DrAndyRoark.com

Articles, Videos, & Training on Pets & Veterinary Medicine

Jessica Vogelsang DVM

There, I Said It: I Do Vaccine Clinics and Don’t Apologize For It

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I have had former bosses tell me that people like me are ruining the future of our profession. I have seen people post online about how vaccine clinics will ruin our business.

There, I said it: I don’t care what you think. I do low cost vaccine clinics to serve the community and help animals and owners. I make the community a better place.

I work with a local spay/neuter 501-c3 group to provide low cost vaccines. The average wait time where I work is one to two hours. The lobby is crowded, dogs bark non-stop, and this is the first time many of these dogs or cats have ever left the yard or house.

Most people have to choose between rabies shots and heartworm tests. The rabies shot costs $10, the exam is $10, but adding another $15 for the heartworm test will break the bank.

I vaccinated, heartworm tested, or microchipped 76 dogs in four hours today. Many dogs were petrified and many large dogs tried to bite. This was the first time they have ever been touched!

I educated every single family today about heartworm disease and benefits of spay and neuter. I discussed parvo and reasons to deworm with every single puppy owner I saw today.

If you work ER, this is one less parvo puppy to die in your lobby because it costs hundreds or thousands to treat. If you work general practice then this is one less dystocia dog whose owners can’t afford a c-section because now they understand why they should spay and made an appointment for the low cost clinic.

I refuse to be made to feel like less of a vet because I perform this valuable service to people willing to wait hours to have these services done.

We need to do a better job of explaining the value of our full clinic services and why exams and preventive care is important and worth the investment.

We also should explain that our vaccine clinic is subsidized with grants and staffed with volunteers to reduce the costs so no, your vet is not ripping you off!

In the meantime, there will be Walmart style vaccine clinics who serve a need for those who struggle to afford veterinary care. That’s one less puppy dying from parvo. You’re welcome.

The views and opinions expressed in this article are those of the author and do not necessarily reflect the position of the DrAndyRoark.com editorial team.

There, I Said It: Cats Aren’t Low Maintenance Pets

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For decades, cats have been considered low-maintenance pets. You would put food in a bowl and your cat lounged around your house, getting steadily fatter, until eventually it passed away. You could just let it outside for a while, if you needed to. Cats were easy – easier than dogs, for sure. Cats required little from pet owners and from veterinarians.

This mentality still persists among a large segment of the population, and it needs to change. If I hear one more person say, “it’s just a cat”, or “she’s sure needing a lot for a cat”, I may scream – or get my cat to claw some eyes out. The truth is, cats don’t bring in as much money for vet clinics as dogs do. Less than 50% of all owned cats will visit the vet each year. People are reluctant to spend as much money on their cats as they are on their dogs, and their expectations are far lower for what a cat will require. Did you know that cats should be on heartworm and flea preventive too? That you can – and should – learn to trim their nails, instead of getting annoyed when they scratch you? That cats deserve annual veterinary exams, since they age much faster than humans, and appropriate vaccination even if they live indoors?
Face it, world – the days of treating your cat as though they require nothing but food are over. You don’t have to walk your cat, but you do need to clean their litter box daily to keep it a pleasant, odor-free bathroom spot. You don’t need to play fetch with them, but you DO need to play with them – be it with a laser pointer, squeaky toy, catnip, or other way of providing a stimulating environment. You do need to provide a balanced, healthy diet for them – defy the common myth that cats just “get fat” as they age. Don’t just fill a bowl with food and leave them alone for days at a time – cats crave affection, touch, and attention as much as dogs, and they’ll wonder where you’ve gone and when you’ll get back.
When your cat is acting strange, don’t call them an “a**hole cat” or dismiss it with “cats are weird” or another platitude. Instead of being upset that your cat only eats food from the center of her bowl, research whisker fatigue and understand why it may be uncomfortable for her to eat from a bowl vs a plate. If your cat stops jumping or playing, using their litter box, or eating – take them to a veterinarian. Run tests. Spend money. Learn how to give them medication, and work proactively with your vet if it’s difficult. There’s been great advances in cat medication, from flavored liquids, to obscuring bad tastes with sweet ones, to transdermal formulations that can simply be rubbed into the ear.
Cats are no longer being treated as small dogs in veterinary medicine, and they deserve their owners to step up just as much. If your cat is stressed, figure out why and learn how you can make their environment more comfortable for them. Cats are so sensitive that even rearranging furniture can send them into a tailspin. Afford them the same amount of time, attention – and, yes, money – as you would a new puppy. Cats can even be trained – everything from sitting and shaking, to the ‘place’ command, to where is an appropriate place to scratch – if you have the patience and good rewards. Research why your cat reacts the way that they do, and why they have the needs that they have, instead of accepting half-truths, myths, and the pervasive stereotype that cats are just jerks. Your vet team is a great resource for fact-based cat knowledge.
The days of a cat being “just a cat” are ending, and it’s time to once and for all show that mentality the door. Don’t bring a cat into your home and expect it to be a ‘low-maintenance’ animal that will never be inconvenient, sick, or needy. Don’t bring a cat into your home if you’re not up to the challenge of giving these amazing animals a fulfilling, comfortable, healthy, and rewarding life.

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The views and opinions featured on There, I Said It are those of the authors and do not necessarily reflect the position of the DrAndyRoark.com editorial team.

There, I Said It: Nursing is Not a Special Accommodation

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By Anonymous

 

You do not want make the moms angry.

 

Here is the reality of working in a majority female medical profession:

 

1 – A lot of us are mothers

2 – We are required to get continuing education

 

So, a decent percentage of us at any time need to feed our babies AND get continuing education at the same time.

 

Since many states have limits on how much continuing education can be pursued online or because many of us prefer in-person continuing education, that means moms need a place to nurse or pump at such conferences.

 

This should not be a surprise. Nor should it be challenging to provide.

 

It would be very rare for a place providing continuing education to not also be a workplace. By law, workplaces should be able to provide “a place, other than a bathroom, that is shielded from view and free from intrusion from coworkers and the public, which may be used by an employee to express breast milk.[1]”

 

Women who make up 50% of our population should be able to perform normal bodily functions in peace and safety.

 

Recently, a veterinarian who was nursing attended sponsored continuing education event and asked for a space to pump.  Without going into the uglier details, she was directed to use a bathroom. Even when clean, bathrooms are not considered sanitary places to produce breastmilk that will be fed to an infant.

 

She was later told in writing that she should have let them know in advance about her need for “special accommodation.”

 

Frankly, many women do not consider performing this non-pathologic, natural, and common bodily function as something that requires “special accommodation.”

 

As a nursing mother myself, when I attended the AVMA convention this year, I certainly wouldn’t have thought to call ahead for a “special accommodation.”

 

Luckily, the veterinary moms from around the world have each others’ backs. They have banded together to try and help prevent things like this from happening again.

 

After discussing the less than ideal pumping conditions at one convention this year, several other conferencest appear to be making concerted efforts to provide more comfortable nursing spaces and a welcoming atmosphere for mothers.

 

Our profession is small. Even if you are not a mother in our field, you likely care about one. Many of us in the veterinary profession are friends with women and mothers in other medical professions too.

 

As the world grows smaller every day, not only are companies who recognize the realities of life as a woman doing the right thing, they helping ensure their financial survival.

 

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The views and opinions featured on There, I Said It are those of the authors and do not necessarily reflect the position of the DrAndyRoark.com editorial team.

 

[1] https://www.dol.gov/whd/nursingmothers/faqBTNM.htm

Why I Don’t Give Clients My First Name at Work

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Back in ancient times shortly after vet school graduation, I sat to dinner with a recently minted MD and we commiserated about people giving us a hard time about our ages.

“I grew a beard,” he said. “It helps.”

That option was out for me, so I cut my hair into an unflattering soccer mom ‘do (it was the early 2000s. We did horrible things back then), dyed it mousy brown, and added glasses in an attempt to make myself appear older and wiser. I don’t really know if it helped. Despite all these efforts and the lab coat with “Dr. Vogelsang” embroidered on it, I would constantly have clients ask me when the doctor was coming in the room. As the years passed and I clearly became old enough to be a doctor, the question persisted. I began to wonder if my age wasn’t the problem.

I once worked for two doctors, a man and a woman who were friends and business partners. He always introduced himself by his first name: “Hi, I’m Peter Foster.” Clients loved it, and afterwards continued to call him Dr. Foster. She did as well: “Hi, I’m Amy Sterling.” It was 50/50 at best whether or not clients called her Amy or Dr. Sterling after that. They usually called her Amy when they were about to complain about something or to see if she would run something by Dr. Foster despite the fact that she was more experienced and essentially his boss.

I guess I am old fashioned in that I prefer people to use proper titles, within context. When I go to my own doctor’s office, I refer to them by their title; it’s about respect, right? In a social context I would use their first name. It’s easier to let go of that need when it doesn’t have an impact on whether or not clients treat your recommendations with the weight your degree gives them, but from my own observations, the clients who want to call me Jessica (or god forbid shorten it to Jess, a fireable offense in my opinion) are also the ones who minimize my expertise.

You’d think that as I got older, this would bother me less. The opposite is true. For a long time I would keep my discomfort to myself, because who wants to be perceived as overly sensitive? Or God forbid, shrill? Maybe it was my fault for not seeming confident enough. Maybe I was being too sensitive. So for years, when people would ask for my first name after I specifically left it out of my introduction, I’d just smile and give it before confirming yes, Dr. Foster thought my recommendations were a good idea.

Most professional women I know have gone through the same internal debate wondering if this was all in our heads. A recent paper in the Journal of Women’s Health showed that when doctors introduced other doctors in a grand rounds environment, women were more likely to use a professional title. Men were less likely to use the title of doctor overall, and even less likely when it was a woman they were introducing. To summarize how often people were introduced using their professional title:

  • Woman introducing woman: 98%
  • Man introducing man: 72%
  • Woman introducing man: 95%
  • Man introducing woman: 49%

It’s hard to discuss these things because it always seems to segue into a “here we go again hating on men” thing. It’s not true. I love men, promise. I married one and I work with one and I admire lots of them. I have been supported and championed by men who want to do the right thing and I am so grateful for that. Are we clear on this? OK, good. The good men I know don’t shy away from listening to me when I share my experiences. When we’re too scared to share our reality because we don’t want to hurt someone’s feelings, we all lose. I don’t know why this shakes out the way it does, but there’s the numbers so at least we can all breathe a sigh of relief that we aren’t making it all up in our heads.

The biggest takeaway from this study, at least for me, is that women seem to care more about professional titles in general, regardless of whom they are addressing. Perhaps this is because for many of us, we rely on it to reinforce our expertise, or we sense when it is being left out as a conscious or subconscious means to minimize us. Perhaps men don’t care as much because they don’t need that title as much? I don’t know. Maybe some day we will understand more.

For now, I’m going to continue to be That Person and love other people who support me in this crusade. I once overheard one of the greatest technicians and friends in existence, my friend Amber, having this conversation on the phone: “Jessica? Who’s that? We don’t have a Jessica here….Oh, you mean DOCTOR VOGELSANG? I’ll take a message.” Did I mention she was the greatest? Because she is. She has three sons and a daughter now, and I am sure they are also going to be the greatest.

To all the strong and wonderful women doctors I know: It’s OK to want that title, and to correct someone when it is left out. We earned it. Don’t be afraid to hold it close, and be generous with its use with our colleagues. It does mean something. To all the strong and wonderful male doctors I know: Thanks for calling me Doc. I promise to do the same for you.

The views and opinions expressed in this article are those of the author and do not necessarily reflect the position of the DrAndyRoark.com editorial team.

5 Reasons Wonder Woman Could Have Been a Vet

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I’m very picky with my movie choices. I mean, I don’t have a lot of free time to begin with and movies are expensive so if I’m going to spend an afternoon seeing one, I don’t want to screw around. It better be good.

To be honest I wasn’t even planning on seeing Wonder Woman, because she hasn’t been a  part of my life since my Underoo-wearing Justice League days. But I had a free afternoon with my daughter and the movie seemed to be getting good reviews, so we went to see it.

 

 

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Holy wow.

It was great. Beyond great. It made me realize the reason I wasn’t into superhero comics and movies wasn’t because I didn’t like superhero stories, it’s just I hadn’t ever seen one that truly inspired me. Like, the Wonder Woman I remember flew around in an invisible jet and lassoed people, which was cool but not exactly aspirational. But at least she was a hero, which is better than the 95% of women represented in comics as passive decorations, victims, or sidekicks.

This, though, this was different. I saw in this story so many strong amazing women, so many veterinary colleagues, and it made me immediately want to lobby the next big vet conference to hold a screening. I spent a lot of time in the theater quietly whispering “YAS QUEEN” and I’d like to be in a room where I could say it a little louder and I feel like my colleagues probably would be down with that.

If you are waffling on whether or not to see this gem, go and do it, and bring your friends and your kids. You’ll love it, and she’ll probably remind you of a few people you know. Here’s why:

1. It never occurs to Wonder Woman that she isn’t supposed to be there.

When Diana leaves her home to go into the world at large, she has spent her entire life preparing herself for her job that she’s really good at it. What she didn’t expect was that the world didn’t know what to do with her. She doesn’t look or act like anyone else in WW1 era London, man or woman, doesn’t pay attention to how things “have always been done”, and she doesn’t care. She strolls into high level meetings with a “what?” look on her face, takes the lead without asking permission, and brushes off input she doesn’t need. She is confidence personified, taking the seat at the table without waiting for it to be offered because, really, it never would have been.

 

 

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2. She wears whatever the hell is comfortable and functional.

There’s a great scene in the movie where her friends are attempting to help her fit in by dressing her up as a proper Victorian lady. In the dressing area she’s evaluating which skirts are best for landing a roundhouse kick (none, really.)

But when it’s time for battle she loses the petticoat and gets her gladiator on. Unlike the creepy Lynda Carter era uniform which, let’s face it, seems to have intentionally offered too little support if you get my drift, this Diana wears armor. I have no doubt that if she needed coveralls to get the job done she’d have rocked those too.

 

 

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3. She doesn’t hide who she is.

It never occurs to Diana that she should be anything other than who she is, that she should hide some parts of her in order to get others to take her more seriously. She cruises down the streets of London carrying her sword and shield like the warrior she is, and also stops halfway down the road to coo at a baby she finds adorable. She doesn’t ever apologize for the way she looks or the clothing she wears, and moves through the world with the expectation that you just better accept it. She succeeds on her own terms.

 

 

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4. Her badassness comes from a place of genuinely believing she is going to make the world a better place.

Diana is truly a compassionate person (or is that Amazon? Goddess?) Her motivation comes from that guileless place, and she goes into it expecting naively that people will recognize the value of her work, support her, thank her. Of course they don’t. At some point she realizes that the world doesn’t really deserve it, and maybe doesn’t deserve her, but she saves it anyway. Not because she needs that salve to her ego, but because she can’t see herself doing anything else.

5. She doesn’t ask other people’s opinions and feels free to ignore unsolicited advice.

There is a scene called No Man’s Land, which I don’t want to spoil too much, that unexpectedly punches you in the gut. It is the point in the movie where Diana has a decision to make. She has a job to do, a mission to accomplish, and not a single soul supports her. In fact, they are actively dissuading her from this choice. No one believes in her, no one is going to help, no one thinks she could possibly save the day. She’s brushed off like a cute little fly getting in their way.

It’s unlike any other scene I’ve ever seen in a superhero movie, and interestingly enough it almost didn’t make the film. To me, this scene is everything. This is every woman I know who has shown up on a farm, the boardroom, the exam room, or the surgery suite knowing she’s on her own in a hostile environment, rolled up her sleeves, and GOT SHIZZ DONE.

And last but not least, you get to see Robin Wright, aka Princess Buttercup and First Lady Claire Underwood, an actress in her 50s who is according to Hollywood trope should be long put out to pasture, doing this and looking 100% glorious:

Because in this world, much like the one in which we sometimes get to exist, the women get stronger with age.

Wonder Woman set a box office record for a movie helmed by a female director, a movie opening bigger than Iron Man and with a 93% rating on Rotten Tomatoes. It is an unmitigated success.

Even if you personally are not a woman, I bet you know someone who is. It’s a great film for everyone. It is not just a movie, it’s a reminder- that when women write our own stories, no matter what those may be, we can and do kick ass.

And you just can’t hear that enough.

How My ER Visits Made Me a Better Vet

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In this article we are going to get a little bit personal. Not telling you the color of my underwear personal, but close. In the past month or so I have had two run-ins with the hospital (human hospitals.)

One was a scheduled elbow replacement that just took place, the other was a very unscheduled hip dislocation about a month before. The hip dislocation took me to the emergency department, while the replacement took place through a scheduled operating room intake. Don’t worry, we are past the time when you need to send me bouquets (fruit baskets accepted year round, though.)

Both of these got me thinking about the differences between human medicine and animal medicine and made me consider how I could take the positives and negatives from my experiences and make my clinic a better place for patients.

For better and worse, the two fields are very different. I have nothing but respect for human nurses, PAs, LNAs, PAs, MDs and the rest of the field. Both of my hospital experiences weren’t especially new to me, but now that I have been out in the field longer I try to look at things from the perspective of my own clinic and patients. I also tend to stay away from the ER, so this was only my second visit there ever. I look on the bright side of these hospital visits and become a better vet because of them.

The first thing that happened when I arrived at the emergency room was that I was asked what was wrong. I knew that I had dislocated my hip because I heard it, felt it and could easily evaluate that it was in the wrong place.

Our animals don’t have this advantage which is why fast, gentle and complete physical exams should always be the first thing that we do. The second thing to do in many situations is pain medication. The speed with which I get pain medication to my patients is light years faster than often happens in the human field. I want every patient that enters my clinic in pain to have the benefit of a very fast resolution. Their pain is hidden better than ours, but directly related to their fear.

I tried to imagine how I would feel if I didn’t know what had happened and couldn’t speak the same language as my nurses and doctors. I was able to reason out what was happening, but if I took only my pain and eliminated the ability to think about a plan for the future I can only imagine how scared I would have been. This is the angle that my patients are coming at me from, and it must always be the forefront of our minds as veterinarians.

Veterinary medicine is much more hands on than human medicine- and let’s be honest, you would rather put your hands on fur than a human as well. Other than vitals, often we go entire visits without our doctors touching us. We typically see physicians for each specialized field, while your veterinarian encompasses all of those fields. My orthopedic surgeon has never felt my spleen, while hardly any pet goes through my clinic without a complete abdominal exam. My surgeon can also rebuild and replace bones in a way that I could not.

It is often said that specialists have knowledge which is one inch wide and one mile deep, while general practitioners have knowledge one mile wide and one inch deep. In human medicine, each field is very specialized. Your veterinarian likely has a wider breadth of knowledge, but must refer you elsewhere for very specific problems.

Now let’s talk about hospitalization. At my ER visit I was in the hospital wearing the clothes I was going to ride my horse in. Once I got fixed up it was 1:30 am. All I wanted were PJs and to take my contacts out. I can guess that when our dogs wake up from surgery all they want is their favorite toy and a soft bed.

When I needed something, I could just hit a call button. I could tell my nurses exactly what I wanted. I could tell them my pain score, if the medicine was working, how well it was working and what needed to change. These are all things we need to try and predict for our patients since they don’t have the benefit of a call button.

Did you know that we monitor all of these things in pets too? We don’t have questions to ask them, but we watch parameters like heart rate, position in the cage, ear position, pupil appearance and breathing to monitor pain.  We use the results of studies to create a generalized approach in our patients, then monitor them as individuals. We make sure that pets haven’t rolled over on a surgical area and have soft beds. We get the benefit of our patients not talking back with the downside of them not being able to tell us how they feel.

A couple of months ago while I was at a vet meeting my husband called because my dog had peed on the floor. She is very well trained and not prone to that type of thing. I questioned if she asked to go out and he said she hadn’t made a peep. I clarified that if she walks to the far end of the living room and back twice with her ears in a certain position it means she wants to go out. He justifiably told me I was crazy.

The fact is that we get very attuned to nonverbal communication from our pets. I never want crying in pain to be my first indicator that I need to intervene on behalf of a patient. It is important that I look for other silent signs to help them before they are in a high degree of pain.

Now that I am on the mend I have the benefit of stepping back and looking at the positives and negatives from my visits. While they made me less able to do intense physical labor for a while, I am hoping that they also improved my skills as a veterinarian. While I am always attuned to my patients’ needs and wants while they are in my clinic, it is helpful (though not actually very fun) to view it from the other angle.

The views and opinions expressed in this article are those of the author and do not necessarily reflect the position of the DrAndyRoark.com editorial team.

image1 (1)Dr. Anna Dunton-Gallagher is a 2011 graduate of Ross University School of Veterinary Medicine. She completed her clinical year at the Virginia Maryland Regional School of Veterinary Medicine and then settled back into her hometown of Rutland, VT to practice. She loves wellness pet care, pain management and her clients. When not at work she enjoys spending time with her pets, snowboarding and horseback riding..