http://channel.nationalgeographic.com/series/dog-whisperer/3252/Overview#tab-Videos/05198_00
Many of you may be aware of a National Geographic television show featuring a charismatic individual who helps dog owners. I recently came across this video on the website and I urge you to watch it (preferably without the sound so as not to be distracted by his talking) and keep your eye on the dog. Here is what you will see:
Within the first 5 seconds, the handler kicks the dog in the abdomen. When the dog turns toward him he is jerked off his feet. A struggle ensues where the handler gets bitten several times and the dog is seen to be struggling for air. Finally he gets the dog onto the ground and the dogs tongue is blue and the dog is gasping for breath. When he finally gets the dog up it appears that there might be urine on the ground and that the dog voided his bladder in distress.
What you have witnessed is not dog training but abuse. Not only does the dog suffer, but clients are at risk if they attempt these interventions themselves. These are not appropriate measures and compromise the welfare of the dog and the safety of people. His explanations are false and not based on science as we know it. We as veterinarians must make our voices heard and let National Geographic and most importantly our clients know that these types of interventions are wrong and not in the best interest of dogs or people.
As a veterinary behaviorist I have dealt with behavior problems in companion animals for over 25 years and would never confront a dog this way. Not only would it be dangerous for me and the family, it would be harmful for the dog. My goal is diagnose the problem, and design humane treatment plans that help the family change the behavior of their dog so that they can safely live together. I hope all veterinarians can agree that this is the best approach.
I would love to hear your thoughts. Most importantly, go to the link and scroll down the page to “contact us” and click on that. Let National Geographic know what you think.
Thank you for your time
Debra F. Horwitz, DVM, DACVB
I was disappointed to read the “Hot Button” column in the November issue of Veterinary Economics. Despite a number of concerns facing the veterinary industry today, VE elected to print the second submission in seven months by the same author, and, more or less, about the same topic.
In devaluing low-cost spay and neuter (LCSN) clinics, Dr. Craig Woloshyn (who is credited as a member of the VE Advisory Board) has even used some of the same language that was printed in his April 2010 article. I responded then, and feel compelled to do so again.
To be certain, I am not a spay/neuter activist – I manage a multi-doctor mixed practice in rural Oregon. We have worked extensively for years with our local shelter and other providers of LCSN programs and continue to run one specific program of our own. Our practice grosses seven figures; our Doctors and staff, as well as myself, are all paid well above the nationwide average salary for our positions – all with a fee schedule that continues to be a bargain by some standards.
My problem is two-fold. First of all, Dr. Woloshyn is wrong…..LCSN programs can be a productive component of fighting pet overpopulation. I don’t have to be a DVM to understand that, with respect to social problems, failing to act has an exponentially negative effect, even if taking action falls short of our desired outcome. Unless he is suggesting that cats and dogs would reach a “nature imposed” population ceiling if allowed to breed freely, then the case can be made that the problem would be much worse if not for our industry’s efforts.
So if we can agree that altering pets improves, even if slightly, the forecast for population, the subject of low cost programs is still left to debate. In the past, our practice typically performed a total of 300 feline spay/neuter procedures per year, and that number was the same from year to year despite economical changes and our practice growth. After expanding our cooperation with local humane organizations and creating our own in-house low-cost cat neuter program, that number rose to nearly 1,000 procedures per year. For anyone doing the math, that’s 700 cats per year that are no longer procreating, and while that may not dent Dr. Woloshyn’s 40% unaltered statistic, it’s certainly a move in the right direction.
Though pet overpopulation pales on the list of other social problems that we face in this world, it’s a relief to know that the same approach is not being applied to decisions about other issues such as famine, illiteracy, or disaster relief. What kind of world would it be if we only applied our resources where total success could be achieved?
My second problem is the decision to print what is essentially a retread of old ideas. All I seem to read lately is ‘101 ways’ for consultants to say the same thing…..Veterinarians should charge more and stop worrying about it. Continuing to focus on this one issue (which we all decide on our own anyway) is shortchanging the need to hear about real problems. For every veterinarian who under charges, there is one who overcharges (that is a blasphemous statement, no doubt), and who’s business is that but their own?
Lower cost practices can’t damage the industry…have you ever seen an association of fine dining establishments lobby to eliminate McDonalds? Instead, they understand the concept of target marketing, and creating (selling) the “experience” of a customer visit, not to mention great food. Here’s an interesting exercise for managers – ask your clients to rank their priorities for a visit to your practice (I have). It’s a truth most would rather not hear, but many clients put the resolution of their pet’s medical problems way down the list - often behind customer service, thorough explanations, wait time, convenience of hours, cost of services, etc.
The veterinary industry faces many serious issues - the evolving role of the certified technician; the lack of business preparation in new graduates; how to bridge the mentor role from one generation to the next; the role of staff in “training” new graduates; and the inconsistency of state’s practice acts, to name just a few. Isn’t it time to break some new ground and get outside of the box? I admit, 15 years ago, I was fascinated by the cutting edge advice from veterinary management experts, but that excitement has been replaced by the feeling that today’s consultants are still singing a few really old songs.
I'm reading a great book titled In the Company of Animals by James Serpell that explores the historical and contemporary relationship of pets to people. I ran across a reference to Aesculapius/Asklepios (Roman/Greek), the eventual god of medicine. You know! The guy with the caduceus, the rod, that symbol used for centuries for human medical doctors: a staff with wings on top and two snakes entwining it.
Yeah.
So it turns out that that rod, with wings and two snakes, is the rod for Hermes, that super-fast messenger for the Greco-Roman gods. Aesculapius' staff has no wings on top and has a single serpent entwining it. That image I've included? It's the veterinary caduceus which, more than often not, is the RIGHT one. The one with no wings and only one serpent.
Is it because veterinary medicine came into its own long after human medicine had been started--so they got it right early on? Are veterinarians just better educated about the symbolism of ancient Greece and Rome?
Take your pick.
Rock those proper caduceuses, doctors!
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This post is in response to Dr. Craig Woloshyn’s article “Cheap spays, neuters won't fix the animal overpopulation,” published in the November 15, 2010 issue of Veterinary Economics. Dr. Woloshyn makes a number of assertions about the effectiveness, financial viability, and quality of spay and neuter programs that require rebuttal:
1. We've had very little effect on the dog and cat population in this county, nor will we with this approach. Dog and cat populations are affected by factors we haven't learned to control.
The simplest factor controlling a population is its fecundity. This is something that we, as veterinary surgeons, have learned to control on an individual basis by spaying and neutering. While we may not yet have mastered the intricacies of human behavior and animal survival rates based on neutering prevalence in a community that in turn affect the population size, we do understand the basis for population growth in companion animals.
And in fact, the past several decades have witnessed a decline in shelter euthanasias nationally, from an estimated 13.5 million cats and dogs in 1973, to 4-5 million in 1991, (Scarlett 2004) to 3-4 million currently (HSUS 2010).
2. This isn't the place for an exposition on procreation, but you won't find a single well-documented study that shows significant decrease in animal populations anywhere in this country. Those few studies that exist show essentially flat shelter fill and euthanasia rates.
Some studies have already shown effects from spay and neuter programs on shelter intake and euthanasia. White (2010) studied the impact of the Animal Population Control Program in New Hampshire and demonstrated a significant decrease in cat intake and euthanasia in shelters during the years after program onset. Austin-based EmanciPET Free Spay/Neuter Program produced a significantly lower rate of increase for dog and cat intake and euthanasia in the municipal shelter for animals from the program areas. Shelter intake and euthanasias in Asheville, N.C have decreased by 75% since Humane Alliance established their low-cost high-volume spay neuter program.
Indeed, more studies are needed to prove the effects of high volume spay and neuter programs on animal populations. Several such studies are in the process of being completed and await publication. In addition, spay and neuter programs and animal shelters have come to understand the necessity of accurate and thorough data collection. Geographic Information Systems (GIS) are being studied for use as tools to track risk for animals coming into shelters and to focus spay and neuter resources on highest risk neighborhoods (Patronek, 2010; Weiss, 2010). Studies such as these will help us better understand the effectiveness of spay and neuter programs and how we can use our resources most effectively.
It would be a mistake to view inconclusive evidence as proof of failure. Evidence-based medicine is, by its nature, based on evaluation of the results of experimentation. If we, as scientists, are not allowed room to form hypotheses and test them, then we can have no evidence-based medicine.
3. If what we said would work were working, we'd see it by now.
In Joshua Frank’s 2004 mathematical model of neutering for animal population control, neutering programs were found to be effective at reducing shelter euthanasia. However, the model also predicted that the full impact of a one-time permanent increase in the neutering rate may not be felt for as much as 40 years (Frank, 2004). In addition, many of the spay and neuter clinics now in existence have been opened within the past five years (Humane Alliance, 2010). Thus, we are only now beginning to see the effects of a movement that began several decades ago.
4. Approximately 40 percent of pets in this country are sexually intact. Apparently we can't sway this population of owners with cost.
Cost is the reason most often cited by owners for not having their cats neutered (Patronek, 1997 and New, 2004). With unowned, feral cats, the percent of caretakers attempting to have feral cats neutered (Levy 2003) or taking feral cats to a veterinarian for any reason (Lord 2008) is small, ranging from 11% to 22%. Cost is likely to be even more of a factor with these cats than with owned cats. Thus, providing reduced cost or free spay and neuter services addresses one of the most common reasons for failure to spay and neuter cats.
Low-cost or free subsidized spay and neuter surgery is the only way to reach certain segments of our country’s companion animal population. In the United States, 14.3% of people live below the poverty line (Bishaw, 2010). People with low incomes are nearly as likely to own pets as are people with high incomes (AVMA, 2007), indicating that large numbers of animals live in households that simply cannot afford full-service veterinary care.
5. Feral cats are so fecund that even if we leave one pair unneutered, we'll soon see the population restocked naturally.
One population model of feral cat populations show that population control can be achieved by ongoing spaying of at least 75% of the fertile female population. (Anderson 2004). While this approach does take ongoing effort and monitoring, the number of surgeries required to maintain a greater than 75% spay and neuter rate is low after the initial, first-year trapping and neutering. Indeed, removal-and-euthanasia strategies, sometimes touted as an alternative to Trap Neuter Return (TNR) programs, also require ongoing monitoring and euthanasia, making them no less effort than TNR. In addition, euthanasia of ferals is often unsupported by the general public and by colony caretakers, and may be morally untenable for the humane agents or veterinarians who would be asked to perform the procedure.
Several studies have demonstrated the success of ongoing TNR programs for free-roaming and feral animal management. A TNR program in Jaipur, India sterilized and rabies vaccinated 24,986 dogs between 1994 and 2002. Direct observational surveys of the local dog population indicated that 65 per cent of the females were sterilized and vaccinated, and that the population declined by 28 per cent (Reece, 2006). A study of a cat colony on a university campus in Florida saw a 66% decrease in the resident cat population after the onset of a TNR program, and concluded that a comprehensive long-term program of neutering followed by adoption or return to the resident colony can result in a sustained reduction of free-roaming cat populations in urban areas (Levy, 2003).
6. We've cheapened the entire profession with bargain-basement spays. We've taught the public that we don't consider ourselves worth much.
Human medicine offers many examples of professionals providing care at low or no cost to individuals who cannot or will not otherwise seek care. Rather than cheapening the medical profession, these services demonstrate compassion while enhancing human welfare and public health. Similarly, veterinary medical services provided to enhance animal welfare and public health by providing services to those who could not, or would not, otherwise afford them demonstrate compassion and enhance the value of the veterinary profession.
7. We've set the standards of care at the level of herd medicine, not something most small animal practitioners want.
Indeed, many small animal practitioners are not accustomed to or comfortable with approaching animal health on a population basis. However, veterinary epidemiology and population medicine is a central part of the veterinary curriculum in our veterinary schools. While private practitioners may not, in day to day practice, think about veterinary epidemiology and animal populations, much of the medicine that veterinarians practice today is based on epidemiological evidence. Evidence-based clinical veterinary medicine relies heavily on the results of epidemiological analyses (Thrusfield, 2007), and veterinarians in clinical practice must use probability-based information to make decisions about individual patients in day-to-day practice. (Pfeiffer, 2010).
Standards of care in high volume surgical settings need not compromise animal health and welfare. The Association of Shelter Veterinarians veterinary medical care guidelines for spay-neuter programs, published in JAVMA on July 1, 2008 (Looney et al 2008), provides practical standards for high-quality, humane, and efficient care of veterinary patients in high-volume spay and neuter programs.
8. And we've exercised our seemingly unbounded ability to take blame for situations that are not of our making.
Taking action does not equate to taking blame. Veterinarians are in a unique position to take action, not because we are at fault, but because we have the skills that can actually change the population dynamics of our cat and dog populations.
9. We've also wasted a lot of time and money sending people to school for four years to perform a simple procedure that takes three months to master.
While a spay or neuter surgery is, in itself, a simple procedure, it is of course false to assume that “cutting and sewing” is all that is involved in spay and neuter practice. Spay and neuter surgeons must know current anesthesia and analgesia protocols that maximize patient comfort and welfare, while being attentive to cost. They must be familiar with patient monitoring techniques and emergency procedures. They must be able to perform efficient physical examinations in order to aid in patient selection and in the modification of treatment protocols. They must know common and uncommon reproductive anatomical anomalies and understand how to address them surgically. They must learn to practice efficient surgical techniques that minimize tissue trauma.
10. Many practices are now feeling the effects of these misguided efforts. Clients who don't understand why real surgery costs 10 to 20 times the price of a spay bristle at the idea of paying us a living wage. Young doctors whine about their student debt yet gladly debase the very profession that should be supporting them.
Efficient, high quality spay and neuter programs need not underpay their veterinary staff. Spay and neuter clinics can and should offer competitive salaries and benefits (Weedon, 2007).
Furthermore, the advent of spay and neuter programs need not imply a decrease in procedures performed by private practitioners. In an analysis of five communities with targeted spay and neuter programs, Frank (2007) demonstrates that low-cost neutering programs are effective at increasing the total number of neuters in the program community, including in private practices, rather than simply causing a substitution of sources for neutering services as some practitioners might fear.
In conclusion, I, as a member of the Association of Shelter Veterinarians Veterinary Task Force to Advance Spay Neuter, feel that High-Quality, High-Volume Spay and Neuter programs have a vital place in our profession and are an essential component to decreasing cat and dog overpopulation and shelter euthanasia. While more data needs to be collected, preliminary research does show a reduction in shelter intake and euthanasias associated with high-volume spay neuter programs. And, finally, compassionate activities directed towards animal welfare and public health enhances the value of the veterinary profession as opposed to cheapening the profession.
Editor's note: Click here to join the cheap-spay discussion online right now on the dvm360 Community message board.
References:
American Veterinary Medical Association (2007) U.S. Pet Ownership & Demographics Sourcebook. Published by AVMA, available at www.avma.org
Bishaw, A, and Macartney, S. (2010) Poverty: 2008 and 2009, American Community Survey Briefs. U.S. Census Bureau. Available at www.census.gov/prod/2010pubs/acsbr09-1.pdf
Frank, J.M., Carlisle-Frank, P.L. (2007). Analysis of programs to reduce overpopulation of companion animals: Do adoption and low-cost spay/neuter programs merely cause substitution of sources? Ecological Economics,62,740-746.
Frank, J.M. (2004). An interactive model of human and companion animal dynamics: the ecology and economics of dog overpopulation and the human costs of addressing the problem. Human Ecology, 32,107-130.
Humane Alliance (2010). Accessed 12/18/10. Available at www.humanealliance.org/index.php/about-us
Humane Society of the United States (2010). Accessed 12/18/10. Available at www.humanesociety.org/issues/pet_overpopulation/facts/overpopulation_estimates.html
Levy J.K., Gale D.W., Gale L.A. (2003) Evaluation of the effect of a long-term trap-neuter-return and adoption program on a free-roaming cat population. J Am Vet Med Assoc, 222, 42–46.
Looney , A. L. et al. (2008) The Association of Shelter Veterinarians veterinary medical care guidelines for spay-neuter programs. Journal of the American Veterinary Medical Association, 233, No. 1, Pages 74-86.
Lord, Linda K. (2008). Attitudes toward and perceptions of free-roaming cats among individuals living in Ohio. Journal of the American Veterinary Medical Association, Vol 232, No. 8. pp 1159-1167.
New, J.C., Jr., Kelch, W.J., Hutchison, J.M., Salman, M.D., King, M., Scarlett, J.M., and Kass, P.H. (2004). Birth and Death Rate Estimates of Cats and Dogs in U.S. Households and Related Factors. Journal of Applied Animal Welfare Science. 7(4), 229–241.
Patronek G .J., Beck A. M., Glickman L. T. (1997) Dynamics of dog and cat populations in a community. Journal of the American Veterinary Medical Association. 210(5):637-42.
Patronek, G. J. (2010) Mapping and measuring disparities in welfare for cats across neighborhoods in a large US city. American Journal of Veterinary Research Vol. 71, No. 2, Pages 161-168
Pfeiffer, D. (2010) Veterinary Epidemiology: An Introduction. 152 pages.Wiley-Blackwell.
Reece, J.F. & Chawla, S.K. (2006). Control of rabies in Jaipur, India, by the sterilisation and vaccination of neighbourhood dogs. The Veterinary Record, 159, 379-383.
Scarlett, J. M. (2004) Pet Population Dynamics and Animal Shelters. In Shelter Medicine for Veterinarians and Staff, Blackwell Publishing, pages 11-23.
Thrusfield, M. (2007). Veterinary Epidemiology, 3rd Edition. 624 pages. Wiley-Blackwell.
Weedon, J. (2007) Strategies for Recruiting and Retaining Spay/Neuter Veterinarians. Available at http://www.sheltermedicine.vet.cornell.edu/working/RecruitingVets.pdf
Weiss, E. (2010). ASPCA website. Accessed 12/18/10. Available at http://www.aspcapro.org/blog/2010/05/are-we-hitting-our-target/
White, S. C., Jefferson, E. & Levy, J. K. (2010). Impact of Publicly Sponsored Neutering Programs on Animal Population Dynamics at Animal Shelters: The New Hampshire and Austin Experiences. Journal of Applied Animal Welfare Science, 13(3), 191-212.
Congratulations! You joined the community. But right now, when you or anyone else goes to look at your profile—which they will—it says “Sorry. YourNameHere hasn’t written anything yet. You can change that in a jiffy. Here’s how:
1. Go to http://www.dvm360.com and click on “community” in the blue navigation bar.
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To get started, fill in a few words that describe you or your interest in the “tags” field, like your role in the practice or your hobby. For example: manager, Washington, skiing, small animal, poodles …
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When I left home over a week ago for my first serious vacation in three years, I was certain I wouldn’t venture far from the poolside lounge chair. Weather and work had left me craving a tropical getaway to recharge. When we checked into our resort in Cabo San Lucas, I wasn’t disappointed……
What I didn’t expect, however, was to start thinking about veterinary medicine and how it’s practiced in Mexico…..but that’s just what happened. It turns out I didn’t miss my job, but I did miss work. After a quick email to the Los Cabos Humane Society, I was informed that they would be holding a Spay/Neuter clinic for two days this week and I would be welcome to come observe. LCHS was having two veterinarians from the Give Some Life Foundation come in to perform the surgeries.
In my life, I really haven’t been too far from home, save a couple of trips, and the idea of being picked up by a stranger and driven across town to the shelter was unnerving. Would anyone speak English? How long would I be gone? Would I have cell service? Though my wife didn’t stop worrying until I returned, I never looked back. We picked up the GSL Doctors, MVZ Joaquin Villasenor and MVZ Rebeca Serrano and headed to the shelter.
I didn’t know what to expect or if I could help (or what they might need help with). The two Doctors went right to work and were joined in surgery by a recent graduate, MVZ Eriksen Beccera. They referred to their approach as the “Efficient Spay Neuter Technique,” and boy was it…… In five minutes, I remembered what I like least about veterinary practice as I know it – all of the waste. Wasted time, wasted supplies, wasted resources. These people wasted nothing.
While the surgeons worked, the Shelter Doctor, MVZ Alan Ortiz, supervised induction, monitored patients, and increased anesthetic when needed. A team of assistants and veterinary students restrained patients for injections, transported them to and from surgery, and helped monitor their recovery. In the USA, there is always someone who is really running things behind the scenes, and it was no different here. Though she couldn’t speak any English, I found something in common quickly with Ceci, a shelter staff member, as she ran around the room trying to put only the needles in the sharps box before her boss could put the syringes in as well.
In just over nine hours of surgery, this group spayed or neutered 84 pets (mostly dogs), all free to residents of the Los Cabos area, and funded solely by donation. They did it without surgery tables, without proper lighting, and without gas anesthesia. The work was grueling. Barely inside (the group performed surgery the previous week on an outdoor basketball court), the lack of air conditioning, little breeze and stifling heat for 10 hours with very little sitting made me reflect on all the luxuries we take for granted. And my job was only to clean all the surgery instruments over and over…… I could see in the eyes of the team that it took an immense amount of mental focus to keep going without any idea when the demand would end, but I could also see a dedication to the cause they had given so much of their time for.
In short, my experience here did recharged me……it recharged my interest in the kind of medicine that can reach patients who may not otherwise get it. It left me ashamed of how we waste at home, but committed to addressing that problem. It left me in awe of these people who spend day in and day out dedicated to fighting a problem they know won’t be easy to solve, do so in the most challenging of conditions, AND do so on a volunteer basis. It also reminded me that no matter where we go, we can be reminded of how small the world really is and what we have in common. When one of the Doctors heard where I was from, he said he’d spent three years of his early training on a small town family owned dairy in Oregon. That dairy is in my hometown.
To help support Los Cabos Humane Society’s permanent no cost Spay/Neuter and education program, go to www.humanesocietycabo.com
To help support the Give Some Life Foundation’s efforts in the Baja region of Mexico, go to www.givesomelife.org
I was a pre-med in college and had every intention of going to medical school. In fact, as a high school senior I was accepted into a program which guaranteed me admission into medical school as long as I maintained an acceptable GPA throughout my undergraduate career. It wasn’t until my senior year as an undergrad that I decided to apply to vet school instead of med school. There were two factors which affected this decision. First, I was taking a couple of fascinating classes relating to animals. One was called Human-Animal Relationships and explored the ethical, biological, evolutionary and economic facets of our relationships with animals, whether companion, farm, wildlife, research, or zoo. The other was Comparative Anatomy, in which we followed the anatomical and physiologic constancies across species, from shark to frog to cat to human.
The second factor was my pre-med classmates. The majority wanted to be doctors because their fathers were doctors, or because they craved the prestige and wealth. Most of them didn’t want to be doctors to help people, to cure the ill or heal the injured. I had already spent four years in classes with that bunch of jerks and couldn’t face another four. So I went to vet school instead. Veterinarians as a rule are overworked and underpaid, so we’re all in this to help animals and people, not to get rich and famous.
The Fourth of July confirmed to me that I made the right decision back in college. One patient I saw was a leopard gecko named Athena. Although I don’t technically treat exotics like birds or reptiles, they occasionally find me anyway. Athena had tried to eat a decorative plastic cactus from her cage, but her eyes were bigger than her gullet and the faux cactus was stuck in her throat. I held her mouth open and my technician gently pulled out the plastic. Athena was fine and her humans were appreciative.
Later in the morning a middle-aged male cat named Al was brought in by his concerned people. They said he had been straining in his litter box but was only able to produce a few drops of blood-tinged urine. I ran blood work and x-rays on Al, and found that he had bladder stones, several of which had migrated down into his urethra preventing him from urinating. So I anesthetized Al, flushed the stones up into his bladder, and surgically removed them from the bladder. When he woke up he was able to pee comfortably and looked content, enjoying his pain medications.
All day I was working sick, and by the afternoon I was coughing and wheezing and was pretty sure I had bronchitis, so I left early to go to InstaCare. There I was seen by a forty-something white male physician. I was wearing scrubs with a doggy-and-kitty print, so it was fairly obvious where I’d come from. He asked where I worked; I told him the clinic name and added, “I’m a vet.”
“What do you do there on a holiday like today?” he asked.
“Well, I did a cystotomy on a cat today.”
“Really?” He smiled and I thought he was impressed. But then he added, “Do you have a vet there or is he on call?”
“Umm, I am the vet,” I said. What I wanted to say was, “He? Were you not listening when you asked me three minutes ago where I work? Why do you assume a vet must be a man? I know for damn sure there are plenty of women physicians in this very hospital. And do you really think so little of veterinary medicine that you assume that a random lay person could do a feline cystotomy?”
What a jerk. I saved lives while he insulted his patient. I treat any species and do everything—from internal medicine to surgery to dentistry. I’m not rich but my patients and their families benefit from my skills.
Recently, some negative statements have appeared on various blogs concerning Purina’s Beneful brand dog food. These allegations and misleading statements indicate that the product may cause specific problems, ranging from basic vomiting and diarrhea to death. These statements are not backed by any scientific studies, and the conditions described in the postings are amongst the most common conditions seen in everyday veterinary practice.
When a pet is sick, pet owners often look first to the pet’s food as the cause. However, it is rare that their food is responsible for the illness.
I’ve read through many of the current comments regarding Beneful and believe they do not provide any evidenced-based rationale for making such claims. Some of the comments mention illness resulting from a “one time feeding,” which in itself could be the cause of the gastro-intestinal symptoms described. A pet’s food should not be changed abruptly. Instead, whenever a new food is introduced, it should be mixed with the previous food on a gradual basis, over a period of a week to 10 days, to help prevent such symptoms from occurring. Other claims are that the dog suffered from chronic weight loss, or even death, but from these internet descriptions, it seems possible that these animals were ill to begin with and thus the diet (Beneful or otherwise) likely had nothing to do with the illness.
I have been a practicing veterinarian for over 40 years, specializing in small animal internal medicine and cardiology. During this period I also have participated in numerous pharmaceutical and food trials as well as writing scientific papers on the results of these clinical studies. I edit and am a contributing author of the Textbook of Veterinary Internal Medicine, a book used throughout the world by veterinary students and clinicians for up-to-date, timely and peer-reviewed information on veterinary medicine, including nutritional aspects of medicine.
While in practice, I have trained externs (preveterinary school graduates), interns (first year veterinary graduates) and residents (graduates pursuing a specialty). One of the hallmarks of the training (and that at accredited veterinary institutions) is the need to look for empirical evidence regarding statements made about diseases, drug therapies, surgical techniques and nutritional requirements. To lay blame on one particular product without substantial studies as proof of claim is inappropriate and misguided.
As someone who has worked in the industry for years, including work with Purina, I have been impressed with Purina’s quality and safety standards. Purina pet food products are made under rigorous quality supervision. Prior to making accusations that may be unfounded, it is first necessary to investigate the actual cause of a dog’s illness. Veterinary scientists can help to identify causes of illness and death and should be consulted for their expertise before making broad statements that have not been shown to have a scientific basis.
I do agree that ANY abnormalities noted by pet owners should be brought to the attention of their veterinarian, and any concerns with a particular product should immediately be brought to the attention of the manufacturer so that information can be collected and products appropriately monitored. The veterinarian and the pet owner then can decide whether to contact the FDA, as well. To date there has been no evidence that Beneful has caused any problems when fed to dogs. Poison control groups have not expressed any concerns, nor has the FDA.
As a final remark, I might mention that my own dog, Katie, a happy, healthy 8-year-old Newfoundland has been fed Beneful virtually all of her life. I feed her Beneful because she is a very fussy eater and has refused every other dry food we have tried. Neither cost, nor for that matter, contents are the reason for her getting this food, but rather her own preference. Until I am aware of there being a real reason to discontinue any pet food product made under such rigorous standards and controls, I will continue to feed her the product she chooses to eat.
Dr. Stephen Ettinger is a world-renowned veterinarian with more than 40 years of experience in the veterinary care industry. His areas of expertise include small animal veterinary internal medicine, small animal cardiology, hospital management and professional veterinary development. He continues to practice small animal medicine and works with a number of animal health companies, including serving as the Nestlé Purina Fellow in Veterinary Medicine and as a spokesperson for Purina Care pet insurance.
At 2:30 am it finally hits me why my left thumb is so sore. Nine and a half hours earlier, I failed to revive a dog with emergency treatment and CPR. I also failed to save him with aggressive surgical, medical and supportive care during the preceeding several days. The chest compressions of my final attempt to save Dog must have hyperextended my thumb. My only two comforts are that Dog no longer hurts and my thumb does. I fall into a troubled sleep.Very recently, I had given two talks, one to grade schoolers and one to middle schoolers about how great it is to be a vet. At the time, I had just started Dog’s treatment, his prognosis still had a sliver of hope in it, and if I had read about his case in a journal article, it really would have made a great story. I feel like a big liar, and to children no less. Right now, I hate my career.
I wake up wondering how Dog’s family is doing.
I stay awake a second night going over and over every detail of Dog’s case, deciding at every remembered step that I would not have made different decisions on Dog’s behalf. I would not have wanted the family to make different decisions. We needed to give Dog every possible chance. Every time my husband asks why I am crying/scowling/staring off (and at one point freaking out when I am in the sun, not the shade, at an outdoor concert), I say “I need to have been able to save him.” I am pretty sure that is not even a valid sentence structure.
Sometimes, being a vet sucks.
It is not as if I have a choice. I could have no easier chosen a different career than I could have chosen to be right handed. I mean, I could have forced myself, but I hear that messes people up pretty badly.
And really, even now, I do not want to be anywhere else than in the middle of grief for a dog I just met and who is technically a “patient” but is really a friend I fell for hard and fought for hard, and a family that is technically a “client” but really a team of fellow pet lovers who also loved Dog – but as a family member, and for years and years, not days. If this week is rough for me, it sucks many times over for them and will for a long time.
I don’t know why this has stuck with me for all this time, but another veterinarian once told me that unless I could rein in my “personality weakness” of letting sad cases hit me so hard,
“You will never be a successful veterinarian.”
It was a great little pep talk (ha!) but honestly, I believe the opposite is true. I can no more let go of my empathy than I could have chosen a different career. If I did not feel such rage and despair and hopelessness at not being able to save a Dog I really, really, really wanted to save, THEN I would concede his point, and truly, I would not be a successful veterinarian.
As it is, my career is a part of me I cannot separate from myself. Good or bad, I cannot care less than I do, or give myself a “healthy emotional distance,” even if I did want to, which I do not. This week sucks, and I do not know when I will be able to say I love being a vet again, but I will. And if I did not hate it now, that would be a serious red flag to me, and I would do everything I could to reconnect emotionally.
There are wonderful veterinarians who are much more emotionally even keeled than I. It is not a requirement of the profession to be a big cry baby sap. In fact, I do need to check myself when families need my support; they do not need me pushing them out of the way for the Kleenex box. It is just that empathy is such a big part of MY veterinary career, that if losing patients were to “get easier” as some older veterinarians promise, trying to be comforting, I would know that I had lost a part of myself, and would hang up my jacket and stethoscope.
I have normal range of motion in my thumb and just a small, persistent ache. I really hope next week is better than this week – how could it not be? I hope the hearts of Dog’s family members heal over time. I know that though it will be a long road, their hearts will heal, almost completely. I really hope that my thumb does not heal, but it is already feeling better. Dang it.
also published on Life With Dogs, reprinted with permission from Neil.
Does anyone find it strange that applying make-up while driving is not frightening? Definitely frightening for other drivers. This morning on my way to work, I witnessed 3 different drivers putting on make-up in the car while driving with their 3rd or 4th hand. Oh wait a minute, which is not possible.
I had not thought of this, is the light better in the car verses in front of your bathroom mirror at home? What if you had to eat too? And your phone is ringing?
Story from BBC NEWS:
http://news.bbc.co.uk/go/pr/fr/-/1/hi/magazine/4788910.stm
I organized our first Helping Hearts Free Veterinary Clinic. I first got the idea from a veterinarian on VIN who hosted a Pets In Need Clinic. Hers was a bit more extravagent then what I wanted to tackle so I designed this to fit the needs of my practice. She was kind enough to share her forms and I just had to edit them....great help. The date for the clinic was Saturday, May 16, 2009 and I have to tell you it was a great success. After I laid out a plan I contacted media to get the story out. We appeared on our local Fox, NBC and ABC stations to discuss this clinic. Wonderful warm and fuzzy marketing as well. I decided that it would be too time consuming to try to hold this based on income. I didn't know what a good income level requirement would be. Next, I thought about offering it to those who were on unemployment but that included some of my staff and though they definately had to make some life stlye changes they weren't to the point of needing free veterinary care. My solution? I had an application and requested they had a referral letter from a clergy member, case worker or social worker. We took applications for about a month. I contacted my vendors and suppliers and most of them were so kind and willing to help. We offered free physical exams, vaccines, FLVT and HWT, intestinal parasite screens along with sending home food, shampoo, flea/tick and heartworm prevention and more! I was freaking out Friday night when I counted 57 pets that we would see in the 4 hours. I had 100% of my staff donate their time and even some spouses who don't work with me. Each room had a DVM/ 2 tech team. We had 2 CST, 3 lab techs, kennel staff, floaters and even someone to man the brochure table and hand out food. We had a wonderful turn out and everyone was so thankful. We ended up seeing just over 60 pets that day! The feeling to be able to help was amazing!
Donna
A client recently asked me about a product, NuVet supplement, which after a little investigation seems to be the yet another fine example of snake oil marketing. It is quite similar to a product I reviewed not that long ago, Protandim, though all quack remedies share a lot of characteristics (as my reviews of DogtorRx, Supraglan, and others illustrate). Many of these characteristics are classic warning signs of snake oil, and in the case of NuVet, these include:
A “kitchen-sink” mixture of vitamins, minerals, herbs, and other ingredients, some of which are essential nutrients or have individually shown some interesting properties in test tubes and mice, but none of which shown to be safe and effective in treating or preventing any disease in dogs or cats.
This hodgepodge is advertised as treating many unrelated diseases (cataracts, Cushing’s diseases, diabetes, allergies, etc) with good results and no risks. These include:
Vague claims are made about treating “oxidative stress” and “inflammation”, with the implication that “anti-oxidant” and “anti-inflammatory” agents must automatically be safe and beneficial.
Glowing testimonials are offered to support the wild claims made, but not a single clinical study has been done to demonstrate the truth of any of them.
A money-back guarantee is offered, though how this compensates for the suffering or even death of your pet caused by relying on an untested and probably useless remedy isn’t really clear.
Too good to be true? You bet!
What Is It?
The two products NuVet promotes are NuVet Plus and the NuJoint Plus. The joint supplement contains glucosamine, chondroitin, and MSM. I have written about these ingredients before (1, 2) and the bottom line is that human and animal research evidence strongly suggests there is no benefit to taking these products for people or animals with arthritis. Barring contamination with something toxic, which happens surprisingly often due to the lack of effective regulation of supplements, NuJoint is probably harmless and useless.
The ingredient list for NuVet is much longer:
Alfalfa (Canine formula only) Alpha Amylase Amino Acids Beta Carotene Blue Green Algae Brewer’s Yeast Cat’s Claw Chicken Liver Copper Evening Primrose Oil Iron L Methionine Magnesium Manganese Oyster Shell Papain Phosphorus Pine Bark Potassium Selenium (Yeast) Shark Cartilage Taurine (Feline formula only) Vitamin A Vitamin B Complex Vitamin B1 (Thiamine) Vitamin B2 (Riboflavin) Vitamin B3 (Niacin) Vitamin B5 (Pantothenic Acid) Vitamin B6 (Pyridoxine) Vitamin B12 Vitamin C (Ester C™) Vitamin E Whey Protein (Feline formula only) Zinc
Talk about everything but the kitchen sink! The rationales given for the inclusion of each range from vague descriptions of what the normal role of some of the nutrients is in the body to totally unsupported assertions about supposed magical clinical benefits. I will address these claims in a moment.
The story behind the “discovery” of this elixir is either a perfect example of the naïve and unscientific thinking that should warn consumers they are being offered snake oil, or it is a carefully crafted marketing gimmick.
It all began years ago when I was noticing certain changes in my beloved furry companion, Elvis…Even though I had always cared for him and tried to give him the best food available, it became apparent that Elvis needed something more. After several trips to our veterinarian and at a cost that I don’t even want to think about, I was left to try and find a solution on my own. All the medications and changes to his diet wasn’t making any kind of significant difference and I feared my best buddy was quickly slipping away from me. I tried all kinds of vitamin and herbal supplements because I knew there was something his body needed that he wasn’t getting but I just couldn’t find the right stuff.
It occurred to me that, like my Elvis, many other dogs and cats were not taking a sufficient regimen of vitamins, minerals and antioxidants equivalent to advanced human supplements used to fight against the damaging effects of free radicals, which are a major cause of disease. I thought that the right combination, in the exact formulation, using only the highest quality of ingredients, would be required to rid pets of these damaging elements and would create a scenario for greater health and a much longer life span.
Blake G. Kirschbaum President
Mr. Kirschbaum goes on to claim his product is needed because of “obvious” deficiencies in conventional pet diets.
Because most pets lack proper nutrients such as vitamins, minerals, and antioxidants in their diet, even when they are getting the top of the line food, NuVet® scientists understood the necessity of filling this dangerous gap. Commercial pet foods can contain harmful “by-products” and useless fillers that can be toxic to pets, causing allergies and serious diseases. This kind of atypical diet creates a scenario whereby their food may actually be creating unstable oxygen molecules known as Free Radicals.
The next step after this brilliant insight was to set up a crack team to develop and promote the magic supplement all dogs and cats apparently need.
I decided to take matters into my own hands and established NuVet Labs®. I put together a team of highly respected scientific, medical and pet industry professionals that had the same goal as I did; to create a nutritional product that would go beyond current supplements that only gave symptomatic relief. Our objective was to make a truly effective nutritional supplement that would attack the root cause of sickness and disease, eliminating the free radicals and other sources of the problem, once and for all. This became my mission and although it took our team 8 years to perfect the formula, we finally got it right. An independent laboratory tested several dogs and cats, varying in age, size, and health conditions, under the direct supervision of a team of veterinarians.
Our Advisory Team is composed of a veterinarian, a doctor of pharmacy, a pet supplement and pet food formulator, a doctor of optometry, a licensed financial advisor, a litigation insurance administrator and a senior hospital purchasing manager.
Eight years of effort dedicated to solving the root causes of all disease finally vindicated by an unpublished test in “several dogs and cats.” Wow!
I have added the emphasis above to highlight the pre-existing faith Mr. Kirshbaum evinces in the nature of his dog’s health problems (nutrient deficiency and free radical damage) and the solution (the “right” supplement), as well as the astounding arrogance and naïveté this narrative demonstrates. The very foundational principles behind this product are unproven and scientifically empty beliefs, not well-established principles of health and disease. And the claim being made is that the One True Cause of disease, and its solution, which has eluded all scientists everywhere in the world has now been cooked up by one visionary and his small team of mavericks Not a good start.
Does It Work?
The underlying theory that all these disparate chronic diseases for which scientific medicine does not have a definitive cause or cure are caused by oxidative damage due to poor diets is nonsense. While free radicals exist and do cause cellular damage and even disease, this little core of real science has been rebuilt into a bogeyman that bears no resemblance to the truth. Like all overly broad and simplistic ideas, the oxidative damage hypothesis has proven far less robust than initial enthusiasm for it would have suggested, and many purported anti-oxidants have turned out to provide little benefit in preventing or treating disease, and even in some cases have been shown to be actively harmful (e.g. 3, 4, 5).
While many of the individual ingredients in the product are essential nutrients, there is absolutely no reason to believe that they provide any health benefits except in cases in which a pet is deficient in a specific nutrient. Providing excessive vitamins and minerals to prevent or treat diseases is seldom beneficial and, again, sometimes actively harmful (e.g. 6, 7, 8). And there is extensive evidence to show that while commercial diets are by no means perfect, they are not the deleterious pile of toxins and garbage described by those who are trying to sell supplements (e.g. 9, 10).
As for the other ingredients:
Alpha Amylase: There is no truth to the claim that digestive enzymes are beneficial for normal animals (11)
Bluegreen Algae- There is no reliable evidence to support the health claims NuVet makes for this ingredient (12). And some species of bluegreen can be highly toxic, especially to dogs (13).
Brewer’sYeatst- A source of B vitamins, but not an effective flea control product (14).
Cat’s Claw- There is weak clinical evidence in humans of anti-inflammatory properties to some of the chemicals in this herb, and there are also reports of serious side-effects (15). There is no controlled research evidence to show safety or any benefits in dogs and cats.
Evening Primrose Oil- There is limited evidence for benefits treating eczema in humans, and otherwise no solid evidence of benefit for any other disease (16). It may be a good source of essential fatty acids, which could theoretically have some benefits for allergic skin disease or arthritis. Obviously, the claims concerning cholesterol and atherosclerosis are irrelevant since dogs and cats do not suffer from this disease.
Papain- There is limited evidence for benefits of papain in humans for shingles and sore throat, and no reliable evidence for any other benefits (17). There is no reason to believe it has value as a “digestive enzyme,” and the limited research on it as a hairball remedy in cats and rabbits has not shown any real benefit.
Pine Bark Extract- There is some laboratory and animal model evidence that chemicals in this extract have anti-inflammatory and anti-oxidant activity, but actual clinical benefits have not been demonstrated in human or animal clinical trials (18). As always for any chemical with real physiologic activities, there is the potential for side-effects (19). I am not aware of any clinical trials investigating the use of this ingredient in dogs or cats.
Shark Cartilage- Shark cartilage has been proven ineffective for advanced cancers of various kinds, and there is inadequate evidence to show benefit for any other condition (20, 21). The harvesting of sharks for this supplement as well as for food contributes to the decline of threatened and endangered shark species (22).
And finally, as well as most important, there appears to be absolutely no published research evidence of any kind evaluating the safety or purported benefits of this product. That is not a good sign.
Is It Safe?
As indicated for the specific ingredients above, harm can result from indiscriminate use of even essential nutrients. The amounts of each ingredient in the final product are not made available to the public, so it is impossible to evaluate the safety of the doses even for those ingredients for which safe and unsafe levels have been established.
Due to the inadequate regulation of dietary supplements and herbal products, it is impossible to ensure the accuracy of ingredient lists or the absence of dangerous contaminants, both of which have been real problems for such products (23, 24). There is also no formal system for collecting and evaluating reports of harm from such products, so the only assurance of the safety of the product is the word of the manufacturer.
Bottom Line
This product is a hodgepodge of nutrients, herbal ingredients, and nutraceuticals thrown together with no clear logic or rationale. The claims that many pet diseases are due to toxins or other deficiencies in commercial diets and to oxidative damage are unsupported by any real evidence. Only a few of the specific claims for the ingredients in the mixture are backed by research evidence, and the quality of this is generally poor and only available for humans. The advertising of the product contains many of the hallmarks of snake oil marketing, but it does not contain any research evidence at all concerning the safety or effectiveness of the product, because none appears to exist.
While I have no reason to doubt the sincerity of the manufacturer of this product, I believe it is unethical to sell a product with no research establishing the safety or efficacy of the product for any disease and with little to no research even into the safety and efficacy of its constituents. Promoting the product with unproven or outright false claims about pet nutrition and disease designed to instill fear in pet owners and with wild and ridiculous claims about the effectiveness of the product for numerous unrelated diseases is wrong regardless of how sincerely the manufacturer believes in their own pseudoscientific theories. Any responsible manufacturer of a medical therapy should be expected to demonstrate their claims through rigorous science before profiting from the desperate need of people with sick pets.
I was in a discussion today about piercing and tattoos and if professionals should avoid them. Here are my thoughts on this. I think people should be able to do what makes them happy and comfortable. I also try my best to always judge people by their actions and not their appearance. On the other hand I certainly do know that extreme individuality makes people judge you differently and act differently and I bet it even holds people back from being successful. I meet lots of people and see lots of speakers and and everyone is very "normal" appearing but I would hope that if I went to a conference and there was a management topic I wanted to hear being delivered by a fully tattoo'd woman with an eye brow ring that I would still attend and not be distracted. I would hope that I would admire her individuality and right to do what she wanted that made her feel comfortable. On the other hand...would I hire her? Well based on my policy manual I couldn't but that would be the extreme. I have 2 staff with tiny nose studs and I myself am thinking of getting one. I find them very feminine and beautiful. I have staff with tattoos but most of them can't be seen. I too, have 2 tattoos but they only show in a bathing suit. I am trying to break in to the veterinary world as both a consultant and a speaker. I love my profession and am passionate about what I do and believe in. I have worked hard to earn my Associate and Bachelor Degree as well as my CVPM certification. would a nose stud make me less knowledgeable? I would hope not. So the debate rages on I guess. I may get the nose stud....and hope that I am not judged. I will see the speaker covered in tattoos but probably wouldn't be able to hire her as my receptionist. Not because I don't want to but because my policy manual for the practice I don't own states that I cannot. I would also feel that the extreme might be distracting and make clients uncomfortable. On the other hand a small nose stud or even a small tattoo on the back of her neck (I have staff with both of these) wouldn't bother me and I don't think would bother my clients. Why the difference? Small is not distracting and extreme is?? Not sure. What about piercings that are part of a culture? Is that more acceptable? I guess this is a debate that will live on. I hope the day comes when we are all judge solely on how we treat people and what our skills are. I wonder if that will ever happen?
Writing and blogging, when I finally tried it a few years back, came easily to me. Facebook and Skype did as well. Twitter was difficult. I gave up a few times. I am so glad I did not give up entirely, as I would have missed out on so many special friendships and links to great information, in the veterinary community and world at large. In case it is as strange to you as it was for me, here are a few starting points. Try it. Then try it again. I hope you find the twitter forum as rewarding as I have!
Start with a personal account. Most of the veterinarians on twitter with whom I engage speak for themselves, not their practice. This gives more freedom to say random, un-veterinary things. If you want to say, “prevent heartworm disease in your pets” in one tweet, then “my dog just did the cutest thing!” then “I got some great sweet corn at the Farmer’s Market today!” no one will say, “Well that’s a weird train of thought for a veterinary professional!” And you do not need to worry that you are representing your business.
But remember that you ARE representing your business. People DO know that you are a vet, and in a few clicks of the mouse, they can find out where you practice, if you have not bragged about it endlessly in your tweets and profile already (which I think you should, by the way.) So…
Keep it clean.
Be kind. I suppose “be kind” is also self-explanatory. Still, twitter is much more fun if everyone is kind. If you have a gripe about a company, send it to them in a DM (direct message). Then when they respond, you can tweet that - “You would not believe how quickly @GreatCompany resolved an issue for me! Thank you @GreatCompany :)”
Be twitter-kind. Twitter has its own quirks that you would not automatically know. Not shouting (THIS IS SHOUTING) is kind. “Retweeting” (Repeating another’s tweet and giving them credit) is kind. Following someone who follows you is kind. Talking directly to others using @ followed by their twitter name is kind.
Be as good at patient confidentiality as you are in Real Life. Do not share patient and client information without the permission of your client and your veterinary hospital leadership. Even with blessings all around, do not share specific medical information about a specific case.
Yes: (with permission of boss and client and photographer) “How cute is my patient?? http://twitpic.com/mjpib”
Even better: (less permission-getting needed) “How gorgeous is my cat?? http://twitpic.com/sh0of”
Follow people you would enjoy getting to know. When I started twitter, I followed family members and friends, veterinarians and other pet lovers and people in Omaha. In hindsight, that was one thing I got right from the beginning.
Keep tweeting till it makes sense. My brother Dave convinced me to start twitter, because he knew I could reach a larger audience with pet preventative care information. For several months I would open twitter, watch the time line of the people I had followed, close twitter, and sigh, “I just don’t get it. It’s like facebook without the fun pictures.” Dave would smile and say “Don’t give up” and I would repeat the process: open twitter-check timeline-close twitter-sigh-gripe. Till one day, I did get it. “Hi how’s it going?” someone tweeted. “Great” I tweeted back. Hey, this was fun! It was like waving to a neighbor, only it was ok if she was three states away…or around the world!
Start a hospital twitter account. Oo, I have not done that yet…maybe that is my next great adventure… :)
The photo above shows a poignant “letter” we received in response to the September 2010 Firstline article “Overcoming the ‘Just a Receptionist’ Rap.” I’m troubled by this feedback for multiple reasons, mainly these two:
1. We’ve clearly offended someone, which we are sorry for and never intend to do.
2. The anonymous “letter” doesn’t give us enough information to address the offending problem.
I take my job as editor of Firstline very seriously. So opening a “letter” like this feels like a punch in the gut. After dusting myself off, I set out to use it as an opportunity to improve.
Discussing the feedback with the article’s author helped both of us realize—again—that different people can interpret the same statement differently. This is especially true when more than 42,000 team members working in all types of veterinary practices across the country read a sentence in an article. The team member who sent the “letter” did not like this sentence in particular: “Perhaps worst of all, the medical team’s low opinion of receptionists may make it difficult for you to maintain self-respect.”
That’s a straightforward statement that doesn’t mince words—especially when it’s read out of the context of the whole article. I can see how a technician who holds great respect for the receptionists might be offended. I can also see how a receptionist who garners respect from the medical team might be offended, and I can see how a receptionist with high self-confidence might be offended. Unfortunately, the nature of this “letter” leaves me guessing as to why the sender was offended.
Like I said, we never want our articles to be insulting. We do want them to be thought provoking. And that’s another way to use this “letter” as a positive. Please share your thoughts. Did the article miss the mark? If so, how? And what could we do better to help front-desk team members who do feel like “just receptionists?” Or is this the (good) problem: We’ve written about an issue that isn’t really an issue at all?
(Don't miss the message board discussion on this same topic.)
The radar images told the story of Gustav. But they could never convey what it is like to experience sustained winds of 110 mph and a foot of water pouring from the heavens.
My guess? Riding out any hurricane ranks as a category 5 on the fear scale. Unpredictable, unknown and unrelenting weather driven by a freight train of sound. The stress must be constant.
Gustav turned into the Gulf of Mexico, and the alarms sounded for evacuation in New Orleans. I heard them 1,000 miles away. We all did.
New Orleans dodged another bullet on Monday. I will never forget the reality of seeing, smelling and touching Katrina’s crime scene in 2005. Can you imagine a flood line 18 feet tall? How about 110 mph winds lashing at your home while intruding water slowly, silently crept up the stairs?
I have a sense of what it might be like after visiting New Orleans veterinarians’ Gary Levy and Patrick McSweeney following Katrina. It’s no wonder they evacuated along with the 2 million other residents. Dr. Robert Gros, a New Orleans veterinarian told me by cell phone this weekend, “It certainly isn’t anything to risk your life over.”
On Tuesday, the clean up and assessment started throughout the region. Once again, like so many times in the past, veterinarians showed up. They are my heroes. Their unselfish commitment to animal health needs to be embraced, talked about, celebrated. Either through their volunteer work at shelters -- like the mega-shelter in Shreveport that is now home to 1,000 displaced animals -- through disaster response teams or within communities, veterinarians and animal-health technicians define compassion for the rest of us.
It’s a shame that it takes a disaster to recognize it.
Dan Verdon is editor of DVM Newsmagazine.
DVM Newsmagazine invites you to share your storm stories here.
This is a bit technical but brief overview on this issue. I will do my best to make it easy for everyone to understand. In the JVB (2007) Overall evaluated the molecular and cellular use of shock on the learning process. She suggested, “we may be changing other behaviors or processes” with these devices technically called E-Stimulus Devices.
Overall (2007) uses what she describes as “a landmark study” by Schilder and van der Borg published in Applied Animal Behavior (2004). Schilder and van der Borg noticed dogs exhibiting more stress related behavior when using these types of devices. Stress related behavior continued with the control group, during free time in the handlers presence while at parks, when dogs should be relaxed. Stress behaviors and/or conflict resolution behaviors is extensively defined in recent dog literature.
The authors, Schilder and van der Borg (2004), concluded three negative effects from the use of e-stimulus devices (shock collars). They are as follows:
Overall (2007) suggests, though some guard type dogs are successfully trained using these devices, other concerns i.e. “heightened uncertainty and reactivity” were reported. She says, president of a regional detection dog group in the US believed “any handler who hits the streets with a dog wearing a shock collar did not have a well-trained or reliably trained dog.”
As said earlier, I am attempting to offer only an overview on the use of e-stimulus devices, aka shock collars, not an in-depth study or research paper. There appears a growing number of dog trainers schooled to use these devices as standard training equipment. One such school is located in Florida. Their slogan “We do this quickly, effectively and lovingly. Plus we GUARANTEE our E- Touch approach and dog training for the life of your dog.”
Guaranteeing results is a very questionable practice in the discipline of behavior and often advised against in literature when selecting a dog trainer or behavior specialist. Not even a human therapist will guarantee your results. This is purely marketing, and when their system fails, because they have not correctly identified any underlying problems associated with a behavior complaint, the owner will either seek other counsel or worse, surrender the dog to an unknown fate at a shelter.
A legitimate concern exists for newly introduced dog trainers, veterinarians, dog owners/handlers, dog-related businesses, and dog owners who are unaware of these findings and literature on the subject is sorely lacking.
The following statement and review comes from a “Letter to the Editor” in response to Overall’s (2007) editorial cited earlier. The response appeared in the JVB (2008) published by a “representative” from Radio Systems Corporation, the world’s leading manufacturer of e-stimulus devices which they refer to as “static stimulation.” The brands represented included Invisible Fence, PetSafe, Innotek, SportDOG, and Guardian Brands.
The author, in the first paragraph says, “We are in complete agreement with Overall…decisions to use such equipment should not be made lightly,” and states their literature includes warnings. I am purposely omitting the author’s reasoning for suggesting e-stimulus devices as a “legitimate means of behavior modification” that would need discussion on learning theory, highly technical and lengthy paper. The intended target audience is to bring attention to dog-related business’s, shelter and rescue personnel, foster parents, veterinarians, groomers, daycare owners, and dog owners.
Before making an informed decision using dog-related equipment for purposes of behavior modification, a complete behavior history and medical workup should be completed. This gathering information about the dog, family, and dog’s environment, help the behavior consultant identify the problem and informed choices how to approach modifying the dog’s behavior.
Additionally, any medical reasons sometimes masquerading and/or contributing to a behavior problem need eliminated first by a veterinarian.
Once these two requirements are completed, any medical problems eliminated, the consultant can begin offering solutions including training, modifying the owner’s behavior, and any necessary management. If the case involves a dog who has already bitten, a risk assessment is necessary. The owner/handler, rescue organization, or foster care person is apprised of any risks and recommendations keeping in mind the public’s safety and anyone coming into contact with the dog.
If a certified behavior consultant (IAABC), board certified veterinarian (ACVB), ABS and/or AVSAB member were to decide the use of an e-stimulus device is warranted, then according to the representative the following must be taken into consideration.
The choice of the targeted stimulation is important, and since instrumental behavior (learned) is usually rewarded by its consequences, “not all behaviors are equally likely to be associated with certain consequences.” They state, “researchers discovered that certain responses can be exceedingly difficult to establish” using shock avoidance!
Here’s the kicker… they admit animals are not ‘biologically prepared’ to associate a negative event when faced with danger. I’m including any type of fearful stimulus. It is widely known animals have choices when faced with threatening situations. They can freeze, flee, defend themselves offensively or offer appeasement behavior (tend-befriend). The author says, “if a trainer attempts to punish defensive aggression in an already frightened dog, the aggression is likely to escalate,” not diminish. Aggression, except predatory, is always associated with fear and unless you change the emotional response, you cannot change the dog’s perspective toward that fear.
The author suggests behavior “targeted for suppression” using e-stimulus devices include roaming, chasing vehicles, prey drive and “other high-arousal behaviors far removed from stress.” The bolded phrase is concerning since “high-arousal” behavior can manifest in a myriad of ways and reasons and often already associated with stress! An example of “high-arousal” behavior could be jumping, barking, or zooming around the house to release energy! All of these suggested behaviors, often undesirable “high-arousal” behavior are always associated with the owner, not the dog.
The dog is often responding using normal dog behavior, often perceived negatively by their owners. Many of these dogs are living in dysfunctional environments. A dysfunctional environment often does not include clear rules and boundaries associated with the dog’s behavior, and in most cases, owner reinforcement is often present. So punishing the dog for owner-reinforced behavior, inconsistency, lack of enough outlets for energy expenditure, and generally not meeting a dog’s needs seem rather cruel.
The following statement made by the author needs understood, especially by dog owners considering these devices for training and/or behavior modification. The author states, “experienced trainers acknowledge…motivating learning through aversive control” is only effective if the trainer concentrates on “one response at a time” and “intermixing behaviors only when performance” of the first target response is “fluent” (reliably trained).
Most problem behavior consists of chained behavior. For example, dog hears owner’s car arrive home, dog begins to get aroused, owner walks in, dog jumps all over owner. If they suggest the correct way to use these devices means, the owner/dog trainer must stop the behavior before it gets started, when the dog hears the car! All other points in the entire chain of behavior must be “fluent” (reliably trained) first, before proceeding to the next! I have to ask, how many of these trainers are training reliably each sequence in a chain of undesirable behavior with the owners? This is exactly how positive trainers shape desirable behavior, but without using punishment.
The author’s argument that other punitive procedures, i.e. time out, are ineffective, citing “electrical stimulation is potentially superior to and safer” than other aversive punishment, i.e. spray bottles, restraint, and noxious tastes, is unsubstantiated. This suggestion is weak lacking any research or quantification.
I purposely left time out from their list; time out, used effectively and consistently, with rules, timing and proper social settings can/is very effective, given the dog wants to stay in the social environment. If the dog’s social environment lacks rewarding opportunities and training an incompatible behavior, sending them to time out will have no effect at all, in some instances, it may offer the dog relief. Therefore, the author’s statement is weak and appears to lack understanding correct time out rules and when/where its use is effective.
The author further justifies using electrical stimulation by comparing it to human cases of “self-injurious behaviors,” i.e. head banging. Dog owners commonly complain about barking, running away and jumping, these common dog behavior problems don’t come remotely close to “head banging” but aversive punishment is commonly recommended. A recent study, on territorial aggression suggested owners are most responsible for their dog’s behavior. See related blog post, “Spoiling dogs, is it really good for them? .” Until owners step up to the plate, take responsibility for contributing to their dog’s behavior… after all, it was their choice to adopt or buy a dog… We will continue to debate this issue as well as how many dogs are euthanized every day and yearly because of unresolved behavior problems.
Lastly, using the author’s own words the use of e-stimulus devices “should never be considered in isolation from positive reinforcement” when used to correct unwanted behavior. My answer is: if more owners were properly educated in the use of positive reinforcement and life rewards, there would be limited need for these devices.
The only consideration for the use of an e-stimulus device might be to control prey drive. However, this requires your presence, a dog allowed to roam freely will still be able to kill. A dog diagnosed with prey drive is a danger to the community and based on a risk assessment, should be remanded to its property, and if taken out in public should wear a muzzle to protect the public and other animals.
Joyce Kesling, CDBC
Certified Dog Behavior Consultant (IAABC)
Professional Dog Trainer (APDT)
Sarasota, FL
http://www.responsibledog.net/
A new study has been published adding to the evidence, which I have discussed before(see articles listed below), that homemade diets are frequently nutritionally inappropriate and less consistent or reliable than commercial diets.
Larsen, JA. Parks, EM. Heinze, CR. Fascetti, AJ. Evaluation of recipes for home-prepared diets for dogs and cats with chronic kidney disease. Journal of the American Veterinary Medical Association. 2012;240(5):532-8.
The authors looked at 39 recipes from websites and published books for both veterinarians and pet owners (most written by veterinarians) and identified as intended for dogs with kidney disease and 28 such recipes intended for cats. Though the optimal amount and proportion of every possible nutrient is certainly not known for pets with kidney disease, there are some nutrients for which it is fairly clear that animals with kidney disease have different requirements from healthy animals. And the minimal amount of most nutrients needed to avoid deficiency (though not necessarily the optimal amount) is known for most nutrients. The authors systematically compared the nutrient profile of the recipes they examined with known minimal nutrient requirements and with the established special needs of cats and dogs with kidney disease.
Almost all recipes were vague about key ingredients, requiring the owner to guess about exactly what ingredient to use. Similarly, almost all recipes recommended some sort of nutritional supplement but did not offer specific guidance as to type, quantity, or nutrients. Some recipes offered clearly incorrect information, such as suggesting baking soda as a calcium source even though it contains no calcium.
The authors conclusions were:
None of the recipes assessed in the study reported here provided adequate concentrations of all essential nutrients…Furthermore, many recipes did not accommodate currently accepted nutritional strategies for managing [chronic kidney disease].
There is no doubt that homemade diets can be healthy and appropriate for dogs and cats, both those that are well and those with diseases requiring special nutrition. However, the case has not been made that home-prepared diets are superior to commercial diets, as is often claimed. And while commercial diets may not be optimal nutritionally for many individuals, they are at least consistent and monitored for minimal nutritional adequacy. Any benefits home-prepared diets might have won’t matter if they are grossly deficient or inappropriate in terms of essential nutrients.
For my own clients who wish to feed home-prepared diets, I always recommend consulting with a board-certified veterinary nutritionist (try the local veterinary medical school, or PetDiets.com) to ensure the diet is nutritionally appropriate for the individual pet. Recipes have been repeatedly shown not to be reliable, even when created by veterinarians, and relying on them is likely to lead to feeding a nutritionally inappropriate diet.
I recently read the “Hot Button” column in Veterinary Economics’ April issue featuring Dr. Craig Woloshyn’s concerns about the evolution of veterinary medicine. No doubt Dr. Woloshyn’s aim was to encourage readers to join the battle for our industry’s future, and I couldn’t agree more with that goal……..it’s just that I’m not sure we’re on the same side.
It may be “contraindicated” to say aloud, and specifically in a management forum like this, but I worry that the biggest threat to veterinary medicine are the experts who seem so focused on fixing something that isn’t broken. Let’s get a few things out of the way in order to frame my comments – I’ve been in the field for nearly 20 years, veterinary medicine has paid for almost everything I own, to this day I still love my job, and I have nothing but respect for my fellow professionals. That said, I still believe one thing as strongly today as at any point in my career – veterinary medicine exists to support the needs of pets and pet owners. It’s not the other way around.
I have no beef with specialists or practices that offer only the highest standard of care, nor would I scoff at anyone seeking that care for their pet. However, I feel just as welcoming to pet owners that must balance what they can spend on veterinary care with the other demands in their lives, and often their philosophy of pet care in general. I’ve never thought twice about the lengths some families will go for their pets’ care, but the growing chorus of consultants that would have the entire industry move that direction are shortsighted.
It’s almost as if they believe that if we all agree to raise our standards to the highest level, pet owners will just have to accept it, and every pet will get only great care from then on. Unfortunately, if all veterinarians were to embrace and require that standard of care, there are only two possible outcomes – the middle and lower class will no longer be able to afford a pet, or (and much more likely) there will be a dynamic shift in the role that insurance plays in our industry.
Right now, insurance is a positive participant in veterinary medicine, but it has to be recognized that they also have no real leverage. The number of pets covered by insurance today is nowhere near the critical mass number needed to empower insurers to lobby effectively for their needs. However, if veterinary medicine becomes too expensive for the average person to own pets, they will turn to insurance to offset those costs, and when enough of them do so, the first steps will have been taken toward diagnostic and treatment options being dictated by a third party payer (sound familiar anybody in the human medical field?).
It all begins with advocacy. Is advocacy upholding only the highest standards of care, or is advocacy working to reach as many patients as possible in some way, even if only slightly? We’ve seen some amazing advances in our field – imaging, analgesia, and pharmacology to name just a few areas, but outside of educating the client and offering the best, who’s right is it to insist on standards? Certainly, many would answer that we must insist, because pets can’t speak for themselves, but let’s face it – we still know precious little about what a pet thinks or feels. Do we serve just our patients, or society as well?
The answer may seem simple, but consider this – many veterinary clinics don’t perform convenience euthanasia, and based on many comments on this site alone, most veterinary professionals are frustrated with clients that would ask. Depending on your viewpoint, however, why should we continue to provide veterinary care to those who raise beef cattle, pigs, or chickens? Are they not going to end an animal’s life simply for convenience (albeit that of the meat eating world)? I’m not a “no-meat” activist, but I’m pretty sure if those animals could advocate for themselves, they’d ask nicely to stay alive. How about breed standard cosmetics……our choice or pets’? It’s all relative!
How about the comment that low cost population control clinics serve only our need to feel good about ourselves? We’ve run a low cost cat neuter clinic for years and I can tell you it’s not to feel good, and it’s not really to profit. It’s sole design is to neuter cats, and as many as possible at that. No connection to population control? Come on…….we may not be winning the war of overpopulation but should we really quit trying? If we apply the highest standards for cat neutering – pre-op bloodwork, IV catheter and fluids, multimodal monitoring device (that takes longer to hook up than it takes to neuter the cat), regional anesthesia, injection for analgesia and meds to go home, heck – why not a 7 day recheck? – we will stop neutering 500 cats per year and start neutering 10 cats per year.
Failing to do insist on “everything possible” in our standard of care will not cost veterinary medicine its place on the “Most Trusted Profession” list, but failing to tell the truth to our clients will. We have to acknowledge nature’s continuing role in the outcome of our efforts and remember that in very few instances can we claim that veterinary science is absolute. There has to be a balance between practicality and best medicine, at least if the client asks for it, and we have to remember that “Plan B” has a pretty good track record of success.
Finally, there is no absolute connection between low cost veterinary care and bad medicine (or between high cost care and good medicine), and a failure to prioritize profit shouldn’t be confused with poor care. Some very bright DVMs approach their care with affordability in mind, just as some “high quality” providers know what they’re “supposed” to do, but have no idea why.
There’s nothing wrong with the state of veterinary medicine – but if we continue to focus all of our energy on requiring only the highest standard of care, and turn our backs on the middle and lower class, there soon will be. “Offer the best, but treat the rest.”
