Spot ate pot? And other strange but not uncommon toxicities...

Everyone seems to know that chocolate is toxic to dogs.  I’m also sure that everyone knows that marijuana (pot) is also toxic.  We see a larger amount of ingestions of drugs than people would probably believe.  Especially now with more and more states legalizing drugs and these drugs coming in higher concentrations and concoctions which can be tasty (pot butter, chocolate pot brownies, etc.) pets find them tasty too.  Sometimes the consumption of pot is an accident and sometimes it can be malicious.  Sometimes a neighbor, ex-boyfriend or other character will intentionally poison a dog.  

While the “tox screen” that they talk about on TV sounds like a great idea, there’s really no practical way for us to do that in veterinary medicine.  In order for us to test for everything under the sun that is a toxin it would involve too much expense (and blood or urine) that it’s just not practical.

We’ll get back to the marijuana toxicity a little later, but let me inform you of some other lesser known toxicities.  Garlic and onions can cause anemia (even though if you look on “Dr. Google” you will see these compounds as homeopathic flea repellants).  Mushrooms can cause liver failure, as can Sago Palms (a common houseplant).  When it comes to plants, I quite often refer people to the ASPCA Poison Control website where they have an exhaustive list.  Even though I'm mostly focused on dogs in this dog post, I would like to make sure everyone knows that lilies are so toxic in cats that even the pollen off of them is enough to send a cat into severe kidney failure where they are dependent on dialysis.  I love lilies and they were even in my wedding bouquet, but I do NOT allow them in my house because of my fear of them.

Xylitol, a compound that is in sugar free gum and other sugar free products is becoming more and more common and some “healthy, holistic” peanut butters now contain it so you must carefully read ingredients.  It is also often found in children’s dental products.  This is so toxic it can cause liver failure and seizures, as it causes extremely low blood sugar (I’ve actually seen this toxicity a couple of times).

Raisins and grapes are another toxin that is just too risky to allow in my house.  While chocolate is dose dependent (it depends on the amount the dog eats per body weight), raisins and grapes are not.  Some dogs can eat them without a problem.  Some dogs die from them.  We don’t know yet which dogs are more sensitive, so there is no way to know if it will be a problem for each particular dog.  Would you really want to take that risk?

In the advent of all the DIY products out there, making your own beer is becoming more common.  Did you realize that just a couple pellets of mash is enough to kill a dog?

One naproxen (commonly known as Aleve) can work great for human pain and inflammation.  It’s enough to kill a dog the size of a labrador.  I still have this medication in the household (it works the best for me) but I keep it in a room where my dog is not even allowed to go in.

When I worked in emergency medicine, it was quite frequently not just one thing the dog got into, but a bunch of different pills, medications or foods.  So it could sometimes be difficult to sort out how to treat each of the different toxins.  If your dog ever gets into something, please bring the wrapper or whatever information (or whatever is left of it) with you or take a picture of it, as that is valuable information for us.  It sometimes becomes a puzzle where we have a small fragment of candy bar wrapper and have to figure out what it is and how much of it is in a package that size.  We have an easy calculator for chocolate toxicity and we can do the calculations on rat poisons (I’ll save rat and mouse poison discussion for another day).  So you can always call a veterinarian up and simply ask if something is poisonous.  Also, common household products will often have a manufacturers number to call for accidental ingestion.  There’s also always the ASPCA poison control, who for a fee, will provide information to owner and veterinarian alike, especially helpful for the more obscure poisonings.

Ok, back to marijuana.  I can honestly say I’ve never smoked it, ate it or really had any other direct interaction with it or any other illicit drugs, but I’ve come to learn a lot about drugs over my past 20 years in veterinary medicine.  I can actually spot people with drug (and alcohol) problems.  It makes our job a little trickier because the people can be obviously impaired, not tell us the truth and be irresponsible (with payment and obviously generally irresponsible).

I’ve become rather adept at the whole, “Is there any way your dog could have gotten into something, maybe a neighbors backpack, or a park or something.”  I’ve found that letting people know you are not interested in calling the cops on them and you really don’t need (or want) to know the exact reasons of an intoxication can help them open up.  “I just need to know what your dog got into so I can help him/her.”  I had one situation early on in my career several years ago where it was quite apparent the puppy had either gotten into something or had a very serious genetic problem.  I asked the owner and his wife, two middle-aged people, “Is it possible he could have gotten something from your kids?”  The man said, “no, are kids are older, they know better.”  “How old are your kids,” I asked.  “15 and 17,” the man responded.  I then went on the line of questioning, “well maybe he could have gotten something out of a backpack of one of their friends?”  All of a sudden a light went on and the man said, “No, I'm going to kill my kids, I'm a cop. They can’t be doing drugs!”.  That was awkward…

I also know of a funny story about a government dog that is trained to sniff out drugs coming to the ER at the same time that there was a little yorkie who had gotten into the “nephew's" stash.  Both dogs needed to stay overnight in the ER.  Somehow they ended up getting placed in kennels next to each other.  Apparently that was a very bad idea because the whole night the police dog was letting everyone know there was pot next door to him.

I've heard all kinds of stories from, "some bad chicken" or a "bad avocado" when it's quite apparent that that is not the case.  Amphetamines, heroin and cocaine, fortunately we don't see as often but they also things dogs can get into.  I did have a dog who got into pot brownies and Ritalin, so it was quite a combination between the chocolate, pot and stimulant.  I've surprised some people before with being able to pick out people by their symptoms and smells, etc..  In this line of work, the weirdest thing will help you become a better diagnostician, even if that means an awareness of illegal substances.  Don't worry, I'm not planning any "independent research" into the subject, I feel I know enough of what it does...

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Where did my son learn that from.

Sometimes it's intriguing to  see what sponges toddlers are.  You really have to be careful because anything you say could be repeated...

My son loves the Berenstain Bears.  I did too when I was little.  Fortunately, my mom saved most of our large collection from when we were younger.  He also likes watching it on TV and while everyone is getting ready in the morning, we have let him watch, or if he's home sick he can watch a little bit of TV too.

My son started telling my husband that his left arm hurt.  This was while he was using his left arm to bang on something.  My husband looked perplexed and was asking him if it was his right arm.  My son continued to say it was his left.  Then I gave a little laugh and realized he was re-enacting a scene from Berenstain Bears where Brother Bear was faking his left arm was hurt to get out of doing something.

Overall the show is a pretty clean show.  There are no words like "stupid" or really other words that I don't want my son to learn and there is always an overall moral to the story and the "Bears" are good with their please and thank you's and friendship.  I overall find the series more desirable than Thomas The Train and a lot of other things on TV.  He still watches Curious George (his first love) occasionally and has also started to like Shaun The Sheep (I need to preview those shows first, but the soccer episode is pretty funny and very clean.  There is very little dialogue).

The other day, my son came over to me, hugged me and said, "Mommy,  there's something I want you to know.  You're my hero."  I wanted to melt, it was so sweet!  Then my husband pointed out Sister Bear said that to Brother Bear during the Birthday episode.  Thanks for ruining the moment sweetie.  At least he seemed to know it was a way of sharing affection.

I knew this was the stage where kids start having imaginary friends, so when Milton the invisible friend showed up, I was not surprised.  Everyone who heard his imaginary friends name was Milton thought it was awesome that my son came up with such an original name for a friend.  I didn't share that this came from a Berenstain Bears obsession.  I'm sure my son will get attached to many shows and things in his life, but an obsession with Berenstain Bears is fine with me.  It's a classic book series, shares some good moral values and definitely has some cute phrases.  I can live with that.

Know Thy Breed

As Part II from last weeks Know Thy Breed and Breeder, I will discuss a little bit more about picking the right dog breed for your family.  A bit of full disclosure here:  Out of the past 5 dogs my family has had, only one has been a purebred.  The purebred (who even had AKC papers) was what I would affectionately call a genetic disaster.  He had congenital neurological issues (issues with his brain and spinal cord).  He was very cute and he walked like a dressage horse, but he he was definitely not the picture of good genetics.

Not only am I somewhat biased towards mixed breeds based on my family pet experience, just looking at the dogs I see coming into the clinic, the mixed breeds often fare better than the purebreds in that they tend to not get as many diseases (their diseases are also not as predictable) and they are almost all dogs who have been saved from a bad fate.  Now as stated in the last post, there are some great breeders who do everything they can to help the breed avoid health problems and carry on the standards of breeds.  I do have some breeds that I really do like and could imagine owning someday (although most likely if I do, they will have some type of special need, that's just kind of how I roll as a vet).  Who better to rescue the special needs dog than a veterinary health professional?

So some breeds I would like to bring to your attention: large breeds, such as Dobermans, Rotties, German Shepherds, Great Danes, Cane Corsos to name a few are best owned by people who can train dogs and can be strict.  A Chihuahua jumping on your lap- not a big deal; a 100 pound dog mowing you down = big deal.  I will confess that jumping is the one thing I have been unable to cure my own dog of even with the assistance of professional trainers.  But I have trained him to be ok to go in a crate, or I put him in a different room, etc so when company comes they are hopefully not knocked down.  Any type of aggression in the above breeds needs to be carefully monitored and managed as these dogs are powerful.

Mastiffs are also another large dog and they can be aggressive in some cases, but they can also be great with small dogs and in apartment situations.  These dogs, though they are big, do not need a lot of exercise.  They are kind of like giant couch potatoes.

Weimeraners, Vislas, Dalmations, German Short-Haired Pointers- these are all breeds that are bred to run.  If you can't give these dogs adequate exercise (and we are talking somewhere around a 3-5 mile run equivalent) then you may end up with some behavioral problems.  They are meant to be active and they only do well with people who are equally active.  (Running and dogs may be another topic for another post, I'm not advocating training for a marathon with these dogs, dogs are best served by having free space to run and not get pavement injuries).

Terriers- oh terriers.  Sometimes in the veterinary community their nickname is "terrorist".  Some are sweet and small and wonderful.  My favorite among the terrier breeds are Rat Terriers.  They just seem to have one of the better temperaments.  But they are still terriers.  This means that they bark and hunt small prey.  I had someone once that I casually met say they wanted to get a terrier (it was a pre-teen).  I mentioned to the Mom that they can bark.  Apparently the family lived in a townhouse.  Perhaps not the best breed for neighbors who don't like dogs...  They also can be nippy.  I would say the nippiest and most energetic and terrier that I would only recommend for experienced people would be a Wheaton Terrier.  They are one of the larger dogs in the Terrier group and they require a lot of exercise and attention.  I would get a Terrier with caution around small children.

Dachshunds and Chihuahuas.  Ok.  A little backstory here.  In my over 20 years in the veterinary profession, I've been bitten (broke the flesh) by 3 dogs.  I've been nipped at by probably somewhere in the 4 figures.  What has kept the number at only 3 dogs?  I don't trust certain breeds, and that is why I have not had a significant bite in 8 years.  Out of those 3 dogs, 2 were Dachshunds.  One of which also bits its owner (There's nothing like being in the ER and the client is also there with a bite from the same dog).  The other dog was a Schnauzer.  All 3 of the dogs were likely painful.  As a rule, I am cautious around all Dachshunds and Chihuahuas.  I try not to put myself in a position where I will be bit.  I handle these situations by either using a muzzle, pharmaceuticals or just telling the owner I can not safely do an exam on their dog without safety precautions.  I do not put a muzzle or drug up every Chihuahua or Dachshund I see, but I am leary if I see one and make sure I have the most experienced and trustworthy people helping me.  These small dogs do not make the bite list of "most dog bites" but they are more feared in the veterinary profession than Pit Bulls are.  Pit Bulls are a breed that really gets a bad rap.  Most Pit Bulls, especially with good owners, are wonderful dogs.  Most of the time if they want to bite you, they will let you know well in advance.  Chihuahuas and Dachshunds will  seem like they like you are doing fine and then they crunch on your fingers.

Small dogs in general can have something I call "Napoleon Complex".  They can have fear anxiety and if they are fearful, they will bite.  They know they only have one shot at getting out of the situation.  Larger dogs- they basically know that if they need to, they can kill you, so they aren't as threatened most of the time.  I don't think most Chihuahua and small dog bites get reported because most of the time it doesn't do enough damage to go to the hospital, or their bites are seen as small annoyances.  We had one client once who had a small dog who bit kids and the owner didn't seem to have a problem with it.  She was told that it was unacceptable and she needed to keep the dog separated.  Bites can become a big problem.

Goldens and Labradors are classic "family" dogs.  They need exercise an

d attention but they are generally happy and go lucky.  Chocolate labradors can sometimes have a unique personality, so I would only recommend a Chocolate lab to a more experienced person, same with Chesapeake Bay Retrievers.

English Setters and Irish Setters I generally like (may be biased because our first family dog had Setter in her).  They, as well as Border Collies and Australian Shepherds, are all very smart breeds, but they are hunting breeds.  They need "work".  When I say that, I mean they need to be properly stimulated through exercise and attention.  These dogs are prone to get Obsessive Compulsive Disorder, Separation Anxiety or other issues if they are bored, even to the point where they can become destructive.  These breeds would not be good in a household that's gone most of the day.

Please let me know if there's any other breeds you would like to hear about, but I thought I'd give just a brief summary of what we observe as veterinarians.  You can understand that if you have a mix of a couple of breeds you can sometimes get the best of each : )

Know thy Breed and Breeder....

A while ago, a distant family member of mine found out I was a veterinarian.  He wanted to inquire about breeding Cavalier King Charles Spaniels for money.  A lengthy conversation ensued where I explained the particular health concerns of the breed and the fact that being a good breeder almost always means not making money.

From early on in my veterinary career, I have held strong opinions on good breeders and bad breeders.  Unfortunately, as veterinarians we see more of the progeny of bad breeding because they have all of the problems and horrific sob stories.  I have seen hundreds of dogs from puppy mills, which my definition is any commercial enterprise that favors quantity over quality.  This includes all those "puppy farms" with poor environments where diseases, genetic and infectious, run rampant.

Some of my colleagues are good breeders and there are many good breeders out there, I do not want to paint them all with the same brush.
Some signs of someone being a good breeder would include people who show dogs and are very involved in preserving and upholding breed standards.  They typically breed to continue to produce show dogs and further the breed and sell puppies out of excess- not to make money.  They pass their dogs through rigorous testing through the OFA, to help prevent and lower the incidence of genetic disease.  They love their puppies so much, they are often happy to take them back, no questions asked.  They ask many questions of the new owner (yes, they interview prospective buyers).  They ask for Christmas cards, or annual updates to see how their puppies are doing and to know how the "line" is doing to impact future breeding.

They are normally well-educated in the healthcare needs of their puppies (and kittens) and have a good working relationship with their vet.  They take care of many of their progenies needs but still have a veterinarian regularly examine their animals.

Puppy mill dogs, on the other hand are sold for profit.  They can be sold through pet stores, the Internet, classified ads, parking lots, flea markets, etc.  There are over 10,000 puppy mills in the United States selling approximately 2 million puppies annually.  (The Humane Society of the US. 2012 USDA Breeder and Brokers Figures and Puppy Estimates)

The dogs from puppy mills have significantly elevated levels of fears and phobias, compulsive and repetitive behaviors and heightened sensitivity to touch.  See article Mental Health of dogs formerly used as "breeding stock" in commercial breeding establishments" in Applied Animal Behavior Science 2008;113 (1-3):236-246. McMillan FD, Duffy DL, Serpell JA.  Also see- Differences in behavioral characteristics between dogs obtained as puppies from pet stores and those obtained from no commercial breeders.  McMillan 2013 JAVMA

Anecdotally, I've seen several dogs from puppy mill situations who are difficult to housebreak.  They got so used to living in their own excrement that it was hard to train them that it was no longer "normal".  These dogs also often have parasites, some of which are transmissible to people.

States that are considered to have a larger proportion of puppy mills than others would include; Arkansas, Kansas, Missouri, Ohio, Oklahoma, Pennsylvania and Texas.  Puppy mills may exist in all states, but these are the ones we tend to see more "problem cases" from.  When buying from breeders in these states, I wouldn't think of buying one without visiting and seeing the environment and the actual parents.  Both infections (such as respiratory and digestive) as well as drug-resistant parasites run rampant in these environments.  Once, when working in a area where there were tons of pet store puppies, I had to call up an infectious disease professor to get her advice because nothing in my textbooks would kill the Giardia those puppies had. 

I still remember my internship year having to explain to two distraught kids that their puppy wasn't coming home.  Their tears were thick and inside mine were too.  They had gotten the puppy because their goldfish died and their parents said the puppy would be a long-term friend and to teach them responsibility.  He had a severe deadly pneumonia and seizures.  There was no practical way we would be able to save him.  His parents had wanted to tell them that the puppy went to "the farm".  I told them eventually they would probably find out that wasn't true and wonder what else they had lied about.

Often, the puppy mills and wholesalers will advertise "guarantees".  Some states have "lemon laws" that help protect the consumer.  Not every state has lemon laws and there are a lot of lobbyists who work on behalf of the industry as they are considered "big agriculture".  Most of the "guarantees" will say something like "guaranteed" for the first year to get purchase price of the puppy.  This has the following caveat: what person who has a heart would ever want to return a puppy they are bonded to, especially when children are involved?  Who wants to explain to a child why their beloved companion was returned, and what child won't worry that they will be returned next?  I've also known of many situations where the breeder told the owner, "yes, you can return your puppy and get your money back, but if you return it, I will have it euthanized."  Again, what person would ever want to send a puppy back to that?  It's all legal and it does happen.  States with Lemon Laws, such as New Jersey have the right train of mind: they say if a puppy has a defect, the breeder pays up to the purchase price towards treatment of the problem.  Many owners just get frustrated and end up spending thousands of dollars to fix their puppy.  I know of one family who recently paid $6,000 to fix a congenital issue (meaning the puppy was born with the problem) and the breeder paid them nothing for it.  They said they would only take the puppy back, but not provide any financial aid for treatment.  Often times though, I've seen people who spent thousands of dollars on the purchase cost of the puppy and have no money to pay for treatment.  This can end up in terminally ill puppies.  No one thinks about that when they are getting a "guarantee".

Fortunately, a lot of the nefarious pet stores have closed.  Some that used to be disasters had picketers shut down their doors.  Unfortunately the rise of the Internet has just provided another way for marketing these puppies to the public.  The rise of scams where puppies are never even delivered and more money is asked for in "transport" fees and a lack of regulation over the Internet have contributed to a whole new meaning for "Buyer Beware".  I have had countless people tell me they have "rescued" pet store puppies and puppy mill puppies.  Seriously.  "Rescue" does not mean paying thousands of dollars to puppy farms so they can continue to operate.  While they may have taken that particular puppy out of a sad situation, until people stop buying these puppies they will stay in business.

Know thy Breed
There are certain breeds that I would consider great for the "beginner" to having a dog, there are other breeds that I really think only experienced owners should have.  I've actually compiled the following non-exclusive list of breeds that I would put in 3 categories-

• 1)good for first-time owner
• 2) good for first time owner who is educated and meets certain compatible criteria    

• 3) good for well-experienced owners who are familiar with the breed.  All categories assume the prospective buyer does their research so they know what health problems and temperament the breed is known for

1)
Boston Terriers
Golden retrievers
Labrador
Poodles
Maltese
Labradoodle
Pug
Cavalier King Charles
2)
Beagles
Pit bulls
Bulldog
French Bulldog
Great Danes
Mastiffs
3)
Rottweilers
German shepherds
Huskies
Terriers
Dobermans
Corgis
Weimeraners
Viszlas
Border Collies
Cattle dogs
Rhodesian ridgebacks

A good solution for finding a good dog for your family would be talking with your veterinarian and working with rescue groups that know their breeds and what types of family they work best with.  It's also good to adopt from a rescue who is willing to take the dog back.  No one wants to "dump" a dog at a shelter, please think before you buy...  

Next week I will discuss more about picking the right dog for your family...

Being the Center of Attention

I was talking with my husband the other day, and before that, I had a conversation with friends and the same topic came up.  Long ago, when I was a small child (ok, maybe even young adult), I enjoyed being the center of attention.  I enjoyed talking.  I still enjoy talking (to an extent) and getting credit for things I do.  I obviously have not become an antisocial hermit, I do have a blog after all.  Some of my glee, though, with socializing with people and being the center of attention has totally left me.

This has happened slowly and gradually.  I didn't wake up one day and decide I didn't like socializing any more.  It has come about after a decade or so of entering an exam room and being the center of attention.  Initially, being called "doctor" and being the respected person of authority in the room was kind of cool.  More often than not, though, it has become more like a stage actor going on a stage.  I do not act when I'm in an exam room per say, I tell the truth, but my presentation has to be much more like that of an actor.  I have to present myself and the options for the pet in a way to convince the owner to believe me and furthermore to make the right decision for their pet.  This really isn't hard when it comes to the mundane things, (well, it's not hard to present it, but harder than you would think to convince people to do things).  It is very difficult, though, when it comes to presenting difficult facts: "no, it's not likely that your pet will make it to Christmas, etc."  It's not easy when you have philosophically polar differences.  An example of this would be when a client took out a pocket knife in response to me providing treatment options and saying, "well, doc, isn't this a treatment option too?" and motioning at the cats jugular.  Yeah, how do you answer that?  They don't teach you that in vet school.

Yep, being the center of attention is not all it's cracked up to be.  Sometimes I wish I could be the fly on the wall to see how I hold my facial expression together (or not) when clients say or do the darnedest things.  Yep, that's more my speed at this time in my life.

Vacation...

Recently, we went on a vacation.  This is after a whole month of pretty much a continuous toddler birthday celebration and grandparent time.  I was almost feeling like the book, "Berenstain Bears and Too Much Birthday."  All four of my son's grandparents are doting and wonderful (I mean, that's what grandparents are, right?).  But over 4 weeks of gifts and "special" things can start becoming not quite so special... Especially when someone wakes up and asks for presents, because don't we all like to get gifts every day?

Normally, I have been proud of my son's ability to go into a toy store or grocery store without expecting to get something.  You know what pride does... It gets knocked down.  We were in the process of trying to leave a toy store and I think the mix of too much travel, too little sleep and being a little past lunchtime without food culminated in a tantrum.  Ironically, right after my son had read the book, "The Grouchies"

Just as I was terrorized to see my son becoming materialistic at the toy store and struggling with him to get him out of the toy store, my son saw it.  His tantrum was busted.  He saw the ocean.  He forgot about the toy he wanted and was focused on the beach.

The beach was pretty far away.  We were walking back to our car, and down a long street was the town's beach.   My husband said it wasn't in "our plans" to go to the beach.  I was determined, if this was the one thing that would break his materialistic tantrum, I was going to do it.  If he was willing to forget about toys, presents and me, me, me, we would feed that desire.  As we headed over to the beach, my son began to get excited.  He wanted his socks and shoes off.  No problem, he wanted his shirt off.  Ok, I thought, may have to put some sunscreen on, but we can do that.  What we then partook in was what I like to think is the absolute joy of childhood.  Pure, unadulterated joy, running through the sand, dancing, something akin to a baseball pitching windup and pure smiles.  Never once during this episode did he talk about toys, or "I want".  It was a gift to witness my son's pure joy in nature and the beach.  Maybe my husband and I weren't doing a bad job after all and maybe spontaneity is the cure for adult ailments too...

On a different note: our garden- we now have radishes, which normally I don't like how they taste, but when they come straight out of the garden, that's pretty awesome.  My tomato plants just might make it, I actually thought my friend had planted some seedlings from the store, but they are actually the little pathetic seedlings I had planted, so we will see what happens : )

Veterinary mental health and coping.

Veterinarians and technicians deal with death and dying five times more often than human physicians.

The US department of labor sums it up by saying this about the veterinary profession "animal lovers get satisfaction with this occupation, but aspects of the work can be unpleasant, physically and emotionally demanding and sometimes dangerous"

Yep, that's my line of work.  There are also rewarding aspects of the job such as watching patients grow from puppies and kittens to active members of the family and even adults and even sometimes well-behaved dogs from rambuctious pups you want to give Ritalin to.  Often times people think our work only involves holding and cuddling sweet, wonderful animals.

There are also the awkward moments, like how do you help parents deal with difficult situations involving their pet's illness and even death.  I have had parents ask me to lie to their kids.  I don't do this.  I just try to say as little as possible or be truthful without all the details, such as, "Fluffy is very sick and I'm going to help him with his pain but you are not going to be able to see him again."  The times I've had to explain to snotty nose crying kids that, no, even my doctor skills can't help their pet break my  heart and their parents as well.  We are grief counselors in a lot of ways and in some ways I think somewhat similar to social workers.  We are involved in very intimate times with families.  I once spent over 7 hours counseling a family while I helped ease it's transition out of this life.  I don't have clear answers at these times.  All I have is a kleenex box and a listening ear.

I do counsel parents to please, please don't lie to your kids about difficult choices.  It's up to the parents to parent their kids and it depends on the individual child's ability to handle things as to how exactly you explain and let them experience things but let me assure you, your kid will find out that your dog didn't go to that magical farm you talked about and they will wonder what else you have lied about.

I heard once from a technician how they witnessed a five year old come out of a room where their beloved dog had been euthanized and blurted out, "Dr So and So just killed our dog."  Yep, that is unfortunately the truth.  But they are able to handle truths sometimes better than we can.

I can't come out of a room and tell myself, "Yep, I just killed that dog/cat/kitten, etc."  For coping purposes I have to think about the pain I saved them from and that it was a more peaceful departure than what it could have been, but it is nevertheless a departure.

We also have those cases where things don't go smoothly or for whatever reason, our peaceful process just isn't peaceful.  I remember ending a day with euthanizing a kitten.  Yes, the kitten had a very bad disease and I was doing it a service, but as that five year old bluntly put it, the truth is the truth.

Through a variety of means of coping with the difficulties of the job, we as a profession get through these times.  Where it really gets difficult is once one of our own pets is when we are in role reversal. The last time I had to take the difficult walk with my family dog, it was like I was grieving all the pets I had put down in that year.  I have no idea how hard it will be on me when I am in that position again with either my dog or cat.  I spoke to my husband about my dread and kind of broached the subject of our choices and options because I wanted some things established ahead of time so we could have "prearrangements" so it would be one less thing to fret about in the future.  My husband was somewhat sheltered from all of these things with his family dog, so when the end is near for our pets will be his first time in these difficult shoes and I informed him I did not want everything to fall on my shoulders.  I may be a vet, but I separate that from being a pet owner sometimes because I'm just not objective with those I love.

I often counsel people to think about three things that make their pet their pet.  Such as jumping into their favorite spot, being at the door to greet you, eating their favorite treat.  I just wanted to share the above so those of you not involved in the profession understand a little more about the many hats we wear and we, like you, hope that our pets will just quietly and peacefully expire without anyone needing to make a decision.

Human Bartonelllosis

Bartonella- it's a disease not many people are aware of and may be much more common than the medical profession knows.

Bartonella is actually a form of bacteria that are transmitted by fleas, ticks, other athropods and animals and their bodily fluids.  Obviously, all of us who work in the veterinary profession are at more risk.  We actually see ticks and fleas fairly frequently on pets when their owners do not use preventatives, or use ineffective preventatives.

Bartonella has been known as "Cat Scratch Fever".  It was also known as "Trench Fever" in World War I.  In the 1990s, the disease was "rediscovered" because it was causing a fair number of cases of endocarditis and fever of unknown origin in patients with HIV.

The difficulty with diagnosing Bartonella is it causes a wide variety of symptoms such as fever, fatigue, malaise, swollen lymph nodes, joint aches and swelling, neurological and physiological abnormalities as well as skin rash and markings.  Illnesses can range from severe illness in immunocompromised people to chronic illness in people with healthy immune systems.  Geographic evidence has documented cases all over the United States, but especially in warmer climates.  It can also be found in most major regions of the world.

The best way to prevent Bartonella- wear protective clothing when outdoors, avoid animal bites and scratches, remove ticks promptly, use preventative measures such as good flea and tick control for your pets.