July 2, 2015-Simple Womans Daybook

FOR TODAY Outside my window… The weather is beautiful. It’s more than beautiful. The sky is clear with maybe sparse clouds here and there, but the blue is deep like a lake and watching the birds fly about, brings a sense of wonder of what God has created. I am thinking… I need an easy…



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Sunflower Faith

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The Big 5 of Vet Med: You know you’re a vet when….

If you have ever had the good fortune to go on safari, you know that everyone talks about the “Big 5″: rhino, lions, elephants, cape buffalo, and leopards. The term was coined by game hunters and refers to the difficulty in getting all 5 because of their ferocity when cornered, but now is mostly used by safari operators as a virtual checklist of animals one must see in order to consider it a successful outing.

When I was working on the book, I tried to pick out a combination of stories that laid the foundation for life in general practice. Along the way, I discovered some of the stories that I thought were so hysterical and weird has happened to EVERY SINGLE VET I know. Now that I’ve been out for a long enough period, my classmates and I can all nod our heads like the sage old people we’ve become and say yes, we’ve earned our stripes, done that.

So in honor of this, I present to you the Big 5: You know you’re a vet when edition. Once you’ve experienced the Big 5, you know you’ve made it.

1. The undercover detective dog

Dogs eating underwear is like the giraffe of the veterinary world: yeah, you see that everywhere. No big deal. The rare and treasured lion of the underwear eating world, on the other hand, is the dog who manages to not only eat something unpleasant, but bust a cheating boyfriend/girlfriend/spouse in the process. Dogs who poop out a red thong that doesn’t belong to the wife. Dogs who vomit up a condom wrapper. Interestingly enough, the dog is almost always the closer companion of the wronged party. They know. They always know.

Family picture of three lions. Taken in Masai Mara national park, southwest Kenya.

Family picture of three lions. Taken in Masai Mara national park, southwest Kenya.

Animal rating: lion. It’s messy, it gets your adrenaline going, and you are so glad you are in the car and not out there with the lion when they go in for the kill.

2. Involuntary nude client exam

No veterinarian wants to see a naked client. This is why we are veterinarians and not physicians. Nonetheless, with the MD shortage out there and the easy access to veterinarians, it is only a matter of time before a client tries to slip in a totally inappropriate question while you’re examining a pet, complete with stripping. In my case, it was a woman who pulled her shirt down and asked me to examine her breast. I consider myself lucky: a colleague once had a client ask her about hemorrhoids and was halfway to dropped trousers before she got him to stop.

Leopard-Kruger-SouthAfrica-2005

Animal rating: Leopard. It sneaks up on you. You can usually chase it away by yelling.

3. The accidental grope

Physical examinations are, by their nature, very hands on. Most clients get this, but on occasion there will come one who refuses to let their pet out of their protective embrace. Usually the pet in question is a small, heavily haired squirrelly dog. There is only so much you can do when a chihuahua is placed squarely in a woman’s bosom before getting an unintended handful of human. This can vary in embarrassment level from mildly mortifying to near criminal, depending on the client, the location of the pet, and their outfit. Lesson learned: any male clients in running shorts must place the pet on the table, no exceptions.

elephant

Animal rating: elephant. Fine from a distance, dangerous up close.

4. The client who makes ass-umptions

I don’t think we spend a disproportionate amount of time dealing with pet’s rear ends: anal glands, rectal exams, fecal exams are but a small part of the work we do- but for some reason some clients get it in their heads that 99% of our interactions with a pet is via their rectum. “Oh no!” they say, when we get the thermometer ready. “Gird yourself, Tommy!” etc etc. These same clients have a hard time believing that medications are administered in any manner other than per rectum. Here’s the kicker: You don’t get to check this item off your list until you’ve been asked about whether each of the following is administered in this manner: Advantage, dewormer, antibiotics, pills of any kind, chlorhexidine scrub.

African_Buffalo

Animal rating: cape buffalo. Comes in herds. You never know what they’re thinking.

5. Face full of anal glands

You are a seasoned practitioner. You know all the tricks about how to angle your thumbs and cover your target area with a paper towel. You know to evaluate glands by feel, how to note the tell-tale pressure of an impacted gland that is prone to blow. It will never happen to you, you say. You are careful.

It will happen to you.

It will happen to you in a moment you let your guard down, when you’re looking over your shoulder to answer a question and the glands sense an opening. You won’t see it coming. One minute you’re chatting about someone’s tapazole refill, the next moment you’re standing over the eye flush station screaming for Altoids and crying. Two hours later, you will relay the story to your family at dinner with great relish, laughing while the waiter makes a moue of horror and rushes away as quickly as possible. Because that is how vets roll.

rhino

Animal rating: rhino. A rare and memorable interaction you are unlikely to repeat but will talk about forever and ever.

How long does it take the average vet to complete the Big 5 Vet Safari? Did I miss any? I’m sure I did.

 

Pawcurious: With Veterinarian and Author Dr. V

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Balancing the scales in medicine

I am becoming increasingly convinced the communication gap between veterinarians and clients is the number one problem we’ve failed to solve. We’re just not on the same page a lot of the time, it seems, and it makes me sad. I can’t read a single article online without coming across “veterinarians are money grubbing pigs that suck” (true blog title) and someone else saying “if you can’t afford x/y/z/q you shouldn’t have gotten a pet, jerk.” I feel as though this is perhaps a bit extreme, but it’s what happens when we don’t work together to identify our goals.

Common Fallacies of Bad Client Interactions

rotten

(In just as many cases, the vet on the left is an associate up to his or her ears in student debt and just trying to make it through the day without getting yelled at one more time, and the client on the right is a stressed out single parent who just spent a grand fixing her car.)

Much of this angst comes from the pervasive assumption that in all cases we will do everything we can medically, no matter what, which was fine a while back when “everything” meant “antibiotics” but as veterinary medicine has advanced, has come to mean “MRI, spinal tap, radiation.”

This assumption, of course, carries over from human medicine: if you’ve got the insurance, you’re getting the treatment. Everyone’s happy, right? Right?

Not so much. Satisfaction with a medical course of action relies on multiple factors.

Sometimes getting to “Everyone Happy” (Square B) is impossible. D’s not so bad either, but A and C are no-fly zones.

Human Medicine Satisfaction

medchart1_edited-2

I would argue that satisfaction with outcomes is directly correlated to the balance between the amount of treatment pursued, and its benefit.

medchart1_edited-3

So really, the goal here isn’t to push everyone towards the far extremes of treatment; it’s about getting to that center line of balance. In human medicine this change is slowly creaking along with things like hospice care, which moves people from C to D in low treatment benefit situations, and increased access to insurance coverage, which moves you from A to B in high benefit situations. With Mom, we were squarely in the D category, and while we’re not HAPPY, it’s a hell of a lot better than if we had treated her to death.

Make sense?

So how does this apply to veterinary medicine? It’s similar, except we tend to find ourselves walking a line most strongly related to finances.

The Veterinary Experience

vetchart1_edited-1

There’s a whole lot of people in square C these days, who spent more than they really had on treatments they weren’t sure they wanted, because they felt like they had to, and when things go downhill as they often do with very ill pets, people can end up really, really disillusioned with the profession.

Now, since we have no ability to magically divine which people are up for specialty treatment and which people are not, we always offer all the options to clients- as we should. There are people who spend thousands, lose their pet, and are still ok with the outcome- but they were also very clear on the risks and made an informed decision. Many clients, it seems, feel as if they are not.

vetchart1_edited21

So what do we do to improve outcomes? In my experience, the best way to move the dial from A to B is pet insurance, at least for emergency situations. There are few situations more likely to prompt a Facebook mob than a pet who died a preventable death because the owner couldn’t afford treatment and the ER vet wouldn’t do the treatment for free- nor should they. Owners need to shoulder some of the responsibility here of financial preparation, and if they refuse to take even basic steps to be prepared, maybe they really are a crappy client.

And conversely, moving the dial from C to D involves good veterinary communication, and a willingness to understand that lots of factors go into the decision about whether or not to seek treatment. If a veterinarian talks a senior on a fixed income into a kidney transplant for a 15 year old cat in renal failure, after she expressed concern about paying her rent for the month and her own upcoming surgery- maybe they really are a money grubbing vet.

But I like to give everyone the benefit of the doubt. Clients and vets both have work to do here. And I believe with all of my heart that the better we get about empowering clients to make informed decisions, the more that will carry over into human medicine- which is a wonderful thing.

I realize this is a vastly oversimplified explanation of some really complicated issues, but hey, we have to start somewhere. Whatever it is we’re doing now sure doesn’t seem to be working too well.

Pawcurious: With Veterinarian and Author Dr. V

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Painting the Roses Red

red

It’s pub day! The book is out at long last! I really hope you all enjoy it- All Dogs Go to Kevin has truly been a labor of love. (That link goes to my new website. Did I mention I have a new website? It’s been so busy around here I think I forgot.)

Last weekend I went to Warwicks to sign the preordered books. Brian and the kids were at ComicCon, so I went to Warwicks by myself. It was a short task, no more than 20 minutes, so I couldn’t figure out why I was so bummed about going alone, and then I realized ohhhh. It’s another one of those moments.

The thing I will miss most about my mom is not the big celebrations, the ones everyone goes to: holidays, book signings, that sort of thing. It’s the little celebrations, the moments no one else would think mattered, but she always did. If she were around, she would never have let me go alone. She’d go with me, we’d get lunch, then she’d talk me into shopping for a little while in downtown La Jolla. But she’s not here, so my twenty minute task was just that- 20 minutes in a little bookstore office with a Sharpie feeling terribly sad.

I’m trying not to let my sadness get in the way of being happy, but it’s so hard not to have her here. We have a series of white rosebushes in our backyard that bloom almost year-round, and I really like them because they remind me of my parents’ yard. Plus, it made it really easy to send random nosegays to teachers and the like since they were always blossoming, scattering white petals all over the grass like confetti. Mom loved them too, of course.

Brian- not so much. He’s been threatening to pull them since we moved in. He’s been talking about it again the last few weeks, and I made him promise to leave me at least one or two, for Mom, and he said, “OK.”

This afternoon he had someone come over to give us a quote for doing some of the backyard work. I peered through the window to make sure Brian saw me giving him the evil eye- not ALL the rosebushes, ok??- and I noticed something I had never seen before in all the time we’ve been here:

redroses

Someone’s been painting the roses red.

paint roses red

The roses stay, obvs.

It’s funny how the moments that impact are not the large and grandiose gestures, but the fleeting surprises that hit you like a much needed breeze. How I can be sad about a less than perfect rose in my garden when so many people in this world know nothing but weeds? Mom’s here in every sunset and every butterfly and her love feels no less potent for the lack of her physical presence.

It’s a beautiful day here in San Diego. The book is out and it’s my fourteenth wedding anniversary- a date traditionally marked by ivory but now the theme is “animals.” Mom sent flowers. How can I complain?

 

Pawcurious: With Veterinarian and Author Dr. V

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Mortgage approvals tick up in Q2: Bank of England – FTAdviser.com

Mortgage approvals tick up in Q2: Bank of England – FTAdviser.com
Mortgage approvals tick up in Q2: Bank of England. 0COMMENTS. 0RECOMMEND. Recommend 0 Print this article Email this article. More on Mortgage Data · Leeds leads the pack with new mortgage deals · Highest number of house purchase approvals in …
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Poplar Weevils Commonly Confused For Ticks
They look just like ticks but they are actually called something else. The good news is, they are harmless. Summertime is almost officially here, and with it, comes the bugs. This year, a small black insect is taking over the area. "These are actually
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Spoon! The Tick Is Back in 'Ted 2'
In the 13 years since The Tick ended its short, but glorious nine-episode run on Fox, fans have wondered when Patrick Warburton would step back into the bright blue costume he wore as the titular hero on Ben Edlund's superhero spoof. Believe it or not
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Winkeler: Time to take the tick check more seriously
Conversely, when I come in from the woods, I immediately remove my clothes, do a comprehensive tick check and take a hot shower. Occasionally, I'll find a tick that has become attached. But, in most instances I can feel ticks, even deer ticks crawling
Read more on The Southern

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Nov 4, Pet products sale up by 7% in the US

Consumer spending is crucial for recovery of the economy. The rising tide isn’t lifting all boats but one of the lucky ones is the pet supplies industry.

High-end pet items drive increase in spending. People like to buy organic dog food, timed cat food dispenses etc

“People are cutting back on themselves more than they’re cutting back on pets,” says Bob Vetere, president of the American Pet Products Association.

“Cheap pet food is selling briskly, reflecting the weak economy, at the same time costly items are thriving,” he says. “It’s the middle of the market that’s shrinking,” he says.
Dog Food Blog | Best Dog Food Guide

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Back in Stock on PawZaar!

After a big run on some of our most popular products in our PawZaar gift store, we’ve restocked! These favorites are now available for worldwide shipping…and, don’t forget, 10…



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DogTipper

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Latest Dog News

Neglected Dog Without a Nose Gets Dramatic Transformation
Harry, a neglected Chow Chow without a nose, came into a Missouri animal shelter with heartbreaking story that quickly evolved into a happy ending. The 4-year-old rescue dog was found by Kansas City Animal Control chained in a backyard, without food or …
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Police respond to man attacked by dog in Ogletown
A man was attacked by a dog Saturday afternoon in Ogletown, county police said. Police responded to a call in the 1600 block of Chelmsford Circle for reports of a 79-year-old man being attacked by a dog, Officer First Class Tracey Duffy said. The man …
Read more on The News Journal

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Links I Love, Right Now

I initially put together the first ‘Links I Love, Right Now‘ post about a month and a half ago on a whim, when I was feeling nostalgic about my now long defunct ‘Friday is for Favorites‘ series. A couple of weeks later I posted another one, and explained that it would not be a weekly or even monthly thing, but more of a ‘when I feel like it’ thing, and/or at the end of a week when there genuinely happened to be a lot of links that I loved. Well guys, this week has been one of those weeks. I spent last weekend at the final Grateful Dead shows with a couple hundred friends from different places and periods of my life (and another 70,000 friends who I didn’t actually know but with whom I shared an unforgettable experience on every level), and it left me feeling both blissful and physically exhausted (a dozen collective hours of nonstop dancing while you’re pregnant will do that to you). This ultimately led to me spending more time that I should this past week sprawled out on my couch surfing the internet at night, which led to me discovering a lot of cool shit online. So here we are. (Do people even say ‘surfing’ the internet anymore? I’m not cool enough to know what the kids call it these days. But you get my point.)

And this brings us to these links I love, right now:

This short documentary on six brothers who were raised in captivity in New York City and ‘saved by the movies’ looks pretty incredible. Have any of you seen it?

On the 4th of July, the Empire State Building was synced up to the Grateful Dead song ‘U.S. Blues.’ I mean, wow. Even if you’re not a Deadhead like I am, this is pretty impressive.

My half birthday was on the first. Anybody want to buy me these shoes for a belated present? Anyone?

My reading time has dwindled to nothing, and I need to change this. Vulture says that these 8 books are the ones I need to read in July.

When America’s librarians went to war. Kind of intense.

15 houseplants that improve indoor air quality.

This summer has been a strange one – full of clouds and cold spells. I’ve been daydreaming of water hangs and sunshine lounging, and am crossing my fingers that the weather becomes more summer-like before our lake vacation in three weeks. I’d also really like to have this amazing lounge swing (also seen in top photo) to take with me on the trip.

An abandoned shipyard was revived with tiny houses on tracks, and I kind of want to live there.

I usually skip the dressing on my salads, because I feel like if I’m going to make the effort to consume greens over french fries or nachos, I should probably avoid drowning them in fat/calorie laden liquids. But my girl Jessica found 8 dressings that actually contribute to the health factor of salads, which means things are about to change for the better at my dinner table.

This rug is perfection, not only because of the gorgeous pattern and color, but also because it’s distressed – which is key when you have a messy toddler. (Or a pet. Or an adult who spills a lot – like me.)

I use this word a lot, but a Google and Apple alum says it can damage your credibility. And I get why.

Sesame Street is the only television Essley watches (along with the occasional Peppa Pig). This article digs deep to discuss the magic behind the show.

These DIY black and white printed napkins are spot on. Making them.

Researchers track the love lives of koalas (aka my favorite animals after dogs).

Although these cotton candy ice cream shots would be a lot more fun with the alcohol, I’m thinking about making the non-boozy version for my pregnant self this weekend. So many sugar cravings…

It’s Friday! This weekend is all about kids’ birthday parties, movie dates, hiking, and good food around here. It will be a stark contrast to last weekend’s activities but I’m ready for some low-key plans. Whatever you may be doing, I hope your weekend is fantastic. See you Monday.

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Bubby and Bean ::: Living Creatively

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Luca

Tiny button nose, too cute for words, this tiny Yorkie was in Gorbio last night for the opening of the most recent exhibition in the Chateau.

He’s only two months old, lives in Menton and is called Luca.
RIVIERA DOGS

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