Tips to make an emergency clinic visit less stressful

low stress vet clinic images

No one ever wants to be the one taking their pet to the emergency clinic. During a recent relief shift at a local veterinary emergency clinic, I decided to compile some tips that could help decrease some of the stress, should you find your pet needing after-hours care.  We are fortunate in the Charleston area to have several great emergency facilities available for our pets after regular business hours.  The level of care you’ll find from these enthusiastic doctors and technicians working in a state-of-the-art 24-hour facility when your pet has a serious sudden illness can greatly exceed the care that I was able to provide after graduation while providing “on-call” care for a small animal practice in rural Georgia.  As excellent as that care is and the comfort you can take in knowing your pet is in the right place, seeing your pet sick and in the hospital can be stressful.  

Here are some tips to make your emergency clinic visit less stressful and more successful:

  1. If your pet has a chronic illness, grab his/her medications as you head out the door. 

    Unless your pet has been a direct transfer to the emergency clinic from your regular veterinary clinic or has been seen at the emergency/specialty center in the past, the emergency clinic is likely not going to have copies of your pet’s records from your regular veterinarian.  This includes any medications, any previous laboratory work, and any history of preventative care (vaccinations, heartworm testing, etc.).  I jump with joy when a client starts bringing out her pet’s pill vials from her purse during the exam, as I now know that I am not going to be prescribing any medication that could have a drug interaction with the pet’s usual medications.  Bonus points if you can keep a folder handy with recent laboratory results too, as this could possibly save you some money in diagnostics to be completed.  If laboratory work is determined to be needed to be repeated, those copies of past lab work can also serve as a vitally important baseline to help determine the severity of your pet’s current illness and aid in establishing a prognosis for further treatment.

  1.  Don’t give any medication before arrival without talking to the emergency clinic staff first, even if it is labeled “over the counter”.

    The biggest culprit is usually aspirin; owners seeing their pet in discomfort try to make their pet comfortable by administering an aspirin first and then decide later to take their pet to the emergency clinic when the pain still persists.  I have had a pet present for a mild lameness of minimal concern, only to have to hospitalize her for a potential ibuprofen toxicity secondary to the advil the owner gave the pet at home to to try to help with the limp.  The most frustrating aspect about these human pain medications is that they can have potentially harmful side effects when combined with medications that we would routinely use in the emergency clinic for pain treatment.  Therefore, my treatment options for making your pet comfortable become immediately limited, and I also have to worry about any adverse (especially gastrointestinal) side effects that an aspirin given at home may cause.

  1.  Please, please, please don’t lie!

    I understand that people don’t lie to be mean.  They know something happened at home (the pet ate something dangerous, someone accidentally stepped on the puppy, etc.) and they are embarrassed or afraid to let the veterinary staff know.  Your veterinary staff understands that accidents happen in the home.  Their main goal is to get your pet diagnosed and comfortable as quickly as possible, and the pets can’t talk to us to tell us what medication they got into and ate 30 minutes prior to when you found them sick at home.   Withholding information can be dangerous (and expensive!), because it can take me down the wrong track of accidentally misdiagnosing your pet.

  1.  Keep your pet’s preventative care with your regular veterinarian up to date.

    Over the past six months of emergency clinic shifts, I have treated dogs with deep bleeding wounds secondary to flea infestations, have had to euthanize dogs in congestive heart failure due to heartworm disease, and had to hospitalize lethargic and dehydrated puppies due to having a high burden of intestinal parasites.  All three of these diseases are caused by parasites and are able to be prevented by a variety of parasite preventatives sold by your regular veterinarian at a much cheaper price when administered prior to clinical signs starting.  Another disease commonly diagnosed in the emergency room is parvo virus.  This highly contagious virus can be deadly to puppies.  Treatment in the emergency clinic can be easily over $1,000.00, but the preventative vaccination can be started at your regular veterinarian for under $30.  Spending a little bit of money on preventative care can easily save you hundreds of dollars in the future.

  1.  Come prepared to pay the bill.

    This is always the most delicate subject when I speak with my clients in day practice about the benefits of sending their pet to the emergency clinic for overnight care.  Usually, I am asked if the visit will be “expensive”.  I suppose it all involves how you look at it.  Many clients today are demanding human grade diagnostics and care for their sick pet members.  Veterinary emergency clinics are able to provide something very comparable to human care at an absolute fraction of the cost.  So, a life-saving surgery that might cost my husband $50,000-$100,000 in hospital bills may only cost $3,500-$5,000 for your dog.  This is actually pretty amazing to me.  Still, we all understand that $3,500 can be difficult/impossible for some to acquire in a weekend.  Without the government assistance or health insurance agreements that human hospitals may receive, veterinary clinics must require funds up front at the time of service.  There really is no other way they can operate, pay their hard working staff, pay their overhead, and stay in business.  Acquiring pet insurance while your pet is healthy (before the emergency) is a great idea.  I tell clients you should either do that or (if you are a good planner with excellent self discipline) store a set amount each month in a bank account of some form to save for such an emergency.  If you are going out of town and having a pet sitter watch your pet, arrange an emergency plan with the sitter concerning who is permitted to make medical decisions and payments, should your pet become ill.

I have been asked by some why I continue to relinquish a valuable weekend to go in to work these emergency clinic shifts that can run into the late evening.  The answer is that I love it!  The doctors and technical staff that I have the pleasure to work with there are so skilled and passionate about their jobs that I believe experience alongside them make me a better practitioner while at my day job.  I hope you never need to go to the emergency clinic with your pet, but should you, I hope the advice in this blog help make your visit a little a smoother.

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Janette Blackwood, DVM at Charleston Harbor Veterinarians

Janette Blackwood, DVM

Frustrated with Fleas?!

Downtown Charleston has a problem…FLEAS! The low country is prime real estate for fleas, but downtown has more than its fair share! Many clients have come in seeking relief for their itchy, uncomfortable pets since we opened our doors. Ridding your environment of fleas can be a frustrating endeavor – especially when it is difficult to control the environment outside your home. Strays, squirrels, and the dog next door may constantly infest the area with fleas. There are a few tricks of the trade that can help you get control through!

The need to know info:

1. Adult fleas like to stay on the animal, therefore you MUST TREAT THE PET. ALL the pets!
First, you must prevent those fleas from biting, laying eggs, and surviving on your pet. Fleas will constantly jump on your pet in the yard, during walks, and at the dog park. There are many oral and topical products available. Talk to your vet about the safest and best option for your lifestyle and for your pet. Some pets have an allergy to the flea saliva so even one flea bite can lead to intense itching. Consistent and appropriate flea prevention will help to reduce the discomfort! And if you only treat your dog but your roommate has a cat…your flea problem will continue. Everyone needs safe flea prevention. (Remember – not all over the counter flea prevention is safe for cats – read the label, and NEVER apply a dog product on a cat!)

2. Flea eggs are laid by those adult fleas on your pet and then quickly fall off. They land wherever the pet spends the most time (cushions, bedding, carpets), therefore you MUST TREAT THE ENVIRONMENT. 90% of the flea population is around the home, not on the pet!

a.Remove all toys, clothing, and storage from floors, under beds, and in closets to allow the areas to be treated.
b. Remove pets, pet food, bowls, fish or snake tanks from the area to be treated.
c. Wash and dry all pet bedding, throw rugs, and blankets.
d. Vacuum the environment daily for several days after the home is treated. The goal is to remove as many flea eggs and larvae as possible to prevent  them from hatching into adults down the road. Remember to vacuum under cushions, in corners of the room, and under all furniture. Flea eggs and    larvae like dark, warm areas! Be sure to empty the bag/canister after each vacuuming session.
e. Apply a safe insecticide to the indoor and outdoor environments. Discuss options with your veterinarian or your exterminator. People and pets       should remain away from treated areas until the product is dry. Remember to address those areas where your pet hides or sleeps such as under the bed! Areas of the yard where the pet plays and sleeps as well as areas under porches will need to be treated too.

3. Those eggs that do survive will hatch into larvae which transform into pupae in protective cocoons. The cocoons protect the pupae from insecticides for up to 4 weeks or longer – therefore treatment MUST BE CONSISTENT and on-going. Even after treating the pet and the environment you may see a few fleas as they emerge from the cocoon and hop a ride on your pet! Don’t worry, they won’t last long! Make sure to repeat the environment cleaning in 2 to 4 weeks to capture each and every cycle of the fleas.

-Dr. Kahuda

 

What does your dog like to do?

By: Janette Blackwood, DVMJanette Blackwood, DVM with pup

My first couple of years out of veterinary school, I worked out in a military town in Georgia. One day, I had a client come in with a new adult shetland sheepdog rescued from the shelter. Even though it was about a decade ago, I still remember reading the paperwork filled out by the original owner at the time the dog was surrendered to the shelter. The paperwork had a list of the standard questions you would see on these forms, such as “Is this dog on heartworm and flea prevention?” or “Is he good with small children?” But, there was one question and answer that really stuck out to me, because it really made me think about the bonds (or lack of bonds) that we form with our pets:

Question: “What does he/she enjoy doing?”
Answer provided by owner surrendering pet: “I don’t know.”

The relationship (or lack thereof) between an animal and a pet can be so valuable, that it actually has a medical term taught in veterinary colleges and recognized by the American Veterinary Medical Association (AVMA): “the human­-animal bond”. The AVMA’s website defines the human-­animal bond as “a mutually beneficial and dynamic relationship between people and animals that is influenced by behaviors that are essential to the health and well ­being of both.” The definition further goes on to state that a veterinarian should work to maximize the potential of this bond between their clients and pets. As a new graduate, my mind was constantly in a whirl to make sure that I was keeping my animal patients’ bodies physically healthy. Were all my dog and cat patients on parasite prevention monthly and properly vaccinated to keep them safe from infectious diseases? Were my senior pets comfortable in managing their arthritis? And, were my senior sets treated appropriately for their periodontal disease, so that they would continue to eat without pain? But, reading that question from that shelter’s paperwork really got me thinking about wondering if I was doing enough to make sure that my pets were also happy in their daily lives, thereby building that human­-animal bond.

At the time that I was meeting that newly adopted Sheltie, my own little white, fluffy mutt Radar was a young guy full of tremendous energy. And, even though we had only had him for a few months, I knew for sure how to answer the question: “What does he enjoy doing?” He has always loved the game of chase with anyone throwing a squeaky toy. He loves long walks in any new area; bonus points if there are random tuffs of grass for him to mark as his own. The end to a perfect day full of activity would consist of a quiet evening with a Greenie chew and maybe a little tomato for dessert after eating his dry kibble. And, if you were sitting on the floor, he can always find a way to position himself directly in front of you in the perfect location for a gaining a back rub.

As Radar and I both grow older and life finds me and my family somehow busier than ever, I do have to make myself stop and reassess: Am I still providing Radar what he needs to be happy? He is so quiet; he rarely complains. At these times, I usually stop what I am doing and grab his harness and leash. Then, we head outside for a walk through the neighborhood, making sure to walk a little more slowly in the areas with tall tufts of grass.

If you feel inclined, comment below on what you feels gives your pets meaning and happiness in life. It might give others ideas of activities to do with their pets, especially as the nice weather is starting to return.

Janette Blackwood, DVM

Website to the AVMA description of The Human­-Animal Bond.
https://www.avma.org/kb/resources/reference/human­animal­bond/pages/human­animal­bond­avma.aspx

Tips for Pets and Fireworks

fireworks

Summer is full of celebrations involving fireworks, none bigger than our Independence Day on the 4th.  Dogs and cats react to fireworks as individuals. Some aren’t upset by the explosions, and others get hurt by panicking and jumping through closed windows or bolting through doors to get away from the terrifying noise and lights.

American pet advocacy groups point out that the number of escapees is so high that Independence Day is the busiest day of the year in shelters — and that many pets get lost, injured, or killed. Charleston is fortunate to have great emergency hospitals that will be open 24 hours in case your pet is injured.  Check our resources page to find their contact info.  Community websites and Facebook pages are also a great tool to help lost pets get reunited with their owners.

Your pets will do better if they’re not left home alone during fireworks events. That’s not always feasible, so think ahead before leaving them alone.

Signs of anxiety can include pacing, trembling, panting, drooling, attention-seeking (vocalizing, pawing, nuzzling, and climbing on people), hiding, and bolting. Escape attempts tend to involve hiding behind furniture, and staying in a basement or bathroom. Because the source of the noise is confusing, inside dogs may want to escape to the outside, and outside dogs may be frantic to get inside.

Nervous pets tend to drink more water, so keep more available than usual. (And remember, these summer events usually mean hotter weather, and the likelihood of power problems, so extra water is already a good idea.) Bring outside pets inside, so they can’t bolt. Keep your cats securely inside, and if your dog needs a potty break during the fireworks, take him outside on a leash, even in a fenced yard. Make sure all your pets are wearing an ID tag or a collar that contains your phone number. Tags and collars can be lost, so a microchip is even more useful in helping you find your lost pet.

Drug-Free Remedies

What can you do to keep your frightened pet safe and calm? For many frightened pets, just staying in a crate (as long as they are used to one) or in a “safe” room with a closed door is all that’s needed.

Synthetic pheromone sprays such as Feliway  for cats and Adaptil (formerly called D.A.P.) for dogs are available at pet stores. These sprays imitate the properties of the natural pheromones of the lactating female that gives kittens or puppies a sense of well-being.

An herbal relaxant called Composure comes in chews or liquid for dogs; the feline version is in chews.
Some pets respond to pressure wraps, such as Thundershirts or Anxiety Wraps. The pressure on the body may have a calming effect.

Ear muffs to muffle sound are also available.

Calming caps cover a dog’s eyes to reduce visual stimulation.

If you can plan ahead for these summer events, veterinary behaviorists often recommend behavior modification, classical counter conditioning, and teaching a desirable coping response.

In behavior modification, controlling the intensity of the fireworks is necessary and often the most challenging part. While it often isn’t possible to expose a fearful dog to only “little fireworks,” controlling other factors can help. Distance from the fireworks can be less intimidating, as would be keeping the dog indoors.  Music may disguise the bursts of noise; consider loud music with a regular beat.

Classical counter conditioning can create a positive association with fireworks if the anxiety isn’t extreme. Give high-value food rewards (canned food or peanut butter), offer your pet his favorite toys or food puzzle toys, or have your pet practice his tricks with you. The goal is for him to learn that fireworks result in highly pleasant rewards.
You can teach a desirable coping response. The appropriate response for a dog facing something frightening is to retreat to a safe place until the frightening thing ends. Providing a safe retreat, such as a crate or a closet, will give security and confidence, although selecting the location is up to the pet. Blankets to muffle the sound and a pheromone diffuser will provide natural motivation for the dog to seek this location. Being able to cope when the world becomes overwhelming is a life skill essential for both people and dogs!  Hiding is not a sign of a problem, if the pet quickly returns to a normal behavior when the fireworks are over.

Medication

It’s easier to prevent a fearful reaction than it is to reverse one. If your pet is nervous around loud, unexpected noises, a short-term sedative before the fireworks start may be just the ticket. Talk to your veterinarian ahead of time, so you can have something on hand to give your pet before the fireworks start. Some medications often used for fireworks or thunderstorm phobias in dogs are Xanax and Valium.
Some severely anxious pets may benefit from drugs like clomipramine or fluoxetine that increase the level of serotonin. However, these drugs can take several weeks, if not more, to build up to an effective level, so this is not spur-of-the-moment fix.

You have many choices of how to help your pet cope with fireworks stress.  Talk to us about what is best for your pet. Hopefully, everyone in the family will then be able enjoy the holiday!

 

Becky Lundgren, DVM

Cats Need to See the Vet, Too!

By: Janette Blackwood, DVM

Do cats need to go to the vet...this one says yes
Do cats need to go to the vet…this one says yes

I was chatting with a friend yesterday when she shared a secret. Her beloved kitty was way overdue for a veterinary visit. When I asked her why, she confessed that she felt that a vet visit wasn’t needed. Her cat does not go outside or have exposure to other cats so vaccines (and a veterinary visit) are not a priority.

Almost every issue of current veterinary journals and magazines are asking this question: why don’t clients feel that their cat needs to visit the veterinarian annually? Honestly, as a veterinarian, I feel that our profession is largely to blame for this incorrect information. In the recent past, members of the veterinary profession used annual vaccines as the sole means for getting clients to walk through the veterinary doors. Therefore, clients started to associate that the need for a seemingly healthy cat to visit the veterinarian was linked only to that cat’s need to be vaccinated. Yet, vaccines aren’t the only important factor in cat check-ups at the vet; so many other valuable health benefits stem from regular veterinary visits!

Besides just vaccinations for your cat, below are some alternative thoughts I would like for you to consider about the importance of regular veterinary visits.

The most important part of the veterinary visit is the physical exam. A lot is happening in the 5 to 10 minutes when your veterinarian examines your pet. During this time, we are:

· looking for eye, ear, and dental infections

· listening to your cat’s heart for any murmurs or arrhythmias

· evaluating his weight and feeling the mobility of his joints for signs of arthritis

· checking to see if any palpable masses can be detected

· assessing the bowel to make sure there is no constipation

· ensuring that the bladder is relaxed and emptying properly

· talking to you, the owner, about any changes in behavior, eating, drinking, or litterbox habits

We complete a thorough investigation because cats are experts at hiding illnesses, even painful ones. For example, if a tooth is fractured and a sharp pain is felt when eating, a cat will learn to chew on the other side of her mouth or gradually just stop eating as much. When you share your home with multiple cats, it can be very difficult to know that one cat is eating 25% less and experiencing daily oral pain. Another opportunistic cat may be taking the opportunity to eat the extra food, and the food bowl looks the same at the end of the day.

Many diseases are much easier and cheaper to manage/treat when caught early or are able to be prevented. A great example of disease prevention is cat’s oral hygiene. Ask me any day and I will tell you that I would much rather complete a Grade 1 dental cleaning and polishing (no oral surgery or tooth extractions) on your cat’s mouth than a Grade 4 (multiple surgical extractions of double rooted teeth). By the time dental disease has reached the end-stage level of infection of Grade 4 periodontal disease, we usually find significant oral pain during the physical exam and a loss of viability of multiple teeth. The amount of time and skill required to treat Grade 4 periodontal disease is why your cost for the procedure is significantly higher (sometimes even hundreds of dollars higher) than if we had just treated the dental disease at its earliest state.

Parasites are a very real concern even for indoor cats. And, people can catch some of them, too! Every winter, I meet a cat strictly living indoors that has a flea infestation so severe that the cat looks like a pepper shaker sprinkling flea dirt (flea feces) across the exam table as it walks. Fleas are experts at finding warm places to hunker down for the winter (such as an indoor cat) after catching a ride inside from another member of the family. And, I have seen indoor cats secretly carrying intestinal parasites too, without any clinical signs in the litter box that would alert an owner that a problem exists. We find the parasitic eggs during a fecal screen (underneath the microscope) and treat them before the cat becomes clinically ill, protecting both your cat and your family. Your veterinarian will also be able to prescribe for your cat a monthly safe and effective parasite prevention to keep your cat free of fleas, intestinal parasites, and heartworms. You have to be careful though because many over the counter feline flea preventives found at common “big box” stores or online are a waste of money, completely ineffective, and may even have severely harmful side effects to healthy cats. Your veterinarian will cover safe parasite control with you during the office visit.

Having all pets vaccinated against the rabies virus is the law. South Carolina law is very clear about pets and their need for rabies vaccinations. Because the rabies virus kills people when exposed, all pets living or traveling through South Carolina must be up to date on their rabies vaccines. This law includes indoor kitties, as cats have been known to escape on occasion and rabid wildlife are known for being particularly aggressive, making accidental exposure to your pet possible. Cat owners who find their unvaccinated pet picked up by animal control while roaming in the neighborhood or involved in a cat bite to a neighbor could find themselves at the wrong end of fines or legal action, even if their cat is completely healthy.

If you have any feline family members who are overdue a veterinary visit, we would love to meet them. You are always welcome to come by and check out our staff and facility, and talk to us about how we can help make your visit easier and lower in stress.

Janette Blackwood, DVM