Rabies invokes powerful fear among veterinarians, public health officials, and most pet owners.  This viral disease has the highest mortality of ANY infectious agent, virtually 100% fatal (there have been fewer than 10 high profile human survivors recently). In contrast Ebola's fatality rate is approximately 65%.   Worldwide rabies causes between 28,000 and 55,000 human deaths a year, many of these children in Africa and Asia.  Rabies is spread when an infected animal bites another animal or human, the virus being found in high concentrations in the infected animals salivary glands.  

The threat of exposure to humans and domestic animals in Europe and North America has been dramatically reduced via vaccination of pets against rabies. Surprisingly, there are 10,000 animal cases a year  in  North America each year; this number includes wildlife and domestic species.  Among domestic animals, cats have more cases of rabies than any other domestic species, three times the number than dogs. 

The reason for this is dogs are more likely to be vaccinated, and are more often supervised outside.

On the bright side, this lethal disease can be prevented by vaccination. While most people in North America do not receive vaccination against rabies, it is required by law that dogs and cats receive this vaccine.  Although no vaccine is 100 % effective, the rabies vaccine is nearly so, and provides your pet with the only known preventive available.  

Homelessness and pet ownership

Today, one of my clients was an elderly homeless woman,- her cracked toenails were visible through her threadbare shoes, most of her incisors were missing. However, a bigger tragedy for her was her cat was dying. Clearly she loved this 16 year old cat, who she had paid for us to examine a month earlier - only to have us diagnose her with cancer.  Instead of taking the "easy" route, she choose humane euthanasia for her beloved feline;wanting her pet to have a dignified, humane ending.  She wanted a photo of her cat, not having a camera or a cell phone- unlike the majority of us these days, she was not connected to the internet.

Pet owners are often faced with tough decisions regarding what is best for their pet. Homeless pet owners have the difficult decision on whether or not to keep their pets. Often pet owners have to choose between shelter and keeping their pet. In Bellingham, WA, the local shelters do not accommodate pets (with the exception of service animals for the disabled).

We also know that pets can bring joy and better health to their owners, but financial hardship can make it difficult for owners to care for their pets. Here are some resources for financially strapped owners, both local, regional, and national.

1)The Whatcom Humane Society (360 733-2080)  has a pet food bank, that provides pet food to the pets of low income residents in our county- they supply pet food to the Bellingham food bank, Blaine food bank, and the Lummi Indian Reservation Community Center. Many shelters offer this service- call them to find out.

2) WeSNiP (360-733-6549)  is a program in Whatcom/Skagit counties that can provide high quality spay and neuter services to low income pet owners. Owners receiving public assistance are eligible

3) Seattle Humane Society  (425-641-0800)   has a pet food bank and provides services to pets of disabled individuals suffering from HIV/AIDS.

4)  The Doney Memorial Clinic (206- 622-5177)  in Seattle : provides veterinary care for homeless and low income individuals (need proof of residence)

5) The RedRover Relief  (916-429-2457)  provide grants for emergency veterinary care throughout the US and Canada.

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Dr. Timothy Kraabel: Anesthesia Fears

Dr. Timothy Kraabel: Anesthesia Fears:       When we recommend a surgical or dental procedure that will require general anesthesia, fear of anesthesia is frequently paramount ...

Two Resolutions for the New Year

1) Discuss training and behavior
I am reluctant to discuss little Phoebe's misbehavior, as she lunges like a snapping turtle toward my face, for fear the owner will take offence. Many owners excuse their dog's behavior ("She's protecting me"," He's scared", or my favorite - "He's never bit anyone BEFORE!").  However, I haven't been doing dogs any favors, as studies indicate 10-17 % of dogs euthanized at animal shelters are due to severe behavioral problems (usually biting).  There are many excellent training aids, and great positive, reward based, HUMANE, training centers.  We are all busy people, and I have heard every excuse (and made them myself).  But, seriously, when someone chooses to own a dog, they have the responsibility to train it. Some resources:
 http://drsophiayin.com/philosophy
http://www.dogstardaily.com/

Local trainers:
http://www.theclevercaninenw.com/
http://www.tails-a-wagging.com/
 http://thinkingdog-lauraberger.com/

2) Discuss insurance with new pet owners.

oblique mid diaphyseal fracture of tibia and fibula distal to TPLO repair

       In the past, I  have been hesitant to discuss insurance, because I don't want to endorse one company over another or come across as a saleswoman. In addition,  the discussion can be time consuming- limiting how much health  and behavioral information that can be covered in an already tight schedule. However, I have seen too many owners struggle with being able to afford medically indicated treatments that would have been covered (in part) by insurance. As an example, the cost of surgically
repairing a  torn cruciate ligament (knee injury)  via tibial plateau leveling (TPLO) is approximately 2000 $. This cost of repairing the  fractured tibia that occurred after this dog (imaged above) slipped at home doubled the original cost.
 Here is a website with comparison information: http://www.petinsurancereview.com/dog.asp

Holiday Hazards to avoid

I mentioned a few weeks ago some of the dangers that Thanksgiving poses for your pet. In that same vein I thought I'd outline some holiday hazards for the month of December.  As an aside, I am not using "holidays" as a politically correct term here- don't sick Fox News on me! I am being inclusive as there are many faiths with celebrations in the month of December- all of which have hazards for our pets.

Prevention is the key  to protecting your pets, and avoiding  an emergency trip to the veterinary clinic.

Some plants found this time of year are toxic. Lilies are found in flower arrangements are are deadly to cats. Make sure your floral decorations don't contain Tiger, Asian, Japanese Show, East, Stargazer, or Casa Blanca lilies, as even a small amount ingested by your cat can lead to kidney failure.  The Ilex genus of holly has 29 species; the best known is  traditional English holly (Ilex aquifolium).

Generally self limiting symptoms are all that is seen with ingestion (vomiting/ decreased appetite, and diarrhea). Best to keep this plant out of reach.   




American mistletoe can cause stomach upset as well, however  European mistletoe is much more toxic.  Fortunately, American mistletoe is the commonly used mistletoe

in holiday decorations.  European mistletoe can cause a drop in blood pressure and decrease the hearts contractions, which would be seen clinically as decreased energy, or even collapse and death.  Be on the safe side and don't let your pets near it.  A plant that is not as toxic as most people think is Poinsettia. However, it can cause mild oral irritation and perhaps some vomiting.

There are a number of hazards around your Christmas tree. Starting at the bottom and working up, the water your tree sits in can harbor bacteria and fertilizers. Ingestion of the water, usually by a thirsty or inquisitive dog, can lead to vomiting or diarrhea. Try to cover the water stand.  Electric cords lighting up your tree can electrocute your pet if they chew through the cord. Cover your cords, and unplug your lights if your pet is left unsupervised in the house.  

Kelso demonstrating his interest in ribbon!

Ribbons and tinsel are attractive not just to us, but to our cats and dogs as well. If eaten, these can cause serious intestinal obstruction, which may require surgery to alleviate.  Don't wrap bows around your pets neck, as this poses strangulation risk. 


The last Christmas tree hazard are the glass and breakable ornaments, as sharp pieces can lacerate the delicate mucous membranes of the mouth and intestines if they are eaten by a dog or cat. Place delicate ornaments and ribbons/ tinsel high up on the tree, out of reach of your pet.  Lastly, you pet should not be left unsupervised with access to the tree or decorations. 

Wishing you and your four legged family a happy and safe holiday season!

My brother, forever young

Today is my brothers birthday, Ian would be 52. But he is frozen in time, as a spirited 23 year old. He died August 3rd, 1986, in an unusual summer avalanche on Mt Baker. There is a saying, "Don't speak ill of the dead", that holds us back from discussing the very human nature of the deceased. His death was a tragedy for his friends and our family,  I miss him daily, but he wasn't an easy older brother to grow up with.

As the youngest of four, I remember trying  to keep up with my older siblings ( Caroline, Ian, Brett- in birth order). My siblings are close in age, and I the afterthought 4 years later.   I took up all things boy: I shot arrows, helped build a fort in the yard, climbed trees, and hiked with enthusiasm. On hikes my brothers would play a game of prisoner, holding me back, then I would run as fast as I could until they inevitably caught me.  We then hid in the ferns waiting to scare our parents.

 My brother was many things, but easygoing was not one of them. He taunted me at an early age to toughen up- using his superior strength to make his point. Using climbing gear, he  hoisted me to a  ceiling beam at age 7, and left me there for over 30 minutes. A few months later he tied me up and put me in a toy chest, but let me out quicker. He could also be generous, helping me with homework or encouraging my skiing.

He grew out of bullying his two younger siblings in high school.  His last letter (when I was a freshman at UC Davis) complimented me on how well I was doing in school. I learned of his death when I was at an ecology field camp in Montana; an early morning phone call breaking the news. All these years later,  as appalling comprehension took hold of me, that moment stands as the the divide in my life, the before and after. Before, death was abstract; after, an ever present reality. He was larger than life to me, vibrant and fearless (he climbed Liberty Ridge , Mt Rainer,  among many other feats). He couldn't be dead... I saw him out of the corner of my eye for weeks, found myself expecting him to walk into the room at any moment.

He was authentic, ornery, enthusiastic, and I  hold his memory dear.

Imperfect medicine

December 1st, 2014

I enjoy puzzles, mysteries, and riddles, which is  one reason veterinary medicine appealed to me. Additionally, all processes of life fascinate me. How is it possible for a polar bear to survive the arctic winter, a hummingbird to fly 500 miles,  your own dog to recognize your voice?

What I did not factor into the decision of becoming a veterinarian is how difficult it would be to treat my own pets.  Recently my dog Kiwi vomited a few times. Not a big deal, I would counsel owners. Dogs eat things they shouldn't (she was a 9 pound Papillion and had a penchant for cat poop among other doggy delights). I took a radiograph (X ray) which was normal. However, as she was an older small breed dog, and she did need to have her teeth cleaned  (an annual occurrence). Her pre-anesthetic blood work demonstrated some problems- and an ultrasound (performed by me) revealed a tumor.

 When our pets are ill, it is suddenly difficult to be the logical veterinarian. Everything we know, all the hours of education, have a way of disappearing.  I knew I was in over my head. Small dogs live forever... at least into their teens- I reminded myself.  My amazing colleague Kim Barron (DVM, owner Northshore Veterinary Hospital) biopsied her pyloric tumor (stomach).  Results indicated a tumor that is locally aggressive, but with complete removal , can be cured (leiomyosarcoma).  I called a surgical specialist, Mark Davis, DVM, DACVS. He performed a delicate surgery to remove 1/3 of her stomach. However , as the pancreas is adjacent to the stomach, she developed severe pancreatitis, and her surgery never healed. I had to let her go 5 days after surgery.

I have asked myself a number of times- what did I miss? Why didn't I notice something earlier? The answer is unknowable. I miss her dearly.