Veterinary Wisdom® Café

Let The Goo Keep On Rolling

As any small business owner will tell you...bad things tend to happen in bunches so that when the goo hits the fan, there's a huge mess everywhere. Recently, we have found that owning a pet hospital can be a royal pain when the gooey mess comes calling.

Our goo started before the holidays when one of the water lines from our dental equipment cracked and ended up flooding our treatment area and surgery suite with several inches of water. But hey, after a $15,000-20,000 dollar repair and professional "restoration," things should be back to normal (if this was to be a holiday gift we would have gone with the rotten eggnog and stale fruitcake thank you very much).

Next came the groomer who has been theoretically renting space from us at our hospital. I say in theory because she owes us several thousand dollars in back rent. A few days ago, she dropped off the face of the earth after removing all her belongings in the dark of night. We've not heard from her since and I doubt we will.

But hey that's okay because the veterinary nurse we hired a few weeks ago just didn't show up for work one day. Not even the police know what happened to her but lucky for us she has a key to the pet hospital and we now must spend several hundred dollars changing all the locks and keys to the building.

Many of you have worked in or owned small businesses so these situations may sound familiar to you. My question to you is how do you get through it all until the bunches of goo stop coming?

--Dana

Eye Contact Or Computer Screens?

One of the newest rages in Vet Medicine are EVMR's (electronic veterinary medical records). Just as in human medicine, many veterinarians are using this technology in caring for patients. EVMR's offer the general practitioner a wealth of easy accessible information. There's no flipping through charts, or trying to read an illegible note or lab report. Digital images also allow for better and more precise x-rays.

The downside of all this? It's easy to get lost in the new technology and forget about the most important thing of all...the client and the patient. I've heard about many pet hospitals who struggle with keeping their services "personal" while implementing more advanced record keeping. For example, EVMR takes some of the doctor's eye contact away (to look at the laptop computer). In fact, a study done in human medicine found that 62% of respondents mentioned loss of eye contact as a concern and a barrier to use. (Banfield, Vol. 5, number 6).

For me, I embrace new technology and all the bells and whistles that accompany AS LONG AS the interpersonal communication remains the same! Making a connection with a client is critical for developing trust whether or not there is advanced technology. Things like open body language, eye contact, and interpersonal warmth must always exist in good working relationships.

Have any of you experienced some problems with your veterinarian after implementing new technology? I'm curious as to your thoughts and ideas.

--Dana

Acupuncture for dogs

This video is of a former colleague of both Laurel's and mine at the CSU Vet Teaching Hospital.

Dr. Narda Robinson is a veterinarian, medical acupuncturist, and osteopathic physician. She teaches at CSU's College of Veterinary Medicine and Biomedical Sciences and she is the director of the CSU Center for Comparative and Integrative Pain Medicine. She treats animals using acupuncture, and teaches the techniques to students and other veterinarians.

This short video shows Dr. Robinson at work with her patient, Jack. The technique is quite amazing to watch! The results speak for themselves with her patients!

Have you ever had acupuncture done for your animals? How about for yourself? I have had it done for me! I would definitely consider it for an animal as well.

--Tammy

Pet Health Insurance...A Good Idea?

According to the December, 2009 edition of Veterinary Practice News, more than nine out of 10 (94%) pet owners know that pet insurance exists but are likely to avoid buying plans because of cost concerns. An online survey conducted by the marketing firm LePoideven Rickinger Group, polled 800 veterinary professionals and 4,600 pet owners to determine their awareness of pet insurance.

One of the most significant findings was the relatively high number of veterinarians who had no opinion (or a low opinion) of the facts of pet insurance (40% of veterinarians surveyed do not recommend pet health insurance). Pet health insurance has gained popularity over the last few years, but it's still fairly uncommon and somewhat controversial.

Those who endorse pet insurance see it as a way to help save a pet's life by allowing the owner to avoid decisions based solely on "economic euthanasia." This sounds appealing, but there are also people who worry that the proliferation of pet health insurance would change veterinary medicine (and NOT for the better). Many  worry that health insurance would make veterinary costs sky-high and become out of control (just as in human medicine). Also, veterinarians worry about these insurance companies dictating for them what treatments they can provide for their patients.

I can see both sides of the pet health insurance debate. What about you? Do any of you have pet health insurance and if so, what are your opinions and experiences? Would you recommend it to other pet owners? What do you think?

--Dana

Should You Get a Refund?

"My vet has been treating my dog for a skin condition for several months and nothing is changing.  Am I entitled to a refund?''  --Impatient

Weelllll.....no.  Think of it this way.  Would you ask for a refund from your dentist or your family doctor if they were treating you for a condition that, despite their skill and knowledge, did not improve your problem?

Veterinarians are doctors, on par with the other professionals we address with this title.  And, while they are committed to using their advanced training to the benefit of your pet, medicine is not an exact science.  Just like with people, there are many reasons a specific treatment may not do what you and your vet hope it will do.

When you agree to pay your veterinarian to treat your pet, you are paying for them to make an honest and earnest attempt to examine, test, diagnose, recommend treatment, and then administer that treatment to the best of their ability.  And, part of that treatment's effectiveness may depend on you.  Are you complying with all your vet's instructions?

I'm not sure why we often think of veterinary care as a negotiable service.  Is it because we don't understand the treatments and feel suspicious of the true need for them?  Is it because, despite our claims to LOVE our pets, we don't really feel we should spend a lot of money on them?  Is it because insurance has created human health care that is "covered" for many and therefore doesn't seem to "cost" us as much out of our own pockets?

You can ask your veterinarian for a revised estimate and treatment plan at any time.  You can also choose to stop your pet's treatment at any time.  A veterinarian can never "force" you to treat your pet.  When you agree to a treatment plan, there is an implied contract that you will pay to have that work done, but there is no implied guarantee that the outcome will be exactly what you both hope for...

I'm interested in hearing what you all think about "negotiating" vet fees.

--Laurel

Doctors In Dangerous Waters

In October, I presented six lectures at the Wild West Veterinary Conference in Reno, Nevada (WWVC).   I was more than a bit tired after coming home but that conference has made me realize that the field of veterinary medicine faces a very real threat. As usual, I presented material to help veterinary professionals communicate more effectively with their clients in order to promotes client loyalty. The audiences were terrific and quite enthusiastic but I was stunned to see how many veterinary professionals wanted help with taking care of themselves as well as their clients.

My lecture covered the topic of compassion fatigue (a deep physical, emotional, and spiritual exhaustion accompanied by acute emotional pain). Compassion fatigue was originally thought to be a condition that afflicts disaster relief workers, fire fighters, paramedics, etc). In the past 10 years, more and more people are realizing that this type of professional burn-out can affect anyone who works in a "helping" profession. In the medical field, human doctors were the first ones identified as vulnerable but in the past few years, consultants, counselors and managers are addressing compassion fatigue in veterinary medicine as well.

The veterinary profession is a highly stressful. There's a a great deal of animal sickness, injuries, and heartbreaking stories. Workers in veterinary medicine witness death death five times more frequently that their counterparts in human medicine. That's a whole bunch of death and stress. Additionally, since euthanasia is acceptable and practiced routinely in vet medicine, these professionals are the ones who actually facilitate their own patients' deaths (obviously done to prevent needless suffering). Ultimately, no matter what the intent is behind it, it's still the purposeful act of taking a life. Doing this and also supporting grieving pet owners can take it's toll over time.

Ways to prevent and deal with compassion fatigue in medicine are still being developed so many professionals out there are in quite a bit of distress. I worry about these folks and hope that they can learn new self-care skills to make their stress a bit easier to bear. I'm curious as to what you all think (pet owners and veterinary professional alike). Do you see this problem in your own lives or in others in the "helping" professions? If so, what do you think should be done to help deal with it? (photo from Dreamstime.com)

--Dana

Breathing Easier

I've certainly had cats on my mind lately and I've got some great news! I just finished reading an article about a possible cure for feline asthma in one of the latest online veterinary journals (AAHA NewStat 10/28/09). Apparently, 1%-5% of all cats suffer from feline asthma (that translates into 4.1 million cats!) This can be a very serious disease and is potentially fatal so it's good to hear about the progress they're making.

The funding for this research comes from the Morris Animal Foundation. They provide essential funding to veterinary schools all over the country for the advancement of animal medicine. This latest study conducted by Carol Reinero, DVM, DACVM, PhD looks to be quite promising.

Have any of you had cats afflicted with feline asthma? If so, how did it affect your relationships with them and their quality of life? Once again, I ask you cat lovers to send us your thoughts!

--Dana

Wanted: Large animal vets

Usually you'll hear more about veterinary news from Dana or Laurel. I go all over the web looking for news about pets, celebrities and their pets, and the like. But, I came across an interesting news piece about large animal veterinarians recently that I thought I'd share!

It seems that veterinary medicine is lacking in veterinarians who specialize in large animals. One state, Kentucky, is taking steps to make sure they have enough veterinarians taking care of their large and food animals. The Kentucky Large/Food Animal Incentive Program offers the possibility of repaying up to $6000 a year of outstanding student loans of eligible veterinarians, vet technicians and veterinary technologists who practice mostly large/food animal medicine.

Kentucky Agriculture Commissioner Richie Farmer said, "This program is important to Kentucky's animal agriculture industry and our food supply. Veterinarians are leaving large animal practices faster than they can be replaced." Commissioner Farmer goes on to say that livestock account for a huge portion of the state's economy and it is important to be sure they have enough veterinarians to care for the animals.

Now, I am not a "farm" girl, but I do know the importance of having veterinary care specialized for large animals. I lived in an apartment on a farm for about 10 years. While I didn't have to care for the animals, I was always aware of what was happening with them. (I really loved having the animals around. It was mainly pygmy goats and horses. Pictured on the left is one of the pygmy babies. He came with me to visit at CSU when I worked there!) There were several times when an emergency vet had to be called. It was so great to know that there was a great veterinarian on call who specialized in large animal medicine. We also lived close to CSU and my friend/landlord had to take horses there on more than one occasion.

I like hearing that states are making programs like Kentucky's to give incentive for specializing in large animal medicine. Do you know if your state has any similar programs?

--Tammy

Close Encounters of The Cat Kind

This past week-end in Denver I lectured to a group of feline practitioners at their annual society meeting (AAFP). It was a fun time, a bit unusual, and a valuable learning experience. It was also the first time that I had ever lectured to veterinarians who work exclusively with cats.

The AAFP is committed to improving the lives of all domestic cats. They support cat advocacy programs and provide advanced medical continuing education for feline doctors. There are those in veterinary medicine who feel that cats are a bit under served when compared to dogs. While it's true that more people own dogs than cats, it's still very important for cat owners to have access to quality medical care.

As I spent time with this group, I started to realize that cat owners deal with some unique emotional issues. As we all know, cats and dogs are quite different as are some of their medical needs. Cats in general, tend to be more stoic than dogs. I've blogged about this stoicism before... but it bears repeating because many cat owners have a hard time knowing when their cat is in any pain. If owners  cannot know for sure, there's always the potential for them to miss a serious illness or problem. This can translate into an immense amount of guilt when their cat dies.

Cats also also tend to have longer life spans that dogs (some live well past 15-16 years and a select few can live into their 20's!)" These longer life spans can create tremendously strong bonds as a person can literally "grow-up" with their cat. When people have relationships with their cats dating all the way back to  childhood, their grief can feel quite overwhelming (they are not only grieving the cat's death, but they are grieving the end of an era as well).

What are some other emotions experienced by cat owners? Do you feel that any of these are quite different than for dog owners? I want to hear from all our cat lovers out there! (photo is of Tammy's cat Henry)

--Dana

A Good Dose Of Job Security

In today's economic climate, almost every business in the country is experiencing difficult times. I was happy then to read about an economic study conducted by "Packaged Facts: a unit of Market Research Group in New York.* According to this study, the overall US market for pet care services will grow annually by about 9 percent and exceed 34 billion by 2013.

That growth is faster than the annual 7 percent rate in the past five years during which the market grew from 17.1 billion in 2004 to 22.7 billion in 2008. The study also says that veterinary services account for 75 percent of the overall pet care services market and is expected to lead growth in the overall market.

This seems logical since veterinary care is the most essential type of service compared to services such as grooming, training, and boarding. I wonder though if the improvement of emotional support in veterinary care is also a reason for this good news? When money is tight, people are probably willing to pay for a service as long as they believe that service is of good quality medically and emotionally.

What kinds of things do you predict for the field of veterinary medicine economically and otherwise? Do you think good communication makes or breaks a business in a slow economy? Let's hear from you!

--Dana

*Source (Veterinary Practice News, September 2009, Page 5).

Let's Hear It For The Nurse!

The September/October issue of Trends Magazine has an interesting article about veterinary as technicians (at our hospital we call them nurses) and how they are under-utilized. Overall, it seems that they are not doing many of the tasks that certified nurses are specifically trained to do. However, with the emergence of larger veterinary hospitals, things are changing. The nurses are no longer limited to just holding patients, drawing blood, and filling prescriptions. In fact, they are starting to take on similar roles much like nurses in human hospitals. This means that they can monitor a patient's condition, summarize intake findings, and carry out treatment protocols that the doctor prescribes.

When nurses take on more tasks and responsibilities, the hospital benefits by saving money (the nurses are doing tasks that are often done by higher-paid veterinarians and the doctors have more time to do things that only a doctor can do ( such as diagnosing a medical problem or performing surgery.) To quote certified nurse, Elise Atkinson at Alameda East Animal Hospital..."we want responsibility , and above all, we want doctors to have faith in us."

At our hospital, we try very hard to utilize our nurses effectively. We even have what we call "nurse-only appointments" (they involve things like vaccinations, wound checks, and removal of stitches). By utilizing our nurses more effectively, they also seems to have more job satisfaction because they are being challenged more. It's a win-win situation across the board.

As pet parents, what do you all think? How do you view the veterinary nurses who work with your veterinarian? What kind of experiences have you had and do you think they are under-utilized? All you nurses out there...please feel free to chime in! (photo from bigstockphoto.com)

--Dana

"Dr." Groomer

Let me start out right now telling you that groomers as a whole, are terrific people and work hard at what they do. They care about their clients and their pets. However, we occasionally have difficult days when a groomer has "diagnosed" a problem with a pet and the owner comes in telling us what treatment must be done.

Groomers, animal behaviorists, trainers, and animal care specialists certainly have experience working with animals and have knowledge that exceeds the average person. They can alert an owner about a change in their animal's coat or other problems. But...it is a bad situation when a client comes to us saying that the groomer has decided her dog has cardiac problems (this happened just last week). ???? How would the groomer come by that conclusion? That's a pretty bold statement and seems out of bounds to me. What's worse is that the client often believes the groomer even to the point where they argue with the veterinarian about the diagnosis. I'm sorry, but this makes about enough sense as it does for me to consult my hairstylist about my cancer treatment. It just seems weird but it happens more frequently than you think.

Because owners are loyal to their groomers, it can be very difficult to convince clients that their groomer is incorrect about advice they've given (especially with dermatological problems). It's also frustrating because the pet is the one who suffers the most. It would be so much easier and save a lot of time and heartache if groomers refrained from diagnosing medical problems all together.

Opinions everyone...what are your thoughts about this? If there are any professional groomers or animal care specialists out there to lend us your opinions? I welcome your ideas and feedback! (photo from bigstockphoto.com)

--Dana

Finding The Safety Net

Most veterinarians who own a practice have experienced it before...it's the stressful and regrettable job of having to "fire" a client. This happens so rarely (thank goodness), but it is an amazingly stressful experience for the entire hospital staff.

Last week, we had to face this stress and ask a client to never come back to our hospital. There's no doubt that we did the right thing (he made several overt threats to our staff members; and he mentioned bringing a gun each time). He started coming to us because another veterinary hospital had fired him the week before. It feels so wrong to turn away a sick animal, but we simply had no other choice. We're lucky because this other hospital warned us when this client requested his records to be sent to us. They helped us to be prepared and it was nice to know that competitor or not, we're all in this together.  

At our staff meeting, we discussed our frustrations about the situation. It's always so hard to see an innocent animal suffer at the hands of a disturbed person but this situation allowed us to talk with our employees about safety policies. You never want to think about those things, but it's necessary and we took this time to debrief. Everyone on staff told us that this debriefing was quite helpful.

I'm curious about your thoughts. At what point is it necessary for a veterinarian to "fire" a client? How should the veterinarian determine these things? I'd like to hear from you!

--Dana

"Soft Skills" Deluxe

Here at the café we often talk about the importance of effective communication in the veterinary profession. In the past 20 years, there's been an impressive "communication movement" that has allowed many more veterinary schools to improve their training and many veterinary organizations are offering more continuing education about these issues. While many veterinary schools and professional organizations are addressing this need, there is still much work to be done.

The September 8, 2009 on-line issue of Exceptional Veterinary Team magazine (myEVT) contains an article discussing this very problem. In the article: "Veterinary School: What They Don't Teach;" Dr. D. shares her frustration about having limited training in this area and how she felt unprepared to deal with her clients emotions in her first job out of school. The author states, "although I was confident in my medical skills, the way the client's tear-filled eyes locked onto mine as I explained the effects of snake bites made me more than a bit nervous...after all, veterinary school taught me how to treat an injury but not how to deal with distraught pet owners."

It's true that many more veterinary schools today are changing and adapting their curriculum to help students learn communication skills. It's also true, however, that there are some schools that still provide no training at all. The financial pressures Universities face in today's economy are just as intense as the pressures in many other institutions and businesses. It can be hard for them to find adequate resources to provide training with Dr. D. calls the "soft skills." When push comes to shove, they feel that the medical information has to take priority.

What do you all think about this issue? How do you go about ranking the importance of topics in veterinary curriculum? Should there be a formula, and what should be done when no money is available to teach communication skills? I'd like to hear your thoughts! (photo from istockphoto.com)

--Dana

A Rock And A Hard Place

Anyone who has ever owned or worked at a veterinary hospital has faced this dilemma...

We have a client who is very kind, conscientious, and cares deeply for her dog. Unfortunately, her dog is outrageously aggressive with anyone besides her so it's very stressful when she brings the dog in to see us. We've tried many times to explain to her the gravity and seriousness of the situation, but she just doesn't seem to want to hear it. We try to remind her that if she were to get scratched, bitten, or injured by her dog during a veterinary exam, we would be the ones held responsible...not her. We've tried many strategies and plans with this dog to keep everyone safe, (certain restraint techniques, behavioral interventions, distraction, the client coming into the treatment area with us, etc., but nothing works very well). The only thing that we've found to be effective is sedating the dog ahead of time.

I understand why someone wouldn't want to sedate his/her dog unless it's absolutely necessary. However, in this case it IS necessary and we can't seem to get through to her. Sometimes she will even acknowledge the potential dangers to herself, but it's very hard to get her to think about the dangers to our staff as well. Just because we work with animals and know about their aggressive behaviors, it doesn't mean that we're safe from the harm caused by that aggression. Our staff depends on us to provide a safe work environment and we simply can't risk safety to accommodate one client and one patient. Unfortunately, we've had to set a boundary with her where we won't see her dog unless it is mildly sedated. This is such an uncommon thing, and it feels just horrible to put a pet owner into a situation like this. The worst part of all of this is that this dog is not receiving adequate medical care as a result.

My question to all of you...how would you approach this client if your were in our shoes? We've tried many ways to explain the issues to her, but so far not much luck. It's almost as if she doesn't want to realize how dangerous her dog can be. It's so hard to tell someone this, and we end up being the bad guy. Because of her frustration, this client calls us frequently wanting veterinary "advice" via the phone since she won't agree to sedate the dog for an examination. Once again, we're the bad guy having to tell her that we can't make a diagnosis over the phone; we need to examine the dog; and only then can we provide appropriate treatment.

I can't remember when I've felt this "stuck" with a client. Help me out here folks...am I missing something? I want your ideas!

--Dana

Computerized Co-Workers

Today's technology...it changes so fast now that you could upgrade your computer (iPhone, Blackberry, etc) on a weekly basis. It's wonderful, efficient, sophisticated, and very polished. Yet, as amazing as new technology is, I sometimes worry about it's effect on human interactions. We're all probably familiar with the joke about 2 teenagers who are texting each other and "conversing" electronically while they are sitting right next to each other. It's funny, but in a way, kind of sad. Are we so seduced by shiny electronic things that we fail to even acknowledge the people sitting right in front of us? I wonder sometimes.

My job as a consultant requires me to do the bulk of my work via computer. There's no doubt that it's more convenient and probably more efficient, but there are days when I really miss the company of another co-worker. One benefit of having a job is the relationships and friendships that you build at that particular job. With co-workers, you feel companionship, camaraderie, and you can easily identify the humorous aspects of your work. Co-workers also help you when you have a difficult or stressful day. For my work, I find that it's really hard to make friends with or build camaraderie with an e-mail account. Establishing a solid relationship with someone whom you've never met, or even talked to is challenging. I try as best as I can to infuse "humanity" into my e-mails, but at the end of the day, I'm still sitting in front of my computer with not another person in sight. It can be lonely, isolating, and unfulfilling from an interpersonal standpoint.

I'm probably biased because I'm trained in communication and that is my specialty, but I think it's an important point. At our pet hospital, we see more and more veterinary software that allows clients to check in or consult with their veterinarian via a website or e-mail address. Sure it's convenient, but does that mean it's better? Is the quality of the interaction as good or as satisfying? Maybe I'm just from an older generation, but I prefer to actually interact with my doctors every once and awhile (at the very least by phone).

What are your thoughts about this? Do you think veterinary medicine is losing it's personal touch from all this fancy technology? Where do you all see the profession going towards? What do you think about our society in general? Let me know your ideas! (photo from istockphoto.com)

--Dana

Cool Customers

Quiz time everyone. How can you tell when a cat is sick? The answer....when the cat dies. While this expression used by some feline practitioners is crude, it's based on experience. An article in the July 2009 issue of Veterinary Forum talks about this very problem. As many veterinarians and cat owners will tell you, It's hard to know when cats are ill because they are the ultimate masters of hiding illness and pain.

Several studies over the past 5 years show that on average, dog owners take their dogs in for regular exams twice as frequently as cat owners. Is this because cat owners care less than dog owners? I highly doubt it. It's just that cats are so stoic, they can be in severe pain while still sitting on your lap purring. At our pet hospital, our associate veterinarian once treated a cat with an open leg fracture and while the nurses were holding her for radio-graphs, she was calming swishing her tail purring softly.

The good news is that veterinarians are doing a better job of educating cat owners about this and advising them to obtain yearly exams even if their cat shows no signs of problems. In fact, the American Association of Feline Practitioners has now created 3 distinct age classifications for cats. 7-10 year-old cats are middle-aged; 11-14 are seniors; and 15 years and older are now called "geriatric" cats. The hope is that this new classification will encourage cat owners to seek more regular veterinary care as their cats get older.

What do all of you cat lovers out there think about this? Are your cats as stoic as their reputation portrays them? What classification does your cat (s) fall into? It's time for some good cat conversation around the milk bowl!

--Dana

Chips Off The Old Block

The August 2009 issue of Veterinary Practice News contains an article about Trakr (a german shepherd search and rescue dog) who has been cloned. Trakr died this past April, but his 4 cloned offspring (Trustt, Solace, Valor, and Prodigy) now live in his image (literally).Trakr was a famous search and rescue dog credited with making hundreds of arrests and helping scores of missing people. He also found the last human survivor in the rubble of the 9/11 attacks in New York City. His owner, retired police officer James Symington, took the 4 cloned pups home this past June. (Symington is pictured with his pups.)

Trakr was cloned at the Sooam Biotech Research Foundation in South Korea under the direction of Dr. Hwang Woo-Suk (the first person in the world to ever clone a dog in 2005). This cloning was authorized and paid for by CioArts International in Mill Valley, California. Trakr was selected from a large group of other dogs because he was thought to be the world's most "clone worthy" dog.

This issue changes the boundaries of how technology affects the natural order of life and death. There is much controversy about cloning but I personally am quite hesitant about doing such things. Although the 4 cloned pups might be identical to Trakr in appearance,they won't necessarily have the same tracking skills or temperament. With canine rescue and assistance work, a dog's temperament, experience, and other personality traits play a very large role in the dog's capabilities. Since the cloned pups will not have the same life experiences, they will probably be completely different from the original Trakr.  After all, life experiences affect a dog's behavior throughout it's lifetime (like with obedience training and early socialization). If this is the case, then what's the point of cloning him anyway? If other german shepherds can be trained to do similar work, why even bother?

What are your thoughts about these questions? Do you think cloning is a good idea? How might cloning affect the human-animal bond and issues such as grief and loss? How should people go about deciding which animals are more "clone worthy" than others? Let's hear your opinions! (AP Photo)

--Dana

Simple Gestures and Peace of Mind

Here in Colorado Springs, we have several veterinary specialty practices (surgeons, internal medicine specialists, oncologists, and even a veterinary dentist)! I've recently had dealings with the surgery center since my own dog Chance had two surgeries on his knee.

On the day of his surgery when we were leaving the hospital, I noticed a small, pretty basket on the front counter that was filled with paw print stones. The stones had little notes attached to them saying "please take one of these stones to keep you close to your pet." Wow...I've known about this innovative product for quite awhile, but I had not experienced the reassurance first hand.

I immediately felt more at ease with leaving my dog in their care, and I felt secure in the knowledge that they were "good people" who I could trust. All of this from one sensitive gesture...it was powerful.

World By The Tail Inc. educates veterinarians about the importance of acknowledging the human animal bond. If veterinarians show clients how much they care, clients will also believe that they will cure. It's amazing how important this perception is.

What does your veterinary hospital do to demonstrate a sense of caring? Do they use any of World By The Tail's products to convey this care? I'm interested in hearing from you!

--Dana

Internet Pharmacy Dilemmas: Part Two

I've written about this topic before...it's the problems associated with pet owners buying their pet's medication via the internet. As I stated then, drug companies won't sell pet medications to these companies. If something goes wrong, the drug company assumes no responsibility and the veterinarian who prescribed the drug is left dealing with the aftermath. Even when the owner signs a written document about the risks of using on-line pharmacies, it is the veterinary hospital who is still vulnerable to lawsuits.

A few weeks ago, this problem got kicked up a notch. One of our clients sent an internet pharmacy a prescription pain reliever (for her dog). What the client ended up receiving was a completely different drug than the one that was prescribed. In the package, there was a note assuring the pet owner that "this medication can be substituted for the prescribed medication."

Now I'm all for free enterprise, but this seems just wrong to me. We probably have good grounds for taking legal action against the pharmacy, but it would takes lots of time and lots of money (these pharmacies make a HUGE profit). It's only a matter of time before some unfortunate pet becomes sick or dies from this crazy behavior.  

What do you think is the best way to warn clients about these pharmacies? Since these companies can often sell the medication at a lower cost, many people buy from them. Yet...is the savings worth it? How should we warn and educate clients without scaring them? Please share your thoughts...we appreciate your help!

--Dana

Understanding Fluffy and Fido

It happens at least once a week. It's the client who needs help with his/her pet's behavior problems. We do the best that we can, but there are situations when the problem requires someone with specific expertise on this issue.

We are lucky at our hospital because we can refer our clients to Dr. Dan Estep, and Dr. Suzanne Hetts at Animal Behavior Associates. They are excellent animal behaviorists and have helped many of our clients with some very complex behavior problems. We also refer clients to Bark Busters (a service for dogs only).

I'm realizing that knowledge about animal behavior is instrumental in  helping pet owners and nurturing the human-animal bond. Some veterinary school teach behavior classes but some do not. What is your opinion about this?  Do you think that veterinarians should have more training in animal behavior? Should the state licensing boards require that veterinarians have advanced knowledge about common problems seen in dogs and cats? Is that placing too much of a burden on the veterinarian? Let's hear your thoughts!

--Dana

Encounters With Wild Kingdom

Last week, one our client's brought in her 30 pound female Sheltie for treatment. Apparently, this feisty little girl had an encounter with a mountain lion! Obviously, the cat must of been scared off before the "battle" could go very far. As it was, the dog  had several deep puncture wounds, lacerations, and some torn ligaments. I always wonder if dogs can appreciate their own size in relation to the rest of the world? This dog was certainly brave, but very, very lucky to have survived this encounter. I suppose some of the answer lies in the dog's type of breed and his/her level of aggressiveness.

I know that many small dogs get attacked by foxes, coyotes, as well as mountain lions. This can be devastating for the pet owner if the dog dies as a result.Lots of people have very strong opinions about this problem. What are yours?  Have any of your pets ever had encounters with wildlife? What was the other animal and what happened?  Please share your stories!

--Dana

Media Mania

There are times at our pet hospital when time is very tight. When talking to clients about surgeries or other complicated procedures, it is very helpful to have written material the client can take home. What do you think about taking a video home?

More and more, veterinary hospitals are using DVDs to help explain procedures and surgeries. This can be very powerful since we all know how "seeing is believing." For example, some veterinary oncologists use DVDs to educate pet owners about chemotherapy. At our pet hospital, we use DVD's for various issues such as behavior problems and specific surgeries.

I'm realizing that using DVDs can be a very helpful tool for educating pet owners. I am now working on making videos for even standard procedures (such as a spay or neuter which of course, is NOT standard for the pet owner. I also want to make a video about euthanasia (what to expect, what will happen, the drugs involved, etc). When Laurel Lagoni directed the Argus Institute at Colorado State University's Veterinary Teaching Hospital, she and her colleagues made videos about euthanasia and pet loss (sponsored by AAHA). These videos yielded positive comments and helped many pet owners.

What about you? Has your veterinarian ever offered a video that explains medical procedures? If so, was it helpful? Some veterinarians worry that using videos might negatively affect the personal connection he/she has with the client. What do you all think?

--Dana

Copping An Attitude

As everyone across the country knows, the economy is in pretty bad shape. Unemployment is very high and many small businesses are struggling. A LOT of people are out of work and competing for jobs. At our pet hospital, we recently had to hire a new technician (nurse). It took only two days for us to receive over 40 applications!

So what now? How do you go about choosing between applicants when they appear to have the same skills and the same level of experience? I asked our hospital manager how she deals with this dilemma. Her answer was simple...she hires the person who has a better attitude. This is a logical strategy but it's also an interesting one. Imagine this scenario: two applicants and just one open position. Applicant #1 has an AMAZING attitude but limited technical skills. Applicant #2 is technically gifted, but lacks enthusiasm for the job. Who do you pick? You probably know the answer...it's time to welcome applicant #1 into the fold!

This answer proves the point that veterinary care is so much more than just knowing how to insert catheters and draw blood. Veterinary care involves sophisticated communication between a pet owner and a pet hospital. You can teach technical procedures but can you teach a person how to have a good attitude? I'm not so sure.

What are your thoughts? If you were a manager interviewing people for an open job, what would you look for? Do you think a positive attitude can actually be "taught?" I'm curious about your ideas! (photo from dreamstime.com)

--Dana

Hitting Close To Home

Last week, I gave a staff training about how to support grieving pet owners. We have recently hired some new staff and I routinely give these trainings to insure that our staff can respond sensitively to these issues.

When the training was over, one employee approached me in private. She was distressed and worried that supporting clients in their grief will trigger her own struggles with death and loss. This is a legitimate concern and it probably happens frequently to many veterinary professionals. I gave the employee ideas about setting good personal boundaries and ways to keep the focus of the conversation on the client. However, it is a difficult reality and can be very hard to work with.

What is your opinion about this? Would you be offended if someone at your veterinarinarian's office shared some of their personal struggles with you? When might this be appropriate and how far should the person go with the self-disclosure? I'm interested in your opinions!

--Dana

"Thank You For Holding..."

The other day I spent two whole hours on the phone trying to contact someone at my insurance company about my medical bills. I finally got my answer but by the time the call was over, I was angry, frustrated, and completely annoyed.

Putting clients on hold is a fact of life in service businesses. There are times at our hospital when we need to put callers on hold in order to help clients that have scheduled appointments. We've all heard it before....the standard phrase, "may I put you on hold for a minute?" but I'm wondering if this is a good way to lose a client. One thing that people prefer about their veterinarians is that they provide superior service compared to that of human doctors. I know that from personal experience that putting clients "on hold" can communicate a very bad message and be interpreted as quite rude.

I always stress that if employees must put someone on hold, they should do it very politely and never make them hold for more than a few minutes. When the call resumes, I tell the employee to thank the client for their patience. Most of our clients are very understanding and tolerant of this.

What do you think is an "acceptable" amount of time for someone to put you "on hold?"At what point does it make you angry and what should the person do to address your frustration? If you're kept on hold for a long time, what should be said to acknowledge your anger?

By the way...I don't mind waiting "on hold" for people to to this question!(photo from bigstockphoto.com)

--Dana

Canine Chemotherapy

In June, the Associated Press reported that a new drug will soon be released to help fight cancer specifically in dogs. Up to now, most cancer drugs used in veterinary medicine were developed for use in humans and weren't specifically approved for animals. That's about to change with the new drug "Palladia" (manufactured by Pfizer Animal Health, Inc).

According to the Food and Drug Administration, this drug has been approved to treat a specific type of skin cancer (canine cutaneous mast cell tumors). These tumors can appear small and insignificant initially. While some are quite easily removed, others can be life threatening.

This is an important "first" for veterinary medicine. It shows that people are willing to spend money and time on cancer treatment just for animals alone. Of course, clinical trials with Palladia are just now starting so it will take some time before we know this particular drug's efficacy. Like most veterinarians, we'll need to hear from respected veterinary oncologists (who are not on Pfizer's payroll) before we consider treating patients with it.

What do you all think? Is this a good use of research money and time? Is it right to focus on just one type of cancer that doesn't even involve humans? We are all aware of the power of the human-animal bond...is this just a logical consequence of that bond?

--Dana

A Different Type of Intelligence

Most everyone familiar with pop psychology knows about the concept of Emotional Intellegence (EI). Originally developed by John Mayer and Peter Salovey, EI has become a wildly popular topic ever since Daniel Goleman's groundbreaking book in 1995.

Over the years, the term EI has become very broad and far reaching. Pure EI theorists (such as Mayer and Salovey) think the term is being diluted from over-exposure. Initially, EI referred to a person's capacity to "recognize, understand, and manage emotions." People with a high degree of EI can recognize emotions as signals, and know what the signals mean over time.

I have a hunch that many people in the veterinary profession have a fairly high degree of EI. In fact, people who interact with pets in general, are probably more skilled with emotions than some others. What do you all think? Which other professions require a high degree of EI? Do you think that people in those particular fields really are emotionally intelligent? What about human medicine? I'm interested in your thoughts.

--Dana

Weather Worries

Here in Colorado Springs, we have many afternoon thunderstorms in the summer. These storms can be very scary and difficult for certain pets (as can fireworks). It's always sad when we see an animal at the pet hospital who got injured from trying to hide or escape from their yard during a thunderstorm. They just don't understand what's going on.

Do any of you have pets that are scared of certain types of weather? Any fears about other sounds (such as the sound of the vacuum)? How do you help your pet in these situations? (photo from dreamstime.com)

--Dana

You and Your Schnauzer, Me and My Cockapoo?

I read an interesting article in the AARP Bulletin (yes, I am THAT old!) this month.  It seems one of the up-and-coming ways to provide health care may be 'shared medical appointments' or SMAs.  They're already happening in some specialty practices, like cardiology.  Here's how they work:

As many as 15 patients, who have similar medical conditions, schedule an appointment with one doctor for a 90-minute session.  The doctor answers individual questions as needed, but spends most of the time addressing issues pertinent to the whole group.  One of the benefits is getting to know other patients who are dealing with the same medical (and emotional) issues.  You get more access to your doctor, more education and overall knowledge of your condition, and the chance to network with others who may be of support to you and your family as you progress through treatment.

What do you think about this model in veterinary medicine?  Could it be of benefit to pet parents, as well?

I could see this in specialty practices and at the university teaching hospitals because there are enough clients there to justify the group sessions.  Would it work in private practice, especially if there were group appointments to address issues like annual vaccinations or maybe behavioral issues?

I'm not sure my dog would behave as well as I would if we were in a group appointment.  As a rule, I don't pick fights, but my dog does occasionally! (Pictured is my cockapoo)

--Laurel

Are You a Super Hero?

Anyone who knows me will tell you that I like to talk about superheroes...A LOT. They are after all, one of my husband's and son's favorite topics. The thought occurs to me that the average veterinary hospital is composed of all sorts of super hero characters. Here's a sampling:

"The Multi-Tasker": With dazzling concentration and seventeen hands, this hero can answer the phone, check in patients, process a clien'ts bill and prepare prescriptions all at the same time. This hero has special powers of patience, diplomacy, and a good sense of humor.

"The Wrangler": Armed with super-human reflexes and a low sensitivity to pain, this hero can restrain fractious cats, fear-biting dogs, and nervous birds with razor sharp beaks. This hero's costume is easily identified by a smattering of colorful band-aids that cover various puncture wounds.

"The Diagnoser": Dressed in a white lab coat and stethoscope, this hero can read radiographs that resemble piles of rabbit droppings while suturing a dog's abdomen in mere minutes. This hero's special powers include remarkable hand dexterity and the ability to see things most other's can't.

"The Steel Stomach": Costumed in fluid-stained scrubs and blessed with dead nasal receptors, this hero can miraculously clean up anal gland expressions, parvovirus blowout, and cat absesses without batting an eyelash.

What kind of super heroes do you have at your local veterinarian's office? If you were to work at a pet hospital, which superhero would you likely be?

--Dana

A Massage For Fluffy

Complimentary and alternative therapies for pets...they can be quite a mixed bag. Some pet owners swear by them, while others have found little benefit. So...what's the real deal here? The answer will probably annoy you...it depends. It sounds wishy-washy but it's true. It depends upon the animal; his/her particular medical issue; and of course...the clinician who provides the alternative medicine.

There are many competent, knowledgeable, and well respected veterinarians who offer complimentary/alternative therapies. Some are experts in their field such as Dr. Narda Robinson at Colorado State University's Veterinary School and Dr. James Gaynor- a pain specialist at Animal Anesthesia and Pain Management Center (www.nopetpain.com). For these types of clinicians, we would refer patients and clients in a heartbeat (when appropriate).

However, it is important to spend a little time doing research before diving into this alternative form of veterinary care for your pets. Once you start looking, you will see that there's a whole lotta cool stuff out there and there's a whole lotta weird stuff out there (don't you like my scientific terminology?) No matter what, you should at least talk to your own veterinarian and find out what he/she thinks.

At our pet hospital, we have seen for ourselves how amazing laser therapy and acupuncture helps animals with arthritis (one of our doctors was certified in veterinary acupuncture). We've also heard stories of clients who have spent a lot of money on questionable procedures without getting much benefit for their pets. As I said...it just depends.

So...what do you all think? Have you used complimentary/alternative therapies for your pets? What were they and how did your pet respond? I'd love to hear your stories! (photo from bigstockphoto.com)

--Dana

Is There A Doctor In The House?

At our pet hospital, we offer many types of appointments so that we can provide the best possible service to our clients. One of our options is having the pet see only the nurse (at a reduced charge). These are typically used for re-checks, bandage changes, wound checks, administration of fluids, etc.

Thus far, this has been a fairly popular choice. That changed the other day when a client had a full scale meltdown about not being able to see the veterinarian. Although he knew ahead of time that the appointment was with the nurse (at a reduced office visit price), he became very angry upon being told that the doctor was busy with another appointment  and wasn't scheduled to meet with him.

He became so agitated in fact, that he slammed his papers, wallet, car keys, and everything else all over the front counter and stormed out declaring he'll "never come back again"  I guess he felt that even though the office visit was at a reduced fee, he still expected to see the veterinarian for at least a short time.

I got to thinking about this and started wondering what the majority of pet owners feel about this. I can understand why a client would expect to see the veterinarian since he/she made the effort to take the pet in. Yet...there are those times when a nurse can handle things alone while still giving the animal (and the client) exactly what they need. I strongly believe that these appointments should have a reduced charge. What about you? Would you find your experience satisfying if you only saw the nurse? Under what conditions? How would it affect your perception overall of the veterinarian's service? (photo from dreamstime.com)

--Dana

Want to Fight?

From all my years working in veterinary clinics and hospitals I have found one particular thing that scares people the most. No...it's not the sight of blood or sharp needles....it's the dreaded and treacherous scenario of conflict. I think it's only natural. After all, we're "wired" to avoid conflict whenever possible. However, did you know that a big, juicy conflict can actually be a good thing? If handled well, it can actually improve and strengthen our relationships with the individuals involved.

Conflict can do all sorts of amazing things. Instead of being scared of it...try thinking of it as your friend. Some positive outcomes of conflict include:

• Improved communication through a better understanding of the person's perspective
• Better group identity, goals belongingness, and self-esteem
• Elimination of irrelevant issues causing problems
• Increased freedom to exchange ideas and feelings
• Increased trust
• Prevention of stagnation
• Increased innovation and better creativity

Who knew that scary ol' conflict could do such amazing things? The key is approaching the conflict with the right attitude and willingness to work through it (by believing that you CAN do it and that it will create some benefit). Of course...you always have to pick and choose your battles, but in some cases, taking the time to work through the conflict can save you from confusion, frustration, and unnecessary stress in the long run. We've had many situations at our pet hospital with clients and staff that have improved relationships after working through a conflict.

What about you? Is facing conflict about as frightening as speaking in front of Congress? If you're like me, you probably shy away from it. What are your thoughts? Have you ever experienced a time when conflict made things better? What about your own local veterinarian? How does he/she handle conflict? (photo from Istockphoto.com)

--Dana

Veterinary Discounts

"Times are hard financially, but my vet won't give me a break on veterinary care -- not even a payment plan! I told her that, at this point, my dog is a luxury and, if I can't get help with her medical care, I won't be able to keep her. What can I do?"    --P.D., Cincinatti, MO

I agree that finding the funds to pay for a pet's medical care is a challenge for all of us, especially if we live with more than one animal. For me, it's usually a cash flow dilemma since my veterinarian expects (and deserves) full payment at the time of the service. I've created several ways to remedy this situation for myself. I have a credit card that I don't use for anything but pet care (see www.CareCredit.com), I designate 'pet care' as a line item in our monthly family budget (so funds accumulate for that purpose throughout the year), and I'm considering pet insurance to help cover the costs of routine care (and perhaps some major illnesses). The point is I've realized that just giving a pet a good home isn't enough. I also have to be sure that I can provide a responsible level of health care for my animals. Trust me, that wasn't my mindset when we adopted four dogs, two cats, two guinea pigs, and an aquarium full of fish. I got caught up in the thrill of 'bonding' and, later, got blindsided by the agony of unexpected vet bills.

Still, I understand why veterinarians can't adjust their fees or their methods of collecting payment. First, they deserve the payment. Veterinarians are doctors, with vast knowledge and experience that they bring to every case they see. They are also independent businesses, with their clinics equipped with a wide range of diagnostic, treatment, surgical, recovery, and routine care necessities. Unlike physicians in human medicine, veterinarians don't have access to a common hospital. Most are self-contained hospitals, capable of providing amazing care.

The other problem vets have is charging a fair market price for their services so they aren't viewed as 'undercutting' the other clinics in town. We had a vet in our community once who was such a soft-hearted man that he often provided discounted or even free services for those who said they couldn't afford treatment. Eventually, he got the reputation for being the one to go to if you didn't want to pay high vet bills. Other vets got annoyed with him because it seemed that he took business away from them and eventually he 'burned out' trying to take care of an overload of hardship cases and closed his practice.

I know there isn't a good answer to this question. The fact is pets can be expensive and that knowledge should be part of your decision to adopt an animal. My theory is that if we practice preventative care (annual exams, vaccines, dentals if needed, etc.), the costs actually stay lower and more balanced over time because you don't encounter the emergencies and chronic problems as often. You catch little things before they become big things -- and, overall, spend less.

What do you think about the cost of veterinary care? How do you view it? How do you handle it?

(Photo from istockphoto.com)

--Laurel