213. Fear Free in the ER: Triage, Handling & Pain Control That Reduce Pet Trauma

0:00 Welcome back, pet parent. I am excited for today's guest. We're talking about a couple of things that we have never talked about on this show before. And so let me go ahead and welcome Doctor Zach Pilasov with us on the show today. Thank you so much for being here with us. How are you doing? I'm doing good, yeah. But you know, I've been watching a lot of the episodes you guys have been out. So, you know, so far it seems like it's been, you know, pretty successful. We've got some good people that have come on here. So I'm happy to kind of be able to contribute. Yeah. No, I appreciate it so much. So you do a couple of things that I have not talked to anybody about in the past. One is emergency veterinary medicine and the other is fear free medicine.

0:43 And so I'd like to talk about both of those. But before we get into any of that, I just like to hear a little bit about you and like the back story and how you became a veterinarian and do what you do all. Right, pet parents, you already know that I talk all the time about needing to stop as much as we possibly can, feeding our fur babies garbage, for lack of a better word. That's what we talked about here a lot. And again, doing the best we can. That is the message above any and everything else. The more we learn, the more we know we need to make some changes. That is legacy biome.com, L e.g.

3:26 A/C, Y biome.com and get some for your pet. And by the way, let me know how it goes. You know me. You can always reach out to me on Instagram. I'm here to talk to you all the time. I want to know. Let me know about it. To try Legacy Biome for your dog, visit legacybiome.com and use code TPPR 10. That's TPPR 10 for 10% off. I'd just like to hear a little bit about you and like the back story and how you became a veterinarian and do what you do. Yeah, for sure. So, you know, so at least, you know, becoming a vet and, and starting at the very beginning, you know, you know, I've definitely can resonate with a lot of people out there that feel like they understand animals better than humans.

4:10 I don't know, human behavior sometimes super confusing. So a lot easier to understand. So, you know, it was always kind of like one of the plans in life. So, but what as a vet, you know, I started out pretty much like, I'd say almost every single vet, you know, kind of conventional route, conventional vet school and coming out of school had a plan. And where I'm at right now is definitely a very opposite or different plan than at least I thought I initially envisioned where I was going. So initially I had thought I was going to be a veterinary neurologist. So that was the path I went down and started with and then found out on that path that it probably just wasn't for me. And simultaneously, I actually started to find an interest in cannabis as a potential therapeutic. And so that was the first thing that opened my eyes a little bit to the idea of integrative and holistic therapies that could be complementary to and work well with the things I've just been taught for four years at Med school. And so, you know, through that route of kind of finding that path was maybe not the one I was intended for. In addition to starting to become a little bit obsessed with the idea of cannabis as being something we should think about as part of treatment plans in the right setting, then that was what what pretty much opened the doors for me as thinking that there was maybe more than one way to go about things. And so through that theory, then that open mindedness allows me anyone pretty much to kind of start to see that there are other options out there.

5:38 It's more about the proper usage of it and timing. You know, there's a time and place for everything. And so that's a model that has allowed me to find a way to do both, you know, your classic standard Western medicine and complement to some more integrative holistic approaches that I think makes sense in other situations. Yeah, I, well, I'm glad you brought that up because I mean, obviously I have had people wanted to talk about cannabis or I, I prefer to call it Kimberly. I'm sorry. My dog, she's just going to take advantage of the situation. She's going to be my cat, my cat's food. Thank you. So I, I try to, me personally, I, I have been really trying to kind of shift my vernacular into saying full spectrum hemp extract.

6:23 And there's a lot out there. I just am of the belief that a full spectrum extract is kind of what is going to be best case scenario. And there are different ways to look at it. I've talked to a couple of different people who are, who are doing full spectrum in different ways. It's very, very interesting to me how the endocannabinoid system being the master system of the like, I don't go a night now without me personally taking it and giving it to my dog. And I wish I were better about my cats. But cats being cats are, you know, they just, they are what they are.

7:06 But how? So how do you, especially being in like emergency medicine, how do you utilize cannabis with your patients? Well, right now there's so much that goes into the cannabis space and even the the, the hemp space, like it's not really something still that Western medicine is OK with. So I'll just be honest in in the emergency setting, I don't really use it too much. But what I often have the opportunity to do is, you know, I'll kind of evaluate how a pet parent is like talking or what they've tried historically. And if I think that they sound like there's someone that is interested in hearing about some options that may make sense going forward or in the same setting could be helpful that we got a lot of pets nowadays that I'd say, you know, in line with animals that are getting allergic skin disease, that a lot of animals have anxiety nowadays for whatever reason in kind of the same path as humans.

8:01 So, but you know, obviously anxiety is one thing that really works with a lot of pets. I'm sorry, that has found a lot of pets in cannabis or, you know, full spectrum HEPA, something that has worked for a lot of pets in that situation. So a lot of times, you know, I'll, I'll look for reasons to kind of open the door to that conversation in the emergency room. But in reality, you know, right now there's a lot of regulations that are preventing most veterinarians in the country outside of a couple of states to actually discuss that a lot in the clinical setting. And so it's kind of a little bit of Gray zone where you're allowed to not only discuss it, but more utilize it. And so, you know, right now there's actually only one state that actually defines that pet parents can utilize hemp in practice, which is Nevada. California has a lot of regulations that make that help with kind of discussions and recommendations. And when it comes to the medicinal side, But for the most part, really out of the other 48 states or so, it's a lot. It's a juggle and a gamble as to what veterinarians can do in the clinical setting right now with, you know, cannabis based product, whether it is medicinal or full spectrum. So if veterinarians are so like they have their hands tied almost, then we kind of have to utilize. I know there's one company that recently got a letter from the FDA that I'm so upset about.

9:18 We're going to talk about that on a on another podcast. But, you know, they're just they're cracking down. And granted, you know, there are arguments to made on to be made on both sides with, you know, making claims and we don't need to get political with the FDA. But it has to be really, really difficult to be a veterinarian and to see something that works so well and that you feel like you can't even talk about it with your client. So, you know, that's a lot of stuff I got, you know, 10 plus supplements that I could probably think about that have been stigmatized for the wrong reasons. Whatever one people in this community want to hypothesize. You know, I have my own theories and I think that everyone that is open minded or looks for things that are more natural has their own theories as to why, though a lot of things at work do get stigmatized and judged both in in, you know, I guess more the media, but also politically slight. There's a hands tied kind of situation, you know, in Long story short.

10:20 So you have to be smart about, you know, well, first you have to educate yourself and, and understand what you are allowed to say and what you are not allowed to say and what you are allowed to do and not allowed to do. And so I did kind of attack that pretty quickly in the space once I, once I knew that that's the way the game was going to be played. You know, I, I worked pretty hard to kind of know what I can talk about and not talk about. And so, but I can see it for sure that most vets, you know, when, when they are hearing a lot of things about there being success stories, but they don't know what they can legally do. And of course, it's, it's, it's I'm, I'm assuming, you know, it's got to be a little bit of a fear, fearful situation. You know, Mets are going to most often, which rightfully so, are going to take kind of the conservative route behind it. Because in vetted medicine, veterinarians, unfortunately, and I found this out myself, are guilty until proven innocent in situations. So, you know, it's hard for us to stick our neck out a lot of times.

11:07 And when it does happen and we try to do the right thing sometimes, you know, it, it puts a lot of risk for our license. So, you know, I can I can understand why a lot of vets are still pretty hesitant to talk about it. Yeah, and I, I appreciate that perspective so much because I mean, we talk all the time about vaccinations and over vaccination. And I personally have been chastised by multiple veterinarians for not doing vaccinations. They don't agree with titer testing which just blows my mind. And and then. Also, you know, flea and tick and heartworm and all the, all the things and I can't, I can't tell you that it's going to be OK if you feed your dog a raw food diet, even though you've been feeding your dog a raw food diet for 10 years and they're perfectly healthy.

11:55 You know, like all of those things, it drives me up the wall. But I appreciate the the other side of that, like where you're just concerned about your license and you want to keep practicing medicine. That really is, I mean, I, I have, you know, not to get too much of it, but I've been reported multiple times for things that always get, they get dismissed with like no consequences from the board. But it's, you know, people nowadays, you know, there's really good people out there and then there's people that have a different agenda or a different mindset. And so it is as scary, honestly, as a veterinarian because that's your livelihood. And so the only thing a lot of times they that we worry about is like, you know, should we do this?

12:35 Is it worth it in terms of like, are we going to get backlash or is this going to put my life at risk? So, yeah, it's a it's a reason for why a lot of that's probably our table, you know, would take a conservative approach about wanting to be OK with things. I think there's also other factors and, and, and and it's always independent. I'm sorry, individual independence. So, you know, but it is a thing that I think is on the back of most veterinarians minds. But but yeah, but I'm not right. So what is it? What happened that got you interested in cannabis to begin with? Well, so, yeah, so I was actually in the in my neurologic neurology internship at that time. You know, obviously, you know, kind of mentioned anxiety is something that has responded a lot of times very really to cannabis therapies or cannabis based therapies.

13:23 So I we're getting a lot of pet parents in though that we're also talking about seizure control as well as pain control. You know, in neurology, you know, there's both, you know, the two main sections, brain and the spinal cord. And so we see a lot of pets that are experiencing obviously seizure disorders as well as pain related disorders. And then third would be, you know, cancer based diseases. So, you know, those are three things that have shown a lot of promise with cannabis based therapies. And so, you know, we were getting a lot of questions and I was getting a lot of questions and I was like, I can't answer any of these questions. So and then I was just curious. I don't know, I've always been kind of curious about things versus writing them off. And so I started doing a lot of research, you know, on, you know, what was happening in the human space because I always start with the human space is kind of something that I've always found has a little bit more information that can help me figure out if something actually has a legitimate side or not or if it is a discussion topic with two different opposing ends.

14:17 And so I found, obviously if you do a 10 minute search on pub Med, what's out there, which is the, you know, 10s of thousands of papers. And so I was like, oh, wow, this is pretty concerning that I never got taught this. And so that was kind of the, you know, the small, the snowflake that led to the snowball effect. And, and since then that was really where I was like, oh gosh, I need to understand this stuff because it looks like the medicine space has been secretly utilizing this since 1960s. Maybe that, well, maybe research since 1960s, but 1990s, you know, it's when the utilization ramped up, the research ramped up maybe in the 60s. So we were far behind in that medicine and I wanted to try to catch up. Yeah.

14:58 Yeah. Well, until, you know, pharmaceutical companies figure out a way to profit off of it, they're not going to let us know about it. Yeah. That's my opinion, yeah. What's interesting is that it does so many things. I definitely have used it for clients with seizure disorders. I absolutely use it for anxiety like you talked about. And then I have used it for pain. I had a cat. I had to let him go last year. It was interesting because he in March, he had his annual, you know, senior blood panel. Everything looked great. And within two months he broke his leg and that was the first indication I had. I took him in to get an X-ray and he had him angiosarcoma and it was like wow, out of nowhere.

15:48 And I actually, you know, actually got THC that I mixed in with a full spectrum hemp extract. So I was like increasing the amount of THC he was getting to manage his pain and that is what he got did. I didn't do any other medication. There were no pharmaceuticals and it was more than enough to manage his symptoms, his pain, because he was totally fine like. I mean, you know, you see this all the time, animals. Are like, they act totally fine. It's just the pain that gets them. And so it was more than enough to manage his pain and so much. So I was actually just telling somebody this, this morning, his last, the day that I had scheduled for him to be euthanized because he was just with food and everything.

16:31 You know, how it, how it gets at the end of life. You're like, once they once they decide they're not going to eat, you're just done. And that day I gave him quite a bit and he thought he was Superman. He was jumping off of like 4 feet, you know, furniture. And I'm like, dude, you still have a broken leg. But he was feeling so good. Well, that's good. I'm glad he had a fun, you know? Yeah, yeah. He, he was feeling totally fine. He was like, there's nothing wrong. But I mean, I think, and, and I say that like, obviously in the moment it was horrible. I was a disaster. I was a mess, you know, just having to let him go. But you know, I can look back on it and say that that gave me Peace of Mind that like, he was fine. He he, if his body could have held out any longer, he would have been fine for quite a while longer just on this without pharmaceutical intervention.

17:29 And to me, it's just like one of those, one of those stories that's like, look what we can do with what nature gives us and not have to rely on, you know, anything else. Fortunately, my veterinarian at the time was like fully on board. She was, she was so sweet. She was like, I'll write you a prescription for anything you want, you know, to keep him comfortable and do all the things. But I was like, no, I think we're good. I think, I think, I think we've got this, you know, I mean, he was already 17 years old. So it's not even like, you know, yeah, it wasn't like, you know, a 2 year old cat that you're like, I need to save them. They have a whole life ahead. He's like, he was already 17 years old. And so I wasn't going to like amputate or anything. And yeah, yeah.

18:14 But anyway, I just think it's such an amazing, amazing tool that I do wish that, but with, you know, the federal regulations kind of kind of clamped down on the states. And then the states are like, no, you can't. You just can't. So I hate that, but I appreciate that that's kind of what drew you into learning more about, you know, what holistic modalities are out there. And one of the more interesting things that again, I haven't had anybody come on the show and talk about is being fear free in the I don't know if there's any way to be like 100% fear free, especially considering like our pets just have a sense about them that we kind of don't tune into a lot cats.

19:00 Oh my goodness, bring in a cat even into like a cat only clinic. It's just like they're they're they're going crazy. But how? Tell me a little bit more about like what fear free is and how like what people can expect when they're looking for a fearfully fear free clinic. Say it 8 times over and see what happened. No, I know it's like it's a tongue tire, but tongue anyway, So but yeah, I mean, so you know, honestly the fear free aspect is something that it just, you know, learning about kind of things like that. Well, actually, honestly, for me, just start off, it was honestly, it made so much sense because I've really only understood animal kind of behaviors and patterns since I was younger in the human side, like I said earlier, is they're honest to me. So for me, it kind of made a lot of sense when I was learning about.

19:49 I know a lot of people, you know, kind of talk about it, but utilizing it in practice is actually a lot more difficult because you know, like you said, like it's a, it's an uphill battle from the moment that they get there. In most situations. You're working in a very a place that has so many. Different stimuli that's it's hard to you know say like oh this is going to be a comforting environment as best as I can do you know, not take not take into account the fact that, you know, most of the pets that I see are, you know sick or uncomfortable to some degree. You know, given that emergencies, what the fear free side of it does really to me is provides as much comfort, emotional comfort to a pet that we are here to try and help as best we can, you know, and so there's a lot of things that you can kind of discuss and more the focal aspect of the specific things you can do in a situation to try to, you know, carry out that goal. But the goal for me when it comes to fear free is like trying to express to a pet, obviously non verbally, that you know, you're here to try and help them as best you can and to hurt them as little as you can in that process. You know, the emergency room is insane environment that I find comforting, but probably no one minimal people else do. So you know, So what we you know, when we're trying to take a fear free approach, we're really trying to understand, you know, the the mental, physical and emotional aspect of a pet. At least that's what I'm trying

21:20 to do. And, you know, figure out which one of those is really the main factor as to maybe what's causing this pet to a fearful experience at the moment and to address that as best we can. So, and you know, that's, I like to break it down like that because there are, you know, those are the three general categories that whether a human or a pet is going to, you know, is going to be where they're experiencing anxiety to some degree. And really that's what fear free is. It's just I'm trusting a pet's, you know, I guess anxiety in a way that they're creating this hyperalgesic state. And how can we, you know, kind of mitigate that? So you know, whether you know, you know, that's understanding that you know, they're better with their owners in the room when they're better without their own as a room.

22:07 Each of that's, you know, a situation, whether they have a lot of built up anxiety pre to the to the exam or pre to, you know, coming into the hospital. You know, that's a lot of discussion that comes up, whether you know, they are an animal that's in chronic pain. And that's kind of the reason that, you know, they do experience a lot of fear when they go to the vet because when they go to that cranking on things, you know, and you're trying to figure out where the problem is. And so, you know, it's kind of understanding for me, like where is a pet stressed or feeling anxious and addressing it out of those 3 categories and doing the best you can in situation. Because obviously, you know, my team has a job to do as well. You know, we're trying to, you know, solve a problem and, you know, kind of understanding that this pet is a living creature with thoughts and feelings and emotions, but at the same time getting the job done too.

22:57 And so, you know, you do your best and you have, you know, a lot of tools in your brain when you're trying to do that as best you can. But I think the teams that I work with understand that that's something that I prioritize, that it's not just about getting a pet and their family in and out the door with meds or with tests on. Like, you know, understanding that this is a living creature too, That, you know, we should try to make it as least stressful and as positively experienced as possible so that, you know, if they don't have to come back next time. That, you know, they're not terrified, that they understand to some degree that we're trying to help and that we're allies. Yeah. And I think, well, I know it actually starts at home. It starts with a pet parent. You know, getting in the car should be for more than just going to the veterinarian's office, right?

23:40 So like, you're not making that experience bad all the time. And for cats, you know, making sure they're used to their carrier or for a dog, like if, if you know, they need to be used to being in a crate, right? Like, because you just never know when, when they're going to have to be put in a, in a kennel, in a, in a vet office or, and, and that they're comfortable being touched. It really starts at home. Like you have to be able to to do these things with your Pets at Home first so that it does get a little bit easier when you're in a vet office. But some of the things I've seen and I'm just curious, like what it translates like for you, especially in emergency medicine.

24:21 I've seen obviously there are cats only clinics. I've seen clinics where like literally one side just has cat rooms. The other side just has dog rooms. There's like, you know, pheromone diffusers. What kind of things are are you utilizing there? Yeah, no, actually, I mean, those are some really good ones that we that a lot of then officers will try to utilize them in the first, like you said, is, is basically understanding that cats are not small dogs and that anything that's not a cat or a dog maybe prey to one of those two. So, you know, if you do work with animals that are different species that, you know, understanding the interconnectivity between them, not alone, not, you know, not just that they're pets and you're not pets. So, you know, that's a really actually what I think is a super important situation to understand and, and knowing that, you know, if, if that's if you are commingling different types of species in the front of the the hospital or in the back of the hospital, that they should be separated. So not only just in the front aspect, but in the back. You know, I've worked with many clinics where there's just a specific cat ward or there's a specific cat exam room that will be much quieter, that will try to be soundproof so that they're not hearing the dogs barking all the time. I mean, if they don't have that, you know, a lot of again, that people have worked with me that, you know, that I usually try to put cats in the back of the clinic if they're not, you know, obviously very sick.

25:42 You know, we don't keep tapping them. But if it's possible, you know, if there isn't another room or a cat where that I can separate them that, you know, the anxious cats or the scared cats. Not all cats are scared. And actually we have that's my show this week actually that were like we were like, wow, this is like a dog. That's so weird. But you know, but in terms of behavior, but you know, we will try to that is something that's actually, it seems like a simple goal, but to understand that these are different species, but different relationships between them. Understanding that cats should be separated from dogs, not only just for visual reasons, but for sound reasons, small reasons, etcetera. So, you know, with cats, that's, you know, one thing that we really try to do with the and in addition to that, you know, if we don't have that opportunity, like trying to create a safe space for them, so covering their their cages or having the windows so that they're only one way, if they're any cat warts that they can't see what's going on out there.

26:30 But they cats like to be kind of recluse away from situations. You know, more often dogs more often, not always, but more often dogs want to be involved with or being able to see situations. You know, those are a couple of things that are good points, you know, and you know, outside of the pharmacologic side, because a lot of times, you know, when we talk about fear free, I feel like the first thing people talk about is pharmacology or or supplements help control anxiety. And like, so I think that the other point you mentioned is actually an excellent one that I do talk to pet parents a lot about. If, you know, if pet comes in super nervous or anxious, is that, you know, a couple of things you could try at home to kind of get them used to this situation, which, like you said, was starting early with taking pets on, you know, drives or in car rides or getting them used to the, you know, the the carrier or, you know, even the simple fact of putting the leash on and walking towards the car versus walking on a walk.

27:29 Like they may see like, Oh my gosh, like we're putting leash on where we're going towards a car. Like I'm about to get stabbed and, and, and stretched and poked. So, you know, that that's something that, you know, we should desensitize to over a period of times. Yeah, I mean, you made a several good points as well. You know, so I think that those are those are all things that we tried to do or at least propose to do to try and help an animal to not basically associate going in the car, going to that office as a torturous event. So, but you really do your best What it's about, it's being and it's about being proactive actually is the last part of it starting early. Yeah, I've, I've even had suggested to people to take their pets to, like, call first to make sure, like whoever's at the reception desk can actually manage and handle. And it's not like a crazy situation when you walk in. But to take your dog specifically to the vet's office just to walk in, to let the people at the front desk love on them, tell them they're a good boy or a good girl, give them a treat, maybe weigh them and then leave. Like so that they're not always associating the vet's office with being poked and being prodded. Yeah.

28:41 Exactly. Yeah, I don't think anyone at about of us would, you know, would make anyone feel bad about that. I think actually people would say we should do this more often because, yeah, I think it would help a lot. And, you know, it's, you know, maybe it's out of your way for a couple minutes, but it could make a world difference for a pet, you know? Yeah. And again, like I, I can only imagine that it is that much harder to do in an emergency setting. What how did you get into emergency? I mean, for me, from my standpoint, just from everything I know, being more holistically minded, the training that veterinarians get in vet school I think is perfect for emergency medicine. Like that's, that's what you're trying to do, you know, diagnostics and emergency medicine.

29:26 But like, from your viewpoint, having actually gone through vet school, how did you get into emergency medicine? What? What sent you down that path? Well, you know, I guess you know, in vet school, it's kind of interesting, I guess just to kind of touch on that point in vet school, what I find actually is that most, at least my experience and what I would say is probably majority of experiences that vet schools for the most part push you to be a specialist. And that the non specialized primary care doctor and the non specialized emergency doctor are kind of like not too much talk about maybe I'd say that you know, where you spend a lot of your time, like on your rotations in that school. I'd say I spent probably the most on emergency so I could that is something that does happen, I guess if you don't overtly like asked to be on a different speciality service for more than that.

30:15 But I definitely would say that that was kind of a natural thing. I mean, for me, I went back to emergency because my internship actually, which I always prior, I always promote to veterinarians is to always do an internship if you can the year after that school. You know, in human medicine, you do either 3 or 4 year residency no matter what, you know, after school, which I think is important because you don't get really any hands on clinical experience in that school. You get observatory clinical experience and maybe get to do 2 surgeries on the, you know, on unless you, you know, do an extra, you know, an extracurricular couple weeks where you get more experience with that. But you know, you're really observing for the most part and being included in the most basic of aspects when you're at school.

30:56 It's an internship is where I was thrown into the gauntlet and I went to a very difficult internship and which I'm super grateful for because I think that it, you know, it prepared me for the world much quicker than if I would have went to one that was less interactive, even though it was a little bit challenging at times with, you know, an asterisk next to a little bit. But but you know, Invesco, I think that really appreciate to be a specialist. And if you don't become a specialist, which is the mindset that a lot of people come out with, then it's like, well, then you're just going to be another one of these vets that are primary care or emergency medicine. It's almost like it's downplayed is not as important. So, so, you know, become an emergency veterinarian for me was actually a consequence, though, of failing to become a specialist or failing to find comfort error or I'm sorry, planning to find passion to become a specialist.

31:49 And so my internship was in like a, a very advanced emergency specialty hospital up in Boston. And so, you know, I still got exposure to a lot of the specialties and I definitely, you know, was still in the path of becoming one or wanting to become one at that time. But what we did there was 90% emergency medicine. So I found it fun. You know, it's definitely a lot of Saturdays than happier days in Merchant and that's a guarantee. But you find find comfort in what you can address or can treat and sometimes even cure, which is not always easy. Which is weird to say that you know most of the things you see you you can't cure. But because you're seeing a lot of pets that are mostly in the end stages of things or have gotten far advanced, you know the ones that are wins.

32:39 You take home as best you can and you try to see it as the ones you can help the most. You try to help the most of the ones you know. Maybe, you know, you're here to provide answers at least or provide a palliative plan that you do that as well. You know, emergency medicine is kind of taking your wins and prioritizing the battles that you came out on top and in the other situations, trying to do the best you can for the pet, even if it means that sometimes it's their last day here with us. Yeah, yeah, I can imagine that. It is pretty sad. I have such a soft heart. I don't know that I could do it. But yeah, it's one of the the questions that I wanted to ask you was around like things you see coming in that maybe really aren't emergencies. One of my biggest pet peeves is with diarrhea. I feel like people freak out so quick over their pets having diarrhea.

33:35 And maybe you have a different viewpoint of this, but like, it happens and like, it's not always something to immediately run to the vet for unless there's like blood. But or if it's a puppy, you know, that's obviously they're much more at risk for dehydration much more quickly. Like, I don't know, I feel like that's one of my biggest pet peeves with, with people is like, it's not always an emergency. Yeah, I think it's subjective like you just pretty much alluded to is that it's a subjective situation. Yeah. I mean, you know, diary happens to us and so we don't but but I could, I definitely could see that. But it is it's really subjective. Like, you know, and that's The thing is that it was a pet parent. You know, especially more nowadays where it's like, you know, it's pet parent, but a lot of people see pets as their non same species child.

34:22 So, you know, a lot of you know, with your kid, you're going to, you're going to educate yourself as a pet, as a parent, you're going to, you know, overtime kind of look and research things. And so a lot of pet parents in this community actually do a great job of that. I, you know, through my telehealth comments have come across the parents that sometimes blow me away with how much research they've done and they are just looking to kind of consolidate that. And so, you know, a lot of times they know as much as me in some situations on topics. So I'm like, well, it's really impressive. But but at the same time, you know, it's and, and so that's just a testament to like, you know, pets, pet parents can be super educated sometimes as much as veterinary can a lot of topics. So diarrhea is a subjective situation, right? And and that's one that you can research. So, and I think I did a, I think I did a video or guide, but I know a few vets have also kind of put videos out in terms of helping to triage at home, You know, triage at home when when diarrhea is a situation that does, you know, may be responsive to some at home therapies. And then what?

35:23 It may be something that doesn't see about. I know that I can't remember it. I know Doctor Katie Woodley puts a lot out around that. That's exactly what I was thinking about. Yeah. She has a bunch of blogs and stuff I've read with her things and she has a great article actually that has several supplements on that you can have on hand at home. I also have a few that, you know, I've included. I like a linterium social media that I have a couple of companies that are some good products I like to have at home for nonspecific diarrhea or loose stools. But but yeah, I know if it's a couple things you mentioned, if it's like a young puppy, especially if they're like in the midst of their vaccination series, their puppy series where they may not believe fully protected from some things. Or, you know, a pet start starting to have, you know, a good amount of blood in it in the stools as well.

36:08 Or, you know, they haven't eaten for, you know, a day and 1/2 as well as having diarrhea. Like those are situations, like you said, where you know, you're setting up not only for diarrhea, but that you may not be able to get the fluids in that you need to match what you're losing. But yeah, it's a subjective call. And so I think you're right that there are a lot of times that, you know, some symptoms at home can be addressed with supplementation and diarrhea is a really a really good one to bring up. And you know, you're looking for other things that can be addressed, but it is subjective call. But but there are resources out there, preference I think to kind of help them, you know, triage at home and figure out, you know, what's the best solution at the time. Yeah. Well, what are some things that I mean, I'm, I guess I'm curious as to like what you're seeing now.

36:55 What do you see come in a lot? Well, right now, I'd say vomiting, diarrhea has always been the ruin. That's how we see that all the time, you know, but you know, out of that list, you know, I could create 12 or 14 different things that can got you there. You know, whether they're GR will not. So that's a puzzle piece aspects for for me, at least for us is that's just like saying like, OK, this I have, you know, three dogs just came in for the same symptoms and, you know, each one of them may have a different reason why. You know, one might have eaten a sock, one might have a history of food sensitivities, one may have a gallbladder infection that's causing them secondary vomiting and diarrhea. So, you know, that's kind of a puzzle piece aspect. That is our job as the vet side.

37:37 And when a pet parent comes in with the situation. And so, you know, out of those three, you know, the, the, you know, well, we'll say it's just diarrhea alone, like the one in the middle, the food sensitivity pet, you know, maybe that one could have been addressed at home with some supplementation or fasting the pet for 12 to 18 hours and offering just liquids. And then the other two obviously are, you know, different situations, one's situation, one's a medical situation, so. For. Sure. But yeah, so vomiting, diarrhea is probably always been #1 you know, we see a lot of pets. I see a lot of trauma pets. I really like trauma pets like I like, but you know, I like, I like dressing those the most, to be honest. But we see a lot of trauma that's kind of like a common thing we'll see, you know, out of that.

38:19 It's a mixed bag, you know, pets coming in for, you know, pain that, you know, it's hard to figure out where it's from. You know, we see a lot of pets that have like different hormonal, endocrine disorders. You know, some diabetic pets, you know, think, you know, if they have different levels of diabetes, that's control. That's a common thing. We'll see you see some affair of like neurologic conditions, you know, whether it is seizure related or spinal related. I work down in Florida a lot. So even though I travel, you know, full time for work up and down the East Coast Florida, there's there's a cane toads or buffo toads down there where and they are like everywhere. So we get a lot of pets, I'd say at least one, one to two at minimum a week, sometimes 1A day of pets coming in because of the pet even licks that toe.

39:01 They have seizures pretty, pretty at least. So toxicities we see, you know, pets eating things they shouldn't that have different toxic variables. Yeah, it's a mixed bag. But I honestly would say vom and diarrhea is always #1 and it probably will always be #1 So that's why it's good to, you know, at home as a pet parent, be like, hey, these are the, you know, red flags I should look for. If I haven't seen, you know, these red flags, maybe I can kind of do some things at home. And then once you start seeing them, if when you start seeing the red flags build up, then, you know, good to come to that. But. Yeah, How much? I'm curious because it is an emergency setting. You probably, you know, it's you're either like dead or you're pulling your hair out, right.

39:42 And like, that's just kind of how how it goes, I'm sure. But how much? Especially considering there is so much vomiting and diarrhea coming in? How? How much do you actually get to talk to pet parents about gut health? Not much at all. And then that's why, you know. I think that was another reason why I kind of found a little bit of interest in expanding my abilities to connect with pet parents outside of this merge setting. So yeah, the merger room, like you said, there's, I'd say depending on the hospital we work at, I work mostly at the busiest 1. So I don't really get too many dead nights or days because I guess most, I work mostly nights, but you know, I guess there's some days mixed in.

40:27 But yeah, I have, you know, 30 to 90 seconds to talk to a pet parent. And so, you know, and so it's it's really you know, what's going on. This is what I want to do, figure out what's going on if I can. If I can figure it out, I can't, great. If I can't, then this is the next step. This is the person you have to talk to you like it's very rapid fire. So Naked Pet, which is like my online business, that was something that I guess I was yearning for was to not only be educated in integrative holistic therapies and, you know, talk about it. You know, in a situation like this, which is kind of what I was doing, I was talking at conferences and I was doing podcast, some of that, but I really kind of wanted to also make a difference with it.

41:10 So, so that's where the, you know, the telehealth aspect of Naked Pet came into play, was getting more than 30 to 90 seconds to talk about what do we do after the acute event? You know, how do we create longevity or the best opportunity for longevity with where we're at right now giving, you know, we have these certain things going on so. Yeah. Yeah, there's not much time. Yeah, I mean, I, I hate to say this, but it's just the truth. The worst experiences I've ever had were in emergency clinics and. Then, so you know, you don't usually go there voluntarily. Yeah. Well, I mean, just like I obviously this is not a reflection of you as an individual, but I have, I have had people and these are technicians usually because the veterinarian doesn't have time to have these conversations, you know, tell me that I'm going to kill my pet if I don't put them on this prescription diet. Like literally you're just going to like walk up in my face. We're going to kill your cat.

42:13 And I'm like, this is not, this is not an OK situation. And I also had one of my dogs pass away at an emergency vet clinic overnight and they didn't inform me. So I had some really like not so great. Not so great. Yeah. And I had, I had another one, another cat who it was at an emergency hospital. But they also had, they had like residents there that were doing studies. And she wanted I I feel very strongly like she kept my cat alive because she wanted him in her study, even though I kept telling her to I was not going to put my cat in the study. That was that was a bad situation also.

42:54 Exactly. I think I agree with this. These are traumatic events. Yeah, so those are probably some of my, my worst experiences, but I still appreciate emergency medicine. We need it. It's it's it's there for a reason, right? Like, we, our pets, things happen. And heaven forbid your dog gets hit by a car and your vet's office is closed, right? Like that's when it always happens. Yeah, exactly. No, I mean, I could definitely understand and I believe you 100%. And yeah, well, the second one, I, I don't, I don't want to believe that one, but you know, at least for the first one, I honestly, what's helped me the most is a veterinarian is knowing that I'm here just for suggestions and that being OK with that.

43:44 Like I find that, you know, you know, they want the vet industry, they everyone in here goes into it because they want to help. That's that's the way you express that verbally and non verbally is whether you're in a vet clinic, whether you're working at United States Postal Service, whether you're, you know, yeah, you're you're doing, you're answering the phone for Apple. You know, that's the variable is the way that emotional human emotion acts in situations. And so I definitely believe that, you know, the first one where, you know, you were told that your cat would die from a certain diet happened because I've seen it multiple times. I work with people that I know of said things like that. I'm just here for suggestions.

44:30 That's the way I approach it. I'm like, I think this is the right thing to do if you don't want to do it. Like it's not my pet and that's OK. And that's on both sides in the emergency bedroom. No, and I'm make a suggestion. I make an estimated plan of what I want to do. You want to follow it Like that's OK. Like it's not my, I think this is the right thing, but this is the best thing and can't do it. You don't want to do it. That's fine with me. Like I'm not going to make you feel bad about it. You can talk to get a second opinion and go from there, you know so. Yeah, yeah. Guidance and I think that that allows me as like an individual as well to separate the facts from the emotions and you know this is what I think is the best but emotionally am I going to get tied up in it I'm not going to get tied up because I got 40 things else I got to do right now and so I think this is the best thing right now if it's not then that's OK we can make a Plan B or you can see you in regular vet tomorrow.

45:25 I don't care with that like you know so I think that I'm a little bit fiery sometimes in ERS where people act emotionally incorrect even though they're trying to do the right thing or say the right thing. So I'm sorry it's. A highly, highly volatile setting. Everybody you know. Pet parents are emotional when they come in to an emergency client. Sure. Yeah, there's so much emotion that's going on. Yeah, yeah, well, tell me more about Naked Pet and what you have going on over there and the telemedicine that you're doing. All right, pet parents, you already know that I talk all the time about needing to stop as much as we possibly can, feeding our fur babies garbage.

46:05 For lack of a better word, that's what we talked about here a lot. And again, doing the best we can. That is the message above any and everything else. The more we learn, the more we know we need to make some changes. And this episode is powered by Legacy Biome. This is no BS. And This is why I think you need Legacy Biome. So legacy Biome offers premium. When I say premium, I mean premium FMT, fecal microbiota transplant capsules. These are products for your dog designed to restore and support a healthy gut microbiome. Yes, you heard me. Top tier microbiome therapy straight from nature's playbook. Gut health isn't optional.

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48:29 A/C, Y biome.com and get some for your pet. And by the way, let me know how it goes. You know me. You can always reach out to me on Instagram. I'm here to talk to you all the time. I want to know. Let me know about it. To try Legacy Biome for your dog, visit legacybiome.com and use code TPPR 10. That's TPPR 10 for 10% off. Well, tell me more about Naked Pet and what you have going on over there and the telemedicine that you're doing. Yeah, so Naked Pet was kind of me expressing my frustrations through a website. So, you know, so in the, in the, you know, integrative holistic side kind of alluded to earlier, you know, I'd say the number one thing we were seeing is, you know, is the extreme rise in pets with allergies and or at least skin and GI based disorders that were rooted in immune dysregulation.

49:27 And so we know, with that being said, you know, I said earlier that I kind of fell the path of educating myself and then started talking about it, you know, through different means. But eventually I felt like you should try to, you know, join the that community that's trying to make a difference with that, even though, you know, I don't really have a space to do it at the moment. So, you know, meaning like the emergency room, like that's not the space to do it. So I was like, Gary, well, you know, I can, I guess I, you know, I see a couple of people doing things. I started to actually was working with the Tel Tel off company that's for conventional medicine, and I was like part of like their research aspect. So I kind of got exposure to that for a little bit and understood where Tel more like more telehealth. You know, it's a weird discrepancy. Again, kind of like the kind of a thing, but the verbiage in the telemedicine or the telehealth space, you know, you have Tele triage, you have telemedicine, you have Tele radiology, a bunch of things that are within it.

50:17 But in terms of like telehealth is kind of like the overarching verb that or absurd word that you can use that the verbiage will describe anything you do via virtual communication. And so, you know, I was like, all right, well, I can probably utilize this in a certain way if I use certain words or I don't, you know, make direct recommendations. We don't talk about certain topics. We can probably still talk about a lot and so, you know, after a year or so of researching, you know, but what I could do through telehealth and in the same vein also, you know, with the allergy side, I really understood why in the vet space, you know, whether it's conventional or realistic. We only talk about oral products when it comes to allergies, stuff like that. Like if you have allergies, the human or immune dysregulation at the skin barrier, like a lot of people you know who have that know that there's complementary topical treatment side to also the oral sides, not just oral meds are always taking. So those two things I kind of just brought together with naked Pet or I helped with a very close friend who's a genius woman on the human space for an holistic topical therapy. She's like paramedical aesthetician and RN and very holistic minded for sure.

51:27 Been friends with her for years. Like we went and work together to create a product line for pets and then I worked on the telehealth myself and figured out what I could do and created topics that I thought I could provide significant value to pet parents over virtual means and then create a website and brought the two together. And so that's kind of how Naked Pet was born. So, you know, we've kind of grown a lot since then. You know, I added a few things like added the tighter testing to that, you know, after the initial launch. You know, we, we do some more advanced testing now through a website, I'm sorry, a laboratory called VDI where we can do like mycotoxin testing or gut health testing or even there's some cancer screening testing that they have through there that you could sometimes do heavy metal testing, you know, through certain means.

52:17 You know, it's kind of expanded since I started out where there was just a couple of consults and you know, the naked pet products, we have a huge oral product company kind of affiliate group that I've slowly vetted over time, added one company a month at a time that, you know, because I don't really want to get into oral products. There's a whole laundry list of reasons why, but stick to the topical state of my lane on that side. But, you know, obviously I use a lot of supplements and nutraceuticals through the telehealth to kind of help pets, you know, as you know, whether pet parents are looking to get away from pharmaceuticals or trying to minimize the amount that they have to give on a daily basis. So but yeah, it's kind of expand into a three arm kind of situation with the telehealth kind of being the the center of it, the topical therapy line, you know, being utilized. And I'd say at least 50 percent, 75% of the pets I see through that console through the consultation side. And then slowly trying to create a collected safe space of products that I personally bet it for safety and do believe are effective to utilize through the telehealth space, you know, whatever supplementation I think is necessary in complement to proper diet.

53:21 Yeah, I'm so glad you said diet because I was like, that's where I was going because I. Of everything. It really, really is. And I mean, I that's, you know, the universe just brings you what it brings you and you're like, OK, I guess this is what I'm doing. And I mean, most of my clients are leaky gut. I have so many dogs with SIBO. Shocked at the number of dogs I have with SIBO and it's just like can't do anything without addressing the diet first, especially with these dogs that can hardly eat anything. You know the hour, hour and a half, depending on what consul we do, you know at least 30 minutes, At least half of it or more is just about either.

54:12 What diets haven't worked? Which diets we could try, which ones we have left, Which proteins are left, which, you know, do we need a cooling, warming, you know, that's, that takes at least 50% of the hour, hour and a half every time. So I definitely agree with you. It's the foundation and but it's also the least talked about I think in other settings outside of like, you know, maybe what you and I are seeing, you know, people seeing us so. It's, yeah. Well, it's so individualized. It's hard to put that kind of content out. I think because it is so individualized, it's easy to put a supplement or a nutraceutical out and say this will do all these wonderful things, buy it, Yeah. Unfortunately, I agree with too much. Everything's the next best thing. For sure, for sure.

55:05 So I I guess you're still doing the telehealth currently, Is that a thing? You're still Oh, yeah, yeah. No, yeah, we all, Yeah, we, you know, we, we kind of initially actually we got overwhelmed. We had too many consults at once. So we actually have, we published the consultation schedule one month at a time. So that could we, we put out like 3 or 4 months and we're booked. We're booked because I work in, I work in the clinic 20 to 22 days a month give or take. And I'm usually flying between on my off days or either flying or something, actually many times on my on days as well. So we try to, I, I basically fit in on any of my off days.

55:46 It's really when I do the, the consults or, or the hour before I'm about to go work a 14 hour ER shifts, you know, So I'm basically fitting into that. And but yeah, no, 100% we do it all time. We right now is the hot season for the tighter testing actually, right, You know, right. February to April, because a lot of people are doing their Wellness exams with their pet parents, which is actually, I do support that. I think that's the best time of year to do it. And you know, before they go to see the vet or they're planning to go see the vet, they, you know, they're the tire testing is a blood draw. So they're like, all right, well, I'm going to go to see that anyway. So I'm like, that's perfect time to do it. And so we get a couple dozen of those, you know, over the last 2 1/2 months, you know, we still do it all the time.

56:33 And you know, you know, I think that most pet parents walk away with that feeling like they were heard #1 and that they got some sufficient value out of it. So for the most part. Yeah, I, I mean that that's something that that we don't talk enough about, like for sure, you know, being heard. That's what I that's why I get so often from people is like, I'm just glad you listened to me and, and didn't shrug them off, didn't say, oh, it's nothing, don't worry about it. Or let me just give you this pill. Like, you know, actually like listening to them because the the bottom line is that yes, vets are trained you all of you, y'all, or you're trained and you see so many animals that you see trends and you can put all of that together, but like nobody knows an individual animal like their their owner does.

57:35 Yeah, no, for sure. I definitely agree with that. Yeah. So I want to thank you so much for your time. And just ask like, if there's anything else that we didn't cover that you wanted to talk about or anything that you want to say to people listening about their pets or about what you do. Yeah. No, I mean, I, I think that actually that was a kind of a good segue to in the closing was that, you know, essentially you're going to find people on in every walk of life that you associate with or you feel you can assimilate to them. So the same goes for, you know, your your pets health and Wellness. You know, you, I think it's good to be for sure. You know, like we talked about an educated pet parent as best you can.

58:19 And, you know, when it comes to kind of consolidating where, you know, you take all these things that you're hearing and you're looking up and then trying to find what's best for your pet, You know, finding, you know, pet professionals that are in the same thoughts category as you, in the same interesting goals as you, which can be harder than it sounds. But trying to find that as best you can is a good place to start. Because, you know, like I said earlier, you're not going to find people that you associate with just right away everywhere. So not being afraid to, you know, try to find that person that in the vet space that is going to listen to you and, and want to work with you as a pet parent when you're trying to do your best.

59:00 Because I think they do exist in all 50 states. You just maybe have to find them and yeah, may take a little bit more work, but I think they do exist and they're out there for you. Yeah, well, I appreciate that. I appreciate you and your time in it. And, you know, wanting to expand beyond just what you learned in vet school. I, I, I appreciate that so much for our pets especially. So thank you again that you guys listening. I want to say thank you to you for. For being here. For listening, make sure to check the show notes for any links for anything that Zach talked about and just give your pets some extra love from both of us this week and I'll talk to you next week.