Not Just Cuddling Puppies and Kittens

Courtesy of: Joye

As a Registered Veterinary Technician, I often hear comments like “It must be nice to play with pets all day”, or “You have my dream job, hanging out with kittens and puppies!”  Although on occasion we do get to share some special moments of cuddling with the amazing pets who come to see us, there are many hazards in the veterinary profession as well.  Last week I experienced something that is one of the greatest fears in our profession…a dog bite on my face.

As members of the veterinary team, we accept that there are many risks in our line of work.   Pets aren’t able to understand what we are doing to them, they are in a strange environment, and often times (from their perspective) we aren’t being very nice.  We don’t respect their personal space and boundaries, and as a result we need to take many precautions to prevent injury to anyone (vet team, owners or pets) when pets become upset.

All of us have experienced some minor injuries in our line of work.  Even a simple appointment such as vaccines for a new puppy can sometimes result in ugly scratches from sharp puppy nails.  Cats come equipped with lots of built-in weapons and often aren’t afraid to show their displeasure with both their teeth and their claws.  Many of these cats are happy house pets who wouldn’t scratch or bite in their own environment, but when they are subjected to strange people, smells, sights and sounds, all bets are off.  We also work with feral (wild) cats who are trapped and brought in to be spayed or neutered and re-released.  We expect these cats to be frightened and aggressive and we take precautions accordingly.

As with cats, some dogs find visiting our hospital extremely stressful.  Dogs are generally much better at giving us warning signs when we are pushing them too far.  They will often start either by avoiding our gaze or by directly staring at us.  We also watch for what is called “whale eye“, when the white part of the eye is easily visible.  These are early signs that a dog is uncomfortable in a situation.  They may then escalate to a growl or a slight lift of their lips to show their teeth.  If we continue our activities without paying attention to these signs, these dogs may bite.  Some dogs who have a history of stressful visits to the vet may simply skip the preliminary warnings, however, and head straight to biting to get their point across.

We are very committed to protecting the safety of our team members, clients and patients.  We have Occupational Health and Safety rules in place to provide guidance regarding handling these types of situations.  Communication and awareness are key factors in keeping our hospital team safe.  We have a system by which pet files are clearly marked with “Caution” stickers if the pet has a history of attempting to harm team members in the past.  These stickers also include helpful information such as what methods of restraint worked best (for instance, some cats respond well to just being wrapped in a towel while some also benefit from an Elizabethan collar).

Towel and E-Collar

With dogs we record the type and size of muzzle we have used in the past.  It is important that we all know the history of an animal before it comes into the exam room and each time we add notes about what methods are most successful.

Even with all these measures in place, unpredictable events occur.   A dog who has only been mildly nervous in the past may suddenly become very defensive if they have to wait for a long time for their visit, or if there are other dogs in the waiting area that are feeling stressed.  There may be strange smells in the hospital that day that are upsetting to dogs or cats.  Hospital team members may be feeling rushed or pressured to get an appointment done quickly for a dog with a history of having a hard time at the vet, in an attempt to get them home and happy as quickly as possible.  All of these factors may result in the nervous dog becoming a fearful dog, and fearful dogs are much more likely to bite.

Dog bite wounds are very rare in our hospital, thanks to our experienced team and good communication.  Minor bites on the arms and legs are certainly serious concerns, but many people who work in our industry carry a little worry in the back of their mind about experiencing a bite on their face.  In addition to permanent facial scarring, there is always a risk of damage to the eyes, which could be life altering.  Thankfully, my eyes were unaffected, but my upper lip was torn and I have a large U-shaped laceration on my cheek.  These required repair by a plastic surgeon and it may be months before we know how well the scars will heal.

Facial scars

Our team will be meeting to discuss this incident and look for ways to prevent something like this from happening again.  While we continuously look for new ways to improve our safety at work, there are many things pet owners can do to help.  Dogs and cats who are well socialized and frequently exposed to new situations in a safe manner are much more likely to handle vet visits well.  If your dog has been nervous about visiting the vet in the past, consider dropping by for more frequent visits to allow team members to pet, play with and reward your dog when no negative procedures need to be done.  Check out this great blog by Dr. Sophia Yin regarding Dog Bite Prevention Week, held annually in May, for more information.  If your pet has a history of biting or showing defensive behaviours, it is important to let us know before your appointment so we can be prepared.  Dr. Yin also has a blog about handling a dog who has bitten someone in the past, you can read it here.

Please respect our experience and best intentions when handling your pet.  Even though your dog or cat may be friendly and happy with everyone at home, please trust us when we express concern over how they are feeling here.  In some cases we may suggest that our technicians and assistants hold your pet for procedures, when we are concerned that the pet is stressed and may bite.  We have all  had training in recognizing the early warning signs discussed above.  When we suggest that your dog may need a muzzle for procedures here, we aren’t trying to be mean to your pet, we are simply trying to keep everyone involved safe.  If we work together, combining your knowledge of your pet’s normal behaviour with our experience and training, we can have every visit be safe and successful.

Muzzle

If you have any questions or concerns about how your pet handles vet visits, please call us at 902-893-2341.  The suggestions above are merely the tip of the iceberg when it comes to making trips to the vet more relaxed and safer for your pets.

 

Truro Vet Says Good-Bye…To Declawing Cats

Courtesy of: Joye

Truro Veterinary Hospital is very excited to announce that we are no longer performing declaw procedures on cats.  For many years, declawing has been the procedure of choice for any owners worried about their household furniture or being scratched by a cat who plays too rough.  However, the veterinary industry, like any medical field, is one of growth and change.  As we learn more, we can do better.

The Procedure

For many people, the medical procedure of “declawing” has always been poorly understood.  Many believe that a cat’s claws grow from the skin, as fingernails do in people.  This isn’t the case.  In fact, the operation may be more accurately called “de-toeing”, as the first bone of each toe must be completely removed to prevent the claw from regrowing.  Each declawed cat has actually experienced 10 toe amputations.  In a human, that would look like this:

Amputation

Ouch!  So, why did we do it?

The surgical technique of declawing was first performing in 1966 and became a very common surgery in the 1970s.  Eventually it became standard code of practice to have a cat’s claws removed at the time of spay or neuter.  Many owners came to believe that this was just part of owning a cat.  Others worried about their expensive furniture and the negative impact cat scratching would have.  Still others were immune-compromised individuals worried about the health consequences of receiving a cat scratch.  Many veterinarians perform the procedure in the belief that declawing is preferable to having a cat surrendered to a shelter or worse, euthanized.

Seems reasonable.  What’s changed?

In the last decade, veterinarians have become more conscious of the ethical ramifications of cosmetic procedures such as tail docking, ear cropping and declawing.  These procedures provide no health benefit to the recipients and are done purely at the preference of the owner.  In 2010 the Nova Scotia Veterinary Medical Association (NSVMA) instituted a ban on tail docking or ear cropping by veterinarians in Nova Scotia.  (Unfortunately, a recent vote by the NSVMA did not pass a similar ban on declawing cats.)  These procedures do not “promote animal health and welfare“, a promise taken by all Canadian vets as they enter the profession.  In fact, declawing is illegal in at least 22 countries around the world.

In fact, declaws do not merely provide no health benefit to the patient, they frequently result in significant ill effects.  As the medical industry is coming to better understand pain, especially that of human amputees, we are able to understand more about the long-term effects this amputation has on cats.  Cats are stoic animals, with genetic instincts built in to ensure that they don’t let the world around them know they are feeling pain (in the wild, this may result in being someone’s lunch!).  We now know that declawed cats may suffer chronic pain which worsens as they age.

One side effect of chronic pain in the front feet is that declawed cats may be more likely to have problems with litterbox use.  Getting in and out of the litterbox, as well as scratching around in the litter, can pose a challenge for these cats and result in urination and defecation in inappropriate places around the house.

Behaviourally, cats use their toes and claws for many activities.

Courtesy of Tree House Human Society

Claws are used in play and self-defense, and even a friendly indoor cat will often give a swat as a request for some personal space.  This is one of the arguments in favour of declawing.  However, studies have shown that removing a cat’s claws simply makes them resort to a back-up plan…their teeth.  Cat bites are much more likely to result in serious injury to humans and other pets than scratches.  Bites often result in deep puncture wounds and bleeding, causing a much higher risk for immune-compromised individuals than scratches.

For the veterinarians worried about pet owners giving up their cats or euthanizing them if they can’t have them declawed, there is good news.  A survey of 276 veterinary clients revealed that just 4% of them would seriously consider these options if they could not have access to declawing.  This may be related to the fact that as many as 95% of declaws are done purely to save household furnishings, with concerns about human safety coming in a very distant second.  Interestingly, the top reasons that cats are surrendered to shelters are for inappropriate urination and biting, two side effects potentially associated with declaw procedures.

If you’ve made it this far, we hope that you have come to understand our perspective and why we are taking this big step forward for our feline patients.  If you’re like me, you might want to see some of the science/research behind this information.  Please visit here for an excellent summary.  If you’re a visual learner, or just want more information about the hazards and long-term effects of declaws, please check out The Paw Project, a ground-breaking movie bringing this issue to the forefront of social awareness.

Cookie Monster

Does our decision to stop doing declaws mean that you can never have nice furniture again?  Absolutely not!  There are several alternatives to declawing that are humane and inexpensive…but they often require some effort.  We think a healthy pet and a beautiful house are worth it!

Declawing Alternatives:

1.  Scratching posts are one of the most effective ways to deter scratching of furniture and walls in your home.  Cats need to scratch, it is a natural behaviour they will always do, so why not give them something appropriate to scratch on?  Not all cats scratch alike, however, so be sure to invest in a variety of options to find out what works best.  Find some helpful hints here.

SimpleComplex

(Scratching posts can be simple….or very complex!)

2. Trimming your cat’s nails regularly will greatly decrease the likelihood of damage to yourself and your belongings.  If you don’t know how, we are happy to teach you.  Also, if your cat has had vaccines with us in the last year, we will even trim them for you once a month at no charge.

Cat Nail Clippers

3. In off limits areas, you can try deterrents such as double-sided tape, aluminum foil, or car/chair mats with the spiky side up.  Cats generally don’t like the sensation of these things under their feet and will find a happier scratching spot elsewhere.  (This also can help with cats who hop on counters where they aren’t invited).

4. Did we mention scratching posts? 🙂

Horizontal post

5. Nail caps such as Soft Paws may be used to prevent damage from scratching.  These caps fit over the nail like artificial nails for humans and provide a soft tip so that scratching doesn’t cause damage.  This may be especially helpful in adult cats as you attempt other techniques to re-train them to proper scratching areas.

Soft Paws

We have tons of great information available about declaw alternatives and we’d be happy to share more ideas, tips and tricks with you.

What if it’s too late?  What if you, like many others, have already had your cat declawed?  Although you may be feeling badly about this decision, know that it’s never too late to provide the best care possible for your cat.  We recommend scheduling a visit with your veterinarian to discuss the more subtle ways your cat may be telling you she’s hurting.  Proper pain management may change your pet’s life.

If you have questions or concerns about declaws, please contact us at 902-893-2341.  We’re always happy to hear from you!

 

 

Diabetes In Our Feline Friends

Courtesy of: Dr. Michelle

Did you know that as many as one out of every 50 cats will develop diabetes in its lifetime?  We tend to see this disease in obese cats that are between 10-13 years old.  70-80% of cats affected by the disease are male!  This blog is intended to teach you what to watch for if you think your cat may be developing this disease, how we diagnose it, and how it is treated.

diabetes

There are two types of diabetes mellitus (DM).  Type 1, also known as insulin-dependent DM, occurs when the body destroys insulin secreting cells that are found in the pancreas. We rarely see this type in cats, but it is very common in dogs.  Type 2, non-insulin dependent DM, occurs when insulin is still being made by the pancreas but not enough is being excreted.  80% of cats with DM have type 2.  Obese cats are 4 times more likely to develop diabetes.

The main function of insulin is to promote storage of glucose in the body into its energy form, glycogen.  It also allows amino acids to be stored as protein, and fatty acids to be stored as fat.  In DM, storage does not occur and the kidneys are then unable to deal with the extra glucose in the body and it is excreted into the urine.  The extra glucose in the urine causes an excessive amount of urination, followed by an excessive amount of drinking.  Since there is a decreased amount of protein being made, animals with diabetes tend to lose weight and muscle mass.  Therefore, early signs of DM that you may notice in your cats are: an increase in the amount and frequency they need to go out to urinate, an increase in the amount they want to eat, and weight loss.  Other signs to watch for are lethargy, a poor hair coat, dehydration (despite the increase in drinking), and hind limb weakness.

We diagnose diabetes with a blood test to check for an elevated glucose level. Sometimes, when cats are stressed (especially after a car ride to the vet!), the glucose can look artificially elevated on the bloodwork.  If a cat’s blood glucose level reads in this zone, we send the cat’s blood to an external laboratory to check another level called fructosamine.  Fructosamine levels can accurately predict what the glucose level has been in the cat over the past two weeks.  It removes the guesswork and will rule in or rule out diabetes.

Cats who are diagnosed with DM often have other diseases at the same time.  The most common is a urinary tract infection.  Often times, after your cat is diagnosed with DM, we will culture the urine sample to check for bacteria.  Pancreatitis (inflammation of the pancreas- an organ near the liver) can also be seen with diabetes because insulin is produced in cells within the pancreas.

The main goal in treating diabetes is to resolve the clinical signs that the cat is showing, and to normalize the glucose level.  We treat DM with insulin, which is injected with a very small needle under the cat’s skin.  Usually these injections are needed every 12 to 24 hours.  In cats (unlike in dogs), diabetes can go into remission after 1-4 months of insulin therapy.  In addition to insulin, with weight loss and a diet change, we can also achieve remission, when the cat’s symptoms resolve completely.  A high protein and low carbohydrate diet is needed in cats with DM. Higher protein levels will prevent muscle mass loss and will increase the metabolic rate of the cat.  Low carbohydrate diets will decrease the insulin demand on tissues.  Canned foods are lower in carbs than dry diets, and are often recommended in cats with DM.

After we diagnose your cat with diabetes, we may need to do several “glucose curves” during the first few months after diagnosis.  This involves leaving your cat in the clinic for about 12 hours.  We check the cat’s glucose level every 2 hours so that we can see how high and how low the glucose level goes in a day.  Depending on the results, we may change the dose of insulin you are giving and recheck the curve in one week.  Once we find an appropriate level of insulin to dose with, we recommend doing a glucose curve every few months, or you can be taught to check your cat’s glucose levels at home.

glucose testing

As mentioned above, cats with diabetes can go into remission.  Things to watch for at home are a change in behavior or severe lethargy, a decreased willingness to play, or weight loss/gain.  These changes happen because the glucose level remains too low when insulin is given and is no longer required.  The cats may stay in remission as long as they are maintained on their special diet.  Occasionally, a cat may come out of remission and insulin injections are once again required.  Rarely, we may not be able to control your cat’s diabetes easily with insulin injections.  Additional testing and treatments may be needed in those cases.

If you think your cat may be showing signs of diabetes, please give us a call at 893-2341 so we can schedule an appointment.

 

Our “Behind The Scenes At TVH” Contest Winner Speaks Up!

Courtesy of: Sara-Dawn

Hey, my name is Sara-Dawn Langille (better known as Sara-Dawn from River John) and I got an amazing opportunity to work with the staff at the Truro Veterinary Hospital on March 20, 2014.  I got to do this because I won a contest on Facebook called “Truro Vet Behind the Scenes” and it is one of the best contests I have ever entered.  Having this experience has confirmed that I do want to work in clinics with animals and I now realize what it takes to operate a clinic.

When I first came into the clinic I was told that Dr. Gwen was already going into surgery and I could go in and watch; I put on a scrub hat and mask and went into the surgery room.  Dr. Gwen was performing a neuter on a Jack Russell.  At first I was scared I would become ill from watching the surgery but it was really cool to watch. The best part was when Dr. Gwen finished, shut off the gas and the dog woke up.  A Vet Assistant named Brea showed me how to wake up a dog after they had been through surgery and we woke him up no problem.

The next surgery for the day was a tooth extraction on a wiener dog, but before that surgery could start I helped Carmen the Vet Technician clean and polish the dog’s teeth.  After the preparation Dr. Gwen came back and we took out a broken tooth.  It had three roots and was a very large tooth.

After the two surgeries were done I got to hang out with Ashley and Brea the two Vet Assistants and they told me what their duties were and about their job at Truro Vet.  For the rest of the day we had clients coming in for appointments and I learned a lot from this too. Before I went into any appointments I helped Brea clean and wrap the instruments that were used in the surgeries.  If I were to become a Vet Assistant or Tech these would be very important things to learn.

Dr. Michelle came in to start the appointments and I got to go into the first appointment with a Vet Tech named Charity to do preliminary questions.  Throughout the day I did visits with clients with Dr. Michelle and I got to meet tons of animals and their owners who were helped by Dr. Michelle and the team at the clinic.

At the end of my shift the Truro Vet gave me a bag of goodies for myself and my cat Oodie which she is enjoying to the full extent.  I had an awesome day and I am so glad I got this chance!  I know for sure I want to work in the Veterinary field because I love animals and I want to make a difference. Thank you Truro Vet!!

 

 

CANDi + Mexico = A Great Adventure!

Courtesy of: Joye

On November 30, 2013 I headed off to Cancun, Mexico for the trip of a lifetime.  Over the next week, working with over 50 other volunteers organized by Cats and Dogs International, we spayed and neutered over 900 dogs and cats!  But I’m getting a bit ahead of myself…

Cats and Dogs International (CANDi) is an organization dedicated to promoting the humane treatment of animals through tourism.  CANDi partners with tourist destinations (such as Cancun, Mexico) to raise funds for sterilization clinics in poor communities in the surrounding areas.  Pet and stray population control is a huge issue, since many people have little or no access to (or funds to support) veterinary care.  CANDi recruits international volunteers (veterinarians, technicians and non-medical personnel) to travel to these communities to provide free spay/neuter services.  For more information, please see my previous blog “Truro Vet Gives Back – In Mexico” and visit http://www.candiinternational.org/.

As I was saying, on November 30th I traveled to Cancun to take part in this amazing event.  We stayed at the lovely all-inclusive RIU Cancun, a beautiful resort that is a proud sponsor of CANDi.  Although we were each responsible for paying for our stay, the cost was greatly reduced and we all appreciated their hospitality.  Our team had a meet-and-greet that evening, where we got our first look at the folks we would be spending lots of time with over the next week!

Morning 1 at RIU Cancun

The clinic ran for a total of 5 days, with one free day in the middle to recuperate.  Each day we spent 12-13 hours at the clinic, catching the shuttle over early and returning late in the evening.  I’m sure the hotel staff were thrilled to see us all trooping in to the buffet at the end of a long, hot, tiring day.  We quickly adopted the concept of “dirty dinner”, which meant heading to the buffet before going to our rooms to clean up.  Somehow, our little section of the restaurant always seemed to have lots of space for us…certainly couldn’t have been because we smelled bad? 🙂

As a technician, I knew before I headed out that I would be assigned to one of three areas: induction/intubation, surgery monitoring, or patient recovery.  All three areas are extremely valuable and present different challenges.  When I learned I would be assigned to surgery monitoring, I was nervous, but excited.  All patients were kept asleep for surgery using injectable anesthetic drugs, with no access to supplemental oxygen or anesthetic gas.  This is hugely different from the normal procedures I am used to, and adds a higher level of risk for the patient.  If they began to wake up during surgery, an alert technician had to deliver the correct dose of anesthetic (based on weight and species) intravenously before the patient became too alert.  It was a tough but rewarding learning curve for the techs involved…but after all my careful planning and preparation…I wasn’t one of them!

A surgery technician all ready to go!  Surgery techs in action

When we opened for the day on the first morning (late, of course…there are always bugs to work out on the first day), I happened to be sitting at the reception table drawing up drugs for sedating the dogs.  This is the “induction” portion of the day, where the awake dogs are given an injection in the muscle to send them to sleep for the surgery.  Since no one else was available, I began greeting people and sedating dogs…a job I continued right until the very end of the clinic.

Drawing up drugs

Induction presents its own level of challenge that is very different from surgery monitoring, however.  The number one concern is that the patients are awake when you meet them.  Some of these dogs are beloved house pets, friendly and happy to meet a new face.  Many, however, were frightened by the noises, strange dogs, funny smells and overwhelming environment they had arrived in, often waiting many hours outside for their turn.  I was the last person they wanted to see.  We also did surgery on “street” dogs, stray/feral dogs who had been captured by volunteers and brought to us in kennels.  These dogs were also frightened and aggressive and required special care.  I had fantastic volunteers helping me with dog restraint and I hardly got a scratch all week long!

Restraint for induction  Street dogs arriving

Determining the right amount of drug for each dog was sometimes a challenge as well.  Sedatives work very differently in happy, relaxed dogs than in terrified, aggressive dogs.  There are also some breeds that are more sensitive to sedatives than others, which was also a factor in calculations.  We also did surgery on very small puppies, who have different drug needs from older puppies or adults.  The most difficult aspect of induction for me, however, was managing the surgical flow.

Puppy induction

After dogs were sedated, they would head to the intubation table where two technicians placed endotracheal (breathing) tubes and IV catheters.  From there they would travel to the surgical prep area, where volunteers would clip and scrub the surgical site.

Intubation  Surgical prep

The next step was surgery, assuming that I had done my job well and there was a table (well, an ironing board) available for them.  If I sedated too many animals, or perhaps too many females in a row (spays take longer than neuters), there might not be a veterinarian available right away.  If I sedated too few animals, there were vets standing idle with nothing to do!

Oops..all backed up!

To add to this mix, another team was busy sedating cats for surgery as well.  Cats present their own special challenges, since they come with many built-in weapons and a very strong instinct to flee.  Many came to us in shopping bags, allowing us to deliver their injections through the bag and reducing the chance of injury (to anyone, pets or people) or loss of the pet.

Cat in a bag

Some other carriers were more creative!

Cats in a bird cage

After sedating, cats headed over to the same intubation/prep team used by my dogs, so it was easy to miscalculate the number of animals waiting for surgery.  Thankfully, by Day 2 I had a pretty good handle on that aspect and we didn’t have many issues after that.

After surgery, patients were carried to recovery by local volunteers (or anyone with free hands).  The recovery team, headed up by Sherrill MacKeigan (who you may remember from her days as a technician student at TVH), had a lot of work to do.  They had to ensure a safe and rapid recovery from anesthesia, monitoring patient temperature, heart rate and respiration rate. They gave injections of antibiotics and pain medication.  They also gave each pet an ear tattoo, trimmed toenails, clipped fur mats, cleaned ears, picked ticks, and any other grooming care needed by the pet.

Sherrill in recovery  The recovery table Ticks!

The pet owners played a huge role in caring for their animals throughout the day.  They helped restrain their pets for induction, waited with them until they went to sleep, and then headed over to recovery with them to help wake them up after.  This was a real bonding experience, and often the whole family was present.  Once the pet was up and walking, the owners would take them home, filled with smiles and gratitude.

Recovering pets  Checking a heart rate

One of the aspects of the clinic that surprised and impressed me most was how quickly the volunteers came together as a team.  Despite the heat, the long days, the aching feet and sore backs, there were no complaints and everyone worked hard all day long.  When you are united by a common purpose of helping others, it’s easier to set aside conflicts and work together to achieve your goals.

The team

Special thanks to all of the industry representatives who donated products to support my trip and the sterilization program.  Thanks go as well to Hector Navarro, professional photographer who took most of these beautiful images.  Please visit his website at www.hectorn.com to see many more great images.  Huge thanks to Dr. Gwen and Juanita for supporting me in this endeavor, and to all of our clients who donated through the complimentary nail trim donation program in November.  The success of these programs depends heavily on all the generous donations of time, money and supplies.

CANDi’s next sterilization program will be held in the Dominican Republic from April 25-28, 2014.  If you are interested in helping dogs and cats in the DR, please visit CANDi’s website at http://www.candiinternational.org/.  There are currently positions open for volunteers, or you can choose to donate to help out.

If you would like more information about my trip with CANDi or have any questions, please call 893-2341 and ask for me (Joye) or email joye@trurovet.com.