Farf the talking pomeranian

Readers may remember Farf from a previous post. The amazing thing about Farf is that when he wants attention, he talks. You'll need sound on for this one. Someone tells me that the vids aren't viewable from iPads. I'm looking into it. Try your desktop computer in the meantime. 

Aside from being heartbreakingly cute, Farf is a rescue dog given a second chance by his new owners. What a great way to change a life. (And yes, he did get the cuddle he was asking for).

Do pet owners expect too much?

This video ("Every Home Needs a Harvey"), which is an ad for TV advertising, was screened at the Australian Companion Animal Council earlier this month. It is funny on the surface but the joke speaks to an important truth about companion animals: sometimes we bring them into our lives and expect TOO MUCH. Consider poor Harvey, who has to compete with other dogs to woo the prospective owners (and what is with those unimpressed expressions???) - we expect animals to fit into our urban environments (not always animal friendly) and our busy lifestyles (also not always animal friendly) and behave according to OUR concept of good behaviour. One of the primary reasons for surrender of animals to shelters (and re-surrender) is failure of the pet to meet the owner's expectations. 

But sometimes those expectations are outrageously unrealistic. Companion animals are domesticated, yes, but they're living, breathing, complex organisms, a bit like us. If you are adopting an animal, its worth considering: what are my expectations of this animal? (For example, do I expect it to be house-trained within a matter of days? Do I expect the animal to be quiet if I am at work for ten or twelve hours?). How realistic are these expectations? Do I have a plan B if these are not met? (for example, engaging a dog minder?  pet play dates? environmental enrichment? Am I going to take a preventative stance and invest in training?) What can this animal reasonably expect of me and how am I going to consistently meet those expectations?

Managing these expectations can facilitate a deeper, richer and ultimately more sustainable human-animal bond.

Three things I learned: heart disease in dogs

Dixie in academic mode.

Veterinary cardiologist Rita Singh gave an excellent webinar for the Australian   Small Animal Veterinary Association reviewing mitral valve disease, dilated cardiomyopathy and patent ductus arteriosus in canine patients. Three things I learned:

1. Although I was taught that coughing was a sign of congestive heart failure (likely due to compression of bronchi due to left atrial enlargement), recent studies including one by Ferasin et al in the Journal of Veterinary Internal Medicine (2013:27) found that there was no association between heart failure and cough. Dogs in heart failure definitely presented with dyspnoea and tachypnoea, but if a small breed dog presents for a cough without tachypnoea there should be a work up for airway disease. Singh herself published a study (JVIM 2012:26) which found that many of these coughing dogs also had airway disease.
2. While no treatment is shown to prolong the time it takes for dogs with sub-clinical mitral valve disease to progress to heart failure, treatment with pimobendan MAY slow the progression of disease in dogs with subclinical cardiomyopathy (as per Summerfield JVIM 2012:26). 
3. PDA is the most common congenital heart disease in dogs (esp miniature and toy poodles, collies, shelties, yorkies, pomeranians) and 65% will develop heart failure within one year. Surgical ligation of a PDA can be used to treat the condition but the use of devices to occlude the vessel are more commonly used now. Complication rates are low but the biggest complication is haemorrhage.

In question time Singh revealed that cardiologists are less reliant on the vertebral heart score to determine cardiomegaly (they are more likely to base their judgement of the presence or absence of cardiomegaly on experience) and it has become very common to assess progression of heart disease from the resting respiratory rate. No matter the size of the patient, an RR of under 30 is good, but dogs with an RR of 40-60 may have moderate heart failure.

Guinea pig treat: fennel

Fennel. You just need to paint some eyes and eyebrows on the bulbs and they look like Beaker from the Muppets.

A few weeks ago I wrote this post on making your guinea pig/s a salad and what to feed guinea pigs in general. Jennifer from Oxbow suggested I try fennel tops.

Fennel tops! 

I'm a simple girl, I only learned about fennel when it was on Masterchef and whilst I have sampled fennel cheesecake, a good old fennel bulb is something I consider more appropriate in a still-life (don't they look like a heart?) than the kitchen.

I asked where she gets them and she replied: 

They generally sell just the fennel bulbs for human salads at the shops so I bought a plant at Bunnings years ago. It went to seed even with daily picking and its seedlings are now available almost year round here in SE Queensland climate.  Oxbow’s original Critical Care is aniseed flavour because that is very popular with pigs.  Then I read somewhere that fennel is an aniseed (liquorice) flavour and thought I’d give it a go.  Well, the little ones here have definitely approved.  You’ll have to let me know if your little neophobes agree!

Well, Jennifer, lets see.

Exhibit A: A small arrangement of fennel leaves prepared for the boars.

Turns out I have been depriving them! They took to the fennel leaves like ducks to water.

Radike Samo and Randy, who run in the other direction most of the time I present a new vegetable, go berserk over fennel.

Thanks for the excellent tip Jennifer. Its not something I would feed them every day, but if I do find myself with a fennel plant or whipping up a fennel cheesecake I will know what to do with those leaves. I also discovered that the bulbs make excellent objects to hide behind, although I didn't want to leave them with the boars in case they went on a fennel binge.

Essential small animal veterinary textbooks

I'm often asked (truly - I must look like a librarian) which are my favourite small animal veterinary textbooks. Well, I love a good book and its hard to narrow down the choices. Aside from the "staples" (Nelson & Couto, Ettinger, Slatter etc), below are some of the veterinary textbooks relating to small animal practice that I have found the most useful, in no particular order.

100 Top Consultations in Small Animal General Practice, Wiley Blackwell. 

Authors: Peter Hill, Sheena Warman, Geoff Shawcross 

Why this book?

* Because common things occur commonly, it is helpful to have a book that considers the most 100 common types of scenarios seen in companion animal practice (ie no room for Zebras here).

* It organises sections by general signs (eg inappetence and anorexia) and specific illnesses (the dog with demodicosis).

* The chapters are concise but cover the most important points. 

* Unlike so many textbooks it provides advice on how to proceed if the patient does not recover, when referral should be considered and potential low cost options where available - reflecting the reality of general practice.

* Peter Hill's intro on diagnostic and therapeutic approaches in small animal general practice is astute, practical and well written.

* It emphasises sustainable practice with appendices on rational use of antibiotics and glucocorticoids.

Where to get it: The Centre for Veterinary Education is having a sale on this title as we speak. Click here for more info, including a full list of chapters.

Differential Diagnosis in Small Animal Medicine, Blackwell Publishing.

Author: Alex Gough.

Why this book:

* Common things may occur commonly, but uncommon things occur more commonly than we think - and, in real life, patients (especially older patients) often have multiple problems. Gough's brief introduction to this book also provides one of the most concise yet helpful introductions to the problem based approach to medicine. I recommend this to students who aren't sold on the idea (pattern recognition will only take you so far - and if you don't consider something a diagnostic possibility in the first place you might never get to that diagnosis).

* It provides a comprehensive list of most differentials for most presenting problems we will see in a very accessible source.

* It provides differentials for historical signs, nonspecific signs and physical examination findings as well as radiographic, sonographic and clinicopathologic findings. So for example, if I have a cat with vomiting and elevated ALT I can look up both of these problems and get a list of all of the potential differentials. No one human being (except one blessed with a photographic memory) can recall all of these possibilities, so this is a really handy book.
* The ideal resource when taking the problem based approach, ie when investigating an unusual presentation of a common condition or an unusual/uncommon condition.

Where to get it: Directly from Wiley Blackwell.

Success in Veterinary Practice: Maximising Clinical Outcomes and Personal Wellbeing, Wiley Blackwell.

Author: Bradley Viner

Why this book:

* The author is a thoughtful practitioner who considers the bigger picture. He says "Whilst financial success can provide a short term basis for our motivation and well-being, long term satisfaction is only likely to be achieved if there is harmony between our personal values and goals and our professional objectives, and we are content with the place that our profession occupies within our lives."

* Because although it is about practice management, this is really a book about who we are as vets - what are our values and how can we uphold these in our professional lives; how do we objectively measure and improve our clinical outcomes and how can we improve satisfaction with our work. Don't think I've yet met a vet who doesn't contemplate these issues!

* It promotes reflective veterinary practice, which you can read about here.

* Among many brilliantly written sections, it contains the following passage:

"...it is inevitable that at certain moments in our professional lives we will go through periods when we become disillusioned. The values that we upheld as important will have been subsumed by the realities of everyday veterinary life: not every case will involve overcoming a complex diagnostic challenge that saves the life of the animal involved and results in the undying gratititude of its owner. In fact, such cases are few and far between. Just as many may involve the frustration of not being able to take a diagnosis far enough due to practical constraints, or an owner that simply does not appreciate what is being done for them. Between these two extremes, the vast majority will be entirely commonplace, and superficially at least, unchallenging.

It is this routine that will make up the bulk of our working lives. Much of the clinical and management advice currently available has been written to help us cope with the extraordinary. That is perfectly valid: we need to know how to tackle the difficult clinical cases: just as we need to know how to handle an unhappy and aggressive client. But as challenging as such instances may be, they are not the main factors that contribute to long-term professional dissatisfaction and burnout: its coping with the largely routine treadmill of professional life day after day, year after year, so we also need to know how to delight in the ordinary." (p 190).

Where to get it: You can read an excerpt and purchase direct from Wiley Blackwell.

Clinical Veterinary Advisor, Dogs and cats: Second Edition, Elsevier.

Editor: Etienne Cote

Why this book:

* While lots of books try to provide a comprehensive, practical handbook of all of small animal practice, some are too light-on and some provide way too much information to wade through. This book gets it JUST RIGHT.

* The main section on Diseases and Disorders provides solid information on around 800 medical problems including a definition, epidemiology, clinical presentation, aetiology, pathophysiology, key differentials, workup, treatment, prognosis and outcome.

* It also contains "clinical pearls" and info on client education for each condition.

* The sections on procedures and techniques, differentials, lab tests, clinical algorithms and drug formulary are actually really useful.

* You can download client info sheets from the website, which saves you having to reinvent the wheel.

As an aside, you can download Dr Cote's wonderful cardiology rounds on iTunes from here.

Where to get it: You can purchase direct from the Elsevier site with a 10 per cent discount and free delivery within Australia.

Small Animal Emergency and Critical Care: Case Studies in Client Communication, Morbidity and Mortality, Wiley-Blackwell.

Authors: Lisa Powell, Elizabeth A. Rozanski, John E. Rush

Why this book:

* Because it is based on real cases where outcomes were less than ideal, either due to communication errors, bad medical or surgical judgement, lack of knowledge etc. and then breaks them down and discusses what went wrong and how outcomes in future cases could be improved.

* It applies the morbidity and mortality model, commonly used in medicine (especially large teaching hospitals) to a veterinary context. Reflecting on less than ideal outcomes is not an exercise in self-flagellation - it is seen as a constructive means of continuously improving veterinary care.

*The best part of this book is that one is able to learn from the mistakes of others without making those errors.

* It acknowledges that errors in health care are real.

* It provides a really good model of reflective practice with the aim of improving patient outcomes and client satisfaction.

Where to get it: You can download three excerpts and purchase direct from Wiley Blackwell.

 

First do no harm: Being a Resilient Doctor in the 21st Century, McGraw Hill.

Authors: Leanne Rowe and Michael Kidd.

Why this book:

* Doctors take the Hippocratic Oath, part of which involves the declaration that one will "first do no harm". The authors observe, however, that whilst working hard to ensure the health of their patients, doctors often put their own health at risk through overwork, poor management of their own health and an "inappropriate professional lifestyle". They believe that a real doctor should apply the "first do no harm" principle to themselves. Its elegant logic: how can you really care for others if you can't care for yourself?
* The authors acknowledge that those traits that make great medical students and health professionals can also make people difficult to live with - unrealistic expectations, perfectionism and so forth.

For example, when I spoke to Professor Kidd about the book, I asked him:

Many vets, like doctors, have very driven personalities which are often a plus in vet school but may contribute to stress in practice. How can you mitigate those effects?

To which he responded: 

Being driven is not a bad thing for a professional person.  It enables us to deal with daily challenges and get the job done.  But even driven people have their limits and can become stressed and distressed.  If we are going to be effective clinicians we need to recognise the warning signs of stress and make changes in our lives to restore a sense of balance. Most of the time we know the right things to do but we delay making decisions and don't actually get around to doing what we need to do to help ourselves.

* It proposes eight general principles that equip one to be a resilient doctor: make home a sanctuary; value strong relationships; have your own doctor;control stress - not people; recognise conflict as an opportunity; manage bullying and violence assertively; make professional organisations work for you and create a legacy. Shocking? no, but sensible and sometimes easier said than done. 

This is a brilliantly insightful book written by two outstanding general practitioners who clearly care about their profession. It lends perspective by encouraging focus on the bigger picture and one's career in the overall scheme of things.

Where to get it: You can buy it from McGraw Hill here.

I'd love to hear from anyone else about the books that they find most useful in companion animal practice - and why? Drop me a line or post a comment.

[Important note: it is a happy coincidence that I've found some sites offering these titles on sale, but I don't pretend to have found the lowest price and nor do I take any responsibility for availability and sale prices etc...I am providing links to save you time, but please double check prices yourself before buying anything!; I have reviewed several of these titles before for the Journal of Small Animal Practice but I've included them again here as they are excellent books. Nope, I don't get any kickbacks from publishers and yes, those astute at pattern recognition will observe that Wiley Blackwell came up frequently - this coincidence reflects the fact that they seem to publish lots of veterinary texts.]

From the archives

Monifa the pygmy hippo, 2008.

I took this photo in 2008 at Taronga Zoo. This is Monifa, a pygmy hippo born at the zoo and raised with the assistance of keepers (whose shoes I would have given anything to fill that day!). At the time she weighed around 6.5kg and looked too good to be real, as if she had been hand-moulded by Jim Henson. 

Zoos do such important work in conserving these species but their efforts are wasted if the rest of us don't chip in and do something about the habitat loss that necessitates these conservation efforts. 

Bloggess Kelly Rheel reveals how a single cat changed her outlook on life

I am not old, but when I caught myself telling a twenty-year-old how bike pants as street wear were all the rage in the late 80s, I felt very much older. When I told one of my friends about this, she sent me a link (as you do when you reassure your friends these days) to a blog by Kelly Rheel, a laser hair technician who just happens to be a gifted comic writer on the side. Not only did I feel better, I also learned that Kelly is a cat devotee and thought I'd interview her on SAT. 

So hi, Kelly. 

Hey there SAT readers! My name is Kelly Rheel and when I'm not blogging about nonsense on therheeldaze, I work as a technician in a laser hair removal spa. I'm also a lover of animals, so I'm really happy to be featured on this site. 

Your cat features in many of your posts. Can you tell us about him?

"I spent forty minutes on a Friday night perfecting this photo. The first twenty was agonizing over which of the dozens of different filters I should choose from. The second twenty I spent deciding if the bokeh lights should be hearts or stars. Look at how annoyed the cat is. This pretty much sums up our relationship."

My cat is a little boy. People always ask me what his name is and unfortunately I don't have an answer. He never told me and I never bothered to ask. See, we met when he was already a cat, not a kitten and I kinda felt it would be weird of me to all of a sudden tell him he was Bob. However I have had a couple of nicknames for him over the years. He's been called Killer, Winks (cause he winks all the time which makes me wonder if he's serious about half the things he tells me or if he's being facetious) Feathers and more recently Skinny Mini because he's a senior citizen now and has lost a lot of weight. Mostly I just call him the kitty though. I think he's a Tabby cat? He has that W thing between his eyes. 

How did you meet?

I used to live in an apartment in Brooklyn that had a window with access to the front porch. In the summer time we didn't even bother to use the door because when we left the window open we could basically step directly into the living room. One night my roommate and I were watching TV and the kitty put one cautious foot through the window, then another. He took a minute to look around before walking in like he owned the place. We let him visit for a while but I told my roommate "Whatever you do, don't feed that thing. He'll never leave." The kitty came back a couple of times after. Once in the middle of the night. I suppose we had forgotten to close the window and around two in the morning I heard a shriek much like a seven-year old girl would make if she got her finger caught in an escalator. My boyfriend at the time came running into our bedroom and said "There's a rat in the kitchen THIS big!" He calmed down once we turned the lights on and and saw who it was. It wasn't long after that I started hooking him [the cat] up with sardines when he would stop by. Eventually he was just a full time guest. Now we're like besties. 

The motto of your blog is "chasing the dream...at a comfortable pace". How does your cat aid in this regard?

Nothing this cat does in regard to me is at a comfortable pace. He screams at me constantly. It starts with my four a.m. wake up call to watch him eat. Yes, watch him eat. Anne, maybe you can shed some light on this odd habit but he won't chow down without me standing behind him. I attribute it to him being from the streets and wanting to know someone has his back when he's in a vulnerable position but a vet once told me that cats are just communal animals and they like to do things together. Either way, it's non-stop. He also yells at me to watch him drink which he now will only do out of the running faucet. So we often make many trips from the kitchen to the bathroom at any given moment. I suppose he keeps me from maintaining too comfortable a pace. 

[Ed - re the eating, cats can be very social although I find that if they have an increased appetite due to metabolic disease, like an overactive thyroid, they often want you to watch them eat so you are on hand to deliver the next course stat. I know cats that are fussy eaters in hospital will often eat when someone is watching or even patting them. It would be interesting to know what your vet says but senior cats often develop conditions that cause an increase in thirst - such as chronic renal insufficiency or kidney disease. Thyroid disease and cognitive dysfunction - aka dementia - will also cause cats to take night walks and talk a lot more. Blood and urine tests can help diagnose metabolic disease, but cognitive dysfunction is a little trickier].

Not sure about in the US, but in Australia there seems to be an exchange of knowing looks between people when one is a woman over 30 who lives with a cat. Do you get those? What is the deal there?

You know what I say to those people? I don't have a boyfriend, I don't have any kids. Something needs to listen to me complain about how Weight Watchers raised the points on vodka from two to four. And at least by having a cat as my little buddy I can avoid all of the massive responsibility that comes along with taking care of a man. Haha! See what I did there? JK, I'm sure husbands are totally cool. 

You mentioned you wanted to be a vet tech. What is the appeal for you?

I wanted to be a vet tech because I love animals pure and simple. I wanted to work in an environment where I could make their lives better. However I decided to go in a different direction because the cost of living in NYC is silly and unfortunately, in the U.S. vet techs aren't compensated very well for the work that they do. I also considered becoming a zoologist but once again, living in New York, unless I was working at the Bronx Zoo it may have been hard to find a job and as much as love to travel, I wasn't comfortable with the idea of picking up and moving to Africa. 

Have you ever had to take your kitty to the vet and what was the experience like?

He is a holy nightmare at the vet. He thrashes around and growls so loudly she can barely hear his heart rate. The vet is actually quite traumatic for me because he appears to be in pain and I have a hard time watching. I can't be in the room when they take his blood. 

What do you think we need to do to improve the lives of companion animals?

I think people should realistically consider what it is to be a pet owner. I have a number of friends who thought it would be fun to have a dog or a cat but ultimately gave them up if they misbehaved or if they had to move. This leaves an abundance of unwanted animals. Pets can be a wonderful addition to your life but they are also at times annoying, expensive and inconvenient. My cat is quite old now and his body doesn't work as well so he often leaves messes of all kinds around the house. It's gross, but I manage it because I love him and this is what it is to have a pet. If that's something you think you wouldn't be comfortable dealing with, think twice about welcoming an animal into your home.

Any favourite pet or vet related websites that you want to share?

Well if I didn't already fit the stereotype of "spinster cat lady" this is going to seal the deal. I haven't always been such a sap but I work with only women so a website like this was bound to make it's way into my life eventually. It's called cuteoverload and I dare you to spend five minutes on it and be in a bad mood afterwards. 

[Ed: Ah yes, the CO remedy...I use it often!].

How has having your kitty changed you?

I think I'm a more compassionate person in general because of him. I used to dislike cats but living with the kitty has not only turned me into a cat lover, but a true animal lover. I donate regularly to an organization that helps to improve the lives of domestic and farm animals. Also, three years ago I became a vegetarian (and sometimes vegan) because I want to do all I can to make sure that animals are not being abused. I'm of the opinion that if I wouldn't be OK with my cat being killed for food, I can't be OK with cows and pigs and chickens being killed either. My cat showed me that critters have real feelings and we should be respectful of them. I don't begrudge meat eaters by the way, this is simply the relationship I've chosen to have with animals now. And it's all due to the kitty. 

"I had thirty wallet sized photos of the kitty made up to send to friends and family along with my Christmas cards as revenge for having to look at pictures of everyone's kids all year. To my surprise, they were a hit and many ended up tacked to office cubicles and home refrigerators. Now kitty's a star! And I'm much more gracious about looking at pics of other people's kids." 

Thanks Kelly! 

Can dogs and cats be friends?

Can dogs and cats be friends? 

This fabulous photo was taken by Dr Heather Apthorpe: dentist, lecturer (I love picking her brains about anatomy of the head and neck and local anaesthesia - the woman is a font of dental knowledge and incredible factoids) and animal lover. The composition of the above moves me to add "artist" to her repertoire.

Of the inter-species politics in her household, Dr A writes:

They are quite affectionate to one another and Belle runs to tell Milo in the backyard when we get home.

They also play hide and seek in the yard with Milo hiding behind bushes and then jumping out when Belle finds him!

Aside from keeping each other entertained, Milo and Belle are the perfect accomplices when one is procrastinating over an essay, as evidenced below.

Milo and Belle relax on the bed...and helpfully obscure the study notes such that one is compelled to throw one's hands in the air and join them. We've all been there.

Of course not all dogs and cats were meant to be together. Introductions should be planned carefully, executed gradually and supervised fully, with escape routes/retreats available for all parties.

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