Monday, January 25, 2016

Perception Can Be Everything


My pups, Charlie (left) and Jekyll (right).
Veterinary medicine isn't about making your pet pretty. Your vet sees your pets problem as a problem, and we vets like to fix problems. Pretty, well pretty is like frosting on a cake.. the cake is the meat of the dessert the frosting is just an extra decoration.

I am a girl, I like pretty, and like many girls I aspire to pretty. Vanity, well, its a luxury every girlie-girl embraces. Veterinary practice does not deliver vanity well. Even though I am a girl who likes pretty and is a bit vane, I fall tragically short of delivering pretty in practice. I need to do a much better job of sending my patients home both treated AND pretty.

I implore the staff all the time to remember that what is normal for us, (i.e. blood, urine, vomit, feces smeared everywhere and everything in between) is just a normal day in the life of a veterinary professional, BUT, these are not so NORMAL for the rest of society. Our clients, (well, most of them anyway) they want, expect, and like pretty. We need to be conscious of this.

Here's what I am talking about in case you don't recognize how poorly the vet delivers pretty. When we shave for a spay it should look like a nice even square box. Not some partial  job with razor burn and erratic incomplete area shaved down speckled tufts of hair. If your shave job looks like a hack job yielded by a blind military barber what does your client think you did on the inside of her beloved Fluffy?

How terribly guilty am I of this cosmetic oversight? Let me introduce the underbelly of my beloved Jekyll. Jekyll had a bump on his sternum that I discovered a few weeks ago. That bump was tickled, probed, pestered, pleaded with, cursed at, and, finally aspirated. Those little bits of cells were then sent to the lab on a slide. The small blemish on my floppy eared best friend came back as a suspected mast cell tumor. Yes, a tumor.. on my precious baby boy. The sequela to the bump having the nerve to show up on my dog was surgery by my hand. One of the most harrowing  aspects of being a vet, being the surgeon to the pets you love.

Jekyll's incisions, 12 days post-op.
I shaved him.. look at how retched that is.
Based on the presumptive diagnosis I knew I had to be very aggressive and get clean clear margins. I was so worried about removing Jekyll's cancer that I didn't care what it would look like after. I also had a large area of skin, fat, and muscle to remove, right on his sternum. The sternum is the area he sleeps on, the widest part of his chest, and I had to close the area after I removed the masses. I went into his surgery worried about getting all of his cancer removed and how it was going to heal if I had enough skin left over. So, you see, the shaving just serves the purpose of access.. I didn't care if it looked ugly. Ugly and  cancer-free is faaar better then pretty with cancer.

Jekyll's incision, 18 days post-op.

I had a dachshund show up last week for an odd looking infection on his neck. The client was worried about a possible bug bite that they had been trying to manage for a few days. The infection had begun as a small tiny speck and now was a half dollar sized red swollen painful mass. We did what we always do, we carried that pup to the treatment area for a firm hold to shave the area so we could see what was going on, probe away, and decide if further treatment was warranted.

Well turns out his parents were not to happy when we returned him missing half of the fur on his chest. Thanks to the shave that infection healed within two days, but, we heard about "over shaving" and the great dismay it caused for the weeks that it took to grow back. Never mind that the "shaved area was not even, centered, or shapely." (I agree that it was all of those things).

Charlie and Jekyll.
They had a long day playing,, can't you tell?
How can an ugly shave cause such stress to a pet parent?

Here is an example I got recently via Pawbly; A user asked this question;

"Unsure about operation quality due to buttons on ear after operation

My dog went for an operation on his ear and came back with his ear full of buttons that looks terrible, it doesn't look very professional or normal. I am not sure if this is safe for my dog because he seems very uncomfortable and the ear looks very messy and irritated.
IS THIS FINE OR SHOULD I SEEK HELP FROM ANOTHER VET?"

Here is my answer;

Hello,
I am assuming that you are talking about a surgical repair for an ear hematoma (aural hematoma)? There are many methods used to fix this, and yes, buttons, stents, and even plastic sheets are some of them. If your dog is in pain, or if the ear is still swollen I recommend that you  return to the vet. If you are concerned about the appearance of the ear I would also encourage you to go back to your vet and express your concerns. We vets are almost blind to physical appearance. We are focused on fixing a problem in a real-life cost effective way (because people get very upset if they think we are charging too much money), so we forget that some clients are more concerned about appearance and less concerned about cost effective treatment options.

I need to be more observant of the work I send home. I sweat every single surgery, procedure and patients care I am responsible for.. but, I am a mom too.. My kids, and everyone else's, represent my work in public. I can't send my heart and soul home to someone who questions the reality that I lose sleep with worry and  proudly wear my heart on my sleeve now can I?

Me and my kids.
Winter storm Jonas, January 23, 2016.
Please join me on Pawbly.com if you have a pet question, or pet expertise of any kind that you could share with other pet parents. Pawbly is free to use and open to anyone.

If you would like to meet Jekyll or Charlie you can find them (and me) at Jarrettsville Vet in bucolic Harford County Maryland.

I am also on Twitter @FreePetAdvice.

6 comments:

  1. Always a pleasure to read your blog. Thank you!

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    1. Thank you for visiting! Send hugs to all of you and the critters!

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  2. I love this blog! You could shave zigs zags all over my critters! As long as the issue is fixed, they feel better, and whatever issue stays away.... I'm a happy mommy!

    Sunshine recently had her belly shaved for an ultrasound. It was a neat shave, but crooked at the end. Halfway through the vet needed to shave over farther. She was already goopy and it wasn't easy to keep neat. Didn't make me think she did a crappy job. It made me think she was being extra thorough.

    I was present for the whole thing. Sunshine doesn't care for strangers and I'm one of 'those' moms! I swear I'm a vets nightmare.

    Actually the years of carefully cultivated good safe positive vet trips were completely negated with an ultrasound and one set of Xrays. Too much non consensual touching! She's back to shaking when we walk through the front doors. IBD was the guesstimate diagnosis and Tylan Powder along with a low fat home made raw diet seems to be doing the trick.

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    1. Hello Jessica,
      Many thanks for reading and taking the time to share your experience. I suppose at the root of everything we do we just need to have open lines of communication and the end visual result is less likely to be disturbing to parents.
      I promise that I am far happier to have an over protective mom as a client than a neglectful non-caring one! I'm sure your vet feels the same way too.

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  3. I just stumbled onto this blog & fell in love. Your comprehensive & down to earth writing style is a pleasure to read!
    Thank you so much!

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    1. Thank you Anarane,
      I hope that you find it to be helpful and please never hesitate to ask me a question on Pawbly.com, or if there is a topic you would like to know more about I am always in search of blog topics.
      Hope to hear from you again soon,
      Krista

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