Posts Tagged ‘veterinary’

Some Online Pharmacies are Awesome. Some are not.

Monday, August 5th, 2013

Near the end of March 2011, I was happily researching for my April heartworm post, Happy Heartworm-Free April! when I came across this website:  I e-mailed the site administrator to let him know that dispensing prescription medication without a prescription is illegal.  (Ever the optimist, I was hoping he just did not know…)  His return e-mail (basically) said, no, it isn’t.

My formal complaint to the DEA (Drug Enforcement Agency) and copied to AVMA (American Veterinary Medical Association) (basically) said:  He’s not playing fair and someone is going to get hurt!

From the Heartworm Medicine website:  “Can I get non prescription heartworm medicine?  Absolutely. All the heartworm medicines available from here are prescription free. This should make the ordering process much easier for you.”

From the website of the “pharmacy” they use:

  • Choose items and place them in your shopping cart.
  • When you checkout you will be asked to create an account and fill out a brief patient profile.
  • Follow the steps to complete your purchase.
  • Fax or mail the prescription from your Veterinarian to us.
  • Your Veterinarian’s prescription will be reviewed and re-written by a Canadian Veterinarian or Doctor and dispensed by an Independent Pharmacy.

I am usually extremely easygoing.  I can find good and the upside to about anything and anyone.  I can count on both hands my non-negotiables.  Among them,

(1)  the welfare of pets

(2)  the well-being of people

(3)  high ethical standards.

OK, I don’t have many non-negotiables, but I admit, the ones I have are kind of big.

And not that this matters in the least, as far as grand sweeping ideals go, but the heartworm preventatative medications carried in house (which is probably true of many veterinary hospitals) are cheaper than those being offered on this “prescription-free” website.

Veterinary teams really do try to keep costs reasonable for pet owners.  We have pets too!  We know what little money-sucks they can be!

This situation made me so angry!  We have the medical protocols in place that we do for very good reasons.

Here is the basic heartworm prevention program of most veterinary hospitals, and most clients are just fine with it, knowing we are trying really hard to keep their pets safe and to keep costs manageable…

  • Establish a veterinary-owner-pet relationship.
  • Have a wellness examination of the pet done.
  • Have an annual heartworm test done.
  • Choose a safe, effective, pet-specific and weight-specific heartworm preventative medication from a reliable source.
  • Obtain it legally right from the veterinary hospital or an excellent veterinary pharmacy trusted by both the client and the veterinary team.

Pharmacies are NOT the bad guys here…Rule breakers are.  Most pharmacies (including Wedgewood Pharmacy online) do an excellent job partnering with veterinarians to keep pets healthy and safe and provide a much broader range of medical options than we can in-house.

It just made me mad enough to write a strongly worded letter!

Dear Rule Breaker,

Pets, and by association, owners, could be seriously hurt by what you are doing.  It is also unethical.  That’s three strikes.  Do not mess with what is important to me.

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Quiet: The Power of Introverts in a World that Can’t Stop Talking

Tuesday, July 2nd, 2013

Quiet:  The Power of Introverts in a World that Can’t Stop Talking

by Susan Cain

Five Stars!


I absolutely love this book.

Remember my sort of new rule?  Always judge a book by its cover.  The cover of this book is a beautiful, soft, cool grey.  It reminds me of our sweet little hairless rats, Fuzzy and Wuzzy.

Fuzzy Rat

I realize that authors do  not always choose their cover designs, and I realize that better people than I say NEVER judge a book by its cover, but perhaps some great mind chose this cover on purpose as a kindness to introverts who would be reading the book.  A beautiful soft cover (I imagine the cover designer thinking) would be comforting as we introverts sat in the corner and read our book about introverts as the world carried on around us.  (It was.)  My theory could be true, because…

According to the author, introverts are highly reactive – things in our environment affect us more starkly than they do others.

THAT was the first big point from the book that I have had to ponder.  I had always defined introversion as drawing strength from internal sources and extroversion as drawing strength from external sources.

Still true, I believe, and I believe the author would support that definition, but she also cited some very compelling research that supported the idea that introverts tend to react more  strongly to their environments than extroverts.  It makes sense.  Introverts often need peace, quiet, time to recharge.  Extroverts often need interaction, people, friends around.

Study of one…

  • I am easily overwhelmed in a crowd.
  • I want to punch the big screen TVs in our church lobby every time I see them.
  • I love music but need to either listen to music or concentrate on a project.
  • I close my eyes when I am talking to clients on the phone so I can focus more intently on exactly what their pets need.

I am an introvert, and I am highly reactive – very sensitive to what is in my environment.  It has been interesting to think of introversion/extroversion from that perspective.

Introverts are great.  We knew that, right?  We are people lovers, we are excellent leaders, we are often amazing speakers and we are thinkers.  Thank you for saying all of those kind things Susan Cain.  We knew that, and it is not always obvious to the world.  It is not like we are going to yell it on a street corner!  We are just going to continue loving people, leading, speaking, thinking and living our lives.

Extroverts are great too.  We knew that too!  They are some of our favorite people.  Without the “other half” we would not have a fun, exciting, balanced world.

Stretching beyond your comfort zone – as an introvert or an extrovert – may sometimes be beneficial when it involves something that is very important to you, but do not stretch yourself too far outside of your comfort zone, and do not be dishonest with yourself.  Be true to yourself and your strengths.  This is a HUGE relief to read after a lifetime of being told to step outside my comfort zone.  Don’t.  Unless you need to and then get back to where you are most comfortable, because you were created to be you, so be you.

If you are an introvert and you love what you do but it has extrovert requirements, find ways to recharge during the day for your own long term well-being and in order to continue to do your life’s work well.  Since reading the book the first time (I read it again to write this review, which made me want to read it a third time) I have made conscious changes in my work day in order to continue to have the energy to do what I love and need to do – work with my veterinary team and client families to protect and restore the health of pets.

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I get to work a half hour early whenever I can.  Not to work, just to sit.

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I chose a desk that faces the corner of the office.

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I spend much of my lunch and break time alone.

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I color between appointments.

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I took on much of the social media portion of the business because I love social media and because I believe in the company, but I have found as a wonderful side effect the ability to invest hours researching and creating, which is healing and restoring down time that balances well the rigors and emotions of the rest of the work day.

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I LOVE spending my days with my coworkers.  I LOVE spending time in exam rooms with clients.  I love meeting people, talking on the phone, consulting with experts.  All of this, as much as I love it, is as physically and emotionally draining for me as I imagine it is charging for an extrovert.  It is difficult to explain what a to-the-core people person I am when I need to spend time away from people in order to be with them again.  Even to me it sounds strange.

Susan Cain says it is not.

And for that – the validation of me as an individual – and the validation of introversion as a trait to be celebrated and nourished, I am most grateful.

Thank you Susan Cain.

AND thank you to Rebecca Tudor, veterinary surgical specialist, for introducing me to this wonderful book.

I think that whether you identify yourself as an introvert or an extrovert, you will enjoy reading this book, and it will stretch your thinking, in a good way, not in a beyond your comfort zone way.

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116 Comic


Tuesday, October 30th, 2012

Our family recently attended our first ever Pug-o-ween, the biggest fundraiser of the year for Pug Partners of Nebraska – one of my all time favorite rescue groups!

Do you know what is cute?

A Pug, of course!

Do you know what is SUPER cute?


Do you know what is so cute I could have DIED?

Hundreds of Pugs and all of their dog friends dressed up for Halloween!

Pug-o-ween this way!

Seriously – hundreds!

Bumble Bee!


Devil and Angel Westies – too cute!

The long dogs – Sundae, Cow and Shark

and…Squirrel! Notice Chia Pug in the background…

A Beautiful Butterfly and…Shark!

Pugasaurus – RAWR

There is nothing cuter than a Pug saying “please”!

What is SO cute about 3-legged Chihuahuas that I have to include them in EVERY photo collection?

…I think it is their adorable little 3 legs and undefeatable Chihuahua spirit. And also their cuteness.

Black dogs just look good in every color!

A Dachshund hotdog is still my all time favorite costume.

This dog has the sweetest soul! We spent some time just conversing telepathically :)

On your marks…get set…

Hope you didn’t have any money on the Pug facing backwards!

“You’re a funny looking Pug!” “Well you’re a funny looking…Pug!”

Lobster Pug

This IS my costume.

Hippo Pug is worn out from that intense race!

You have our full attention. And hopefully treats.

This Poodle was so happy to be pet he almost fell over!

Lots of minis to be seen…which are just adorable on Pugs.

Of all the raffle prizes of the entire party, there was only ONE that I felt like I NEEDED as soon as I saw it.  In fact, I was only half way through carefully evaluating the huge numbers of awesome Pug things to win when I saw it, and in an uncharacteristically passionate split-second decision, I put my raffle ticket in the tiny overstuffed box, and spent the rest of the party hoping. And…I won!  Meet Gary II. Can you believe he is mine??

If there is anything in the world that rivals the cuteness of a Pug, it is for sure a crocheted Pug!

Thank you Pug Partners!  Thank you Pug people!  Thank you Pugs and one-day-only honorary Pugs! We had a very fun time with you!



Words that are Hard to Spell

Saturday, September 15th, 2012

In general, I cannot spell well in English.  English spelling is ridiculous.  I can spell medical words fairly well because they are usually just obnoxiously compounded Greek and Latin descriptions of medical things.

Dalmatian has never been difficult for me to spell.  I have always thought the third “A” looks nice with spots.  That is the best I can explain that.

Basset, as in Basset Hound, is almost impossible for me to spell.  In fact, I looked it up just now to tell you that.  There is a city in Nebraska and there was a furniture store in Omaha, and of course there is the incredibly awesome dog breed.  Those three need to get together with each other and anyone with the last name of Basset or Bassett and agree on one spelling.  For me.

I need to get all my stupid thoughts out here on Riley and James because at the beginning of the New Year I am helping to develop the online stuff for Gentle Doctor, and it probably needs to be more focused and a bit more serious.

If I start a weekly hospital blog, will you read it sometimes and come discuss stuff with me?

As always, here on my personal blog, you get stuff like my thoughts on how cool I think the word Dalmatian is, which, though less important than medical issues, is something about which I feel just as strongly.  Thank you for being here.  I think you are awesome.



Congratulations Dr. McIlnay!

Wednesday, May 30th, 2012

Dr. Tonya McIlnay, Omaha’s wonderful veterinary ophthalmologist and her equally wonderful team, moved into a new building recently and had their Open House tonight.

Remember when I went to the Farmers’ Market and I saw a dog and Vernon said (paraphrase) “It is going to be alright” and then it was? I again walked into a crowd On Purpose tonight and again it turned out just fine.

In fact, it was a very fun evening.  A hug from Dr. McIlnay right as I walked in the door and a tour from Jen and Shelly (MY coworkers, who were just being nice because they know how much I unlove crowds) is equally comforting as seeing a dog and having Vernon say everything will be okay.

Jen and Shelly - Thank you both! I think you are great.

Anyways, I am a grown up now.  I join crowds.  Because so many of my Favorites were there.  And I like Dr. McIlnay so much.  And her new hospital is really nice.  I would not have wanted to miss THAT.

So here are some pictures.  I forgot to get a picture of Dr. McIlnay’s vet tech, Susie, and my coworker Dr. Kanne, who are also my Favorites.  The pictures also do not do the beautiful building justice.  I bet if you called ahead and were super nice, they would give you a tour sometime.  It really is great.

Whitney, Trey and Becky, more awesome Gentle Doctor coworkers

Allison and Rhea, MORE awesome Gentle Doctor coworkers

Angie and Erin, still MORE awesome Gentle Doctor coworkers

Amanda, yet another awesome Gentle Doctor coworker

Pastor Mark and Pastor Wenda - They stayed after the Open House to offer a blessing for the new location and pray for Dr. McIlnay and her team. How cool is that?? I know! Very!

Pastor Wenda and Shawn McIlnay, Dr. McIlnay's husband who is AS NICE as his wife!

Dr. McIlnay and Dr. Backlund, another very nice Omaha veterinarian

May your pets never have problems with their eyeballs.  But if they do, may they be blessed with Dr. McIlnay as their doctor.



Thursday, August 11th, 2011

A veterinarian friend recently mentioned that she was interested in attending the Pfizer FRANK Communication Course offered by the Argus Institute of Colorado State University College of Veterinary Medicine and Biomedical Sciences.

Sometimes I get an idea in my head and obsess over it until I have explored every possible angle of the idea that I can manage or have driven everyone close to me crazy.  It is one of my most <endearing> qualities.  Ha!  My kick since my friend’s comment (well, one of them) has been communication.

Soon after I heard about the CSU course, I read my now second favorite book in the world, Skills for Communicating with Patients, an in depth review of the human medical side of doctor-patient communication.

And this week I found out that I get to attend a FRANK Communication Course through my work this fall!  Woo!  Can you believe it??

In case you want to see this obsession through with me…or learn more about communication like a normal person…here are some fun veterinary communication information links…

Dr. Nancy Kay’s FRANK Post

The Learning Vet’s Communication Post

“A Vet’s Guide to Life” Communication Post

CSU FRANK Course Link

FRANK Website

“Frank Communication” on Web MD

Argus Institute at CSU

Denver Post Article on Argus Institute

I can almost be all inclusive in my list of resources, because “Veterinary Communication” is just recently being formally researched and taught.

And thank goodness!  Who cares how much I know about <heartworm disease> if I can’t communicate to Baby Shar Pei’s owner WHY heartworm prophylaxis is so vital?  Five Year Old Future Shar Pei with fulminant heartworm disease does not care how much I know!  He is counting on me now to get this communication stuff right, as are all of my dear patients and dear clients.

I would LOVE your input…on how vet teams (including ours) can communicate better…on how it applies to YOUR career…stories of successful or failed communication…

I am SO looking forward to this FRANK course, and I will let you know what I learn as I learn it!

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On Becoming a Small Animal Vet, Two Short Stories

Saturday, July 23rd, 2011


I decided to be a small animal veterinarian when I was nine years old because I liked pets.


My friend Jerry started his veterinary career as a large animal vet.  One spring, he preg checked a herd of his friend’s cattle.  Not one of them was pregnant.  The next day, his friend killed himself.  Jerry has practiced only small animal medicine ever since.

Happy Heartworm Free July!

Friday, July 1st, 2011








Heartworm Disease in Cats

The Good…

Cats are not a natural host for heartworms. They are infected roughly a tenth as often as dogs.

Cats on heartworm preventative medication are completely protected from heartworm disease.

The Bad…

Heartworm disease is difficult to diagnose in cats.

  • Before an infection is fulminant, sometimes there are no signs.
  • When signs appear, they are often non-specific.
  • The ELISA test detects antigens from mature female worms.  Cats usually have a low adult worm burden (typically one to three worms), so the odds of all male heartworms is pretty high.  If that occurs, the test will read as negative.
  • An antibody test is available, but can also yield false negatives.  (Back to the good for a second:  The two tests together may increase accuracy.)
  • A cardiac ultrasound can detect adult worms in or near the heart, but is much more expensive than a blood test.

I am convinced that because of all of these hurdles to diagnosis, feline heartworm disease is underdiagnosed.

At this point in time, heartworm disease in cats is untreatable. We manage secondary signs and inflammation while we wait for the adult heartworms to die, which can take several years.

The Ugly…

Cats become sick with a very low worm burden.

A common sign is difficulty breathing, which can be mistaken for asthma.

The most common sign of heartworm disease in cats is sudden death.

The End of Feline Heartworm Disease…

Every cat should be on a monthly heartworm preventative medication, even an indoor cat in Nebraska.  That the risk is relatively low would not make one bit of difference to me if Max the Cat were the one to contract heartworm disease and I could have prevented it.

Great information at American Heartworm Society’s website:

Feline Heartworm Disease

Today’s Checklist for the Finch Household:

Noodle the Poodle – Wormshield tablet

Max the Cat – topical Revolution

Give treats to the fish and Joy the Puppy, who is on ProHeart6

Hope you have a happy, healthy, minimal-mosquito heartworm-free summer!

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Veterinary Pen Holder

Monday, June 6th, 2011

I was helping take out trash at work the other day, when, for the first time ever, I noticed that empty blood vial containers look really cool.  Instead of recycling the one I found (I mean, like normal people recycle!) I took it home and wrapped it in wrapping paper, and now I hold my Sharpies in it.  It is my favorite pen holder ever.

It is super easy to make a veterinary pen holder…

1.  If you work in a veterinary hospital, go dumpster diving in your recycling container and find a test tube or blood vial holder.  Note:  The dividers in the boxes that hold purple top tubes will be too narrow to hold Sharpies or big highlighters, but will be fine for regular pens.  The one in the picture held red top tubes.

Also, if you dumpster dive in front of your boss, she may assume you are doing so out of necessity, not to make a Super Awesome Veterinary Pen Holder, and may give you a Pity Raise.  This is not as cool as a Merit Raise, but hey, it is something!

If you do NOT work in a veterinary hospital or other medical facility, ask your pets’ veterinary team to set aside a blood vial box or test tube box for you.  They may not have one to give you right away, but probably will not mind saving one for you!

2.  Gather your favorite wrapping paper, stickers (Secret Penguin stickers are the best!), clear wrapping tape (narrow), clear packing tape (wide) and scissors.

3.  Take the cardboard divider out of the box.

4.  Wrap the box like a present, tucking the edges of the wrapping paper into the top of the box.  Tape all of the loose edges with the narrow tape.

5.  Tape the four top edges of the box with the wide tape to reinforce it.

6.  Decorate the box with stickers (or whatever!) and put the cardboard divider back into the box.

7.  Add pens.

8.  Take a picture and send me a link to it!

9.  Make a pen holder for your favorite veterinary team to say THANK YOU for letting you dumpster dive/humoring your odd request.  They will probably get a kick out of it!

Meeting Marty Becker

Tuesday, May 10th, 2011

Marty Becker, DVM is on his Big Bus Tour across the country to promote his newest book, Your Dog, The Owner’s Manual and also to promote veterinarians and veterinary care.  (Thanks Doctor!)

He will be at the PetCo in Council Bluffs from 12:30 – 2:00 pm on Tuesday, May 17, 2011.

Dr. Wittler and I have cancelled our Tuesday lunch meeting (Thanks Doctor!), which is one of my very favorite parts of the week, so that I can go meet Dr. Marty Becker with Joy the Puppy.

Come with us if you can!  This is a great opportunity.  Dr. Becker has done SO much to promote the human-animal bond and the veterinary profession.

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I do just fine meeting people in exam rooms, but in The Rest of the World, I am well-known among friends and family for my ability to flub even that simple cultural nicety, especially if it is someone I am excited to meet!

My brother Dave introduced me to his friend Stephen Baldwin, and I messed that up.  In my defense, Sara walked up with Riley (my Great Dane-niece of the “Riley and James” duo, who was a super-cute gangly adolescent pup at the time) at the exact moment I was shaking Stephen’s hand, and I got distracted.  When I looked up from petting Riley, he was gone.  (Sorry Mr. Baldwin!  Give me one more chance!)

A guy walked up to the reception desk of Banfield Pet Hospital of Oakview here in Omaha when I worked there several years ago and asked me a puppy question.  He was very nice and fun to talk with.  We chatted for a few minutes, and he wandered off.  That night, I told Russ I met someone who looked like Nick Nolte, and when I described him, he said, “No, you met him.”  When Russ showed me pictures, I realized he was right.  Oops.  *Putting this out into the universe*  It was nice to meet you, sir!

Before that, it was Rich Mullins about fifteen years ago.  (I did say “Nice to meet you” after I said “um…”!)  SO glad I had the opportunity to meet him.  He was one of my heroes.

I messed up meeting the members of the band Geoff Moore and the Distance during veterinary school in Ames because I was rushing to get out of the crowd and did not recognize them.   (Yup, even though we had just experienced their awesome music for the preceeding two hours.)  We found the same back exit the band was using, and I was in tunnel-vision get-me-out-of-this-crowd mode.  They said “Hi guys!” and, thinking they were other fans being friendly, we said “hi,” but did not stay to chat, which, in hindsight, was the chance of a lifetime.  *sigh*   (Sorry guys!  I really do think you are great!)

Oh!  I remember a success story!  The day I met Lorie A. Huston, DVM, we had pasta for lunch, and I did not even spill marinara sauce on myself…or Lorie.  Yay me!

Having a puppy with me this time will help me to not be flustered…though I may get distracted…

Wish me luck!  Dr. Becker, if I forget to say it…

“Nice to meet you!”

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