Clayton Veterinary Associates
A DAY IN SURGERY

Surgery days are always fun for me. I really enjoy surgery. Way back in veterinary school I used to think it was a bit daunting, but working for ten years in emergency medicine where I was the only doctor available at two a.m., I learned to love it. The years spent in the emergency room taught me how to think on my feet and react to whatever was thrown at me. It was there that I took out my first kidney, did my first gastric torsion (bloat) surgery, did my first foreign body removal and intestinal anastamosis (putting two ends of the bowel back together), and repaired all kinds of traumatic wounds.  Now that I am in general practice, surgeries are much more routine, but still enjoyable.

For the owner of the pet having surgery, the day is usually a bit more stressful. Owners worry about what is happening, how their beloved pet will react, and how much pain will be involved. So, let’s walk through the surgery day to help you feel better!

Pets need to be fasted for about 12 hours prior to surgery. The drugs used for anesthesia can make them vomit and we don’t want them to aspirate (inhale) any stomach contents. When your pet is admitted in the morning you will fill out a lot of paperwork to make sure we understand all your instructions. Questions about additional procedures (nail trim, shave mats, take off a couple skin tags) will be asked. It’s much easier to do some of those things while they are sleeping!

After the paperwork, your pet will have blood drawn for pre-operative testing if it hasn’t been done prior to surgery day. We need to know how the liver and kidneys are functioning so we can tailor the anesthesia to the pet’s condition.  We check clotting profiles to make sure there won’t be any bleeding issues. An EKG will be run and evaluated to make sure there are no heart problems that can be detected.  If your pet is having a tumor removed, we may xray the chest to make sure there has been no detectable spread of the tumor prior to surgery.  While the tests are being run, your pet will be made comfortable in a cage or holding area with blankets to snuggle.  Some even like to snuggle with large stuffed animals.

Dr. Hoog-CrellinIf everything checks out and your pet is safe to be anesthetized, an intravenous catheter will be placed and hooked up to a bag of intravenous fluids.  The fluids are run through a pump to make sure your pet receives the correct amount of fluids.  The fluids help maintain blood pressure in the correct range during surgery and replace fluids that your pet is not allowed to drink for 24 hours.  The catheter is also used to inject the medications that will induce anesthesia. Once the pet is sleeping, a tube is placed in the trachea (windpipe) and hooked to a gas anesthesia machine. We use pediatric gas anesthesia which is very safe and can easily be adjusted up or down to keep the pet at the right level of sleepiness. A blood pressure cuff, EKG monitor, and oxygen monitor are attached to monitor the vital signs of the pet. Pain medications are given by injection to keep the pet as pain-free as possible.

The area where the incision will be made is shaved, vacuumed, scrubbed with antibacterial soap, and sprayed with antibacterial spray. Surgery is performed by the doctor and the technician monitors the anesthesia, keeping close track of any changes in vital signs. Once surgery is completed, the animal is given oxygen through the endotracheal tube for a few minutes to help cleanse the system. After that, the pet is moved back to their blanket to wake up under the watchful eye of the doctor and technician. The tube is pulled from the throat once the pet is able to swallow and is breathing well on their own.  Usually, within an hour the pet is sitting up, standing, and wobbly on their feet.

Before being discharged in the evening, incisions are checked for swelling, redness, or bleeding. The incision area is cleaned and the pet is checked over for any signs of a problem. Pain medications are sent home with your pet to keep them as comfortable as possible during the healing phase after surgery.  Our goal is to make the procedure as pain-free and pleasant as we can.

Your job at home is to keep your pet as quiet as possible for a few days, using a leash when outside. We ask that you check the incision area and notify us if there is any swelling or redness or if your pet is licking the area. If your pet will not leave the area alone, an “E” collar (cone) will be fitted to your pet. Campho Phenique mouth medicine is available over the counter for people and can be painted around an incision in a pinch to keep the pet away from the area. You can also try putting a tee shirt on the animal if that will cover the incision. Do not try to bandage an area, as that may be damaging to the wound.  Call any time you have a question!

Sutures are usually removed 8 to 10 days after surgery. Biopsies usually take 5 to 7 days to come back.

Scanlon’s Weight Loss Journey Continues

We are pleased to announce that Scanlon’s continual weight loss efforts have begun to pay off!  Scanlon came in today for his weekly weigh in, and read a whopping 102.6 pounds on the scale.  His owner has been doing a great job maintaining a very strict diet and has been making sure Scanlon gets plenty of exercise.

Scanlon’s current daily diet consists of 12 ounces of Stella and Chewy’s - 4 in the morning and 8 at night.  He is walked a minimum of two miles each day and rewarded with two healthy biscuits for his hard work! 

Dr. Morgan’s Musings: Management

When I decided I wanted to be a veterinarian, many moons ago, I never really thought about owning my own practice (or two). In veterinary school they taught us a ton about all the different species of animals, but there was never any mention of how to run a business. Hey, we all just wanted to help animals be healthy.

So, here I am, 27 years later, trying to run a business.  It was easy being a practice owner at first, because I was a minority partner and my partner handled all the business aspects of the practice. When I bought the entire practice in 2007, I had no clue what I was doing. I just paid the bills and tried to keep the staff and clients happy, having no idea there were so many government agencies, insurances of twenty different types, rules and regulations to follow, etc, etc, etc. By 2008, I realized I had no clue what I was doing from a business standpoint. Rude awakening.

As luck would have it, I was approached by a management consultant (do these guys have some inside track that tells them who needs help or do they just get lucky?). I was so shell-shocked at all the redtape involved with running the business, I figured I had better hire them. We still use the same consultants and they have helped us over lots of hurdles. I discovered I needed a new accountant, as well, when I found out how many different taxes and fees have to be paid to different governmental agencies. It sure is better to plan ahead than to be hit with a big bill and no way to take care of it.

So, two weekends ago, I decided to take Kathy (my Office Manager) to hear another business manager speak about running the perfect practice. We are always trying to improve our service and hoped he would have some new explosive piece of advice for us. Sadly, he didn’t have anything new that our first consultants had not already taught us. It was more a sales pitch for his incredibly expensive training in pain management for chiropractors. Now I see why he’s worth millions – charge people a ton of money to sit through lectures and follow that with another ton of money to learn his techniques through a ten-course series, each costing thousands, followed by advanced courses for thousands more. Unfortunately, these kinds of seminars occur way too often. Sort of reminded me of listening to a time share pitch (and how many of us got sucked into those?).

Anyway, what I did learn, is that our most important asset is our clients. We love our clients and want to take incredible care of them, and their pets. I am going to make a huge effort to really offer stellar service and the first thing we are going to tackle is waiting times. I realize everyone has too much to do and can’t afford to spend hours in our office. So next time you have to wait, let me know. Help us fix anything that bothers you. Help us to offer better service.

And, yes, we do want you to send your friends with their pets. Help us turn them on to a different kind of veterinary medicine, where it’s more about good food and good health, and less about pills and vaccinations and chemicals. 

 - Dr. Judy MorganDVM, Owner and Head Veterinarian at Clayton/Churchtown Vet

Scanlon’s Weight Loss Journey: Week 5 at Home

Scanlon stopped in for his weekly weigh-in. We are happy to announce that he’s shed another 1.5 pounds!

Frequent exercise has yielded great results for Scalon, but this week he also exhibited some soreness and limping. A jump in activity for an obese animal should be closely monitored by a veterinarian. Think of it like a human beginning a weight loss regiment. Unused muscles and joints are prone to soreness and injury. The difference is a human has control of his own pace, while a dog can’t tell you when he or she needs to stop or is in serious pain.

For very obese dogs, like Scanlon two months ago, try low impact exercises like walking or swimming. Gradually add more distance as your pet gets acclimated. 

If you have any more questions about weight loss and your pets, don’t hesitate to call or email our clinic!

Dr. Morgan checks Scanlon’s progress. Another positive week for the big guy!

Scanlon looks anxious as he gets weighed. No reason to worry Scanny, you’ll be able to fit in that harness soon!

Dr. Morgan’s Musings: “Cats and Dogs Hate Each Other”

While winging our way across the country on a Frontier airline jet with Kathy and Hue, I asked for suggestions for blog ideas. Hue said, tongue in cheek, “why dogs and cats hate each other”. Well, I want to know who started that rumor. In our house we have 7 dogs and 5 cats (and, no, that does not constitute hoarding; just an amazing love for the little creatures that are incredibly well cared for and rule the house). Anyway, there is definitely no hating going on in our house.   In fact, it’s pretty much the opposite.

As many folks know, we have been rescuing and fostering Cavalier King Charles Spaniels for the past 5 years. Along the way, quite a few have stayed with us, resulting in us owning 5 dogs. Add to that my son’s cocker spaniel that came with him when he moved in and we hit 6. Then there’s my daughter’s cavalier that moved in with us when she went off to college, and we have 7.  The cats started with two barn cats that came with me when I sold my farm.  One hates to be inside and she spends most of her time outside or in the garage curled on soft blankets.  Last summer we raised two orphan kitten litters from birth and failed to find homes for all of them, resulting in three kittens staying permanently, bringing us to 5 cats.

The best thing about raising 3 kittens with 5 spaniels is that they don’t know they are cats. They were raised with spaniels, and they think they are spaniels. We have renamed them “spats”, as in spaniel cats. They like to eat with the dogs and love the dogs’ raw meat food. They sleep curled up with the dogs in the dog crates and dog beds. They run in and out of the house with the pack of spaniels. They line up at the fence and peer out to see who is coming up the driveway. They play fetch and chase with the dogs, sometimes with the cats in front and sometimes with the cats chasing the dogs.

But the best is the odd couple of George and Eggplant. Eggie is MADLY in love with George. She follows him everywhere, sleeps on him, grooms him, kneads his back, and acts like an adoring girl in the shadow of a rockstar. George puts on the “poor me” face, but seems to enjoy every minute of it.

So don’t believe the old rumor of cats and dogs not getting along. In reality, they may be best friends.

 - Dr. Judy MorganDVM, Owner and Head Veterinarian at Clayton/Churchtown Vet

Dr. Morgan’s Musings: Pet Rescue

I was following a feed on Facebook the other day where some friends were complaining that is so expensive to get a pet from a rescue and they couldn’t understand how the rescue organizations could charge so much. They seemed to feel the rescue centers should be paying them to adopt the pets and give them a good home. So, it seems to me, there is some misunderstanding out there.

Let’s look at the purchase of a purebred dog from a breeder or pet store. I’ll use Cavalier Spaniels as an example, since I am familiar with the breed. If you want to purchase a cavalier from a reputable breeder, you can expect to pay anywhere from $1500 to $3000. If you decide to purchase from a pet store, you will pay anywhere from $700 to $1200. If you decide to bypass the pet store and go directly to the puppy mill to buy a puppy, you may be able to get one for $500 or less. Once you own the puppy, you have only just begun. There’s the series of puppy vaccinations, deworming, heartworm testing and prevention, spay or neuter, and treatment for any defects like skin disease, hernias, dental care,  luxating patellas (bad knees, common in the breed), heart certification (bad hearts, common in the breed). Total up all that, and you have easily spent another $1000 to $2000.

On the other hand, you look up a cavalier rescue organization on the internet and find out it will cost $500 to rescue a dog. You probably won’t be able to get a puppy through a rescue, but you will get a dog that has been spayed or neutered, is up to date on vaccines, laboratory testing, heartworm and fecal testing, is free of parasites, has had dental care, and any heart or knee problems have been discovered and treated if possible. AND, you get to feel great because you gave a home to a dog someone else couldn’t keep or didn’t want.

BUT, make sure you are adopting through a good rescue organization. I recently treated a Dachshund that came through a “rescue” for $300. The dog was supposed to be young and in good health. He was actually over 10 years old, in heart failure, and had rotten decaying teeth. Many dogs are being brought up from the south and are carrying heartworms, fleas, ticks, and intestinal parasites.

Most good rescue organizations spend a lot more on the care of the pets than they charge for the adoption fee. They rely heavily on donations and fundraising activities. I adopted my first spaniel for $400 and they gave me medical records showing over $2,000 spent on medical care to save her life. I think I got a bargain, and a best friend for life.

Do your research. Find a good rescue organization. Donate your time or money to help where you can. Adopt if you can. Support spay and neuter. And if you must buy from a breeder, make sure they are reputable. Don’t believe a glossy website. Go meet them in person. Meet the parents of the puppy and evaluate their temperament and health. Make sure the puppy is free of any defects or potentially longterm health problems.  Once you get them, have them seen by your veterinarian as soon as possible.

 - Dr. Judy MorganDVM, Owner and Head Veterinarian at Clayton/Churchtown Vet

Dr. Morgan’s Musings: A Visit to Merrick Pet Food

After two grueling days at a management conference in Denver (not worth the price of admission, but that’s another story), Hue and I watched our office manager Kathy get on a plane back to Philadelphia and we headed out on the tiny commuter plane to Amarillo, Texas. Amarillo is a small city of about 180,000 people, but it sure doesn’t look like the cities out east. There are only 3 or 4 tall buildings (and tall means over 10 floors!) and lots of old west stuff. Hue grew up in this area, so we are visiting his mother and brother’s family.

Hue reminded me on our way here that Merrick Pet Foods is headquartered in good old Amarillo. Wow! I love this company! So, with only a very small amount of begging, he agreed to find their office. As it turns out, it’s about 4 blocks from where mom livesJ. So, we walked in unannounced and said we were from a holistic veterinary clinic in New Jersey and just wanted to say we were here. The folks were extremely nice and one of the customer service reps gave us a tour.

We talked about their products and why we loved them and I learned a bit about a couple of new products. I said I was disappointed that all the BG dry foods had chicken meal in them, and within two seconds the rep showed me their new pork product with no chicken or poultry! She also showed us their seasonal four-pack cans and told us how someone won a trip to Hawaii for coming up with one of the names. Pretty cool!

We met the CEO of the company, as well as one of the founders, Garth Merrick. Garth had his gorgeous chocolate lab with him, who gets to come to work every day (as he said, it’s like taking an alcoholic to a liquor store every day!). His dog was well-behaved and I snuck her one of the turkey treats they had given me as a sample. She kept presenting her back to me and she had some mild tenderness over her mid-back. I’m going to send the blog to Garth, with a recommendation that he take her to see a veterinary chiropractor. (You should hear me critique horses at horse shows – hip up, slightly off, sore back….ugh….I’m no fun at all.)

I explained a bit about how we use the energetics of food in our practice, from an oriental medicine standpoint. I’m not sure he really got what I was talking about, but he was very nice. I also told him how I originally started carrying Merrick foods in the practice. My partner at the time liked to sell prescription veterinary foods and wasn’t into the holistic side of veterinary medicine. So I would go to the local pet store and buy eight-packs of Merrick. I would take it to the clinic and re-sell it for the same price and tell folks how great the food was. Talk about a non-profit service! But, we got people hooked and now we sell a lot of Merrick foods for folks who don’t like the idea of feeding raw or can’t cook for their pets. I have loved this pet food company since I discovered them around 2003, and I like them even more now.

Next time we come to this area, we plan to go to their processing plants and take a tour. There are three plants, one for canned products, one for dry foods, and one for treats. I discovered they do make products with tripe (a doggie super food, but boy does it smell yucky!) and they are very proud of making a high quality product using human grade ingredients. All in all, a great visit.

 - Dr. Judy MorganDVM, Owner and Head Veterinarian at Clayton/Churchtown Vet

Scanlon Update: The First Month At Home

This past summer, Dr. Morgan took in an overweight seeing eye dog with hopes of getting him into shape. Scanlon, a Labrador retriever, was so large that he couldn’t fit into his working harness. Over the course of 9 weeks, Dr. Morgan got him to drop 14 pounds with the help of a raw, balanced diet and plenty of exercise.

But there was still much to be done. Scanlon needed to lose at least 40 pounds to be able to resume his job as a seeing eye dog for his human companion.

We are happy to report that Scanlon continues to make progress. In the course of a month, the big guy has dropped another 4.4 pounds; bringing his total to 18.8 pounds!

Scanlon’s owners have elicited the help of friends and neighbors to get him walked everyday. For their part, Dr. Morgan is offering to donate a healthy diet of Stella and Chewy’s Raw Food as long as Scanlon keeps shedding the pounds. 

After four weigh-ins since going home, Scanlon has yet to gain any weight! 

Scanlon, his owner and Dr. Morgan.

Scanlon’s owner and Dr. Morgan discuss his weight loss progress.

Looking good Scanlon!

Every time I take pictures of Scanlon, I capture him doing this at least once!

He’s come a long ways, but there is still work to be done!

Dr. Morgan’s Musings: A Day in the Life

Some time ago, a client approached me and told me he heard it was impossible to get an appointment with me because I only worked one day a week.  I wasn’t sure whether to laugh, cry, or scream. You see, it may seem that I am never available, if you need me right at that moment. The real truth, however, is that a normal work week for me spans a minimum of 50 to 60 hours or more. The week starts around 7:00 am on Monday, ending around 4 pm on Friday, with a weekend event thrown in for good measure.

So, I thought I’d discuss a typical day. Thursdays are always a big day, so we’ll use that schedule.

I awake to 6 barking, scratching, restless spaniels moving around the bed and licking my face to get me up around 6 am.  Scrambling to jump up and get them down the stairs without any accidents along the way (you know, urine, poo, me or Hue falling down the stairs in our dementia), we chase 4 cats down the stairs as we head for the back door and flip on the outside lights. If it’s raining, we have to push everyone out the door. Otherwise, it’s a stampede. I feed cats while Hue makes coffee, the gift from the gods. Then back upstairs for the morning ritual, back down to feed the starving herd. If we can spare the time, we take a 3 or 4 mile walk, but that’s an added bonus.

Then it’s off to the office to check email, read the mail, and check on any lab work or messages that came in overnight. At 8 am, the doctors meet to discuss cases, new protocols, and issues that have come up. By 9:00, the first patients are waiting in exam rooms. The technicians are busy admitting patients for surgery later in the day and the receptionist is manning three phone lines single-handedly, while welcoming clients as they arrive. Two doctors start seeing appointments and work diligently for the next 3 to 4 hours, handling a new case every 20 minutes. While seeing appointments, the doctors also have to approve any medication requests, answer any phone questions presented by the staff, and handle any emergencies that may come in unexpectedly.

By 1:00, the patients awaiting surgery have finished their pre-op preparations like EKG’s, IV catheters and fluids, pre-op blood work, and anesthetic calculations. Surgery cases become priority for the next few hours, but there are still prescriptions to fill, emergencies to handle, and clients to call. Surgeries may be routine or complicated, but each is handled like one of our own pets.

By 3:00, the afternoon outpatient appointments begin to arrive. Again, the staff works hard, trying to stay on schedule until appointments end at 7:00. But who can predict the dog hit by a car, the broken leg that needs x-rays and splinting, the dog that ate all the Halloween candy, or the cat with pneumonia? Anything out of the ordinary takes more time and we get behind. Usually, by 8:00, the last client has left the building. The doctors gather charts, notes, and lab reports, and try to find a spot to get things organized. Receptionists close out the books, and the technicians start the long cleaning process. By 9:00, the job is done, the building is clean, and we all head out, vowing to return in 10 short hours.

You might have noticed, I didn’t mention lunch. We used to have a lunchroom with a table, but it never got used. If we are lucky, we have sandwiches delivered and eat while working. Otherwise, I’m REALLY happy to get home at 9:30, where Hue usually has a phenomenal meal ready, with my much desired martini. And 6 spaniels full of hugs and kisses.

   - Dr. Judy MorganDVM, Owner and Head Veterinarian at Clayton/Churchtown Vet

Dental Care For Your Pet (Pt.2)

Oral disease is the No. 1 health problem diagnosed in dogs and cats. Pets don’t get cavities like humans do. Rather, they get a buildup of tartar that, in time, leads to infection, gingivitis and eventually, periodontal disease. The good news is that dental disease in your pets can be prevented.

Getting started with the brush:

For those who’ve never brushed a pet’s teeth before, Nash offered the following tip: “I’ve developed the habit of brushing my dog’s teeth after I’m done brushing mine. I talk to my dog through the procedure, praise her when we’re done, and then give her a treat to chew on. Now when she hears me brushing my teeth, she comes into the bathroom wagging and waits for her turn.” 

While brushing, look for signs of problems such as red, swollen gums; bad breath; a yellow-brown crust of tartar swollen around the gumline; and pain or bleeding when you touch the gums or mouth. Also look for fractured, discolored or missing teeth, as well as any bumps or masses, advised Nash.


Other plaque removers to try:

In addition to daily brushing, dietary choices can also help your dog’s dental health. Feeding raw, whole foods, including raw meat and especially bone simulates the natural food selection of dogs and cats. Both animals have teeth designed for tearing meat, grinding bone and generally working for their food with helps to strengthen gums and clean teeth. In captivity they eat kibble or canned food, which both consist of ground up ingredients. Essentially, their teeth go unused.

Products are on the market that are designed to help dental care, including chew toys, rawhide chips and dental chews. None, however, are as simple or as effective as uncooked bone. (**These two paragraphs are not from the original the Inquirer Article. They reflect our feelings on diet and are NOT the original author’s views nor that of Dr. Nash.)

Veterinary Care:

During your pet’s wellness examination, the veterinarian is likely to check your pet’s teeth, gums and jaw. Tell the veterinarian if you’ve noticed any signs of dental disease in your pet. Veterinarians (whose offices offer dental care) will be able to remove the tartar and plaque from the animal’s tooth surface. Note, this outpatient procedure may require that your pet be under general anesthesia.

Keeping your beloved pet’s teeth in fine shape ensures not only its nutritional health, but it can keep your furry friend free of pain and up to its usual silly antics. 

(*Courtesy of the Philadelphia Inquirer, Tuesday August, 9th 2011 Issue)