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Life With Clients

Hips Don’t Lie – The Incidental OA (HDYTT)

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This week on the Cone…

Dr. Andy Roark talks to the one-and-only Dr. David Dycus. Andy was taking radiographs looking for a possible foreign body in a young dog when… he found terrible hips as an incidental finding. What do we do? What should he tell the owners? What are their options? FIND OUT THIS WEEK!

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.

ABOUT OUR GUEST

Dr. Dycus currently practices orthopedic surgery at VOSM; he obtained is veterinary degree from Mississippi State University, completed an internship at Auburn, and returned to Mississippi State for a combined surgical residency and Masters degree. In addition, he received his canine rehabilitation certification in 2015. His current focus is on total joint replacement, arthroscopy, and fracture repair along with working with our canine working dogs and canine athletes. Aside from clinical practice he is an associate editor for orthopedics for Veterinary Surgery, an orthopedic consultant for VIN, faculty for AOVET North American, is on the board of trustees for ACVS, and is a council member for the Association for Veterinary Orthopedics and Research (AVORE). He is involved with a number of research projects as well as the co-editor for the textbook Complication in Canine CCL repair due to be published in 2021. Dr. Dycus is frequency asked to lecture and teach labs not only within the United States but also Internationally.

Unspoken Truths About COVID-19

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This week on the Cone…

Dr. Andy Roark and Dr. Anita Link discuss her article on the challenges and unspoken truths about dealing with the COVID pandemic.

Article: anitalinkthoughtfood.com/2020/04/15/v…oken-truths/

We are supported by PSI Vet!
The PSIvet Healthcare Initiative hopes to introduce new ways to ensure all Veterinary Professionals get the healthcare coverage they need. Learn more at www.psihealthcareinitiative.com/

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.

ABOUT DR. ANITA LINK:

“I am a small animal veterinarian who graduated from the University of Queensland in Australia in 1997. For the first twenty years I worked in small animal practices in both Australia and the UK, but I am currently taking a break from veterinary work while I concentrate on my other two passions: writing and mental health advocacy.

I completed a Master of Arts in Writing, Editing, and Publishing between the birth of my two children. My interest in mental health advocacy was borne of my experience of living with Bipolar 1 Disorder, which was triggered by the birth of my first child in 2006. I have written a memoir, which is due to be published this year (Covid 19 permitting) and run Thought Food, a website, which is home to my blog. Most of my posts are opinion pieces relating to living a good life with mental illness.”

Becoming a Manager During a Pandemic

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In February of this year, I was chosen to become the new managing DVM of the hospital where I currently work. I was to take over the role April 1st, 2020. At the time I had been out of school for almost 8 years. I was excited. I had so many ideas. I wanted to change so much. I wanted the clinic to become loved by all. I wanted us to grow and become like a family. And then… COVID-19 hit. 

A few weeks before I was to take over as MDVM, the news was spreading in regards to veterinary clinics potentially having to shut down due to the pandemic. This was mid-March so it had not really affected our area but all of the doctors were getting news from the AVMA and local representatives that we need to have a plan in place. Even though I wasn’t officially the managing DVM, everyone kept looking to me to create a plan of attack. With the help of another colleague and the support of corporate, I put out a message for the clinic and our clients regarding what changes may need to be incorporated during this time. We wanted people to be prepared if we had to go curbside or limit entry into the clinic. Unfortunately, a few days later I was told I was overreacting and overstepping my boundaries. I was defeated. I was just trying to make the staff feel safe during an uncertain time. I’d rather be over-prepared than underprepared. But I was told to hold my horses and not take the virus too seriously. 

A day later, our office manager put herself in quarantine due to recent travel out of state. Three days later, our state went into non-essential business lockdown. A day later, twelve members of our staff went on furlough due to having young children, sick/immune-compromised parents, and lack of resources for their kids during the school shutdown. The next day, the current managing DVM became sick and went on quarantine for two weeks. It wasn’t even April, but I was pushed to handle what was going on. I was asked to step up during this unprecedented time. 

April 1st came and went. I still haven’t fully received any major training for the job. With the lockdown, most of the corporate staff were forced to work from home, which meant no “in person” training for me. The weekend MDVM training courses were canceled. I couldn’t even rely on the former MDVM to help out because they had gone down to part-time and we had opposite schedules. I can’t blame corporate either – they were giving me weekly updates and holding phone conferences to help with any issues that were occurring. My main goal was to keep the staff from quitting and setting the clinic on fire. It was tough. The sheer amount of angry clients and non-clients was outrageous. I can’t even count the number of times my staff was verbally abused over flea medication. We all felt mistreated every day, and sometimes it was hard to get through the day. 

It is now almost June. The county is partially reopening. Most of our staff is back in action. We are still faced with a lot of angry clients and non-clients daily. I am still figuring out how to run a hospital. But I think if I can make it through a pandemic then when things get back to normal (or as close to normal as we can get) this job will be a piece of cake. Who am I kidding? It is going to be rough, but I am stronger because of the crisis and the help of all of my staff during this difficult time. You never know what you can achieve when you are put in the hot seat. I think one pandemic is enough for me though.  

Stay safe everyone!

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.

In Defense of the Hard Way: The Most Important Time to Love Your Neighbors Is When You Can’t See Them

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If you had dinner with a group of veterinarians in any given year B.C. (Before COVID-19), you probably heard variations on these stories:

  • The one about the client who wanted his pet treated but didn’t want to pay for anything
  • The one about the client who wanted medication without an exam
  • The one about the client who went to the pet store or the internet for answers instead of the vet
  • And we can’t forget the one about the acquaintance who Facebook messaged them in the middle of the weekend to ask for free vet advice

Well, it’s not B.C. anymore. Now, vets exchange comments without irony in online forums about variations on the following stories:

  • The one about the client who barged into the waiting room past the signs that said “no clients inside”
  • The one about the client who cried or lashed out because she couldn’t be with her lethargic, vomiting cat for his exam
  • The one about the client who was experiencing signs of illness himself but wanted to bring his dog in any way because he was worried about him
  • The one about the client who messaged them on Facebook at midnight to ask whether their pet could contract and transmit the novel coronavirus 

If I had to pick one metaphor to summarize most of the human condition, it would be that the grass is always greener on the other side of the fence. It’s normal to want what we can’t have. But just because it’s normal doesn’t mean we can’t work on our assumptions about what we DO have.

At least the client who ignores the “no clients” sign is bringing us business. Maybe he was laid off from his job, or maybe he has a high-risk family member at home, and he’s worried about having to spend time and money at the vet – but he’s doing it anyway.

There’s a good chance that the client who desperately wants to be with her sick cat loves him just as desperately. Maybe the cat is her emotional support during a time of terrifying anxiety and isolation. What would I be like if one of my animals got sick right now and I had to hand him to a stranger and wait in the car? Probably not as sweet as I’d like to think, and I fully agree with the transition to curbside care and the reasons for doing it now. 

What about the client who admits to being sick but asks for an appointment and cares enough about his dog to put his own comfort aside – and enough about the health of our team members that he admits to his clinical signs before showing up? Maybe he doesn’t have someone to bring his dog in for him, or he isn’t aware that telemedicine might be an option. Possibly he doesn’t know that exceptions might be made to the “no meds without an exam” rule we spend so much time training our clients to accept. He probably couldn’t imagine a world in which we would just say, “here’s some medication.” Three weeks ago, neither could I. And now vets are joking about chucking it through the car window as he drives by. Nothing wrong with joking, by the way – but there’s a difference between laughing at a scared client and laughing at ourselves. 

It’s actually a sign that our message has been getting through when a client who is terrified his pet might get sick from COVID, or could transmit it to his elderly mother, asks us about it and not his cousin’s sister-in-law who works as a groomer. Also, if a client sends us a Facebook message at midnight or at 4 a.m. on a Sunday, it’s not because they want to wake us up or act like our time isn’t valuable – it’s because they’re awake and worrying about their pet. Yeah, been there myself. 

We spend so much mental energy under normal circumstances wishing for more – more trust, more money, more respect. Honestly, it’s taken a global pandemic for me to realize that most people are ready and willing to give us ALL THOSE THINGS. We’ve asked for them and we’ve earned them. And now we have to be gracious when they’re offered, even if the package in which they come looks a little different than we’d choose. 

A side effect of social distancing is that we are all online all the time. It’s great, actually – imagine having to be socially distant during a time when that really meant isolation! I mean, I had an 80’s dance party in my living room over Zoom last week! But it also means constantly being subjected to the media, to updates on deaths and equipment shortages, and most of all, to other people’s actions, opinions, disagreements, politics, choices… many of which will not align well with our own. The constant simmering anxiety we all feel, along with an inability to look these people in the eye and remember they are also anxious and facing unknown demons, makes us even more likely and willing to judge them. 

In this new reality, when we can’t see two weeks into the future, when our policies and protocols are changing not just daily but sometimes hourly, it’s never been more important to remember that we are all struggling with something – and for once, we’re all struggling with the SAME big thing. We don’t have to travel too far in strange shoes right now to understand the view.

Measuring others against standards we’ve created in isolation – that’s the easy way out. Anger, bitterness, and knee-jerk reactions are streetcars offering faster travel down that easy road. Withholding judgment and assuming everyone is just trying to do the best they can with what they have – that’s the hard road. It requires a lot more maintenance, but it’s leading to a better destination.

How does that article you’re reading today about teens throwing spring break parties in Florida affect how you will relate to your clients tomorrow? That client who hates the thought of being separated from her dog while either of them is sick? You and I ARE that client, or we could be, and a lot sooner than we ever expected. When it’s our turn, how will we want to be talked about? How will we want to be treated?  

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.

COVID-19 and Your Pet

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It has been a life-changing week in Northern Minnesota. Less than a month ago, COVID-19 was known only as “The Corona Virus” and thought to be a disease of foreign countries on the other side of the world. We were warned but didn’t really believe that it would make its way to the United States. Suddenly it’s here and our lives have changed dramatically overnight – schools and restaurants are closed, events are canceled, and everyone is urged to keep a six-foot social distance from each other.

As we slowly adjust to this new normal, many will start to wonder what this means for their four-legged companions. The truth is, at this time, we don’t know exactly how our pets will be impacted. Here is what we do know:

Both dogs and cats can become infected with strains of coronaviruses. But these coronaviruses are not COVID-19. COVID-19 is a novel virus, meaning that it is a virus that we have never seen before. The coronaviruses that commonly affect dogs and cats are not the same and they do not cause disease in people. Although COVID-19 is believed to have originated in an animal (some reports say a bat), there is no evidence as of yet that the virus is transferred from dogs or cats to people.

There has been one report of a dog testing positive for COVID-19 after his owner became sick with the disease. The dog never showed signs of illness. Further testing is in process to determine if the dog was just exposed or if his immune system produced antibodies to COVID-19, meaning his body was infected with the virus. Another dog who was also exposed repeatedly tested negative for COVID-19. On March 13, 2020, Idexx, a veterinary reference laboratory, announced that it has tested thousands of dogs and cats for COVID-19 and has not obtained any positive results.

There is a possibility that COVID-19 may transfer from a person to a pet, but the primary mode of transmission is person to person spread. However, until more is known about COVID-19, if you are infected with the virus, the American Veterinary Medical Association recommends to avoid contact with your pet. The website states:

“Have another member of your household take care of walking, feeding, and playing with your pet. If you have a service animal or you must care for your pet, then wear a facemask; don’t share food, kiss, or hug them; and wash your hands before and after any contact with them.”

A bigger concern to pet owners is that pet fur may act as a fomite, an object capable of carrying an infectious agent.  If an infected person coughs on their pet, the virus may be present on the pet’s haircoat. How long it will survive there is not known at this time, but it could potentially be hours or more. Collars and leashes can also act as fomites and carry the disease. This is another reason why it is strongly advised to avoid taking care of your pet if you are sick.

There is still so much we are learning about COVID-19 and new information is coming out daily. If your pet is showing any respiratory signs, the best thing to do is to contact your veterinarian for guidance.

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.

Our Little Moments May Be Bigger Than We Think

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I had an interaction with a client recently that reminded me that “small” moments to us, may be “big” moments to others.

An elderly woman, who happens to be a retired RN, brought in her 13-year-old Poodle for some help with chronic arthritis, to look at a few lumps and bumps and address some dental disease. He had been examined by other doctors in our practice, but I hadn’t examined him personally for maybe two to three years.

After my routine exam, I informed the client of my findings and recommended that we take care of her dog’s fairly advanced dental disease soon. She told me that she was concerned about anesthesia safety because she had recently lost her husband and couldn’t fathom losing her little fur baby boy as well.

I reassured her that we would take every precaution possible to ensure safety before, during and after the procedure. I briefly described our procedures and said that I understand her concern, but her dog’s dental condition was affecting his quality of life. I couldn’t see any immediate reason on my exam why we couldn’t do the dental.

I then asked her about her husband. She told me that she lost him a little over two years ago to cancer, and it was absolutely life-shattering. This is something I have recently experienced in my own family, with my mother passing four years before my father. I sat down on the bench next to her and gave her a little hug, as I could see the tears welling in her eyes. I recalled how it took a couple of years for my father to not feel like a “boat without a rudder,” but gradually he was able to figure out what a meaningful life without her looked like. For him, things got better eventually. I said that mortality is something I contemplate for the future with my own relationship with my wife. That kind of stuff. I sensed that she really needed a conversation, and I’ve always got time for that.

She told me that she had to euthanize her other dog shortly before her husband passed. She said, “Dr. Francke, you waited until we could get my husband into the animal hospital to say goodbye. You took us into your personal office, made us comfortable, put our baby on my husband’s lap and explained everything to us in detail. It meant so much to us and I’ll never forget the compassion of you and your whole team. So, if you think that my boy needs a dental, I trust 100% that you believe it’s in his best interest. If his blood work is ok, I’m going to schedule it with you.”

So, here’s the thing. Until she prodded my memory, I had no recollection of the events on that day with her husband and the euthanasia visit. I’m not proud of that fact, seeing as it was SO life-changing and meaningful to her. Honestly, it’s just the “type” of thing that goes on in our practice every single day. We do so many euthanasias, that sometimes we do what we do, and then we do our best to put it out of our mind. I don’t try to over-analyze it after 29 years, but I’m sure it’s a mental defense mechanism. However, for the pet owner, it may be one of the most consequential and memorable days of their entire life!

It’s important to remind ourselves from time to time that the little things we do during our workday, may not be “little” to others. We need to always do the small things well. We need to strive to do the right thing in every single interaction, despite our occasional imperfections.

My first boss used to tell me, “Don’t spend too much time explaining things to people. They just want to get their dog a shot and get the Hell out of the hospital!” My response to that advice was, “With all due respect, if I ever find it impossible to give people what they need from me to understand, make good decisions, and be comforted when necessary, that’s the day I’ll leave the profession and go do something else with my life.”

I only worked for that doctor for two years. We had different philosophies on what a doctor should be, and that’s OK with me. There’s a place in the profession for his approach. To use a sports analogy, at the end of the day, I’d rather “leave it all on the field.”

So, my amazing veterinary friends, your small deeds matter to the World! You are some of the best, most compassionate people in our society. Our work makes the World a better place. Thank you for all the “little” things you do each and every day! 

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.