Sunday, June 21, 2015

Pyometra. The Challenge of Finding a Happy Ending with this Preventable Disease. WARNING GRAPHIC SURGERY PHOTOS!

Tell me that you could look into those eyes and not try to save her?
The story is so consistently the same that I almost gag repeating it.

A middle aged dog walks into the clinic with the presenting complaint of  "not eating and lethargic."

Patient has not been to the vet in years and the dog is not spayed.

That's all I need to know....
The diagnosis is always the same;

This dog has a uterine infection and she is dying of internal infection. She has a pyometra.

She needs;
  • Surgery (usually) immediately.
  • iv fluids,
  • iv antibiotics,
  • about a day in the hospital, and
  • antibiotics for about 2 weeks after surgery.
The problem is always two-fold. The dog is dying in front of you and the client hasn't had their pet spayed for a reason; they never could afford to.

So, now their $250 spay is a $1,000 (plus) emergency surgery.

Me and Pheonix just before surgery.
And so it was with Pheonix.

I dare not even think how many dogs die simply because their owners couldn't afford, or didn't realize the importance of spaying, and then felt compelled to euthanize because the cost to treat was too great.

An ultrasound to confirm our suspicions.. a distended angry uterus takes center stage.
Pheonix should have had her pyometra surgery the evening that she  presented to us. She should have gone to the emergency clinic nearby and had the festering infection that used to be her reproductive system removed. The estimate for her surgery there was over $2,000. A $200 spay was now prived at a $2,000 life or death investment.

Pheonix returned the next morning and had what I call a "bare bones last ditch" effort to eradicate her of the uterus she never needed and now was rebelling against her.

All of the nasty discharge of an infected uterus.
It is far better for the pet to be expelling the infection than holding it within the uterus.
Diagnostics are nice. They provide answers to questions and little fearful voices in veterinarians heads. They are also considered "standard of care." Our nice politically correct way of saying "in the best interest of our patient they should be done." Another line item on an invoice that inflates a clients bill. There are many line items in this disease, hence, the hefty price tag. If Pheonix's owners couldn't afford the $200 spay, they definitely can't afford the $2,000 pyo surgery.

A uterus of gargantuan proportions. A mad, angry, nest of puss and fluid that feels like rotten heavy fermenting sausage.

Finished with Pheonix's surgery. It took me about two hours to remove her infected uterus. She had minimal blood loss and did very well under anesthesia. 

Can you see how much thinner she looks from the photo of her above standing up?

One long incision is required to get a 4 pound uterus out of the abdomen.

My video plea about this disease;

You aren't ever out of the woods until the endotracheal tube comes out, they open their eyes, and they walk home.

Waking up.
I have some very strong feelings about this disease.

Veterinarians tend to feel angry that clients get themselves into this dilemma. We recommend spaying at 6 months old to avoid this disease from happening.
Here are some of the reasons clients don't spay their dogs;
  • it was too costly to spay her, 
  • I forgot to do it, 
  • time got away from me, 
  • I was always planning on breeding  her, 
  • etc.
Clients find themselves at the ER or vets office with a quick diagnosis and an expensive treatment plan. This disease has no time to wait for the scrambling of finding funds amongst friends.

Pheonix got help from us because we have two things in place;
  1. The Jarrettsville Veterinary Center Good Samaritan Fund.
  2. Vet Billing Solutions.
I have a back up plan for my back up plans. For those clients who do not have pet insurance, or a pet savings plan in place (my favorite option), there is Care Credit. Most people don't have insurance (like 95% of our clients), most don't have pet emergency funds (like 80%), and most cannot qualify for Care Credit (like 80%). That leaves the huge majority of clients with a dying dog, a huge vet bill, and no options.

I know this. I am prepared for this. I have the most generous friends and clients in the world. If I ask for help they help. It is a point of pride I hold dearest to my own abilities to help a pet in need. We do not turn away a pet in need I can only say this and do this because I have help.

I also have Vet Billing. Every client who is denied Care Credit is sent through Vet Billing. They provide us with third party billing for the clinic. No longer do I have to act like the bank, the creditor and the bitter nag begging for reimbursement months after I have bailed our butt out of a disaster. 

Two days after her surgery Pheonix still refused to eat. I took a trip to the grocery store to buy junk food incentives. The rotisserie chicken was the lure that got her eating. After a post-op patient eats they get the green light to go home.

This is Pheonix at her two week post-op re-check.

Yeah, I can't say no to those eyes.

She is doing great!

Her incision looks perfect!

There are happy endings if you work a little harder than  you have to, and care a little more than you are expected to. Pheonix's bill was about $1400 when she left us. About $1000 for her surgery alone. She spent three days in the hospital (at her families request) and is expected to have a full recovery.

If your dog has is diagnosed with this disease please know this:
  1. It is treatable. I will know vets have to hedge and be cautious, but trying might save your dog, and giving up will not.
  2. Discuss every single possible option to getting your pet the emergency surgery they need. Cut every corner, decline every elective and make it happen. Max your credit card, get a cash loan, pawn your stuff, go to,, your faily, friends, VetBilling is through your vet (click here to see which hospitals participate),, your vet, every vet in the state, whoever, where ever, and find a vet who will help you. 
I have unrealistic expectations. I will admit it. But, I will not let a treatable dog be denied care based on cost. It is not a widely held opinion. I am not alone with this opinion in this profession, but I would rather be ostracized by my peers than neglect my purpose. If you were provided the means and guidance to help I believe it is your responsibility to do so.

I saw a Facebook post the other day from a very well respected veterinarian and friend who posted, "I hate it when a dog has to be euthanized over such a preventable disease." I don't know the particulars of the case, but I don't ever agree with the statement, "has to be euthanized." Why is there a "has to be?" because we are the all-knowing and there is no chance? There is ALWAYS a chance! 
Please do not euthanize over this disease. 
Get your pet help!

If you have a pet question please visit the kind knowledgeable folks at Pawbly is free to use and open to anyone who cares about helping animals.

If you would like to visit us at the clinic please stop by Jarrettsville Vet in Jarrettsville, Maryland.

If you want to see my patients, share my vet stories, and chat via another platform I am @FreePetAdvice on Twitter.

Related Blogs;
Vet Billing Solutions  blog.

Working and Living in the Land of Liability.

How to Get the Best Deal at the Pet ER.

Tuesday, June 16, 2015

Uniting Pet Care Globally.. Why I love

Why I love

There are a few characteristics in ones life that you realize perhaps are not the best suited for "winning friends and influencing people." Truly, I am deficient in almost all of Dale Carnegie's long list of needed skills.

Often, while dealing with difficult clients,  I hear the little devil on my right shoulder squealing in my ear to remind them that, "If I liked people I would have gone into human medicine," or, "Dude you're just the chaffeaur attached to the other end of the only thing I really care about."

Pawbly was designed to be a place to help people. Our hope was that we could create a credible free resource open to anyone who loved animals. With the vast array of knowledge out there, scattered across the globe, surely we could help more pets if we could just connect those people.

And so it has become...

I'm going to share some of the discussions that have filled my long nights of work, and my empty self-funded pockets with purpose.

Question from 
Alan Rowlette in Indonesia..
I took two sparrow that were from a fallen bird nest, i saw four birds but only two alive, i put them in a box put some dry leaves and gave them some sugar water, they are sleeping i guess because they closed their eyes. What to do next?

Krista Magnifico, DVM, Founder of Pawbly answered ...
Put them back in the nest. Mom is looking for them. If you think that the mom is not with them, or isn't able to care for them, see if there is a wildlife rehabilitator in your area? If you can't find anyone you can feed moistened cat food on a toothpick. They should be fed about every 3-4 hours until they are full. I don't know the age or size so it's hard to provide more instruction than that.

Alan Rowlette commented ...
ah thank you, I don't know how old they are, but they are sleeping right now it's 10 pm (gmt+8) i was going to feed them at 8, but they are already asleep and i don't want to disturb them, i gave them sugar water at 6, I'll be giving them that cat food in the morning. About that nest, well it happen while i was going out near my home then the wind blows and the bird nest fell i stop the car put them in a safe place near the tree where it falls. I didn't took them yet. When i was back i saw them still there, then i took them to my home. There aren't any wildlife rehabilitator here, i know vet but I'm guessing they don't really care about sparrows, it's a common birds here soo..yeah..I'll try to take care of them.

How amazing is that? Someone halfway around the world helps a baby bird even when they don't have access to a veterinarian! That's what I love about Pawbly.

If you have a pet question, or would like to help someone with their pet please join us at There is enough information out there to cure every disease and help every pet, all we need is each other!

If you would like to meet me in person and talk about your pets issues please visit me at the clinic Jarrettsville Vet in Jarrettsville, Maryland, USA.

I am also on Twitter @FreePetAdvice

Thursday, June 4, 2015

Summertime Beach Safety

Outer Banks 2012
Summertime is full of so many wonderful things. A veritable oasis of life, activity, and joyful play.
Many of the same dangers that exist for our children also exist for our pets. So, if you would worry about a 2 year old's response to beach activity worry also about your pets.

Here are a few tips as you prepare your family for the warm sunshine of summertime.

Our baby Jekyl. Our first beach trip.
Vacation planning; There was a time when we would plan our whole four months of summer around our one week long trip to the ocean. We drove 8 hours just to plop our pasty white skin on the shores of the North Carolina beaches. Why drive so far when the nearest ocean is only an hour away? Well, because in NC you can bring your puppies on the beach. Even though I had my pups by my side I found that one week was full of worry.

Here are some of the beach hazards I worried about;

Number 1 Dog friendly spots
Nothing ruins a vacation faster than sneers and disgust from your neighbors. Find a place that loves pets and share your pet centered vacation with other pet focused vacationers. Who knows your Summer love might just be another dog?

Number 2 Overheating 

As the temperatures approach anything over 75 degrees F (24 Celsius) it is time to begin seeking shade and water. When your pet starts to pant they are telling you that they need to dissipate heat more efficiently and rapidly then they can normally. A panting dog is a dog on the way to overheating OR overheated. Offer water, shade, or water and if your pet prefers to stay there, stay there. A playful  happy pup, or two, can quickly and easily over heat. Limit playtime and activity to short sessions and then retreat to a cool place.

Number 3 Sunburn

Yes, we all burn, especially  those of us humans with months long previously covered throughout the winter legs. If your pet is fair, short coated, or lacks pigment on their nose, be extra careful to avoid sunburn. Best Tip; Avoid the beach between the hours of 10 am and 5 pm. Sunrise and sunset walks are both safer and magnificent. Or, stay under the shade of an umbrella.

Number 4 Humidity

Its not just the heat, it's also the humidity. Warm air temperatures and the mercury on the thermometer can be deceiving. If it is hot, sticky, and hard to breathe it is equally, or even more so for some breeds, for your pup. Pay attention to the weather and head for the air conditioning when the heat index rises to dangerous levels.

Number 5 Thermal burns

The sand in the full sun of most Summer days is hot enough to burn your feet. Equally dangerous is the pavement where you park your car. It is so hot that it can truly fry an egg or your pets foot. Bring shoes and keep noses, toes, and bare skin off of the hot areas of the beach. The skin in the lower abdominal region of most pets is thinly haired and very susceptible to burning. Walking or laying on any hot surface can cause very painful and even life threatening burns. Protect feet and accidental ingestion by monitoring your pet closely.

Number 6 Car rides

If you aren't able to stay with your pet in the car with them the entire time you are traveling then leave them safely at home. Stopping for even a few minutes can be deadly. There are no good options other than to stay with them in the car with the air conditioning on. Leaving your pet in a car even for a brief period of time can be deadly, will cost you a broken window, or a trip to the police department should some good Samaritan or busy body like myself stumble upon your car with your pet in it.

Number 8 Fireworks frenzy 
Loud midnight festivities may not be what your pet is used to. I recommend crating your dogs while you are out and keeping the crate handy just in case the neighbors kick up their heels and light off the pyrotechnics.

Number 9 Being prepared

Bring lots of drinking water, a leash, a poo bag, and tent or umbrella to shield the sun. Keeping cool refreshments is not only a way to cool off, but also calm the pets down for a mandatory beach time out.

Number 10 Comfortable around water

The ocean is a loud, overwhelming thing to a pet. Keep your dog on a short leash and encourage a slow gradual introduction to the water. Some dogs will jump right in, others will be life long toe-touchers. Regardless of which your pup is keep them on a leash and be mindful of the possibility of turbulent water and undercurrents. If your dog wants to swim keep them on a long leash attached to a safety harness on a flotation vest so that you can be their anchor at shore should they get overtaken by the waves or the current.

If you have a pet question, or are a pet parent with experiences and expertise that you would like to share, please join me at Pawbly is an open online community dedicated to helping pet people. We are free to use.

If you would like to visit me please find us via our Facebook page or our home page Jarrettsville Veterinary  Center in Jarrettsville Maryland.

Summer is the time of year to share the great outdoors with your family.
Here's to wishing you all a safe and wonderful Summer!

I am also on Twitter @FreePetAdvice.