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Santa, Keanu, and the art of the dab

December 24th, 2017

I am told that to remain relevant on social media, you must post at least once a week. Considering I haven’t posted for over a year, that makes me a fossil.

But it’s Christmas Eve, I’m enjoying a take-away coffee and excellent steak pie (that breakfast of champions) as I type and it seems like an appropriate time to look back on the year. The take-away coffee is important, but that comes later.

For me, the year has brought changes. Mostly subtle, but one irrevocable in that my mother passed away in March aged 93. That she was able to stay at home until her final weeks is testament to the care she received from all the carers at Southcare and from Jenny,Gloria,Adita and Mirna. Cathy, one of her principal carers, only felt able to retire when my mother and other long-term clients passed away.

Through the year too. we lost three dear friends and clients: Clive, Rusty and Lucy. Every time I think of Clive and Rusty I think of the scene in “My Fair Lady” where Audrey Hepburn takes down Rex Harrison by explaining why his Professor Henry Higgins is not a gentleman and Wifrid Hyde-White’s Colonel Pickering is (this may be getting a bit obscure for readers under fifty who aren’t film buffs but I’m getting to the point).

As she tells him, a gentleman is not a reflection of status in life or an accident of birth, but is determined by how you treat other people. By this measure, as by any other, Clive and Rusty were gentlemen. Lucy’s warmth and generosity of spirit was reflected in the temperament of her cats because, I believe, she poured love into them.

Perhaps because of all the above, this year has made me reflect. And one of my first stops on that journey of reflection was that, at the age of fifty-seven, the present generation of pups and kittens entrusted to my care will be the last I follow all through their lives. After thirty-three and a half years as a vet that brought me up short, because being a vet in general practice, helping my patients (and through them, their people) has been all I’ve ever wanted to do and, as an adult, all I’ve ever known.

Thankfully retirement is still, I hope, at least a decade away so I can leave you with three anecdotes that will, I trust, make you smile.

For the first, we must retrace our steps to the take-away coffee from the cafe where the lovely, highly-skilled, and generally all-round good bloke of a barista told me unprompted (promise) that he and his gorgeous, charming partner referred to me as Keanu Reeves’ Dad. As you may imagine I was pretty chuffed, and the cares of the day receded far away. So far away I was moved to txt my lovely wife and very best mate about it. Denise, with the good sense that is her trademark was, prudently, non committal. Not so my bestie who fired back one of those txts that leap out of the screen to inform the recipient that, for the record, Keanu Reeves himself is now 53!

Recently, in the same week, a really delightful client suggested I should dress up in a Santa suit and have my picture taken at the practice with my patients. After a little while to establish the merits of her argument (well, the beard is snow white now and it would mean I could let it grow from September without risking spousal disapproval) I reckon, for a small fee and with all proceeds to charity, I might be in this next year. Let me know if there is popular demand.

Third and finally, I have to take you to school drop-off for my youngest son, the family comedian and now a teenager (how did that happen). He’s a good sportsman but his summer sport of basketball is not his main one, so as a regular B-teamer guesting for the As on this day I thought he may be a little nervous.”Good luck, mate” I said as he got out of the car. “Dab on the haters!” came the reply.

Well,that cracked me up. After wondering where that came from (not unusual as far as this almost-always good natured young fellow is concerned) it struck me how useful that phrase can be. Firstly, it makes me smile always, every time. But secondly it is very useful for dissolving the frustrations of everyday life. Stuck in a Christmas queue at the shops behind someone who insists on using the slowest means of payment possible including, but not necessarily limited to, multiple different kinds of gift vouchers that have to be entered into the computer system manually; dab away mentally and feel the calm return. It does work. And if you’re not sure what a dab is, follow my boys’ sporting allegiance and search for : “Paul Pogba dabbing” on You Tube. Memo to parents – turn the volume down low and screen first for any bad language on the sound track. But you’ll get the idea.

So,from my family and everyone at Millpoint, we wish you and your loved ones (which includes of course all the furry members of the family) a very Merry Christmas and a peaceful and Happy 2018! And may all your haters be dabbed!

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Mrs Shirley Mort – a living legend

September 4th, 2016

I like newspapers. Always have. Especially on a lazy weekend with a nice breakfast and a lovely view. Intelligent writing, whether it confirms my views or challenges them, is lapped up and appreciated.

My darling wife views newspapers with more suspicion, regarding them as a defence and barrier against conversation and the intrusions of family. Never happened in my household, no sirree, not in my lifetime.  Nonetheless she holds that view and it has proved hard to dissuade her.

So last weekend chez Buchanan, a funny thing happened. Opening the weekend West to find the usual diet of atrocity, natural disaster and endemic corruption, I started to shake my head. No,no, said Denise, keep going – you’ll find something you’ll like, really like! So I did and I did.

On page 18 of the West Australian of August 27-28 there was an article about Mrs Shirley Mort, marking her retirement from fundraising for the Salvation Army at the callow age of 92. In the course of the last 26 years Shirley has shaken her collection tin on the footbridge between the city train station and Forrest Chase. In the course of that long and faithful service, she has collected (and are you ready for this because if you didn’t read the paper that day you are going to need to sit down) $1,700,000. No, there is no typo – $1.7 million.Let’s try and put that in perspective. That same weekend a house on Forrest St in South Perth was auctioned and passed in with a highest bid of $1.45 million. That’s a pleasant 3/4 bedroom family home on one of the best streets in one of Perth’s best suburbs. Shirley bought that for the Salvos and then some.

And that’s only half of it. Before she climbed up the stairs to stand on that cold overpass day after day, she would have been up in the early hours making sandwiches and soup that she helped to distribute to the homeless on the Salvos soup run. I think, without any exaggeration, she saved some lives and changed  more.

Back in the noughties I treated Shirley’s dogs, so I can tell you first hand that she is just as pleasant and just as unassuming as you might expect. An ordinary person doing something truly extraordinary. She gave my eldest son a cuddly toy. Struck immediately by a lady, even then in her early eighties, who gave so much of herself to help others; I wrote a piece about her in the practice newsletter. It may have had a loyal readership in single figures, but one of my readers walked passed Shirley on the footbridge one day, exclaimed “Oh, you’re the lady he was writing about!”, opened his wallet and put a $100 note in her tin. I have never been able to trace that gentleman, though I would like to, but I thank you sir. As Giovanni Guareschi, the author of the Don Camillo stories, wrote in far more momentous circumstances “then for a moment I thought that rather than an unimportant fool I might be one of some little importance”.

Of course, the other $1,699,900 had nothing to do with me. I haven’t seen Shirley for almost seven years. During which time she will have raised over $450,000 to help the homeless. I’m not sure I’ve spent that time as productively. But surely, surely, Colin, Malcolm, the governor, governor-general or whoever else reads the blog of a suburban vet – give the lady an Order of Australia, name a park after her, name a new suburb after her but for God’s sake (and I am not blaspheming here) do something and do it soon!

Shirley, if you read this: a very happy retirement from my family and all of us at Millpoint.

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Endocrine disease from an owner’s viewpoint

March 15th, 2016

As vets I think sometimes we (OK then, I ) get caught up in the diagnosis and treatment of our patients to the exclusion of all else. This is, after all, what we are trained to do and what is expected of us. In this post I will try and step back and consider endocrine disease (diseases of the body’s hormones) from an owner’s point of view.

Let’s consider the more common endocrine diseases of cats and dogs:

1/Diabetes Mellitus

When we talk about “Diabetes” we mean, almost invariably, sugar diabetes or diabetes mellitus. In pets this is caused by a relative or absolute lack of insulin. Insulin producing cells in the pancreas have been destroyed. It is equivalent to type 1 or juvenile onset diabetes in humans, so it cannot be treated and controlled by drugs, diet and exercise. You will have to inject your dog or cat with insulin twice a day (these days it is ALWAYS twice a day). This freaks some owners out. I trot out something that my father said when I was learning to drive; when you first learn to drive you think steering is the hard part. When your pet has diabetes you think the injections will be the hard part. They won’t. After a week you will be quite confident. Even one truly needle-phobic client is making a good fist of them with an insulin pen, so relax. You will need to set aside some money for repeat glucose testing, the continuing cost of insulin and syringes, and someone needs to be there twice a day to inject the pet. All that said, follow the mantra of a sportswear company (they’re not sponsoring my website so I’m not name-checking them ) and JUST DO IT! You will save your pets life and enjoy many more months or years of good quality life together. Early detection and treatment is the key – increased thirst and appetite are often the most obvious symptoms. Stabilising a sick diabetic is way harder so get on to this early.

For cats the news is even better. I can stabilise most diabetic acts using a minimalist approach as an out patient, on a special diet and with one visit to the clinic a week, There will be some cost involved but it is not likely to be unaffordable. Cats are fascinating creatures and can drift in and out of a diabetic state, so not all cats need to be treated for life.

2/Hypothyroidism in dogs (underactive thyroid – never seen in cats in practice)

An overweight, slothful dog of any age should have thyroid function tested. There are grey areas with the blood tests so you may get a yes, a definite no or a maybe for an underactive thyroid. Trial treatment may be appropriate. Treatment is easy with twice a day pilling and very satisfying as the weight falls off and your dog’s demeanour improves rapidly. Thyroid function affects many body processes so other symptoms may occur and resolve with treatment. The only reason you wouldn’t treat this is if I’ve missed it (or you don’t let me run the blood test)! Sadly, most overweight dogs do NOT have thyroid or adrenal gland disease (see below) – they are just fed too much.

3/Hyperthyroidism in cats (overactive thyroid – very rarely seen in dogs)

The classic hyperthyroid cat is old,thin and has a ravenous appetite. Unfortunately a wide spectrum of clinical signs are possible with hyperthyroidism, and a diabetic cat may present with the signs I’ve just described. Diagnosis is not usually difficult provided a thyroid test is included in the blood work. Cats with thyroid hormone levels approaching the upper limit of normal are almost certainly becoming hyperthyroid, but most affected cats have levels well above the normal range.

Treatment however, will present you with some challenges unless you feel confident giving your cat tablets. For the first two weeks of treatment you will need to pill your puss three times a day (yes, I know that’s really inconvenient but you just have to) and then, after a second blood test, you drop down to twice daily pilling. There is a cream you can rub on the inside of your cats ear but it’s (comparatively) rubbish. The tablets work really well so “stiffen the sinews, summon up the blood” and get pilling. Your cat will gain weight, feel better, have lower blood pressure and less risk of heart disease.

4/Hypoadrenocorticism in dogs ( underactive adrenal glands – Addison’s disease )

Addison’s is an emergency. Addison’s patients cannot cope with stress, and lack other steroid hormones that stabilise membranes and bodily functions. Following transient episodes of vomiting and diarrhoea, these patients often present as really unwell. Serum electrolyte changes ( electrolytes are included in routine blood work) are highly suggestive and an adrenal function test is diagnostic. Recovery is prompt,usually, but patients require treatment for life. It’s worth it as the dogs are normal on their medication. Owners are (usually) delighted.

5/Hyperadrenocorticism in dogs ( overactive adrenal glands – Cushing’s disease )

Now having spent all of this post telling you how rewarding you’ll find treating a whole heap of conditions, and how doable it all is, we come to Cushing’s and I have to be a little more guarded. Cushing’s disease is an underdiagnosed and undertreated disease. The more you look for it the more you’ll find ( and trust me, I don’t need to drum up business ). Usually, and there are exceptions, Cushing’s is a disease of middle aged and older dogs. In addition, I have to tell you that treating the older Cushing’s patient will not extend their life. So why do it? Why go through the expense of diagnostic adrenal tests, medication and regular follow up blood testing? Well, you may not lengthen your dog’s life (they are not usually acutely ill – just overweight,lethargic, hungry,thirsty and with a poor hair coat and pot belly) but boy do you improve the quality of their lives! For this blinding insight you have to thank the very good owners who have bitten the bullet and gone through diagnosis and treatment. I can’t tell you how satisfying it has been to give some lovely dogs and great people a good result. Do consider treatment – I don’t think you’ll regret it!

And finally, a note on blood testing for some of the conditions described above. Fast your pet overnight, and pill them 4 hours before we draw blood. In practice, as we usually close appointments at 11am so I can start on the day’s surgery, you may have to get up a little early that day.

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Could you offer a home to Rosie?

May 17th, 2015

Look, I wouldn’t do this normally but there are always exceptions and this is one. An elderly and terminally-ill owner brought her cat in for euthanasia, reluctantly, as part of the process of setting her affairs in order. But Rosie is a young and apparently healthy cat and I’m well past the stage (if I was ever in it) of euthanasing healthy animals (unless they pose a danger to people or other animals). So Rosie is here, at the clinic, waiting for a loving home.

She’s a desexed domestic medium-haired tortoiseshell and white cat. She was quite timid but I’ve just taken her out of the cage for a cuddle and  she’s starting to trust us. She seems a real sweetie and I think she’d be best suited to a home where she is the only pet and where she will be kept inside. If you or someone you know can offer her a home we’ll vaccinate and worm her to keep your costs down.

If you own and love cats but can’t help on this occasion, please read the last post in this blog on current retrovirus prevalence in WA – and act on it!

PS Thanks to Olivia, Rosie found a really good home in the country. We got a lovely Christmas card from her!

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Never mind the Wookies, be very afraid of the retrovirus stats

May 17th, 2015

A long time ago in a galaxy far,far away a private veterinary laboratory did a remarkable thing. They tested every sample of blood from cats that they received for FIV. Every sample from every cat, and the results were frightening.

Now I have to do two things straightaway. One is to acknowledge George Lucas and his copyright on Wookies and the opening sentence in the excerpt. The second is to say that this really happened in Perth in the early nineties. Every feline blood sample sent to that laboratory was tested, and 1 in 3 tested positive for FIV (Feline Immunodeficiency Virus or Feline AIDS). But that was more than twenty years ago and these days vets have educated more cat owners to keep their pets inside and we’ve had a vaccine for quite a few years now and, well things just couldn’t be that bad still, could they?

In this age of corporatisation and cost recovery it seemed very unlikely such a public-spirited survey would ever be repeated. But this year, from various sources, a good estimate of the prevalence of FIV and Feline Leukaemia Virus (FeLV) has been put together, state by state throughout Australia. So let out a cheer parochial Sandgropers ‘cos yes we won! Both for FIV and FeLV. Easily. No, I don’t feel like celebrating either.

You’ll have to read (or scroll but shame on you if you do that!) to the end of the post to get the actual figures but, bearing in mind that the ’90s survey must have included a large proportion of sick cats (otherwise why would their blood have been sent to the lab anyway) and so be a skewed sample group. my take on this is that not a lot has changed, and I find that depressing, profoundly so.

So if we’re in the consult room discussing vaccinations for your cat be prepared that I may be a little more forceful in my recommendations. My advice has always been : If your cats are inside (or their only access outside is to a cat enclosure or walled courtyard which NO other cats can access) then vaccination for the basic diseases required by a boarding cattery (Feline Panleucopenia and Feline Respiratory Disease) is the most that is required. Mind you, if you have more than one cat in your home I’d want to know their FIV and FeLV status  and protect any at-risk cat with vaccination.

BUT, if you can’t/don’t/won’t keep your cat inside then he/she should be tested and  vaccinated for both FIV and FeLV, REALLY! FeLV is spread between cats by social contact (mutual grooming spreads the virus in the saliva from infected cats) and FIV is spread by anti-social contact (cat bites in plain english – you need a deep puncture wound to inject the virus into the tissues).

Yes that will cost you money but with 1 in 25 cats in WA carrying FeLV and a staggering 1 in 5 carrying FIV, will you be counting the dollars when your cat dies of diseases related to immune deficiency or cancer caused by these viruses?

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