always), the ones who need you the most are the ones who are the sweetest souls. This cat was pure love. Young, adorable, and desperate to pee. He purred the entire time we squeezed his rock hard massively overfilled bladder.
Here is his story in synoptic detail, video style.
Blocked Cat. Get Out Alive series. Cost and treatment for blocked cats. - YouTube
There are articles and discussions of this condition listed below. While I am not here to argue that there are absolute benefits to maintaining ideal standards of care I firmly beleive that the biggest failure we provide is not offering assistance regardless of clients financial abilities. When we as a profession decide collectively to support our patients first I will with hold posting prices and offering cost saving options. Get Out Alive series is coming. Blocked Cats is first on my list. Next, pyometras.
The typical cost of a blocked cat at my clinic is; Exam; $50 to $75 Radiograph $100 * Intravenous catheter $40 Intravenous fluids $40 Intravenous fluid pump $40 Anesthesia $100 Urinary catheter placement $75 Hospitalization care about $100 per day. Usually stays for 3-5 days. Bloodwork $150 * Urinalysis $50 *
Feline Urethral Obstruction: Diagnosis and Management. By Today's Veterinary Practice. A very thorough description of how, why and what happens to these cats along with detailed description of treatment options. I recommend taking this article and discussing each step with your veterinarian as they provide an estimate for the cost of care. Know how much each step costs, know where your cat falls within the spectrum of the disease process and know that one size does not fit all! You may be able to cut some costs with the use of this step by step guide. Get everything in writing and GET OUT ALIVE!
Controversies in the management of feline urethral obstruction. Journal of veterinary emergency medicine. 2015, PubMed. Please read the prognosis section; "Feline urethral obstruction is associated with 90-95% survival, with reported recurrence rates of 15-40%." How many people cannot afford to treat their cat when the survival rate is this high? I would guess that there is not a single other emergency condition that pets get that has this high of a survival rate when compared to the number of economic euthanasia's due to cost. What is the rate of economic euthanasia for this condition? At my clinic it is zero. What is it elsewhere? (Good question? Anyone want to share their numbers? Speculative numbers?)?
Can these cases be managed at home? Without a veterinarians intervention or assistance? I would strongly discourage this. I feel the prognosis is far better with a urinary catheter placed and intravenous fluid therapy to flush the bladder, kidneys and remove the toxins and systemic imbalances, but here is a widely cited article on managing these cases at home. Which is better than nothing (although I would still argue it isn't enough!).
If you have questions about your cats care, the cost associated with this diagnosis and most importantly ever feel pressured to euthanize based on economics please ask/beg/insist on options and please seek a second, third, or even fourth opinion so that your treatable cat can GET OUT ALIVE!.
I am here for you. Find me on Pawbly.com and remember "never go quietly into the night."
Parting thoughts; 1. Get Out Alive. Ask about options. Insist on care. Document everything. There is help available even if you have to be insistent on it. This is an emergency condition and your cats life depends on your actions. Be kind. Always be kind. You can't ask someone to be someone you are not. 2. If you do not have any financial constraints almost every vet and emergency facility can care for your cat with this condition. 3. If you do have financial constraints ask for a written estimate. Go over each line item. Ask which is most imperative at the immediate time. Ask the vet to rank these. Start at number one. Stay at the clinic as each line item is addressed. Once your cat can be transferred to your vet it might be more affordable to get their care with them. 4. Ask about the incidence of recurrence for this condition? Ask how you might be able to avoid this? My advice is a diet and lifestyle change. Less dry food, less poor quality dry food, more exercise, less stress. (Ask about cat stressors? Often clients cannot, and do not see the world the way their cats do). 5. Ask about a PU surgery. Start planning and saving for it. The second, and definitely the third time a cat blocks we put this surgery on the table. This is about GETTING OUT ALIVE! remember. PU surgery info here. Perineal Urethostomy by Michigan Animal Hospital. Cost is between $1,000 and $3,500.
If you have a pet story that you would like to share, or an experience with this condition please add it to our Storyline page at Pawbly.com.
There is a culture in veterinary medicine. It is pervasive, overarching and in many cases detrimental. We cannot say "No". We are taught not to, conditioned against it, and therefore it persists and cripples us. Inside the profession of veterinary medicine there is never a welcomed voice of dissent. There is also not a culture of open acceptance that others have different goals nor sense of purpose. And, with all of that truth we still cannot say "No". Would any of us want to teach our children to be so passive and prejudiced to not question what intrinsically does not feel right? And, yet, we are these parents. You do as your profession has dictated. You accept the reality as it is laid out for you. There is not a line between species outside of human and non-human. It is confusing, painful and nonsensical to admit outside of our own ranks.
Luna. Rescued from the Humane Society. Looking for a second chance and perfect in every way already.
Spend a few minutes explaining to outsiders how and why the way we practice medicine is so different and disparate within the separation of the type and/or species you practice on and it becomes apparent. There is a huge difference in the ethics and laws within our profession. Say, for example, if you are a food animal practitioner versus a small animal specialist. What about a feline exclusive practitioner versus a poultry practitioner? After all they exist on the same pieces of real estate. Do you think that any boarded feline specialist is paid to practice "herd food production management" by calculating acceptable losses for cost savings versus medical need based interventions? The spectrum is wide and the rules to play vary so significantly we cannot put them into words and rules without species delineation to qualify them as "just" and/or "appropriate" when in fact they are much more likely to be simply based on "archaic practices" and/or "profit margins." Within this large spectrum of diversity there is a lack of oversight, accountability and an almost complete abandonment of enforceable laws based on compassion at the end of the 'less than canine' spectrum. Ask the USDA slaughterhouse vets how differently humane euthanasia resembles the in home euthanasia's that are franchised and marketed to be the "peaceful passage" we would all want for our beloved pets. They aren't even remotely similar. Why is that?
Dimples. Rescued from the local Humane Society. "Dimples lives her truth everyday. She is kind, gentle, and longs for human companionship. Living in the present and full of second chances - please help us help us find Dimples her happily ever after." Laura
How do we get to a point where vets assault patients in their clinic? Or shoot their neighbors dog? Or euthanize themselves with Euthasol? We are a fragment of society without a consistent code of ethics and the nuances to allow transparent public perception with the derivation from them. We are also an old, humble, gritty profession. We don't adopt change quickly enough even when the death rates and discord dictate the critical nature of the current time. We are a profession who says "Yes" to financial incentive more than "No" to the ethical divisions, or our obligation to all species to unite us. It is the power of being trained to not question abandonment of our own internal "No" response meets simple basic greed with an unwillingness to permit the other side into our discussions for "best practice" management.
I have found that I far more regret the "Yeses" than the "Nos". Maybe because it took me a long time to find my voice, assert an opinion and start to protect my own soul? It has become a matter of life: professional and personal, and death: personal and professional. How much does "Yes" versus "No" cost you? It is a question I would like to ask every veterinarian. I would also like to know how so many got to this pervasive place of indifference basking in shaming blame that seems so pervasive in general society today? Was it when you started to accept not saying "No" more often?
It is the nature of being a student to not question authority when your purpose is to absorb first. Every person in medicine remains a life long student. We veterinarians are all students our entire lives, UNTIL at some point you get to be in charge. Once you reach that pinnacled place you have to learn the word "No" as a matter of survival. In the end, (and there is always an end), it is all about survival. Not the financial kind, nor the status, popular, nor celebrity kind. It is about the little voice who guides your ability to even like yourself when the crowds leave you for the next new enlightened thing.
I was interviewing a new vet grad a few weeks ago. I was telling her about our clinic. How hard I work to protect the emotional toll being a veterinarian can take on you. How we are a practice that protects our patients and staff and the ethical crossroads that living the life of a veterinarian that can often present. "We are a safe place for our patients and staff first." She went on to tell me how this had already become a point of inner conflict for her. "I was at a practice where a chihuahua came in with a puppy who had been stuck in the birth canal for two days and the people had no money. We sent them away without anything to die at home. I will never forget her." It is a scenario that plays out every day, in every practice and I reassured her that here, under our roof, no person will ever leave without feeling like we hadn't offered every single option to make a happy ending possible."
That night I couldn't sleep feeling that we failed so many. We failed this new grad who is feeling and being taught to be powerless, voiceless and being conditioned to remain this way. We are failing our clients who were brave enough to seek help. And worst we perpetuate cruelty we blame the owner for without taking a moment to reflect upon ourselves as being complicit to it. Did that vet who turned them away ever follow up? Did they at least call Animal Control, (as awful as that ending might be?), at least the dog would be humanely (?) ceased in her suffering with a dead puppy stuck inside her? I would venture the answer is again "No". We don't speak up often enough, (even if we are now bound by law to do so. More on the Mandatory Reporting of Animal Cruelty here).
Our conversation resonated so hard with me that later that night I sent her this text message; "Hello. I wanted to say how nice it was to talk to you. I hope that you have a wonderful trip back to school, and most of all I really hope that you never lose your sense of compassion for even those it seems that you cannot help. (That last part of that sentence I also hope proves to be your most treasured asset as you leave vet school). I keep thinking about your chihuahua case. Indifference is learned and conditioned in vets. It is shameful so many vets abandon it for reasons I do not understand nor accept. You never have to walk away feeling helpless. I hope that you always remember that. Even 40 years from now when you have seen everything. Enjoy your last weeks at school. They are precious and life is never the same (which is definitely both good and bad ;-) ). "
I have learned to say "No" because I had an accelerated path of defining where my loyalties and ethics were rooted. I am not here to perpetuate outdated selfish practices and ethos. I am not here, in the trenches to believe the outdated, unmarketable internal dialogue we still cling to. We should not be a profession serving ourselves first. Protecting outdated cruel practices to protect profits, "property" designation, and disfigurement to our patients. I am here to serve my patients. Not only the patients who can afford me, but all of the patients who need me. (Where and why did the debate about pain management, declawing, debarking, and factory farming ag-gag laws take precedence over our obligation to be our patients advocate?).
There needs to be a reminder to all among us what the indifference, silence and bullying culture costs both us and the society we live in.
Questioning is the advancement of science. The innovation of professions. And most importantly the protection of liberty that every soul deserves.
We need to start pulling back the veils, dismantling the incestuous relationships with producers, manufacturers, lobbyists, and put our patients and our people first. Please start to question, and even mutter "No" to the slaughterhouse practice of overpopulation herd management (this includes, cows, horses, pigs, cats AND dogs).. "No" to toxic people.. "No" to clients who hit their dogs, threaten, deny basic care, neglect, harm, hurt, perpetuate disease via their neglect, and allow pets to die horrible suffering deaths. We see it, we don't do enough (or anything?) about it, and it undermines our ability to recognize it even in our exam rooms. It also makes us complicit. We are just as responsible, (perhaps even more so?), and we are part of the indifference that makes killing in society "ok". I may be a single solitary voice in a profession of pleasing paying people but the core of why and who I am is preserved and protected. It is also the influence I have every intention of fostering and perpetuating in my practice for my staff, my clients, and most importantly for my patients. It is time to have a voice other than the lobbyists hushed threats about what we will lose if we stand up and demand a kinder approach to serve the animals first. It is this internal conflict that each vet sees, feels, and knows that is the greatest consequence to our work-life inner peace.
Stuart and Falcon. rescued from the Humane Society. A long story of their own and now ready for a home of their own. Call me, email me, ask me about them, or any of our rescues. They are all proof positive of the power of "NO!"
The profession is at a cross roads. Societies views of pets as members of the family, the financial incentive for us to acknowledge this, and the power of social media when we forget these are all testament to this. We are acting like we are making huge efforts to curb the suicide rate, job dissatisfaction, dwindling numbers of vets seeking ownership, and stagnant pay when compared to rising costs of our educations, but, we are still promoting, permitting and accepting a culture of exclusion and complacency. We are trying to empower, encourage and inspire each other while at the same time not acknowledging the most obvious reason we feel so trapped. Yet among all of this we don't have our own voice. We are sheep in a pack of masses huddling to stay alive while the wolves hover. I will attest to the pain found outside the pack. It might be better to follow the school and avoid the sharks but the inability to exercise your second amendment power is more than I can bear.
The profession has become a lobbying firm. You either adhere to the pervasive culture or get (forced) out. In most cases they won't really mind if it is at your own hand. It is stifling to live here. I hate it. I will come out and say I hate living here. I am losing hope. It is the fundamental lifeblood to a passionate person borne into a profession that alienates and destroys life on whims, economics and opinion. It is a reflection of the bullying that society does not adequately address nor protect.
There is a storm brewing. Maybe I will be some part of it? Maybe I will be yet another vet deemed collateral damage to a profession that doesn't say "No", doesn't have a voice of its own, and doesn't care enough about anyone or anything outside of its bottom line? We are far too worried about preservation of our power, our influence over lives without voices, and our lack of oversight from the human sides restrictive, profit driven corporate controlled medicine practices. The cruelty in vet med is alive top to bottom, across all species lines. The culture of accepting it is crumbling too slowly. And the death is both inside the pack and around us. Start to question who you are? Why you are here? And why hope for change is so elusive? Say "No" to being unkind, unwilling, and unable. We aren't sheep, and we aren't replaceable. I'm here to say "NO!" to being a part of death of compassion of this new grad. I am also here to say "NO!" to sending a chihuahua home to die because we think we can't afford to care anymore.
There is liberation in having a voice that is your own to guide you. Being even more than who your white coat and oath asks you to be. There is the place where trust, integrity, innovation, inspiration peace, and purpose lives. If you can't learn "no" you will pay for the assumed "yes" whether it be in inconsistent drama based business, sleep deprivation, bankruptcy, or collapse. At some point something gives and you learn to say "No".
Where is your "NO!" living? What is your silence costing you?
Me and my Jekyll. Another "No", one of the best ones I ever muttered and stood up to.
More information on chihuahuas and dystocia here. Coco's Story.
When it comes to pets there is an endless supply of "free" replacements available. Endless. There is NEVER a time where the shelves are clear at the shelter. There are multiple rescues within a 30 minute drive that have upwards of 500 cats available (begging for homes) under their roofs for adoption. The numbers are staggering, the supply unyielding and the consequences too often unimaginable.
At the present time cats are FREE and, with a FREE gift (for the holidays) at the local shelter. It is becoming a fairly common practice for high volume shelters to offer "free pets" in the busy and overcrowded periods. For example: The Spring kitten explosion. The housing of hoarder interventions. The days after the holidays when people deposit unwanted pets for vacation plans, new pets, and company visiting. Free is a wonderful marketing tool. BUT what happens if you can't even give them away? At the shelter they are advertising and including "a present as an extra bonus" incentive?!. (face palm). This is part of the problem. It is not an easy problem to solve, BUT, it has to be addressed. The best answers to overcrowding, over populated pets likely lie within all of society. But the brunt of it is shouldered by the shelters and rescues. They are after all the catch all for the castaways, forgottens, abandoned, and lost. They NEED to exist. You are not going to change these. People die, lose their homes, cannot afford to care anymore, etc, etc. Shelters and rescues NEED to exist for the pets no one wants, and those who are missing. Pets deserve a chance to find their own (old or new) family. BUT relegating them to "free" may not be our best way to preserve their safety and value?
Luna. Rescued from the shelter,, loving life at JVC
If the replacement value is so low and the supply so great this only leaves an emotional tie to keep the system running. The debate over emotional bonds between pets and their people is undeniable. If you haven't had your heart stolen by a purr, a wag, a nuzzle, or the unyielding unconditional love of a pet you haven't let your heart open long enough to enjoy the most wonderful part of sharing a life with the love of a companion.
Pets own us. They do with each moment we get to spend with them. The emotional ties have evolved into bestowing of names, personalized beds, blankets, and bowls, monthly treat deliveries and a market that grows faster than (almost) any other. It is so lucrative and strong that venture capital is pouring into it every-single-day.
Mouse. Abandoned three times. Then he met us. Turns out he is deaf and a dog. Embrace who you are and there is someone for everyone.
For those of us in the shelters, who know these unwanted cast-aways it is a tough acceptance that giving them away to the wrong people is worth the chance of euthanasia to reduce in shelter numbers. If people can't, or won't, invest in their pets care are they good parents? Are we setting everyone up for disaster and disappointment. After all no pet is really "free". They will need basic care this will inevitably include veterinary care, and this might even be more expensive than "free". It is a real-life dilemma that I don't have any other answer to than "anything is better than dead. I think?"
The Littles.. Stuart and Falcon. Rescued from the shelter where they couldn't shake their upper respiratory infection. They needed love, time, antibiotics, and antivirals. Some cases are easy and some remind you why it takes 4 years to get through vet school.
One of the hot topics on the human side of healthcare is how to manage limited resources in the face of an overwhelming need and critical shortages?
The scenarios range from anything like a massive flu pandemic where things like life saving medications or ventilators are in shorter supply than the demand requires.
Another would be oxygen in areas where natural disaster has hit. Think about a hurricane hitting an island and the power is lost. People need supplemental oxygen for surgery, respiratory disease, infection, burns, etc. What happens when the ability to provide supplemental oxygen is at a place of rationing?
What about food? Shelter? Medications? Or any kind of medical, health or supply that the masses need in a catastrophe? What about epinephrine pens that are now 800 times more expensive than it was a few years ago and needed in seconds to save lives? What about generic drugs that are no longer profitable (enough) to manufacturer but would be basic and life saving on a scale that hundreds of thousands of people might need immediately? Who would be given them if there wasn't enough for everyone?
Would you give it to the children first? The patient with the greatest chance of survival? The patient who provides the greatest contribution to society? Like the doctors? Nurses? Emergency response personnel? Yourself? Your family?
It is a tough thing to answer. It is also a real-life scenario in much of the world.
Does it happen in vet med? Of course. Every single day. Resources are limited. Access is limited. And not everyone gets the best of veterinary care even if it is available and accessible simply because they need it.
It is a common practice to utilize the skills, practice and lessons of another profession when trying to decide the best course of action in a current dilemma. So, why wouldn't human medicine follow our guidelines and protocols for the same set of scenario's?
The same scenarios apply in both human and veterinary medicine, BUT, the compassion is lacking on one side of the care giving side. Veterinarians provide care to those that pay for it. If it was free and available on the same scale to everyone who needed it we would face the same ethical decisions to deciding who gets what when they need it. But alas we don't. It is far simpler to ration based on economics. Cut and dry.
Should it be this way? I am not sure? I think that the reason we on the veterinary side don't provide everything we can to everyone who needs it being simply based on a case of economics limits our ability to understand more complex scenarios. It skews our reasoning skills, our preparation, our sacrifice for a common good. It reduces humanity to individually centered scenarios and decision making trees. It promulgates and promotes self preservation on an individual level. It is impossible to make life saving decisions in mass casualty scenarios when the individual is the source of the lack of compassion on a larger scale.
So the next time you need help ask not what you have access to, ask what you are willing to sacrifice to provide it. Maybe the abandonment of self is the salvation of all?
Lately I have been feeling a little lost,, so I thought I would put my demands, pleas, and requests to paper.. a small sputtering to the cosmos to not forget about me,, here goes;
Demand: happier self with more time to enjoy mundane tasks that involve glue, scissors and paper.
Or how about my classified ad;
WF seeks: Forlorn frenetic feminist in search of destiny that meets expectations.
Missing: Well educated veterinarian seeks former self who stood nubile, supple and sensuous on open scallop ready to parlay pearls of prideful tutelage onto appreciative receptive pet loving world.
Lost: Former people-pleaser seeks effigy to burn to a crisp. (Maybe if I burn her, I won't walk around feeling perpetually toasted?)
Seeking: Mid-life crisis kit Ikea version.
Suggestions Sought: Stigma free vice to adorn daily, (or more often, should the desire strike me to imbibe).
Appreciated: Sir David Attenborough's Planet series without any animals dying option.
Desired: Less a$*holes, more kittens.
Desperate: More adoptions, less puppy mills... (I am drowning in puppy mill puppies and the horrors they hide behind their scared eyes and clutching arms).
But, instead, here is where my veterinary life pleas are;
Mandatory Animal Cruelty Law that comes with easy button to summon the Commissioner Bat-Signal style. (Yes, damn it, I have to call and rat on people that often. There are awful, vicious, stupid, greedy people out there. And, now I HAVE to report them (although I always did even when I wasn't compelled to).
Orthopedic professional shoes in BRIGHT colors (think Cabaret meets Jean Paul Gaultier) AND I feel sexy in. (PS I don't care if I smell of urine and have anal sac perfum in my hair.. this is my whole retched life, at least let me feel sexy.)
Scrubs that don't sag in the crotch and suffocate in the lassoed boob, my own Tropic Of Cancer zone. (Are they all made with an empire silhouette? If I was perpetually pregnant I wouldn't care that they drape so shitty,, they ALL drape shitty. (Hence the sexy shoe plea!))
Recalibrated owner olfactory shop. A place to stop in and tune up the noses of every owner who can no longer smell the dead fish stewing in their Cocker Spaniel's ears. How do these parents NOT smell those ears when they get home everyday? I can smell them when they walk in the building. (sage, incense, smelling salts, what does reset the pet owner olfactory immunity?)
Nail Trim Courage. There needs to be a class, a badge, a road to Oz where pet parents gain the elusive nail trim courage. Perhaps a three day quick-athalon,,, get over your fear of quicking your pet in three days.. (must sign waiver for cruelty charges first).
Puppy Mill infrared Army goggles. You show up in a parking lot to exchange cash for a puppy in box, and your Big Brother Vet hits the "ABORT" button for you. Cops show up to confiscate puppy (it goes to a wonderful home,,, because everything here has a happy ending and this is my life Law and Order style (duh-dunt-duh!) and arrest Cruella DeCanine.
Pet food procurement comes without false hopes that protein is all they need to look like AHnald in his Terminator days. Your dog isn't a wolf. In some cases your dog doesn't even pee outdoors, never mind hunt for its food.
Viral videos of ranting vets (yes pun intended) leads to better care for pets,, not shunning and shaming, and for Gods sake, NOT stopping to vaccinate for treatable often deadly diseases. Want to make an educated AND safe pet care decision. Titer before boycotting, or cutting vaccine doses into guesstimate fractioned amounts and think.. don't share a video without science and biased data to support it. Let the cry be heard roud the world, people LOVE their pets, don't mess with that, or them!
Just one nickel, like from the Goddess of Common Sense, for each time an itchy-bald-bare-assed pet comes in with fleas, and the owner says "My pet doesn't have fleas!" in the same harsh defensive accusatory tone they would had I said "Do you use any flea preventatives?" Like I own stock in preventatives, like that's a solid investment.
And a dollar for every time a rat poisoned dog eats rat poison and their owner tells me "they don't eat it because they know better."
The pregnant sister of the impregnating brother, and the quiet uncomfortable pause as I question whether I need to get out a dry erase board and start educating Pictionary-style.
The questionable ethics of going on vacation for two weeks and leaving "enough food" for the cats. (Commissioner I need a call back).
The diet/weight loss plan that insures a shrinking waistline because you purchased an at-home piece of gym equipment and/or fenced in your yard. If your pet isn't being taken for exercise and your Stairmaster is for drying clothes you probably won't see the benefit of your lacking exercise regimen.
I am tired and cranky, and having a tougher and tougher time being happy to see puppy mill puppies sold by Amos and Amish. I am also struggling to be the receptacle for every broken, dumped and diseased kitten with no other options (apparently I am the only one who feels bad,,?). The vet who takes the most vulnerable pets from the shelter, trying to save their lives, and work tirelessly to find them a home,, so happy to find them a home, and the new parent leaves to go "back to their vet." Where are those scissors, better stick with the ones with rounded edges.
...and the prayer for the end of the day..
Certification Sought: For humble, slightly sarcastic Sagittarius still thinking the glass is half full and the sunset is just a rosé away.. I don't need glasses, I'll just view through the goblet.
Be well everyone,,, let it out! Vent! Soapbox! Be you,, all ugly shoes, smelly hair, and visions of cat walking in stilettos dancing in your sleep deprived head.
If you are interested in help for your pet and don't know where to go please find visit us at Pawbly.com. It is a free online community dedicated to educating and inspiring pet people everywhere. It is free to use and open to everyone.
If I could allow myself a conscious vice it would be to splurge on free time more often.
For all of the self-critical New Years resolutions to be a more "correct" picture of someone else's persona we are too often very hard on ourselves and it costs us to measure ourselves by a ruler of others choosing. Eventually you will fail to maintain the vision of perfection that isn't of your own volition. Being a fake never fits.
For the life of a veterinarian there is never a short list of to-do's awaiting. There is always some phone call to make, some patient to tend to, (even the ones you saw last week who still haunt you as you try to fall off to sleep when they haven't provided the thumbs up "I'm all better" update, (OH GOD! Please don't let them be dying behind the refrigerator at their home? Are the parents able to get the antibiotics in? Will they come back for a re-check if I ask/beg/plead? What if they don't because they think I will charge for it? Okay, I'll offer to do it for free.." the internal dialogue of fear-meets-paranoia-encapsulated in over bearing responsibility (very healthy for the psyche)).
What life changing event has to force me to slow down and smell the cat fur? It is death. Looming, unrelenting, gravity fed death. I all too often don't stop to sit and tell my furry kids that I love them until I am driven to my knees begging for the hands of death to loosen their grip for just a few more minutes on one of them.
I have stood here before. Holding vigil, plotting attacks, preparing myself quietly for letting go, and listing the excuses to convince myself to get through.
Death is knocking again.
The calling card can come in little clues. Subtle innuendos so slight only a mom can pick up on them.
Jekyll is 8. Only eight!! (That part pisses me off). He's a beagle. We breed them to be invincible. He is at the point where his mid-life crisis should be calling him to the couch and off the rabbit trails. I expected some twilight days with him. He can't go from scent possessed wanderer to six feet under, can he? Is that fair? Doesn't anyone play by the rules?
Jekyll is true to his ancestral genetics. He is rugged, docile, and compact enough to be lithe and wily. BUT, he is a lemon. Has been since day 1. He got the short end of every needed life preserving quality shy of cuteness, (he got an abundance of that one). It has served him to be spared time and time again. For all of his misgivings and mischievousness those sad beagle eyes, that low fluttered tail of wagging, and the way he just throws himself into you when he greets you as if you were, and always will be, the most important human who ever lived, melts you. There is no human being capable of not recognizing genuine devotion and adoration from this dog. It is a talent I will never possess. He is never shy to dole out his whole heart to someone he has never met. And, by chance if he does know you he will jump, kiss, lower and fast wag, while casting his already too big, already too low, velveteen ears to the floor. If you can say "No! Get OFF!" to that face you lack heart, and you therefore lack purpose. He is my righting rod for humanity.
He is a beagle. Built around a nose. Assigned to three tasks in life; 1. Collect and sing for food. In the off chance event of a zombie apocalypse you need only to grab him. No need for the allocation of hard to come by square footage to save food for that dark day,,,, just grab the beagle he can find a corn kernel in a cavernous catacomb. He will sound the "beagle-bay" alarm when the kernel is cornered. 2. Slay hearts. No dog possesses more unadulterated unbridled charm than a beagle. The Casanova of the canines. The saddest part of their pedigree is this possession. It is used to their demise. Ask any researcher which dog is used for testing and why? Answer; the beagle because they are so sweet they won't complain even when you hurt them. 3. Be a companion. They are loyal to their death. They know which side their bread is buttered on and they never walk away from bread (or butter),, or any other food (or condiment).
Here we are. Eight years into our love story. And then the shoe drops. He has been struggling for a while. It took me weeks to find the source to his struggle. He has a mass in his urethra growing inside the pelvis that is making it difficult to pass urine and feces. He is pushing against a plug and in the end it will kill him. It is the stumbling block I will do everything I can to keep from today being the day I have to say goodbye. But this, this will be his undoing. I am furious and falling. I am slowing down again. Trying to capture more moments and not let anyone else's problems steal the few days I have with him. I know that life is fleeting and precious and that we all have choices on how we spend whatever time we get. I am here, I am going to fight to keep him happy and comfortable. I will lose to his disease but it won't ever be because we surrendered. It will be because we loved, and we lived, and we made the best of each moment.
There is one more important thing to talk about here, in the midst of the sea of despair. I am going to go on.
The most heart breaking part of being a veterinarian is to see people suffer through the last days/months of their pets lives and then close their heart to having another pet forever. The burden of caring for an ailing companion is the ability to give your time and love to someone else. It is the greatest gift we get; To give love away and live again to share with another soul.
Jekyll is a pup who needed me. He was the sidekick to my pitbull pup after losing his predecessor. The beagle for my ailing Savannah's last slipping days. He is slowing me down. I am taking a new lease on what a "resolution" should include. I don't need to be better, I just need to be present. Again, and again. And when it seems like it might all be too much,, again.
Here is a small sampling of the life I have lived with my beloved Jekyll.
There is this pervasive gnawing of vulnerability following me. I'm running without the time to look back to see their red eyes of furious feverish pursuit hunting us, while in my arms lies some sick-dying desperate soul to save. It is always the same dream. All on me, all alone and fleeing.
In the trade we call it "imposter syndrome". Any mortal who is honest with themselves and humble in the magnitude of this profession understands that we cannot be everything to everyone and yet also be expected to hold the bar to the scrutiny of the specialists should the shit hit the fan.
At some point the dam breaks and you accept that you can only be true to your own sense of ability meets inability. You also learn to always be honest, inside and out. After that the cards fall where they will and you go on.
I have lived about 10 years as a veterinarian between insecurity-hugging-imposter AND activist-holding-up-compassionist. Quite a dichotomy. Plato's symposium meets my real-life. I can only be pulled into two different directions for so long. Every two headed-four legged sideshow freak suspended in formalin died for the same reason; at some point either one half dies, or they both do.
There is not one day that we aren't reminded how fragile life is and how many suffer just to survive. One of 17 feral cats we are trying to save in the middle of a harsh winter this kitten weight 2.5 pounds and is over 6 months old. She should weigh at least three times that. Instead parasites, pneumonia and fighting for resources has stunted her to this state. Could you walk away? After all there are thousands, millions (?) just like her.
There are quotes of inspiration that transition into motivation. If you dwell long enough they can even convert your unsettled inertia into purposeful kinetic momentum. I am one of those people. I don't like the sidelines. I don't wait for a coach to blow the whistle of permission to enter the game. Sunday I euthanized half of the patients I saw for the day. Quite the statistics to drive my point home. Death waits for no one. You can grow old, decrepit, and exhausted waiting for permission.
"Find out what breaks your heart, and do whatever you can to fix it." Abby Wambach. If I were one of the tattoo yielded kids I would have it emblazoned on my wrist. (You know the web-slinging place of Wonder Woman days.)
My heart breaks every single day that I am in practice. There isn't one day where we aren't faced with the reality of the state of our profession. People need us and we are not there for them. These people LOVE their pets and are desperate to help them. They get faced with closed door after closed door of unwillingness to even speak to them, never mind offer real meaningful care. It is the example of the desertion of humanity at its most basic. For me it is the most classic day-to-day reminder of how broken our society is. The smallest and weakest always suffer far beyond the wealthiest's purview. They land here, in our doorway, begging, every single day. To turn my back on them is torture, there is no denying their existence and yet there is no time to try to negotiate the terms to resolution.
I am left with a soapbox, a desperate call for action, and a profession who has come to terms with the divide between responsibility, profit, and castigation. It breaks my heart. It propels me to act and it leaves me vulnerable as the scale overflows my practices ability to hear the cries from below.
Maddie. My muse. The source of the inspiration that broke my inertia.
This shadowed mob of lynch men is real. If you don't think that we live in an angry hateful world ask whoever is on the other side of your political affiliation. We are not so tolerant of the other side. It weakens us all. The system doesn't like change. It fears disruption as a vulnerability deserving of inoculation, eradication and excision.
If I am not heartbroken by the indifference that is so overwhelmingly pervasive in our professional culture I would be both an imposter and a liar. There is a point where you get pulled apart and die from collateral damage to the host. How can I kill the girl who still gives a damn, remain sitting on the sidelines waiting for the pandemic of indifference shored up by excuses and vitriol to blame the other half to win?
If the statistics were available my point would be fueled by a mob so great the profession would fracture into its own broken system of public health practices and couture clinics. The non profits would start dominating the landscape at a precedence the corporate practices would take note of. If the advent of the human medicine minute-clinics restructured access to quick affordable basic care the high volume-low cost practices diversify to meet the need. The walls of secret hidden price schemes based primarily on lack of access and professional pursed lips will fall. If epi-pens were met by lawsuits and lynchings the vet profession better start looking inward.
Let's take some examples; if there is a 90% cure rate with medical intervention in urethral obstructions what is the economic euthanasia rate? How do we justify this growing statistic of unaffordable care when nothing about the treatment plan has changed? How do we answer the public when the cost of this treatment has escalated from less than $800 to over $4,000 in a decade? The difference is corporate profit.
There are inherent rights to every living thing; 1. They all are in the same race. Live and perpetuate living. It is fundamental and undeniable. 2. Action and inaction have consequences. 3. Inner truth is the only salvation to inner peace..
What are you willing to lose in an effort to remain whole? It is a question I ask myself every day as I try to outrun and outlast the mob at my heels.
Like every other civil movement there is a groundswell of people demanding change. For me, in this movement to return medicine to the place of compassionate discussions focused on patient care, and not corporate profits, it is a return NOT a redirect. It will take a war of anger, heartbreak and unwillingness to tolerate the system as it stands, or has evolved into, before the negotiating will begin. In the end the indifference for profit will never prevail. I don't care if this is over "property" and responsibility. It is about love, companionship, and ultimately our ability to recognize that each species, and all beings within these species, need each other.
Where am I? Just swimming against a tide of forgotten little guys still trying to save every single wet nose and still fighting for their tiny voices to be heard with a sea of sharks behind me.
What is my soapbox going to get? A voice on a stage with a megaphone to amplify the stories of the souls we have forgotten to serve. There is a change looming on the horizon, a mob who will have to answer some tough questions, and a whole population of under served who will have their day of reckoning.
What breaks your heart?
And what are you doing about it?
August. Found as a stray at the shelter with a broken femur. Recovering with us and looking for a home. She's the most precious kitten!
If you are interested in help for your pet and don't know where to go please find us here at Pawbly.com. It is a free online community dedicated to educating and inspiring pet people everywhere. It is free to use and open to everyone.
Exits are the inevitable precursor to change. Change happens, death is inevitable, and if you can foresee both early enough you might be able to succumb to them on your own terms. Isn’t that what we all hope for? To be able to exit stage right when YOU are ready, and not when the shepherds hook is secured around your waist and demanding you do so.
It has been a time of exits for me. Too many friends and colleagues are having to make quick decisions to protect the business they spent a lifetime building and invested everything into. We do it. We get caught up in feeling needed, wanted, and irreplaceable. It is the reward to the sacrifice we don’t want to face. The loss of a life in the creation of an empire. You have to build a life outside of your business or your exit will become an abrupt transition to a life you suddenly have to manifest from the few foreign tangible raw materials left over from your last chapter. Abrupt changes don’t work well. Our bodies, our minds, or being, is about gradation and slow evolution. Waking up in a hospital to be notified that the curtain call is approaching faster than you had anticipated is a stark harsh reality. For some of us it arrives in life changing accidents. For others it is a house of cards under someone else’s hand that collapsed. And for a few others it is the realization that escape is the only way out. To us, the “flee and be free” crowd the collateral damage is not simply protecting a lifetime of efforts, it is about getting out and hoping to still be alive on the other side. (Maybe it is that way for all of us at the threshold of the “emergency exit”?)
I am really (really) hoping that this isn’t all I am meant to be and do. That there is a life on the other side. More concerning, that this life, in whatever form it has, has meaning and purpose? That there isn’t just a shell of stuff with my scent on it. Some piece of detritus I left behind to mark my presence like some ancient hieroglyph to a life left and lost.
At some point we all have to face the fact that life has choices and you’re going to have to accept the consequence of the choices you made and the life you built, (or forgot to make time to build). No one likes change. Especially a forced change. The answer to accepting them is to try to manage them on your own terms with your own fate in your own hands. If you do so quietly I think you torment yourself into fear based options. Fear and doubts are the devils recipe book.
Here are a few quotes I am stuck in between these days;
“Don’t wait to get sick or have some dramatic life-changing event. Build a life, not just a business.” Angela Benton
“When fear isn’t dominating you, there’s very little you can’t accomplish in business or in your personal life.” Tony Robbins.
I am working towards this one;
“I convinced myself that whatever was the worst thing that was going to happen, it wasn’t really that bad.” Sarah Kauss
And here I am, a new year, the same old insecurities, and the same old challenges (only apparently on a larger scale, or I just haven’t slayed the old ones and therefore the festering masses of dismay grew,, like some cancer I didn’t get clear margins on), and I have to get through, get out, or wait for the hook to pull me away on its terms.
Shit, if there’s a legacy here I hope it fits on a headstone and isn’t some snarky remark about the veneer of a girl who just couldn’t make it easier for herself.
P.S. This is a blog about a girl who dreams big, falls hard, and tries to coach herself back to the path of being kind and compassionate to the patients of vet med life.
If you are someone who struggles you already know you aren't alone. It is the single best directive for finding humanity and the quest for inner peace.
More information on me, this blog, and who we are at Jarrettsville Vet can be found here:
Pawbly.com is about saving lives, and providing options with data. Let the data set the standard of care and integrity via transparency be the guide.
There are a few Never, Evers! in veterinary medicine. They are the secrets that every veterinarian knows because one of our clients has learned the lesson the hard way.
Like grandma used to say, "Never, Ever.. do this!"
Here is my list of things that no sensible veterinarian would ever do. I hope they help you and your pet avoid a potential trip to the vet.
This is Samantha. She is like many pets in that she licks her feet.
She licks her feet for two reasons;
1. She has allergies.
2. The allergies have led to secondary skin infection on her feet. The licking causes infection, and dogs make their sore feet feel better by licking them. This is a cyclical snowballing syndrome.
Her parents tried to discourage the foot licking by putting socks on her. But socks don't stay in place without help. So, they put a rubber band around the socks on her feet to keep them in place.
My Never Ever part of this story is, NEVER, EVER use a rubber band on a pet. In fact, I would even go so far as to say, if you have a pet in your house "don't have rubber bands in your home."
This is even more important if you have small children and cats.
One of my worst rubber band story came from a cat who has an obsession with playing AND swallowing them. Two abdominal exploratory surgeries later, (to the tune of about $2500), and in all we have removed over 50 elastic bands from this "My Strange Addiction" feline edition episode.
My other "worst rubber band" story came when a cat was brought in for limping. Turns out the cat was frequently the Barbie doll replacement for the young daughter in the family. She routinely dressed up the cat, brushed her, and played house with the family cat. At some point she also tried to 'do her hair'. This included placing a rubber band on her leg. By the time I saw the leg it was swollen and the cat was unable to walk on it. It wasn't until we did surgery to amputate the leg that the rubber band was found acting as a tourniquet and cutting off the blood and nerve supply to the leg. Rubber bands have been found on tails, feet, legs, necks, and all with the same dire results.
In Samantha's case the sores from the rubber bands go all the way around her ankles and wrists. She may never grow hair back here. But, she walks normally, and it seems that no permanent damage to her feet or legs has occurred.
Samantha is a very loved dog. Her family didn't ever intend to hurt her. Accidents happen. It is our hope that her story will help others avoid the same situation.
If your dog is licking their feet excessively the answer lies in identifying and treating the underlying cause of the itch. This is almost always require a trip to the vet. There are some very good, very effective, and even much safer medications available these days. In cases where licking is severe and red, inflamed, smelly feet have resulted it is also important to get an antibiotic/antimycotic for the infection. If cost is a concern ask about over the counter options; Like foot soaks, topicals, or even over the counter antihistamines. As always, cheaper options are often available online, or at the local pharmacy.
It is also important to discuss prevention products like e-collars, booties, and pet shirts so pets cannot access the area that is bothering them. If you are considering stopping the licking by denying access to the area (with the use of an Elizabethan collar, booties, socks, muzzle, whatever) please remember that you are not helping your pet in an effective meaningful way. I see these as torture devices if used inappropriately, or incorrectly. How would you feel if you had poison ivy, allergies, an itch that was so compelling you couldn't stop itching it, and then someone put handcuffs on you? Don't put anything on your pet without asking your vet if it is ok to do so.
Stay tuned for more tips and Never, Evers!
If you have a story to share, or a pet mishap that you think others might benefit from please add it in the comment section below.
Farewell 2017. It has been a year of ups and downs. A year I am struggling to find a reason to ever want to traverse through again. There were hard lessons and the end brings forth preparation for resolutions more reliant on self-preservation to protect from losing the part of myself I hold most dear. The end brings graceful acceptance and gratitude that I am still standing.
There are lessons in struggles. It is my belief that if you don't stop, dissect them, understand the cause to the pain, suffering, and disease, you are likely to be back here again. Medicine is the same. Every disease/illness/affliction has a cause; a sequence of events that allowed it to happen, a host response that saw some benefit to permit it to perpetuate and flourish, and there has to be a conscious effort to provide a cure or your host self will succumb, or, lie in wait to become the victim once again. Who wants to relive, revisit, and get stuck in the same merry-go-round of pain and struggle? You can throw in the towel to be replaced by a headstone and a memory, OR, you can learn to live and walk on stronger. Parvo puppies who survive never get parvo again.
I am here. Stuck between a belief that is the very core of the person, (the vet as they are one in the same) I am, standing beside what I believe in, and facing the reality that at some point I may have to chose to just get out alive if I cannot convince myself that I am strong enough to keep going. At some point you have to put up armor, stop beating yourself up, and care a whole lot less about what other humans think about you, while trying to not become as uncaring as these same people have become to you.
At some point you walk away older, wiser, and stronger. Or, you give up. You learn hard lessons and become grateful for them. They build you into a stronger, more resilient, gritty soul.
At some point you seek more credible sources for judging your own self worth and trust the puppies, kittens, your own kids, and your own patients, who love you unconditionally. If you can trust them perhaps you can even grow so much as to try to reciprocate it to all others across all species lines? I have to learn this. It isn't easy. I'm not having an easy time with much of it.
How many of my colleagues hope I give up? How many will celebrate in their successful destruction of another? Is their gain, my loss? Or, is it the concession to the chips I am willing to throw on the table? This profession of mine. Where death is so rampant, is trying to become the death of one of me. It is the sole source of the pain I am burying with 2017's departure.
The problem of killing each other, our companions, and our own soul is as pervasive as the hateful judgmental vitriol that spreads like cancer we cannot put into remission long enough to reflect on the gifts of gratitude and beauty we all know lies in the ripples of each struggle. Economic euthanasia, the indifference we hold with it, and the abandonment of serving all of those less fortunate then ourselves are my enemies. I bring these old enemies with me into 2018. But I do so with a resolve to search for healthier ways to do it, and more resolve to cure them. I HAVE to bring them with a clearer firmer steadfast course forward. 2018 holds new challenges, old struggles and back up plans I never thought I would have to consider. But as with each new beginning there will be an end. I just have to get out alive, and still care about the person I carry through every journey. My patients need the exact same commitment from me.
To every vet reading an obit to some soul who fell along this journey I hope that you remember compassion matters most while we are still trudging away from fates indifference.
I am grateful to be challenged. I am grateful to know who I am. To be able to walk away because there is a problem I can tackle better from the outside without fear of alienation, castigation, and recourse. You can be stripped and beaten but you decide if you walk away to hide, or to be who you were born to be. I'm here exchanging exoskeletons on the dawn of a new year ripe with possibilities, burgeoning on the eruption of the rebirth of humanity or demise of trust in loves endless hopeful potential.
At the end I am going to try to be grateful that life wasn't easy. I am most grateful that I am not hoping or expecting that it will get easier. To fear that wishing for easier is going to cost me more than I can die with. I can at least leave without feeling pushed out of the nest. I can leave for another quest, a higher purpose, a better resolve to a problem that fear prohibits my peers in facing. I am not going to read one more obit for one more vet that says "I never knew she struggled so much". This profession of excuses to protect us from feeling responsible eats us away.
I hear you. Each person out there struggling silently.
I would much rather stand with the masses I serve, the patients I hope to help than the hateful crowd whose infighting, neglect and sheer indifference marks time by obits to each other. Never in my life have I been treated so hatefully by strangers. I am not denying my contribution in the passion that emotional ties to our pets elicits, but, the problem of our societies hate and misery lies within our ranks as much as it lies outside of them.
Gratitude for the really difficult times of 2017 lies within my family too. This family extends from those who have known me through every year and decade to those who share their family with our Jarrettsville Vet family every day. If I have to carry a torch to find more compassion whilst feeling alone and damned I can only do so because I have them to remind me that I am not alone. Alone is a terribly heartbreaking place to be. Courage, determination, and conviction cannot offset crushing despair from loneliness.
Farewell 2017. I have few parting words to leave you with, therefore, I will greet 2018 with optimism, eagerness, and gratitude. I don't have to sum you up to want to leave you behind. I can just march forward less inclined to slow down to answer the demands of the angered mob, and more determined to build something worth preserving.
Here's my To-Do list for 2018; 1. "Get Out Alive" series. A blog, a plan, a schematic for the most common conditions that cause economic euthanasia to be chosen. 2. Storylines. We share, you learn, pets win. 3. Veterinary Patients Bill Of Rights. 4. Build a grassroots network unlike any before, more powerful than corporate controlled greed allowing the chasm between available and affordable pet care to grow wider and deeper. (This might be more than I can accomplish in one year).
Be who you are. Be not ashamed to be different, and always be kind.
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