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« Wherein I love Jon Stewart for money | Main | Veterinary Medicine: How much do you want to know? »

26 October 2007

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Great Dane Addict

All I can say is that I have the bestest vet ever.



"Dr. Morgan’s special interests include pain management and nutrition."



http://tinyurl.com/yu5mhu



Oh and she's certified in chiro and acupuncture too!



If she retires, I will have to stop having pets.

Christie Keith

Because my vet was in another area and couldn’t dispense the meds the local clinic would not even honor the request from another vet.



In defense of that clinic, it would be a violation of pharmacy laws -- it would be ILLEGAL -- for them to dispense this medication to anyone not their patient.



Only pharmacies may dispense drugs on a prescription. Even though it is frequently done that one clinic "fills a prescription" for a vet out of the area or even a local vet who doesn't carry the drug in question, it's absolutely against the law.



Why didn't your vet just call in the prescription to a pharmacy? Even if it was a veterinary drug, some pharmacies do carry those, and if they didn't, pretty much every drug I can think has a human counterpart that's close enough.



The pain control point is well taken, but I think the pharmacy issue is also very important here.

Christie Keith

Modern ideas of the pan-pharmacopia have simply not gained their respect and depending on the details which we do not know, you shouldnt sit in automatic harsh judgement.



I am not sitting in judgment on this vet. As I said, there are lots of facts in this case, we don't know them, and the media often gives only bits and pieces of a story.



But I can and do evaluate the actual words and facts themselves, as statements. And when incorrect medical information is given, I defintely judge it. There is no other responsible thing to do.



I do not agree that this is all "gray area" stuff. There is not one study to support the idea that letting animals or people "tough it out" is better than managing their pain.



And it's not all big pharma, either. Many of the pain control techniques are other than drugs -- physical therapy, massage, hydrotherapy, acupuncture, supplements, lifestyle changes.



Taking pain seriously as a medical issue is not about work ethic or values.



The moral judgment of an individual who takes or fails to take pain seriously is absolutely dependent on their viewpoint, education, lifestyle, cultural issues, etc.



So the question is not: Is this vet, or other vets with this attitude/belief system, good, evil, or somewhere in between -- which we can't know and isn't, to me, the point -- or are the statements of fact themselves correct.



Animals, and people, recover faster and with fewer complications from surgery and injury if their pain is controlled. There are perfectly good people who don't know that or don't believe it. I just don't want any of them treating my dogs, or me.

Nancy Nielsen

I, too, live with chronic pain. I can choose to medicate it or not depending on other factors. But having been through surgeries and broken bones and painful burns I know that I do sometimes choose pain relief. On the other hand, my animals have no choice. I make that choice for them. Am I to decide, that because I have a strong work ethic (it's got to be done and if not me, who?) I should choose to leave my companions in pain? In that case, if I should become unable to make the choice for myself, should I be left in pain because I live in a rural area, or because the pain will "keep me quiet"?



I firmly believe that appropriate pain management should be a part of veterinary care. I believe those responsible for pets should try to avoid unnecessary suffering. If rest is important, I already have ways to limit my pets activities to a therapeutic level.



If I ever break my back again, I sure hope that my physician doesn't point out that we live in a remote rural area and that consequently I do not need medication.

Dorene

While this vet is trying to frame the issue as country/city, I thihk it's more a function of age of vet.



In my own experience, (suburban Philadelphia where the local vets pride themselves on having the Penn Vet School close at hand), my 35+ years of practice vets are fairly slow to hand out pain meds. I don't remember being given pain meds when any of my animals were spayed (Persians 20 years ago and Pepper 5 years ago). In fact, when Pepper was attacked by a Dalmation (this was one troubled dog) 3 years ago and required surgery to close the wounds, my vet (who I know genuinely cares about her) very specifically told me that he WASN'T givening her pain meds "because she's a Border Collie and I want her to rest. If she feels better, she'll do too much. The pain will tell her to rest and that's what she needs." I spent days sitting next to her, just gently stroking her as she laid there in pain -- I felt so bad for her as she seemed miserable, but -- prior to finding this site -- I thought we were doing the right thing.



So, I think this "difference in treatment" is more a function of the vet's age rather than location. But I've also found that the city/country arguement plays better in country courts, so I'm not surprised the lawyer is playing up that angle.

Bernard J. (Bernie) Starzewski

Well, as perhaps the only blogger here that is from a farm background I have to weigh in.



There most definately is a difference between attitudes on pain between city and farm (notice I said farm and not just rural) people.



This extends to humans as well. This stems from the specific type of work ethic that says that you get up and do your job and just block that bad knee from your thoughts because there isnt anyone else there to do it. Many the times I went out on cold winter mornings with colds and flu and various injuries and found a way to get it done.



This can extend to animals from farms who have their routines too and I think just getting outside is part of that. Certainly, if you sit inside staring at the TV to see what Briteny is up to today you become more aware of your condition than you would be if you were preoccupied with milking sixty cows in a stantion barn. I have seen dogs with terrible injuries who are used to being with the boss who you would think would just not want to get up become disraught at the prospect of not being where they were supposed to be and will hobble out on three legs or crawl if they have to to be with the boss. Its a sick sick dog in that life who will not respond in this way.



I think you have to look at the animal in each situation. They can tell you if they are in distress by their eyes and their actions. Failure to attempt normal activity is certainly a sign that they need some help and I suspect this vet would tell you that.



But, do not discount the natural pain relief of simply not dwelling on it. That at least is where he is coming from and it may well have something to do with age. People with that ethic and commitment to their lives and work are harder and harder to find. Modern ideas of the pan-pharmacopia have simply not gained their respect and depending on the details which we do not know, you shouldnt sit in automatic harsh judgement.

The OTHER Pat

My response to this comes from a number of angles:



1) Recall the recent thread on Rimadyl and other NSAIDS, and the whole question on whether or not vets were adequately educating their patients on what to be aware of when such drugs were given out. I think the responses on that thread pretty much established that vets are NOT doing a good job of informing their clients about the pros and cons of administered NSAIDS. I remain leary of the use of Rimadyl, and yet - as a cat owner whose cat is in today for her spay surgery - the whole question of pain management/Rimadyl in particular is very much on my mind as an inadequately-resolved issue.



2) Many of us have experienced how stoic our pets CAN be in the face of pain. When I was in school, I was simply told that animals have "a higher pain threshhold". Whether or not hard scientific evidence exists to support such a statement, it is well entrenched in the consciousness of many veterinary practitioners.



3) What I describe in #2 above is the primary reason - I believe - that postoperative pain medications have not traditionally been a part of customary veterinary practice.



4) On the "city v.s. country" thing - I do believe there is a difference here, and that - in addition to the factors Bernie describes - that it is also influenced by the daily practices of animal husbandry used on agricultural animals. Pain meds are not only NOT routinely used in a lot of procedures, but they are in fact generally prohibited (I don't remember exactly how the guidelines go) due to the fact that an animal who is destined to become part of the human food chain cannot carry pharmaceutical drugs in its system.



In addition, there are the economics of agricultural practices. If I am a pig farmer and I have to neuter 200 baby pigs, it would be pretty costly to go through pain management (and this includes anesthesia during the procedure) for all of them. You just go into the pig yard, grab one of those little boys by his hind legs, lop off his "privates", slap on a brushfull of iodine, and go on to the next one. This is what farmers get used to doing with their livestock, and so telling them that their dogs and cats require more than that just doesn't "fit" into their worldview. (Am I generalizing here? You bet! But having gone to school in a rural community taking coursework having to do with small animal care, I saw this dichotomy - and heard it spoken to me from fellow students who were in the Agricultural programs - on a daily basis. They just didn't see the point in expending that kind of money and effort on the care of their cats and dogs.)



All that having been said, I'm not sure Dr. Seemann is being well-served. It was pretty clear to me that emerging trends in pain management have NOT been codified in any formal way. It's not unlike the emerging trends in new vaccination protocols, for example. Nowadays you can pretty easily find a vet who'll agree to forego yearly vaccs, but not that many years ago, a lot of vets were afraid for their licensure if they did NOT vaccinate yearly. And back then, who could have predicted which way the pendulum would swing? There was nothing formalized, and the vets who were fearful to depart from a yearly protocol were not being entirely unreasonable in that fear.



The valid point I think Dr. Seemann has is that if there are going to be actionable changes in accepted practice, then there needs to be some more formal mechanism put in place than just "you should know about this stuff because it's what everyone else is doing now".

The OTHER Pat

Comment by Cardimom — October 26, 2007 @ 8:29 am



"The excuse that ‘that’s just the way it’s done around here’ or that that’s how it’s been done in the past, or that farmers are desensitized to stock animal pain is no excuse."



Cardimom, there's a difference between an explanation and an excuse. Taken in the context of traditional agricultural practices, this entire question becomes more complex than a simple "right v.s. wrong" question.



Yes - it was hard for me to understand how my fellow students were so dismissive of what I felt to be a minimum acceptable standard of care for pet dogs and cats. However, as I learned more about the normal husbandry practices they were being taught as reasonable and acceptable, their viewpoint made more sense to me. Not from the standpoint of me agreeing with them - but rather, from the standpoint of me gaining a better understanding of how their viewpoint had come to be formed.



I'm not sure if USDA rules allow anesthesia and pain management in animals destined for the human food chain even to this day. But knowing the reality of what is being taken for granted in those whose livelihood is based on these kinds of animal husbandry practices helps one at least understand where these ideas come from - a first and very necessary step if there is ever goind to be any reasoned discussion on such questions.

Diana Guerrero

Amazing--this topic came up with some of my clients yesterday. They were complaining that clinics are guilting pet owners into tests and meds that are not really needed and are taking their business to vet clinics that are not run that way.



I reside in a rural area outide of a major urban sprawl. How animals are managed and cared for here is vastly different between households but also definately not the urban model.



We have two veterinary clinics and I've worked with all of them for years. We also have a horse vet that commutes up to treat the ranches and private horses around these parts.



Ultimately, it is a choice. Each case is different and each animal responds differently.



Animals are hardwired differently and most wild animals do not show signs of weakness or illness until severely along. I believe a vestigial component remains active in domestic animals which is why you don't always identify or see pain.



Some animals do not show any symptoms of pain and their activity remains normal after procedures. Some do not.



Something not brought up yet is the increasing tendency of some clinics to boost their profitability through additional sales of specialty foods, drugs, and other pet owner needs.



In this area, the big chain (VCA) has lost a large number of clients because they have become too corporate and to uninterested.



I've had a long standing professional relationship with the clinic since the early 1990s and I won't go there any more either.



Here is my short story, when my vet called in a pain medication prescription (she was coming up to euthanize my dog) the week of the euthanasia, the clinic refused--stating that my dog had to come in for an exam.



In the past, my professional standing in the local animal community has always been met with professional courtesy and this was ridiculous--leave the animal in pain because they wanted to examine him?



Because my vet was in another area and couldn't dispense the meds the local clinic would not even honor the request from another vet. Okay, so I went elsewhere and got it and immediately saw relief on his face--broke my heart.



What I hear from my clients is that they get additional fee after fee for tests and other preventative care practices. They don't like it and the fees are prompting people to not get vet care or to drive an hour and a half or more to get veterinary care.



Selecting random clinics and practioners is not an answer. As mentioned previously, our animal management standards are NOT national or cross industry.



Finally, it is up to the pet owner to decide what is needed with guidance. So how far does that go? How many people reading have had similar problems with human doctors who do not outline options or side effects?



I don't think this matter was handled wisely and believe it is a symptom of change that is in the air concerning animal care and management.



Until management of livestock for food consumption is done humanely, regulation and enforcement how animals are being managed in their households is standardized, changes in the sheltering and animal service standards are consistent, this is just another mess to take up court time. Slapping one hand when there are a ton of others operating in the same way is not the solution.

emily

In a rural practise I would expect to have to ask for pain management like lidocaine and NSAIDs, but I would ask at the beginning and insist on it. Even if a vet doesn't do this routinely they shopuld certainly be capable of doing it upon request.



re: "I’m not sure if USDA rules allow anesthesia and pain management in animals destined for the human food chain even to this day."



Yes, they vertianly do--under labelled use or AMDUCA and with an appropriate withdrawal period. It isn't common but it most certainly is entirely legal, possible and safe for public health as NSAID withdrawal periods are only a few days (4-7, typically). Some large animals vets do routinely use local anelgesic and anesthetics for all invassive proceduries.

Deanna

I too grew up in an agricultural community and support Bernie's view that there is a different way of looking at things -- not wrong or bad, just different. I can see where a person might refuse to pay for analgesic drugs, perceiving them to be unnecessary. I also support TOP's POV.



Heck even just a few years ago (3 and 5), I was not sent home with painkillers following spay/neuter surgeries. And these were not surgeries done in "podunk" locations -- they were done in suburban clinics. It's been only in the last 2 years that I've come home with Deramaxx or Rimadyl after various procedures. Age of the vet has not been a contributing factor. This seems to be another area of vet practice where views of what is the appropriate protocol have changed rapidly.

Cardimom

Well, as someone who lives with chronic pain, I whole heartedly advocate pain management. That doesn't mean that I don't suck it up and go to work and do housework and take care of my dogs and live my life. But boy, a little bit of medical help does make all of that easier. The excuse that 'that's just the way it's done around here' or that that's how it's been done in the past, or that farmers are desensitized to stock animal pain is no excuse. Just because pigs have been neutered without anethesia and after care in the past, doesn't make it right. And as far as keeping a pet quiet after injury or surgery, and pain management making it harder, that's where crates come in handy. Sorry if I've ruffled any feathers, but this topic hits too close to home. There is no doubt in my mind that not offering pain management is cruelty.

straybaby

you mean to tell me, when i move to the country, my pets won't need pain meds?! umm, ok.



i think it's up to vets to stay very current and always inform their patients and give them choices. i've had several young cats spayed at once with varying recovery results in the pain and picking at the stitches areas. my dog is EXTREMELY pain sensitive, where as one of my rescues who went through bladder surgery wasn't (damn! that boy bounced back well!) i think pet parents should be given the info and each case should be discussed by the vet. they need to know the pros and cons of the meds and what to expect. i stopped the pain meds on my bladder boy early. basically tapered off petty quick as he dictated. i think we could have lived anywhere, and his pain management would have been the same {rolls eyes}



my vets are both traditional and holistic, so we basically get a choice of care and a run down on the different choices. now they know the route i want to go, so we generally start there and talk about future options, unless they feel traditional my be better. i expect a vet to treat the particular animal and inform me of my choices (with full explanations including drug effects and interactions) with back up info. animals do not have cookie cutter solutions anymore than we do (sorry big pharma!) i can't imagine my pain sensitive dog going through ortho without pain meds. or even the average not so sensitive dog. they may just not need as much, but i would like to know they could have what they needed!



and if they think i'm projecting feelings onto my dog, i challenge them to manage her when she's in pain. and that includes getting her to eat.

EmilyS

rural vs city... you know, it's not that different with people.

Folks who live in rural areas are more stoical about pain too... it's partly cultural and partly practical (there aren't nearby medical practioners)

Bernard J. (Bernie) Starzewski

EmilyS, you said it best.

But in my experience it is a much deeper cultural view. The best comparisson I can make is to Zen Bhudism. I have seen farmers in their 80's limping around completely surpressing severe arthritis symptoms and not thinking a bit of it except to cuss a bit when they can't grip something as well as needed or perhaps can't climb a ladder.



I could also tell some stories about standard agricultural procedures that have not changed that much like castration that is never done with any form of anasthesia that would have a PETA purson chewing their own limb off.



An old line vet or farmer would watch the animal carefully and make sure that it is not rigid or distracted. Then, non drug methods would be used such as massage or warm or cold compresses long before the pills came out. But even those would in fact use it if nothing else was working.



I have seen animals tear their stitches out many times and think nothing of it. This is not to say that they do not feel pain but I am convinced that they prioritise it differently. When an animal is in decided pain the behavior changes and a practiced eye can spot this.



Now if a hurried urban vet in their tightly scheduled modern practices doesnt have time they are many more times likely to hand over the pills. It prevents re-visits and possibility of pain developing without having the "waste" that well managed time...



Also, country vets are more likely to be dealing with someone who is themselves more experienced with animals and vet care than the average urban pet owner. I offer myself as an example. I began school in pre vet med but ended up in ag, have worked as an artificial inseminator and have assisted vets in any number of procedures. I know what to look for and so would any of my farmer friends.



As a result, in these communities it is simply not necessary to use drugs as a blanket prophelactic because that is what the owner is for.



I think these days, younger vets do not understand this and the collission of rural and urban populations are creating a mismatch of intentions and expectations.



I happen to be doing some writing on this very subject but it is fiction involving the changing of the guard (as it were) in rural communities.

Lynn

Re comment "Folks who live in rural areas are more stoical about pain too… it’s partly cultural and partly practical (there aren’t nearby medical practioners)"



Response: I doubt that this has ever been scientifically studied [who tolerates pain better or who is more stoic, city folk or rural folk] - at least no one quoted a source. But I, a city girl, beg to differ. I can tolerate pain with the best of them, if not better. And I have. But why should I when it only results in a protracted recovery? [Yes, many studies to support this, for both animals and humans.]



My upbringing was that you grin and bear it until it becomes obvious that you need pain management. However, as an adult my belief [which IS supported by scientific findings] is that reasonable pain management from the outset goes a long way towards a faster and uneventful recovery process. Now it’s true that animals don’t know when to take it easy when they are taking pain meds, but it’s up to the human supervise.



Judicious pain management should definitely be added to the DVM practice guidelines and mandatory CEU courses in this area should be part of licensure retention.

Gina Spadafori

This post and subsequent discussion is very timely to me. I'm in Texas, visiting with friends who run a small working cattle ranch. And I do mean WORKING: I flew in on a red eye (no sleep) and then spent 12-plus hours helping with ranch chores.



Yesterday, I went with my friend to pick up some new cattle. Watched as they were herded through chutes, squeezed in a contraption I'm sure someone else will have a name for to be weighed and vaccinated, loaded on to a trailer, taken to the vet and then sent through more chutes, squeezed in an even more deluxed contraption and then castrated. That last? A couple quick slices and that was that. No numbing before, just a wash of the area before and after with Betadine solution.



The veterinarian was fast and skilled, and the procedure was over in seconds. On calf didn't even react; the other bawled a little. Half hour later, both were grazing in a new pasture as if nothing had ever happened.



My friends adore and respect their cattle, and so, too, do the people we went to pick up the new ones from. They're all into sustainable and animal-friendly ranching -- this is not a feedlot or factory farm. The animals are healthy and friendly, and they were patted and talked to throughout the day. (The vet even offered a sympathetic "sorry, guys" before his work.)



Weird experience for a city girl, I tell you, but a very interesting and thought-provoking one.

Bernard J. (Bernie) Starzewski

Gina, that was a stock chute you were seeing.

Most vets have portable ones but I had built a home made one into my heifer shed that was probably not as sophisticated as the ones you saw.

Many of the portable ones can also be tilted to make a kind of operating table if need be.



What you may not have noticed was that first the vet observed the animals post procedure for a bit. He probably just looked back at them briefly and just looked at their gait to make certain that none of them were walking stiffly and then a little closer to see if there was any excessive bleeding. Then the owner would have checked them later for the same things. To a casual observer they might as well have been just taking in the view.



Lynn,

I am not talking about toughing it out or working thru the pain. I am talking about being able to just not feel it.

Maybe I cant sight a study but I have watched it again and again in both animals and humans and well... there it is.



I think that rural (meaning farm rural not just gentlemen farmers) are more active and put a higher priority on doing their daily tasks where I have seen any number of city folk sit in their easy chairs and focus on their ills instead of their lives.



Hang around any group of older people and the bulk of the conversation will be their latest afliction. Do the same in a farming community and that part of the talk will take less than a minute. If you ask a farmer how things are going he is likely to respond "Gotta go!". Ask a city dweller and you are more likely to hear how their back is acting up again.



I firmly believe that you can teach yourself not to feel pain as you can also teach yourself to feel every little ache.

I think this is the normal state for most animals who aren't apt to sit and dwell on what just happened to them.

The OTHER Pat

Gina, you may or may not be aware of Temple Grandin and her work on livestock squeeze chutes:



http://welcome.colostate.edu/index.asp?url=programs_grandin



Temple Grandin is autistic. When she was young, she noticed how the pressure of the squeeze chutes seemed to calm the cattle. She related that to her own experiences of being calmed by the application of uniform, steady pressure, and built a "squeeze chute" for herself that she found helped her calm down when she became very agitated.



As an adult, she has formalized this field of study into studies on humane livestock animal management. She has redesigned a lot of the squeeze chutes and other livestock restraint systems so that they are safer and even more effective at calming animals.



Her work - as well as her personal history - is truly fascinating.

Gina Spadafori

I've read her books and heard her speak. Interesting stuff.



back to work. No rest on the ranch, that's for sure.

Christie Keith

I firmly believe that you can teach yourself not to feel pain as you can also teach yourself to feel every little ache.

I think this is the normal state for most animals who aren’t apt to sit and dwell on what just happened to them.




Which would matter more if, number one, hiding pain wasn't a survival strategy for animals in the wild, where being impaired increases your chance of being dinner for another animal, and number two and most importantly, study after study in humans and animals hadn't shown that recovery time is shortened and complications are lessened when pain is controlled.



That is the bottom line. You can speculate all you want that animals don't "feel" pain because you can't observe it, but research doesn't support that view, even if it's rational.



The argument that people who believe this aren't monsters is absolutely valid, but so is the argument that they're incorrect to believe this, based on the facts.

Lynn

Lynn,

Bernie:



Re your comment, "I am not talking about toughing it out or working thru the pain. I am talking about being able to just not feel it.

Maybe I cant sight a study but I have watched it again and again in both animals and humans and well… there it is."



Bernie, hopefully you have also observed this in city people and animals. If you haven't, you should.



Nonetheless, ignoring pain takes energy that might be better used elsewhere.



The REAL question is this: What kind of recovery do you want? If you want the fastest and best recovery without adverse effects, then pain management might be indicated. If you choose to go the stoic route because that's "what we did in my family" or "it's sissy to take pain meds" then you're not in tune with today's modern practices.



Remember, I'm talking about JUDICIOUS and medically ADVISED pain management.



Seriously, if you have a headache you take a Tylenol. Who wants to tough it out?

Deanna

Lynn says "Seriously, if you have a headache you take a Tylenol. Who wants to tough it out?"



For every action, there's a consequence. I don't pop a Tylenol for every little headache; in fact, I'm pretty pill adverse, choosing natural methods for pain relief. Frankly, pain doesn't deter me much. If it did, I'd never get out of bed. I don't think anyone knows enough about physiology to make routine pill popping truly safe. To each their own.



I personally think we're a pill popping society with everyone looking for solutions that come in a prescribed bottle, even for our animals.



Gina, the castrations that you witnessed were actually pretty humane. Ask about the "other method" and prepare to cringe. But the calves don't seem to get all upset about it.



Christie, love ya, but you need to join Gina at the ranch.

catmom5

To me, when pain impedes quality of life, pain medication is indicated. My cats show little to no pain until they are very, very sick. So I don't think that not showing it doesn't mean they aren't feeling pain.

With that said, I am sure there are folks at both ends of the spectrum ~ some who overmedicate and some who don't medicate at all.

I also think that all farm animals deserve to be treated humanely (I'm a vegetarian) and when necessary euthanized humanely. My former in-laws had a small dairy farm. I remember one cow who delivered a calf who died. That cow stood where her calf had been laying and cried for a very long time. Any animal that can express that kind of emotional pain surely deserves to be kept as physically comfortable as possible.

Lynn

Deanna,



We know a lot more about FDA-approved drugs as opposed to herbs, natural methods, and supplements, not to mention WHERE these drugs and supplements are manufactured and how well [or not] quality-controlled.



Remember - I said JUDICIOUS use of meds, not pill-popping. Nor do I pop a pill for every minor ache. But I'll be darned if I would deny myself the choice.

Bernard J. (Bernie) Starzewski

Lynn,

No I have not seen it in city people. certainly not to the same degree which is qhite a wide gulf. In my experience city folks will sit and wallow in the discomfort because their work is somewhere else that they do not got when they are sick or injured. Farmers live in their work and do not have the opportunity to think about it.



I think its all in the focus of your life. You either controll the pain or you are controlled by it. The best way to control it is to look past it. But its like telling someong to NOT think of an elephant for a half hour unless you are trained for it from little on.



Animals are like this. They are busy getting on with the things animals do and dont sit and focus on it.



As Gina described, the calves were up and eating within minutes. The significance of their injury simply does not occur to them so they simply ignore it.



We as humans have the curse of anticipation and can feel the dentist drill long before it enters our mouths. But if you have never been told of the pain and come from an experience base that tells you to focus on something else, that is what you will do.



This may be hard to understand is you have not seen it at work but it is there none the less. So, its understandable that with your experience you would opt for pain killers when others with a different background would not.



Pet owners tend to be empathetic with their animals and not clinical. In truth, there is nothing wrong with that. But there is also nothing wrong with the culture I know in managing pain by observation first and medication or therapy when indicated. Its both practical and effective IF you know what you are doing.

straybaby

"In my experience city folks will sit and wallow in the discomfort because their work is somewhere else that they do not got when they are sick or injured. Farmers live in their work and do not have the opportunity to think about it."



ok, that's it. i'm getting pretty darn sick of these generalizations. i'm a rough and tumble city gal (at the moment) that can handle quite a bit and my life can't stop for a freakin' hang nail which you are getting pretty close to implying. but maybe that was because i was born and raised in the burbs, so i'm not quite as delicate?! kinda funny that i was the one who filled in for my farmer when he was struck with lyme and needed help with the Sat CSA. He took it easy while i did the hauling etc, even though i had 2 hands healing from an injury (the kind of injury that breaks open and bleeds all over, but not too painful). and i was more than happy to do it. neither one of us whined or discussed it and everything got done. teamwork. understanding. sometimes ya just need some time to heal. which my hands had pretty much had. but his body hadn't. he could have gotten it done i'm guessing, but why should he when i and another could.



so where do you put us born and bred suburban folks on your pain vs lay back and complain scale? and what about the city folks that endure all kinds of hardships farm folks wouldn't begin to understand. or just your average Construction Dude working through whatever in a heatwave in August in NYC?! (which can be deadly, btw)



us 'city folk' have a lot more backbone than you seem to want to believe. you might be better to break it down by up bringing and personality. it's an individual thing. not a mass labeling issue. my sister would wilt under conditions i take in stride, for example. and as i said early on, my dog has a very low pain tolerance, where as some of my rescues haven't. should i let her suffer because other dogs are more stoic? and before you suggest it's a projected thing by me, believe me, it isn't! her behavior is how i would find her injuries. same with my cats.



please Bernie, i totally respect you from what you've written here, but people can't be categorized by city folk/farm folk. and you can't lump all city folk into one category. i'd say most of NYC and surrounding is hard working folks that must work through things. think of single mothers working more than one job, for example, that can't afford to miss work. or me. i'm the only one responsible for me and mine. i can't just blow things off to sit back and complain and take pain killers. and i think you'll find that is the general drift in many urban settings. i may be like a farmer in that my work is at home ( ;) ), but many city folks go 'somewhere else" to get the job done no matter what. they don't have a choice.

Lynn

Bernie:



I'm sorry that you have a false perception of how "city folks" deal with pain. I must say that I am disappointed that you feel I "would opt for pain killers when others with a different background would not."



Some people thrive on suffering, Bernie; I am not one of them and I certainly would not perchance this with animals.



While I may be a city girl, I have seen horses gelded. Not pleasant - it was a fast process, but frightening for them being held and controlled.



I think you need to look beyond your immediate environment. You might be surprised at what people in the city endure. We are hardly pill-popping wimps.



That said, I will say that pain is arguably a perception with a variety of threshholds. I've got one friend in the deep suburbs who whines with a headache; I've got a 35 year-old cousin, mother of 4 kids under 12, dying of cancer in the next 6 months. She lives in the city and is ever so grateful for exacting pain management so that her kids have a better experience of what is left of their mom.



And you can also make a good psychological case that those who whine or those who overload on drugs probably have serious psych issues [on the farm and in the city - mental illness doesn't discriminate].



EVERY case is unique, every individual different. Perhaps your experiences are limited.....but it's really unfair to make such generalizations.

Bernard J. (Bernie) Starzewski

Lynn, I was born in Chicago and did not come to Wisconsin until I was 13. I still have plenty of relatives there and have made a life long study of observing the differences first hand.



Its enough to say that there is a readily visible disconnect between the two. People here are seen by IL folk as crude and rough and maybe a little dumb. When IL people come here on vacation they are referred to as "FIBs" which does NOT stand for Fine Illinois Boys. They are seen as whiney self interested and materialistic.



When I talk to Chicago relatives they are much more likely to discuse their (or another family member's) last operation.



When I talk to Wisconsinites its more likely to be the weather or some aspect of work or life unless someone they know actually died recently.



For me, coming to Wisconsin was like discovering some lost civilization where local vets had their instruments in the back seat of their cars and medications in jars in the kitchen cupboard and their wives maintained paper ledgers of the accounts. Their clients were skeptical of new advances and change happened slowly over generations.



Those differences are fewer now which may be why this particular event came to our attention where it would not have been given a second thought even twenty years ago. But the practical, pragmatic and stoic soul of the region is still here.



Just because modern technology has given us new options does not invalidate millenia of evolved animal (and human) husbandry.

Lis

Bernie, your smug superiority and condescension are not helping you convey whatever actual value there may be buried somewhere in what you're saying.



Ignoring pain on a conscious level does not mean that the physiological effects are not there, or not taking their toll. Appropriate use of pain relief eases the physiological strain and makes of a speedier recovery with fewer complications; this is amply documented in repeated scientific studies. There is nothing practical or pragmatic about ignoring this information. Stoic, sure, but "practical" or "pragmatic"? Sorry, no.



Just because modern technology has given us new options doesn't mean we can't still get from the east coast to the west coast by well-stocked wagon train (and it's been done, fairly recently); that the wagon train will still work, however, doesn't mean that choosing to do that rather than taking a plane is "practical" or "pragmatic."

Lynn

Thank you, Lis.

Bernard J. (Bernie) Starzewski

This is exactly the kind of disconnect I am talking about.



The modernists always think they have the next best thing.



The reason these people are skeptical is that so much of the modern solutions that have been presented have failed them.



Go back and read Silent Spring and you see one of the most obvious. I remember products like Lasso and Dual used for anual grass control in corn and potatoes that was supposed to be an entirely safe herbiced. Then it was found that it was not only carcinogenic but liked to leach down into the water table instead of breaking down the way Dupont claimed.



A non ag example is hormone replacement therapy for women. Breast cancer anyone?



At the turn of the last century there was a man namde Dr. James who promoted the "James Way" of handling livestock. He was a pundit in the field and a comtemporary of Kellog, Post and Frank Loyd Wright - all self contained practitioners with all the answers....



James founded the Jamesway Corp., a major maker of cattle handling and feeding equipment. IT was quality stuff. The company is still in business but has merged with competitor Starline to create J-Star.



James invented the head lock stantion and influenced the Wisconsin dairy barn in the same way that Wright affected the prarie style home.



But as time wore on people discovered on their own that his methods had problems and although they were used in thousands of barns later studies showed that they were in fact rather inhumane because it restricted the cows movements and often lead to severe injuries and even death, certainly losses in animal productivity.



None of James' methods are used in new barns anymore. While many farmers did a good job in managing their cattle with his equipment no one would go back to that again.



Today we are arguing about how to manage pain in animals. Some see drugs as the only alternative and others see it as a last resort.

Yet the proponents of mandatory medication are as likely as not to believe in accu-puncture, yoga and meditation for the same purpose all the while refusing to believe that there is something very similar at work here.



The hallmark of rural society is health skepticism being unwilling to quickly abandon tried and true methods for the latest bit of research. They have learned over the centuries that research is only as thick as the next study.



Is there any better way to observe the gulf between city and country attitudes than to read this blog?



Use the meds if thats what you believe in. But do not dismiss these people as a cult or backward or cruel. Their experience is deeper than yours.

Lis

Use the meds if thats what you believe in. But do not dismiss these people as a cult or backward or cruel. Their experience is deeper than yours.



When IL people come here on vacation they are referred to as “FIBs” which does NOT stand for Fine Illinois Boys. They are seen as whiney self interested and materialistic. (This offered as, apparently, a reason we should be guided by the opinions of those smart, sensible Wisconsin farm folks.)



In my experience city folks will sit and wallow in the discomfort because their work is somewhere else that they do not got when they are sick or injured. Farmers live in their work and do not have the opportunity to think about it.



You're not asking us to consider your information and experience, Bernie. You're demanding that we acknowledge the moral superiority of your farmers because they are hardworking, intelligent, practical, pragmatic people, and admit, or at least accept as fact, that we are lazy, whiny, stupid, self-indulgent slackers who couldn't find our way out of an open paper bag.



And you wonder why you're not convincing us that your way is better.

The OTHER Pat

Okay Bernie. You're all better than all of us.



(Now back to healing from my broken leg that went for three weeks without a proper diagnosis while I kept going to work in my city job every day . . . . . )

Bernard J. (Bernie) Starzewski

Liz, you and others have completely mischaracterized what I am trying to do here.



I love my animals and would never let them suffer for a minute. I had my old freind Brandy put to sleep because I thought she was suffering even though it broke my heart. If my new pal Scout was injured and aparently in pain I would not hesitate to buy the medicine to relieve it.



These people have no less empathy for their animals than you do but have developed different strategies to deal with it that have proven themselves successful over an extremely long period of time.



Quite the contrary to your assertions I am simply asking the non-rural among you to reserve judgement on a group of people that have not always been served well by the latest technology and are (I would hope) understandably skeptical about its benefits and cost.



Consider organic farming. The rules for the identity of organic milk totally prohibit the use of even antibiotics in treating cows for mastitis. Non-organic producers must withhold milk from sale for a fixed period depending on the drug but organic farmers must take the cow out of production entirely if treated.



Left untreated this condition can cause the complete necrosis of the affected quater (cows udders are divided into quaters). It is not at all pretty and extremely painful but pain medications are not allwed either!



I'm going to say this again for effect: PAIN MEDICATIONS ARE NOT PERMITTED IN ORGANIC FARMING!



I would be much more convinced of the sincerity of the urban consumers concern for animal rights if that concern for the animals extended to allowing that this same vet would not hesitate to employ.



But no. It is easier to personally attack me even though all I have done is give some background and plead for a little understanding in considering the possiblity of an alternate method.

Bernard J. (Bernie) Starzewski

One other poing Lis,

In quoting me you plucked out only the side of my comments that were negative toward urbanites.



I also pointed out that urbanites have similar prejudices against rurals but you chose to ignore that.



Is it any wonder why our country is so bipolar divided into red states and blue?

Lis

One other poing Lis,



Well, at least this time you paid enough attention to get my name right.



In quoting me you plucked out only the side of my comments that were negative toward urbanites.



I also pointed out that urbanites have similar prejudices against rurals but you chose to ignore that.




Um, Bernie, you expresed your prejudices against urbanites--and then you expressed some of your other prejudices against urbanites, your beliefs about what you think we believe about farm people. I'ts like the Madison cab driver, who with the friendliest intentions, referred to the "fact" that I think of Wisconsin as "flyover country." Um, no, sorry, I don't. I've never even heard the phrase except from midwesterners expressing their beliefs about what people on the coasts think about them.



To provide the balance you think exists in this one-sided sneering contest, you'd have to either point out negative comments about farmers made by others here, or genuinely positive comments you've made about urban people in this discussion.



Finding either might be a bit of a problem, though.



Is it any wonder why our country is so bipolar divided into red states and blue?



None whatever, Bernie, none whatever.

Lis

Oh, and the organic farming thing?



Right now, there are a several different groups and organizations, with competing standards and rules, all vying for primacy as "the" standard for organic foods. That's the reason that the "organic" label on something is of limited to zero value. I don't doubt your word that one of them is as kooky as you say. If there were any easy way to know what the word "organic" means on any particular package, people would be in a better position to decided whether or not it's something they want to support.



As is, I prefer to be guided by terms that have real meanings, and specific information from the companies marketing/producing the foods--including whether or not they'll actually answer specific questions for concerned consumers.



I'm afraid I don't quite see, though, what the shaky and unreliable meaning of the word "organic" has to do with whether or not you give appropriate pain relief to a pet you claim to regard as a member of the family, or just decide for them that they're just going to have to "ignore" the pain because pain meds are for city wusses.

Bernard J. (Bernie) Starzewski

Yes, companies like Wal-Mart have in fact diluted that standard but my comments still stand.



The issue is: What exactly is "appropriate" treatment?



According to your experience automatically assuming pain is the only allowable course of treatment. This so much so that Lynn wants to pull the man's license if he does not conform. Yet none of your are vets rural or otherwise.



But I have repeatedly said (and you have ignored it) that what these vets do is rely on actual observations of the animal that effectively lets the animal themselves request the meds. I know of no vet or rural pet owner who would knowingly allow their animal to suffer and I reject any characterization to that end.

Bernard J. (Bernie) Starzewski

Lis, Here is my full quote...



"Its enough to say that there is a readily visible disconnect between the two. People here are seen by IL folk as crude and rough and maybe a little dumb. When IL people come here on vacation they are referred to as “FIBs” which does NOT stand for Fine Illinois Boys. They are seen as whiney self interested and materialistic."



Notice that I was pointing out that each sees the other in a different light and not exclusively attacking city folk.



If it seemed that way in other places it is because it is my perception that in this thread it is the rural philosphy that is under assault.

Lis

It's not just "companies like Wal-Mart"; the standards for what's "organic" and what's not are genuinely in flux.



As for assuming pain or not--I'll yield to the guys on the question of whether castration is a sufficient physical trauma to warrant pain relief. In the case of major surgery or major physical trauma, though, sorry, yes, pain is a physiological fact, and you can disbelieve in it all you want; it's still there, and like gravity, it still has real physical effects. Gravity will cause you to fall to the gorund if you jump out a window, even if you sincerely believe you're Superman, and untreated pain following major surgery or physical trauma will slow your recovery and potentially cause complications--even if you think you're Superman and can just "ignore" the pain into non-existence. That's because pain is real and physical, and it uses energy and physiological resources to "ignore" it, that could better be spent on healing.

The OTHER Pat

Coursework. Lynn was talking about *coursework*:



Comment by Lynn — October 26, 2007 @ 11:04 pm



"mandatory CEU courses in this area should be part of licensure retention."



CEU stands for Continuing Education Units.

Lynn

Bernie:



Do NOT misquote me or attempt to paraphrase me or presume to know what my feelings are. I am particularly very clear on what I write and what I mean. And do not falsely infer that any of us call people in the rural area backwards. That is YOUR faulty assumption in operation again.



NEVER did I say that I wanted to pull the veternarian's license if he didn't conform. [Your statement, "This so much so that Lynn wants to pull the man’s license if he does not conform."] Check your arguments before you post them. I don't appreciate being maligned.



You need to learn to read and critically think about the opinions that others express without bias.



While it is appropriate to write of empirical experience, and I daresay we appreciate knowing the views of others, never presume that your view is the ONLY view. Listen with an open mind.



One of the things that keeps this country divided is the unwillingness of people to listen to and respect the other side.

Bernard J. (Bernie) Starzewski

Hopefully I have not misquoted this...



"One of the things that keeps this country divided is the unwillingness of people to listen to and respect the other side"



This is in fact my plea.

I have repeatedly said that if you feel that this is appropriate for you pet then do it.

But that these people have developed strategies that have worked for them for hundreds of years and they are not to be discounted because you feel that you have developed a superior notion.



Their society has developed thru a health skepticism of the next big thing and have survived not by embracing every notion of new science or technology that comes along but by reserving judgement and adopting only they practices that have stood the test of time.



Your comment about licensure is still the same. In your opinion of this guy is simply not educated enough so his is license will have to be held hostage by attending a re-education camp.



So, yes. The issue is in fact about respect for the opinions of others and at least making some attempt to understand their motives and concerns. You should try it some time.

The OTHER Pat

Comment by Bernard J. (Bernie) Starzewski — October 30, 2007 @ 6:17 am



"Your comment about licensure is still the same. In your opinion of this guy is simply not educated enough so his is license will have to be held hostage by attending a re-education camp."



Bernie, are you aware that many, many professionals in many, many fields are required to provide evidence of yearly training to remain current in their fields in order to maintain their licensure? This has NOTHING to do with being "held hostage" or "re-education camps". This is simply an acknowledgement that a responsible professional remains up-to-date with the new findings in their field. That's WHY the acronym "CEU" for "Continuing Education Unit" is such a widely understood concept. You don't go to school in a professional field, and 20 years later continue practicing based on 20 year old knowledge that has never been updated.



The open, educated mind WELCOMES the opportunity to remain current on new findings and new learnings - regardless of whether or not all of these things get incorporated into one's personal practice.

A.C.

Bernie, right about now you probably feel pretty maligned. Normally, I stay out of discussions like this, but I felt compelled this time to speak.



You are clearly an intelligent, articulate individual. I was born into a city background, spent several years in the US Army, settled into a rural setting for a decade, and currently reside in more of a city environment. I understand your viewpoint as it relates to the differences between city and country living, completely.



I think what's setting folks off here, however, is that you're presenting your pain management thoughts (which, in and of themselves, do promote an understanding, if not agreement, with the rural mindset) through your rural/city perception as if that perception were a universal truth.



Which, of course, it isn't, ‘though I can empathize that it feels that way from where you sit.



You are dismissing pre-emptive pain management out-of-hand because you believe the concept is a soft city-folk idea and not worthy of rural consideration. What if you're wrong? You say the current lack of pain management has worked for years and years. What if pre-emptive pain management allowed those animals to return to full health sooner? Or even saved the lives of some that just couldn't "work" through the pain?



If you remove the negative "city-soft" connotation you've attached to pain management and consider it simply on its own merits, even disregarding the many studies that show healing occurs faster in the absence of pain (which I don't), there's no harm in granting an animal relief, be it a cow, a working dog, or a housecat. Given that, why wouldn't you?

Lis

Hopefully I have not misquoted this…



“One of the things that keeps this country divided is the unwillingness of people to listen to and respect the other side”



This is in fact my plea.

I have repeatedly said that if you feel that this is appropriate for you pet then do it.

But that these people have developed strategies that have worked for them for hundreds of years and they are not to be discounted because you feel that you have developed a superior notion.




That may be what you think you are doing. In reality, though, you are the one who has repeatedly and persistently described the people you disagree with in insulting and demeaning terms. City people "wallow" in our pain. They are "whiney(sic) and self-indulgent and materialistic." Rural people are "pragmatic and practical." We should defer to the judgment of rural people because "their experience is deeper than your own."



You do not just disagree, but actively express your disrespect for anyone who "believes in" (apparently, in your imagination, similar to "believing in" astrology) the effectiveness of pain medication as demonstrated by both personal experience and extensive, well-documented, medical research.



And you're offended by the suggestion that veterinarians, including rural veterinarians, should be required to take some number of Continuing Education Units every year. You describe this as "re-education camp"--and please, no whining that you're not calling us all un-American commies when you use that particular phrase; that's where it comes from and that's the image you intend to provoke. We're supposed to be afraid to keep arguing, lest we be tarred as evil unAmerican commies! Sorry, I'm not playing your game.



CEU requirements are
standard across a wide range of licensed professions. Lawyers. Accountants. Teachers. Nurses. Doctors...what was that last one? Doctors??? Human doctors, who only have to keep up with the state of knowledge in the medical field for one species? Yup, human doctors.



Would you care to explain to us why you think it's so insulting to suggest that veterinarians, treating multiple species and not knowing for sure which species is either going to come in the door or require a housecall next, should be required to take some Continuing Education Units, so that they stay current and aware of what's going on in their field, regardless of whether any particular development seems applicable to their patient & client base?



That's some mighty big chip you've got on your shoulder, Bernie. No one participating in this discussion has described you or your farmer buddies in anything remotely comparable to the terms you've described city people in, and you regard even the most mundance suggestion that veterinarians shoud be treated like any other licensed profession. And yes, by the way, those CEU requirements for lawyers and doctors do apply to rural practitioners just as much as to urban practitioners. No free passes for being morally superior to us weak, lazy, corrupt city people.

Bernard J. (Bernie) Starzewski

I think that rural people are insulted by the continual insinuation that they are somehow less educated or backward or stupid compared to city people.



If you are interested in education why dont we all come down to my farm for a minute and take a class on accumulated farm knowledge 101.



Why do we feel pain?



When you sprain your ankle your ankle is sending you a message that - hey - you had better not use me for a while. We have a problem down here.



Now, you can use a cane or a crutch and you can go to a doctor and have him give you an ankle brace to keep you off of it. You can also ask for something for the pain that will not cure the ankle but will make it feel just fine.



But, if you go out and run a marathon you are likely to do yourself a huge amount of harm. In fact substances like "bute" have been illegally in horse racing for years to convince them to do exactly that.



I don't think that anyone has figured out how to have a conversation with a dog or cow or cat explaining that although they might well feel much better after they get this pill they still should stay off that leg and not go chasing rabbits.



Pain tells the dog the lay still and is doing you and your pooch or whatever a great service. It reminds them to stay off the limb until it feels better which is the appropriate time to resume normal activity.



Of course, the effect of pain and its severity have to be monitored closely and unless you have the ability to fully sedate the dog or restrain him or otherwise enforce the inactivity sometimes the message that pain sends is exceedingly useful.



If you dont think that pain can be a useful tool in managing the behavior of animals consider what an electric fence does. It teaches the heifer not to go there where she might get into trouble.



Similarly, shock collars for dogs are used for all kinds of training from teaching a hunting dog not to run too far afield to preventing a dog from barking excessively in town. NO, I dont use these things myself but I can also accept that a particularly defyant dog can be saved from loss or death if nothing else works.



A wise vet can also use observations of pain to diagnose other problems or an animals lack of progress in healing which are completely negated when it is medicated. In fact even the most modern vet schools will teach this in discussing diagnostic skills.



Pain is an important feature of evolution and an entirely natural informative tool and as long as it does get out of hand and become debilitating any animal can and does use it effectively to help in the healing process.



These are the things that people who have spent their lives close to animals know. Their education comes from many lifetimes of observations and wise vets will accept this and learn from it themselves.



As long as people choose to intrude into their lives and livelihood there is always going to be that disconnect and resentment I see festering here.



Before you imply that someone does not know what they should know, best you are certain that you know all you should and not assume that you have nothing to learn from them.



No CEUs, sorry. But if you are wise you will take something from it.

Gina Spadafori

OK, so I've been reading this for a few days now, from a Texas cattle ranch. I really do think people need to step out of themselves sometimes (and I'm NOT singling anyone out here) and look at the situation from outside their own point of view.



I've lived in the state of mind that is urban California, most of my life. (Although mind you, Sacramento is an urban oasis in the midst of some of the biggest ag counties in the nation -- from Shasta, Butte, Sutter and Yuba all the way down to the Nos. 1 and 2 ag counties in the world, Fresno and Tulare.) I've also lived in the very rural and very poor fishing and timber communities of Franklin County, Florida. Have a passing knowledge of rural Texas (this morning I notice bruising from where a ranch gate hit me, and a cut from a barbed-wire fence!) and other parts of this truly interesting and diverse country.



I have always, always found that everyone has something to offer, and something to say, if you just shut up and LISTEN for a while.



Nobody here is saying rural people are bumpkins. Certainly not me. This weekend I listened to a PhD economist and a board-certified veterinary internist, both women, both ranchers, as well as a country vet and some really good smart stock hands. (One of whom was a young man of around 16.)



I listened to an explanation of advanced artificial insemination techniques that will mean that one great cow will have multiple offspring implanted in other cows. And I listened, too, to plans to breed a great field dog to two top males -- one of them deceased. (DNA will be used to sort out the parentage on the resulting double-sired litter.)



This is not "tried and true" old methodology, but cutting-edge, high-tech modern agriculture.



And yes, continuing education is essential for country vets, farmers and ranchers, because the world is changing everywhere.



Now, on top of the interest in using new techniques and technology to advance the "production" of better farm animals in terms of yield, conformation, temperament, what-have-you, where are the open minds when it comes to making the environment more comfortable for an individual animal?



I'm seeing a disconnect here. Am I the only one?



On the original situation in Minnesota, I gotta be honest here: I think the vet needs to retire. Because when you close your mind, you're done. Whether or not he should be struck off is up to the state board of veterinary medicine to decide, but I guaran-damn-tee-ya I'd never take a dog to him.

A.C.

Bernie, not one person here has implied that you are somehow "less educated or backward or stupid compared to city people". Quite the contrary.



As for the rest, since you're clearly joking, I'll just shake my head (can't quite laugh) and go read something that's relevant, maybe even something from one of those *gasp* hard-studying vets who should be learning from you.

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