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Creature Comfort Care

A housecall might conjure up the image of the old-time country doctor with his black bag, visiting the ill at their bedsides and delivering babies on kitchen tables. That picture has been transformed for the times, only instead of children with polio or mothers with rheumatic fever, this traveling doc treats arthritic St. Bernards and terminally ill cats.

Dr. Christina Lehner took her veterinary practice on the road eight years ago after two years in a clinic setting. She found she could better treat pets one on one – in their familiar habitats – than in an often commotion-filled office. Her mobile veterinary service, Creature Comfort Care, covers a 100-mile radius of Oshkosh and operates on a housecall-only basis.

When did you realize there was a need for what you do?

The clinic where I worked had a client call for a housecall euthanasia. It was a big dog, with very painful arthritis, and the client was physically unable to get this dog to the office. Nobody wanted to go – they didn’t know what the setting would be like and were concerned about complications. As the new person at the practice, I was first to volunteer. I thought it could be exciting to get out of the clinic.

I was so touched by how much better it was not only for the owners but the pet, who was resting by the fireplace, comfortable in his favorite bed, with toys and family around. The family was throwing thanks on me, and I was thinking I’m the one who’s grateful for this experience. Not long afterward I asked my boss if I could offer this in conjunction with the practice after hours. It took off from there because there was a niche need.

So you enjoy not working in an office?

Yes, definitely. Many other doctors don’t. Many people in any field feel more safe and secure in a regular office. I find it exciting. You get to see where the pet is living and even help with things like organizing the pet’s living space, making things easier for the pet to get around or get to the food bowl. For me, that’s all part of patient care. Plus, the client gets longer appointments, and that’s important. I’d rather earn less but have a more fulfilling job and get to know patients and their families.

What does a mobile vet service do?

I have three niches: acupuncture as well as cold laser;  hospice and palliative care; and home euthanasia. I was just certified in hospice and palliative care in one of the first-ever programs, so there are only about 40 of us worldwide so far. I do help with regular veterinary care by request.

What is pet hospice?

We lump hospice with palliative care, which is pain control and comfort care. Patients typically have a life-limiting disease such as bad arthritis that limits normal functions or a terminal disease. It’s really a mind-shift where we go from curative to comfort care, which can be from pain control to preparing for when to consider euthanasia. In some cases there’s even debulking surgery, as with a tumor. Sometimes even partially removing a tumor can offer some comfort.

What’s the benefit of pet hospice?

The goal is to enhance quality of life, and often you can actually extend life a little longer than if you were doing purely curative measures. I’ve had pets diagnosed with cancer that were given one month to live end up living a year and a half of really good quality of life. It sounds really sad, and hospice is one of those hot-button words that sounds intimidating and scary, but it can actually be a beautiful time. Often the pet does much better than anyone ever anticipated because it’s much more comfortable and can deal with things better.

What animals do you work with?

Mostly dogs and cats and the occasional goat. I’m definitely not a goat expert, but occasionally we’ll get calls for them. I’ve done acupuncture on rabbits. A lot of us have special niches related to those pets so it’s easy to refer people to someone with the specific equipment and handlers geared toward them.

How does pet acupuncture work?

The pre-acupuncture exam starts with feeling the muscles for areas where the pet is tense,  often by watching their body language for little flinches or a look that tells us there’s pain, or by watching them walk. A lot of time in conventional medicine, you’re looking for more overt signs.

The acupuncture points are points where there’s more nerve density, the nerves are superficial and can be targeted more easily. Other times we’ll find trigger points where the muscles are tight and sore. We can use an acupuncture needle in that area and we’ll see the needle fold over, showing that the muscle is more relaxed. It’s neat how you can place a small needle into certain areas and create a cascade of events that affects pain control and pain management throughout the whole body. It’s scientifically based and a safe and effective way to modulate pain control and help with other conditions. It’s a nice complement. Many times a pet is on multiple pain relievers and still not getting the relief they need.

What other things can acupuncture treat?

It can be helpful for seizures, anxiety, bladder inflammation, skin conditions and so much more. I definitely use it most for pain control and mobility, but the sky’s the limit.

Where does one learn pet acupuncture?

Only a few schools nationally offer it. I went to Colorado State University, which was a solid year or 18-month program. I wanted a program based more upon scientific evidence versus traditional Chinese medicine. Even though it’s the same practice, there are different languages used between Chinese and Western medicine. I was really happy with the curriculum and everything I learned.

Do you do typical vet services like X-rays?

We don’t have X-ray capability but I definitely practice Western medicine as well. It’s the best of both worlds, holistic and Western. If an X-ray is needed, I’ll refer out to a local clinic and try to get that relationship started between the vet, the family and our care. I prescribe medications, do blood work checks, etc. I have a small lab at home with a centrifuge. We also use a lab that picks up samples.

Euthanasia sounds depressing. Is it difficult?

It certainly is almost always hard, but it can be a beautiful gift that you give your pet when you’re able to love freely with an open heart and know that you’re making the right decision for your pet. But without a doubt, they’re hard situations, and I think if you don’t understand the love of a pet and personally experience what that’s like, I think it would be hard to relate.

What happens to the pet’s body when you leave?

Families have several options – some will want to pursue home burial or taking their pet to a crematorium on their own. Sometimes we just help with that transition and help the family after separation.

If the family chooses cremation, we work with two excellent crematoriums. There are only two in the state I’ll work with. If families elect cremation, certainly we’ll take the pets and go directly to the crematorium, or pre-arrange for the crematorium to come to us just like a regular vet clinic.

What challenges does your line of work pose?

One of the biggest is the urgency of requests. Often it’s when families have a pet with a newly diagnosed condition, or there’s a lot of pain and they didn’t realize it until that moment, and families want help right away. That can be hard, just not having another backup veterinarian.

Same-day requests are very common. Sometimes we can get to them, but sometimes they’re far away, where it could be an hour drive one way, and you can see how that could easily take up half the day if you’re trying to get to an urgent appointment.

Do you get calls in the middle of the night?

I have, and I’ve taken some very late calls or very early morning calls in the past. But one year I got the flu and got three of those requests. It was awful. After that, I realized I needed to set some business boundaries in order to be there for other patients and still stay healthy myself. I feel like we’re very fortunate to have a couple emergency clinics in the area. I certainly help with urgent and emerging situations during the day, but at night I really encourage using the emergency centers.

Do pet owners ever become an issue, since you’re in their territory?

Most times no. Certainly it’s expected with what I do when the emotions tend to run high, but families are grieving, whether because of euthanasia or perhaps they learned their pet has a bad illness. So there are a lot of highly emotional cases.

The difficult ones are where the family is going through the anger stage of grief and directs it toward the family veterinarian. Thankfully that’s not very common, and that’s why it’s important to know the stages of grief and understand what it’s like to go through it and keep it in perspective. Often the family just needs to get the anger out and have somebody who recognizes it and will listen.