Thinking of setting up your own blood donation programme in your practice?
These are the factors you need to consider when accepting cats and dogs into the programme!
Th ideal blood donor should be in good health, in good body condition and on the large size (but not obese) so that a decent amount of blood can be taken! They must be up to date with their vaccinations to ensure they are not harbouring any infectious diseases that could be passed on to the recipient. No travel outside of the country is essential for the same reason. Cats ideally should be from single cat households and live indoors only - this reduces the risk of FeLV and FIV being a concern.
It is essential that any donor on the programme has never had a blood transfusion.
These patients will require iv catheter placements and prolonged restraint for bleeding, they must be placid, easily handled and not highly strung. They should not find the process of donating blood scary and stressful.
Pre-blood donation checks: PCV + TP/TS + General health/recent illnesses + blood pressure + the last time they donated blood.
Always attempt to rule out underlying heart disease in cat before accepting them onto a donation programme - donating blood can kill cats that have heart disease,
Today could not be a more stereotypical Friday the 13th of it tried.
Surgeon an hour late. Only 3 people in spay/neuter. Severely dehydrated, severely anemic, dyspneic kitten emergency that we placed an intraosseous catheter in and I had my husband bring in my cat to act as a blood donor (kitten went neuro, was euthanized before transfusion). 9 year old dystocia chihuahua, evil, bred by her brother, puppy presented breech yesterday and was gross and elongated and it took a ton of effort to pull it out because we couldn’t get it to go back in. Dehydrated neuro kitten II, currently on iv fluids. 2 hours of surgery time and we’ve done a whopping 6 surgeries with 20 left to go….
Day only half over….
Halp
Yikes. Feels like you had my week but condensed into 1 day. (I’m in a general practice.) We had several scheduled surgeries, 2 emergency surgeries (a GI foreign body obstruction & a nasty pyometra), and a very dehydrated old lady cat with horrible dental issues (her surgery’s scheduled for next week). Today we had a lab with dystocia (5 pups on x-ray). Is it still dystocia if she should have gone into labor 4 days ago but never did? When my shift let off they were inducing her and prepping for a C-section just in case.
The best restraint tool in vet med is a towel, hands down. Do you know how many things I’ve restrained with a towel?
Angry cat? Burrito it.
Scared bunny? Burrito it.
Tiny squish faced dog that you cant get a muzzle on? Burrito it.
Screaming macaw? Burrito it.
Injured wildlife? Burrito it.
I burritoed an arctic fox today. Last week it was a cormorant. Before that it was a blue heron. When in doubt, burrito it.
“A towel, [The Hitchhiker’s Guide to the Galaxy] says, is about the most massively useful thing an interstellar hitchhiker can have. Partly it has great practical value. You can wrap it around you for warmth as you bound across the cold moons of Jaglan Beta; you can lie on it on the brilliant marble-sanded beaches of Santraginus V, inhaling the heady sea vapors; you can sleep under it beneath the stars which shine so redly on the desert world of Kakrafoon; use it to sail a miniraft down the slow heavy River Moth; wet it for use in hand-to-hand-combat; wrap it round your head to ward off noxious fumes or avoid the gaze of the Ravenous Bugblatter Beast of Traal (such a mind-boggingly stupid animal, it assumes that if you can’t see it, it can’t see you); you can wave your towel in emergencies as a distress signal, and of course dry yourself off with it if it still seems to be clean enough.”
And, apparently, Burrito Goddamn Anything with hit.
You should always know where your Towel is.
I literally was telling an owner about Hitchhiker’s Guide and towels yesterday! I sprayed a towel with Adaptil pheromone and wrapped her sketchy little Chihuahua in it, and after the exam the dog seemed more comfortable but anytime I slightly moved forward to her, she would retreat back to Her Towel XD
Calling all vetblrs and those in the veterinary community!
I’ve been on my first rotation (placement) since COVID and the team are awesome and I want to treat them when I leave next week, but I’m not sure what to get them? Here are my considerations:
Got a card sorted already
Some team members are on a diet so I was thinking grapes cause everyone loves grapes?
I can’t bake anything as I don’t have the facilities where I’m staying
I’m a student so can’t spend tons of money
I’m in the uk
Roughly 6 vets on each day and 8 vet nurses, but would like a little extra for those not working on my last day/on call over the weekend
What do you guys think I should get/what would you love to get?
Fruit in general is always great! Everyone always goes for cake (which is also fab) but there’s something sooooo good about a load of fresh fruit. Just like a variety of fruit!
I hope your placement went well! I remember those days :’)
I second the fresh fruit! :)
LOL I’m the only one who doesn’t like fruit ;) I do love chocolate or bagels. But I would say the things that touch me most are the cards, especially if they are specific about what helped you and what you learned. I literally squirrel away every card from a client or student I’ve ever received and look at them when I’m down. If your card includes a photo of yourself with an animal that can be pretty cool because I for one am terrible at remembering faces. it does sound like you were working with a big team so I wouldn’t worry about addressing every single person, though if there was a tech or doctor who you worked closely with and really helped you, you could consider writing more than one card.
Left photo: trachea of a “normal” dog Right photo: trachea of a brachycephalic dog
Sad, isn’t it?
Please think about this before you buy one of those “cute”, trendy breeds like pugs or Boston terriers or french bulldogs. Those grunting, wheezing sounds you hear them make sometimes? - it means they can’t get enough air and are struggling to breathe.
Me: “Hi, it’s Dr. Blank. What’s going on with Doofers?”
Owner: “He had surgery Wednesday and when we took the bandage off leg, the bone is showing!”
Me: “I see we neutered Doofers on Wednesday. Nothing was done with his leg other than a catheter. How long ago did you notice this?”
Owner: “Wednesday”
Me: “His bone has been exposed since Wednesday?”
Owner: “Yes”
Me: “I’m sorry, this sounds serious. Can you send a photo?”
Owner:
“His skin is gone”
Me: “Ok. So, his fur has been shaved for the IV catheter. But his skin is intact, is there a wound you can see?”
Owner: “You can see the bone right there. It wasn’t like this before the surgery.”
Me: “You can see the shape of his bone, yes, but his skin is still covering it. If you look at your own wrist see how you can see that bony bump? But it’s not exposed bone, it’s covered by skin.”
Owner: “His skin has been shaved off. His arm is skinny.”
Me: “His fur is shaved off. His skin is under the fur. It’s like when you get a hair cut.”
Owner: “But I can see the bone.”
Me: “Ok well let’s get him in for an appointment because that is serious. You can come right now.”
Owner: “I can’t come until Wednesday.”
Me: “We really need to see him, he could be very sick.”
Muzzles are a fantastic tool to help keep dogs and people safe.
The Muzzle Up! Project is here to help teach you all about muzzles and their proper use.
Did you know that dogs wear muzzles for all sorts of reasons?
Dogs might wear muzzles because:
He eats rocks, socks, or other non-food items that can be toxic or cause expensive and life-threatening surgeries.
She is nervous of other dogs, and the muzzle helps keep everyone safe during off-leash hiking or on-leash walks.
The muzzle works as a cue to tell other owners to give the dog some space.
The owner wants to teach their dog to be comfortable wearing a muzzle in case the dog must wear one someday at the vet’s office.
A properly-fitted basket muzzle can do all of this, and more! Best of all, if you take the time to train your dog to wear the muzzle, it should be comfortable for your dog”
There is a trend of posting videos and stories of animals faking injuries, over reacting to minor injuries, or copying their owner’s limp. I’m not linking to them and I urge people not to go look for them because the best way to stop content like that from happening is to completely ignore it. Anyway, this is troubling to me because animals don’t fake injuries or walk with a limp because their owner has one. These animals are actually in pain and have a medical problem.
Because I know it’ll show up in the comments somewhere, yes, you can train animals to fake a limp on command. This is not something they just start doing on their own and its not a super common trick. And also yes, birds like Killdeer do fake an injured wing to lure predators away from nests. These videos and stories are not these cases.
This radiograph is of a cat that came in for urinating outside of the litter box. The distal radius is completely disintegrated. This cat was limping and the owner said it just did that to “get attention” and the owner didn’t have any concern about it. The cat had cancer which caused the bone to fracture and then was eaten away.
Not all cases have something this dramatic going on. Sometimes there are small cuts in between toes, arthritis in a joint, torn ligaments, and other not readily noticeable injuries. Pain is also very subjective and just because you don’t think something hurts that much, it could be very painful to someone else (including an animal).
So if your pet is limping or seems painful, it actually is and it needs to go to the vet. And if you see stories and videos that seem really cute, remember that this is a form of abuse. These animals are suffering but instead of getting help they are getting turned into memes.
When I get lab results I always go over them with the owner. Generally if there isn’t anything concerning I’ll say everything looks good and there is nothing to worry about. If there are abnormalities we discuss what they mean and what the next steps are, if there are any. Most discussions take less than ten minutes and everyone moves on with their day.
More and more often I am asked by owners to send them a copy of their pet’s lab work. Some people just want a copy to keep in their pet’s file at home which is totally fine by me. Other times something worse happens. The lab results are shared with FB groups, forums, human physician friends or even worse… Googled. Then the emails and phone calls start.
There is so much more to diagnostics than just reading the numbers and seeing if they are red or black. What was the test run for? Was the patient fasted? How old is the patient? What species is the patient? What medications are being used? And on and on.
This lab work below is from one such case. I told the owner everything was within normal limits and we would proceed with the spay. I got a frantic phone call asking why I had not let them know their cat had leukemia and was in liver failure. Let’s look it over. Buckle up because this is a long one.
Before we even look at the results we need to look at the chart for information on this patient. In this case it is a four month old, intact female domestic short hair who was not fasted for this sample. This cat has no medical issues and is not taking medications
First of all we look at the CBC. The reticulocyte hemoglobin is the first red finding. What are reticulocytes? They are immature red blood cells. If there are abnormally high numbers of them it can mean the patient is anemic. Looking at the reticulocyte count we can see that it is within the normal range. So what does the reticulocyte hemoglobin mean? Hemoglobin is the protein that allows blood cells to carry oxygen. Indirectly reticulocyte hemoglobin measures the amount of iron available in the body when the cells were produced. The result is 14.9 pg and the normal range is 15.3-22.9 pg. This cat is completely normal on physical exam and has no symptoms of illness. The rest of the RBC parameters are normal and because this is such a minor decrease we don’t really care.
The next abnormality is a slightly increased white blood cell count. That in itself is pretty non-specific so we have to continue on. We see that the lymphocytes are elevated. This can be because of leukemia, infection, antigenic stimulation, stress response, and other things. It’s really common for kittens to have elevated lymphocyte counts. They are getting vaccinated, have epinephrine going through their systems like crazy at the vet, and are getting antigenic stimulation from the environment. I am not excited about this finding and would just move on.
If you read the little blurb under the CBC it says platelet clumping was noted and may affect the platelet count. This is also a normal finding in cats. This platelet count is normal so it doesn’t matter anyway.
Next we see there were smudge cells present. These are just broken pieces of WBC’s. This can be a sign of leukemia in people and sometimes animals but generally is because cells were broken during transport to the lab or during the blood smear. We know there are high numbers of lymphocytes so there are more cells around to create smudge cells. Not a big deal in this case.
Finally we see the ALP is elevated. This is a liver enzyme but is also found in bone, mammary tissue, and the intestines. It is usually elevated in puppies and kittens because their skeletons are growing so quickly. Not to mention we don’t usually become concerned unless a liver value is approaching 3 times its normal value.
As you can see interpreting lab work is much more complex than you might think. I do that entire process before making any phone calls or talking to owners. When you pay for lab work you aren’t just paying for the diagnostic itself you are paying for the expertise involved in collecting the sample correctly and in interpreting it.
Something I have come to dread are cases that are coming to me for second opinions.
Of course it is well within the right of every pet owner to seek out another opinion but most people don’t do it for the right reasons. What are the wrong reasons?
Not wanting to spend money on tests
This is the category of second opinions that I see the most of. “My regular vet wanted to charge me $200 for tests before giving me an answer!” We need diagnostics in order to determine the best way to treat your pet. It should be a big red flag if your vet says they know exactly what is going on and how to fix it without running any tests (within reason). Even something obvious like a broken leg needs x-rays to determine exactly how it is broken so it can be fixed properly.
Wanting a Different Outcome
Now, this can be a valid reason sometimes. But often owners just don’t like the answer they were given. This can tie into not wanting to spend money on tests too. Owners are frustrated because the problem isn’t getting fixed but won’t let the doctor run any tests so they can’t figure out what the problem is and end up trying different things just to see if maybe they work.
Wanting a Prescription Fix
Some problems require the owners making environmental changes or pursuing behavioral consultations/training. Sometimes owners just want medications instead. Unfortunately meds generally don’t fix the problem.
Wanting Cheaper Care
This also could be grouped with not wanting to spend money on tests. I see lots of “My vet wanted to charge me X for Y. How much do you charge?”. This is really complex because many times owners will simply seek out the cheapest procedure and assume its the same. You have to ask what is included in the price. Yes, you can get a spay done for $75 some places. Often that doesn’t include monitoring, IV catheter, fluids, pain meds, or after care. IMO that is substandard care but I don’t make the rules. You cannot compare that to a hospital that does lab work before hand, places an IV catheter and has fluids going, monitors vitals, gives pain meds, and has staff monitoring aftercare. Also keep in mind where you are. It is more expensive to operate a hospital in Manhattan, NYC than Manhattan Kansas so the prices won’t be the same even for identical procedures.
If you still want a second opinion, you are welcome to do so. But please keep in mind:
Bring medical records! (Better Yet, Send Them Ahead of Time)
Way, way too often I see a patient and the owner has no medical records. You aren’t getting a second opinion in this case, its a first opinion because we have to start over. Your pet’s medical records belong to you and you have a right to get a copy. I promise your previous vet doesn’t mind if you want a second opinion. Please don’t wait until you arrive at another hospital and ask them to call for records because all too often the other practice is closed or can’t do it right away and waiting for the records plus the time it takes the vet to go over them takes away from your appointment. If I have 20 minutes for an appointment and 15 of that is spent waiting for and reviewing records, you get 5 minutes of my time because I can’t make the next appointment wait.
You Must Pay
“But I just spent $100!” Yes, and I can understand how that is frustrating. But you are coming somewhere requesting a fresh set of eyes on a case and that requires doing an examination, going over previous records, and maybe running more tests. If tests were done very recently and are the tests we need, then you won’t have to repeat them in most cases.
Don’t Be Rude
You can seek a second opinion at anytime. Sometimes you must sign a records release form but that’s about it. Even if you want a second opinion you still have to pay for the first doctor’s time and for any lab work or meds. Just politely request records from the front desk staff and be on your way. The number of times owners have angrily threatened me by saying they’ll go elsewhere for care is comical. Often they calm down quickly when I say “Ok. I’ll get your records, I am sorry we aren’t meeting your needs.”
Older cats urinating outside of the litter box is such a common occurrence that it has become a comic. The internet is full of memes and jokes about cats doing things seemingly because they just don’t care, are assholes, or are vindictive.
The truth of the matter is that much of what we deem to be shitty cat behavior is because of medical problems. Older cats pee over the side of the litter box because something like 90% of cats over the age of 10 have arthritis. Their joints are so painful that they physically cannot squat anymore.
Cats that pee on piles of laundry or other places in the house is usually because their litter box is dirty, doesn’t feel safe, or they are painful and associate the pain with the box so avoid using it until they can’t hold it anymore. They don’t do it out of spite.
Often cats have been sick for months or years before they get brought to the vet and often only because the owner simply cannot deal with the urine all over the house. Imagine being so sick and painful that all you can manage is to wet your bed and instead of finding out what’s wrong with you, your family just tells everyone that you are a jerk and hate everyone.
Cats can be funny and do silly things but they deserve more than just being made into funny memes when they are sick and need help.
“There’s not enough medicine in there to last that whole time!”
That tiny tube of eye ointment contains enough medication for about 30 applications. But you have to know how to use it. Here are a few tips that will help when you have treat your pet’s eyes:
Tip 1
Unless told not to by your vet use a warm, damp cloth to very gently cleanse the eyelids and surrounding fur before putting in meds.
Tip 2
Get help. If your pet is small you can gently wrap them in a towel and have someone hold them while you put in the meds. If doing it by yourself put your pet on your lap or stand behind them with their back toward you. Use one hand to gently open the eye and the other to apply the medication. If you practice you can hold the medication in the same hand you use to open the eyelids and this makes application easier.
Tip 3
If you have multiple eye medications to use it matters what order you use them in. You always apply drops first, then suspensions, then ointment, and wait 5 minutes in between.
Tip 4
If you run eye ointment under some warm water it will make it easier to apply.
Tip 5
Barely use any pressure on the tube or bottle. You can easily lose several days worth of medication in one go if you squeeze too hard. For ointments remember you just need to apply the smallest, thinnest line of ointment over the surface of the cornea. You aren’t spreading peanut butter on a piece of bread.
Tip 6
Ask your vet to show you how to apply the medication before you leave. If you have questions make sure you ask them. Eyes can go from bad to blind in a single day so you really need to make sure you are able to apply the medication as directed.
Tumblr deactivated my account for my post showing the snake heart. Apparently it had been flagged as “human mutilation”
So unfortunately I’ll have to be more careful about what I post which is frustrating. Seems like Pillowfort may be the best Tumblr alternative if it ever gets out of beta. Until then, I’ll stick around.
And all these dogs are super fear-aggressive towards strangers as well. The vast, *vast*, majority of dogs a year old or less that we have come in for my shelter’s spay/neuter services are either borderline-traumatized fearful and shut down or they are trying to bite me for the crime of existing within 10 feet of them.
It is not ‘normal’ for a 4 month old shih-tzu puppy to be growling at me from 5 feet away.
It is not ‘normal’ for a 7 month old aussie to lunge for my face when I offered him some food.
It is not ‘normal’ for the 9 month old lab mix to be completely uncontrollable by the owners, up to and including grabbing their arms with his mouth when they tried to put him on the scale and literally knocking them over and dragging them away.
It is not ‘normal’ for the 6 month old golden to be cowering and urinating in fear.
This is a major issue that every level of veterinary and animal care professional is going to be dealing with for the next 15+ years. I sincerely believe that in a few more years, the rate of behavioural euthanasias is going to skyrocket and we’ll be seeing massive increases in incidences of dog bites.
@ all the people in the notes shrieking that because of the pandemic you couldn’t take your dog out: unless you were in one of the few places that had a truly extended lock down, most of this year you have been totally able to take your dog out and let it see the world. Socialization isn’t all about meeting and greeting- exposure is a big part of the program (and too often neglected, but I digress). But meeting “strangers” was not impossible. You probably have people and dogs in your life already you trust enough to meet your puppy at the end of a leash while you stand back. This is honestly who I want a new dog’s first experiences with “strangers” to be with anyway-no surprises because they’re not strangers to me.
It’s also not impossible to avoid separation anxiety when you work from home most of the time. People who work from home or stay home already schedule alone time so their dogs are OK when they do go out for a day.
There were always options. People were ignorant, and wound up with dogs that know them and only them, and the consequences are here. Ignorance isn’t a crime, but you need to own up to all your mistakes as an owner, even the ones you weren’t aware you were making. It’s how you grow as an owner and trainer.
Also it’s never too late to train! Yes some of you may have older dogs, but they just need a little more time, attention, and patience. There’s still hope to socialize them again and help them become the happy pups they were always meant to be. Just make sure to get good info from experienced people and trainers. In general don’t be afraid to ask for help, it’s been a rough year. But usually people are willing to provide help if they can tell you want better for your animal <3
