Category: Advice & Stories (page 1 of 21)

The Harsh Reality of Vet Med

As I look back over the past few months, I am reminded of so many happy, successful moments that involved my patients and their families.  From giving good news that a tumor was benign, to helping a lost pet get back home due to the simple power of a microchip, and treating a little miracle kitty who ate a string and lost 70% of her intestine getting to go home and live a happy life.  These are the moments and the days I treasure and live for in my career as a veterinarian.

But sadly, the job isn’t always puppies and kittens or success stories.  It’s challenging at times to not become emotionally invested in our patients especially the ones we see fairly often if they have a current illness or chronic health problem.  Some of these patients are ones we can be completely confounded by.  Understandably, a pet not getting well is taxing on their family but it has a similar yet less devastating effect on the veterinary team.

Sometimes we will recommend you visit a specialist due to procedures being beyond the skills of a general practitioner.  Face it, there’s just some things they don’t teach you in the 4 years of veterinary school.  Other times, it’s the value of that specialized second opinion and a lot of the time they can help.

For Better or Worse

We (the vet team) try our best; nobody is perfect.  Some patients will keep us awake at night as we mull over what we should do next or contemplate the impending surgery the next day.  In the worst of cases after a few months or longer of dealing with a chronic illness, all we can do is help ease them of their suffering.  It’s in these moments that we realize it’s not possible to fix every problem or save every patient, no matter how hard we try.

This was the case with Maggie.  A very sweet dog, with an even sweeter owner.  Maggie was adopted with known problems that her family diligently addressed and more so if new ones appeared.  Maggie was a patient of mine for almost 3 years and her skin was the biggest issue that nobody was ever able to figure out.  This past fall Maggie developed cancer and combined with her other issues, it was time to say goodbye.  I hated that we couldn’t help her.

harsh reality of vet med

One of my last visits with Maggie

And so it goes, we have to pick up the pieces because there are more pets that need help.  In all this though, we take the experience and information we learned from one pet and, perhaps years later, remember the lessons they taught us to hopefully help another.

Disclaimer: Blog posts may contain some opinions which are my own and may not reflect those of any current or former employers. 

Don’t forget to follow along on Instagram @drryanllera , Facebook , or  Twitter for more pet info.

Tell Me Your Pet’s Secrets

pet historyBeing a veterinarian is a very fun and rewarding career, but it’s also immensely challenging.  The only other job that might come close is being a pediatrician.  Face it, our patients can’t talk…unless we’re watching the Eddie Murphy remake of “Dr. Doolittle” (which was quite enjoyable I might add).  Being completely honest, your pet has secrets and you are the secret keeper.  No, I don’t mean what Rover really thinks of your new party outfit; but rather the all important pet history taking that starts every vet visit.

The best doctor in the world is the veterinarian.  He can’t ask his patients what is the matter-he’s got to just know.” – Will Rogers

Okay, so there’s some truth to this quote.  We can’t ask our patients what the problem is (and I know some pretty awesome veterinary doctors).  The false part is that we’ve “got to just know.”  Unfortunately, it doesn’t work like that.  This is where you come in and why veterinary medicine is a team effort.

A Costly Secret

When we ask you questions at the beginning of the appointment, these details may be quite pertinent to figuring out what the problem is that is plaguing your pet.  There was once a dog I saw that came in for being unable to walk and had some progressive weakness in it’s legs.  It was a young Rottweiler that the owners had assured me had gotten into nothing and had not suffered any trauma.  It was still quite a mystery even after a thorough physical exam.  Her owners authorized some radiographs & blood tests and left her at the hospital for the tests and supportive care.  A few hours later when I called for an update and to go over the results, the owners informed me they had used pure tea tree oil to address a flea problem.  Diagnosis: tea tree oil toxicity which can cause a temporary paralysis type syndrome.  Had this been known earlier, she could have been treated more promptly and for less cost.  No worries though, she recovered and was back to normal within a few days.

Honesty Leads to Success

When you call the hospital before coming in, it allows us to get prepared for taking care of your pet.  But we can only be as ready as the information given to us is complete.  One of the craziest toxicity cases I’ve ever seen involved a dog who had gotten into his owner’s medications…all 9 of them!  How would we know what to treat first without knowing everything involved?  That little dog did fine too especially since his owner admitted to some narcotics in the house.

pet historyBe up front with us.  Be honest.  Veterinarians don’t make a habit or policy of calling the cops on you or telling everyone they know about your pet and their antics.  Don’t be afraid or ashamed to tell us the truth about what might be going on with your pet.  The more information you can give us, the better.  We won’t judge.  So don’t hold back; tell me your pet’s secrets.

Disclaimer: Blog posts may contain some opinions which are my own and may not reflect those of any current or former employers. 

Don’t forget to follow along on Instagram @drryanllera , Facebook , or  Twitter for more pet info and interesting daily happenings!

Cats, Strings, & Intestinal Things

cats and string


The country song goes “Mamas don’t let your babies grow up to be cowboys…” and the same thing applies to cats playing with string.  Media is chock full of images of kittens playing with balls or yarn whether it be cartoons, advertisements, or the endless supply of cute videos on YouTube.  But behind all this cuteness lies a deadly risk if a cat eats string, thread, yarn, or dental floss.  These kitties can be fixed but it’s not easy.  This is Mira’s story…

Mira cats and string


Sometimes you see your cat eat the string and sometimes you don’t.  Often times the first thing you may notice is vomiting.  This was the case with Mira.  At just 2 years old, she’s still an intensely curious cat.  All cats may vomit from time to time – hairballs, catching a mouse, chewing on plants, but never just vomiting out of spite.  When Mira started vomiting multiple times over several hours, her family knew something wasn’t right and brought her in to see us at the Kingston Veterinary Clinic.  The diagnosis was easily found as soon as Dr. Vander Wilp, a colleague of mine, saw the string wrapped over and under her tongue.

When a string gets trapped at this spot, the other end of it starts moving through the stomach and intestines.  Essentially what happens is the string begins to act like a saw cutting through the intestines as it pleats them like an accordion.  Palpating a cat’s abdomen like Mira’s you can feel the intestines bunched up and thickened.  At this point, we weren’t sure how long the string had been present.  What we were all sure of was that Mira needed help in the form of surgery.

Yet, surgery isn’t just a simple snap of the fingers.  Many factors need to be considered.  Due to her vomiting, Mira was dehydrated.  With the risk of the string cutting into the intestines, blood and protein gets lost through these injuries which can complicate healing as well as leaking intestinal contents contributing to infection.  And the biggest mystery, what will you do once you’re there actually seeing the abdominal contents.  Mira’s family elected to go ahead and get her fixed up.

cats and string

Mira’s plicated intestines

Once we had her on some IV fluids and got her a bit better stabilized, I took her into surgery and investigated the damage.  In total, 7 perforations were noted and I discovered the other end of the string was in the colon.  Effectively, it was acting like a drawstring on pair of sweatpants pulling on her intestines at both ends.  Due to the number of perforations and their locations, the best option was to remove a large section of intestine and reattach the good ends.  After releasing the ends of the string through separate incisions in the stomach and end of the small intestine, I removed 32cm of the small intestine and reattached the ends before rinsing her abdomen and closing her up to recover her.

Over the next couple of days, we monitored Mira in the hospital.  Things weren’t going as we had hoped.  She wasn’t eating, kept spiking fevers, and seemed generally quieter than expected.  She only would eat tiny amounts when her family visited.  On the third day post-op, we checked some blood as she still wasn’t doing as we expected and noted several changes in the blood cell count and protein levels that concerned us and raised the suspicion that something had broken down inside.  The results were worse than before the initial surgery.  Despite all the precautions and steps we had taken to help Mira, something was leaking.

After some discussion, her family elected to have us attempt a second surgery as a means of fully discovering the extent of the problems and to fix what we could.  As soon as I got back into her abdomen, I had all the explanation we needed.  Her anastomosis site (the reattached portion) had broken down and a small leak was seen near it.  Given the amount of damage that was found and the previously removed section of intestine, I felt it best to call her family immediately and give them an update.  Assessing the extent of everything internally, I let them know her prognosis was very guarded to poor even with attempting a second repair and advised them that euthanasia was not an unreasonable option.  Her family conferred for a moment and told me to do my best to save her.  Back in surgery, I removed as little intestine as possible that was no longer viable and reattached the new ends.  After a very thorough rinsing of the abdomen and closing her back up, we all hoped for the best.

blood donor cat

Pioneer, the blood donor

Great news the next morning!  Her temperature was normal and she greeted us with alertness and purring unlike any other morning before.  A recheck of her blood now showed dangerously low levels of red blood cells and protein.  Mira needed a transfusion to give her the best chances for survival.  Luckily, one of our staff members volunteered to have her cat donate.  Mira received the much needed blood and was on the complete road to recovery.  By the next day, she was feeling spunky, her blood values had improved, and she was eating everything we gave her.  Mira was going home.

cats and string

Mira getting her transfusion

I like to think of Mira as a little “Mira-cle in May.”  Not all cats get this outcome.  It took the right combination of family commitment, veterinary team care, and a bit of luck.  The important message here is that when your pet seems sick, it’s best to not wait to see if it will pass — at a minimum, please talk with your veterinarian.  Waiting too long could make things worse.

Disclaimer: Blog posts may contain some opinions which are my own and may not reflect those of any current or former employers. Mira’s story is published with permission from her owners and some non-essential details have been omitted for brevity.

Don’t forget to follow along on Instagram @drryanllera , Facebook , or  Twitter for more pet info and interesting daily happenings!

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