That's probably alluding to heartworm prevention. Heartworm prevention can be given in different ways, but monthly is one way to give it. As Kyle mentioned in the earlier video, not only does it prevent heartworm, but also external parasites like flea and ticks, and internal parasites, like intestinal worms. A lot of preventatives have a combination effect. That would be a monthly one. Other things, depending on if your pet has a specific problem, might include the monthly allergy medications they need. There may be some others that are specifically monthly. That's all I can think about right now.

The first thing that we do is talk to you about the history. If you're there and your pet is completely well, those visits are few and far apart because somebody almost always thinks of a question or a concern that they have, but they save it until their visit because they didn't think it was serious enough to come in before, which is fine. We can talk about that. So we are really big on client education. We typically talk about the pet's lifestyle, which we talked about in the previous episode, because we want to know what your pet does daily and how things are going.

So history and conversation are one of the very first things that we do. Then we put our hands on your pet. The physical exam is a really important part. Our pets don't always talk to us and tell us what's going on. They might give us a clue, and we may be observant, or we might have busy lifestyles, and we don't notice that they've had a raging ear infection or problem that we didn't see. So we put our hands on them and do a physical exam, and then we may talk about testing. Depending on what that visit entails, we may do blood work and poop checks. We do a lot of poop checking for parasites. It tells us a lot about the health of a pet's gut. Then we educate on the next step, how to go forward in keeping your pet healthy if they are healthy. I know you've talked about the exam as being from the tip of the nose to the tip of the tail, so you check their eyes, nose, ears, mouth, teeth, and lymph nodes.

A lot of times, if a pet comes in for limping on the right side of the back, I don't go to that back right leg initially because if it hurts, the first thing I do is hurt your pet. Then everything's going to hurt when I touch it. So I'll start maybe on the front legs or the left, and then the right, and owners will often say, no, it's the right. I did hear you, but there is a reason for examining the whole pet. As you said, you don't just say, okay, well, that leg looks okay or that leg has an issue. Let's look at everything. It would be a very rare occasion if your pet came in for one problem that we didn't do a full physical exam because we feel like that's very necessary to do. We listen to the heart and lungs and feel in their belly to see if there are any enlargement of organs, anything out of place. We palpate the abdomen, and we feel the joints by flexing and extending the joints. We're feeling for any problems. Sometimes we can feel problems internally just by palpating outside, whether it's a mass or tumor, an enlargement of an organ, or maybe it's a stone in the bladder. There are certain things that we can feel from the outside. And then just listen to the heart and the lungs, feel the pet from top to bottom, check their skin, look for external parasites, and lift the tail. We check everything.

Our general recommendation, as far as the veterinary visit and exam go, is twice yearly for our pets. When they get older, we may talk about more testing and things that need to be done. Preventative care may entail more things throughout the month or the year besides just exams.

It's all about stopping a problem or preventing it before it happens. So it's risk avoidance. We would rather not have a problem happen than talk about trying to treat it. It's a lot cheaper that way, too. What you put out, to begin with, is a lot cheaper than what you have to take care of if you ignore it.

Initially, for every acute pain episode, absolutely. That animal should be assessed. For chronic pain, sometimes animals that we're diagnosed with arthritis chronic pain, for example, are on something daily. So we will refill based on their mandatory one to two exams a year and their blood work once to twice a year. So in the cases that we've got them on a maintenance plan, and it's a management plan, they can just have it dispensed at times, but if there are any changes in the animal's behavior or we haven't seen them for over a year, we need to see that patient.

You can give medication to your dog, usually by mouth. Sometimes you may have to hide it in something which is like a pill pocket, or, depending on the dog, a little piece of cheese or something like that. There are also liquids, which we sometimes have access to if you have a dog that does a little bit better with something on the food or squirted in the mouth. There aren't so many available for dogs, but there are also some transdermal options. We tend to use those more in cats because their skin's a little thinner. We can also help if you have to give it by mouth, without any of those extra things. We can help teach you how to do that. In fact, I think we have a video or will have a video on how to peel your dog. We give injections in the clinic, and then there are a few kinds of medications that are considered nutraceuticals. One of them, Adequan, is injected, and it can help with chronic pain as well. There's a variety of alternative therapies that we can use to help with pain as well.

At this point, I would not call anything an alternative. Even some of the herbal things can get metabolized into products that may interfere with medication that would be more effective for your dog. When they talk about that, they're talking about the CBD wonder meds, and there's just not enough research out there to make those decisions. What studies have been done on CBD oils? CBD products have not shown efficacy in a dog for pain, and they actually sometimes affect liver enzymes. So typically, those aren't even recommended, and we can't recommend them due to legal reasons.

I don't recommend that you give your dog any human pain medication without at least consulting us to see if it's okay. There are very few recommended things for a dog. Regarding dosing, your veterinary professional would have to help you with that, as they're all very different. Some of them are based on the age of the patient and their kidney and liver health, and so on.

We commonly prescribe nonsteroidal anti-inflammatories, which is what NSAID is short for. They're very effective pain medications, and there are lots of them available. They all have different safety profiles, and we choose them based on the individual and what their blood work might look like. Also, regarding the delivery system, some are liquids, some are chewable, and some are capsules, and that's really important for a lot of owners because some dogs have preferences about what delivery they want.

Most over-the-counter medications are not recommended because they interact with more effective things that we can give. Typically, before you give your dog, and your cat especially, anything at home, we would recommend that you call, and we might recommend making an appointment to get an appropriate medication for your dog. Many times we've heard that owners have given Tylenol to their dog, which limits what you can do for the pain to help the dog. Some of those medications are quite toxic to their liver and kidneys. Tylenol in excess, for instance, and even aspirin can have some side effects on the stomach. Even baby aspirin.