Shawn M. Finch, DVM

January

February

March

April

Actually we have had two cases of heartworm disease this spring, which is really discouraging.  Another sobering fact - last year Banfield Pet Hospital diagnosed over 5000 cases of heartworm disease!  I did not hear how many cases were treated or how the dogs did, but FIVE THOUSAND!  Granted, there are 750 + Banfields across the country, but that is still so many for a disease that is 100% preventable.  As a community of pet people, we can do so much better.  The number will not be zero this year (It will be at least two) but I hope it is WAY lower than 5000!

This month’s topic…

Proheart 6

Where does Proheart 6 fit into the world of heartworm preventative medication?

Proheart 6 is an injectable sustained release medication labeled for dogs only (not cats or ferrets).  Its active ingredient is moxidectin, which, like the heartworm larvae killing component of all of the oral and topical preventatives available, is a macrocyclic lactone.  Moxidectin is also found in Advantage Multi, a combination topical heartworm-flea preventative that is applied monthly.  Proheart 6 is also labeled to treat hookworms.

Why is Proheart 6 only given every six months?

The moxidectin in Proheart 6 is in a sustained release formula, which means medication is constantly released over several months.  It stays in the dog’s body at therapeutic levels for six months, after which it tapers off to levels that are both ineffective to kill heartworm larva and are also safe when combined with another full dose.

Will Proheart 6 save the world?

No.

Pfizer recommends that veterinarians not give Proheart to dogs who are too thin, dogs who are ill, puppies under six months of age, and dogs who have not had Proheart before the age of seven.  If they have had Proheart before the age of seven, they may then have it at any age.  They also recommend that Proheart not be given to dogs who have allergic dermatitis.  Generally, allergic dermatitis includes any allergies, food, inhalant, or contact allergies that manifest as itching or skin problems.  Reactions to Proheart may occur.

Who should be on Proheart 6?

Every other dog, unless he or she has issues your veterinarian has deemed incompatable with injectable moxidectin, should be considered for Proheart 6.  I really think this is a great tool in the fight against heartworm disease.  Joy the Puppy had her first dose of Proheart 6 on February 1, 2011 and has done great.

Things to consider when deciding whether to use Proheart 6:

• Proheart 6 is an injection given every six months (thus the clever name).  You have two chances a year to space giving your pets’ heartworm preventative instead of twelve!
• Even better, the responsibility, at least in part, for remembering your pets’ heartworm preventative switches from you to your veterinary team!  You will receive a reminder when the time for Proheart is approaching, and the visit itself will be a quick one, or incorporated with a biannual wellness exam you would already have planned.
• The cost of Proheart tends to be similar to that of monthly topical and oral heartworm preventative medications.
• You will not be tempted to flout the American Heartworm Society’s year-round heartworm prevention recommendations and guess at future weather and moisture and presence of mosquitoes in those iffy (AND VERY DANGEROUS AS HEARTWORM RISK GOES!) spring and fall seasons, as the twice yearly Proheart administration will protect your pet all year.
• You could put a box of chocolates for yourselves on that safe-from-pets tip-top shelf where you used to keep the box of heartworm preventatives.

Great Heartworm Posts I Have Read This Month:

“Reading About Heartworm is One Thing, Watching a Dog Suffer is Another” - guest post by Pet Saver Ashley on Dawg Business by Jana Rade

“Don’t Let Heartworm Become Heartbreak” - guest post by Awesome Veterinarian Lorie A. Huston on Dawg Business by Jana Rade

…And maybe the best, and also the most discouraging, heartworm post I have read this month is on heartworm preventative resistance:

Heartworm Prevention for Dogs:  New Concepts and Concerns - by Lorie A. Huston, DVM on her website, Pet Health Care Gazette

Yes, heartworm preventative resistance does indeed seem to be a reality in a very, very small portion of the dog population…*sigh*  I was hoping it was not.  But I trust Dr. Blagburn, one of the very best veterinary parasitologist in the world - I have always very much admired his work, and I trust Dr. Huston…It sure looks as if it is true.  All the more reason to be neurotically vigilant about heartworm prevention…And because Proheart is so easy and convenient, you can be vigilant without being neurotic…if you want.

Tomorrow’s Checklist…

Noodle the Poodle - Wormshield tablet

Max the Cat - topical Revolution

(Joy the Puppy is on injectable Proheart 6.  Perhaps I will spend the few saved minutes reading her this post.  Naw, I will give her a cookie!)

In the July 2010 edition of Veterinary Economics, Tom McFerson wrote an AWESOME article called 25 Books for Your Summer Reading List.  I have finished the list!  Woo!  What a fun project.

I decided to take the project one step further and review the books I loved.  It is much easier to criticize a book than invest several months or years into actually writing one, so that is why I decided to only review the ones I loved and could give…

Five Stars!

✩✩✩✩✩

Here are links to the reviews of my favorites…

Freakonomics

Blink

Start-Up Nation

How to Win Friends and Influence People

Truman

Switch

Good to Great

Management Lessons from Mayo Clinic

Skills for Communicating with Patients, Second Edition

And some “update posts” about the project…

What I am Reading This Week:  Veterinary Economics

What I am Reading This Week:  Big Important Books

What I am Reading This Week:  The Same Big Important Books

Coming Soon on Riley and James

And some other books my daughter Abby and I reviewed during the year of the book-reading-and-reviewing kick…

Houdini Was…

Speaking for Spot

Marvin the Golf Caddy Dog

Anesthesia for the Pet Practitioner, Third Edition

The Complete Cat’s Meow

And HERE is a super-cool book shelf graphic from Shelfari.  I had seen it on friends’ websites, and NEEDED it for this post!  How cool is this book shelf??

So now I need a new project!

I have been keeping track of the books YOU have recommended this year and plan on reading all of them!  The ones you have recommended and I have read, I have loved.  What other books would you recommend?  I like almost everything!

Next Up on Riley and James…

Book Project Bunny Trails

I have some pretty major issues surrounding the story “I Know an Old Lady Who Swallowed a Fly.”  It is worse than “Rock-a-Bye Baby!”  Saying that is a kids’ story is like saying The Grimms Brothers’ Fairy Tales are for kids.  Who screens these things??

Recently, two seemingly unrelated and pretty routine (as far as my life goes) events occurred.  One of my Very Favorite Kids asked me to read him a story in Sunday School.  Later in the week, I did a pretty cool surgery.

Anyways, after my very small friend jumped off of my lap and ran to play with his Hot Wheels in the Super Cool Preschool Sunday School Room Fort, with a good thirty years before the horrors of the story we just shared really occur to him, I put my head down on the very small table and thought “Why?  Why did she swallow a horse?”  (She died, of course.)

So, to deal with the flood of childhood memories, I have come up with a happier version of the story.  Also, it is true, and based on the aforementioned pretty cool surgery I did later.

I know a young cat who swallowed a dime.

We removed it in time

When she swallowed that dime.

She’ll be fine.

The End

Even in Real Life, foreign body* ingestion can be very dangerous and even fatal.  Five possible outcomes to foreign body ingestion may occur:

1. It will pass.
2. It will be barfed.
3. It will cause a partial obstruction, which can cause illness and may progress to a complete obstruction.
4. It will get stuck and cause death.
5. It will get stuck and be removed - usually by surgery or endoscopy.

(*foreign body = veterinary speak for “stuff that ought not be eaten” that may cause a blockage in the stomach or intestine.  Toxins are another catagory of “stuff that ought not be eaten” and deserve their own post as they are also very dangerous.)

As with the old lady and the fly, I don’t know why Kitty swallowed the dime.  It was more a Retriever Puppy sort of thing to do than a Cat thing to do.  Cats tend to play with string and such and accidently swallow things that they are unable to spit out because of how their mouths and tongues work.

The dime became lodged in Kitty’s small intestine.  Food was unable to pass and the dime caused considerable pain and vomiting.  Without surgery, she would have died from lack of nutrition, or more likely, because the dime would have ulcerated through her intestinal wall, causing sepsis.

Such a cool surgery, but I hate foreign bodies because of the pain they cause and danger they pose.  (No, not really because of the story.  It is actually entertaining in a twisted sort of way.)  Kitty is home and well.  But how in the world does a person cat-proof an entire house, including making even spare change inaccessible, when cats can reach everything?? As complex as foreign body removal surgery and medication and aftercare can be…I think I had the easy end of that case.

Next up, an open and ongoing brainstorming list of every foreign body case we can collectively think of…Please add things your own pets have eaten and cases you have heard about or been involved with!  I hope that if you have had to deal with this with your own pets, your stories have ended as well as Kitty’s did.  And may you never (or never again) have to deal with a gastrointestinal foreign body with your own pet.

Stuff Pets Eat

golf balls

bouncy balls

rubber balls

tennis balls

wedding rings

engagement rings

electric blankets

pencil erasers

fishhooks

fishing line attached to fishhooks

buttons

leashes

rawhides

rope toys

chicken bones

glass

toy suction cups

Nerf darts

bullets

rocks

pantyhose

panties

socks

shoes

slippers

string

balloons

string attached to balloons

thread

needles

thread attached to needles

pacifiers

Gorilla Glue

rubber chickens

toy dinosaurs

Australian palm fruit

peach pits

fishing bait

possums

birds

rats

bunnies

beavers

table legs

door frames

tv trays

kennels

dental floss

poop

towels

stolen food scraps

pizza and the pizza box in which it came

fuzz from the bottom fabric under the couches

rubber bands

Nativity sheep

mulch

Nerf footballs

pins

condoms

tampons

pads

plastic bottles

bottle caps

Nylabones

plastic bags

paperclips

nails

bath mats

pens

pen caps

bright pink leotards

sticks

carpet

stuffed toys

plastic eyeballs of stuffed toys

dimes

Anesthesia for the Pet Practitioner, Third Edition

Five Stars!

✩✩✩✩✩

I love this book.

Anesthesia is the most important thing we do as veterinary teams.

Those are some pretty strong statements.  OK, not the first one.  I love almost every book I read.  I have no minimum standard.  Everyone’s in!  But I love this book on a whole deeper level than most.

Is anesthesia really the most important thing we do as veterinary teams?  I mean, we do a lot of things!  I asked my own team the other day, actually as we were all standing around a dog who was at the beginning of an anesthetic procedure.  Around the dog… “Yeah.”  ”Yeah.”  ”Yeah.”  ”Yeah.”  ”Really, guys?”  I said.  ”We do a lot of things.”  They proceeded to tell me exactly why anesthesia is the most important thing we do much more articulately than I am about to do here, but I will try to share their wisdom…and my convictions…with you.

Anesthesia is the most important thing we do.

I realize that is a sweeping statement.  I realize that between all the team members and all the pets and all the clients and all the diseases and injuries and preventative care measures, there are countless things we do, and it is unfair to say ONE thing is the most important.  It is.  Nothing else we do carries the same risks, even to healthy pets, as anesthesia does. It is a powerful thing. This book reflects that well.

The Cover: I would be remiss if I did not mention the cover of Anesthesia for the Pet Practitioner.  It has a sleepy (not sedated, just sleepy) Golden Retriever at the top!  What’s not to love?  SO cute!!  And the bottom half of the cover is a pretty blue with a bit of orange.  Still getting used to the orange, but it is nice.  So…

Five Stars on the Cover!

✩✩✩✩✩

The rest of this review is at:

The Wagging Tail Blog

I was going to put it all in one place, but The Wagging Tail is a professional site geared towards veterinarians, and I did not want to leave out the silly parts of my review, you know, like how cute the cover is!  Also, Banfield’s website was just updated, and it looks amazing.  I haven’t clicked through all the pages, but what I have seen looks really neat.

So that is here, and more is there, but if you really want to know if the book is all that…don’t take my word for it!  I think you will really like this one, vet teams.  I saw that it on Amazon for twenty-two dollars new - crazy inexpensive for a veterinary text!  I may buy a copy to have at home.  I also just saw that it is available online for free!  I am still not used to “turning pages” on the computer screen, but if you are not stuck in the last millinium and like things like Kindle and iBooks, you will like that cool feature!

And to all our other friends…Aren’t you glad we obsess about this stuff?  Do you agree that anesthesia is the most important thing that veterinary teams do?

Wouldn’t that be something?  If we went through this entire month and NOBODY was diagnosed with heartworm disease??  We just saw another case of heartworm disease very recently…So sad.  I know I have been on an “I hate cancer” kick lately, but as always, I am on my “I hate heartworm” kick too.  (I have quite a few kicks…)  Heartworm disease is 100% preventable, and though treatable (treatable in dogs - not so much cats and ferrets), prevention is so much less expensive and easier on the dogs’ systems.

I promised to be more upbeat here at Riley and James as soon as possible!  So here goes…

Today’s monthly heartworm post is on how heartworm preventative medications work!

Science…medicine…the wonders of canine physiology…heartworm examined not as a pet stealer or dog damager, but more clinically, as a very cool (disgusting) mortal, intricate parasite.  How exciting is that??  Well, I think it is exciting…

The Medicine

All heartworm preventative medications currently on the market are a form of macrocyclic lactones, medications derived from bacteria in the Streptomyces genus.  They do not prevent heartworm infection in the strictest sense, they prevent heartworm disease - they kill the larvae (L3 and L4, “baby heartworms”) before they can mature into adult worms.

(Interesting side note!  Until the late 1980’s, only daily medications were available because they were only powerful enough to kill the “L3″ stage, which lasts only two or three days.)

Macrocyclic lactones are neurotoxins to the heartworm larvae (L3 and L4), paralyzing their mouthparts and causing them to starve to death.  The medication needs to be repeated monthly because they kill all of the parasites that are in the pet’s system that have infected him or her in the last thirty days.  The picture that came to mind when I was trying to make it understandable was one of a rainstorm.  Bear with me…

Heartworm preventatives are not umbrellas - they are windshield wipers.  Your dog is continually at risk of being bitten by a mosquito that is carrying heartworm larvae (L3) - the mosquito would be the cloud and the heartworm larvae would be the raindrop…if clouds were buzzy and annoying and raindrops were potentially fatal.

The Worm

We think of heartworm preventatives as protecting our pets against heartworm disease, and they do.  But they do it more as a windshield wiper (that sweeps every thirty days) than an umbrella that is a constant barrier to infection.  Our pets are at risk of being infected by heartworm larvae - but are protected from heartworm disease that is caused by adult heartworms in the pulmonary vessels and heart.

The Disease

I think the disease should be called subcutaneous-tissue-then-pulmonary-arteries-and-if-it-is-a-really-heavy-infestation-even-right-heart-and-vena-cava-worms, but it is not.  Heartworm is too cute of a name for such a horrid disease.

That’s All I’ve Got.

If that helps you understand the pathogenesis of heartworm disease, awesome.  It helps me to be disciplined when giving heartworm preventative medication to my pets to think of it as a “windshield wiper” stopping heartworm larvae that may have already started their unholy travels to the very heart of my pets, rather than a barrier or “umbrella” that I can just put up when it is sunny and warm and just right for a heartworm attack.  If it just grosses you out, and you like being grossed out, that is good too, I suppose!

Coming Soon…More Awesome Heartworm Information of Some Sort

Let me know what other heartworm related topics you would like to cover.  Ideas…heartworm disease in cats and ferrets, treating heartworm disease, I would love a guest post from someone who has had a pet with heartworm disease, or worked in a rescue organization and dealt with heartworm disease, or any guest post with a heartworm-related story!  Let me know if you have topic ideas or would like to write a guest post here!

Today’s To Do List:

Noodle the Poodle - Wormshield tablet

Max the Cat - topical Revolution

(Joy the Puppy is on injectable Proheart 6.)

Coming Next Month…

How do injectable sustained release heartworm prevenative medications (Proheart 6 and Proheart 12) work?

Previous Happy Heartworm Free Month Posts…

January 2011

February 2011

March 2011

American Heartworm Society Website

Isn’t this FUN?

The more that you read,
The more things you will know.
The more that you learn,
The more places you’ll go.

-Dr. Seuss

Management Lessons from Mayo Clinic - Inside One of the World’s Most Admired Service Organizations

by

Leonard L. Berry, PhD.

and

Kent D. Seltman, PhD.

Five Stars!

✩✩✩✩✩

This is a really good book about Mayo Clinic, an organization I previously knew nothing about.  And THAT is my favorite thing about it - learning so much about <Mayo Clinic>.  I love to learn.

The cover isn’t awesome.  It is red, white, blue and yellow, but I have not been wearing my fuzzy red mittens in this warm spring weather, so I did not need something to coordinate with them.  I was going to say “Look how much I have matured over this year, no longer judging a book by its cover…” but I just spent an entire paragraph on the cover, so I will not say that.  Maybe next year…

Dr. Berry is a marketing professor and author, and Dr. Seltman was the director of marketing at Mayo Clinic from 1992 to 2006, so they know that of which they write.  They keep the book professional and structured in such a way that even those in fields other than healthcare can extract leadership lessons from the book.  However, the best parts of the book (as is often true) are the stories and pictures.  Even in their strict professionalism, they capture well the love doctors, nurses, support staff, patients and families have for Mayo Clinic, and I loved reading about that.

The history of Mayo Clinic is fascinating.  (Yes!  New thing!  I’m a history buff.)  Dr. Mayo and his two sons started the clinic over a century ago on a solid, medically and ethically sound foundation from which the clinic, now on three campuses and associated with all sorts of other health care partnerships and health care websites, has seemed to stay very true, which is super impressive.

I also loved learning about the excellence of the present-day doctors of Mayo Clinic.  They have to be team players to make it.  Very persuasive cases were made for the validity of standardized procedures and evidence-based medicine, which are big parts of Mayo Clinic.  The typical Mayo doctor is truly on the cutting edge of medicine.  Many of them lead within the organization and research and teach.  That is the part of the book that was most challenging to me as a veterinarian and that will stay with me the longest I would guess.  We as veterinarians have much to learn from our human MD friends, and as often as I can put my scruff down and accept that, I come away a better doctor.

*****

This fits nowhere in a professional book review, as is a subpoint of a subpoint in the book, so I will put it here anyways, because it is too awesome not to mention, and it was one of the first things to really cheer me up during this sad season of Finch pet loss…

As you know, I am unhealthfully obsessed with the show Scrubs.  In one particularly tasteless gag, J.D. tells a family their grandfather has passed away while he is dressed as a clown.

That really happened in Real Life!  It is in the book!

It was casual Friday…It was Halloween…A doctor was celebrating, as was the rest of the hospital…I will apologize now to the grown grandchildren to whom this happened and who are now dealing with more severe clown phobias than the rest of us, but I am still laughing, and I read that section a month ago.  It is just too horrible to take seriously, and not, as the book authors propose, a valid argument against casual Fridays.  I am quite sure it has never happened before or since.

*****

I honestly can say I agree with the rest of the book and will read it again to find more parallels to my veterinary life.  Whether you are in an entirely different profession, are a veterinarian, or are a real … human … medical doctor, What in the world are we supposed to call you guys?? …um…you will enjoy and learn from this book.

(B&G Tasty Foods kept a couple of these clown oil paintings from the original restaurant and let me take a picture for my 24 clock project of Blogathon 2010.  In the original post, I cropped the clown out to protect you. I think it fits nicely with the clown paragraph of this book review, though.  The sandwiches at B&G are so good they are worth the clown night terrors you will have for weeks after.)

Coming Soon to Riley and James…

Do Pets Mourn?  The Story of Joy the Puppy and Ebony Dog

Happy Heartworm-Free April

Happier Posts…

A friend has asked when I will return to my normal, more upbeat posts here…I am working on it Georgia Little Pea!

Summary of the 25 Veterinary Economics Leadership books - two books to finish!  Woo!  This has been such a fun project!

And Elsewhere…

Wuzzy Chronicles

I have taken a break from my monthly column at Omaha.net, but I do miss it.  Genius idea to name the column after a mortal pet.

The Wagging Tail

This is a collaborative blog to which I contribute about once a month.  I think it is time to get back on the ball here as well!

Dr. V has a Brody Signal - it is a picture of her super cute pup that she puts over a flashlight and shines into the night.  Other pet lovers the world over see the signal, get the message and join her in her mission to make the world a better place.*

Today’s Mission:

“A Virtual Fundraiser to Aid Animal Relief Efforts via World Vets”

I do not think we even know how bad this tsunami and earthquake disaster in Japan is yet.  Not everyone is found.  The nuclear scare is not over.  I cling to stories of individuals because the big picture is just too much.  Everyone seems to be two degrees from loved ones in Japan.  Or one.  Or zero.  World Vets is in Japan, helping with relief efforts.

Sometimes people rescuers need to focus on finding and rescuing people and need pet rescuers to come along side of them to rescue the pets.

Sometimes pet owners need to know they are loved, and we understand how awful it is to be be seperated from and even lose loved ones.

Sometimes communities need to know that we care and that we long for a concrete way to show that and that we would do anything to make the situation better, even though we cannot fix it.

Sometimes people cannot take in the horror of an entire country in pain and need to hear one encouraging account of a rescue…a reuniting…a hopeless situation that ended happily.

Pray for Japan

Reach out

Support World Vets

“Rejoice with those who rejoice.

Mourn with those who mourn.”**

*Dr. V does not have a Brody Signal.  *sigh*  I wish she did.  But her super awesome blog Pawcurious works just fine when pet lovers need to be gathered for a common goal.  I think she should do both.

**Romans 12:15 (New International Version of the Bible)

March 18, 2011 Veterinary Practice News Article:  Vets, Animal Groups Rally to Help in Japan Relief Efforts

While I wait for life to get less sad, I have been writing considerably less than usual.  After Fuzzy and Wuzzy Rats and Piggy the guinea pig passed away, I could see where this season was heading, and put a few Very Favorite Writing Projects on hold (The Wagging Tail Blog and Omaha.net) and cut down my writing here to a much slower pace.  My Carefresh Ask-a-Vet project is still full speed, but that one is Q&A - much easier, and a good respite from the sadness.  Good call on the slowing down thing, though.  Ebony Dog and Princess Gerbil passed away soon after.  Russ has gotten me “I’m a winner” stickers that I wear every day I get out of bed since Ebony died.

100% success so far.  I am a winner.  75% success staying out of bed.  I am STILL a winner.  I still get a freaking sticker.  (Yes I really wear them.  Unless we just met, and even then, really, it should be obvious what a dork I am.  I LOVE the stickers.)

Anyway, that is all my prelude to my Super Awesome List I have for you.  Until I can get back to writing more regularly (and even then), here are some MORE great veterinary blogs I found thanks to veterinarians on my first list of great veterinary blogs. If there are more veterinary blogs you love, let me know! Yes, this is getting out of hand - I love it!  And yes, we should be out saving and preserving lives.  We take turns.  You know, as a worldwide veterinary community.  Save-write-sleep-repeat.

More Great Veterinary Blogs

Also, I included a few blogs from human medicine, because they are just awesome.

can’t spell, dvm

CantSpell, DVM

Funny Vet

Dr. Scott

The Real Housecats of Orange County

Dr. Kelly Wright

The Story Behind the Pictures

Dr. Leslie Brown Sheridan

VETBLOG

Toronto Vet

A Vet’s Guide to Life

Dr. Chris Bern

Vogue Vet

Vogue Vet

The Weird Veterinary World

C. Todd Dolen, DVM

and 2 people blogs…

Dr. Grumpy in the House

Dr. Grumpy, MD, Neurologist

33 Charts

Bryan Vartabedian, MD, Pediatric Gastroenterologist

And, of course, remember to visit the wonderful pet bloggers in the Saturday Pet Blogger Hop…

Coming Soon on Riley and James (and quite a few other blogs, I have a feeling…)

Tuesday, March 15, 2011

Adopt the Internet!

Happy 15th Birthday Petfinder!

Thank you Pet Savers everywhere for all you do to help pets!!

Our herd is down from eight to three, 37.5% of capacity, and we are not repopulating.  Fortunately, Max the Cat, Noodle the Poodle and Joy the Puppy all tolerate hugs*, because they have been put on Grief Duty.  I find myself asking “Who’s next?” and waking the poor things up if they are sleeping too comfortably.  Noodle has been known to sleep with all four paws up on occasion.  He has been the recipient of the rudest awakenings.

In an attempt to back off from this dangerous path, I am making the conscious decision to appreciate my pets on a day-to-day basis and enjoy the time I have with them.  Yes, approximately 67% of the remaining herd is oldie-old, but they are also all healthy, and probably tired of being included in my late night panics.  So hold me accountable.  There is much grieving yet to do, but I do not want to miss out on today.

I can’t really pull myself out of this of course, even with all of your wonderful support (And you ARE wonderful - thank you so much for walking through this with us) - This is going to take the power of God Himself.  While I hope you are in a happier season, this next quote is a good reminder to us all, and then a word of “encouragement” from my very favorite singer ever, Rich Mullins.  And then, I will come visit the blogs of other pet blogger friends on the Saturday Pet Blogger Hop.  And then…I am going to go hug my cat.

“Do not worry about tomorrow, for tomorrow will worry about itself.  Each day has enough trouble of its own.”

-Jesus

“It’s hard to be like Jesus.”

-Rich Mullins

*Note:  Hugging most dogs is ill-advised.  Normal dogs do not like hugs.  Hugging most cats is just asking for it.  Our pets are all sorts of special.  Do not attempt this at home unless you are a Trained Pet Hugger.  I am not.  I just have really tolerant pets.

1

Overcoming Team Conflict

2

Building a Best of the Best Clientele

3

A Dramatic Wellness Exam

4

Recommending a High Level Standard of Care

5

Effective Communication Stratagies

6

Self Evaluation

7

Changing Times

8

Twitter for Veterinarians

9

Year in Review:  2010 in Veterinary Medicine

10

Conflict Resolution

Click on the article title to get to the article itself.  I know it would be cooler if I did not actually mention this and just let people find this out for themselves, but I never claimed to be cool (quite the opposite)…

Every one of the ten articles has a Scrubs link in it that pertains to the article.

Awesome.