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Tag: Anthelmintics

  • When is a dog not a dog?

    When is a dog not a dog?

    Every vet has their niche, speciality or personal interest. I think I’m slowly finding that mine may be located somewhere in the gastrointestinal (GI) system; as the daughter of an endoscopy nurse I like to think I’m following in the family footsteps.

    I was really enjoying my lectures on the topic until we reached the point of hiatal hernias.

    The unfortunate cognitive dissonance of veterinary medicine is that the more interesting or objectively “cooler” the case, the more likely it is often incredibly sad from the perspective of the patient.

    Vet geek

    In this case, I personally was finding the concept of a sliding hernia pretty “cool” (don’t judge, I’ve been out of the game for a year and I’ve missed nerding out over-vetty stuff), until I learned that the majority of brachycephalic dogs suffer from the condition.

    The mechanism behind this being that, in an effort to breathe through an actively collapsing airway, a brachycephalic dog can effectively create such a negative pressure that it sucks its stomach through its diaphragm and into its thorax.

    The worst part of this is that it’s suspected the majority of cases are subclinical (or, at least, subclinical to the owner), as the main clinical signs associated with nausea, such as drooling and lip smacking, are characteristic of short-nosed breeds anyway.

    Less love?

    I wonder if a pilot finds it impossible to enjoy a flight? Even if you stuck him in first class with a martini, the Friends box set, comfy slippers and a sirloin steak on the menu, would he be able to switch off, or would he find his mind focusing on minute turbulence? Would he keep checking the altitude, or picturing the cockpit, wondering: “What on Earth is going on up there?”

    Can a pilot enjoy just being a passenger? Image © xixinxing / Adobe Stock

    Along a similar vein, by the time I finish vet school I wonder if I will ever be able to truly enjoy a dog in the way I used to? If somebody had presented me with the fluffiest, most adorably friendly puppy in the world the day before I’d started first year, I’d have been ecstatic – I may even have passed out from happiness.

    Not just a puppy

    Now, don’t get me wrong, I’m never NOT going to love being handed a puppy, but it’s not just a puppy anymore.

    • Has it been vaccinated?
    • Was its mother healthy?
    • Did the breeder socialise it effectively, or will it forever have a fear of bearded men in funny hats?
    • Is there a cleft palate behind those tiny teeth?
    • Are there worms lurking in that adorable pot belly?

    It’s like my subconscious races to take a history in every animal – even if they’re not a patient!

    Natural versus artificial selection

    As a constant reminder of my disturbing lecture notes, while tutoring GCSE biology I regularly cover the topic of “natural versus artificial selection” with my students. This includes covering the staggering feet of man’s journey over the past 1,000 years to convert the wolf into anything from a small bear to something that fits in a handbag.

    Each time I teach this topic I find myself fighting the urge to be overly pious, knowing no exam will ever ask them to list the ways the pug is destined to a snorting existence or why the dachshund can’t jump onto his owner’s lap for fear of shattering his spine.

    I feel including that sort of thing in the syllabus could certainly go a long way – and perhaps the best way to promote healthy dogs is with re-education from the ground up. But is that my responsibility? More importantly, is it the responsibility of vets in general?

    Flawed from birth

    With some owners (especially breeders), mentioning any predispositions or hereditary conditions of their dog is akin to attacking their personal brand.

    Some people are “dog people”, while some are very passionately and unequivocally only “pug people” or “sausage dog people” or “golden people” – and it’s generally a struggle not to cause offense when telling an owner their animal is slightly overweight, let alone that their pride and joy is genetically predisposed to be flawed from birth.

    Image by ExplorerBob from Pixabay

    Do better by your pet

    The frustrating thing is that if owners knew the risks to their particular pup then prophylactic management could really make a difference to these animals’ lives.

    Not walking brachycephalic breeds on hot days, keeping the weight off of larger dogs to take the stress off of their joints – prevention is always better than cure, and if we can’t prevent the breeding and purchasing of puppies with a gene pool so shallow only a gnat could drown in it then at the very least we should be aiming to prevent suffering and promoting comfort.

    Balancing act

    The danger, as always, is that if you tell an owner what they don’t want to hear too many times, they won’t come back. So, the balancing act lies in maintaining the client-vet relationship so as to ensure animal welfare, while not being too pious or condescending.

    This is equally important in day-to-day life. Being able to switch off is a must for any professional to maintain mental health, yet it’s sometimes hard to stay quiet when your friend mentions their aspiration to own 50 sausage dogs.

    My question for you is, does a vet ever stop being a vet, and is a dog ever really just “a dog”?

  • Staying motivated

    Staying motivated

    When your course is a minimum of five years long, and your days are filled with lab work, lectures and study, it can be easy to lose sight of the big picture – the real core driver behind why you wanted to be a vet in the first place.

    Forgive me if I’m wrong, but I’m sure no 18-year-old, fresh from 14 years of full-time education, has ever signed up for their degree purely for a love of spending the fleeting British summertime in an exam hall and 9am-5pm every day staring at a white board.

    For most of us, investing the money and dedicated years of our lives that university demands are all part and parcel of building the foundations for our futures.

    What’s it all for?

    For vets especially, many options are available: whether you’re driven towards specialised surgery, welfare, research or first-opinion practice, it all starts with the same degree, the same path, the same investment.

    However, while the journey may be unavoidable, the repetitive humdrum of student life (and life in general for that matter) can make it difficult to keep your eyes on the end goal.

    How bad do you want it?

    It’s not a matter of commitment. Trust me; if you even manage to get an interview for a veterinary course, you’re as committed as they come. There’s no way you’ll find a teenager voluntarily scooping poop – from a staggering variety of sources – on their weekends without a real solid mindset as to where they want to be.

    poo
    “There’s no way you’ll find a teenager voluntarily scooping poop – from a staggering variety of sources – on their weekends without a real solid mindset as to where they want to be.” Image © chelle129 / Adobe Stock

    When I was applying to vet schools, the standard requirements for work experience ranged from four to 12 weeks. I just about managed the latter, but I had friends around me doubling that – don’t ask me how.

    Getting sidetracked

    University life can be repetitive, not to mention full on… in a particularly heavy week, I managed to have a dream about revising ectoparasites, so let me tell you, sometimes there really is no escaping it.

    Through all this it’s understandable you might lose track of the driver that got you here in the first place, let alone what you want to do when you leave. When you‘re struggling to keep your head above water to deal with the task in front of you, how on earth are you supposed to look so far ahead?

    Personally, I didn’t realise I’d reached this point until very recently.

    The epiphany

    My university had organised “practice consult sessions” with some of its vet surgery’s genuine clients. Each client came to us with his or her dogs and had been told by our teaching staff to be as difficult as possible in an attempt to get us out of our shells.

    In groups, we had to practise gathering a patient history – not easy, as it turns out, when the client’s been instructed not to play ball – and describe a simple neutering, addressing both pros and cons.

    Not only did this supply a very realistic “hands-on” scenario, it forced us to use the collective knowledge provided to us in countless lectures and seminars and regurgitate it in a manner that was both professional and understandable. For example, a lot of the clinical terms we’re encouraged to memorise aren’t commonly used by the general public, so you must find easier ways of explaining things without oversimplifying anything important like surgical risks.

    Remind yourself

    I can’t describe how motivated I felt when I came home after that practical – I was buzzing.

    I had stood behind real vets in real consultations for so long, watching how they interacted with clients and patients and itching, from such a young age, to do what they did. I wish I could carry that feeling with me every day, but, of course, after a while you find yourself treading water again.

    I think the important thing is to give yourself moments every now and then to stop and reflect on how far you’ve already come, as well as where you want to go. The course, the workload, life in general – none of it’s easy. But if you want it enough, it’s so, so worth it.

  • Pedigree prejudice?

    Pedigree prejudice?

    The decision of whether or not to get a new pet is an important one, but the decision of where to get it from might be more important.

    Volunteering for two weeks this Christmas at a cattery has really made me believe we, as a society, need to undergo a significant evolution in terms of how we approach buying our furry friends.

    Every year, thousands of dogs and cats kept in rescue shelters are euthanised because they never manage to find a new home. At the same time, according to Government estimates, 560,000 puppies are born in the UK each year, at a minimum.

    Changing attitudes

    As a second year vet student with little experience as either a breeder or a dog owner, I recognise I have little position in which to tell people where to purchase their pets. But if our attitude to pet buying remains unchanged, this self-perpetuating issue will only continue – in fact, with dog and cat ownership on the rise, it might get worse.

    We appear to prefer the new to the old when it comes to pets, in the same way that, given the choice, most people would opt for a brand new car over a second-hand model.

    We also seem to be very blinded by the ideology of our favourite breeds. Pure-bred animals make up a very tiny percentage of shelter occupants and are also often the first to be adopted.

    Domino effect

    Most sheltered animals are there because their owners couldn’t cope, changed jobs, moved abroad or even passed away. The animals that never make it out of shelters aren’t necessarily aggressive, undisciplined or even unfriendly, it’s simply because they don’t match up to our idea of the perfect dog – which, to me, is truly heart breaking.

    So many advantages exist to adopting from a rescue shelter, for starters you kick off a really positive domino effect by not only creating room in a shelter for another animal to be taken in, but by educating your family and friends to an option they may never have fully considered, potentially leading to more adoptions.

    The process will also be less expensive than buying a pedigree puppy or kitten and you have the added bonus of knowing you are both changing and saving an animal’s life.

    Happy and healthy

    Even if you do decide to go with a breeder, you can still look out for animal welfare by buying from one you trust and is properly licensed.

    You can help to validate the health of the puppy/kitten by asking to see the mother – if she seems happy and healthy this is a good indication of the same for her offspring – and ensuring the animal you are taking home is fully vaccinated and treated for worms.

    By buying from recognised and responsible breeders, rather than puppy/kitten farms, you are still helping reduce the number of animals that needlessly end up in welfare and to move towards a future where shelters never have to put a healthy animal down.

  • Corporate vet school

    Corporate vet school

    The announcement of a corporate veterinary group’s collaboration with the new Keele University/Harper Adams veterinary school struck a few chords, and seemingly opened a figurative can of worms that (like their literal parasitic counterparts) just doesn’t sit well in my gut.

    A few points to consider here, the first of which I have written about before, although not about this particular arrival on the vet school scene.

    More vet schools needed?

    Do we need more vet schools? The short answer, in my opinion, is no. The employment crisis in the veterinary industry as it stands is multi-faceted – pluck a reason out of the air and it almost certainly has some impact on why practices are begging for vets:

    • compassion fatigue
    • poor working conditions
    • work-life balance
    • salary
    • lack of long-term prospects
    • Brexit
    • client pressure
    • under-supported young vets

    I could talk about any one of these reasons at length (and have done), but, for the purposes of discussing the above gem of veterinary news, I will focus on the last point: support for new graduates or young vets.

    Vicious cycle

    circle
    “This lack of support leads to high stress levels, young vets becoming fed up and looking elsewhere for a different career that provides them with the mental stimulation they desire, but with better support, hours and pay to go with it.” Image © Michael Brown / Adobe Stock

    Some practices are excellent at providing a nurturing environment for young vets, but many are not and often not through any fault other than lack of staff.

    This lack of support leads to high stress levels, young vets becoming fed up and looking elsewhere for a different career that provides them with the mental stimulation they desire, but with better support, hours and pay to go with it – thus the vicious cycle of extremely talented young people leaving the profession after a few years begins.

    Problem solver?

    Will opening more vet schools help the staffing problem? No. It is a short-sighted, temporary solution to fill a gap nobody seems to be able to plug. But the more graduates that accept jobs from practices who ideally wanted an experienced vet and can’t source one, the worse the retention problem will become. It is unfair on both parties to take on a new grad if a practice does not have the resources to sufficiently train and help them through their first few years.

    To solve the retention problem, the profession needs to improve working conditions and encourage vets to stay, not just find more avenues to farm out new grads to try and bridge the gap.

    Are corporates good for the profession?

    I could (and probably will) discuss corporates at great length, but there is no clear answer for them being good for the profession. Having been stung with the sore end of the corporate tail once before, I’m inclined to say no, but that would be based on my experience of one particular practice. Conversely, I have colleagues who work for corporate practices that seem to be very well run and provide a great environment for learning.

    My opinion is not fact and, to keep it short and sweet, is summarised below:

    • The idea behind corporate practices is often well meaning, but does not always work when put into practice. For example, the graduate schemes sound great, but only work if they are implemented correctly on an individual practice level.
    • Some corporates are extortionately priced compared to independents – there is a fine line between charging appropriately and taking the biscuit. This is likely exaggerated because many independents have been selling themselves short for years; however, it is not okay to triple prices in a week when an independent practice is taken over. All it does is feed the myth that vets are only in it for the money.
    • Long-established corporately owned practices seem to have better client satisfaction than practices newly acquired under a corporate brand as the shock of takeover, staff changes and price increases are long gone.
    • Corporates aim to provide better working hours (a four-day week, for example) and flexible working patterns, but, again, this varies on an individual basis.
    • The hand of many partners in independent practice has been forced as the profession continues to change. Young people do not have the disposable cash to buy into partnerships, as was the tradition. Corporates have taken advantage of this by buying out those wishing to retire without any new blood coming through.

    Corporate practices can vary wildly even within the same group – much of it comes down to the individual practice, as with independents. As much as corporates offer many benefits with their nice shiny contracts, many independents match or better these. Likewise, an independent or corporate practice can be an equally catastrophic place to work in if managed badly at the practice level.

    Now, to the elephant in the room…

    Should a corporate group be running a vet school hospital?

    Is a corporate running a vet school hospital any different from the outsourced rotation format of the other newest veterinary schools – Nottingham and Surrey – whereby they have no on-site university clinic, but rotations are undertaken in nearby hospitals?

    nocash
    “The hand of many partners in independent practice has been forced as the profession continues to change. Young people do not have the disposable cash to buy into partnerships, as was the tradition.” Image © MHChristine / Adobe Stock

    The concern with new veterinary schools popping up and proposing this sort of final-year teaching is the associated practices are then less available to provide EMS placements for local students. The purpose-built corporate hospital that is to be partnered with the new veterinary school avoids this particular hurdle in part, at least (there’s no mention of an equine hospital or farm clinic), but is it still a good idea?

    Remaining impartial

    It comes down to whether the corporate presence is going to be ingrained into the teaching. Will the graduate scheme offered by the group be heavily recommended? Would the business structure and branded drugs be taught to the students?

    At university, we were always told to learn drugs not brand names to remain impartial. Would that impartiality be maintained appropriately in a hospital that uses own-branded drugs and whose bigwig advisory boards dictate which products should and shouldn’t be offered?

    Encouraging research into all available treatment and diagnostic options is a key aspect of learning and practising evidence-based medicine on rotations.

    Familiarity breeds

    Even if no direct corporate emphasis exists, surely the undercurrent is going to sway the students into applying for jobs in sister practices under a graduate scheme.

    As a new grad, you are bewildered by everything and getting a heads-up on even the smallest of obstacles can make a huge different to your day in the first few weeks. Therefore, simple things, such as the practice management system used in every practice the group owns, may be enough to sway the decision between accepting one of two jobs, simply because using a system you’ve gotten used to on rotations will make your life that bit easier during day-to-day practice.

    Conclusion

    It remains to been seen if a corporate partnership with the new vet school will be a success for the students under their care and the profession as a whole, and I’ll withhold judgement for now.

    However, with predictions corporate takeover will saturate at 70% of practices in the profession, it is undeniable the veterinary landscape is moving further adrift from its once independent roots as the corporate giants continue to tighten their grip.

  • In at the deep end

    In at the deep end

    Being a new grad is scary. And, although I don’t think I’ve been dropped in the deep end as much as some of my colleagues may have, I feel entirely overwhelmed the majority of the time and question several times a day whether I actually went to uni.

    Starting in practice has made me realise how little I actually know…

    The first challenge was getting my head around flea and worming treatments – with so many products on the shelf (yet somehow someone is still to come up with one that just kills every ectoparasite and endoparasite), where do you start? It’s ridiculous something so simple that so many vets seemingly do without thinking about is actually so complicated and never explained at uni.

    Without a net

    highwire
    “No matter how confident I was under supervision, as soon as that safety net wasn’t there, things were much scarier.” IMAGE: retrostar / Fotolia.

    Surgery is a whole new ball game too. I’ve done plenty of neutering, but always with someone there to confirm what I was doing was correct. However, on my own, scalpel in hand, I suddenly realised I had no idea what I was doing. Or rather, no matter how confident I was under supervision, as soon as that safety net wasn’t there, things were much scarier.

    Consults themselves are okay – I just feel like I’m constantly in a communication skills tutorial, putting on a friendly face, trying to assure the owner their decrepit dog that is trying to eat me and of a breed I’m not keen on is just lovely.

    However, it’s all the resulting admin that seems to take all the time – writing clinical notes, charging, recording batch numbers, etc. Nobody tells you at uni how much paperwork there is in the real world.

    Fraudulent feelings

    I feel like an imposter, blundering along, feeling entirely unqualified to give out professional advice. Any minute someone is going to tell me it was all a mistake, I’m not qualified enough to be a vet and I need to go back to uni.

    And I’m getting paid for it, which feels completely alien, after years of unpaid EMS. Why would someone want to pay me for not really having a clue what I’m doing?

    Some things I’m sure of (or as sure as you can be when you’re dealing with medicine and animals), but most things seem to trigger a very distant memory from vet school, leaving me wondering why I didn’t take things on board more at the time or whether I’ve actually just got a really poor memory, and how an earth I passed any exams if I can’t remember what any drugs are called.

    Unfair comparisons

    One of the main things I’ve come to appreciate is how good other vets are – those that are a few years qualified seem in a totally different league.

    To begin with, I was despairing a bit. I felt completely inadequate compared to vets who have a bit, but not a massive amount, of experience, yet seem to be able to deal with anything. However, I’ve been telling myself that I’m not seeing the stages in between – I realised I hadn’t really come across many “just-qualified” vets on EMS (except interns), so I was comparing my ability with someone a minimum of two years out, not six weeks.

    It is difficult to not compare yourself to others around you, but it only causes distress, especially if, like me, you’re a new grad surrounded by good vets.

    Everyone has to start somewhere.