Tuesday, December 23, 2008

T'is the season for dietary indiscretion

When our little furry critters eat less than wholesome, harmful, or obstructive items that subsequently make them sick, we call it dietary indiscretion. At no other time in the year are dietary indiscretion cases more common for both canines and felines, than the holiday season from Thanksgiving though New Years Day.

Case in point, to date since Thanksgiving, 2008, I have surgically removed turkey neck vertebra from a canine esophagus, a lobster claw from a canine small intestine, an ornament hook from a canine stomach, a sponge from a canine stomach, and a 6 inch section of yarn removed from a feline colon. In addition, while I cannot recall the exact number of vomiting and diarrhea cases I have treated in this time period due to owner feeding of rich holiday food, or pets being naughty and getting into holiday food or garbage, off the top of my head, I have treated at least 50 cases.

Therefore, in my final post of 2008, I implore all pet owners to be vigilant in keeping holiday food, ornaments, and garbage out of the reach of pets. I also strongly recommend resisting the temptation to allow pets to partake in the indulging of rich holiday food - while this may provide a moment of intense pet gratification, the negative consequences can last longer and be far more costly than the reward.

Wishing you and your families, including the furry ones, peace and happiness through this holiday season, and a happy New Year!

Sunday, December 14, 2008

Pet Health Insurance Rising In Bad Economy

With the average American's earning potential continuing to decrease in the current economic downturn, while veterinary costs steadily increasing nonetheless, pet health insurance has become more popular among pet owners, according to an article in Veterinary Practice News. Per the article, Pet Health Insurance premium sales this year have increased by 100,000 - 150,000 policies written from previous years nationwide. The article went on to cite a report that indicates that the pet health insurance industry is forcasted to grow by 25%-35% annually over the next 5 years.

From a veterinarian's perspective, this trend generally speaking is a poositive for the veterinary industry, but there are still some aspects that concern me. On one hand, quality pet health coverage helps pet owners pay for necessary veterinary care in the untimely incidence of pet illness or injury. Sick animals do not have to go without treatment because of financial constraints, and we get to perform our jobs to the best of our ability, unhampered by owner financial constraints. On the other hand, however, not all pet insurance companies are quality, and some pet owners are bound to get duped into purchasing premiums that ultimately do not fulfill expectations.

The solution for pet owners is to properly research pet health insurance companies before committing to a policy. Utilize consumer reporting agencies such as the better business bureau, and ask fellow pet owners and people in the pet care industry, such as groomers, trainers, and breeders, if they have pet health insurance preferences.

With more pet owners inquiring about pet insurance and veterinary clinics encouraging quality pet health insurance to help pet owners offset vet costs, many veterinarians are increasingly keeping a close eye on the industry, getting a solid feel for which pet health insurance companies are of good quality, and which ones should be avoided. This may make your vet a good source of pet health insurance company information and reputation.

Overall, I think that pet health insurance with a quality company under the current industry structure (re-reimbursement for vet costs remaining a matter directly between the owner and the insurance company with no veterinary clinic billing responsibilities), is a good idea for pet owners that do not think they could financially handle a sudden work-up and treatment regimen for their pet, that these days could approach a few to several thousands of dollars. A pet health insurance policy with a reputable company could be the difference in having to make the tough choice of choosing between the financial the stability of your family and saving the life of your beloved family pet.

Monday, December 1, 2008

We Love Lucy

About three months ago, a very nice lady brought in a 6 year old Labrador Retriever named Lucy to be put to sleep. The lady was agonizing over her decision to put Lucy down, because she had belonged to her best friend that had recently passed away in his sleep. The lady's friend told us that Lucy's owner had very little money, but whatever he had, he put into the care of his dog, cherishing his canine companion above everything else in life.

After he died, this friend of Lucy's deceased owner felt it was her obligation to take Lucy in both out of respect for the owner, as well as for the sake of a dog who had just lost her companion. However, once the lady's landlord caught wind of the fact that she had a dog in her home, he went ballistic, threatening to evict her on the spot due to his no dog policy. After she pleaded with him to make an exception to his rule given the special circumstances, the landlord did not budge, telling her that the eviction proceedings would begin immediately if she did not get rid of the dog.

Having no money to relocate, having no friends or family to take Lucy, and a cold hearted landlord that would not even grant her some time to seek other arrangements, the lady was left with two choices, either bring Lucy to the county shelter, or have her put to sleep. She chose the latter because of the fact that, although she was decently healthy, Lucy was middle aged, had very bad teeth, had chronic recurring allergic skin infections, and as such she felt that her chances of getting adopted were slim. She was unfortunately correct in her assumptions, and thought of her sitting in the strange setting of an animal shelter after having spent her life loved and doted on by her deceased owner, only to be put to sleep when nobody adopted Lucy was too heartbreaking for her to consider.

We were all devastated about the situation as well, and the fact that Lucy was a wonderfully sweet dog, made it all the more heart wrenching. With every one of us having reached our capacity in the number of animals we have adopted through the years, however, it did not look good for our ability to help Lucy and her new guardian. With very heavy hearts, we moved forward with getting the paperwork signed and the necessary injections drawn up.

At the last moment, one of my technicians, Melanie, overcome with tears, despite being already overburdened with rescue animals in her home, asked me if she would take the dog, would I spay her, repair her teeth, and treat her skin. To this I did not hesitate in telling her emphatically, "Absolutely!"

At this, we were overjoyed to enter the room and tell Lucy's guardian that there was a home for her, complete with a dedication to get her properly spayed and manage her ailments. The nice lady who had taken Lucy in on behalf of her deceased friend, was elated, relieved, and overjoyed. Although still grieving for the loss of her beloved friend, at least now she could engage in the grieving process without the guilt of knowing that her circumstances would not permit her to help the one thing her friend held dear in life.

Since then, Lucy has been spayed, her teeth repaired, and her skin comfortable and managed with appropriate medications. She is thriving in Melanie's home, getting on well with her assortment of rescues animals, and proving to be one of the best dogs Melanie ever had. Although Melanie's house is even more crowded than ever with rescue animals, she does not regret her decision to keep Lucy at all.

Just last week, a regular client of ours came in with his dog for a routine yearly, thanking us for helping the dog of "Sam, the one man band." As his name indicates, Sam was a one man musical act that performed some of the local pubs in the area, and was known by a select few pub goers, as a talented musician, as well as a kind and personable man who lived for his dog, Lucy. Only months after Sam's death when a few of his fans had wondered about his absence from the pubs, had they had learn of his circumstances. Their first concern being for Lucy, the one cherished treasure in Sam's life, all who knew him were relieved and moved to know that she had found a special home.

A heartwarming tale we can enjoy for the holidays.

Monday, November 24, 2008

Lindsay Lohan PETA's Latest Target

I wrote an article about the animal rights group, People for the Ethical Treatment of Animals (PETA), explaining how I have mixed emotions about the group. On one hand, their existence keeps those who engage in animal cruelty on notice, and often their work exposes legitimate animal abuse. On the other hand, however, sometimes some of their more extreme members can engage in controversial, odd, or in a few cases, even violent behavior, that hurts their credibility and imparts on them a aura of extremism.

The Daily Dish of SFGate.com reported on a recent incident where PETA has recently made news. According to The Daily Dish, as mink stole adorned Lindsay Lohan entered a Paris night club on Saturday night, November 15, 2008, an anti-fur activist pelted the actress with a large sac of flour and covered her with its contents. Aside from the humiliation of being dowsed in flour and having to rush to the bathroom to clean up, Lindsay was unharmed.

The Daily Dish article did not reveal if the anti-fur activist was affiliated with PETA, but PETA Europe's Robbie LeBlanc quickly applauded the attack, stating, "There is nothing remotely fashionable about the torture and death of animals killed for fur. Lindsay Lohan might be able to ignore images of bloody animals skinned alive for their pelts, but we hope a dash of flour will help her rise to the occasion and forsake fur once and for all." This seems to indicate that there could be a connection between PETA and the flour bomber.

When I first heard of this, I must admit that my first reaction was to have a pretty good chuckle, both because of the absurd nature of the incident, and because I am no fan of fur garments. However, I will concede that my dislike of fur could be fairly criticised as carrying and air of hypocrisy, since I do wear leather shoes and belts as well as favor leather seats in my cars. My only justification for this is that my skins come from animals that are already being slaughtered for food, and whether you buy into this justification, I do not approve of the killing of animals simply for their fur, although my use of leather certainly disqualifies me from being an anti-fur activist.

What should be clear to any rational person is, while a stance against the wearing of furs can be viewed as a humane and justified opinion, behavior like this is not the way to get the message out. Pelting Lindsay Lohan with a sac of flour will not likely cause her to rethink her wearing of furs, and to many people, these actions will cause people to view anti-fur people as kooky extremists rather than legitimate activists.

A better, more credible way to denounce Lindsay Lohan's choice of animal fur wardrobe, would have been to use blogs and other multimedia to bring attention to the fact that Ms. Lohan is setting a bad example in their opinion, of advocating the killing of animals for the purpose of harvesting their furs. In presenting this case in a more civilized fashion, perhaps Ms. Lohan would have suddenly seen the light and realized the implications of what she was wearing and pronounced that she would no longer wear animal furs. Perhaps she would have done this just for the sake of eliminating the potentially bad press.

Even if she had not responded at all, taking a higher road may have led many to be sympathetic to their cause, whereas following the flour bomb, there are probably more people that dismiss the actions of this PETA linked anti-fur activist as extreme, uncivilized, and mean spirited.

Roger Welton, DVM
Founder, WebDVM.net

Monday, November 17, 2008

Pets in the White House as American as apple pie.

Barack Obama, per his election victory speech promise to his daughters, will be carrying on the time honored tradition of pets in the White House. While this tradition has recently gained notoriety, probably due to our current historically peak levels of per capita household pet ownership, as well as ever expanding mass media, pets cohabiting with the first family in the White House is nothing new or even recent.

George Washington began the pet tradition as first President of the United States, as he kept with him one of his famed and beloved Revolutionary War steeds, Nelson, as well as an array of many other prized horses. Our first first lady had with her a cherished parrot.

Abraham Lincoln had an assortment of pets in the White House that included a pig, a turkey named Jack, and a dog named Jip. Not to be outdone, Theodore Roosevelt had a collection of pets that dwarfed that of honest Abe, including Algonquin, a calico pony, Pete, his favorite bull terrier, along with several other canines. President T. Roosevelt also had a Macaw named Eli Yale, as well as a lion, hyena, wildcat, coyote, five bears, two parrots, zebra, barn owl, snakes, lizards, rats, roosters, and raccoon.

Calvin Coolidge also had a literal zoo-like array of pets at the White House, which included as many as 12 dogs, several exotic bird species, two cats, a bear, a donkey, a wallaby, a bobcat, a bear, and a pigmy hippo.

Recently, our nation has become quite familiar with the Clinton's famous chocolate lab, Buddy, as well as President GW Bush's well known Scottish Terriers, Miss Beasley and Barney (who recently made headlines for biting a reporter).

A Presidential display of adoration of animals sets an example of compassion, illustrates the human animal bond at the highest level, and sets the bar high for responsible pet ownership. While we are still very much a work in progress in reaching optimal animal welfare standards as a nation, Presidential pets remind us that the majority of Americans are compassionate people, capable of selfless love and respect for animals.

I am please to know that Barack Obama and the first family elect will continue this endearing tradition.

For more indepth Presidential pet information, please refer to my primary source for the information contained in this post, the Presidential Pet Museum.

Roger Welton, DVM
Founder, Web-DVM.net

Sunday, November 9, 2008

The ultimate charlatan

In my January 24th article, "Careful pet owners, charlatans now target your pets!", I touched on this miracle canine medication creator whose credentials do not go beyond being a dog owner and self proclaimed independent researcher. As part of that article, I used him as a charlatan example with his peddling of a cure he developed for Cushings Disease that utilizes ingredients found at a local supermarket. In his sales pitch, he accused veterinarians of suppressing this knowledge because of our alignment with pharmaceutical companies that keep our loyalty with "great kickbacks, such as a free vacation for the family or a "convention meeting" (as they call it) that some how finds it's way in the good Dr's mail box."

Using the same advertising theme, "4 Facts Your Stupid Vet Failed To Tell You About [name your disease du jour]," Michael Dole now has a household supermarket item cure for the deadly canine viral disease, parvo. In his marketing of this product, Michael Dole suggests that veterinarians do not offer the best available treatments for parvo, indicating that the treatments we offer regularly fail because they consist merely of:

"Treatment A: No treatment at all (there's nothing we can do). In this case they will simply send your dog home to die.


Treatment B: An IV and an overnight stay (maybe 3 nights). BUT don't be fooled by the complicated Dr talk. What you are basically paying for is an IV drip full of water and electrolytes meant to rehydrate your dog."

He goes on to say that veterinarians do not understand that the key cause of death from parvo is merely, "a simple matter of dehydration."

Please allow me to clarify the truth about parvo from a veterinarian's perspective. While dehydration is a significant factor in clinical disease and can lead to death by hypovolemic shock, the consequences of parvo are far more complex than just dehydration. Parvo attacks rapidly dividing cells of the GI tract or the bone marrow. In the GI tract, the result is sloughing of the lining of the GI tract, causing malabsorption and bleeding (hence the bloody diarrhea associated with the disease). In the bone marrow, the virus inhibits the patent's ability to make red blood cells and white blood cells. Red blood cells are the solid component of the blood stream responsible for oxygenating tissues, white blood cells are the first line of defense of against infection. Death can result from all this due to anemia, hypoxia (tissue oxygen depletion), and sepsis (systemic blood born infection).

According to Michael Dole, all we do to treat all this is offer an IV drip. Realistically, an IV drip to replace lost hydration and electrolytes, is but one component of a multifaceted treatment protocol. We also treat with antibiotics to fight secondary bacterial infection in the immune compromised patient. We treat with GI protectants to reduce GI hemorrhage and sloughing of the gut lining. In cases of severe anemia, we administer blood transfusions.

So Mr. Dole, since you have zero animal health care training, obvious both in your own listed credentials, as well as your twisted perceptions of veterinary care, please allow me to enlighten you. To call veterinarians stupid, insults the sacrifice, discipline, and hard work we poured into our education and training, as well as our ongoing dedication to the profession. To misrepresent how we implement treatment is appalling whether the result of ignorance or intentional deception. Not having purchased your product and not knowing what your supermarket parvo cocktail consists of, I will concede that there may be some benefit to parvo patients, perhaps even a decent alternative for pet owners who just unequivocally cannot afford veterinary care. But to try selling people on the notion that they should forgo veterinary medicine when parvo is suspected, in favor of your cocktail that you tout as a parvo treatment superior to the best treatment protocols veterinary medicine has to offer, is ridiculous, irresponsible, and puts pet's lives in danger.

I e-mailed this blog post to Mr. Dole. I challenge him to respond.

Thursday, October 30, 2008

A Veterinarian's Presidential Election Perspective

Political discussions often lead to heated debate, anger, and hurt feelings. However, with this upcoming election coming at a time when the country has so much at stake, it is difficult to resist political discussion in any setting, be it work, golf, in the gym, and of course here in this blog. While I ventured to broach some political issues in previous posts this year, one criticising government bipartisanly gouging small business, and one exposing Sarah Palin's abysmal wildlife record, I touched on where my support was leaning in this election, while falling short of a full out endorsement. In this post there will be no question where my allegiance lies in this election, but for the sake of this blog's integrity and audience, I will my views based on how political implications have and will continue to impact my life as a veterinarian.

In the early years of my career as an undergraduate biochemistry student working part time as a veterinary assistant right smack in the middle of the Clinton years, I witnessed a monumental change in veterinary medicine. With the prosperity and dramatic increase in mean income of the 1990s, people increasingly began to have the disposable income to focus on the family pet's health care. As a result, the profession improved with an increased ability to pursue aggressive and comprehensive diagnostic work-ups and treatments.

Veterinarians became more medically and surgically savvy, the additional revenue that this paradigm shift created increased veterinary hospital employee benefits, mean income, and as a result attracted higher quality staff. This combination of pet owner willingness, better diagnostics, treatments, and quality staff, meant better health care standards and quality of life for family pets, considered by many as cherished family members.

Personally, I had received a small inheritance as a young man, a helpful but modest sum of money. But because it was conservatively invested in the greatest bull stock market our country had ever known, that modest amount was stretched considerably to pay for undergraduate college (including a summer trip to Europe), a car that I drove for 8 years, a portion of vet school, and ultimately there was just enough left to purchase my wife's engagement ring.

Through my tenure as a veterinary student and during the early few years of my career, I continued to see the profession get better in all the ways I described before. Working in this environment and being subsequently able to practice a high level of medicine was extremely gratifying. This unfortunately was not to last, as around the middle of 2003 I began to witness a downturn in pet owners willingness to place pet health care among their higher financial priorities.

This was not a yet devastating reality at the time, not yet leading to losses, but instead a slowing or at worst, plateau effect in practice growth. The decreasing willingness to pursue high standard pet health care continued, however, by 2006 even deteriorating into outright cynicism from some pet owners presented with work-up and treatment estimates. Most scarily, we have seen our daily deposits which traditionally break down as 60% credit cards to 40% cash (or check), transform to 90%credit cards to 10% cash. It saddens me a great deal to see these good people still have the dedication to care for their animals but clearly no longer wield the disposable income to match their determination.

The good people in question, are the middle class, the biggest supporters and patrons of small business, and the group that has suffered the most under republican rule. Under Bush, we saw tax cuts that amounted to very little for the middle class, but provided billions in tax relief to the country's wealthiest corporations. Rather than use their gift from Bush to create jobs and uplift their eomployees letting that wealth trickle down as the republicans like to say, they instead stuffed the pockets of CEOs, shipped jobs overseas, and squandered employee pensions. The banking industry finally placed the icing on the cake, when massive republican sponsored deregulation helped pave the way for collosal Wall Street abuse that has led to our current credit crisis.

George Bush's abysmal economic policies and complete lack of regard for the middle class, a class of hard working, strong valued, decent Americans that are the life blood of small business, has created dire consequences that I see examples of every day. No longer is the middle class fallout a phenomena that we read about or fear the coming of - it has arrived, it is real, and it is in our faces every day.

Not only do I feel great sorrow for many of my clients that have been hit hard financially (many of whom are families that I have come to care deeply about), this economic disaster that George Bush has driven us into has compromised the very people I rely on for the existence of my business. He has created a chain effect that has the potential to compromise my business and its 8 other staff members. Without the middle class there is no Maybeck Animal Hospital.

In my years in the profession, I have witnessed the impact of how the financial health of the middle class supported by compassion and sound economic policy in the White House can uplift and bolster veterinary medicine; and how the exact opposite can occur under White House leadership that is rampant with greed, corruption, and gross incompetence. I have seen how a President who supports the free market and capitalism, but with proper regulation and oversight, can create a healthy investment environment; and how a President that lets big business have its way without oversight and regulation can create and environment where investing holds worse odds than Las Vegas. The current administration's blatant forsaking of the middle class while steadfastly pledging undying support for abusive big business is unconscionable.

And now the current republican presidential candidate who voted 95% of the time in lock step with George Bush (and bragged about this fact during the primaries) and has still yet to display one significant way in which he differs economically from George Bush, is trying to convince me that small business should fear a Barack Obama presidency? I am supposed to fear a man whose main tenant is support of the middle class, providing tax cuts for 95% of Americans and promising to not raise taxes on anyone making $250,000 per year or less?

Let's talk about health care. One aspect of my hospital policy that I hold dear is providing health care benefits for my employees and their families. John McCain's health plan is to provide a $5000 tax credit to put toward health insurance, but will in turn tax employer provided health benefits as income. Doing the math for all my employees, the tax credit makes some of them at best have the tax credit negated by the tax on their health benefits, while some of the employees actually end up paying more money to the government (in my case, for example, I would owe the government $1800 more).

Barack Obama by contrast, plans to provide my company with a 50% tax credit on the benefits I provide for my employees, freeing up money for equipment upgrades, staff and doctor continuing education, and better employee salaries and bonuses. Clearly, Barack Obama is not the candidate for a small business owner to fear. Indeed, John McCain with a health care policy that is even more tragically flawed than his economic vision, is the candidate in this election that small business owners should be running scared from.

That said, I am not so naive to think that Barack Obama is going to fly in on his unicorn and create an economic utopia with the wave of a wand. Thanks to his predecessor, he will be left with a dire economic reality, record deficits, and an oppressively expensive war to contend with, which may force his hand to dismiss or at least delay some of the programs on his wish list. But having a campaign that has been focused on the health of the base of small business, the middle class, I see a consistent and unwavering message that he will focus on looking after the great Americans that are the driving force of our nation and who I am proud to call my client base. By contrast, all I see from John McCain's campaign is a consistent and unwavering determination to vilely attack his opponent, trying to win our vote not on substance, sound policy, or concern for the middle class, but instead by trying to convince us that we should fear or distrust Barack Obama.

I have already casted my vote for Barack Obama. If you are a member of the middle class, a small business owner, or or simply care about the wellbeing of your country, you would be wise to do the same.

Roger Welton, DVM
Founder, Web-DVM

Sunday, October 26, 2008

Tiffany's Fund Saves Its First Furry Life

Six months ago, in memory of my late beloved Labrador Retriever, Tiffany, I started a charity fund in her name, that would pay for health care for pets of the less fortunate whose lives are threatened by treatable injury or disease. Fund raising has been a combination of internet donation and waiting room collection box, waiting room candy machines, book sales, and yard and bake sales.

Fund raising has been slow going, and weather has until recently hampered our ability to have outdoor yards sales. Nonetheless, the fund finally reached a point that it could begin to be used sparingly, just in time for a case that epitomized the situations that Tiffany's Fund was intended for.

This past Tuesday afternoon, in walked Lady, a 4 year old Labrador Retriever, Doberman Pinscher cross, one of our cherished patients because of her extraordinarily sweet, gentle disposition, as well as her remarkable beauty (she wears the best features of both breeds that she's comprised of). Her owners are an elderly couple that do not have much money, but never hesitate to keep Lady up to date on her yearly visits and preventives.

On this particular day, Lady was very sick, having thrown up a sock the previous night, and hadn't stopped throwing up since. She was listless, severely dehydrated, and very painful in the abdomen. X-rays and a radiographic technique known as upper GI series, we ascertained that Lady likely had additional foreign bodies obstructing her bowels, a situation that would lead to certain death if left untreated.

When I presented the estimate for the necessary surgery and intensive care hospitalization to the owners, Lady's father agonizingly told me that he could not afford the surgery and would have to put her down. At this point, I did not offer Tiffany's Fund money to help, since we have three main rules for considering candidates for Tiffany's Fund. These criteria are in place to weed out those seeking to misrepresent themselves and fraudulently, take advantage of our fund that we work very hard to raise money for.

(1) The patient's condition must be potentially life threatening. (2) The client must not come in asking for the fund, or indicate in any way that they brought their pet to us specifically because of the fund. (3) The client must apply for and be denied Care Credit, a third party, interest free medical lending company we offer as a payment option. Of course, there are subjective assessments that my experienced technicians and I consider, that one gets a feel for the quality of a pet owner from years of experience (e.g., don't tell me you can't afford health care for your pet, when you show in a BMW or walk in with a Louis Vuitton purse).

In tears, Lady's elderly father told me that he would likely get accepted for Care Credit since he retains a good credit rating, but living on a fixed income of $1200 per month, he refused get himself into debt that he and his wife would have to starve in order to pay back, even without interest. He agonizingly told me that he adored his dog, but he could not justify putting his wife in harms way by spending money they don't have.

Seeing that this dog was always well cared for, and knowing this sweet old couple for 4 years, I knew that Lady's father was being sincere. As such, I waved the Care Credit criteria and offered our fund to pay for Lady's treatment.

On abdominal exploratory surgery, I found that there were two socks jammed in her small intestine, causing obstruction and hemorrhage. I removed the obstruction via enterotomy, flushed her abdomen, closed her incision, then treated her aggressively with IV fluids, antibiotics, GI protectants, and narcotic pain management. Lady went home yesterday eating, in good spirits, her pain under control, and ecstatic to be reunited with her owners, a sentiment that was mirrored by her owners. I got to experience the joy of a life saved through the inspiration and memory of the greatest friend I ever had. It is my goal to ensure that this is only the first of many to come.

If you would like to read more about Tiffany's Fund, and/or wish to contribute, please visit the Tiffany's Fund page of my hospital's website at:


Roger Welton, DVM
Founder, Web-DVM

Monday, October 20, 2008

Owners, Please Warn Your Vet If Your Pet Bites!

To most people, it would seem logical that if one's dog or cat has aggressive or fear biting tendencies, that one would warn the veterinarian, a complete stranger performing sometimes uncomfortable clinical tasks on a patient, that he/she should be careful. Yet, at least a few times a week, I find myself finding out that a new patient is aggressive the hard way, getting bitten, scratched, lunged at, or all of the above. And when any of the above happens, many of these owners clearly has previous knowledge of their animals' aggression, as evidenced by their statements immediately following the episode, such as, "Oh yeah, he's always nasty to vets."

In response to this, I always say, "In the future, please warn us about a pet's potential for aggression, or people can get badly hurt." Staying politically correct like this requires a great deal of restraint on my part, as I often am seething with anger inside, especially following an exceptionally dangerous experience. Under these circumstances, I sometimes have the impulse to just throw the pet owner out of my office and ban him/her from the clinic, or to at least say, "How about a warning, you moron!" Thankfully, better tact typically prevails.

I do not know why some pet owners think that they do not need to warn veterinarians, assistants, and veterinary technicians about a pet's aggressive tendencies. I have speculated that some naively think that our veterinary training has endowed us with Dog Whisperer like abilities to make animals readily cooperate. In some cases, it has seemed that some pet owners are in denial that their pet has the potential to inflict harm on people. In a rare few instances, I even experience owners that find it amusing or cute that their animals have attacked and that failed to warn us (under these circumstances, all political correctness goes out the window).

To pet owners, please let me be clear that we do not possess a divine ability to make your pets like us. In fact, that opposite is true. When your pets see us, we smell like many other animals unfamiliar to your pet, that we have handled throughout the day. We are strangers to your pet, instilling an automatic sense of trepidation in fearful animals, but made worse by the fact that we do scary things to patients, like shine bright lights in their eyes, palpate abdomens, clean ears, trim nails, administer injections, and take temperatures.

If you have seen your pet act aggressively and do not warn us out of denial or wishful thinking that your aggressive pet may do better with a new vet, understand that your denial or wish that your pet may come around this time, can get people seriously injured. For those of you that thinks it is amusing or cute to see your vet attacked by your aggressive pet, talk to my first employer who had her lower lip bitten off by a rottweiler and required skin grafting and 4 surgeries to offer some semblance of cosmetic integrity. Ask her how cute her experience was!

Thursday, October 9, 2008

Animal Hoarding Revealed

About a year ago, a client of my clinic brought in a little chihuahua that was in a very disturbing state. The little dog had come from a home that my client's brother had been contracted to make some repairs. This gentleman was appalled at the condition of the home inside, where he witnessed at least 40 chihuahuas roaming, interbreeding, and eliminating at will throughout the house. The dogs were flea infested, dirty, and many of them fraught with varying degrees of injuries, ailments, and deformities.

My client ended up with the little chihuahua that she brought into my office because her brother found this little chihuahua particularly suffering, and made the decision to whisk the dog away without the owner's knowledge. Specifically, the dog was blind in both eyes due to untreated ocular infections and/or trauma, a badly deformed and shortened right front arm (the likely result of inbreeding), and severe flea infestation complete with skin infections, hair loss, and severe discomfort that typically accompany fleas.

We ultimately had to remove both eyes surgically as they were damaged beyond salvage. The skin cleared with antibiotics, medicinal baths and flea control. There was no beneficial options for the deformed little leg, but the dog managed to ambulate effectively nonetheless. This little dog miraculously lives comfortably, eats enthusiastically, and happily plays with my clients other animals - it was a happy ending for Mattie (as she was affectionately named by my client's loving family). As for the owner of these numerous dogs living in filth and squalor, she was reported to animal control, who ultimately had the dogs taken from the home and the owner dealt with legally.

The owner of these little dogs is what is known in animal law terms as an animal hoarder. Recent reports of animal hoarders in my local news reminded of the case of Mattie, and prompted me to raise awareness to my readers to learn to recognize these types of people.

Animal hoarders are distinguished from a people that keep an unusually large number of pets that care for them properly, as they are distinguished from animal breeders who have my animals as a nature of their business (who also care for the animals properly). According to one study, the distinguishing feature is that a hoarder, "fails to provide the animals with adequate food, water, sanitation, and veterinary care, and . . . is in denial about this inability to provide adequate care."

Animal hoarding of often goes hand in and with other compulsive hoarding behaviors, or could be part of a severe underlying obsessive compulsive personality disorder. Alternately, animal hoarding could be the result of addiction, dementia, or delusions. Being commonly the result of mental disorders, hoarders often have homes that are poorly maintained, dirty, and in many cases seemingly falling apart.

Although it is typically not the intention of an animal hoarder to harm the animals, the hoarder is incapable of recognizing the suffering that their behavior causes the animals they recklessly collect. Animal hoarding is therefore considered a form of animal cruelty, as is clearly evidenced in Mattie's case.

I implore all citizens to be aware of the signs of potential animal hoarders and report them to the authorities if animal hoarding is suspected in your communities.

Roger Welton, DVM
Founder, Web-DVM

Friday, October 3, 2008

Web Poll Suggests 32% of Pet Owners Not Interested In Preventive Health Care

A recent web poll conducted by this blog's parent site, Web-DVM.net, indicated that 68% of dog and/or cat owners participated in regular preventive health care for their pets, while 32% did not. The poll defined regular preventive health care as updating vaccines, heartworm screening (dogs), examination, and stool analysis, performed at least once yearly.

The implications of this alarmingly high number of household pets that are not kept on some preventive health care regimen, are many. For dogs, this means that a significant percentage are not protected from serious canine diseases, such as distemper, parvo, and heartworm disease. For cats, this means that many are not protected from serious feline disease, such as panleukopenia and feline leukemia.

For both species, forgoing updated rabies vaccine, not only risks a deadly nervous system disease for animals, but also for people, as rabies is contagious to people and other mammalian species. This human health risk potential makes failing to keep a pet with an current rabies vaccine is a violation of the law in most municipalities.

Also for both species, not performing regular stool analysis leaves the animal at risk for parasites, a situation that will exert ill effects on the pet, but also can pose a significant risk to small children in contact with the pet. While children are not the definitive hosts of these parasites, following infection, their naive immune systems can allow the progression of the life cycle of some parasites to reach a larval stage that migrates through the skin and eyes, leading to potential skin rashes and blindness, respectively.

Many people I come across that come to see me only when their pets are sick or injured, but not ever for preventive health care, justify their position by stating that they don't ever go to the doctor and they're fine. What I try to explain to people of this ilk is that people are better equipped go extended periods of time without check-ups and health screening for two important reasons. First, most of us do not engage in exceptionally risky behavior as pets do, such as sniffing or rolling in decaying organic matter, drinking out of puddles or other stagnant water, fighting with or eating wildlife, etc. Second, one year of a dog's or cat's life is a much larger percentage of an animals life when compared to a human, leaving proportionally alot more that can adversely effect health in this time period.

Denying pets the benefits of even basic preventive health care leaves them susceptible to illness, often leads to chronic poor health and diminished quality of life, and can even place families and communities in danger. For this reason, people who cannnot afford preventive health care for their pets should seriously reconsider pet ownership until they are in a better financial position to provide pets with at least minimal preventive health care. For those who simply do not care to engage in preventive health care for their pets, display apathy, irresponsibility, or both, either of which alone make them bad candidates for pet ownership in the first place.

Roger Welton, DVM
Founder, Web-DVM

Thursday, October 2, 2008

Way To Step Up For Animals, Body Shop

Regularly observing or learning of unconsionable acts of animal neglect, abuse, and cruelty in the United States of America, a country that is very developed and for the most part is comprised of a compassionate citizenry, I have often wondered about the potential plight of animals in less developed and/or antiquated countries. This has led me to often shudder at the thought of the treatment of animals in places where there is little regard for even human rights.

As such, I was so very pleased to learn of a report by The Wall Street Journal's MarketWatch.com, that The Body Shop, a natural health and beauty product chain, has partnered with The World Society for the Protection of Animals (WSPA) in raising awareness to sign sign a petition in support of a Universal Declaration on Animal Welfare. The "Make Yourself Beautiful Campaign", as it is called, will run from October 4-10, and for the duration of October at The Body Shop stores throughout Canada and the USA. During this time, customers will be encouraged to sign an online petition in support of the Declaration on the website www.makeyourselfbeautiful.org. The website also encourages individuals to "surround themselves with beautiful people" by getting their friends and family to sign as well.

The Universal Declaration on Animal Welfare is an agreement between people and countries that recognizes that animals can experience pain and suffering, and that working toward ensuring that the lives of animals are free of pain and suffering needs to be a top priority. Specifically, The Universal Declaration on Animal Welfare would help animals of the world by, as directly quoted from MarketWatch.com:

"-Raising the status of animal welfare as an international issue.
-Encouraging governments to establish or improve existing national animal
welfare legislation.
-Inspiring positive change in public attitudes and actions towards

A campaign of awareness alone may not seem adequately proactive, but remember the old proverb, "a journey of 1000 miles begins with the first step," and spreading awareness is an effective and neccesary first step. I encourage all my readers in joining the Body Shop in their mission and signing the petition.

Roger Welton, DVM
Founder, Web-DVM

Monday, September 29, 2008

University of Minnesota Discovers Gene Responsible for Excercise Induced Collapse in Dogs

The Minneapolis based StarTribune.com reported yesterday that researchers at the University of Minnesota have identified the gene mutation responsible for Excercise Induced Collapse (EIC) in Labrador Retrievers. EIC, whose signs include wobbliness sometimes progressing to collapse in the rear legs, sometimes loss of muscle control spreading to the rear legs as well, and in rare cases, death, affects about 3-5 percent of Labs.

A mutation of a gene, known as dynamin 1, produces a protein involved in the chemical signaling system between nerves that allows the brain to control muscle movement. The authors of the study believe that the mutant protein hinders the ability to send signals between nerves, suggesting that EIC occurs because the signaling system can't keep up with the rapid firing required during intense exercise. Like other recessive genetic disorders, 2 copies of the gene are required to exert a clinical effect.

Previously, veterinarians had a significant challenge in arriving at a diagnosis of EIC, because other causes for collapse had to be ruled out. According to StarTribune.com, however, this disease can now be detected with a simple and inexpensive DNA test.

The implications of this discovery are very important. Since all mammals carry dynamin 1, learning more about how the gene's protein functions may potentially contribute to understanding disorders in other mammals, including humans. Regarding animal health primarily, not only can a diagnosis of EIC now be attained much more easily, but breeders can now test potential breeding animals for carrying the mutant gene. This type of genetic screening can go a long way to significantly lowering the incidence of this disease in Labs.

Roger Welton, DVM
Founder, Web-DVM

Wednesday, September 24, 2008

Dead Animal Prank Not So Funny

On September 20, 2008, KTVU.com reported that a 20 year old in Dublin, California was arrested for, and confessed to a prank that involved his stealing 2 dead cats and a dead dog from the morgue of a nearby animal hospital, and stuffing them in three yet to be assigned lockers in the local high school.

The first body was discovered that morning, according to police. The second body was found the first week of September, followed by the third body on Sept. 9th, after a smell was reported coming from a locker. 20 year old Brian Goett was shortly later arrested for suspicion of grand theft, tampering with school property, and improper disposal of animals. Goet has no affiliation with Dublin High School, and no motivation for his actions have been revealed.

As a veterinarian who deals with pet loss to death by natural causes or euthanasia due to prolonged suffering, I regularly see first hand the grief that clients experience as a result of the loss of their beloved companions. As a pet owner for many years, I have endured this same grief when I have had to part with my own pets. For those of us who feel our pets loss as more than just the death of an animal, but as the loss of a cherished family member, we wish for the remains to be treated with the same respect and dignity as our human family members - I have my late yellow labs ashes in a tower with an engraved plaque and her picture prominently displayed in my living room. For any of us to know that our deceased family pets were treated like in the manner that Brian Goet treated these deceased pets would be most distressing and compound the already present sadness of loss.

Although no one in the naivety of youth can claim to have been immune to occasionally exercising poor judgement and not thinking something through before acting, I would expect better from a 20 year old who should have by now left high school far behind. And while it is not my hope that the ramifications of his actions permanently scar this young man's life, I hope that his penalties will be sufficient leave an impression on him that his actions were harmful on many levels and even border on sociopathic. Most importantly, I hope that in addition to sincerely regretting breaking and entering, theft, and creating potential human health hazards, that the young man also realizes and feels regret for the fact that he desecrated the remains of what were likely cherished family members.

Roger L. Welton, DVM
Founder, WEB-DVM.net

Wednesday, September 17, 2008

Top 10 most destructive dog breeds

As reported by Skynews.com, a UK study of 3000 dog owners recently compiled a list of the top 10 most destructive dog breeds. I would wager that some of these may come as a surprise to many. The study's findings below are reported in terms of the amount of monetary damage one can expect to the home, throughout the course of the dog's life.

1.) Great Dane - 670 pounds ($1293)
2.) Chihuahua - 630 pounds ($1136)
3.) Mastiff - 586 pounds ($1043)
4.) Whippet - 515 pounds ($917)
5.) English Setter - 485 pounds ($863)
6.) English Bulldog - 446 pounds ($794)
7.) Dachshunds - 440 pounds ($783)
8.) Boxer - 400 pounds ($712)
9.) Beagle - 400 pounds ($712)
10.) Bassett Hound (ranked last, but article did not specify monetary damage)

Surprised by the Chihuahua making number 2, and Labrador Retrievers not even making the list? I certainly am!

Knowing which dog breeds pose the greatest risk to one's home is interesting, even useful information for one that is in the market to adopt a dog. However, when preparing to adopt a dog, regardless of the breed, my experience has proven time and again that owner ignorance and/or laziness tends to play the biggest role in determining the amount of damage a dog will enact on the home.

That said, use this list at your leisure for your own knowledge or even to help you select a dog breed. But, if educating yourself and maintaining a proactive role in a dog's life are not priorities of yours, then perhaps it would be better to stick to having goldfish as pets instead.

Roger Welton, DVM
Founder, Web-DVM.net

Thursday, September 11, 2008

"Miles" The Miracle Cat

KTLA.com reported yesterday that an Anaheim woman drove to Irvine early last month before she realized there was something strange under the hood of her car. After the woman immediately pulled over and looked under her hood, to her surprise, she saw a frightened cat wedged into a tight compartment behind a headlight and the hot engine. After she called animal control, attempts to free the terrified feline were unsuccessful, with a very hot engine proving to be a significant obstacle.

That is when the officer contacted a nearby animal shelter, Irvine Animal Care Center, where veterinarian Dr. Karen Moreland came to the rescue. Through use of sedation and Dawn dish soap for lubrication, Dr. Moreland was able to get the kitty out of the tight spot he was stuck in.

There were no serious injuries reported except for some burns to the paw pads.

The kitty had a microchip in place to identify the owners, but when the shelter contacted the owners to pick up their lost cat, the workers made him available for adoption. They affectionately named him "Miles," in honor of his surviving against the odds, a 14 mile journey. The workers report that Miles is a sweetheart, and anyone interested in adopting him can contact the shelter at (949) 724-7740.

Having treated many unfortunate cats that have received much more serious burns and injuries from seeking shelter in car engines, Miles is clearly one lucky boy. Feline owners should pay close attention to this story. Left outside, cats are affected by the elements no less than we are. As such, they seek shelter from cold, wind, and rain.

A car engine is sometimes an attractive place for felines to weather the elements, since they are both dry and warm. The consequences can be serious if not tragic. Thankfully, Miles came through without serious injury, and hopefully will find a loving home for his trouble.

Tuesday, September 9, 2008

Sarah Palin's Record Shows She Is No Friend To Wildlife, But Is In Fact, One Of Its Worst Enemies

As reported by a September 4, 2008 Associated Press article titled, "Environmentalists say Palin's record on wildlife as harsh as Alaska itself," Sarah Palin's policies and record clearly illustrate little regard for wildlife and the environment. Beginning with her time at the National Governors Association conference spent primarily making her case to Interior Secretary Dirk Kempthorne against classifying the polar bear as a threatened species, Sarah Palin has continually maintained troublingly dismissive environmental and wildlife policies. Some months later, she once again confronted Dirk Kempthorne, arguing against even the Bush administration that they, "didn't use the best science in concluding that without further protection, the polar bear faces eventual extinction because of disappearing sea ice as the result of global warming."

During her 20 months of governor of Alaska has opposed federal marine scientists who concluded that the Cook Inlet Beluga Whale needs protection under the federal Endangered Species Act. Most appallingly, Palin has defended the right of Alaska to shoot wolves from the air for the benefit of boostering the populations of moose and caribou herds - not for the sake of the moose and caribou, but for the sole purpose of leaving more live moose and caribou for the human sport hunters to kill! Interestingly, this is a view that is contrary to that of her running mate John McCain. Finally, Palin remains skeptical that human created greenhouse emissions are responsible for the dramatic acceleration of global warming in this century.

As a result of her harsh environmental and wildlife policies, environmentalists have nicknamed Palin the "Killa from Wasilla," and John Toppenberg, the director of the Alaska Wildlife Alliance, has said that, "Her philosophy from our perspective is cut, kill, dig and drill," and that she is "in the Stone Age of wildlife management and is very opposed to utilizing accepted science."

It is the attempt of people like Sarah Palin to hijack the republican party, that have encouraged me through the years to move from a consistent republican voter to an independent that would now give strong consideration to a candidate possessing a democratic ideology over a republican of Sarah Palin's ilk. The party of small government and fiscal conservatism that I was inspired by as a young man, I am saddened to see has gradually and progressively become embraced by those who value relentlessly pushing their agendas, even at the expense of compassion, tolerance, justice, and even science.

With another running mate at his side, I may have considered voting for John McCain as president, a man who has throughout most of his career embraced the core, fundamental values of the conservative movement, without sacrificing compassionate and progressive environmental policy, tolerance, justice, and science. However, when he chose consolidating his base by choosing as his running mate, someone who embodies what has gone wrong with both the republican party and our country in general, he instantly lost my vote.

Choosing to run with Sarach Palin, John McCain is telling the nation that he would put the "Killa from Wasilla" a heartbeat a way from leading our country. This not only makes me question John McCain's judgement, but it also leads me to believe that the compassionate, impassioned, and justice seeking maverick I supported in 2000 may be truly gone.

Wednesday, September 3, 2008

Government Is No Friend Of Small Business

This year has presented big challenges for small business to say the least. Fewer jobs, skyrocketing fuel costs, a generally downtrodden economy, and the uncertainty of a heated presidential election, have all led to decreased consumer spending and significant corrections in revenue. Combined with ever increasing inventory supplier costs (a direct result of the high cost of fuel), rising employee health care premiums, steadily increasing insurance costs, and a myriad of other progressively rising practice expenditures, the outlook for relatively new small businesses such as my animal hospital causes great concern - all this, while practice, equipment, and practice real estate liens continue to have to be met.

Despite these challenges that my small business currently faces and will likely continue to face for some time, my government just sent me notification that the property tax on my building will be increased by nearly 50% come November of this year, a property tax that is already an oppressive financial burden at its current figure. What's more, this gouging pays for my right to own and operate a building that was originally built in 1952 and subsequently quite dated, a building that I have to invest thousands of dollars per year in order to keep a reasonable degree of aesthetics and acceptable functionality.

Unlike big business and Corporate America, I do not expect my government to come to my rescue and offer me handouts during tough times. However, I do not expect my government to relentlessly and arbitrarily add stress to an already taxed financial condition. This is an especially hard pill to swallow when I see bank after bank receiving corporate welfare in the form of financial government bailout, following a mortgage default disaster that was the result of the banks' own poor judgement. And let us not fail to consider how government allows countless tax loopholes and tax credits that feed the pockets of corporations and even pave the way for abuse, clearly exemplified in the Enron Loophole that has allowed speculators to tax our national economy by orchestrating astronomical fuel prices.

So to my readers, whatever your political affiliation and whatever issues you base you vote in these upcoming elections, do not bother making small business an issue which sways you. Both sides will talk of their regard for small business and their intention to protect small business. But make no mistake, once in office, whichever candidates you choose to represent you, one thing is for certain: small business will remain the government's whipping boy.

And if any of my readers happen to be government representatives at any level, before the next instance that you decide to exploit small business as a means to fix government shortcomings or pander to big business, remember the words of the great Winston Churchill:

"Some see private enterprise as a predatory target to be shot, others as a cow to be milked, but few are those who see it as a sturdy horse pulling the wagon."

Monday, August 25, 2008

Hero Dog Saves Infant's Life

This past Saturday, CNN reported the story of a dog who sheltered a newborn baby that was abandoned by its 14 year old mother, in a field in rural Argentina until the boy was rescued. According to the story, a resident of rural La Plata had telephoned police indicating that he heard a baby crying in a field behind his house. The man then went outside and found the newborn infant lying beside the dog and her 6 newborn puppies.

The dog had apparently carried the baby 50 meters from the original area where the baby was abandoned by its mother, to the spot where her puppies were huddled together. Doctors remained convinced that, with an outside temperature a frigid 37 degrees, that the baby determined to be only a few hours old, would most certainly have died if not for the shelter provided by the dog and her puppies. Aside from a few superficial scratches, the baby, thanks to the shelter provided by a very dedicated canine mother, was otherwise in good shape.

As for the baby's human mother that originally abandoned the baby for dead, she was driven by a neighbor to the hospital where she admitted that the infant was hers. The teenage mother was then promptly hospitalized for psychological treatment.

Below is a photo of the hero of the day.

Apparently, the dog has become a local celebrity and is being hailed as a bonafide hero. However, what the future fate of hero mom and pups cannot be confirmed at this time, as CNN did not say and I was unable to find any information about this.

Wednesday, August 20, 2008

Breast Cancer Awareness (In Dogs and Cats!)

With the uncomfortably high incidence of breast cancer in women, there is a great deal of awareness regarding prevention and early detection. What many people do not realize is that mammary or breast tumor development is even higher in female dogs, as high as 1 in 4 unspayed female dogs. For cats, mammary tumors are also quite common, with mammary cancer being the third most common type of cancer affecting unspayed females. These are staggeringly high numbers, yet awareness among female dog and cat owners is overwhelmingly lacking.

Mammary Tumors In Dogs

The good news is that mammary tumors are very preventable in female dogs by having them spayed before their first heat cycle. One can expect virtually zero risk of the development of mammary tumors in a female dog that is spayed prior to experiencing the first heat cycle. If a female dog is allowed to experience one heat cycle prior to the spay procedure, then the risk of developing mammary tumors increases to about 5%, still quite low. However, if a female dog is allowed to have more than one heat cycle, then the risk of mammary tumors goes up to 1 in 4.

Since female dogs will come into heat the first time before the age of 1, and given the fact that it is not recommended to breed an immature female dog for a variety of reasons, people must often choose between having a litter of puppies and prevention of a very common cancer. On the other hand, since the development and growth of mammary tumors is promoted by the presence female hormones, spaying at any age is still beneficial in preventing mammary tumors.

About one half of all mammary tumors are benign (not cancerous), which would fall into the category of mammary fibroadenoma, tumors that form out of the glandular portion of the mammary gland. Mixed mammary tumors with both glandular and non-glandular components, can present as either benign or malignant (cancerous).

Maligant varieties of mammary tumors induce mammary adenocarcinoma and inflammatory carcinoma. Inflammatory carcinoma is an especially aggressive form that has a high metastatic index (tendency to spread to other tissues), carrying the most poor prognosis of all mammary tumors.

As with people, early detection of tumors is paramount in offering the best prognosis with treatment. The sooner the detection, the more surgically removable a tumor is, the lesser the likelihood of spread to other tissues. As such, the mammary glands of the dog should be inspected by feel often, especially if one’s female dog falls into a high risk category based on spay status.

Unlike women who only have 2 mammaries, dogs have 10, along the ventral (underneath) surface of the torso, spanning from the groin area to the chest forward to just behind the front limb armpits. Each mammary has its own nipple. If one ever feels a nodule, firmness, or unusual swelling in thee areas, one should have the dog checked by a vet ASAP.

Diagnosis of mammary cancer is sometimes achievable through a non-surgical technique known as fine needle aspirate of a mass, which offers a diagnosis about 68% of the time. If fine needle aspirate is found to be diagnostically lacking, then a tissue sample known as a biopsy is necessary to confirm the diagnosis. In order to help determine whether or not a malignant mammary tumor has spread to other tissues at the time of diagnosis, chest and abdominal x-rays, and abdominal ultrasound are recommended.

Depending on the nature of a mammary tumor, treatment may not be necessary, surgery alone, or surgery in combination with chemotherapy. Benign and/or minimally aggressive mammary tumors may be treated surgically by removing a portion of the mammary gland along with the tumor, a procedure known as lumpectomy. Benign to medium grade malignant tumor are often treated more aggressively with removal of the entire gland, known as mastectomy. High grade or highly aggressive malignant mammary tumors typically require removal of the entire mammary chain and lymph nodes, a procedure called radical mastectomy.

Prognosis with treatment depends on the aggressiveness of the tumor(s) involved and degree of spread to other tissues at the time of diagnosis.

Mammary Tumors In Cats

Like dogs, mammary tumors in cats are very common, with mammary cancer being the third most common cancer affecting felines. Unlike dogs with about 50% of mammary tumors being malignant, in cats, mammary tumors are malignant 90% of the time, making prevention of these tumors and awareness for early detection even more important.

Similar to the canine, early spay in the feline is the single most significant determining factor in the risk of the development of mammary tumors. Spaying prior to 6 months of age reduces the risk of mammary cancer in cats by about 90%, while spaying prior to 1 year of age reduces the risk by 85%. Spaying before 2 years of age reduces the risk of mammary cancer by 10%, with no apparent reduction is risk in cats spayed after 2 years of age.

The types of mammary tumors most commonly found in cats are mammary adenocarcinoma and inflammatory carcinoma (see the canine section for descriptions of each type). Given the high malignant potential of mammary tumors in cats, more aggressive surgical techniques such as mastectomy (removal of the entire mammary gland) and radical mastectomy (removal of the entire chain of mammary glands and lymph nodes) are more commonly utilized.

Prognosis with treatment depends on the aggressiveness of the tumor(s) involved and degree of spread to other tissues at the time of diagnosis. For more aggressive malignant mammary tumors, the disease free interval following surgery can be increased by 75 to 100 days with conventional chemotherapy.

Sunday, August 17, 2008

Breeding Kennel Atrocity Prompts Pennsylvania Dog Law Reform

According to an ABC News article posted August 16, 2008, dog breeding kennel owners Elmer and Ammon Zimmerman of Maxatawny, Pennsylvania, shot 80 of their breeding dogs and closed their kennels in response to having been ordered by dog wardens to enact kennel repairs (their kennel was cited for extreme heat, insufficient bedding and floors the animal's feet could fall through), and veterinary checks for 39 dogs suffering flea and fly bites. Unfortunately, there is currently no law in the state of Pennsylvania that prohibits the killing of animals by firearm.

The fact that these kennel owners who exploited these animals for profit while providing no health care (not even flea prevention!) or humane conditions for them to live in is an example of greed at its worst. The fact that they would sooner murder each dog rather than comply with minimal standards of health and living conditions is a very troubling commentary on our citizen's attitude toward animals. Even more troubling, however, is the fact that in the eyes of the current laws of Pennsylvania (and I would not doubt, many other states as well), these individuals have done nothing wrong, however ghastly their actions.

The only positive note to some out of this very sad event, is that the incident gained the attention of Pennsylvania Governor Edward Rendell, prompting him to urge the Pensylvania House of Representatives to pass his proposed reforms to the state dog law. According to FoxBusiness.com, Governor Rendell made his appeal accompanied by Maggie, one of the two Golden Retrievers who were former breeding dogs that were rescued and adopted by the Rendell family. The new legislation would prohibit breeding dog euthanasia by anyone other than a state licensed veterinarian, along with other important animal welfare provisions. Quoted directly from FoxBusiness.com, below is a list of other regulations proposed in the reform bill:

House Bill 2525 also:

-- Doubles the minimum floor space for cages.

-- Requires outdoor exercise. Current law does not require even that dogs be let out of cages, much less given access to outside exercise.

-- Requires solid flooring. Dogs now can spend their entire lives on wire floors, which damage their feet over time.

-- Prohibits the stacking of cages. Under existing law, cages can be stacked so high that inspectors can't see whether they have food or water, or even if they are still alive.

-- Requires veterinary checks annually or during each pregnancy. Many dogs now never see a vet throughout their entire lives.

I applaud Governor Rendell and his efforts in reaction to this cruel act that occurred in his state. It is my hope that politicians within other states with outdated and inadequate animal welfare laws, follow his example in making humane treatment of animals a priority. I encourage all my readers to check on the provisions their respective municipal and state laws have for breeding animals, and organize pressure on their local and state government to enact reform if the laws are less than adequate.

Tuesday, August 12, 2008

Arthritis Supplements Decoded

Arthritis refers to inflammation within a joint. There are many causes for arthritis, including trauma, injury, infection, or age. Age related degenerative arthritis is known as osteoarthritis, which is the type of arthritis addressed in this article.

Osteoarthritis is perhaps the most prevalent chronic disease that affects senior to geriatric aged dogs and cats. As such, it is not surprising that there is literally a sea of health supplements marketed for the treatment of arthritis, with each new one claiming to be better than the last. What complicates matters even further when deciding which supplements are best for our animals, is the reality the these products remain grossly unregulated by the FDA, meaning that quality control is suspect at best. In order to help pet owners make sense of what works regarding the management of arthritis, what doesn't work, and why, I will break down the most common ingredients provided in many of the supplements available in the small animal arthritis market.


Glucosamine is a precursor involved in the synthesis of glycosaminoglycans, which are major components of the cartilaginous articulating surfaces of joints. Given this correlation, glucosamine is believed to facilitate the rebuilding of joint surfaces, helping to treat osteoarthritis.

Unfortunately, the jury is still very much out on this substance's benefits, with success for the management of osteoarthritis in dogs and cats being at best anecdotal. At this time, there are no reputable scientific studies that prove a direct improvement of osteoarthritis cases by administration of glucosamine.

While I do not feel that glucosamine is by itself a very good supplement for osteoarthritis, I have been witness to case by case benefits in the treatment of osteoarthritis on several occasions, including one of my own pets. Although I am a big believer in non-biased scientific study and remain skeptical of its true benefits for osteoarthritis cases, there is enough case by case evidence for me to recommend glucosamine as part of any comprehensive osteoarthritis management program.


Chondroitin is a major component of extracellular matrix, and is important in maintaining the structural integrity of this and other tissues. The loss of chondroitin in cartilage is believed to be a major contributing cause for osteoarthritis, adding to the belief that supplementing the diet with chondroitin will strengthen cartilage and aid in the treatment of osteoarthritis.

Like glucosamine, however, the jury remains out on chondroitin, with no sound statistical evidence of any real benefit for canine and feline osteoarthritis patients. What's more, chondroitin absorbs poorly in the canine and feline gut, leading to most ingested product getting defecated out of the patient, and causing diarrhea in many patients.

Combined with the lack of any unbiased scientifically proven evidence of improvement for arthritis sufferers, poor absorption in the canine and feline gut, and a propensity to cause diarrhea, I have dismissed chondroitin as a beneficial arthritis health supplement.

Perna Canaliculus

Perna is a type of mussel found in New Zealand waters, called the Green-lipped mussel. These mussels have particularly high concentrations of glycosaminoglycans, major components of the articulating cartilaginous surfaces of joints.

Glycosaminoglycans are believed to provide relief for osteoarthritis patients by helping rebuild and maintain damaged cartilaginous surfaces within the joints, while also inceasing the amount of synovial fluid within the joints, and easing joint pain by providing more natural lubrication.

Research based on a technique called forced plate analysis has indicated a real benefit for arthritis patients when treated with glycosaminoglycans, offering credence to the use of perna in the management of osteoarthritis. This combined with my own positive experience with perna based products makes me a believer.

Omega-3-Fatty Acids

In addition to a huge number of other proven health benefits, omega-3-fatty acids have been conclusively found to provide relief for osteoarthritis patients (clinically and through forced plate analysis). It is believed that relief comes from the natural anti-inflammatory action of omega-3-fatty acids, whereby inflammatory pathways are diverted to pathways that are inert, non-reactive, and non-detrimental to tissues.

With so many other proven health benefits, I am undoubtedly an advocate of omega-3's as an integral part of any joint health supplementation program.

Given the evidence at hand, it is clear that a comprehensive osteoarthritis supplementation product should contain glucosamine (I know the jury is still out, but I think it has some benefits, and at the very least cannot hurt), perna canaliculus or isolated glycosaminoglycan, and omega-3-fatty acids. However, with virtually no FDA regulation on the myriad of products available for this purpose, pet owners must be very careful about selecting reputable supplements. A blind study reported by DVM News Magazine proved that 3 out of 4 randomly selected, pet store sold arthritis supplements were found to not have the ingredients that the labels claimed.

Therefore, it is best to select veterinary grade supplements available through your veterinarian, offering a guarantee of pharmaceutical companies with alot to lose should their products be found to not live up to their labelling. Also, pet owners should be careful about trying to save a buck by getting even reputable veterinary grade products online, as there is alot of knock off, garbage being peddled through even big name online pet med retailers.

Sunday, August 10, 2008

Animals And Small Children

During my 7 week old boy's "wakey time" earlier today, I watched as both my little boy and my dogs (7 yr old, spayed female, border collie mix, and 2 yr old neutered male, Labrador) were thoroughly interacting and enjoying one another. Little Austin was completely enthralled with the mere presence of the two dogs, while the dogs were wholly intrigued by the the happy baby talk coming from the infant, as well as the random blissful movements of his arms and legs. The circumstances were ideal for baby and dogs alike, providing fulfilling stimulation for baby and dogs. It filled me with a sense of joy that my dogs, who have been with my wife and I long before Austin was ever conceived, could be part of the miracle of our new addition and not have to sit on the sidelines or take a back seat as we raise the boy through his most fragile and formative years. We have begun our life with our new addition as a family, and that includes the dogs and the cats (all that comprised our pre-Austin family for years) as well.

As fun as this interaction has continued to be, I have been a vet long enough to have been made aware of many occasions when this sort of pet inclusion has gone bad -in some cases, very bad. And while there are some animals that have a demeanor that does not make them candidates to be near small children under any circumstances, the majority of animal/small children cases that I have been made aware of, were very preventable.

The first mistake people make with small children and animals, is not understanding the inner workings of the animal's character. Dogs that are fearful or aggressive toward strangers, other dogs, or act territorial or exhibit dominance, are dogs that people need to be very careful with. Dogs like this may view small children as new pack members, ones that need to understand their place in the hierarchy of the canine pack dynamic. As such, dogs like this may exhibit aggression toward a small child when in close proximity, aggression that could have dangerous consequences to a fragile toddler or infant. For these types of animals, one should avoid interaction between the pet and the small child for months, as the animal adjusts to the presence of the child and all the changes associated with that (crying, Mommy's and Daddy's doting, feeding, etc.). Only after a significant adjustment period, should the child be allowed near the dog, but even then, this should be done under the most concentrated supervision. Of course, if the dog has a history of chronic and/or severe fear, dominance, or other types of aggression, then the dog should not be allowed any access to the child. For the safety of the child, it is sometimes best if a dog i found a new home, one without children or the possibility of children, such as with seniors or others not planning to have a family.

Whether or not a dog has a history of fear, dominance, or other types of aggression, one must look out for the telltale signs of canine anxiety, such as ears pinned back, showing of teeth, growling, or crying. If any signs of these signs arise in the animal, the interaction should be aborted immediately. Even in the absence of obvious problem postures, licking and close sniffing should be avoided before many safe distance encounters have passed without incident, and interactions always should occur under close supervision.

For my own dogs, the 6 pound Yorkie is not allowed access to the infant at all. In his youth and middle age, he had been known to show dog aggression even to canine members of his own household. Even though in his geriatric years, he has not shown dog aggression for years now, and despite the fact that he never once in his life ever showed aggression toward people, my wife and I are not prepared to take the chance. Besides, the Yorkie does not seem put out by our decision, as he really wants nothing to do with the boy anyway, preferring to curl up in his little bed most of the day.

The yellow lab never once showed aggression toward anyone or anything, even when dogs have shown aggression toward him. When dogs have snapped or growled at him, he has always simply back up and looked to me with confusion, not even seeming to understand aggression from the other dog or even perceiving the danger to himself. The border collie mix is also a very peaceful dog, choosing to expose her belly in a submissive posture when aggression is directed toward her.

Even given the gentle temperament of my big dogs, however, I still practiced what I preach, being every bit as careful as I have described in this post. However, even though my dogs are big gentle goof balls, it does not mean that they are not capable of accidentally harming little Austin. Smacks with excited tails, knocking over the infant chair with baby in it, tripping Mommy or Daddy while carrying the baby, etc., are all very dangerous potential incidents that could still occur with no ill intentions from the dogs. For this reason, it is important to train the dogs to act appropriately when the baby is in these positions, discouraging over-rambunctiousness or obstructive behavior in the presence of the baby. Thankfully, my wife and I have over 2 1/2 decades of small animal care experience between the two of, so we have been quite capable to handle the transition ourselves. However, for those with little canine experience or who lack of confidence in their canine training skills, do not be shy about asking your vet to suggest an animal behaviorist to help.

For those who are planning to adopt a dog for a family with small children, there are certain breeds to consider that are known to be gentle with small children, and many breeds that should be avoided. Having dedicated an entire chapter of my book, "Canine and Feline 101," to this topic, I leave pet owners to get the information from there rather the reiterate the chapter, or seek the guidance of a vet or animal behavioral specialist. However, no matter how a family selects the appropriate animal, aforementioned precaution must still always be taken, with determined supervision still essential.

With regard to cats and small children, most cats, even when outright agitated by a child's presence, will simply avoid the child. However, some may approach out of curiosity and if annoyed, could swat at the child with little warning. Again, concerted supervision can easily prevent a dangerous incident, but if a cat is known to have little tolerance, then contact should be avoided and discouraged until an age that the child can understand to be trained as well (child training is a whole other topic, to be addressed in a later post).

Sometimes cats can be very sweet to the point that they would happily crawl into the crib with an infant and sleep. While this may seem very adorable, let me caution that this is something that must be discouraged and avoided. The sweet cat intending no harm, could inadvertently lay across the infant and smother the little one. For this reason, leading up to the birth of our son, my wife and I layed scat mats in the crib, bassinet, infant seats, and stroller. The scat mats emit a static shock when a feline steps on or comes in contact with. The mats are gentle enough that they are acceptably humane (my wife and I tested them on ourselves), but just strong enough to get the point across. In addition, the cats are never allowed access to a room where the baby is sleeping.

A household with both animals and children is mutually beneficial when approached with the proper prudence. Children an animals stimulate one another, provide entertainment for one another, while providing amusement for the adults that supervise them. The animal/child interaction enables children expand their imagination and to grow up with a sense of animals as part of their families, ingraining a sense of respect, comradry, and love of animals that they can take into adulthood.

Sunday, August 3, 2008

Shocking Violence By Animal Rights Extremists

The San Francisco Chronicle posted a story earlier today, reporting that recent firebombings of the homes of two biological researchers from University of California at Santa Cruz, seem to be the work of animal rights extremists. According to the article, Santa Cruz police Captain Steve Clark, an investigator involved in the case, noted that the deadly explosive devices were similar to ones used in the past by violent animal rights activists. In addition, unsigned pamphlets were found in a downtown Santa Cruz coffee shop, which printed 13 researchers' pictures and addresses, called them "murderers and torturers" and said, "Animal abusers everywhere beware."

Assistant Professor of biology Dr. David Feldheim (the other victim chose to remain anonymous), who uses mice in laboratory research on brain formation, told The Chronicle that he and his wife, along with their 7-year-old son and 6-year-old daughter, had to drop a ladder from the window of a second-floor bedroom to escape after smoke filled the home's first floor, following the strike of a firebomb. The Chronicle also reported that both of Dr. Felheim's feet were injured during his escape. The investigation is ongoing.

This kind of violence is appalling and sociopathic. It is inconceivable that people can have such a proclaimed deep passion for the wellbeing of animals, yet carry no regard or regret for the harming of human life, even that of innocent children. The fact that acts of terrorism like this are performed under the banner of compassion make it all the more disturbing.

People that engage in terrorism as a means to advance ideals are people that live on the fringe of society. Their actions are not the result of passion for animals, but more the result of a need to fulfill an underlying desire to disrupt and damage society. People like this are a detriment to any cause at best, bringing both shame and decreased credibility to any movement.

The article highlighted the remarks in reaction to this incident, of Mr. Jerry Vlasak, a Los Angeles-based spokesman for the North American Animal Liberation Press Office, which often posts on its Web site, communication from activists taking credit for attacks. He stated that the benefit of animal research did not justify its expense or the "exploitation of animals."

Vlasak further voice that the bombers likely were not trying to hurt Feldheim, but were instead, "trying to send a message to this guy, who won't listen to reason, that if he doesn't stop hurting animals more drastic measures will be taken ... it's certainly not an initial tactic, but a tactic of last resort."

Mr Vlasak, not condemning these actions and glorifying other reugnant acts on your website, you and your organization are no better than the wretched individuals who would wreak violence upon a family.

Wednesday, July 30, 2008

"Food Pets Die For: Shocking Facts About Pet Food"

This is the title of a book by Ann N. Martin that exposes the fact that euthanized dogs and cats have traditionally been appallingly common ingredients in many commercial pet foods. In addition to this practice, Ann also contends that pet food companies have been known to include other less than wholesome ingredients to fulfill minimum nutrient requirements, such as: diseased cattle, contaminated meat, moldy grain, roadkill, and rancid fats from restaurants to name a few. At first glance, these charges may seem outrageous, but upon reading the book, the sources of information are quite credible. There is also the reality that if one really looked into what went into the creation of a hot dog prepared for human consumption, these claims would not seem so over the top for pet food.

Further evidence of abysmal ingredients being included in the production of commercial pet food was detailed in the reputable news show 20/20 on an episode aired last year that confirmed allot of what Ann Martin's book claims. From personal experience, I recall after performing necropsy (post mortem examination for the determination of cause of death) in pathology lab during my senior year of veterinary school, unless owners were interested in arranging burial or private cremation, the carcasses and body parts were stored in barrels that were periodically picked up and transferred to rendering plants. Rendering is the process by which animal tissue waste is converted into valued, stable materials that are utilized in the production of many items ranging from glue to soaps and moisturizing creams. In her book, Ann Martin contends that in addition to these items, nutrients derived from rendered animal tissue waste end up in many commercial pet foods.

Whether or not one chooses to believe Ann N Martin and/or the 20/20 pet food expose piece, one cannot deny that there is enough credible evidence to at least consider the possibility that many pet foods are derived from what most pet owners would consider dreadful ingredients. What's more, in an industry that is still grossly unregulated, pet food labels are allowed to be deceiving, gaining pet owning consumers' trust with less than forthright presentations of pet food ingredients. In her book, Ann N Martin presents the limited information offered in this blog post in much greater detail, as well as delves into a great many other unspeakable ingredients that end up in pet food. She also explains the deceptiveness of the pet food labels, and the reasons they are so misleading.

Monday, July 21, 2008

Online Pet Medication Retailers Hurt The Pet Owning Consumer In The Long Run

As the popularity of purchasing pet medications from online pet medication retailers continues to increase, it becomes an ever increasingly controversial aspect of the pet health care industry. Veterinarians are disturbed by this trend first and foremost because of the loss of pet medication revenue being funneled instead to large pet medication online corporations. From an ethical standpoint, the sale of many of these medications occurs by unethical means, that is, manufacturers whose policy is to enforce quality control by making their products veterinarian exclusive, have this policy circumvented by online pet med corporations that entice a few o greedy vets into buying mass quantities of these medications on their behalf to be channeled into the online retail market for a fee. According to the May 2008 edition of Veterinary Practice News in an article titled "Product Diversion," the online retail pet med market diverts $200 million to $300 million per year on flea preventive medication alone, representing a staggering amount of revenue lost for veternary clinics.

When pet owners choose to save a buck by using these outlets, they think that they are getting one over on the system and sticking it to us greedy vets, but they never stop realize that they hurt themselves, other pet owners, and the community as a whole in the long run. From a strictly economical standpoint, when pet owners choose to buy their pet medications from an online pharmacy rather than a local veterinary clinic, they divert their money from their local economy, and instead feed a corporate giant could that not care less about the economic stability of their city. Local veterinary clinics use revenue to provide health care for their employees and provide them with regular bonuses and raises. Health care, bonuses, and regular raises allows veterinary clinic employees the financial freedom to spend, thereby infusing their own money in the local economy.

Revenue is also used by many clinics to give back to the community. In my clinic, we donate net profits on certain products to a memorial fund established to provide health care for pets of the less fortunate that could not otherwise afford it. We also provide significantly discounted health care services for many animal rescue groups in our county. We are but one example of countless veterinary clinics that engage in giving back to the community for the benefit of animals and pet owners.

By choking off a significant share of the pet care industry's revenue by choosing to patronize corporate giants for your pet health medication needs, veterinary clinics are left with a diminished capacity to provide for their staff and engage in community works. As this trend approaches a critical point where revenue is lost to the point that practice ability to maintain quality employee standards (a situation that is already occuring), practice owners have no choice than to either cut staff, cut benefits, and/or seek alternate ways to make up for that revenue.

One aspect of veterinary medicine that corporate giants cannot touch or capitalize on or exploit is our minds and our skills. With preventive medical sales becoming increassingly a less significant source of revenue for veterinary clinics, practices are gradually establishing a shift where a greater focus is placed on services rather than products. As a result, while the online pet med retail shopper may save $5.00 to $15.00 on preventive medications, they and other pet owners will pay more for examinations, dental prophylaxis, in-hospital treatments, surgeries, and just about any other aspect of veterinary medicine that falls under the category of "services." The Veterinary Practice News Article quoted from earlier in this post is actually a how-to article for veterinarians to begin a veterinary practice paradigm shift from a reliance on product sales to a greater reliance on revenue procured from services, as the result of the increasing popularity of online pet med retailers.

The ones that indeed get hurt the most from online pet med retailers are the many pet owners that continue to choose purchase their preventive medications from veterinary clinics. They unfortunately share in the burden of increased costs of services at no fault of their own. However, while pet owners who frequent online pet med retailers may save a little here and there, when the time comes that their pets require veterinary services to maintain or sustain their pet's health, they too will feel this burden, and in the long run, their preventive medications savings will be at best minimal, if not negated or worse.

My message to all that order pet meds from online pet med retailers is to realize that you purchase veterinarian exclusive medications that are obtained by unethical means dictated by greed above all. If this does not detract you from buying meds online, then consider that you contribute to the compromise of your local economy by funnelling your local money out of your community an into the pockets of corporations. Consider also that this loss of veterinary practice revenue comes at the cost of maintaining optimal employment conditions for veterinary practice staff and leaves us less disposable income to engage in community works that help people and animals of the community. Finally, know that in the long run, your patronage of online pet med retailers will ultimately cost you significantly more in pet health care services, likely negating any savings you may have gained under the best of circumstances. However, for the pet owners that loyally purchase their products from veterinary clinics, through no fault of their own, have to help shoulder the burden of increased cost of services that your actions contributed to.

Saturday, July 12, 2008

A Long Overdue "Thank You" To My Pet Owning Clients

Client relations can be the single most frustrating and stressful aspect of veterinary medicine. The medicine and surgery for the most part are the enjoyable aspects of the veterinary industry, and while challenging cases can lead to difficulty and stress, this stress pales in comparison to the strain poor client behavior places on a practice. Whether clients are difficult because they are ignorant, demanding, stubborn, overbearing, callus, or downright mentally ill, client actions or lack thereof can make for an occasional disagreeable work environment. Given this reality and our human tendency to more acutely remember bad situations as opposed to the more pleasant ones we experience, many of my posts reflect client troubles, especially in my "Incredible But True" segment.

What unfortunately gets overlooked when these few bad apples take center stage in our minds, are the thousands of dedicated, compassionate, generous, and amicable people I feel privileged to call my clients. While I remain ever cognisant of these quality individuals, the recent outpouring of well wishes, cards, and gifts that came with the recent birth of my son (who came early by a tense emergency c-section), I was emphatically reminded of the the kindness of the majority of my clients. Subsequently, this post is dedicated to showcasing the wonderful ways that clients brighten our lives.

Leading up to holidays, clients frequently surprise us with home baked goods, sandwich platters, candy, flowers, and other goodies. Our office becomes so overflowed around Christmas time that we have to dedicate an entire 4x6 cork board to hang all the greeting cards up, and the food and treats fill up all the spare space in our treatment area.

Many clients bring us food and treats when even there is no holiday, just because they want to do something nice for us. One particular client that travels a great deal and has several pets that are treated by us, always presents a neat little gift from yet another interesting place he has just returned from visiting. Another client who frequently brings his beloved black lab in for yearly visits and grooming, always makes it a point to bring the office a box of freshly prepared, still warm, Krispy Kream Donuts.

Other clients astound me with their dedication to their pets. One gentlemen works an extra job to pay for all of his dog's veterinary care, with all of his dogs having been obtained by rescue. Recently, a lady who had been putting off a well needed knee surgery for her dog for some time, booked it finally, apologizing that she took so long, but explaining that she had to wait to get her IRS tax return check to pay for the procedure. Another dear client that is disabled and cannot walk or drive, brings her shihtzus in on her lap as she navigates the streets and sidewalks on her motorized wheelchair, in the process having to cross a busy highway to reach my office.

So often my day is brightened repeatedly by clients that come in for visits that I have known and built a repore with for so long, that I consider them friends. Interaction is so casual and enjoyable with these clients, that appointments often take on more a manner of social pleasantry, than professional doctor-patient-client relations. Repeated experiences like this create relationships with clients on an intimate level, where we share personal anecdotes, advise one another about good restaurants and offer other helpful tips, and sincerely inquire about the well being of one another's families.

To all of you wonderful clients that brighten our days and who are the life blood of our practice, I thank you from the bottom of my heart for allowing us the privilege of being entrusted with the wellness of your beloved pets. Please never forget the gratitude we feel for your dedication to your pets and the agreeable manner in which you treat us and carry yourselves in general.