Why is it that men always seem to keel over first? Though the ones that “know thineselves” are smart enough to walk away at the first sign of an impending needle or bodily effluence, I always seem to get the ones who pretend to want to be “in on the action.”
And that’s often a bad idea.
Today’s roster smacked of the full moon lineup. You know, the list of new clients coming in for acute conditions from dog bite abscesses to popped out eyeballs and gory cancers of the penis(!). It was not a day for a man to strain himself to show true colors in the exam room. Not this day.
Yet two of three tried. And one earned himself the visceral reaction smackdown. Next thing I heard was a slump against a wall followed by a slurred, “Doc, I gotta sit down, OK?”
Despite the warning signs, only my assistant’s reaction clued me in to the happenings behind the bushy dog whose face I’d been concentrating on. Her release almost earned me a canine snap, but I guess the pale man almost falling off the exam room chair provided her sufficient excuse. After all, better for the vet to get bit than the client to bash his head in on the stainless steel exam table.
So here's where I ask: Why is it that men seem ten times as likely to lose it in the exam room? While the sight of a flowing abscess or a bleeding wound seems rarely to elicit more than an appraising, “Wow!” from a woman, a man will typically back up in utter disgust: "Gee, thanks that was more than I needed to see."
What’s that all about?
Though I relish the opportunity to minister to the fallen, it’s always an unwelcome adventure, this testosterone-related free-fall. What is it I’m supposed to do for this now-demoralized human male?
Worse, yet, is the knowledge that while this happens to me with some regularity, it rarely afflicts my male colleagues’ practice. Do their male clients know better? Do mine feel the need to prove their salt in the presence women and watch what they know they shouldn’t?
Dunno about all that but I do know one thing: A fainting client is a surefire recipe for getting zero complaints about the bill. Imagine that!
by Dr. Phil Zeltzman and Dr. Patty Khuly
You might find this odd, but there’s a whole world of denial out there with respect to aggression in dogs. These are the pet owners who ignore the growls and snarls, live with the snaps or suffer near-misses...and for what?
Because they can’t face the reality of what their pet’s aggression might say about their ownership skills? Likely. Because it is a way to reinforce their ego? Their self-worth? Maybe. Surely there are more constructive ways to do that, though.
I, for one, have an aggressive animal for whom I make zero excuses. I’m working on it...gently. I also recognize that many of you have also made the choice to work with your pets on this issue. And that’s how it should be.
Not so with the vast majority of canine aggression owners, it would seem. And that’s a big deal not only for the individual dogs whose pathologies are swept under the rug and remain unresolved, but also for those of us who have to work with these often unworkable animals in our daily lives.
According to the Centers for Disease Control and Prevention, 4.5 million Americans are bitten by dogs each year. One in five dog bites is serious enough that it requires medical attention. And here’s what the AVMA has to say on the subject.
It’s a risky business, veterinary medicine. But it’s a fact of life for us.
That’s why Dr. Phil Zeltzman, veterinary surgeon and newsletter author extraordinaire (available for free at www.DrPhilZeltzman.com), wants to raise the profile of this issue.
Because I love working with Dr. Zeltzman––and because more dogs deserve to get the help they need––he and I have collaborated on a compilation of top ten reasons owners cite when their pets display aggression at the vet’s.
Here they are:
#1 He's never bitten anybody.
This is the most popular excuse we receive––supposedly by way of allaying any silly fears we might have about a growling pet’s raised hackles, stiff tail and impending lunge.
#2 She never did this with my previous vet.
It’s obvious that every hospital and every individual circumstance will have its different effects on a dog. But here the implication is that we’re doing something to trigger this “very strange” behavior in their pet––as if it’s truly never happened before. In most cases we don’t buy it for a second.
#3 He's never growled before.
Sure, it’s possible. After all, a veterinary hospital is a strange and forbidding place...and there’s always a first time. Fear aggression is the number one version of aggression we see in dogs. But again, the owner’s point is that their dog is not aggressive at all––and that they are genuinely surprised that their dog would ever display any sign of aggression.
That’s what scares us. Because as top trainers like to say, “All dogs are fine...until they’re not.” Ultimately, every owner needs to recognize their dog’s capacity to do harm.
#4 She was abused as a puppy.
A Dr. K sidebar: I’ve had two aggressive dogs in my life. Both arrived at my place as pups. One was so fearful she’d cower over any loud noise...from day one. We used counter-conditioning techniques to keep her reactions at a minimum, but we always knew she had it in her to snap when freaked.
Was she abused? Ummm...highly unlikely. Are some dogs abused? Of course. But it’s no excuse for living with aggression––not without taking steps to relieve the dog’s fears.
#5 He's just playing with you!
Hmmm... after all our years in this biz we think we can tell when a dog is playing and when he’s not. Don’t insult our intelligence. Accept our help, instead.
#6 People think she's aggressive because she's big, wrinkly, black, looks like a Rottweiler, or [insert-adjective-here].
Yes, it’s true. Big black dogs inspire fear. We get that. But as veterinarians, we’re not usually biased against color or breed. We’ve got enough examples of friendly dogs of all breeds, colors and sizes to rest our case on that front.
Instead, we’re usually reacting to clear warnings: stiff tail (with or without a wag), raised hackles, a cowering stance with other evidence of fear aggression, or an outright, leash-straining lunge, etc.
#7 He doesn't like men.
Dr. Zeltzman says he’s only heard “he doesn’t like women” a couple of times in his career, whereas “he doesn’t like men” is a common utterance. And Dr. Khuly agrees with this observation.
While it’s indeed true that some pets are wary of male humans (either because of auditory cues, past experience, size or lack of familiarity), the vast majority of these dogs can be helped––and should be.
#8 She’s just mouthy.
Yeah, mouthy is one thing. But when she grabs our entire hand in her mouth just as we try to clip her nails...you’ve got a problem.
#9 He’s just a talker.
Growly dogs and barkers are warning those who approach. Why would you not take that seriously as a sign of aggression?
#10 She's just not that into you.
Yeah, of course. We’re the veterinarians. Most dogs don’t especially like us when we’re in our whites, even those who walk in with friendly looks on their faces and happy tail wags in tow. But that’s an explanation for her aggression...not an excuse to dismiss it.
***
Beyond what happens at the vet’s place, what scares us is that one day, your dog could very well attack another pet. Veterinarians in general practice, veterinary surgeons and ER vets see bite wounds on a regular basis. Well, guess what? 99% of canine biters are attached to pet owners in complete denial.
Even worse, one day, your dog could attack a person, or a kid––yours or somebody else’s. Maybe all of the above sounds tongue-in-cheek, but here’s where the fun has to stop.
Physicians and ER doctors often see kids that have been seriously injured or disfigured because somewhere, someday, a dog owner decided to dismiss their dog’s problem as being funny or otherwise benign.
Then there's the impact on the individual dog to consider: How do you suppose these dogs who live with aggression feel? They're not happy dogs in most cases. They're stressed. And what do you suppose happens to them once they've acted out on a human? They're often killed.
So what should you do, once you’ve decided to accept reality?
#1 Talk to your veterinarian.
Some veterinarians are eager to help with behavioral issues, with or without drugs.
#2 Talk to a trainer or a behaviorist.
That’s their job and specialty. There are countless methods, which may or may not include whispering… “as seen on TV.”
Ultimately, help is out there. After all, we’re not talking cancer here. We’re talking about a condition that can be dramatically improved in the vast majority of cases. But that can't happen unless dog owners start dispensing with their denial. Let's hope this post helps.
Today’ post is inspired by Tripawds.com and Maverick's Story, two pet health sites dedicated to a couple of individual dogs and their diseases.
Tripawds is all about Jerry, an osteosarcoma patient who lived well after amputation. But it’s also about all the other pets who may lose limbs, live with cancer and survive their diseases comfortably with the assistance of their humans.
It’s a site I’ve been championing since I discovered it a couple of years ago. Since then, at least four of my patients have received amputations after their owners discovered Tripawds and adopted the position advanced by Jerry’s family, Jim and Rene: “It’s better to run on three legs than to limp on four.”
Maverick’s is much newer site. It’s dedicated to Maverick the Weimeraner, the first canine patient with acute lymphoblastic leukemia to receive a bone marrow transplant cure. His site is dedicated to canine leukemia and lymphoma patients whose owners seek some of the same kind of hope Maverick’s family received.
It never fails to impress me, this kind of dedication to the lives of our pets expressed through the power of new media. But building and maintaining these sites is not for everyone. After all, it’s expensive to bring a story to the masses. And if you’re like Jim and Rene at Tripawds, you’ll soon find that your popularity can have serious consequences.
Now that Tripawds has outgrown its hosting plan, it’s looking to its readership to help pay for more server space. And it’s not cheap. That’s why they’re raising about $4,250 for Tripawd’s continued life beyond Jerry’s demise.
Because it’s no longer about Jerry––not really. Now it’s more about all the lives Jerry can still influence beyond his death through his family's dedication...and the support pet people like us can provide them with our donation
Maverick’s site still has a way to go before it hits Tripawds level, but I’ve been in contact with Marna and Howie about how much good their site can do should they take their own dedication to the next level and grow Maverick’s fan base...by following the Tripawds model.
***
Though Dolittler’s still a small blog by world-class standards, I too understand the travails of growth and the ups and downs of running a site on a shoestring and sweat. My server gets 80,000 hits a day. And though that sometimes seems like it’s getting close to breaking the bank, I make it happen knowing that 1-I couldn’t NOT do Dolittler every day and 2-one day Dolittler might receive a sponsorship I can live with.
When all else fails, I think of it this way: Other people sink their earnings into boats (a hole in the water into which to dump your cash) and I get by begging for rides while sinking MY money into a labor of love that grants me more than a simple guilty pleasure.
I think that’s what drives these other pet site-runners, too. Like Gina over at PetConnection. Like Heather Houlahan and Megan and Barbara and Stefani and all the rest of you who keep your pet sites up and running in spite of a down economy and the nagging feeling that your dollars might be better spent elsewhere. But in the end, it’s all about love (OK, and maybe a little obsessiveness), right?
PS: Help us help others by donating to Tripawds and Maverick’s causes. These sites can’t continue to do their excellent work without YOUR help. Please give as generously as you can.
Things in Miami don’t happen the way they do in the rest of the US. Unlicensed usage of dangerous chemicals is my newest example. After being accidentally fumigated with a variety of bug-killing chemicals (whose true provenance we’ll likely never know), this gorgeous kitten suffered a variety of neurologic effects that ultimately rendered him homeless.
I know what you’re going to say. What kind of an idiot fumigates his own cat with an unlicensed purveyor of chemicals then can’t bother to take proper responsibility for the outcome?
But a story is never as straightforward or as two-dimensional as we might like it to be. In this case the elderly owner was taken by an unscrupulous exterminator (these things happen far more often to the elderly, as you probably know). The kitten was supposed to be secluded in one room of the home but, in his confusion, the owner had left the door ajar––or so says the merchant.
The kitten was “fine” the first day. The day after the fumigation he was “quieter than normal.” And by the following morning the ten week-old seal-point was unable to hold his head upright and appeared to have lost his vision entirely.
Though it was difficult to obtain a list of the chemicals employed, the exterminator eventually complied with the ASPCA Poison Control’s investigation via AT&T telephone interpreter.
The upshot? The chemicals listed by the fumigator should not have caused the kind of neurological signs we were observing. An extreme head tilt, blindness (despite a normal pupillary light reflex) and ataxia (off balance-ness and generalized “wobbliness”). According to the list, tremors or seizures should have been the thing, if anything––not this. (A pyrethrin toxin was at the top of the fumigator’s list.)
Conclusion: Either this process had nothing to do with the fumigation (unlikely, given the timing and my previous experience with a well-tested, healthy kitten as recently as of one week before the event), the kitten was experiencing an “adverse” reaction to one of the fumigation ingredients, OR....the unlicensed fumigator was not telling the truth in its entirety.
It’s Miami. I’ll take door number three, please.
Indeed, repeat testing of this kitten found nothing of interest. We bathed him with Dawn (my go-to product for reducing topical poison exposure), soaked his veins with fluids, and plied him with activated charcoal for good measure.
After a couple of days, the kitten regained his sight, despite an inability to focus. Four days later, his head-tilt was still pronounced, but improved. One week after the inadvertent kitten fumigation procedure...and the kitten’s still not quite right, but he’s no longer blind––and sooooo lap-cat sweet. Here he is with one of our staff’s children:
But normality is still a way’s away. That’s why his owner’s agent, his daughter, has rescinded all rights to the kitten. If he can’t be “normal,” it’s not right for her father to keep him. After all, she says, her father is a [very] elderly gentleman who cannot properly care for an invalid kitten. Never mind that the kitten can eat, drink, use the litterbox, play with toys, etc.
Nonetheless, I can’t exactly blame her. Though the kitten is looking better every day, with excellent hopes for a complete recovery given the pace of his improvement, a week was her cutoff date, it seems. Why continue to stress out her father with a sick kitten when there are so many healthy ones out there? (And no, this case is NOT about the money.)
Sad. But understandable, I guess, from a protective daughter’s point of view––more so if you understand her history with neurologic cases.
Still, I have a master plan. I intend to keep little Gaston in my care until he’s 100% (with any luck, he’ll get there in a couple of weeks). I will then approach the owner’s daughter with the fruits of my labor and offer to place him back with Dad.
Except for the fumigation incident, everything else points to a wonderful, loving relationship between the two parties: gentleman and kitten. How can I possibly break that bond over an accident that’s highly unlikely to be repeated? (Yes, he fired the fumigator.)
All I want is that amazing relationship back. So can you blame me for all my “stealth” maneuvers?
I’ve got an in to lots of new stuff happening in the world of oncology. Two of my classmates from back at Penn are tops in this field at the academic level. They’re both working hard to find a cure for lymphoma in dogs.
That’s why I jumped at the chance to blog about lymphoma when BFF Dr. Steve Suter (VMD, MS, ACVIM-certified and PhD) emailed me his latest excellent and thoroughly watchable media spot on the subject. Sure, he’s a lot more funny and personable in real life, but it’s not about him, after all. It’s about his cancer patients.
But here he is in his video, anyway:
According to my favorite client resource, Veterinary Partner,
“Lymphoma is a rapidly growing malignancy that is able to go and grow anywhere where there is lymph tissue. This is virtually every organ in the body. Eventually, the cancer will infiltrate an organ to such an extent that that organ fails (often this is the bone marrow or the liver). The patient loses his/her appetite, vomits or gets diarrhea, weakens and dies.”
Sounds horrible. And it is. More so because many of the affected dogs are young and otherwise healthy. Currently, there’s no cure for canine lymphoma that’s readily available for dogs. But it’s a very common cancer. Again, Veterinary Partner’s take:
“The “typical” canine lymphoma patient is a middle-aged dog brought to the veterinarian because one or more lumps have been found. The veterinarian rapidly determines that all of the peripheral lymph nodes (those near the skin surface) are enlarged and firm. Usually the dog has not been showing any signs of illness. The next step is a blood panel and urinalysis to more completely assess the patient’s health and one or more lymph nodes are aspirated or biopsied to confirm the diagnosis of lymphoma.”
But there is some hope. Though most untreated dogs live only two months from the time the diagnosis is made, our humane chemotherapy protocols developed specifically for dogs can increase the comfortable life of our patients for 7 to 12 months. In dog years, that’s equivalent to an average of five years of your life––a not insignificant length of time from a dog’s perspective.
That’s why we urge you to consider the widely disseminated protocols almost every veterinarian can implement. Sure, it’s always best to see an internal medicine specialist or an oncologist, but if you can’t afford the specialist’s $5-$10 K price-tag, lymphoma treatment can usually be had for about $2,000-$4,000 at your regular vet’s––even less if you’re able to find a deal on the meds yourself (though you should know that many veterinarians won’t work this way and I don’t blame them).
But enough about the disease and it’s now-routine treatment’s cost. This post is about canine lymphoma’s new options. And it involves the newest thing to hit veterinary medicine’s university settings: a cure.
Yes, it’s true. Some patients can be cured the same way humans are: with bone marrow transplants. Though the procedure at North Carolina State University’s oncology department runs about $15,000-$20,000, a growing number of pet owners feel it’s worth a shot at an actual cure. Chemotherapy-based palliation of lymphoma is great. But a chance at a real live lengthy life is undeniably alluring.
Though not all cases will qualify, it’s worth looking into. Here’s the skinny:
Dr. Suter first filters out all the important stem cells from the dog’s blood then applies a beam of radiation to kill all (or most) of the rapidly-dividing cancer cells in the dog’s body. Fresh stem cells are later fed back into the patient.
Here he is describing the radiation beam's trajectory:
And now describing the bone marrow transplant machine's workings:
According to Dr. Suter, “[This method of treatment] tends to make the overall first remission time longer but [currently] does not cure the vast majority of dogs.”
But he believes that the new procedure could increase the cure rate to 50%. And when you consider that the rate of actual “cures using conventional methods of lymphoma treatment are reportedly 0%-2%, that’s a BIG deal.
Though he’s now sticking with patients that weigh over 45-50 pounds and have received enough chemotherapy to put the disease into remission, here’s what he has to say about his current work:
“We think these dogs will do better than other dogs, and we really want to work through the protocol...I believe if we are careful with our patient population initially, it’ll be a boon for dogs across the country.”
Right now the technique requires that dogs be larger because the machines required don’t service smaller ones. But he’s confident that if this works out he’ll be making it work for smaller dogs. After all, kids as young as 18 months are treated with this technique. So why not smaller dogs?
Referencing the initial dog-based research that allowed bone marrow transplants to treat human patients, Dr. Suter offers us this heartening statement:
“This is a really fantastic opportunity that allows us to give back to dogs something they helped us develop 30 years ago.”
And I, for one, am blitheringly proud of him (can you tell?).
