Here are a collection of my most popular blogs posts this month from Tumblr. We’ve had quite the debate about pugs and related brachycephalic breeds
Decisions, decisions, decisions.
A veterinarian makes them all the time. Our training provides us with the ability to offer Gold Standard Treatment to all of our patients and we would provide that treatment with no qualms except for the limitations animal owners often place upon us.
The biggest limitations are time and money. Other limitations may arise because of the pet’s temperament, allergies, reluctance to swallow pills or tendency to only eat food flavored like fish. Cats are particularly funny like that.
In most cases the veterinarian is in a position to offer multiple treatment options for an animal, whether it’s a pet or livestock, with any given symptom. Gold standard, the most obvious good decision, may include multiple diagnostics, intravenous fluids and both symptomatic management and direct treatment. That may be overkill in many scenarios. A dog that’s had a single bout of diarrhea, especially after eating something unusual, probably doesn’t warrant having abdominal radiographs taken, even though it’s Gold Standard.
In some cases, such as in Gastric Dilatation Volvulus, there are only two options: emergency surgery which may or may not succeed, or humane euthanasia. Neither of those decisions are obviously the right one, especially after considering factors like the dog’s age and other medical conditions. There is one obviously bad decision in this scenario though; doing nothing.
If you’re not familiar with medicine then it may confuse you to know that death is often considered neutral. Suffering and pain, especially when prolonged and extreme, are considered far worse. This is why we as veterinarians spend so much time talking about quality of life.
In the above example of the GDV ‘doing nothing’ is the obvious bad decision, and the other two choices are equal, so both these choices become ‘acceptable’ decisions. They’re not great. They’re not black and white. They are definitely two shades of grey.
Cancer treatment is another common scenario where multiple treatment options exist with no obvious good decision. Depending on the cancer type, e.g Osteosarcoma (bone tumor) options may include: surgery, chemotherapy, surgery followed by chemotherapy, palliative care, and euthanasia. In practice, as long as something is chosen with the welfare of the pet in mind, then those choices are good enough.
When multiple good enough choices exist I can make a recommendation but not push one more strongly than the other. I will steer them away from the obviously bad or worse choices but I always assume that an animal’s owner knows a bit more personal information about that animal than I do.
The medical decision spectrum also intersects other decision spectrums in relation to the owner’s finance and ability to care for the pet. An owner might be willing and able to manage a pet’s chemotherapy, but the price tag may preclude it.
Often we don’t get to make perfect decisions. If we put off all our decision making until a perfect scenario presented itself then we’d be paralyzed be indecision. Our job is to navigate the choices we’ve got, do our best, and guide our clients through this minefield into the ‘good’ side of the decision spectrum.
An option might not be perfect, but as long as it’s better than inaction, it’s worthwhile.
The Big Ears Animal Sanctuary receives all the royalties from the sale of ‘Fairy Tales Written By Rabbits’. On Sunday after the book launch I had the opportunity to visit the sanctuary and its residents.
The Sanctuary is profoundly peaceful, save for the occasional crow of a rooster or squawk of a cockatoo. The animals are all relaxed and well cared for. While we didn’t feed them, most were more than willing to walk in out of their paddocks for a scratch or a cuddle.
These animals were all either found as strays, or surrendered by owners with suddenly changed circumstances. Many of them are quite elderly and will be able to live out their days on the sanctuary with members of their own species, indulging their natural behaviours. These are profoundly lucky animals, and this is where the funds raised by the novel are going.
I first encountered Big Ears whilst working as a vet in Tasmania. The one certain way to make friends with any vet is to provide the animals in your care with an excellent standard of living, and Big Ears does just that. Jacqui and Brett Steele were also always willing to take in any stray creature in need of a home, no matter how many of the poor critters I sent them. It was hugely comforting to know that if an injured stray came into the clinic, I could patch it up with no concern about finding it a safe home afterwards.
Of course, some strays I rehomed there generated more vet bills after they arrived at the sanctuary. A certain little pig turned out to be quite a lot of trouble, but Jacqui and Brett never complained. They were always willing to try. There was no such thing as ‘just’ an animal.
Sadly, in 2011 Jacqui was diagnosed with breast cancer. It is a terminal diagnosis, and placed the future of the sanctuary in doubt. Big Ears runs primarily on donations and only survives from year to year.
After initially slowing down whilst undergoing treatment, Jacqui has never given up and Big Ears continues to provide a safe, permanent home for hundreds of animals in all shapes and sizes. There are struggles, of course, and some days are worse than others, but the good work of Big Ears Sanctuary has continues despite this tragedy.
Though I no longer work near the sanctuary, I wanted to be able to help in a concrete, long term way. I decided to write ‘Fairy Tales Written By Rabbits’ for the sanctuary and for Jacqui. I hoped it would bring some comfort on the bad days, alongside royalty payments from any and all sales.
I never told Big Ears that I was writing a novel for them. I wanted it to be a huge surprise, and I didn’t want them to know in case I failed. I’ve sent them a copy of the book today, along with a letter explaining why I have written it, and promising them every scent of royalties from all sales. They should receive it on Friday.
Good people like Jacqui and Brett deserve good things to happen to them. Fate has been uncaring and unreliable, but by our own two hands we can make the world a better place.
All photographs in this post are (c) Big Ears Animal Sanctuary. Click here to visit them.