A month or so ago I offered up a post on the wide variety of veterinarians newly building their second homes on the Internet. In that post I sought to build up the veterinary blogosphere, but I should have been more inclusive. Veterinarians like dr. Phil Zeltzman are maintaining sophisticated sites that responsibly and clearly address major issues…but they’re not exactly “blogs.”
Dr. Zeltzman does have a pseudo-blog thing going, though. He writes a weekly newsletter you can sign up for (which I heartily recommend to all Dolittler fans). Apart from the labor of love that is his website and his newsletter he practices as a full-time veterinary surgeon and writes a very helpful surgical column (geared to veterinarians) in the same publication in which my monthly rant of a column appears: Veterinary Practice News.
Because I LOVE Dr. Zeltzman’s column and strongly believe veterinarian-authored sites like his deserve more play than they get, today’s post is all about my personal favorite Dr. Phil. To that end, I interviewed him. Enjoy!
K: Let’s start with why you became a veterinarian. Forgive me for asking the obvious but always seems like a different answer for every one of us so I’m curious…
Z: Well, according to my parents, the idea stuck in my head when I was 5. I loved watching Flipper, Daktari and Lassie on TV. I loved animals. So it all made sense in my mind.
Of course I had no idea how difficult it would be. And I had no clue that I’d be studying for the rest of eternity…K: Why’d you choose a specialty like surgery?
Z: I’m not really sure… I like the concept of fixing things. I love the opportunity to make a difference in people’s lives. I cherish the idea of saving lives.
A dog comes in bleeding internally from the spleen, we take it out. A cat comes in with a shattered bone, we fix it. A dog is attached to a tumor the size of a pumpkin, we remove it.
Nothing is more gratifying than removing a slipped disc that is putting pressure on the spinal cord of a paralyzed dog.
Granted, it may take weeks to months to heal, but for the most part, if patient and owner cooperate, we should be done from a surgery standpoint.
The other thing I love about surgery is that it is incredibly varied. It requires some knowledge in multiple disciplines besides surgery. Obviously, we need to know about anesthesia and pain management, but also about anatomy, endocrinology (hormones), nutrition, internal medicine, neurology, radiology, cancer, physical therapy, emergency medicine, critical care etc.
And one more thing I am very fortunate about is that a vet surgeon is not restricted to one organ or one body part, as opposed to a human surgeon. So in one (busy) day, I could be fixing a broken bone, removing a foreign body in a Lab puppy’s intestine, removing a tumor from a cat’s chest, removing a slipped disc from a paralyzed dog, and doing a skin graft.
And yesterday, I fixed a fracture on a macaw from the local zoo!
It doesn’t get any better than that! K: Do you teach or are you exclusively working in private practice? Which do you prefer and why?
Z: Most of my time is spent in private practice, at Valley Central Veterinary Referral Center, a specialty group in Whitehall, PA, in the far suburbs of Philadelphia.
I “teach” when we have vet students or visiting vets coming to the clinic. And I guess I teach through writing… Whether in my weekly email-based newsletter, my monthly surgery column in Veterinary Practice News or various conferences, I love to share what I have learned over the years.
My mentors shared with me what they have learned, so it’s only fair that I “pay forward.” K: I’m always interested in veterinarians who make the leap from working or being educated overseas (Belgium in your case). Nick Trout and a few other surgeons I’ve met come to mind. Your perspective on animal health is always a bit more welfare centric, big-picture oriented and lateral in thinking. Do you think that’s true? If so, how do you think it happens? Is it nature or nurture? Or is it just that it takes more interesting individuals to endure the US immigrant experience?
Z: I’m not sure I can answer these questions… I think it depends on each individual. As far as who’s more interesting, I’ll leave it up to you!
Some vets are more welfare-centric than others, both in Europe and in the US.
I came to the US to become a surgeon. It was supposed to be for 4 years. It’s been 13…
It’s been an amazing experience. By the way, I studied in Belgium but I’m French. Initially there was a tiny cultural shock, as I moved from downtown Paris to downtown Athens, Georgia.
Since then, I’ve worked in California, Illinois, Ohio, and now Pennsylvania.
K: Why’d you start writing?
Z: One reason is simply that it enables me to share information. In my newsletter, I try to explain how to avoid getting in trouble. My idea is, if one client didn’t know that you can kill a dog by giving aspirin along with an anti-inflammatory drug, then hundreds of readers don’t know either.
Thanks to the magic of the Internet, I can share this information with people who read my newsletter all over the country, and even abroad. So statistically, one dog out there might benefit from this tiny piece of information.
My favorite story is from a lady in Ohio who spontaneously wrote to me after reading my newsletter about the benefits of spaying and how it can prevent breast cancer in pets. She was concerned that her co-worker’s Rottweiler wasn’t spayed and she told her about what she had read.
That evening, the colleague checked her dog out and found a lump around one of the nipples. The next day, the dog was scheduled for surgery with her local vet.
That’s the power of the Internet. Very indirectly and very modestly, I helped a dog I have never met, and made a difference in a family I don’t know.
That’s why I write.
K: I love your newsletter and your columns in Veterinary Practice News because I think you have a unique voice in veterinary medicine—partly because unlike me, you never offend. So diplomatic and yet so outspoken. How do you manage it?
Z: Are you really going to publish that???
You are way too kind, thanks! I love you column and your blog, too!
I guess I spend an unreasonable amount of time proof reading and correcting and changing until I am somewhat convinced that nobody will read my column and feel bad about something they did or didn’t do. I write to inform, not to blame anyone.
Oh yeah, and I also try not to use expressions like WTF :- )
K: WTF! OK, so what subjects do you most like to write about and why?
Z: The beauty of surgery is that topics are endless. Every organ can be involved. And pets constantly find new ways to get in trouble, so I like to inform other pet owners that they should be aware of such and such “new” danger.
So over a year, I could write about 52 different topics and never repeat myself.
Like you, I also interview other vets and professionals to share different perspectives. For example, early 2009, I will publish an interview of the world guru of an emerging and devastating disease in Labradors.
And in my free time (!), I am working on several book projects.
K: Are you a big reader? What writers do you admire and why?
Z: I love reading, and unfortunately don’t have enough time to read books except on vacation. I read a lot of medical and surgical stuff. Daily.
Although I initially thought it was sacrilege, I now listen to audio-books in the car. This enables me to brush up on other topics. For example, I recently listened to the excellent “Freakonomics.” I also listened to “BLINK”, which unexpectedly led to a surgery column in Vet Practice News!
These days, I am listening to a book on the history of the US…
K: What's your favorite animal and why?
Z: Possibly one of my cats. They sleep a lot, they eat well (just enough to be thin of course), they play like maniacs, and they have zero worries. Actually, they have one worry: “When is my next meal?”
Then again, they don’t do a whole lot for the benefit of mankind or world peace…
K: If you could pick another career, which one would it be and why?
Z: I often wonder myself… Is being retired and sipping a drink on the beach in the Bahamas a career? I don’t know… Journalist, maybe?
K: Do you have any advice for anyone who would date a veterinary surgeon? I need some.
Z: Who wouldn’t want to? I mean, [date] a surgeon. Surgeons are patient, open-minded, creative, mature, profound, and above all, unusually modest. What’s not to love?
Anyone else have questions for Dr. Zeltzman? I’m sure he’d be wiling to entertain them here. In lieu of that, you can support another worthy veterinary Internet project by signing up for his newsletter here. Keep it coming, Dr. Z!
by Marcy LaHart, JD
[Ms. LaHart is an attorney who practices animal and environmental law in South Florida.]
Like Dr. Khuly, my holiday was sullied by the ugly aftermath of puppies spawned by the pet store/puppy mill industry.
On Christmas day I got an email from a woman that had gone to “Crazy About Pets” in Margate, Florida with her girlfriend a few days before Christmas. Her girlfriend purchased a Boston Terrier puppy; she went back the next day and purchased the puppy’s littermate. Three days later both puppies were in a veterinarian’s office fighting for their lives against the highly contagious and often fatal parvo virus.
They are not in just any veterinarian’s office, mind you, but at the office of the veterinarian the pet store insists they use. This was not her first trip to Dr. Incahoots. She took “Beanie” to him the day she bought him-and he diagnosed the puppy as having giardia, just like her friend’s puppy, even though he had certified them free of internal parasites days earlier.
I spoke with her the day after Christmas, and had the woman fax me her purchase contract and Official Certificate of Veterinary Inspection. By then there was another puppy from the same pet store being treated for parvo by Dr. Incahoots—and not a Boston Terrier, meaning the infection was not contained to just that litter.
By the time we talked she had called the pet store and demanded they stop selling puppies because of the parvovirus, but they refused, insisting their puppies were all healthy. Broward Animal Care apparently told her that there was nothing they could do, as did the Margate police department.
The Florida Department of Agriculture and Consumer Services has the authority to investigate and quarantine the rest of the puppies if they feel such action is warranted. I can sort of understand why the Margate police department didn’t know that, but certainly Broward Animal Care should have referred her to the appropriate authority or, better yet, actually been the slightest bit proactive and reported the parvo outbreak themselves.
I did call the Florida Department of Agriculture Law Enforcement, and spoke with an officer that seemed genuinely concerned and promised to get an investigator there on Monday. Unfortunately tomorrow is Sunday and the pet store will be open again. How many puppies will they sell? How many of them have been exposed to parvo-how many other animals will those puppies spread it to?
Parvo is serious stuff—the virus is extremely hardy and very contagious. It can live in the ground for months. Your dog can be contaminated even if s/he never encounters another dog with parvo because it can be brought home to your dog on your shoes, hands and even car tires.
My new client’s new puppy Beanie is still in critical condition, and may not survive the weekend. Dr. Incahoots claims he is doing everything possible to save the puppy’s life, but is clearly starting to worry about whether Beanie’s mom will be able to pay him for treating this puppy—as is she. Her friend elected to transfer her puppy to Coral Springs Animal Hospital where she would be treated by an independent veterinarian and receive 24 hour care that Dr. Incahoots does not provide. Her puppy is doing better, but the bill already tops $5,000.
I spoke with Dr. Incahoots, who told me that of course the pet store wants to sell healthy puppies, but it is hard because the puppy can be incubating something but show no symptoms. Of course it is hard for them to sell healthy puppies, I thought, because the puppies are all shipped from out of state puppy mills where health and welfare take a back seat to profits.
The two Boston Terrier puppies were bred by a woman named Christina Collins in West Plains, Missouri. A quick internet search reveals other people that have been sold puppies bred by Christina Collins that also had serious problems, not just Boston terriers but Italian Greyhounds and at least one German Shepherd-suffering behavioral problems, kennel cough, luxating patellas, all standard puppy-mill maladies.
Ms. Collins has had more than 100 puppies and dogs on her premises on occasion, and is suspended from the AKC until 2015 for refusing to make her dogs and records available for inspection. But she cannot refuse inspection by the USDA, who has found her in violation of the even minimal provisions of the Animal Welfare Act on multiple occasions.
One inspection report states as follows: “Wind/rain breaks should be placed on the houses in the southern row of runs, the house provided for dog #38, and dog microchip # 124955763A. Wind/rain breaks are not in place. These breaks should be put in place to protect the dogs and bedding from wind and rain. Affects 8 dogs.”
I wonder how Dr. Incahoots would like to be sleeping outside in February in Missouri without protection from the wind and rain? Does he ever think about the conditions endured by the mothers and fathers of these puppies when he signs off on a health certificate, or only about how much profit he will make thanks to his monopoly on treating the pet shop’s “product”?
PS: This is a picture of Beanie. He died last night as I finished writing this blog. RIP Beanie 10/19/08-12/27/08. PPS: Beanie’s sister has greatly improved and will hopefully be able to go home soon.
“A rabies shot costs $30? I bet you buy that vaccine from the manufacturer for $3. So you want to charge me a 1000% markup. Seriously?”
This outburst was brought to you by one smart-cookie client from last week. She’d worked for a veterinarian in the past so she’d always received her vaccines at cost. She new what a lot of you don’t know:
Vaccines themselves are cheap!
But vaccines never sell for the standard 100 to 300% markup other products are subject to. Unless you’re getting them in a “vaccine clinic” setting (where their cost is subsidized by the government or via high-volume sales) they tend to sell for huge multiple markups.
Why do vaccines enjoy such a high markup relative to other drugs and supplies? I’ll give you five reasons:
1) Because vaccines must be handled and stored carefully. It costs much more to manage a stash of vaccines than it does to manage almost any other drug or supply in the hospital.
2) Because we have to buy in bulk and therefore have to factor in the cost of product expiration and the financial cost of large up-front payments to manufacturers and distributors.
3) Because the cost of our related supplies (syringes, etc.), staff and overhead must be considered.
4) Because the regulatory aspect of vaccines means we have to maintain detailed records and fill out regulatory forms when they’re administered. Computerized record management and trained staff are expensive.
5) Because the professional know-how should be factored in and compensated. This includes the selection of vaccines and their administration protocols as well as the explanation of their actions and any treatment of their potential reactions.
This list of reasons explains why in the human medical world pediatricians are up in arms over how poorly they’re reimbursed for vaccines. On NPR this morning this issue was discussed in some detail in a five-minute segment on the Morning Edition program.
A recent study covered by the segment showed that prices and reimbursement of vaccines varied so widely as to price some pediatricians out of the vaccine business altogether. When the government or insurance company will only pay you $5 for a vaccine that costs you $3, you’re sure as heck not going to carry it. Not when it costs you a total of $12 to bring it to each patient.
It would seem that the government and the insurance companies are as confused as last week’s client on the issue of vaccine reimbursement. What these entities don’t understand is that physicians and veterinarians don’t consider vaccines to be moneymaking items. Not anymore.
Sure, we might have believed so in the past. In fact, you’d be correct in surmising that vaccines were once quite profitable for veterinarians. It used to be the lifeblood of our practices.
Yet while we don’t make much on vaccines these days (reference items 1 through 5 on the list above) it would be unthinkable to outsource vaccination. After all, we know what damage vaccines can do when their administration is handled sloppily.
For my part, I often have cause to cringe when I see that my patients have gone to a local vaccine clinic or a “better-priced place” for their last set of boosters. Usually, that’s because my patients didn’t need the vaccines at all (I stick to the three-year protocol and exempt many geriatric or chronically diseased patients). And sometimes it’s because the patient was sick at the time, receiving vaccines along with steroids and/or antibiotics for conditions I’d never consider compatible with routine vaccination.
What many human insurance carriers and price-sensitive clients don’t understand is that vaccine administration is an art and a science. It’s not the simple draw and push that makes a vaccine safe and effective. It’s the care, the caution and the know-how that makes a $30 rabies worth its pricetag.
A shocking news story out of Northeastern Pennsylvania: A basement-dwelling groomer offers “Gothic kittens” for sale on eBay. The uniquely “Gothic” quality? A pair of pierced ears, a pierced neck and a pierced tail.
What the seller didn’t know is that not only is it illegal to sell live animals on eBay (hooray for eBay!) it’s apparently illegal to pierce cats in Pennsylvania.
No, it’s not that there’s any specific law against feline ear, neck and tail piercing. It’s simply that doing so is considered sick and inhumane—by the vast majority of the US public, anyway. And I would hasten to agree.
Here are a couple of pics in case you're wondering what these kittens might look like:
So you know, using a 14 gauge needle to poke through a cat’s tail is a recipe for tail loss (the probability of tail sloughing is very high). And those earrings? Pretty soon they’ll rip through after they catch on something. Promise.
Yes, piercing a kitten’s ears, neck and tail for simple human vanity is a bizarre and irreprehensible act of feline vandalism. Sure, it’s your cat and she’s your property but here’s one way in which our pets are, legally-speaking, NOT like toaster ovens:
You cannot harm your animal any more than you can wantonly disregard their need for food and water. And thank God for that.
But there are some exceptions to this rule when it comes to dogs and humans. After all, many cultures pierce children and babies' ears. Many societies (including ours) engage in neonatal circumcision. And in the US, cropping and docking dogs' ears and tails is still widely accepted.
Though most veterinarians I’ve heard from (in a thread on the Veterinary Information Network) agreed that this kitten-piercing situation represents a new low in human behavior, canine and human analogies were raised by way of questioning the entire spectrum of this welfare issue:
Sure, we all accept that it’s wrong to pierce cats’ ears for an "enhanced" cosmetic appearance. But is it any less wrong to crop ears or dock tails? And how does this compare to the human side of things where babies have their ears pierced purely for cosmetic gain or are circumcised solely for religion’s sake?
I come from a Cuban-American family where female babies’ ears are pierced at 30 days, just prior to their christening. Having a boy, I never had to make this decision. But there’s little doubt as to the pressure I’d have felt to do so had a different set of chromosome been at work.
In my view, my culture’s approach is little different than that of the Jewish briss, despite the health benefits dubiously conferred by circumcision and the religious significance of the act.
Whether God’s involved or not, tradition is tradition. Though some acts are more easily defensible from our complex cultural points of view, invoking religion or tradition doesn’t make it any more or less right. After all, other religious and traditional, mutilation-oriented rites of passage have gone the way of the Dodo for their extremism (reference foot-binding, so-called “female circumcision,” and human sacrifice, among others).
Nonetheless, we defend our existing traditions vociferously from a wide array of angles.
OK so now that I’ve offended half of the human universe…back to the animals:
Kittens with their ears and tails pierced. This is wrong on so many levels that you’d be right to argue against comparing it with some of our more benign human traditions. Nonetheless, I consider it a worthy exercise in rethinking why humans engage in some of these behaviors.
From canine ear crops to foreskin excision…what is it that makes us want to pierce, puncture and slice when we now know there’s no health benefit or utility to defend it?
Every year I like to offer a rundown of my holiday nightmare cases. Usually, these are the pups purchased in pet stores. With their…
…unrelenting coughs, watery eyes, sniffly noses, undescended testicles, whopping umbilical hernias, honking heart murmurs, popping knees, crunching hips, stunted sizes, abnormal dentition and full-on pneumonia…
…these pups make me cringe with their crises and get me hopping mad at the injustice perpetrated against them and their (typically) first-time puppy owners.
In case you’re wondering who in the heck would buy a sick pup, I’ve also got a short list of reasons why pups manage to make it home from the pet shops.1-First-time pet owners (or those who haven’t had a pet in many years): This group of individuals is more likely to be unaware of how pets should be purchased or the benefits of adoption. They buy at pet shops thinking this is the way everyone does it, not knowing the risks they face.
2-The rescuers: This group sees a puppy in the window and wonders why he looks so sad. Sometimes he’s sick. Sometimes he’s just depressed. Either way, the puppy finds its way home with the “rescuer,” in spite of his potential illness.
A full 50% of my pet shop clients claim to fit into this category. Know what that means? More pet shops hawking defective wares knowing someone will take them home out of pity and misplaced good deed-ism. It’s an ugly and vicious circle. But I rarely have the heart to tell these owners how their “good deed” contributes to more suffering than they’re relieving.
3-The expediency experts: Last-minute shoppers tend to shop pet shops first. Why not? There’s one on every corner and the exact breed your kids are clamoring for is likely to be represented. Not there? The shop will find you one within 24 hours. Promise.
This year I’ve seen all the problems on my first list except the honking heart murmur. Lucky me. It seems heart murmurs are either killing them off earlier or falling out of fashion. I don’t know which alternative is worse.
The worst case is a pair of distemper pups—“mini” Schnauzers, “littermates.” But one of the pair is twice the size of the other and has significantly more fluid in her lungs. I suspect she’s not long for this world. But her owner still paid full price—some $800 for what was marketed as a “teacup Schnauzer varietal.” (Puh-lease.)
The majority of my clients only buy from pet shops only once, though I do have some kooky rescuers who insist on “saving” pet shop pets serially. You’d think they’d learn to save shelter pets instead but there’s no talking to some people.
Thankfully, however, the first time is usually enough for most. They’re so angry at the establishments for their treason and inhumanity that I’ve taken to downloading Better business Bureau and Florida Department of Agriculture forms so they can lodge their complaints immediately.
Despite my efforts, what I do affects the retail pet-purveying industry minimally. For all the ways there are to complain, there are far more channels through which to raise, transport and sell sick pets. I know this for sure because every year I see more and more of the same.
