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Friday, October 3, 2014

A butterfly was born at my dad's funeral






June 10, 2014 my father John Foote passed away peacefully at his home in Jarman  Center Senior living, surrounded not only by his immediate family, but also a terrarium full of butterflies that lived with him in his final days.  These monarch caterpillars were gathered in from the outdoors to live and become chrysalis's  later to be released after emergence as part of the Monarch butterfly restoration project at Jarman Center.  Dad had released the first butterfly that was "born"   when the monarch butterfly restoration project started a few years ago. 
Dad is releasing the first butterfly born a few years ago

  To help put a positive spin on dad's final days, Cindy Pringle one of his care givers,  brought a terrarium with 5  developing caterpillars in to live in dad's apartment.  Dad was able to witness the first caterpillar actually transform into a chrysalis. All 5 of the caterpillars transformed into the chrysalis stage as dad declined.  By the time dad passed away, the first chrysalis was 6 days into the typical 10 day incubation period.  There were some hopes that a butterfly would be born before dad passed, but that was not to be.
Dad and I are admiring the j formed caterpillar ready to become a chrysallis

On the morning of dad's funeral, Cindy brought the terrarium to the funeral.  The chrysalis dad saw develop was just about  ready to emerge. She thought maybe it might happen at the funeral.  If not,  at least these developing butterflies could "attend" dad's funeral .  As Cindy said maybe it is wishful thinking to hope it will emerge, my sister Nancy and I said - " It will.  We just know it"   
The little  terrarium sat to  the side of the alter, just under the statue of the Virgin Mary .  I don't think too many people were even aware of it until my sister's closing comments pointed out the butterflies and how special it was to see the connection of dad's physical  transformation like the caterpillars.  We proceeded out of the church, following the casket down to the hearse.  As dad was loaded into the vehicle, Cindy ran outside and exclaimed " Sally, Nancy the butterfly is being born!"   I literally jumped up, and yelled at Tim the funeral director " The butterfly is being born!!  How fantastic" and ran back into the church.   Sure enough, there was the butterfly just hanging out of its old shell slowly unfurling it's wings.  Nancy grabbed the I pod  - I grabbed the laptop with my sister's family in Switzerland  on SKYPE, so they too could witness this miracle.   It was so wonderful to watch the little wings open up with friends  crowded around this little terrarium.  It only took about 6 minutes for the wings to fully open and to really see how beautiful it was.   The butterfly was invited to the funeral diner and  later that afternoon my sisters and I with residents from Jarman went to Wimple Park in Tuscola to release it.
Many of the residents came along for the release

Nancy, Barb, and myself with the butterfly at Wimple Park

There is an abundance of Milk Weed near the entrance to the park, by the small creek.  The butterfly  climbed onto  my sister's fingers lingering  for a few minutes before  resting on a nearby milkweed.  It was a female, fitting since dad had 3 daughters and 2 granddaughters as his offspring.  The butterfly flew off into the wind, strong, agile and knowing exactly what it was and where it needed to be.  
  This experience was so like my dad's  nature.  Positive, forward moving and in tune with nature.     Although dad is buried in Chicago, now I have a local place of remembrance also  filled with nature.   When I go here, I notice all the birds, butterflies and other creatures that make Wimple Park home.  It really helps me remember to be present in this moment with everyone I encounter.

 Maybe to some it was just a co incidence that the butterfly  emerged  at the end of the funeral.  I won't argue with them.    For me, I felt there was a reason for that timing, and it has been one of the most uplifting experiences of my life, helping me through my grief over losing dad.  As a veterinarian I have heard lots of stories from families about how their pets helped them spiritually.  One woman related how the family dog would find personal items of a daughter that had recently passed,  and bring them to a family member having particular difficulty with the daughter's loss.  This little dog was trying to help a person in grief take those difficult first steps of acknowledgement.  Another friend told of how the family cat laid with the dying elderly mother right up to the end, and then would not leave the body when the funeral home staff came.  The cat kept finding a way to get back in the room to lay right on the woman slowing down the transfer process as if on purpose.   Personally, I don't think any of these situations were just co incidence.

There are many more stories like these where animals - be they pets, butterflies or any other creature have appeared when someone  needed a  sign that a spirit is still here.  For many of us, this is a wonderfully strong affirmation of our belief in life after death.  Personally I don't think it is crazy - I think these connections of animals and the spiritual is  real.  The longer I am a veterinarian, the more often I witness that animals are angels among us.
Me and my dad

I hope for anyone in grief that you too have an affirming experience - your butterfly moment.   Be open to the world of nature around you, especially your pets.     I hope it gives you a sense of wonder and awe as it did me and my family.
Thanks, Dr Sally J Foote  
    

Tuesday, April 22, 2014

Storm safety plans - everyone needs one!



Tornado / Storm safety drills for pet  watch here  
Do your pets know where to do when a storm is coming?

I recently presented a thunderstorm phobia - storm safety plan talk  in my community  - Tuscola Illinois.  Our town was lucky  to escape the touchdown of  tornadoes that passed through central Illinois last November.  A few homes in rural Tuscola were badly damaged, and I thought about this as April approached.  I wondered how many pet owners have trained their dogs and cats to quickly come to the basement, bathroom or into their crate when a storm is approaching?  My staff and I began to ask clients on every exam how well their pets would go to a safe place.  The results varied with many clients admitting to not having a plan.  I made it a point at my presentation to include how to train one's pet to go to a safe place no matter how calm the pet was during storms or afraid.  Here is the information for you: 

 storm safety plan for dogs: 
First, set up a comfortable storm safe area.  For the  basement, put a blanket  for them to lay on.  Some dogs like to lay on the concrete or tile and that is fine.  There is some theory that this may be grounding the pet to reduce the electrical charges in the air that they sense.  If your dog like the concrete then don't worry about a blanket.   
Second, hang a leash near the basement entry.  Use the leash for fun things like a walk, or going to the park so your dog will like the leash.  A 6 foot leash,( not a flexi type)  is best.  Using the leash  will help your dog to know where you want them to go, quickly and you will also have a hold of them to prevent escape. 
If you have multiple dogs, have a place you can tie  the leash in the safe room as you can gather up the other dogs.  This will prevent one from getting out  as you get all your pets in.  A grab bar meant for showers can be installed low on the wall to tether them.   
make the tether spot fun - use a food puzzle

Here is the drill:  Do not feed them dinner out of the bowl.  Put the food nuggets in your pocket and call your dog to you.  Give them a few nuggets  for coming.  Walk towards the leash and give them food as you walk to the leash, attach the leash and go to the basement/bathroom door.  Reward as you open the door, every few steps into the bathroom/basement area.  The key is to keep the dog focused on the reward every few steps .  Toss kibble into the tub to get your dog to jump in.   Step into the tub yourself with your dog and lots of reward here.  You may need to be in the tub with your pets during a bad storm so get them used to the huddle.  If you can have a cd player that plays heavy rock music in your safe room to calm your pets.  Avoid radios that will sound alarms which may startle your pet.   Repeat this drill every few days so it is fun and automatic.  Then when the big storm comes you will have a plan that your pet knows and everyone will be  a lot  more calm and safe.  

 Storm safety plan for cats  -   First train them to go to their carriers easily so  you can take the carrier to your safe room.  Even in a hallway, the carrier increases the safety for your cats.  
  Cats don't like their carriers because they  are only used to go to the veterinarian.   The goal is to get your cat to love running into the carrier.
yes, cats can love the carrier

 First,   keep your carrier out at all times.  Make it a part of the family room furniture.  Put a favorite blanket in it.  Do not put your cat's food out for a day.  Take the food nuggets and toss them on the floor around the carrier.  Make it a game by tossing just one nugget at a time around and then into the carrier.  This is a great way to play with your cat.  If the dry food is not enticing enough, then try small bits of tuna or other tasty treat tossed into the crate.
When your cat will run right into the carrier for a treat, close the door without latching it.  Just close the door and then allow the cat to come out after eating.  When the cat is eating the food with the door closed, then go to latching it.  Keep practicing calling your cat - tossing nuggets into the crate and latching the crate door as your cat is calm in the crate.   Now you can put the crate in the bathroom, take it to the basement or leave it in a windowless area.  

Watch  demonstrations of storm training  on my youtube channel drsallyjfoote.  You can get there directly from my clinic home page by clicking the you tube button on the home page.

If your dog or cat is nervous on the storm days,  there are non sedating medications available to calm your pet.  If your pet is too nervous to take a reward, they need anti-anxiety medication or supplement to help them.  Adaptil pheromone collars help many dogs, lasting 30 days without any side effects.  Supplements such as Zylkene, the milk calming supplement or the Anxitane can also help.    The right product for your pet  determined by your veterinarian knowledgeable in behavior, will help your pet be more calm.  There is more storm information at  my  clinic website www.okawvetclinic.com  that may help you.   I also offer consults for storm phobic dogs and cats to get them on the right medication, supplement, and safety plan. 
carrie is all set for storms with her Thunder shirt!
Thanks Dr. Sally J Foote Okaw Veterinary Clinci Tuscola Il 217-253-3221




Sunday, February 23, 2014

Senior dog dental care can turn the clock back - Abby's story

Abby is a sweet, timid terrier mix who loves  her walks and play time.   At 14  years old,  age has caught up with her.   Arthritis has crept into her back and other joints over time. J/D diet, joint supplement and anti inflammatory medications  have helper her over the years, but she was recently slowing down.

Abby's teeth were collecting more tartar causing inflammation as she aged.   Brushing her teeth regularly helped to decrease the speed of build up, but as time progressed the tartar grew.  For us to really help her, a full dental under  anesthesia was needed.   Abby is not a young dog - 90 years would be her human age equivalent.  So, understandably, the risks of anesthesia are a big concern.  It was clear that she was having  increasing pain from her mouth,  so her quality of life was decreasing.  At this point, the benefits of a dental cleaning  were out weighing the risks of anesthesia.

 I talked to the family about the risks of not removing the infected  teeth versus leaving them in.  Intermittent antibiotics could be used to give some relief, but there were risks of creating resistant infection, and rarely can the antibiotic have a real effect on the pain. .   I outlined how staging her dental procedure was important.  This meant  we would  start her on antibiotic ahead of the dental to decrease the amount of bacteria released into the body during the procedure.  We ran blood  tests  to screen for any kidney and liver problems . Knowing her internal  health  helped me  pick the safest method of anesthesia which reduced her risk.

On the day of her dental procedure, Abby was put on an IV catheter with fluids, heart and oxygen  monitors with a  Certified Veterinary Technician  directly assisting her anesthesia through out the procedure.  Local anesthetic nerve blocks and pain medication were given during the dental to minimize while her her anesthetic level while controlling pain.  I had to remove number of teeth and treat gum   pockets around the remaining teeth to address  infection.  Infection  is not apparent when you just look at a tooth.  It is by careful probing, measuring gum pocket depth, and even dental xrays that a veterinarian determines the best treatment.  She did great through out  the procedure with careful monitoring and care.  When   Abby  went home her mouth was comfortable and her pain was well managed.  I dispensed additional pain medication and soft A/D food to feed her as I I was concerned she may not want to eat well for a day or two. 
The brown tartar is hard like a rock and holds a lot of bacteria

One of the techs called to see how Abby was doing the next day.  We do follow up calls to see how everything is at home, and I was anxious to know if Abby was able to at least eat and drink. .  When the tech  talked to her owner, they found out Abby was eating and active and even playing !    A few days later Sue, the owner,  marveled at how much more lively and playful Abby was.  Abby was  getting up on the furniture now and playing with the new kitten the family had adopted. They felt she was much healthier and happier than she had been for a long while. .  All that inflammation and infection was  gone. It was so hard to tell what was affecting Abby before the dental, but with her sudden improvement now we knew it was the teeth that were affecting her.  What a wonderful change.

Dental care in pets is not as straight forward as it is in humans.  Dogs and cats can not brush their  teeth or complain that their gums are sore.  They find ways to avoid the pain by chewing on the opposite side, avoiding chew toys, or being less active due to the chronic pain.  It is easy to miss these signs especially if you have an older pet.  Witnessing the transformation of Abby was a big reminder to me that teeth are at the core of physical and even behavioral health.  I have had cases of aggressive pets who became very sweet after removing infected painful teeth.  Yes it is scary to think of the anesthesia.  Veterinarians have a very difficult time working on teeth without the help of sedation and anesthesia.   Even the best pet will not tolerate someone scraping and probing the teeth.  If you find a painful one - they will react against you due to the pain.  So deep sedation to anesthesia is important to provide the best dental care.  Staging the dental, by addressing the health before the anesthesia and taking extra care through IV fluids, pre-dental antibiotics or anti inflammatory medication  are some ways to reduce the risk for an older pet.
I used a special dental rinse for Butter scotch as he aged to help his teeth
  If you have an older cat or dog with stinky breath who  moves slowly, it is very likely the teeth are a problem .  Take your pet in for a dental exam.  We have photos and ways to explain how the tartar is pushing infection into the mouth and putting the heart, kidneys and liver at risk for damage.   Treating or removing the problem teeth is important to remove the source of chronic pain and inflammation in the body.  Staging dental care  to prepare your senior pet will  greatly reduces any risk. .  Abby is one example of how a dental can make a difference.

Thanks Dr. Sally Foote


Sunday, January 26, 2014

Mercy's Paw Report spot - Cognitive Dysfunction in dogs and cats

Many of you who have been to my clinic have met Mercy, our older office cat. 
Yes,I am old. I still have a life that is good
She is now 18 years old and coping well  with her aging problems of arthritis, hyperthyroidism and  blood pressure concerns.  She is on  joint diet, supplements and now medications to manage these things and is doing pretty well.  Her vision is decreased due to the increased blood pressure damaging part of her retina ( it is controlled now but is still a concern) so this makes her anxious when the front office is busy.  She rests in her kitty condo in the back and  before our day begins she has time to socialize with the staff.  Her life is still pretty good.

 Kate Pleasant, the hostess of " The Paw Report" on WEIU TV  pbs ( here is a previous episode )  asked me to focus on senior aging for an episode.  The episode will air Monday January 26 at 6:30 pm central time.  If you live in Central Illinois/Western Indiana it is channel 6 - or you can watch it online here.   We talked about Cognitive Dysfunction Syndrome  (CDS)  in dogs and cats. CDS is a syndrome, so there are a group of signs that develop in pets as they become geriatric.  It has been recognized in the dog for approximately 20 years, and in recent years has been studied in cats.As we discuss on the show, CDS has a number of signs that can be confusing for an owner to interpret. If there are other aging or health problems, the signs that look like CDS may be due to another problem, so it is essential to have your older pet keep up with health maintenece checks and screening tests yearly.
Mercy, a grand dame at 18 years

What are the signs of CDS?  Think of DISH - Disorientation, Interaction, Sleep, Housetraining.  So if your dog walks into the family room and stops, staring into space like " why did I come in here?"  or stands at the hinge side of the door to go outside like they are confused, it may be CDS.  If your cat is going towards the room where the litterbox is, then stops and paces around like she is looking for something, it may be CDS.  Does your cat or dog greet you when you come home?  Do they bark or meow and seek attention from you or housemates like they usually would?  Some dogs and cats will wake in the night as if they need to relieve themselves but don't.  They may want to be fed or just meow loudly.  This is the sleep cycle interruption we can see with CDS.  It is very irritating to owners.  Houstraining problems can be seen as well in both dogs and cats.  If your dog is by the door but suddenly goes, it may be CDS.  In cats they may get lost finding the litter box.   Answer the questions here to see if your dog has CDS     Here is an article explaining the signs in cats

  These signs could also happen in a blind, arthritic pet or one with kidney disease.  This is why it is so important to bring any of these signs up to your veterinarian.  There are alot of ways to help your older pet with medical problems  and they will  feel better, relieving some of these symptoms.  Our cats seem to suffer the most before an owner brings them in  for care.  Please do not wait.  Age is not a disease.  When they are showing these signs, it is difficult for you and your pet.  Find a veterinarian who offers senior pet care, and is knowledgeable in senior pet behavior to help you and your senior pet. I have had a number of senior pet patients  where it was not clear if they had early CDS or other problems.  With a little investigation we were able to adjust pain medication and diet which helped a number of them.  Just focusing on signs is not enough.
my beloved Butterscotch - he still asked for walks but neeed some reminding

 In my 30 years experience as  a veterinarian, the most common early to mid stage signs of CDS in dogs is disorientation and interaction.  From this I have also seen an older dog become anxious about noises, or being left alone unlike the past.  My own dog Tropper developed a lick granuloma, a spot that he chronically licked on his back leg despite good pain management for his arthritis.  When he went on Anipryl, one of the approved medications for CDS, he stopped licking his leg and was less upset about loud noises.  In cats the most common signs I see are problems finding the litter box and night time vocalizing.  Both of these problems really upset the owners and they may think the cat is just being naughty.  Many of these cats are also dealing with arthritis in the lower back or elbow making it difficult to get to the litter box or sleep normally through the night.  This is why it is essential to bring any cat over the age of 10 to regular yearly check ups.  I know, your cat may not like coming in - there are ways to make it better for your cat!  CJ is an example of an older cat who changed her mind about us with our gentle handling - here is her you tube video   
Amazing CJ - she likes her exams now at 16 years young
Seek a veterinarian who offers less stressful, fear free visits for cats ( and dogs!) when you need to bring your pet in.  I have many videos on low stress handling on my you tube channel ( http://www.youtube.com/user/DrSallyJFoote) that you can see and even try some of the ideas with your veterinarian.

 There are many treatment options for your dog or cat to help with CDS.  B/D diet by Hills, supplements  such as Novafit, Neutricks and Senilife are available.  Anipryl by Zoetis is also an option.  A veterinarian knowledgeable in senior pet health and behavior can help you and your pet make the last few years good years.  You and your best friend will feel a whole lot better.   Thanks and here's to wonderful days with your super senior pet.
Butterscotch, me and Bella at the office

Saturday, December 21, 2013

Instruments of terror -  what sets fear off in our pets at the veterinary office



 cat carrier = fear if exams are scary

Last week as I was holding a spoon of baby food that an anorexic cat was finally eating, my tech laid the ear thermometer on the floor next to me.  The cat took one  look at the thermometer, stopped eating, turned away and crept to the back of the cage as I stayed motionless with the baby food.  I asked her to remove the thermometer and when she did, the cat came right back up to me eating the baby food. 
So what was happening here?  The thermometer was an anxiety trigger to this cat.  That one item - an ear thermometer- was enough to shut this cat down.  How often have you had a happy dog suddenly snarl and become agitated  just before an injection is given?  Very likely this dog saw the syringe and that triggered the aggression.  That dog remembered the pain and irritation that the syringe injection gave.
If you don't have a reward, all this dog will remember is the pain
 When I present to veterinarians and technicians, some  of the audience acknowledge the trigger effect of our equipment.  They too have had an episode like the one I had with the cat.  Others can not believe that something so innocuous as a thermometer could set off that much anxiety.  These instruments are triggers.  They are items, or settings that predict for the pet what is coming next which may be unpleasant. 

These are some of the most common triggers that I see ( and my face book friend have added!)
                Stainless steel topped tables       small room syndrome - the close quarters of an exam room
               syringe and needle attached       white coat/smock/scrubs - especially on the DVM
               thermometers                              otoscope
               Stethoscope                      nail trimmers          electric trimmers             
Here is the challenge.- how do we perform our work, needing to use   these instruments and avoid setting off fear aggression and anxiety?   Here are a few tips that have helped reduce the anxiety and aggression we see from patients. 

1.   Hiding these triggers is a first step.  Be creative.  When you have drawn up the vaccines, keep the syringes hidden under a paper towel or piece of paper.  Hold the thermometer palm down so the pet cannot see it.    Cover your table with a beach towel to hide the stainless steel.  Use a towel or blanket as a hood  or a calming cap ( from the  thundershirt company)  over the pet( dog or cat's) face so they cannot see what is happening.   
2. Reduce  pain and discomfort when  using these instruments.  Use lidocaine cream around the rectum and wait a few minutes before using a fecal loop or rectal thermometer.  Smaller gauge needles (25ga for most injections)   reduces pain during injection.  Give pain relief before a procedure such as oral buprenex.
Latex gloves + pain unless you use lidocaine
3.  Reduce the anxiety the pet is feeling.  Try the pheromone products early and often.  Adaptil may take 5-15 minutes to help reduce anxiety.  Give the client a bandana to put on their dog so it is taking effect in the waiting room and during history taking.   Spray feliway on a paper towel to rub on the door of the carrier and on the exam table.   Offer food reward, verbal praise and petting that the pet enjoys throughout the steps of the exam and treatment. 

Here is a video showing how varying the triggers helps a nervous dog in for an exam  nervous dog exam you tube video

  Whatever steps you take with a patient to reduce anxiety,  record it in the record.   This will save staff  time and improve every visit for that pet. I have a medical record labeling system  Bella Behavior Label System available at wwwldrsallyjfoote.com to make this easy.   It is essential that  the doctor is a part of  stress reduction for this pet. Technicians can take the lead by suggesting  they removing the lab coat or hold the syringe so the pet cannot see it.   Tell your doctors what you notice when the pet became tense and that you want to try reducing anxiety by removing a trigger or 2 and see the effect.  Some of us doctors get so engrossed in doing the tasks of diagnosis and treatment we don't pay attention to  what may be triggering the patient's anxiety.  We can't see how the animal is responding as we bend over to look in an ear or are at the rear of an animal.  Doctors - be open to changing a few things for the benefit of your patients and your staff.  Everyone wins when we decrease fear in the veterinary clinic.
This little dog took rewards because I left my lab coat off - the Bella system reminded me to do this Bella Behavior Label System                  




Dr. Sally J Foote DVM CABC-IAABC   www.drsallyjfoote.com