Dentistry- all creatures

Earlier this week my husband had to have dental work done.  He came home and started talking to me about dental radiography.

Let me preface the following with this:  I have a long and sordid history with dentists, mouth pain and a horrible gag reflex.  I have a dislocated jaw and have had jaw surgery and I have had braces 3 times and have been told I am an excellent candidate for getting my jaw joints actually replaced.

Ok.  I will get back to my husband's revelation.  He said, "Did you know that you can't really find out if a tooth is diseased without an X-ray?  Did you know that dental X-rays are essential to having good dental health." yada yada.  He went on and on.  I looked at him, probably with at least one eyebrow raised and responded, "do you know I have this conversation with people on a daily basis?".

He was concerned that I hadn't gotten dental X-rays lately.  I got out of them at my last dentist appointment on a technicality.  The time before I had gotten X-rays, it ended up resulting in two painful sessions of me trying not to gag and having jaw pain.  I really wasn't jumping to go back for more.  To my husband's chagrin, I fortunately have great teeth (despite my lack of knowledge of where dental floss even resides in our house).  My husband has excellent dental hygiene habits and well, I won't get into details of mine.  I don't have cavities, he does.  I told him that's the miracle of genetics : )

I am taking my toddler to a pediatric dental specialist, and at 2 1/2 years of age, this is going to be his third visit.  I want him to have a positive relationship with dentists (while my childhood dentist didn't even wear gloves and looked like Papa Smurf, my son goes to a office with I-pads, a rain forest and "themed rooms" complete with hygienists who sing songs and give toys out.  I wish they had those when I was young....

I told my husband in response to his educational lecture, "yes, I know about dental radiographs, that is why the only clinics I will do dental procedures at are clinics that have dental radiology."  I also went on to tell him, "yes, I know about dentistry, I DO dentals!"  I have the knowledge, I just don't look forward to getting it done and I will probably procrastinate a little (Maybe I will draw strength from going to my toddler's dentist appointment).  On my part, there is not a lack of knowledge, there is a lack of willpower/desire.  On the part of a lot of my clients; there is a lack of knowledge.  Let me share some common misconceptions with you:

1) "In the wild, animals never got dentals or got their teeth brushed".

Response: Animals in the wild fractured their teeth quite commonly on the bones they would chew on.  They also didn't live as long as we expect our pets to.  If you have questions about how it's like to live without teeth/oral pain, just read up on the life of George Washington
http://www.mountvernon.org/george-washington/the-man-the-myth/the-trouble-with-teeth/

2) "I only need to brush my dog's teeth once a month"

Response: What would happen if you only brushed your teeth once a month?  Um.. gross!

3) "My dog/cat is eating ok, if there was a problem, they wouldn't eat"

Response: Not eating is incompatible with life; if a pet is in pain, they will still eat or else they would die.  Doesn't mean it's not painful or a cause of distress.  Eating ok does not equal good dental health.

4) "My pet doesn't need a dental under anesthesia, the groomer/ hygienist brushes his/her teeth"

Response:  In order to get a full exam, radiography should be performed, at least as a baseline, this can only be done under anesthesia.  Also, without anesthesia, the pet's airway is not protected and aspiration, so pneumonia can occur.  When I worked in the ER, I saw a greyhound in cardiac arrest from this.  The dog did not make it.  Also, without anesthesia, they are only able to treat the crown (the part of the tooth that you see) 75% of the tooth is under the gumline.  This is the most important part of the tooth to assess and treat.  It is possible for a pet to have abscesses and a rotten mouth with nice shiny teeth.  It's also painful.  Not recommended.  Check out the following link for more reasons why this is not a good idea:
http://www.avdc.org/dentalscaling.html



5) "Someone told me not to get a dental performed because the tartar/calculus/rotten teeth is what is holding my dogs mouth together."

Response:  I don't know exactly where to start here.  No- Tartar/calculus does not hold your pet's mouth together.  Bad teeth and infection can actually abscess and rot through the bone and cause the jaw to fracture.  Painful, messy and then you have to potentially wire jaw shut for 6 weeks.  Not a good idea.  Getting disease out = good= less pain = happier dog/cat

 As a final incentive for your pet's health, isn't it much better to get kisses from a pet that has good breath?

The end of summer...

I can't believe it... The end of summer is here!  This is the third summer I've had with my little guy and it always goes so fast.  The first summer we were just trying to make it through nursing and getting to know each other.  Last summer we were learning how to walk and on the cusp of a childcare change, and this summer....  let's just say there's been fireworks other than the 4th of July.

My son has a temper (not surprising, since both of his parents are also passionate people).  As fall comes, I'm going to need some new ideas for trying to distract and re-direct his temper tantrums (Going for a walk outside, blowing bubbles outside, eating meals outside and trips to the park may be more difficult when there's a couple of inches of snow on the ground.)  Of course, my son waits to the very end of summer before he will try wearing sunglasses for the first time... Hoping to get him in goggles for swimming by next summer...


As an update, the raspberry bush is getting about a pint of raspberries every day to every other day and thanks to my dog Dewey, a whole lower branch has gone to the birds and other critters as it is his favorite pee post.

There are actually two gigantic pumpkins on their way.  As my husband said, the one pumpkin obviously didn't get the memo that it's not supposed to turn orange yet.  However, its color morph does confirm that it is a pumpkin plant (as discussed in a previous post, I wasn't sure if it was a pumpkin or watermelon plant I had planted there).

School in our area is getting back into session (I forgot how much worse this fact makes traffic) and I'm actually starting to think about Halloween costumes.  My husband thinks I'm crazy for trying to come up with a dog and a toddler costume to match, but I think it's cute : )

Tomatoes are still growing and so is some kale and I just made a bunch of homemade pesto which my son refuses to try.  He will eat quinoa, but not pesto?  I think he has his tastebuds mixed up.  I don't think I'm ready for allergy season, Fall, or most of all, my son continuing to grow up.... But it's not about if we are ready or not is it?

Rabies... 6 Key Points

Rabies has been around for thousands of years.  It is found all throughout the world (I saw cases in India and Mexico and have had exposure in CT and the mid-atlantic).  Historically, to date, there are very few survivors of this awful disease, it is very rare and considered to have close to 100% mortality.  

Non-veterinary professionals and even a lot of veterinary professionals do not regularly get vaccines for this disease.  I got my vaccines in veterinary school and subsequently when I have had exposure to the virus.

Here are some key points to know about Rabies:

1) Please vaccinate your pet.  Whether they be "indoor" or "outdoor", rabies vaccine is the law and is necessary unless your veterinarian and you decide that your pet has a particular medical condition that makes it too risky.

2) Don't touch wildlife (squirrels, bats, etc.).  These animals can potentially expose you to rabies virus.  Call animal control or law enforcement.  They know what to do and they have protection.

3) The only way to test for rabies is post-mortem.  There is no blood test or any other test that can be performed at this time on a live animal/human that can let you know about exposure to rabies.  If your pet has contact with a potentially rabid animal and then begins showing symptoms, the only way we can get an answer is when a necropsy (similar to an autopsy) is performed.

4) Rabies vaccine is not fun.  The only place that typically carries rabies vaccine are emergency rooms and they typically cost about $500 a shot.  Also, they are painful (in the muscle) and can cause flu-like symptoms.

5) Often exposures happen in what people might perceive as "low-risk" situations.  Two of the exposures in my area this year have been in condos.  Not farmhouses in the country.  Suburban condos where a bat got into the house and was later tested as positive by animal control.  That means everyone in the house had to have rabies prophylaxis and the pets, if they weren't caught up on their vaccine, needed to go into a 6 month quarantine.

6) It's the law.  All states in the US have laws regarding rabies.  Rabies vaccine and travel regulations are regulated by the States and are very serious.  When in doubt, contact your veterinarian or animal control.

Any questions?

Bravery or Insanity?

As my one friend told me when I told her I took a 9 hour drive by myself with a toddler and a large dog, "you must be brave."  My response was yes, or insane....

My son was actually remarkably good for a trip most adults would find downright annoying.  We made it almost all the way to West Virginia without any mishaps.  I stopped at a Burger King, (yes, I am that mom who vowed that her son would not get fast food until he was five or older... that clearly went out the window.)  On a hot day with a dog in the car, there was no stopping for a leisurely meal. First of all, let me tell you, if you take the wrong turn in the hills of West Virginia, there is quite often not an easy fix.  They do not have "blocks" to go around there... That added about an additional 15 minutes to our trip and possibly a couple of grey hairs.

We went in to the Burger King, I went to the bathroom with him strapped to his stroller in a handicapped stall and then went to order food.  I got this, I said to myself.  I even navigated the restaurant doors for the most part with the stroller without a hassle.  I got out to the car and then... When I picked up my son from the stroller, the stoller tipped back, knocking off the back m
y purse, the diaper bag backpack and most importantly the vanilla shake I had bought for my son as an awesome treat.  I still needed to get the kid strapped into the carseat, so as I was wrestling with him (he now was seeing that a longer car ride awaited him and was not thrilled), I imagined the shake getting everywhere.  "I got this," I quietly said to myself to try to keep it together.  I cleaned up the stroller, and of course all of the liquid shake had escaped and gotten everywhere.  Got it cleaned up and thought, "oh yeah, I got almond milk," as my child was screaming for his shake and his fries were too hot to eat and pretty much nothing was going to satisfy him.  I got the almond milk (I had tossed it in because it didn't require refrigeration and who knows when you're going to need almond milk?) and diluted the ice cream of the shake into a cup for my son.  This took several dilutions.  I tried to keep my chill.  Just as I was starting to pack up, an older couple comes by and the man says, "just think, someday he's going to be a teenager, I'd start praying now!"  I responded, "I started praying when I was pregnant."  "Good move, " he said.

Bravery... We went to the Newport, Kentucky Aquarium on Monday.  The boys had a great time running all over the place, seeing "fishies".  At the very end, they had a 75 foot long rope bridge (enclosed by netting) that walked over their huge 385,000 gallon tank with nearly two dozen sharks,  four exotic shark rays and more than 300 fish.  It was so narrow that my son had to put one foot in front of the other (it did have netting on both sides and as one of the workers said, over 250,000 people have walked across it uneventfully).  It was still scary.  My friend and her son wanted to cross it and I was so hoping that my son wouldn't and that would be my way out.  Of course he wanted to go across (thankfully he didn't try to show off his spiderman skills on the netting.)  It's kind of funny when a two year old get's a mommy to do something she doesn't want to do.   Isn't it supposed to be the other way around?  I guess being a mom to a two year old takes a different kind of bravery : )

Verizon Date and the complicated Cat

So... if you told me three years ago going to Verizon to buy a cell phone could be a "date", I would have laughed in your face.  But as parents of a toddler, I did rather enjoy that time sitting at Verizon with my husband (while my in-laws watched our son).  We did end our "date" with a trip to a new Hibachi place in town (where we wouldn't normally be able to go because of our food allergy worries).  It was nice just spending some kid-free time (as much as we both love our kid).  The Verizon lady was also amused when as she apologized for the wait, I told her this was our "date".  As we left the store, she said, "Hope you had a great date night at Verizon".  Life is always interesting as a parent...

When my husband and I got married, my parents gave us a backpack/picnic kit, which pretty much as soon as I got pregnant, we realized we would probably not use, at least not for a long time...  Due to the change in my schedule and a new flexibility that I didn't have when I wasn't an independent contractor, we are going to be able to take our son out to a picnic concert tonight.  They are doing Brazillan jazz and the place has a huge water fountain.  Hopefully this experience will be a hit based on the fact that my son tonight said, "Thank you Jesus, for water fountains" (unprompted : )  I'm very excited that we will get an opportunity to go to this free entertainment in my area, which I have wanted to go to since I moved here over 5 years ago (at that time I believe I had envisioned a romantic date with the man of my dreams).  Now I get to share a fun date with the man and son of my dreams : )  Now if we can just find that backpack we thought we would never use...

Our cat Duchess has been showing more signs of arthritis (and probably doesn't help when the 2 year old puts his hands on her and says, "Ride Duchess?"  I decided the injections I had been giving her were not enough, so called up my favorite compounding pharmacy.  (Compounding pharmacies are places where they compound, or make medication into different formats, such as liquid, treats, flavored pills, etc.)  I called them up hoping they could make a pain medication (my favorite for cats) into a tasty, crunchy treat.  The pharmacist, (humored that I was both vet and owner and also humored that I used to live in Arizona, had a Michigan phone number and now live on the East Coast) told me that a crunchy treat was probably not going to work.  I asked, "what if you put a really small amount in the crunchy treat?", his response, "It's so bitter, even a small amount won't work, and if she's even a remotely smart cat, she'd figure it out in a day or two."  I told him, "Unfortunately she's not remotely smart, she's crazy smart."  He recommended liquid medication (which I had tried with a different medication for my cat two years ago, even in her favorite flavor).  I told him that lasted less than two days with her and it took me weeks to repair our relationship after that.  I then asked him about something called transdermal.  This is where you have a syringe and you actually just put a tiny amount on the ear and it absorbs through the skin.  It has been shown to be somewhat effective for thyroid medication.  The pharmacist said, "well, that's creative, there's no studies on its effectiveness."  I told him it was worth a try, as that was probably the only hope I would have for medicating her.  He said, "fine, if you want your own kitty to be your guinea pig."  I told him the worst that would happen would be it wouldn't work and I'd be out of some money, but I was confident if it became a battle of wills of shoving a pill or liquid down her throat, I would be out of money AND have an angry cat.  I'd take the risk.  I'll keep you posted, so far, so good : )

Dr. Meg's Mom's Famous Chli Recipe

As summer is winding down, I want to try to delay the start of fall as long as possible (although I do love the season of fall, I'm just not ready to let go of summer yet).  I am about to embark on a visit to a good friend and while 8 hours of being the only adult in a car with a toddler seems somewhat daunting (maybe I'll have some good stories to tell later?), I am looking forward to the visit and hopefully trying to fill up my friend's freezer (she is about ready to have a baby and she has a toddler my son's age).  As I was thinking of what great things to bring to her, I thought this recipe would be a great one.

This recipe is one that has been used at many football tailgates and I think even for bribery during my internship year.  The stew meat and pork makes it quite differe
nt from most chili recipes and even my husband who is a picky eater enjoys this occasionally.  I have modified it by using the slow cooker as that works best for my schedule, but the best way is in a large cast iron pot if you have the time.

Dr. Meg’s Mom’s Chili

• 4 pounds stew (chuck) meat cut into smaller cubes 
• 1 pound of lean pork  (i.e. pork steak) cut in same size cubes
• 1 jumbo or 2 extra large onions coarsely chopped or more to taste
• 2 large green peppers coarsely chopped
• ½ cup chili pepper -   I used chipotle chili pepper 
• 2-3 Tablespoons cumin seed ground
• 2 or more finely chopped Jalapeno peppers

In very large pot, brown meats on high, stirring. Add onions and peppers, cook till slightly tender. Add chili pepperand cumin (even if just using regular chili pepper) and stir well. Cover and simmer, stirring occasionally for 2-4 hours. Then add:

• 3- 4 or more 14oz. cans of stewed tomatoes to desired thickness and taste
• 1 or more cans of kidney beans –dark or light

Cook 1 hour or more to taste.

This obviously makes a couple gallons but chili freezes very well for a long time in quantities of 4 cups or more.

Top with grated sharp cheddar cheese, sour cream, green onions and Fritos, if desired.

+++ If you use ground beef and ground pork the first cooking time will be cut substantially .  Adding more stewed tomatoes will ‘cool’ it if you find it too spicy or just put 1 jalapeno in to start. 

Getting too old for this...

Oftentimes lately I found myself saying, "I'm getting too old for this."  It's funny when I'm taking care of my two year old, I can find myself getting goofy and acting like a kid again without a problem.

In the work environment is often where I say, "I'm getting too old for this."  Especially when dealing with difficult people, or with animals that want to kill me.  There is a certain point, I'm not sure exactly where it happened, when I went from the naive uber-compassionate vet to the seasoned, still compassionate, but a little more realistic vet.  The point where I realized I just don't have the emotional capacity to care more about everyone's animals than they do (There are still special cases where I can go to my reserve and for whatever specific reason go above and beyond.)  But really, nasty people, or nasty animals?  I was probably too "old" for that long ago.  Who wants to deal with that.

I'm not sure if the saying "I'm getting too old for this" does anything helpful, but it does maybe help with perspective.  I found myself getting a little too close to the dangerous end of a cat and being a little more adventurous near its teeth than I normally like (maybe this means I'm due to get reminded of what a cat bite feels like).

Maybe I'm getting to the point where I've seen and dealt with so much that there's not much that surprises me (like the fact the other day I realized why my fingernail was hurting... um, I kind of drilled an actual hole in it when I was doing a dental.)  After this revelation, my husband looked at me and said, "how did you not realize you did that and why were you in a position to do that."  The answer to that is a recurring theme in veterinary work.  First of all, I didn't realize I did it because I was so frustrated and focused on the procedure I was doing pain was not really going to get me out of focus (most vets have laser-like focus, kind of like how my cat is with prey) and secondly, I did it because I remember being frustrated with the piece of equipment and trying to see if it actually worked and I tried to test it on my glove and apparently it worked very efficiently and went through my glove : )

With difficult people- well, that's been a long-time of adjustment that in the customer service world I work in, you really do have to go above and beyond to be polite and courteous to people who are either not having their best day, are entitled or were just never taught manners.  It is the exception that when people answer their cell phone while in an appointment actually apologize for it.  I have a couple of circumstances lately where clients have been "surprised" that I am the doctor they are seeing.  I sometimes feel like apologizing, "I'm sorry I'm not a tall, grey-haired skinny woman, there's not much I can do about that, but I can tell you that that doctor respects me enough to let me work here, so let's start there."

There are times when wrestling with a 120 pound labrador to try to clip his nails or get a temperature the phrase, "I'm too old for this," is quite legitimate.  I mean, too old might not be the right phrase, maybe I should add on, "too inflexible, too out of shape/ not a rodeo rider?"  (I don't think most non-veterinary field people understand the amount of bruises and the locations of bruises we get from our "rodeo" work.)  We do use sedation for anything that is too stressful for our patients or too risky for us, but in non-painful procedures with energetic dogs, it's a lot more stress on everyone to anesthetize them for a mani/pedi.

Yet, while I'm saying all of this, "I'm too old etc", I go back to my son.  He has absolutely no boundaries/ excuses or mental restrictions.  In his world, he could eat donuts all day and watch fireworks and play ball and climb anything (I do mean anything).  Like I said in an earlier post, http://allcreaturesgreatandcrazy.blogspot.com/2015/07/just-when-things-seem-to-calm-down.html he can put the trampoline on top of the couch with no mental restrictions.  While some of the restrictions we put on ourselves are well- learned from experience, some are just psychological.  Maybe we can learn something from toddlers in their boundless energy and exploration.

After all, even though I say, "I'm too old for this,"  I go back to work each day and there is a certain amount of gratification in getting the job done.  I guess I'm not too old for it after all.

Toddler Cuteness

Every evening we say prayers together as a family.  We end the prayers with what we are thankful for.  It is very entertaining to hear what a 2 year old is thankful for.  The other day he said, "thank you Jesus for castles, American flags, big houses" and paused and said, "cannons and fireworks."   At the end of prayers the other day, he blurted out, "in the name of the father, the son and the holy beer".  At least it initially sounded like Holy Beer.  Then he said Holy Spirit.  Maybe he knows beer is a type of spirit?  Just kidding.

Sunday morning, after I had gone for a run, I came back to the house and my son and hubby were going through pictures from when I was pregnant, my husband commented on how our family room used to be a lot less cluttered, even the day before we had our son.  It was an interesting observation.   A little bit later, as I was making biscuits in the kitchen (great and easy recipe at: http://www.abeautifulmess.com/2015/07/buttermilk-biscuit-breakfast-sandwiches.html), my son started trying to lift my shorts, even my undergarments, I could not figure out what he was doing or what he was gibbering, confused, I ask my husband and he comes in.  "Oh," he said, "we were just talking about how he came out of mommy's belly and he is saying he wants to get back into mommy's belly."  Apparently he is quite literal!

In a future post, you will hear about how I sometimes do a rodeo routine at work.  One of my classmates/colleagues remarked when I was doing work at the sheep barn that I should have been a quarterback because I was great at tackling sheep and catching them.  I told her it had more to do with my impatience than my athletic ability.  Apparently my son is following right behind me in the rodeo circuit.  The other morning my husband caught him siding up to our dog and saying, "want to ride doggy".  He swung his arms over as if he was about to mount up but Daddy intervened before any damage could be done to either one.  The dog apparently has forgiven him because his little cowboy still likes to leave banana bread and other crumbs as consolation for him.