My Book is available: Laughter & Tears: A Veterinarian's Memoir and Advice

This is to let my readers (and their friends) know that the book I have written  Laughter & Tears: A Veterinarian's Memoir and Advice is now available as an e-book through Amazon. In 3-4 months it will be out in paperback (and I will send another announcement). The e-book is $5.99 and the paperback should be about $12.99.

Here is the link

 to Amazon.

Amazon does include a brief description of my book, but: I'd like to share my own thoughts.

This veterinarian’s memoir is inspired by an almost forty year career that overflowed with wonderful people and their devoted pets. In this book you meet animal lovers who struggle with guilt even though it is obviously time to say goodbye to their pets. You share the anguish of those who have no idea how to select the right pet and are shocked when their choice turns out to be totally inappropriate. You read about a house call where a client has a heart attack only moments before her pet is put to sleep; you witness a Rottweiler escape from his owner and lunge at my face. I will describe the cruel and sordid picture of corporate veterinary America where monetary ambition is considered more important than the practice of quality medicine. The stories of my own pets are scattered through the book. Each is introduced with a short novelized autobiography (and a picture). You laugh out loud when my Golden Retriever, Bailey, compares road kill to the delicacies in a buffet line. But, for the most part, this is a poignant story of people and the pets they love.

The last section is an appendix with 13 valuable lessons. Included are topics ranging from selecting the right pet to why you should feed a measured amount of a quality pet food.  Suggestions for easier house training and essential obedience training are reviewed. I offer advice on how to identify the exceptional veterinarian as well as how to save money on your pet’s medications and veterinary care. More appropriate and safer vaccination protocols are examined in detail. (Are your pets still getting vaccinations every year? You need to read and understand why they should not be!) Why your pet should be neutered, ear disease, and understanding your cat are all discussed before the closing lesson on euthanasia embraces the inevitable heartbreak we face with each of our pets. If you enjoy reading about people and their pets, you’ll love this book. If you want to partner in your pet’s health care, this will be a great help.    

Please send me your comments; praise or criticism, I'd still like to hear.

Kenneth H. Cohn, DVM    

    

Pet hoarding and why it makes good pet care so difficult (and expensive)

One day I made a home visit to vaccinate a healthy dog.  When I parked in front of my client’s home, I noticed all the empty cat litter boxes stacked in her garage. I started thinking: am I sure she wanted her dog vaccinated?

Once she opened the door I had to ask if I was here to vaccinate her dog because all I could see were cats. I’d walked into her small bungalow and there were cats everywhere. 34 to be exact but that doesn’t count the 4 in her bedroom (that don’t get along with the others) or the 5 on the enclosed back porch (which are relatively new arrivals). I had to start petting them because these were very friendly cats. Each level of the cat tree was occupied; four more cats were scattered across the living room sofa. Each dining room chair was occupied by 1 or 2 felines. Everyone was happy and if I got close enough, the heads swayed my way for rubbing and caressing. No one could get enough attention.

The litter boxes were relatively clean and filled the end of the dining room. There was plenty of food left in the bowls I could see. (I’d have to give her my advice about this later.) It was kind of fun to be surrounded by all these cats that each wanted all your attention, but where was the dog?

The dog was confined in a small second bedroom. My client explained that the elderly neighbors had both gone to the hospital and left the dog behind. Now, she had found out that they weren’t coming back. But the dog was fine with the cats, and the cats weren’t afraid of the dog but she didn’t trust them together (yet?)

As we looked over the dog and talked, it looked like he was getting the short end of the stick. Yes, he had a loving home but he was confined to a small spare bedroom. Periodically he was led out to the back yard where he spent some time, but there were no walks, minimal exercise and not a lot of stimulation.

This was a very busy woman and she was doing the best she could with all these pets, but Bosco was a very nice dog, and he belonged in a new home where he would get more attention and stimulation.

The cats seemed to be doing well with the exception of one who had lost a lot of weight and was not responding well to treatment after his diagnosis of diabetes. If you read my posts on the importance of limit feeding your pets and how to treat the diabetic cat, you will understand how complicated this 43 cat household becomes. How do I know who is eating and who is not? How do I feed the most appropriate diet as well as the right amount to each cat? It can be done, but it’s not easy and is very time consuming (as if any home with 43 cats wouldn’t be time consuming). I had had a client in St. Louis who managed quite well with her 24 cats. At meal time (twice each day), each feline knew to go to his or her food bowl and wait for their particular diet. With 24 cats of various ages and needs, there were 4 different diets spread between these cats.  

Ultimately the couple got divorced but had to continue to live together because where can you move and take 12 cats?

Most of us don’t have the time, energy or finances to take care of this many cats. It’s hard to say no to each additional cat that needs a good home, but you have to be fair to yourself as well as the cats. Also, the more cats in one household the more likely behavioral problems (such as urine marking) and even fighting will result. 

As far as Bosco: There was food sitting in his bowl and he exercise was limited to visits to the back yard a few times each day. If patterns didn’t change he would continue to put on weight and ultimately suffer all the side effects of too much food and too little exercise. Unfortunately, this kind woman had a bad knee and couldn’t walk this big dog. My recommendation was to find a new home for the dog. Until that happened, I suggested feeding a precise premeasured amount of a light diet twice daily, and when possible, going out into the yard with the dog and throwing a ball for him to encourage more exercise and activity.

When can I no longer postpone the inevitable euthanasia?

Ten days ago, while my wife and I were driving our small motor-home through the Superstition Mountains in Arizona, “Debby” called to request a home visit to euthanize her 13 year old dog. She explained Sunny was having more and more trouble getting around and that she and her husband had finally agreed this was the time. He was taking Tramadol which helped some, but he was an old, arthritic dog and he had had a long, good life. I explained that I wouldn’t be back for another week and we set up an evening appointment for the day after I planned to return.  I asked Debby to leave a brief message on my home phone with her address and said I would call once we were in town. A few days later she called again. Her husband wanted to wait until after the weekend and we postponed the visit till the following Monday. I was surprised that once we returned to Tucson, there was no phone message. I thought maybe they’d changed their minds or decided not to wait so I called to check. She apologized; she thought she had called and left a message. What bothered me most about this exchange of phone calls was the obvious lack of urgency. Typically, if I am traveling and someone needs their pet put to sleep, they can’t wait a week for me to return. They simply call someone else. Something about this house call wasn’t quite right, but we set up a date and time, and I headed to her home on Monday morning.

When I’m greeted by a bunch of pets wagging their tails, I always assume (and pray) that the pet I’m here to see is not waiting at the door with everyone else, but instead, painfully confined to a comfortable bed in another part of the house. I should never have to wonder, “Am I putting to sleep one of these?” When I’m going to someone’s home to euthanize their pet, I want to walk in the door and easily recognize the pet that will be much more comfortable once I’ve done my job. He is ready to go to sleep and will appreciate this final rest.

Once Debbie had identified the biggest (and slowest) greeter as Sunny, I gently petted this old dog and tried to visually evaluate him before carefully asking, “Do you want me to first examine him and then we can talk about what we might be able to do to make him more comfortable so he can spend some more time with you? Or, have you and your husband already made up your minds that this is what you want to do?”

With no hesitation she responded. “We’ve had this big dog for 13 years and it is time. My husband said goodbye to Sunny when he left for work and for days we have been preparing ourselves for what we know needs to be done. Let’s get it over with.”

Her estimate of Sunny’s weight seemed pretty accurate and I asked when the vet had last weighed her. Most people aren’t good at guessing their pet’s weight and can’t easily weigh an 80 pound dog in their own home.

“I just guessed his weight because my son’s dog is almost as big and he was just at the vet. Sunny hasn’t been at the vet since we got him from the Humane Society.”

I innocently asked when that was. “That was when we got him 13 years ago.”

I always ask if the pet owner has seen this done before. Most have, but I still go through the procedure step by step so that they will know exactly what to expect. Debbie made it clear that she and her husband had already talked about this quite a bit and they wanted no further discussion. Once Sunny was resting comfortably on his bed, I placed a tourniquet on his leg and put him to sleep.     

Lesson: a pet needs a yearly examination. As he gets older,lab tests and other diagnostics need to be added to his workup. Proper exercise, diet and pain management can add quality years to our pets’ lives.

These previous blogs include additional information for keeping your older pet healthy:

http://kennethcohndvm.blogspot.com/2014/05/does-arthritis-always-meaneuthanasia.html
http://kennethcohndvm.blogspot.com/2014/06/limit-feeding-dogs-and-cats-to-prevent.html

Dental disease in dogs and cats: why you should brush your dog’s teeth! Part 2

The most important question pet owners fail to ask is how often do I need to brush my pet’s teeth?  For you to take the best possible care of your pet’s teeth, they need to be brushed once daily! A daily brushing will certainly reduce your pet’s frequency of professional veterinary dental cleanings, but probably will not eliminate them. Remember, under anesthetic and with the best possible lighting, your vet will see things you cannot and can perform a very thorough exam and cleaning.

If you take care of your pet’s teeth (and that means daily brushing), the gums will remain much healthier and the dental procedures will be simpler and less frequent. Almost 15 years ago I adopted a 5 year old rescue dog with very heavy tartar accumulation, but fortunately little gum disease. After a thorough dental prophylaxis, I began brushing his teeth every day. It wasn’t easy to get him used to it (he was 5 years old and no one had ever tried), but in a few weeks he was becoming much more cooperative and ultimately came to enjoy it (they love the taste of the veterinary pastes). He lived another 11 years and never needed to have his teeth cleaned again. This dog was the exception, but had I not chosen to brush his teeth every day, he would have needed to be anesthetized for professional dentals every 6 to 12 months for the rest of his life. 

Our pet’s dental health is similar to ours and once the gum tissue has become infected and receded (leaving the exposed dental roots), it will not grow back. After a thorough dental prophylaxis, this area will rapidly refill with tartar and the gum disease will continue to progress. Ultimately the involved tooth or teeth will become unstable and need to be pulled. So don’t wait to have your pet’s teeth cleaned and to begin home dental care.

The sooner you begin to practice good dental hygiene with your pet, the healthier his mouth will remain. It is important to remember that we are not simply talking about cleaner teeth. Heart and kidney disease and other serious health issues are known to be caused by untreated periodontal disease and the associated bacterial infection that floods our blood stream. And, we aren’t even talking about the pain and discomfort caused by infected gums and loosening teeth. 

Yes, your pet will need to be anesthetized to have his teeth cleaned, but with new anesthetic regimens and appropriate monitoring, this is a safe procedure. In fact, the odds of serious complications from untreated dental disease are much greater than the risks of general anesthetic for most pets. Neither you nor your vet should ignore your pet’s dental health! Don’t rely on the occasional dental prophylaxis to take care of your pet’s teeth without the benefit of home dental care. You wouldn’t stop brushing your own teeth and simply rely on your dentist to take care of your teeth and you shouldn’t take this approach with your pet! If you need more suggestions on how to brush your dog’s teeth or how to take better care of your cat’s teeth, talk to your veterinarian.

Dental disease in dogs and cats: why you should brush your dog’s teeth! Part 1

Dental disease is all too common in our pets. Every time you go to the dentist the hygienist gives you advice on how to better care for your teeth. Does your veterinarian suggest how to take the best care of your pet’s teeth?

When your pet is getting his annual exam, be sure that the mouth is opened and there is a thorough oral exam. Not only ask but take a careful look to see how your pet’s teeth look. Inquire about what you might be doing at home to help your pet maintain a healthy mouth.

The simplest suggestion is one that will help both canines and felines: limit feed dry food. Canned food tends to leave a paste residue over the surface of the teeth. Free feeding (the food is allowed to stay out all day) and nibbling throughout the day is no better for your pet’s teeth than frequent snacking is for our teeth. Every time we eat, more plaque is left on the teeth.

Dental diets and treats may help some, but not at all if your pets doesn’t chew them thoroughly, and some pets, especially cats and small dogs, may simply swallow them whole. Unfortunately, there is no substitute for brushing your dog’s teeth. (The same could be said for our cats, but while few cats will allow us to brush their teeth, almost all dogs can be trained to have their teeth brushed.) We are only talking about 1 to 2 minutes daily.

When you adopt a puppy, you should get him used to your opening his mouth and looking around. When you need to give your pet a pill, the process will be much easier; it will be possible to pull something out of his mouth if you need to, and once his adult teeth have all erupted (about 6 months of age), you can begin brushing his teeth. Until this time he will be getting used to your handling and playing with his mouth.

For most dogs a small or pediatric tooth brush works well. A used brush (with the bristles somewhat crushed) is great. Always use a veterinary tooth paste. Human paste actually contains soap and is not meant to be swallowed, and pets hate the foaming action of our tooth paste. In addition, because we live so much longer than our pets, their past can be much more abrasive (and effective) than ours.

Push the paste down into the bristles, hold your pet’s mouth closed (pets hate to have their mouth forced open), lift the cheek on one side of the mouth and brush away. You are mostly interested in brushing the surfaces of the maxillary (upper) teeth. These actually scrape off and clean the lower teeth as your pet chews. Be sure to include the last molars on each side as well as his fangs (canine teeth). Check his incisors (the smaller teeth between the canines) carefully. Many (especially large breed) dogs maintain healthy, clean incisors and they don’t appreciate your brushing them (because you are often closing you pet’s nose while you try to get to these teeth). However, some dogs (especially smaller breeds) accumulate heavy tartar and plaque between these smaller teeth and the gums become red and irritated as they recede. If a careful examination shows anything but perfect incisors and gum tissue, this area will need to be brushed also. While you are at it, check the lower incisors. In some dogs this can be a real problem area and may also need your attention. On a weekly basis I try to hold my pet’s mouth open and briefly brush the inside surfaces, but this is difficult (and often ineffective) and the inside surfaces tend to accumulate much less tartar than the outside surfaces.

We’ll continue this discussion in another week!

Part 2 of 2: Euthanasia of the Potbellied Pig

The big mastiff calmed down quickly and the couple led me to the barn to see why I was here. I retrieved my house call kit from the car and followed them between two old barns out into a fenced area that looked like it once held livestock. Other than 2 goats in an adjacent area there were no more farm animals to see now.

“We got our potbellied pig, Jimmy, for our kids about 15 years ago. He’s lost so much weight. He used to be fat and now he’s skin and bones. He can hardly walk. Our regular vet put him on some medications a while ago, but they are not helping anymore. We think it’s time.”

I first drew up a sedative and gave him an injection in the neck muscle. (Recommended in this area because the pigs have so much fat everywhere else and the injection needs to go into the muscle and not the fat.)

Euthanasia solution is best given directly into the vein and the most accessible vein in a pig is in the ear flap. Mrs. Arnez headed into her house to get me a bowl of water to wash up the area. I needed to thoroughly clean the outside of the ear and improvise a tourniquet to force the vein to stand up for me. This would be the sight of Jimmy’s injection.

He was sleeping soundly from the sedative. Once the ear was clean and the tourniquet was in place, I could still not see a vein. The next step was dousing the area with alcohol and tapping or lightly “slapping” it with your hand until the vein stood out. My worry was, what if after the sedative and the prep, I still couldn’t find a vein? Or what if I found a tiny vein but couldn’t successfully feed the needle into it?

There was no problem. The vein became obvious after the alcohol treatment. Jimmy felt nothing as I gave his injection and he peacefully went to his final rest. 

Part 1 of 2: The Brazilian Mastiff and the Potbellied Pig

Have you ever driven down a street and seen a sign: aircraft may also use this road for landing? Or seen a street sign that says: aircraft only? If you haven’t, then you haven’t driven through an air park in Tucson where homes, planes, horses and wildlife share space. When I was heading to a house call a few nights ago and saw these signs, coyotes, jackrabbits, multiple Gambel quails  and the many homes that shared their backyards with private aircraft, I knew my GPS had mislead me. I had even been forewarned by my new client. Luckily, I still had cell phone reception and could get directions. Making house calls in unfamiliar areas around Tucson, the most frustrating experience is to be lost and not have cell phone reception.

I was heading out to euthanize a potbellied pig. He was weak; he was old and had been losing weight for a long time. I hadn’t dealt with one of these guys for many years, but I had done my homework and was prepared.

It took me so long to find their home that it was getting dark by the time I arrived.  The directions weren’t easy (I have a terrible sense of direction anyway), but when I passed their barn, rusting antique tractors and horse stalls, I knew I was in the right place.

As I pulled over to park, 2 huge dogs came running over to greet me. The Great Dane was quiet and friendly. His much larger companion wasn’t happy to see visitors; he barked and snarled as foaming saliva flew all over my dust covered car (I had just driven 3 or 4 miles down a dirt road to get here).  I assumed when I saw my client walking across his driveway that he would call off his guard dog, but he paid no attention. I wasn’t getting out while this snarling giant was waiting on the other side of my car door. Finally a woman walked out the front door and she thought to call this big boy to her side.

When I felt safe enough to leave my car, the first thing I asked was, “How big is that dog? He kind of dwarfs your Great Dane, doesn’t he?”

“He’s about 225 pounds. The only thing we could get that was bigger was a steer.”

I had to agree and you’ll have to wait for the next blog to hear about the pig.