Treats are not bribes - especially at the vet office

If you have ever brought your pet to my clinic, you know that every single staff member  will try lots of ways to help your pet be less upset during the visit.  Over the years we have become very creative  using towels, treats, happy voices and even taking off our white coats to make the visit less stressful.  While this may seem like a lot more work at first, it really saves a lot of time and work in the long run.  And that is what really counts - the long run.

This how I examine a timid cat

 High volume    - get them in get them out veterinary visits are easy on the pocket book but not on the  pet, vet or owner.    Why would I want to just rush you in and out?  This approach leaves  little time to fully  examine your pet and inform you about what is best for your pet.  The wham - bam approach leaves you to the internet, magazines or television to get your pet information which is not always accurate..  Rushed visits taking your   to "the back"  it often increases the stress for your pet.  "What are they doing to my baby?" you may wonder. 

 Many clinics focus on efficiency by taking the pet to a treatment area where the trained technician and veterinarian work together.  Many lawyers have strongly counseled veterinarians  to take this approach. Why?   Owners who become bitten, scratched have sued veterinary clinics even when the owner insisted on restraining their pet. Often  these  owner won large monetary judgements so the resulting solution was do not allow the owner anywhere near the pet while at the vet.  So the legal advice focuses on the liability of the veterinarian ,not the pet's experience and behavior.At our office, we use our technical staff to reward the pet in all areas of the office. This will take a little more time the first visit or 2, but soon the pets are co operating much better to go to the exam area and we allow the clients to stay as the techs handle the pets in a low stress manner.  It is a win -win for pet, staff and owner.

treats in the waiting area - calm not nervous

Through all of this, we have ignored the effect on the pet.  Finally the tide is starting to turn.  Veterinary technicians, assistants, and veterinarians are becoming educated to identify pets showing anxiety and pain during the veterinary exam.  The early signs of fear need to be recognized to change the methods of handling to reduce stress on the pet.  This is a new concept in handling animals.  Classes are not routinely taught on this in college - it is at the post graduate convention level that many veterinarians and staff are learning how to reliably read the signs of low grade pain, fear, and aggression.  When we immediately start to offer treats or use a calming spray, our  clients comment about how this exam is one of  easiest exams on their pet ever.  They are often amazed when their little terrier  now accepts the muzzle with treats and is not attempting to bite.  The few minutes of rewarding, and reducing stress makes each visit quicker, more complete and safer for the staff and the pet. .

this dog hated her nails clipped until she got treats

When clients call around looking for a veterinarian, often the first questions are about the cost of care. Sure care costs money and there are different prices at different clinics.  Not all clinics are managed, staffed and operated exactly the same.  This is often where the price difference comes in.  When a clinic takes a minimum of 30 minutes for a wellness exam, they charge more since they have more time and staff involved.  This time is often spent in making the exam less upsetting for your pet, as well as time to help educate you.  Ask the clinics you call what will they be doing - ask if they use less stressful handling techniques and rewarding.  If they stumble to answer - keep calling around until you find a place that puts your pets mental/emotional needs ( and yours) equal with the physical needs.

Even cats get treats during exams!

  Yes, my clinic charges more than some others in my area - and charges less than others too.  When you come here you get that longer exam, the licensed Certified Veterinary Technician, and time with me, the doctor doing all we can to decrease the stress of the visit for your pet.  I am committed to less stressful handling and rewarding during exams because it is in the best interest of your pet and my staff.  I cringe now when I see  a dog trembling in fear at another clinic and more and more handlers are called in to restrain this fearful dog.  It can be better. See my videos on my youtube channel drsallyjfoote   and you will understand the difference.

As I present the concept of Bella Behavior - rewarding and recording what helps this pet to have the least stressed exam - I see staff starting to understand how and why low stress handling is best.  Practice by practice change is happening.  Be a part of that change by choosing a low stress clinic.

Good Bye Butterscotch - you were a great teacher

Butter still liked his walks as he aged

About 2 1/2 weeks ago, our beloved yellow lab mix Butterscotch had a stroke.  He started off with some increased stumbling and balance problems on Saturday night, that progressed the next day to a full blown head tilt and falling to the side.  Despite treatment, he became worse over the next day and my husband, daughter and I made the decision to end his difficulties by bringing him to a friend DVM for euthanasia.  It was difficult for us, and Butterscotch was able go go peacefully with Tom and myself at his side.  We miss him, and Bella is adjusting without the big guy.   You read an awful lot about the crazy Bella dog, but now I will tell you about  Butterscotch. .

Butter loved to have a toy in his mouth all the time

Sissel - the super senior at the pet show

We adopted Butter from the local shelter about 7 1/2 years ago at an estimated age of 8.  He was picked up as a stray with a leg so crippled with arthritis he could not walk on it.  He was gentle, friendly, and looked like the first dog Tom and I owned.  When I saw him, I knew we had to keep him.  Our dog at the time Sissel was getting a bit older and we needed  to have the back up dog to avoid the empty house syndrome after the older pet dies.  Sissel was not always receptive to other dogs so, I thought let's have them meet  and see how it goes before making a commitment.  Do pets know what we need and want?  Sissel just came up to him, sniffed him over, and laid down and ignored him.  There was not tension, no staring, guarding or anything.  Butter was his usual laid back self so home he came.  The two of them always got along - no fighting over toys, food, space or anything.  Butter thrived on medication to reduce the pain in his knee, joint diet and daily walks.  He was such a loveable dog around people and kids he was almost perfect.

One day while walking him, he saw a dog across the street - he immediately wanted to rush up to that dog in a very forward and not exactly friendly way.  The dog was a little toy breed and the manner that Butter hunkered down with his head level, silently stalking I knew right away - we have some predatory aggression here.   A few days later in the back yard  he quickly lunged after a squirrel using the same manner  and I realized this dog very likely predated on small furry animals, so he has a strong predatory aggression drive.  There was even a time Butter got a squirrel in his mouth and Tom had to wrestle the poor creature out.  I learned very quickly that not all dog aggression presents the same.  Some is very specific to the situation - such as predatory aggression but is still something to manage and watch out for.  From this incident I knew Butter would not be a dog to have at a dog park.  He would very likely aggress on a small dog badly and there was no way I would take that chance.  Butter did not get into a fights with a little dog, but there were a few close calls when little dogs off leash would come trotting up to him and we had to get him away.  It was very surprising to people who knew how friendly and sweet he was.  I guess that is my point - Butter showed how there are different types of aggression and it takes a specific situation for it to show up.  One aggression screen does not screen for all types of aggression.

a calm moment with Carole

Butter had thunderstorm phobia.  I never had a dog with this problem, but I was aware of other client's dogs who were affected.  I had been reading on new treatments using pheromone products and other medications but I was not really clear on what worked best.  The first time we had a storm with him home, the kitchen table started shaking.  I was wondering what was going on when I saw that Butter was trembling and laying against the legs of the table thus causing the shaking.  I could not coax him to settle and I could see him drooling and panting and pacing.  I had just gotten the DAP/Adaptil collars in so I ran back to the office and put one on him.  He settled down after 10 minutes which made us all feel better.  Over time I learned more and developed a plan that had Butter sleeping through many a storm.  From my experience with him I wrote out Butterscotch's play list of songs that soothe dogs through storms and my blog entry Thunderstorm nightmares no more showing how to set up an area for a dog to calm during a storm.   So, Butter is still helping other fearful pets learn to settle and calm with fears.

Butter was a wonderful guest on television .  He appeared on CI living Champaign a couple of times and was on the Paw Report with WEIU twice.  He was such a hit at the stations.  When I would walk through he greeted everyone at every desk and they loved to pet him.  I don't think he ever upstaged any host and he was very polite about any bathroom needs taking care of that before we entered any building. He is also featured on some of my instructional videos on my clinic website www.okawvetclinic.com  again, teaching clients, veterinarians, and technicians about rewarding during the veterinary visit to make it less stressful on the pets and everyone.   So, again he is still teaching others about behavior and good pet care. 

Every pet has a special place in one's heart.  Butter certainly has that in my families.  I do miss him. My sadness is passing and writing about his gift of teaching here really helps me to accept his loss. If you have also lost a pet - I sympathize with your loss.  It is never easy to go through.  I hope that you too can see he ways your pet has helped teach you about life and that those memories give you peace.

Dr. Sally J Foote CABC-IAABC

Pressure fit custom cat tree

Merry Christmas Ranger and Mercy

Cat tree for Ranger and Mercy

Putting a cat tree in a home is an environmental enrichment - something to make the inside more exciting for your cat.   Many clients agree it is a good idea, but won't do it.  Why?????   Most of the objections that  I hear are - they are ugly - too big - I don't want to put any screws in the walls - they clash with my decor.  I saw an idea or a pressure fit cat tree on http://www.ikeahackers.net/2011/12/stolmen-cat-tree.html website and thought that would be a great addition to our waiting room for Mercy and Ranger.  It would also serve as a demonstration of a cat tree that would answer a lot of those client objections. 

here is the sketch following the website ideas

 I thought I would enlist the help of my husband Tom Wold.  He is really good at scrutinizing the details of a project and constructing unusual things.  After a few lively discussions, he understood that I wanted absolutely no brackets or screws to be put in the walls, floor or ceiling. He was concerned that a very active Ranger would knock the tree loose.  I doubted that would happen, and  I needed a solution for the clients who refuse to have anything mar a wall.  Some of the other important features were  a cubbie off the floor with a bunny hole for a cat to go from the floor into the cubbie then out the top.  This would provide an  escape hatch from a big dog or other threat.   Spacing the shelves to make it easy for Mercy with her bad hip to navigate was also important.  I knew fleece was the way to go for covering the shelves.  Cats love fleece and it is easy to clean.   Working out the details on paper before starting  made the whole process easier.

Supplies needed :
1 Stoleman pole - IKEA  online   (or store)   it will extend up to 129 inches!

1- 2 boxes of Stoleman pole brackets - there are 4 sets  to a box and one set per shelf  is needed 

carriage bolts, washers and nuts

2 inch long carriage bolts  you will need 2 per bracket installed

4 washers per bolt on the brackets -

1 7/8 inch hole saw  - this size worked

drill and bit for carriage bolt holes

jig saw. sawz all, or hand saw -

shelves -  1 X 10 inch shelving  2 - 20 inches long  2 - 24 inches long 
1   24 X 24 inch plywood ( base of cubbie) - this made it like an end table too
1 12 X 24 inch plywood ( top of cubbie)
2 12 X 15 inch plywood ( sides of cubbie)

recycled wood from the old cabinet - free!

             I reused  the  wood we saved from an old cabinet we took apart years ago

1 yard fleece fabric  54 inches wide - all fleece is this wide -

Rubbermaid shelf liner 

The cubbie end table replaced the function of the table that used to be in the corner  The bottom of the cubbie was the 24 inch square cabinet door, and the top another 12 by 24 inch door.  Luckily the edges were already rabbited so the plywood sides were easy to install.  Tom used a jig saw to cut the bunny hole.  You could use other kinds of saws - just be sure to smooth out the edges.  We made the hole 7 inches by 7 inches on the top and bottom.

marking the placement of the hole saw and bolts

Tom drew out a template for placing the drill holes for the pole and the bolts.  This made the placement very exact and consistent.  He drilled the pole hole 5 inches from the end of all the boards 

washers in place with brackets installed loose

finished boards

The pole hole and bolt holes were cut then the brackets installed.

First Tom extended the pole to fit the  ceiling height including the ceiling board.  Then we took it down to the floor for assembling the shelves.  

sliding the first shelf/cubbie on

This is the awkward part - not too bad really

measuring the distance desired between shelves - then tighten

Now  slide the shelves onto the pole with the plastic sleeves in place, then tighten using the wrenches supplied.  This was the fiddly part that frustrated Tom the most.  It really was not that hard, just a bit awkward so be patient with it.  Figuring out the distance between shelves and the way we wanted them to point was a big help when putting the pole together.  All Tom had to do was install the first shelf, then measure up and put the next one and rotate it into position and so on.

pole is now set to go up

Time to put up the pole.    The base plate was in  position  and ceiling board was nearby. 
 In one motion,  Tom hoisted the pole up like a Christmas tree and slipped the board on the ceiling.  I just held the center of the pole to keep it in position as he adjusted the base to fit the pole snug against the ceiling.  Hooray!  The pole and shelves were up and almost ready.  The whole process to install was quick and easy.

Painting the shelves would come later - I wanted to get the fleece up so Ranger and Mercy could start to investigate the cat pole and enjoy it.
.

measuring wall distance for plumb

cutting the rubber shelf mat to fit

The actual laying/perching area of the shelf is about 14 inches long, so I cut 12 inch wide strips from the width of the fleece, then folded that about 4 times to make a thick soft cover.  Cats really love fleece - better than carpet and it would be easy to wash.  The Rubbermaid shelf line was cut to fit the surface and this prevents the fleece from slipping on the shelf.

little cups for finding food

  Ranger can be a little slow figuring things out at times, so I got some small dishes at Pier one and put some of his food in them.  Putting the dishes up on the shelves rewarded him for climbing the pole and is also a way to encourage your cat to "hunt" their food.  We also re oriented some of the shelves after it was up.  All we had to do was loosen the brackets a little, rotate the shelf the tighten.

As you can see, Ranger likes the pole.  Even Mercy has enjoyed the cat tree.  There are at least 4 more perching places available in the clinic for the cats  expanding their space. .  There is also the cubbie for times when Mercy wants to hide out.  It has held up well and we are showing it off  to clients to encourage them to understand what their cat needs.

Merry Christmas Ranger!

 You could decorate this any way you like to have it work with your home. Shelves could be made of fine wood that is stained, the  pole can be painted or even wrap fabric around it to beautify it.  Wrapping the pole with jute rope would make a great scratching area for cats too.  Our pole was finished just in time for Christmas so Rachael wound greenery around ours.

Add a custom cat tree to your house.  Your cats will love you for it! 

   

Mercy in her favorite spot

Calming a cat's anxiety with CALM by Royal Canin

Mercy is one of our clinic pet cats.  She and Ranger have some basic understandings to keep the peace between each other as you have read in July 2011 post.  In the mornings Mercy was acting a bit more agitated at Ranger, also hissing at some people and just out of sorts. I could not find any medical reason outstanding to be making her attitude upset.  There were not any overt big fights, and I did not want it to get like that. 

Mercy is on J/D  for her arthritic false hip ( she had a femoral head ostectomy about 14 years ago), pumpkin to reduce hair balls, joint supplement and periodic pain reliever.  Her medical management seemed to be at the best it could and I considered if she may be feeling some anxiety or was that developing with age.  We have added lots of additional perches in the office to enrich the environment for them so competition for space was not likely.  We also ordered some feather toys on a stick for structured play time for Ranger and what ever Mercy would do so there was social interaction with the staff but still, she just did not seem happy.  I thought this would be a good chance to try out the CALM diet by Royal Canin and see how it might help her.

The J/D diet by Hills has given Mercy some benefit with her hip so I did not want to abandon that diet completely.  I instructed Racheal, one of the techs to mix the J/D and CALM  50/50  for the trial and see if there was any effect.  The supplementation would not be a much, but I figured - there may be some benefit.  The behaviors we were looking to see improvement on were - less hissing and avoidance of staff members and Ranger.  That was about it.  We did not have any soiling problems or real aggressive fights - just the crankiness towards Ranger and some of the staff.  We had figured her avoidance of dogs and some clients to be just the way she was.

 Typically Mercy does not seek affection and want to be petted by women.  Men with strong aftershave or cigarette smell on their hands is what she loves - why I have not clue!  Really - she will roll, rub, and purr for a man with the strong aroma of  Polo or Aramis.  She likes to sit on Racheal's lap, tolerate petting from Debbie, and really does not want to have anything to do with Leeza even though Leeza  does her feedings and care.  So one day about 1 1/2 weeks after we started her on the CALM diet I was at the clinic after hours.  Mercy came right up to me and started to rub and weave in between my legs purring.  I had to double check it was her and not Ranger.  She let me pet her and continued to purr!  This was really surprising to me.  She rarely sought out affection from me and would usually only tolerate some head pets before leaving.  Here she was continually seeking petting.  Then the next day she was laying in her bed which is on the shelf under where the microwave is.  I put my mug in the microwave which would typically have her jumping out of her bed to go elsewhere.  As my coffee was warming up I saw she was laying peacefully in her bed, just taking in the day.  Wow - this is unusual.  She let me pet her in her bed - another big step toward less anxiety! 

Later  I told the staff to observe her interactions with staff members, clients and Ranger.  As each day passed we saw her go up to clients and head butt them as well as allowing them to pet her over her head and body as she has not done before!  Men were no longer the only Mercy magnet!

Mercy loves to be with Leeza now

The really surprising day was when Mercy sat right next to Leeza as she worked on files and was head butting her.  In a cautious way Leeza picked Mercy up and held her.  Typically Mercy would have resisted and even tried to swat or bite at Leeza.  Not now.  Mercy loves Leeza now.

Play time has also improved for Mercy.  She will now chase after the feather as it is dragged across the ground and play Kill The Bear with her toy.  She and Ranger still have their am attitude adjustment period.  This has been a bit challenging to figure out.  They each jump and pounce on each other and will co groom just before.  There is not any hissing or tension about perching spaces.  It may be that they like wrestling but it is hard to tell.

Mercy is much more lovey

The CALM has really helped Mercy be a more social, affectionate and less anxious cat.  With each week we are seeing her be more lovey and interacting well even with dogs that come in.  If your cat is hiding, avoiding petting, or interacting with other pets or people I would strongly advise to talk to your veterinarian about trying the CALM diet.  Mercy really likes the taste of it and has not had any problems with her stool or vomiting.  The diet is adjusted to be good for urinary health and dental health as well.  CALM for cats is available in 8.8 lb bags which at 1/4 -1/3 cup dry food per day will last quite a while.  There is a rebate available on the Royal Canin Face book page so be sure to sign up for that.  We print those out for our clients to make it easier to follow through with the rebate.

Good luck and let me know if you give CALM a try.
Dr Sally J Foote

Latest updates on Bella and the summer

It has been a busy summer, so sorry for the delay in posting.

Grace as prairie field assistant to Dr Sheila Sobaski

Bella has continued to progress will with her CALM diet.  She is decreasing in her agitation and reactivity daily.   A big step forward for Bella was when my good friend Sheila and her daughter Grace visited at the end of July.  Normally I have kept Bella at the clinic for the 2-3 days that Sheila is here doing her field work since Bella does not have to know them; they visit once a year.  This time I thought - let's see how it goes. I can always board her if she is not less agitated.  Grace was also a fantastic child for working with Bella.  Grace has gone to training classes as a volunteer to help dogs get used to kids. So Grace immediately understood the need for her to give Bella her food kibble quick after  sits and to follow my instruction on where to walk. There were a few times Bella jumped up suddenly at Grace but she would settle down and take rewards right from Grace's hand.  Grace even had Bella coming, downing, and sitting on command.  I think Bella even allowed Grace to pet her too!

Bella knows Grace has the goodies!

  I did not give Bella any additional medication - just the CALM diet.  I did keep the gentle leader on her with the drag line in the home. This was a good way to redirect Bella and put her in the areas that would give her more space with additional people in the house.  My friend also felt more secure with a barky, jumpy dog  in a head halter to have more control over the mouth.  The gentle leader head halter is not a muzzle and it does not mean Bella is failing to become a better dog.  It is a humane way to have control and safety when there are triggers for reactivity and possible aggression. We use head halters all the time on horses and cattle - it is not any different for your dog. 

This weekend Bella and I walked all around Meadowbrook Park in Urbana.  She was far less reactive to unknown people - many that would look her right in the eye as they walked past.  She would sit calmly and just be curious.  There were a few dogs on leash where she was barking and lunged out at one who did the same to her.  This is the first time between the horrible heat and available time I have had to take her to a busy park for counter conditioning.  She even laid and rested on the outside of the dog park and greeted a dog through the fence well.   So her progress continues.

I also made a few more videos that are posted on my you tube channel   http://www.youtube.com/user/drsallyjfoote?feature=results_mainand linked through my website  www.drsallyjfoote.com.   Barking like crazy 1 and 2.  I show how to set up a tether, rewards that are handy and use a dragline.  My dad, John Foote was a willing participant to show how to keep things safe and sane while someone is coming in the home with a walker.

I hope you have had a great summer, and please let me know how this information is helping you to know your pet.  I promise to have a post for our cat lovers next month featuring pain management in older cats for good behavior.
Take care!

Thank you Grace for helping Bella become a better dog

Bella's progress on CALM
Saturday June 23rd.
Bella has hit some major milestones this week.  One of the most frustrating things was  Bella would bark and lunge at other dogs when she was on leash unknown people, especially men, and big objects that rolled or made a lot of noise.  In the past, we could continue our walks with a zig zaggy way of avoidance to keep the space between her to these things big enough so she was not go bonkers.

The market is on a busy corner - with music too

  This morning was the first  trial of Bella out on a walk that would put her into the things that would set her off.  Although Bella would typically do anything for food, on a walk it does not  help her to be rewarded or relax. I have noticed at other times verbal praise, and instructing her  what she needs to do - sit, come, settle is more effective for her.  So this morning we walked up Main street towards Abundant Market day at Festival Corner just as  the vendors were setting up. We did not need the challenge of lots of people  coming up to her and try to pet her.  That I know would be too much.  A couple of dozen people taking big boxes out of vans, putting up tents, and making eye contact, saying hi  as we walked right by their booths.  This was enough of a trial. I figured it would be best to build on success rather than get frustrated with failure.

Bella is taking rewards as the dogs bark and one growls at her

On the way up, a friend who Bella does not see often  commented how calm she was.  She did bark and jump up once but immediately settled into a sit and calmly sat there as Ann and I talked.  This was big for Bella!!!!!  While she did not get an A grade on greeting, she has advanced to at least a C student rather than flunking stranger approach.   We continued  past the post office where hand carts full of mail were being loaded into the delivery cars.  Right next to this area was a fenced back yard with 2 dogs barking and running the fence line.  Bella was sniffing the grassy area right by the post office lot, and greeted the 2 dogs at the fence area without any reactivity.  This was a huge step for her.  We continued walking on to Ervin Park, past other walkers and one woman with her big chocolate lab on leash.  There was only one point where the lab was pulling towards Bella that Bella was turning and pulling but not barking and going bonkers.  She continued to pass others and doing well all the way home.

Later she was calmly taking a reward from a girl with lots of people, cars, bikes , etc!

She is observing people approaching 

One thing I notice in Bella is if she is staring to react, she will go into a  sit and if she can just observe what is going on she is more calm.  It 's as if she needs a little time to take it all in and see that nothing bad is going on.  When I continue to make her heel and walk past something upsetting it does not seem to help her see that it is not a problem.  For Bella a balance of heeling, sniff walking and getting her settled to observe is the first part of counter conditioning her to her fears.  This is level one of learning.  Get to a point of feeling neutral about stuff that used to be scary.

I will keep you posted as I work with her in more and more challenging situations and try out ways to help her be happy about  scary things.  Getting my daughter and husband to work with her is also a part of the plan.  We'll see how that goes!  I find this food  is helping her to be more calm so she can learn.  I think she will need to be on it a few months before any weaning off or adjusting the diet.  I am not clear if  all dogs need to stay on this lifelong, but if they did, that would not be any health problem.  Right now there is a $10 rebate through the company for CALM food which does help the pocket book.  You can go to the facebook page for the coupon.  We have the coupons printed out for you when you come in to purchase a bag.   

A great day for a market - we will come back for more learning

Bella is work, but she is worth it!

Have a great weekend! Dr. Sally J Foote CFBC-IAABC

Updates on CALM diet for dogs

So it has been another week with Bella on the CALM diet.  There have been some major milestones without really getting into any training or counter conditioning ( it has been busy, I am the only one at home really working on this, and after work I am just too tired at times to bother!).  The other day the neighbor was outside with his dog, just across the street.  The dog was barking at Bella which would have had her barking, pulling at the tie out, and just going nuts.  She ran to the edge of the yard, barked once and came to me as soon as I called her.  That was big.  

Unknown men would get her all worked up but now she is not nearly as concerned about them.  I was walking her up to work and a man was walking behind us by about 2-3 feet.  She turned to look at him 1-2 times but kept up on her heel and would focus on me.  In the past she would have been constantly twisting around, barking, hair raised.  Now she can take the command and be happy about heeling. 

This was the biggest achievement so far.  I was walking her in the neighborhood and she was sniffing at the edge of someones yard.  All of a sudden the pug, lab and another bigger dog came running down the yard barking at Bella.  She looked up and I turned her around where by she heeled with me to get across the street so we would not have any fur flying.  She heeled, looked at the other 3 dogs a time or 2 but would otherwise focus on me and follow the command to keep moving away.  Her reactivity to them was much reduced over her typical reaction which is especially good when you consider they were barreling down the yard at her.

I have put 2 cases I have recently seen on behavior consult on this food.  My techs call or email the clients on behavior consults at least once weekly checking up on progress.  I am eager to see  how this food is going to work with these cases.  One of the cases is on Clomipramine and the other is not on any other medications or supplements.  So we will see how other meds with this diet compare to this diet alone. 

Thanks for reading - now I want to find a cat case to get on the CALM.
Dr. Sally J Foote