Friday, October 30, 2015

Female vets

With all the recent Hillary Clinton/Carly Fiorina/ women shattering the glass ceiling talk, let me tell you a little bit about it in my profession.

Only recently have female veterinarians begun to outnumber their male counterparts.  Practice owners and other positions of the leadership in the field are still very male-dominated, for a variety of reasons.  It's very interesting to speak with some of the baby boomer veterinarians, and even older veterinarians, about how things used to be.  I give so much credit to the veterinarians who were the only female in their entire class.  I'm sure, with the typical temperament and sometimes uncouth manners that our profession sometimes has,  it could be difficult.  Just imagine spending 20 hours a day with people and dealing with flying cow poop, can bring out the less feminine nature.  We are a PROFESSION and I'd like to think veterinary medicine is a calling and not a career, we are much more colorful with our language and sense of humor than a lot of professions.

My class only had about 5 men in it, to go along with about  96 women  (not sure if the numbers are exactly right, but it was close to that).  Can you imagine that?  Let's just say a single man in vet school is typically high in demand : )  That can make for a whole other conversation..

In many other countries, veterinary medicine is still fairly male-dominated.  I had to deal with sexist comments prior to getting into vet school, and even later on as a veterinarian.  Many "big cowboy-types" would make comments about my 5'2 petite stature and how it would be hard to stand up to a thousand pound cow, or over a thousand pounds of horse.  My response was always the same, "I'll take my 100 pounds over your 250 pounds, I can move a lot faster than you over that fence and 1,000 pounds to 250 pounds still can do a lot of damage."

When I was in Ireland, I worked with a veterinarian, John.  He was fun!  He could gossip as good as a woman and he had a fun sense of humor.  He also introduced me to Bulmer's Cider, but that's a whole other story.  John was typical guy in some ways.  I found myself roomies with John and Susan, two coworker vets who were different in many ways (John was a nominal Catholic and Susan a devout protestant).  Having an American stay with them was a hoot for both of them, I'm sure.  Just to give you a sense of John, he once used Susan's expensive wool Scottish plaid to rescue a seal on a local beach.  Then he put it in the washing machine.  You can figure out the rest of the story.  I just share this to illustrate John was an animal lover and not afraid of a little dirt.

I was doing a lot of lambing and calving work in Ireland and oftentimes, the farmers wouldn't get to the sheep until they were really bad off (either they couldn't catch them, find them, or get a hold of their schedule).  A farmer, an old man with a strong dialect, brought his sheep in to the clinic.  You could smell the stench when the sheep was still outside the clinic.  John said, "There's no way, I'm doing anything with that sheep."  She had gone into labor a couple of days previous and the lamb had rotted inside of her uterus.  I will try not to get into too many details.  Just know it was the worst smell I have smelled ever, and for a vet, that says a lot.

John was ready to euthanize the sheep.  I said, "No, I want to give it a try."  The old man farmer looked at me and said, "girls can't be vets, this is a man's job."  I think I looked at him straight in the face and said, "yes" or something simple, irritated by his statement.  My husband wanted me to include this link for illustration:

The farmer walked the sheep up to the rail, I put on my big rubber pants, boots and a garbage bag over the top.  I got downwind.  I almost puked. It's quite possible I did and swallowed it.  I just tried to go to my happy place and think about saving this ewe.  The farmer was on the other end of the sheep (the definitely less stinky end), with a bandana and his shirt covering his mouth and he was trying not to vomit.  I cleaned out the sheep, gave her some antibiotic and wished her the best.  This process took about 20 minutes to a half hour of trying to ignore my sense of smell and my gag reflex.  As the farmer left, he shook my hand and said, "I was wrong.  Girls can be great vets."

Later on either that week or the next week as I went for a pub crawl, I went to the one pub in the town that used to be a man's only club (had only been open to women for a couple of months).  That farmer was there.  I found him buying me a Smithwicks. 

I'm not a big beer drinker (although with my son loving Irish drinking songs and "In Heaven There is No Beer, that's why we drink it here,") you would think otherwise.  That was a good, hard-earned beer.

Tuesday, October 27, 2015

An excellent race and pre-race meal

I had my big 10k run this week and my husband went above and beyond all around.

He made his delicious pasta recipe;

1 pack of italian sausage
1 box of penne pasta or rigatoni
1 jar of tomato sauce
1 cup heavy cream
Parmesan cheese 

Brown and crumble sausage in large skillet
Boil water in pot and cook pasta to instructions on package
Once sausage is browned, stir in tomato sauce and cook on medium for 8 minutes
Stir in heavy cream and cook additional 2 minutes
Drain pasta
Serve sausage/sauce over pasta, top with cheese

It is a delicious and simple recipe he based off of one of his favorite meals at a favorite restaurant.  We use REALLY good, high quality sausage in the recipe and Trader Joe's spaghettis sauce.  I also use the homemade bread and we either have garlic bread or just regular bread and butter.  (See previous post:   )

And he and my son got up early Sunday am to go to my race (while I felt bad about waking him up early, there was a certain type of satisfaction in changing the tables on him).

I had a great run and I love the race.  It's in the nation's Capitol, so there's the Musuems, monuments and Capitol you get to run by and you finish in Arlington National Cemetery. It's great to run by all the marines, giving them high fives and thanking them for their service.

It's also neat to see all the original signs people have, such as "you run better than the government," or "you dragged me out of bed so you better finish this race."

Some people where costumes too.  I remember, just as I wanted to stop and walk, there was a woman ahead of me in a Dunkin Donuts coffee cup. "I will not be beat by a Dunkin Donuts coffee cup".  This is the mantra I continued to tell myself to keep myself going.  I did not let that coffee cup beat me...

My son had a great time and cheered me on and cheered others on saying, "yay, runners".  He ran around so my husband the "spectator' may have almost done as much running as I did.  Overall it was a great weekend!

Friday, October 23, 2015

When It's Time To Say Goodbye...

This is a difficult post to write, but it's a frequent subject in veterinary exam rooms.

As medical technology improves (veterinary medicine mirrors human medicine, as discussed previously- see ), our pets are able to live longer, healthier lives.  Gone are the days of the farm cat living maybe 2 or 3 years.  Everyone wants better than that for their pets.  There are different lengths people are willing (or able) to go for their pets.  Some of my patients have received kidney transplants, brain surgery and heart surgery, just to name a few.

One of my most often used lines when speaking with people about end of life issues is, "Just because we can, doesn't mean we should."  Procedures like CPR, treatment of sepsis and total organ failure and other treatments that in my experience are futile just seem to prolong life.  Supportive care like reversing toxic doses, feeding tubes and hospitalization with fluids are often helpful and non-painful. I've noticed that while many people do not have the medical awareness or knowledge of specific procedures, consistently people want to know that their pet is not in pain, is not suffering.  This is the most important information for me to communicate to owners as the pet can not talk, the pet can not say "stop,  I've had enough, let me go."  In some circumstances, I've found myself strongly advocating against medical treatment for patients.  It is definitely an awkward position to be in.  Suffering is something that we just don't want to see as veterinarians.  Sometimes people make decisions that are different then what we would make.  Sometimes people have selfish motives, sometimes they are just in denial.  Sometimes they just need time to take it all in.  This is where the veterinarian's role as grief counselor and hospice consultant come in.  There are many things we can do to make animals more comfortable when they receive a terminal diagnosis.  Pain medication and hospice care are very common for our patients at the end of their life.  The most important component of hospice care though is the communication the owner gives us.

I tell people once a terminal diagnosis has been made in their pet (unless it's an emergency situation).  "Don't rush, this isn't the point where you need to euthanize, you can take some time to come to terms with the diagnosis.  Go home to your family and discuss as a family what are 3 things that your pet needs to know they have a good quality of life."  These can be things like eating their favorite meal, coming to the door to greet you and sunning in their favorite window.  Whatever makes that pet "happy" in their owner's perception.  I then tell them that they can come to me at any point and say that their pet does not have that quality of life, is there something we can do to restore that.  Once they have their written list that they decided on when their pet wasn't so sick, it's easier to make a decision that at that  time when they wrote that list they were more subjective and they are making a decision in the best interest of their pet.

Sometimes letting go is the greatest gift we can give our pets.  It's the ultimate act of selflessness to let them go peacefully and not draw things out when they are truly in pain and uncomfortable.  I've seen many patients that stay alive for their owners.  They just simply need permission to let go and not fight anymore.

What do you think?

Tuesday, October 20, 2015

5 things I'm loving this week

1) Fall.  I can't deny it, I will miss the sunshine, warm days and my garden.  I do like the smell of burning wood in fireplaces, beauty of falling leaves, crisp air and apple cider.  Also, I love college football season!

Okay, so as much as I enjoy discussing with clients the diagnostics, treatment and management of chronic diseases (and after 8 years of being a vet, I have a "spiel" for most anything), it is nice to have a website that can assist.  I find now that I spend about half my time re-educating people after they got a bad tutorial with "Dr Google".  Frankly, if "Dr Google" was any good, I would be out of business.  I'm not.  Conclusion- reputable internet sites = good idea.  This includes for humans.  For my own medical needs I try to stick to (Centers for Disease Control) and the National Institute for Health website.  I also hit up my other friends with medical degrees ; )

3) A limited data plan on my phone.   Yes, I am listing this as a "like".  Really, it's not necessary to instantly upload pictures or instantly look things up or to basically be attached to your phone.  Having limited data and trying to make it to the end of the month is a type of "electronic" fast and is good for the spirit, albeit annoying at times, it helps me remind me about what's most important and that doesn't include my data plan or phone...

4) Slowcooker.  Between chicken parmesan and pot roast, this device was hard-working this week and produced some great hearty food.

5) Date night with hubby.  Had a great time Saturday going to see "The Martian".  It was a good movie with a great storyline and left you feeling better about mankind.  It was also nice to sit at dinner without having to coax a toddler to eat or not have tantrums.  Also nice to have adult conversation with my husband.  

Those were the five things I loved this week.  Thanks for reading!

Friday, October 16, 2015

Health certificates

Many people don't realize how easy, or how hard it can be to transport your pet around the world.  I have met the "UN" of dogs and cats (besides my own travel).  There are dogs and cats in the US from Chile, Japan, Africa, the UK and Poland, just to name a few.  A recent trend has been for people to get dogs from the "Islands" in the Bahamas.  There are stray dogs all over the world that need rescuing.  There are also dogs in Afghanistan and the Middle East who "adopt" military units, become friends and even unofficial guard dogs for soldiers.  Check out the following link:

While international travel can be stressful for people, just imagine for animals.  In a future post, I'll write more about traveling with your pet.

There are some countries (mostly the island countries like Japan, Taiwan and the UK), that don't have rabies in their wildlife.  They are understandably super-protective about keeping it out of their country.  Dogs and cats going to these countries require a very particular process before they can go.  I recommend to clients if they are planning on traveling internationally, particularly to these countries, that they make an appointment to talk to their veterinarian 1 year before travel.  6 months prior to travel, a microchip needs to be placed in the pet (if it hasn't been done already) and a rabies titer needs to be drawn and sent to a particular lab in Kansas.  This applies to animals all over the world

Interesting enough, when I went to Mongolia, they had me bring back paperwork from the lab in Kansas (they thought I would be faster and more reliable transport of the super-important paperwork than the international postal system).

To sign a international health certificate (and interstate health certificate), the veterinarian actually needs to be accredited by the federal government.  This requires additional training and additional liability.  We become "sub-agents" of the federal government.  The government doesn't have the money or desire to have their own veterinarians for this job, so we fulfill it.

Then there's a variety of paperwork that as a veterinarian feels like it changes way too frequently.  We have a website we can go to that has international regulations, but a lot of the time the particulars can be dependent on the embassy, airline, or mood of the government official.  In our area, once the final physical exam is done by the veterinarian, the paperwork has to be sent to a government official 3 hours away from here, so often clients have to take a long drive to get an official stamp on their health certificate.

If things are not done 100% properly, this could mean the pet doesn't get to take the trip, is turned away at the airport or even worse that they get put into quarantine for up to 6 months in the country they travelled to.  Besides being separated from their family, the quarantine charges can add up to over $30,000.  Very expensive.  There are many veterinarians who choose not to do health certificates because the potential for liability (and the massive paperwork headache) are just not worth it.

Just some info to be aware of if you think your pet might become an international traveller... Let me know if you have any questions : )

Tuesday, October 13, 2015

My conscientious toddler...

I try to have at least a day (preferably a day and a half) home with my son during the week.  Last Tuesday (the day I was supposed to have a half day with him) ended up being a sort-of disaster.  Let's just say it ended up with me feeding my son pizza at a softball game past his bedtime...  My disaster/his idea of a great day.  My husband was sweet and gave me roses Friday for all that happened Tuesday...

This week, I have been working at a job that requires roughly 3 hours of travel a day.  Needless to say, my son's "hanging with mommy day" was hopefully going to be a homebound day for the two of us, except my son was INSISTENT that we go to Mass.  I mean, I wanted to go (certainly could use a little extra time with the Lord this week), but the lazy, hermit side didn't want to...  But who is going to say "no, you can't go to church," to an insistent two year old?

Before anyone canonizes him, you have to know the rest of the story...

As I go to put his nice shoes on (previously referenced last week), he shoos them away and insists on his grubby tennis shoes.  "Ok, fine, you can wear your tennis shoes", I tell him.

We arrive at church, get out and he is a man on a mission.  Those big puddles that were there last week are no longer there!  He was a bit disappointed.  I then made the connection that he had insisted on Mass and tennis shoes because he was intent on puddling ; )

"Phew," I thought to myself.  You are a normal little boy and very thoughtful with your shoe choice.  He did behave well for Mass and when we came home, he did "puddle"  a bit and then basketball, football and climbing on the playground.  We had a good and refreshing "hanging with mommy day" on all fronts.

Friday, October 9, 2015

Anal glands- Alert- Don't read if you get grossed out...

My husband said, "really? really? you're going to write about that?".  Yes, I know it's a gross topic, but it's a very common ailment.  I would say the general practitioner's "bread and butter" is allergies (ear and skin infections), anal glands and nail trims.  These are just the things we deal with.

My hubby asked if I was going to use one of my favorite food analogies to talk about anal glands and I informed him, I do have some standards for sharing on the internet...

The anal glands are small "scent" glands on either side of the rectum.  They are present in both dogs and cats (although thankfully, they are rarely a problem in the latter).  As a dog defecates the scent/fluid gets released from the glands and leaves a type of "postcard" of where the dog has been for other dogs to smell (like the marking behavior they do when they urinate on things, especially males).

In cases of allergies or lower gastrointestinal (GI) issues, the above process does not work as well and the glands can get "backed up".  This can happen to the point that the enlargement of these glands causes great pain, can even obstruct the dog and even form painful abscesses (infections).  If your dog is scooting, licking at the hind end or having pain defecating, definitely have your veterinarian look at the anal glands.  This issue is so painful and uncomfortable, I have seen it misdiagnosed before as a herniated disk (when it was really the anal glands).  The difference between back surgery and expressing anal glands is pretty big, but to some dogs, the pain is similar.

The best way to prevent anal glands from impacting is to treat any underlying allergy or GI issues and feed a diet that has plenty of fiber.  I sometimes even recommend a teaspoon to a tablespoon of canned pumpkin in their food to help keep things "regular".

Sorry for the gross topic, but like I said, I see this quite regularly and it is something to be on the lookout for.

Tuesday, October 6, 2015

6 things I loved this week

1) Mango llasi.  This is a wonderful beverage I got hooked on when I was in India.  It goes great with spicy food and really tempers it.  Mangoes are entering the end of their season (and the time that they are on sale).  I use 1 mango, milk (you can also substitute coconut milk or almond milk), Greek yogurt and some honey.  I'm trying to get my son to try it, but have been unsuccessful.  At least it's cute to hear a two year old say, "no Mango llasi"

2) Korean chicken and Daikon radish- never knew I would love these foods.  The Korean fried chicken was some of the best fried chicken I've ever had.  Paper light fried exterior which was also crispy with a little spice.  The Daikon radish is a little sweet and calms down the spice.  Sometime this week I will try to recreate it and hope my sweet-toothed two year old falls in love.

3) While it would be easy to make the whole week about food, I will try to focus on other favorites as well.  Catching up with an old friend.  Sometimes it's hard to keep up with people but friendships with people who have good hearts are worth it!

4) Indoor playgrounds.  With over a week's worth of rainy weather around here, the indoor playground at Chick Fil-a was a perfect reward for my son after his flu shot.

5) College football.  Both my hubby's and my teams won this weekend and my son is becoming a fan.  One of my favorite parts of Fall.

6) Puddling.  On our way to Mass Friday, my son was determined to jump in every puddle he could.  Of course,
wearing the expensive nice shoes his grandma got him.  While I tried to get him to stop so he wouldn't damage his shoes, I was happy that he was ready to share one of my most favorite activities from childhood (and even when I was in high school).  The last time I had gone "puddling" was when I was on the Cross Country team in high school.  I promised my son that after mommy worked Saturday, I would take him puddling.  I went to the local consignment shop and got him a nice pair of boots and made sure we did all the "puddling" he wanted.  We both had a great time and we both got about equally wet from all of the pouncing in the water.  It's great to see the magic in what some people find as annoyances from rainy weather.

Friday, October 2, 2015

No kill shelters and other things to think about...

Everybody thinks "no kill shelters" are great.  Simply by the phrase, " no kill" who would disagree?

Let me just fill you in on some information, because quite frankly, my money and time is going to go to rescue groups and animal control.  This is where the real difference can be made.  The following are just examples, I'm sure there are exceptions and I'm not painting everyone with a broad brush.

There are even some rescues who will "cherry pick" which pets they take from the shelters, there is a bias against animals that are black (black cats are typically not adopted in October out of concern for their well-being as there are all sorts of weird people who will do things to black cats in October).  Pure-bred animals are also more likely to be picked out of shelters by rescue groups.

No kill shelters simply means that that particular shelter won't kill the pet.  What this could mean is when the no kill shelter gets filled and there is no more space, they send their "unwanted" pets to local animal control where hundreds of animals can be killed in a day.  One person I worked with had  worked in an animal shelter where this happened.  She later went into treatment for "Compassion Fatigue", the caretakers' version of PTSD.  So basically, the no kill shelters are the Pontius Pilate of "animal rescue."  I've also known some shelters that put restrictions on who can adopt pets and what type of household they have.  I understand the reason behind this, everyone wants the most ideal situation for everyone, but that's not possible, and frankly, I would rather a person live in an apartment, or declaw a cat than for the cat to be  euthanized.  If it's going to come down to restrictions and regulations, I choose giving the pet the opportunity to live.

One of the reasons I am writing this is because of what happened last week.  I was at a clinic that is heavily involved with rescuing feral and other types of kittens.  The woman in charge of the foster program was called and told, "if you don't pick up 20 kittens in the next hour and a half, they are going to be sent to animal control and killed."  That's a nice friendly conversation.  So next time you see an ad on TV, or hear about a wonderful no kill shelter, ask them if no kill means once an animal walks through their doors they are safe or if it means they just kick the can down the road...