I have been thinking about veterinary medicine a lot lately.  Well, for years and years really.  It is the best job there is.  I love being a veterinarian.

     I would like you to know a veterinarian’s perspective on a few things.  Well, at least THIS veterinarian’s perspective anyway.

     I do love animals.  I do love puzzles. Putting those two together was the best decision I ever made.  Veterinary medicine is about taking an uncommunicative, sometimes uncooperative, patient, gathering clues to the picture and setting a course for treatment.  My job is to recommend how to collect those clues and then put them together.  Sometimes I am left with little choice in gathering that information. 

       I do not love to talk financials with clients.  I do not love to choose between the best medicine and diagnostics and your financial constraints.  I understand everyone has them though.  My job, if I do it right, is to recommend the gold standard.  My OBLIGATION to the animal is to recommend the gold standard.  I get that you might not be able to afford referral to a neurologist for a CT scan or an emergency clinic for a blood transfusion.  I understand that.  It is my job to tell you, with the available information I have, what is the best course for your pet.  It is YOUR job, as the guardian of your animal’s best care and the supervisor of your wallet, to balance those two interests.  I cannot see the depths of your bank statement all I can see is your pet and its illness or its longevity.

      I am focused on preventing disease and alleviating suffering of your family member.  I don’t know that you need 4 root canals, or your kids need new shoes for school, but I understand when you tell me that is why you can’t do the gold standard care for your pet.  I can work within your budget, but then you need to budget your expectations of my results.  If I do not get to do all the diagnostics I need to see the whole picture, I may head down the wrong path for treatment and the outcome may not be what either of us want or expect.  I use my head and experience and odds ratios to pare down my tests and treatments to the most likely scenarios that might cause your pet’s issues.  This is part of the caveat emptor, you get what you pay for, of veterinary medicine. 

     Unfortunately the financial constraint approach often ends up delaying appropriate treatment and with less than stellar results. 

     In this ramble I really want to say that I want what is best for your animal.  It is my job to recommend that.  I know you have limits, I accept that you do. You need to tell me what those limits are and remember you get what you pay for.  I will always try my best in each circumstance, but even so results are NOT guaranteed, we are dealing with a living breathing thing whose mysteries sometimes are not fully discoverable.  

Rabies!

    One of the scariest words in veterinary medicine is “rabies”.  Recently right here on the Olympic Peninsula a domestic cat was diagnosed with rabies.  Several people, including the owner of the oddly behaving cat and a veterinary technician, are undergoing rabies treatment, according to the article in the Peninsula Daily News (November 5, 2015). 

     The reservoir for rabies in Washington State is bats.  That means even strictly inside cats and dogs need to keep up to date on their rabies vaccines- since we know many stories of bats getting into houses.   It is county law and state law (and a darned good idea) to vaccinate puppies and kittens for rabies as soon as 16 weeks of age.  We are pretty aggressively pro vaccine here at Family Veterinary Clinic and rabies is a must.  Until a few years ago rabies was a uniformly fatal disease to humans.  Only a few cases of people surviving the virus are in the textbooks and those people were put into comas until they outlasted the virus!  Rabid bats are easy targets for cats and dogs.  If you find a bat that is not normal (out in the daytime, stumbling, flying unstable, chewed on by your pet, etc) DO NOT TOUCH IT.  Use a gloved hand to pick it up and put it in a plastic bag.  DO NOT FREEZE IT, double bag it and refrigerate it until you can get in touch with someone from the health department or a veterinary clinic.  Funding for rabies testing is very low these days unless human exposure is suspected, so you will have to pay to have any bat tested that your dog or cat plays with out of your own pocket, it is very expensive.  There will be charges from your veterinarian and the health department.  Our last case was in excess of 200 dollars just for the health department charges and overnight shipping!

     Rabies virus vaccines are killed vaccines so there is NO possibility of your vaccinated pet getting rabies from the vaccine.  And the only preventive measure against rabies is vaccination.  After the first rabies vaccine the next vaccines last 3 years which decreases how many vaccines a pet needs through its lifetime.  The vast majority (99% here at Family Veterinary Clinic) of animals vaccinated have no significant adverse reaction to being immunized against rabies.

    If you are opposed to vaccines we still urge everyone to have their pets get that first vaccine for rabies.  Yearly or every 3 year titers can be done to verify immunity after that.  Titers are much more expensive than a vaccine every 3 years though!  If your unvaccinated pet bites someone it is possible they could require your pet to be euthanized to be tested if you cannot show that it has ever been vaccinated for rabies.  Better to be safe than sorry.

     This week has been a good week.  The onslaught of euthanasias has lessened.
     It seems we have been helping a lot of our long time patients out of their misery in the last month or so.  It gets to me.
     I do not regret euthanizing any of them, but I mourn the loss of the bond between them and their owners.  I remember some of these fur babies from when they were just kittens or puppies.  As a veterinary student I did not realize grief was a part of the job. The vet schools could do a service to students by some kind of counseling on how to cope with it.   Still, even after 20 years, occasionally a loss just overwhelms me with sadness and existential despair.  Ultimately all of my patients end up dead.  No matter how hard I try or how many things I study to keep up to date.
     I accept the inevitability of it, but still when I realize Molly is 12, it comes as a surprise.  I try to focus on the memories I have of Molly or Lexie or Emma or Scully.  Remembering the good times is sometimes the best I can do.  It is true each animal takes a piece of me.
     And then I find the joy in meeting new puppy Boo for the first time.  And the cycle begins anew.

Hit By Car

     We all try to keep our animals safe but sometimes the delivery guy leaves the gate open or the back door is propped to allow a breeze and the dog or cat, in search of adventure, runs off.

     The worst case scenario is your beloved fur baby gets hit by a car.  If you happen to be nearby such an event I have some words of advice for you. 

     If the animal is in the road, pull over in a safe area and park your vehicle.  If you have someone with you have them help direct traffic, NEVER try to help an animal and risk your own life at the same time.  Your personal safety is essential to being able to help the pet.  If you have reflector signs, etc in your trunk kit, use them!

     If you have a blanket in your car, bring it with you to the animal.  Often times the animals are overwhelmed with pain and a blanket can help protect you from getting bitten trying to help.  If the animal is trying to bite you can use a heavy blanket over the animal’s head to enable you to move it to the side of the road.  It is always a good idea to secure the mouth closed when moving an injured animal- you can use a piece of rope or a belt to tie around the muzzle also.  Move the animal to a safe place off the road.  If the animal is cooperative you can use the blanket or a board (a car mat works great w medium to small animals) to transport with minimal movement in case of fractures.  Keep the animal warm with blankets or body heat; this will prevent shock which can make conditions worse.  If you have access hot water bottles or electric heating pads also can prevent shock, be careful to not apply on hot or for very long as skin can burn w prolonged contact to heating pads.  If there is heavy bleeding apply pressure or a tourniquet (only to legs if the wound is far enough away).  Open fractures (where bone is showing) should be covered w a towel or other cloth if possible.

     Call a veterinary clinic that has emergency service listed.  Most clinics have a veterinarian on call and can come in relatively soon after assessing a case over the phone.  If you are NOT the owner make sure to call the owner to arrange for them to meet you and that they want the animal taken care of, where they would like it to go (who their regular veterinarian is) and what their restrictions are for costs.  If possible, have the owner call the emergency vet to arrange when to meet and directly communicate their wishes. An animal who has been hit by car can be a severe financial burden and cost thousands of dollars.  It is much better to have the owner of the pet deal with the veterinarian directly where possible.

     After a veterinarian has been called and located, drive carefully to the clinic.  If possible have someone sit w the injured pet to help calm it and keep it from struggling. 

Use the blanket or board or car mat to transport the pet into the clinic.  A brief history and exam will ensue and then the pet will likely be taken in for lifesaving procedures, xrays and labwork.  Expect to leave the pet for hospitalized care.  A few lucky animals may be able to go home the same day with recheck appointments scheduled in the near future to reassess.  Not all damage from a vehicular trauma is apparent immediately and some animals can deteriorate over the next day or so from lung contusions (bruises) and other issues.

      Avoiding loose pets, keeping them on leashes or behind a fence is the best way to avoid this whole scenario.  Indoor only cats live twice as long as outdoor cats do.  HBC’s are only one of the reasons.

     We offer 24 hour emergency calls.  We are in a call sharing arrangement with 3 other clinics, a total of 7 clinicians who rotate through a week of call at a time.  Keep in mind that 4 clinics call can mean that the on call veterinarian is already seeing an emergency and you may need to call again to try to get ahold of the veterinarian.  There are times when three emergencies call in a short period of time.  If you are not getting a response please keep calling or call another veterinarian.  There are two emergency veterinary clinics within 2 hours’ time of Port Angeles- Animal Emergency and Trauma in Poulsbo and Animal hospital of Central Kitsap in Silverdale that can see you as well, but usually time is of the essence to stabilize a trauma victim.

     Our emergency number is (360) 912-2425. If you do not receive an answer or a call back within 10 minutes, call again.

We are seeing a lot of very itchy dogs and cats here.  It seems to be a very bad year for fleas.  If your pet is itchy from the waist back it is probably fleas.  You can check for fleas by putting a light colored cloth or paper towel under your pet and scratching their backs gently with your fingernails, brush any flakey stuff on to the white material- if there are tiny curlicues those are likely “flea dirt” and by that I mean” flea poop”!  If there are tiny flecks of dark you can add a touch of water to them, if they turn a rusty reddish color that is the hemoglobin in blood that was not digested by the fleas….and you have fleas!

Good spots to visualize fleas are on the belly and around the anus and tail base, but watch carefully fleas are very fast!

I asked our veterinary dermatologist what he is using for flea problems these days and he still uses revolution and capstar.  Capstar kills all the fleas within an hour but has no residual effect.  Revolution is a topical and kills fleas for 28 to 30 days.  There are lots of new products out there but even our dermatologist is still using these two great products. 

We can look over your furry family members and help you with their itchies any day Monday to Friday.  For established clients we offer Saturday hours too!