Archer, dogs, a 12 year old boy, 1600 miles, and me

Regular readers of Honest Dog and Pet Connection know that after my husband passed away last year, I had to find his dog, Archer, a new home. Archer was in full panic mode because Paul wasn’t coming home and Archer got worse as time went by rather than better. Thankfully my cousin and her husband, Jennifer and Dean, have had Australian Shepherds for years and took Archer in. Archer bonded to Dean like glue and became a well loved member of their family. They began doing therapy dog visits with him a few months ago; something that he and Paul had done, too, and enjoyed.

After it became clear that this was the right decision for Archer, I promised myself that I would go see him after he was settled in. This month was a year so I gave myself permission for a road trip. So last week my 12 year old nephew, Adam, and I took Bashir and Sisko, loaded up my Ford Flex ‘the Dragon” and we hit the road.

This was Adam’s first road trip with me so we went northeast from San Diego to the Grand Canyon first. Adam hadn’t been here before and it exceeded his expectations. “I knew it was big,” he said, “But I didn’t know it was THIS big!” While hiking along the south rim, Bashir decided that Adam needed to be incorporated into the family and he took on the supervision of Adam. Adam, I know, didn’t think that he needed to be supervised by a dog but hey, Bashir likes to look after his own.

My cousin, her husband, and family of Aussies lives in Phoenix so we headed there after the Grand Canyon. When we arrived, I had Adam wait with Bashir and Sisko. Jenny put her dogs outside and I went out back to greet Archer.

When I went to the back yard, all three dogs came to greet me, Archer included. But when he got close he realized who I was and became a whirling dervish. Happy cries, spinning in circles, and a tongue licking anything he could reach. Then I brought Bashir out and it only took a few seconds for them to reconnect – both dogs licking, barking, touching, running – it was wonderful to see. Bashir and Archer are half brothers.

I was thrilled to see that Archer is happy, well bonded to Jenny and Dean, and is healthy. He enjoys his therapy dog work with them. I hated to give him up but he’s in a great home, is no longer grieving,  and that does my heart good.

Jenny and Dean’s youngest dog, Harley, is my Sisko’s littermate so we brought them together next. They hadn’t seen each other in a year and a half when they were about five months old.  They were a little more standoffish and did some growling initially. But it wasn’t long before they were playing, too.

Over the next day and a half it was fun to watch the two sets of brothers interact.  And they did pair up as brothers – Bashir and Archer then Sisko and Harley. Although I visited with family and enjoyed it; I also did a lot of dog watching and enjoyed that just as much.

Our trip continued down to Tombstone where Adam and I looked into some of Arizona’s notorious cowboy and outlaw history. Interestingly enough, Bashir and Sisko got more attention in Tombstone than anywhere else during our trip. Several people stopped us to talk about the dogs.

We then visited with Sisko and Harley’s breeder, then headed home.

1600 miles later I pulled into the driveway. The front of the Dragon is covered with a zillion dead bugs and it’s going to be great fun (cough, cough) to get them all off.

Adam says he enjoyed the trip and is up for another one in the future. Bashir is a seasoned traveler and as long as he’s with me he doesn’t care where we are. This was Sisko’s second long trip and I was happy with him; he did very well.

Me? I was thrilled to see Archer doing so well and to be well loved member of his new family. And I love road trips. I guess I just have to decide where the next one will go. Hmmmmm…….

Top photo: Archer

Middle photo: Archer and I. It’s been a year since we had seen each other.

Bottom photo: Sisko (black tri) and Harley (blue merle) play. 

Biting down on anesthesia-free pet dentistry

You’ve probably seen it advertised on a flyer, pinned to a pet supply store bulletin board: “Anesthesia-free dental cleanings for dogs and cats.” You looked at it with interest, maybe even some excitement. Who doesn’t want to avoid the risks of anesthesia for their pets, especially older or sick pets? After all, we don’t need full anesthesia to get our teeth cleaned, so really, why do our pets? And wouldn’t it be nice to get all that nasty tartar off your dog’s or cat’s teeth and have a fresh, clean mouth breathing in your face first thing in the morning again?

If you look into it a little further, what you’ll discover is that during “anesthesia-free dental cleaning,” tartar is removed from the visible part of your pet’s teeth. The teeth are brushed, then rinsed, and sometimes the mouth is given a visual examination and the teeth polished to the extent the pet allows. After this cleaning, the mouth looks and, at least for a while, smells a lot better. This service is usually offered in grooming shops, sometimes by the owner or staff of the grooming business and sometimes by individuals who visit the shop on a periodic basis.

Dig a little deeper and you might find out that the person offering the service calls him- or herself a “pet dental hygienist” or “pet dental technician.” But since there are no recognized licensing, training, certification or registration programs to back them up, those titles are just marketing slogans. Even if the person offering this service is a human dental technician or registered veterinary technician, laws in most states require that dental operations be performed by or under the direct supervision of a licensed veterinarian. California courts, for example, have found that “Without question, the techniques of anesthesia-free teeth cleaning … fall within the definition of a dental operation.”

Where the procedure is done or by whom or even its legality aren’t the most important issues, however. “Periodontal disease is a disease of the teeth that occurs below the gum line,” says Dr. Steven Holmstrom of the Animal Dental Clinic in San Carlos, Calif. “The calculus and tartar that ‘anesthesia-free’ procedures attempt to remove is above the gum line, on the crown of the tooth. It completely misses the plaque and calculus that are doing the damage below the gum line.”

Isn’t some cleaning better than none at all? Holmstrom says no: “The teeth can visually look great on the crown. This gives a false sense of security, because, meanwhile, the disease is silently progressing below the gum line.”

He expressed concern over serious dental and other health issues that can easily be missed when exams — even exams done by veterinarians — are conducted without anesthesia. “All too often we have patients come in that have had repeated, even monthly [anesthesia-free] dental cleanings,’” he said. “We do a clinical exam, correctly anesthetize the patient and take dental radiographs. I’ve had many patients where multiple extractions were necessary to treat the advanced disease. What might have been easily treated, now was untreatable, except by extractions.”

If all that’s true, why are so many pet owners afraid to let their pet be anesthetized for a procedure that has so many benefits? The answer is that, just as with humans, anesthesia carries some risk to animals. Respiratory and heart problems can occur and, in rare cases, even death.

Holmstrom, who is a board-certified specialist in veterinary dentistry, agrees that concerns over the safety of anesthesia are the biggest selling point of these procedures. “The chief reason these ‘anesthetic-free cleanings’ are popular is the public fear of anesthesia,” he told me. “But over the past two decades, veterinary anesthesia protocols and drugs have improved dramatically. Anesthesia done properly is much less risky than people imagine, and they should be encouraged not to fear it. They should ask questions, naturally, to ensure their pets will receive optimum care, but as we all know, even very elderly and very young patients can be anesthetized safely.”

Nancy Campbell, RVT, DVT, is a registered veterinary technician in the Seattle area. She has been specially trained and certified in advanced dentistry and anesthesia techniques.

“It infuriates me to see the way so many people who perform this procedure use the fear of anesthesia as a marketing tool,” she said. “Instead of educating pet owners, they frighten them, then offer something that will supposedly allay their fears. But it doesn’t. There’s not only no benefit, there’s real risk. Worst of all, by intensifying the owner’s fear of anesthetizing the pet, they don’t only discourage owners from getting proper dental care, but make it harder for the owner to consider letting their dog or cat be anesthetized for other procedures, as well — even life-saving surgery.”

Dental procedures themselves might be considered “life saving.” The American Veterinary Medical Association says that “80 percent of dogs and 70 percent of cats show signs of oral disease by age three, often indicated by bad breath, a change in eating or chewing habits, pawing at the face and mouth and depression. Besides causing receding gums and tooth loss, the infection may enter the bloodstream, potentially infecting the heart, liver and kidneys.” The AVMA calls oral disease “the most frequently diagnosed health problem for pets.”

Although some pet owners might be unaware of the need for pet dental care, they aren’t the main market for anesthesia-free dental cleanings. It is, in fact, those pet owners who are most concerned about their pets’ health who are drawn to what they perceive as a safer way to get needed care for their dog or cat. What they don’t realize is that it’s not possible to properly examine and clean a dog or cat’s teeth without anesthesia — and that’s something a lot of pet owners find extremely confusing. Why do we anesthetize pets to do dental procedures that in humans are usually done without anesthesia?

If we could explain to the pet what we’re doing and that they need to hold still, if we were able to put equipment in their mouths to prevent them from inhaling dental debris, if we could be sure they wouldn’t move during the procedure, then there would be no more reason to anesthetize them for a dental examination and cleaning than there would be for a human being. But that isn’t the case. Animals who are appropriately anesthetized are not afraid, not in pain, and are completely restrained, permitting an unrestricted dental examination and cleaning.

There is an even greater benefit to doing dental cleanings on an anesthetized pet: protecting the lungs. Campbell explained that, during cleaning, tartar and other debris from the mouth can be inhaled by the pet, which can lead to pneumonia and other respiratory complications. “This is why we use a cuffed endotracheal tube,” she said, “which can only be used if the pet is under general anesthesia: to protect the airway and the lungs from accidental aspiration during a dental cleaning.”

Of course, knowing all this, many pet owners will just feel more uncertain about what to do. Sure, dental disease is scary. So is anesthesia. What can pet owners do to minimize the risks of both?

While some of the tendency to poor dental health in pets is due to genetics, some of it is due to things we can control. Daily brushing of your pet’s teeth really does make a difference in their dental health. You can ask your veterinarian about new products that help prevent dental disease in your pets. And you can think about diet and how it might impact their oral health. While wild animals eating their natural, wild diet can suffer broken teeth and other dental problems, they rarely have problems with tartar.

The other way to minimize the risk of anesthesia is to get truly expert veterinary care for any procedure requiring anesthesia. Anesthesia protocols, for dentistry or any other procedure, should be individualized and state-of-the-art. Your dog or cat must have an IV catheter inserted; this isn’t optional. Make sure that there is a trained staff member whose only task during your pet’s procedure is monitoring his or her body temperature, heart rate and rhythm, respiratory rate, oxygen levels and other important vital signs. During anesthesia, your pet should be kept well hydrated and warm.

Talk to the veterinarian doing the procedure about pain control and treatment. Analgesia — the control of pain — has advanced enormously in recent years in veterinary medicine and has been shown to reduce the stress of anesthesia and surgery and to improve recovery rates. Proper pain control can also reduce the amount of anesthesia used during the dental procedure.

While there are fewer than a hundred board-certified veterinary dental specialists in the United States, several of them practice in the Bay Area, including Holmstrom. You can locate a diplomate of the AVDC by searching on their Web site.

Remember that the real culprit in dental disease is not the tartar you can see but the bacterial growth you can’t see: under the gums, in gingival pockets and in the bone. It’s not possible to properly examine a pet’s mouth while he or she is awake, let alone actually probe gingival pockets and detect infection in the bone. Scraping off the visible tartar may make the teeth prettier, but it does nothing for the pet’s health. And if it stops an owner from getting proper dental care for a pet who needs it, masks a serious dental problem, causes aspiration pneumonia or seeds the bloodstream with oral bacteria, how is this a good thing? How is this safer than anesthesia in the hands of an expert?

So while your fear of anesthetizing your dog or cat for a dental cleaning is natural and understandable, the solution to that fear isn’t to seek out less qualified individuals who tell you what you want to hear, but to work with more qualified practitioners who really know what they’re talking about.

Holmstrom is blunt in his evaluation of the practice, saying, “If this was a legitimate treatment, why is not one of the almost one hundred diplomates of the American Veterinary Dental College (AVDC) offering this service? The answer is simple: It does not work. It is misleading the public and, in fact, may be harmful.”

The ethics of high-tech (and high-dollar) pet care

A recent NY Times discussion on the ethics of expensive treatment for pets (and the associated costs) got me thinking about this topic recently. Cost is always an issue, and it becomes a bigger issue in the ER where diseases are usually more severe and costs higher.

The tension brought on by medical advances intersecting with shrinking budgets makes this issue an everyday topic of discussion in veterinary hospitals and around kitchen tables. Just having a pet doesn’t mean (to me) that you need to go all out financially, every time. I have no ethical issue with people who are unable to give their pets bleeding-edge therapies for budgetary reasons, as long as they are able to adequately feed, house and provide routine care for their pets. For those able to afford them, Dr. Temple Grandin’s metric of judging the appropriateness of the treatment based on the anticipated benefit to the patient seems like a sound way to approach the topic, and one that I try and adopt myself. If the answer to the question of “will this benefit the patient?” is “yes” (or at least a hearty “probably”) then the next hurtle is a financial one: Question 2 is “Can you afford it?” The unspoken corollary to question #2 is oftentimes “without losing the house or being unable to feed the [human] kids?”

Where I think our moral compass goes into the ethical Bermuda Triangle is when people who could reasonably be expected to pay for a beneficial procedure don’t do it solely because the money is going towards the care of an animal. If the decision is made to not spend on pet care when it could be done easily and with a high degree of success, it is hard not to hold those people in contempt. I have to make the distinction here between those that choose not to spend for budgetary reasons (as in “I could do it, but I’ll not make rent this month”), those who don’t want to spend it (as in “I don’t want to spend large sums of money”) and those who don’t do it on ethical grounds alone (“I don’t want to spend large amounts of money that I have because it’s a cat”). It boils down to the difference between can’t, won’t and shouldn’t. The shouldn’ts are the ones that get me.

Obviously, I don’t know the financial situation of each of my clients, so this rarely comes up such an overt fashion. However, I do think it is a breach of our ethical responsibility to our pets if we can afford to do something that will help them (with a high degree of success) but choose not to when the sole reason being “it’s only an animal.”

I also want to clarify the point about the benefit to the patient. I am not talking a gamble here. I am not talking “let’s try hemodialysis because it might help” or “let’s try this advanced technique that has been done twice before.” I am talking about proven therapies, but ones that have a hefty price tag. As an example, brain surgery for meningioma (a type of benign brain tumor – not likely to spread or recur, just happens to grow in a bad place) has a pretty good prognosis in cats. The median survival is more than 2 years. The surgery is no fun, to be sure (as much as I like our neurosurgeons at Purdue, if given the choice between “sunny tropical beach vacation with fruity umbrella drinks and my sparkly wife” versus “brain surgery” I’d have to go with the umbrella drinks just about every time), but with modern ICU care and weapons-grade painkillers, it’s a pretty sure bet. Yet, few people opt for it, largely due to the $5,000-7,000 price tag. Most of them probably can’t afford it, and of those, some probably could but don’t. I don’t fault any of those folks. The ones who don’t do it because they think it is wrong or ethically questionable to do something like this on a cat are the ones who I would like to be visited by the bad karma fairy at some point during their tenure here on this rock. Nintendonitis, maybe, or rhinotillexomania.

How do you feel on the topic? Do you feel you have a responsibility or obligation to treat your pets with high-end therapies if you can honestly afford them, or do you think I am off base and asking too much of pet owners?

Lessons in living while dying

A couple weeks ago Dr. Tony Johnson was in Davis, which is next-door to where I live, more or less.  Scheduling was tight, but I managed to grab him for breakfast together before taking him to the airport. I was planning to bring a dog with me, and that morning I had to choose just one.

“OK, who wants to meet Dr. Tony?” I said. “Hospice Dog, Cancer Dog or Crazy Dog?”

Cancer Dog got the gig, not only because McKenzie is just perfect in all social situations (the same can’t be said about her daughter, FayBee the Crazy), but also because I wanted Dr. Tony to say something like, “This dog? THIS dog has cancer? You’re kidding me! She looks great!”

Which he did, and which she does.

Hospice Dog looks pretty amazing, too. I’ve lost count how many cases of lactated ringers we’ve gone through, half a one-litre bag every day, but I do know we’ve gone through two 100-count boxes of needles. Drew gave me a scare last month with a little stroke, but he recovered quickly and fully, enough so he spent an entire day at Napa wineries a week ago when Kim and Jerry Thornton visited along with their two Cavaliers, Twyla and Harper. (Picture above:  Andretti Winery, Napa)

As I’ve written before, Hospice Dog is 15 and change, and although I’ll sob myself sick when I lose him, that loss is expected. He’s an old dog doing great, but he is, still, an old dog.

Cancer Dog, though? Every breath McKenzie takes I listen for the wheeze of the tumors in her lungs. And I don’t hear them, not at all. She is the same dog she was last year, as far as I can tell. A perfectly healthy, 7-year-old dog with a breed-specific cancer that is statistically likely to kill her before her 8th birthday.

That doesn’t seem possible to me, but I know it’s true. I saw the rads and I read the pathology report. I just can’t stop thinking about how both of these dogs will be gone this time next year, most likely. And yet … they seem dutybound to divert me from my darkest thoughts.

We’re all dying, as a boss of mine used to say. But these two? Since they don’t know it, they focus on living. And I’ll be damned if they aren’t making me focus on it, too. (McKenzie, above: Mud? What mud?)

***

Yes, I’m still working on The McKenzie Project to develop a breeding program that will no longer accept these insanely high rates of cancer at young ages as “normal for the breed.”  A little bit every day, while rehabbing a house, working and preparing for a new book tour.

I’m still in the research phase, trying not to duplicate efforts, and have about half of a good steering committee on board. I’m not going to be able do much until I get moved in to the new place, and I plan to get a huge chunk of the development and planning work done before fall. What I come up with will almost certainly involved planned outcrosses (I have a geneticist interested), and I will be taking it to the breed club for consideration.

A year ago I would have said there would be no chance of any change in How Things Are Done. But given what has happened at Crufts and what is happening under the surface everywhere — and certainly to judge by “secret” interest in changes to breeding rules — I won’t begin to guess what will happen this time next year.

I do know I don’t want to fix what’s broken by breaking it in a wholly different way, and I also know I’m writer, not scientist. That all factors into my learning curve. So far the biggest thing I have going for me is that I’m not invested enough in the current system to be a strong believer that working within it is the only acceptable way to proceed.

I’ll keep everyone posted when I have some news to report on my efforts. In the meantime, I’m trying to live the life my dogs are, as much as my gloomy self can manage it.

For no-kill opponents, we should show animals are valuable by killing them

After I blogged about a sign on a shelter  door recently, I found myself arguing with a number of people who said we shouldn’t make it easier on people to surrender their pets, but instead, discourage it at all costs.

Their reasoning was this: Anyone who surrenders a pet at a shelter is betraying the human-animal bond, and making it easier, or acceptable, to bring a pet to a shelter is just going to cause people to value pets and their place in our lives even less.

I’ve heard a version of this argument before, made by opponents of the no-kill movement who want to hold on to shelter killing as a weapon against what they see as irresponsible pet ownership. They argue that by letting people know their pet is not at risk of being killed inside the shelter, we’re facilitating the devaluation of companion animals. We’re telling them it’s okay to give up on a relationship with a pet.

Know what I think?

I think what devalues companion animals is the fact that’s legal to kill homeless pets and send them to the landfill in body bags. And I think defending that practice just devalues them more.

If I had a pet who circumstances forced me to give up, it would reassure me of her value — not just to me, but her own intrinsic value as a sentient being — to know that my community would move heaven and earth to make sure she found another loving home, and that anything else would be not just unacceptable but both unthinkable and illegal.