Oncology distance education

Bella the chihuahua sent her photo this week. What a gorgeous girl!

I’ve spent the last couple of days at the Centre for Veterinary Education doing the face-to-face component of their distance education program in oncology. If you’re a veterinarian thinking of doing some extra training, I can’t recommend it enough.

There are ten modules, each with assignments, all of which relate to cases you see in practice. The workload is quite reasonable and the material has been designed to be useful. The DE courses are great if you have an interest in practice you want to pursue (medicine, surgery, imaging etc.) and you want to learn from the best in the field. For example, the tutor for our oncology course, Peter Bennett, is boarded in both medicine and oncology (if you want to sign up for distance ed in 2015 you can score early bird rates til October 31 - see here).

Now that we are getting to the end of the course I feel that I have a much better knowledge base around cancer and can offer clients better information and (depending on the patient and diagnosis) more options. I also feel better equipped to manage complications of cancer and therapeutic monitoring.

Dr Bennett with our oncology class. Now THAT is a decent staff to student ratio.

Should you treat cancer in pets at all? Some people ask the question. But cancer is the most curable of the chronic diseases. If you think about diabetes, heart disease and renal disease, clients and vets are often more ready to treat those but when “the c word” is raised both may be less keen. The truth is the outcome of treatment or management can be as good or better than for these conditions.

I’ll be sharing more about veterinary oncology (from the perspective of a general practitioner) in the coming weeks. 

Meantime I just caught this interesting link on a working dog that herds emu chicks. Stunning images here.

Which products and foods are cruelty free? If you’re in Sydney next weekend you can find out at the 9^th Annual Cruelty Free Festival. Check it out here. 

Fly your pet in a private jet

The future of travel? Pet friendly flights.

Why is it that companion animals are treated as companions on land, and cargo in the air? Within Australia it’s just about impossible to fly with a companion animal in the cabin, which means they are stowed in the hold.

Imagine if your pet could sit beside you for the duration of the flight? Imagine sharing your in-flight meal with your cat or taking your dog for a walk around the cabin?

We spoke to “Petsin the Air”, a UK based company that provides private jet transport for pets – and their people.

Imagine where you could go.

Why is there a need for "Pets in the air"? 

Pet owners like to travel WITH their dogs in the comfort of a private jet with their dogs uncaged and free to walk around. This affords both types of passenger a stress free trip.

You allow pets in the cabin. Exactly where can they sit?

Generally they prefer to sit on the settees or seats. There is no restriction where the dogs can go as long as they do not make a nuisance of themselves, which they never do. We have in the past removed seats where there are a few dogs travelling.

Can they walk around during the flight if it’s a long flight? 

Absolutely, the pets are free to roam. We always insist at least one adult passenger remains awake at all times.

Do you serve snacks for non-human passengers? 

Snacks or full service meals for both dogs and humans are available, with or without additional cabin crew.

What species do you fly? 

Any, as long as they are domesticated and are happy to walk up the aircraft steps.

Are there some pets you don't allow in the cabin? 

Yes, those pets which are too wild … (untamed). We have to adhere to CAA rules etc. Dangerous animals aren't allowed on aircraft.

Do you have in-flight entertainment?  

Yes, whatever is required, the animals mostly look out of the windows or sleep!

What's the longest distance you've flown? 

Far East to West Coast of USA.

Have you had to cater to any interesting special requirements? 

All food requirements are catered for, including fillet steak for those pet owners who request it. Some celebrities are happy with a sandwich!

Is there anything else that pet owners should know before flying with their pet? 

We brief the owners thoroughly about feeding pets before they travel [Ed - good call - and a good travel tip in general. If your pet gets queasy in the car it might be worth skipping breakfast til you arrive at the destination]. We ensure no flight leg is too long as to make a pet uncomfortable. All flights must be tailored individually as all pets travel differently. 

We provide a bespoke travel service at not such an unreasonable cost as

people may think. In recent years, we have looked after a small amount of high end clients on an individual basis and we're now launching this business to provide the same service to a wider clientele.  

Wow. 

Five ways to use your smart phone to improve your pet’s health

As we have stated before, cats alone justify the existence of the smartphone. 

A picture is worth 1000 words and when it comes to some topics, such as the texture, volume and colour of diarrhoea, words don’t come easy…

The emergence of the smartphone has, mostly, been a plus for pets (with the exception of their owner’s attention being diverted by it of course). I think it improves the human animal bond and certainly have been shown countless photos of patients looking cute by owners – which is always nice.

But astute owners also use their phone to aid their pet’s health. They may not all be pretty, but here are five ways you can use your device to the betterment of your best friend.

1. Record episodic health problems – Seizures can be difficult to distinguish from syncope, or fainting, but a video of an episode (together with a physical examination and other diagnostics) can be helpful in distinguishing the two. Similarly there are phenomenon like reverse sneezing which can be challenging to describe, but a video will show your vet exactly what you are talking about and can help localise the problem.
2. Collect a “visual” sample – People used to bring me all sorts of take away food containers with horrendous stool samples within. Most of the time – especially if these have been sitting around for a while – we can’t do much with them, but a photograph of stool, diarrhoea or vomit can be really helpful. If we need a sample we can always collect one or send you home with a sterile specimen jar (and a pair of gloves). But sometimes there is enough information in the photo for us to understand a bit more about the type of diarrhoea, for example, and what might be causing it. (Speaking from bitter experience if you take these kinds of photos you might want to be cautious about who scrolls through your phone – there’s nothing like a shot of frank blood in vile stool between selfies to really turn someone off).
3. Monitor clinical progress – sequential photographs can be used to document wound healing, the reduction or progression of a lesion or lump and so on. It gives you a more objective measure but also some sense of the rate of progress which can be helpful. Of course you need to communicate this info to the vet – simply photographing a lump won’t make it go away.
4. Documenting behaviour – problem behaviour is common in the home setting but pets aren’t always their usual selves in the consulting room. They might be excited, scared, subdued or hyper – but some animals simply won’t do at the vet what they were doing at home. This is where a video can help enormously.  
5. Keeping records – a phone is a handy way to record medications, vaccinations, flea treatment, heartworm and reminders (there are lots of apps for doing this, I'm not going to plug any particular one).

Images and video are no substitute for a physical examination by a qualified veterinarian, and diagnoses should not be made over the phone. Photographs and pictures can be misleading, but used well they can be very helpful. Images are more useful if they contain something that gives an indication of scale (eg a ruler, tape measure or even a standard sized object like a coin) and location (take an establishing shot that shows the whole animal as well as the close up).

Can money buy love?

Cook Islands currency. This story didn't unfold in the Cook Islands but their money is certainly stunning.

We stumbled across this news piece and were floored. Does love have a price? We may be showing our age here but back in 1993 there was a film starring Robert Redford and Demi Moore called Indecent Proposal. Remember that one? Some rich dude offers a couple a million dollars for a romantic night with his wife. It’s an interesting if uncommon ethical dilemma. They take a utilitarian approach, weigh up the costs and benefits, think they can hack any negative consequences and off they go. Of course it turns out that life is a bit more complicated than that (and as every ethicist knows, one downside of a utilitarian approach is that we can be awfully wrong when it comes to predicting consequences).

So what if a wealthy person turned up to your open house and offered you $140,000 for your cat? They’ve just paid over 2 million for the house, you may not be in need, but $140,000 might be nice, right?

One family thought so. The thing about this story is that the cat wasn't for sale. But, knowing that "everything has a price", the buyer of their house offered them another 140K in exchange for their family cat Tiffany. They decided to take the cash and leave the cat. Their 19-year-old son wasn’t too pleased. After all, he bought the cat himself.

But in the Sun Herald article mum justifies the decision thus:

“We’re thinking we’ll put $20,000 in a pile next to the cat and say to Sam: you choose.”

Interesting. Is this family selling the right values to their son? What about the family who purchased the cat for their child - will that child grow up thinking love can be bought? And what about Tiffany's say in this matter? I'm gathering she's not getting a commission.

What if this were not a middle class family but a family in need of money to pay for live-saving medical treatment?

My hope is that Tiffany is happy to stay in her home with her new owners.

If a mystery buyer or indeed Robert Redford strolled into your life, what would you do? (And, Sam well may ask, “what about the other $120K?)

Veterinary student fees, and are vets superheroes?

Helpful or unhelpful metaphor: vets as superheroes.

The Australian VeterinaryAssociation is one of a number of organisations lobbying against proposed university fee deregulation, as this is set to hit students even harder.

The AVA has just submitted its response to the Higher Education Research Reform Amendment Bill (2014), which you can read in full here.

According to the summary, the impact on veterinarians will be severe because:

• Veterinary qualifications require 5-7 years of university training.
• Veterinary courses are expensive to deliver with significant laboratory, technological, clinical and live animal inputs.
• Veterinarians have lower earning potential than other similar professions with a starting salary of $47,330 and average total income of $77 ,000 (201-12 tax return data). Veterinary remuneration compares unfavourably with graduates of similarly-priced courses – for example average total income for medical GPs in 201-12 was $149,000 and for dentists was $147,000.
• Veterinary schools are already underfunded and this was acknowledged in the report of the Review of the Demand-Driven Funding System.
• Veterinary students are predominantly females (around 80-90%) who often reduce their employment while looking after children. The new arrangement will severely disadvantage these women.
• As the course requires a large amount of face-to-face class time and clinical placements, veterinary students find it extremely difficult to maintain any reasonable casual employment to help fund their education.

The AVA is calling for a moratorium on fee increases to Commonwealth supported places for veterinary students.

Given all of this talk about the veterinary workforce, I was surprised to note that the American Veterinary Medical Association has released this online comic book to highlight the joys of being a veterinarian. 

As loyal SAT readers will know, some of us love superheroes. Wonder Woman and the Phantom are important fashion icons. But the admiration goes so far. I wouldn't take their career advice. So is this portrayal of vets perpetuating some problematic ideals?

For example, none of the superhero vets had to charge for their services, present complicated options to clients, discuss bizarre test results or negotiate consent, nor did they deal with any workplace stress, and the outcomes were all fantastic. They were available the moment their clients called, got definitive diagnostics rapidly, had recently developed drugs immediately at their disposal, accessed any resources they needed etc. There were no post mortems or deaths.

It seems to me there is a major gulf between what people THINK being a vet is going to be like and what it IS like, and selling the superhero fiction is – I would argue – a tad irresponsible (This “fantasy” element is alluded to in one of my favourite tee-shirts of all time - check it here).

Don’t get me wrong, I love being a vet – but not for the reasons portrayed in the comic. It’s a bit like what shows such as CSI have done to misrepresent forensics: suggesting that every crime can be solved rapidly with you-beaut forensics by glamourous detectives. And when we are talking about a profession with a) a massive rate of attrition and b) a very high suicide rate, we need to take these gaps between reality and perception pretty seriously. 

I think the AVMA are trying to point out the diverse, important and life-saving roles of veterinarians - none of which I would deny. I'm just not sure the superhero metaphor is helpful in this case.

(And on a lighter note, I would qualify that this post was written by someone who spent a substantial proportion of this year dressed as a superhero for a fundraising exercise, and I can say categorically that being dressing like a superhero and being a vet should never be combined. Those things don’t protect you from paws and claws. Walking around in one of those suits is also breathtakingly awkward. You want to be feeling fairly confident when everyone else is in jeans and tee-shirts and you're rocking a colourful leotard).

You can view and order copies of the comic here.