If you want to be a veterinarian, you better like people!

My advice to anyone aspiring to be a veterinarian? Get used to talking to people.

Pursuing a career in veterinary medicine is tough. Just considering the process of applying to veterinary school is daunting. There are numerous standardized tests, the need for superior letters of recommendation, and the stress associated with composing the perfect personal statement of why you’re choosing this particular path. Individuals must have top notch grades, possess a wide breadth of animal-related work experience, and be well-rounded in their extra-curricular activities.

Plenty of worthy applicants are denied admission based due to a lack of available spots. The competition is palpable, and is potentially one of the biggest detriments to the vocation. The aggressive nature of the application process selects for individuals who excel academically. All too often, such individuals lack critical attributes such as comfort with public speaking or interpersonal interactions.

It’s no mystery that veterinary medicine requires a love for animals and science. Whether pursuing small or large animal practice, or a career as a wildlife or zoo vet, or even biological research, individuals are driven by a passion to preserve the health and welfare of animals.

What is often overlooked is the extent to which veterinarians must work with people. Though driven by a passion for helping animals, those working in the profession will be always be surrounded by owners, other veterinarians, technicians, assistants, co-workers, practice managers, owners, etc. who each require time, energy, and attention.

Every pet that steps through my exam room is attached to at least one human being. My interactions with animals comes easy, but those with people come less naturally. Further complicating my particular scenario is that as a veterinary oncologist, I meet people at an extremely emotional time in their lives. I possess no formal training in grief counseling or psychology. My education regarding “bedside manner” comes entirely from personal experience, both as a patient myself and over my years of worming in the field.

I may be walking into my third canine lymphoma consult of the morning, while the people I’m meeting with have never even considered their dog could be diagnosed with cancer. I have to be able to connect with those individuals despite having to repeat facts multiple times within the same work day.

I could be running a half an hour or more behind on appointments, or lack appropriate support staff, or simply not feel well and am still expected to complete my daily roster of appointments with the same amount of kindness and care as I would on a less busy or emotionally tolling day.

The animals I work with never consider my credentials or bedside manner, but I will constantly be judged by their owners on my knowledge, compassion, and ability to make them feel as though their dog or cat is the only pet I am seeing that day. I’m cognizant of how owners acutely remember every word I say and every interaction I have with them and their animal, even when doing so exceeds my reservoir of compassion and my abilities are worn thin.

The best advice I could give would be to learn how to be comfortable speaking to people and in front of groups of people. Learn about how people learn and process information. Discover new ways to listen to people. Observe and record their behavior. Consider ways to keep yourself interactive, even when you don’t feel as though you want to. There will be so many times during your career as a veterinarian you will want to withdraw, but be forced to continue to talk. You won’t always be comfortable doing so, but you need to find sooner rather than later if you’re able to push through your comfort zone.

Attempting these activities is especially important if you’re a particularly shy person. While studying, and memorizing facts will afford you the academic qualifications, what will carry you through this profession as a career will be the way you interact with other people. The more you practice these tasks, the more comfortable you will become with the process.

Is a cure for FIP on the horizon?

Feline infectious peritonitis (FIP) is caused by a mutated version of a feline coronavirus that transforms from a benign, minimally pathogenic virus to an aggressive and deadly version. Feline infectious peritonitis (FIP) is a devastating diagnosis for a cat owner as the disease is considered 100% fatal.

FIP is considered an incurable disease and the mainstay of treatment has focused on providing comfort and supportive care to affected patients. Since FIP is a deadly disease, there have been many efforts to develop effective treatments for it, with disappointing results.

However, progress is being made in developing new therapeutic options for FIP in cats. Researchers at Kansas State University devised a new antiviral treatment, which led to full recovery in cats experimentally infected with FIP who were treated at a stage of disease that would otherwise be fatal.

The antiviral treatment works by blocking the replication of the virus, a process required for it to survive within an infected cat. Six out of eight cats treated with the antiviral had resolution of fever, ascites, and low white blood cell counts, and returned to normal health within 20 days or less of treatment.

More on the experimental treatment below, but first, a primer on FIP.

Clinical Signs of FIP

Cats with FIP show non-specific signs of illness, including lethargy, inappetance, and weight loss. They may present with persistent fever and owners can notice abdominal distension or difficulty breathing in cases where fluid build-up within body cavities (effusion) is present.

There are two clinical forms of FIP recognized in cats: the “dry form” (noneffusive) and the “wet form” (effusive). In the dry form of the disease, cats develop mass-like lesions within their abdominal and chest cavities called granulomas. In the wet form of the disease, cats show fluid buildup in these same anatomical regions. There can be overlap between the two forms; cats with the effusive form often can have microgranulomas present and cats with the dry form can develop effusion.

Diagnosing FIP

Diagnosing FIP is difficult, and your veterinarian will likely recommend several tests to determine what is causing your cat’s signs.

Radiographs (x-rays) can help determine if fluid is present within the abdominal or chest cavities. An ultrasound can show enlarged lymph nodes or granulomas within the abdomen and confirm the presence of fluid. Bloodwork may be normal, but one of the most consistent findings is an elevation of a specific protein called globulin.

There is a blood test that measures whether or not a cat has circulating antibodies to the feline coronavirus, but this test is considered of limited utility. Most cats with circulating antibodies never develop FIP. High amounts of antibody make FIP a likely diagnosis, but 10% of cats with FIP will not have circulating antibodies in their bloodstream.

If effusion is present, analysis of this fluid will show a high protein level along with a relatively low cell count. In cats with nervous system involvement (e.g., brain and/or spinal cord), MRI or CT of the brain can show changes including hydrocephalus, which is a build-up of fluid in the brain. Analysis of the pet’s cerebrospinal fluid (CSF) will show high protein and cell counts.

The most reliable test for FIP is detecting the feline coronavirus antigen within white blood cells of the affected patient by special stains.

Treating FIP Experimentally

As I mentioned at the beginning, FIP is considered incurable, with treatment consisting mainly of providing comfort and supportive care. For cats in respiratory distress from fluid buildup around the lungs or within the abdomen, removing the effusion and providing oxygen support can aid in immediate relief.

Though the experimental antiviral treatment at Kansas State University seems promising, there is concern that the coronavirus that causes FIP could acquire further mutations, rendering it resistant to antiviral treatments such as the one developed at Kansas State University. In addition, this form of treatment was only studied in cats with the effusive form of the disease; its efficacy in cats with the dry form is unknown. It is also unknown whether the antiviral will be successful in treating cats naturally infected with FIP as all of the cats in the study were infected experimentally.

Polyprenyl Immunostimulant (PI) is an investigational biologic used to lessen clinical signs associated with herpes virus infections in cats by promoting immune responses to the virus. PI also has been used to treat FIP. In a small study, three cats with the dry form of FIP were treated with PI. Two cats were alive and still receiving treatment two years following diagnosis. The remaining cat was treated for only 4.5 months and lived a total of 14 months. A larger study was done in 58 cats with the dry form of FIP. Five percent of those cats lived longer than one year and 22 percent lived at least 5.5 months.

Though PI might seem like the magic bullet for treating the dry form of FIP, there are a few caveats to consider. In the smaller study, the amount of disease present in all three cats was minimal; two had no clinical signs at their time of diagnosis. In the larger study, cats who were very ill or died within a week of starting treatment with PI were excluded from the survival analysis, likely skewing results.

As some cats with no or minimal signs of disease and localized lesions can spontaneously recover from FIP without treatment, the role of PI in aiding the convalescence in these marginally affected cats is unclear. PI is also completely ineffective in treating cats with the effusive form of FIP.

Though these new treatment options seem promising, further research is necessary to determine how successful they will be for cats affected with FIP.

FIP Prevention

Controversy exists concerning the efficacy of an intranasal vaccine to prevent infection with FIP. The vaccine it is not thought to be effective in preventing disease in cats previously exposed to feline coronavirus, but it may induce some level of protection for a cat that has never been exposed to the virus.