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Dec 08
2014

Client Education: Fecal Sample

Posted by Dean Scott in Untagged 

Dean Scott

Often a veterinarian will ask you to bring in a fecal sample (also known as poop, poopy, poopoo, doodoo, excrement, midden, brownie, colon cobra, dung, dookie, scat, lincoln logs, mud bunnies, or Hell's candy) from your dog.  They will have many reasons for this, the primary one being to see if you'll actually do it.  This can create a high level of anxiety for most clients.  To help you not fall in it, smear it around, or otherwise mess up a pretty simple task, we have put together a guide to ease your burden.

1.  There are various methods on how to obtain feces at home.  Here are some ideas:

    a.  if you have a child, have them do it.  Give them no instructions to add humor to the project, especially if they're home-schooled.  This is called character-building.

    b.  use a container (preferably a hard plastic one with a child-proof cap; why a child would want to get into this is a mystery, but they do a lot of stupid things don't they?) to scoop feces or part of feces into it.  A downside is that some fecal molecules may adhere to the outside rim, thus warranting cleaning of the outside of the container.  You will then have many days of anxiety wondering if some might have gone unnoticed and be hiding somewhere in your house.

    c.  use another implement to scoop a piece of feces into the container.  Challenge yourself to drop it perfectly into the opening without hitting the edges, thus preventing extra cleaning of the container.  Need it be said that this now becomes an implement that you will no longer want to use?  So, choose wisely.

    d.  alternatively, you can use an intermediary piece of plastic or small bag to put the feces in before the container.  If you do this, make sure you squish it around a lot, because most veterinary staff members like a surprise when trying to get the sample they need out.  You can make it even more of a surprise if you use something opaque, so they really don't know what they're getting into until they have to peel it apart.

    e.  do not use your hands, even if gloved, because that is just icky.

    f.  like bread, you want to pick the freshest feces of the day, preferably while still warm.  If the feces is white, it is too old.  And you need to clean your yard more often.

    g.  do not try to catch feces while still in mid-air.  I don't know why this needs to be said, but I just know some of you out there will try to do this unless you're told not to.  It's not like when you have to catch a urine sample, ok?  If dirt or grass gets on the feces, it doesn't make it grosser.

    h.  as in "g" above, do not play in the feces.  Shouldn't need to be said.  But you never know.

Finally, once you have the fecal sample, follow these steps:

3.  Seal container in continuous layer of clear plastic wrap.  You want to use clear wrap so you can verify that the feces has not escaped.

4.  Place in sandwich-sized sealable plastic bag and roll bag around container.  Since this is also clear, verify that feces has still not escaped.  No?  Good.

5.  Wrap in several layers of absorbent paper towels.  While it is unlikely that fecal gas or oozy fluid will dissolve or otherwise cause, by expansion, hard plastic to explode, you can never be too careful.

6.  Place in sealable, hard plastic container.  Like the implement you may have used to get feces, this should be considered non-reusable.  However, for fun, you can insist to the veterinary staff that you want it back, just so they can talk about you later.  It's a great way to be remembered by them in the future.

7.  Finally put everything into a gallon-sized sealable plastic bag.  Alternatively you can place this in a festive bag or maybe put a bow on it to hide the otherwise disgusting nature of the contents.

8.  It is now safe to drive your pet's fecal sample to the veterinary clinic.  Drive slowly, avoid pot-holes, sudden stops, or unnecessary jostling.  Make sure you obey all traffic laws.  The transportation of feces outside of a body cavity is illegal in some states.

9.  If you have any questions regarding the above steps, please feel free to call your nearest veterinary practice.  They love answering these kinds of questions.

Nov 10
2014

Thanks. Thanks A Lot.

Posted by Dean Scott in Untagged 

Dean Scott

Since it's November and I'm Americo-centric, I thought I'd write a few thoughts down about giving and receiving thanks. When I was heading down that really long road (you know the one that disappears over the horizon) toward becoming a veterinarian and even having once achieved that dubious goal, never once did I think what kind of thanks I might get from the people I might help. After twenty-one years (or thirty-four years if you count the entirety of time I've spent in this profession in some capacity), however, I can't help but notice a trend. In order of appearance, according to the level of thanks I get in a typical year, it goes something like this:

Thanks for euthanizing pets
Thanks by my wife for doing something (really, anything, that's how appreciative she is)
Thanks for something related to FunnyVet
Thanks from co-workers
Thanks from random encounters with people (foodservers, cashiers, etc.)
Thanks for passing something to someone (salt, newspaper, remote control, etc.) and, coming up a very distant seventh place:
Thanks from owners for making their pets better in some manner

Now, I'm not so egotistical as to not acknowledge that you can look at that list and think to yourself, "Well, he must be lousy at his job." Especially if you look at the bookend 1st and 7th placed "thanks". However, I don't think that those bookends are very much different for anyone else in this profession. In the almost ten years of running FunnyVet, I have been thanked a hundred times more than I ever have in the twenty-one years of being a veterinarian. Now, I'm ignoring the first place "thanks" when I say that. If you're ever going to get thanked as a veterinarian, it seems like it's when you help a patient to die. Really the only medical profession where that happens. It just doesn’t happen in dentistry, podiatry, ophthalmology, etc. When you euthanize a pet you will get cards and sometimes cookies or cake and I often want to tell clients that they are rewarding the wrong behavior. I guess I should accept thanks where I can. And I suppose there are ways to just do euthanasia wrong; ways that wouldn’t get “thanks”. I've even had clients refer their friends to me (even if it is a bit of a drive for them) to euthanize their pets because I do it so well. A bit disconcerting to be known that way. And while it’s certainly not quite why I got involved in this profession it puts pets’ nervousness during their clinic visit into perspective. We really need to get thanked more for all of those pyometra surgeries that pull through, or those blocked cats that the owners sat on for a week that we make better, or the complicated Cushing's/diabetes cases we manage, or the parvo cases, or, or, or.....I mean, the list does go on. Even on those rare occasions we do get thanked (at least, as I've said, for me it's rare to the point of being memorable when it happens) there is often a qualifier of how much it cost or how long it took to get better or how put out they are that they have to treat this long-term condition. Especially the cost.

On a strange note, I've been thanked, sometimes profusely, by our "rabies only" clients. I give the shot, do a little flourish with my signature, and these clients go on about what a great doctor I am and I'm the only one that sees their pet. "Yes, yes," I think, "I give good rabies."

I will admit, also, to not being good at accepting thanks. Maybe that's because I haven't had enough practice. However, I've run into situations where I've had clients on their first visit loudly extol my many virtues (regardless of what their visit was for) and how unlike and better I am than any other veterinarian they have ever seen. These guys make me leery because in almost every instance there is a future consequence. Almost as if karma must maintain the balance. I've had these same clients turn on a dime, like some poorly trained dog, and go on the attack about how lousy I am. And I've found that often they lead with so much praise in order to curry some favor later. And when that doesn't happen for them, well, I guess I'm not the great vet they thought I was. Or the manipulatable vet they thought I was. So, when clients upon first meeting me tell me that I’m the best vet ever? Well, I just think, “I see disappointment in your future.” Now it could be you're out there thinking, "Well, a lot of people don't get "thanked" for doing their job, you ungrateful bastard." And, yes, that's true; I am an ungrateful bastard. However, what I'm commenting on is the severe dearth or drought of thanks. As if thanks were a commodity and there's a terrible depression in our area, people jealously guarding their hoarded stash like survivalists in an atomized thankless wasteland. Am I the only one that sees this or this happens to? Because when you don't get thanked, even in difficult situations, time after time, over the years, it does make you think that what you're doing isn't appreciated or valued. Especially when the complaint department seems ever-full and back-logged. People seem to have a keen radar for perceived slights or feelings of entitlement. I've been thinking of a title for my future memoirs (not to be confused with Renoirs of which I have none). The title I've come up with is "Waiting For My Thank You". Here's the thing though. While I notice the phenomenon, it really doesn't matter to me much any more (he doth protest too much since this blog stands in direct repudiation of that thought). However it is true. It's difficult to have expectations of others. So you end up lowering your expectations, knowing they (probably, statistically) won't thank you for your best efforts. That's ok. I will continue to do the best job I can and take solace that my thanks comes in the non-verbal, self-fulfilling type of healthier pets. And, really, at this point in my "career", such as it is, clients can keep their thanks. I don't really need it. I'm fine with never being thanked again. They can, however, also keep their complaints of which there seems to be a constant wealth and abundance.

Personally I like to thank most everyone. I thank the cashier, the foodserver, my mechanic because he's awesome, my staff because they’re awesomest (and no, I don't care if the spell-check says this isn't a word), even my clients, especially the ones who listen and follow my advice (another rarity - again, may just be me). Perhaps I devalue "thanks" by using it too much.  I hope not. The other reason I did this blog this month is I went to vote. Was the first one in line before they opened the doors at 7 AM. One of the people setting up came out to have a conversation and I kind of off-handedly thanked him for being there so early so that I could vote. He looked at me strangely for a beat, then said, "Well, we get paid!" Which then took me aback for a moment and I replied, "I can still thank you. After all it isn't everyone who wants to be up this early to perform this kind of work." And it made me think, maybe other people don't have practice in getting thanked and maybe we all should make more of an effort to appreciate those around us. So, thank you for reading this entire blog to the end. FunnyVet would not be around without your continued support and I thank you for all of the thanks that you have expressed my way.

Sep 06
2014

Crazy Vet Rant Nothing To See Here Please Move Along

Posted by Dean Scott in Untagged 

Dean Scott

I didn't really have a concrete idea for this month's blog.  Don't get me wrong - I have plenty of ideas.  Some are vague one-line thoughts that need expanding on, others require more work than I have time for right now, and some I'll just have to be in a certain mood to get into them.  Humor is a fickle thing.  So, this month, please indulge me (as if this whole website weren't an ongoing, perpetual indulgement) as I'm just going to do a little stream of consciousness thing on thoughts I've had recently.

People are weird.  And I realize I'm a people too, therefore I must be weird in my own way (no need to post in the comments section, thank you).  However, I routinely seem out of sync with my fellow primates.  They seem like a different species, Homo clientensus, perhaps, or Homo ignoramus.  I had an owner recently who makes a very decent living and seems in the many ways society expects, to be educated and "normal".  He uses Palmolive for flea control and a "concoction" (his words) for cleaning ears that includes, in part, pink eye medication, athlete's foot powder, and salt water.  He also stated that the dog is an outdoor dog except in the winter (because, you know, here in Florida winter can be pretty brutal).  I told him that Palmolive just makes cleaner fleas.  He retorted with how it was a vet who told him to do it.  When I told him to not use that concoction in the ears, he replied rather arrogantly, "Well, it works."  Granted at the visit the ears looked fine, but he had already said that they are a recurrent problem and he has to treat monthly, which makes it seem, that, oh, I don't know, his concoction "doesn't work".  His next line of defense against a reasonable conversation was that it cost him $500 - $600 the one time he took the dog to a vet for an ear infection, which has to be an exaggeration, because he either had other things done as well as dealing with the ear problem or he's just pulling numbers out of a bodily orifice.

Three things I took away from this conversation.  One is that people aren't necessarily coming to us to get good and proper information.  It's not like I'm the neighbor giving unsolicited advice.  You brought your pet to me.  I'm going to do my job well and tell you what's best for them.  I'm sure human physicians get ignored by their patients as well.  Two, this encounter was a great example to show that ignorance crosses all educational and socioeconomic levels.  The last thing is that many of us got into this profession because we are most certainly attuned more to animals than people.  Yet we can't get to the animals except through people and only if they really allow us to.  And the more we deal with people, the more we like the animals.  It's quite a conundrum.

Let's talk about misdiagnosis.  This word gets thrown at us (or maybe just me, I don't know) and I don't think people know what it means.  If I tell you your dog has feline leukemia, yeah, that's a misdiagnosis.  If I tell you your dog has lymphoma and we treat for lymphoma and it really has ebola, that's a misdiagnosis (as well as a potentially bigger problem).  However, if I tell you that your dog might have neoplasia and actual testing reveals, instead, an immune-mediated disease then........not a misdiagnosis.  And besides, along with mentioning neoplasia, I also said it may be other things, such as an immune-mediated disease.  It doesn't help if a client has selective hearing.  If you run with your dog in the summer, in Florida, during the day, while it has an upper respiratory infection and its temperature reaches 106.7, yes, that's heat stroke.  Just because 3 or 4 days later it continues to cough because of the upper respiratory infection (which we're treating), doesn't mean your dog was misdiagnosed.  If your dog is fine on a visit from 9 months ago, but now has a heart-related condition, that is not a misdiagnosis.  That is because the problem wasn't there before, now it is.  If I had the ability to see the future, I'd charge more.  Lastly, if tests haven't come back yet and your pet's condition worsens while getting supportive treatment, that is not a misdiagnosis.  That is a "wedon'tyethavea"-diagnosis.  There's a difference.  If we didn't have to do testing to get a diagnosis, if I had the ability to just look at a pet, or do that "laying on of hands" thing, and tell exactly what something is every time, well, I'd charge more for that too.


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