Medical Excellence and the Four Foot Tall Milkweed

An important life lesson I have learned is that when you think you have things going really well, think again. At The Cat Hospitals of Denver we really (okay, I really) strove for excellence in our delivery of medical care and customer service. Over the years, I saw that about one percent of my employees did too.

We had weekly meetings to teach our staff and doctors medical knowledge and excellence in customer service. A true "learning organization." Everyone got paid over-time to be at these three-hour long, Wednesday afternoon meetings, that were very fun and interesting. I even had some employees that could parrot back some of our key service axioms like, UA-Fecal-EAG, and "it's not customer service, it's customized service."

So with all this going on, I thought our staff members had a real grasp on doing an excellent job in taking care of the clients and patients. I even didn't feel it necessary to make weekly stops in at all my five Cat Hospitals to check up on the people working at them. Then one late summer afternoon, I had to deliver some special surgical instruments to my Lakewood Colorado office, and I was aghast at what I saw.

As I pulled up and parked in front of the hospital, I saw a client coming out the front door with her cat in a carrier, and she lifted her leg up high as she STRADDLED OVER a three to four foot tall milkweed right in the center of the front step. I was so embarrassed, I sat in my car until the client drove off. I went inside and asked who let a four foot tall milkweed grow right in the middle of the front steps.

Of course, no one knew, and it must have just grown up over night. After all, we had daily duty rosters that included sweeping the front steps and making sure there was no trash or debris around the entrance of the vet hospital. But I have to give them credit, because the duty rosters did not mention anything about pulling up milkweeds if they were growing right in the front step, where the clients walked in.

The even odder part, was that two of my supposed top people, let's call them Carol and Brent, were working at this hospital and were entirely responsible for it. They were let go soon thereafter, because the inside of the hospital was a pig-sty as well and those two employees had also worked it out that they were clocked in all the time and were rarely even there.

So it comes back to the lessons I learned from reading William Marriott Junior's book about his Marriott Hotel Chain. You have to check on everything yourself. Bill Marriott actually goes into his various hotels and checks under the beds, and behind the toilets, and under the sinks to make sure his hotels are actually being cared for to the standards that are the Marriott Brand. You would think the president of a multi-billion dollar Hotel conglomerate would have better things to do, and he does, but it is this single step that rattles the chains and keeps his well paid employees actually doing what they are paid for. I wish the world was a better place.

Dr. Doug Ikeler http://www.ikelerbooks.com/

http://www.lifeextensionbooksbydrdougikeler.blogspot.com/

Old Doctor Burr and Coster's Cascade of Criticism

During the eight years that I worked at Wilshire Animal Hospital in Santa Monica, California, I had a chance to tell my employer and friend, Dr. Ian Coster, about the first vet I ever worked for when I was younger. His name was Dr. Isaac Tucker Burr, and he had a very general country practice in Walpole, New Hampshire, and he was quite a character. Dr. Coster reminded me though, that I was just in my twenties and even though I liked to tell "Old Dr. Burr" stories, that someday too, people would be telling "Old Dr. Ikeler" stories. It probably is true, and I'm sure they're good stories.

The best stories though involved unique elements of Dr. Burr's personality. He was raised in Boston and went to Harvard for college, "just to be educated" as he would describe it. He then went to Cornell Veterinary College after his time in the military, after the second world war, and he told that the only reason the Germans were defeated was because they had ten times the power fighting against them, and still it was close!

My years with Dr. Burr were spent rambling through the countryside of New Hampshire delivering calves, testing for mastitis, splinting broken dog legs, and spaying and neutering a lot of cats and dogs. Dr. Burr had the most eloquent vocabulary, but he liked to swear and sometimes it came out so comically. During a Saint Bernard ovariohysterectomy (a dog spay) one time, a ligature slipped, spurting blood everywhere, and Dr. Burr yelled out, "Oh Jesus, Jesus," and then with a little reflection added, "I wish you were here", as though a little help from above was needed and appropriate at that time.

Dr. Burr also did not understand the modern form of the Learning Organization. Because I was a teenager and wanted to be a vet, he somehow assumed I knew everything there was to know about what to do in a veterinary hospital. Instruction was minimal and so I took it upon myself to know everything for how to be a great veterinary assistant. Self-taught, of course.

Dr. Coster was different. He was very much a teacher and, in reality, taught me how to be a great veterinarian. The twelve years of college I have attended only filled in the details. One thing Dr. Coster did though that was very funny and unusual was he couldn't stop himself when he had to tell an employee they did something wrong. He started out with the mistake, and stated it clearly, but then he had some unconscious need to continue, as though to get to the real underlying reason why this person made the mistake in the first place.

He would go beyond the first criticism, then add that they must have done it due to something inherently wrong with themselves, then go further to add that it must be something wrong with the gene pool of their relatives that was inferior that lead to the mistake made in the hospital. I labelled the phenomenon "Coster's Cascade of Criticism" to let Doc know he didn't need to go that far when telling someone they had goofed up. Luckily, I somehow escaped the cascade for the eight years that I worked for him during college and vet school.

Dr. Coster had lived in the back apartment of Wilshire Animal Hospital where I lived while I was finishing up my undergrad studies at UCLA. He said I was the last of the line to have lived in that apartment and then gone on to become a veterinarian like he and his boss, Hal Snow had done before him. I think there was even one vet before Hal who had done the same thing. Johnny something comes to mind. He had a bad drinking problem and Hal spent a lot of time covering for Johnny while he left Hal alone in the hospital to play veterinarian while Johnny went off drinking.

Being able to live and work at a vet hospital was quite a privilege looking back on it. I got paid good and got a free apartment and amenities. Quite helpful to a young man from New Hampshire working his way through college. It wasn't a simple place to live in though as friends would point out when they visited. My brother Fred, summed it up perfectly: He said, "Is it ever quiet here? All day long, it's just ring, ring, ring, ding, dong, and woof, woof, woof, and what am I sleeping on here, some dead dog blanket or something?" "When do you ever get to take a break?" "At night, when I watch the hospital, that's the only time I need a break," was my answer to him.

He just didn't understand the privilege of living at a veterinary hospital.

Dr. Doug Ikeler http://www.ikelerbooks.com/

http://www.lifeextensionbooksbydrdougikeler.blogspot.com/

Slaughter House Earth and the Evolution of Veterinarians

Charles Darwin called our lovely planet "Slaughter House Earth" back in his hay day around the 1850's. He called it this because he noticed that life was so brutal. From insects vomiting up digestive acids on their prey, while they're still alive, to the cruel and vicious deaths brought upon prey by their predators. My own experience is that mankind isn't much nicer, even a hundred and fifty years later.

Veterinarians have been around since man began to domesticate animals thousand of years ago. The profession didn't evolve to a doctorate program though until about a century ago. Harvard had one of the most prestigious veterinary programs, but it dropped this curriculum with the advent of the horseless carriage, thinking erroneously, that veterinary medicine would go away with horses. Surprisingly, their are more horses around now than there were a hundred years ago. Harvard should have kept the Vet Med curriculum and kept turning out top notch vets.

When I entered the profession thirty years ago. The big controversy was between vets who hunted and those who didn't. Today, the debate is between vegan vets and those that still eat meat. Even my best friend from vet school, Dr. Richard Thoresen, who was a hunter, evolved (most probably from the influence of his wife) to become a vegan veterinarian, and he doesn't hunt any more too.

Before the hunting controversy, there was an arrogance among veterinarians that treating cats and dogs was a waste of time and below the dignity of a Doctor of Veterinary Medicine. Most vets today just treat dogs and cats. I am personally glad the issue now is whether or not we should be eating animals for food. It is a brutal industry that raises and slaughters millions of animals each day. That figure is correct. Millions Of Animals Each Day. Billions each year, worldwide.

A little known fact about one veterinarian, Dr. Dunlop, is that he invented air filled rubber tires that we all drive on now in our cars. He thought the cobble stones were too rough for his son to ride his tricycle on, so he made air filled rubber tires for his son's trike. Dr. Dunlop went on to expand his product line for car tires, that many of us drive on still today. You should know the tire brand, Dunlop, pretty well.

There is a little kindness on the horizon as slaughterhouse techniques are becoming less brutal and more people are eating less meat. I was beef raised and we even said with disappointment to my mother,"oh, steak again" when I was a child, because we ate so much of it. The starving children of Africa might think I was a little spoiled, even back then.

The future is bright though, as organizations like PETA, who are unfortunately too far ahead of their time, will bring about more changes to improve the lives of people and animals. The change is needed, and will surprise you. One day we will even look at keeping animals as pets as cruel too. For the luxury lifestyle that my two cats live though, that day is far away. They happily hog my bed and cover the furniture with cat hair. I feed them twice daily and clean their litter box twice daily too. I think if we asked my two cats if keeping them as pets is cruel, they would answer with a resounding, "No." I know this to be true as Moe got out and was lost for over a month last summer and he couldn't have been happier to have me find him and bring him back home after he had lost half his weight. He ate constantly and purred for a week straight! Me and Bunny are glad to have him back!

Dr. Doug Ikeler http://www.drdougikeler.com/

http://www.lifeextensionbooksbydrdougikeler.blogspot.com/

Blacula And Flea Allergy Dermatitis

During college, I had the privilege of living at Wilshire Animal Hospital in California. It was the perfect place for a pre-veterinary student to live as it provided lots of animal hospital experience and free room, phone, laundry, and electricity, as well as a decent salary. I lived at Wilshire Animal Hospital for three years while I finished my undergraduate studies before going to Vet School. They were wonderful times, to say the least.

While living in the back apartment of the hospital, I adopted one of the blood donor cats as my pet. Her name was "Blacula" because she had a pure black fur coat and longer than normal fang teeth that stuck out all the time. She was more than happy to relinquish her life as a cage dwelling blood donor and at least have some family life with me.

Blacula had Flea Allergy Dermatitis though, that I had to manage by giving her a once a month injection of Depo-Medrol. That's the long acting corticosteroid medication that I have mentioned before that reduces inflammation in pets and people and works really well in cats, especially for flea allergy dermatitis.

Cats get a miliary dermatitis (small scabs that look like millet seeds on the skin) from the bites of fleas. Cats are actually allergic to the saliva of the fleas and it is this antigen/antibody reaction that produces the lesions of flea allergy dermatitis. In areas of great flea infestation, the problem sometimes never goes away.

Dr. Ian Coster, who I worked for at Wilshire Animal Hospital told me one time that seventy five percent of his hospital's business was flea related. He even had a friend, that was a very wealthy veterinarian, who drove a Rolls-Royce and had a flea painted right under the Rolls-Royce car logo. Fleas had made that man rich.

Blacula did well with her dermatitis treatments and she brought great joy to my life as a pre-veterinary student. Two things she did in particular still make me laugh today. The first was, every morning she would go out and take a poop in the flower box right outside our kitchen table window. I can still see Blacula's back arching and flexing as she defecated right in front of my roommate, Steve Smith (also now a veterinarian), every morning while he ate breakfast. For some reason, it didn't seem to bother him, and would make an America's Funniest Videos winner today.

The other thing Blacula did was sleep on my wife Kelly's neck at night. With absolute stealth, Blacula somehow would sneak up on the bed at night and curl herself around Kelly's neck so Kelly looked like she was wearing a black scarf by morning. Somehow Blacula got there and never woke Kelly during the night.

I will always remember Blacula for the dear sweet kitty she was. She gave blood that saved many other kitties' lives, and gave us love and entertainment that even the best money could never buy. Our love still goes out to you Blacula, even though now you are in cat heaven, and a part of eternity.

Dr. Doug Ikeler http://www.ikelerbooks.com/

http://www.lifeextensionbooksbydrdougikeler.blogspot.com/

Feline Obesity

If you think you have a hard time losing weight, just think of your cat. Cats get fat easily and they lose weight with great difficulty. They are so sedentary, that with twenty hours of sleep a day, it is amazing that they use any energy at all. Dogs are different, because you can walk your dog many times each day to make it lose weight, if needed.

The cause of all obesity, in pets and people, is simply eating too much food. Metabolic problems, genes, "big bones" and all the other excuses are equally invalid in people as they are in overweight cats. Fat cats are getting too much food and they, like us, love to eat.
What should a cat weigh? Female cats should be in the six to nine pound range. Male cats should be in the nine to twelve pound range. Any cat over fifteen pounds is obese. Even the larger breeds don't get that heavy unless they are suffering from obesity and being overweight.

How do you get weight off a cat? There's only one way: Caloric restriction. See also my book on life extension and the benefits of caloric restriction with optimal nutrition: http://www.ikelerbooks.com/ and my blog on the same subject at http://www.lifeextensionbooksbydrdougikeler.blogspot.com/

You have to feed a kitty a limited amount of food each day. Typically one cup of food per cat per day. That is one leveled measuring cup of weight loss food, like Science Diet R/D, and you can divide it up into three or four meals to keep kitty satisfied with multiple meals throughout the day. With a person too, it helps to eat before you are hungry, and have four to five small meals each day that add up to twelve to fifteen hundred calories of dietary intake.

It will take weeks to months to get your cat back to ideal weight, but it can be done. The need to do it is the same as in people: Health Benefits. Cats get the same diseases we do from being overweight. Diabetes, arthritis, asthma, kidney disease, hepatic lipidosis, and cancer all have an origin in obesity. Cats don't appear to get cardiovascular disease as much as people do and that may be due to the fact that they don't live as long and have a slightly different physiology than we do and don't inflame their arteries and veins with alcohol and tobacco products.

The heaviest cat I have ever personally seen was exactly thirty pounds. He was huge! The world record is 46 lbs and that cat died of respiratory failure at age ten. No surprise, since all that fat would be pushing up on it's diaphragm and make it very difficult for the cat to breath. The oldest cat I have ever seen, just to throw in a point of interest, was twenty nine years old. He was one old stiff bugger, but he was hanging in there. The world record for oldest cat is thirty eight years old. Pretty amazing since the average cat lifespan is fifteen.

Obesity shortens lifespans dramatically in people and in animals. Take steps today if your cat is overweight. See your veterinarian for help with this process. See your physician or join Weight Watchers if you are overweight. I have seen many of my clients over the years lose tens of pounds of excess weight, and invariably, they said they did it through Weight Watchers. It is an honorable thing to do to respect your health and live at ideal weight. I applaud the people who take the steps to do it.

Dr. Doug Ikeler http://www.ikelerbooks.com/

http://www.lifeextensionbooksbydrdougikeler.blogspot.com/

Cat Fur Balls, Hair Mats, And This Award Winning Web Site

The inspiration for this article is my new vacuum cleaner. I have used nothing but bag type vacuums my whole life, but this time, I bought a tornado type vacuum. I am endlessly fascinated by how this vacuum cleaner turns vertical air suction into a lateral swirl that uses the hair, dust, and lint to create a perfect hairball that attracts other hair, lint, and dust into it's mass to form a hairball within the canister. When you are done vacuuming, you just pour the hairball out and that's it. No more bags to buy, and you get to see this perfect hairball form every time you clean. I know the novelty will wear off, but for now, it's amazing.

Cat's get hair balls and mats too. The internal hairballs are already covered in another article on this web site, so go to the search function if that is more precisely the topic you are looking for. Cat fur is subject to getting twisted up on itself and forming a mat. Cat's groom themselves by licking their fur, but sometimes, this isn't enough. When a cat gets matted, it is going to need professional help.
In the worst cases, the hair mats are so bad, the cat gives up on grooming itself completely. Then the mats get worse. I have seen many a cat where the mats became one on top of the cat and then continued to grow to encompass more and more of the top and sides of the cat until it even interfered with their ability to walk. We did a lot of cat grooming and the Cat Hospitals of Denver over the years and most of our patients came in really matted.

Our standard procedure was to sedate the cat and shave it's whole body. Our most common clip was called a Lion Cut and it involved shaving the body, but leaving the head, legs, and tail still covered in fur, so the cat looked like a little lion. The clients were very satisfied with this grooming procedure and many came in early in the summer to get a lion cut for their cat just for the cool sleek look it gave them.

We had a few stray cats that we fed out the back door of CHD that got very matted too. One was named "Jaws" because his jowls were so big and thick from being un-neutered and from fighting with other tom cats so frequently. I saw Jaws groom himself one day as he sat and just ripped his mats off with his teeth. Nature has a way of solving it's own problems. The best way to avoid hair mats on your cat is with regular combing. A steel comb is best because it penetrates down through the fur to get to the deeper levels and clears away any hair tangles.

Congratulations go out today to Rebecca Anderson, a former CHD employee, who is expecting her second daughter in February of 2010. Also, Thanks go out to http://www.i-love-cats.com/ for designating us as one of their Award Winning Cat Web Sites. We appreciate the honor!

Dr. Doug Ikeler http://www.ikelerbooks.com/ http://www.lifeextensionbooksbydrdougikeler.blogspot.com/

Is My Cat Being Difficult?

One of the most common questions I was asked at The Cat Hospital of Denver during a patient exam was, "Is my cat being difficult Dr. Ikeler?" Most often times they weren't, as a cat will hiss and cower in a strange environment. Sometimes though, they were really difficult.

We were known at CHD, and had a reputation for, being able to handle the most difficult cases. My hope for that reputation was that people meant the most difficult "Medical" cases. We had that reputation too, but difficult extended to mean "hard to handle" cats as well.

Our advantage was we were actually very skilled at handling difficult and "fractious" cats. The staff also had standing orders to never tell a client that their cat had been mean, aggressive, scary, fractious, or difficult. We told every client we were able to take care of their cat without a problem, and quite frankly, that was very true.

We used the best restraint technologies to our advantage. The best restraining device was a fish net with a long handle. With this we could "catch" any cat in it's cage, in it's carrier, coming out of it's cage or carrier, or on the run inside the hospital. It may sound a little odd, but it was the best form, and least harmful method, of cat restraint.

With the cat in the fish net, and rolled up tightly, we could give it an intramuscular injection of ketamine to sedate it without ever having to risk harm to ourselves or the kitty. With the cat sedated then, all procedures were possible.

The things we didn't use for getting a hold of a difficult cat were: leather gloves, as I had been bitten through them many times before at other veterinary hospitals while I was a student, aquariums, because you had to get a cat in them first to gas them with anesthesia, and squeeze cages, also because they were harmful to the cats and the people using them.

So when a client asked me if their cat was being difficult, I would tell them about what really difficult cats acted like: They could defy gravity and run around the walls of the exam room or treatment room. They would clear off entire shelves as they ran through them to escape. And they could literally climb walls and end up near the ceiling before gravity assisted us in their recovery.

The worst case scenarios were when a cat got caught in behind the computer system. With a central computer that connected all five of my Cat Hospitals, a mass of wires and equipment sat beneath one of my desks in my office. When a fractious cat got in behind there, it was near impossible to get them out. The wires, modems, and main frame computer created an impenetrable maze through which we could not get a net or towel or any thing back there to catch them.

In their fear, the cats often defecated and urinated all over the computer equipment and wiring and left the area a mess, which took hours after to clean. So everyone knew, at all cost, don't let a cat get in behind the computer system. I was so good at catching fractious, angry, and difficult cats, that my staff members even called me "The Fastest Net In The West."

Dr. Doug Ikeler http://www.drdougikeler.com/ http://www.lifeextensionbooksbydrdougikeler.blogspot.com/