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Tag: Clients

Festive threats to four-legged family members

Now well into December, and getting ever closer to Christmas, there will be an abundance of “goodies” around the house that are not so good for the four-legged family members.

Jordan advises colleagues to ensure clients keep an eye on their pets during the festivities. Image: © Freeimages/s22k.

Most owners are aware of the dangers of chocolate and so are likely to rush down to the vet on Boxing Day when their Labrador has broken into the tin of Heroes – but what other festive dangers are there that owners are not so clued up on?

Pudding

The festive favourite Christmas pudding, while enjoyable for us, can be lethal for pets. It is the raisins, currants and sultanas that may lurk within that are poisonous.

While the mechanism of toxicity is poorly understood, we know it can cause acute kidney failure in dogs.

The treatment protocol for poisoning by raisins, etc, is similar to general suspected poisoning with an unknown agent: give an emetic (to make the animal vomit), an adsorbent (for example, activated charcoal) and supportive care (IV fluids) to protect the kidneys for a few days.

Antifreeze

Ethylene glycol, more commonly known as antifreeze, is extremely toxic to pets, with consumption of tiny amounts resulting in crystal formation in the kidneys, and so acute renal failure. Antifreeze smells and tastes sweet, so pets are often attracted to it. For this reason, it is best for owners to ensure it is kept in a secure container, well away from pets.

Early symptoms include neurological signs, such as wobbliness, twitching, seizures and depression. As the poisoning progresses, the animal will have cardiac and respiratory signs, such as increased heart and respiratory rate. It’s vitally important owners look out for these signs if their pets have had any possible access to antifreeze (for example, if they’ve got into the garage or if a cat has been missing for a few days and potentially been locked in someone’s shed).

The antidote for ethylene glycol poisoning is ethanol, because it replaces ethylene glycol as a substrate for the enzyme that breaks it down into toxic products. More specifically, lab-grade ethanol is best.

Sweetener

Xylitol is a sugar-free sweeter that is used in chewing gum, cakes and sweets, particularly diabetic foods. Xylitol causes insulin release in the body, resulting in hypoglycaemia and, later, liver damage.

Symptoms include vomiting and signs of hypoglycaemia: lethargy, weakness, collapse and, if it progresses, seizures and coma. Unlike ethylene glycol, there isn’t a specific antidote, but supportive care, including fluids and liver protectants, is vital. The prognosis for xylitol toxicity is good if the animal’s hypoglycaemia is corrected quickly, so it is essential for owners that suspect this to contact their vet immediately. If you’re trying to determine whether xylitol is in a product, it is often listed as a food additive, code E967.

Decorations?

And don’t forget the potential foreign body too – if the cat has been playing with the tinsel and managed to swallow some or the dog has ingested a few tasty looking baubles.

Enjoy the festive season, but advise owners to keep an eye on their pets this Christmas.

December 15, 2015
A high-risk profession

Currently nursing a bruised tailbone after being propelled twice from a four-legged fiend I had a disagreement with regarding a small upright jump, I can’t help but wonder why we do these stupid things.

“HorseKick” by Daniel Johnson. Licensed under CC BY 2.0 via Wikimedia Commons.

Horses can be hazardous enough when you’re on top of them, but they’re not all angels at ground level either. The results of a 2014 study commissioned by BEVA revealed equine vets are at the highest risk of sustaining injury out of all the civilian occupations in the UK.

While these results have been published for some time, and whether the news was surprising or not on first reading, my recent injury certainly made me consider more seriously whether we are cautious enough around horses in a veterinary context.

I was probably about as safe as possible this week during my falls, kitted out with a high standard helmet and air jacket, yet I still got injured. We can’t prevent every injury or accident possible, but we can try to take measures to minimise the damage.

The second most common site of injury reported by equine vets in the study was the head, but when was the last time I saw a vet enter a stable wearing any form of head protection? Never.

In some cases, I believe this is a matter of pride, practicality or even client confidence. If a vet turned up at the yard with a riding hat on, clients may believe they’re not confident around horses – and how difficult is it to look into a horse’s mouth while rasping teeth with bulky headgear?

“Jousting? No, I’m just off to the stables…”

However, safety should come first and perhaps vets should consider being more vigilant, despite the potential judgemental attitude they may be presented with.

What about repro work? I’ve seen many a fractious thoroughbred mare lash out with her hindlegs while being scanned, luckily with an appropriate board or stocks used to protect the vet. But I have seen an equal number of occasions when vets have been rectal scanning with nothing except confidence in a “good tempered” horse to protect them.

So, how can we make situations like that safer, short of carrying a portable kick board in the car or persuading clients to invest in appropriate equipment.

It should be a daunting prospect entering a profession that has been proven to carry the highest risk of injury in the country, and yet most of us take this as a given, not giving it much thought. The results of the study have only confirmed what many of us already knew about equine work, but I think it should act as a wake-up call to encourage vets or practices to alter policies to maximise safety in the field.

After all, it would be pretty miserable work if most of the time was spent hobbling around like I currently am.

November 16, 2015
The wrong end of the telephone

Jordan and Pepsi in happier times.

A couple of weeks ago, I received the phone call I’ve been dreading since moving away to university.

My horse had had an accident in the field, hurt her leg, and the vet was on the way. That’s all the information I received until the next call, with the vet on the other end.

“Communication within the tarsal joint… leg swinging… don’t think the long bone is actually fractured but significant damage to tendons at the back… rapid respiratory rate.”

As soon as I knew which way the conversation was going, I barely heard the rest.

My girl, who I’d had for 10 years. My girl, who’d been passed from pillar to post before we gave her the stable long-term home she’d never had. My girl, who had taught me to ride by being an infuriatingly awkward cow at the best of times.

My girl, who, when in the mood, was unbeatable and with whom I achieved a national title. My girl, who was the only one I trusted not to hurt me after my four-week stint in hospital when another horse landed on me. My 21-year-old girl, who’d been steadily getting stiffer from arthritis over the last few months. My girl, who, when I last rode about a week before this incident, was 10 times better than she’d been in a long time.

“My girl, who, when in the mood, was unbeatable and with whom I achieved a national title.”

My girl was about to be shot…

All the vet language stopped making sense, the clinician rationale went out the window. I just needed to know one thing, vet to vet student: is this fair? Could it wait five hours for me to tear down the M6 to say a final goodbye or would even that be an unnecessary amount of suffering?

I think I already knew the answer.

I felt utterly helpless and beyond reason for the following days, but as the shock wore off I was able to consider things retrospectively.

Having spoken to the family that were with her at the time, I’ve gathered a bit more information and been able to convince myself it was the right and only decision.

RIP Pepsi.

I’ve seen many animals have to be euthanised, for varying reasons. Some cases were more upsetting than others, but, for the most part, I’ve been able to detach myself from it – always telling myself it was for the best, in the animals’ interest for welfare reasons, and that there were no alternatives.

They say clients will only take in a small proportion of bad news. Now I know what that means. All the vet talk just went straight over my head, and the only thing I really got was that there was only one way it was going. This has outlined the importance of clear and concise communication when delivering bad news to my own clients in the future.

In communication skills classes, we’re told to encourage owners to bring someone with them who can write down key points and ensure they understand before proceeding. Now I appreciate the value of this so much more, having been the receiver instead of the bearer of bad news.

While the pain is still raw, I think I can take something from this to help me be more empathetic and ensure I communicate effectively in the future.

You can steal all the ham sandwiches you want now, Pepsi.

October 15, 2015
Dealing with children and other animals

Image ©iStock.com/Photo_Concepts

Not everyone loves children and, certainly, a proportion of people who choose to become vets would rather avoid them and stick to dealing with animals.

However, it’s important to realise early on that, depending on the type of vet you become, you’re likely to see a large number of worried pet-owning children walk through your consulting room door.

Practice types

In general practice, farm vets are most likely to have adult clients to deal with, although some children will be very involved in the family business from an early age and may attend appointments.

Equine vets will treat a lot of children’s ponies and, as such, may be expected to discuss the pony’s health and prognosis with the child as much as the parents.

However, it is the small animal practice vet who is most likely to meet children as the owners of small, caged pets, as well as part of family units worried about their dog or cat.

Appropriate communication

Not everyone is comfortable with children, but you must be able and willing to hold a conversation with them to ensure you fully explain the care and treatment of their beloved pet and the importance of their role in that.

If the thought of this causes panic, consider becoming a farm vet rather than a small animal vet, where you are likely to encounter young owners most often.

If a child is obviously interested and asking lots of questions about pet care, try not to get frustrated and do your best to answer in a way the whole family can understand. Remember, you are providing a service to all the family, not just the bill payers.

Saying goodbye

Unfortunately, many young owners attend with older, ailing small pets, including rodents and rabbits. Treatment options in these cases can be limited and humane euthanasia may be required.

Parents may have anticipated this. However, life and death is a difficult concept for children, and the family may prefer to outline the situation their own way.

If possible, before proceeding, allow parents a few minutes alone with their children, so they can explain the fate of the pet in a way they are comfortable with.

December 5, 0001