Thursday, 5 December 2013

Breeding Difficulties part three - Breeders, and what to do about it all

In the last couple of blog posts, I've talked a lot about dog breeding, and the problems associated with it. In this final part of my epic trilogy. I'd like to briefly discuss the people responsible (and I do use the term very loosely) for producing puppies - breeders.

You can, I think, break breeders down into several types (rather than, say, their component atoms, which readers of my previous blogs may suspect would be my preference). Let's start with the type most commonly encountered by vets in general practice: the 'responsible' breeder.

'Responsible' breeders

The reason we encounter this type of breeder more frequently is, sadly, not because they are more common than any other type, but simply because these are the breeders who do everything possible for the pups that they produce - vaccinations, worming, flea treatment, nutritional advice, hip scores (or whatever test other the breed needs to pass to make it's suffering less than it otherwise would be) - and so they're the ones who come to the vets. Often. Very often. In general practice, you'll often be on first-name terms with them.

'Responsible' breeders occupy a strange position in many veterinary practices; generally liked (or at least tolerated) by practice owners, and largely resented by all the other vets, nurses and support staff - and by resented, I mean that their faces are likely to be pinned to a dartboard in the coffee room.

Here's the problem in a nutshell: breeders bring in a lot of money to the practice - both directly and indirectly, because if they like you, they're going to recommend you as the vets to go to. They are well aware of this, and as a consequence of this they frequently feel (not entirely without reason) like specially valued customers, which usually translates into them behaving as if they own the practice.

Responsible breeders have a tendency to be inpatient with (if not downright rude to) the receptionists, nurses, and junior vets who have the temerity to obstruct them in their quest to be immediately seen by the senior partner. They'll assume their particular problem is going to be more important to the practice than any other client's, and they'll be very ready to write a complaint letter if it isn't treated as such. They'll expect vets to drop everything to kowtow to their wishes, and they will usually hold the views of younger vets in disdain.

I can't tell you how many times I've heard some variant of the mantra 'I've been breeding dogs for thirty years, young man,' , with the strong silent implication that my own decade or so of treating sick animals every single day of my working life preceded by five years at university is worthless in comparison to this enormous achievement. Being my usual diplomatic self, at times like these I bite my tongue rather than point out that it's really not too difficult to produce a dog (if you're not familiar with the procedure, the main requirement is to have two dogs - ideally of opposite sexes, but I am clearly not an expert in such matters, as I am often reminded). Even if they personally haven't been breeding dogs for very long, they will almost certainly be accompanied by a friend who has been, and with whom every single statement you make as a vet must be checked and verified.

Now, I'm being unfair here, because for every two obnoxious, rude and demanding responsible breeder, there is one that is extremely pleasant (yes, that's the correct ratio as far as I can make out). Not only that, these are, and I mean this genuinely, people who care about what they are doing. They care about the puppies that they breed, and the mothers, and they want to see them go to good homes. They want to do the very best medically for their animals, and they would be horrified to think that they were causing any degree of animal suffering at all.

However horrified they might be, however, they are most certainly causing suffering. Quite apart from the severe, dreadful misery caused by inbreeding (which I wrote about in part two of this post), for every puppy sold to a new home, there is a dog in a rescue centre denied one. A dog that will either ultimately get put to sleep, or will spend the rest of its life in a kennel. Every single puppy. They don't mean to cause misery, but I am here to tell you that even the most caring, responsible, well-read and clued in breeder is causing it nevertheless.

And these are the good ones.

Irresponsible Breeders

If responsible breeders are likely to find their faces on dartboards in vet practices, then irresponsible ones are more likely to find their way onto the toilet roll. Irresponsible breeders don't really care about vaccinations, or worming, or nutrition. All of those cut into the profit margins. They care about mum, in so far as they need the bitch to keep producing puppies, but when she's past breeding age they'll pass her on, or put her to sleep (vets are not very commonly involved in this last procedure).

Irresponsible breeders are the type who lead to situations like my first blog post. They may attempt lip-service to the fact that they're dealing with a living creature rather than, say, a money-printing machine, but their actions belie their motives.

Breeders like this are frequently encountered for the first time in the middle of the night, having 'just moved to the area' or 'not registered the dog before', both statements being euphemisms for having run up a huge bill at one of the other vets in the area and having no intention to pay it. It's considered unprofessional for vet practices to inform other vets in the area that such clients haven't paid their bill, but you usually get the idea pretty quickly.

Despite the fact that a single puppy from a pedigree breed would generally cover more than double the cost of a caesarian, irresponsible breeders forget to bring their wallets with them surprisingly often - and frequently find them again very quickly when they are informed they must pay at the time they collect the dog.

Such breeders are the cause of immense amounts of suffering - principally to the deformed, unhealthy puppies that they produce, the females of which are destined to become dog-shaped money machines like their mother, but also to vets and nurses. Being faced with a client that simply refuses to pay and an animal that is in severe pain and in need of a caesarian is every vet's nightmare scenario. Yes, we can, in principle, simply offer to euthanase the animal on humane grounds, but if anyone else can manage to do that an still get to sleep at night, I'd appreciate some tips.

Not only this, breeders of this type are far, far more likely to report your actions to the Royal College of Veterinary Surgeons - so for those people who suggested to me, after reading my first blog, that performing the caesarian described without speying the poor bulldog was unethical, all I can say to you is this: not according to the Royal College. Performing a surgical procedure on an animal without consent is very definitely going to get a vet struck off, and so is the 'whoops, the uterus broke so I had to take it out' strategy that has been whispered about behind closed doors.

As time goes on, and I become (yes, I admit it!) more of a fundamentalist about breeding in general, I am starting to include anyone who breeds dogs of such obvious anatomical unhealthiness as pugs, bulldogs, basset hounds and so on as automatically, and by definition, irresponsible (yes, I know pugs are beloved by the internet. I also know that, because of their shape, they suffer; perhaps if you had treated several that prolapsed their eyeballs because they had a nasty coughing fit, you might feel similarly).

Puppy Farms

It is with sorrow that I even have to include this category, as I would have thought these would have died out years ago, but nope, they're still going strong. Puppy farmers are, effectively, irresponsible breeders who have embraced the principles of battery farming, and applied it to dogs.

A lot of vets know very little about what goes on in puppy farms, because the never visit them, and they never hear from the breeders. The first they know anything at all about such places is when they are presented with a puppy that someone has bought from them. Even by pedigree standards, puppies from here are going to be in pretty poor states. Often these puppies are bought on the internet, and while it boggles my mind that anyone could be so stupid as to order a puppy in the same way that your order your shopping, it still happens. Thankfully, a recent petition requesting the banning of the such places by the excellent PupAid charity has very recently topped 100,000 signatures, which means the issue must now be debated in parliament.

I haven't got much to say about puppy farms at all, to be honest, other than to say that they are vile, evil places, which cause about as much suffering and death as anywhere I can think of outside of... well, outside of a battery farm. Which does spur me to make one last point about them - if, like me, you can't stand the thought of a helpless dog, trapped for its whole life and forced into repeated pregnancies to produce animals simply for profit - then please stop and consider what you're doing when you buy cheap eggs, or pork, or veal.

What to do?

Now, I promised that this last blog in my trilogy would be proactive. So far I have, I hope, given a pretty clear indication of the suffering that is caused by the puppy trade. Is there anything that can be done to prevent it?

Well, fortunately for me, I've saved the easiest part of my blog for last. Yes. Yes there is. It's really very, very simple.

I could give some simple advice here about never, ever ordering a puppy if you haven't seen and visited it's mother, and made sure it's in comfortable surroundings, and healthy, and well. Never even think about buying a puppy online, and don't ever, ever get anyone a puppy for a present, no matter how good an idea it seems. But, y'know, typing out the words 'ordering a puppy' makes me feel a little queasy. Here's my much simpler advice (and I warned you I'm a fundamentalist on the topic):

Don't buy puppies. Don't breed puppies. Get your animals from rescue and rehoming centres. Always.

That's it. That's the sum total of my advice. Follow it, and I can guarantee you'll be reducing animal suffering, and you will have a wonderful new addition to your family.

As to the rebuttals to that advice that may have sprung instantly to your mind, then I'll deal with them below.

But... if everyone did that, there wouldn't be any pet dogs! Is that what you want?

No, it isn't, but... don't be silly. Rescue centres are absolutely full. Animals are getting put to sleep right now. Read my blog post Dog #86324.
You know what, if they ever get even close to emptying, I'll change my advice. I suspect that I won't ever have to do that. Don't spring your reducto ad absurdum on me, it's a logical fallacy.

But... I want to know what I'm going to get!

Well, I can tell you what you're going to get with a pedigree dog, but let's not go there. You can, and I hope I'm not sounding rude here, possibly get a reasonable idea of what you're going to get by, y'know, looking at the dog you're rescuing, as opposed to assuming that a dog that you've ordered from a breeder and that doesn't yet exist is going to be fine.

But what if the rescue dog is aggressive?

What if the pedigree dog is? At least the rescue dog will have been screened for its behaviour. The pedigree one won't. I've met plenty of 'well-bred' dogs that took a disliking to my nose too (maybe it's my nose that is the problem here...)

But I want a dog that won't shed any hair, I'm sort of allergic to dog hair. Think of my children!

Well, labradoodles need to be rescued too, y'know. Failing that, buy a better vacuum cleaner, or, if you and/or your child is allergic to dog hair then, am I'm only suggesting this, possibly a dog isn't really the pet for you. I'm extremely uncomfortable with this idea of getting a pet 'to order' - it's this sort of thinking that got dog breeds where they are today, which is to say, suffering.

But... my Brunhilde is amazing, I just want one litter of pups from her.

I understand this impulse. You love your dog. You don't want that to be it when they're gone. Listen, no one in the world loved their dog more than I loved Geri - but I wouldn't have bred from her, even if I had the option. Why? Because there are thousands of dogs like Geri, and yes, like Brunhilde, already waiting for a home. The world doesn't need more of them. It really doesn't.

I'll be happy to answer any more queries, but until then, here's my final word on the subject... once more, with feeling...

Don't buy puppies. Don't breed puppies. Get your animals from rescue and rehoming centres. Always.

Saturday, 16 November 2013

Breeding Difficulties part two - breed predipositions

As a vet student, and as a new vet, I hadn't really thought much about dog breeding. Dog breeds, to me, meant a list of predisposed diseases that I had memorised by rote as part of my training - something a little like this:

            West Highland White Terriers: Atopy, Lens Luxation
            King Charles Spaniels: Mitral valve insufficiency, syringomyelia
            Boxers: Aortic stenois, neoplasia, idopathic syncope          
            German Shepherds: Anal furunculosis, atopy, pannus, dilated cardiomyopathy, hip dysplasia, chronic degenerative radiculomyopathy[1]

 ... and so on. Questions on this would pop up all the time in exams, so you needed to know this stuff[2], but I never really considered what this list meant. It was just something else to learn: parathyroid hormone is responsible for the regulation of calcium levels within the body, the average pH of a pigeon's rectum is 6.3, and greyhounds are predisposed to develop osteosarcomas.

 Our family pet when I had been growing up was a cocker spaniel, Silky[3]. I loved her dearly, as you would expect. It was harder for my dad to; she was extremely protective of her bed, and would growl and snap at him whenever he approached. She did the same to all of us if she ever wriggled under the bed, and she once bit me quite badly on the finger when I tried to extract her. At university, I learned that this was in inbred trait of spaniels - rage, it's called[4]. So, it turns out, was the heart disease that claimed her life. Still, these things never really connected; by the time I qualified, Silky had been dead a long time, and my parents had another spaniel at home[5]. We knew the breed, you see. We liked them.

In practice, this knowledge of breed diseases was very helpful. Young labrador, unsteady on its back legs? Definitely worth x-raying the hips for dysplasia. Westie with breathing difficulties and crackling noises on auscultation of the chest? Need to investigate the possibility of pulmonary fibrosis. Very helpful. Essential, in fact.

In those first few months, I was living from one consultation to the next, terrified that I was just one slip of the needle away from making some colossal mistake. Eventually, though, as the terror of being a new graduate slowly settled into a dull, lurking fear, and I started to see consultations that weren't wholly new to me, I began to notice just how much of my time was being taken up treating diseases that were on that list. Even for someone as slow on the uptake as me, when faced with my third westie in the same week with severely inflamed and infected skin due to its chronic allergic skin disease, I started to ask myself questions about whether there might be a better way of dealing with this stuff.

Suffering. It's a word that's followed me through my life, and through my career. As vets, we use it a lot. We are, we like to think, its enemy. Our whole raison d'etre, our vocation, is to reduce it whenever and wherever we can. It's the reason we can euthanase five animals in a day, and still get to sleep at night  - we didn't want them to suffer any more.

Working in general practice, it finally started to click with me - this rottweiler with entropion wasn't helping me out by presenting me with a disease I knew it was predisposed to. It was in pain, because its eyelashes were pressing onto its cornea. This springer spaniel with purulent otitis externa was yelping when I examined it because it hurt. That great dane that I put to sleep last week due to dilated cardiomyopathy wasn't just another tick box on my mental list of breed diseases. It was dead, because it's heart gave out. Because it was a great dane.

That's when I started to wonder about that list. Breed predisposition. It meant that, genetically, these breeds paid a price for their long ears, or their curly tails, or their short, cute, forelimbs. It meant that they were more likely to get certain diseases - and, from my experience in practice, I was realising that this didn't just mean a bit more likely. Something like fifty percent of westies have atopy. The same proportion of bulldogs can't give birth without a caesarian. I was coming to understand that the price a dog pays for being a certain breed is that it suffers.
I finally started to think very seriously about dog breeds, and just what we were doing to man's best friend. 

The bulldog caesarian I described in my last post is, I don't deny, an extreme example - but the point of this post is to demonstrate that no breed is immune. The pedigree dogs we have now are not the same creatures that existed fifty years ago; through more and more inbreeding, they've become caricatures of themselves.

Next time, I'm going to talk about breeders, puppy farms, rescue centres, and what we can do to try to fix this problem, and therefore stop me blogging about it - something I think that we can all agree would be a good thing ;).

[1] This is not, by any means an exhaustive list for any of these breeds.
[2] And why, due to a particulcarly stressful 'steeplechase' exam in my fourth year, I will remember to my deathbed that Belgian Shepherds are predsiposed to gastric adenocarcinomas.
[3] This is what happens when you allow your children to come up with names for your family pets, of course. We all liked the name, anyway. Don't judge us.
[4] Which puts me in mind of the excellent not-zombie film, 28 Days Later. Definitely worth seeing! But I digress - I suppose I'm allowed to in a footnote, now I think about it...
[5] Bilbo, if you must know. Hey, I like The Hobbit, okay? (The book, obviously).

Thursday, 14 November 2013

Breeding Difficulties Part One - The Truth about Breeding

Heidi, the three-year old bulldog, waddles across the floor of the prep room. She tries to sit, but her hugely distended abdomen makes that uncomfortable for her, so instead she stands, and pants. Her thick eyelids droop with weariness. Sam and I lift her onto the prep table with some difficulty. Heidi gurgles and splutters as we set her down, then starts panting again. Green viscous fluid drips from her vulva, onto the table. We haven't much time.

            Sam raises Heidi's vein with some difficulty; this is uncomfortable for Heidi too. Not because of her distended abdomen, this time, but because her elbow dysplasia makes it hard for her to stretch her leg forward. I look sadly down at her. Her whole life is a struggle with her own body - whenever she tries to walk, or eat, or defecate, or breathe, she has to wrestle against her own bizarre anatomy. I inject the propofol into her vein, her eyes roll downwards, and she starts to sink to the table.

            'We'll take it from here, love,' I say, and Sam smiles. Placing an E-T tube is difficult too - Heidi's soft palate is too long for her mouth, and it takes some searching before I manage to locate her epiglottis - but the moment it's in place, Heidi's tongue loses its alarming bluish tinge and turns a reassuring pink.

            'Probably the best lungful she's had for a while,' Sam says, as she ties the tube in. We roll Heidi onto her side and start prepping her abdomen for surgery. I don't want to roll her on her back until absolutely necessary; her abdomen is so bloated I'm worried what the weight of it would do to the spine, and the blood vessels that run below it. We can't support her blood pressure nearly as well as I would like - Heidi's owner has declined intravenous fluids on cost grounds - and so I just want to get on with the caesarean as quickly as possible.

            It's late on Monday night. Heidi was booked in for an elective caesarean this Thursday, which would have been her 63rd day of pregnancy; a sensible precaution, because fewer than fifty percent of bulldogs manage to give birth without the operation, but in the last few days Heidi's abdomen has swelled to alarming proportions, and over the course of the day it's become clear that the pups need to come out, ready or not, or Heidi isn't even going to make it to Thursday. The green discharge, which started in the last hour, generally indicates that the placentas have started to separate from the wall of the uterus.

            Sam and I carry now extremely-heavy dog into theatre, and I only swear and complain about my back once; something of a record, as Sam, who is just over half my size, politely points out. I look at Heidi's immense abdomen, and suggest there is probably more swearing to come. I'm right.

            As I scrub, my mind wanders back to a consultation I had with Heidi and her owner, three years ago. It was her first adult vaccination, when she was about fourteen months old. Heidi's owner, a short, likeable man, tells me that he was thinking of breeding from Heidi, and wants to know what I think. I glance at Heidi's clinical notes, and try to hide the expression of dismay that must have crept across my face. Despite her tender years, Heidi has had surgery four times - twice to replace prolapsed tear glands, once to correct her entropion (a condition where her eyelids are so fleshy that they scroll inwards, allowing her fur to press against her eyeball, leading to chronic pain and frequent eye ulcers), and once to surgically remove her tail, which is so deformed it has formed a tight-corkscrew shape, leading to repeated severe infections around her back end and, again, chronic pain. I wonder how I can delicately state that Heidi is about the worst candidate I can imagine to have more progeny. I want to grab him by the lapels, and scream 'No, no! A thousand times, no! Can't you see how much she is suffering, just trying to walk?', but I feel that's not very professional.

            While I am thinking, the hitherto likeable owner, who seems slightly surprised that I am not immediately excited at the prospect of Heidi producing puppies, says, 'I'll have all the tests, you know. I want to make sure I'm doing the right thing.'

            This gives me an in. I calmly, and, I think, quite logically, explain that I don't need to do any 'tests' to tell me that Heidi is a poor choice of mother, both medically and genetically. All the conditions that she has had surgically corrected, as well as the many she has which can't be, are heritable conditions, and any puppies that she has is likely to suffer from them too. I further explain that the Kennel Club, finally drawing a line in the sand long after the country behind the line has been invaded and razed, wouldn't allow any pups to be registered, due to the number of corrective procedures that Heidi has had to endure.

            As I talk, I see Heidi's owners attention start to wander. I'm not saying what he wants to hear, so he's stopped listening. I say it again, in a slightly different way, and then again, finally ending with an extremely strong recommendation that Heidi is speyed as soon as possible. This last is too much for Heidi's owner. At reception, I hear him asking never to see 'that vet' again.

            Now, three years later, Heidi's owner doesn't have much choice, because I'm the vet on duty tonight. When I admitted her tonight, he didn't mention his request not to see me, and I didn't mention my advice never to breed from her. There didn't seem like much point.

            Now scrubbed up, I enter theatre and don my surgical gloves. Heidi's abdomen already has a long scar along it; this isn't her first caesarean. In fact, it's her third. Heidi's owner says he won't let her have another litter after this one. He said that last time, too.

            I open her abdomen with a large incision, cutting through the scar tissue of her previous surgeries, and ease the huge, bloated uterus out of the wound. Incising it, I remove the first puppy in its amniotic sack. It is enormous: truly a camel would have more chance passing through the eye of a needle than this puppy would have had of passing through Heidi's pelvis. I hand the puppy to Sam, who quickly breaks the sac, clearing the fluid, while I start to milk the next puppy towards the incision in the uterus.

            'Nick...,' Sam says. I look up, and understand why Heidi was so bloated. The puppy looks like someone has been at it with a bicycle pump, bearing more resemblance to a hippo that a bulldog. The skin is thickened and distorted with fluid, and has torn in a number of places around the mouth. As Sam gently shifts the puppy's position, its abdomen splits open, and she gasps in dismay. Fortunately, was dead before I ever removed it from the uterus.

            'Anasarca,' I mutter. Also known as 'water' or 'walrus' puppies: a condition of bulldog pups that causes severe oedema in the days leading up to birth. Mild cases might, just might, survive. The pup I have so far removed is not a mild case.

            So it goes for the remaining four puppies that I extract. All of them are severely affected. Two of them have weak heart beats, so I ask Sam to euthanase them for me.

            Heidi's colour has improved dramatically now that we have reduced the load on her uterus. I wish, once again, that we had her on fluids, but she seems to be doing well now that all the puppies are out. I start to suture up the uterus. When I admitted Heidi, I asked the owner if he would like me to spey her at the same time, as he already had suggested that Heidi wouldn't have any more litters. He declined.

            Suturing up a caesarean is often done to the noise of puppies crying for their mum's milk, but tonight Sam and I finish the operation in silence. Afterwards, Sam stays with Heidi while I telephone the owner with the news. He's annoyed and depressed. Of course he is: a single live pup would have recouped double the cost of the caesarean. He wants to know how many of the pups were female. We didn't think to check at the time, and I do so now. Only one of the five was a bitch, which seems to be some comfort to Heidi's owner. Bitches are worth more than dogs. Finally, with genuine concern, he asks how Heidi is. I reassure him that she's fine, and he sounds relieved. He thanks me for my help. I put the phone down, and sit down in dispensary, looking up at all the medicines I have at my disposal to treat sick animals, and wonder just how complicit in Heidi's suffering I am.


Well... this was going to be a short introduction to a post that discussed dog breeding, breeders, and some of the difficulties I encounter in practice... but I'm afraid it rather got away with me! I'm going to follow this post up, hopefully at the weekend, with a (hopefully) less emotive piece discuss some of the points I touch upon above. The above caesarian is an extreme case, but the details are not, I'm afraid, exaggerated. This exact scenario was occurred, with minor variations, to me personally, on three occasions, and I suspect it won't be entirely unfamiliar to any vets reading it, either.

Saturday, 19 October 2013

The Sin of Wages

There it lay, in my hand, as rare and exotic to me as one of Willy Wonka's golden tickets. I'd seen them before of course - my parents, used to their magical nature, had left them lying around the house from time to time before they were filed. I remembered being fascinated by them as a kid; a small slip of paper, covered in squiggly black ink as if a thousand spiders had been ceremonially squished onto the thin paper in order to prevent unwanted peeping at the contents. It hadn't really struck me before that I might ever have one of my own, but now, here it was. My first pay slip.
            Earlier in the week, aware of the glimmering riches that awaited me at the end of the month, I had driven to Bridgwater's local electrical goods store and gazed avariciously at a huge television until an attendant, noting my gaze and politely ignoring my drool, introduced me to the concept of 'Hire Purchase', and that same afternoon we were driving back to my house with the television in the boot.
            I was so proud. A man provides for his family. At the moment, the family consisted of Kerry and me, and the thing that I was providing today was a massive telly. Literally massive; this was before the days of plasma screens and LCDs, and so the 32-inch screen tube television weighed forty kilos[1]. Kerry was going to be home in an hour or so, and a wise man would have left the TV in the boot and waited for his girlfriend. I, however, was neither wise nor patient, and so I lifted the monster out of the back of my car, screamed in pain, and dropped it on the floor. The front panel that covered the various input sockets snapped off, but otherwise the damage was minimal, and so I proceeded to drag the thing up the small path to my house like a murderer disposing of a small, square, dense body - or perhaps more accurately, like an idiot attempting to move a very heavy television set on his own[2].
            The TV looked wonderful in my living room, but it had been frighteningly expensive. What's more, I had student loans to pay, but none of that mattered now, because the fabled pay slip had been delivered to my in-tray this morning, and now here I stood with it in my hand.
            I tore it open and read the figure at the top of the page. I frowned a little. I read the figure at the bottom of the page.
            'Hmm,' I said.
            The one thing that everyone knows about vets, of course, is that they, along with the Royal Mint, have a licence to print money. It had been at the back of my mind during vet school that the pay was pretty good. It certainly wasn't why I had joined the profession, of course - if it was, I might have looked into it a little more carefully - but I always sort of thought things would be very nice, pay-wise. Seeing practice as a veterinary student, I'd had a few vets tell me 'Well, y'know, the pay isn't quite as good as you might think...'. I had nodded, and smiled, and secretly thought 'Greedy bastards, how much more do they want?'
            I stood and looked at the figure at the bottom of the pay slip. I mentally subtracted the student loans payments, and the first instalment of my now-looking-rather-extravagant TV payment. I added the total to my current bank balance. My face went a little pale.
            The preceding week, I had worked (including on-call work, which certainly felt like work to me) around about a hundred hours. I looked again at the pay slip. Before tax, I had earned roughly three pounds fifty an hour.
            Hm. I wasn't very experienced in such matters, but that didn't sound like an awful lot to me. I drove home, where my huge telly stared accusingly at me, now appearing to me as the product of near-Liberace levels of excess. It did look good though.
            Now, I'm not telling this story for sympathy - I was, being polite to my past self, a bit of an idiot in just assuming that I would be absolutely loaded the moment I became a vet. All that I needed to do was mentally readjust quite how much money I had, and I was fine. Nor am I trying to suggest we're terribly hard done by as a profession: being a vet is hard, and occasionally soul-destroying, work, but it's also tremendously rewarding - there's nothing quite like the feeling that you've made something better when it otherwise may have died. Things have, of course, improved from my new-graduate days, and I feel that I get paid what I deserve - no more, no less - and there's a great deal of satisfaction in that, too.
            No, I'm writing this because I still frequently encounter people who, the moment they learn my profession, get a little glint in their eye and smile at me knowingly[3]. I understand the perception: you go to the vets, you're in there for ten minutes, she tells you to pop these drops down your dog's ear, and you have to pay fifty pounds for the privilege. What may not occur to you is that of that fifty pounds, the vet earns about fifty pence. The rest pays for the receptionist's and nurse's salaries, the rental of the premises, the ear drops that you bought, the electricity bill, and so on. At Beech House, my starting salary was £17,000, plus a house and a car. According to the recent Society for Practising Veterinary Surgeons survey, the average vet salary - including partners - is around the £37,000 mark. That's lower than it was the year before, due to economic pressures, and possibly due to more vet students being available. It's also lower (quite a lot lower, in some cases) than the average salaries of doctors, dentists, teachers, police officers, architects and many other professions[4].

As I say, I'm content with my pay; it would be in very poor taste for me to be complaining about it with so many people in terrible economic difficulties at the moment. I think I'm paid fairly, and I certainly earn my money. All I ask is that, please, when you hear what I do, don't get that glint in your eye. You're liable to get the rest of my drink in it, too.


[1] Which is nearly ninety pounds, to those of you who haven't come over to the far, far less confusing metric side of the fence
[2] It may have been heavy, but it still works perfectly - unlike three LCD TVs I have bought since then. It wasn't that long ago that we were making things that were actually built to last, you see.
[3] The kind of glint that suggests the drinks are on me for the rest of the night.
[4] It's tangential to my point, but shamefully (especially considering we're an increasingly female-oriented profession) there is still a 10-20% gap between male and female vet's pay

Sunday, 29 September 2013

The hardest part of the job

Death. It's not something we like to talk about. It's not something that most of us like to think about, unless it's affected us recently.
            The first patient that I ever saw die was in my second week in practice: a big, young and beautiful black labrador with wide brown eyes, a face that was always smiling, and perpetually wagging tail. When she was admitted (she came in to see Corrie, my colleague at Beech House Veterinary Surgery), she was vomiting badly enough that she couldn't keep water down - never an encouraging clinical sign. It was my ops day - one of my first - and so it was my job to take the blood sample and place her on a drip. She licked my nose as took the blood. A few minutes later, as we were bandaging the catheter in, she was sick again. I got on with my day.
            Just before the start of evening surgery, I went to see how she was getting on - not well. She'd vomited several more times, and was now lying on her sternum, groaning. I lifted her lip, and was worried to see that the colour of her gums had turned a little pale. I went and grabbed Corrie, and asked her to look at her patient. Corrie checked her over, checked her temperature, and nodded.
            'You're right. Not going well. I think we're going to need to operate in the morning, find out what's going on in there. X-ray wasn't all that helpful, but something's clearly not right in there.'
            Corrie was right; the x-ray hadn't revealed any foreign bodies, obvious tumours, or gas build-up. I looked at the labrador. Her tail thumped against the inside of the kennel as my eyes caught hers, and I asked the question that so many owners have asked me since.
            'She's not going to die, though, is she?'
            Corrie shrugged. 'Not tonight, at any rate.' She left. I stayed with the dog for a little while, tickling its ears, still worried. I looked at her. I remember very clearly thinking that Corrie must be right. She couldn't die. She was too big, too vibrant an animal for that to happen to her overnight. Tickling her warm ears, with her grunting in pleasure, it was hard to imagine her dying at all.
            I didn't have to imagine it. By the end of evening surgery, her abdomen was so painful that if you touched it, she was sick. Her colour was now deathly pale, tinged with red around the edges, and Corrie knew she'd have to operate then and there. We never made it that far. As we were prepping for surgery, the beautiful big-eyed smiling labrador stopped breathing. She never started again, despite all our efforts. Half an hour later I was standing in theatre with her dazed owner - a dark haired young woman with a large silver cross around her neck. She had her hand on her pet, who was already growing cold. I was explaining to her about the pancreatic cancer.
            'I just... it can't believe it,' she was saying. 'It doesn't make any sense.'
            It didn't to me, either. Right up until that moment, I had made it through my veterinary training without ever really believing that death happened like that. Our brains have something of a blank spot to do with death; unless you absolutely and finally hammer it home, it never really sinks in. That evening, it sunk in for me. Death, final and irrevocable, happens. It happens all the time.
            Thinking back to that evening now, all these years later, it seems almost impossibly naive that I thought the labrador couldn't die, but I still clearly remember that thought, impertinent and against all logic, that she was too big to just... die.

*          *          *          *          *         

It seems that every few years a newspaper article is printed about vet suicide rates - solely for the purpose, in my opinion, of worrying my mother. We consistently come at or near the top of the charts - although occasionally we're beaten by doctors or paramedics. There's lots of suggested explanations - the stress of the job itself, the working hours - but for me the answer is obvious. Death isn't taboo for us, just as it isn't for doctors. It's something that happens, and it's not always something to be feared.
            Death happens, but for everyone else life, of course, goes on. As a new graduate, I swiftly learned that one of the first things people say to you when they learn that you're a vet is 'Oh, I couldn't do that, putting all those animals to sleep. It must be that hardest part of your job.'[1]
            When people said this to me, I'd nod, and look serious, because... well, you have to. Obviously it was the hardest part of the job. Except that honestly, it wasn't. In my time at Beech House, I was fixated upon getting the practical things right - talking things through with the owner, clipping the hair on the leg without causing distress, hitting the vein, easing the animal to the floor without letting them fall. A euthanasia consult meant a lot of things at the time - a longer consultation, a practical challenge, a professional challenge. It meant, and there's no denying it, a resolution; an end to worrying about difficult cases, and a full stop at the end of suffering. Owners were often grateful that you've made something they've been dreading for weeks go relatively smoothly. There is - and it's hard to write, but it's true - a great degree of satisfaction to be gained from performing a euthanasia professionally and competently.
            The shock of that evening surgery, where the fragility of life hit me in the way that it's hit so many others, soon wore off, and for a time, euthanasia was just one more thing I did. I was never happy about what I was doing, and it was never enjoyable, but it was, as I say, satisfying - in a way that isn't talked about outside of veterinary medicine. So when people used to ask if it was the hardest part of my job, I would nod, and agree, and think of the hundreds of other things about the job that I was finding more difficult.
            Over the years, however, a strange thing has happened to me. I find euthanasia harder and harder to perform. I suspect it's because, over time, my worries about 'getting it right' have faded into the background - it's almost second nature to me now. This gives me more time to dwell upon what it is I'm actually doing: bringing a life to an end. It's a selfish and irrelevant thought to have in the consultation room - it's far more important that it's done painlessly and quickly than that your veterinarian feels remorse about what he is doing - but nontheless the feeling grows. Now, when people say to me that it must be the hardest part of my job, I nod, and look serious. And I agree.

[1] Actually, it's usually the third thing people say; the second is 'Hey, you have to put your hand up a cow's bum!'; but always, always in at number one we have some variant of the time-honoured 'A vet eh? You do all right for yourself then.' This is usually followed by a wink, and the unspoken suggestion that for the rest of evening, drinks are on me. 

Thursday, 15 August 2013

Lingua Medica - medical terminology deciphered

It has, of course, been literally the worst week for the English language ever. A bad week for me, certainly; how am I supposed to snigger in a superior and condescending fashion when one of our nurses tells me that 'When the phone rang, I literally turned round and shit myself.'? Sigh.

All is not lost for me, however. Fortunately for me, I have a whole language that was pretty much custom-designed to make me feel superior to normal mortals: medical terminology.

You see (and this may come as a surprise to you, so I'll whisper it) - many years ago, doctors didn't actually know very much. Sure, they could prod you, and prescribe leeches to suck blood out of you, but it couldn't really escape the notice of the general population that your chances of getting better with the treatment weren't dramatically better than the chances of getting better without. A poser. How could one make a living as a quack when it was patently obvious that you didn't know what you were talking about?

The solution: make it sound like you know what you're talking about. Language is, and always has been, a useful tool for those in power to keep the masses subjugated; Orwell's Big Brother understood this, with his doubleplus sinister idea, NewSpeak, and the founders of the Christian religion understood it too. Latin survived as a language largely because it wasn't understood by the poorly educated masses. The bible was always written in Latin so that churchmen (who had a similar credibility problem to the proto-medics) would be able to interpret it for the poor - and thus control the poor. If you know your history, you'll know the violence and consternation that surrounded the eventual translation of the bible into languages that everyone could read, and if you don't - go and read about it! Fascinating stuff.

In a similar spirit, early practitioners of the medical arts realised that suggesting to a prospective patient that 'I'm going to suck out a lot of your blood and hope that you feel better,' tended to garner a less-than-enthusiastic response. However, if you told them 'I'm going to perform a phlebotomy in order to balance the humours within your body,' people tended to nod, smile hopefully, and (crucially) hand over their coins.

And so medical terminology developed largely as a way of keeping knowledge (or lack of it) from the masses. As medical arts slowly transformed into medical science, it became more than that, however; much of medical language has a very specific and precise literal meaning (unlike, ironically, 'literally', any more - in fact, my money is on 'ironic' to be the next one on the list) which can get across a lot of information very quickly, and nowadays it's an invaluable tool to precisely explain your thoughts on a case in terms that, in theory, mean exactly the same thing to any medically trained personnel who reads or hears them.

I've been told a number of times that learning the medical lexicon is like learning another language. I'm suspicious of this claim...

(certainly there's nothing in medical terminology to compare to my excruciating 2nd year French classes, where Mrs McKee used to point at random suspects in the class room and utter the dread nonsensical phrase 'Eresbotty' in a low growl (everyone else in the room seemed to know what she meant, and after a few lessons I was afraid to ask; fortunately, fate never selected me for such punishment and it was only several weeks into term that I realised she was saying 'Error Spotting,' meaning they had to comment on the next pupil's French skills. I'm not sure why I was considered a bright child, to be honest)

... but I can't deny that I get a certain thrill from being able to say that I'm suffering from post-prandial narcolepsy, rather than 'I'm feeling dozy after eating'. However, I am, as you may be aware, a writer as well as a veterinarian, and as a writer it's my job to attempt to make my thoughts as clear as possible. In the spirit of this, I'd like to offer you up a number of medical terms, and explain to you what they mean, how they're useful (and, hopefully, regain some of my sense of patronising superiority that has been cruelly snatched from me by the opening up of the word literally).

1. Shock

I know, I know, it doesn't have ology at the end, or sound particularly clever - but it's a word that arises often in emergency situations - 'Is he in shock, doctor?' (I do get embarrassed when clients call me doctor, but I'm far too polite to correct them. Okay, okay, I get a thrill out of it too).

I chose this one because it's a good demonstration of the preciseness of medical terms - shock, in medical language, does not mean 'surprised' or 'pissed off that a car has just hit them' but that the patient's tissues are starting to run dangerously low on oxygen, because there isn't enough blood getting to them. Shock is further divided into several categories which more precisely define why the blood isn't getting where it needs to be, such as: cardiogenic (the heart isn't pumping the blood around the body properly), hypovolaemic (literally 'low volume' - you've lost a lot of blood), endotoxic (the blood vessels have become leaky due to infection; you've still got all your blood, but it's leaked out of the blood vessels). It's a useful and descriptive word, and nothing at all to do with the emotional shock experienced when, say, discovering that your evil twin brother has been performing an elaborate decade-long revenge against you culminating in them stealing your job and knocking off your wife. For instance.

2. Cranial/caudal/medial/lateral/dorsal/ventral/left/right

These are among the first medical terms I learned; they're all terms used orientate yourself anatomically so that you can describe exactly where on the body you have encountered a lesion or abnormality. Fans of Jaws (and this will, presumably, include all my readers, as it is literally the greatest film ever) may be familiar with 'dorsal', due to the terrifying image of that grey triangle slicing silently through the water, signifying the arrival of Bruce the Shark. The triangle is Bruce's dorsal fin, named because 'dorsal' means 'on the same side of the body as the spine'. Ventral means the opposite - the side of the body opposite to the spine, so that your belly button is on your ventral abdomen (and if it isn't, a trip to the doctor's may be in order, if you haven't been already).
'Cranial' means, perhaps unsurprisingly, 'towards the head', whereas 'caudal' means towards the tail - so your stomach is cranial to your colon, but caudal to your lungs (unless you really are in trouble) - and you'll see that these terms can refer to internal as well as external anatomy.
'Medial' means towards the midline (i.e. towards the spine) and 'lateral' means away from the midline - so your thumb is (usually) medial to your little finger, and both your eyes are lateral to your nose.
I include left and right as an anatomical point of order - such terms are always from the patient's point of view, so 'left eye' means 'the patient's left eye'.

There's a whole load more of these, for more precise localisation - 'buccal' and 'lingual' for 'on the same side as the cheek' and 'on the same side as the tongue', for instance. Hopefully you can see these terms are very useful for medics, and this help you to understand such gobbledygook as '3mm ulcerated lesion approx 2cm caudal and 3cm medial to most cranial nipple right hand side'

3. Acute and Chronic

A little like shock, these terms are occasionally used correctly, but more frequently abused, by the general public. Taking a history, I often see acute and chronic used as descriptive terms for how severe a condition is, so let's be specific - from a medical point of view, these words say nothing about a condition's severity - all they tell us is about is how long you've had the condition.
'Acute' means the condition appeared suddenly, and has tended to change rapidly - this means, of course, that acute conditions also tend to be more severe when we see them, and more likely to be a crisis - but the term in itself merely means sudden onset, rapid change.
'Chronic' conditions are the opposite - slow to develop and cause symptoms. There can be mixing of the terms; often a chronic disease will arrive in our practice in an acute crisis, because that tends to be when you notice something going wrong.

4. ...otomy/...ectomy/ ...ostomy

Ahh, now we're getting to the good stuff - the Greek. The above are suffixes that we apply to parts of the body to explain what we've done to them, only to do it in such a way that makes us sound clever.

'...otomy' means to cut a hole in something. So, instead of saying 'I have cut a hole in your dog's stomach', we can instead gravely pronounce the far sexier 'I have performed a gastrotomy.' It works with anything you can cut a hole in - bladder (cystotomy), small intestine (enterotomy), large intestine (colotomy), chest (thoracotomy) and so on. To perform a phlebotomy, as mentioned above, you make a hole in your patient's vein so the blood can leak out - usually done nowadays with a collection tube to send the blood for analysis.

'...ectomy' - remove entirely. So, no languishing in the 'I cut your cat's kidney out' for us - nope. We performed a nephrectomy. Works for anything you can chop out, so enterectomy (section of intestine), hysterectomy (uterus), orchiectomy (testicles). The ancient Incas were, of course, skilled practitioners of cardiectomy, although this is generally not good news for the patient.

'...ostomy' means to create a permanent hole in something. We don't do this very often in veterinary medicine - possibly the most common operation (and it's not all that common) would be a urethrostomy, a procedure where we permanently open up a male cat's urethra (the tube that runs from the bladder down through the penis) to prevent it getting blocked (stop wincing, men! It's a life saver) although you may be more familiar with a colostomy, performed in humans with damaged or blocked bowels.

5. Hyperplasia/ Metaplasia/ Neoplasia

All to do with tissue growth - or, more to the point, cell growth. If you have hyperplasia, then the organ in question is perfectly normal, but bigger than it should be. This is rarely anything to worry about, but occasionally this can cause trouble if you haven't got a lot of room somewhere. Prostatic hyperplasia - enlargement of your prostate gland - a common ageing change in men - is the reason is gets harder to pee as you get older, owing to the fact that the prostate gland is annoyingly wrapped around your urethra.

Metaplasia is change from one type of cells to another type of cells, usually as a result of some kind of injury or stress. It's reversible (usually if the stress is removed), and benign, and we don't see it all that often - usually because by the time we find out about this, the cells have moved onto the next stage, which is...

Neoplasia. The medical term for cancer. Similar to metaplasia, except that once they get to this stage, the cells aren't going back to their previous state. They're very different cells to the ones that should be there, and unlike normal cells, which know when to stop growing, they just keep dividing. This, as I'm sure you're aware, causes all manner of problems, which I won't go into know. Neoplasia doesn't necessarily mean a malignant tumour - a wart is a form of neoplasia.

For the record, neoplasia, cancer and tumour are all synonyms - none of them mean malignant or benign by themselves, although 'cancer' tends to be used to mean malignant, nowadays (If I'm being pedantic, tumour simply means 'swelling', in the same way that 'rubour' means redness, but almost no-one uses it in this context any more). The difference between a malignant and a benign neoplasm is not clear cut, but it's related to how they behave. Benign tumours tend to stop growing when they reach a natural tissue boundary, and not spread via the lymph tissue or blood. Malignant tumours, unfortunately, are less respectful of tissue boundaries.

6. Idiopathic and ...opathy

And now we really enter the realms of sounding clever, without saying an awful lot. Very, very helpful terms, these. Idiopathic means, effectively, 'we don't know'. More to the point, it means that the consensus of medical opinion is still unsure as to the cause of this problem. So, when I tell you that your dog has 'idiopathic vestibular syndrome', I might be sounding very knowledgeable, but what I'm really saying is that you dog has a condition that no-one in the veterinary world quite understands.

That's not to say this term isn't helpful - just because we don't understand where a condition comes from, doesn't mean we can't treat it, or at least recognise the pattern of the disease - idiopathic vestibular syndrome, for instance, has a well-understood course (i.e. it usually gets a lot better within 24-48 hours) and, if I write it on my notes, other vets who read it will know what I'm thinking. I'm just telling you that it's a shorthand way of us saying 'Oh, it's that thing where their balance centre goes wrong, but usually gets better again'.

...opathy is along the same lines. It's another suffix, and when attached to a particular organ, it means 'something is wrong with it'. Brilliant, eh? Works with anything. Pneumopathy - lung disease. Dermatopathy - dodgy skin. If I tell you that your hamster has an 'acute idiopathic hepatopathy', I'm telling you that your furry friend's liver has gone wrong. I don't know how, or why, but at least I can tell you it happened pretty quickly.

7. Iatrogenic

A classic face-saver. Iatrogenic means caused by medical examination or treatment. In other words - that thing that's wrong with your pet? I did that. So, iatrogenic Cushing's disease is caused by your vet giving your pet too many steroids. In you vet's defence, they may have had no choice, because the disease that they're giving the steroids for is probably more severe than the Cushing's disease they're creating.

Iatrogenic haemorrhage is a euphemism along the lines of a surgeon tell you 'I'm afraid he lost a lot of blood during the surgery'. He didn't lose it - the surgeon did. It's nice that we have a special word for our balls-ups.

8. Borborygmi

Finally, I wanted to make special mention of my favourite word in the whole of veterinary medicine. It's pronounced BOR-BOR-IG-ME. Say it with me, because this word is onomatopoeic - which is to say, it sounds like the thing it's trying to describe.

Borborygmi is the medical term for the sound of stomach gurgles. Say it again out loud, and tell me that isn't the greatest word ever invented. Literally.

Thursday, 1 August 2013

Some Personal Thoughts on Animal Welfare

You don't need to know much about biology to understand that humans are animals too; exceptional animals, in that we can think, and reason, and imagine esoteric concepts in a way that very few, if any, other species can. Debates have raged for centuries over to what degree animals can even form thoughts rather than act on instinct; the answer, most likely is that some can, and some can't. Humans are at the extreme end of a wide spectrum - but it's still a spectrum. How much are other animals able to reason?

Again, however, it's not a helpful debate. 18th century philosopher Jeremy Bentham realised the problem with this line of thought, cutting to the chaste with the famous quote that has shaped my life ever since I heard it, many, many years ago:

"The question is not 'Can they reason?', nor 'Can they talk?', but 'Can they suffer?'"

As Bentham saw it, the only relevance that higher cognitive powers have on the question of suffering is in the way that they make suffering worse. It is (I believe) self-evident that a human diagnosed with terminal cancer is going to suffer far more than, say, a cat, thanks to their imagination and understanding of the situation they are in, but both parties can suffer from the physical effects of the tumour itself. 

My position here is much the same as Bentham's - I, personally, can see only one distinction between humans and other animals with regards to how much they can suffer - the distinction I mentioned above. In all other respects, how much pain is experienced depends pretty much on how well-developed your nervous system is; which is why I suspect a sprout is less able to suffer pain than a newt, which in turn is probably less able to suffer pain than a primate.

Bentham was the founder of utilitarianism, a philosophy that judges action's moral rightness based on the greatest good for the greatest number; utilitarians are the accountants of the moral philosophers, totting up pain versus pleasure for everything we do - the most moral action being the one that rates highest on the pleasure chart, or at least lowest on the pain chart (there isn't actually a chart, it's a metaphor). The only distinction this makes between the species is the difference in their ability to feel pain or pleasure.

It's as good a philosophy as I've heard of, personally. There are problems with it - some of which we'll encounter below - but for myself, I find it helpful to at least consider my actions from a utilitarian point of view. It helps me think about how much emotion I'm allowing to cloud a particular issue; ultimately, for me, all I care about is relieving as much suffering as possible.

For the last part of my post, I'd like to look at the different positions that animals exploited by the human race find themselves in, and I'd like to discuss my thoughts on the matter. I don't expect you to agree with all, possibly not even some, of what I say, but what I'd like you to do is at least consider your own reaction to these situations, and how it compares with mine. All I can ask, really, is that you think about this stuff, and come to your own conclusions.

The Single Pot of Compassion

Before I do that, though, I'd like to tackle a criticism that anyone who mentions that they're interested in the welfare of animals is likely to come across one time or another - I suppose I'd call it the 'there's children starving in Africa' approach. I have been told, many times, that caring about the fact that animals are suffering, suffering badly, in the world, displays some kind of moral bankruptcy when there are, as I say, children starving in Africa.

Indeed there are. There are children starving in the UK. There are innocent people dying in Syria, and Afghanistan, and in a hundred battle zones across the globe. There are millions of people dying of AIDs, and malaria, and even preventable diarrhoea. It horrifies me. But I fail to see why being concerned about animal welfare takes away from any of this. It's as if there's a single pot of compassion, which humanity can only direct in one direction at a time, and that any attempt to push it in another direction will mean that children die.

There's enough compassion - enough money - in the world to deal with, and at least think of all these problems. One child suffering, terrible though it is, does not reduce the suffering of anyone or anything else. To suggest that we're not allowed to worry about anything until the (in your eyes) most worrying problem has been thoroughly sorted out is, to be frank, bollocks. If you make this argument to me, then I've got to assume that before you've ever complained or worried about anything at all in your own life, you've checked to make sure there isn't someone, somewhere in the world that has more to complain about than you have, thus eliminating your right to worry. 

It's a similar argument to the 'single pot of money' argument about space exploration, as if every single dollar spent upon looking to the stars would have otherwise been spent upon curing malaria. It's a pathetic, pointless point, and I don't intend to spend another second of my life rebutting it (this is where the link to this blog will come in handy again!).

Well, I think that's enough preamble. What do I actually think about animal welfare? As ever, in my blog, I'm going to be totally honest about the next points. I don't mind if you disagree (I suspect many of you will, strongly) but I will show my working so that at least you can understand how I'm coming to my conclusions. If you disagree, feel free to do so to me, but please show your working too, so that maybe we can understand each other.

My Feelings on Animal Welfare

So, as I've mentioned, my general approach to thorny ethical problems is to attempt to apply utilitarian principles to them. When I come up with an answer that I really don't like using this tactic, I then (like everyone else, I suspect) desperately flail about for reasons and excuses to justify the position I have already taken. On rare occasions, if I really can't justify my position in anyway that lets me sleep at night, I change my position; hence my vegetarianism. More on that in a sec.

The utilitarian approach is useful to at least frame questions in a way that you can attempt to answer them. For instance, my question from earlier - what does emancipation even mean to an animal? - is rather woolly, philosophical, and ultimately unhelpful. Framed in a utilitarian way, it becomes - would emancipation of the animals cause less suffering and more pleasure than not doing so? 

Still a strange, emotive and argument-ridden question, but at least one that is, in theory, answerable. So, with that in mind, I'm going to look at some ways in which humanity interacts with/exploits/enslaves (depending on your point of view) the rest of the animal kingdom.

1. Pet Ownership

Yep. Pet ownership. I like to start with the tricky ones. The slavery viewpoint seems controversial here, but with a moment's thought and using a strict definition of slavery, it's hard to argue. Pets are owned, legally, by their masters. They are often neutered without their consent, and are not able to act freely according to their desires. The master has complete control over them, to the extent of even deciding when it is time for them to die.

I, personally, am complicit in the deaths of many hundreds, if not thousands, of such creatures. I endeavour, in my job, to relive suffering, but still I have inflicted many hours of pain and suffering upon pets in the form of neutering operations. Pain relief and good care dramatically reduce this suffering, but I would be lying to myself as well as all of you if I said that being speyed is an entirely painless and stress-free procedure.

It could be argued that castration and speying carries health benefits far in excess of the suffering they cause... but I could argue to same for you, reading this, too, and I'd have to be particularly charismatic to convince any of you reading this to part with their gonads. The point is, given the choice, the pet would rather not go through the operation.

There are other compromises to pet's freedom's too - dogs are walked, but they generally don't roam the streets freely. Cats have more leeway in this regard - except the many of the species that are never let outside at all. Pets eat what they are given, and must accept any punishment given to them; if they retaliate against violence with violence, then they are likely to be killed; in fact, if they attack a human in any situation at all, then they will probably be put to death.

It may seem extreme, but all the above is true, expressed from the point of view of animal slavery. You may argue with how I've written it, but it's hard to disagree with the fundamental truth of it. So, should pet ownership be banned? Should pets be emancipated? There are many people - some vets, in fact - that feel that they should be.

Here's my opinion - living in the wild, is, as I have previously suggested, not fun. Really, really, not fun. It is, quite literally, kill or be killed out there. If you're not on top of your game, you're probably going to suffer a slow, lingering death or, if you're very lucky, get killed and eaten. If you're being eaten by a Komodo dragon, you get to do both.

My point is, from a utilitarian point of view, I have no doubt whatsoever in my own mind, that the vast majority of pet animals suffer far less than their wild counterparts (although not all; there are some very, very bad owners out there). I accept that neutering is a compromise to a pet's welfare. It's a compromise that I feel comfortable (though not too comfortable) about making in order to reduce the suffering of all the other animals that would otherwise exist and likely starve to death (that's nature for you). I see it as part of the pet's social contract - it is neutered, and in return it receives food, board and medical care for the rest of its life. The quality of all three varies from pet to pet, of course. It does make me uncomfortable that the animal is given no choice as to whether to embark upon this contract or not, but I have to be pragmatic. Such understanding is, as far as our best neurologists can tell, beyond the mental capacities of a dog, or a cat (though I wince as I type because in my head, I can hear that sentence being repeated in a Tennessee drawl, only talking about other humans and not animals).

Pets - in the form of dogs and cats - have been with our species for tens if not hundreds of thousands of years. Tradition is no excuse for terrible morals, of course, but I make the point because it's possibly to argue that being a pet is now the natural environment for many dogs and cats. From a utilitarian point of view, pets give a great deal of pleasure to their human owners, and (I suspect, although it is always hard to know for sure) receive at least some of that pleasure in return. I struggle to see how releasing them all into the wild would lead to a net gain in pleasure, or a net loss in suffering. I am very aware that simply being a pet is a compromise to an animal's natural behaviour, and its freedom (and this is ignoring unfortunate pets that suffer terrible at the hands of their masters) but I genuinely feel that the difference in a pet animal's cognitive ability - the fact that, as far as we understand it, they are unable to imagine, and aspire, and dream of more than they are - compared to a human means that this form of slavery is a morally acceptable one, if not entirely as benign as our modern eyes may first assume.

My opinion on this would change if it was demonstrated that our companion animals were able to understand their servitude, and wish for it to end. My opinion does change when it comes to animals where the mere fact of keeping them as a pet means that their freedom is severely restricted. Birds, for instance, denied the freedom to fly, or even leave their cage. Rabbits that never leave a hutch. Fish and reptiles - call me picky, but my feeling is that any creature that requires its own life-support system to exist within your house is not suitable pet material. In these cases, the compromise becomes too much for me.

2. Food-producing Animals

If an immoral act can be defined as one that produces more suffering than other alternatives, then factory farming of broiler chickens must be seen, in my opinion, as one of the most immoral acts ever perpetuated by humanity. Before your gut reacts strongly against that proposal, let me put this to you - I personally believe you would be hard-pressed to find a sentient creature that suffers more during its short life that a factory farmed broiler chicken. Never seeing sunlight, never experiencing even a second of freedom, broilers grow fast enough that by the time they're a month old many of them struggle to walk at all due to their weight. By two months old, they're dead, and in your sandwich.

If you did find a creature that suffered as much, it would probably be a caged hen producing eggs. Unfortunately for them, they live a lot longer, spending all of those years in a box about the size of a sheet of paper. 

I don't want to rant. There are humans that suffer as much in their lives as these chickens, due to illness, war, or disease... but we're talking about millions of creatures. Millions upon millions. You can google the precise details. I have done. I don't want to again. That, my friend, is a whole lot of suffering. From a utilitarian perspective, it's going to take an awful lot of pleasure to counteract that. Quite how much pleasure you get from your chicken sandwich... well, that's up to you. And really, I mean that. I'm not trying to convert you. Those two paragraphs above aren't news to you, are they?

I don't object to the principle of eating meat. It's hard to, really, faced with the evidence of evolution. We're designed for it... well, okay, we're actually omnivores, but many, many animals are designed to eat other animals.

I don't object to the taste of meat. Far from it. I bloody love it. The smell of bacon is still likely to make me dribble, even though I've been a vegetarian for over twenty years now. It would hardly be much of a sacrifice it I hated meat, now, would it? If that was the only problem, I'd call myself a... whatever someone who never allows celery to pass their lips is called. Bleh. Celery.

Here's my point: if you eat meat, you are complicit in the death of animals. Many hundreds of animals. More, even, I suspect, than I am with all the euthanasias throughout my veterinary career. Now, I'm not judging you for that - but I would like you to at least judge yourself. If you eat meat, I would argue that you have a moral responsibility to investigate exactly how the animal that has fed you lived, and how it died. If you do look into it, and you're okay with it, then, and I mean this honestly, you're fine by me. I looked into it, and I didn't like what I saw, so I stopped. 

I try not be judgmental in life; I spend so much of my time being unsure of my own actions that I'd find it exhausting to have to find fault with other people's too. However, there's one area in which I'll brook no compromise. If, in the course of a conversation with me, you mention that you 'don't want to know where your food comes', that 'it'll upset you too much', then you might notice a slight flicker in my eye. I'm British, so I probably won't say anything to your face, but from that moment on you are dead to me. I will, from that point onwards think of you as the worst kind of moral coward. You're quite happy to profit from death, not even wanting to know the nature of the lives that supported you? Then, quite frankly, fuck you. I hope your gonads shrivel up and fall out of your arse.

Even worse than this, however, are the people that tell me 'Oh, I couldn't eat anything that had a name! That would be horrible!' So, you're telling me that because you find it uncomfortable, any creature that is lays down its life to fill your gut isn't allowed to have a name, or a personality, but must remain a numbered egg-machine in a box for its whole life? And this must be so that you aren't in any way reminded that the thing you're exploiting could possibly have a better existence than the one you're forcing upon it so you can eat a fried egg with your toast? Then I hope your next thirty-thousand reincarnations are as a battery hen... except that I don't. Because I wouldn't wish such an existence on anything.

Here's why I'm a vegetarian: I believe that if you're going to kill a creature simply to give you pleasure, then that creature deserves your utmost respect for laying down its life for you, even involuntarily. I believe you should make it your mission that such a creature experiences the best life it could possibly have, given the massive compromise it is going to make, just for you.

I've been in a chicken abattoir. You can't even count them as they whiz over your head, let alone imagine each of them as an individual creature - not reasoning, not talking, but suffering.

The more astute amongst you, however, may have noticed that I keep saying vegetarian. Not vegan. The title of this section is food-producing animals. That includes milk. And cheese. And eggs. All of which I eat. 

Here's my excuses - I only buy organic milk and cheese at home. Organic milk, by itself, is not good enough, but if you make sure it's stamped by the soil association, then you can rest assured this is an association that actively tries to cut down the suffering in the dairy industry. As one example - they try to use milk from beef herds. This means that male calves are worth something, unlike a largely worthless male dairy calf, and so they aren't immediately killed. The calves run with their mothers, rather than being taken from them at three days old, to the great distress of mother and calf.

That sort of thing. You can look into it yourself, and if you take nothing else from this blog, please take that.

I only ever buy free range eggs - not just free range, but freedom food eggs. Never, never never from caged bids, and I check the packs of egg-containing food to make sure it's from free-range sources. I'm not perfect. I'm a hypocrite, like most of us are. But... I've followed by own rules; I've looked into it, and I made my decision. Please do the same.

3. Animal Experimentation

Well, I totally managed to keep my emotions out of the last section, and produce a thoroughly impartial piece of work, didn't I? Go me.

This section probably isn't going to make me many friends. Remember: opinions - model's own. 

I'm a scientist - well, I like to think that I am. It's hard, sometimes, being a vet. Scientific people like evidence behind their decisions. There's precious little evidence in veterinary medicine. A lot of studies are underfunded, or use too small sample sizes, or sponsored by a drug company interested in hawking their new flea treatment or painkiller. The point is, I believe in the scientific method. I believe in experimentation.

Not when it comes to animals, though. And here we go. I know. I know that huge leaps have been made in medicine using animal models. I know that some of my friends, diabetic or with severe inflammatory diseases, would almost certainly be dead by now if it wasn't for animal experiments. It's entirely possible that you're boiling with rage reading these words because your mother, or your son, or you yourself would be dead right now without them. I may be too; so many of our drugs used have come down from animal work. I would also save fewer lives than I do at the moment - almost all my drugs come from animal testing. I know how many bodies would be left in its wake if it had never happened. I know.

The utilitarian approach is hard to apply here; it's hard to know exactly how much suffering would have been caused if animal experiments hadn't provided the many breakthroughs that they had, although it is, I think you might even agree, indisputable that animal experiments themselves have caused immense amounts of suffering to the subjects of the experiments themselves. Utilitarianism helps with some aspects of animal experiments, however. Any animal test which causes suffering to the animal, but that is unlikely to reduce suffering in itself (including all cosmetic testing, animal experiments where the benefits to knowledge are dubious or already known) is, according to our rulebook, morally wrong. Let's not do that.

My gut, however, tells me it's wrong. I know I said I shouldn't think with that thing (even though it is, sadly, much bigger than my brain) but... well, if it were morally clear-cut, an obvious choice, or even a slightly more grey area than it is already, I would accept it. It isn't. Not to me, at least. However much I may nod in sympathy when you tell me your child today is alive because of medical tests performed on animals, however much I need my pharmacy at work or be rendered largely incapable of fixing any animal at all, my heart would leap for joy if I woke up tomorrow to find that all animal experiments were banned forever.

I know you probably don't feel the same. Maybe I have a different perspective. It's a hard thing, morally, to explain why the drugs I'm using to get dogs better were developed using experiments on dogs. Was one dog worth more than the other? Was it because one dog had a name? One dog was lucky enough to be deemed a pet, another a lab animal. You can substitute rats, rabbits, cats, guinea pigs or mice in there. They're all experimented on. They're all kept as pets. I find that a very hard position to defend, morally. Being pragmatic about it - okay, we have had our breakthroughs. Now, let's stop. There are other ways. They're slower. They're more expensive. Some breakthroughs will never be made if we stop. But they cause suffering. Real, tangible, terrible suffering. Knowledge for knowledge's sake, absolutely, but if that knowledge came at the expense of pain and death of an unwilling creature... I'm afraid that I, for one, don't wish to know.

4. Animals for Entertainment

This can be where utilitarianism falls down. How about if one person, or one creature, was tortured to death in front of a baying crowd of people? An incredible amount of suffering is caused to that one creature, but... what if the crowd enjoyed it? I mean, really, really enjoyed it? Is one hundred people's pleasure enough to cancel out the suffering? No? Okay. How about five hundred? Screw it, let's televise it. How about five million?

How many people have to enjoy it before the pleasure outweighs the suffering? You could fudge the numbers a bit, so that suffering is worth, far, far more than pleasure, but still, that implies that if enough people enjoy a spectacle, then any amount of suffering is fine. You could use utilitarianism to suggest that the Roman gladiatorial games were morally right... but I suspect you still wouldn't think it so.

Whenever you get a strange result like this, it's worth taking a hard look at the facts, and seeing how much emotion is playing into it; and there is some. The natural disgust that I (and I hope you) feel at thinking about the scenario above is to do with the pleasure. There's something obscene about people taking pleasure at suffering being caused to another; at least, there is to our modern eyes. 

This is where the emotion comes in; the pleasure or lack of it makes no difference to the individual being tortured (well, not quite; it's quite conceivable that a baying crowd may add to the suffering experienced) so, as ever in life, it depends upon your perspective. Let's break from the 'greatest good for the greatest number' for a moment, and look at things from the point of view of the crowd, and of the victim.

Firstly, the crowd - their pleasure comes from the suffering of the victim. If there's no suffering, there's no pleasure. However, if the crowd can be fooled into believing that the victim is suffering, we can imagine a situation where a great deal of pleasure is created with no suffering.

Secondly - the victim. Their suffering is dependent solely upon being tortured. Whether the crowd experiences pleasure or not makes no difference. If the torture isn't carried out, the suffering does not happen.

So (and bear with me here) we have now imagined a situation where the crowd experiences the same pleasure, but no suffering is caused. This is an alternative to the suffering situation, which is, according to our utilitarian rules, a more moral position than the first. Therefore, the first situation is, at least from this perspective, immoral.

Phew. Took a bit of rules-bending though, didn't it? There's two important points to take from it, though, that inform my views upon this.

First point - the disgust at the pleasure of the crowd. It's the same reason that people who hate fox hunting (and I must be honest and include myself as one of those people) generally hate it more than they hate the suffering caused by factory farming. The suffering of the fox, though extreme during a hunt, is small compared to that experienced throughout its life of your average broiler chicken, yet I suspect that not all those opposed to fox hunting are vegetarians. The point I'm trying to make is that the passions inflamed at the thought of animals hurting each other for entertainment are somewhat exaggerated by the disgust of other people's pleasure. I still hate such events, deeply and profoundly, but I try to keep in mind that objectively the suffering is less, perhaps, than other forms of animal exploitation.

Second point - any way of simulating such an event must be more moral than the event itself. We all have TVs and smartphones now. Let's not cause suffering in real life.

Third point - (and a bit more personal) if you take pleasure from watching pain caused to another living being, whether I try to think like a utilitarian or not, I'm going to think that you're a sick fucker, and not want anything to do with you.

My thoughts. Please add your own if you made it this far. And show your working if you want a response!