Saturday, November 26, 2011

How we differ from Dr Pol

So, I thought since Dr Pol is setting the perception of veterinary medicine back about 50+ years, I would explain how I am a different sort of veterinarian and how the clinic where I work is progressive instead of backwards.

Patients during surgery are availed of the following:

1) An IV catheter and IV fluids to help control and maintain blood pressure, as well as to administer pain medications, blood or plasma transfusions, and life-saving medications such as atropine and epinephrine.

2) Full anesthetic monitoring including oxygen saturation measurements, end-tidal carbon dioxide (very important), heart rate and rhythm, and blood pressure. Patients are monitored by expensive equipment but also by a technician that is making sure that the machine readings are believable. The technician assesses pulse quality, gum color, and heart rate and rhythm periodically by actually laying hands on the patient. This ensures that we know how are patient is REALLY doing - at all times.

3) Our surgery table is heated to ensure that patients do not lose too much heat during surgery. Anesthestic gases causes vasodilation and a drop in blood pressure. As a result, body temperature drops. Opening up the body cavities exacerbates this. The technician monitors body temperature and measures are taken when necessary to keep the patient warm.

4)Sterile technique is always observed. All surgical instruments are cleaned and steam autoclaved (sterilized) between patients. All patients are fully draped, and the surgeon wears a cap over the hair, a face mask, booties, and a sterile surgical gown. The technician wears a mask, cap, and booties unless assisting. The surgical room is used for NO other reason than invasive surgery (opening the thoracic or abdominal cavities).

5) All patients are intubated and hooked up to an anesthetic machine and ventilator. This way, respiration can be closely monitored and supplemented as needed.

These are just some of the ways we protect our patients surgically. Outside of surgery, we are just as meticulous. Patients receiving IV fluids are on IV pumps that control fluid rate. These are in turn monitored by the technicians to ensure that they are working correctly. That way no patient receives an overload of fluids, which can be fatal.

Patients with infectious diseases such as parvovirus or feline respiratory tract disease are isolated from the ICU in a separate ward. This is to prevent nosocomial infection, as well as to protect animals with compromised immune systems (as in parvovirus).

If a patient presents injured and in shock, permission to administer (cheap!) pain medications is obtained right away. Pain medications indicated for severe trauma and shock, such as a mauling, are opioids. NSAIDs or steroids are not proper medication for a patien in this condition. They are not potent enough, quick acting enough, and have side effects that can be greatly worsened by shock. Patients are also started immediately on IV fluids to stabilize blood pressure. Oxygen is administered as needed either via face mask or incubator/oxygen cage.

If a patient comes in with severe neurological deficits or other problems that cannot be addressed at our clinic, referral to the nearby specialty practice is immediately offered. If referral is declined, discussion of the options is initiated, and an informed decision made with the client's help.

Patients are never sent home in a state of heavy sedation or anesthesia. All patients are fully recovered and monitored before they are sent home with their owners.

There are a thousand ways I could compare us to show that we practice up-to-date, forward thinking medication. We use constant rate infusions of narcotics to keep our post-operative patients and very sick, painful patients comfortable. We utilize the most recently recommended treatments for a variety of conditions - including choosing our antibiotics wisely and carefully rather than placing all patients on them. Steroids are avoided in cases of shock and head trauma and used judiciously where indicated. We have an ultrasound machine, digital radiology (many human clinics do not even possess this technology), and a radiologist on call who can review difficult to interpret xrays. Our technicians are highly skilled and dedicated to patient care.

As a clinic, we work hard to offer our clients the most current and best diagnostics and treatments we can. We do not cut corners to save money. Yes, we're in it because we love animals. We're also in it because we want a job that matters, and we care about what we do on every level.

We're not all Dr Pol.


Elizabeth said...

All of that has my vote!

Jamie Lynn said...

How would you suggest discussing these things with one's vet? Would it be offensive to a vet to get asked these questions from someone with no vet. training? I find myself trusting my vet without really knowing much about his practice because I don't know anything about vet. medicine. After your last two posts though I'm left wondering and concerned if my vet is doing the best he can by my dog and cat. ~ Jamie

The Homeless Parrot said...

Jamie, I think you should interview a veterinarian just like you would a pediatrician or a dentist or any other healthcare professional you choose to patronize. They are charging you for a service. I would never be offended if someone asked me about our protocols in a friendly, interested manner.

Questions: are IV catheters placed during surgeries? Are fluids administered to maintain blood pressure? What sort of pain management protocols are used for surgeries? Are patients monitored by a technician while under anesthesia - including end-tidal CO2 (VERY IMPORTANT) and blood pressure?

I could give you a whole list if you are interested. The answers would give you a good idea about the sort of medicine practiced by your veterinarian. Let me know if I can help. My email is

Anonymous said...

I've asked practices what their pain management protocols are. Some are not thrilled to be questioned, but that is often the ones who aren't doing a great job.
Personally, I just ask whatever question I like. If they aren't happy answering such questions, I'll go find another vet to ask. As long as one is polite, I believe they're fair questions.
I think your practice sounds wonderful - but, I think a lot of practices are going to be a step down from what you are doing. A step however, not a mountain like Dr. Pol.
Posting a list of questions is a terrific idea. Perhaps indicate which questions NEED a "yes" answer, and which are ideal, but smaller practices may not have.

Elizabeth said...

HP, I would love to have a list of questions to ask when you are looking for a new Vet.! This is a fantastic idea...