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Thursday, January 19, 2017

All Cat Eyes on New Jersey: Your State Assembly Votes for Felines Next Week


Congratulations to the great state of New Jersey!

Your Bill A. 3899 to prohibit cat declawing was just posted to be voted on by the New Jersey Assembly. The date for the vote is: this coming Monday, January 23rd.
   



This is the furthest any state declaw ban has advanced without weakening amendments to date. New Jersey stands to be the first state in the United States to make the inhumane and misguided practice of declawing illegal. Here in New York, we do not take this lightly, as our (more lenient!) declaw bill has been struck down for a possible vote 2 years in a row, despite having bipartisan sponsorship, overwhelming popular support, and the endorsement of almost 140 veterinarians and 50 shelter/rescue organizations statewide.

As many of you know, declawing is not merely nail removal. It involves 10-18 painful amputations of bone, and has the potential to cause short or long-term pain, health issues and behavioral problems. It has a whopping post-operative complication rate of up to 50%. Despite this convenience surgery being ingrained in the lexicon of veterinary "medicine", it is actually associated with dozens of medical problems, while conferring no medical benefit.

Several years ago, the American Veterinary Medical Association rightfully "condemned" the same procedure being performed in captive exotic cats as small as bobcats, which typically weigh 18 lbs. However, the AVMA remains reluctant to completely condemn the practice for house cats. Veterinary businesses don't typically see clients with credit card in hand, requesting a bobcat declaw. However, as many as 25% of American house cats are declawed. Consequently, some vets see condemning housecat declaws as a threat to business or their perceived right to practice, no matter how far the procedure may be out of line with medical ethics, and no matter how many shelter vets/medical agencies say it isn't helping feline welfare or public health.

Declawing ban legislation is supported by the Humane Society of the United States, Humane Society Veterinary Medical Association, The Paw Project, Ethical Veterinary, and many private veterinarians and hospitals who refuse to perform the procedure. Declawing is also illegal or condemned by veterinary medical associations in over 28 countries worldwide.

Some veterinarians continue to state that this controversial procedure should stick around for certain rare instances; some propagate the notion that more cats will end up in shelters or be euthanized if caregivers are not allowed the option to declaw. This sweeping and poorly supported claim is being convincingly debunked. Cat intake and relinquishment data from the several major U.S. cities that enacted declaw bans within the last 13 years show that none of their shelter services had a documented increase in cats being relinquished to shelters after the laws were enacted. In fact, most showed a decrease in cat relinquishment and all showed a reduction in cat intake numbers after the bans were in place; these numbers have remained lower every year since.

If you live in New Jersey and would like to see the declaw bill pass, your assemblymember's office needs to hear from you before Monday, Jan.23rd. If you've never called a legislative office, you will laugh afterwards at how easy it was---it's as easy as ordering takeout! You simply tell the aide your name, town/county of residence, that you strongly support Bill A. 3899 to ban cat declawing, and that you hope your assemblymember will vote "yes" on it. They will write that basic information down. If you wish to say more, or share your own experience with declawing, you can. If not, they will thank you, you thank them, and you hang up (knowing you've done something small but great for animals).

And how do you find your NJ assemblymember's name and office phone number? With your zip code and a simple click here. Very important: Please only call if you have an address in New Jersey - legislators need to only hear from residents in their district. If you do not live in NJ, feel free to share this widely with friends or family who do. It would make a huge impact on the bill's fate.

Good luck, New Jersey! All cat eyes are on you!

Wednesday, December 7, 2016

Smash the Control Images, Smash the Control Meme

Well, America, you wanted to "shake things up" with the election.
In the ongoing spirit of shaking things up, perhaps the local butcher can now be your surgeon, a kindergartner with an abacus can be your accountant, and--- this is potentially the only good part---- a veterinarian can now be your social critic. Enjoy!
_________________________
After years of absence from the blogosphere, I am returning, just so I can punch the internet in the face. Ironic, isn't it?

In the month since the election, there have been a storm of social media posts, ranging from depressed-faced selfies to prayer offerings, to organizational calls-to-action. Many people have shown their outrage over Donald Trump, bigotry, the electoral college, and everything in between.

However, I've yet to see anyone on the internet opine that social media culture (including that of the Left) enabled this unprecedented degree of narcissism to infiltrate the White House, paving the way for even more dangerous forces to exert influence.

Racists, bigots, science-deniers and the like have had a muffled presence in this nation throughout the entire modern political era. Isn't it peculiar that they gained a vocal stronghold now, right in the middle of our most "socially conscious" information age? Many would say it was just bigoted backlash to our recent black president or a woman candidate. Those are legitimate factors. However, we are missing something huge if we don't acknowledge the narcissistic, group-thinking and enabling cultures that amassed themselves on the internet and helped usher a non-presidential, exploitative narcissist right into the White House.

Having been part of the "fringe" animal advocacy movement that exploded into the mainstream only with the dawn of social media, I have seen how technological, sociological, and psychological factors play out in everything - especially in modern politics.

But foremost, I am a veterinarian. So first I will say that our nation at this moment reminds me of a herd of animals with an outbreak of upper respiratory infection. The "causative" virus is rarely the focus of treatment---after all, viruses are everywhere, and have been for ages. The way to combat a virus isn't to focus on the virus. Rather, it is to focus on strengthening the weakened, susceptible hosts and correcting their lack of healthy distance from one other. This is the new American people, who are emotionally crowded and vulnerable in one place: mainly, the internet. 

Theoretically, the information age should be a great thing. It allows nearly everyone with a computer or smartphone to access unlimited knowledge. However, this is only useful if people are being discerning and analytical. Otherwise, the internet-- moreso than even TV-- can be the opposite of great. It can be a system of control, or a gargantuan forum that reinforces groupthink and spreads it faster than it's ever been able to spread before. Modern advertising started blurring the lines between reality and non-reality decades ago. TV escalated it. Now, social media has all but drowned out the difference between facts and opinions --- between lies, hyperbole, and reality.

Because of where I happened to grow up, I know quite a few Trump supporters. If I were to draw an analogy to veterinary clients: just look at how many insist on feeding those over-marketed, neon orange dog foods from the grocery store, and then honestly wonder why their animal is sick. (Trump, of course, is neon orange too, so perhaps it all comes down to color preference.)

Entire books could be written on cognitive dissonance and groupthink as it relates to Trump supporters. But instead of banging my head against "the wall" (pun intended), I'll focus on the other impressionable demographic - left of center Millennials.

Although I'm on the generational cusp and identify as Gen X, I've known enough Millennials and have read their Facebook offerings over the years. I'm not alone in seeing that social media has catapulted America into its worst ever culture of narcissism and groupthink. Social media has also accelerated the spread of baseless information and programmed an intense fear of social derision. Then, as the final blow to character--- it rewards displays of "activism" that have no constructive or didactic value. As time goes on, more and more of the eligible voting population will have had its perception of reality distorted by social media.

Bloomberg recently reported that, "in a departure from past voting patterns, young Millennials were keen on third-party candidates this year—nearly one in 10 voted for Jill Stein or Gary Johnson or wrote in their own candidate." (We can be sure that some voted for themselves, Taylor Swift or Grumpy Cat, the last of whom is clearly the best choice of the three.) Considering that Millennials made up the same portion of the electorate as in the previous election, that is a surprising amount of expected votes that were diverted away from an election of such unprecedented importance.

When I hear anyone say this election "wasn't that important", this is my reaction:



This election was crucially important. It was important to prevent the possible collapse of American democracy and block the path for neo-fascism, which is rising in other parts of this globalized world. It was important to prevent an unqualified, completely inexperienced and unstable anti-diplomat from potentially sending the world into dangerous instability or war. It was important to oppose the bigoted devaluation of language, science, our fellow citizens, and human beings at large. It was important because---as I always say in veterinary practice---it's easier to prevent a serious disease than to cure it.

Many Millennials on the Left seem to regard social media the way Baby Boomers on the Right regard Fox News. If you ask non-voting or third-party-voting Millennials about the election, many will give a knee-jerk response that Trump and Hillary were equivalent. I'm hard-pressed to find anyone over the age of 35 to agree with the idea that Trump and Clinton are "equivalent", except for the most irrational Baby Boomers, who wear Peter Pan syndrome on their sleeves and still treat reality like it's some kind of inconvenient option. Among them, and especially among Millennials, there was indeed a social media-goaded movement to "vote for an ideal rather than an actual possibility", or "check out altogether" from the election. This mindset factually affected the election's outcome. In other words, "Trump equals Clinton" must have been a hard-hitting meme.

Speaking of memes, members of the so-called Alt-Right are utilizing white supremacist, Neo-Nazi, and misogynstic memes. It's not surprising, because internet memes are the most viral method that have ever been invented for planting ideas in people's brains. If you stand back and look, our era is ripe to become more Orwellian than anything Orwell could have imagined.

Adding to this groupthink problem, there seems to be a young Millennial tendency to regard atrocities like the Holocaust ---which happened 70 years ago--- to be as distant as events that happened 700 years ago. To the youngest voters, these are things soooo of the past, soooo over and done with, and soooo not happening in their America, where even 911 may not be in memory.
As much as the new multicultural, tolerant Millennial experience is great, it cannot be taken for granted and go so undefended, because the reality is that such tranquility never lasts.

There is a widespread Pollyanna notion that fascism cannot take hold in America. There is a widespread Pollyanna belief that it's "mean" or too alienating to call out atrocious behaviors, even from one's computer. This mindset, more than any specific political figure or group, should be harrowing to us all. Why? Because the morally unhinged, exploitative narcissists in world history --including elected ones--- have only functioned because of their masses of enablers. If enablers evaporated from Earth, narcissists would just curl into the fetal position (their hidden internal state) and become paralyzed.

Yet, now that the election is over, and all the threats are real, there is a continuation of the same  enabling behaviors from much of the Left that got it here. The fraction of the population that used to fiercely protect the rest of society from itself --the young dissenters and strategists---the would-be Susan B. Anthonys, the would-be MLKs, and even those in-your-face Jello Biafras, are no longer engaging in the same degree of impacting dissent. It's simply easier and more validating to generate good feelings and be "liked" in cyber space. No smashing of the control images going on here, Mr. Burroughs.

The American activist persona was always more polite than its oppressors; that's why it evolved strikes, passive resistance, or music and art with a message. However, it's never been so polite that it quaked at the thought of using mere words when appropriate, like "immoral" or "ignorant." This fragile new America seems to fear unfriending and negative "comments" the way people used to fear going to prison, or standing before a firing squad.

The internet may be raising a more socially conscious youth, but it is also creating a more self-conscious youth than ever before. Not only is this new America removed from the memory of tragedy, it is also programmed to need validation like fish need water. That is what makes this new populace the most oblivious and easiest target for exploitative forces yet, in the history of our country.

For example, what happens when clearly ill-intentioned people with zero regard for facts start dominating the media, as they are masterfully doing now? Part of the population will inevitably be distracted and duped. But will even the concerned citizens just hide behind their computers and type statuses about the beauty of love...because that's what generates the most Facebook likes? It sure seems that way.

Young "activist personas" are being conditioned to seek validation and generate warm feelings instead of engaging in real activism, which involves constructive (and often sacrificial) action. What would happen in a world where even "that time-trusted activist persona" engages only in so-called "slacktivism?" Slacktivism is defined as "actions performed via the Internet in support of a political or social cause but regarded as requiring little time or involvement, e.g., signing an online petition or joining a campaign group on a social media website."

I didn't make this diagram. Maybe some other Gen Xer did, in which case neither of us knows if it even qualifies as a meme, and neither of us has the remaining eyesight left to read it. Anyhow, it's accurate (even the low positioning of "blogs", which is why I haven't written a post in years). I would replace "Property Damage" or "Sabotage" with "Lobbying", but I appreciate that disinvestment is recognized as the most effective form of activism, while "prayer, thoughts and FB likes" are on the opposite end of the spectrum--- exactly where they belong.

No matter who made the diagram, I would bet anything that a Millennial wrote the feel-good disclaimer at the bottom, out of concern that friends might be offended. I imagine that the crippling Millennial fear of judgment would end abruptly, if this demographic was stripped of its iphones and led off in chains to a barren cell, if even for one evening. 

Given all the hazards of social media, some intelligent people support the idea of abandoning it entirely. However, it seems that voices of reason are needed there as much as in the non-virtual world. The mindsets being established there are affecting outcomes in reality, for better or worse.

Judging from a decade of my own experiences in political advocacy, the most successful movements will be the ones that use social media as a mobilization tool rather than a self-validating forum that breeds petty infighting and disorganization. Sadly, I can foresee the far Right doing more of the (surreptitious?) mobilization, whereas the Left is already guilty of endless emoting and self-validating displays. 

What social media on the Left often "forgets" is that the most effectual changing of the system usually comes from inside the system, not from the bleacher seats. Like it or not, our system is one big baseball game, where lots of players are on steroids and being bought and sold for millions of dollars. Most of us dislike that. However, we will stand no chance of affecting the outcome of the game at all if we don't show up to the game...or if we show up in robes with a magic wand, rather than with a uniform and a bat. (Aside from that, it never, ever hurts to have a bat.)

Whether we're trying to mobilize action for animal protection or for political candidates, we need to be aware of the dangerous degradation of thought, language, facts and truth that are occurring on the internet. We need to resist the rapid decline of individual analysis and pragmatic action.
 
Otherwise, we are just locked into one space like that crowded herd of animals, becoming increasingly susceptible to the virus.

This presidential election taught us that...or at least, it should have.

Saturday, March 29, 2014

Are You Overlooking This Major Potential Cause of Dog Cancer?

People often ask me what kinds of vitamins, supplements, vaccine abstentions or foods will save their dog from cancer. It’s an expected concern, since cancer is the primary disease-related cause of death in dogs. I have watched as health-conscious clients have blamed themselves when their dog is diagnosed with cancer, often believing they (or their vet) must have exposed their dog to carcinogens. 

Despite what marketing forces out there are saying (buy this wonder supplement! buy this natural pet food! Buy this well-bred purebred dog!), in my experience, many if not most canine cancers are facilitated hugely by genetics. We should not make the mistake of assuming that dogs are at highest risk from the poor nutrition/carcinogenic exposure/stress/lack of exercise combination that causes so much human illness.  These factors should not be ignored, but none of them, in my professional experience, tends to be the biggest problem for dogs. Rather, the primary issue is that they tend to be much more genetically vulnerable than humans. Unlike most cats or people, most dogs were deliberately inbred, or their recent ancestors were, so their risk of having genetic cancer is much greater.  It’s important to make this distinction.

So before you become preoccupied wondering if your purebred dog’s toys, rabies vaccine or dog bed might cause cancer, it’s helpful to first learn about the cancer statistics for its particular breed.  As just one example, according to the Morris Animal Foundation, 60% of Golden Retrievers die of cancer.  Sixty percent. They’re strongly genetically predisposed to lymphoma and hemangiosarcoma, as all vets know.

Similarly, a single type of aggressive cancer (disseminated histiocytic sarcoma) accounts for up to 25% of all deaths in Bernese Mountain Dogs, a canine whose average lifespan is a mere 7 years.  Great Danes, Greyhounds and Rottweilers are strongly predisposed to osteosarcoma (bone cancer). Boxers and English bulldogs are strongly predisposed to mast cell tumors. Schnauzers are at increased risk for cutaneous melanoma. The list goes on and on.

So if you ‘d do anything to avoid experiencing a cancer diagnosis in a canine companion, you might be asking yourself - should I purchase any purebred dog? It’s your choice if you wish to do so. However, before you do, it’s important to know that the dog breeding world is frequently unconcerned with the long-term health of dogs. Its actions are often shortsighted and its claims  deceptive.  In my experience, regardless of what many dog breeders (or their websites) claim, they often know only whether a puppy has the looks to sell, and little else.  I would not be the first veterinarian to share that the majority of my purebred patients have been  1.) genetically afflicted or at-risk at some stage in their lives and 2.) purchased by people who believed their dog had exceptional breeding that made the latter unlikely. 

If you do choose to go the route of buying from a breeder, please:

Know there’s a good chance you’re not getting what you think you’re getting.

Resist the urge to blame your veterinarian if a purebred dog of any kind is plagued by expensive, persistent or devastating genetic illness.  We cannot change genes. We can only manage the symptoms of those genes expressing themselves. Unfortunately, the diagnostics and treatments we need to do this are often costly beyond our control.

Resist the urge to insist that buying, branding and selling dogs is completely unrelated to pet overpopulation and shelter deaths. Dog breeding’s effect of creating “more dogs, less adopters” is frequently cited, but it requires more explanation:  if deliberately bred dogs or their potential lines of progeny don’t end up in shelters (which many do), most people breeding dogs still project the idea that their dogs are superior home companions. In actuality, many were instead “designed” to be either intense working dogs, or, on the other end of the spectrum, have been indiscriminately bred into health risk for the sake of “a look.”  One of these health risks is cancer. Unfortunately, breeding is now fueling the mindset that dogs are commercial objects before they are anything else. People from all walks of life and all levels of financial (in)ability are being “sold” on purebred dogs. Less adopters, indeed. More “objects” with overwhelming breed traits (including medical ones) being disposed of at shelters, indeed.

I know many wonderful people who show intense personal responsibility when it comes to their purebred dog--- they love it and would go to any lengths for it. They are model dog parents. But I try to encourage taking that devotion one step further; if we consider ourselves to be "dog lovers" concerned with the fate of dogs on the whole, buying and selling purebred dogs can be more medically and ethically consequential than we tend to assume.

So, are you someone who can’t stand the thought of having a dog go through genetic illness? Do you cringe at the thought of vet bills that amount to hundreds or thousands of dollars? Or can’t stand the thought of millions of healthy dogs being put to sleep in shelters annually? If so, when you’re thinking, “Should I buy this dog food?” or “Should I buy this supplement?” you might also want to consider, “Should I buy this purebred dog?”

When people ask me what kind of dog I recommend for being the most medically sound, I tell them, the more recent the purebred is in its lineage, the greater its predispositions to illness. Adopt a mix from a shelter or rescue - it will thank you, and you will thank me.

Tuesday, December 3, 2013

A Perspective on 20/20's Vet Segment You Won't Read Anywhere Else

The Segment and Its Backlash

You probably know that 20/20 aired a segment on alleged dishonest practices within the veterinary field.  A veterinarian named Dr. Andrew Jones (who had left the profession) tried to discuss some issues I've addressed over the last 3 years in Ethical Veterinarian.  Among these were over-vaccination, "upselling" of unnecessary procedures, and the potential for veterinarians to put business interests above animal well-being.

Firstly, I never expect a media piece to report accurately on science topics.  This was obviously a shaming attention-grabber, not the effective educational piece it could have been.  Any compelling scientific comments that the interviewed vets made, if they existed, probably ended up on the cutting room floor.  Let's face it, they wouldn't have been alluring to the average TV viewer or easily interpreted by a TV journalist.

So yes, trying to incriminate a vet for recommending a dental cleaning, of all things, was lame.  Conducting an undercover investigation was also lame...we're not the mafia or an illegal prostitution ring. And since I do not know Dr. Jones personally, I can't even say with certainty what his motive was for doing the interview.

But I have to point out that throughout the segment, 20/20 did say that "some veterinarians" engage in unethical business practices.  It never generalized this to the entire profession. Nonetheless, this approximately 7 and 1/2 minute piece still incited the biggest emotional uprising of veterinarians I've seen for any reason.  A factual correction or two about dental cleanings and lumps would have sufficed. However, an astounding number of vets were galvanized to start reactionary blogs, or at least their posts seemed to be shared like never before.  Contained in these posts was an overflow of outrage, defensiveness, melodrama, self-validation and calls for professional solidarity.  It was as if a national tragedy with pervasive loss of life had occurred.

I'll be the first to state that the veterinarian job is no picnic, and most people criticizing vets could never fathom the stresses and impossible situations we have to deal with in a given day.  Even the most honest vets are inevitably misconstrued and disrespected at some point.

However, our defensive backlash still irked me more than anything about the 20/20 piece itself. Why? Because it was the same unproductive, in-unison, knee-jerk reaction vets seem to show whenever someone else implies they may be wrong.  After the segment aired, vets immediately set to work trying to refute everything about the 20/20 segment, even the parts that were accurate or could have been legitimate in certain instances.

Also, I've been expecting a TV expose on the vet industry for years, so I'm not on board with the shock. (I knew it was coming for sure when the plaintiff in the Corpus Christi cat vaccine case personally contacted me. After losing the life of her beloved cat and the case, the flabbergasted plaintiff stated, "I lost my veterinarian lawsuit because "if all veterinarians adhere to the same standards then it's not negligence.")

I never wanted to see veterinarians tossed into the sensationalist media ring, but that's why I and a handful of others in the field have been working to engage vets in a professional, internal setting on these potentially explosive issues---for years.  I would have never taken my concerns to TV news. But, on the other hand, can I tell you what response I've gotten from other vets using professional appeals rather than the silly mainstream media? Almost nothing.  A frustrating, empty silence.  One closed-minded VMA after another.  An ongoing belief that the veterinary status quo will be just fine---permanently.  An insistence that we don't have to evolve at the pace of society in our decisions about animals.

Dr. Jones said he needed to say things that "weren't being said." Again, I think he used some examples that were too vague and situational to be considered valid. But his sentiment was justified - there are problems in this profession that it refuses to address internally. Business practices that conflict with animal (and veterinarian!) welfare are among those. You quickly hit a wall inside this profession if you disembark from the collective view, even with compelling evidence in hand. If you're a vet and don't think so, maybe it's because you've never disembarked from the collective view. Have you? I've done it, both as an associate and as a practice owner, and you should see the juvenile behaviors I'm met with. They shock me much more than the 20/20 piece.

Vets are not bad people, and most are not greedy.  But vets often have unexamined allegiances; they think they're right even when they are so, so wrong... just because a huge number happen to be wrong together.

I call this "pig farmer syndrome."  If you tell people running a swine factory farm they're engaged in animal cruelty, they tend to act appalled.  They'll assure you that no one in their facility is punching, beating or molesting any pigs.  Most truly don't think that keeping sows in lifelong movement restriction (the industry standard) is inhumane--- precisely because it is legal, that's "the way it's done" and it's conditioned within that industry.  Nevermind what science and common sense tell us-- that inside the gestation crate lies one of the most tortured of tortured animals.

I have seen that same kind of groupthink running amok in the veterinary industry.  The majority of exasperating things in this profession happen not out of malevolence, but rather because some obscure voice is always saying "this is the way it's done."  And almost everyone does it.

Are vets particularly susceptible to groupthink?  Well, do you think vets aced 8 years worth of multiple choice exams and collected countless glowing professional recommendations, by challenging other people or refuting their ideas? Veterinarians, in general, are an obedient, cautious, even neurotic lot. There is very little trailblazing going on in this profession. I even had difficulty getting vets to sign initiative petitions stating all animals deserve to have access to food, water and exercise. It's not that they personally disagree with this. But they've been conditioned to think I'm trapping them in some kind of hidden agenda that is in violation of their rigid profession's rigid views. They fear their colleagues will scorn them for associating with a vet who's volunteering with an non-vet organization. After all, that non-vet organization might have one time endorsed something that was potentially in disagreement with what their local VMA learned from the AVMA they are expected to support. You see what I'm saying.

Everyone's experiences are a little different, but after working at 7 different practices and interacting with numerous others, I've seen my share of incriminating things in the veterinary profession. More than I ever imagined I'd see. Even when I have witnessed vets hitting dogs to get them to "behave", vets on a commission biopsying a dog's elbow calluses, or vets doing the 6-vaccines-in-one-visit bit, it's still been due more to groupthink than criminal dispositions. But we all know from history that groupthink can have sad consequences.

Most veterinarians are well-meaning people who do what they think is best for their patients... and work extremely hard at it. But our profession does not engage readily with other fields (journalism, politics, philosophy, law), and can take itself way too seriously. The AVMA Executive Board is all too often viewed as a panel of gods, whose every word is assumed perfectly accurate, unbiased and infallible. The current generation of vets (age 40 and younger) didn't actually make any of the veterinary business "policies." However, vets tend to follow them religiously, because much of the profession has been convinced that's always best for animals, even when it's just what's best for the industry and allied industries.

So yes, most vets doing the things Dr. Jones criticized are just dutifully adhering to a barrage of "rules." Only sometimes are they impractical rules from a textbook. Often they are rules imparted by pharmaceutical/vaccine companies and the pet food industry---who go over the top to sway vets, aggressively imparting revenue-driven recommendations that are in turn passed on to clients. Other vets are following outdated recommendations set decades ago by their employers. Most of all, vets are taking their cues from the AVMA, the force that most influences the profession.

What few realize is that even the most far-reaching AVMA policies are ultimately decided by a frighteningly small group of voting Executive Board Members. And despite our demographic changing to young, female vets centered on the human-animal bond, it's worth mentioning that every one of these voting members happen to be white males over the age of 50, who are tied to industries known to put animal welfare on the backburner for economic productivity. Historically, that was the foundation of the profession.

What this means is that the touted views and ingrained habits in the veterinary profession are not generated by the average associate vet clients meet in an exam room---the one who gushes pure love on their cat or dog---the one who is more concerned with honest medicine than having a booming business at the expense of honest medicine. Very few people realize how disgruntled the younger generation of vets may be, or why. We're not the ones setting the mill-like pace of the profession; we're just running to the point of exhaustion trying to keep up with it, and in a framework we didn't create. The emotional exhaustion this can cause is worse than the physical.

Veterinary medicine is like a well-meaning but dysfunctional family... so when things get noticeably contentious inside (which is going to increase), people from outside are going to come knocking. Maybe with more cameras. After all, before the 20/20 piece, we had been implicated for having the highest suicide rate, a high rate of mental illness, the fifth most unhealthy profession, and the number one most exclusively white profession. Don't laugh --- the latter is important, because homogeneity is not particularly conducive to open-mindedness. While we persist in our insular ways, others are noticing. (Please read my previous 20-something blog posts for specific examples.)

The Glazed-Over, Overvaccination Topic

I used to keep a stack of scientific journal articles on my desk at work. They all concluded that yearly distemper vaccines were unfounded and needlessly exposed millions of animals to risk of adverse effects. (Did you know that a veterinarian, armed with decades of scientific facts and the most current professional guidelines, actually attempted to sue other practicing vets in his state to call attention to this issue?) Yet annual vaccines are still being administered left and right.

Why is this not a bigger deal? We continue defending bad policy by saying that despite a closed scientific debate, "it's ultimately up to the discretion of our fellow doctors." We can demonize the Dr. Jones character to no end, but we won't acknowledge the shortcomings of so many among us who insist on thoroughly debunked practices? Clients should not be in a buyer-beware situation when visiting a doctor, and it's not their fault they don't know vaccine science. Over-vaccinating vets are completely out of line, given that they've had over a decade to get the memo that these additional shots serve no purpose. Eventually, people have to assume they are either ignorant or just trying to put more money in the cash register.

So not surprisingly, one veterinary professional in the 20/20 segment stated, "Distemper is typically an annual vaccine." When research confirmed that immunity from the distemper vaccines actually lasted for at least 5 years (if not the life of the animal), the information arose inconveniently. After all, the industry had annual vaccinations as a cornerstone of its income and a basis for drawing clients. (To correct the Chicago journalist who implied vets don't make much money off vaccines, a single shot may not cost much, but hundreds of thousands of shots arguably bring more revenue and vet visits than anything else.) To limit the financial fallout, veterinary associations devised a compromise "every 3 year vaccine" policy, currently recommended by the AVMA, AAFP, and AAHA.

Still, in the wake of this 20/20 piece, vets are continuing to defend the "discretion" to ignore these already business-placating vaccine guidelines. The consequence is that many dogs will receive this and other vaccines every year... at a rate potentially 10 times more often than what is medically warranted or effective. If we're worried about pets being adversely affected by 20/20's short-sighted reporting, we should also be worried about pets adversely affected by our downplaying of overvaccination.

Sometimes I wish I had a banner-flying blimp that could debunk dozens of such myths propagated to veterinary clients. Among them are the pharma-driven myths---the kind that assert indoor cats should be on heartworm preventative through a New York winter. Does a New York mechanic say that one should have snow tires on for the summer, emphasizing it could mean a life-or-death safety issue if one of those July blizzards came along? If so, we shouldn't forget to wear a helmet while walking to our mailboxes, either. You never know what might fall on you and cause a concussion.

Conclusion

This 20/20 piece did what journalists wanted it to do - it caused a stir.  But it also might have been the only thing that brought words like overvaccination into people's living rooms. It also forced vets to say something about these concerns. At this point, I'm glad for any conversation starter. When millions of animals and a profession of suicidal people are at risk, silence is not an option.

The 20/20 piece also brought this profession's collective insecurity to light. Again, most of the criticisms in the segment weren't strong ones. However, we all know there are vets who do (deliberately or unthinkingly) put their business interests ahead of animal well-being. But how many lip-syncing singers, dishonest politicians or rough-handed police officers have also been exposed on TV? Does their entire profession instantly take umbrage? So why does ours? If you're a good vet operating on examined values and solid knowledge, this shouldn't damage you or your relationship with your clients at all, should it?

If anything, I hope it inspires you to become more involved in ensuring that your profession does everything it can to come to the rescue of animals, clients, and not withstanding---itself.

Sunday, July 14, 2013

The Art of Animal Handling

If you overheard that a given person "needed to be physically restrained", what would you figure about that person?  Probably that he/she was assaulting someone, behaving in a psychotic manner or verging on self-harm.

When it comes to handling animals for exams and procedures, physical "restraint" is an everyday term and practice in veterinary medicine.  The problem, though, is that most animals who come in to vet hospitals are unlikely to act psychotic or assault anyone.  The majority are either unfazed, skeptical or reversibly frightened.  In other words, these animals (especially cats) would benefit from more reassurance and less domineering "restraint."

I have always preferred to do my own patient handling, and from my first month out of school, I was surprised by how often I heard, "I can't believe how good he's being with you", "I've never seen her so calm at the vet's", or "You really have a knack for making him comfortable."  On other occasions, clients expecting something different than what I was doing would insist their animal was going to hurt me... and then act stunned when it didn't happen.

Was I really doing something unusual?  After some observation, I realized I was.  I was not adhering to the conventional methods of animal restraint, because they contradicted what I innately knew about empathy, dogs and cats.  While most of the restraint practices we engage in are for "safety first" purposes, I found the typical spin on restraint actually made many animals defensive, even if they weren't initially.  If it's not broke, why fix it? If it's not broke, why break it?

When I started my house call practice, I was a-ok with not having an assistant for most things.  However, I knew there was one thing I could not do alone: feline blood draws.  Believe it or not, my inclination was to find an assistant who had no veterinary experience whatsoever and therefore no preconceived notions about how a cat or dog "should" be held.  That person turned out to be my other half, and I can't tell you how pleased I've been with the outcome.  In the last two years, we've handled the most difficult cats out there (in-home ferals, semi-ferals, cranky geriatrics and the ones who never even make it into carriers).  So far, there has only been one cat from whom we did not successfully draw blood (and it was because he seemed to completely defy physics; we still refer to him as "that elusive snake-cat").

I've always hesitated to write on the topic of animal handling, because I feel much of the finesse of reading animals through their eyes, voice and body language stems from innate empathy; it's difficult to teach.  But, here is my attempt to describe in detail "what I do", albeit most of it reflexively and subconsciously.  I hope this is helpful to clients, veterinary technicians and other vets.  If you don't already do these things...give them a go!
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1.) Cat Exams: First and most importantly, I do not engage in abrupt movements with any cat.  No yanks on the scruff, no sudden grabbing, no pulling on a tail when inserting a thermometer, no heavy placement or banging of my implements onto the table, no slamming doors, no dragging the cat out of its carrier.  I give the cat a chance to come out of the carrier on its own, while I talk to its person.  If it doesn't come out, I tilt the carrier (as much as perpendicular to the table if necessary) until it does.  I never shake the carrier--and most cats will not adhere to the walls like Spiderman unless you shake the carrier.  If it's a top-opening carrier or bag, I make my first physical contact with the cat (usually a few soft pets on the head or upwards strokes on the bridge of the nose) while it's still in the carrier. Then I gently lift the cat out.

Once the cat is on the table, I spend a minute petting its head and saying hello.  You wouldn't want a doctor coming into an exam room and just shoving his stethoscope up your shirt; you would expect a cordial exchange and a greeting first, wouldn't you?  Once that's settled, I then perform my whole exam with the cat facing away from me.  Many cats are flattened on the table in an "I have no idea where I am right now" stupor and are quite malleable for this.  Some of them are more "dog-like" and walk around the table exploring.  I don't try to pin the latter cats too long in one place.  I might examine their head, let them walk around while I talk to their person, then listen to their heart and lungs, then let them walk a few paces this way or that way...for the most part I move with them, and whenever I need them to hold relatively still, I periodically give them something they want--pets or a little slack perhaps--and they are generally cooperative. I have never scruffed a cat for an exam.  Contrary to popular belief, a mother cat firmly carrying a kitten by the scruff is not the same as an adult cat having its scruff pulled on by a human. It's just not.

2.) Cat blood draws: I always try to trim nails beforehand, provided the client wants it done.  I then give each cat the chance to "choose" between the neck (jugular) blood draw position or rear leg (medial saphneous) blood draw position.  A common pet parent misconception: unlike humans, cats and dogs rarely care about the needle or its insertion--what cats primarily dislike is someone forcibly holding them down.  So, I merely position them first and see which scenario they are more comfortable with.  I find that if held correctly, most cats actually prefer the leg over the jugular. Once gently placed onto their side, the scruff must be held gently but firmly and the head tilted back. The scruff should NOT be yanked or pulled.  The hand holding the cat's head should be as immobile as their head, and if you're doing it with empathy rather than undue dominance, it will be.  Your forearm should be as flush as possible along the length of the cat's back.

Now, all of the aforementioned advice for holding the cat during a blood draw is sound IF AND ONLY IF the second requirement is met: the person drawing blood (FOR THE LOVE OF CATS!) must not PULL on the leg.  There is a HUGE difference to a cat between gently, slowly extending its leg and pulling on its leg.  Yanking on a cat's leg is the single most common reason why things go south up in the head area, because the cat is struggling backward to get you to somehow stop pulling on its leg.  They DESPISE it--it's the fastest way on the Earth to agitate a cat other than forcibly pulling on its scruff or jabbing it in the abdomen.

During a blood draw, I have never rapped on a cat's forehead, bopped its head repeatedly against the table to "distract" it, or even tapped it between the eyes.  Why?  Because it's not necessary if you're doing everything else right--and I wouldn't want anyone doing it to me.  I have repeatedly pet cats gently on the bridge of the nose, however; this is calming and distracting, as opposed to annoying and distracting.  I also talk calmly and encouragingly to all animals while I'm doing procedures; it makes for a more "normal" experience, since most animals are accustomed to being talked to while being touched.

3.) Truly fractious cats: I find that most defensively aggressive cats behave that way because they have an illness that makes them irritable (pain, hyperthyroidism, etc) or because they've been goaded/overstimulated at some time (perhaps the present!) by someone (a child or rough-handed adult, for example) who probably does not realize that their handling is too rough and well...unacceptably violating in the mind of a cat.  Cats like things done on their terms...and believe me, it's much more constructive to work with them than against them.

All that said, I consider a truly fractious cat to be one who responds to any handling, no matter how gentle and respectful, with aggression.  Often these cats are striking and spitting before you've even approached.  The most empathetic thing you can do for these animals is a quick rear limb IM injection of sedative with a towel placed (not thrown) over the rest of their body--because no amount of cat whispering is going to win back that animal's trust in a day, let alone in an hour or 20 minutes. Attempting to physically restrain, or worse--dominate--this type of cat will only worsen its fear-based aggression and its temper.  I have never in my life tried to emotionally dominate a cat, and good luck to you if you choose to do so. Even if you feel like you've "won", every person who handles the cat after that is going to lose.  Leave your ego on the sports field, champ.

4.) Dog exams: Have you ever noticed that the higher-pitched and more excited one's voice is, the faster many dog tails seem to wag?  The secret to dog exams is definitely talking--happily--to the dog.  Staring a dog in the eyes, looming over it, standing statuesque and especially not talking to it, are the most surefire ways to creep out a dog.  If someone you didn't know stared at you without saying anything, you'd be creeped out too.  This is the simple explanation for why dogs can "sense fear"; they normally enjoy (non-threatening) activity and reassuring voices, but resent an absence of those things.  So they get suspicious when everyone's looking at them but not engaging them in any positive way.  Even if a client thinks I'm completely nuts, I cannot and will not suppress my doggie voices for anyone or anything.  Anybody who knows me personally is probably laughing or nodding knowingly right now.

I prefer to examine dogs on the floor if they are over about 40 pounds, but even before I've come down to meet them, I've acknowledged them and put them more at ease with my voice.  As with cats, I obviously don't make sudden lunging motions towards a dog or its person.  Many dogs will come to you readily, but if they are timid, approach them respectfully and while talking.  Though most dogs are open and need less personal space than we do, don't put your face directly in front of a dog's face, unless you know the dog very well...it's not your prerogative to immediately assume the dog has limited need for personal space.

Most dogs are receptive of exams, as long as talking and/or petting occur periodically throughout.  Also, talking to their person usually makes them less uncomfortable. It's a more normal experience for them to hear human conversational exchanges, and in their mind, it dissipates a lot of the "something unusual is happening" sentiments. 

When I take a dog's temperature on the floor, I crouch so the length of my left leg above my knee is entirely under the dog's abdomen, right in front of its knees... so it's not moving backward or forward.  For dogs on the table, you can use your non-dominant forearm in the same manner. While holding the base of the tail (not yanking it!), I then ever so gently and slowly insert the graciously-lubed thermometer (stop laughing).  Seriously though, I wish I had a dollar for every time I saw someone ram a thermometer into a dog's rear and then act surprised when the dog resented it.

5.) Dog nail trims (because, let's face it, they hate this more than any other procedure): Unless you want them to become increasingly unruly beasts, large dogs with thick, black or overgrown claws should either have twenty-plus minutes on the schedule allotted for their nail trim, or they should be sedated.  If they're awake, I prefer getting dogs like this to lie on their side and having someone give firm, distracting tummy rubs while I focus on one nail at a time.  Treats are good too.  Regardless of whether or not you can see the quick or a change in contour of the nail, you can always give a little "test" squeeze with the clipper; if the dog doesn't react and the nail feels hard and more brittle under the metal of the trimmer, it's unlikely you're on the quick.  No matter how large dogs are held for nail trims (often it's multiple ways before you're victorious), the main technique is pure patience.  Manhandling or tethering a dog to quickly bang out a nail trim still rarely results in it getting done quickly. But it does more often result in "quicking" and typically makes the dog's aversion to nail trims worse.

6.) Potentially aggressive dogs: If a person tells me their dog has bitten or has tried to bite a person, (not usually including puppy teething/mouthing), I always put a soft muzzle on the dog--the reason not only being safety, but also that I'm not going to be appropriately focused on reassuring the dog if I'm necessarily guarding myself against a warning snap or a bite.  I will also muzzle dogs if they're displaying warning signs, like low growling or the "whale-eye". 

Since most dogs behaving aggressively in a vet hospital are coming from that place of fear-driven defensiveness, the last thing I want to do is add to the fear. So once any dog like this is properly muzzled (usually it's less threatening to have the dog's person put on its muzzle), its important to examine the dog more slowly, more gently and with even more voice reassurance than you would with the average dog.  Otherwise, they'll forever associate the appearance of that muzzle with "bad things", their view will get worse instead of slightly better, and it will be increasingly difficult to put a muzzle on next time around.

When a muzzled dog is being examined, this is not a time I find it constructive to be punitive or use harsh, scolding tones of voice, especially if the dog is giving a low, fear-based growl.  Some of these dogs are so poorly socialized that they will actually growl more with sweet talk--in that case, just remain as quiet as possible. Most defensive dogs are much better in the company of their person or family, so in hospitals I was never a proponent of taking fearful dogs "to the back", unless their person was the mentor for their neurosis (insert knowing vet professional chuckle here), or if they were trained/otherwise inclined to "protect" their person in the presence of strangers.  The latter, in my opinion, is actually rare and an overstated reason for taking dogs away.

I do not believe tying dogs' heads to exam tables is ever a good idea, except in the last-resort case where an aggressive dog brought in on a leash cannot be muzzled by anyone and absolutely requires an IM sedative for some necessary procedure.  We already know that dogs tend to become more reactive when tethered, chained or even when people choke up on their leash while walking.  I've seen dogs become phobic of things they normally don't tend to mind (vaccines, for one) if they have a history of being tethered during the procedure.  It's similar to how humans find tickling to be much more, at least psychologically, when being forcibly held down and tickled. Seriously.
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I think most of this advice is straightforward, but sometimes veterinary businesses can be so concerned with moving at a fast pace that the patient's experience is not properly prioritized. Sometimes this is for economic efficiency or so as not to disappoint clients.  However, just like the lowest quality food is dished out in "fast food" restaurants, unfortunately the lowest-quality medicine and patient care is often found in vet hospitals where there is an overemphasis on a rushed pace.  That said, I did almost everything the same in hospitals as I do now, so it's definitely doable to be efficient while keeping the patient's stress at the lowest possible level.

I don't know if the word creates the action or if the action called for the word, but much of the forcible "restraint" used on animals is not conducive to their health, comfort or our safety.  I do think something about that word "restraint" tends to puts us in a weird psychological position, where we imagine ourselves to be in a defensive scenario, whether or not we need to be.  After all , many of the animal behaviors we complain about in vet hospitals were unnecessarily set in motion at previous veterinary visits.  Just like most dis-eases, these behaviors are easier to prevent than to deal with once they've developed.

This is why I think veterinary "restraint" would be better replaced with compassionate "handling" anywhere it has not been already. Compassionate handling is indeed an art.  But I can't imagine doing my job without it. It is a very, very worthwhile art.

Saturday, July 6, 2013

Laying a Necessary Smackdown on the Purebred Hype

I see so many animal-related posts on the internet that are short-sighted, misleading or just plain inaccurate.  For the most part, I ignore them.

But I recently came across this article that made me want to weep for how poorly and manipulatively scientific information can be disseminated to the public.  Let me explain what the veterinarian author (a purebred dog enthusiast and former advertising writer, for full disclosure) has done. 

The author has taken a single research study, and before its findings have been published, has given an incomplete, slanted representation, and then generalized/oversimplified the findings for the sake of achieving an end.  I'm not expecting to see the most research-oriented minds in the profession congregating on VetStreet.com (it is a veterinary marketing hub), but come on, this is abysmal.

The article is plainly misleading, as plenty of non-veterinarian readers pointed out.  It uses "mixed breed" as a blanket term for all non-purebreds, as though "designer breeds" (resulting from 2 purebreds ) are genetically comparable to Heinz 57 mutts who haven't had purebreds in their lineage for generations. 

It then states, "it was assumed crossbreeding would eliminate: hip dysplasia, epilepsy, cancer, hypothyroidism, eye disorders and more."  In actuality, no person with an elementary school level handle on genetics would have ever "assumed" these diseases would be eliminated, or claimed any dog was “immune to genetic disorders.” 

It's obvious that first generation mixes still have a likelihood of displaying the same disorders as one or both purebred parents.  The article misrepresents this finding as a sensational, newfound revelation equally applicable to all mutts.  Any veterinarian who has examined tens of thousands of dogs can tell you that purebred dogs and designer breeds are afflicted with inherited disorders much more frequently than Heinz 57’s.

It is already well-known that people in closed ethnic groups are more prone to predictable genetic diseases.  Dogs on the whole are unfortunately an inbred lot, much moreso than people.  However, creating an impression that all dogs are equally inbred and equally afflicted is absurd.  If the mixed breeds at UC Davis were showing the same disorders as purebreds, it's most likely because purebreds have become so rampant and overbred that more and more "mixed breeds" are closely related to them and therefore more likely to carry on their traits.  Heinz 57's are like an endangered species at this point...thanks to our ever-glorified obsession with breeding and selling dogs.

Many people who have purebreds and designer breeds are completely unaware that their animal’s problem results from a genetic predisposition.  They falsely attribute it to food, environmental factors, or just don’t think about the underlying cause at all.  I see this constantly.  Or they might say something like, "I've had several of this breed live past 13!"  However, life span does not correlate with a dog's inherited disorders.  Many dogs live out normal life spans with mild to severe genetic illness or have genetic predispositions that never manifest (because a dog is not exposed to a trigger allergen, etc).  It doesn't mean they aren't carriers of genetic traits that may manifest in their siblings or potential offspring.

After years of hearing people say that they purchased a purebred to “know what they're getting”, it's past time to debunk that.  Most people who say this to veterinarians do not know what they are getting with regard to health problems.  Often they don't understand the responsibilities that come with having any dog...and hope to minimize their responsibility by believing "good breeding" will put their dog’s behavior and health on some kind of cruise control or autopilot.  It is not uncommon for people to abandon these dogs when strong breed-related behaviors or health problems become more than they wish to handle.  Sometimes they've placed so much stock in finding and paying for the "well-bred" dog that following through on basic responsible care--like spay/neuter or microchipping--becomes a secondary concern or is forgotten.

I can't say for sure if that VetStreet article was just written carelessly or if it was written carefully for the sake of marketing propaganda, but it clearly wasn't written to help the millions of mixed breed dogs who are put to death in shelters every year because society already has misconceptions about the value of mixed breed dogs.  This article appears to be giving a shot in the arm to the breeding industry as its reputation plummets further and further downhill.  As a culture, we are being duped into patronizing that industry, whose primary purpose was never breeding for utmost health, but rather for appearance and performance.  Now the industry breeds more recklessly than ever before, primarily for superficial appearance and marketed breed stereotypes.

If we as a society are going to claim we regard dogs as “family members” and “best friends”, we need to reconsider why we are viewing them as mere genes to be molded or uniform objects to be bought and sold.  If veterinarians are going to push propaganda, at least have the propaganda benefit our canine patients, like this: 

Adopting a mutt is a great way to say “no” to the objectification of dogs that is growing out of control in our culture.  It is a great way to reduce the sickening number of genetically afflicted dogs that are overrunning veterinary clinics across America, apparently including UC Davis Veterinary Hospital.  Dogs are wonderful simply for being dogs.  If they are treated more like individuals and less like models of cars coming off a factory line, we (and they) will be better off. 

Monday, December 17, 2012

Protect Animals, Protect Yourself: New Role of Veterinarians in Animal Advocacy

When working in an animal shelter or humane agency, it's difficult to make your only concern the animals in front of you.  It's nearly impossible to toil 9-5, go home, see a new set of afflicted animals the next day and not make connections between them.  Individuals who do this work aren't only concerned with animals they happen to be helping at the moment; they also care about the bigger societal failings that created those animals' problems. That's why so many in these fields write op-eds, lobby, or engage in humane education.  While it's important they take personal steps to avoid burnout, working on the big picture is the most reasonable way to attempt long-term elimination of the problems that ultimately get unloaded on them in the workplace.

Although the average private practice veterinarian doesn’t have infinite time outside work to engage in animal advocacy, it's unsettling how little our profession acknowledges that our daily stresses and obstacles also stem from the bigger societal view towards animals.  Although veterinarians have 8 years of higher education and the same level of scientific training as human physicians, we also have a burden that limits our efficacy; our patients are currently regarded by much of society as inferior lives to be exploited, abused, neglected or thrown away. 

What an obvious contradiction. What an overt problem!  We have CT scans, MRI's, phacoemulsification, and even prosthetic limbs for the luckiest of these animals.  Yet, how many times does the general public still display lack of basic respect for animals, or deem their suffering as tolerable?  How many times do we recommend spay/neuter to no avail?  How many times do we urge against patronizing puppy mills but still fail to curb this epidemic?  How often, for the sake of convenience, are we asked to medically neglect or physically modify other people's animals in ways we never would our own?  Keep in mind that vets don’t even see the worst cases out there; someone at least cared enough about the animals in front of us to take them to a veterinarian.  Billions of animals in our society never even have a home or the freedom to turn around, let alone a veterinary exam.

I hate to see this profession exemplify claims that society is surging ahead with scientific advancement while vegetating in a state of ethical defectiveness.  This is why it’s imperative that change happen  outside the exam room.  As a profession, we should be at the forefront of promoting and endorsing proposed measures to protect animals' basic interests.  However, our veterinary medical associations and societies have an alarming track record of going out of their way to thwart or avoid endorsing even the most modest animal welfare legislation.  They do this so as not to upset allied industries like the giant agribusiness sector or make enemies of special-interest groups like the American Kennel Club (AKC). 

Busy veterinarians who want to speak out against puppy mills or gestation crates, or speak in favor of properly enforced animal cruelty laws, need not necessarily huff and puff and blow up 1000 balloons for the sake of it.  But my hope is that those veterinarians will try to blow up one or two balloons per year, when the opportunity presents itself.  At the very least, I hope they will not pop each existing balloon simply because their old-school veterinary medical associations are irrationally afraid of balloons.  If vets don’t help lobby for better laws, write to local papers, or give their signatures to campaigns, we can’t complain about all the problems animals face that cannot be cured with medicine.

I speak to members of a profession with one of the highest rates of compassion fatigue and suicide when I say that overall, better lives and more respect for animals also means a better life and more respect for your profession.  It means better public embracing of your best medicine.

It's been two years since the Veterinarian's Oath was revised to emphasize our role in animal welfare and the prevention--not just the alleviation--of animal suffering.  Let's ensure those aren’t empty words.

Let’s get to work!