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Medicine

The Walking HBC Dog (HDYTT)

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It’s the CONE OF SHAME SHOW!

In this episode, Dr. Andy Roark and David Liss RVT, VTS (SAIM, ECC) talk about treating the HBC dogs that walk into your clinic with nice, pink mucous membranes and normal mentation. No big deal, right? You need to check this episode out!

Want a video shout-out from Dr. Roark to someone on your team (or for your whole team)? Just leave an honest review of the podcast here on iTunes, and then send us an email at podcast@DrAndyRoark.com and tell us who Dr. Roark should shout out and why.

ABOUT OUR GUEST:
David Liss has an incredibly rich and diverse background in the field of veterinary technology. A registered veterinary technician in California, David holds a Bachelor’s in Sociology and an Associate’s Degree in Veterinary Technology. He also holds double board-certifications as a veterinary technician specialist in emergency/critical care and small animal internal medicine and has a diverse background in emergency and critical care nursing in addition to being a certified veterinary practice manager (CVPM) and professional in human resources (PHR). He has been a technician manager at two different twenty-four-hour referral/specialty facilities in the Los Angeles area, has contributed to numerous veterinary texts and was awarded the Veterinary Technician Educator of the Year award by Western Veterinary Conference. David also holds a Master’s in Biomedical Science. David currently is the director of operations for Amerivet in Los Angeles, runs his own consulting business: Veterinary Training and Consulting, Inc., and lectures worldwide.

Bird Medicine Basics for People Afraid of Birds (HDYTT)

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This week on the Cone…

Dr. Andy Roark asks an amazing exotic animal veterinarian for help with a lethargic Cockatoo. When you don’t generally see birds and then one needs your help… how do you treat that?

Want a shout-out from Dr. Andy Roark for a friend or co-worker? Rate this podcast on iTunes and then send an email telling us who we are shouting out and WHY. The email address is podcast@unchartedvet.com

ABOUT OUR GUEST

Originally from New York City, Dr. Laurie Hess is one of approximately 150 board-certified avian specialists worldwide. After graduating from Yale University, she earned her veterinary degree at Tufts University and completed an internship & residency in avian/exotic pet medicine at the world-renowned Animal Medical Center in New York City where she practiced for more than a decade. She is Director of Pet Health & Nutrition for the pet food company ZuPreem and owns a bird and exotic pet specialty hospital – the Veterinary Center for Birds & Exotics – in Westchester County, New York, where she treats birds, rabbits, ferrets, rodents, reptiles, sugar gliders, hedgehogs, and other non-traditional pets, as well
as wildlife.

She is the author of Unlikely Companions: The Adventures of an Exotic Animal Doctor – a memoir about her life as an exotic animal veterinarian. Dr. Hess is the Social Media Chairperson for the Association of Avian Veterinarians and an active member of this association, the Association of Exotic Mammal Veterinarians, the Association of Reptile & Amphibian Veterinarians, and the Association of Zoo Animal Veterinarians. She also is a frequent contributor to websites, radio broadcasts, and TV shows about exotic pets, as well as a lecturer on exotic pet care internationally.

Placebos For Pets: The Truth About Alternative Medicine in Animals

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This week on the Cone of Shame Veterinary Podcast, Dr. Andy Roark interviews Brennen McKenzie, VMD, MSc of The SkeptVet. They’ll talk all about his new book, “Placebos for Pets? The Truth About Alternative Medicine in Animals“, and how we can sift through claims and evidence in order to make better choices for our patients.

To get registered for the $100 weekly giveaway, just head to www.drandyroark.com and sign up for the newsletter and you’re all set!

If you want a shout-out video from Dr. Roark, just leave a review for the podcast on iTunes and then send an email to podcast@drandyroark.com. Tell us that you wrote a review and then who you want the shout out to be for and what is great about them.

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 THE GUEST:
Dr. McKenzie has always pursued a wide range of interests both within and outside of science. After completing a bachelor’s degree with majors in English Literature and Biology at the University of California at Santa Cruz, he obtained a Master’s in Physiology and Animal Behavior and worked for several years in environmental and behavioral enrichment for captive primates.

Dr. McKenzie then attended the School of Veterinary Medicine at the University of Pennsylvania and began working as a small animal general practice veterinarian. In addition to his clinical work, he has served as President of the Evidence-Based Veterinary Medicine Association, lectured on evidence-based medicine at numerous veterinary conferences, and published journal articles on such topics as over-diagnosis, cognitive bias in veterinary clinical decision-making, and the philosophical underpinnings of evidence-based and alternative medicine. Since 2009, Dr. McKenzie has managed the SkeptVet Blog and associated social media outlets, including a series of science-based pet health videos on YouTube. He has also been an occasional contributor to the popular Science-based Medicine blog.

While working as a practitioner, speaking, and writing, Dr. McKenzie has continued to pursue post-graduate training, and in 2015 he completed his MSc in Epidemiology at the London School of Hygiene and Tropical Medicine in 2015. He also teaches veterinary students in his practice as well as undergraduate biology majors, he writes a monthly column on evidence-based medicine for Veterinary Practice News magazine, and he has published a book for pet owners and veterinary professionals—Placebos for Pets? The Truth About Alternative Medicine in Animals.

In his sparse free time, Dr. McKenzie enjoys reading, hiking, playing his mandolin and guitar, traveling with his family, and sitting on the couch with his dogs watching the hummingbirds and woodpeckers outside his living room window.

Blocked Cats – The first 15 minutes (HDYTT)

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Cone of Shame Show!! A blocked cat has just rolled into your clinic. The first 15 minutes are going to be vital. How do you treat that?

Megan Brashear BS, CVT, VTS (Emergency & Critical Care) – Megan graduated in 2000 with a BS in Veterinary Technology. She worked in ER/ICU specialty from 2000-2018 in Portland, OR including 8 years of technician management. Megan is currently the Small Animal Veterinary Nursing Manager at Purdue in West Lafayette IN. She loves all things emergency/critical care, German, shorthaired and pointy.

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 Watched Your Dog Die Today

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I watched your dog pass away today. I did everything I could but it still succumbed to its disease. I watched your dog suffer for days as I tried to comfort it. I watched your dog continue to vomit even with the best anti-emetics. I watched your dog groan in pain even with high doses of pain medication given.

My technician cleaned up your dog for the fourth time today after it had explosive diarrhea. My technician tried to comfort your dog by giving it a hug and petting it – but your dog was still scared being in a cage all by itself.  My technician cried as your dog vomited for the tenth time. My technician watched your dog pass away today.

My staff had to call you again and tell you there has been no progress. My staff had to let you know that we are approaching your financial limit. My staff had to sit there and not respond to people telling us we are heartless because of your dog. My staff watched your dog pass away today.

I watched your dog pass away today and it could have been prevented. I watched you scramble to find enough money to try to treat your dog and it could have been prevented. I watched my staff get torn apart on social media and it could have been prevented.

I watched your dog pass away today because you did not vaccinate it. I watched your dog pass away today because you didn’t seek treatment right away. I watched your dog pass away today because you tried “cures” you read online before bringing it into the professionals. I watched your dog pass away today because you didn’t take responsibility for its life.

Parvovirus is fatal. Parvovirus is awful to watch an animal succumb to. Parvovirus is preventable. Please vaccinate your puppies.

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.

Please Stabilize Before You Transfer

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I’ve written before how amazing we are as veterinarians. We are 10 different specialties all wrapped into one spectacular person. When we decide what type of practice we are going to work for we may narrow down the spectrum of care we produce. GP clinics focus on vaccinations, nutrition, and common ailments that affect our pets daily. Specialty clinics focus on the complicated and sometimes unusual. Emergency clinics focus on trauma cases and true emergent situations. It’s great that we have all sorts of specialties in the veterinary world. The biggest obstacle is us working together for the good of the patient. Its not that we do it intentionally but I think a lot of clinics don’t have protocols set during times of emergency and this makes it harder for the referral clinic to treat. Here are a couple of basics to put on a checklist if you often refer emergency cases.

  1. Call the referral clinic- if you plan on sending a case please call the referral center and discuss the situation. The best route is to have the doctor call and give information to a technician or the referral doctor for a clearer line of communication. Having a receptionist call is not a good option because they cannot properly answer basic questions like, were radiographs taken or how stable is the pet. Many times we have been given the absolute wrong information because of the mechanics of the game telephone. When in doubt always relay the information directly to the referral doctor.
  2. Start an IV catheter- There aren’t many situations where this isn’t necessary but unfortunately, pets get transferred without catheterization and fluid stabilization all of the time. Think about it- hit by car– place a catheter and start fluids to reduce a shock state before transferring. Blocked cat- place a catheter and start fluids to stabilize. Bloated dog-place a catheter and start fluids. This is a critical step in stabilizing and many animals do not receive this before going to a referral center.
  3. Provide pain control- too many times patients are provided no pain control before being transferred. It is fairly easy to have a go-to chart for a quick buprenorphine or hydromorphine dose to relieve acute pain in unstable animals. Wait on any NSAIDS or steroids before a full workup can be done but a short course of an opioid can truly affect how a patient recovers.
  4. Send diagnostic results- If you plan on referring please send the results of the diagnostics you have performed. It does not help when you have taken radiographs but don’t email them to the referral clinic. It also is a big waste of the owners’ money if you perform blood work by sending it to an outside laboratory where results won’t be ready for 24 hours. If you don’t have in house labwork equipment and plan on referring that day its best to allow the referral center to perform it versus wasting time and money.
  5. Inform owners. Please make sure your owners know what they are getting themselves into. Too many times pets are transferred with no knowledge of the next steps towards recuperation. Several times I have seen blocked cat owners choose euthanasia after having to pay a second exam fee and blood work because they were not prepared for how expensive treatment can be.

You might not know a specific number but please warn owners that certain surgical cases can run a few thousand dollars (depending on the area) and it is a huge waste of the owners’ funds and time if they do not want to go forward with treatment.

We all want what is best for the pet and to do that we need to work together. Communication is key but also don’t forget your basic triage skills. You can truly make the difference if a patient lives and recovers well versus tragically succumbs to its crisis.

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.