911 VETS Goes Hybrid: Highlander is Cool

The current escalation in fuel prices has been especially hard for mobile professionals. Our business continues to expand throughout So Cal involving greater distances traveled and greater fuel consumption. The replacement of my trusty 2004 Toyota Highlander with the latest in Hybrid technology: 2008 Toyota Highlander Hybrid Limited with GPS and voice activated map and phone capabilities is ideal for mobile practice in a busy metropolitan area like LA.

I am learning the ropes of EV driving. The Highlander, as do other Hybrids, display the power consumption (and re-charging) on a screen above the GPS. The combustion engine kicks in during acceleration (it has great acceleration with the V6) and as you reach a cruising speed, I coast or barely maintain pressure on the pedal to go EV and stop burning fossil fuel. The EV is great for city driving under 20mph or cruising at 35mph. I cringe when the combustion kicks in. It's a great feedback mechanism to force you to slow down. Being on the go from Malibu to Long Beach, Sylmar to San Gabriel and all points in between I have had to rush and burn fuel getting an average of 15 MPG on the prior Highlander. Now I am in the 23 MPG range. I forcing myself to consider: Do I absolutely have to go so fast? I force myself to relax and cruise in green EV mode as much as possible and cut down on my CO2.

Even though the car is pricey, I feel I am doing what I can for the environment. Thanks to Carson Toyota for the great deal and excellent service!

Dog Saved by Viagra

Another beneficial use of the most popular medication on the planet has turned up in veterinary medicine: Viagra AKA sildenafil citrate. I have recently learned its other miraculous uses other than the drug's emotionally and over-utilized beneficial side-effect.

A wonderful cattle dog, Rat, was seen for weakness and exercise intolerance. Rat lived with his two owners in beautiful Topanga, the town that lies nestled in the Santa Monica Mountains. Rat is an avid hiker and energetic explorer, so for him to be tired was unusual.

At the time of exam he was clearly in distress and the excitement triggered him to worsen. His tongue had started to turn blue (cyanosis). We quickly applied an oxygen mask to relieve the distress. I placed a nasal oxygen catheter to more efficiently deliver oxygen. As the history was revisited, the owner mentioned that he had always had trouble breathing. In fact, another vet mentioned while he was a pup that he wasn't going to live long. Well, it took 13 years for the crisis to develop. Upon stabilization by 911 VETS Providers, Rat was transported to the local Specialty practice and rushed back to the treatment table where the case was handed over to the Cardiologist on staff. Rat spent some time in oxygen until he was evaluated by ultrasound. He was diagnosed with COPD (chronic obstructive lung disease) and pulmonary hypertension (high blood pressure in the right side of the heart). He was put on a new heart medication, pemobendin, as well as VIAGRA to combat the hypertension.

After a few days of agonizing decision-making, the owners elected to wait it out to see if Rat could come out of oxygen. His lungs had lost their full elasticity and caused severe back pressure on the heart. Finally after 3 days of treatment he was able to breathe room air and maintain a normal pink color to his gums. The medication is working. Thanks mostly to the quick assessment and skilled specialist, Rat is now continuing his rugged lifestyle back home in the canyon with the miraculous medication used as originally intended to combat high blood pressure.

These owners are one couple who actually pay attention to the VIAGRA spam in their e-mailbox.

The Importance of Veterinary Follow-Up Care

I have witnessed the sad effects of the lack of verified understanding of instructions between pet owners and veterinarians both as a hospital clinician and working in the field as a housecall vet. The state of veterinary medicine with all its advancements to rival or even exceed human medical care is at a crossroads. The shortage of veterinarians and trained technicians, especially RVTs (Registered Veterinary Technicians) is taxing the ability to effectively manage health care in keeping up with demand from the public.

The biggest problem is not simply the lack of ongoing communication between the vet and the pet owner, it is the lack of verified understanding of follow-up needs, and the ability to correctly carry out the administration of medication, physical therapy, dietary recommendations and timely recheck exams. We as veterinary care providers want to cure ailments and at least keep chronic conditions under control. I believe that sometimes there is what I call a "co-delusional agreement" that the pet owner understands the veterinarian's instructions. In actuality, the owner does not fully understand or is embarrassed to admit they don't understand the instructions or are not physically able to carry them out. The vet assumes that the owner understands and is able to carry out the treatment.

Statistics have shown that pet owners complete the recommended medication somewhere between 27 and 50 percent of the time. This situation may demonstrate that many ailments will resolve in spite of or without treatment. This may also be the cause of treatable disease becoming a chronic condition. The more problematic situation can arise when the patient is misdiagnosed, incompletely treated and is not reevaluated to monitor efficacy of prescribed treatment plan.

In summary, it is the responsibility of the veterinary health care provider to present a clear, concise treatment plan and follow-up care and verify that you, the pet owner, understand and are physically able to carry out the home treatment. It is your responsibility as a pet guardian to be proactive. Ask questions. Don’t be embarrassed to admit you don’t understand. Take your vet to task and ask for their diagnosis or possible diagnoses. Have them explain the treatment, demonstrate the treatment, and make you aware of signs of any side-effects that may occur. Ask to be shown how to medicate, change a bandage, and ask when to return. Ask what the possible outcome may be with the best and worse-case scenario. Be informed. Research the condition yourself on the web, newsgroups and discussions with other pet owners who have been through similar ordeals. You owe to yourself and your pet.

Veterinary Home Care Providers Have Unique Insight

Throughout my career in veterinary medicine, I have practiced both in numerous facilities as well as practicing as a mobile veterinarian since the mid-eighties. I have discovered that those vets who choose housecall practice have a unique insight into the health of the pet living in the home environment. While obtaining the history of my patient, I find myself looking around the home for factors that might contribute negatively to their health. I observe the interaction between humans and other animals. I see, smell, and feel the environment. My history is affected by the situation in the home. In contrast, the clinic veterinarian is only able to hear and believe what is told by the owner in the exam room.

The number one reason people state as to why they chose a housecall is the negative experience simply getting to the hospital. People report that their pet becomes very agitated, eliminates all over, becomes aggressive, or causes considerable damage to humans or themselves. The majority of these pets, when examined in their home, remain calm and friendly when trust is gained and are gently handled. Even the most fearsome pets can be examined, permit laboratory sample collection and receive treatment without sedation. Sedation can be used if there is no other option and can safely facilitate needed care.

Behavioral issues almost always require a home visit to observe the pet while exhibiting the undesired behavior. At the time of the visit a remote pet-cam video recorder may be strategically installed to further determine cause and effect. In multiple pet households where behavior problems may be complicated and magnified it is particularly beneficial to manage and treat in situ when the natural balance of interactions can be assessed. The advantage of a veterinarian Provider over a trainer or behaviorist who may or may not be licensed, is the ability to rule out medical problems masquerading as a behavioral problems can be ruled out before pursuing behavior modification or treatment. Many times the busy hospital practitioner is limited in time, and as in human medicine is more likely to throw a psychotropic medication at the problem.


In summary, the unique perspective of the housecall veterinarian combined with the reduced role of stress on all parties involved, makes home pet medical care a valuable and often necessary choice. Please feel free to comment on your experiences with housecall service and what services you would like to have handled at home.