6 Keys to a Successful Integrative Veterinary Practice
A day in the life of a busy practitioner.
My cell phone rings at 6.47am, and I jump out of bed to hear one of our clients on the other end of the line. She’s very concerned about her nine-year-old Staffordshire terrier, Zak, who doesn’t seem able to stand on his back legs and has been panting for the last hour. I arrange to meet her at the clinic in 20 minutes, already thinking that this will be a musculoskeletal injury and shouldn’t be too tricky.
On arrival at the clinic, I learn that Zak is far worse than I expected. He’s unresponsive, lying on his side, paddling his legs and having a seizure. I get baseline blood work, inject intravenous valium, which settles him slightly, then place an intravenous line giving vitamin C. Covering all bases, I inject him with an anti-inflammatory, antibiotics, Atropine and Vitamin Bs. By this time, my colleague Karen has arrived and she brings out her acupuncture needles to help settle Zak.
KEY 1 – OFFER YOUR PATIENTS MULTIPLE TREATMENT OPTIONS
In our clinic, we offer homeopathy, TCVM (traditional Chinese veterinary medicine), nutritional medicine, hyperbaric oxygen therapy, NIS (Neurological Integration System), conventional medicine and surgery. We approach every case from the holistic paradigm – there is an imbalance contributing to current and past symptoms. The goal is to relieve current symptoms while rebalancing the animals. Each animal is unique and needs different treatments. We encourage clients to continue treatment until the patient is healthier in all ways.
Today, there are back-to-back consults through the morning, and surgery to do as well. Our first case is Zen, a Siamese cat in for a laparotomy because Karen has identified an abdominal mass. Zen is one of my oldest patients and we’re all hoping for a simple fix and a good outcome. Because he hadn’t been eating for a few days, we were concerned about him being able to survive the anesthetic, so he had the benefit of a pre-anesthetic session in our hyperbaric oxygen chamber to hyper-oxygenate his body. We find this to be of awesome benefit to geriatric and compromised animals.
KEY 2 – HELP GERIATRIC AND VERY COMPROMISED ANIMALS LIVE LONG, HEALTHY LIVES
Animals presenting in the hospice category can often completely resolve their issues, and with continued support can live a long life. Not all individuals can be cured, as each is unique. Having a variety of holistic options available, in addition to conventional care, is essential. In our clinic we have the following available and continue to learn more:
• Flower essences • Hyperbaric oxygen treatments • Optimized nutrition • Minimal toxins (vaccines, flea chemicals, etc.) • Homeopathy (very gentle and easy for clients to administer) • TCVM (acupuncture) • Neurological Integration System • Botanical medicine
A little blue penguin is dropped off, having just been found floundering in the waves. Its body condition is poor and it is dehydrated and anemic. With the help of our nursing team, we give him fluids and warmth and hope for the best, but we know our efforts are likely in vain; much of the wildlife work we do is relentlessly unforgiving. We use Emergency Essence, which is the Australian version of Rescue Remedy, with our wildlife cases. We receive an abundance of baby birds that cats have caught or wellmeaning people have found, thinking that they need veterinary care, and our integrative approach can often help.
Our first consult for the day is Diesel, a gorgeous 52kg Bull Mastiff with a huge hotspot on his face. He’s always glad to see me, despite the occasional atrocity that I commit, such as squeezing his anal glands. I shave and clean his hotspot, clean out his ears which are full of black debris, and send him home with antibiotics and some conventional anti-inflammatories to address the current inflammation. Holistically, a Heel combination remedy with the following components – Traumeel, Nux Vomica, Berberis and Lymphomyosot – is prescribed, both to ease Diesel’s current discomfort and help get his body back in balance to prevent another hotspot from developing. As Diesel’s owner pays at the reception, the dog gives a great big shake of his head and a glob of slobber gracefully flies over the counter into the lap of our receptionist, Emma!
KEY 3 – ENSURE THAT YOU HAVE WELL TRAINED AND GRACIOUS STAFF
Emma is great at taking the goo in stride. She embraces the holistic approach and will often suggest this approach to the clients when they make an appointment.
• Staff training is done on a regular basis. • Regular classes and handouts on raw meat diets are available. • Staff are encouraged to take courses to add to their skills and knowledge base. • Our culture – “that we’re here to help” – is ingrained in our staff, who are selected because they have a natural ability in this regard.
My next patient is Pepe, a little Chihuahua, who is in for a dental examination and nail trim. As long as I don’t poke and prod him, Pepe is an angel, but last week when I attempted to give him a health check and trim his nails I was met with ferocious growls. I had to use sedatives. So today, I was glad to find some tooth decay to justify the help of sedatives to investigate his mouth further and give him a manicure.
It’s only 10am and it’s time to perform the laparotomy on Zen. I quickly do a last check on the little blue penguin – he’s not looking much better – and Zak, who has settled down relatively well and only has a slight head tremor but is still pretty dazed. We induce, shave and prep Zen and I do a midline incision and begin to investigate. It’s not good news: an extensive pancreatic tumor is adhered to his spleen and stomach. I ring his owner and share the news. She’s upset, but glad that we finally know what is wrong with him. She requests that we put Zen to sleep on the table. I share the news with our nurse Louby and tears well up in her eyes. As Silent Night plays on the radio, we put Zen peacefully to sleep.
I go check on the penguin and find he has just died as well. At least Zak is doing okay, even though we’re not out the woods with him yet.
Pepe is next on the list for this morning’s surgery. He’s nice and chilled out after his pre-med and is easily anesthetized. Once intubated, I find both sides of his jaw have severely infected molars, most likely the reason for his stroppy behavior last week. I’m delighted to find a logical reason, and best of all it can be remedied. I extract his teeth while he receives vitamin C by IV, Traumeel, various flower essences, and anti-inflammatory, as well as vitamin B injections at strategic acupuncture points to assist his recovery. He wakes up quickly after his procedure, and within an hour is looking bright.
It’s nearly lunchtime, and I quickly squeeze in time to reply to some emails and return calls to clients. At lunch, I race off to the gym for a quick workout. I normally go after work, but tonight I have a massage booked that I’ve been looking forward to for weeks.
KEY 4 – MAKE TIME FOR PERSONAL CARE
Be sure you take time to remain healthy, mentally and physically, even in a busy practice. I do my best to eat a wholesome balanced diet and take some incredible nutritional supplements to help keep me in optimal health. Whenever possible, I get to the gym or go for a walk in nature, and make sure I get a good night’s sleep. Running your own business and having regular holidays is particularly challenging, but I know it’s important and is something I’m working towards. In the clinic, we include time for lunch and breaks, and encourage our staff to look after their health and well-being.
I arrive back to see Karen with Roxi, a gorgeous little Bichon who came to us three weeks ago. She had been to two other veterinarians, who diagnosed a prolapsed disc with paralysis of her hind legs. Roxi underwent several sessions of acupuncture, had some Chinese herbs and sessions in our hyperbaric chamber, and was standing within a few days. It’s so lovely to see her walking around and happy!
KEY 5 – PROMOTE YOUR SUCCESSES
We posted Roxi’s picture on our success and thank you bulletin board, as well as on our Facebook page, which our clients love.
The afternoon is full of animals booked in for NIS, a therapy derived from applied kinesiology and osteopathy, which I have found to be incredibly helpful for an array of health problems. Kim, a human practitioner, works with me on animals one afternoon a week. Our first case is Petal, a very timid cat who has suffered from severe milliary dermatitis that hasn’t responded to other therapies. Petal’s owner wonders how we’ll treat her as she’s very scared and doesn’t like being handled. Like most cats, after the first few things we do, Petal calms down and to the amazement of her owner lets us do everything needed. We advise that she ideally needs another treatment, but today’s work should start to make a big difference within a couple of weeks.
Our next case is Leo, a gorgeous Russian Blue, who is in for his third session of NIS. Leo’s back is still sore and we’re baffled, as most cases respond well to two sessions. I ask Karen for her input and we devise another strategy of adding in some herbs and Pentosan (injectable polysulpahted glucosaminoglycans).
KEY 6 – UTILIZE OTHER HOLISTIC PRACTITIONERS FROM THE COMMUNITY OR WITHIN YOUR PRACTICE
This greatly broadens the range of therapies you can offer your patients. For example, it’s wonderful for me to have Karen’s input and help after being a solo veterinarian for six years, and to work with Kim for animals requiring NIS.
The afternoon flows on, and we finally have Zak’s lab results. They indicate hugely elevated muscle enzymes, which may indicate trauma, heat stress or poisoning. By now, Zak has also had a treatment in our hyperbaric chamber; his head tremors have stopped and he is more responsive. I speak to his owner and offer her overnight hospitalization or the option of taking him home. We’re pleased that she prefers the latter. Since most of our clients are very responsible, they often elect to monitor their pets overnight and call us if problems arise. I warn that Zak could start fitting again, and dispense magnesium and grape seed extract (proanthocyanidins), as well as valium if needed.
Pepe is discharged but wouldn’t walk to his owner. He insisted on being carried. Moments before, he’d been out for a walk with Louby and happily trotted along wagging his tail. We figured Pepe would be milking his owner’s sympathy for everything he could!
I love being on call, but tonight I’m overjoyed to give the responsibility to Karen and head off to my long-awaited massage. As I drive onto the massage therapist’s property, I see Abby the Labrador scooting her butt along the ground as a special greeting just for me: “Yay vet, you’re finally here, my butt needs your help!” So I park, get out a rubber glove and some KY jelly, squeeze her full anal glands, wash up, and finally lie down to my wonderful relaxing massage.
Back at work next day, our first patient in is Zak. After a sad day with Zen and the penguin yesterday, Louby is reluctant to come out of the staffroom, dreading further issues with Zak. As his owner pulls up in her car, I walk out to meet them, expecting to have to carry Zak into the clinic. But before I get to the car, he has jumped out and is running towards reception, eyes bright and tail wagging.
What an awesome start to the day! It’s successes like this that make this job so worthwhile.