Monthly Archives: August 2012

“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…”

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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.