Dr. Angie Krause (00:00)
Welcome back to Tails of Truth where we tell the truth about veterinary medicine. I'm Dr. Angie, and this is my co-host and veterinary nurse extraordinaire JoJo And today we're going to talk about what I saw in practice this week.

JoJo (00:14)
I think this is interesting. I've been wondering, I'm gonna ask you question before you go into it. Now that you're in a clinic full-time, you're full-time in a clinic, do you think that you are still labeling yourself holistic, integrative, or do you find that you're like, what is it like being in practice? I guess is what I'm asking. It's a little different than having your own house call practice where you're fully holistic.

Dr. Angie Krause (00:22)
Mm-hmm. Mm-hmm.

⁓

Right. I would say the practice I'm in, I'm still pretty integrative, but like definitely I'm serving the whole spectrum of people that don't want to do anything integrative, that want to just do the kind of basic stuff. ⁓ And that's okay. That's an easy, that's easy for me to do. But I'd say most days I'm still practicing in a really integrative way.

JoJo (00:41)
Mm-hmm.

Yeah.

Dr. Angie Krause (01:04)
like diet recommendations and yes.

JoJo (01:08)
I just, I was curious. So, so launch into it. Tell us what you saw. What'd what'd you learn this week?

Dr. Angie Krause (01:12)
Well,

I have a heartworm positive dog that happened.

JoJo (01:17)
Which you guys, that's

crazy in Colorado. That doesn't happen very often.

Dr. Angie Krause (01:21)
Right. And the reason is, you know, the reason why this dog's heartworm positive is because he came from Texas. And so, I had to remember how to treat heartworm positive dogs. I, there's a whole kind of like, um, protocol that like on certain days, like the first 30 days you do doxycycline and the heart guard and you know, like,

And then you give the first injection and then, you know, like, and then on this day you do that thing. And so I had to, I had to remember because we hardly ever see heartworm positive cases here.

JoJo (01:58)
And I feel like the

heartworm positive that we had in practice, we did a slow kill method versus the fast kill method. There's like different methods.

Dr. Angie Krause (02:05)
Well,

yes, my gosh, this is so good to talk about. So slow kill is definitely not recommended by the American Heartworm Association. But we had, and you're right, you saw this, we saw these cases together. had, I think there were two or three very elderly dogs that were heartworm positive and had comorbidities, meaning they had other disease. And unfortunately,

JoJo (02:23)
Mm-hmm.

Dr. Angie Krause (02:31)
treatment, once your dog has adult heartworms and an active infection, it's a difficult treatment. It's hard on the body. It has some pretty negative side effects. And so there was some worry that these dogs might not do well with the treatment. And the idea with the slow kill is that you keep killing off the young heartworm, like the larvae,

The idea is that you keep killing those off and that eventually the adult heartworms just die of old age. And so those are the methods that they decided to do. For a young dog, that would not be recommended because then they're still living for years with these adult heartworms. Yeah.

JoJo (03:16)
Hmm.

And are you still having to, is the recommendation still to crate these dogs? Is that still part of the recommendation?

Dr. Angie Krause (03:21)
Yeah, so there's still, yeah,

there's still all the exercise restriction after the treatment. So, man, if you live in a place that has heartworm disease endemic, preventing heartworm disease is so much better than treating it. I know I've said that before, but I will say it again. And so I will die on that hill know people that want to do everything naturally. I, I get it, but

JoJo (03:26)
⁓

Yeah, that is a hill you will die on. ⁓

Dr. Angie Krause (03:49)
a little bit of ivermectin once a month is going to definitely save you a lot of problems.

JoJo (03:56)
And you said that, and I really want to write it down to start the Sage on her heartworm medication, because it's been such a hot year that I bet. But we haven't had much moisture. I don't know what our mosquito season is going to look like.

Dr. Angie Krause (04:04)
I

I don't know anything anymore when it comes to weather in Colorado. This has been like the scariest weather event of like not having snow. We never had a winter. don't, yeah, I don't think I wore my long underwear. Like, no, my...

JoJo (04:21)
Mm-mm. It's the first

time I've thought, please let winter be here longer. Like I feel like we just didn't even get it.

Dr. Angie Krause (04:25)
Yeah,

we just didn't get it. And so I I'm not sure what's going to happen. Usually I don't worry about heartworm disease too much, like in Boulder County, because we don't see a lot of transmission if any transmission, because I don't know that we actually have the type of mosquito required to transmit heartworm disease or if our mosquitoes live long enough. But I have seen

Parasites over the last 19 years I've been here changed so much as the earth warms up. I still recommend doing heartworm prevention, especially if you travel outside of the Boulder bubble. So I'm a big fan of the heartworm prevention for that regard, but I don't want any of my patients or anyone to be the dogs and cats that we find out like, ⁓ no, no, actually we do transmit heartworm disease and now you have to do the immiticide like the adult treatment.

And it's because it's pretty toxic. No one wants to do it.

JoJo (05:21)
So did they adopt this dog knowing it had heartworm or did you find it just in routine testing or was he symptomatic?

Dr. Angie Krause (05:24)
No.

No symptoms, that's good. So I saw this dog for the first time and I got all the records and I could never find a negative heartworm test. And I thought, well, this is strange, especially being in South Texas. And so I was like, well, let's just do this. And I came back positive. So I know the good news is this dog is young and healthy and we will probably treat him without any incident.

JoJo (05:37)
Hmm. Aww.

⁓ such a bummer.

Dr. Angie Krause (05:56)
That's the good news is that I can make this dog heartworm negative. Yeah. So we're, we're going to do that.

JoJo (05:59)
Okay, okay, see, it's all heartworm

positive. That's unique.

Dr. Angie Krause (06:04)
Heartworm positive. I saw a client with her cat, she's a lovely person, and she asked me, she said, hey, I'm gonna be traveling to the EU or maybe moving to, can't remember which country in the EU, but I read that you can get a microchip that will read your cat's temperature, which is amazing.

And the reason why it was important for her is because she's moving to the EU and the microchip has to be in place before we do a rabies vaccine. And so we were talking about all of that and the EU requires a certain kind of microchip. But then I got to start looking at all the technology now where a lot of microchips have the technology to read your cat's temperatures. We don't have to do a rectal temperature in clinic, which is a game changer.

JoJo (06:54)
It's game changer. So you just have to have a different type of scanner that's aligned with that microchip.

Dr. Angie Krause (06:58)
Right.

And it's yes, you would have to have that. And it seems like, yes.

JoJo (07:01)
Okay, and then it has a temperature reading and and

like a ⁓ chip reading like a serial number. Yeah!

Dr. Angie Krause (07:07)
It seems like you would want to have that at home, right? Like, I feel like not just

veterinary professionals should have the ability to check the cat's temperature. Like everyone should. So, yeah. So, well, are the microchips we carry in the clinic don't have that and there's that particular company doesn't manufacture it. So I told her if she gets it for me, I'll definitely, you know,

JoJo (07:17)
That's interesting. Yeah, did you find it were you able to do it or are you gonna be able to do it?

Dr. Angie Krause (07:34)
place the microchip for her, but we don't have any. I think Home Again. Right, because it has to be ISO compliant, and I'm pretty sure all of Home Again's are, but there was more than one company making the technology, so I think it's up and coming. I don't know if it'll catch on or not, but.

JoJo (07:39)
and it's EU acceptable.

Hmm.

Yay!

Why wouldn't it catch on?

Dr. Angie Krause (07:55)
We tend to not take rectal temperatures in clinic because cats don't like it, and then we often lose their compliance. unless I, my patient is sick, I'm not.

taking rectal temperatures as part of my normal exam. And so, I don't know. Like, do you think that's something that people would want?

JoJo (08:14)
Yes, I do. People, do you want that? That's the question. Do you? Yeah, that's interesting, which our ick episode, our yucks and yums episode, this is what I thought about. I am so icky to have to do the microchips when the cats and dogs are awake.

Dr. Angie Krause (08:17)
Tell me.

my gosh, microchip placements.

JoJo (08:36)
because

it's just such a big needle. Yeah. But when you travel, you have to do it.

Dr. Angie Krause (08:38)
Yeah. Yeah.

Right. And you want to find your animal if you lose them. So definitely do it. But yes, we as veterinary professionals, there's one nurse in the clinic whenever we need to place them. Although Jojo, the brand we use, and now I'm not going to remember at Boulder's Natural Animal, they're the smallest microchip needles I've ever seen. So I don't feel as bad about those. But the one, I think we were using home again.

JoJo (08:46)
Yeah.

Okay. Okay.

Yes, it was big. And when we were doing it for the rescue and all the kittens that she got, that would be my after job to run over there. And I'm like, ⁓ I feel so bad. Yeah, anyhow, that was a side note. That's really exciting technology. I think it's exciting technology.

Dr. Angie Krause (09:07)
Yeah.

I know it feels terrible. Yep. Yep.

Maybe it will be maybe it will be yeah

JoJo (09:29)
Yeah, but don't

some people not use microchips in the holistic realm because of there's some, I think it needs, I think it's been debunked, these myths about how, how it's getting the information.

Dr. Angie Krause (09:39)
yeah.

Yeah, a lot of people think it's like emitting EMFs. And it's actually, it's not. So you don't have to worry about that. ⁓ Definitely microchip your cat. ⁓ It's only transmitting when there's something to pick it up. So it's not just like constantly send. Right. Yeah. It's not just like, and so people are like, I'm worried it's going to cause cancer or whatever. doesn't do that. And so you don't have to

JoJo (09:44)
That's right. Yeah.

Mm-hmm, like when you turn on the scanner. Yeah.

And the temperature aspect of it is the same way. It's just like initiated once something

Dr. Angie Krause (10:12)
That would be my guess. Right. I mean, all most people now are putting GPS trackers on their pets. They are really fun. Yeah. So.

JoJo (10:12)
I don't, it's like turning it on for reader. I don't know. Interesting.

I know they're so fun. don't know. They are really kind

of fun to see like what cats do in the neighborhood. It's interesting. Yeah.

Dr. Angie Krause (10:30)
Yes. I

mean, that would have to emit more.

JoJo (10:33)
For sure. Okay.

Dr. Angie Krause (10:34)
but I don't know if we're worried about

that. I don't know the science behind that. Nor am I worried about it. I actually want you to put that GPS tracker on your indoor outdoor cat, because I want you to find them. Yeah, let's find them. So we've got our microchip. I saw a lot of diarrhea. All the dogs had diarrhea this week. Everyone had diarrhea.

JoJo (10:45)
Yeah, exactly. Okay, what else you got?

Ew.

⁓

Was it pretty uniformly like the same reason? ⁓ like our dog's stress? Is there something in the environment like what's going on?

Dr. Angie Krause (10:59)
No, no it wasn't.

What is going on? That's what I want to know. ⁓ I'm not sure, but I think the hard part about treating dogs with diarrhea is we, we have kind of everyone trained in the practice. If your dog has diarrhea, we, you we want you to bring poop by and then we'll call you. We don't make every dog that has diarrhea come in, which is, it's so great because it's so reasonable. I love boulders, natural animal for that reason.

JoJo (11:27)
that's nice.

Yeah.

Dr. Angie Krause (11:34)
And so, if your exam is, you up to date and we can prescribe you things, we don't want you to have to come in just because your dog has diarrhea, all the time. It's not that we don't ever see them, but if it's just like a one-off thing and you want to check for parasites, we do that. And we often find Giardia. And I have the same conversation a million times a week where I'm like, well, your dog has some Giardia present in their stool.

JoJo (11:51)
Mm-hmm.

Dr. Angie Krause (12:00)
It could be the cause of the diarrhea or it could just be part of the normal flora. And then we have to go through, like we can treat with antibiotics. We can treat with phenbendazole. We can treat with both. We could do nothing. And there's such a big push to get away from using antibiotics. And so we're really trying to not use them. And so we're doing more like bland diets and we're using more probiotics, but because

JoJo (12:17)
Mm-hmm.

Dr. Angie Krause (12:25)
Like you were saying, the cause of the diarrhea is so different for every case. It's kind of a lot to kind of parse out and decide what people want to do. And so some weeks I get tired of saying the same thing. I need just like a recording.

JoJo (12:39)
Well,

the Giardia one too is just like, ⁓ because you have to do something, especially if you have kids and stuff in the house, and they're presenting obviously that's symptomatic with the Giardia. Because a lot of times dogs will have Giardia and you just don't know that your dog has Giardia because they're not symptomatic. Yeah.

Dr. Angie Krause (12:58)
and it's part of their normal flora. And so

you don't do anything about it. And...

JoJo (13:02)
So

the question is, is the giardia even what's causing the diarrhea or is that just something we found?

Dr. Angie Krause (13:07)
That's, yes. And that's the conversation I have over and over and over again. ad nauseam.

JoJo (13:10)
Yeah. And

you have to take metronidazole out of the equation now.

Dr. Angie Krause (13:15)
I don't though, I love-

JoJo (13:17)
I did that just to poke you.

Dr. Angie Krause (13:20)
I know, I love it.

Pry it out of my cold dead hands. But like if someone is like, hey, I was up 10 times last night with my dog, I'm gonna give them some metronidazole, whether I think it's giardia or not. Because I care about the whole household's health. We're not gonna tough it out with probiotics at that point.

JoJo (13:33)
Yeah, gosh.

It takes three to four weeks. I don't know. I feel like probiotics are the slowest answer to that. And we're changing the diet protocol too, right? Like the bland diet is no longer rice and chicken.

Dr. Angie Krause (13:43)
You know...

slowest answer.

I guess not.

JoJo (13:57)
with a little splash of pumpkin. Like, it's not like that anymore. I don't remember, but it's changing. Because there are some things that I'm like, why are we changing? This works. So I still boil chicken and rice.

Dr. Angie Krause (14:00)
People still do it. What is it then? mean, that's the thing. Yes, I suppose.

I

And you know what, it does work because people do it and it works. And maybe the diarrhea was going to get better anyways, but I know someone put out some study and maybe you and I could like pick the study apart where it's like rice is actually the worst thing. And you're like, no way. But you know, maybe I'm just old.

JoJo (14:27)
Yeah, I think we need to do an

episode on studies. Like there's some like really fun studies coming up, like what I told you earlier about cats and CBD.

Dr. Angie Krause (14:31)
Yes.

⁓ yes, we could just talk about miscellaneous studies that aren't helpful but are fun. Yes.

JoJo (14:41)
Yeah, super fun.

Somebody spent money on. Yeah.

Dr. Angie Krause (14:46)
Yeah, somebody's been putting on that.

my gosh. then, okay, so we've got the diary. I've been talking about GRD all week. I have another ER gripe.

JoJo (14:54)
⁓ no. Wait, did you ever resolve your other ER gripe?

Dr. Angie Krause (14:58)
No, no.

So I made an appointment to talk to them. And then like, I don't know if we, maybe it's because I got the flu, it just never happened. But I'm gonna, they offered to come to the practice to talk to us. So, cause I felt like it's not fair for me to complain and not be in communication about my complaints. So I really try not to be a complainer and not try to actively solve it. And so.

JoJo (15:11)
Okay.

Yeah, no, you're

really good at having the hard conversations. I think you're fantastic at that. You don't just let it you don't just sweep it.

Dr. Angie Krause (15:28)
Yes.

No, not sweeping it. So that's in work in works, like in the works, but there was a bigger specialty center, that one of my patients visited because the dog had diarrhea and maybe some vomiting and in the ER they went through like all the things it could be, all the things that we could do for treatment and the diagnostics this dog got.

JoJo (15:36)
Okay.

Dr. Angie Krause (15:55)
was to, it was an ACTH stimulation test.

JoJo (15:59)
Interesting choice.

Dr. Angie Krause (16:01)
to check for Addison's. And now for those of you listening, Addison's disease is where the adrenals don't make enough steroids. And what that can look like is kind of this waxing and waning vomiting diarrhea. It's exceptionally rare. Like I have diagnosed one in 20 years.

JoJo (16:24)
I say even when we have thought it could be, it's come back negative.

Dr. Angie Krause (16:27)
Yeah.

No, it's extremely rare. mean, you know, every practitioner, like we have, I think we have two Addisonian dogs in the practice that I helped manage. it's, it's out there, but it's something that you do later. And they had talked about doing an abdominal ultrasound. They talked about doing all these things, which I felt prickly because I'm like, that's my job.

JoJo (16:30)
Yeah.

Dr. Angie Krause (16:52)
Your job is to stabilize this patient because I'm irritated that they would recommend those diagnostics in the middle of the night when I know I can do it at my practice with a radiologist for half the cost. And I'm starting to get really prickly with these ER clinics that are spending way too much of my client's money. Like I'm feeling really protective. And so that's what this dog got.

JoJo (17:06)
Mm-hmm.

Hmm.

Dr. Angie Krause (17:19)
no antibiotics for the diarrhea and maybe that's fine because we're stepping into the new era of no antibiotics for diarrhea. I get it. Totally support it. But of course the dog did not have Addison's disease and it never needed a stimulation test because they could have just checked a single cortisol. It felt like a money grab and I know we had a whole episode about this, but I just thought

JoJo (17:32)
What?

you

Dr. Angie Krause (17:42)
For one, that's not good medicine to immediately jump to the zebra. And then part of me is like, no, you let me do that. That's my job as a general practitioner. Now, if this dog got transferred to internal medicine, internal medicine can do whatever they want. That's them. But I kind of felt like you skipped a bunch of stuff. Your job is to stabilize my patient and send it back to me for workup or internal medicine for workup.

JoJo (17:51)
Mmm.

So are you going to have that conversation? Were the people upset? Or did they not know any different?

Dr. Angie Krause (18:10)
So yeah, heck yeah. I didn't talk to him

about it. just, because every time someone goes to the ER and they send us the report and I looked at that and thought, no, we're doing ACTH stimulation tests in the middle of the night for a dog that's had diarrhea and the dog had diarrhea two weeks ago. It's kind of like.

JoJo (18:35)
Oh

no. Yeah, because emergency rooms aren't getting records either, you know? So they don't know the medical history beyond what the client's telling them. Which often has gaps to no fault of people. I do it too. I show up and I'm like, I don't remember how many milligrams my dog is on, whatever. I mean, it happens because you're in an emergency room in the middle of the night. No.

Dr. Angie Krause (18:41)
No.

No.

Totally.

Yeah.

Right. I just

thought, who are these ER doctors that are doing this? You know what we should do is have an ER doc on and talk about my gripes and be like, no, I only want an ER doc that's going to agree with us. I'm just kidding. I'm just kidding. But like what, like what's going on? What's going on? Like it wasn't even good medicine to do that. Like there were

JoJo (19:07)
put us in our place. It'll be like, huh.

No, no we don't.

Dr. Angie Krause (19:25)
Like 10 diagnostics ahead of that that made way more sense Yeah, anyways

JoJo (19:27)
Yeah, that's strange.

Do you think

that the client could have mentioned that they wanted that? And that's how they came to be? You know how some did like, did they get on chat GPT And that was one of the rule outs? I don't know. I'm just wondering how they got to that place.

Dr. Angie Krause (19:35)
You know what? That's fair. Did someone Google it? They weren't.

That's

true. And you know what? I am complaining about this and I wasn't there. And so that is a, it's short-sighted.

JoJo (19:52)
Sorry. Well,

I don't know. They could have also just jumped to that, but who knows?

Dr. Angie Krause (19:59)
But then also, why would you do that? Like if someone said that, then it's your job to say, that's so rare. Here are all the diagnostics we would do ahead of that.

JoJo (20:05)
Yeah.

Yeah, I don't know. I've never worked in an ER. I couldn't manage. I wouldn't do well.

Dr. Angie Krause (20:09)
So, anyways.

Yeah.

But like you would be fine working up diarrhea if you were a veterinarian working in like that's like the most basic thing ever.

JoJo (20:19)
Yeah,

is. Yeah, most of the time that's pretty straightforward in terms of stabilization and hydration and all the things. ⁓

Dr. Angie Krause (20:27)
Yeah. Anyways. Yes. Yeah. Just stabilize

it so I can fix it the next day, the rest of the way. Yeah.

JoJo (20:34)
Yeah.

so hard because you have to be so PC. It's not a good look to throw another veterinarian under the bus.

Dr. Angie Krause (20:43)
No. No.

JoJo (20:44)
And I don't hear you doing that. I don't hear you doing that. And also it's like to the client like that, that it was just so unacceptable.

Dr. Angie Krause (20:45)
No.

no.

I would never do that. No.

JoJo (20:53)
We had that happen to us once. Well, I'm sure it's happened more, but I remember, didn't they send, I don't know, something with like records. yeah. You remember? Because I'm trying to piece together, I'm just noticing the feeling of remembering, but not the actual story.

Dr. Angie Krause (20:55)
yeah.

⁓ I'm just gonna say it. I'm gonna say it. yeah.

Yeah.

cats in Boulder told our longtime client won't say her name that I diagnosed her cat with kidney disease by like the most universal guide, iris staging. I diagnosed her cat with early stage kidney disease and they told her not only was I wrong, was incorrect about the diagnosis, but that she should stop seeing me.

JoJo (21:13)
yeah, that's right. Yeah.

Hmm.

Dr. Angie Krause (21:36)
And you

know who this is because we saw her for years, like all the love, like we're like family. And she told her you shouldn't see Dr. Krause anymore because she was wrong. It wasn't even like a subjective thing. Yes.

JoJo (21:43)
Yeah.

That's such bad practice. It's

so unacceptable. And that wasn't the only time, because when you said that there's another story about that, a different person, yeah, yeah.

Dr. Angie Krause (22:02)
Oh, was it, did it happen again? Oh, and I was just like,

I'm not even like, it wasn't even like an outlandish thing to say that, your cat has early kidney disease. was like, yeah. Anyways, that, that was hard. And I did reach out to them to talk to them about that and they wouldn't talk to me. Yeah. Boo. Cause I thought we're not, we don't do that to each other. Like I would never say.

JoJo (22:12)
Yeah.

⁓

⁓ boo. Yeah.

Dr. Angie Krause (22:29)
don't ever see that vet again. Just you got to tell them what you think about it and then let the people decide.

JoJo (22:31)
Good job.

Dr. Angie Krause (22:36)
Anyways

JoJo (22:36)
Any more

cases? Like, do you have any cases that are keeping you up at night right now?

Dr. Angie Krause (22:39)
Yes, I have a case. gave her my cell phone number because I really, I do that. Yeah. When I'm worried, I'm like, I want to know everything that's happening. So before you go to the ER, let me know. But I saw this dog that's really allergic and ⁓ saw Dr. Dell, Darin Dell at Wheat Ridge, my favorite dermatologist and is getting managed. All the allergies managed, but she called me like.

JoJo (22:44)
Yeah, you do that.

Dr. Angie Krause (23:06)
midweek and was like, he's just not right. And something he keeps trying to take his back leg and scratch, but something's not right. And so I finally got her in because she was not sure if she needed to come in and she came in on Thursday, which was yesterday. And she showed me this video of her dog trying to walk, but like also doing the scratch, but like never making contact with anything. And then showing

JoJo (23:27)
Mm-hmm. Mm-hmm.

Dr. Angie Krause (23:32)
him leaning against the wall, kind of like not head pressing, but almost like he couldn't quite stand up and then like would feel better if we could just like massage the jaw. Anyways, I think so then I looked in his ear and on one side, the tympanic membrane, the eardrum was all white and bulgy. Like it looked like I was like, ⁓ is there an inner ear infection?

which is very rare to diagnose an inner ear infection or to be suspicious. So I'm worried. One, I'm worried I'm wrong. And two, I'm just worried in general, because I don't like inner ear infections. But then the worry is, like, well, what if that ear drum was just normal? We've just had chronic ear infections. What if you were missing something? And that's the kind of...

JoJo (24:05)
Ouch.

Hmm.

Dr. Angie Krause (24:22)
Those are the thoughts that keep me up. And so she has my cell phone number.

JoJo (24:25)
Yeah,

and he's having some vestibular, like he's off balance. Yeah.

Dr. Angie Krause (24:29)
Right. And he like, and

then he's dragging his ear, like his face along, but you know how dogs that have ear infections, they will like get into their ear with their, with their foot and he, wasn't doing that. He's not making contact. Yeah.

JoJo (24:34)
Aww.

yeah.

Yeah, but he's not making contact.

Interesting. Maybe it hurts

if he makes contact.

Dr. Angie Krause (24:48)
because of the inner ear hurts.

JoJo (24:49)
but

he still has that reflex of having, I wonder, I wonder, curious. All right, we'll go.

Dr. Angie Krause (24:54)
Yeah. So then I had

to, put them on Baytril which is a big gun antibiotic, but that's what you do for inner ear infections. and then I gave them a little steroid because I had to worry about, well, if I give them nonsteroidal anti-inflammatories, which is like carprofen, like Rimadyl if we needed something, like if this turns out to be something weird and we need steroids, then I've ruined it for us. So I did something that I normally don't do and prescribe steroids and ⁓

JoJo (25:16)
Ugh.

Dr. Angie Krause (25:20)
Big gun antibiotics. I'm just like, I hope this dog feels better stat.

JoJo (25:21)
Yeah.

⁓

yeah. The good news is if it works, it probably will feel better pretty quickly.

Dr. Angie Krause (25:29)
Yes,

pretty quickly. Have you ever had an ear infection? You just had one.

JoJo (25:34)
I just had one. Yeah. It hurt.

Dr. Angie Krause (25:37)
Did it hurt? Did it radiate along your jaw?

JoJo (25:39)
Well, I had a sinus infection on top of it, so that does hurt. Yeah, but my ear would just hurt just constant. But you do wanna put your finger in it to close it off. Kinda makes it, yeah.

Dr. Angie Krause (25:42)
You're like everything hurt.

You do.

Did your eardrum burst? Yeah.

JoJo (25:55)
No. ⁓ But Bodhi

had that when we first adopted him. Like it was just so bad in his ear. I was like no wonder he was biting people. Maybe he biting people because he was in pain.

Dr. Angie Krause (26:03)
an inner ear infection.

Yeah, yeah, it's gotta be pretty painful.

JoJo (26:11)
Well,

they're lucky to have you.

Dr. Angie Krause (26:13)
Yeah, I just want to keep him out of the ER for all the reasons I can't protect. I know totally.

JoJo (26:17)
Yeah, sounds like you have a lot of conversations to have.

Dr. Angie Krause (26:25)
So that was my week in practice. Those were my practice gems had a great week of practice. And if you would like me to help you with your pet, you can go to boulderholisticvet.com and you can hit book a consultation with me. And if there are no times open on the calendar, you can reach out to Jojo and she'll make something happen for you.

And when you grab some time on my calendar, we'll grab records from your veterinarian if you want. I'll read them over. We'll meet on Zoom. It's all recorded and I will help you make an integrative healthcare plan for your dog or cat.

JoJo (27:05)
I think this episode was a good plug for that because it's clear you're advocating for the pets and the people. so video consultations, that happens too. Just want you to know that if you've not received gold standard care or you don't feel like the care that you've been offered is correct or aligned, Dr. Angie does a really good job of piecing that apart without throwing your veterinarian under the bus by helping you.

Dr. Angie Krause (27:11)
Yes.

Yes.

JoJo (27:32)
helping

you find a way to a path that feels aligned for you and your pet.

Dr. Angie Krause (27:35)
Absolutely. And the other thing you can do is leave us a comment. Tell me what you think of this episode and leave us a five star review on whatever platform you're listening.

JoJo (27:48)
Yes, I like this episode. think it could be like a quarterly what's happening in practice.

Dr. Angie Krause (27:53)
Yeah, I love talking about it because every week is very full, this was especially good one and we'll see you next time. Bye.

JoJo (28:02)
Take care.