Wednesday, May 13, 2020

Covid-19 A Veterinary Journal (6)


As we cruise into the middle of May, we find ourselves almost back to full strength, staff wise, at Crawford.  There are still challenges to face as New York prepares to move towards allowing certain businesses to start to open up.  Our goal and the goal of our upline management remains to maintain staff safety while meeting the needs of our patients and their owners.  I can’t lie, it has been a challenge for us and understandably a frustration for pet owners.  This past week saw two staff members return to work and one more announce her intention of returning in two weeks.  We hope to welcome Dr. Wu back from leave at the end of June.  As the staff ramps up, we are maintaining vigilance while keeping an eye forward to the time when we can be back to a full-service veterinary practice.

So, what are we doing to move towards that goal?  We have started to allow drop off appointments in addition to our curbside check in appointments.  This gives us greater flexibility to work in sick animals rather than sending them away to specialty practices when that is not indicated.  This allows the pets to be in a more familiar environment and helps contain costs.  We have been working with a new urgent care center in Carle Place for our after-hours emergencies when that is the appropriate level of care.  We have experimented with different schedules during the day to see what gives the best capacity to care for pets that need more immediate attention, while still providing the essential preventative care so that we don’t see sick puppies from inadequate immunization or a public health crises due to lapses in Rabies and Leptospirosis vaccinations.  We continue to dispense parasite control for both internal parasites as well as fleas and ticks. 

As I was out today (social distance running) I thought how thankful I am that so many of our clients are appreciative of the work that the doctors and staff are putting in to help care for the pets in our area.  I am also thankful for the support that we have received from our field supervisors and corporate managers.  Their compassion for your pets and our safety have really helped us to maintain a safe, effective, and professional environment at Crawford during this period of stressful crises.

Thursday, May 7, 2020

Covid-19 A veterinary Journal (5)


What a lovely day today is.  The weather was perfect, and my team and I are off after a long two weeks.  The other team headed by Dr. Waters was on self-quarantine for 14 days, but today they are back, almost at full strength.  My team is off today and then we have a long weekend after one day back tomorrow.  Working with a reduced staff has been a real challenge for everyone, but I am happy to say that the Crawford team pulled together and we were able to take care of all essential health issues for our patients.

Going forward, we are getting ready for the changes that Governor Cuomo will propose next week and we will see how that impacts the services that we can offer.  We are hoping that we can start to once again offer routine preventive care in addition to essential veterinary services so that we can keep our furry friends healthy going forward.  While we do not see an imminent end to social distancing and curbside check ins, we are working on plans to improve on the efficiency of our processes and the effectiveness of our client communications so that we can serve the owners and pets of our community.


But back to today.  After a morning of errands, always stressful in this environment, Bella and I returned home.  I left her and I went for a run in the neighborhood.  It is easier to maintain distance here than many of the places that I like to run.  Not ¼ mile from my house I came upon a little Yorkie jogging towards me down the middle of the street.  Fortunately, there were no cars.  Also, fortunately, he was friendly and had tags with his name and phone number.  I called his owners and indeed, he had escaped when grand mom had come to help take care of the kids and left the door open.  I tucked him under my arm, continued on my run and dropped him off at home.  This just emphasizes the importance of watching out for our pets while our regular routines are disrupted.  It also shows the importance of proper ID for our pets in case they do get out.  Tags and microchips are the best combination for pet identification.  Maybe once restrictions are lifted, we can offer reduced pricing on microchips to pets that are not identified in this way.
In the meantime. 

Enjoy this weather and stay safe.



Thursday, April 30, 2020

Covid-19 A Veterinary Journal (4)


The rigors of working under the corona virus guidelines have made finding time to post a bit of a challenge over the past week.  We’ve been running short staffed and then the other team was forced to go into a one-week quarantine, putting the burden of keeping the practice open on my team.  We’ve made some logistical changes to try to maximize our ability to take care of our patients without jeopardizing the safety of pet owners or our staff. I’ve spoken with friends and colleagues throughout Long Island and they are facing the same difficulties as we are and the stress on the doctors and staff is quite apparent when we talk.  For now, we will remain open 6 days a week but the operating hours have been curtailed.  The staff and I are in from 8 AM to 4PM to see patients and perform required procedures.  Shelley came up with a great idea, and we shifted our procedures to first thing in the morning from mid-day to try to make things a little more controlled, time management wise.  I have been doing a weekly Facebook Live "Ask the Vet" and clients have responded well.  Details are usually posted over the weekend.

But through all off the challenges that we are all facing day in and day out, I wanted to share one of our cases with everyone.  This is the type of case that gives me great satisfaction, helping a dog and his owner.

Enzo is a really sweet Pittie that came to me as a second opinion in January, before the current pandemic changed the way that we are practicing medicine. Enzo had a skin problem.  Look at this poor pup’s photograph. 
The original veterinarian made the correct diagnosis, generalized demodectic mange.  He had the correct treatment started, but for some reason, he didn’t think that Enzo was responding and was recommending euthanasia.  After reviewing the records and examining Enzo, I counseled the owners about this disease in adult dogs, made some minor adjustments to his treatment plan and encouraged them to come back for regular rechecks.  This went well until the end of February when rechecks became more problematic.  We were able to manage the changes in Enzo’s skin via e mail photographs and medication adjustments.  The last set of photos, sent last week, show what can be accomplished with a conscientious owner and an appropriate treatment plan.   Needless to say, everyone is happy now.  We still need to do some work to find out why Enzo got so sick and set up a protocol to keep this from flaring up again, but this was a ray of sunshine in an otherwise dismal week.
I told Mom that these pictures made my week.
 

Enzo responded with this dapper selfie.  All dressed up but socially isolated. 




The entire team here at Crawford Dog and Cat Hospital is happy that we are still able to help our patients, even during these difficult times.  Our goal is to continue doing so and we will adapt as the situation changes.

Stay safe. Be well.  Wash your hands and don’t touch your face.

Wednesday, April 22, 2020

Covid-19 A Veterinary Journal (3)


Our team is back in the hospital after just one day off.  Fortunately, Dr. Waters’ team is scheduled to return to work tomorrow and we will all be back on the regular rotation.  This morning was very busy in the office with several pets needing updates of essential vaccines (Rabies and leptospirosis).  In addition, we agreed to see two emergencies from a practice in the area that did not have the capabilities to help the patients due to the ongoing pandemic.  We are glad that we are here and able to support our colleagues and help them to care for their patients.  One pet had advanced cancer and was humanely euthanized.  This was very sad for all of us and even though we allowed the owners to be present for the procedure.  Distancing protocols and masks and gowns make the experience difficult for all.  The second case was admitted to the hospital for support and diagnostics. Blood work is being run in house, fluids are being administered via an IV catheter and   we will have our ultrasound doctor come in tomorrow to evaluate his abdomen.
We have two feral cats in today for part of our TNR program. They will be spayed or neutered and released back to their colonies once they have fully recovered.  Since the feral cat population is expanding rapidly this year due t the mild winter, we really feel that this service is essential if we are to ever get a handle on this problem.  Fortunately, we can admit these pets, perform the surgery, and get them back to the organizations that brought them in with little interpersonal contact and therefore very little corona virus exposure risk to our staff.

Saturday, April 18, 2020

Covid 19 A Veterinary Journal (2)


It’s a rainy Saturday morning and I’m at the office.  Usually, my Saturday routine would not include working, but difficult times call for new routines.  The teams are on a rotating weekly schedule, Monday, Wednesday, Friday on week one; Tuesday, Thursday, Saturday on week two.  So, to paraphrase, if this is Saturday, this must be week two.

Saturdays for my team are a little different than for the other team.  As, many of our clients know, Dr. Robin Sturtz joined the Crawford Team about a year ago when the feline only practice that she was working at closed.  She came over and filled our vacant Sunday schedule with cat only office hours.  A triple win situation.  She filled a vacancy in our schedule, allowing us to stay open 7 days a week; she had a place to continue her clinical practice; her patients now had a full-service animal hospital supporting their doctor and their pets’ needs.  Of, course, Covid changed all of this.  We adapted by closing on Sundays but putting Dr. Sturtz on my team.  Now every other Saturday, she is seeing her feline patients in the exam room and we are seeing dogs in the treatment area of the hospital.  All of our precautions as still in place.  Curbside check in, no clients in the hospital, extensive PPE for all staff members, and now in compliance with Governor Cuomo’s executive order, clients are also wearing face masks when the hand their pets off to us. She is seeing her patients for all of their essential needs: illness, injuries, chronic health problems and essential vaccines (Rabies).


So, that’s what’s going on here during the NY Pause initiative.  Hopefully the rain today will not be too dreary and will help people to stay in and away from one another for one more day.


A Puppy always brightens a dreary day, especially a corgi.


Friday, April 17, 2020

Covid-19 A veterinary Journal


It’s been almost a year since we last posted on this blog site.  Things had gotten really busy, we moved to video and live events on Facebook as well as an upgraded e mail program to communicate with our clients and area pet owners.  So, the blog sort of fell off the radar. But, the world has changed dramatically in the past month and I thought that this would be a good time to resurrect the blog.  Not so much as a source of information, Facebook and our e mail outreach are still the best channels for that. Rather, as a way for us to give our clients insight as to what is going on behind the doors and personal protection equipment here at Crawford Dog and Cat Hospital.

So, how did we get to where we are today, sitting here in the office, face mask and gowns in place, isolated from each other and our clients. 
I don’t mean how did the world get to where we are today, that is a question that will be debated for a long time, multiple possibilities, special interests, and plenty of finger pointing to go around.  I mean, how did Crawford get to where we are today?

At the end of January, I sold the practice to a corporation.  I  hadn't planned to to sell and I don’t intend to retire, I’m working full time here at Crawford as a clinical veterinarian, free from the stresses of finance and management. Indeed, due to this crisis, there have been very few changes here.  Everyone that worked here was offered their same position with the new company and all but one stayed.  The two biggest changes are things that you might not have noticed as a pet owner.  The first is that there are deep corporate pockets that have allowed us to stay open and pay the staff while the economy crumbles around us.  Rather than scrambling to survive, we have seen enhanced benefits for employees that have covid related problems, either of their own or their immediate families.  We have been lucky that none of our employees have been ill to date.  Several have had family members fall ill, so far, all are doing OK although there have been some rough patches.

The second benefit that we have seen is that we have the support of a large management team.  They offer us logistical support as well as improved access to a vast supply chain, helping us to maintain medications and supplies so that Crawford can continue to provide essential veterinary services to the pets in our community.

As we moved through February, it became apparent that the Covid 19 virus was going to pose a greater threat to us than the experts had led us to believe.  We worked as a team with our new  management and in early March, the medical staff, Drs. Wu, Waters, and Myself, decided that we had to come up with new procedures so that we could remain safe.  Several staff members elected to take a family medical leave made available to them by our new employer.  The rest of us divided into two teams, each headed by a doctor (Dr. Wu is currently home taking care of her children. She is consulting remotely on cases and we all eagerly await her return).  The teams are isolated, working every other day.  That way, if one team is exposed to the corona virus, we won’t have to close the hospital, just rotate that team out for their isolation.  This is a situation that happened this week where one of the team members who had no clinical signs but was exposed to someone that is sick, tested positive for covid19.  That team member had been self-isolating for almost two weeks so the team only lost one day (today) which the other team covered.  The hospital did not have to close.  We have also put Dr. Sturtz on a team and she is seeing her cat patients every other Saturday.

We were very proactive with this team approach and our social distancing policies.  We are currently doing curbside check in.  For now, clients are checking in by phone from their cars when they arrive.  We are sending a staff member out in appropriate protective gear to bring the pet into the hospital for examination and treatment while the owner waits outside.  Communication is by telephone and video chat and the pet is returned to the family in the car when we are done.  While not ideal, we feel that this offers us the best option for safety while allowing us to treat our patients.  The procedure has been well accepted by owners, pets, and our upper management who have held our initiative out as an example to other practices in the New York Metropolitan area market.

So that is how we got to where we are.  I intend to continue with our weekly live Facebook sessions.  Join me and Bella as we try to bring some understanding to our community as new information becomes available.  I also want to use this blog as a journal, to post regularly so that you can see what we are up to and how we are adjusting to our new reality. I’ll share what we’re doing, how we’re doing and who we’re doing it with.  The pets that we have been here to help have ranged from a seeing eye dog yesterday, to older pets with multiple health issues.  So check back and keep up.  I know we all have some time to read.  Comments on the blog page are welcome as are questions on Facebook. 
 

Stay safe. Be nice. Wash your hands and don’t touch your face.

Wednesday, May 8, 2019

Spring Is Here and So Are the Ticks


Spring is officially here.  How can I tell?  Well, first off, my car is coated in a yellow powder from all of the tree pollen. The sky is finally blue and the air is warm enough for me to go running without donning 57 layers of clothing. Days are longer, and, oh yeah, I am seeing dogs and cats with ticks almost everyday in the office.



Now, ticks alone are gross enough but these blood sucking parasites also spread diseases.  Some you have heard of like Lyme disease and Rocky Mountain Spotted Fever.  Others, such as anaplasma, ehrlichia, and tick paralysis (yes, it is a real thing), may not be as familiar.  Do to a second mild winter in a row, we are expecting a bumper crop of ticks, and so, a bad season for tick borne diseases.  Quick side note, epidemiologists have a really cool way of predicting the incidence of Lyme disease.  You see, the deer tick that carries Lyme disease actually spends part of it’s life on a mouse.  When we have a good acorn crop, the mice have lots to eat.  When the mice are well fed, well, mice will be mice, we get a lot of mice.  A population increase in mice mean more hosts for deer ticks, and subsequently, a bad tick and Lyme season.  You’ve probably guessed it, great year to be in acorns for the second or third year running and we are expecting another bad year for Lyme disease infections in our pets.

How can you keep your pets safe?  The first leg of the protection platform is to detect and remove ticks before they can attach and transmit disease.  It takes about 48 hours for a tick to infect your dog with Borrelia burgdorferi, the bacteria that causes Lyme disease.  A useful hint is to run a lint roller over your dog whenever you suspect that there has been a potential tick exposure.  The little buggers will stick to the lint roller.  The second leg is to use an effective tick control product to kill those ticks that you didn’t catch with the lint roller.  We recommend an oral monthly product such as Simperica or a 6 month Seresto Collar.  (Bella wears a collar).  Please be aware, there are counterfeit products out there, we saw a counterfeit collar brought in by a client that purchased it on line last week.  Check out our Facebook or Instagram pages to see a picture.  Finally, vaccinate your dog against Lyme disease.  There are no vaccines against the other tick borne disease, but Lyme is the most common in our area and vaccination is an important component of disease prevention.



In cooperation with Zoetis Animal Health, we have put together a special package to help you protect your dog.  If you vaccinate your pet and purchase a years worth of Simperica oral flea and tick control product from us, we will discount the package 10%, offer a manufacturers rebate for the Simperica purchase (total rebate varies according to their current program), and Zoetis will offer a $7500 insurance policy towards treating your dog for Lyme disease should it become infected.  Details are on our web page and this package is a great way to save some money while using the best technology currently available to protect your pet.



Oh, did you think I forgot about your cat?  While felines are less susceptible to Lyme disease than dogs, they can get other flea or tick borne disease.  Protect them with a Seresto Collar or a monthly topical application of the new Revolution Plus which will protect them from heartworm, intestinal worms, fleas and ticks with an all in one treatment.