Tuesday, April 8, 2014

Puppies!

So along with the question about Banfield, you wanted to know about puppy stuff.  A great place for me to start with this is vaccines and exams.  I love vaccines.  I had such an "ah-ha" moment when we went over immunology in school and puppy/kitten series.  When I talk about vaccines I really hope people understand the importance of why we do so many.  And exams!  90% of people just think a vet is good for two things: shots and sick visits.  Sure, we do those, but the best part of an annual or semiannual is a good thorough exam.  I'll get more into those after I go from puppies to adults.

So I'm going to start with puppies.  Depending on how long this post is, kittens maybe be a separate one (also due to the fact that out of the people I know read this blog, I think I'm the only crazy cat lady >_<).

Core puppy vaccines are a distemper/parvo series, a bordatella, and a rabies.  The distemper/parvo series, also called a DHAPP or a DA2PP, is generally a 4 vaccine series that covers various diseases.  The series should start around 6-8 weeks of age, with the puppy getting 4 vaccines in the series (usually at 6, 9, 12, and 16 weeks).  This vaccine is an important one.  The "D" is for distemper virus; young puppies (up to 6 months) are most vulnerable to this one.  It can be fatal, and if contracted, there is only supportive treatment available.  The "H" or first "A" is for canine hepatitis which is caused by adenovirus-1.  The second "A," is for adenovirus-2, which can cause some strains of kennel cough.  The first "P" is parvovirus, which is also another one young puppies are more susceptible to.  It razes the intestinal tract, and can affect the heart in some forms.  Also another disease that can be fatal if contracted, and the only thing we can do is supportive care.  The final "P" is for parainfluenza - another culprit in kennel cough.

The reason for boostering this shot four times has to do with maternal antibodies.  When babies are born, they have little to no immune system.  They get most of it from mother's first milk, which is a special type of milk called colostrum.  This is the reason why doctors will try to get you to breastfeed right away after your baby is born (unless the baby needs pressing medical attention).  It transfers maternal antibodies (read: temporary immune system) to the baby, so the baby has protection until it's own immune system has time to boot up.  Now these maternal antibodies last until somewhere between 6-16 weeks, depending on the individual.  When vaccinate a child or puppy or kitten, the point is to jump start their own immune system against the disease you are vaccinating for.  However if maternal antibodies are present, they interfere with the vaccine response, and the baby's own immune system does not create it's OWN antibodies to the vaccines.  Since there's no way of knowing if your puppy's maternal antibodies will wear off at 6 weeks and 1 day, or at 13 weeks, we booster this important vaccine at four 3 to 4 week intervals to minimize any risk of the vaccine "not taking."  Why not just wait until after 16 weeks?  Because while dogs of any age can get the viruses in the DA2PP vaccine, the MOST susceptible dogs are puppies in that 6-16 week age group.  And because of the maternal antibodies, even this vaccine series is not 100% - we had one puppy that broke with parvo while her parents were in the middle of this series.

The other two vaccines are given later in the puppy series.  Bordatella is a vaccine that gets a few more strains of kennel cough.  Puppies generally get this around 12 weeks of age, and they generally get the intranasal form.  The reason for the intranasal is that this type of vaccine is squirt up the nose, and stimulates the local immune system in the nose for a faster, better response in a puppy that has never had it before.  Older dogs can get the injectable just to booster it after their puppy vaccines.  The last in the series is rabies.  Rabies is no laughing matter.  This vaccine can be given at 16 weeks; we usually wait until 20 weeks at our clinic.  Rabies is a legal require in every state (I'm pretty sure about this one).  If rabies is contracted, there is no cure, and it is almost always fatal.  Then head has to be sent in for testing (gruesome, I know).  Out of all the other viruses we've talked about in this post, this one is one people can get.  And it is just as fatal in people.  Which is why there are laws about this, because it is a human health issue as well.

Then there are non-core vaccines.  When a person brings in a puppy, we always risk factor them - will they be camping/hiking/hunting or going to rural or wooded areas with you?  Will they be show dog?  If it turns out a dog will be going to or living in a wooded area, a lyme vaccine is also suggested.  If the dog will be in a rural area where there's standing water or they could be in contact with animal urine, a leptospirosis vaccine is suggested.  For show dogs, they may also suggest a K-9 influenza vaccine.

Other than vaccines - there are several other things that are suggested.  At least two negative fecal tests for any puppy.  The reason for two, is that the test in not 100% accurate (it can only detect worms if the puppy is current actively shedding worms), so two tests a few weeks apart is thought to increase the chance of catching any potential worms.  Also, 2 to 3 dewormings are recommended, even if the fecals are negative.  The reason for this is that some crazy high number of puppies (like 90%) are born with roundworms that they get from the mother in utero.  The dewormings are generally something like pyrantel, that'll get your roundworms, plus a couple other worms.  If the fecals show other worms outside the scope of pyrantel, you may be given additional worm medications.

And of course, let's not forget booster visit exams.  These let the vet get their hands on the puppy to make sure our development and growth is normal.  That teeth are coming in properly, testicles are descending like they should, etc.  It is also a great time to ask questions about potty training, teething problems, and anything else!

Another important thing we can work with you on at this time is getting a good quality diet on board.  Food is the easiest thing that you can do to help your puppy have a good, healthy life.  You feed them every day!  They only see us like once or twice a year.  Puppies should be on puppy food, not adult food, because they require extra nutrients and calories to grow.  Good brands that we like to recommend are Science Diet, Royal Canin, Purina's higher quality foods (think Purina ONE and higher), Iams, Eukanuba, etc.  I'm not too familiar with "natural" brands, mostly because A) there are too many on that bandwagon, and B) I think the whole "natural" movement is 90% marketing and about 10% quality.  I like "big name dog food companies" because they've been around longer, and I've seen long-living, healthy dogs on those foods.  But that's just my humble opinion.  I also like the above brands because they feed test.  Meaning they come up with recipes, then they feed them to real animals in studies to see how they do on them.  A lot of other brands are just "formulated to meet AAFCO standards," which means they made a recipe, but they never did a test to see how animals do on that recipe.  Personally, I feed Science Diet to both my babies.  I always get comments from my coworkers about how nice their haircoats are.  And it helps keep them at nice weights.

Finally, we'll also get you started on a heartworm prevention regime at this time.  Your puppy won't get tested until he's older than 6 months, since it takes 6 months for baby heartworms to mature into adult heartworms.  However, if we get him on prevention at that first visit, it only leaves a 6 week window where the puppy may have become infected.  If your puppy didn't come fixed already, we'll also talk to you about spaying/neutering around 6 months of age.

Whew, that's a lot more in writing than I thought.  So I guess I'll make a continuation post later about vaccines and visits as a puppy grows into a dog.  And kittens will have to wait.  I hope this is helpful.  Ask questions if you feel like I've forgotten anything!

EDIT: One thing I forgot about is breeders.  Most clinics will recommend ignoring/re-doing shots that a breeder does.  The reasoning behind this is that breeders get their vaccines from feed stores.  Vaccines are very temperature sensitive - there is no guarantee that the feed store kept them refrigerated, or that the shipping to the feed store, or the breeder themselves actually properly stored the vaccines.  Also, breeders don't always give vaccines properly at the proper times.  I've seen pups that got their bordatella vaccine at 8 weeks of age.  That one really shouldn't be given before 12 weeks, since it doesn't get boostered like the DHPP.  Another thing to keep in mind - there are reputable breeders out there, however, there is no training or schooling needed to become a breeder.  So beware where they may be getting their information.  And please, DON'T take the word of a breeder over that of a veterinarian that went to school for 8 years. 

Monday, April 7, 2014

Life Musings and Pinterest Fail

This past week I've been feeling a little...let's say, unsettled.  For the longest time, my life has a been a fast blur of a hot mess.  Too many things going on, with me just barely hanging on.  I've become way to used to being too busy for everything.  But now that's changed.  I'm out of school with a stable job, and so is the husband.  We're both settled into our new jobs and really like them.  For the first time, we are both working normal work weeks (close to 40 hours, rather than 50 or 60).  And without both of us being in school, we have time to come home and just relax.  As terrible as this may sound, we live far enough away from family now that we aren't obligated to spend every free weekend with them. (For the record, it would be nice to have them closer, but I guess this is kind of a silver lining.  It is nice that we can talk to them every weekend - yay cellphones!)  With all of the above, I can actually watch TV or play a video/board game or knit or EVEN HAVE A BLOG in my spare time!  Hah.

Anyway, this normal amount of spare time was starting to make me feel weird.  Like I'm doing something wrong.  Everyone else is so busy, I must be forgetting something out of the manual of life.  But you know what?  I realized I'm looking at this the wrong way.  When we were both in school and working at the same time a little over 2 years ago, the type of person I am now is who I used to look at in envy.  Past-me would have looked at present-me and thought that how unfair it was that my life is so easy.  It's easy because I accomplished my goals.  This is my reward, and I should be grateful about it and enjoy it right now.  I shouldn't be looking elsewhere and worrying that my life isn't hard enough.  That's silly.  I was feeling unsettled for all the wrong reasons.

It doesn't mean that I've run out of goals; we're just transitioning between goals.  We've finished our goals of school and getting started on our career tracks.  Now we're just hanging out here for a bit and refining those goals and working down debt before tackling the next big thing.  I'm sure once we decide that children should enter the picture, life will be anything but easy.  But that won't be for a least a couple years.  We like where we are now, and we want to enjoy it a little.

On a different, less philosophical note: I had my first Pinterest fail the other day.  Let me start from the beginning.  I was trying to rearrange our living area.  This is what our living area used to look like.
Pardon the 2 minute photoshop job - I didn't have a "before photo" so I (BADLY) photoshopped the after photo.
When we first moved in, we thought it would be great to put our monster of a TV up on the mantle.  That ended up being problem #1 with the set up.  If you were sitting on the sofa, you'd have to look up to watch, and you could end up with a crick after a long movie.  Plus, the remotes weren't registering too well with the height.  Problem #2 was that bookcase - we had LOTS of DVDs and games, to the point where we were stacking them two to three stacks deep in the bookcase.  The problem with that was we never played/watched a lot of our stuff because it was such a pain to get it out.  Plus, it looked cluttered and terrible.  Problem #3 - if the curtains were closed, and it was dark inside, in order to get enough light, we had to use all three light source to get decent lighting.

So, my ideas were to move the TV and add a hanging light.  We turned the bookcase on it's side so it's more like an entertainment center and put the TV on top of that to free up the mantle.  Then I got a CD/DVD case binder and ditched the plastic covers movies come in.  This opened up a lot of bookcase space - nothing is double stacked and is easy to access.  Then I got rid of the paper floor lamp the husband found in the dumpster while at Emory and got a swag kit to hang a light from the ceiling without too many holes/destruction.  This is where the fail comes in; I found this light on Pinterest and thought "hey, that's cool, I can do that!"
 
as found on http://www.craftynest.com/2009/03/hemp-pendant-lamps/
FAILURE.
Actually, not so.  I cannot do that, and it was so frustrating and gooey that I gave up.  And went out and bought a regular lampshade that I thought looked cool.  So I ended up with this.  Still looks much better, and we only really need the one lamp to light the room.  The other two are still sitting next to the sofa, mostly because I don't know what I'm going to do with them yet.
Final result: feels much less cluttered.
Now, I just need to make up my mind on what to do with the mantle.  Right now it's just holding a bunch of photo frames that I didn't know what to do with.  Overall, I'm much happier with the result.  Also, we discovered some movies and games we'd forgotten we had because they were hidden in the mess!

Tuesday, April 1, 2014

In my humble opinion: Banfield

So it's been awhile since I updated.  I think part of the problem is I started to think too much about what vet subject I wanted to shared that I just bogged myself down.  So we're going to keep it simple.

This is based off the comment about Banfield.  So not really about animal health, as to more about the opinions I've formed about the company.  Disclaimer: I am not a huge fan of Banfield, and this post will probably reflect that.  If you don't like that, I suggest you stop reading.  I did a small internship through a Banfield when I was in school.  I'm not going to go into details about the internship, but I did get a look at how they run things.  A lot of people think that Banfield is the cheaper place to go.  Not true.  The truest thing you can say about it, is that it is corporate.  The have wellness plans that they are forced to sell, and they have a way they have to do things.  The end feeling I get, is they have a bunch of mandates as to what they "have" to do, that you don't get a lot of personalized care, so much as you get put through the "hospital machine" and hope you come out fixed.  Most problems are common, so 95% of the time this model works.  It doesn't work so well if you happen to be in that unfortunate 5% that has a really weird disease process or problem. 

The other factor with Banfield being corporate is they charge a lot for everything.  I feel I have to address this problem delicately, so I'm going to frame it.  The main complaint I get from people, is the impression that veterinary clinics are gouging you for money, and if we really loved animals, we'd do all this for free.  I am all for getting paid for doing the work I do.  Even then, the important part that people don't realize is, we don't get paid a whole hell of a lot comparatively.  I get paid maybe a half to two-thirds what a human nurse's average salary is.  And (this is not a negative comment against nurses) I have to know how to do a lot more than a nurse, in many more species.  This comparison is the same for vets and human doctors.  And for them - vet school is just about as expensive as medical school.  Please, I invite anyone to come look at the parking lot at my clinic.  99% of the cars our staff (two of our doctors included) are maybe one good wreck from being junked and are at least 8 years old.  The only nice car we have is the doctor that owns the clinic - and he's a few years from retirement after being a successful businessman for years and years and being married to a lawyer.  It may seem that I've gone off on a tangent, but I just really feel like people outside the field don't understand the problem.  They just see the bill and resent the vet clinic.

All that being said, there is no shame in us charging for our services.  There are a range of vet clinics from cheap to more expensive.  There are cheaper ones that will do a dental with just sedation (no anesthesia, no pre-op bloodwork, no proper patient monitoring, no x-rays with extractions, and no endotracheal tube) for barely a $100, but if your pet gets aspiration pneumonia, you're SOL.  There are clinics that are more expensive because they take all the precautions.  So there's no problem in dishing out the bucks, if you know you're paying for quality.  Banfield unfortunately is not always like that.  They have a price tag that goes across the board.  However, quality can range widely.  At one, they may have excellent services and licensed staff that are well worth the price.  At another, they may have mediocre services with some half trained staff that they got off the street - not worth that same price tag for the much better medicine you would have gotten at the other Banfield down the street with the better staff.  So I'm not saying that high price tag = terrible evil, money grubbing vet clinic.  I'm saying that the price tag should equal the quality you're paying for.  If you pay $20 at a vaccine clinic - don't expect more than a couple shots a from a tech (you probably won't even see a doctor).  If you pay $150 to $200, your doctor better do a full exam on your pet and answer your questions, in addition to your shots, etc.

So hopefully that sheds a little light on the Banfield business model.  I'm sure there are some great ones out there, but overall, I feel like they get lost in the corporate structure.  Besides, I'm all for supporting your local businesses and going to a local vet clinic.  You'll get more personalized care and the staff there will appreciate your business more.  And if you find a good local vet clinic, they'll treat their employees better, and happier staff means better care for your pet!