Last week I stopped by the specialist’s hospital to drop off some X-rays. In the parking lot I spied a yellow lab with a shaved knee as he jumped sky-high into the seat of an F-350.
“Was that your patient?” I asked when I noticed one of the surgeons shaking his head wistfully nearby. “Sure is—but I wish he wasn’t.”
There’s nothing more frustrating than doing your best work only to find that some clients won’t accept even the most fundamental advice. Rest. In a crate. No jumping. No running. At all. We’ll sedate him if need be. She needs to heal, dammit! What more can I say?
And yet it seems there’s nothing more difficult for a vet to convey. Too often, I‘m forced to qualify the kind of rest I want by going through the pet’s daily routine:
Help her up the steps—carry her if you can.
Don’t let him jump onto anything—not even the sofa or the bed.
Confine her to the crate when you’re not home to watch her like a hawk.
Leave her in the crate for a few minutes if she goes wild when you initially arrive.
Leash walks only.
Separate him from other dogs if he’s playful.
Keep her in a small room with no jump-up spots.
Shall I go on?
This list is absolutely necessary because without it I might get the worst kind of compliance imaginable. “Oh, I didn’t think you meant he couldn’t jump up onto my lap!” “Oh but it’s just three steps, not a whole staircase!”
You get the picture.
Then there are people willing to shell out $2,500 for a cruciate tear then let their dog jump way up into the pickup’s cab. What were they thinking??
If she CAN jump, they must think…it’s a good enough sign of her fitness for me. But what they don’t always get is that their pets are 1) lubed up on pain relievers so they don’t feel the hurt and 2) they’d probably jump anyway just to make you happy and because that’s what they always do. Remember: cats and dogs are creatures of habit.
That’s animals for you. They can’t be made to understand the things we humans easily grasp after spending a day in the hospital having our knee scoped…or whatever.
Cats and declaws? This is not only among my least favorite procedures because it’s too often unnecessary, it’s also on my s--- list for its high rate of complications. In my experience, nine out of ten of these complications are related to post-surgical activity (which is why I keep them in the hospital for two days).
What is it about amputating their cat’s knuckles they didn’t understand? Is keeping her in a small room with no high perches for a few days so terrible?
How about the dog with a neck injury whose owner still brings him in on a choke collar—after everything I’ve explained about the dangers of certain collars given this condition? Unless I personally fit the dog with a front-clip harness I can see that I’m not going to get very far…
I try. I swear I do. I talk myself blue. And yet it happens constantly. I know I’m not talking about most of you reading this. But I offer you this here because I believe we all can learn a thing or two from those of us not yet doing our best to allow our pets the chance to heal.
I am pretty damn conflicted on declaws. Clearly I would not do it to my cats, but people really will put their sofa (or their laziness in providing better clawing options) over their cats so the end up in shelters.
Maybe suggesting alternative activities to relieve stress and boredom would be helpful? Especially for those of us with high energy dogs. Someone suggested teaching scent games to one of our dogs the last time she was forced to undergo mandatory rest (flyingdogpress.com has a neat article about them). Of course it's not much help to the dogs who must-not-move, but it's fabulous for the dogs who just need their enthusiasm curtailed for a few weeks. Keeping dogs mentally stimulated while they're resting physically helps alleviate their boredom and human guilt.
After I dropped $2K on a cruciate repair for my lunatic pit bull, I sure as heck kept her in a crate and followed the instructions the surgeon gave me. It was not much fun, but once we got into the routine, it wasn't as bad as I thought it was going to be. She did jump a baby gate once, several weeks after surgery. I could have just died.
I understand that for most dogs, rest is not a problem...it's the owner's problem. But like someone else mentioned, I have a working GSD that goes nuts (pacicng, whining, chewing, howling) if she's run for less that three miles a DAY. I can't imagine what would happen if she was on forced rest for weeks. What do you do in these situations to keep high energy, high strung dogs from going kennel crazy? I'm thinking I'd have to sedate my girl nearly comatose for the entire time. Not a pretty option when you're talking 6-8 weeks. Conversly, I'm sure my other GSD, a pet type dog, would be perfectly happy so long as I gave him plenty of chew toys.
I think you just need to give long detailed discharge instructions, and then give them a printed sheet with all the instructions, which when you give it to them, you go over the headings again - 'As I mentioned, you'll see your dog can't do x,x,x,x.' I think many people simply don't understand what they need to do & they need it explained - 3 times cause they're stressed & not thinking & probably worrying about the bill - and they need it in writing to put on the fridge. From my exp. in human medicine, it also helps if the primary carer (dr./surgeon/etc.) gives the instructions first, & then they're given again by the discharge nurse. When people hear it from 2 different people, it sinks in better.
The big expensive clinics here have the staff do demos on using slings etc & show the type of equipments (ramps etc) that will need to be used temporarily. (Maybe it's a good idea to offer to rent out ramps?)
And by all means, the instructions should include links to articles or references to local trainers who may be able to come & help devise some scent games or low key trick training for the animal during their rest period.
Boy oh boy, Dr. Khuly----Do you know how many vets don't even discuss or STRESS strict crate confinement?? Anyone should go on Dodger's list to hear all the stories. I just spoke to another Sealy owner who's dog went "down" last week & was prescribed high doses of pred---but NO (according to owner) warning or instructions of 30 day (minumum) crate confinement. Dog went in for surgery this week, with lost deep perception in one leg.
I have nothing but accolades for the PC Vet(s) and Dr. Troxel (surgeon), that must have stated to us at least a 1/2 dozen times----NO ACTIVITY, NONE!!!
Ok, now that I got that "rant" out, I am sure that the overwhelming majority of discharge instructions for owners stress, that none means "zero". The patient feels "so much better" that the whining & carrying on can become unbearable---benedryl should become part of the treatment! And then there are just the plain old "stupid-os"
For Barbara- you're right on the sedatives, but benadryl has exactly zero effect on my pups' energy. I use it for atopy, and it doesn't slow them down a bit and never did, even when we first stared. :) Fortunately there are lots of drugs that probably would knock them out if needed, even though they're sure to be more expensive. Speaking of which...I need to go get a refill on my ace script.
Part of the problem is that a lot of people have the misconception that crating a dog is cruel; they view it as a jail. We do rescue, and we recommend crate training for puppies & young dogs. Frequently we have people tell us that they would "never put a dog in a cage".
Even though we explain the benefits of crate training, which include being able to rest the dog quietly if it is injured at some point later, many people are resistant. If an adult dog is injured and has never been crated in its life, that's much harder to deal with.
It would be better to encourage people to get their dogs accustomed to a crate early on, when they are young and healthy. Once the dog is house trained, the crate can be left with the door open or off as the dog's private space. Then if rest is needed for an injury to heal the dog is already used to the crate - and the owner is used to the idea.
Mary: Great point. Every pup I see I ask about crating and I have handouts on getting them accustomed to it. But I find many of my clients still haven't heard about this method (lots of Central and South Americans, especially) and have the misconception that it's cruel. It took a lot of chewed Manolos to convince one Brazilian client but finally her shoe fetish won out and little Maltese's inappropriate defacation problem also magically went away.
Two things would really help, I think. Written instructions on home care for the client's reference, and talking to the client before they see their pet after the surgery. I took my dog to the "local" teaching hospital for a cardiac workup a year ago, and they went over the test results *before* they brought her back to me. It was much easier to pay attention to what they were saying without 50lbs of nudging, panting, whining dog simultaneously telling me what they had done to her. They also entered the test results in their computer and gave me a printed sheet with results and recommendations.
I think the printed sheet with checkboxes for the type of rest and maybe another sheet for how to keep a high-energy dog calm during enforced rest. My Border Collie does 10 miles a day -- going from that to "crate rest" is quite a stretch for her and I'd definately need some help in keeping her calm.
When my Persians were spayed, they weren't supposed to jump. The althetic one was really depressed because she couldn't jump. One of her favorite places to sit was my ironing board -- I collapsed the legs so that she could just walk onto it -- it really seemed to help that she could still sit on the ironing board, even though it was on the floor instead of 5 feet in the air. So, sometimes, you can make accomdations so that they can be where they like to be and feel more "normal" until they are healed
Someone suggested teaching scent games to one of our dogs the last time she was forced to undergo mandatory rest (flyingdogpress.com has a neat article about them). Of course it's not much help to the dogs who must-not-move, but it's fabulous for the dogs who just need their enthusiasm curtailed for a few weeks.
Keeping dogs mentally stimulated while they're resting physically helps alleviate their boredom and human guilt.
The big expensive clinics here have the staff do demos on using slings etc & show the type of equipments (ramps etc) that will need to be used temporarily. (Maybe it's a good idea to offer to rent out ramps?)
And by all means, the instructions should include links to articles or references to local trainers who may be able to come & help devise some scent games or low key trick training for the animal during their rest period.
I just spoke to another Sealy owner who's dog went "down" last week & was prescribed high doses of pred---but NO (according to owner) warning or instructions of 30 day (minumum) crate confinement. Dog went in for surgery this week, with lost deep perception in one leg.
I have nothing but accolades for the PC Vet(s) and Dr. Troxel (surgeon), that must have stated to us at least a 1/2 dozen times----NO ACTIVITY, NONE!!!
Ok, now that I got that "rant" out, I am sure that the overwhelming majority of discharge instructions for owners stress, that none means "zero". The patient feels "so much better" that the whining & carrying on can become unbearable---benedryl should become part of the treatment! And then there are just the plain old "stupid-os"
Even though we explain the benefits of crate training, which include being able to rest the dog quietly if it is injured at some point later, many people are resistant. If an adult dog is injured and has never been crated in its life, that's much harder to deal with.
It would be better to encourage people to get their dogs accustomed to a crate early on, when they are young and healthy. Once the dog is house trained, the crate can be left with the door open or off as the dog's private space. Then if rest is needed for an injury to heal the dog is already used to the crate - and the owner is used to the idea.
When my Persians were spayed, they weren't supposed to jump. The althetic one was really depressed because she couldn't jump. One of her favorite places to sit was my ironing board -- I collapsed the legs so that she could just walk onto it -- it really seemed to help that she could still sit on the ironing board, even though it was on the floor instead of 5 feet in the air. So, sometimes, you can make accomdations so that they can be where they like to be and feel more "normal" until they are healed