Dedicated to providing compassionate care throughout the life of your pets.
April 2024
Congratulations To Carbon!
Carbon is a ten year old neutered male domestic shorthair cat who recently had a successful fear-free vet visit with Dr. Gottman. Carbon and his owner have struggled with vet visits in the past due to Carbon’s fear, anxiety, and stress. His owner suspects his fear of the vet started after he was hospitalized for urinary crystals when he was one year old. Although hospitals can do things to mitigate fear during hospitalization, being away from home can be really scary for pets. He started acting aggressively when handled below his ribcage; he would hiss and even try to bite if pushed too far. Once he became fearful, it was difficult to get him to relax again.
Dr. Gottman took note of Carbon’s behavior and recommended Gabapentin. This is a medication commonly used to treat anxiety in cats by helping them relax. Carbon’s owner has tried the capsule form of Gabapentin, but struggled with feeding him the full dose due to its bitter taste. We recommend when attempting to have a cat swallow a pill, hiding it in a meatball of tasty wet pate and they may swallow the whole capsule with the food. If the capsule must be broken open to mix the contents in food, it should be mixed in a larger volume of high value, smelly food to cover the taste. Luckily, we have a liquid form of Gabapentin that can be given orally via syringe. Carbon’s owner decided to try the liquid instead and found that giving the medication went a lot smoother as she was able to give him a little bit at a time until the full dose was administered.
Carbon’s owner said trying to “pill” a cat is as difficult as taking a steak away from a lion. This is probably relatable to many cat (or dog) owners as some pets are skilled at tasting medications and spitting them out. Our staff wants to know when an owner is struggling to give any medication as we can work with them to find a solution. Pairing the meds with a training session and some treats that do not contain medication can help disguise the pill even more. If you find that giving medications is a struggle, reach out to your vet to brainstorm some solutions.
Most situational anxiety medications are given 2-3 hours prior to a stressful event so the medication can reach peak effect at the vet office. In Carbon’s case, he was seeing Dr. Gottman for his annual wellness exam and a vaccine. He was taking treats and accepting chin scratches. She performed his exam with no problems. She avoided touching his rear end as this locations has previously caused him to act aggressively due to fear, anxiety, and stress. We often look at painful, or triggering, parts of a pet last in order to avoid escalating their fear, anxiety, and stress. When it came time for his vaccine, Dr. Gottman decided to vaccinate in his shoulder instead of his hip to avoid triggering him. He grumbled a bit while eating his treats, but continued to focus on the yummy food. Carbon’s owner was relieved. This was the first time that he hadn’t been outwardly aggressive in 9 years!
Carbon’s owner mentioned that the mild side effects of the Gabapentin were well worth the outcome of a successful wellness visit and vaccine administration. She noted that Carbon was relaxed and seemed “drunk” with slightly altered motor skills; she said he was like a “sleepy toddler that you have to keep an eye on” but that Carbon was back to his normal self in a few hours. It is important to monitor your pet while they are taking a medication that affects their motor skills so they don’t injure themselves. The dosage of an anxiety medication can always be adjusted if the desired effects are not achieved. Vets rely on owners to let them know what they are seeing at home so a dosage can be adjusted.
Wellness visits are important to your pet’s health so a doctor can monitor their physical and emotional health over time. It is also a great opportunity for owners to ask questions and stock up on heartworm and flea/tick prevention. The doctor will listen to your pet’s heart, feel their joints for signs of arthritis, check for ear infections, among other things. Dr. Gottman understands that although Carbon may act aggressively while at the hospital, he isn’t a “mean” or “bad” cat. Fear, anxiety, and stress affects humans and pets and there are many tools that can be used to make pets more comfortable at the vet. Dr. Gottman and Carbon’s owner were able to work together to come up with a plan leading to the best outcome during Carbon’s wellness exam. Our staff is happy knowing that although Rock Bridge Animal Hospital may not be Carbon’s favorite place, he is a healthy kitty at home where he enjoys running the house ahead of his siblings. He is part of a bonded pair and they get up to many shenanigans, particularly with their mice toys. Carbon can also be found sunning himself, with his arms fully extended, dreaming about how he won’t have to see Dr. Gottman again for another six months. But when he does have to visit us, Carbon’s owner is grateful she’s found a solution.
March 2024
Congratulations To Sampson!
If you’ve seen a Rottweiler in a t-shirt lately, it might’ve been Sampson! When Sampson first came to us, he was fearful of procedures, like many other pets during their visits to the vet. To avoid further escalation of his fear level, we utilized sedation to perform his annual preventative care. However, in December 2023, we discovered Sampson is diabetic. Managing diabetes in pets can include routine, invasive procedures, such as pricking the ears or foot pads, insulin administration, and more. To help Sampson feel comfortable with his new daily routine needed to monitor and manage his diabetes, his owner worked with our team to help him adjust by using fear free techniques. She used treats and petting to help distract him during his insulin injections, and she found that acting calm and making the injections “no big deal” helped Sampson a lot.
In clinic, we desensitized him to having an area of fur shaved to apply a flash blood glucose sensor, called FreeStyle Libre, by slowly introducing him to the clippers and sensor and rewarding him with treats and petting as we made progress. Today, Sampson routinely receives his insulin injections at home, and he takes pre-visit prescriptions to help manage his anxiety and fear level before he comes to the clinic for his sensor applications. With this medications and training on board, Sampson, his owner, and our team have been able to successfully provide him the care he needs. He’s even discovered a new passion for fashion, as he wears fun t-shirts to help protect his sensor! Pets like Sampson are the reason why we stand by our fear free practices. By utilizing these techniques, we are able to help many pets overcome fear and anxiety in and out of the clinic.
FreeStyle Libre flash blood glucose sensors are a tool that allows pet owners and Veterinarians to quickly and easily monitor a pet’s diabetes. Though designed for humans, these sensors can be applied to a pet’s bare skin and scanned with a smart phone while using the associated app. They provide a way to easily attain a pet’s glucose level reading at home or on-the-go without having to prick the animal for a blood sample. The sensors themselves are only about the size of a quarter, and take readings by implanting a small sampling catheter beneath the pet’s skin, rather than gathering a reading from the blood.
https://veterinarypartner.vin.com/default.aspx?pid=19239&id=9150771
February 2024
Congratulations To Lady!
Lady is a 9 year old Miniature Pinscher who has been coming to our hospital since 2019. Upon Lady’s first appointment, it was noted by the owner that she was very fearful of the vet. When the doctor and technician approached Lady during her first appointment, Lady did try to nip and cried out at the staff. We were able to perform an exam that day, but Lady was extremely fearful of all the handling and instruments. Because we are Fear Free and only want the best for Lady and her care moving forward, we made a plan with the owner to work on modifying Lady’s behavior to become less fearful of the vet.
Our first recommendation for Lady was to be started on pre-visit pharmaceuticals. Pre-visit pharmaceuticals are medications that the veterinarian prescribes to help alleviate anxiety and stress prior to stressful situations. Sometimes, one or two medications are enough to take the edge off to handle pets in a Fear Free manner. However, there are pets that need a combination of medications with behavior modification. In Lady’s case she was too stressed about nail trims, more invasive portions of her exam, and blood draws that even with pre-visit pharmaceuticals, she had to be sedated. Pets that are highly anxious still when they come back with pre-visit pharmaceuticals will do better if they are sedated. When giving the sedation injection for Lady though, she would become so worked up that we had to pick her up with a thick towel to keep her still while we gave it. So for Lady, her best interest was to continue the pre-visit pharmaceuticals while working with Dr. Forbes on behavior modification to avoid having to sedate her forever and have her become less fearful of the veterinary hospital and procedures that come with it.
During these behavior modification visits, there is nothing medically necessary done to the pet. We strictly focus on behavior, desensitizing, and counter conditioning the pet that the veterinary hospital is not a fearful place. Counter conditioning is a behavior modification technique in which a stimulus that creates a negative emotional response is paired with something known to create a positive emotional response in the animal. Desensitization is a behavior modification technique in which an animal is gradually and systematically exposed to a trigger stimulus until the stimulus no longer triggers an emotional response. We do this with positive reinforcement. Positive reinforcement is the process of rewarding or reinforcing desirable behavior in order to increase the likelihood that the behavior will be repeated in the future. For Lady, we found that she highly valued chicken and began working on her behavior modification
During Lady’s behavior modification visits, Dr. Forbes first started with basics of getting Lady comfortable with her presence in the exam room. This involved tossing treats to Lady to get her to come explore the room and the doctor to become acquainted. From there we gave recommendations to the owner on training Lady to a mat or rug. This would give Lady a “place” where the training would be and if at any point Lady were uncomfortable, she could easily walk away from the mat indicating that training has stopped and she is uncomfortable. This gives Lady the opportunity to provide consent. If she’s ready to proceed, she will get on the mat and training would continue. This would aid in the behavioral modification as it would let Dr. Forbes know what procedures were okay with Lady and what procedures were not. In the beginning, most things were scary and uncomfortable for Lady, so we just focused on touching her. But with repetition and positive reinforcement, Lady became more and more comfortable with each visit with us petting her, staying on the mat, and eating her high value treat.
Over time, we decided to have the owner work on training chin rest, as Lady was very nervous about approaches and instruments. Chin rest is a learned behavior where a pet holds its chin in the palm of your hand for the duration of each procedure, and then being rewarded for holding this position after the procedure is finished. This would give Lady something to focus on while the procedures are being done, knowing that a yummy treat would be rewarded after. As time went on, she no longer needed it for most of her exam. We now use it primarily to look in her mouth. Lady was and still is leery of the stethoscope. She will allow it for brief periods, but we’ve learned that she tolerates it better when we are holding her in our arms. This was a challenge as well, as Lady did not enjoy being picked up. So the owner taught lady a command to prep her that she is being picked up and we have practiced picking her up and then putting her down since.
With repetition and giving Lady the option to walk away, she began to become even more comfortable and eager to come here, knowing she would get rewarded for the positive behaviors. She has even developed a strong bond with Dr. Forbes. For procedures like a dental where a pet goes under anesthesia and needs pre-surgical blood work, a thorough exam and a catheter placed; we simply sedate Lady first so she is completely asleep for all of this so we don’t regress any of Lady’s progress. After these larger procedures, Lady usually does very well and actually seeks attention from Dr. Forbes- something she never used to do.
Currently, Lady is still doing behavior modifications to this day. The frequency of the modifications has lessened as Lady has gotten more comfortable with all of the handling and procedures. We are so proud of the owner and Lady for working so hard and coming so far. Congrats to Lady for Pet of the Month!
Below is a link for teaching chin rest: https://www.youtube.com/watch?v=K2lnaerPR5o
January 2024
Congratulations To Sydney!
November 2023
Congratulations To Maddie!
September 2023
Congratulations To Bader!
Once we had diagnosed that Bader did have mast cell tumors, the next best treatment was removal. This was performed under anesthesia and we also took chest x rays to confirm that the tumors had not spread to other parts of Bader’s body.
Unfortunately, due to one of the tumors being on a high movement area on Bader’s leg, the incision site did start to reopen. This required Bader to come back in every day for a week for sedated bandage changes until the wound had healed enough to finally reclose it.
August 2023
Congratulations To Brescia!
Visiting the vet for many people can be a daunting task, let alone spending a night alone while your family is away. However, this was not the case for Brescia. Allow us to share what set apart Brescia’s time with us and how we are making a difference in Brescia’s life with our Fear Free approach.
Now let’s meet Brescia!
Brescia is a beloved Siberian Husky mix, who was rescued by Mya from a hostile environment in February 2020. Within hours of caring for Brescia, Mya felt an instant unbreakable bond with her. Despite Brescia’s destructive tendencies, Mya says Brescia’s loving nature brings light and warmth into their home. Brescia loves chasing squirrels and rabbits during their long hikes, and she embraces all opportunities to explore and experience nature.
As Brescia began to feel more comfortable, she revealed her unique personality and formed a positive, trusting relationship with our team. She introduced us to her favorite stuffed beaver, which she loved to snuggle with every day. We enjoyed playing Tug-O-War, offering plenty of cuddles, and taking her on exploratory walks around the facility.
Over time, Brescia’s confidence grew, and she transformed from a nervous girl into a confident one. Mya and her companion Brescia continue to board with us; Brescia eagerly awaits to make new memories during her stays with us.
A week later, Truman was placed under anesthesia and the tumor was surgically removed. He was sent home with pain medications and an e-collar to prevent him from bothering the incision site. His sutures would be removed in 10-14 days and the doctor would check how things were healing.
A few days later, Truman’s mom called to let us know that Truman had been reaching around the cone to lick at the incision site. There was still quite a bit of swelling, bruising, and drainage from the incision site. We modified his cone by taping two of the largest sizes together to extend their length and prevent Truman from bothering his knee.
Truman was brought in for an exam and Dr. Sappington recommended microscopic cytology to look at the drainage under a microscope. A small sample of the fluid from the wound was applied to a glass slide and stained to help the bacteria become visible under the microscope. A shape of bacteria called cocci was seen as well as neutrophils, a type of white blood cells that fights infection. Truman was started on clavamox, an antibiotic that treats bacteria most commonly introduced to wounds by a dog’s mouth.
A week later, the incision site on Truman’s knee pulled apart. Dr. Sappington decided to use a type of bandage called a tie over bandage. This involves sedation to add sutures (stitches) around the open wound to allow a bandage to be tied down. Sugar has been used for centuries in wound care due to its ability to pull out moisture, preventing the growth of bacteria which thrive in a moist environment.
The bandage needed to be changed daily to replace the sterile gauze and sugar being used to dry the wound. Dr. Sappington sent a sample of the drainage to a veterinary pathologist to culture the bacteria (grow in a laboratory setting) and test for it antibiotic resistance. Antibiotic resistance is when an antibiotic is unable to kill bacteria due to biologic properties of the bacteria that allow it to defeat the antibiotic.
During one of Truman’s recheck appointments, his knee was healing well so Dr. Sappington recommended sedation to reclose the wound with sutures and allow it to finish healing so there would be no more bandage changes. Unfortunately, this opened up again a few days later, likely because the incision was over a very mobile part of the knee. The wound was left to heal by second intention which is a process of healing involving granulation tissue which covers the entire wound over time. His family continued bandage changes and wound care at home.
Finally, two months after the mass was removed and two weeks after he was started on the biofilm blast and ointment, Dr. Sappington determined that Truman’s wound was fully healed. Thanks to the patient and thorough care provided by Dr. Sappington and the Rock Bridge staff, his loving family, and the laboratories that consulted on his samples, Truman is doing great! His family tells us that he loves to play with his coonhound brother and human little sister. Truman’s mom told us that although it sometimes it felt like his wound would never heal, they are thankful for the care he received.
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