If "denial" is a long river (I know, bad pun), then veterinary medicine offers a zillion ports of call. Unfortunately, I deal in denial daily when it comes to my clients’ take on their pets’ well-being.

It drives me crazy. And it would you, too, if you were a fly on the wall of my exam rooms. Because it’s easy to spot the denial that inevitably happens when you’re a rational outsider. But as a heavily invested party? Not so much.

Still, I know from personal experience that when evidence of my own denial is presented to me in non-judgmental terms, I’ll often take a step back in service of the almighty objectivity I know I can sometimes muster, even when it comes to my own furred family members.

With that kind of personal success in mind, I’m hoping I can help head off some naysaying behavior in you, dear readers, by offering up the top ten areas my experience suggests are those most likely to earn your denial:

1. Weight

Yeah, that’s always number one. Food is love. And nowhere more so than in the U.S., where our vision of the ideal pet weight is skewed. You doubt? I challenge: Tell the next owner of an overweight pet that their pet is fat. Now you know how I feel on an hourly basis.

2. Aggression

"She doesn’t bite." Which is always rapidly followed by, "She never did that before."

3. Trauma

Another reason to say, "She never did that before." As in, "She never jumped out of the truck before." Or, "She never got over the fence before." Need I go on?

4. Dental disease

"She has bad breath and I see all the green stuff on her teeth and the white stuff dripping from them, but she eats so how much pain can she possibly be suffering?" Dante’s circles of hell surely will make room for people who speak thus on their pets’ behalf.

5. Anything requiring anesthesia

It kind of irks (OK, so that’s an understatement) to have people agree that their pets are suffering but then decline to help them on the basis of the anesthetic risk. Still, I hear it every day.

6. Spaying and neutering

Ordinarily, I’m not a stickler. I’m one of those veterinarians who considers a spay or neuter an elective procedure, not a mandatory one. However, when your boy dog has a prostate the size of a melon, or your girl dog a uterus teeming with pus … well, then, you’re an idiot if you remain in denial.

7. He doesn’t have that disease.

OK, so here’s where an owner’s lack of trust will sometimes translate into an uncomfortable back-and-forth. Depending on the owner’s emotional state and our history, it might take a month or more for the diagnosis to sink in. In the end, however, it’s always the pet that suffers.

8.  How can he have that disease?

A corollary to 7, this is slightly different in terms of its emotional starting point. It’s the Kubler-Rossian form of denial that often accompanies death. But here, owners are sadly and understandably feeling bereft when a horrible diagnosis has just been handed down. They just don’t want to believe it.

9. She doesn’t need vaccines.

An understandable sentiment. But almost always unwise unless the pet lives in a biological vacuum.

10. We don’t need to spend money on testing.

OK, so why are you here, again? By definition, your interest in seeing a medical provider for your pet presumes an interest in testing — whether by physical examination or otherwise. But maybe I’m just being presumptuous …

Got any more denial hot zones? I'm all ears.

Dr. Patty Khuly

Pic of the day: "Luna in denial, ringing out the old Year of the Dog and in the New Year of the White Tiger 2010" by Beverly and Pack