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Ryan Llera, DVM

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

January 13, 2017 by Ryan Llera, DVM

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.

Filed Under: Blog

What a Four Year Old Taught Me About Vet Med

October 27, 2016 by Ryan Llera, DVM

“Hello? It’s me. I was wondering if after all these years you’d like to meet.”  Okay, so maybe it sounds better coming from Adele.  But you know who else wants to meet?  Your younger carefree self.  For many of us in the veterinary field, that version of ourselves is lost.  We find ourselves in a worsening spiral of stress, depression, and apathy.  Maybe it sounds like a trip down the rabbit hole but maybe it’s better described as a “swirling vortex of terror.”

It wasn’t always like this.  I’m an assistant instructor for my taekwondo club and our students range anywhere from four years old to 50-plus.  For the little kids, we’re not majorly teaching them to be the next Bruce Lee but rather encouraging listening, respect, and being active as part of a healthy lifestyle.  But those kids grow up and some of them choose to help the younger kids.

One student-assistant in particular I’ve noted is very attentive to those newer students who need a little extra help and it warms my heart to see him pass on the knowledge.  Something else I noted is a mutual respect between the students and the younger assistants.  And none of these kids I’m speaking of is even a teenager yet!  I remember it being like this when I was a kid.  Couldn’t our politicians learn something from this?

Now we’re grown up and many people have joined the veterinary field.  Veterinary medicine is tough.  It’s a hard job but somebody has got to do it.  That special someone is you!  It can be very easy to get lost in the day-to-day shuffle of sick patients, angry clients, and clinic dynamics.  You may want to give up; maybe you change jobs, maybe you change professions, or maybe you decide there’s only one way out of this mess.

The Kindergarten Complex

It doesn’t have to be that way.  Don’t lose hope – those kids I was talking about earlier are wiser than we give them credit for.  As kids, we are innocent.  We don’t know hatred, bullying, or anger.  I like to call this the Kindergarten Complex.  Think back to that time….we wanted to be friends with everyone.  We shared and we were kind.  We were apologetic to each other.  This is what we need to get back to.

Let’s find our younger selves.  Your five year old self is out there and along the way, your friends will help you out. Yes, everyone should have a Mad Hatter, Cheshire Cat, and wise caterpillar – just like Alice.  Where will you find your own collection of varied sages?  Right in your own clinic or family!  Who knows you better and is concerned about your well being?

If you work in the veterinary field: veterinarian, technician, client services, management, kennel staff…be respectful and friendly to your co-workers.  Treat them courteously.  Try to be helpful at work and don’t put anyone down because of their position.  Be loyal and don’t gossip behind their backs.  If you think they are having trouble or seem distressed, reach out to them. Let them know you are there to talk. If you are the one being affected, know that there are people that care about you and places you can get help.  Chances are one of your co-workers may be experiencing the same feelings.

For those of you who are not in the veterinary field (friends, family, clients), know that we are trying our best for you.  Don’t participate in online gossip or internet shaming of anyone in the veterinary field. Once in awhile, let us know that we are appreciated.  Anybody can ask how another person is doing; listen to them, empathize with them.  Nobody has to be alone in this.  Just being nice can make a huge impact in someone’s day and life.  And that might make all the difference.

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.

Filed Under: Blog

How to Tell If You Are a Cyber Bully

September 12, 2016 by Ryan Llera, DVM

In the past few years, veterinary clinics around the country have been victims of cyber-bullying.  Most recently a clinic in North Carolina was the victim and with no good reason.  For those not clear on what I mean by this, I would explain cyber-bullying as a mostly aggressive, non-defensible attack through the internet that is often unwarranted.  How could this happen to a veterinary clinic you might ask?

Sadly, this is nothing new since the dawn of social media.  As people, we can get frustrated and need to vent some steam.  Who we vent to used to reside with our closest friends, neighbors, or family; nowadays, it can be anybody with access to the web.  In the recent case in North Carolina, a dog was brought in by a person who “found” a bleeding dog and claims he was denied care because he couldn’t pay for it.  A conflicting report in the local paper with an interview from a client of the clinic who witnessed the exchange claims a different story that the man actually “hit the dog” with his car and they weren’t able to care for the dog as the doctor was in the middle of a surgery and could not leave the patient under anesthesia so he was told to a different clinic would be a better option.

The vet clinic has been smeared in newspaper article comments and has seen their reviews on Facebook go from 5-star reviews to their average dropping to 1.5 stars as a result of numerous scathing comments and reviews from the general public.  People who have never been to this vet and are relying on a Facebook post to shame the clinic, clamoring for them to be shut down, and going so far as to utter death threats to the veterinarian.  This is a classic “he said, she said” scenario where we get opposing viewpoints.

Let’s be honest.  I get it.  The bond that people and animals share is really close.  When something doesn’t work out like the pet owner hopes, there can be the understandable and expected reactions involving anger, finger pointing, and denial.  It’s natural to want to vent and it’s hard to hold those emotions in sometimes, plus it’s not always healthy.  It’s good to express your feelings but not at the expense of others.  What I want to recommend is not to air your grievances in a public forum and certainly not in the form of cyber-bullying your veterinarian or vet clinic.

Honestly, the people I’m trying to reach here about this are not the original posters.  Nothing I say or do is going to change their minds about what they’re going to do.  It’s everyone else who makes a difference.  Oftentimes, the poster may not even be the pet owner.  Some details may be altered or left out to make the person’s social media post weighted heavily in their favor.

Many of you who come across these posts will naturally be curious.  And you will wonder why the vet clinic doesn’t speak up to defend themselves.  Truthfully, we can’t respond directly for reasons of client confidentiality and professionalism.  There are two sides to every story and in time, both sides can be heard.  Forming an opinion based on hearsay sets a dangerous precedent for others.  Pausing for a moment to consider this can prevent a lot of unnecessary anger or sadness.

As an example, common remarks within these social media posts are that the veterinarian or staff are uncaring, money hungry, or not being pet friendly.  These sentiments can be quite damaging more than the poster realizes.

Cyber-bullying is damaging emotionally, financially, and in the worst cases physically.

Veterinary clinic staff & doctors can feel threatened and unsafe while at work but also when leaving.  By being associated with the vet clinic, staff may feel too ashamed to go out in public or be unwilling to talk about things that may be upsetting them or bothering them.  Keeping these emotions in is unhealthy and explains the reasoning for the extremely high rate of depression and suicide in the veterinary field.  Financially, when the clinic comes under attack, many employees worry about losing their jobs if the business starts seeing less patients.

Yes, I said it…a veterinary clinic is a business.  In reality, it’s virtually no different than an auto mechanic, human physician, farmer, or any other job really except our field involves living animals.  No different meaning that just because we love animals doesn’t mean that we don’t have to earn a living to support our families.  If cyber-bullying is aggressive enough to shut down a business, a few more people who are not at fault are now unemployed.  That’s not a position I imagine many of us would want to be in.

So what can you do?  Most importantly, as I’ve already mentioned, don’t feed the fires by also being a bully.  If you feel that you must interact, ask questions to try to understand the situation and empathize with the person.  Note, you can do that without condemning anybody else.  What if you come across a post and it’s about your veterinarian or clinic that you happen to love?  It can be hard to avoid jumping in the conversation, but that may be best to help put out any fires (don’t keep a post going).  However, you can (and should) write a review of your positive experiences to help balance out the negative atmosphere which may be present on the internet.

Next time you come across something negative about a person or a business, think twice before rubbing salt in anyone’s wounds and don’t click that post or share button.  You will be making a difference in someone’s life and that is a pretty good feeling.

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.

Filed Under: Blog

I’m a Card Carrying Pro-Neuter Guy. Here’s Why

July 2, 2016 by Ryan Llera, DVM

I love talking to pet owners.  After we’ve handled the matter at hand of the physical exam and it’s findings, I like to settle into a more friendly conversation to help answer any other questions they have and to review topics that I feel are pertinent to that pet.  Some of these things may include weight loss, exercise plans, recommended procedures such as dental cleanings, and preventative care such as spaying or neutering.

Yes, I consider spaying & neutering to be procedures that are beneficial and prevent problems later in life that almost every pet should have done.  We’ve already talked about the ladies so now it’s time for the boys to have their turn.

When the talk of neutering comes up, here are some replies I get:

“I don’t want to take his manhood.”

“I want them to have a litter.”

“I want him to have some fun first.”

I’m sure my colleagues in the veterinary field have heard these and others.  And assuredly, we get some chuckles out of these replies and others.  But let’s get real…dogs and cats are not a man, the shelters are overrun with unadopted pets, and it’s been scientifically proven that only humans and dolphins derive pleasure from such activities.

The debate over neutering has raged on for the past couple of decades as opinions change and new research is released.  And you know what?  I don’t think we’ll ever have the best answer!  People against neutering will often cite literature that supports the ideas of intact dogs living longer, healthier lives.  And yes, the sex hormones do help with bone development but after those growth plates fuse, is there really still usefulness from the testes?  I’m a proud card carrying member of the pro-neuter faction and if you aren’t already, I want you to join me.  Let’s use the following as a set of tools to help others accept our point of view.

Hormones kill dogs.

Yeah, this sounds contrary to what the anti-neuter camp will tell you.  I spent a number of years working emergency medicine.  I’ve lost count of how many times a dog’s sex drive led to his death.  Easily, I can say two-thirds of dogs that I saw hit by a car were intact males.  Driven by hormones, these dogs may have been chasing girls and didn’t watch out for traffic.  In one other instance, death by sex drive was confirmed when a patient was separated by a fence from his chosen girl.  In trying to get to her, he suffered from heat stroke.

I’ll say it again, hormones kill dogs.  Dogs are not inherently born bad.  And I know several dogs who aren’t neutered who are quite friendly.  But for every friendly intact male dog I see, there is usually 1-2 unfriendly intact dogs.  Behavior problems are one of the most common reasons dogs get placed in another home, surrendered to the shelter, or euthanized.  Because of the testosterone, these dogs are more likely to show signs of territorial aggression even if they’re not in their yard.  It’s in their nature.

Let’s be honest though…most of us in the veterinary clinics are not experts in behavior.  I know I’m not and with any aggression issue, neutering is my first recommendation without a second thought.  Behavior is a tricky area to work in and fortunately more training is being done during our schooling years.  Until that time, removing the drive is the best solution I can propose aside from encouraging clients to seek training while their dogs are young.

No, I can’t give your dog a vasectomy.

First off, I’ve never learned…they don’t teach this in school.  I’m not saying I can’t or won’t learn.  I’m just not convinced that it’s a viable alternative to neutering.  There are more complications than with neutering including failure of the procedure.  As mentioned above, intact pets do have a higher tendency to fight and roam.  These patients also run the risk of testicular cancer and prostate problems.

Wait; cancer you say?  Yes, whether they get neutered or not, a cancer risk still remains.  If a pet gets testicular cancer, we can fix that.  On the flip side, I think the reason we might see more cancer in neutered pets is that they are living longer because they are neutered.  And for our clients, ask them if they have ever smelled the urine of an intact cat.  Who really wants that in their house?

Sex hormones do have their benefits and are good for helping manage weight.  We can use this as an opportunity to discuss proper diet and exercise to alleviate that post-surgical weight gain.  And we can’t forget bone growth.  There’s a reason we don’t recommend it before 6 months.  Our colleagues in the shelters will do the procedure as young as 8 weeks and this is the kind of thing we should be discouraging.  These shelter pets need to have their alteration surgeries postponed and affordable to eliminate barriers to the owners returning when the pet is of age for the surgery.

The benefits to castration far outweigh any potential gain from cats or dogs “keeping their manhood.”  Neutering them just makes sense in terms of pet over-population and the control of unwanted behaviors.  It is also a simple and cost-effective procedure that we can provide to our clients.

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.

Filed Under: Blog

Spays Really Are a Matter of Life and Death

May 4, 2016 by Ryan Llera, DVM

The following are true stories.  *Names have been changed to protect the furry and innocent.

The past few months have brought up a few emotional challenges as a veterinarian.  But none more difficult than those cases and patients whose problems could have been avoided.  On more than one occasion, technicians that I work with and myself have surrounded a patient as we said goodbye and more than a few tears were shed.  It’s not only the situation that was disheartening, but also the circumstances of how we got there.

Maggie* was middle to older aged shepherd cross who was brought in to the clinic for vaginal discharge.  The next question is always the crucial one…is she spayed?  In her case, the answer was “no” and the diagnosis became much more suspicious for a pyometra.  She was an otherwise healthy dog.  Financial costs were a concern for Maggie’s family.  Diagnostics were not an option, but more importantly, neither was treatment.  Every attempt was made to find a financial solution that would work.  Even a payment plan was offered of which the terms of could not be met by her family.  Sadly, euthanasia was elected.

Gertie* was another patient who presented with vaginal discharge.  She was a middle aged English Bulldog who had not been feeling well for a few days prior to her examination and her family needed to figure out finances.  During surgery, I came across a significantly enlarged ovarian mass which was closely attached to the kidney.  I was able to remove it, explore the rest of her abdomen, and finish the surgery.

Gertie took much longer to recover than we expected.  We began to worry and ultimately went back into surgery only to discover an abdomen full of blood & clots.  All of the ligatures were in place and we could not find the cause of the bleeding.  Given the appearance of the ovary earlier, we were suspicious of a malignant tumor which may have weakened tissues or spread to other organs.  With the constant flow of blood and no way to stop it, her family made the decision to let her go.  I felt a sickness and surge of emotion as her heart stopped and the monitors went silent.

Two dogs and two different situations.  In both cases, pets’ lives ended and the bond with their family broken prematurely.  And patients like Maggie and Gertie are not the only ones; this happens almost daily within the veterinary profession.  Myself and the rest of the veterinary team hate this part of our jobs.  The knowledge that we can save lives and help animals, but in some circumstances fail to achieve that goal, is gut wrenching.  A simple ovariohysterectomy years earlier could have avoided both of these incidents.  Month after month, we end up euthanizing patients for potentially preventable issues.  So where did we go wrong?
Oftentimes, the weakest link in this chain of events may be our communication.  Many times, the discussion goes along the lines of “you should spay your dog and this is why” and it’s a very simple conversation sometimes.  Perhaps we need to be more serious and real about it.  As veterinarians & technicians, it is our job to advocate for the animals.  It doesn’t mean we have to be the “bad guy” but we should be more stern about why preventative care is so important; and this goes for any disease or condition.   Another thing to consider, is that we don’t bring it up as seriously as we should because we’re afraid to discuss costs and the lingering fear that clients will think we’re just “in it for the money.”  Well, if that were the case, we would never recommend vaccinations, spay/neuter surgeries, or parasite prevention!  We need to turn that perception around and at the same time help our clients in whatever way we can.

Many communities have low cost spay/neuter programs or vouchers that many clients don’t know about.  More hospitals are starting “angel funds” to help subsidize pet care at the discretion of the clinic…so maybe that’s what we need more of.  One suggestion I give to clients is to start a savings account for their pet.  If an owner were to save just $10, $20, $25, etc. from each paycheck, it would help to get started on diagnosing and treating their pet in an emergency.  This is not meant to be a knock on pet insurance but a savings option may put owners more at ease that they are still in control of how their hard earned money is spent.

I don’t have all the answers and maybe it’s a different solution for each clinic.  The first step though begins with having that honest discussion with your clients.  Aim for those preventative care steps to help avoid that unexpected heartbreak when you know you could have saved that pet.  Pull up that chair and have a conversation, not a lecture.  Don’t make it scary; let it come from the heart.  Remember, lives and a bond are at stake.

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.

Filed Under: Blog

7 Reasons I Chose Vet Med Over Human Medicine

March 7, 2016 by Ryan Llera, DVM

I’ve been out of veterinary school for almost ten years now and just like back then, I occasionally get asked why I chose animal medicine over human medicine. Some of the reasons may have changed but the core remains the same.

7 – Veterinary Medicine… because humans are gross

You may have seen the internet memes, t-shirts, or coffee mugs that have this emblazoned across them. Personally, this is true. I don’t handle human blood very well. That’s really the root of it…I admire the work done by MDs, nurses, and paramedics; I just couldn’t handle the “ick” factor.

6 – We can be the ultimate teammate during a zombie apocalypse

In my experience, veterinarians are aware of zoonotic diseases much more so than human general practitioners. This is not a knock on the human medical community because certainly infectious disease specialists do amazing work and work very closely with veterinarians, but whenever I’ve been faced with a patient that has something transmissible to people, the family has had difficulty getting info from their physician about how to take precautions at home. And if you ever need to stop a zombie, I’m sure we can take care of that too.

5 – Every day is different

On any given day, I (and our awesome veterinary technicians) take on the roles of general practitioner, x-ray technician, anesthesiologist, surgeon, parasitologist, food inspector, phlebotomist, dentist, dermatologist…the list goes on! We can specialize as a veterinarian but many of us choose to enjoy this variability for the fun and different challenges it brings. It’s almost like the Swiss army knife of jobs, except don’t ask me to fix anything automotive.

4 – Intense problem solving with a unique challenge

Very much like our pediatrician counterparts, our patients can’t tell us what the problem is. We must rely on the info we get from the family and then our physical exam. After that, we bring all the pieces together from any blood tests or radiographs to develop a plan. Sometimes it’s like a large logic puzzle, and I enjoy the challenge of our non-verbal patients that some of my human counterparts miss out on.

3 – We can humanely euthanize our patients

This is a gift that we are able to give to our patients, though sometimes it can also be a burden.   How does one weigh such a decision? It’s not always easy, but it is a blessing that we can relieve that suffering. In most of the world, this is not a benefit that human doctors have although that perception is changing in some places, including recently in Ontario. If I were a physician, I would find immense difficulty in watching a patient with a debilitating terminal illness and not be able to end that suffering. It’s the hardest part of our job, but in some cases one of the most rewarding as we can help animals pass on with some dignity.

2 – I can hug & kiss my patients

Yes we can, and nobody will get upset for it! This really helps break the ice with clients if their pets wants to snuggle and give sloppy kisses but they are concerned their pet might be nervous about the veterinarian. Even though I know how dirty a pet’s mouth can be (we can fix that!), it pleases me when they seem so eager to make a new friend who happens to be wearing a white coat. The cuddles and hugs we get from our furry patients help brighten up any day!

1 – I get to help take care of those who can’t care for themselves

This is truly the core difference (aside from #2) in what made me want to be a veterinarian. I believe in a world where we do our best to look out for each other and that includes our animal friends. I get the best of both medical worlds where I get to help animals but also their people as we strengthen the bond they share and keep it happy as long as possible. In this way, I’m helping people almost as much as animals – that’s a win-win. It’s hard to imagine doing anything else!

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.

 

Filed Under: Blog Tagged With: Perspective

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