Saturday, February 20, 2010

Deciding on Euthanasia

This is the most difficult decision a pet owner faces in the lifetime of their pets (and sometimes in their own!)
Don't we wish our pets lived longer? We, as veterinarians, are working on that but there's only so much we can do to change nature. We all die sooner or later and pets in many ways bring that reality back to us. We tend to put off thinking seriously about our own death until we have to face the death of those we love, especially when it has to be our own decision to end that life. So pets die and it's not just the death of our beloved companions but the reality of death itself that sets off deep feelings of loss, fear and the unknown.
But, back to pets. When do we decide? How do we know? Is now the right time? Should I wait a bit longer and see if my friend gets better? I don't want to make this decision prematurely. I don't want to prolong suffering. I don't want to come home a pet who passed away alone, possibly afraid, possibly in pain. So many questions and absolutely no way to predict the future. So what do I recommend as a veterinarian? I try to put myself in your shoes, where you are, what your family situation is and how you handle personal loss.
I like to have the family in agreement. Often, if the decision is clear cut to me, ie, the pet is in pain, not treatable and no hope of recovery, I will step in and say it's time. But often it's not that easy. Often, pets hang on, day after day, one day acting better than yesterday, giving us hope that tomorrow will be even better. We get on a rollercoaster of inaction due to changing forces over which we have no control. In some cases owners are going on vacation and don't want to leave their pets in a kennel or with strangers when their last days or near, or they don't want to contribute to the pet's stress by leaving. I know families who have not been on vacation for years because of the guilt they would feel. I know in my own case with 4 cats and 2 dogs, I am not comfortable leaving for more than a few days for fear something might happen in my absence.
I've had clients who were traveling overseas or somewhere they could not be contacted give the the "power of attorney" to me to make the decision to euthanize their pet if illness was so severe I felt it was the right thing to do. That's a lot of responsibilty even for an experienced veterinarian to take on. Bottom line is there is no easy answer. You need to have an honest conversation with your veterinarian who will be gentle and understanding of your emotions regarding what you want for your pet. Some people can never make the decision to euthanize in which case I do my best to keep that animal pain free until they pass away.
Most people hope and pray that their pet will go to sleep on their own so that they will not have to make that awful decision. I'm here to tell you that almost never happens. Pets have a strong will to live and they will
valiantly make every effort to fight death even in pain. It's your responsibility as a loving, mature and responsible pet owner and as the guardian of this wonderful friend who has been by your side through thick and thin, to not allow suffering, to make that decision no matter how much it hurts you, no matter what your 5 year old wants or even your teenager. Most children cannot make such a decision and even some teenagers will want you to hang on forever, so you may not get a consensus at home. At least try to and if you have to blame it on the vet. (Don't say anything bad about me to your children, just that I had to make the pain go away). Thanks.

Digital X-rays

Does your doctor use digital x-ray? Most veterinarians do not. I went to a conference for advanced surgeons learning a new bone surgery and I was the only one in the room who raised their hand when asked who had digital x-rays. It's the same as the difference between film cameras and digital cameras. There is so much more detail contrast and ability to enhance film images. It's also faster so that moving pets still get good images and fewer pets need sedation. That's great for everyone! If you need to measure, it's inch for inch accurate. If you are doing advanced surgery there is software to add to make the placement of plates and screws almost perfect. Until digital we depended on the talent of the surgeon to know how to put bones back together and place the screws in the right places. Most of the time they succeeded with much practice on plastic bones first. It just shows you how far veterinary medicine has come. Everyday it's something new!!
Of course our pets deserve the best, too.

The Real Truth about vaccines, Dogs and Cats

The word is finally getting out. Vaccines last a lot longer than the manufacturers would lead you to believe. They recommend to veterinarians that they give vaccines every year but now we know their interests are financial. Studies show that even Rabies vaccines last longer than the law says they do but that will never change; it's important to have legal dogs and cats so always keep the Rabies shots up to date, even older

There are CORE vaccines and there are NON-CORE vaccines, CORE meaning required and important for the health of your pet. All the veterinary university websites and the American Animal Hospital Association have established similar CORE vaccines recommendations. Basically cats need at least two distemper/upper respiratory vaccines, one of those after 14 weeks of age, Leukemia vaccine if they go outside and Rabies vaccine after 12 weeks of age. Those vaccines will be boosted in one year. The distemper/upper resp vaccines will then be good for 3 years, leukemia and Rabies for one year (there is a 3 year vaccine for cats
but the once yearly type is most recommended). NON-CORE vaccines are not essential for every pet. For example, if you live in an area where there is no Lyme disease, you most likely will not want to vaccinate your dog for Lyme disease (cats do not get Lyme disease!!). If you are a hunter and your dogs have a history of coming home with ticks, Lyme vaccine would be important for that dog. There are now other ticks besides the deer tick carrying disease, so a history of ANY ticks is considered at risk. Other non-core vaccines are canine flu, giardia, bordatella, feline infectious peritionitis and dental disease bacterial vaccines.
Forget feline infectious peritionitis, giardia and dental bacterial disease altogether. Bordatella (only get the
nasal) is important for boarded and groomed pets and dogs who frequent dog parks. Some veterinary immunogists are saying that after the age of 8 dogs and cats need only Rabies and bordatella vaccine (if exposed as above). This is a new recommendation and I am not ready to go quite that far yet but I believe that will be the case in the near future. If your vet insists on a host of vaccines all on the same day, go somewhere else. The maximum recommended number of vaccines in one day in 3. Any further vaccines should be given at least 3 weeks later. This is especially true for small dogs. You can e-mail me for further information at Be sure to put in the line Blog question so I don't send you to spam!

Heartworm tests

Ah the buzz over heartworm tests!! Heartworms are actual worms that form in the heart 6 months after an
infected mosquito infects your dog (and sometimes cats!) Therefore wherever there are mosquitoes there
are heartworms. Dogs who are not on heartworm preventative once a months DO have a more likely chance
of heartworm infection and the preventatives are almost 100% effective so I believe it would be most foolish
to NOT give heartworm preventative. In addition that one monthly pill also prevents most intestinal parasites.
What a bargain! Really! As far as testing, unfortunately there are occasional veterinarians who prey upon the
fears of the public and recommend too many tests. Once a year is plenty and sometimes ( dogs in Alaska for example) can go two years. I live in the mid Atlantic states where we have plenty of heartworm disease.
IF a client is confident they have given the pill without fail for the past 12 months, the liklihood of heartworm
developing is near zero and I will let them go two years. I have not been wrong yet in 35 years. The problem is some vets won't give you a prescription for the preventative unless you have had the test at their recommendation. I think this is highway robbery but there isn't much you can do about it unless you change vets.