Missouri, you should be ashamed!

The puppy mill situation in our nation is appalling beyond comprehension. For those of you that are not aware of what a puppy mill is, it is a facility where tens to hundreds of dogs are kept in cages and repeatedly bred to continuously pump out litters of puppies. In many cases, the breeding animals are let out of the cages very infrequently or not at all. Puppy mill dogs are treated as production machinery, often with more neglect than one would treat machinery - it is less expensive replace a dog then it is production machinery, and money is the bottom line for the despicable individuals that run such places. The cages are found to be unsanitary, with wire floors that cut the pads, kept outside at the mercy of the severe extremes of summer heat, winter cold, and biting insects. Vaccines and other preventive care are not given, and the rate of mother/puppy death is very high. It doesn't matter, with little to no investment in caring for these dogs and puppies, and hundreds more dogs to keep putting puppies out there to replace the ones that regularly die, it is all profit. Profit is the bottom line regardless of the suffering involved in achieving their profit.

Puppy mills are the primary means by which many (if not the majority of) pet stores obtain their puppies that they sell. This explains why pet store puppies are commonly associated with being sick and immune system depressed, with a high incidence of congenital disease from inbreeding. It costs money to bring in unrelated, novel breeding animals to create genetic diversity. Puppy mill owners, regardless of the tragedy for puppies and owners they create, solve this economic dilemma by just continuously inbreeding from the population they have.

Puppy mills are an ever present problem in rural America in general, but I single out Missouri in this article, because in my experience, pet store puppy mill puppies most commonly come from Missouri, whether when I practiced in NY or here in Florida. Missouri is known for this in our industry, considered by many to be the capitol of puppy mills in our country. When people come in with their new pet store puppy pridefully inform me that their puppy was shipped in from out of state, I always ask them, "Let me guess, was he shipped in from Missouri?" The answer eight out of ten times is yes. The remaining two out of ten that come from elsewhere include other offending states that turn a blind eye to the cruelty of puppy mills, including: Nebraska, Kansas, Arkansas, and Georgia. For a clear picture of what these puppy mills and their "inmates" look like, please visit Prisoners Of Greed.

The citizens of these states that read this article may say that it is unfair of me to blame an entire state's population for the relatively small minority of their population that engage in and/or condone the cruelty of puppy mills. To that I maintain that I and the rest of the country are completely justified in holding all of you responsible for the actions of these individuals. I blame you for not demanding that state officials regulate and closely monitor to ensure that breeding facilities provide shelter from the elements, clean living conditions, preventive medicine, adequate exercise and social interaction, adequate rest between litters, and a max age where breeding females are retired, spayed and offered for adoption. I blame you for not listening to the pleading of countless Americans for your state to act and band together to lobby your state legislature to stop the cruelty of puppy mills. I blame you for having no passion for compassion and turn a blind eye to atrocities that occur to living, emotional, feeling, social creatures, right in your back yard.

If you wish to help countless puppy mill dogs and puppies and maybe one day put an end to the suffering of these animals, you can start by visiting the aforementioned Prisoners Of Greed, to join and contribute to the coalition to put an end to puppy mills. Do not purchase pet store puppies, as this contributes to, and supports the puppy mill industry. Educate others that when they purchase pet store puppies, there is a strong likelihood that puppy will be inbred and genetically deficient, and it will have come from parents that are confined, neglected, and grossly mistreated. Remember, greed is the bottom line - if there is little demand for pet store puppies and subsequently no money in puppy mill peddling, they will be less numerous. Finally, if you live in Missouri or other states known for puppy mills, band together with like minded people to force your state legislature to make laws to have facilities closely regulat, monitor, regularly inspect, and fine heavily or have facilites closed down when humane requirements are not met.

Roger L, Welton, DVM
Founder, WebDVM

"But doc, isn't he too old for anesthesia?"

This is a question I get at least once, some times several times a day in daily practice, following my recommendation for a senior age patient to undergo a necessary procedure that requires anesthesia. Whether it is a severely needed dental prophylaxis, tumor removal, or castration for an enlarged prostate, pet owners tend to have serious trepidation toward the administration of anesthesia in canine and feline patients over the age of 7. They generally seem to fear anesthesia with their pets more so than for human loved ones or even for themselves.

I find it both curious and frustrating that people can have no qualms about 78 year old Grandma going under for a hip replacement, but they are terrified to let Fluffy go under to have desperately needed dental work for teeth that are causing serious pain, infection, immune suppression, and could potentially lead to life threatening heart and kidney infection. The result of this fear of anesthesia is that many patients whose quality of life would benefit greatly from anesthetic procedures, live on in pain, discomfort, or other diminished quality, because their owners fear that the greater danger beyond everything is the anesthesia itself.

Please let me assure you that anesthesia is not the enemy. Anesthesia technology, monitoring equipment, and pharmacological and other life support measures in veterinary medicine, rival that of its human counterpart. Anesthesia is statistically very safe, with incidence of anesthetic death very low. Dental disease, enlarged prostates, rapidly growing tumors, orthopedic injuries, and a host of other ailments that can be treated with the aid of anesthesia, are real the enemy.

To be fair, however, not all veterinarians are created equal, and not all may be necessarily keeping up with the most current anesthesia protocols, induction agents, and monitoring equipment. While the majority of veterinarians make staying current and maintaining the utmost safety for the patient a top priority, vets like the former are out there - I know, I have worked with a few of them in the past. Therefore, in order for you to proceed with that procedure Fluffy so desperately needs with the least possible risk of anesthetic incident, I have compiled a list points you should address with your vet prior to anesthesia:

1.) Even if healthy, any patient age 5 years or older should have a routine blood panel run prior to anesthesia, to include at a minimum, blood chemistry and complete blood count. This enables the veterinarian to rule out any increased anesthetic risk due to organ compromise or anemia.

2.) Preanesthetic pain/anxiety injections are good medicine. Pain and/or anxiety can lead to stress hormone induced cardiac arrhythmias and other anesthesia complications. Reducing pain and anxiety is not just the right thing to do for the comfort of the patient, but it is also good medicine. A good preanesthetic injection protocol should include an opioid pain reliever (I like morphine, butorphanol, or buprenorphine) and a neuroleptic anxiety reducer (I like acepromazine or metetomidine).

3.) Safe induction agents (intravenous injections that get the patient into a sufficient plane of anesthesia to insert the breathing tube) are an important aspect for safe anesthesia. My induction agent of choice is propofol, a drug that is metabolized and eliminated easily and efficiently by the body, leading to the smoothest possible recovery.

4.) The anesthetic gasses halothane and methoxyflurane are partially metabolized by the liver and therefore associated with a higher degree of toxicity. Thus, these should be avoided. Isoflurane for use in both dogs and cats; and sevoflurane for cats are much safer and better choices for gas maintenance of anesthesia.

5.) At a minimum, a patient should be hooked up to a pulse oximeter to monitor blood oxygen saturation level and audible heart rate. However, the more monitoring equipment the patient is on the better. In addition to pulse oximetry, EKG, doppler blood pressure monitoring in addition are invaluable tools to monitor the cardiac and circulatory stability.

While it is impossible to guarantee that an anesthetic incident will not occur, taking the proper precautions reduces the risk considerably. Administered correctly, anesthesia is a far safer option than letting a patient live with an injury, ailment, or illness that can be treated or even eliminated with the help of anesthesia.

$50 Rule

Ti's the time of year for spending money one does not have. Little Suzy gets that laptop she wanted so badly, little Johnny gets the I-phone he insisted on having, and let's not forget the matching diamond earrings and necklace for the Mrs. With all this mass spending, some aspect of the family budget frequently has to suffer. Unfortunately, too often, the holiday gifts for little Suzy, little Johnny, and the Mrs. come at the expense of the family pet's health care.

It usually begins around early November. Patent's are brought in with various conditions that require diagnostic work-ups and treatments, and people implore me for the sake of increased holiday expenditures, to offer payment plans, treat on empirical evidence with no diagnostic work-up, give them temporary solutions to get them through the holidays to a time when they can better afford the veterinary care their pet needs, or offer less costly, even mediocre alternatives to treat a given ailment. When owners refuse to apply for or do not get accepted for Care Credit (a third party lender for medical services known to be even more lenient than credit card companies), I try to work with them the best I can, but in the end, these aforementioned approaches to medicine often lead to less than ideal results.

Since veterinary clinics are businesses that survive on the sale of services and products just like any other types of business, giving away our services and inventory is not a practical solution to people's holiday financial woes, nor is it remotely fair to burden our industry with such a demand. The solution to this problem is for pet owners to have a realistic approach to preparing for the veterinary costs that may be incurred when pets get sick or injured.

A member of the message boards of the parent site to this blog, Web-DVM.net, recently posted what sounds to me like a great solution to budget one's pet's health care needs, not just during the holidays, but for always: the $50 rule. Under the $50 rule, one should have a separate bank account where every month, $50 is deposited in the account for each pet in the home. According to said message board member, if one cannot afford $50 per month for a given animal, then one has no business adopting that animal. This member has 4 Labrador Retrievers, which means that 4 dogs X $50 per dog = $200, gets deposited in his dogs' health care account monthly. He stated that this covers all the yearly visits, preventive testing, and preventive medications, with plenty left over in the event of more financially demanding illness or injury.

Incredibly simple yet so effective, the $50 rule is a great way for a family to figure out if they can fit the financial demands of a pet into their budget. It just might be enough to ensure that families with pets do not have to choose between treatments or procedures that Fido needs, or gifts for the children.

Roger L. Welton, DVM
Founder, WebDVM

Holiday Tips For Your Pet's Safety

Holiday seasons statistically are the most dangerous time for pets, as is evidenced by my clinics typical inundation with all kinds of emergencies the day after Christmas. In order to help you to avoid your pet from becoming one of these statistical holiday mishaps, I have compiled a list of tips to help you avoid the most common health incidents that occur during the holidays.

1.) Do not leave your garbage cans unattended in the presence of your pet. Raw uncooked meats scraps, gizzards and other undesirable food items may be irresistible to your pet, but could lead to GI disturbance, food poisoning, and parasites. Poultry bones pose a serious danger, with their tendency to snap and splinter, making them a grave risk for gastrointestinal obstruction and perforation.

2.) Do not let one of your devious friends or relatives feed your dog alcohol. While cats typically will avoid booze, dogs seem to like it with the same enthusiasm they like milk. Their tolerance for alcohol is considerably lower than ours, making them very susceptible to intoxication, vomiting, and liver toxicity.

3.) Keep chocolates and chocolate deserts out of reach! Chocolate has a component called thiobromine, which is potentially toxic to the canine liver. Of the different kinds of chocolate, semi sweet and bakers chocolate, both essential component of brownies, chocolate chip cookies, and most other chocolate baked goods, have the highest concentration of thiobromine. If your dog eats a large quantity of chocolate or chocolate based desert or cookies (1 ounce per 10 pounds of body weight or more), then get the dog to a vet ASAP!

4.) If New Year's Eve marijuana brownies are your thing, BY ALL MEANS, keep out of reach from the dog for two reasons. As previously discussed, the chocolate component of brownies has potentially toxic thiobromine. Marijuana can lead to listlessness, loss of urinary and bowel control, excessively low heart rate, and loss of consciousness in severe cases. The combination of both thiobromine and marijuana toxicity can have devastating consequences.

5.) With the winter holiday season comes a spike in the number of household electrical cords from Christmas tree lights to window sill menorahs. Both dogs and cats have trouble resisting the temptation to gnaw on electrical cords, a behavior that can lead to severe burns in the mouth, oral tissue death, and even fatality. For this reason, keep all electrical cords out of reach, or confined to areas off limits to pets.

May you and your pets have a safe and peaceful holiday season!

Roger L. Welton, DVM
Founder, WebDVM

Michael Vick

23 months in prison camp (not maximum security) for having provided the financial means and real estate to enable absolutely vicious acts toward innocent living creatures, with atrocities that included death by electrocution, slamming, setting on fire; cruel fighting, starvation and rape boxes. Does this sentence even remotely approach the realm of justice? If these acts were perpetrated toward people, multiple life sentences in maximum security prison and/or death penalty would be in the legal discussion, not a matter of months or even years in prison camp, less with good behavior. Are the pain and suffering of dogs and other animals worth so much less than that of people, that punishment for inhumane crimes against people vs dogs should be a difference of life in max security prison or death penalty vs 23 months in prison camp??

Strictly from a veterinary standpoint, I can tell you from a physiological point of view, that dogs and people are virtually identical, complete with the same complement of nerves, sensory perception, and organs. They are also complex emotional social creatures. This means that they feel pain, hunger, neglect, and isolation no differently than we do. Despite this, however, vicious and sadistic crimes against them carry a mere fraction of the penalty when compared to crimes against people.

The saddest comment on this how this whole ordeal reflects us as a society, was evident from what I witnessed on prime time television during Monday Night Football, when the Atlanta Falcons were playing. The owner of the Atlanta Falcons and founder of Home Depot, Arthur Blank, expressed how sorry he felt for Michael Vick and where his poor choices had led him. When asked whether the Falcons would ever allow Vick to play for the Atlanta Falcons again if allowed back in the league, Blank even did not completely dismiss the possibility. The stands were full of fans that wore Michaels Vicks Jersey in support him, and teammates garnished t-shirts that said "Free Mike Vick." These athletes and thousands of fans actually felt that what he did does not deserve any jail time at all!

This tells me that people care more for their fallen hero than for the hundreds of innocent animals that were tortured, tormented, and killed in a venue that he provided, in a despicable sport that he helped finance. At a time when Arthur blank, Falcons fans, and Falcons team members should have set an example and rallied behind animal rights supporters to make the cruel, sadistic, and illegal sport of dog fighting the primary issue, they instead tried to turn the ring leader into a martyr. It is truly sickening and disheartening to know that there are so many that share my American nationality, that have such little compassion and care for the suffering of innocent lives and crimes committed against them.

Michael Vick and any other people that are capable of treating animals in the dreaded manner that those dogs were treated, are sociopaths of the worst kind. They are vicious and sadistic, posing a grave danger to society. They should be regarded and treated as such!

Roger L. Welton, DVM
Founder, WebDVM

Elevator Mishap

This is one of the those stories that seems too unbelievable to be true. My hospital's associate veterinarian admitted a small chihuahua for having a few broken teeth. The story of the events that led to the broken teeth just blew us all away!

The owner of this chihuahua lives in a multilevel retirement condominium that requires constant elevator use to get downstairs for any reason, including to walk her little dog. The chihuahua's owner uses one of those flex leashes, where the leash is coiled up in a plastic mechanism within a handle, where the owner controls the length of the leash with a button/lock mechanism. These leashes can be as long as 10-15 feet, unravelling without resistance as the dog moves foward until the owner either stops the extension by pressing the lock button, or the coil runs out of slack. For the record, I detest these kinds of leashes.

The chihuahua and her owner had entered the elevator to go up to their home and the elevator made a stop at one of the lower floors, where there was a man waiting to enter. Being the territorial ankle biter that many chihuahuas are, the chihuahua aggressively ran at the man that was still on the other side of the open elevator door. The owner did not press the lock button on the flex leash in time, so the dog was able to run out of the elevator and into the hallway. Unable to reel the dog back in, the elevator doors closed with the owner inside the elevator holding one end of the leash, and the dog on the other side of the closed elevator door still attached to the other end of the leash. From the owner's perspective, as the elevator started to go up, the leash slid to the bottom of the closed elevator door, became very taught with tension, then quickly snapped.

From the other side of the elevator door, the gentleman who had remained in the hallway for fear of the little dog that was attacking him, did not enter the elevator. After the elevator door closed and continued to go up, from his perspective, the dog still attached to its leash, began to slide up the closed elevator doors. Acting quickly and heroically despite the dog's bad intentions for him, the man ran to the dog's rescue and unsnapped the dog's collar, just nanoseconds before the end of the leash with collar, got sucked up into the elevator shaft through the tiny slit of the closed elevator doors. Had the man not acted so quickly, the dog truly would have likely been decapitated.

Thinking that her dog had indeed been decapitated, upon the owner's return, she was elated to see that the dog was not only alive, but alert and responsive, only moderately bleeding from the mouth and terrified. Ultimately, aside from a few damaged teeth that had to be removed, the chihuahua escaped the incident unharmed.

That is one lucky dog to have been saved by a man for whom the dog showed blatant aggression. I hope she learned a lesson!

Roger L. Welton, DVM
founder, WebDVM

Bubbles, My Inspiration.

Upon assuming ownership of my current practice 3 years ago, I would have loved to immediately hire Dr. Mengering, (the doctor I purchased from), but with the financial uncertainty of a change of ownership, I feared that it would not end up financially feasible. As such, I ran the practice without the services of Dr. Mengering my first year (thankfully, this has changed and she is now a part time associate), which did not sit well with some of her regular clients, none less than a senior aged owner of a chubby little chihuahua named Bubbles.

I first met Bubbles one week after after I had taken over in December of 2004. Bubbles owner was rather blunt about her displeasure that she could no longer have her beloved Bubbles seen by her trusted veterinarian of many years, instead having to trust her dog's life with the likes of me, a 30 year old vet who was only 3 years out of vet school. I did not take it personally not only because I could understand her point of view, but also because of Bubbles medical history.

Upon thumbing through her record, I saw that Bubbles has battled and survived repeated bouts of life threatening pancreatitis, that were later finally determined to have been precipitated by and endocrine disease known as Cushings Disease. Once the treatment for Cushings was in place, her pancreatitis had stopped returning and her health was in a delicate, but effectively managed state. Having had such an extensive medical history, I could completely see why Bubbles owner had some apprehension about starting with a new vet, a young one at that.

Within a fairly short time, however, Bubbles owner began to trust me, and we gradually developed a very nice professional relationship. In fact, she was quickly becoming one of my most beloved clients, and I just adored little Bubbles. Even after Dr. Mengering's return, she comfortable to see whichever one of us was available, not hold out to be seen only on Dr. Mengering's days, as some of her regulars chose (and still choose) to do.

In year 2 of managing Bubbles health, she suddenly became very ill one day. Blood work revealed that the medication that was managing her Cushings Disease was causing her kidneys to shut down, creating the need to both hospitalize her and stop the Cushings medication. Aggressive treatment was successful and Bubbles was discharged in a few days, but I could no longer treat her Cushings disease for risk of harming her kidneys.

Over time her Cushings Disease began to take its toll on her body, and she had yet another bout of pancreatitis. We were once again able to stabilize Bubbles, and thankfully a new cutting edge Cushings Disease treatment with virtually no adverse side effects had come available, so we now once again manage her Cushings Disease.

In the next 2 years, while Bubbles' Cushings Disease has remained under control, I have had to treat Bubbles for upper GI ulcer, herniated disc in her neck, anal sacs abscesses, tooth root abscess, chronic obstructive pulmonary disease (COPD), and in every instance, she has recovered. During this heights of her illnesses, she remained sweet, affectionate, and never once resented any blood draws, catheters, or any other procedures we had to implement in her diagnostics and treatments. Her daily medication regimen was a long as a grocery list.

In my most recent visit with Bubbles, her COPD has led to secondary enlargement of her heart and the subsequent development of congestive heart disease, and once again, she had bounce back from the abyss and is doing well on yet more treatment. This little dog's courage and will to live, as well as her mother's dedication, has touched my heart in an unforgettable way. Now 12 years old and juggling so many health issues, I know that the day will come that we will lose the battle. While that will be one of the most difficult days of my career, I will always be grateful for having had the honor of taking care of Bubbles and her wonderful Mommy.

Roger L. Welton, DVM
Founder, WebDVM