Allergy, the Miracle and Maneuvers

August 15 2011

You head out to another Sunday night emergency they come like clockwork especially during the full moon when the crazies are out and the police copter searchlights the area and now you’re stuck at La Brea near Olympic where the cops have walled off the block and you are trying to get to a whimpering pup in pain. You eventually pass the drama as the popo scans for perps and slither your way to the Larchmont hood. Two lovely English ladies and their ailing cocker Cammy (not her real name) with back pain. Except the dog is up and running around. The medication that was given for pain and inflammation had kicked in. Low and behold. It works! It is here where you picture a lovely Sunday evening tea with these fine ladies. Instead the emergency aspect turns into an allergy consult and blood screening and connecting with a nice pet owner seeing the value in the service. You feel good about that. You try to remember all the pets you’ve seen and you realize you can form a finite amount of close bonds with people and see the brilliant and the amazing stories of survival through love and care. These people out shine the horrors you have found along the way, ignorant neglect, or the holding on too long.

You come upon the strange case of Leo (not his real name) the cat at the home of a race car driver. Leo is a miracle of science. He is living with a Creatinine of 18 and that is unheard of. This cat should be a case study for the ages. You come to realize the race car driver, a man’s man, is really a pussy cat love magician. His undying faith and removal of doubt keeps the cat on an even keel with him. The unbelievable bond has defying all laws of medicine. OK, so the man is force feeding the cat and giving him a laundry list of medications designed to strengthen kidney function. There are jars of things you never have heard of that he is religiously giving to his precious Leo. It is then you realize that the owner’s unfailing drive to save his beloved cat is so powerful that it defies all reason and logic. You have never seen a cat continue to live with those numbers. But the number is not a life. It is a magical thing of beauty and mystery.

You maneuver through traffic jamming heading east at the wrong time 545PM. No westbound street is spared and you catch up on email, Facebook and your calendar. You make a game of shortcutting your way across town from Brentwood a measly 4 miles back to the clinic, but other shrewd drivers are on to your game. They swerve and accelerate up the side streets right along with you. They follow your interference boldly crossing 6 lanes of Olympic Blvd to get to the other side. Your deftly avoid collisions snake-laning inept drivers to bypass them on your quest to shave 10 minutes from the 4 mile commute. Side street, alleys and corner-cutting gas stations fill the repertoire until you finally slither only slightly against traffic when needed, pull though the private alley to the garage you call Central Service.

That’s the day before ATTACK WEEK...

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.