DrAndyRoark.com

Articles, Videos, & Training on Pets & Veterinary Medicine

Ryan Llera, DVM

A Resolution for Pet Owners: Tell Me What I Did Wrong

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It’s that time of year where everyone makes resolutions to do something better or differently over the next year.  Maybe it’s to quit smoking, to lose weight, to play with your dog more, or a resolve to not break your resolutions.

But there’s one thing I want to ask all the dedicated pet owners out there – resolve to be more transparent with your veterinarian.

We have a few of philosophies in veterinary medicine; pet care is a team effort, we can only work with the information we are given, and you can’t save them all, to name a few.  And as much as we want to help all the pets we can or perform miracles on a weekly basis, we can’t.  But we do want to make sure are doing our best to continually improve ourselves to serve you better.

Here’s where you come in with that increased transparency.  Something that happens more often that we’d like to admit in veterinary medicine is pet owners not being forthright in their feelings.

No, I’m not talking about their fear to admit their dog ate marijuana or it ate their mistress’ underwear.  Actually, it’s more confounding when clients request to no longer see a specific doctor or just outright leave the clinic for another clinic.

Understandably, sometimes personalities just don’t mesh or there is a communication barrier.  It happens, and that’s cool.  What’s not kosher is when a colleague is left clueless as to how to improve.  Over 12 years, I’ve seen it happen multiple times. It’s happened to me and it’s happened to friends and co-workers.

We think the appointment went great, answered all your questions, came up with a plan to help your pet, and gave extra love ad treats to your pet but the next thing we see in the file is “does not want to see Dr. X” or “files transferred to Animal Hospital Around the Corner.”

So what did we do wrong?  We almost never find out.  Almost never = 99% of the time.  A lot of the time we chalk it up to personality differences and move on; there’s other patients that need our help.  But sometimes it does hurt.

What could we do better?  These are the things that we would like some transparency.  Yes, the truth might hurt us but it’s not fair to give us a false sense of doing a good job or maybe even a disservice to another client.

Yes, we love hearing the good reviews but sometimes we need to hear the not so good.  This doesn’t mean berating the vet or clinic in the waiting room or online social media but actual constructive criticism could be mutually beneficial for your vet, hospital, AND your pet.  Imagine how much better we could help you and your pet if we were on the same page in our communication.

So before you walk away from the last veterinarian you saw or the vet clinic you’ve chosen to be your other family doctor, take a moment to see if there’s a way we can find a middle ground to move forward in a positive

What They Can’t Prepare You For in Vet Med

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My grandmother died on July 24, 2017. While I feel sad, I don’t know how to fully express my grief.  I have shed a few tears but something still seems off about how I feel and how I should feel. I’m not writing this to get sympathy, but rather to let those who have a veterinary person (anyone who works in a vet hospital or animal shelter) understand how we act when a loved one dies.

We deal with death far too often, almost on a daily basis. This is likely the cause of the problem. Most of the time we are euthanizing elderly or sick animals. We justify this by knowing that they won’t suffer, feel any pain, and will be free of their maladies.

Sometimes though, we’re are having to euthanize a younger animal due to a freak accident, owner financial reasons, or bad luck from some contagious disease. It’s harder to justify this scenario but somehow we have to plug on to the next patient.

The case with my grandmother is similar to the former scenario. She had been diagnosed with an aggressive form of cancer just as my other grandmother passed away. The doctors initially didn’t give her much time. She was unable to eat and lost almost 40% of her body weight. Chemo was tried and failed. A second protocol was tried and ultimately also failed.

We knew there was no cure but all we were hoping for was a good quality of life and fun times while they could last. She lived for her grandkids. Her first hurdle was watching the 13th be born two months after her diagnosis. Then the next goal was Christmas. After that, I like to think the rest was bonus time.

When I conversed with her the last time, I didn’t know it would be the last. Three days later when she entered hospice and my family reviewed the blood test results, I knew it was a matter of days.   Yes I was sad, but also I found myself rationalizing the experience. She had lived a full life. She was going to be with her true love, my grandfather, once again. It was a mixture of feelings…part of me felt guilty for rationalizing everything; the other part of me felt sad but I didn’t know how express it.

I don’t think I’m the only veterinary person who feels this way. For the most part, maybe it’s just that we’ve forgotten how to grieve.  This is not something they taught us in vet school. They can’t prepare us with how to fully deal with death.

Assuredly, we do feel sadness. Mostly though, we have learned to suppress this as our jobs don’t always allow us to express our emotions either through the reasons of time or professionalism. Believe me, I don’t think any of us are happy with this or proud of it. Certainly, there are times when we do break down and let it all go – but we rarely let anyone see this.

To my colleagues in the field: Don’t lose your humanity. Take time to cry. Don’t forget what’s right in front of you – whether that be your work team, your past, present, & future patients, and your family. To our families who love and support our crazy or confusing veterinary lives, trust that we do hurt and trust that we will share when we are ready.  Thank you for supporting us and for understanding.

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.

The 5 Dr. Seuss Characters in Your Clinic & Why You Need Them

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Working in a veterinary clinic requires everyone to have devotion, ethics, and a sense of humor. It really does bring together people from all walks of life into a wubbulous melting pot. Yes, wubbulous because every vet clinic can be like stepping into a new story of the world of Dr. Seuss. No clinic is the same and the people you meet there are special, in their own sort of way. In this mix of people, they will bring characteristics or traits that make the job and environment better.

1. Sam-I-Am

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“I do! I like them, Sam-I-Am!” Sort of like the class clown, there is always somebody who is fun loving, free spirited, and maybe sometimes the butt of jokes – just like Sam-I-Am. This really can be anybody in the clinic and they help boost the mood and morale of everyone by cutting loose. Whether it be putting their foot in their mouth and opening up to some playful mocking or the person who ruins everyone’s diet plans by bringing candy, they have a need to lift everyone’s spirits in unarguably one of the most challenging professions in the world. Face it, the clinic needs more of these people than anything else.

2. The Lorax

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“Unless someone like you cares a whole awful lot, it’s not going to get better. It’s not.” The Lorax is wise and we should listen to him more. Ask anyone in vet med and they’ll say they got into the field because they love helping animals and people. But that’s often not enough…they detest a stale environment and crave change. They are constantly looking for ways to improve how things are done or new ways to practice medicine. They are adventurous when it comes to suggesting and trying new procedures or protocols especially. Think of it like trying to teach an old dog new tricks. Typically, this is going to be a new graduate from veterinary or vet tech school because they’re stepping into an environment that others might view as “normal.” The kind of change they suggest should be evaluated & embraced and their opinions valued as it will make for a stronger team.

3. Mack

“I know up on to you are seeing great sights, but down here on the bottom, we too should have rights.” Truer words may have never been spoken but Mack the Turtle shares this profound wisdom. You may not know Mack but surely you know someone just like him. Mack is the turtle at the bottom of the stack in “Yertle the Turtle” which is about a tyrannical turtle (Yertle) who desires to be higher than the moon. Mack, our hero, steadfastly questions authority and tries to look out for the little guy. Someone in the clinic, possibly in some sort of manager or supervisor role but not the owner, is well suited for this. It’s possible to question the decision makers and still maintain a respectful tone. An overall healthy morale in the clinic will lead to better success and productivity for the team.

4. Horton

“I meant what I said, and I said what I meant. An elephant’s faithful, one hundred percent!” Kind hearted and faithful, Horton the Elephant helps us retain our natural humanity. We already give 110% of ourselves so what more can we do? Nothing more really. But when times are tough, our inner demons may awaken and that little devil on our shoulder encourages us to give in and embrace our dark side. And there, on our other shoulder sits Horton reminding us of our true purpose as healers and not to give up. Someone is counting on us and every now and then we need a cheerleader in the clinic; surely there is one bubbly person at work who encourages you to keep being awesome.

5. Thidwick

“You wanted my horns; now you’re quite welcome to ’em! Keep ’em! They’re yours!” Thidwick, the Big Hearted Moose is someone we all should strive to have a little bit of in ourselves. The story of Thidwick revolves around his generosity at letting multiple forest creatures dwell in his antlers. He is so giving of others, that he doesn’t look out for himself. Finally, like all moose do, he sheds his antlers thus relieving himself of the burden of being a mobile condominium. He is effectively practicing self-care and looking out for himself for a change. We all need to be able to say “no” once in awhile.

I see a little bit of all these characters in myself changing as the situation calls for it. It’s a hard job that we do but there’s gotta be some room for a little Seussing up in your clinic; and I don’t mean any Grinches or Zax (no matter whether they be north or south going Zax). So which positive Seuss are 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.

How This Vet Answers, ‘What Would You Do?’

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I’m a veterinarian.  I also sometimes play the role of counselor, therapist, or all-around whatever you need in the moment.  And on an almost daily basis at the vet clinic, I get asked one question: “What would you do if he/she was yours?”  Now depending on the situation, this question can take on various connotations.

Sometimes it’s an easy question to answer.  When a very sick pet comes to me, and the family is already considering euthanasia, I can comfortably guide them to know that if I were in their shoes that saying goodbye to their pet is the right decision.  In many of these cases, it’s the fairest decision for everyone involved.  Once a family has made this decision, I am simply reaffirming that they are doing the right thing as this can avoid remorse by changing their minds later.

Other times, this can be a variably complicated question.  I’ve been in the client’s shoes on a few occasions.  When my cat Gremlin was diagnosed with a heart murmur at the age of 4, I didn’t panic.  Sure, it was weird to find a problem at such a young age; but hey, she was my “special in her own weird way” cat.  Now when I break this kind of news to a pet owner, I recommend they dig a little deeper and visit the specialist.  At the same time, I can relate and help them learn what to watch for in case they don’t go for some advanced diagnostics or further evaluation.

It can be harder when the situation is more serious as it was when Charlie’s spleen ruptured.  Deep down I know that many these dogs don’t live very long after the surgery as they are often malignant…and that’s if they even make it out of the hospital.  Deep down, I want everyone to try because I understand that bond between the you and your pet.  But I realize my job is to guide you to a decision that is realistic and that you may be comfortable with even if the outcome is not desirable.

I made the decision to take Charlie to surgery knowing the odds were against us.  But I’m not you, the pet owner of your own pet.  Not everyone might be able to stomach the decision to consider euthanasia on the table or take the risk of the post-operative care.  This is where the question of “what would you do?” gets complicated and where sometimes I find a moral dilemma.

No matter which way your veterinarian answers that question, if things go opposite the way you want or expect, we can feel guilt or worry – and this is why I don’t like to answer this question sometimes.  We may feel guilty that we’re not giving you the answer you want to hear but deep down we know it’s the right answer.  We worry that things will go awry after giving the answer and the trustful bond we share with you will be broken.  So, if you ask us what we would do, be ready to hear the answer.  I implore you to know that we’re being honest for you & your pet even though it may not be easy have that question answered.

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.

I’m Not Your Grandpappy’s Vet

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I’m not your grandpappy’s vet. We’re also not living in the age of the infamous Disney movie “Old Yeller.” No spoiler alert here but the movie doesn’t end happy for the kid or his dog.  We’re in a different time than we were 40 years ago- heck, even ten years ago from when I graduated!

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Recently, I got a letter from an upset client. Why where they upset? I had to euthanize their pet and it didn’t go as they had planned or envisioned. It was a sad moment for the family and I genuinely feel bad about it. It eats at my very soul to have to euthanize a beloved pet; but even more so when the family isn’t granted the circumstances they wish to say goodbye in.  But from this instance, we can all learn something.

Their letter was not the first time I heard from a client that “my previous pets never needed a catheter or sedation to be put to sleep.” And I understand. In the last generation, medicine and the perception of pet health care has advanced. So why the catheter and sedation now?

Many pets come in sick and finding a useable vein to give the euthanasia drugs can be difficult. The veins can collapse due to poor blood pressure or dehydration. If the solution goes under the skin outside the vein, it can be uncomfortable for your pet. Having that catheter in place prevents your pet from unnecessary pain and if they happen to move their leg, we don’t have to poke them in front of you.

As far as the sedation goes, this component of vet med branches out further than just euthanasia. Some pets are anxious or scared when they are in the vet clinic. X-rays, nail trims, clipping out hair mats, cleaning ears, and more can be a stressful time for your pet, you, or the clinic staff. Sedation allows your pet to not be afraid and helps procedures happen in a safer and more efficient manner. Getting back to the euthanasia component though, it’s a peaceful way to ensure your pet’s final moments are as fear-free as possible.

Times are different and we, the veterinary community, are asking for your patience and understanding when it comes to your pet’s health. Yes, we have to see your pet to prescribe any medication. Yes, we need to examine your pet before they get a vaccination.

Certain medical conditions are now treatable and it’s our job to advocate for your pet and their quality of life. Things have changed such that our medical records must be detailed for others to follow them but also to erase any doubt of what was discovered, performed, or discussed in the care of a patient. We don’t set these rules, our licensing boards do. It’s changed and no longer are we practicing in a time like that of James Herriot.

It would be nice to turn back the clock sometimes and get back to a simpler time. Instead, we have the benefit of years of experience to make pet care a better, safer, and less fearful experience for you and your pet. And that’s more valuable than any of us may yet realize.

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.

Veterinary Superstitions (Friday the 13th is a laughing matter)

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I ain’t afraid of no ghosts! Or broken mirrors, ladders, or black cats. Yes, these are some of the most common superstitions people have and I’m not afraid of any of them.

But what does get me are the ones that we have in veterinary medicine. It seems that when any of these things happen, something unfortunately crazy or strange is about to happen.

Pets named “Lucky”

All right, I see where this name comes from and oftentimes the case is animal who was taken in (rescued) from some unfortunate circumstances or has made a miraculous survival after help from a good Samaritan. The truth is, at least in my experience, is these animals have a tendency to come across more mischief or accidents than anyone would like.

The “Q” word

This is the dirtiest word in veterinary medicine. Imagine the clinic schedule is allowing you to spend extra time with patients, get caught up on phone calls, and do a little extra research on those tough cases. Then somebody says it: “It sure is quiet in here today.” That’s it; Pandora’s Box is opened. The hit by car case happens, somebody walks in with a cat who has been vomiting for one week, and then there is the dog who has been in labor for two days…and this all happens just before everyone goes on lunch or closing up for the day.

“What a pipe!”

My technicians hate hearing this just as they’re about to draw blood from a patient. Yeah, that vein might be highly visible but I guarantee you it’s either going to be an incredibly mobile vein, the patient is going to squirm, or their blood pressure is going to seem non-existent.

White pets bleed more

Maybe it’s like Murphy’s Law. Trying to clean up one of these patients after taking blood is like trying to clean the carpet while wearing muddy boots. They just don’t seem to get clean!  Key fact: hair color has no bearing on bleeding ability.

Must be a full moon

About once a month, for a day or two, everything just seems chaotic and weird. Cases come in sets of three.  You finally see that weird case your professor warned you about 10-15 years ago. And  your clients are eating dog treats in the waiting room.

These are some of the most common ones and our top five at my workplace. While we hope nothing bad ever happens, these cases around these circumstances are usually the ones we remember years after they happen. So it’s Friday the 13th. What are you being cautious about today?

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.