Torn and Frayed

There is an unwritten and sacred rule in veterinary medicine. With very few exceptions, veterinarians refrain from talking badly about a fellow veterinarian. We don’t throw colleagues under the bus and we try to give other veterinarians the benefit of the doubt.

This is not due to veterinarians all being in cahoots with one another, or trying to protect bad vets from the public. This rule is in place because as veterinarians we know for a fact that there are ALWAYS two sides to a story. There is the client’s side, and the veterinarian’s side. Often the truth gets lost somewhere in a haze of emotion, denial, lack of understanding, guilt, miscommunication and anger.

Here is an example…Mrs. Smith brings her cat, Mycroft in to see Dr. White. Mycroft has been vomiting for 7 days and not eating. After examining Mycroft Dr. White tells Mrs. Smith that she needs to run blood work and take some x-rays to figure out what is going on. Dr. White also tells Mrs. Smith that Mycroft is seriously ill. Mrs. Smith does not have money for the testing. She feels guilty about this, and is angry at Dr. White for not doing the testing for free, or accepting payments. Mrs. Smith walks out of the clinic with Mycroft. A few days later she takes Mycroft to see Dr. Holmes. Mrs. Smith tells Dr. Holmes that Dr. White said there “was nothing they could do” for Mycroft and that she should “just take Mycroft home to die.”

This scenario plays itself out all the time in veterinary clinics. A client says that an Emergency Clinic didn’t run any tests on a pet and just gave it antibiotics. The truth is that the emergency vet recommended testing and the client declined. A client tells all of his friends that his veterinarian killed his pet but fails to mention that he did not follow a single treatment recommendation given to him by his veterinarian.

I have had this happen numerous times to me. I have even had clients complain to me about the evil doctor they saw a few days ago, not realizing that that evil doctor was actually me. What I told them and what they turn around and tell others are sometimes in no way related or truthful.

Now some of this is because we are dealing with medical terms that can be confusing. The client may be overwhelmed with information, but does not want to look “stupid” in front of the vet. The client may be upset at the illness of their pet, and understandably not processing information being blasted at them. However, sometimes the disconnect is because the client feels guilty, and instead of blaming themselves heaps the blame on the “money grubbing”, “incompetent” veterinarian.

In this day and age, social media sites like Facebook allows disgruntled clients to vent and lie to the extreme. They can go to sites specifically designed to rat out and expose bad veterinarians and shout to the rooftops about how awful their experience was. It doesn’t matter if it is the truth. It doesn’t matter if it makes sense. Through social media an unhappy client can whip up a feeding frenzy and ruin a good, caring veterinarian who cannot defend themselves. The veterinarian will be quickly tried and found guilty in the court of public opinion, all on the basis of lies, omissions and the crazy mob mentality that so readily pounces on social media stories.

I am not exaggerating. Recently a fellow veterinarian, Dr. Shirley Koshi, took in a cat that a rescue group brought to her clinic. The cat had been “rescued” by a woman who adopts friendly animals in shelters and dumps them in parks. She feeds them once a day but otherwise they are left to fend for themselves. This particular cat was suffering from cystitis, a painful bladder condition that is often brought on by stress. The cat was treated, and adopted to a warm, loving home.

The original “rescuer” threw a fit. She claimed that the veterinarian stole “her cat” and was refusing to give him back! She blasted her story on various social media sites, contacted the local news and even staged a protest outside of the veterinarian’s office. Lost in all of this was the fact that if the cat was returned to her she would ultimately dump him back onto the street, and that she had absolutely no proof of ownership.

It did not matter. The vultures pounced. They cyber bullied, harassed and threatened Dr. Koshi. Facebook pages such as Veterinary Abuse Network and Regret a Vet called her a “massively insecure, ignorant, impotent weak individual.” People stalked her clinic and made threatening phone calls. Again, lost in all of it was the truth. This veterinarian was doing nothing more but providing compassionate care to a cat in need…a cat who had been previously living in a freezing, snowy park.

Ultimately the hate, vitriol, and poison were too much for the veterinarian to bear. She committed suicide. The earth was robbed of a kind woman with a huge heart, and you know what? The very social media sites that contributed to her death celebrated. They excitedly tweeted out her obituary. The cat in question was taken back to the original “rescuer” and people expressed gratitude in the final outcome.

I cannot imagine the isolation and despair that Dr. Koshi must have been feeling. Veterinarians have huge hearts. We deeply and passionately care about the animals that we have dedicated our lives to. Our hearts are torn and frayed with every euthanasia. We grieve with our clients. We want to make everyone happy, and we question ourselves when the outcome is not perfect.

Although I did not know her personally, I have been mourning the loss of Dr. Koshi since I learned of the news. All I can picture is her taking in and internalizing the venom that was spewed her way. I can see her sitting with her cats, stressing about the looming court case. I can only imagine how lonely and isolated she must have felt.

I also know that she will not be the last veterinarian to take their life. My profession has four times the suicide rate compared to the general public, and two times the suicide rate compared to other health professions. We are battling against massive student loan debt, increased competition, market saturation and a general public that sometimes trust “Dr. Google” or their breeder over our knowledge. We are also dealing in a time where one angry client on a site like “Yelp” can destroy our hard earned reputations.

Please remember that there are always two sides to a story. Please remember that it is way too easy for people to bully and abuse others when they are hidden behind a username and a keyboard. Please remember Dr. Koshi, who only wanted to save a cat and ended up being driven to the point where she felt death was the only option. Please remember that love and forgiveness work far more miracles than anger and hate.

The hard truths about the costs of veterinary care

I am a veterinarian, and right now I am depressed and disappointed.  I am also angry.  Last night on 20/20 there was a segment aired that basically painted my beloved profession as being full of dishonest charlatans who recommend unnecessary treatments and tests, and who take advantage of the close bond that people have with their pets.

 For those of you who didn’t see the trashy piece of journalism, here is a link:

 I know that I only have a small voice on this blog, and I know that I will never change the minds of people who truly believe that veterinarians are a bunch of crooks.  However, I cannot stay silent right now because I know that thousands of honest, hardworking, compassionate veterinarians have been harmed by this report.

 Let me lay a few things out for you.  First of all, NOBODY, and I mean NOBODY goes into veterinary medicine because of the money.  If someone enters veterinary school dreaming of the fortune they will make when they graduate, they are an idiot.  The fact is, we all chose this profession because we want to help animals and we love science.  That is it.  If we wanted to make money, we would have gone to human medical school, or mechanic school, or school to become a Wal-Mart manager.  Just to give you an idea, the average starting salary of a newly graduated veterinarian is around $45,000-$55,000.  That may sound like a decent living, but we are medical doctors, and often are graduating with hundreds of thousands of dollars in debt.

 Second, when we make recommendations to owners, whether it is to get their pet on Heartworm preventative, or schedule a dental cleaning, or biopsy a suspicious mass, we are doing it because we are advocating for what is best for the pet. I want every single one of my patients to live long and happy lives.  If I see a dog with an incredibly painful mouth, I will strongly recommend a dental cleaning with extractions.  If I see a cat that is older and getting skinny I will recommend blood work to check and make sure that he isn’t developing diabetes, or thyroid disease, or kidney disease. If I see a mass on a dog that could potentially be cancerous, I recommend immediate removal and biopsy, since many skin cancers in animals can be cured by early surgical intervention.   I don’t recommend these things because I see dollar signs.

 In fact, if you were to ask most veterinarians, we would tell you that discussing charges and estimates with owners makes us uncomfortable.  If I know an animal needs treatment, I have my technicians come up with the estimate and discuss it with the owner.  I often stand outside the door hoping that the owner has the ability to do what is best for the pet.  Many technicians encourage their veterinarians to NOT be part of the payment process, because frankly we suck at it.  We get our heartstrings tugged on quite easily, and will start marking off charges that we should account for.

 I have seen countless veterinarians cut charges for struggling clients, search for the most cost effective source of medication, take payments, and care for and adopt out orphaned animals without charging anyone a cent for the care that they have provided.  I have seen veterinarians set up “Angel” funds at their hospitals to help people that don’t have money to pay for the treatment their animal needs. I have seen veterinarians struggle with depression and burnout as they try to navigate dealing with accusations that they are allowing animals to die just because the owner has no money.

 Here’s another hard truth…it is not a right for anyone to own a pet.   If you buy or adopt a pet, you are taking responsibility for its health and life.  You are agreeing that at the very least you will provide basic veterinary care for your new family member.  If you buy a pet that you do not have the money to at least vaccinate, don’t blame us for being cruel and heartless when you can’t come up with the money to treat it when it comes down with Parvovirus.  If you buy or adopt a pet that you do not have the money to spay or neuter, don’t accuse us of being money grubbing thieves when you can’t come up with money to do an emergency spay or to treat your dog that has been hit by a car because he was not neutered and was roaming around the neighborhood.

 Veterinarians have the right to make a living. Our hardworking staff has the right to make a living. The only way this happens is if we charge for our services. The only way we ensure our clinics are stocked with the equipment and medication we need to treat your pet is to charge for our services.

 Let me explain another truth. If you know of a veterinarian who is “super cheap,” I am telling you right now that the vet is super cheap because they cut corners.  They may do things like reusing needles and syringes, not offer pain medication to animals undergoing surgery, not maintain sterility in surgery, or not stay up to date on the best treatments and medications available. Most owners don’t know what goes on behind the scenes of the super cheap clinics, and I have a feeling most of them would be shocked if they knew.

 Now, are there people in my profession who are dishonest?  Of course!  You find them in any profession. Even Men of God are not totally clean in this regard (Remember Jim Baker?). If you have had the misfortune of dealing with one of these vets, I am sorry and shame on them. They don’t deserve to be in this profession. Trust me though, they are few and far between.

 I am proud to be in this profession. I feel honored to be among men and women who are some of the most caring, compassionate people on the planet. I feel blessed to count myself among those who have been called to help the most helpless of patients.

 To any fellow veterinarians that may read this posting…don’t get too down. Have faith that our profession’s compassion and dedication will ring out much louder and clearer than any junk piece of journalism. The vast majority of your clients are grateful for what you do, and the world is a much kinder place with you as part of it. 

The Case for Cats

The other day, I went to PetSmart to buy some cat litter and a few cat toys.  I am a bit of a nerd, so usually when I go to PetSmart or any other pet store I wander the aisles looking at products.  I do this in the vain hope that when a client tells me they are giving their pet “that natural, holistic, neutroceutical all organic urine be gone formula” I will at least have a vague idea what they are talking about.

 While we are on the subject….you know that Plaque attack spray they sell at pet stores?  You supposedly spray it once a day in a dog or cat’s mouth and it cures the most rotten, abscessed, disgusting, decaying teeth.  It supposedly saves you tons of money on greedy vets that only want to nickel and dime you.  Guess what…  IT DOESN’T WORK!  EVER!  YOU MAY AS WELL SPRINKLE FAIRY DUST IN YOUR DOG’S MOUTH!  JUST PUT THE BOTTLE DOWN AND SCHEDULE A DENTAL CLEANING FOR YOUR POOR PET ALREADY.

 Anyways, as I was wandering through the aisles of PetSmart I noticed a rather sad trend.  There were dozens of aisles stuffed full of food, toys, treats, dishes, clothes, beds, shampoos and diapers for dogs.  There were only two aisles total for cats.  You find the same phenomenon if you look in the Pet section at a bookstore.  

 Sadly, unless you wandered into a feline only practice, you would see the same thing at veterinary clinics.  Although more people own cats in the United States, far more money and time is spend on veterinary care for canine companions.  This is even true in the veterinary pharmaceutical business.  Millions of dollars and years of research are poured into developing FDA approved canine medications, while cats are left having most of their medications used off-label.

 Shelters are often stuffed full of cats, and yet there are very few feline specific rescue groups.  An unneutered, slightly aggressive pit bull has a better chance of having a rescue adopt them than a friendly, middle aged, neutered cat.

 I can’t tell you how many times I have had clients bring me old, sick, decrepit, cats that are dying of end stage kidney disease, or intestinal lymphoma.  They don’t want to spend any money on diagnostics or treatment because it is “just a cat.”  While this certainly also happens with dogs, it is far more common with my feline patients.  By that same token, cats just don’t get the same level of preventative care.

 Why is this?  I suppose there are a variety of factors, but in my opinion the main reason cats get shafted is because most human beings just don’t understand them.  They use words like “aloof,” “snobby,” “bizarre” and “moody” to describe cats, while they use words like “loving,” “loyal” and “obedient” to describe dogs. 

 I think many people see more pay off in their relationship with a dog.  After all, most dogs worship the ground that humans walk on.  They want to be with us, and loved by us at all times.  If we scold them, they hang their head in shame and seek our forgiveness.  They are anxious when we leave and succumb to ecstatic fits of joy when we return, even if we were only gone for a few minutes.  They are easy to leash train so they can join us on our daily errands and family vacations.  They are mostly excited to wear whatever ridiculously cute costumes we put them in.

 Cats, on the other hand, are not involved in utter human worship.  It may be because they remember the time when ancient Egyptians worshiped them.  If you scold a cat, odds are that it will look at you with stony eyes and dismiss your ridiculousness.  Sometimes if you scold certain cats they will go and shred your pillow or pee on your jacket.  Very few cats will tolerate a leash, and tend to have to get tricked/stuffed into a carrier to go anywhere.  When they ride in the car with us it is often a very unpleasant experience for all involved.  Most cats look absolutely disgusted when we put them in costumes.

 Here’s the thing though…many, many cats actually make very affectionate, loving, dedicated, comforting, entertaining companions.  They just express it in much different ways than dogs do.  When a cat head bumps you, or wraps its tail around your legs, or grooms you, they are expressing deep affection and devotion to you.  When they sit across the room staring at you and slowly blinking, it is similar to a dog jumping on your lap and frantically licking your face. 

 It is just that we humans are horrible at reading the subtle nuances of cat body language.  It is pretty sad, if you think about it really.  This whole time, cats are practically shouting their love and affection, and we describe them as being cold and odd.

 There are some cats that will suddenly turn and bite their owners in the middle of being stroked.  The owners will get angry, and call the cat moody.  In reality, prior to the bite the cat dilated her pupils and flared her whiskers.  This is direct feline language for “STOP RIGHT NOW I AM BEING OVERSTIMULATED!”  We dumb humans just don’t pick up on this and continue petting the poor cat until she has no choice but to bite us.    

 In my line of work I see many students that are afraid of cats or that dislike cats.  One day I was summoned by a group of students to help them with a “really mean, fractious cat.”  She was just a tiny calico kitten that was scared to death.  She was trying to compensate by fluffing up in the corner of the cage and hissing.  I told her I wasn’t scared, and that I thought she was pretty cute, trying to act all tough.  I then started gently petting her head.  In a minute she was standing on my shoulder purring and head bumping me.  The students thought I was some crazy cat whisperer, but the reality was that I just knew how to read her body language.  She was terrified and just needed some reassurance.

 I have four cats that are awesome companions.  They great me when I arrive home, and they become anxious when they see me packing for a trip.  They tend to gravitate to whatever room I am in.  The other night, I was watching the news coverage about the horrific tragedy in Connecticut.  They all could sense that I was upset, and reacted by licking my hands, and purring by my face.

 I didn’t use to like cats at all.  I held the typical stereotypes about them.  To me, they were a pile of fur with sharp teeth and claws.  It all changed when I adopted (somewhat unwillingly) my first cat, Pete.  He was a former research cat that spent the first two weeks of life in my apartment cowering behind my toilet.  I thought he was strange, and weird, and was not sure why on earth I adopted him. 

 Then, one night I was feeling kind of down.  I was watching some depressing reality show on TV.  I felt a warm, fuzzy cat body brushing up against my back.  I looked down and saw Pete standing there.  I scratched him behind his ears, and he responded by settling on my lap purring like a motor.  That was all it took.  We were buddies.  He slept on my bed at night, greeted me when I arrived home, and never let me feel alone. 

 Now, thirteen years later I have also acquired Sally, Tommy and Roger.  They all have been wonderful companions, and they have taught me an immense amount about the ways of cats. If you asked any of my coworkers or students they would probably tell you that I don’t disguise my favoritism for cats very well.  In all honesty it is probably because somewhere along the way my brain was infected with Toxoplasmosis and it changed me into one of those crazy cat ladies. 

 At any rate, I wish more people gave cats a chance.  I wish more people took care of their cats like they take care of their dogs.  I wish there were more rescue groups that were feline specific, and drug companies that spent their time and energy on feline specific drugs.  After all, as Albert Schweitzer’s famous quote states “There are two means of refuge from the misery of life – music and cats.”

So, you want to be a veterinarian…

Part of my job as the Resident Veterinarian at Broadview is to chat with potential students.  Usually I talk to them about our program, the rigor, hands-on experience, etc.  Lately, there have been a few students that have wanted to chat with me because they can’t decide if they want to be a veterinarian or a veterinary technician.

 I have to admit, that I’m always perplexed when I get this question.  Usually, the people asking it are young, and bright eyed.  I can tell that most of them have this idea that becoming a veterinarian is easy, fun, and involves lots of time spend petting and cuddling kitties and puppies that are cute and fluffy.  I want to tell them that deciding between being a veterinarian or a technician is somewhat like wanting to be a nurse OR a doctor.  That is not to put down nurses or technicians…if you think I don’t hold my technicians in high regard, then read my last post.

 Here’s the thing though…it is HARD to become a veterinarian.  It depresses me and sometimes infuriates me that many people in the general public have no idea what we go through to earn our degree.  I swear that some of them think we got it online from some random school in Mexico, or that we went through a two year program at a trade school.  This must be why they think that or knowledge is equal to or less than the supposed knowledge of the kid working at PetCo or their breeder, or some whackadoo that posted stuff on the internet.

 Let me repeat…it is hard to become a veterinarian.  It takes AT LEAST 8 years of schooling…four of undergraduate work and four of veterinary school.  Your undergraduate work often must include classes such as Microbiology, Organic Chemistry, Biochemistry, Anatomy, etc.  Then, you have to apply to veterinary school.  To this day I sometimes think I bamboozled the admissions people at Colorado State, because I know of several highly intelligent, talented, awesome people that applied to vet school many times and were not accepted.

 If you do get into vet school, you can expect four years of long hours hitting the books.  You have to cram knowledge of the anatomy, physiology, disease processes, behavior, pharmacology, etc. of dogs, cats, horses, cattle, exotics, etc. into four years of schooling.

 Guess what?  Dogs are not humans wearing a fur coat, and cats are not small dogs.  Even when you compare dogs and cats, they have different diseases, react differently to medications, and even have differences in their anatomy.  For example…dogs can get HYPOthyroidism, which is a disease of low thyroid hormone production.  Cats can get HYPERthyroidism, which is a disease of too much thyroid production.  They are two separate diseases, treated completely differently.

 Once you graduate from veterinary school, these days you are considered fortunate if you can land a job that pays you enough salary to cover the massive student debt you have incurred.  Contrary to popular belief…veterinarians are not rich money grubbers.  For example, the standard salary a brand new veterinarian can expect is generally between 40,000-50,000 a year.  That sounds pretty decent, but consider that many vet students have hundreds of thousands of dollars in student loans to pay off.  AND they went to school for 8 years.  AND they are a doctor. 

 As a practicing veterinarian, you work long hours.  You deal with clients that think you are only after their money.  You deal with clients that think their breeder knows way more than you do.  You deal with clients that think it is awesome that their rotten, unsocialized, unneutered dog wants to eat your head. 

 Also, you deal with death.  You deal with death on almost a daily basis.  You play with the cute fuzzy animals as a way to keep your sanity on the days you have euthanized 8 animals and diagnosed others with untreatable disease.

 I realize I have just spent this entire post knocking the profession I am in.  I actually happen to love being a veterinarian.  I really do this to help animals and their people.  I love doing surgery, diagnosing disease, and being there for grieving clients.  I happen to be fortunate enough that my student loans are not killing me.

 I just wish more people understood what this profession is like.  If you are a fellow vet and you are reading this, you understand exactly what I am talking about.  If you are not a veterinarian, please be kind to your vet the next time you take your animals to see them.  Remember the hard work and long hours they put in.  When they give you a treatment plan, please remember that they are doing what is best for the health of your pet.  They are not lining their pockets…they are trying to make living enough to eat and save a little. 

 If you are someone that wants to be a veterinarian, read this post about 5 times.  Then read the other ones, especially “Communicating with the Crazies,” “The Unanswerable Question” and “The thing I hate about being a veterinarian.”  Then go volunteer at a veterinary clinic for a few months. Research the cost of veterinary school vs. the salary you will make, and make sure it is something that won’t bankrupt you. If, after all of that, you still want to be a vet….then go for it with everything you have. 

 This is a worthy, noble profession to go into.  Just make sure you fully understand what it will be like before you take that jump. 

A BIG SHOUT OUT to Veterinary Technicians

This week is National Veterinary Technician Week.  It is meant to be a week to give recognition and gratitude to the thousands of veterinary technicians that work in the industry.  I would like to take this opportunity to give a big shout out to veterinary technicians.

 Many people in the general public have this idea that a vet tech spends their day playing with cute and fuzzy kittens and puppies, or that they are nothing more than glorified kennel cleaners.  Nothing could be farther from the truth. 

 On a daily basis, veterinary technicians are expected to be able to draw blood, place IV catheters, run lab work, provide excellent nursing care, anesthetize an animal and monitor them under anesthesia, perform dental cleanings, take radiographs, manage wounds, give medications, fill prescriptions, assist in surgery and take an initial client history.  In addition, they are often called to be receptionists, schedule managers, bill collectors and grief counselors.  They are peed on, pooped on, bit, scratched, banged up and of course, covered with the lovely scent of anal glands.  They do all of these things while working long hours, often missing lunch, and for dismally low wages compared to what their human nursing counterparts receive.

 It is physically demanding to be a veterinary technician.  They lift and restrain heavy dogs.  They are on their feet most of the day. Many veterinary technicians have back and neck problems from all of the lifting, squatting and restraining.   They are the ones that do the back breaking work in veterinary medicine.  They often suffer from neck and back problems from the physical part of their job.

 If you know a vet tech, ask them to see their hands and arms.  Changes are very high that they are covered in bruises, scratches and bite marks.  I have been a veterinarian for 8 years, and I have one scar from a dog bite.  This is not because I am particularly talented, but because I have had awesome technicians. 

 On top of all of that, they also deal with rude clients and grumpy doctors.  It is not terribly uncommon that a client will be snide or rude to a technician, only to be full of praise and fawning when the veterinarian walks into the room.  I have witnessed stressed out doctors yell, snap at and sometimes actually throw surgical instruments/syringes/a Mayo stand at technicians.  I have to admit that unfortunately there have been more than a few times I have taken out my frustrations on the closest target, which is usually the poor tech.

 You may be asking yourself why on earth anyone would choose this profession.  I’ll tell you why…it is because they love animals.  That really is it.  They don’t do it for the money, or fame, or glory, or the fat retirement package waiting for them after a cushy desk job.  They do it for the animals.  Vet technicians often have a herd of animals at home, many of whom have been adopted from the clinic they work at, or rescued from a shelter.

 When there is a sick dog or cat in the hospital, it is usually the vet tech that is keeping them warm, dry and comfortable.  I have seen vet techs sitting patiently next to a sick anorexic dog, hand feeding them pieces of a rotisserie chicken that they bought at the store.  I have seen vet techs patiently bathing Parvo puppies that are covered in foul diarrhea.  They are the ones that will request more pain medication for the dog with the broken leg, and cuddle the chilly kitten. 

 Because veterinary technicians generally spend much more time with the patients than the veterinarian does, they will often be more affected by the death or euthanasia of the patient.  They care deeply about their patients.  They are offended when they see cases of neglect and abuse.  They often are involved in and passionate about animal rights. 

 If I do an amazing surgery to save the life of an animal, I get the gratitude and praise of the client.  What the client doesn’t often realize though, is that it was the technician who placed the difficult IV catheter, who saw their critical animal safely through a risky surgery, and who did the most important nursing care in the recovery days.  Often times it has been the vet tech who tells me to breathe and calm down in surgery when an artery starts gushing blood up to the ceiling.

 I always secretly laugh when clients insist that the DOCTOR trims their dog’s toenails, or when the DOCTOR cleans the cat’s teeth.  In all honestly, I suck at toe nail trims and technicians are much faster than I am at dental cleanings.  If a skilled technician is having a hard time drawing blood and turns to me, I am secretly afraid.  How on earth will I get it if they can’t?

 A good technician is a lifesaver for a veterinarian.  There are days at a vet clinic where the schedule is triple booked, an emergency is on its way, the phones are ringing off the hook, and it looks like a bomb went off in the treatment area.  On those days, I am comforted if I have good technicians surrounding me.  They have brought me lunch when I didn’t get one, boosted my confidence after a screw up, and consoled me when I felt like everything I touched was dying.  If you are a lucky veterinarian you have had a technician stroll into your office with a big coffee, soda or hunk of chocolate when you are having an awful day.

 So, here’s a shout out to all veterinary technicians…especially the ones that I have worked with over the years.  Thank you for the amazing, compassionate work that you do.  You will never receive the pay or recognition you deserve.  Please enjoy this week that is meant to honor your hard work, compassion and dedication.  You are the unsung heroes, and whether you know it or not you touch countless animal and human lives on a daily basis.


“But my BREEDER said…”

I think most veterinarians would agree that NOTHING raises their hackles more than when a client argues some medical point with them by saying “But my BREEDER said…”

For example:

A) “But my BREEDER said that Teacup Chihuahuas MUST get half a dose of vaccine or they will die!”

B) “But my BREEDER said that this breed must absolutely never get (insert name of an anesthetic agent or medication) because they are really sensitive to it.”

C) “But my BREEDER said that it is impossible for my dog to have Parvo because she vaccinated them!”

D) “But my BREEDER said that heartworm disease is not an issue and you vets just make it seem all scary to get money out of us.”

I could go on and on, and I’m sure my vet friends could fill a book about things that breeders have said.

Here’s the thing…most breeders are “experts” on breeding and selling dogs. They do NOT have a medical degree. They didn’t go to 8 years of college to get a diploma making them an expert in breeding. They pretty much know how to watch two animals do what nature intended. Many of them only have dollar signs in their minds, and not necessarily the health and well-being of the animals they breed and sell.

On the other hand, veterinarians have gone to school for at least 8 years. We are experts in immunology, infectious disease, parasitology, anesthesia, surgery, preventative medicine, etc. Every year we are required by law to attend continuing education courses to stay up to date on the latest knowledge and medication. Everything we do is dictated by what is best for the animal.

Now, I will admit that there are some good breeders out there. They are a rare breed indeed, hahaha. A good breeder is NOT in it for the money. They are in it for the health and betterment of their breed. They listen to their veterinarian.

A typical Golden Retriever Breeder will take an in heat female that is “papered” and an intact male that is “papered,” put them together, watch them breed, and sell the puppies for an exorbitant amount of money. A good Golden Retriever Breeder will only breed dogs that have been checked to make sure they have good quality hips, elbows and eyes. They will ensure that the sires and dams they use are up to date on vaccines and parasite preventative. They will have a working relationship with the veterinarian, so that they can do the tests necessary to know how many puppies to expect. Once the puppies arrive, at the appropriate time they will take them to receive veterinary care and vaccinations. They will only sell the puppies to good, quality homes.

It costs a great deal of money to be a good breeder. I wish there were more of them.

The other thing that kills me is when I will make a diagnosis and recommendations and the owner will call the breeder to see what they think. GRRRR. Sometimes the owner will even hand me the phone and suggest that I consult with the breeder because they have “over 10 years of experience with this breed.”  When clients do this I want to wave my diploma in their face and ask them what they think it means. What about my experience with ALL breeds? Did their breeder even graduate from high school? I don’t think many clients realize how insulting it is when they do that.

Imagine if I went to my human doctor. I have a cough. He examines me and tells me it is a virus. I should rest, and drink plenty of liquids. After he says this I immediately call my grandmother, who has over 50 years of experience raising kids! She tells me that I absolutely need an antibiotic. I give the phone to the doctor, and tell him he “needs to consult with my grandma.” Can you imagine the reaction? This is NO different than what clients do when they consult the breeder.

Think about some of the statements I opened this blog with…

“My breeder said that Teacup Chihuahuas must get only half a dose of vaccine or else they will die!”

Really? When I get my flu shot I get the same exact dose that Lebron James would and he’s way bigger than I am. Vaccines are dosed specifically by the manufacturer in order to train the animal’s immune system to respond to a certain disease. Size does not matter. It would be detrimental to only give a dog 1/2 dose of a vaccine. Honestly, do you think I want to kill your dog? Trust me when I say it needs the full dose of vaccine, every time.

“But my BREEDER said that this breed must absolutely never get (insert name of an anesthetic agent or medication) because they are really sensitive to it.”

There are some examples of breeds that are sensitive to certain medications. For example, we have to be careful with giving Ivermectin to Collie type breeds. Some anesthetics are dosed a bit differently in sighthounds. Here’s the thing though…veterinarians know these things. We know because of research that has been done. We know due to physiological reasons. For instance, the reason that some Collie type breeds are more sensitive to Ivermectin is because of a genetic mutation that affects the blood-brain barrier. There is even a test we can do to see if a particular Collie has that gene!

When breeders make a blanket statement like “Boxers cannot have Propofol because they are sensitive to it” they are not basing it on cold, hard science. More often than not they are relying on anecdotal evidence that has been blown up in breeding circles and message boards.

Here’s how it works. One time when I was young I ate a box of those little Valentine Candy hearts that have messages on them. That same day I vomited my brains out. I was throwing up because of a stomach virus, but at the time I associated the puking with the candy hearts. Now, imagine if I said “AHA! People that are less than five feet tall are SENSITIVE to those demonic candy hearts! Don’t ever let them eat them!” Imagine that people took me JUST based on my word, and spread that statement around.

That is what many breeders do. Somewhere, at some time a Boxer that received Acepromazine had a bad reaction. It may have even died. It is sad, and tragic, but that breeder will then determine that all Boxers everywhere are sensitive to Acepromazine and should NEVER receive it! This message gets distributed to breeders everywhere, and suddenly it is the gospel truth. Sigh.

“But my BREEDER said that it is impossible for my dog to have Parvo because she vaccinated them!”

Vaccinology is a science. Vaccinating a puppy or kitten amounts to WAY more than just giving it a shot. There must be an understanding regarding maternal immunity, host response, vaccine storage, appropriate vaccine intervals and risk assessment. Many breeders wouldn’t understand a word of that previous statement. They think that just because they poke an animal with shots that it is protected. Often, the more the better! I have seen so many 6 week old puppies that are declared “fully vaccinated” because they were given a Distemper-Parvo combination every week from the time they were 2 weeks of age. If the breeder that did that knew anything about veterinary medicine, they would realize that they may as well have been sprinkling sacred water from the Crystal Springs on the puppy.

Oh, and the thing about how vaccines are not needed and just poisons dogs and cats? Tell that to the puppy that is dying in isolation from Parvovirus, or the kitten that is dying of Panleukopenia. Vaccines, given in an appropriate time in an appropriate fashion are VERY important for the health and safety of puppies and kittens.

“But my BREEDER said that heartworm disease is not an issue and you vets just make it seem all scary to get money out of us.”

I’ve said this before, but I’ll say it again. Veterinarians are NOT in this business to make money. If we wanted to be rich, we would have gone into human medicine, or investment banking, or dentistry. If I tell a client that Utah has mosquitoes and Utah has heartworm disease, and their dog needs to be on heartworm preventative, it is because I don’t freaking want their dog to get heartworm disease! I am not thinking of padding my pocket. I want their dog to be healthy! I would LOVE it if I never had to treat a heartworm positive dog again. For those of you reading this that don’t know… treating a dog for heartworm disease usually involves injecting a substance similar to arsenic into the muscles in the back. It is very painful. The dog then usually has to be strictly crated for a month after the injection. Not fun at all.

Preventing heartworm disease involves giving your dog a tasty, beef flavored treat once a month.

It is more expensive to treat a dog for heartworm disease than to prevent it. If I was really in this for the money I would not recommend preventative and get all excited that I have positive dogs to treat. Seriously????

If you have any doubt that most breeders are in it for the money and not the well-being of the animal, look at Bulldogs. They are cute, and have great personalities, but they can’t really breathe, they can’t usually breed or give birth on their own, they tend to have horrible skin issues, and they like to spontaneously die. It is ALL in their breeding. If Bulldog breeders all banded together and tinkered with the breed standards, they could produce healthier Bulldogs. But no…they see dollar signs and it is left to the veterinarians to work on these poor animals.

Veterinarians HATE it when a movie comes out that features a particular breed. Take the live version of 101 Dalmatians. The movie came out, people fell in LOVE with Dalmatians, and breeders saw dollar signs. They started rapidly breeding Dalmatians without a thought to confirmation, family tree health, temperament testing, etc. What happened? The shelters were rapidly filled with Dalmatians. It turns out they can be rather snappy, and can have significant bladder stone issues. The same thing has happened with German Shepherds, Chihuahuas, Boston Terriers, etc.

When the Obamas decided to buy a Portuguese Water Dog, I groaned. It was only a matter of time before breeders started spitting out this breed, again with little regard to health. I really wish they would have adopted a mutt.

So just remember…veterinarians care about the health and well-being of animals. Most breeders care about making money. If your vet tells you one thing and your breeder tells you another…please for the love of Heaven listen to your vet! I promise that we didn’t get our degrees online. I promise that we care deeply about the health of your pet. I also promise that if you want to see your veterinarian spew smoke out of their ears, grit their teeth and growl just say something prefaced with “BUT MY BREEDER SAID…”

The “Practice” of Medicine

Want to be rich and famous? Don’t become a veterinarian. Want to have a career where you can wear designer clothes that stay pressed and clean all day? Don’t become a veterinarian. Want to eat a big fat slice of humble pie on a regular basis? THIS IS THE CAREER FOR YOU!!

Seriously…the veterinary profession tends to keep you humble. You’ll make a tricky diagnosis and start strutting around like you are the next Dr. House one day, and then miss a case of ear mites the next. You’ll be a kick ass surgeon and rework a cat’s intestinal tract on Monday, and then on Wednesday you’ll puncture a bladder while performing a routine spay. One week you will be the golden child, the one that clients absolutely love and adore, and the next week you’ll be getting nastygrams, or letters from the Better Business Bureau.

Make no mistake…this career will humble you. When I graduated from vet school, I was on top of the world. I was going to be the best veterinarian ever…clients would adore me, animals would calm in my magnificent presence. They would write books one day about my awesomeness.

(In reality, I was fairly terrified my first year out and oftentimes had no idea what I was doing. Of course, I couldn’t let clients or my technicians see that, so I learned to fake it pretty well. I was sort of like the little weeny Chihuahua that barks really loud at a passing Rottweiler…I sounded tough but often felt like running away with my tail between my legs)

A few months out of school, a 5 month old pit bull presented to the clinic with a two day history of vomiting and not wanting to eat. It did not have diarrhea. Those of you that are experienced vets probably know already what the diagnosis is. I had no clue.

I did take a history and performed a physical exam. The owner assured me that the dog was “totally vaccinated.” The dog was dehydrated, lethargic and actually vomited during the exam. I was certain it was a foreign body or some kind of toxicity. I recommended taking x-rays of the abdomen.

As I was confidently walking the dog back to the x-ray room, one of my technicians asked me why I wasn’t testing the dog for Parvovirus. I glared at her a bit, puffed myself up and told her that it couldn’t possibly be parvo, because the dog didn’t have diarrhea! DUH. Also, the owner said it was fully vaccinated. DOUBLE DUH. The technician stated that a lot of times Parvo dogs came in initially vomiting. I rolled my eyes and told her to get the x-rays.

As they were x-raying the dog, it puked a few more times. As they were developing the x-rays it sprayed bloody diarrhea over every surface of the x-ray room. I would later find some on the ceiling.

Well, as it turns out the x-rays were normal other than showing very angry looking small intestines. I muttered under my breath that there was NO WAY it was Parvo, but reluctantly allowed the technician to run a Parvo test. Low and behold, it most definitely was Parvo. I had just paraded a dog with a VERY contagious disease all around the hospital. The dog had sprayed Parvo infested diarrhea all over the imaging room.

I learned from that episode to A) Never trust an owner when they say their dog is “vaccinated.” B) Parvo dogs can present initially with just vomiting. C) Listen to your technicians.

Another time my head got pretty swollen because a client actually requested me to change her dog’s splint. It was a little Chihuahua with a broken radius that my boss had been treating by splinting. The splints he put on kept falling off, which annoyed the client. I happened to put on a splint that stayed, and she was singing my praises in the lobby.

I took the dog to the back, hemmed and hawed to my staff about my vastly superior bandaging technique, and even managed to put two little red hearts made out of vet wrap on the splint. The client loved it! I was awesome! I walked on water! As she was bowing down to my immense greatness the Chihuahua shook its leg a little bit and the splint came flying off. Oops. The client didn’t really care so much about the vet wrap hearts at that point.

I have tried to spay a neutered male cat. I’ve accidentally cut into a bladder during a spay. I’ve raved to clients about how AWESOME they are doing with weight loss on their fat cat only to find out that the cat is a diabetic. I once did a physical exam on a newly adopted Boxer, and told the owners it was in great health and there were no abnormalities. They called the next day, pretty upset because overnight their “normal” dog gave birth to 12 puppies.

On a more somber note, I’ve made mistakes that have resulted in the death of my patients. A little Labrador puppy was bitten pretty badly by a neighbor dog. I saw some deep puncture wounds, but not much else. I cleaned her wounds and put her on antibiotics. I missed the hole that had been torn in her intestines, and she died a few days later of a raging abdominal infection. I misdiagnosed a cat with asthma, when it had heart failure. That night when the owner attempted to give him medication for the asthma, the cat died of heart failure, most likely secondary to the stress of medication. I missed that a dog I put on Rimadyl was also on steroids, and ended up causing the dog to suffer a perforated stomach ulcer.

I even had a cat die after I neutered it. I still to this day am not sure what happened, but I know that he was very little, and I was “fairly” sure I was cutting a testicle. Whatever it was that I cut wouldn’t stop bleeding and he died a few days later. A cat neuter is considered to be one of the simplest surgeries we do as veterinarians.

Now, I know you are all thinking that after knowing all this there is no way in heck you would use me as a veterinarian. Here’s the thing though….we all have messed up. We have all missed diagnoses, screwed up a surgery, given a wrong medication. My grandma always says that is why they call it the “Practice” of medicine.

As horrible as some of the mistakes I’ve made have been, I have learned from every single one. Today, I would not miss that Parvo diagnosis. I treat dog bite wounds very seriously and always look for deeper injuries. I am careful to try and differentiate a cat with asthma and a cat with heart disease. Every time I neuter a cat I think of my neuter that went horribly wrong, and I remind myself to not treat it lightly even though it is such a straight forward surgery.

I also don’t let myself get too cocky or confident. I’ll smile when I make a tricky diagnosis or do a tough surgery, but I don’t strut. I know that probably within a day or so I’m going to do something that will knock me back down to earth. When I hear of mistakes other veterinarians have made, instead of feeling superior, I nod with sympathy and think back on the mess ups I have had.

Phyllis Theroux, in Night Lights states that “Mistakes are the usual bridge between inexperience and wisdom.” If you are a new veterinarian or technician, give up on the idea that you are going to be perfect. You will make mistakes. You will harm a patient because of those mistakes. Learn from your mistakes. Don’t blame others, or incessantly beat up on yourself. Take a deep breath, file it away in your memory, and keep carrying on.

When it’s time….making the decision to euthanize

Companion animals are such a blessing in our lives.  They provide us with unconditional love.  We laugh at their antics, and enjoy their company.  Many of us post pictures of them on Facebook, celebrate their birthdays, and buy them presents on the holidays.  They give us friendship when we are lonely, and comfort us in our darkest hours.  In turn we adore them, feed them, clean their messes and allow them into our hearts.

It would be a wonderful world  if dogs and cats died peacefully in their sleep.  Unfortunately, very few of them do.  Instead, we are left to make the difficult, heartbreaking decision to euthanize them.  We give them the gift of a painless, peaceful death, but we still have to decide the time.

This is often an agonizing choice for owners to make.  Many of them are worried about making the decision too soon.  They will make up their minds and steel their resolve only to wake up the next day and find that their pet is having a “good” day.  They desperately wish that their pet would pass peacefully in their sleep.  They contemplate what life will be without their friend.  For some, they look ahead to coming home to an empty house, with no wagging or tails or happy meows.

Owners often ask their veterinarian when and if they should put their pet to sleep.  Most of us won’t answer this question.  We know the power that our knowledge and experience wields, and we don’t ever want to have owners feel pressured into making such a crucial choice.  We don’t want them to look back on it and feel that the vet made them do it.  I know what a heavy burden this choice is, and although I will not make the decision for them, I often will counsel owners to help them know when the time has arrived.  Here is what I usually tell them:

Trust yourself.  You will know when it is time.

The main reason I will not make the choice for owners, is because I will never know their pet like they do.  They have spent years with their dog/cat, and know their personality.  They know when they are happy, upset, angry, jealous, afraid and sad.  I also honestly believe that dogs and cats will “tell” their owners when it is time.  It is a look they have in their eyes, or a certain energy that they give off.  Through the years I have had many people tell me that they woke up one day and their pet looked at them and told them that it was time.  I tell owners to trust themselves because their instincts are almost always right.

Make a list of what defines a good quality of life for your companion animal

Decide what makes your dog or cat who they are.  What is it that they enjoy most in life?  Contemplate this, and write it all down.  Do they absolutely LOVE to eat?  Write that down.  Chase a ball?  Put that on the list.  Sleep in the sun…go to the lake…jump on your bed at night…put them all on the list.  For example, if I was making this list for my cat, Tommy, I would write the following:

 Eat.  Have his chin scratched.  Sleep in the sun.  Torment the other cats.  Chase fuzzy mice. Ruin toilet paper rolls.  Demand his food LOUDLY at 530 every morning.

Once you have your list, use it to keep track of your animal’s quality of life.  When you see things on the list disappearing, cross them off.  This can help you in the decision making process.  If you need guidance with this, ask your veterinarian.  We will always help you evaluate your animal’s quality of life.

There will be good days, there will be bad days

Aging animals, and animals suffering from terminal illness will have waxing and waning health.  There will be days where they act like the puppy or kitten they once were, and days that it is obvious they are in pain.  It is very common that when you have decided to euthanize that your animal will have a “good” day.  When this happens, ask yourself if one good day outnumbers the bad days.  Consult  your quality of life list.  If your pet has one good day after a week of bad days, ask yourself how you really feel your pet is doing.  Remember that dogs and cats live utterly in the moment.  Unlike us, they don’t contemplate having another day, week or month of life.  They know what is happening right now.  If they are in pain, and their now moments are bad, the kindest gift you can give them is to relieve their suffering.

Remember that animals don’t always show us when they are in pain

A few months ago I saw an 18 year old cat.  She had not been eating or really drinking, or moving for about a week.  I diagnosed her with end stage kidney failure, and discussed the options with the owner.  At that point it was to hospitilize her, knowing the prognosis was grave, or to put her to sleep.  The owner was shocked I brought up the option of euthanasia.  “But she’s not in pain,” she said “She is not crying or meowing.”

Animals usually don’t cry, whimper or vocalize, even if they are in immense pain.  It is in their nature to hide signs of illness and discomfort to the very end.  It is a protective mechanism…in the wild it is the animals that are obviously suffering that are easily spotted by predators.  Animals that are in pain will do other things, like stop eating, become lethargic, vomit, drool, stop drinking, and stop doing other things on their quality of life list.

Remember that we veterinarians are solemn and serious about euthanizing animals.  We never treat this lightly.  If your veterinarian tells you that your animal is in a great deal of pain, trust them.  This is as close as we often will come to telling you directly that the time has come to euthanize.  We would never exaggerate or be dishonest about this.

Involve the entire family in the decision making process

Some of the most stressful euthanasias I have participated in where those where there were family members that disagreed with the timing or were left out of the loop entirely.  Come together as a family, and discuss your pet’s quality of life.  Unless your children are very young, I would recommend involving them as well.  If you have a family member in complete denial, schedule an appointment with your vet to discuss quality of life.  I do not recommend simply euthanizing the animal behind their back.  Everyone needs their chance to say goodbye and you don’t want anger and resentment to be present during the grieving process.

It is rare that you will make the decision too soon

In my eight years of being a veterinarian, I have had one owner tell me she felt she euthanized her cat too soon.  She really didn’t…the cat was comatose and non responsive.  Her feelings came from the immense grief she went through after losing her companion.  Other than that, I have never had an owner tell me that they made the decision too early.  On the other hand, I have had several owners tell me they waited too long to euthanize.  Once their animal dies a painless, peaceful death and their suffering is ended, the owner will look back on it and feel that they let it go on too long.

Even in these cases, I try to ease the owner’s guilt.  This is a really, really hard decision.  You are making a conscious choice to end the life of a companion you love.  It shouldn’t come too easily.

I hope some of those suggestions help.  There are numerous other resources that your veterinarian can provide to help you through this process.  Don’t be afraid to ask for guidance.  We will answer any questions you have about the euthanasia process.  Bear in mind that by choosing to euthanize your pet, you are granting them one last loving gift of a dignified, peaceful death.  It is heartbreaking and gut wrenching, and one last way to thank them for their years of companionship.




Communicating with the crazies

Good communication skills are essential for a veterinarian. If you cannot communicate with owners about their animals, it doesn’t matter if you are a kick-ass surgeon or an internal medicine whiz…they won’t like you. In fact, they may even label you as a “bad” veterinarian. The reverse is also true…you may be the world’s worst surgeon, and may treat every ailment with a shot of Depo, but if you are a good talker, many clients will label you as a “good” or even “awesome” veterinarian.

I cringe and generally want to punch something when I hear people say “Oh, I always wanted to be a vet because you don’t have to work with people!” Sometimes I think that I actually deal more with people than certain human doctors do. I mean, if a client calls wanting to talk to me, if I am not busy I will get on the phone and chat with them. I don’t know many human doctors that would do that.

As a vet, I have to be able to extract an accurate history from an owner, explain to them my exam findings, get them on board with necessary diagnostics and explain the treatment plan. This can be extremely challenging at times. The following incident happened to me about six months after vet school, and taught me a very valuable lesson in communicating with a client.

It was a fairly typical day at the clinic. I was seeing appointments and the other vet, Dr. M, who was older and wiser than me, was doing surgeries. All of a sudden an older woman, who I’ll call Mrs. Roberts, came running in with her 14 year old shih tzu, Max. He was collapsed, gasping for breath and quickly turning blue. A quick physical exam revealed a raging heart murmur and fluid in his chest. I ran Max back to the treatment room and started him on oxygen. My technician placed an IV catheter, and we took x-rays of his chest. They showed he was suffering from severe heart failure.

At that point I brought Mrs. Roberts back to the treatment area. I explained what was happening. I showed her the x-rays and pointed out Max’s enlarged heart and the fluid in his chest. I went over the options, which were to admit Max for critical care, or to consider euthanasia. I have to admit I was very proud of myself for so quickly and competently making a diagnosis, and explaining it to her in such an awesomely clear, compassionate manner.

“What is THAT?” Mrs. Roberts asked. She pointed to the oxygen mask the technician was holding on Max’s face.

“It is an oxygen mask.” I said. “He is having a hard time breathing, so we are trying to give him as much oxygen as possible.”


I was fairly stunned. “Mrs. Roberts,” I said. “We are not poisoning Max…we are giving him oxygen.”


“Mrs. Roberts, Max will die if we take away oxygen.” I said. I was shaking at this point. “If you do not wish to continue treatment, then we need to consider the option of euthanasia so that Max doesn’t suffer.”

“I am going to take him home!” Mrs. Roberts said.

I shook my head. “If you take him home without treatment he is going to die a painful, stressful death.”

Mrs. Roberts shook her finger at me. “HE NEEDS TO DIE A PAINFUL DEATH TO GET TO HEAVEN!”

I was lost at this point, and getting angry. “What are you talking about?” I asked.


At this point in the conversation I was very angry. I should have recognized that the client had jumped on board the crazy train. I should have taken deep breaths, given myself a second, and tried a different approach. Instead, I jumped on the crazy train with her.

“Do you know Saint Francis of Assisi?” I asked. I was referring to the patron saint of animals.

“YES.” Mrs. Roberts said.’

“Well, he would say it was BAD for an animal to suffer. He believed strongly in euthanasia.” I said. Of course, I had no idea if that was true, but it sounded good.

“How do you know he said that?” she asked, glaring at me.




At this point, the technician very wisely left and got Dr. M. I have a feeling she told him that his new, bright young veterinarian was arguing with a crazy woman about who really talked to a dead saint.

Dr. M walked into the room. He was the calm in the midst of Hurricane Insanity. He quietly told Mrs. Roberts that he understood that she was upset. He said he was sorry that Max was ill. He said that we either needed to treat him, or end his pain.

Mrs. Roberts at this point started to cry. She hugged Max and tearfully agreed to euthanize him. Dr. M. quietly walked her through the procedure, and ended Max’s suffering. There was no more mention of St. Francis.

I had definitely failed to communicate with her. I made an accurate diagnosis, and made very appropriate recommendations, but in the end my lack of compassion and sympathy unhinged the whole conversation. I allowed myself to get angry and irrational, instead of asking myself how this poor woman was feeling in the situation. Her dog went from being happy to dying in the course of a day, and here this young cocky vet was demanding that she make a decision NOW. I was more intent on being “right” and getting her to listen then I was on truly helping her make a good decision about Max.

Yes, Mrs. Roberts was crazy and yes she was being a wee bit irrational, but I reacted in a manner that made it much worse. I learned that day how important it is to stay calm no matter how the client is reacting, and to NOT join them in their craziness. I also learned to try to keep compassion and understanding at the forefront of all of my client interactions.

This is certainly not easy. There are certain clients that can be downright hostile, mean, abusive, non-compliant, rude and sometimes psychotic. I have had clients tell me that they don’t “trust lady doctors” or that I “don’t look like I know what I’m doing.” I have acquired a pretty darn good poker face, where I can smile and nod and NOT say the things I really, really wish I could say.

Now, as a side note to the Mrs. Roberts story…as she was checking out she informed me that she became Catholic because God saved her from being stung by 1000 fire ants that came after her, from being assaulted by a gang of Hell’s Angels that went after her, and from being injured even after she fell down a flight of 100 stairs and hit her head on EVERY single one. I nodded and said she was quite the survivor. What I REALLY wanted to tell her was that she needed to talk to St. Francis more.


The Unanswerable Question

Clients have asked me a lot of questions through the years. I generally lump the questions into the following three categories:


These are my favorite types of questions, because they often allow me to discuss important things like behavior or nutrition with clients. Examples would be “What is the best food for my cockerdoodlesnicker puppy?” or “I am a small, frail elderly woman and my grandchildren want to buy me a Lab puppy. What do you think?”

(For what it’s worth, Lab puppies in general are NOT good gifts to give your frail, elderly grandma or grandpa. Same with Border Collies, Australian Shepherds, or Saint Bernards)


The “tinfoil hat questions” are the questions that make me want to put on a tinfoil hat to ward off the crazy beams radiating out from the client in front of me. If you are confused about the reference, watch “Signs” starring Mel Gibson.

A few years ago I was wrapping up an exam I did on an adorable Siamese kitten. When I asked her owner if she had any further questions for me, the owner cocked her head, furrowed her brow, and said “Well, yeah. She like, totally wants to nurse on me like a baby would.   I let her, even though I don’t make milk. Is that weird?”

Ummmm…..yeah. I bit my lip really hard, and mumbled something about orphaned kittens and the suckling reflex. I managed to talk to her about it with a straight face, but what I really wanted to do is open up my skull and pour some bleach on my brain in order to clean up the image I suddenly had in my head.

I would also include in this category the men who have asked if I could do their prostate exam, the women who ask if I believe in alien mutilations, questions about government conspiracies and microchips, and pretty much any question that begins with the phrase “My breeder said…”



This question is the one I am most commonly asked, and the one that I still don’t have an answer to. It is usually asked by grieving clients who have just euthanized their beloved dog or cat.

“How do you do this?”

By ‘this’ they mean euthanasia. They are asking how I deal with euthanasia….with the loss of an animal, and with the grieving, heartbroken families.

Here’s the thing…euthanasia is part of my job. I personally consider it to be the most important part of my job. I am there to give an animal the gift of a peaceful, painless death, and to help the owners start the grieving process. I want the last memory an owner has to be of their animal passing away quietly in their arms.

We are fortunate as veterinarians that we have euthanasia as an option. I cannot imagine being a human doctor, and having to watch as a patient dies a painful, slow, excruciating death. I have felt the most sorrow and anger in dealing with owners that absolutely refuse to euthanize their pet, and instead watch it slowly and painfully fade away to skin and bones.

That being said, euthanasia can be very hard on veterinarians. We all have had those days, weeks or even months where it feels like all we do is kill our patients. We usually react to times like this by it by making jokes about how our name should be “Dr. Death” or “Dr. Terminal.” We stuff ourselves with chocolate and/or wine. We go home and watch trash TV. We jump at the chance to see a kitten/puppy appointment. We exercise. We read. We somehow push through it and carry on.

Except….sometimes we don’t. Sometimes all of that death and grief can be overwhelming. As a profession, we have one of the highest suicide/addiction rates. Get a group of veterinarians together and ask who among them knows a colleague who has been treated for addiction or committed suicide. Most of them will raise their hands.

Over the past year I have given a few lectures to vet tech students and shelter workers on compassion fatigue. Compassion fatigue is just what it sounds like…it gets so emotionally/physically/spiritually exhausting to care for grieving clients that we get to the point where we cannot care for anything anymore…including ourselves. We withdraw, isolate, self-medicate, become angry, bitter, and zombie-like.

So far, every single time I have lectured on the causes and symptoms of compassion fatigue I have seen most people in the audience nodding their heads or wiping away tears. It is a real problem in this profession.

A few years ago, I went through a nasty bought of compassion fatigue myself. I dreaded going to work. I had once loved my job, but found myself dragging myself to the clinic. I was easily annoyed at my clients and co-workers. I wasn’t sleeping, and kept obsessing about patients that were dead. I was told by some that I was perhaps not meant for this profession…that I needed to toughen up or get out of it.

Fortunately, through the love of my family and friends, and the invaluable help of certain colleagues and other professionals I pulled through that dark period and returned to loving my job. I found healthier ways to cope with the tougher aspects of being a vet. I learned valuable lessons, and now I try to help others when I can.

So, for any vets/technicians/others that are reading this, here is my advice, for what it is worth:

For starters, as simple and new-agey as it sounds, make sure you are taking care of yourself. This means all of those things like eating well, exercising and sleeping. I know that many days we are lucky if we have time to cram down a Del Taco burrito and slurp a Diet Coke, but I personally have found that when I force myself to take care of me, I am in a much better space to handle the tougher parts of my job.

Second, make sure you have a life away from veterinary medicine. As best as you can, when you leave the clinic leave your work behind. I used to go home and read vet journals and watch Animal Planet. Now, I read trash magazines and watch shows like Toddlers and Tiaras (Seriously).

Cultivate hobbies. Play an instrument. Hike. Fish. Read.  Take a vacation, even if you don’t think you should.  These are ways to recharge yourself and keep your brain and spirit strong.

Third, you know those cards and letters that grateful clients send you? Keep them. When you feel like you are doing nothing but killing animals, go back through and read those cards. Remember and recognize the people that you have touched and the good that you have done, even in the face of euthanasia.

Fourth, remember that it takes a strong person to recognize when they can’t heal themselves. There is no shame in seeking out the help of a therapist or family doctor. Many times just having a sympathetic, compassionate ear can be a life saver.

Last, remember that MANY of your colleagues have gone through this. You are not alone, and you are not some weird weakling. There are many resources out there for you…use them, and then pass what you learn onto others. There is always hope, and you can find your way back to loving and enjoying this profession.

So…to answer the unanswerable question. How do I do this? To be honest, I still don’t know. It is something I know I will work on and struggle with every day. I’ll be kind to myself, play with puppies and kittens whenever I have a chance, and ensure that my tin foil hat is nice and shiny.