Wanna know what I spend my time doing...day after day? It’s pretty simple really. The hard part’s the talking, explaining, teaching, cajoling, reasoning, recruiting, empathizing, etc. The rest? It’s mostly a breeze.
That’s because veterinary patients tend to observe the 80/20 rule. 80% of our “problem” cases are routine. The remaining 20? Complex cases with complex solutions. Bloats, diabetics, Addisonians, Cushingoids, liver shunts, FIP, heartworms, etc.
That’s not to say our routine cases aren’t potentially complex. In fact, they typically are when you get down to the nitty-gritty of the underlying process. But they’re so common that the accepted steps to follow as we unravel their solutions are relatively obvious for the experienced.
Because I was recently asked by a reporter to discuss the most common pet problems I see, I got a little curious about the actual stats behind my daily work. The results surprised me, since I had no idea how much time and energy I’d been dedicating to my patients’ individual disease processes.
For your consideration (and edification), here are my stats for the past month (a relatively normal one as far as I can tell):
#1: Allergic skin disease
The biggest surprise was the amount of time I dedicate daily to skin disease. While allergies are huge here in South Florida, year-round, I was shocked to discover that almost a full 25% of my [non-well pet] appointments are dedicated, exclusively, to the evaluation of allergic skin disease.
Forget spays and neuters and other basics––their volume pales in comparison to the itchy pets among us. Flea allergies, food allergies, inhalant allergies, etc. are my bread and butter, it would seem.
#2: Other skin disease
Add the allergic pets to the other [not necessarily allergic] skin cases I see and you might start to wonder why I didn’t specialize in dermatology: Demodectic mange, anal gland abscesses, ear infections (though, strictly speaking, most are allergic in nature, too), non-specific hair loss, sarcoptic mange, ear mites, fur mites, ringworm, etc.
#3: Gastroenteritis
Diarrhea, with or without vomiting as an additional symptom, is the next most common cause for pet visits to our place. Extra soft stools, runny or bloody stuff is wickedly widespread. And, in case you’re wondering, Mondays are the day for these. Barbecue, anyone?
#4: Urinary tract disease
Cats made up the bulk of my urinary tract issues with their lower urinary tract diseases (blocked boys) and idiopathic cystitis (ouchy bladders), but leaky dogs and chronic renal failure (in both dogs and cats) were significantly represented, as well.
#5: Dental disease
It was a little tough to quantify this one only because so many of my patients in for something else get flagged for dental issues, too. In many cases they don’t make appointments until after it’s too late, but my busy “routine dentistry” schedule proves there’s still a hefty interest in prevention.
#6: ADR (“ain’t doing right”)
This is a harder one to claim as “routine” because a significant percentage of the time my ADR cases turn into something more sinister than simple sniffles and common kennel cough.
#7: Limping
Limping cats and dogs is definitely routine. “Can’t get up” is another variation. But most of the time, it’s a simple sprain or strain. Next up in frequency? The dreaded osteoarthritis.
#8: Lumps and bumps
So many tumors...so little time.
#9: Bites
Limping cats usually fall into this category, as do all those cat bite abscesses I see. Evidence of inter-dog and predatory aggression also makes its way. Interesting how most of my pet bite patients are repeat offenders. you’d think it would eventually make sense to keep the cat inside, right?
#10: Simple Trauma
Lots of simple traumas here in Miami, where every day of the year is another opportunity for going out and getting hurt––just a little. Fractured claws, small lacerations, fence wounds and bleeding tails are everywhere. And let’s not even begin to factor in the “hit-by-cars” and “fell-off-the-roofs.”
***
Think that’s enough solid work to make a reporter happy?
Add Comment41 Comments
This is ranked by time, not money, eh? ;)
For time, my guess for our pack is routine preventive care and/or ADR (learned a new technical term today!). For money, orthopedics, with the dog fights coming in a close second, sigh.
Julie in OH April 26th, 2009 10:15:18 AM
Having spent the last 5 days cleaning up pudding-poop (Opened a new bag of our regular dog food, Mr. Sensitive Tummy is not doing well on it although everyone else is fine.... I really just need to start adding pumpkin every time I change ANYTHING about his food, including which bowl it's served in, I swear....) I can see why you would see a lot of patients for it!
Cait April 26th, 2009 10:58:56 AM
I know vets ask about food/diet. Given 1-5, maybe 1-6, do vets actually note the food/diet on a routine basis in the animal's file?
PJBoosinger April 26th, 2009 11:09:12 AM
As a multi pet owner...and make that MULTI, your post is interesting. I will have to think about the vet visits I have made in the last year and see how they coorespond with your stats.
1. No visits for skin allergies. No one has any...guess either the diets are good, or we're lucky. Though one of my doxies gets crud aroudn the bottom tip of her ears...we are always scrubbing and scrapping it off.
2.2 cats with ear infections this year...progressed from sniffles/sneezes
3. I have 3 IBD cats, one visited the vet this year specifically for chronic diarreaha
4. 2 cats with UTI....one boy with chronic crystals every time he gets the dog food.
5. 1 dog needs a dental, one cat broke a canine
6. ADR's....sigh....
7.limping cats often occur, unless someone is not weight bearing, we do go to the vet for this, as by the time we get to the vet, there is no more limping. However, this USED to be somethng we went to the vet for several times in the past. Cats simply can not help themselves. IF it is there, then they will leap to it and inevitably leap from it.
8. feline lypoma removed a few years ago, sebacious cyst also removed...different surgery same cat...
9. I get bitten....usually stuffing a pill down someone....or by my basement cat....he has misplaced aggression, but seperated from others he's doing better, of course it's only taken us 3 years to get to OKAY.....I'd like to kill whomever abused him before I got him.
10. my cats NEVER go out and my dogs only go out supervised. We have very little of this....though my polydactyle cat ripped one of her extra claws off on something and although it bled a lot and was pretty sore for a few weeks, it did heal and grow back without veterinary intervention.
the dogs do sometimes get into my raspberry bushes and we have to remove stickers from various places...
and yet I still manage to spend thousands every year.....
LorriM April 26th, 2009 11:21:20 AM
Over the years, the "non-annual" trips for the dogs have almost always been for the itchies.
With the cats, there was one bite (self inflicted - the other cat liked to jump on him when he was grooming his paws), one UTI, and one upset stomach from trying to eat detergent. (Not too bad considering they lived to be 14 and 15!)
Cindy April 26th, 2009 11:38:06 AM
Looking at the list, and if I looked back in time at our own pack about ten years ago or so, I'd say I'd agree with the order. We're like LorriM in that unless it is somewhere important (neck) or the critter isn't bearing weight, or the limp remains for more than 3 days, we don't go to the vet for limping. Too many rough players in our group. We've had sprains, strains, ripped toenails, cut pads, foreign objects in pads, etc etc. Unless there is a lot of blood, we can't get it to stop, or it won't stay closed, we don't go to the vets for wounds, either. Through past experiences, we've learned what type of wound can have sutures, which ones should stay open, and which ones can do just fine on their own. We've learned more than we ever wanted to know about blood flow, wound abcesses, etc.
In exchange, our vets know that when we do bring in a critter, that we have evaluated the situation and we rarely are there for something that will otherwise waste their time and our money. They all listen to us with the understanding we know what we are talking about. They know they don't need to sugar coat something and that we prefer the straight truth, no matter how gross.
On the other hand, I'm sure our vets would prefer we do more regular maintanence such as teeth and ear cleaning and toenail clipping. We admit that's where we lack. I'll hold my hand to a gaping wound, clean up watery poop, and gag through cleaning a draining abcess. But brush their teeth? Ew. I *know* where that mouth has been.
PaulaO April 26th, 2009 11:49:43 AM
Wow. Are my pets so a-typical?
Reasons for non-annual vet visits:
Now I see even more why my vets joke that my pets never have simple ailments...
Xslf April 26th, 2009 12:50:19 PM
That list looks about right to me, too, for what my clinic sees. For my own personal pets (5 cats, 2 dogs), funny enough, I've rarely dealt with any on the list. No ear infections, no skin issues, no GI or UT disease, no trauma, etc. Except for the one dog, who's had two mast cell tumors, a broken toenail that eventually required amputation, and a cystotomy to remove a HUGE calcium oxalate stone (the one silver lining is that, despite persistent crystalluria with the recommended therapeutic food, she's asymptomatic and routine bladder rads are always clear). Funny how animals work.
anna April 26th, 2009 02:43:45 PM
How do you track this information? Do you post diagnoses in a computerized medical record? The docs at our clinic are inconsistent at remembering to post diagnosis codes (myself included) but I can see how it would be invaluable (eg how many parvo cases did we treat this month?).
I, too, was a little surprised not to see kidney disease in your list--I feel like I treat a lot of it (most surprisingly in a lot of dogs recently).
Thanks for the post, it's interesting to compare notes.
JCB April 26th, 2009 03:54:28 PM
I dread the ADR visits. Inevitably, I either wind up looking completely insane- ADR cat mysteriously appears to be DR the moment we set foot in vet's office, everything comes back WNL, etc. (in my defense, something usually is amiss, it's just not readily apparent yet).. or we wind up making an appointment at the Big, Scary Expensive Specialty Clinic where we invariably receive some form of Bad News (if we're lucky, it's just a massive bill).
We've been lucky enough to have avoided most of the top offenders this year. Unfortunately, they've been replaced with things like echocardiograms, eye issues (specialists and titers and scraping doxycycline barf off everything in the house, oh my!) and temporary dysregulation of diabetes. Dentistry's next on the list, once we recover from the $ spent on echocardiograms and eye issues and such.
Ramen Connoisseur April 26th, 2009 04:03:05 PM
Animals are a big responsibilty and they do get sick and wind up costing us trips to the vet. One really important thing to remember when transporting pets that are injured, just been adopted or even on a daily ride is to use a crate to transport them. I went to adopt a cute border collie/lab mix 6 month old pup, it was in the back of the car on a leash. We passed some cows, It got off of its leash, and climbed into the fornt seat of the car and then the dog bit me 17 time on the arms while I was driving on the freeway. They said it was a scared aggressive reaction. Anyway it was a mess- bloody arms, police, the dog was impounded and it all could have been avoided had I used a crate to transport the dog. I learned my lesson!
Louise April 26th, 2009 04:40:54 PM
Chronic renal failure was indeed listed. It was under urinary tract issues. I see plenty--mostly in cats, but in at least 2 dogs this past month.
How did I track this data? By looking at each individual visit's "presenting complaint" for the past month--we worked from there, recalling each case, one by one. Unlike actual diagnoses, presenting complaints are always entered into the computer. Can't wait until our records are fully computerized....sigh...
Dr. Patty Khuly April 26th, 2009 07:58:25 PM
Your list reflects my practice as well, and our climate/environment is very different. I would've thought all kinds of parasite issues would've been more common "down" there - I mean, parasites other than the common ones. There should be a mandatory 3-week rotation in dermatology...I took one week in fourth year (did not specialise in companion animals), and it turned out to be the most valuable one of the year. Not just skin conditions, but for lumps and bumps as well.
brebis noire April 27th, 2009 07:36:12 AM
Oh, Louise, how awful! I hope you are okay - or as okay as one would be after something like that. You didn't mention a crash - which sounds amazing if you managed not to with that happening inside the car while other cars are zooming around you. You must be an amazing driver - kudos on that, at least!
I agree with your comment. We don't see many animals who've needed treatment from things like that (I guess that's where the human docs have to do more there), but we have had a few clients (mostly with cats) who don't use proper restraint, and have issues. One dog and three cats got stuck (or just wouldn't come out nicely) under a car seat on trips to see us (all from different families), and the dog family had to have a garage unfasten the seat (don't know how) to get the dog out (and, yes, the mechanic got bit). One of the cats, in getting into the footwell, got 'tangled' in the owner's feet, and she hit a curb and mailbox, and then when she got to the vet, the cat bit her as she was getting it out. Second cat, when they arrived, the owner was kneeling to pry kitty out, and the cat jumped out, clawed her arm, and back while disappearing into the bushes, where she was actually caught, without further issues, amazingly - until inside the clinic, where without a being in a carrier, was scared by a barking dog, and clawed the woman's face and landed behind the desk, where we threw a jacket over it - at which point the cat released its anal sacs - just lovely! And third cat, refusing to come out, finally did, and zoomed right into traffic. That wasn't good. A carrier is a must - or at least a pillowcase with a tie around the top, for all cats. Dogs need some restraint, too (carrier, seat belt harness, barricade). Years back a client's dog jumped out the window while on the freeway - that was horrible.
K April 27th, 2009 06:09:43 PM
The dog biting me in the car was the scariest thing that ever happened to me. I didn't get in a crash- I had to keep the dog on my lap in between the steering wheel and myself. When I think about it it really seems dumb that I didn't have the dog in a crate. Hindsight.. Louise
Louise April 27th, 2009 07:51:44 PM
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