As we navigate these waters with our clients, it is very helpful to be able to answer their questions about which treatment is associated with the longest survival time. 

There are currently four treatment modalities: medical management with oral medications, dietary management with iodine restricted diet, surgical thyroidectomy and radioactive iodine treatment. Medical management using oral pharmaceuticals and dietary management are both reversible treatments that do not provide a permanent “cure” because signs will recur with discontinuation. Obviously, thyroidectomy and radioactive iodine are more permanent solutions since they involve removal/destruction of the thyroid gland(s).

Medical management with methimazole was preferred by 66% of the veterinarians, while 28% favored surgical thyroidectomy in a retrospective study in the UK.² We have many factors that influence which of the modalities is best for each individual patient, including the ability of the owner to medicate the patient long term. 

Other studies have looked at survival following radioactive iodine,³ but in clinical practice (especially those that do not have this modality readily available), it is good to know about survivability of cats treated with the most common choices; oral methimazole versus surgical treatment. 

A retrospective study published in Macedonian Veterinary Review in March compared these two treatments.⁴ They found that treatment with methimazole and with surgery produced comparable longevity with a median survival of almost two years in cats without comorbidities. We do know that because hyperthyroidism is a disease often found in geriatric cats, there is a greater risk that other diseases will be present. 

This study looked at these factors as well. Thankfully, no significant impact on survival was found in cats that have both thyroid disease and renal disease, or thyroid disease with a concurrent heart murmur. They did find that the age of the cat at the time of diagnosis decreased longevity regardless of treatment. 

Because the surgical intervention and medical management were found, in this study, to have no significant differences in survival time, veterinarians can feel confident in allowing the other factors (such as owner compliance and/or budget concerns) be their guide as they select individual treatment plans. It is important to note that although the cost of surgery is more of an investment on the front end, with a median survival of 23-25 months, one must consider the monthly cost of long-term medication. 

Each case is individual and the owner’s input must be sought. However, it is helpful to be able to explain that longevity may not be a factor in their choice. +

References:

1. Peterson. M. E., (2020, September). Hyperthyroidism in Cats: Considering the Impact of Treatment Modality on Quality of Life for Cats and Their Owners. Veterinary Clinics of North America: Small Animal Practice, Volume 50, Issue 5, Pages 1065-1084 https://doi.org/10.1016/j.cvsm.2020.06.004

2. Forrester, S., Towell, T., Shenoy, K. (2012). Nutritional management of feline hyperthyroidism. Conference Proceedings of the Veterinary Medical Association, 130th Annual Meeting, Iowa: p.87-91. https://www.avmi.net/information/hyperthyroid-hints/nutritional-management-of-feline-hyperthyroidism/

3. Slater, M., Geller, S., Rogers, K. (2008, June 28). Long-term health and predictors of survival for hyperthyroid cats treated with iodine 131. J Vet Intern Med. 15(1): 47-51. https://onlinelibrary.wiley.com/doi/10.1111/j.1939-1676.2001.tb02298.x

4. Mata, F. and Bhuller, R. (2022, March 28). Hyperthyroidism in the Domestic Cat (Felis Catus): Informed Treatment Choice Based on Survival Analysis. Macedonian Veterinary Review, vol.45, no.1, pp.71-78. https://doi.org/10.2478/macvetrev-2022-0015

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We LOVE our java! It is a well-rounded cup of alertness that can help us love ourselves in a million ways. It is warm and smooth on a cold day. It is a social experience or a solo soul search. It goes with cookies, ice cream, or by itself. Because we love our cup of Joe, we wanted to share with you an amazing way to make a truly smooth and delicious pot in a short time, every time, with BUNN coffee makers. 

People say I am a coffee snob because I am so picky about it (I believe that a good cup of coffee must be poured within 20 minutes of brewing…I know, coffee snob), and I happen to have a BUNN at work and one at home. The only time I have ever contacted their support, it was on a very old pot, but they overnighted me a part with the instructions for how to fix the issue at no charge. 

I do not work for BUNN, but when I reached out to them for this article, they generously shared a discount code just for us! 

Get the details at https://retail.bunn.com/VET10 and Happy Brewing!

A robot that cleans up pet hair while you are away? It sounds too good to be true—but it is true! Our polling groups love this product. The Shark learns your home, cleans while you are gone using HEPA filtration (perfect for pet dander) and then empties itself. We adore coming home to the neat rows in the rug—very Zen. It makes you feel fresh and relieved, and effortlessly takes one thing off your list. So far, my own Shark has been a good value. It seldom hangs up or needs assistance, and you can control it from an app on a smart phone!

Get $200 off the latest robot, the Shark^® AI Robot Vacuum with XL HEPA Self-Empty Base, Bagless, 60-Day Capacity, LIDAR Navigation, Home Mapping, and perfect for pet hair (Model RV2502AE) with code ROBOT200.

When asked about products that have made their work day better, several veterinary professionals specifically named OOFOS shoes. The company says that the reason why so many people find comfort and support from their shoes is because they are made with proprietary OOfoam® technology. The foam absorbs 37% more impact than traditional foam footwear materials and the OOFOS footbed cradles and supports arches. The two features together, they say, reduce energy exertion in the ankles by up to 47% compared to competitors’ footwear. So walking is easier and recovery is faster. Don’t you want to maximize your energy? I do! And this is one way to do it. Helping more pets feel better and feeling better your self sounds like a win-win. And, looking good while doing it is a bonus.

OOFOS Recovery Footwear has offered to give a free pair of clogs to a lucky reader! Visit https://www.oofos.com/pages/petvet to enter the contest now. 

Ever come home to withered house plants because you have been working so much you forgot to water them? This handy pot lets you water just one to two times a week and keeps your plants low-maintenance. They also feature a water level indicator to let you know how much to water the plant. They are elegantly simple and let you have the calm and healthy feeling that house plants can create without the guilt of repeated plant loss from lack of care!

Go to www.t4u.site/collections/new-plastic-planters and enter the single-use code PURRFECT to get 10% off your purchase!

When I asked my colleagues about products they love, this one popped up A LOT! FIGS was founded and is run by women who identified a need for healthcare professionals to love and feel comfortable and confident. They have pioneered shapes and fabrics that make your day in the animal care trenches better. According to Co-CEO Heather Hasson (who actually took time to call me herself to thank me for all my industry does to help pets), they have fabrics that resist staining and pet hair. They are comfortable and attractive, and they even have special FIGS gifts: Animal-printed socks, hoodies, mugs and so much more!

Another meow-valous part…they created a promo code for our readers only (named after my animal hospital) that gives you 25% off your order! Enter FIGSXApplebrook at www.wearfigs.com

The post Dr. Kat’s Products You Will Fall in Love With appeared first on PetVet Magazine.

She had very striking eyes. In fact, her eyes looked almost like broken window panes or like a spider had spun a web in each of her eyes. The shelter photographer, Brian Sterrett, says that Sonnet looked as though she had a “galaxy in her eyes.” She did not seem particularly uncomfortable, but the team was not sure she had full vision, especially in her left eye.

It turned out that Sonnet was affected by an unusual congenital disorder called Persistent Pupillary Membranes (PPM). According to William W. Miller, DVM, MS, DACVO, PPM is a congenital anomaly that has no known genetic predisposition. During development, the pupillary membranes serve as a source of nutrition to the emerging ocular structures. Once the eyes are fully developed, the role of the membranes is over and they usually regress. In some cases, like Sonnet’s, they fail to dissolve like they should and leave behind the remnants of the membrane network. 

PPM can occur in other species including humans, dogs, cattle and horses, but it is still unusual.

Although Sonnet would be spayed prior to placement in her permanent home, PPM is not a condition that she would have passed on to her offspring. The condition is not painful for Sonnet, and in some cases, it regresses during the first 6-8 months of life. She is six months old now, so we don’t yet know if her “galaxy eyes” will be permanent. 

Dr. Miller says that the good news for Sonnet is that PPMs cause few problems unless they are attached to the lens (which could precipitate cataract formation) or attached to the cornea (which could cause a corneal opacity). 

After her recovery from the upper respiratory infection and her short stint as a shelter celebrity, Sonnet was placed in an AHS Foster Hero home and was later adopted. She is, by all accounts, a playful and happy kitten, living her best life with her new family.

The Arizona Humane Society in a non-profit organization that takes in the area’s most vulnerable pets. They have a field rescue team that responds to calls for animal rescue and helps animals whose families are facing hardship. All pets adopted through AHS are spayed/neutered, vaccinated, microchipped and receive appropriate veterinary care. 

Since AHS is a non-profit organization, they do not get government funding, so their good work depends on donation. Every pet entering their care requires an average of $1,000 to treat, manage and place in a forever home, so they are always looking for intriguing stories like Sonnet’s to raise awareness of the plights of animals and their efforts to assist them. 

Anyone interested in donating can find out more at
www.azhumane.org/donate. +

The post A Special Kitty “with a Galaxy” in Her Eyes appeared first on PetVet Magazine.

With the significant investment we have made in our education, we feel obligated to be “productive”. This obligation drives us to do things like work long hours—or when not working, spend long hours worrying over patient outcomes or relationships with team members. It gives us feelings of guilt if we take our focus off of work, or we work and then feel guilty that we are not the perfect spouse or parent.

Productivity is a word that dehumanizes us. It is a word that applies to automation, not humans. According to etymonline.com, the word productive comes from an economic term for “rate of output per unit”. 

Some of us receive pay based on productivity, and even if we don’t, we hold ourselves—even outside of work—to a high standard of productivity. We are not machines. 

This is the veterinary trap.

So how do we get out?

1. You are only human after all. Recognize that you feel like you are in a productivity trap and that it is a very human trait. As human beings, we are programmed to want to create order out of chaos and to set goals for ourselves that lead us to a better life. Productivity alone is not a bad thing. It is only bad when one feels that they needs to be productive for the sake of being productive does she become dehumanized. No one is saying that you should stop trying to be the best you can be. 

2. Set clear boundaries. This means when you are working you focus on work and on patients, but when you are off, you must be off. Schedule yourself some time outside of work when you get no emails, no texts and no social media. Or maybe just schedule a limited time for these things so that you can relax but are not completely unplugged. Many of you feel like social media and venting to friends (and strangers) is therapeutic, but studies have shown that it can be destructive to your wellbeing. 

3. Set reminders. If you have anxiety about forgetting a task (or a patient), set a reminder in your phone to alert you about the task at an appropriate time, when you will be able to focus on it. We have technology, use it. Once your brain knows that you will not forget the item when the time comes, it is easier for you to focus on the things at hand, even if that thing is yoga with your dog or cooking a meal. 

4. Pull up a seat at the bar. We don’t mean the actual bar (unless you enjoy it). Recognize that your life is like a three-legged stool, and if one leg is broken, the stool will not stand. The three legs represent your work, your home, and your health. Make sure that if you are leaning onto one of the three legs too much that it does not break, because then you will be on the floor. Finish your charting. (Doesn’t that feel great?) Organize your closet. (Now there is feng shui!) Rearrange your furniture. (So much better!) Make a smoothie with healthy ingredients. (See, you are taking care of you!)

5. Give up. No, we don’t mean give up as in quit! We mean give up your time to help others. Multiple studies have shown that generosity makes us feel good. Generosity restores the humanity that the concept of productivity takes from us, and you will not have to look very far to find someone that can use your gifts. Read to children or even shelter pets. Volunteer at a cat café. Make meals for senior citizens. 

Think about ways you can shore up your three-legged stool. Don’t forget that your family, friends and pets can be a part of all three legs, so they need to be a part of any escape plan. +

The post The Veterinary Trap (And How to Get Out) appeared first on PetVet Magazine.

We all know it…the sinking feeling we get when we see the alert, a single star and a nasty diatribe about how awful you are. Rejection leads your brain through a sequence of emotions much like the stages of grief. Emotional pain brings these coping strategies to life for everyone.

Elisabeth Kubler Ross introduced the world to her concept of the five stages of grief in her book, On Death and Dying, way back in 1969. Her stages were denial, anger, bargaining, depression and acceptance. Since then, people have debated her ideas and presented all kinds of steps and stages of their own. But think for a moment, does it matter whether she got it “right”? No. What matters is understanding how your brain copes with seeing a negative review about yourself and your business. Can we not only survive a bad review, but convert it to a teachable moment? The five–stages model works really well to answer that question.

1. Denial

“It can’t be true.” The first time I saw a bad review, I was aghast. The review was completely unfair and untrue! Yes, in some cases reviews are completely false or even rest on mistaken identity, but most reviews, like myths and legends, contain a grain of truth. Find that truth and use it to drive improvement.

Find something that justifies the opinion. Perhaps it is just a misconception that you can correct! For example, my animal hospital got a review saying that we were ridiculously overpriced, stating that their dog’s annual visit cost them $400—I wish! I know that amount is not accurate because we have bundled our annual offerings at a standard price. So I posted a public reply that explained the mistake and invited that reviewer to contact us privately so we could fix it. We never heard from her, of course, but we have demonstrated integrity by offering restitution.

If there is truth in the criticism, use it to improve your practice. Suppose someone complained that your receptionist was rude. Whether or not it was true (everyone has bad days), take the opportunity to remind your team to smile when they answer the phone. Provide refresher training with this exercise: Make yourself invisible to the others (use another room, a screen, blindfolds), then speak to them. Let them vote on whether you were smiling. You will be amazed at how easily your message is understood. Follow up by rewarding smiles with praise or goodies. Trust me; if you start handing out chocolate to every smiling face, those Pavlovian employees will soon smile all the time!

2. Anger

Critical evaluation is bound to arouse your anger; wait for it. We all take pride in our work. Your team is your family, and anyone attacking them can bring out your beast and not your best. The adage, “Don’t get mad, get even” has it wrong. It is OK to get mad, but then you have to get better. Most of your clients will appreciate it. To those that never complain and always take your advice, send thank–you cards just for being a wonderful pet parent. You will find your anger dissipates as you write details of how terrific each good client is and you imagine their pleasure when they read it.

3. Bargaining

Like grief, criticism is so painful that we are tempted to answer back in self–defense or appeasement. Neither response is appropriate in a public forum. Answer, of course (you want to show that you care about your service and your business), but just make a single statement in your defense, like, “I’m sorry we remember this incident differently.” Then offer a private exchange: “Please contact us personally so we can make sure you have been treated fairly and received our standard exemplary service. We take pride in our mission and strive to give top–notch care for pets and their people.”

Don’t get into a back–and–forth on social media. Just don’t do it, no matter how wrong they are. Those with justifiable complaints will contact you to right the wrong. Those complaining with ill intent won’t, thankfully—you do not want them for clients.

Remember, no matter how much you want to try to bargain with a critique, it’s always a mistake to let yourself be dragged into the fray. Mark Twain warned, “Never argue with a fool. Onlookers may not be able to tell the difference.”

4. Depression

Having failed to erase a bad review through anger or bargaining, we may feel helplessly discouraged, defeated and disheartened. But it’s a mistake to give up. A bad review will go away, as everything does. Your good reviews will soon scroll it off the page. Let’s face it, if you only have 5-star reviews, won’t people feel skeptical that you are buying them?

Let the discomfort of feeling helpless and hopeless prompt you to seek good reviews. Put a note on your invoices asking people to share their experiences on Google. With a sign or a wall of pet photos (people love to show off their pets), remind people to check you out on Facebook where they are automatically asked to review you.

The last stage of dealing with bad reviews is…

5. Acceptance

Eventually, you remember that you are not a loser and realize that the angry mobs will dissipate (if they really formed, it is very hard to rally people for long, even if there’s a little buzz). People may jump on the negativity bandwagon at first, but soon their attention is pulled elsewhere. It will blow over, I promise.

Accept that you cannot be the right fit for every client. No one can. Legitimate concerns need to be resolved. Others need to be cautiously curtailed. Remember, rational people will see through ridiculous claims, and those rational souls are the demographic that you want. As for the others…well, we have a saying, “You can take your crazy somewhere else because we are all stocked up!” +

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