Friday, January 20, 2017

What do clients think of consent forms in veterinary practice?

consent; veterinary consent
Getting consent in veterinary practice can be tricky for a number of reasons. Cartoon by Aileen Devine, conceived by Anne Fawcett.

Have you ever signed a consent form? Do you read the fine print? Do you feel like you’re signing over your rights? What goes through the mind of veterinary clients when they sign a consent form? These are really important questions to ask, and UK veterinarians have done just that.

Martin Whiting and colleagues surveyed 470 clients from the Queen Mother Hospital for Animals about the consent process and the findings are surprising.
To backtrack slightly, informed consent in medicine is a concept that was developed to ensure that patients have autonomous choice, and to protect their interests. In veterinary medicine consent is never obtained from the patient (another can of worms that I’m working on a paper about at the moment), but 
from the owner/guardian or client.

It usually also includes agreement about expected costs.

When asked about signing consent forms, most clients recalled signing forms (records indicated that 100 per cent signed a consent form – this was an inclusion criteria for the study).

But the majority of these found the process disempowering – the opposite of what it’s meant to be.

More than half did not read the form – 60 per cent “trusted their veterinarian”.
Most (71 per cent) felt that the consent process explained the proposed procedure/procedures in a way they could understand, and 77 per cent felt they could understand potential risks. Yet 33 per cent felt frightened by the process.
Only 15 per cent felt in control of their choices. Half (51 per cent) did not feel in control, nor reassured (51 per cent) by the consenting process.

Almost half (45 per cent) believed that consenting removed their right to compensation for negligence, while 31 per cent felt the veterinarian could do something different from the agreed procedure anyway.  More than one third of clients did not realise that they could change their mind. And 7 per cent did not understand what the consent form meant.

These findings are interesting. It’s not known whether similar findings apply in a general practice setting – animals attending referral hospitals like the Queen Mother Hospital for Animals may be undergoing advanced, invasive or higher risk procedures. The authors indicate that they may undertake further studies to determine if this is the case.

What can be done?

The study found that it wasn’t about time – 96 per cent of clients were satisfied with the amount of time offered to consider a procedure before consenting.
But better communication may be helpful. For example, some people dismissed the form as a standard agreement and therefore didn’t read it, others were too worried to read the form (suggesting scope to address further concerns), and some just preferred to listen to the vet’s explanation. The study found that clients want to hear about a few treatment options, risks of procedures and treatment, prognosis and an estimate of fees. They want the opportunity to ask questions about the treatment, and they want to be talked through the aftercare.

From a client’s point of view, what might help the process? Asking for more time to consider a process if needed, getting a second opinion (not always possible in the case of emergencies but possible for some procedures), and telling the vet what you are most concerned about (is it the anaesthetic? Is it the procedure itself? Do you feel that there’s something else you would like the vet to look at before proceeding? Is it the recovery or post-operative care?). As a consumer of health care services (including veterinary services) myself, I want to know as much about potential risks and benefits that the vet can impart, and I seek out a clinician who seems to genuinely care.

As the authors suggest, perhaps we also need two different consent forms – one regarding a fee estimate, and another regarding procedures. By combining the two, some clients may feel that the consent form is simply an instrument that the hospital uses to ensure it gets paid, i.e. to protect its own interests. By signing two different forms, it may be clearer that consent to procedures is about ensuring informed consent and protecting the interests of the client/patient. Of course, additional forms increase administrative load and may not be favourably perceived by clients.

It would be really interesting to find out and compare vet’s perceptions of the consent process.

You can read the paper here

Reference


Whiting M, Alexander A, Habiba M & Volk HA (2017) Survey of veterinary clients’ perceptions of informed consent at a referral hospital. Veterinary Record January 7, doi 10.1136/vr104039

Wednesday, January 18, 2017

How to introduce a new guinea pig

Guinea pigs; cavy; guinea pig introduction
Osler (left) and Fitzy (right) some minutes after meeting.

Guinea pigs are herd animals. They enjoy companionship and often fret when kept alone. The problem of course is that even well-kept guinea pigs die eventually, and unless that is due to an accident or natural disaster, one is left without a companion.  Thence the eternal “guinea pig chain” that those in the know speak of.

Isolated guinea pigs appear to be stressed, and may be more prone to physical illness. In my experience a lone guinea pig is less active and more flighty than one with a companion. Many publications recommend a group of three guinea pigs – two females and a neutered male. This is a species that should not be kept alone.

But how do you go about introducing another guinea pig? One has to respect that not all animals will take to each other immediately. You cannot just stick a new guinea pig into your established guinea pig’s enclosure and walk away. This can lead to fighting, wounds, secondary infections and distress. They can’t get away from their flatmates if they don’t like them.

This week we introduced a new boar, Fitzy, to Osler, an adult sow. Fitzy is three-years-old, desexed (this is imported as Osler has not produced offspring – if they don’t breed by nine months their pelvic symphysis fuses, making a caesarean necessary and these are high-mortality procedures) and had recently lost his female companion.

Here’s our policy on introducing guinea pigs:

  • Know the sex. Confession: I’m guilty of not doing this on one memorable occasion. I had a boar who was fretting, and I admit I was in a hurry. It was after work, I’d been looking all around Sydney and I found a contact who had a young “boar” to introduce to my older boar (its usually easier to introduce a younger boar to an older, established boar). I trusted that she had checked, took “him” home, introduced him to my new boar and noted they got along like a house on fire. Several days later I checked “his” sex, only to be confronted with female genitalia. There are several morals to this story, one being that guinea pigs are exceptional at multiplication. Cornflake gave birth to two beautiful babies – Osler and her brother Cushing. (And yes, you need to separate young males from their mothers fairly early on).

  • Quarantine the new guinea pig or at very least have a vet check to rule out infectious disease, e.g. the cavy might Trixacarus caviae.
    Trixacarus caviae
    The guinea pig mite, Trixacarus caviae.
  • If you have time and both guinea pigs are well, consider scent swapping. This is where you take an item from one enclosure and place it in the other guinea pig’s enclosure, so they can get accustomed to each other’s scent.
  • Introduce them in neutral territory. They are less likely to fight or disagree if both are in a new environment. I use the bathroom because I can close the door and give them space if they hit it off.
  • Provide a salad. Lots of species bond over food and guinea pigs are no exception. Greens and herbs like fennel and mint are popular. Usually I put this in between the guinea pigs in their neutral environment, and let them work their way towards it.
  • Clean the enclosure. Fresh substrate, bedding and food mean fresh smells that both pigs can explore. Provide at least two water sources and scatter food through the enclosure so everyone can access food.
  • Provide one or more hides. The best are open-ended, e.g. tunnels that guinea pigs can run through. This way no one can be cornered.
  • You may need to perform several introductions before all goes smoothly, but it often does. Usually guinea pigs become very vocal, walk around each other, sniff, occasionally “popcorn” and then share a salad.
  • Keep an eye out for any tensions once they’re in the enclosure together.


In the case of Osler and Fitzy, they were enjoying their fennel salad within minutes of meeting and settled in without any problems.

Monday, January 16, 2017

Mental health resources for vet employers and students, and national galleries host dog day out

vet cook book; ploughmans lunch
The ploughperson's lunch: my variation on the ploughman's lunch. The bull terrier teapot is more for show - her lip is a bit wonky so when you pour from her she dribbles everywhere. 

As regular readers will know, one of the projects we took on last year is The Vet Cook Book, an initiative to promote collegiality in the veterinary profession.

For some it’s a bit of an odd thing for smallanimaltalk to blog about. And those who have seen me in the kitchen (not my natural environment) raise their eyebrows when they hear I am co-editing a cook book. The background is that those working in the veterinary profession have a higher rate of suicide than the general population. That’s part of it. The bigger part is that plenty of vets, nurses, kennelhands, practice managers and others suffer from stress and burnout. And that impacts them, those around them, and their patients. Not that we have a monopoly on stress. It seems the modern world is geared towards everyone feeling overwhelmed, overloaded, over-contactable yet isolated, and suffering FOMO because everyone else on social media seems to have their lives in order.

The Vet Cook Book really is a One Health/One Welfare project: we need to be well in order to look after animals to their best abilities.

As one of the editorial team I was interviewed about the project last week by Dr Jo Righetti and David Prior on 2UE (you can listen to the segment here). 

During this period we’ve uncovered some really useful resources including Heads Up, an online resource to assist in developing a mentally healthy workplace. This is a fantastic resource for veterinary practice owners and managers (as well as business owners in general). You can check it out here

The Australian Medical Students Association, in conjunction with its New Zealand counterpart, also produces a guidebook for medical students which covers everything from mental health care, life tips, eating well on a budget, finding the right GP for you, surviving rural rotations and  managing your finances. It is a very helpful guide and can be downloaded for free

The recipe for my variation of the Ploughperson's lunch pictured above is:

1 bag potato chips (corrugated are better)
1 tablespoon of cashew cheese with dill (made by Peace,Love and Vegetables but I am told those possessing a food processor can work similar miracles).
1 block of cheese (I used soy cheese)
1 carrot or parts thereof
Small tomatoes of some kind or other
Pickles (I used Grandpa Jack’s Artisan Pickles: Strong pickled onions with garlic and habaneros)
Fresh bread (note I've revived some frozen bread with my toaster in this version)
1 cup of tea

The great thing about this recipe is you don’t need to cook anything…just assemble it. Quantities can be varied according to taste and hunger.

And for those wondering what on earth this has to do with ploughmen, check out Wiki on this meal here



PAWS FOR ART

Over the break we visited the National Portrait Gallery to check out the Popular Pet Show (you can read our interview with curator Dr Sarah Engledow here).

This weekend, on Saturday January 21, the National Portrait Gallery will join the National Gallery of Australia to host an outdoor event for dogs. If you live in Canberra, or your dog loves a road trip, this may be the place to be.

Dogs won’t be allowed in the galleries as such, but there will be plenty of dog-friendly spaces and activities outside. For more info, click here

Friday, January 13, 2017

Do pets grieve for each other?

Owners report that dogs and cats exhibit behaviour changes when a companion animal dies.

Do companion animals grieve when another animal in the household dies? It is a question often asked of veterinarians, and the truth is we don’t know. Where an animal from a multi-animal household dies in a veterinary hospital, it is common for the owner to request that the other animal/animals see the body. One question I’ve always wondered is whether this helps other animals, or does it reinforce a fear of the veterinary hospital? Or neither?

We also see our fair share of animals who are lethargic or display other signs since the passing of a household member. Sometimes we cannot find a cause, at other times there happens to be an underlying illness.  I’ve seen enough of the latter to advise owners whose pets are lethargic or off-colour following the death of a companion animal to come in for a check-up.

We don’t know much about grief in animals. There are dozens of reports of elephants having very strong reactions to the death of a family member, and spending a lot of time exploring bones and carcases. There are reports that many primates continue to carry deceased offspring – for hours, days, weeks and even months. Then of course there are studies documenting the stress response in farm animals (for example, dairy cows and calves) when separated from one another.

Unfortunately, we can’t ask the animals themselves. But we are getting a bit better at measuring both negative and positive emotions in other species. For example, comparative study of nervous systems, behaviour and physiology evaluation, qualitative behaviour assessment, and detection of cognitive bias are often used. Observations can also highlight trends in behaviour which can be further explored.

A paper by Jessica Walker and colleagues found that, at least from the owner’s point of view, the behaviour of dogs and cats changed following the loss of a conspecific.

They analysed 279 surveys from owners who had lost a dog or cat in the previous five years. According to the owners surveyed, the most common types of behavioural changes related to affectionate behaviour and territorial behaviour. Thus 35 per cent of dogs demanded more attention from their owners following the passing of a conspecific, 26 per cent became more clingy or needy, and 10 per cent sought less attention from the owner. A total of 60 per cent of dogs showed changes in territorial behaviour, with 30 per cent seeking out their former companion’s favourite spot, and 14 per cent spent increased time hiding. Changes in sleep behaviour were common in dogs (42 per cent), with 34 per cent sleeping more than previously. Both the amount and speed of eating changed, with a decreased amount eaten by 34 per cent of dogs and reduced speed of eating in 31 per cent. The behaviour changes lasted from 2-6 months.

Cats differed, although when it came to behaviour changes relating to affection they were similar to dogs, with 40 per cent demanding more affection, 22 per cent reported to be more clingy or needy and 15 per cent seeking less affection. Almost two thirds showed a changed in territorial behaviour, mostly (36 per cent) seeking out the other animal’s s favourite place. Unlike dogs, cats changed the frequency and volume of vocalisations, so for example 43 per cent of cats vocalised more often. The duration of the changes relating to affection was 2-6 months, while other changes lasted around 2 months.

In terms of seeing the body of the deceased animal, 58 per cent of dogs and 42 per cent of cats saw the body, but owners reported no difference in behaviour changes between animals that saw the body and animals that didn’t. Most animals (73 per cent) sniffed the body of their deceased companion, but it is impossible to conclude what thought process was going on. For example, failure to sniff or engage with the body does not rule out recognition of the body or grief.

So what can we conclude? The authors acknowledge some limitations to the study. The survey was completed by owners who volunteered, and may have been biased towards those who felt they’d noted a change in the animal’s behaviour. Owners might also be biased in expecting grief or behavioural changes they associated with grief.

And we have to interpret the findings with care. Behaviour changes do not prove grief. For example, I was devastated when my cat Lil’ Puss died due to cancer. Yet the other cat, Michael, seemed to blossom and flourish in the wake of Lil’s death. As the authors of the study point out, behaviour change may be a result of reduced competition for access to the owner, or removal of a resource competitor for food or territory. Its often the case that animals in a household are of a similar age. Therefore changes in sleep may reflect age-related changes (e.g. older animals often sleep more), rather than grief as such.

What’s the point of all this? Ideally it would be helpful to understand how best to manage death in a multi-animal household. For example, are behaviour changes less pronounced in animals that have viewed the body of a deceased household member? Is there something veterinarians can alter in our practice to reduce grief in animals? Is there an easier way to distinguish grief or mourning from signs of illness?

You can read the full study here.

Reference


Wednesday, January 11, 2017

Interview with artist Helen Norton

Helen Norton with Cookie (image supplied by the artist).

Late last year I visited a colleague who had a stunning painting on her wall. It was a work of art called Perilous Journey by Perth-based artist Helen Norton. There was something about this image that really spoke to me (it might have been the white dog with those magic ears). I admire the way some artists are able to tell a story in one picture.

I did some research and learned that “Helen Norton left home at sixteen to spend the next ten years working and living in the most remote desert locations in Australia. Not intending on becoming an artist, her ambitions focused on immersing herself in as much adventure as was possible to extract from life. Settling in Broome in the North West led to a void in adventures so she took up the paintbrush to create a continuing invention of adventures on the canvas.
Norton continued her travels throughout the Kimberley, Pilbara and overseas. She used the experiences to inject her artwork with more complex layers of narrative. Her work gained acclaim quickly, and led to commissions from Qantas to paint two front covers for their in-flight magazines, an exhibition on the QE2, and exhibitions in London as well as successful exhibitions in Melbourne and Sydney. She currently lives in Perth WA.”

Wonderfully, she was happy to answer our questions.

What’s your day job?

I am a visual artist – working in oils, acrylics and watercolours. I also manage and operate my art publishing web business Helen Norton Art – which creates prints of my works for a more affordable product.

Your art prominently features animals, particularly dogs. Why are they a theme in your work?

I have always had animals around me of all sorts since I was born therefore I fully understand the exquisite gift they bring to humans. I find animals to be the most objective subject of all subjects despite having a deep emotional connection to animals. Using them in my work gives me a rest. During many difficult periods on my life, an animal (dog or cat) got me through my problems easily, simply because they create a sort of Tao situation by being firmly rooted in only the present, the now.  Love and food now please, and I offer you my affection and attention unending.  It does not get any more pure than that. What a great subject.

How long does it take to create a painting?

Anywhere from an hour to a few years.  It depends on so many things. Sometimes artworks might sit half finished for months because I do not know what to do to them next.  Other times things just flow instantly.

Where do you draw your inspiration?

From being alive to be frank! Therefore everything! Change brings the best inspiration I have found.  Going to a different place stimulates the creative juices.

Why do you think the human-non human animal relationship is important?

The motive of animals is hard to misconstrue (unless you are projecting skewed fantasies onto the animal), therefore animals feel to me like a bringer together of all people, a great leveller.  For those who do not like animals?  Well I believe this is only because they have not been exposed to them, therefore do not understand the simple joy animals bring to the complicated human life.

Animals have few expectations of humans. Different types of animals of course have different natures and needs. The main thing is that they are uncomplicated and for most domestic animals such as dogs and cats – they are a perfect and simple mirror on a person’s behaviour. When you take on the responsibility or custody of an animal – your level of responsibility as a human is tested. You are required to feed, shelter, train and love the animal. If you do not – that pretty much speaks volumes about your attitude to life. Give nothing and get nothing in return.  Pretty sad but often chosen as we can see by the huge amount of dogs and cats in abandoned animal shelters. I find people who really dislike animals concerning. To be frank people who dislike animals (even after having had a chance to experience their company) are usually quite narcissistic. There is no room for narcissism when you care for animals. That might sound harsh but it is accurate and I have seen it over and over.  It is spot on and nothing has proven me wrong on that.

Do you share your life with non-human animals? How did you meet?

What a funny question! Non-human animals! Yes I do. I have one cat in my care now who is 12 years old. I have not had a dog for a few years but would like to look at this again in a few years. I enjoy looking after other peoples dogs, cats, chookies, cows, horses, and all sorts now and again on house sits so that their owners can go away knowing their animals are really taken care of. I have a family member staying at home who can fill the gap for me at home but there is nothing worse than having to put your animal in a kennel to go for a break.  I have done this and never ever enjoyed my ‘break’ as I knew my animal was suffering.  Okay so some animals like the kennels, but not mine!

Any advice you’d like to share with veterinarians and future veterinarians?

I think you do a great job. To love animals, then have to witness, and deal with their suffering and illness including human cruelty must be one of the hardest but noble jobs in the world – if it’s done with compassion. Animals are ALWAYS innocent, no matter what the charge because they are animals and are living directly as themselves.

The only errors humans ever make with any assessment of animals including terrible accidents with children from say dog attacks – is that they do not understand that they are dealing with an instinctual innocent creature. Any accident is caused by either bad training, ignorance of the owner or approaching person as to the nature of the animal. E.g. if a dog is a protective aggressive breed and not respected for the dangers of this by the owner or the victim then this is not the animals fault is it? How can an animal have evil thoughts or plot a murder? Would you behave differently if it was a lion? Of course, and some breeds deserve the same respect for handling.  If a dog breed is dangerous then there should be consideration of this (the onus on the owner) to show they are protecting the dog properly from being placed in dangerous situations (for humans).

Vets would see the human stupidity on animal care over and over and if I were a vet I could find it hard to keep a stiff upper lip on this. Hail to vets!

Thank you Helen for your time. If you want to see more of Helen’s work, follow her on facebook or twitter , or check out her website.


Monday, January 9, 2017

What can we do about rabies?

Ms B is fortunate enough not to live in a rabies endemic country. But there are things we can do to help animals and humans who are impacted by rabies.

What is the scariest disease you can think of? There are some top contenders, but rabies is definitely on my list. It is invariably fatal, causes severe pain and suffering, and affects humans and animals (farm animals, companion animals, stray animals, wildlife) alike. It is also entirely preventable and only persists because we just aren’t putting enough resources into prevention (including human behaviour change and education) and post-exposure prophylaxis.

According to the World Health Organisation,

  • Rabies is a vaccine-preventable viral disease which occurs in more than 150 countries and territories.
  • Dogs are the source of the vast majority of human rabies deaths, contributing up to 99% of all rabies transmissions to humans.
  • Rabies elimination is feasible by vaccinating dogs.
  • Infection causes tens of thousands of deaths every year, mostly in Asia and Africa.
  • 40% of people who are bitten by suspect rabid animals are children under 15 years of age.
  • Immediate wound cleansing with soap and water after contact with a suspect rabid animal can be life-saving.
  • Every year, more than 15 million people worldwide receive a post-bite vaccination. This is estimated to prevent hundreds of thousands of rabies deaths annually.



The problem is, not everyone is lucky enough to live in a country where they can afford post-exposure vaccination. It would be good to prevent the exposure in the first place.

What can we do about it? Veterinarians and nurses can volunteer in animal birth control and anti-rabies (ABC-AR) programs overseas. A colleague is doing just this and seeking some funding.

As my colleague wrote, ABC-AR programs "come under the One Health Ecohealth (OHEH) banner, endorsed by WHO, whereby human health is understood to be bound up with environmental and animal health.  Rabies, which is fatal in humans if you don't receive post-exposure vaccinations, cannot be controlled unless the dog population is vaccinated.  The size of the dog population is, to a great extent, determined by the local environment. Rabies can affect all mammals and so rabies is also detrimental for farmers with loss of their stock. Control of rabies is now looked at as the 'canary in the coal mine' for progress in human, environmental and animal health".

"In ABC-AR programmes the local community/street/roaming dogs are caught.  They are taken to a clinic where they are surgically sterilised, vaccinated against rabies and permanently marked (usually an ear notch done under the anaesthetic) and then returned to exactly the place where they were captured within 3 days. This means that, these very socialised dogs will be back on their own territory and now act as a buffer between rabid dogs that may enter the locality from further afield and the human population.  Being sterilised, the dog population will be low and stable. Of course, there is also always an education part to the programmes regarding avoiding bites (usually children), what to do if you get bitten and dog animal welfare."

"On the 15th January I am joining a group of vets and vet nurses, a few of whom I worked with in India, Ladakh, who have organised a self-funded ABC-AR programme in Cambodia.  We are all paying our own way and taking as much as we can with us from Australia. We will not be able to carry any medications with us and will have to purchase them there. Once in Cambodia we are linking up with some established NGO's (Non-government Organisations) that are involved in animal work. They will enable us to have facilities to do ABC-AR camps."

If you wish to support this initiative, visit their Gofundme page here.

Another way to help fight rabies is to undertake a free certificate, through the Global Alliance for Rabies Control, in rabies education, animal handling and vaccination, and/or community coordination. Visit here to enroll (nb. you don't need to be a vet or vet student; the more people that know this information, the better). You can do this from the comfort of your own home, in your pyjamas if you want.

We are fortunate that Australia is currently a rabies-free country - but we should be concerned about its presence in other locations.


Friday, January 6, 2017

Vets and cooking: what I've learned so far.

chocolate biscuits, vet cook book
Leftover dough from my biscuit recipe has been used in this incidence to convey the nature of my post-festive case load (i.e. I saw a lot of dogs with diarrhoea after they indulged in ham, lamb and sausages). Cathartic and delicious! (Photo - Dr Deepa Gopinath).

Around the middle of 2016 I was part of a team that hatched a plan for a project to promote collegiality in the veterinary profession. Like many projects, this started with a small, humble goal (to produce an e-book with 5-10 recipes) which developed into a major objective (to compile 100 or so recipes from vets and nurses into a print book in an effort to fundraise for veterinary mental health charities).

Exotic salsa (photo by Steve Gibson).


We’re halfway there. We’ve been inundated with inquiries, and clocked 85 recipes from vets, nurses, receptionists, pathologists, dog groomers, parasitologists, laboratory technicians, specialist surgeons and kennelhands. (We’re accepting entries til January 31). We've had some exceptional mental-health experts provide self-care tips. Shortly we will enter phase two, which involves editing, formatting, and potentially crowdfunding to print this amazing tome.

Ivan makes his signature salad (Photo: Ivan Gavazov).
One of the highlights of this week has having co-editor, veterinarian and foodie Deepa Gopinath over to mine to test some of the recipes. This is science at its most delicious, without the pressure.

One of the aims of the project is exactly this – to encourage people to get together and make, test and (hopefully) enjoy food and each other’s company. To our delight it has been happening. We’ve received photos from cooking sessions from around Australia and overseas. People have been making plans to hang out, cook together and eat and chat! Face to face as opposed to online. Perhaps inevitably, the Labrador is the breed that features most heavily in the background of these photos.

The occasional feline has assisted in food preparation. (Photo - Jenna Moss Davis).
We measure everything by its outcome these days, but this project has most definitely been about the journey. Here are a couple of things I’ve learned along the way.

  1. Vets love chocolate. As if we needed any more evidence to prove. At least 10 per cent of our recipes involve chocolate in some form or other. If this collection does not satisfy your appetite for chocolate cake, biscuits, brownies or pudding, I don’t know what will. There are gluten-free, nut-free and vegan varieties so no one has to miss out. We didn’t plan a chocolate chapter when we set this up, but it looks like we need one. The people have spoken.
  2. Cooking is a great way to spend time! Not only is it relaxing (except when attempts to substitute a Nutribullet for a food processor throw a spanner in the works – see below), its potentially social AND you can enjoy (and share) the fruits of your labour. If you’re clever you can dine off them all week. There’s nothing like rocking up to work with a delicious home-made lunch and knowing you won’t have to try to scrounge something from the staff room or survive off junk food.
  3. The majority of vets and nurses (n=200+ that we’ve asked) will tell you that they cannot cook. They can repair complex fractures, resuscitate a moribund animal, treat and rare and exotic species, diagnose hyperadrenocorticism or a pheochromocytoma, manage diverse teams, place an IV catheter in tiny kitten, approach a horse with a potentially fatal zoonotic disease or lance a basketball-sized abscess on a cow, but ask them to assemble something other than toast or cereal and they will tell you it can’t be done. Is it perfectionism creeping into the kitchen? Fear of failure? An aversive food experience haunting them? Reliance on home-delivery? I don’t know but I feel like “home economics” should be a subject in veterinary school. I don’t have the stats to prove it, but there’s a good chance that our non-human animal companions are more likely to be enjoying a complete, balanced nutritious diet than ourselves.
  4. A Nutribullet should not be used instead of a food processor. They both kind of pulverise things, which you’d think would yield the same result, but for whatever reason this not so. I’ve tested this several times now – with potatoes, cashews and the like – and each time it has ended in total disaster. You wouldn’t perform dentistry or surgery without the right tools, and apparently the same applies in the kitchen. Sometimes. Occasionally you can get away with it but it seems to be only the food-literate like my co-editors who know when to substitute a teaspoon for a piping bag and still get a good result.

If you’re still keen to be part of the Vet Cook Book, there are a couple of ways you can assist:
  • Contribute an original recipe. Just email vetcookbook[at]gmail.com for our instructions.
  • Provide a story, cartoon, photo, illustration, poem or something else we can print relating to the best advice you’ve ever had, overcoming a challenging time or helping a colleague.
  • Tell us (and show us) how you chill out and wind down. We’re putting together a page on this and would love photos and ideas.
  • Volunteer to test a recipe and photograph it for us. A small number of contributors have sent us the recipe but no photos, but we feel the photos are helpful for people to have a photo of the recipe as some of us (e.g. Anne) can’t tell what it might look like by reading the text alone when others can read a recipe like Mozart reads music (e.g. Deepa and Asti). We’ve also discovered some potential recipe pitfalls and modifications in the testing phase (e.g. my chocolate biscuits have been infinitely improved thank’s to Deepa’s suggestion to switch Nuttelex for coconut oil).