Comparing Veterinary and Human Health Care

While this is a gross oversimplification of the system, Balaker makes a couple of interesting points.

I should be a poster girl for health care reform. I’m middle-aged, self-employed and I’ve got a bunch of potentially bankrupting preexisting health problems. But when I see the kind of unintended consequences that arise out of relatively simple, well-intentioned programs like South Carolina’s certificate of need requirement, I remain convinced that rapid institution of broad sweeping reforms is a very bad idea. Changing a few things at a time would mean that problems in the system (and there are plenty of them) will take longer to fix, but a step by step process of reform could help prevent potentially catastrophic adverse effects.

In the world of politics there is sometimes a drive to achieve change by pursuing a system completely different from the status quo. But effective change is rarely made in a spectacular way.  Like our world’s climate, health care is an incredibly complex, dynamical system well beyond anyone’s capacity to understand or model accurately. I really hope our elected representatives don’t unintentionally throw it into a dangerously chaotic state of disequilibrium.

Charlie’s Angels

Charlie and I took a field trip last week.  We went to see a veterinarian whose specialty is orthopedic surgery.

Charlie has had a noticeable limp since he arrived here.  He avoids putting weight on his right leg, his knees turn out in an odd way, and he can only get up on the furniture if we help him.  I waited to take him in to get it looked at for a couple of reasons.  First, he was a snarky, stressed-out little snot and I wanted to wait until he’d progressed to a point where the visit would be only moderately stressful for him and the vet; and second because I had a nagging suspicion that the help Charlie needed would be more than either NESR or I could afford right now.

Last week I knew we were both ready to make the trip — and now I have good news, bad news and more good news to report.

Good news:  Charlie stayed remarkably calm for more than an hour while he was in a strange place surrounded by strange people who did strange things to him.  It was a bit of a hike to the clinic — the kind of drive that would have provoked a frantic, scrabbling, whining, puking reaction in him a couple of months ago — but today Charlie and Audie rode together without incident.  The clinic staff didn’t coo or gush over Charlie (he hates that), and he and I both appreciated the professional, matter-of-fact way this clinic operated.   I stayed with Charlie and held him during the exam.  While I’m sure it was painful, he took it like a trooper and we didn’t need to muzzle him.

Bad news:  Charlie has a grade four luxating patella on the right and a grade two on the left.   The right knee isn’t just painful, if it isn’t repaired soon the misalignment will damage his knee and hip.  The left knee, while not as severely affected as the right, also needs to be repaired.  Net cost – about $3,500.

Good news:  Not only has the surgeon offered to give us a discount — but in a stroke of wild, wonderful, good fortune — an anonymous benefactor (or benefactors) has volunteered to pay for Charlie’s surgery.

This wonderful, beautiful, unselfish, anonymous gift was given in the true spirit of Christmas.  And we will always be grateful.

I’ll call to schedule surgery on Charlie’s right knee this week.  The goal is to stagger his surgery and mine by a couple of weeks to reduce the level of inconvenience involved.   One armed handler and three-legged dog, Charlie and I will rest, heal and work on physical therapy together this winter.   Audie will go back to being my service dog, and Zip will sulk because we’re not focusing on her needs (throw!)

By summer both of Charlie’s knees should be healed.  According to the orthopedic vet, when both of a dog’s knees are damaged as badly as Charlie’s are, repairing them has an almost immediate positive effect on behavior problems like shyness, reactivity and aggression.  So this surgery should help heal his soul along with his body.

Thanks to Charlie’s Angels a truly wonderful little dog who was once tossed out like a piece of trash gets a chance to move on to the kind of life and home he deserves.

Thank you, from the bottom of our hearts —

Next winter Charlie will be leaping through the snow - at his forever home

How Holistic Are You?

A couple of days ago Christie Keith over at the Pet Connection Blog wrote a great post about what holistic pet care is – and what it isn’t.

Christie summed it up beautifully when she wrote:

Which is why it comes as such a shock to so many of my holistic brethren when I go on one of my semi-patented diatribes against people who won’t do diagnostic testing or use antibiotics. “Christie,” they mutter darkly, “isn’t holistic enough.”

But you know what? I think I’m more holistic than they are. Because holistic isn’t about the substances you use; it’s about how you think.

It’s about looking at the whole animal and his or her whole environment, genetics, and lifestyle. It’s about making the best, most informed decision possible using all available resources, the one that relieves suffering and illness without doing harm. Balancing risk and benefit. Not seeing the animal as a collection of parts, but as a living creature in a dynamic environment.

‘Holistic’ is currently the buzzword of choice to market anything natural, edgy, new age or outside the norm.  Holistic sells.

Hey, don’t get me wrong. I think a holistic approach is great. In fact, I believe that I am a holistic dog trainer.

But using a holistic approach doesn’t mean that I only use the latest, hottest, hippest, natural and organic approaches.  In a true holistic approach we look at the whole system instead of focusing on individual parts (no matter how fascinating those parts might be).  And, as we are beginning to discover (yet again) in the new science of emergence – the whole really is greater than the sum of its parts.

Emergence can be described as a property or phenomena of a system that can’t be predicted from the properties of its constituent parts.

A simple example of an emergent system is a cake. Considered separately, none of the ingredients we use to bake this tasty concoction has the properties of “cakeness” (frosted, light-textured, sweet, solid and yet crumbly) however, when we mix those ingredients mix together and bake them, the properties of “cakeness” emerge.

We can see emergence at lower level of organization in our “cake” system.  Individual molecules of carbon, hydrogen and oxygen have no flavor whatsoever.  But mix them together in the specific formula C₁₂H₂₂O₁₁ and the taste of sugar emerges.

Like cakes and sugar, most systems exhibit emergence not only several different scales but also with respect to many different properties.

So, what does this have to do with dogs, dog health and dog training?

Everything! 

Behavior problems emerge from the systemic effects of improper diet, health problems, lack of exercise, lack of mental stimulation, improper socialization, stressful living environments and more.

Spinal problems can make a dog dislike being handled by the neck or collar.  Being carried everywhere and never learning to develop proprioceptive skills can make a dog nervous and insecure.  Allergies can make dogs restless and irritable.  Some foods, like corn, seem to make dogs feel hyperactive and nervous.  Too much noise, action or other stimulation can make a dog crabby or even aggressive.  Spinal problems can make a dog dislike being handled by the neck or collar.  Being carried everywhere and never learning to develop proprioceptive skills can make a dog nervous and insecure.  Allergies can make dogs restless and irritable.  Some foods, like corn, seem to make dogs feel hyperactive and nervous.  Too much noise, action or other stimulation can make a dog crabby or even aggressive.

Health, diet, confidence-building exercises and mental and physical exercise are all valuable parts of a good behavior modification program — but if we focus on just one piece and ignore the rest we’re not going to see a broad-based, emergent change occur.

Your dog’s health, diet, exercise regimen (including both the type and amount of exercise he gets), living environment and early socialization experiences are all part of his training regimen – whether you consciously guide and control them or not.

It’s food for thought. 

 

 

 

 

 

Better Health May be Another Benefit of Dog Ownership

Canadian researchers are studying the health benefits of dog-walking, an exercise that most dog owners probably don’t realize offers real health benefits to them, as well as to their dogs.  An important factor in the equation is that many dog owners feel obliged to walk their dogs regardless of the weather or other extenuating circumstances.  These regular walks keep both the dog and its owner fit and makes them both feel better once they get out.  According to Ryan Rhodes of the University of Victoria, only about half of dog owners actively walk their dogs. “So there’s still room in there to try to get people who own dogs to walk more.”

The goal of Rhodes’ research is to find the best ways to motivate people to walk their dogs.  And as a dog trainer who specializes in helping problem dogs, I think this work will help dogs as much as their owners.

Another study conducted at the University of Portsmouth, found that along with health benefits, walking a dog provides a ritual that can create a deeper bond in human families.  Parents who participated in the study were pleased to discover that their children were happy to leave behind the television and computer to get some fresh air and exercise by walking the dog.

Is There a Dogtor in the House?

A recent article in Scientific American reports on a new technological development: the electronic nose.  The electronic nose consists of an array of olfactory sensors activated in unique patterns by different aromas.  Software identifies each odor analyzing these patterns.  The technology was originally designed to detect chemical leaks and identify spoiled food, but it may also have diagnostic potential.

We can't help but wonder if this technology was inspired by the work of dogs who have been trained to detect impending seizures, asthma attacks, hypoglycemia and even some cancers.  The dog’s sense of smell is amazing.  Canines can detect chemical constituents in the part per trillion range.  To give you an idea of how incredible this is, consider that one part per trillion corresponds to one minute in 2,000,000 years!

How do they do it?
One theory is that protein molecules called the major histocompatibility complexes (MHCs), exist on the surface of all cells in our bodies. Each individual has a unique combination of the MHCs, making each unique.Besides coding individual identity, MHCs also display fragments of other proteins that are present inside each cell. White blood cells (WBCs) check each cell’s MHC. If the WBCs only see familiar MHCs they ignore them, but if alien fragments, such as those from bacteria or viruses are detected, the WBC will kill the cell to stop the infection from spreading. If the cell has and MHC coding that don’t match the white blood cell’s (as in a transplanted organ) the WBC mistakes it for an infected cell and kills it.

MHCs stick to and display fragments of other proteins.  These fragments don’t ordinarily have an odor but some researches theorize that they may be broken down into smaller, odor-carrying molecules by decay or other metabolic processes or that they aquire odorants in the blood along with the protein fragments. When  the blood serum is processed into urine in the kidneys, the body breaks down the MHCs and releases odorants to the urine. Untreated blood serum has no individual smell because the odorants are still stuck to the MHCs. But once the proteins are digested (by the kidneys, in perspiration or by decay) odorants are free to be detected. 

"This isn't anything magic," says Dr. Larry Myers, associate professor at the Auburn University College of Veterinary Medicine in Auburn, AL.  Dr. Myers has tested the olfactory capabilities of more than 4,000 dogs in the last twenty years.  "Physicians have always used their own senses to determine the presence of absence of disease."  Serpil Erzurum, a pulmonologist at the Cleveland Clinic says that "When you have an exhaled breath, there are all sorts of volatile organic compounds that are produced.  Those compounds are a result of metabolism and, when you have cancer, metabolism changes and the volatile organic compounds are altered.  The changes are detectable by an electronic nose."

Whether it is furry and four-legged or has an electronic display, we look forward to seeing more of these new -- and old -- technologies in the future.

The Best Pet First Aid Kit

The domestic dog is the most diverse species in the world.  Dogs range in size from tiny, four-inch tall Chihuahuas to enormous mastiffs weighing over 200 pounds.  They live in cities, on farms and in suburban homes all over the world – and they can be injured by a wide variety of hazards.  The amazing range of sizes, shapes and lifestyles that dogs enjoy today means that there is no single commercially available first aid kit that is suitable for every dog.

So, what’s a responsible pet owner to do?  Why make your own kit of course!

I could probably devote an entire book to the impossibly long list of all the the things that could be put in a kit – but not only would that be boring, it would also keep you from conducting a bit interesting and helpful research on your own, so instead I’ll present information you should consider when putting together your kit.

What Size is Your Dog?
Important items like bandages, medications and restraints should be selected based on the size of your dog.  The four-inch wide roll of self-adhesive bandaging tape that is perfect for a 100-pound Rottweiler is probably not going to be particularly useful on a 10-pound Papillon.

Where Do You Spend Time With Your Dog?
If your dog spends all his time in highly urbanized areas, you can probably leave that nifty tick removing tool at home, but if he spends time in areas where ticks are common you may want to put it on your keychain.  The importance of other items like insect repellents or pliers to remove cactus spines also varies greatly depending on the environment your dog frequents.

Does Your Dog Have Any Known Health Problems?
If your dog takes prescription medications on a daily basis to control a disease or disorder, you should include them in your kit, especially when you travel.   You should also contact your veterinarian about medications or supplements that would be therapeutic for your dog in a health crisis.  One of my dogs suffers from both Addison’s disease and epilepsy.  Our vet provided me with a list of things that she recommended we keep on hand in case of emergencies and they have proved to be priceless the few times that we needed them.

You should also consider the common, minor health issues likely to affect your dog.  Many relatively minor problems like diarrhea, constipation, hot spots, and ear infections can be treated with over-the-counter medications.  Make sure you have the right dosage and check with your vet (if you haven’t already) to make sure that these treatments don’t interfere with any perscription medications your dog takes.

If you prefer to use natural, herbal, homeopathic or holistic remedies and want to include some in your kit it is a good idea to discuss this with your vet.  Although many veterinarians are skeptical about these kinds of treatments it is important to discuss them with your vet as some may cause adverse reactions with the prescription medications your dog takes.

Never put any unlabeled treatment or medication in your kit.  In the excitement of an emergency it is easy to misidentify an item or to grab the wrong item.  If you must put a treatment or medication in a package other than the one it originally came in (and I don’t recommend that you do this) you must  label it accurately and include dosage information.  Be sure all containers are sealed tightly and don’t store treatments or medications in excessively hot or cold areas for any longer than you have to.

What Information Do You Need?
One item many people forget to put in their pet first aid kit is a list of emergency contact numbers.  These can include numbers to contact you; your vet; local emergency clinics (don’t forget to look up number for the area you’re travelling in); the Animal Poison Control Center; your local animal control authority; and a friend, relative or boarding kennel who can take care of your pet if you can’t.  It is also important to include information on the names and dosages of any prescription medications your dog is taking.  When you travel, keep photos of your pet in the kit in case you need to identify a lost dog or make lost dog posters.  It is also a good idea to carry a copy of your dog’s license, vaccination records and insurance information.

The most important information you can carry is a good working knowledge of pet first aid and CPR.  Studies have shown that approximately 25% of all fatally injured pets could have been saved if they had been treated with just a single first aid technique.  Because many of the methods you should use to treat an injured dog (most notably when performing CPR) are considerably different than the procedures you would use to treat an injured person it is important to learn pet-specific method of treatment.  Taking a class from a certified pet first aid instructor is the best way to get this essential information.

Basic Items

• Sterile pads, gauze rolls, self stick adhesive tape or other bandaging materials
• A muzzle that allows your dog to pant (NOT one that holds his mouth closed!) or a strip of cloth to make a muzzle with
• A multi-tool with a knife blade, pliers, scissors, and tweezers
• Latex or nitrile gloves and hand sanitizer
• Plastic baggies (preferably the zip kind), poop bags, trash bags
• Styptic, alum or cornstarch to control minor bleeding
• Graduated oral syringe (one with measurements on the side)
• 3% hydrogen peroxide to induce vomiting (NEVER induce vomiting without discussing the situation with your vet or poison control first!)
• Activated charcoal (NEVER to be used without the recommendation of a vet or poison control staff!)
• Benadryl for allergic reactions (contact your vet for dosage information)
• Small, rigid plastic card to scrape off stingers or small thorns
• Lightweight slip lead
• Blankets or towels
• Rectal thermometer and petroleum jelly
• Antibiotic ointment
• Cleansing wipes
• Crate
• Notepad and pencil

Optional Items (A partial list – this could be almost infinitely long)

• Hot and cold packs
• EMT Gel for cuts
• Trimmer or mat breaker to remove hair
• Otoscope
• Duct tape
• Specialized dressings (for burns, odd shaped areas, different sizes)
• Elizabethan collar or BiteNot collar
• Magnifying glass to find foxtails, thorns and ticks
• Eye wash
• Ear cleaning solution
• Saline solution for irrigating wounds
• Nail trimmer
• Tick removing tool and jar for ticks
• Disposable camera
• Sling or stretcher to transport a large dog

You’ll also need something to put the kit in.  This can be either a bag that zips closed or a plastic storage container.  I suggest that you choose something brightly colored and label it clearly to make the kit easy to find when you are in a panic.  You may also want to consider doing what I’ve done – create two or more kits customized for different situations.  I have a very large kit that I keep in a cabinet in my home, a medium-sized kit in a bright purple bag that I carry on trips and a small fanny pack kit for short hikes and day trips.

Things You Don’t Need
Don’t waste valuable space in your kit by carrying an electrolyte drink for your dog unless your vet specifically recommends that you do so.  Dogs don’t sweat to cool themselves off, they pant.  Unlike sweating, panting doesn’t result in a loss of electrolytes.

You probably don’t need a snake bite kit either.  Because of the vital importance of early treatment, your car keys are the most valuable item available to you in a snake bite emergency according to Dr. Joe Trueba, director of Pima Pet Clinic and Animal Emergency Service in Tucson, Arizona.  Dr. Trueba’s clinic sees one of the highest numbers of snakebitten pets in the country.  Along with Dr. Trueba, most veterinarians today recommend against using tourniquets or “cut and suck” methods of treatment.  Take the money you would have used to buy the snake bite kit and use it to get an inexpensive disposable camera to get a photo of the snake instead.  Most snakes are not venomous, but if your dog is bitten by a venomous snake you may need to know EXACTLY what kind of snake it was to get the dog proper treatment.

Specialized splinting materials are another item that you are not likely to need.  Splinting a terrified, injured dog is about as simple (and as dangerous) as hugging an angry, soaking wet cat.  If you suspect your dog has a broken bone you are almost always better off securing the dog in a crate and transporting it to the vet ASAP than in messing around with an injured limb yourself.  If you do find yourself in a situation where you need to splint a limb – and you have the training to do it properly – you can combine things like rolled gauze, duct tape and adhesive wrap from your first aid kit with other items you find in your home or car to get the job done.

In Summary
Take some time, consider carefully, get advice from your vet, be creative and enjoy making your own pet first aid kit.  The lists I’ve provided include general recommendations.  Take a pet first aid and CPR class to learn more – and remember – the life you save may be your dog’s!