Not a day goes by that I don’t think about my dog’s brain tumor. Strange, this ability of a questionably animate thing to bore a hole in my soul so effectively. Of course, it doesn’t compare to the stress people and their family endure with human cancer––at least I don’t think so, never having been in that unenviable position. But it’s harrowing in it’s own unique way, I promise you.
The most challenging part? Living with the time bomb factor.
In case you don’t understand this concept, let me explain: Each day, every hour, isis another opportunity for Sophie’s symptoms to revisit her––and us.
I know it’s bound to happen. That’s why I feel like every time she stumbles (which older dogs are wont to do), every time she wakes with a lower energy level than what I’d like to see (again, to be expected), and every time she turns up her nose at food (common for her), that same old, broken record starts playing again in my head.
It happens at least a couple of times a day. Yet contrary to what you’d expect, it’s not really so sad. It’s more bittersweet, really, knowing that I only have so much time left to enjoy her and coddle her and snuggle to our hearts’ content. After all, most people never get a chance to experience that heightened sense of awareness that comes with enjoying the simple minutes before we both have to get out of bed, the car rides we share and the special meals she relishes.
Though I’m well informed of rare circumstances under which radiation completely cures brain cancer, I live under no delusion that Sophie’s case will prove so miraculous. Everything comes to an end, eventually. Sophie, me, the Universe, everything. Though I know it’ll all end in tears, for the moment it’s all better than OK––in fact, it’s perfect.
I have a relative whose two adult dogs were both neutered last week. So I knew to expect the cross-country phone calls––in spades. But nothing prepared me for the onslaught of incision site issues that awaited me in the wake of this simple procedure.
Sure, they’re nervous nellies. But they’re really no different than you and me when it comes to watching out for the minutest signs of an unhappy suture site. Redness, puffiness and weeping is not a pleasant sign and I would hope that any pet owner would be on the lookout for these symptoms post-operatively.
That’s why I’ve been fielding photos from afar, checking the site remotely due to their own [wonderful] veterinarian’s 1.5 hour distance (you know she’s beloved if they’re willing to travel so far for her care).
Before:
After:
Her take? Haul ‘em in for a close-up look-see. It’s best, after all. Mine? Here’s my basic recommendation for any angry-looking incision site:
1-Avoidance Part 1
Make sure the E-Collar fits well. Can she get around it? Is he licking it when you’re not watching? Is it just long enough to bang into the surgery site and undo all our good work?
2-Avoidance Part 2
Try a light, loose cotton T-shirt, some boxer shorts or a clean sock, depending on the area affected. A light dressing, changed often, will sometimes be indicated if the area allows.
3-Pack it
Alternate applications of warm and cool packs on the affected area (with a clean kitchen towel soaked in comfortably hot or cold Epsom salts works for me). Though you should know that many veterinarians despise the idea of any wetness on their suture lines.
4-Meds?
Sadly, antibiotics are sometimes necessary. We often culture the affected area to make sure we’re killing the right bugs with our choice of drugs.
5-Movement restriction
Crate ‘em, please! No exercise for a week or two (unless your surgeon recommends more careful, lengthy restrictions, as for orthopedic procedures). And for some areas, especially after mass resections in highly mobile spots (underarm or inner thigh, for example) we recommend keeping your pet in hospital for a few days so we can watch pets carefully and limit their movements.
***
After dealing with all this neuter-site stress, another family member underwent eyelid surgery. More careful attention to sutures, swelling and local antibiotic application.
And then, the kicker: A second-opinion case (I hate these). A local surgeon had refused to see him due to the lack of a direct referral from the original veterinarian (this is typical). So he was all mine. (Gee, thanks, Dr. Surgeon.)
After one month and three surgeries (a mass removal on his right flank) the dog’s sutures had continued to open up...completely, every time. The long incision (about 8 inches!), was a scary sight. Thankfully, the large dog’s capable healing mechanisms had led to a nice, dark pink bed of granulation tissue.
“Let it heal all by itself,” I’d said, after cleaning the area, culturing it and changing his [too-small, non skin-specific dose] of antibiotics. Hot packs for three days, some crating for a week, and the site should be three times as pretty by next week’s re-check. If I’m lucky.
Pets are tough on suture lines, it’s true. They’d love nothing better than to lick the wound into submission, lie in the dirt, roll in carcasses and run around like silly creatures after surgery. Meanwhile, you and I would be feeling sorry for ourselves in bed. Pets are just special that way. Too bad they can’t be a little more like us on these occasions.
After spending more time than is reasonable explaining WHY dogs are gaining weight in spite of all owner attempts at the reverse, I get tired...really tired.
That’s why, lately, I’ve taken to suggesting my clients keep a diary of everything their fat dog eats in a week (and how much exercise they get) by way of explaining how vigilance and diligence is sometimes no match for intelligence. And, in this case, intelligence doesn’t necessarily translate into “smarts.”
Gathering intelligence is my newest method of helping my clients with their pets’ weight concerns. The prescription? Track it all. Write it down honestly. Then we’ll figure out what you’re doing wrong––if anything.
The first sticking point? It always comes down to measuring everything the dog eats and does. The kids might have fed X. I didn’t know the treats counted. (Seriously?) My mother-in-law sneaks her food under the table.
The second sticking point? You mean she can only eat 300 calories a day?? How is that possible??
Oh, that’s easy. The average dog needs to take in a certain number of calories based on his weight, her need for weight loss, his neuter status, her activity level, and his propensity for weight gain.
It’s simple math, really. Here’s the idea:
Base calories/day (resting energy requirement) = 30 x (your dog’s weight in kg) + 70
Example: So if you have a 10 kg (22 pound) dog, he needs to eat 370 calories a day.
But then it gets a little more complicated. That's because the “resting energy requirement” is only a measure of the amount of energy (in calories) he needs to keep his basic functions going comfortably. So if he’s a busy dog who runs around a lot in your big yard, he’ll need a lot more. And if he’s a neutered couch potato who’s seriously obese he may need no more than his basic bodily functions require to actually lose some weight.
And here's where your veterinarian comes in. Based on how much weight your dog needs to lose (which is based on her body condition score, something I’ll treat in a future post), and taking all of your dog’s health concerns in mind (along with her age, propensity to gain weight, exercise habits and spay/neuter status), your veterinarian may add some more calories to the mix. Here’s a general idea of how this gets factored in:
Weight loss needed, neutered/spayed = 1 x base calories Weight loss needed, intact = 1.1x base calories
If she’s active, add another 0.2 to 0.4 to the multiplier. If she’s a couch potato, stick to the bare minimum number of calories designated by these calculations.
Example: The 10 kg (22-pound) neutered, obese couch potato needs 370 calories. The active neutered version needs about 1.2 x 370 (444 calories).
Easy, right?
But now comes the obvious problem: Getting dog owners to actually begin counting calories on our patients’ behalf––which can be a nightmare, given that calories are not commonly listed on the side of your average bag of dog food. And that’s a shame. I see no reason for this not to happen. After all, we’d be hard-pressed to consider the same acceptable for ourselves.
Of course, you might argue that our culture is increasingly obese in spite of the labels on everything from jelly beans to frozen burritos. (But then, nutritional ratification of “foods” through labeling is probably part of the problem.) Nonetheless, pet owners need some tools to determine how caloric their pet foods are.
How else to achieve an understanding of how much you’re contributing to your pet’s obesity problem than by knowing how many calories your dog needs...then counting the number of calories in that Pupperoni you feed three times a day? Without this ability, many pet owners will doubtless feel unduly justified in plying their pets with the caloric equivalent of a Big Mac as a feelgood freebie any time of the day or night.
Yet calorie counts can be had. They’re on every major pet food and treat manufacturer’s website. Some manufacturers are even leaning towards leaner treats knowing you’re starting to count your pets calories. This includes the Pupperoni people, who now produce a “50 calorie Pupperoni” (which probably means the traditional Pupperoni probably amounts to a third of the base calories required for the 22-pound pet in my first example).
So how about you? Calorie counts may not be necessary for all dog owners (indeed, I simply feed a visibly smaller amount for a couple of weeks if I see my dogs starting to get chunky). But if your pets are overweight and you can’t imagine why, you have no excuse not to get started on gathering some caloric intelligence.
Bad things happen. But you expect them to happen less often to the horses that play the Polo Club circuit. Living with in-house masseuses, fancy veterinarians, frequent hydrotherapy, and first-class flight accommodations––while boasting an asking price of $200K––has something to do with it. Never mind that they’re treated like celebrities wherever they go.
That’s probably why yesterday’s Miami Herald detailed Sunday’s horrible death of 21 polo ponies at the US Open in Wellington, FL––on the front page. Rarely does any animal news make the big headlines here. But this was an animal event worthy of periodical rubbernecking if there ever was one.
One by one, the horses belonging to one team staggered, fell and died––in front of the 4,000 fans assembled for this SuperBowl of polo. Tarps were set up to shield the horses’ death throes from the onlookers as veterinarians rushed to place IV catheters and administer medications in an attempt to reverse the symptoms. To no avail. Every single affected horse died...and fast.
Whether you own polo ponies or gerbils, whether you’re a witness to the events or not, a series of deaths this widespread and swift is both frightening and tragic. Is this a communicable disease? What’s responsible? Am I going to take it home to my horses/gerbils? Do my animals have the possibility to succumb like these? How would I handle it?
By all account everyone was desperate and in tears. The grooms, the players, the spectators, the officials. The event was cancelled. Everyone went home to cry over the dead––except the veterinarians, who were up all night trying to salvage the still living. None survived.
Now it’s the pathologists’ turn. They’re working hard to find a toxic substance that may have been accidentally, negligently or deliberately fed to the horses in their water, their grain, their supplements or their roughage. Sure smells like a toxin. You don’t have to be a horse vet to see that diagnosis coming.
At least local fears over a transmissible disease have been [mostly] allayed in this horse-addled enclave of suburban Palm Beach––to be replaced by conspiracy theories concerning the Venezuelan team’s potential enemies and political foes, by concerns over mandatory drug testing in the sport.
I, for one, can’t help thinking about Barbaro, Eight Belles, Big Brown and all the other horses who succumbed to their sport. Though nothing’s been revealed and no evidence yet exists to point fingers or assess blame, I get that same game-day-gone-wrong feeling, nonetheless. Can you blame me?
After reading your comments from yesterday’s post on the cost of routine dentistry, I got to thinking: Do we humans often treat our pets better than we treat ourselves?
Don’t bother answering; I know the truth. Most serious pet people are too willing to put off their on medical issues in favor of their pets.’
Since I’m a veterinarian who makes her living from making sure her patients get the care they need, you might think I’d be elated to entertain a client’s day-after-day visits with one and another pet who sincerely needs attention. But sometimes––too often, in fact––the client is more in need of help than the pet is. And that raises a whole host of issues you might not think veterinarians would need to handle.
Many of my clients are avid pet people––in the extreme. (In case you’re wondering, this is true of all veterinarians. We deal in atypical pet adoration every day.) And this is OK. Not only because this is how we make our living but because we can identify similar, pet-addled behavior in ourselves, too.
Still, that doesn’t mean we don’t concern ourselves with the very personal issues our clients clearly face when it becomes obvious that they care more for their pets’ health than they do for their own.
Sure, I know many veterinarians like to keep themselves out of the emotional loop. Compassion fatigue is a recipe for burnout, as we all know. But this attempt at personal preservation just not doable for some of us. Burnout or not, some of us believe, this job isn’t worth having without its inherent psychological risks.
That’s why we’re willing to stress out when we see my clients wither away while tending to their brood of pets. That’s why some of us spend inordinate amounts of energy holding our client’s hands when they’re having trouble making decisions. And that’s why we sometimes lose sleep over our clients when by all rights we should be concentrating on our patients.
But there’s another aspect to this that all veterinarians––not just especially sensitive or eccentric ones––should keep in mind: All clients make decisions for their pets based on their personal experiences. This may include how things went with their own cancer care, how their parents’ end of life care was handled, or whether they fear doctors for themselves.
On Dolittler, I’ve heard you say things like:
I’m fat but that’s no excuse for failing to keep my dogs lean. I hate the dentist but I’d never forgo dentistry for my pets. I’d never do chemo again but I wouldn’t blink for chemo if my cat had cancer. I wish I could elect euthanasia for myself.
Sure, I also hear the opposite expressions––perhaps more often (except the euthanasia comment)––but it’s all to my point: people personalize patient care on behalf of their pets. And if my experience is any guide, they’re doing it more often now that more sophisticated care is available for their pets.
That’s why I’ve gotten to thinking: Is this because pets are treated more like kids (who are treated more carefully by their parents than adults typically treat themselves)? What can I do to recruit my clients into seeking better healthcare for themselves? I know it’s not my role. But is it, nonetheless, my responsibility as a human being?
I know some of you fall into this category of pet healthcare providers who neglect themselves. How so? And what's a veterinarian or veterinary technician's role, if any?
