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.

new-client-form-button-2016

Janette Blackwood, DVM at Charleston Harbor Veterinarians

Janette Blackwood, DVM

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

Puppy Social Hour for Pups 10 weeks to 5 months old

Purely Positive Dog TrainingCharleston Harbor Veterinarians logo blueblack horizontal

Does your puppy have more energy than you ever thought possible? Is the early sunset making it tough to fit in playtime or walks?

We are excited to invite you to a puppy social hour at Charleston Harbor Veterinarians.  This is an opportunity for your pup to have some playtime while you relax with a snack and a glass of wine or beer.

Purely Positive’s C.C. Casale will be here to answer your questions about behavior and training as well as to encourage appropriate puppy play.

Puppy Social Hour
@Charleston Harbor Veterinarians

Wednesday November 18th
6pm
280 Rutledge Avenue

RSVP – CHVTeam@charlestonvets.com
Free for our CHV pups and owners – $10 at door for visitors

Please make sure your pup is over 10 weeks old (under 5 months) and up to date on deworming and the DHPP booster vaccine.
Please keep your puppy at home if you have recently noticed diarrhea, vomiting, sneezing, or coughing.

Collage of puppies at Charleston Harbor Veterinarians

Blood Sample with Heartworms

Have you ever wondered what heartworms look like? If you look closely, you might catch a few wiggling heartworm microfilariae in this video of a blood sample!

On the 1st of each month,  don’t forget to give your monthly heartworm and flea/tick prevention to protect your furkids from these nasty guys!

What you should know about the confirmed case of canine influenza in Mount Pleasant

June 26, 2015

A case of the new canine influenza H3N2 has been diagnosed and confirmed by laboratory testing at a veterinary clinic in Mount Pleasant this week.  This is the first confirmed case in South Carolina.  This is the same strain that made headlines earlier this year with an outbreak in the Midwest.  The dog is a visitor to our state from Georgia, a state that has had several reported cases of H3N2 over the past month.   From speaking with the attending veterinarian directly, it is my understanding that this dog had recently stayed in a boarding facility in Georgia that later had confirmed cases of H3N2.

What you should know about canine influenza:

  1. There have been 2 strains of canine influenza in North America.  The first one was H3N8, which was documented in 1999.  The second strain is the new one H3N2, the one of which there is current concern.
  2. Although there is a vaccine that has been available for several years for H3N8, at this time it is completely unknown if there is any cross-protective immunity for H3N2 from this vaccination.  From the start of this year, two pharmaceutical companies have told us that they have been testing this older vaccine on the newer H3N2 strain, and at this time we have not received any reports on results that proves that protection exists.  Even so, after the spread of H3N2 in the midwest, the vaccine has been in very high demand, and has quickly reached a backorder status.
  3. At this time, there has been no reported cases of people getting sick with H3N2 from their dog.
  4. Canine influenza is spread through aerosolization of the flu virus into the air.  It can live for 2 days on contact surfaces, but is easily killed through disinfecting.
  5. About 75%-80% of dogs that are exposed to influenza will develop clinical signs.  These clinical signs include coughing, sneezing, lethargy, fever, and possible decreased appetite.  For most dogs, the symptoms appear to be mild and they recover in 2-3 weeks.
  6. A small portion of the above listed dogs that develop clinical signs will have moderate to severe signs that will require treatment by a veterinarian, such as fluid therapy and antibiotics for secondary bacterial infections.
  7. Currently, it has been recorded that 1-5% of dogs contracting canine influenza will become severely ill and die from this disease, often by developing pneumonia.  Like influenza in people, dogs that are the most likely to become this severely ill are ones that are immunocompromised, such as geriatrics, pediatrics, and patients receiving chemotherapy.

 

What you should do if your dog is sick/developing respiratory signs:

  1. Call your veterinarian.  At the time you make your appointment, let your veterinarian know that you are seeing respiratory signs (coughing/sneezing) as your veterinarian will wish to schedule your appointment in a manner that decreases the risk of other patients in the hospital being exposed.  Your veterinarian will complete a physical exam to confirm if the signs you are seeing are consistent with canine influenza or possibly another disease that can cause a cough (for example: heartworm disease).
  2. Your veterinarian can offer you a diagnostic test to be completed by sending a sample to an outside laboratory to help try to confirm if influenza is present.
  3. If influenza (or another type of contagious respiratory infection is suspected), your veterinarian will strongly recommend that you protect other pets by keeping your dog separated from other dogs for about the next 2 weeks.  This will include not going to boarding facilities, grooming facilities, dog parks, etc.

 

How you can protect your healthy dog:

  1. Restrict your activity with any dog that is coughing, sneezing, or showing other signs of contagious illness.  Unfortunately, as canine influenza can be spread in the 2-4 days from when a dog has been exposed to before it develops clinical signs (incubation period), just because a dog is clinically healthy it does not guarantee that they are not spreading the virus.
  2. If your dog has a chronic medical illness, is very old, very young, or otherwise immunocompromised, I would recommend limiting exposure to other dogs in high volume areas such as boarding facilities, dog shows, and dog parks.
  3. If your pet is going to board, especially in areas like the Midwest or Georgia where several cases have been reported, you may consider getting the influenza vaccine for H3N8.  However, as mentioned above, supply for this vaccine is not completely reliable due to the recent backorder.  The vaccine requires 2 doses administered 3 weeks apart and has not been proven to be effective against H3N2.

For more information see:

Canine Influenza Facts from The University of Georgia College of Veterinary Medicine: http://vet.uga.edu/news/view/canine-influenza-facts

AVMA- Influenza frequently asked questions

https://www.avma.org/KB/Resources/FAQs/Pages/Control-of-Canine-Influenza-in-Dogs.aspx

Intersection of Crosstown, Rutledge and Line