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Dr. Coates is a veterinarian based in the other “Sunshine State” – that's Colorado to the rest of you – where she lives and plays with a varied range of animals. She shares her professional and personal experiences, Monday through Friday, here on petMD's blog, the Fully Vetted. Log in for your daily dose of her insight and wisdom.

 

Five Things This Veterinarian May Never Understand About Her Clients

August 10, 2010 / (29) comments


Compassion is a beautiful thing, but sometimes, upon close observation of my veterinary clients' behavior, its true meaning eludes me. Why? Because I can't for the life of me walk in some of my clients' shoes when it comes to the following five stressful topic zones:

1. Fat pet persistence

I can understand how pets can get fat. Really, I can. I just can't understand how they can stay that way. How hard is it to get a dog, in particular, to lose weight? Safe weight loss is achievable by all breeds in the canine camp. For felines I know it's tougher. But when the vet says she's overweight already, how is it that year after year she continues to come back fatter and fatter?

Discuss ...

2. Theft of services

They'd never walk into a department store and steal a pair of jeans, but given half a chance, some people will happily steal my services. Usually it happens in the guise of the "I-forgot-my-wallet" form of non-payment (and so you know, keeping pets hostage until owners pay is considered poor form in most communities). But I've seen it take on many forms, including my favorite example: the Amex payment cancellation. "Because I never authorized that blood transfusion." Yeah, right.

3. Dental denial

This one takes on many forms. The "I'm-afraid-of-anesthesia" version I can understand. But I start to get really unsympathetic when the pet's mouth resembles a gaping wound more than it does an entryway to the digestive tract.

4. Muzzle-it! (not)

"OMG she does NOT need a muzzle!"

"Dr. 'X' never had to use a muzzle."

"She is not aggressive at all."

"That was a smile, not a snarl."

"That's just how she talks."

And my clients might be right on all counts. But if I take out a muzzle, it's because I prefer to keep all my digits, thank you very much.

5. Skinny pet phobias

This one is a corollary to number one, but I include it last because it's my biggest pet peeve of all. When owners of chronically on-the-thin-side (but otherwise perfectly normal) pets complain bitterly about their inability to get their pets to gain weight, I confess I'm never very helpful. I tell them to consider themselves lucky, and I tell those who keep flapping their lips about their pet's weight to shut up and enjoy the extra years of comfort their pets will enjoy relative to those pets whose excess poundage will doubtless lead to more troubles than a lifetime of leanness ever would.

Yes, I know I would be a much better veterinarian if I could muster more compassion for my clients' POVs. So I do try. For example, I use my Hispanic origins to wrap my head around the cultural issues surrounding feeding and eating, I remind myself that everyone's values are informed by a variety of complex variables I may never be privy to, and I acknowledge these differences in the exam room so as to educe some honest reflection and rational thinking when needed.


Dr. Patty Khuly

 

Pic of the day: "George...looking confused" by play4smee

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COMMENTS (29)
1
Client issues
by on 08/10/2010 01:54am

I would be an A+ client for you then, Dr. Khuly. I love my dog the way he is, perfect white teeth (he gets dental chews and biscuits daily, plus his teeth get brushed at least once a week, and I scale them a couple times a year), lean bodied (a nice thin padding of fat over the ribs but you can still feel each one, very neatly tucked belly and a nice hourglassy shape when viewed from above) and muzzled (when neccessary, he gets nervous when he gets grabbed by a stranger). I also think it's a disgusting thing to skip out on paying for vet care. Sure, some vets inflate prices a bit, but medical supplies aren't cheap, I know, my boyfriend is in med school and some of the bills for even his SCHOOL supplies make me go "EEK!!" It's just terrible that someone would do that. I mean, in the interest of the pet, It's better than completely ignoring the fact that the pet needs help because you know you can't afford it, but it takes money away from buying supplies and medicine to help OTHER pets, so it just hurts every other pet who uses the practice.

2
fat animals
by on 08/10/2010 06:37am

my cat eats dry food,from the USA.i have tried canned food from the US and europe,she will not eat them.she will only eat canned tuna,not packed in oil,only water.she has to watch her figure. the tuna is 100% fish and works out cheaper than a can.

3
by on 08/10/2010 07:26am

About weight: I am surprised that this surprises you. Look at Americans and their kids. We can't control our own weight. (I'm guilty, too - I need to lose a bunch.). I have one dog whose diet I've gotten right - though he acts like I'm starving him to death, and another who needs to lose a few pounds. He's not freak sized, but he is beginning to look a bit sausage-y. It's hard to cut his food back because he's actually picky, so I know I overcompensate. But I WILL get him under control. It isn't easy, though. He stands up and wrinkles his lips and gives the most beseeching look. However, I want him here for a long time, so I will do it. It will also help when the weather gets more moderate and we can go back to taking him to the park every day for exercise. Last winter it was too snowy, and this summer it has been too darn hot.

4
How hard is it?
by on 08/10/2010 07:46am

Well, I fed a should-have-been 45-50 lb dog a *literal handful* of low-cal kibble daily (couple of tablespoons), exercised him more than the other dogs, and I swear he gained weight. We were so baffled by his inability to lose weight we got him tested for all kinds of things.

After getting some advice from a panel of vets, I added fat into his diet, and he lost weight. Very counter-intuitive. Their hypothesis went along the lines of "he gets so little protein/fat that he has no energy and so he doesn't move all day except when forced to."

Yeah. It *can* be extremely difficult to get a dog to lose weight.

5
We LOVE our Vets!!!
by on 08/10/2010 08:11am

Hi Dr Khuly-----PLEASE know that there are those of us out here that so appreciate our Vets!!! I remember once last Fall when I took my beagle for a visit. Our Vet checked her out quickly and was not going to charge me, I promptly chimed in with a "Oh yes you are!" I ALWAYS make sure that ALL charges are on my bill. Just this last week I made sure that a nail trim was on my bill. He was not going to charge me and I insisted!!! I had one vet who seemed to charge me for just walking through the door. We quickly changed Drs. Also you'll be glad to know that all four of my dogs are at their perfect weight!! I have a 16 year old Terrier, a 13 year old Beagle, a 10 year old Fox Terrier, and we just found 8-10 year old Miniature poodle!! All seniors!!! Plus I prefer to muzzle, that way I don't worry, and our dear Vet doesn't worry!!!!!

6
Skinny Dogs
by on 08/10/2010 08:27am

As a Dane owner and rescue person, we always hear comments about how thin the Danes are. It is tough to educate that a fat dog isn't healthy and particularly with Giant Breeds - Skinny is Good!
But I do have a fat cat...working on it slowly.

7
Educated owners
by on 08/10/2010 09:17am

With all the reasons for pets being overweight, I think education is a big factor. I spend quality time learning about our dogs' and horses' health, including what to feed and what not to feed. As a result, our three dogs are healthy, happy, and in perfect form.

For those who don't want to study about animal nutrition, perhaps vets could provide a booklet to guide the owners to better care of their animals. Learning to read labels...not buying dog food that contains (among other things) corn, wheat and soy; a list of people food not to feed, etc.

There's a saying, something like..."It's better to light a candle, than curse the darkness."

8
Overweight dogs
by on 08/10/2010 09:19am

How about the vets who tell clients their dog is "fine"?
Each Bichon that gets adopted from our rescue is at it's perfect weight. We give a menu with the brand and type
of dog food with the exact amount per meal along with vitamins, supplements, snacks, etc.

Each year at the Bichon Bash we see these terribly overweight dogs! I hear: "The vet hasn't said anything." or "Our vet said he is just fine."

Our mantra: Keep them lean, keep them longer! And measure, measure, measure! Remember: how much is a handful? And whose hand? Use actual measuring cups!

Again: "Keep them lean, keep them longer!"

Please!

9
overweight dogs
by on 08/10/2010 09:51am

I think a lot of owners suffer from guilt at leaving their dogs home alone all day, albeit to sleep all day on the bed in the AC (horrible to contemplate, I know!), so the treats and the feeding of unhealthy human foods get priority over a well balanced diet.
I feed my own dogs treats, but we also walk two miles every day to work those treats off.
Most overweight dogs I've seen get fed a lot at the dinner table, and when you ask the owner, they always tell you that "Baby" just won't eat dog food! I have a friend who has a chihuahua that "only" ate steak and eggs, LOL, but I showed the owner how to gradually wean her off the garbage and onto a balanced diet of dog food. She's glad not to have to buy steak every week!
As for the people who cheat vets, when I worked for a 3 vet practice in Virginia, I taught myself how to go after these people in court (they also often write bad checks to cover services), it's not very time consuming and you collect on about 50% of the debts for the most part. Each practice should determine if it's worth dedicating a staff member a few hours a week (for paperwork and time spent in court) to doing this.
I think the worst people are those that bring an animal in on an emergency, you spend hours fixing them up, and then the owner never comes back to pick the animal up or refuses to pay for services rendered.

10
Issue #2
by on 08/10/2010 10:16am

In regards to a stop payment on a credit card, If a customer did this to me, they have better make it good because I that would be their only chance. After that, they would be required to pay the bill in full prior to other services, and following payments would be in cold, hard cash only. If the customer is an arsewhole, I'd would not provide services to them regardless.

11
Muzzles
by on 08/10/2010 11:17am

As a dog groomer I can't even count how many times I have been told "they don't bite"!! When I started my business I actually believed everybody but after a few near misses and actual punctures I quickly learned my lesson!! They may not bite you but I definitely am a different story!
Karen :)
http://www.pawsiblegaytails.blogspot.com

12
by on 08/10/2010 11:56am

I think either some vets are delusional and/or they've given up hope of educating their clients. Recently I worked on a project with some vets and vet students that required BCS to be recorded. There were some who consistently gave dogs a 5 when they should have been a 7+ or even a 4 when the dog was somewhat overweight. Those clients walked away thinking their animals were normal or even UNDER weight.

Rattiemom, I agree that education is important, but as far as I know soy, corn or wheat aren't bad for most dogs. People need to buy complete nutrition foods and tinker with portion control until their animal can maintain the right weight. People come in with their dog looking like a sausage or with all the ribs visible saying "But I give her two scoops like the bag says!" Sigh.

13
by on 08/10/2010 11:58am

Well, my pets are in tip-top shape and are already years old and I never complained about my veterinarian. Or maybe I am just lucky?

14
Veterinarians
by on 08/10/2010 01:21pm

Will we love our Doc. never (cheat anyone). If we knew everything, we would not need our VETS. We thank God for each of you, who care for pets with love and understanding. Thank-you

15
by on 08/10/2010 01:51pm

I confess I once told the vet I forgot my checkbook. Then I raced home to get it and back to pay the bill (no, they didn't keep my dog as collateral :-). Embarrassing.

As for skinny dogs - a few years ago the Humane Society raided a person near here who bred Salukis (she had a few Azawakhs too), claiming the dogs were in poor condition. TV covered the raid, talking about how the dogs were starving. They looked fine to me, for Salukis. And a healthy Azawakh looks even skinnier than a Saluki. They are the ultimate canine ectomorphs. I have heard of several cases of people with healthy sighthounds being harassed by Animal Control. It's even worse if the dog is an adolescent or elderly and not in the best health, in spite of being given good care.

16
by on 08/10/2010 01:53pm

PS. I wasn't meaning to be contrary - your column just made me think of those stories. Fat dogs are one of my pet peeves too.

17
Uncouth Pet Owners
by on 08/10/2010 02:30pm

We have 4 housecats & a newly-rescued German Shepherd. The 14-yr-old cat, Oliver, is crippled & overweight. The other 3 cats are purrfect. The dog is thin, my vet says by about 10 lbs, so we're working on that (who knows how long was loose...) Oliver has been the same weight (minus 1/2 lb or so) since he was 2. His last check-up, my vet said he looked more like 4 than 14.

Whatever my vet says one needs, it gets it. Period. No matter the cost. (Oliver was a "freebie" upon whom I spent $3000 in 1 year, fighting to keep him alive as a kitten from the pound).

Pet owners DO reflect today's society: obesity, yucky teeth, rudeness, & always want something for nothing. But, don't get me started.

BTW - we've sent everything to our vet & staff from fruit arrangments & plants to meal gift certificates & car washes. He charges what he does to make a living - HE went to vet school, not me. But you can never thank them enough for their compassion. And my pets' lives are in his hands.

I can never say "Thank You" enough for (most!) vets!

18
me=fat, dog=thin
by on 08/10/2010 03:29pm

A thin, wiry friend of mine has taught me the secret to controlling my dogs' weight: He looks at his animals and adjusts their food often. For instance, he has mentioned to me that my pit mix needed a bit less food when the pit mix was up 3 lb (not a huge amount to add to a 57 lb dog, but not a good direction to go in).

As a person who has struggled with her weight since adulthood, I tend not to notice the difference in my body until I'm already up 20 lb or so. My friend adjusts his own intake when he is up 5 lb or his pants are just a bit tighter.

My dogs are mostly vegan (Nature's Recipe vegetarian plus added fruit, veg or grain) and have been living to great ages (including a 17-yr-old malamute mix whose weight varied by only 3 lb for 8 years). So it seems that keeping them lean has helped them, and I'm trying to apply that lesson to myself!

I wonder whether many chunky folks with chunky animals, like me, don't think to monitor for small gains?

19
oops
by on 08/10/2010 03:30pm

I meant "chunky folks (like me) make their animals chunky because they don't think to monitor for small gains?"

20
Fat Cat
by on 08/10/2010 03:33pm

How does one shink a kitty wth a weight problem? My cat turned two in June an she's monsterous! I have four cats. They each have their own bowl that I fill in the morning and before I go to bed. So i don't really feel that I overfeed, but maybe I do. My other cats seem fine. My male kitty is large but he's just big. She on the other hand is petite in build but looks pregnant. (she's not, she is spayed.) Any tips? Thanks
(and diet food does not work for her and I cannot afford it.)

21
by on 08/10/2010 04:57pm

One strange client phrase I'll never understand is, "I'd do ANYTHING for my pet, but..." As in, "I'd do ANYTHING for my pet, but I don't think he really needs that senior bloodwork," or, "I'd do ANYTHING for my pet, but he doesn't really need a dental cleaing- his teeth can't be as bad as you say they are or he wouldn't still be eating so well."

I much prefer the people who tell me that, while they love their pets dearly, they still have to pay the mortgage and bills and can't afford to pursue X diagnostic or treatment right now. Be honest with me that the root of the issue is financial and maybe we can find ways to work around it. If I think you don't want the bloodwork because you don't think it's important, then no financial adjustments will make that bloodwork important to you, so I don't even try. And if you refuse my recommendation for a dental cleaning because your pet's teeth are rotting out of his mouth and he's in pain... well, then, you wouldn't really do ANYTHING for your pet, now would you?

22
Vet vs. Clients
by on 08/10/2010 05:18pm

A young boy took his badly injured dog (hit by a car) into my grandfather's clinic for help. My granddad charged him 25 cents. The boy cried and said that his family didn't have that kind of money - mind you this was during the Depression. Doc told him he could bring in a penny every week. Neighbors thought that Doc was TOO harsh on the boy, and that he should have fixed the dog for charity. Doc said that the boy and his family were NOT charity cases... they were just sorta 'poorish' right now. (Doc made a whopping $600+ per month in those days!) The boy paid his bill within 6 mos. and his dog was healthy and happy. His family sent LOTS of business to my grandfather's practice. The young boy became his 'Kennel Lad', and THEN went on to vet school. My grandfather gave him a job when he graduated, and he became a partner, in that same hospital, with my uncle. POINT? No service should ever be assumed 'free'. Philip would probably never have become a dedicated veterinarian... otherwise.

Sure I grumble at the prices nowadays, too. I MISS living around vets!

Fat animals? Sigh! Just look at their owners! It's called moving away from the food dish, and keeping treats to a minimum. My nine month old Doberman gets trained with 'dry' popcorn bits. Works for him AND works for me - we BOTH get the treats!

23
by on 08/10/2010 08:24pm

Number 6 to add to your list...

"I can't afford your vet bill" ... says the client with a pack of cigarettes in his pocket.... or a million tattoos all over her body... both very expensive habits. (Also muttered by friends of mine who are trying to have children. Really? If you are stressed about paying an odd vet bill, what makes you think you can afford to feed children on a regular basis?)

The clients who sparked this opinionated reply took their Very Sick [intact] Dog, along with a handful of medications and SQ fluids, and walked out on their $300 bill. More proof that good deeds never go unpunished...

24
Fat versus Skinny
by on 08/10/2010 09:23pm

I think the main problem here is that people still don't understand this well enough.

They don't understand the ramifications of obesity and they don't understand that 'skinny' is ok. Of course I don't mean skin and bones malnourished, and neither do you.

I wonder if this is still something we are carrying from the past. I know that in my old country, particularly the older generation BELIEVED that a chubby kid is a healthy kid. This was the generation that when through the starvation of World War II. Back then such outlook made sense.

Are our minds stuck in the past?

I do know that there is not enough understanding what the healthy body condition is and WHY among dog owners.

25
by on 08/11/2010 01:23pm

We've had several clients in lately who have taken to hand feeding their (fat) dogs because the dogs just won't eat "well". They'll eat but won't finish. Each one of these dogs was at the highest weight ever. Goodness gracious, do you think these poor dogs were just saying "hey, I'm not hungry"?

I had a vet I used to work for lecture me about my little pit bull girl being too skinny. She wasn't. Yes, you could see her last couple of ribs. Yes, you could feel all of them with only light pressure. This is good! Especially in a breed prone to a) running around like maniacs and b) bad knees. I am grateful that I kept her skinny when she was young, because when she did blow out her knees, she didn't have anything to take off. She's the same weight at not-quite 8 as she was when I sprung her from the pound at a year. I think she looks fantastic.

26
Befriend your Vet /staff
by on 08/11/2010 04:47pm

It is so enjoyable to RELY on the expertise of a Veterinarian....Why some people cannot realize how fortunate they are to have the expertise and advice available, and be open to learning what most vets will willingly teach if one is ready to listen. Some folks cannot get out of the way of their own assumptions and listen to an expert.
Sadly, with regard to the obese pets issue; body dysmorphia can evidently be projected on to ones' animals sometimes. Seems some cannot really see how fat their animals are. Overfeeding does not equal love.

27
More fat cats
by on 08/12/2010 11:51am

My cat is pretty big also (about 15lbs.) and my vet accuses me of over-feeding. I feed Scout 1/4 cup of dry food in the morning and another 1/4 cup at night. She won't eat meat or canned cat food except maybe a little canned tuna on an occasion (she's pretty big on the tuna water). I think she'd benefit from a high-protein diet, but I hate the idea of starving her until she finally caves. Any thoughts on that?

But seriously - it's frustrating that my vet doesn't believe me. I'm sure a lot of clients fib, but maybe she should try taking me at face value just once and see if maybe there's something more serious going on.

28
Depression Inflation
by on 08/12/2010 06:55pm

If Granddad,DVM was making $600/month during the depression that's the equivalent of about $6000 to $9000 now, depending on the exact year. I can't feel too bad for him.

http://data.bls.gov/cgi-bin/cpicalc.pl

As for weight, I know from experience that it's difficult to take off but I don't understand letting it get totally out of control either in humans or animals.

The mini-pot bellies I and Fatcat have aren't invisible and it's much easier to do something about them earlier than later.

29
controlling quantities
by on 08/15/2010 05:34pm

Our current dog is benefitting from our experiences with a diabetic. That's when we started measuring food portions. So from day one the new boy's food has been measured and the meal volume adjusted to account for things like food given during training sessions. So far he's holding at the high end of his ideal weight. I want to take his weight down a pound or two to get to the thin side of ideal.

I do have to say though that, in working with people with diabetic dogs, I do find a lot of confusion over the concept of calories and weight gain or loss. We wind up with a lot of dogs who actually need to gain weight they lost prior to being diagnosed with diabetes and quite a few people do not know how to get their dogs to gain weight!

So I tend to think that a lot of people really don't understand the direct connection between calories and weight lost or gained. That gaining (losing) weight is simply a matter of increasing (reducing) calorie intake as long as there aren't other endocrine problems involved.

I always tell people working with diabetic dogs to forget about the feeding recommendations on the bag or can. Usually way too high. Just figure out how many calories you're feeding now and reduce or increase for the desired goal.

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About fully vetted

Patty Khuly, VMD, MBA

Photo of Dr Khuly

Dr. Khuly is a former petMD blogger and small animal veterinarian in Miami, Florida, where she practices medicine at Sunset Animal Clinic and serves on the board of the South Florida Veterinary Medical Association. She is a graduate of Wellesley College, the University of Pennsylvania School of Veterinary Medicine, and The Wharton School of Business.

As a significant sideline, she writes...a lot. She authors pet health columns for USA Today, The Miami Herald and Vetstreet. She also writes a popular monthly column for Veterinary Practice News and serves as regular contributor to Veterinary Economics, The Bark, and the Veterinary News Network.

Dr. Khuly lives in South Miami with her brood of hens, goats, dogs, cats...and humans.

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