Just in time for Black Friday/Cyber Monday, Understanding Your Pet’s Labwork: A Guide to Communicating with Your Veterinarian is on sale for a limited time. Looking for the perfect holiday gift for the pet lover in your life? This unique reference book is designed for the discerning dog or cat lover who would like to understand in more detail what it means when your dog’s ALKP is high, or why imbalances in electrolytes are so concerning.
Empower yourself as a pet parent to ask the right questions when faced with certain test results, and have a better understanding of why your veterinarian recommends certain courses of action.
Veterinarians and veterinary professionals may also find this resource useful when explaining the implications behind certain test results, and open up a clearer dialog between you and your clients.
This is a reference book that can be used in many ways: as a resource when looking up specific test results, as a text to be read over time when you’d to know more how veterinarians view diagnostic testing, or if you’d like a simple analogy to explain how the kidneys or the pancreas works.
Understanding Your Pet’s Labwork has been discounted for this weekend alone, so grab your copy at this price while you can!
It’s a fact of veterinary medicine that sometimes we must muzzle our patients in order to have their cooperation and to protect the people handling them. This isn’t something we like to do as a matter of routine. For years, I’ve been using cheese and treats to make the vet experience positive for puppies and kittens, and many of those animals grow up being excited to see us.
But that method doesn’t always work. Farm dogs who only see a vet for the occasional rabies shot, dogs who have more important things to do and resist the notion of holding still, cats who never leave the house except when they are ill, animals that have had bad experiences elsewhere or are so terrified at the vet’s office they shut down, unable or unwilling to accept rewards–these are challenging patients. As are the aggressive patients or undersocialized patients: the feral tomcats, flock dogs that have never seen the inside of a building, animals who believe a good offense is the best defense.
It doesn’t help that the veterinary profession has been under a lot of strain for years–and only just now are getting the recognition of this fact. Job burnout is high. Clinics are chronically understaffed, staff members are chronically overworked. The job itself is fraught with emotional, physical, and mental stress. The veterinary profession must deal with what researchers call “the caring-killing paradox“, in which we are sometimes forced to end the life of a patient we’ve been taking care of since it was a puppy or kitten, even though this may be the humane, necessary, or only viable option. Clients blow up at staff members, accusing us of “only being in it for the money” when the costs of practicing high quality medicine are often outside our control and because if we can’t afford to pay our staff and our bills, we won’t be there for your pets. Cyberbullying has a huge impact on the mental health of those in the profession. Professionals have been literally threatened–even killed–by disgruntled clients. The suicide rate among female veterinarians is 3.5 times the national average, and male veterinary technicians are five times more likely to commit suicide. According to the CDC studies, one in six veterinarians has contemplated ending their lives.
As one article I read said, “You’re always failing someone.”
In the past, I have worked in practices where appointments were booked every 10 minutes, and the emphasis was on getting things done and staying on schedule. There is very little time in situations such as these to accommodate a fearful or aggressive pet. Thank goodness, by far and large, the profession has moved away from this model!
But often, it’s not a simple matter of slipping a muzzle on the animal and presto! You can suddenly draw blood samples or palpate a tense abdomen. Sometimes, even the most competent professionals cannot get the animal safely contained.
Fortunately, with the advent of Fear Free training and the emphasis on fear-free veterinary experiences, we’re seeing the tide turn when it comes to restraint practices. This often means using what we call the “chill protocol” (a combination of anti-anxiety and calming medications) prior to the vet visit, which not only brings the fear levels down in the patient, but also in the people who have to handle them in the clinic. We still have to use muzzles and restraint methods on many of these pets, but everyone is much calmer. This not only facilitates drawing lab samples, but performing physical examinations on some animals that will not allow anyone except their owners to touch them. If your veterinarian suggests something along these lines, please understand we are trying to create a more positive experience for all concerned.
Many of the patients we’re seeing now were pandemic puppies and kittens–an entire generation of undersocialized animals who saw only their own people during lockdown. While I wouldn’t wish this on any of us, one of the good things to come out of this is the recognition that something needs to change when it comes to handling such fearful pets on a regular basis.
But we still have pets who freak out when muzzled–an apparent panic attack–even with anti-anxiety medication on board. It wasn’t until an experience at the dentist several years ago that I figured out why. Like some animals and vet visits, many of us have a fear of going to the dentist. We’ve felt extreme pain, or our jaws ached for days after having work done. I don’t like going myself, despite the fact I have an outstanding dentist. (In fact, I drive almost an hour to see him because I trust him when it comes to painful procedures).
At that time, I had to have an impression mold done for some dental work I needed. This required filling a tray with what seemed like Silly Putty and having me bite down on this until the jelly-like mass filled my mouth. Then I had to sit there for several minutes, breathing through my nose, while the molding putty hardened. The glutinous mess filled my oral cavity and pressed on my upper palate. It obstructed the back of my throat. And while I labored to pull air in and out of my chronically inflamed, allergic nasal passages for those two minutes I had to endure the process, I gripped the armrests of my chair until my fingers ached and drummed my heels on the seat, all the while my adrenaline surged. I thought I was going to die.
I came away from the experience understanding why some dogs flip out when they are muzzled. See, the type of muzzle most often used in vet med is a nylon or mesh muzzle which holds the mouth tightly shut. Dogs cannot pant wearing this type of muzzle. We can only leave it on for brief periods of time, as the patient is at risk of overheating. It’s not the sort of muzzle for home use, and so animals learn to associate it with vet visits as well. There are different muzzles designed for the flat faced breeds and cats, but I’d observed that some animals with regular snouts didn’t breath well when muzzled (so we worked very fast).
My experience at the dentist changed everything. Now I got it. I really got it. Some muzzled animals believed they were going to die.
The first thing I did was begin instituting the use of basket muzzles for those highly fearful dogs that needed to wear a muzzle for their entire visit. These are plastic or wire muzzles that allow the patient to open their mouths, pant, drink water and accept high-value treats but not bite. (I prefer the plastic ones for veterinary use because getting punched with a wire muzzle still hurts a lot!)
The difference in some dogs was amazing. They still weren’t happy about their vet visits, and most still needed medication to make things easier for everyone involved. But that level of panic that would make us abandon further attempts to perform our exam, draw blood, etc. wasn’t there. Best of all, clients could order their own muzzles and practice habituating the dogs to them at home. They could arrive wearing a basket muzzle because overheating wasn’t an issue. And we didn’t have to start our visit trying to corral a patient into wearing a safety device. Frankly, I wish I’d instituted basket muzzles sooner.
The brand I recommend most often is made by Baskerville. They are well constructed and come in a variety of sizes. (The one linked here is for a medium sized dog–make sure you read the specs before ordering any for your own dog). I recommend placing a little squeeze cheese or peanut butter inside the muzzle and encouraging your dog to place his snout inside, holding it in place for short periods while he gets his treat, and gradually working up to buckling it on and having him wear it for longer increments of time at home. This is the sort of training that needs to be done well in advance of vet visits. But training your dog to wear a muzzle and the use of the chill protocol can ease the trauma of vet visits for these pets–and it is a trauma to them. But having less terrifying experiences over time lessens the fear and aggression for many of these dogs, and these visits become less traumatic for everyone.
I recently had to have an emergency root canal. I told my dentist up front about the fact I didn’t breathe well through my nose and the panic that ensued when I thought I couldn’t breathe. He took these things into consideration, and we arranged a sort of “safe signal” so I could tap out when I needed a break. We got through the procedure, even though I wouldn’t wish it on even my worst enemy. Afterward, speaking slowly in an attempt to enunciate with half my face numb, I told him what I’d learned at his hands.
He laughed. I’m sure he’ll be dining out on that story in the future.
Recently, I had a client come in with her senior dog, concerned because he wasn’t eating with the same enthusiasm as he did before. This is not uncommon in senior pets, and can be rooted in medical problems, which should be ruled out. But after determining that her dog’s lab work was normal (CBC, chemistry panel, urinalysis and fecal), and performing a complete physical to rule out underlying conditions that might affect his appetite, such as heart disease, or dental disease affecting his ability to chew, we came to the conclusion that her dog Sonny simply needed more supportive care around the house.
Not all that long ago, I took an online seminar on aging pets with speaker Dr. Mary Gardner, and I was pleased to find out I was already implementing many of the things she suggested in her talk. So the first thing we looked at was Sonny’s feeding arrangements.
It turns out his owner was using a slow feeder bowl for Sonny because he used to gulp his food ravenously. Hey, I’ve been there! My previous German Shepherd definitely needed a slow feeder bowl, but when I got my current dog, it took him over an hour to eat his dinner out of the same bowl! Clearly Captain didn’t need a slow feeder, and likewise, Sonny didn’t either. The needs of your pet can change over time. Most likely, Sonny found getting food out of the slow feeder bowl too challenging, and as a result, gave up on eating while there was still food left.
Another thing we observed in the exam room was that Sonny had mobility issues on slick floors, and seemed to have difficulty lowering his head to eat and drink while maintaining his balance. Many dogs are less active with advanced age, and the hair on the bottoms of their feet can grow excessively long, acting like little slippers on slick surfaces. Sonny definitely had fuzzy feet, so we shaved the bottoms of his paws between the pads to help with traction. Dogs who get groomed regularly usually get this treatment, but Sonny had never been groomed before. I suggested to his owner that she invest in a small cordless trimmer like the one we used in the clinic.
I also like to make safe pathways through the house and around feeding stations. Yoga matting can be ideal for this situation. You can even purchase it in commercial rolls to cut to the size needed.
If altering the flooring situation isn’t feasible, there are several products out there aimed at improving traction. I frequently recommend Dr. Buzby’s toe grips for dogs. They aren’t for every dog–some resent having anything on their nails and will chew them off–but for many dogs the improvement in traction greatly improves their desire to be more mobile, which in turn helps maintain muscle mass.
Another type of traction device are these pad grips. Just like slipper socks worn in hospitals or by elderly people at home, these pads provide little friction bumps on the bottoms of the feet. Dr. Gardner suggests actually cutting them and adhering them separately to each pad so they fit better, which is an excellent suggestion and one I utilize now. There are many different brands out there; I’m linking to one here.
The other thing I recommended for Sonny was to consider an elevated food and water bowl. Arthritis in his neck was probably impacting his ability to stand with his head lowered for a significant period of time, and he would just give up. It wasn’t worth it to him to continue trying to eat under those circumstances. Again, there are a wide variety of options out there, I am just linking one as an example.
One of the most valuable tools I got out of Dr. Gardner’s webinar, however, were the journals and guides she’s created for the senior dog and cat. I’ll do a separate post on the special needs of cats in the future, as well as one on sundowning behavior in our senior pets, but I found both of these products very useful.
As someone with a senior dog who is starting to slow down, as well as show signs of some hearing loss and cognitive changes, I think having the means to track these changes will be very useful. Speaking of which, I was one of the beta testers for Suzanne Clothier’s Functional Assessment Tracking app for dogs. FAT is a unique tool for tracking a dog’s cognitive, physiological, and social well-being. It’s not just limited to senior dogs, however. The implications for its use are widespread among trainers, veterinarians, service dog handlers, boarding facilities, you name it! I highly recommend you check it out.
By the way, a week later, Sonny’s person called with an update: after instituting some changes, Sonny was back to cleaning up his meals with gusto!
The second announcement goes hand in hand with the first: I’m so pleased to be offering a digital course on Understanding Your Pet’s Labwork in conjunction with Suzanne Clothier on October 12th, at 3 pm EST.
If you’re not familiar with Suzanne, she is a highly respected dog trainer, international speaker, the bestselling author of Bones Would Rain From The Sky, and the founder of Relationship Centered Training.
I met Suzanne many years ago when I had a German Shepherd named Abbey, who’d become dog-reactive after being attacked by a neighbor’s pack of dogs that had every intention of killing her. As far as Abbey was concerned after this event, a good offense was the best defense. At the time, Suzanne was running Camp Dances with Dogs, and she agreed to have Abbey and I join as participants. I’ll never forget watching Suzanne assess my dog very accurately within a matter of minutes and determine that she wasn’t aggressive–she was terrified of being jumped again. I could scarcely believe it when Suzanne was able to select dogs out of the group that would be non-threatening to Abbey and introduce her in a controlled setting. I watched my dog relax and play for the first time in years.
My experience at Camp DWD that year had a profound impact on my life. I came away from camp not only wanting to have a different kind of relationship with my dog, but wanting to practice a different style of medicine too.
During one of my camp attendances, Suzanne invited me to be a guest speaker. I chose to talk about lab work, and why I thought it was important for pet owners to have a basic understanding of the most common test run and the implications of their results. Afterward, she encouraged me to write a book about it, and Understanding Your Pet’s Labwork was born.
It was many years in the making, however. At the time, self-publishing wasn’t possible, and I had a hard time finding a publisher who didn’t want to reduce the text to a series of bullet points. When self-publishing became widely available, it still wasn’t possible to format the charts and tables I needed. When the industry changed to accommodate such needs, it had been so long since I’d written the original material, that I had some serious editing and updating to do. In the end, I’m glad it was such a lengthy process because I’m a much better writer now than I was when I first started this project.
So I am greatly honored to be doing this webinar in conjunction with Suzanne. I’ll be hitting the highlights of the book, explaining the CBC, the chem panel, the urinalysis, and other common lab tests run. There will be a Q&A at the end, too! Not to worry if you can’t make it to the seminar live: everyone who signs up for the course will have access to the recorded material later. Win-Win for everyone!
