Wow! Who had the fun job of shaping the poop into a heart shape? That's just....creative.

KateH February 17th, 2009 08:38:30 AM

...

I've never had a vet suggest that.  Even when I called and said "My dog had a really unusual bowel movement JUST NOW, should we come in?" and they said yes, they could work us in as soon as we arrived.

(They've mentioned coming in with a urine sample if they couldn't get one while we were there, but my dogs pee on command, so it didn't come up again.)

Bringing in a fecal sample is a good idea.  I'll try to remember it in the future.  Thank you.  Is there anything I need to do to make sure it's uncontaminated or otherwise usable?

Galadriel February 17th, 2009 08:48:06 AM

Hey Dr. Khuly - I love the poster!! Did you makeit yourself? I tried to take a fecal sample in on my last visit... however, after failing to tromp through the 2ft of snow in my jammies when the sample was fresh.... I went back several hours later to find it frozen. Darn!

JH February 17th, 2009 09:20:15 AM

Yes, thank you, made this all by myself with a little help from my Mac and a couple of pilfered on-the-net pics. 

As to bringing in the sample: Best fresh (within the hour), but we'll take it anyway you want to bring it. Leaves, grass, kitty litter...doesn't matter much. A Ziploc is as high tech a mode of "non-contamination as you need.

Dr. Patty Khuly February 17th, 2009 09:33:58 AM

We're dealing with mystery diarrahea in our kitten (6 weeks now), so believe me, I've gotten the fecal sample lecture time and time again. But the stricture "Must be less than 2 hours old" has made it impossible. I'm sure my vet is inwardly rolling his eyes when I show up with a kitten instead of a sample, but it really is harder than it sounds sometimes, Dr. K! And it 4 of us to hold the little guy while the vet tried to get a sample on-site. Believe me, if we could, we would.

If anyone has hints for how to reliably collect a sample in a 4-cat household "on demand", I'm all ears. Plastic in the litterbox freaked everyone out and resulted in one adult cat deciding to go outside the box -- for a week.

Feline February 17th, 2009 10:47:31 AM

Do you charge extra if you have to "fish it out"?  That may help.

Could you put it on the appointment reminder card?  "Bring in Fluffy, and don't forget the baggie of poo!"

Feline - with the four cats, can you seperate into small rooms (like a bathroom) with a box?  Knowing when your cats go helps too - Zelda almost always goes after breakfast, so I have an idea of when to look.

teri February 17th, 2009 10:57:45 AM

Teehee, we either get no sample or enough to clog a portapotty.

We include in our kitten care kits a fecal container we get from out lab. It's small with a little spoon attached to the inside cap, so it insures we get a sample quantity we need plus it's ready to go to the lab. Of course, there's always empty jelly jars and plastic spoons, lol.

Teri and the cats of Furrydance February 17th, 2009 12:02:11 PM

We don't generally go poop mining unless it's a pet there with a problem. For routine visits, if clients don't bring a sample along, I'm a big fan of the pre-paid fecal. They get sent home with the little Fecalyzer container, directions, and a plastic bag. Most of them come back since they've already paid for them.

Katie February 17th, 2009 12:02:49 PM

With so many products like revolution already worming the pets, I image that the thought process is why do I need a poop sample...

or maybe getting the pet to the vet is so traumatic, they forget....I've forgotten samples at home..fortunately I live right around the corner from my vet...(at least until I move that is...)

LorriM February 17th, 2009 12:17:32 PM

My dogs poop at about 7 AM and 7 PM.  The chances I can hit that tiny window of time within which the Vet wants to get it (and who won't/can't schedule the appointment to accomodate their poo schedule) and deliver it, especially when I live 45 minutes from their office..  Well, not going to happen.  Somebody needs to come up with a kit that preps the sample so there's more of a time window.  (I've also been asked for urine samples but have yet to have a Vet who could tell me how to accomplish this one. :)

LOVE the poster but it's too late once they're in the waiting room, isn't it?  (I'd giggle and then forget about it before I even got to the car wrangling my babies.)  If you want me to do something, send me an email reminder.

PJBoosinger February 17th, 2009 01:11:31 PM

Love the poster!  Nobody has ever asked me to bring in a sample, except one time when it was a way to avoid bringing in the actual dog, a foster who had been under treatment for giardia and we wanted to make sure he was clear before he went to a new home.

So it may just be that people aren't used to the request.

Anne February 17th, 2009 01:21:38 PM

Maybe I just have a high tolerance for the ick-factor, but I'd much rather collect my own sample than subject my dogs to the poo-rod. I typically cut down a plastic party cup to use as my scooper, then drop that in a ziplock.

Really, you only need a little bit ... right?

I was mortified when I realized I'd been bringing WAY too much. :o)

Roxanne @ Champion of My Heart February 17th, 2009 01:30:56 PM

Tee hee...my vet includes a full 8.5 x 11 sheet of paper with the appointment reminder: "Don't forget the poop!" I hang the reminder on my fridge with a magnet; never fails to elicit some comments from guests in my home, but I show up with the poo every year, so it works. I have a 4th grade sense of humor anyway. I usually schedule my dog's appointments first thing in the a.m. so I can get the sample to them fresh. I start giggling first thing as I'm following Alfie around the dark yard at 6 am with a flashlight; I think it might give him performance anxiety, but I always get the sample, lock it up in a ziploc, then put it in a brown bag with my address and "Alfie's Poo" written on the side. If it's during the holidays I'll add some nice festive Xmas stickers and a red ribbon to the bag. OK, I'm weird, I know, but it's just so insane to me the things I will do to ensure my babies' health, and collecting poo always gives me the giggles.

Shasta February 17th, 2009 01:56:05 PM

It sounds like you do a fecal with every routine dog exam -- is that necessary? I haven't had a fecal done on any of my dogs in many years. If I needed one, I'd bring a sample in, either before or after the exam, it doesn't need to be at the same time. I'd never put my dog through an uncomfortable process unnecessarily. I like Katie's idea best -- just send them home to get one if needed.

Mary Straus February 17th, 2009 02:00:04 PM

I've never seen a vet use the rod before.. and honestly had no idea such a thing existed! Perhaps this would be why the boys are so amenable to visiting the clinic.

The vets we've used have always just had us drop off a sample later if they wanted one. Admittedly, I'm a little lax in the fecal department because the cats are strictly indoors and have no interest in catching things.. their fecals invariably come back negative. (Did bring home tapes from the kennel once, though.. bad mom forgot to Frontline before dropping them off for an extended stay. After  having to  administer those god-awful Drontal kitty horse pills to 17.5 lbs. of *very* displeased feline, bad mom no longer forgets the Frontline. Ever.)

Unless there were a very pressing, immediate need to obtain a sample right then and there, I don't think I would ever consent for the rod. They'll provide a timely sample at some point in the near future, so why subject them to the unnecessary trauma?

Ramen Connoisseur February 17th, 2009 02:04:19 PM

Mary: We live in Miami. It's probably malpractice not to check a stool sample routinely (at least once a year).

;-)

Dr. Patty Khuly February 17th, 2009 02:37:15 PM

Oh, I should explain: Miami is parasite heaven. 

Dr. Patty Khuly February 17th, 2009 02:37:58 PM

In Missouri, my Vets rarely do poo checks; in Houston, it's SOP with annuals.  Long summers, no winter to speak of, high humidity, high density of humans and critters = well fed petrie dish.

PJBoosinger February 17th, 2009 03:21:30 PM

I always bring a stool sample, even when I'm not sure I need one.  To be honest, I'm shocked that people show up without one (in the absence of "Oh darn, I forgot, sorry!" of course). I was never told that my sample has to be within an hour or two, though - I just bring the freshest I've got. Sometimes that means a 7am poo for an 11am appointment, but no vet has ever complained or told me it was unusable.

I also didn't know there was another way to get a stool sample until I started reading your blog. I assumed if I didn't bring one my pet was, if you'll pardon the expression, SOL until I could get one to bring in.

Maddie February 17th, 2009 03:29:26 PM

Mary Straus, my dog's hookworms were diagnosed just after her annual through her poo sample. She didn't show any symptoms prior to that, so thank goodness it's SOP in Texas to get one done with the annual. I think it's just good practice to do it, especially if your dog is otherwise healthy and only sees a vet once a year or so.

Shasta February 17th, 2009 03:57:57 PM

That is too cool, love that poster!

I have not had a positive stool sample (randomly chosen) in over 10 years. I guess Interceptor does what it claims.

I thought that if it could not be a fresh sample, it was acceptable to put a baggie sample in the fridge...ditto for urine. Years ago, it was often suggested to take pieces of multiple (days of)samples & put in a container (in the refrigerator)Maybe that was post-treatment?

The funny part is when someone brings in a "big pile"!

Pocket's Story from New Hampshire

Barbara A. Albright February 17th, 2009 05:19:30 PM

Might be a good idea to ask your receptionist or whoever in the office sets appointments by phone to remind the client to bring a stool sample. They can give instructions if needed. Then maybe people will write it down on their calendar with the appointment.

Mary February 17th, 2009 05:20:58 PM

Our local vet now requires not only a fecal sample, but a urine sample for the annual exam.  I'm not convinced the urine sample is necessary for *all* animals, but I do have a fecal done every year.

Nita February 17th, 2009 05:34:16 PM

That poster is brilliant !  LMAO  what a great idea !

LC February 17th, 2009 05:36:04 PM

I have to admit I prefer collecting a sample as opposed to having someone bring it in. I'd say 90% of the dogs and 50% of the cats I work with don't mind the fecal loop, as long as it's well-lubed and done gently (I know that probably made some cringe). It's just easier - a good-sized sample cleanly collected inside the loop, which goes straight into a centrifugation tube and mixed w/fecal floatation solution. Gloves aren't even necessary as you're only touching the clean end of a piece of plastic (which is washed and sanitized thoroughly after use) and the tube gets thrown away after use (although I do still wash my hands, of course). On the other hand, people who bring samples in often do so in ziploc baggies, trash bags, wrapped in paper towel, etc. - so now I've got a big mess of poo, usually smeared around (especially if it's loose). It's pretty nasty to have to don gloves and weed out the leaves, gravel, kitty litter, etc., from a fecal sample, especially when there's so much of it that the smell is about to knock you out. I almost always end up gagging (and I have a pretty strong stomach) when faced with a baggie full of diarrhea than with a fecal loop's worth. For fractious animals that go berserk, then yeah, I'd prefer a sample brought rather than wrestling with the pet. But for all others, the fecal loop is definitely preferred by my coworkers and me. Just my two cents.

anna February 17th, 2009 06:35:17 PM

I love the poster, Dr. K!!  I may just print out a little version and bring it to Fable's next check up for a giggle with my vet... lol

The reason being I think the vets at my clinic may tend to lean towards Anna's POV.  I've never seen anyone use a rod (they generally just don a glove and a lubed pinky finger - but of course I've only ever seen large dogs done, so this could be the reason) but I have seen the bugged out eyeballs when we walk in with the troops and a handful of plastic baggies - all colour coded for each dog/cat.  LOL.  The techs are always like "Geez... thanks... just what I wanted to spend my afternoon doing... a dozen fecals... :OP"

As for the yearly/not yearly argument, we do twice yearly fecals on all the dogs because we do twice yearly heartworm tests (we don't use heartworm or flea prevention, and therefore are at a higher risk of picking up parasites).  So far my pups haven't picked up anything that couldn't be traced back to a rescue dog - what can I say, they're checked and dewormed when they come in, but trying to keep them all seperated is a nightmare, particularly for something as simple as round/tapeworms. (when one is diagnosed, we just treat them all for safety's sake)

Sometimes we do them more often if we happen to be in, or if bloodwork suggests it (we do annual bloodwork on everyone too - I had a special needs guy for ten years and most of our rescues are special needs, so bloodwork is kind of second nature to us).  Full bloodwork in the first year, basic yearly until the fifth, and then full panels and the occasional urinalysis every year after that.

Personally, I don't think that enough vets stress the importance of setting "normal range" values for each individual animal.  For example, when my oldest guy's kidney results came back high normal at ten years of age during his checkup, a lot of animals would have required a ton of follow up work and perhaps unnecessary worry.  Not my boy - he's been high normal since he was four and has stayed there ever since.  He was a tad bit higher than usual, but was a bit dehydrated at the time (it was the middle of July and we had shown up early for the appointment) and so was no cause for concern.

I have the same feeling with annual fecals.  I think that they should be far more common than they are, across North America.  Animals can harbour all kinds of nasties (not to mention zoonotic nasties) with few, if any, symptoms - until the infestation and damage are severe.  People tend to poo-poo the idea (ha!) until you show them a roundworm, inform them that they're zoonotic... and they migrate.... ewwwwy!

Kim February 17th, 2009 07:01:56 PM

One of mine isn't feeling well today.  We took him to the vet (45 mile drive mind you), they did blood work.  They also did this fecal rod thing.  I had no idea!  WOW.  My poor dog.  They apparently got enough to test that he has some kind of bug in his intestines, but told me I had to get a "full load" to send out, apparetnly they couldn't get enough and he wouldn't "do it" while we were in town.

So, with 6 dogs, this is going to be interesting.  Watching everyone poo and making sure I get the right one and then running it to town to be sent out....too funny....

and it only cost me $557.55 today.

Kelly February 17th, 2009 07:42:13 PM

We almost never take out the fecal rod - if we need a sample, we send the owner home with a pre-paid fecalizer container (with instruction sheet and labeled with the pet's name).  Since they've already paid, most bring them back.  Granted, most of our clients live within walking distance, so it's not a big deal to come back.  I've been thinking that we should be running more fecals - we're in New York City, and dog density is high, so we're probably missing parasites.  We're very good about doing them on puppies and kittens, but tend to get pretty lax about it as they get older.  And I often need to be reminded that rabbits get parasites too!

Deborah February 17th, 2009 10:07:40 PM

Our clinic advocates twice yearly fecal exams for all pets - as expected, most indoor-only cats and only-goes-outside-to-potty dogs (or those receiving heartworm preventives w/added dewormers) generally test negative. I think most people get the impression we do this to pad our bottom line - I won't argue that, but a significant number of animals w/moderate to constant outdoor exposure are carrying parasites (hookworms and whipworms seem most common) and are totally asymptomatic.

anna February 17th, 2009 10:20:33 PM

Dr. K, Any chance of getting you to do a youtube video of  a standard exam for a cat and a dog; talk us through it?  Or a checklist?  Bloodwork?  I don't think my dogs have had any in 8 years except for pre-op.  No Vet ever asked and I certainly wouldn't know where to start for them.  I've learned all this for myself in recent years.  Guess I need to do the same for them.  Geez.  Sorry, makes me wonder if I'm paying professionals or techs except from looking at my checkbook I'd say I'm paying professional fees and often getting tech level services.

Kim: "I don't think that enough vets stress the importance of setting "normal range" values for each individual animal"  I knew that was true for humans; should have realized it's probably more true for animals.  Thanks for pointing that out.

Anna, my first adopted dog tested negative three or four times on fecals and blood sticks for everything.  She had a grande mal seizure and that's when we started hunting; found she had heartworms.  It's also when I found out those screening tests aren't all that great.  Although I do wish Vets would explain that (and I'm sure they've improved since then [1990ish]) and even though many of us are quite good at spotting parasites, I wish there was more standardized, regular testing for pets and humans.  Personally think that would be the biggest step toward better health for many since I'm convinced the infection rates especially of zoonotic diseases are much higher than anyone knows and more detrimental than we've been lead to believe.

PJBoosinger February 18th, 2009 03:10:15 AM

Another YouTube video!! Yes! I know this is OT so I'll entertain any suggestions for video subjects through the 'contact us' section. Thanks for the idea!

Dr. Patty Khuly February 18th, 2009 06:13:00 AM

Our receptionists always remind clients to bring in a stool sample when the appointment is made, AND when they call with a reminder of the appointment the day before.  We still have to use the loop more than I like.  As for frozen poop!  In Michigan this winter, we have come up with some creative ways to thaw out the frozen poop brought in for us to check!  I refuse to tuck the Fecalyzer container in my bra, though!

We ask for a sample no older than 8 hours. Works for us, anyway.  We also allow clients to refrigerate the sample if needed.  Just not the freezer, please! As for amount, well, we've occasionally had a garbage bag full brought in (I'm talking 33 gallon garbage bag)!  I think the client just went out in the back yard with a shovel and brought us everything!

We see a lot of parasites, since we are in a small town, with a lot of clients from farms and country homes.  So we really push yearly fecals.  I love the poster!  I'm going to contact you for a copy, Dr. K!

Sassy February 18th, 2009 06:14:07 PM

My vets don't want us to bring our own samples of anything. And now I am beginning to think that I need to be more firm about it since I AM paying for it. They say they can't be sure that it isn't contaminated. I even got a urine sample, straight from the stream of pee, into one of their containers, right outside their office and that wasn't good enough because they couldn't be sure about contamination. Are these just anal vets?

My dogs get fecals twice yearly and have always gotten the rod. One hates it and the other doesn't mind. Now I feel horrible. I don't want them to go through that unnecessarily. They go through enough at the vet as it is.

ckbruce.blogspot.com

Christian Kay February 19th, 2009 10:27:34 PM

CK: Bring it in. Insist. Reference this blog post. (tee-hee)

Dr. Patty Khuly February 20th, 2009 05:01:13 AM

Now you've hit a nerve!

The fecal loop returns less than 1 gram of feces from a good swipe.  It takes at least 3 to get a good diagnostic screening test, especially if you live in an area that sees a lot of whips. 

A good fecal examination includes centrifugation, simply letting gravity do the work isn't enough.  You'll see your positives at least double when you start centrifuging.

As ugly as it sounds, I've found that animals response MUCH more positively to the lubed (gloved) finger than they do the fecal loop.  One, I have tactile feedback, which is much more difficult through a 12" rod, two, if they don't have feces in the length of your finger, you shouldn't be digging any deeper...one quick movement and you could have a perforated bowel. 

I can see the use of the fecal loop for pets that are presenting with GI problems, but for routine examinations, the fecal loop has NO PLACE in veterinary medicine. 

Recently I have started "selling" prepaid fecal containers.  We get them from our lab, little cups with a spoon.  I put a label on it with the clients name and pets name, all you have to do is put a little sugar solution in the cup, give it some good shakes, then strain it into the test tube.  While some clients will still request that we collect the sample, I find that most are more than willing to do it themselves with this option.  I simply tell them that they pay for the container, they walk in, hand it to the receptionist and get a phone call within 24 hours with the results.

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