Posts Tagged ‘Medical Advocacy’

Reasonable Expectations Part III: Access to Round-the-Clock Care

September 12, 2010

This is the third part of an ongoing series describing how people are developing new expectations when it comes to veterinary care for their pets.Parts one and two can be found at www.speakingforspot.com/blog.

If your dog is sick enough to require hospitalization or has just undergone a major surgical procedure, how will he or she be cared for overnight and on weekends?  As much as the mere thought of this makes me cringe I must advise you that even though your dog or cat is “hospitalized”, in some veterinary clinics this will involve no supervision whatsoever from closing time at night (perhaps 6:00 PM) until early morning when the first employees arrive back at the hospital.  What if your dog manages to slip out of his Elizabethan collar and chews open his surgical incision? What if your kitty begins experiencing pain during the night?  What if your dog vomits and aspirates the material into his lungs? All these “what if’s” are what make me crazy whenever I think about a hospitalized animal left alone for 8 to 12 hours at a time.  And here’s what makes me even crazier- some people don’t think to even ask how their beloved family member will be supervised when the clinic is closed, likely because they cannot fathom the possibility that adequate supervision would not be provided.

Please know that it is perfectly reasonable for you to expect that your hospitalized family member receive round-the-clock care.  There are a few different ways this can happen.  While a 24-hour hospital staffed with a veterinarian is ideal, this simply does not exist in all communities (but if it does exist in your neck of the woods, by all means take advantage!).  Here are some other viable options:

-A veterinarian comes into the clinic multiple times during the night and on weekends to check on the hospitalized patients (some vets prefer to take their patients home with them to help make monitoring and supervision more convenient).

-A skilled veterinary nurse (technician) comes into the clinic multiple times during the night and on weekends to check on the hospitalized patients and has access to contacting the vet should the need arise.

-Your dog or cat comes home with you, but only after you receive thorough monitoring instructions along with a way to reach your vet should questions or concerns arise.  As scary as this might sound, this remains a better option than leaving your best little buddy left completely unsupervised overnight.  Just imagine how you would feel lying in a hospital bed, hooked up to intravenous fluids, and no one entering your room to check on you for twelve long hours!

How would your dog or cat be cared for overnight and on weekends should the need arise?  Please do tell.  And if you’re not sure, no time like the present to find out.

Now here’s wishing you and your four-legged family members abundant good health.

Nancy Kay, DVM
Diplomate, American College of Veterinary Internal Medicine
Author of  Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Recipient, American Animal Hospital Association 2009 Animal Welfare and Humane Ethics Award
Recipient, 2009 Dog Writers Association of America Award for Best Blog
Recipient, 2009 Eukanuba Canine Health Award
Become a Fan of Speaking for Spot on Facebook

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot is available at Amazon.com, local bookstores, and your favorite online book seller.

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A Summertime Reminder

June 18, 2010

Tuffy, a scruffy and adorably sweet little terrier arrived at my hospital earlier this week in a state of collapse with profoundly labored breathing, purplish gums, and a temperature of 106 degrees Fahrenheit (the normal body temperature for a dog is 100-102 degrees).  Tuffy’s well-intentioned family let him accompany them on a brief outing and, while they were in the store for a mere ten minutes, Tuffy remained in the car.  The problem was, the outdoor temperature at the time was 92 degrees. The temperature within the car must have quickly soared to well above 100 degrees. Tuffy is one of the lucky ones.  He survived his episode of heatstroke without any lingering complications and has gone home to rejoin his grateful (and more knowledgeable) family.  Most patients with heatstroke don’t fare nearly so well.  Thank you Tuffy for reminding me that it’s time to rebroadcast a blog I posted last summer.  I encourage you to share this with anyone you know who loves a dog with hopes of preventing a needless tragedy.

 

Dog Days of Summer

Some of us take “dog days of summer” literally- we want to go everywhere accompanied by our beloved canine companions!  As tempting as this may be, keep in mind that when temperatures are soaring your dog is likely best served by staying home.  Heat has the potential to be hazardous to a dog’s health. 

Dogs are incapable of significant sweating- their only sweat glands are located on the undersides of their paws.   The major mechanism by which dogs dissipate heat is by panting, but this cooling system is easily overwhelmed when the temperatures climbs.  Panting becomes even less effective in humid conditions or for dogs with underlying respiratory tract ailments (collapsing trachea, laryngeal paralysis, lung diseases) or dogs that are overweight. Bulldogs, Pugs, Boston Terriers, and others I lovingly refer to as “smoosh-faced” breeds readily overheat because of their unique upper respiratory tract anatomy. 

What happens when dogs get too hot?  The result can be heatstroke, a life threatening condition.  Symptoms of heatstroke tend to occur abruptly and can include increased heart rate, labored breathing, weakness, collapse, purplish gum color, and even seizures and coma. Of all the “summertime diseases,” veterinarians dread heatstroke the most because we know that, even with aggressive therapy, many heatstroke victims will succumb to organ damage and death.

Most cases of canine heatstroke are a result of confinement in cars.  Perhaps the vehicle was parked in the shade, but the sun shifted, or a well-intentioned person thought that leaving the windows cracked or returning to the car quickly would be a safe bet.  Overactivity in the heat is another common cause of heatstroke. The desire to chase the ball trumps all else, and the person throwing it doesn’t recognize when it’s time to quit. 

If you suspect your dog has or is on the verge of heatstroke, spend just a few minutes cooling him off with water from a hose or covering him with towels soaked in cool water.  Then get to the closest veterinary hospital as quickly as possible. Time is of the essence- the earlier heatstroke is detected and treated, the greater the likelihood of a positive outcome. 

Knowledge is power when it comes to preventing heatstroke.  Here are some pointers to help keep your best buddy safe during these hot summer months: 

-Never leave your dog inside the car on warm or hot days.  A panting dog in an enclosed space quickly creates a muggy greenhouse environment that can quickly cause heatstroke.  Even with the windows down, temperatures inside a car can rise to 120 degrees or more.  If you happen upon a dog confined in a car on a hot day, find the owner of the vehicle or contact a police officer- whichever will most rapidly liberate the dog from danger. 

-Exercise your dog early in the morning or during evening hours to avoid the heat of the day.  

-Allow for plenty of rest and water breaks during play activity and exercise. Your dog may not know his limits and will continue to enthusiastically chase the Frisbee even when his internal thermometer is getting ready to blow a fuse. 

-Keep your dog indoors, ideally in air conditioning, on very hot days. 

-If your dog is left outside, be sure he has plenty of shade and provide him with access to a sprinkler, wading pool, or sand pit soaked with water. 

-If flying with your dog during the summer months schedule your flight for nighttime or early morning.  Check with the airlines to find out whether or not the cargo hold is temperature controlled. 

Now, here’s wishing you and your four-legged best friend a most enjoyable and safe summer!

Nancy Kay, DVM
Diplomate, American College of Veterinary Internal Medicine
Recipient, American Animal Hospital Association 2009 Animal Welfare and Humane Ethics Award
Recipient, 2009 Dog Writers Association of America Award for Best Blog
Recipient, 2009 Eukanuba Canine Health Award
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life

Website: http://www.speakingforspot.com
Become a Fan of Speaking for Spot on Facebook 

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot is available at Amazon.com, local bookstores, or your favorite online book seller.

Everybody’s Gone Surfin’ (Part Two)

December 26, 2009

I happen to enjoy hearing about what my clients are learning online.  I sometimes come away with valuable new information, and I’m invariably amused by some of the extraordinary things they tell me- who knew that hip dysplasia is caused by global warming!  Surf to your heart’s content, but be forewarned, not all veterinarians feel as I do.  Some have a hard time not “rolling their eyes” or quickly interrupting the moment the conversation turns to Internet research.  Who can blame them- they’ve grown weary of spending valuable office visit or telephone time talking their clients out of crazy cyberspace notions and reining them in from online wild goose chases.  How unfortunate this is.  Nowadays, people rapidly and reflexively reach for their keyboards to learn more about their pet’s symptoms or disease diagnosis online.  It’s only natural (and in their pet’s best interest) that they will want to discuss what they’ve learned with their veterinarian.

Is there an effective way to communicate with your vet about your online research that is neither irritating to her nor intimidating for you?  I truly believe it is possible, but it involves some work and planning on your part!  Listed below are some secrets for success- things you can do to converse about your Internet research in a manner that is comfortable for you and your vet and, most importantly, beneficial for your pet’s health.

-I may be preaching to the choir, but I cannot overemphasize the importance of working with a vet who is happy and willing to participate in two-way, collaborative dialogue with you. Your opinions, feelings, and questions are held in high regard and enough time is allowed during the office visit to hear them. A veterinarian who practices this “relationship centered” style of communication is far more likely to want to hear about your online research than the veterinarian who practices “paternalistic care” (far more interested in telling you what to do than hearing about your thoughts, questions, or concerns).  Remember, when it comes to veterinarian/client communication styles, you have a choice. It’s up to you to make the right choice!

-Let your vet know that you appreciate her willingness and patience in helping you understand how best to utilize what you’ve learned online.

-Ask your veterinarian for her Web site recommendations- those that have already been “vetted”.  This is a collaborative approach that lets her know you intend to spend some time learning more, plus a respectful recognition of the fact that she is the one who has spent her career learning about your dog’s health issues. 

-Wait for the appropriate time during the office visit to discuss what you’ve learned on line.  Allow your veterinarian to ask questions of you and examine your precious poopsie rather than “tackling” her with questions and discussion about your Internet research questions the moment she sets foot in the exam room.

-Be brief and “to the point” with your questions.  Remember, most office visits are scheduled for 15 to 20 minutes, max. 

-Let your veterinarian know that you’ve learned how to be a discriminating surfer!  You know how to differentiate between valuable online resources and “cyber-fluff”. You ignore anecdotal vignettes and Web sites trying to sell their products in favor of credible information provided by veterinary college Web sites and forums that are hosted by well-educated moderators who provide cited research references that support their recommendations.  If you need a little refresher course on how to be a “selective surfer,” I encourage you to read Part One of this article (http://speakingforspot.com/blog/?p=654).

-When you begin conversation about your Internet research, I encourage you to choose your wording wisely.  Communicate in a respectful fashion that invites conversation as opposed to  “telling” your vet what you want to do. Most veterinarians don’t like being told what to do by their clients, and who can blame them?  After all, we expect veterinarians to provide a collaborative approach- it’s only fair that they expect the same from their clients.  Consider the following conversation starters about Internet research:

Approach one:  “I’m wondering what you think about mixing some canned pumpkin in with Sophie’s food.  I’ve been doing some Internet research about diarrhea and this suggestion seems to comes up frequently.”

Approach two:  “I’ve been doing some online research and learned about the benefits of canned pumpkin.  I want to begin mixing this in with Sophie’s food.”

Approach three:  “I’d like to give Sophie some canned pumpkin for her diarrhea.  A moderator from an online forum suggested I do this.”

Approach four:  “I’ve been following an online forum about canine diarrhea. One of the moderators suggested I consider adding canned pumpkin to Sophie’s diet.  How do you feel about this?”

Which of these approaches sound like invitations for discussion? Which are more likely to be a “turnoff” for your veterinarian? If you’ve selected approaches one and four as successful ways for broaching the topic of Internet research with your vet, well done!  Give your dog a hug and yourself a pat on the back!

In the Internet, we have an extraordinary tool at our fingertips. I encourage you to be critical when choosing which Web sites you intend to take seriously and which ones you wish to visit for a good chuckle.  Approach conversations with your vet about your Internet research thoughtfully and tactfully. These strategies are bound to create a win-win-win situation- for you, your veterinarian and your beloved best buddy! 

Wishing you and your four-legged family members abundant good health,

Dr. Nancy Kay
Specialist, American College of Veterinary Internal Medicine 

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot is available at Amazon.com, local bookstores, or your favorite online book seller. 

Order  a copy of Speaking for Spot personally signed by Dr. Kay – http://www.speakingforspot.com/purchase.html

Join our email list – http://speakingforspot.com/joinemaillist.html

Look for us on Twitter – http://twitter.com/speakingforspot

Become a Fan of Speaking for Spot on Facebook

Listen to Dr. Kay’s interview – A Veterinarian Advises “How to Speak for Spot” on NPR’s Fresh Air with Terry Gross

Frankly Speaking

December 6, 2009

In 2001, the Journal of the American Veterinary Medical Association stated, “Veterinarians’ responsibilities have expanded to include the mental health and well-being of their clients as well as their clients’ pets.”  For me, this came as no great surprise.  Having graduated from veterinary school in 1982, I’d already learned that if I wasn’t taking good care of my clients’ emotional needs, it was far more difficult to take good care of my patients’ health needs.  Admittedly, it took me a few years to catch on to this notion.  During my formative years, I recall thinking that good client communication would be a “slam dunk”.  After all, I fancied myself to be a good teacher and a nice person.  It didn’t take long for me to realize that the “medicine part” was becoming a whole lot easier than the “client part.”

Thus began my avid interest in the art and science of client communication.  I read whatever I could get my hands on (not much in the veterinary literature at that time) and attended communication workshops. I began studying my clients, trying new tactics and techniques, and asking questions of them not necessarily directly related to their dog or cat (Kleenex consumption increased exponentially).  I founded and continue to facilitate a community Client Support Group (talk about a front row seat in terms of understanding what is going on in our clients’ minds) and have enjoyed teaching client communication skills to local and national audiences.

The unfortunate fact of the matter is that few veterinary colleges provide any formal client communication training to their students- doesn’t make much sense does it?  One of the schools that doesn’t overlook this important subject is Colorado State University.  Here veterinary students receive fabulous communication training via the Argus Institute (www.argusinstitute.colostate.edu).  This organization’s stated mission is “to strengthen veterinarian-client-patient communication and support relationships between people and their companion animals.” In addition to providing formal client communication training to CSU veterinary students, the Argus Institute also makes communication training available to veterinarians.  These workshops are called FRANK (based on the notion of “frank” communication), and the emphasis is on relationship-centered care, an approach that emphasizes collaboration and shared decision-making between veterinarian and client.  Pfizer Animal Health was involved in the creation of FRANK in 2007 and continues to generously fund this program.

I just completed my first FRANK training workshop- what a fabulous experience.  I left the program feeling invigorated, renewed, and eager to apply what I had learned. The majority of the workshop time was spent in small groups within simulated exam rooms.  Professional actors played “the client,” each getting in character with their assigned emotional agendas (they were awesome and totally believable).  Everyone took turns as “the veterinarian” during these mock office visits.   The interactions were videotaped after which respectful, constructive critique was offered within the small group setting. We worked on several communication skills including delivery of empathetic statements, maintaining focus on the “common ground” (the well being of the patient), reflective listening, facilitating silent pauses (time for clients to gather their thoughts), disclosure (sharing stories of our own that might parallel what the client is emotionally experiencing), and asking open-ended questions (allows the client greater opportunity to share their stories).

A veterinarian can be a sensational surgeon or a dandy diagnostician, but such skills may wither on the vine if he or she is not a successful communicator.  More than ever before, people are becoming savvy consumers of veterinary medicine and better effective medical advocates for their pets.   My sense is that these wonderful trends will drive the awareness that client communication training for veterinarians is profoundly important.   Frankly speaking, I think it’s about time!

Wishing you and your four-legged family members a joyful and healthy holidays season.

Dr. Nancy Kay
Specialist, American College of Veterinary Internal Medicine

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot is available at Amazon.com, local bookstores, or your favorite online book seller.

Order  a copy of Speaking for Spot personally signed by Dr. Kay – http://www.speakingforspot.com/purchase.html

Join our email list – http://speakingforspot.com/joinemaillist.html

Look for us on Twitter – http://twitter.com/speakingforspot

Become a Fan of Speaking for Spot on Facebook

Listen to Dr. Kay’s interview – A Veterinarian Advises “How to Speak for Spot” on NPR’s Fresh Air with Terry Gross

Get Out Your Reading Glasses!

November 25, 2009

When was the last time you took a close look at your pet’s prescription medication label?  Would you be surprised to know that, by law, the label is required to include twelve different informational items? Have a look at this mandatory dozen and see if every single one of them appears on your pet’s prescription label.

Speaking for Spot's advice on reading your pet's medication labels

1.   Date the medication was prescribed

2.   Your pet’s name

3.   Your name

4.   The prescribing veterinarian’s name

5.   Address and telephone number of the facility filling the prescription

6.   Amount of medication dispensed (milliliters, ounces, number of tablets or capsules)

7.   Strength of the medication (milligrams, micrograms)

8.   Dosage and duration of treatment

9.   Route of administration (orally, applied to the skin, in the ear)

10.  Number of refills

11.  Cautionary instructions (“shake well,” “keep refrigerated,” “don’t let your dog drive”)

12.  Expiration date 

After performing this exercise, please let me know what you learned, other than, that’s one heck of a lot of information for such a tiny label?  It’s no wonder I need my reading glasses! 

Wishing you and your four-legged family members abundant good health,

Dr. Nancy Kay
Specialist, American College of Veterinary Internal Medicine 

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot is available at Amazon.com, local bookstores, or your favorite online book seller. 

Speaking for Spot, signed by Dr. Kay, a great gift idea for holiday 2009 shoppingOrder  a copy of Speaking for Spot personally signed by Dr. Kay – http://www.speakingforspot.com/purchase.html

Join our email list – http://speakingforspot.com/joinemaillist.html

Look for us on Twitter – http://twitter.com/speakingforspot

Become a Fan of Speaking for Spot on Facebook

Listen to Dr. Kay’s interview – A Veterinarian Advises “How to Speak for Spot” on NPR’s Fresh Air with Terry Gross

Pain Management 101

September 4, 2009

My husband and I just returned from a wonderful stay at a dog-friendly campground. We encountered just about as many dogs as we did people! We made some new friends including Buddy, Sierra, Milo, Otis, Judd, Lexie, and Homer (please don’t ask me to recall the names of their humans). Our next-door neighbors were Milo and Otis, two middle-aged black Labradors. When these goofy brothers weren’t off on family hikes they spent their time meandering about with sticks in their mouths and checking our campsite in case we managed to “misplace” any food items. By day three, I observed them to be exploring less and lying around more. I also noticed that Milo was favoring a front leg and Otis was showing discomfort in his hind end. When I mentioned my observations to our neighbors (I cannot seem to keep my mouth shut in such situations), they told me that Milo and Otis both have arthritis and their stiffness and soreness was predictable in response to their increased activity level. They routinely gave them pain medication (the equivalent of aspirin or ibuprofen for us) as soon as arthritis symptoms became apparent. In fact, they had administered their first dosage that morning. These poor folks had no idea that such innocent comments would prompt a mini-lecture from the likes of me! Here is what I explained:

Whether for ourselves or for our pets, the ideal time to treat predictable pain is before it begins. Investigational studies have documented that pain can induce a “kindling effect”. In other words, low-grade pain has the potential to self-ignite into a flare-up of pain that is more severe, therefore more difficult to control with medication. Far better to take proactive measures (medication, acupuncture, rehabilitation therapy, glucosamine, chondroitin sulfate, etc.) before the onset of predictable or anticipated pain than it is to attempt to douse the discomfort once it has already “caught fire”. It’s also important to keep in mind that many dogs, particularly those with stoic demeanors, may not demonstrate any overt symptoms until their pain has progressed well beyond what would be considered mild.

I suspect that my new friends Milo and Otis will be far more comfortable on their future camping trips! I must confess here- I also counseled their humans on the benefits of weight loss (both dogs were chubby) as a means of benefiting their arthritis pain. Those poor people certainly got more than they bargained for! Does your dog predictably become stiff or sore following increased activity? If so, please share what you do to prevent the discomfort.

Now, here’s wishing you and your four-legged best friend good health! 

Dr. Nancy Kay
Specialist, American College of Veterinary Internal Medicine 

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot is available at Amazon.com, local bookstores, or your favorite online book seller. 

Join our email list – http://speakingforspot.com/joinemaillist.html

Look for us on Twitter – http://twitter.com/speakingforspot

Become a Fan of Speaking for Spot on Facebook

Listen to Dr. Kay’s interview – A Veterinarian Advises “How to Speak for Spot” on NPR’s Fresh Air with Terry Gross

Back By Popular Demand- Dr. Nancy Kay on Fresh Air with Terry Gross!

August 30, 2009

“A Veterinarian Advises How to Speak for Spot”

Monday, August 31, 2009

This week will be “Animal Week” on the popular NPR show, Fresh Air with Terry Gross.  The lead interview will feature Dr. Nancy Kay and her book, Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life.  This interview originally aired in March and earned the #1 spot on NPR’s “most recommended” list.

Dr. Kay’s interview will be broadcast on August 31st by your local NPR station and streamed via the NPR website (http://freshair.npr.org).  In the future you can readily access the interview as a Fresh Air archived podcast and via ITunes. 

Visit http://www.npr.org/audiohelp/progstream.html to access links for each of these options. 

Please feel free to share this information with friends and relatives along with any organizations devoted to the well being of animals.

Dr. Nancy Kay
Specialist, American College of Veterinary Internal Medicine

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot is available at Amazon.com, local bookstores, or your favorite online book seller.

Join our email list – http://speakingforspot.com/joinemaillist.html

Look for us on Twitter – http://twitter.com/speakingforspot

Become a Fan of Speaking for Spot on Facebook

Listen to Dr. Kay’s interview – A Veterinarian Advises “How to Speak for Spot” on NPR’s Fresh Air with Terry Gross

Gut Feelings and Second Opinions

July 10, 2009

I am a “regular” at the local corner coffee stop, so much so that my drink is often ready for me before I’ve had a chance to order it.  Amongst the eclectic group of shmoozers gathered most mornings are the schmoozers’ dogs.  This morning while waiting for my coffee, Molly, a massive Rottweiler mix, greeted me.  As usual, her voice and body language told me in no uncertain terms that she expected me to toss her a cookie (a bin full of dog biscuits resides beneath the shelf holding Half-n-Half, sugar, and other coffee accoutrements). Today, I noticed that Molly’s demands were less vigorous than usual.  My veterinary antennae began to quiver and I paused for closer inspection.  I was aghast to see one of Molly’s eyes almost closed and filled with pus; the other had a completely cloudy cornea.  Jill observed my startled expression and explained that she had taken her darling Molly to see the vet three times in the past couple of weeks.  In spite of treatment with various ointments, her eye problems were clearly worsening. 

I bit my tongue for approximately one millisecond before my concern for Molly forced me to question, “Have you considered getting a second opinion?”  Jill responded that the thought had crossed her mind, but she’d not acted on this impulse- she didn’t want to hurt her veterinarian’s feelings.  After some serious coaching-  “A second opinion results in a new diagnosis as often as 30 percent of the time.” “Veterinarians are used to people desiring second opinions.”  “What’s more important, Molly’s health or your vet’s feelings?”- Jill agreed that it was time to contact our local board certified ophthalmologist. 

Is Jill’s story unusual? No, but I wish it were. When it comes to our own health issues or those of a beloved four-legged family member it’s not uncommon that, even when our gut tells us it’s time to consider a second opinion, we ignore the feeling.  I believe that this gut feeling, sixth sense, intuition, or experiential wisdom- whatever one chooses to call it- is a true gift.  In fact it is one of the few things that actually seem to improve as we age. All we need to do is pay attention to this gift rather than ignore it.  Second opinions are invaluable for our health and our peace of mind.  

I’m keeping my fingers crossed that Molly and her eyes will be sparkling and bright the next time I see her.   

Wishing you and your four-legged family members good health, 

Dr. Nancy Kay

Specialist, American College of Veterinary Internal Medicine 

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot is available at Amazon.com, local bookstores, or your favorite online book seller. 

Look for us on Twitter – http://twitter.com/speakingforspot

Become a Fan of Speaking for Spot on Facebook

Listen to Dr. Kay’s interview – A Veterinarian Advises “How to Speak for Spot” on NPR’s Fresh Air with Terry Gross –

The Lowdown on Nutritional Supplements

July 6, 2009

The nutritional supplement industry has become big business as people are looking for more natural ways to care for the health of their pets.  For example, a person might be inclined to try glucosamine or chondroitin sulfate for their dog’s arthritis pain rather than a nonsteroidal anti-inflammatory medication (the equivalent of doggie Advil).

The number of nutritional supplement manufacturers has grown exponentially.  Unfortunately, the quality of products hitting the market is somewhat hit or miss.  There is no FDA approval process for nutritional supplements, and incidents of contamination with heavy metals, pesticides, or other unsavory ingredients have been reported.  Additionally manufacturers are not required to comply with specific formulations for their products- the strength or concentration of the active ingredient may be inadequate, too much of a good thing, or just right.

Knowing this, how in the world can the average consumer purchase a product that is safe and effective?  Certainly query your vet for his or her recommendations.  We veterinarians are taught to use the ACCLAIM system (described below) to assess nutritional supplements.   You too can use this system to make educated choices about these products for yourself and your four-legged loved ones.

A = A name you recognize.  Choose an established company that provides educational materials for veterinarians and other consumers.  Is it a company that is well established?

C = Clinical experience.  Companies that support clinical research and have their products used in clinical trials that are published in peer-reviewed journals to which veterinarians have access are more likely to have a quality product.

C = Contents.  All ingredients should be clearly indicated on the product label.

L = Label claims.  Label claims that sound too good to be true likely are.  Choose products with realistic label claims.

A = Administration recommendations.  Dosing instructions should be accurate and easy to follow.  It should be easy to calculate the amount of active ingredient administered per dose per day.

I = Identification of lot.  A lot identification number indicates that a surveillance system exists to ensure product quality.

M = Manufacturer information.  Basic company information should be clearly stated on the label including a website (that is up and running) or some other means of contacting customer support.

Wishing you and your four-legged family members good health,

Dr. Nancy Kay
Specialist, American College of Veterinary Internal Medicine

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot is available at Amazon.com, local bookstores, or your favorite online book seller.

Look for us on Twitter – http://twitter.com/speakingforspot

Become a Fan of Speaking for Spot on Facebook

Listen to Dr. Kay’s interview – A Veterinarian Advises “How to Speak for Spot” on NPR’s Fresh Air with Terry Gross –

Way to Go, Alabama

July 3, 2009

Alabama is the last state in the union with a law requiring annual rabies vaccinations for dogs and cats.  I was delighted to learn that this is about to change – plans are in the works for the state to amend its requirements from once a year to once every three years.  Why am I so pleased about this?  If you’ve read Speaking for Spot you know that I am a proponent of vaccinations, but I am adamantly opposed to overvaccinating (giving unnecessary vaccinations and giving necessary vaccinations more frequently than necessary).  Giving a rabies vaccination once a year is definitely too much of a good thing. 

Vaccines are not without potential adverse side effects.  As with any other medical procedure, all of the risks and benefits of a particular vaccine should be weighed before a pet is inoculated.  A once a year rabies vaccination offers all the risks with no benefits (protective immunity lasts a minimum of three years).  Kudos to the Alabama state legislature for waking up from their “vaccine slumber.”  I’m delighted they’ve chosen to do what is in the best interest of our pets.

Wishing you and your four-legged family members good health, 

Dr. Nancy Kay
Specialist, American College of Veterinary Internal Medicine 

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot is available at Amazon.com, local bookstores, or your favorite online book seller. 

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Listen to Dr. Kay’s interview – A Veterinarian Advises “How to Speak for Spot” on NPR’s Fresh Air with Terry Gross –