fruit-cake with a side of rat poison

Well, its been a REALLY long time since my last post.... I've just been busy with life, I guess. But this little gem was so good, I absolutely had to share!


One of my receptionists just came to me laughing SO HARD... Here's the conversation she just had:
"Hi I was just making fruitcake, and my dog got into the rat poison. What do I do now?"
"Excuse me? Did you say you were making fruitcake? And the dog got into the rat poison?"
"Yes."
"How long ago did this happen? And how is the dog acting now?"
"Just a few minutes ago. And he's fine. He's just sitting on the couch watching Sesame Street and waiting for the fruitcake to come out of the oven."

Bwahahahaha!!!! She really wanted to ask if the fruitcake was for the evil in-laws, or some other "we don't claim them" relative.... As it turns out, the woman had a mouse problem, put some rat poison in the low cabinet behind the mixing bowls, and since the bowls were out of the way, the dog got into the poison. However, our staff STILL got the memo not to accept any fruitcake brought into the clinic this holiday season! ;)

its in the BLUE bag

Oftentimes, in the course of a veterinary exam, the topic of pet-foods is brought up... what kind is best? what ingredients to seek out? which ones to avoid? what brand is worth the extra money? Many of these questions come from the pet owner... and one of the most common questions is "How much should I be feeding her Doc?" Inevitably, my next question is 'What are you currently feeding?' You see, its kind of like asking "How much food should I eat every day?" without mentioning if your primary diet is Chocolate Cake or Spinach Salad. Most of the time, my clients respond with "Science Diet Senior" or "Purina Pro-Plan Large Breed" ... but often, people forget what brand they buy. So they will say something along the lines of "Well, I think its Eukanuba... or maybe its Beneful... its that one you see on TV all the time. You know, the one in the BLUE BAG!" Each time I receive this answer, I smile inwardly.... thinking to myself 'I wonder exactly how many "blue bags" of dogfood are on the market?' Wouldn't it be nice if it were that simple? Nine kinds of dog-food - Red, Orange, Yellow, Green, Blue, Purple, White, Brown & Black. No fussing with "low cal" vs. "weight control" - no worrying about "urinary health" or "diabetic diets." Just give me the Blue Bag, please. Yes, that would make trips to the pet store easier - and then, I really would know which food my clients were feeding, just by knowing the color of the bag. But, we would lose access to many of the health benefits of Rx veterinary diets.... and I wouldn't have any more fun guessing games to play during the course of my day. So I guess I'm happy with things as they are. I would, however, love it if once - just once - someone simply said "I really don't know" instead of looking at me like I'm crazy when I can't win their guessing game.

"I'm not argumentative"

"I'm worried about my cat" says Mrs. Contradictory. "He's been occasionally vomiting and is just not eating as much as normal. He's lost about a pound in the last 2 weeks... I'm really concerned that he might have kidney disease, or diabetes, or liver problems." Yes, those are all things to be concerned with, given Sylvester's history... So lets run some bloodwork and see what's going on, ok? "Yes, absolutely. I want to do whatever you feel is needed to make Sylvester feel better."

... so we draw the blood ... and I recommend some symptomatic care for Sylvester to make him feel better. Nothing too involved, given that he's stable and I want to know the results of his bloodwork before we nail down a treatment / management plan. I offer some SQ Fluids (a pocket of fluids placed under the skin that is slowly absorbed - it helps keep the patient hydrated despite his decreased water intake) - an injection for nausea - and some appetite stimulant pills (that are given once every 3 days). Does this sound like a good plan to you? Well, before I can get those words out of my mouth, Mrs. Contradictory is cutting me off. "No, I will not do any fluids. Or injections. Or medications. When Sylvester was here last month, that guy Doctor gave us some eye meds - it was easy, and simple. Then at the recheck exam, that other lady Doctor gave us a medicine to give by mouth - and that was a nightmare. So I am not doing any medications this time." Ok, but I can give injections and you won't have to do anything... and Sylvester will feel better until we find out what is wrong. "No. I will not do it. I'm NOT being argumentative, I am just refusing complex treatment." Ohhhh-kaaay. Then we will do the bloodwork and nothing else. "Yes, that is what I want. Bloodwork only. I really want him to feel better."

So I get the bloodwork back... no major issues with diabetes, renal failure, etc. So I call Mrs. Contradictory - and again I recommend some symptomatic care... thinking she will refuse. Surprisingly, she willingly agrees to make another trip to the clinic for basically the same treatment I offered in the first place - and she is very thankful for my phone-call and treatment recommendations. Sometimes I just don't understand.

True Colors

I've noticed something. Stress - and stressful situations - bring out a person's true colors. Maybe that color is blue... down in the dumps, constantly complaining, woe-is-me. Maybe that color is red... anger, rage, yelling, cursing. Maybe that color is green... peaceful, easy going in the midst of the storm. Maybe that color is yellow... bringing a little sunshine to those around them despite the chaos. Do you want to know the true character of a person? Observe them in stressful situations. Watch carefully. At first they may be able to disguise their true colors. But when the stress continues... when the stress is long term... when everyone around them is stressed as well? Then. Then their true colors will emerge - and you will know what is at the heart of a person.

hhhmmm

I suppose lately I've had a run of fairly 'normal' clients & patients... This is strange for me. Even my recent relief shift at the ER Clinic was relatively uneventful.

Today, though, I did meet an interesting patient. A dog named Toby with a painful left front leg. He had a little swelling at the area of the carpus (wrist) - the rest of his physical exam was normal. And he was a sweetie. Kinda nervous, liked hiding under the chair his owner was sitting on, but definitely a sweetie. And he captured a piece of my heart. Why? Because he looks & acts exactly like my own dog. Same type of Heinz-57 mutt. Same big brown eyes. Same nervous & excited tail wag. And same "I'm so excited to be going HOME" hopping-walk as he left the clinic. Its a good thing that I have a full house with three big dogs already... and that Toby has a good home. A great home, actually - with a family that loves him very much. Toby is one lucky dog - and his leg should heal up just fine. Sometimes, its nice to have "normal" patients and clients.

Iguana Inspector

I heard the funniest story today from a coworker... Let me set the scene:

Another doctor in our practice had just finished examining a sick iguana. The doctor stepped out of the room, and his assistant was getting ready to take Mr. Modest up front to check out. Mr. Modest unzips his jacket and tucks the iguana inside... Our assistant thinks this is a little odd, but hey, it was a cool day, the iguana needed to stay warm, and we see a lot of people who don't use a carrier for their cat, rabbit, etc. (Here comes the strange part.) Just as she's getting ready to walk out of the room, she realizes that Mr. Modest is unzipping his pants, tucking the iguana's tail into his pants, doing a little tail-situating-shimmy, and then proceding to zip up his pants back up with the tail still inside them. At this point she's thinking "aaarrrgghhh, brain bleach! WHERE is the brain bleach?!?"

Our assistant clears her head, and then decides to find the doc who'd just examined the iguana. She tells him the above story and waits for the inevitable look of "eeew - I just touched that iguana, and he probably carried it into the clinic the same way." LOL - after hearing the story today, several of us decided that the doc's new nickname should be "the iguana inspector."

short, but unbelievable

*sigh* I wasn't even sure what to title this one... I was in a room with a client, taking care of all the normal stuff associated with a vaccine visit - is Dexter on heartworm preventative? - has he had any coughing, sneezing, vomiting, diarrhea? - has he ever had problems with vaccines in the past? etc.... Well, part of the routine is taking vitals - temp, pulse, respiration... and yes, we have to take animals' temperature rectally. So, while I'm taking the temp (with an assistant holding the dog) Mrs. Uneducated says "Oh dear, will that make him gay?" Excuse me?? "I know you need to know if he's running a fever, but I'm just not sure what I'm going to do with a gay dog after you take his temp that way." Oh my... We tried to explain that no, it wouldn't make Dexter gay - but I'm not convinced that she believed us. *shaking head*

Quick! My dog is falling apart!

I heard a funny story today from a coworker, and couldn't help but share. Apparently Debbie's neighbor came over to her house late last night - when she opened the door, he said "Quick! You've got to come see what's going on - I need you to help me - my dog is falling apart!!" So, Debbie headed over there not quite knowing what she might find. When they arrived, her neighbor said that the dog's insides were falling out and he didn't know how to get them back in. Take a guess.... can you figure out what Debbie saw?

Debbie saw a female dog giving birth to a puppy. Yep - just a normal, happy, healthy birth - and a freaked out man who'd never seen anything of the sort. Three puppies later Debbie was ready to go home. And hopefully, now that her neighbor realizes that his intact male and his unspayed female CAN and WILL mate, he will get at least one of them fixed!!

Wed morning funny

A friend sent this to me today... and its too funny not to share!

blatent lies

Does it ever amaze you how comfortable people are with lying? I mean, lying with the knowledge that they will be caught in their lie. It happens so often. I'm sure veterinary medicine isn't the only field where people do this... but unfortunately, it IS a field where people can get away with it on a fairly regular basis. People are afraid they'll 'look bad' if they tell the truth... don't they realize they look even worse when they are caught in their lies?

Example #1 - a typical scenario... Rex comes in with vomiting & diarrhea of 3 days duration. Has Rex had any unusual food? Gotten into the cat food? Eaten scraps out of the trash? Been fed any people food? "No. Absolutely not. We don't give Rex ANY table food." Any toxin, chemical, poison exposure? "Nope. None of that in our house, and he hasn't been anywhere else." Ok... well, lets start talking about other causes. Wait - it appears Rex is going to give us a fresh stool sample for analysis. Aaannndd... yes, he's going to demonstrate the vomiting as well. Hhhmm.... is that pork bones, green beans, and partially digested bologna? "Yes, he wasn't feeling well and he wouldn't eat his dogfood, so I gave him what we had for supper - plus a little bologna because he just LOVES bologna. Its so cute how he will sit and beg for bologna!" Hhhmmm... I thought he NEVER gets any people food? "Well, nothing that WE wouldn't eat, doc." *sigh* I'm fighting a losing battle here... Maybe I can't convince Rex's family that their feeding table food has directly contributed to his nausea / diarrhea. Maybe there is no point in trying... but my line of thought? If you're going to feed it, you'd better be willing to own up to it!

Example #2 - a family comes into the clinic, knowing that payment is due upon receipt of services... they approve an estimate, sign a form saying that they will pay in full, or that they will pay 1/3 down and make payments on the rest... they are given chances to ask questions... to clarify any misunderstandings they may have... and yet, when the time comes to pay, they 'forgot' their checkbook, or 'didn't know' that their credit card was maxed out... they say "I have $200 to pay today" and then 'realize' they only brought $50 with them. I understand that they have good intentions... they want the best for their pet. They want to do everything, but don't have the money to pay for it. But do people go into the grocery store and try to get $200 of groceries for $50? Do they think they can go to the bank and request a loan, simply on the good-faith-promise that "I'm good for it - I swear - I'll pay it off the Friday after the first Monday of December, because thats when I get my disability check, and my car will be paid off by then, and...."

*sigh* When did people drop all sense of honesty, trustworthiness, and responsibility?

Is NOTHING inappropriate anymore?

So.... remember my post about Molly & the clients who cut the Ecollar down and then wondered why it didn't work? Well, apparently that they're at it again... only this time, its not Mrs. Clueless doing silly things and wanting services for free... its Mr. Clueless being completely inappropriate!

Yesterday, I worked at our small clinic again - with the same doc as last week. Molly came in for a recheck... turns out she's doing alright, didn't have the surgery, but did need her ear drained - again. So, my colleague and one of our technicians went into the room to examine Molly. They told Mr. & Mrs. Clueless that they'd take Molly in back, drain the ear, and return shortly. It was then that they were caught completely off-guard as Mr. Clueless said "Do you mind if I come with you? I'd love to hold both of you while you hold Molly and tend to her ear." Seriously?!? This man is in his 70's, his wife is sitting right next to him, and he is not at all joking. *sigh* Apparently nothing is off limits.

how sweet is TOO sweet?

A very sweet woman came into our office today, bringing her very sweet, very large dog for vaccines. As usual, our clinic assistant met Mrs. Sweet in the lobby and escorted her to the exam room. On the way, they stopped to weigh Hugo on the floor scale - 124lb of happy, energetic dog! Then Mrs. Sweet said "Can I use your scale to weigh myself?" Uuuuummmmm, sure, I guess. "I'd better take these shoes off - they weigh at least 2 lbs!" (oh, my - there goes the quick step-on-step-off I was hoping for) "Now, honey, don't look at that number! But what do you think I can subtract for all of these other clothes? The jacket and jeans have to weigh a few extra pounds right?"
Finally, our assistant got Mrs. Sweet and Hugo back to the exam room - before I walked in, the above story was relayed to me... and it put a smile on my face as I entered the room. Then, as I was performing my exam, and Mrs. Sweet was chit-chatting my ear off... she stopped mid-sentence and said "Honey, you're just SO pretty!" while reaching over to toussle my hair. I must say, thats a first! Quite an invasion of personal space, incredibly odd, and yet, I knew she meant nothing by it. Still, I was happy to finish the exam and send Mrs. Sweet up to our cashier. I suppose it is possible to have too much sweetness in one place!

Really, you're suprised?

So I'm working at one of our smaller vet clinics today - myself and one other Doc. This morning, I noticed that she had a patient with an ear hematoma - basically, the pet's ear infection was bad, the dog was shaking her head constantly & broke blood vessels in the ear flap so the space between the skin and the cartilage filled with blood. Its a common thing in dogs, and looks rather funny - as if someone blew the dog's ear up like a balloon! So, if the hematoma is small, we can drain it, give meds for the ear, and it will likely resolve. But, if the blood fills the whole ear flap, it often needs a surgical repair... So Molly's owner had dealt with this once in the past - years ago. The issue was small then, and draining the ear worked - today, however, the entire ear was involved. Despite my colleague's advice (and warning that there was a 95-100% chance the hematoma would not resolve, given its size), Molly's owner decided to take her chances... so, the hematoma was drained, the ear was wrapped securely to the head with a bandage, and an Ecollar ("lampshade") was applied to keep Molly from tearing the bandage off.

Fastforward a few hours... the woman calls back, saying the ear is all filled up with blood again. By this time the other doctor had gone home for the day... so it became my problem. I'm thinking to myself 'HOW did that dog get the Ecollar AND the bandage off?!?' Should've known. Stupidity at work again... Molly's owner says "Well, she couldn't stick her head past the end of that thing, and she hated it - so I trimmed it off to make it quite a bit shorter. That way she could see and it didn't bother her. She still had it on when she got the bandage off. I just don't think those things work well at ALL. Is there something else we can do?"

Really?!? I don't know if I'm surprised more by her comment / action, or by the fact that it surprises me. I really shouldn't be surprised anymore. Common sense is CERTAINLY not common...

So, we scheduled a recheck appointment for tomorrow, to replace the bandage and get a new Ecollar - and told her now we'll need to do surgery next week. Ok she says... "But do I have to pay for the new Ecollar? And can we just take all the money I spent today and deduct it from the cost of the surgery?" Uuummmmm..... NO. We recommended surgery in the first place. YOU decided not to take our advice. YOU cut up the first Ecollar. *sigh* I'm glad the day is almost over.

Veterinarian or Psychologist?

I think they should offer psych classes in veterinary school. Or maybe they should require them! Many, many times I feel that I'm treating the person rather than the animal... The elderly gentleman who comes in 3-4 times a month to pick up meds for his animal when he could get them all in one trip - instead, he says "Well, I don't have anything else to do, so I'll get them one at a time and I can visit with you as well." The woman who thinks she has bugs crawling on her skin, but her MD says she's fine - still she brings all her pets to us to check for the elusive "bugs." And today, the elderly woman who lives a very sad, paranoid life. Her dog is totally normal, but she feels he's being poisoned by relatives & the "meth-heads" down the street. Poor woman is convinced she has been threatened, poisoned, followed, and even had people steal the 'evidence of the poisonings' from her lockbox at the bank. I do my best to visit when I have time, to convince them their pets are bug free, and to appease them that we're looking into the allegations of abuse / poisoning... And yes, its all part of the job that I had been warned about, that I knew to expect... yet I often feel underqualified.
Today, we called the division of aging services... I hope the elderly woman finds the help she needs.

show & tell

Today I thought I'd break out some photos from a case I saw while working in the animal ER...

My patient was a middle aged cat that presented for vomiting of several days duration... he was dehydrated & painful when I pushed around on his abdomen. I suspected I was palpating a foreign object, though it was hard to tell for sure since he resisted my exam. His owner ok'd xrays, and this is what we saw...

Can you spot the foreign object?

Now, a little help for those not familiar with xray anatomy...

And, for the "fun" part... we always like to play Guess-The-Foreign-Body - basically, we see who can come closest to predicting what the foreign object will be... THIS particular xray had us all stumped...

Have you guessed yet?!? Well, here it is...

What is it, you ask? Well, I still don't know! It appeared to be a hoof from a small hooved creature (baby sheep or goat). But none of us could figure out how or why this cat could have gotten hold of such an object... turns out, neither could his owners! Even when we showed the "hoof" to them, they couldn't ID it... never seen it before. If only animals could talk! I'd love to know what this was and where our kitty friend found it! The good news is that our patient recovered well with no post-op complications. :)

Eeeeww.

We get a lot of strange phone calls in the veterinary profession. A couple of examples:

- Can I come by your office and get that allergy injection for my dog? You know, the shot you give him so that I'm not allergic to him anymore? (gee, I wish I had that - I'd be a MILLIONAIRE!!!)

- My dog has been vomiting for 5 days, has been having diarrhea for 4 days, hasn't eaten anything or been able to keep water down for 4 days, and is acting really listless... can I give him something at home so I don't have to bring him in? (oh, and PS - when I finally do come in to see you [10 minutes before the office closes, demanding to be seen because its NOw become an emergency], I will tell you I only have $20 to spend on my beloved pet that is like my child - I have a $200 purse, drive a $40K car, and have obviously had plastic surgery, but your $40 exam fee is simply outrageous and I refuse to pay it - but do everything you can for my sweet dog, I will bring you the money in 7 weeks - I'm good for it, I swear)

Today, however, I heard a new one... and I literally just shook my head, and then didn't know if I should laugh or shudder... so I did both.

- I've been breastfeeding my baby, but I have extra milk. Can I bring my breastmilk in and donate it for the cats and dogs? (ok, so this is strange, and would in no way help the animals [we need species specific milk replacer], but it was a very nice thought - an animal lover with good intentions, no doubt. on the other hand, as our staff began talking, we discovered that sometimes, even good intentions can be taken WAY too far - someone once knew a woman who literally BREASTFED puppies [or was it kittens?] - didn't pump the milk and bottle feed it to them, she literally breastfed them - now that?!? THAT is a little disturbing)

Gross. But part of the job.

I see a lot of disgusting things in my job. Maggots in a pus filled wound. Bloody diarrhea. Anal gland secretions. But today, I was reminded of one of the worst possible sights and smells that comes with my job - a crazy hyper puppy.... so crazy that he vomited the entire contents of his stomach - partially digested food, dewormer, and oh-yeah... partially digested poop. Yep, the puppy at his own poop, and then vomited it up - and then tried to eat it again! The most disturbing / funniest part of the whole thing? Those of us in the room were simply laughing at the whole situation. I love my job! :)

is this a vet school exam?

I never know what is going to happen when I walk into an exam room. Maybe the client is going to be pleasant and the patient will be healthy. Maybe the pet will be an angel, but the owner has a chip on their shoulder from a bad vet experience in the past, and they will hate me before I ever walk through the door. Maybe the cat will try to scratch my face and bite my finger, or the dog will try to lunge at me from across the room. Maybe the owner will burst into tears as I walk into the room. Or maybe I will walk into the exam room and endure a barage of questions designed to "proove" my competence. Today was a day for questions... Today, I was "interviewed" by a biomedical statistician. The interview was disquised as a simple "recheck" appointment. I stepped into the exam room expecting to discuss repeat bloodwork and changes in medication. About 45min later, I emerged from the room feeling like I'd traveled back in time and had just finished one of the legendary "oral exams" from veterinary school. An exam where one student endured a question and answer session with 1-2 faculty, answering numerous detailed questions designed to quiz our knowledge of every single aspect of a particular disease process. The exams tested our analytical skills, our "calm under pressure" attitude, and were enough to make any vet student sweat nervously in anticipation. I'm happy to report that today, I was not sweating as I left the exam room after my "interview." I'm happy to say that I feel confident in my ability to stay calm under pressure. I have to admit that I failed in my ability to recall every single case I've treated with this particular condition, and although I could say the incidence of treatment failure was approximately 3-7%, I couldn't pinpoint what exact percentage of my PERSONAL cases had a certain outcome - and I'm OK with that! Two months ago, I looked at a patient during a wellness / vaccine exam and suspected an underlying disease process. I ran bloodwork, diagnosed said condition, began proper medication, and recommended appropriate followup. I may not be able to recall every case I've seen in the last 5 years, or spout off detailed stats from my personal caseload - but I diagnosed a serious problem before it was causing clinical signs at home - and THAT is what proves my competence.

Is that normal?

I saw a case today... A case that made me want to laugh at the questions Mrs. Embarrassed was asking. And yet... there was something else there instead. Funny? Yes, it was funny. You'll soon see what I mean. But it also made me realize just how much trust people put out there when I step into a room as "the doctor." Trust that I have done nothing to deserve - nothing other than going to 8 years of school & wearing the white coat. Trust is something people don't usually give freely - it usually has to be earned, and that takes time. But somehow, many people give trust the second they step through my exam room door. And today, the weight of that responsibility hit me in the middle of an otherwise hilarious situation.

I was examining Marshmallow's eye... he was a little white dog, a neutered male. His eyes started watering yesterday and today they were very red. I stained his eyes, prescribed the proper meds, and was on my way out the door to see the next patient. But then Mrs. Embarrassed stopped me. "Doc, I've got one more question for you." Sure, I've got time... "Well, you see, Marshmallow is neutered. But he has this teddy bear. And he humps the teddy bear sometimes. And then a long red thing appears, and he licks and licks it until it goes away. What IS that? Is that NORMAL?" So I explained that even neutered dogs can get 'excited' so to speak, and that red thing is his penis, and yes, its "normal" for some male dogs to do that, neutered or not... Mrs. Embarrassed is an African American woman, but you know what? I swear I saw her blush. And then she thanked me for answering her questions, and said she was glad she knew it wasn't something to worry about.

Trust. Today I met Mrs. Embarrassed for the first time. And today, she trusted me fully - almost instantly. And I'd like to think that - funny as the situation was, and as much as I wanted to laugh - I'd like to think that I earned the trust she gave me. That is my job. And I love it.

No, I don't diagnose HUMAN parasites - thank you for asking

Typical appointment written on "to be seen" board - K9 with possible worms. Easy. Boring. Right? Bwahahaha! You'd think so... but no.

I am presented with a worm segment that appears to be a tapeworm. In the room are 3 patients - a cat and 2 dogs. They're sure this segment came from a dog. But do the others have worms? Maybe - thing is, tapeworms don't come up on fecal floats all the time. Often times, we diagnose them based on finding the segments on the pet. Thing is that this one wasn't found ON the pet - it was found on the floor. Solution? Treat all 3 pets. Easy, right? Again, bwahahaha! Owner agrees to treat all 3 pets. But then Mr. Owner says "we have three more at home. Two more cats and a dog. Can we get meds for them too?" Sadly, no... we haven't seen them in the last year, so we need to examine your other three pets as well. Ok, they say... we'll set up the appointment.

Casually, on the way out the owner says "Oh, by the way, can we get tapeworms?" I get this question a lot - nothing unusual. So I say "Only if you eat fleas. That is the only way tapeworms are spread - you can't get them directly from your pet."

Fastforward a few days... I see an appt that is a request for me. Ah, how nice. I always like requests (ok, I lie - MOST of the time I like requests - this turned out to be one of the exceptions!). Its the couple with their other 3 pets. Fabulous. Quick appt, and be done with their worm issue. Take care of the fleas on all 6, and we're golden. So this time, I enter the room, greeted by Mr. & Mrs. Owner & their other 3 pets. Mrs. Owner has a ziplock baggie. In vet med, ziplock baggie always = INTERESTING (and thats not always a good thing!). In this bag? About 30 small, dried tapeworm segments - and 4-5 LONG tapeworm segments. She says, "Doc are these tapeworms?" I confirm that they are, indeed tapes... She says "Do you know where the bag is? I need those back. I need them to show my doctor." Okaaaay.... usually people don't ask for their parasites back, and if she needs it to show her doctor... well, yes, that implies that SHE has tapeworms. I'm not going to ask. We get meds for her other 3 pets, and take the stool samples to check for other parasites, and send her on her way. End of story? You guessed it - nope! More fun is in store!

Mr. & Mrs. Owner come back in a few days for another request for me. They bring several more worm segments, a few pets, and ask "Are you sure that the only thing found in the stool samples was tapeworms?" Yes. All 6 samples negative except for tapes. "And you're sure that I can't get them from sharing a bed with them, or anything else besides eating fleas?" Correct. "And would tapeworms cause all of those lesions I see on your parasite poster?" No - those are human photos of migrating parasites, like hookworms... not tapeworms. "Well, doc, look at these marks! Don't they look like your posters?" Oh my. The woman has just lifted her shirt, exposed her entire abdomen, and is showing me multiple skin lesions on her breasts, belly, and STOP! There is no need to show me things below your belt line!! I say she should consult her MD because I'm not licensed to practice human medicine. The lines do look similar to our poster, but her pets are worm free except tapes, and even if they had some other parasites we simply didn't find, the dewormer they've been given would have gotten rid of those as well. Mrs. Owner says "but my doctor says its an infection and its not going away." Well, then you should ask for a referral to a dermatologist. "But if this was a dog, what would it be?" I'm sorry, I can't tell you that. I don't know - and if I did know, and told you how to take care of it, I could get in trouble that puts my license in jeopardy. "Well, do tapeworms cause little white things to come out in the mouth?" Noooo.... not that I know of. Why? Are you noticing white things in your pets' mouthes? "No." Mrs Owner says while reaching into her own mouth.... "Every time I go to eat, I start to salivate, and I get these white things appearing in my mouth." Really, you should go to see YOUR medical doctor! I can't help you with this... "But my doctor isn't doing anything about these things. If it was a dog, what would these be?!?" Sigh. For the last time, I can't say what those are - I do not know. What I do know is that you need to see an infectious disease specialist if your MD can't help you.

I guess that was enough information for her. Because its been a good 6 months.... and I have seen no more of Mr. or Mrs. Owner... thankfully - because I saw WAY too much of Mrs. Owner than I'd ever care to see again.

The Good Samaritan

Oftentimes, the daily experiences that stand out to us as veterinarians are the crazy, weird, silly, oh-my-goodness-did-that-just-happen moments. However, sometimes, we are struck by the wow-that-really-touched-my-heart moments. I will always remember one of those experiences I had as an ER vet...

I was working the ER on a crazy-busy day. Our ER clinic had just opened a new location, and we typically weren't overly busy - not a lot of people knew about the new place yet, and we were still "working the kinks out" of the new building. So, as usual, I was the only vet on duty. So far, the arrangement had worked well - however, this day was an exception. We were slammed all day long - a 2-3 hour wait - and amazingly enough, our clients were quite understanding. That in-and-of-itself was unusual. Its common-place in the animal ER to have clients yelling at screaming at us because they're stressed, worried, tired, etc. On this shift, my staff and I were tired and stressed, but everyone was holding up well.

We had a client with a dog that needed to be admitted to the hospital. What for, I don't recall - and it doesn't really matter. What matters is that the young woman who owned the dog didn't have enough money to provide the care he needed that day. Financial concerns are a huge part of every veterinary office, but especially animal ERs. In this case, Miss Concerned was trying to call family, friends, etc to come up with money for treatment.

Now, our waiting room was busy. But not too busy for one of the other clients to take notice of the young woman with financial concerns. When Mrs. Goodheart was checking out, she let my receptionist know that she wanted to pay for Miss Concerned's entire bill. Whatever the total, she wanted to take care of it. No strings attached, except she wanted to remain anonymous.

These are the things you hear about in storybooks. Chicken-Soup-for-the-Soul type stuff.... In the middle of our chaotic day, every one of us on staff took a moment to wipe tears from our eyes. Tears of joy and amazement as we watched Miss Concerned become Miss Not-a-Care-in-the-World.

Parasites?!? Not where WE live.

I'm sitting in the exam room, finished vaccinating "Precious" - so I ask the next routine question: "Do you need any Heartgard or Frontline today?" And I get the most interesting response... "No, my little sweetie doesn't have any fleas or ticks. I take her outside for just a couple minutes at a time to go potty." So I tell her that we should at least take care of the heartworm preventative, because mosquitos are common in our area, and it only takes a second for them to bite. Then comes the stunning reply... "Oh NO. Precious is NEVER exposed to mosquitos. Or heartworms. Or Fleas. WE live in 'hoity-toity' subdivision and there are NO PARASITES allowed within the gated community." Should I laugh, is this a joke? Oh no. Mrs. High-n-mighty is completely serious.

WAY too much information.

As a veterinarian, I'm quite honored that my clients often trust me with very personal information. Sometimes, though, the information they choose to share is much TOO personal.

For instance... Picture a typical exam room moment - me, the doc, examining a dog, answering the typical flea / tick / vaccine / heartworm questions. Then comes the odd question - "Can you see if Fluffy has a yeast infection in her mouth?" I find this a little strange, but decide to ask for more information. Is she having trouble eating? Have you noticed a bad odor? "Oh no... her mouth seems fine, but every time she kisses me and her tongue ends up in my mouth, I end up with a yeast infection. I was wondering if she was a carrier or something."

Sometimes, I just don't know how to respond.

I swear, Doc, there is NO WAY she's pregnant!

This is, unfortunately, a conversation I've had numerous times... usually goes like this...

"I think something is wrong with my (female) dog - she looks like she's getting fat and there's milk dripping from her belly."
"Is she spayed?"
"No, but there's no way she could be pregnant!"
"Has she been around any un-neutered male dogs?"
"No, just her brother."
"Well, I can feel puppies when I push on her belly, and that is in fact milk - she's likely to have these puppies soon."
"Thats impossible! Its her BROTHER - they KNOW not to do that!"

Did I hear that correctly?

While examining a terrier-breed dog, the husband and wife clients start asking me why he doesn't know how to breed their female... They describe that the male gets "all excited" when the female is in heat, but all the wants to do "is sit there and slobber - he has no idea there should be any interaction between himself and our female." So we discuss a little about how natural things like breeding don't always come naturally to all dogs... We continue our discussions, and the husband manages to work the following comment naturally into our conversation somehow.

(to his wife)
"I still don't understand why he can't figure it out. Its not like its hard. And he's watched us enough times, you'd think he'd know how by now!"

Not knowing quite what to say, I continued with the vaccines, heartgard / frontline talk, and got out of there - only to walk in back and BURST into laughter with my tech - "Did we really just hear that correctly?" Why yes - unfortunately, we did.