Blood draw difficulties

[AlysonR]

@Dr. Jeff, @Dr. Christina My dog, Merlin, is a difficult dog to draw blood from. The first vet I took him to had to anesthetize him to get a blood draw. The second and third vets managed to do it without anesthetizing him. I watched the third vet do it, and she kept his front paw on the ground and managed to get the blood out, though Merlin grumbled the entire time (he was muzzled). That vet, however, wasn't a good match for my animals and me for other reasons. This new vet, Dr. Doyle of Animalia, holds his front leg parallel to the floor. Between that, and the hold her vet tech has on him, there's no danger he'll bite (and I honestly don't think he would, anyway), but he pulls his leg back and jerks the needle out. After doing that twice for the VDI blood draw, she finally resorted to ACE to get him to hold still long enough to get the last bit of blood out. Even then, he jerked his leg back, just not as far. Now I need to have a 4Dx done on him -- i.e., another blood draw. She's already decided she's going to use ACE to get him to hold still. I'm really not very happy with this, but she is otherwise, the best fit I've found among the limited number of vets in the area, and the only one who is actually holistic (and quite good at it, from what I've read in the reviews). Does anyone have any other ideas besides ACE? I think if she'd hold his leg on the ground, she could get the blood out without him jerking his leg back(up), but that might be too awkward for *her*. --If anyone *does* have ideas, do you also have ideas on how I could present those ideas to her without getting her dander up? I'm not really very good at trying to tell a vet how to do something she's been doing for 20+ years.....

 

[Dr. Jeff]

Does anyone have any other ideas besides ACE?

I'm super glad to hear that you and Dr. Doyle are a good fit!

Yes, I think if you say that you're not comfortable with using drugs to sedate Merlin for a blood draw, she will be OK with that.

In my days of solo home blood draws, I relied heavily on doing standing blood draws using the saphenous vein (outer rear ankle are) for blood draws.

You may also want to be giving Merlin little treats throughout the draw (make it fun).

Also, Rescue Remedy, TTouch (last week's webinar), Reiki, etc. all work well.

@Dr. Christina may have other ideas as she;s an expert in helping dogs tolerate the home exam, nail clips, blood draws, etc.

 

[Dr. Christina]

How long do you have before the next blood draw?
Start now training Merlin to love having his blood drawn, if you have time.
Pick a place in the house that is his "exam" place. Pet him for a few minutes there, telling him to stay quiet. Then reward with play or food or whatever he loves. Next day or later that day, for only a few minutes, pet, then run your hands down each of his 4 legs. In very tiny steps (dictated by his ability to love it) have him lying down and you pulling out on his leg. Etc.

Then go to Dr. Jane's office, walk in then walk out and reward. Another day walk in and sit a bit, then walk out. She pets him. She slowly does what you have trained him to love. Etc.

AS SLOW AS NEEDED.

Dr. Jane worked on the Hopi reservation for years. Ask her if there are some shamanic approaches that may help. let her know your commitment to not use ace unless you need an emergency blood draw before the training is done.

Dr. Christina

 

[AlysonR]

Well... the next blood draw is this Wednesday, so training isn't an option for this one. Last time she gave him a very low dose of ACE -- he was still able to hop in the car afterwards. I am wondering, for *this* time, if I can give him treats during the draw, even though he'll be on ACE. Is this possible?

The idea of pulling out his leg to the position he'd be in for a blood draw (done incrementally, of course) is a good one. From day one he hasn't liked me handling him (just moves away). He is getting better about that. Working specifically with the 'blood draw leg' might be helpful, especially pairing it with the cheese (or leftover chicken, when I have that available). As for doing dry runs at the vet, the practice is a 50 minute drive each way, so that's not really practical. That said, Merlin had no problem walking into the place, or getting on the scale. And Dr. Jane got a pulse, listen to his heart, and even a rectal temperature on him without any difficulty -- all to Dr. Jane's credit. At the previous vet, once the exam and blood draw was done and I unmuzzled him (right there in the office), he willingly and happily performed all of his tricks for pieces of chicken. No trouble at all. It's not the location (though that may become a problem if we continue to have to use ACE) so much as the blood draw itself. And even that depends on the technique used.

I will definitely ask Dr. Jane about shamanic approaches. I'd love to hear about her experiences, anyway. And it might allow me to broach the subject of when she'd feel comfortable not using the ACE. I'll have to see how Merlin does with (hopefully) just one 'jab'. Last time, it was only the third try when he got really unmanageable (picture whining, pulling away, difficult to hold still). I *wish* Dr. Jane could use the back leg, but I asked her last time, and she thought it wouldn't help. I also get the distinct impression that sitting on the floor might not be easy for her. I could be wrong...

 

[AlysonR]

Got through the blood draw without using ACE! They were having a slow day, and when I reminded them that Merlin had stood for 2 punctures the first time, and had only had trouble with the third (3 times because he did keep jerking his paw back, but only after a bit of time), and when she told me it took very little blood to do a 4Dx, we agreed to try it first without ACE. They took their time, Gina (the vet tech) scratching him and making friends, both she and Dr. Doyle talking to him. That + the treat I brought for him seemed to help a lot. He made it through no problem! I am now working with him at home, sandwiching him between me and the couch (so that I can get my hand under his belly to lift up the front paw on the far side) and giving him treats while I work towards touching and lifting his paw. I'll build toward a straight paw and duration. (I think duration is key, here, as well as making the position seem somewhat natural, or at least not anything to be suspicious of.) Plenty of time between now and September, when we'll need to do the VDI again. As a bonus, I got to explain to Dr. Doyle why I wanted the VDI test done in the first place (because the symptoms of cancer can be pretty subtle, not hitting one over the head until it's too late!). She got it. The 4Dx came back as a weak positive for Lyme (antibodies), and everything else was negative. So...not clear if Lyme residue (as it were) is causing the elevated TK1, but it's certainly a possibility. Because Merlin is showing no symptoms, we're not doing anything about it. September's test will give us a clearer picture as to what's normal for Merlin, hopefully.

And Dr. Doyle's definitely not going to be getting on the floor to do any manipulations, though Gina can and did. -- I didn't get a chance to ask her about working with the Hopi. Maybe next time.

 

[Dr. Jeff]

Fantastic that Merlin did well for his blood draw!

 

[LilF]

Got through the blood draw without using ACE! They were having a slow day, and when I reminded them that Merlin had stood for 2 punctures the first time, and had only had trouble with the third (3 times because he did keep jerking his paw back, but only after a bit of time), and when she told me it took very little blood to do a 4Dx, we agreed to try it first without ACE. They took their time, Gina (the vet tech) scratching him and making friends, both she and Dr. Doyle talking to him. That + the treat I brought for him seemed to help a lot. He made it through no problem! I am now working with him at home, sandwiching him between me and the couch (so that I can get my hand under his belly to lift up the front paw on the far side) and giving him treats while I work towards touching and lifting his paw. I'll build toward a straight paw and duration. (I think duration is key, here, as well as making the position seem somewhat natural, or at least not anything to be suspicious of.) Plenty of time between now and September, when we'll need to do the VDI again. As a bonus, I got to explain to Dr. Doyle why I wanted the VDI test done in the first place (because the symptoms of cancer can be pretty subtle, not hitting one over the head until it's too late!). She got it. The 4Dx came back as a weak positive for Lyme (antibodies), and everything else was negative. So...not clear if Lyme residue (as it were) is causing the elevated TK1, but it's certainly a possibility. Because Merlin is showing no symptoms, we're not doing anything about it. September's test will give us a clearer picture as to what's normal for Merlin, hopefully.

And Dr. Doyle's definitely not going to be getting on the floor to do any manipulations, though Gina can and did. -- I didn't get a chance to ask her about working with the Hopi. Maybe next time.

Alyson, Your experience with the blood draws sounds so incredibly stressful. I would be a mess!! Some vets are really good at it. Just putting my own experience out there..... I had a vet who retired who took blood from my dogs neck. He was good at it. At first I was nervous but saw how quick it was and my dog never yelped. He said that the blood flows faster through the neck versus the leg. Then when he retired I went to the new vet who made my Gabby wince in pain trying to take it from the leg. I told her that her predecessor always took blood from Gabby's neck and she was used to it. The vet literally ran out of the room crying because I told her Gabby never had a problem with blood in over 12 years and is used to getting it from the neck..... I guess she couldn't do it.... She never had good " I mean business control" over dogs and the dogs picked up on her lack of confidence. Later I found out from another vet that there is a nerve right by the vein in the leg and if the vet hits that it is painful. The vet was probably hitting the nerve over and over again. It hurt ME to know that Gabby was being hurt during a blood draw. The vet TECH actually came in to draw the blood from Gabby's neck successfully. We never went back to Dr. Boo Hoo who could not draw blood without hurting her. I then had a holistic vet who took 20 minutes to get blood from Gabby from the neck and finally I told her to "forget it." and left. The vet blamed me for letting Gabby wiggle (she had fired her vet tech) and then she blamed Gabby for being maybe "dehydrated." We then went to our new conventional vet who took it within 20 seconds. So not all vets are good at getting blood and some vet Techs are better than the vets. I don't know what ACE is that you refer to.

 

[LilF]

@AlysonR any new updates on Merlin? How are things going?

 

[AlysonR]

@AlysonR any new updates on Merlin? How are things going?

ACE is acepromazine. It's gotten a notorious rep. in the training world because it used to be used for things like thunder-phobia, but it doesn't actually ease the anxiety. It just makes it so the animal can't really do anything about the anxiety.

Anyway, nothing new with Merlin. I'll definitely be taking him in for another VDI test at the 6 month interval to see how things have progressed. He's still exhibiting no symptoms -- of anything! He plays like crazy with my one year old GSD (Kaya). Considering that he's 5, he's doing amazingly well!

I had a vet tech who used to take the blood from the neck. She was AMAZING! She's now 3 hours away, so I don't go there anymore. I'm afraid blood draw methods aren't something one can negotiate, in general (unless you have a super-special vet/vet tech). Merlin's first blood draw difficulties may have been related to dehydration. While I didn't withhold water, I did have to fast him, so he may not have drunk as much as he usually would have. And...the vet may have gotten unlucky and hit that nerve you mentioned. In any event, I'm working on a 'long shake' with him. He's getting better. For him, it's probably best to let him do a short shake, first, and then relax into a longer 'shake'.