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:

http://www.maybeckvet.com/tiffanysfund.html

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
animals."

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