Category Archives: Animal Health

Blog posts primarily addressing animal health issues.

R.I.P. Kwayze and Sloan, My Sweet Angel Beardies


It’s been too difficult to post this year after Kwayze’s passing in June, which I didn’t even update on here.  The last I have shared is that Kwayze was about to have surgery.

Kwayze made it through surgery and then died during the recovery phase.  The surgery was complicated and really, she probably should have been euthanized during it.  Basically, the mass in her stomach was an egg sac/cyst that formed on an ovary.  However, there was already broken yoke in her abdomen and an infection that had abscessed and shot out tentacles of blood vessels everywhere.

I am sad to say that Kwayze passed during the night of June 22, 2013 while on IV fluids.  She was my baby girl and losing her pretty much killed my soul.

In a turn of events, Sloan, our other bearded dragon who was slightly younger than her and from a different breeder, appeared to be going into brumation as he did every year.  He had a fecal performed in the summer and was treated for parasites.  Everything should have gone better after that.

However, during the last week of October, Sloan appeared to be straining to poop.  He was still eating, however, and I assumed that he was impacted.  I ensured his temperatures were correct and kept soaking him and giving him water.  I also gave him organic pumpkin which usually works for this.

On November 2nd, Sloan was running around the house and looked up and at ‘em.  Everything seemed fine.

The next day, Sloan looked very lethargic and there was blood in his stool.  We brought him to the vet immediately and treatment of this mystery illness commenced.

By the next morning, it was unclear whether or not Sloan would improve.  I had to go to work but my husband was able to work from home.  Sloan had regurgitated his carnivore care that my husband gave him, and his antibiotics.  I had to work late that night until about 8/9 o’clock at night.  Chris kept trying to get me to come home, but didn’t say why.

When I got home, what I saw was heartbreaking.  Sloan’s beard was solid black and appeared to have fluid filling it.  I knew it was over.  I held him as long as I could that night and took him to the vet the next morning as soon as they were open.  I had to say “goodbye” on November 5th, 2013.  The poor baby was gasping and could barely breathe.  He was still pooping out pieces of his intestine and blood.

Sloan sits in a memorial box (cremated) on my mantle now.  I wish I had done this with Kwayze, as well, but I was too messed up to think straight at that time.  I miss them both dearly and it hurts me every day.

It makes me question whether I know anything about reptiles.  With as much research as I do, as much time as I’ve spent on forums and talking to people in the industry, with as much money as I’ve spent on their vet care, everything was ultimately out of my control.  They both died at about 5 years old.

Kwayze and Sloan were like children to me.  I never pictured them not being around.  I don’t have my own “human” children right now for various reasons, and I am an animal lover to the core.  They were my family members and at many times my best friends.  Though they couldn’t talk to me, the look in their eyes told me everything.  I could feel the bond between us and I know they could too.

The worst part about having animals is coping with their death.  Many people don’t understand the connection and think that you can just move on and buy another.  No – animals have their own personalities and special place in one’s heart; they are not inanimate, throw-away things.  I risked losing my job by taking the day off to bring Sloan in and relieve his suffering.  I took off during a time that wasn’t optional.  Thankfully I still have my job but this is how important my animals are to me.  I love them to death and would do anything I could to make their live’s better.

It feels as if I have lost a son and a daughter this year.  Truly, 2013 has been one of the worst years of my life, not only for what happened to my babies, but also for many other reasons.  I hit a lowest of low point and that’s all I care to say about that.  At the same time, I have many friends who have lost their animals this year as well.  This year has not been good for pets.  I am not sure what is going on  with the cosmic order of things, but I can only hope that better times lie ahead for all of us.

Despite all that has happened, during the loss of Sloan, I found spirituality and faith.  I hope it sticks and allows me to be happier and more able to cope with the good and the bad in life.  At the same time, I live with the fear that my remaining pets are more vulnerable than I ever thought and that they too may not live to see next Christmas.  I try to cast these thoughts aside, however, and just continue to hope for the best.

This is how I want to remember them, enjoying the sunny days:

Sloan, the bearded dragon, enjoying some sun by the kiddie pool

Sloan hanging out outside with his daddy

Kwayze, bearded dragon, hanging out getting some rays

Kwayze, bearded dragon, chilling out

 

 

 

Bearded Dragon, Kwayze, Needs Surgery for Mass on One Side of Body


Well, I have bad news; my bearded dragon is not well.  It seems that she has a large mass on one side of her body that could be a tumor, an egg sac, or a variety of things.  The xrays are not clearly indicative of what it is.  As a result, she needs exploratory surgery tomorrow, June 21, 2013, which could also be a fatal event.

Here’s the xray:

Kwayze Bearded Dragon Xray - Mass on One Side

Kwayze, our bearded dragon, appears to have a mass on the right side of her body. This mass could be an egg sac or tumor.

So, here’s some background on the situation. We’ve had Beardie (aka Kwayze) for 5 years since she was a baby. She has had the best care possible in terms of husbandry and food. We’ve had our ups and downs with her. Often times, she will refuse to eat a proper percentage of vegetables and will hold out for worms or crickets, for example.

Every year Kwayze lays infertile eggs like most female bearded dragons. Her patterns are as follows: Around the May/June timeframe she eats a lot and then starts getting bigger. It becomes more obvious that she is gravid. After a bit she runs around frantically searching for a place to lay. We provide a laybox, but not being “mother of the year,” she refuses to lay in it and spreads them all over her cage instead. Right before she lays, she stops eating.

This year, she did not show that level of activity. However, her right side kept getting larger and larger and lumpy. I thought that perhaps she was eggbound and took her to a vet. This vet, we will call him “Dr. B” is not her usual vet as “Dr. S” is. Dr.B has a larger facility that is a 24/7 emergency animal hospital. Thinking she was eggbound and that she might need surgery and to stay overnight, I took her to Dr. B.

Yesterday at the vet, Dr. B initially stated that it seemed like eggs and conservatively she could just go home and we could wait it out to give her some additional time. However, another option is to take an xray and go from there. I decided to go with the xray since I knew she was not acting normal and since she was not eating.

The xray results came back as above, with a large mass on one side. Dr. B said that we could do an exploratory surgery with her on Tuesday. The surgeon is experienced with reptiles but is limited on availability. Additionally, Dr. B wanted to take a bloodtest to ensure that she is healthy enough for surgery and was not going through kidney failure.

This morning, Kwayze looked very pale and uncomfortable. She was laying around in unusual ways and I panicked and thought she was dying. To test this, I offered her one of her favorite foods, superworms. She would not chase them but would let me handfeed a couple. After eating a few more, she started gagging like she had a sour stomach and refused any more. Then she looked even weaker.

I decided to call Dr. B up again and ask if we could rush the surgery. I explained that I was worried she would not make it through the night. He noted that we could use a less experienced surgeon but that it would not be as well planned out. Based on his experience with her yesterday, he thought she could make it until Tuesday. However, he recommended that I might want to bring her in for a reassessment today to make sure she is okay. He even said I could take her back to my normal vet, Dr. S. since he is available to do the surgery tomorrow.

That’s what I did. I took her to Dr. S. this morning who gave me a second opinion and feels that it is likely an enlarged egg sac mass. He said that he performs surgeries on exotics all of the time and has done many on beadies with similar situations. He also showed me some pictures of surgeries that he had done. Overall, I felt comfortable that he could do a good job at it.

I think it’s best to have it done sooner than later. She is clearly uncomfortable.

So, right now Beardie is at Dr. S’s office and he actually called me while I was writing this blog. He stated that she is in good condition and even perked up after the fluids and the heat from the incubator. She will go in for surgery tomorrow and we will continue to hope for the best.

I am worried however, that it is one of those things that we don’t want it to be: a tumor wrapped around her intestines, cancer, etc. For her sake, I really want her to survive to continue to live a happy and healthy life. She deserves it and she is like a child to me. I don’t know where I will be tomorrow if it turns out to be unsuccessful. I don’t want to know that this morning was my last time with her; it just may destroy me.

Truthfully, and not to make this into a rant, I don’t handle death well. Chris is much more spiritual than me. I think nature is cruel and that certain things are not fair. -but as Chris or even my mom would say, “why does anything happen? Why are kids born with cancer? Why does anyone or anything get cancer? Why are people killed in accidents?…” You get the idea. It’s completely random in their minds, whereas I tend to look at it as a personal attack against me. I typically find myself to be very unlucky, especially since I used up all my good luck in one shot by meeting Chris and marrying him.

Anyway, if you read this, please pray for Kwayze for her sake, as ironic as it may sound after reading the past paragraph.

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For an update, please see:

R.I.P. Kwayze and Sloan, My Sweet Angel Beardies

Aside

I just wanted to share this website with anyone who has kids that they want to learn more about reptiles: http://www.aliceandkizzie.com/

Update: Reptile Cage Options, Still Seeking Perfection


In May 2011, I wrote an post on reptile cage options and what I was looking for in cages: Reptile Cage Options Still Waiting for Perfection.  Over a year later, I thought it would be good to revisit that post and to add updates and make changes based on my experiences this year.  I will also add some more images.

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Have you ever sought the perfect enclosure for your reptiles, spending hours poring over available cage options and speaking with the companies/owners, and still felt unsatisfied? I have this feeling multiple times a year. There is no perfect enclosure out there yet to meet my needs for my various reptiles. I will consolidate my needs and research below in an act of goodwill to save you time.

My Needs:

To put things in perspective for new readers, I want to point out that I have 6 lizards and 4 snakes. For lizards I have 2 bearded dragons (pogona vitticeps), a cuban rock iguana (cyclura nubila), an argentine blue tegu (tupinambis merianae), a chuckwalla (sauromulus ater), and a weber’s sailfin (hydrosaurus weberi). As far as snakes go, I have a white-sided rat snake (elaphe obseleta), king rat snake (elaphe carinata), jungle carpet python (morelia spilota cheynei), and a california king snake (lampropeltis getula californiae). See “Meet the Family” for more information on our reptile family.

With these particular animals comes a great variety of caging requirements. We have the drier climate species: king snake, bearded dragons, and chuckwalla. Then, we have the more humid climate species: iguana, tegu, jungle carpet python, king rat snake. The white-sided rat snake is somewhere in between. Within each of those groups are different subgroups: large lizards, small lizards, escape-artist snakes, terrestrial v. arboreal ,etc…you get the idea!

What I Have:

Okay, so I have several different types of caging right now. None of these are perfect. All of these have flaws. I will tell you what they are and what I wish I could change about them (or what I might particularly like about them if there is something). Here we go:

  • Lucky, our Blue Tegu – 7’x3’x3′ BoaMaster cage with stick-on tile that we added
    • Cons: This thing is a behemoth! It must weigh 200 pounds! Once it’s installed, it is extremely awkward to move and therefore becomes a permanent fixture wherever you assembled it. I feel bad for the floors. Looks-wise, it is not the prettiest thing I have seen. I would not want it in my living room or any common area, but that is just my personal preference.
    • Pros: On a positive note, it is reasonably priced and can hold giant terrestrial lizards. It is even stackable if you buy the insert and another cage of the same size. I would not risk my floors trying that though. Also, it is sturdy and seems to hold in Lucky’s humidity requirements quite well.
  • Iggy, our Cuban Rock Iguana – temporary cage that we constructed (poorly, I might add)….this is the guy we are trying to find the perfect cage for. I think we have found something close, however. We met a guy at the White Plains Reptile Expo who showed some cages that he constructed with amazing craftsmanship. I actually wouldn’t mind them in my living room in a chocolate brown stain! He is reasonably priced and can fully customize your cage. His name is Ross Swieehowiez and he owns Beeger Boxes. They are working on getting a website up but it appears to be offline still as of today. (Update: We actually decided to let Iggy have our spare bedroom!  We decided it was the best solution to meet his needs. Today is the first day that he moved in there so we still have to take the curtains down.  His room will be a post for another day.)

    Iggy the Cuban Rock Iguana in His New Room

    Iggy the Cuban Rock Iguana in His New Room

  • Kwayze & Sloan, our Bearded Dragons – 4′ Showcase Cages in Black Granite
    • Cons: The fact that the sliding doors are tempered glass makes me nervous. I could see my iguana ramming them to get at one of the beardies and smashing it. Therefore, I have to watch him when he is running around the house. Additionally, I’m afraid they will just break from use. I do not think Showcase Cages would be appropriate for snakes either as there is a grommet hole in the back that they could feasibly get out of. The cages do not come in sizes large enough to accommodate bigger species of lizards. I think the maximum size that they have is 5′. Finally, the prices are a bit steep. (Update: I am also having issues with the fact that they are not very tall and therefore it doesn’t give the animal inside much climbing room.  Additionally, the fact that the UVB tube cutout and the heat source cutout is in different spots requires the animal to choose which spot he wants to be in.  An MVB would be very difficult to have with these cages because there is less than 10″ between the grate and the floor.)
    • Pros:Overall, I like these cages for bearded dragons and other species that would need the same requirements. They are a good size for these lizards and come with built in vents for both UVB and UVA. Furthermore, they are stackable, lightweight, and actually look nice.
    • Showcase Cage Bearded Dragon Enclosures

      Showcase Cage Bearded Dragon Enclosures

      Showcase Cage Bearded Dragon Enclosures

  • Chuck, our Chuckwalla: a 4’x 3′ x 2′ BoaMaster
    • Cons: Pretty much the same problems as with the larger BoaMaster mentioned above. It is STILL very heavy. I can’t even lift it with my fiance. I have to have someone else help him.  Also, it is a little dark and dreary with that black background.
    • Pros:It seems to be a good size for a chuckwalla to run around in. We do have it stacked on the other cage but are using 2x4s to support it on the lip of the other cage. You can usually buy these cages used on Craigslist, FaunaClassifieds, and other sources for dirt cheap.
      Chuck the Chuckwalla in His BoaMaster

      Chuck the Chuckwalla in His BoaMaster
      Chuck the Chuckwalla in His BoaMaster
      Chuck the Chuckwalla in His BoaMaster
      Chuck the Chuckwalla in His BoaMaster

  • King Rat Snake: 20L gallon Zilla Critter Cage with Premium Lid (escape-proof top)
    • Pros & Cons: This cage actually doesn’t have anything wrong with it for a baby terrestrial snake. I actually really like this cage. The problem is, the largest size they have is a 40 gallon breeder that might be too small for adult snakes, depending on the species. The reason why I like this cage so much is that it solves the escaping problem. The top is an ingenious design that locks in and provides no holes, not even tiny ones, to get out of. It’s also great for sticking a heat pad underneath and sitting a heat light on top. Again, really really like this for baby snakes like mine. These are a bit more expensive than the standard tanks with basic terrarium lids. The prices are fairly reasonable as well.  (Update: Now that Selma is bigger, she is in an Exo Terra Natural Terrarium with the rock background 40 breeder.  This is not her permanent cage so I will need to get something that can hold a gigantic snake in the future.  Here are the pros and cons of the Exo-Terra Natural Terrarium that I can see so far:
      • Pros: You can access the animal from both the front and top.  It is taller than a typical 40 breeder as well (or so it seems to be).  It comes with the rock background which is kinda nice but made out of styrofoam.  Also, it has curved edges on the bottom to provide for some natural airflow for undertake heaters.
      • Cons:The top is made of flimsy plastic and mesh wire.  If you put any pressure on the top, it will bend and break.  Since the doors push into the top, the entire cage is shot by any deformity in the top.  We actually bought two of these and had to return one because the top was bent when we removed the packaging.  Another issue is that the rock background is not affixed and has some openings to run wires behind it.  A snake could easily go through the holes and go behind the background.  We actually had to turn it upside down and put paper towels into the holes.  We also used these square sticky mounting squares.)

        Selma the King Rat Snake's Exo Terra Natural Terrarium

        Selma the King Rat Snake’s Exo Terra Natural Terrarium

  • White-Sided Rat Snake & Weaver, the King Snake: Tank with Basic Terrarium Lid
    • Cons: *Sigh*. These cages are a pain in the ass. They would be good, if they had the upgraded lid like the cage mentioned above. Weaver has gotten out of his cage on 3 separate occasions and I have been lucky enough to find him. The rat snake has gotten out once and met one of our cats who identified his location for us. This is after I go through the extremes of buying the cage clamps to hold down the lid and then taping the rim and any possible escape route. Not only is this not fool-proof, it also makes getting in and out of the cage a real chore. Needless to say, both of these guys will be upgraded to more secured enclosures at some point in the near future.
    • Pros: Fairly lightweight, good for heat pads and heat lamps.

    (Update: Buttons, the white-sided rat snake is now in a 40 breeder Zilla Critter Cage with the Premium Lid.  This was bought in place of the Exo Terra noted in the king rat snake section above.  It has all the same advantages as the 20L mentioned in that section as well.)

    Buttons' Zilla Critter Keeper with Premium Lid

    Buttons’ Zilla Critter Cage with Premium Lid

  • Surya, Weber’s Sailfin: Zoo Med Reptibreeze Iguanarium36″Lx48″H (Note: This whole section is new as we bought Surya in September 2011, after the original post date)
    • Cons: Despite the fact that the Reptibreeze is marketed as an “iguanarium,” no iguana or other animal that needs high humidity should be in this enclosure without significantly altering it.  It is an open air enclosure; how are you supposed to keep the humidity up?  What Chris and I did was a tedious task but it was worth it because now the enclosure is perfect for Surya until she gets to full adult size:
      1. We bought heavy duty plastic report covers from Staples, mini black zip ties, and a hole puncher.  We hole punched the corners of about 30 report covers and zip tied them to the mesh caging.  This helps to keep in the humidity.
      2. We set up an ultrasonic cold air humidifier and pipe it into her cage.  (Don’t forget that cold air humidifiers have been known to cause Legionnaire’s Disease and therefore should be used with bacteriostat.)
      3. We don’t have the report covers on the top of her cage so we can still just place her lighting components directly on top.
      4. We painted and sealed a sturdy poster board and affixed it to the outside on the back to provide a background.
    • Pros: I guess it is what you make it out to be.

      Surya the Sailfin's Enclosure

      Surya the Sailfin's EnclosureSurya the Sailfin's EnclosureSurya the Sailfin’s Enclosure

  • Bella, Jungle Carpet Python: New Reptile Cages enclosure 3’x3’x5′
    • Cons: Okay, so these guys made my cage custom. There are a few cons that have come up. First, there’s the obvious construction lag time as these are not pre-made cages. Second, the cage windows were taped over with a sticky clear tape so as to prevent breaking during shipping. However, I have not been able to get this tape off fully ever since I received it. Third, it was shipped to me with the wrong door locks the first time. Innocent mistake, I’m sure. Fourth, the wood inside is unfinished. When we spoke to the builders, they said that they believe this is in the best interest of the animal as it would not have to inhale the fumes. However, I have begun to notice over time that it is very difficult to keep anything wet from absorbing into the wood and possibly creating a bacterial nightmare. This includes urate, poop, and water that occasionally gets spilled from the water bowl and this is despite the substrate.
    • Pros: These cages actually look really good and they can stain it any color that you ask. I actually have mine in the dining room stained in a nice chocolate brown color. (Yes, chocolate brown mentioned again…I have an earthy feel in my design scheme!) The cage comes on casters and is not ridiculously heavy. Also, the prices were fair.   I have to take more pics but you can see part of the inside of the cage in this pic:

      Bella the Jungle Carpet Python Inside Her Enclosure

      Bella the Jungle Carpet Python Inside Her Enclosure

My Research on What is On the Market for Caging Options

While trying to find the perfect cage to upgrade my iguana to, I researched many cage options, including those already mentioned above (BoaMaster, New Reptile Cages, Showcase, etc). Cuban rock iguanas grow to be extremely large and unlike green iguanas, they are terrestrial lizards. Yet, they seem to like to do some climbing, so the cage has to be tall enough to allow him to sit on a rock or whatnot. Without further ado, here’s what I came across:

  • I have to admit that I almost pulled the trigger on a terrestrial version of the aluminum cage that Repti Racks sells. It would have been a completely custom size. I had trouble swallowing the price quoted to me in relation to the fact that I haven’t seen proof of a terrestrial version of this cage and had not read the experiences of others using it yet. I would be happy to hear if any readers have this cage.
  • As for the acrylic cages, I just wasn’t interested in them. They look the same as all of the other plastic cages on the market. Read the comments below.
  • They appear to sell melamine cages. However, their website is very difficult to navigate and was an immediate turnoff. Sorry, I’m picky. Hopefully you will have more endurance to get through it.
  • Melamine cages are generally heavy in my experience.
  • *Update as of 1/31/12 Was chatting with Chris Allen, the original bearded dragon breeder and reptile enthusiast who created the ubiquitous vibrant red morp of bearded dragon that everyone sought after before the morph actually bore his namesake. Chris Allen was so impressed with the different line of cages that Critter Condos / Critter Condos designs that he is distributing them at all the various shows. Check out Chris Allen’s facebook page for contact information as to how to order one. Chris said that he will have a website up soon but until then… https://www.facebook.com/ChrisAllenReds So the story is that the Company produces 3 high quality caging systems to appeal to all budget ranges and needs. However the Company prefers to deal wholesale. I guess this is where an expert hobbyist like Chris Allen can probably come in handy to answer any of your needs before ordering. If we had known that one series of the Critter Condos had a wood exterior but a humidity resistant laminate sheet on the inside of the cage, they may have been a front runner for our Jungle Carpet Python caging option!
  • Cages seem nice and are made of melamine. As I mentioned above, melamine is heavy and I just don’t prefer it.
  • Comes in a variety of sizes from small to absolutely huge. I’d like to hear from anyone who has one of these.
  • Color choices are limited. It is likely they could not go in my living room which is where the iguana needs to go.
  • Most of their cages are good looking and they have the convenience of an eBay store.
  • The cages didn’t appear big enough. The largest size I could find on their eBay store was 60″x18″x18″. I imagine they’d be able to customize the size further.
  • These cages seem nice and are very customizable. However, I honestly think they are downright overpriced for the materials that they use. That is just my opinion. Any extras are an extra cost….it adds up fast!
  • JWorld‘s (price = better have a serious bank roll)
  • These cages are gorgeous! What can I say, a girl can dream, right?
  • I actually know of someone who uses these for his snake collection and he is very happy with them.
  • One thing I like about these cages as opposed to other plastic cages is that it is made of HDPE Marine grade plastic that is FDA approved. Honestly, with the other plastic cages, I question how safe they are and that alone rules them out for me. Do they bow? Do they let off toxic fumes? etc…
  • Not a fan of the color options and therefore it couldn’t go in my livingroom!They have a stackable option – I like that.
  • Their sizes listed online aren’t quite what I am looking for for a large lizard but if I recall correctly, the owner may have told me that they are customizable. Sorry, I tried looking for the email and couldn’t find it to verify that fact.
  • See #2 under Constrictors NW.
  • See #2 under Constrictors NW.
  • These cages are very unique looking. They have 3′ stackable cages and also 12-48″ cage/rack systems. I know people that have the older version of NPI cages and they swear by them. Back in the day they used to make a 6′ version of the cages. Now, they are limited to 4′ maximum that is just not in-line with my needs.
  • Furthermore, you really need to buy the rack which is sold separately because the cages are a bit slanted and have a lip on the bottom.
  • Based on reviews by others, these cages are known for turning an orange hue when exposed to the reptile lights.
  • Additionally, I question whether a snake or tiny lizard can get out of the front. I also would like to know how you set up the heating in such an odd shaped cage. If you have experience with these cages, please comment below!
  • Sentec Reptile Cages ($685 and up)
  • I’m really interested in these cages but not for Iggy. The color choices aren’t really in-line with my living room, yet again!
  • These cages have some interesting features that seem promising. First, the 6′ and 8′ versions have removable dividers in the middle. That may save you money if you have two smaller snakes or lizards. Second, they have a slam latch with keylock that seems really interesting. It’s hard to explain so check out the website.
  • Furthermore, the cages just look professional. Take a look at the website for yourself. I really have nothing against these cages other than the color.
  • *Sigh* – I’ve spent so much time trying to figure out how to make a Vision cage work into my household. I like how they are lightweight and stackable. Additionally, the come in multiple sizes.
  • I am of the opinion after conducting my research that these cages have problems. I’ve heard stories of them melting and bowing. The maximum lighting that you can use is 75 watts. Additionally, you have to pay for the light cutouts as an accessory! The UVB tube light strip is positioned in a spot where if the animal is basking under the heat they would not be receiving UVB. -and, you can’t use your MVB to solve that problem because it’ll melt right through that.
  • Furthermore, I am not a fan of how short these cages are. They hardly give the animal room to stand up.
  • Lastly, I’ve heard stories of snakes getting out of the front sliding doors. The lip by the front would need to be filled with foam. All of this additional hassle just seems like too much work for what you are paying!
  • As for the Monster Reptile Cage, I think overall it is a very interesting prospect if you have a arboreal iguana. It is gigantic. However, it is open air and imagine it would be a challenge keeping the humidity on target.
  • The Colossal Corner Cage is very tall but not wide at all. Another good one for a arboreal iguana.

*Please note, these are only my opinions of caging options that I have researched for my animals and their various needs. I mean no harm to the owners of the stores represented above. Their cage options are viable for certain species that I do not have.

So, there you have it. This is what my research came down to. There is no perfect cage out there! Will someone just design one and make it reasonably priced, please, oh please!

Please feel free to post your comments and experiences with these cages or other brands. I would love to get your feedback.  Also, please check out our Facebook page and follow us on Twitter.

Follow Up – After the Storm: How to Prepare Your Pets for an Emergency Situation


Hello, everyone. If you will recall, I wrote a post on How to Prepare Your Reptiles and Other Pets for an Emergency Situation right before Hurricane Sandy. Now that the storm is over, power is back and life is returning to normal (at least where I live), I wanted to let you know how everything went.

We were without power, internet, and cell phone service for 8 days. As mentioned in the original post, we have a generator that could support up to 4,000 watts of usage. We had the hot hands packages and the boxes for the animals set up. We also had baby blankets in case we needed them to wrap hot hands or provide some cushion for the animals, masking tape to seal their bins, extension cords to run all around the house, a space heater for heat, etc.

It turns out that we were well-prepared for the storm but there were some things that we did not expect. Our lessons learned are as follows:

1) If the authorities say that you might be without power for a long time, say 7-10 days, plan to be without power for 10 days. This is something that we never really thought would happen and therefore, we only had a few small gas cans. As you may have heard, areas hit by Sandy had gas shortages due to power outages and impassibility on the roads. If I had to do it all over again, I’d buy about 5-10 10 gallon gas cans and fill them up before the storm. Chris and I ended up going out every day spending hours looking for gas. We’d get in a long line at a station and they’d run out and we’d have to go to the next place. It was horrible and cold. Eventually Chris found a Napa Auto Parts that still had gas cans for sale. We were able to pick up another gas can but we still had to go out. When the weather is cold and you have pets, plan on running your space heater in a small, enclosed room 24/7. We were going through about 5 gallons per 8-10 hours with a Champion generator.

2) As noted above, we ended up not being able to use much of our house because it was so cold. The animals were confined to the tubs in our small bedroom with the space heater and hot hands. Each day we would try to run cords to individual enclosures to give proper UVB. However, our animals were more stressed out than we expected and some of them stopped eating, despite having their heat bulbs. The rest of the house was so cold that it was reducing the ambient temperatures in their enclosures regardless. There is nothing that I can really suggest here other than if you think you will be without power for more than a week, bring your pets with you to a place that will not be affected.

3) The hot hands worked really well but here are a few issues that came up. One, they are too hot to the touch so they had to be wrapped with a baby blanket. Some bins needed 2+ hot hands and some needed one. You had to be really careful not to burn your animal, overheat them, or to cause them to freeze. Chris and I found ourselves continuously checking their bins at all hours to ensure that they were not at risk of dying. We had our temp gun out at all times. Another thing that came up is that they caused condensation on the inside of the bins. We had to keep wiping up the humidity for animals that need drier conditions. Additionally, they only lasted 10 hours at most and therefore we ended up going through 2.5 boxes in an 8 day period. Here’s the thing: we only had one box! We never thought we’d even have to open them! Fortunately the store we bought them from opened up after a couple days and we were able to buy two more 80 pack boxes. That was a life-saver.

Here is a pic from the first night without power when we were downstairs waiting for the storm to be over because we thought a tree might land on our house. These aren’t all the bins. Sorry for the image quality and the mess haha.

Animals in Bins During the Storm- Part of Our Emergency Plan

Animals in Bins During the Storm- Part of Our Emergency Plan

4) We did not have to tap into the canned foods but I still suggest having them available. We were able to keep a supply of fresh greens with limited stores that opened up.

5) We should have stocked up on firewood before the storm. It gets really suffocating staying in the same room all the time. We used the fireplace a few times with the little bit of wood we had but it was limited. We still could only stay close to the fireplace and couldn’t move around the house much because it was freezing.

6) As noted above, we had to go to gas stations several times. Many gas stations could not take debit cards and some could not take credit cards. As a result, cash was required. We spent about $300 on gas over the 8 days. Plan to have some solid cash on hand to survive.

7) The firewood and space heaters cause the air to dry out. However, the hot hands cause condensation to build up in the bins. This constant going back and forth almost got Surya the sailfin dragon sick. She started getting this wheezing sound, almost like she was coming down with a respiratory infection. Thankfully we were able to provide her humidifier with the generator and could give her a hot steam bath because we had hot water. Many people I know didn’t even have hot water. This is just something to consider…if your animals are without their ideal conditions for too long, they are going to go down hill. The good news is that after a few days she was back to normal.

8) While the batteries and candles proved to be absolutely necessary, a battery powered satellite radio would have been nice. Listening to the news is absolutely necessary because you need to know what is going on around you and what is going to happen. A few times we used the generator to connect to an electric powered radio and that is how we found out how bad things are and what the gas situation was, etc.

Okay, on to what I learned about other people’s situations. Many people’s houses flooded out and the storm surge became very real. Further, massive fires were spawned by burning embers that were forced into other people’s houses by the hurricane winds. People died that could have evacuated.

If you are in an evacuation zone and you have pets, you really should go. Go to a family member or friend’s house out of harm’s way if possible because some shelters don’t take pets. Further, it’s going to be really difficult to grab all your lizards and get rescued in a flood. If you live on the shore, unfortunately, really consider that you are going to lose everything. I mean, this is the same thing if it is some other type of pending disaster, like a wild fire. If you can’t leave your home, at least try to get someone to foster your animals for a week or two and then make arrangements after things start to become more clear after the storm. I really hate to think of all the animals that were displaced or killed in the storm because they were left behind. I don’t want to think about that.

I think it’s important if you aren’t in the line of danger but have friends and family who are, to consider that you should support these people and consider taking in their pets for a couple weeks before the disaster strikes. You could be a life saver.

…and to lighten the mood, now that the storm is over and the power and heat is back on at my house, the kids are very happy. Iggy is happy to have his couch seat back too:

Iggy the Cuban Rock Iguana Sleeping on the Couch

We finally have power again, 9 days after Hurricane Sandy, and enduring 30 degree temps


Just wanted to include a quick  blog to let you know that all of our animals are safe and sound post Hurricane Sandy!  I just removed all of the extension cords that we used to wire up a little 4000 watt portable generator. While Ash and myself froze in our heatless house with no power and my nasal passages swelled because of the cold dry air to the point where I couldn’t breath, we shuttled all of our cold blooded reptiles into a room using small clear containers with holes punched into them. We then placed the boxes in a circle with an electric space heater. Between the space heater and constantly changing the chemical hand warmers in their boxes, we were able to give the reptiles adequate heat to keep them alive through this event. We hope to share more info in the weeks to come. Just wanted to let everyone know that all the animals are safe!

Refer to How to Prepare Your Reptiles & Other Pets for Emergency Weather for more information on how we prepared for the storm.

How to Prepare Your Reptiles & Other Pets for Emergency Weather


I am sure many of you, especially East Coasters, have heard the news about Hurricane Sandy coming and for those of you who have cats, dogs, and exotic pets, I am sure you are concerned.  As such, I thought I’d share with you our emergency plan.

Okay, okay…I know I said that my next posts would be on our Costa Rica trip or on rattlesnakes or this or that.  And that was in May 2012.  We are already in October.  What happened this year is that I have been REALLY busy with work as I am still climbing up the ladder, and I have been spending my limited free time doing things for my animals and hanging out at the Reptile-Parrots Forum where I am a moderator.
Anyway, we live a bit inland and have never been forced to evacuate.  This wouldn’t really fully apply to those who have to evacuate.  I  will share with you what I would do if I were in your situation at the end of the post.  Again, I cannot speak from experience on this.

Last year’s Hurricane Irene was the first kick in the butt for us to make us realize that hurricane gail force wind is scary, can cause power outages and tornadoes, and can cause loss of life and property.  We didn’t have a generator in that storm and got lucky that we weren’t one of the ones to be affected with a power outage.  Many of those in surrounding towns and areas were flooded and without power for days.  Some of our neighbors (on the same street!!) had trees fall on their houses.  Local roads were impassible for over a day as trees were just scattered across the roads.

Here are the steps we have taken to be prepared for future storms, including Hurricane Sandy:

  1. The first step is to make sure that you and your animal kids do not get flooded out.  Therefore, we ensured that our electric powered sump pump is operating effectively.  The sump pump that came with our house when we first bought it was old and ended up breaking down during a storm prior to Hurricane Irene.  Our basement flooded by a foot!  The backflow valve on the sump pump did not operate correctly and caused a nightmare.  During that storm, we got to Home Depot in the knick of time, and was able to set up a new sump pump and get the water back out.  However, this it is not ideal to wait for that situation because they will sell out of sump pumps, generators, and other supplies very early.  Yesterday we saw lines by the generators where people were waiting in the hopes that another generator supply would arrive.
  2. To support an electric powered generator, we needed to make sure we had a contingency plan if the electric were to go out.  As such, we finally bought a Champion generator a few months ago from BJ’s for about $300.  We also made sure we have enough gas and oil to run a generator for an extended period of time, and that we have enough heavy duty outdoor safe cables to run to the sump pump and potentially to reptile lights.
  3. We also made sure we have enough flashlights and batteries as well as candles if need be.
  4. We keep a supply of reptile-shipping heat packs and/or hot hand warmers and soft blankets to wrap around them (so as not to burn the animals), in case the above plans do not provide enough heat and warmth for the animals.

    Hand Warmers for Keeping Reptiles Warm

    Hand Warmers for Keeping Reptiles Warm ($20 at BJs)

  5. Because we have many snakes and lizards, we bought multiple sized Tupperware containers that seal tight, based on the size of each lizard and snake.  Further, in advance of the last storm, we drilled holes to provide air to the tops and sides of the containers.  Finally, we keep a supply of duct tape to seal the tops.  The snakes WILL get out if it is not sealed; trust me!  Of course, we have cat carriers on hand for the cats as well.
    Safety Bins with Air Holes

    Safety Bins with Air Holes

    Safety Bins with Air Holes

    Safety Bins with Air Holes

  6. In advance of the storm, we stock up on food for ourselves and our animals.  We bought additional water for ourselves and ice in case we need to use it to extend the life our perishables.  As a last resort, we bought canned collard greens, mustard greens, and turnip greens (canned in water) for the vegetable eating lizards.  Of course, we have dry and wet cat food, oxbow chinchilla pellets, live feeders, etc.

    Greens Canned in Water

    Greens Canned in Water (no brand endorsement intended)

  7. During the storm, when the weather starts going awry, we put the animals in the tubs with a soft blanket and bring them to our lower level to the most interior and safest portion of the house.  It’s better safe than sorry because you never know if a tree is going to fall or if a tornado will come into fruition.  We use our judgment in determining whether we need to add the wrapped heat pack to each container.

Fortunately, nothing has ever gone past that point (*knocks on wood*).  However, the generator is our back up for a power outage and the food is as well.  When it is safe to return the animals to their enclosures, we do.
I suppose if you live in an area where you would have to evacuate, you could take some of the same steps.  Get containers ready with heat warmers.  Get canned food and other non-perishables ready to go.  Some shelters will let you bring your pets and you will need this stuff.  If you are not going to a shelter, you can probably go to a family member’s house outside of the emergency area and you will need back up supplies to take care of your pets in those areas as they will likely not have these.  Please don’t leave your animals behind!

Hopefully all this planning will pay off and that our family (including our pet family) will stay safe when Hurricane Sandy arrives.

Argentine Black and White Tegu Diet, Feeding Behavior and Habitat – Study


Summary of The Diet of Argentine Tegu Diets as Presented in “The Diet of Adult Tupinambis Teguixin(Sauria: Teiidae) in the Eastern Chaco of Argentina,” A Study Performed by Claudia Mercolli and Alberto Yanosky  (aka – The Argentine Tegu Diet Care Sheet & Summary of their Natural Habitat and Feeding Behavior)

*NOTE: This study was conducted in 1994.  In 1995, the Tupinambis genus was restructured at the prompting of Avila-Pires.  Pre-1995, the Colombian tegu went by the species name Tupinambis nigropunctatus and the Argentine black and white tegu went by the name Tupinambis teguixin.  However, post-1995, the Colombian and Argentine species names were changed to Tupinambis teguixin and Tupinambis merinae, respectively.

In the Herpetological Journal, Vol 4. , pp 15-19 (1994),Claudia Mercolli and Alberto Yanosky, published the results of their study ofthe digestive tracts of 77 Argentine Tegus near El Bagual Ecological Reserve.  According to the publication:

the food items revealed the species to be a widely-ranging opportunistic omnivorous forager.  Tupinambis consumed a large proportion of fruits, invertebrate, and vertebrates.  The species forages in both terrestrial and aquatic habitats, but no evidence was obtained for arboreal feeding habits.

*Note- I rounded the numbers
General Findings On Diet:

  • Both Diet Mass  and Diet Volume Consisted of Approximately 67%Plant Matter and 33% Animal Matter
  • “Plant material (stems, leaves, and vegetation remains) was the most frequent item recorded (90%), followed by snails (69%),Coleoptera (53%), pindo fruits (33%) and anura (27%).  Weight values revealed that pindo fruit were most important with 27%, followed by palm fruits (12%), anura (11%), and mora(8%). “
  • “For total biomass consumed, vertebrates were more important than invertebrates.”
  • “Large proportions of the diet of Tupinambis teguixin are flying/aboreal invertebrates, but this does not suggest that the lizards feeds in arboreal situations.”
  • “At our site, Tupinambis teguixin is 71% herbivorous and 29% carnivorous”
  • “Principal food items were fruits, snails,coleopterans, lepidopterans, anura, and rodents.”

Plant material (stems, leaves, and vegetation remains) was the most frequent item recorded (90%), followed by snails (69%),Coleoptera [beetles] (53%), pindo fruits [Queen Palm fruits] (33%) and anura (27%).  Weight values revealed that pindo fruit were most important with 27%, followed by palm fruits (12%), anura (11%), and mora(8%).

At our site, Tupinambis teguixin is 71% herbivorous and 29% carnivorous

Behavoral Notes:

  • Not arboreal – fruit is the type that is droppedfrom trees and birds are of the type that are terrestrial and poor fliers
  • Tegus will enter shallow water to eat fish,crabs, and snails.
  • Tegus do not chew their food as full snailshells were found.

Habitat Summary Considered In Conjunction with the Diet Studies:

  • Flooded savannas and forests subject to cyclic fires and flooding
  • Soil is made of volcanic ash and have poor drainage
  • Mean temperature is 22 degrees Celsius with maximum average of 27 degrees Celsius and minimum of 17 degrees Celsius
  • Annual rainfall of 1200-1900 mm

This chart was included within the findings published.  I added and removed columns to make it more customized for the type of information we need.  For example, I added the English column and the additional information column.  I removed some quantitative columns:

Chart Published As Part of the Study

Food items found in the stomachs of Argentine Tegus

Note: This was a joint effort between this blog and the Reptile-Parrots Forum

How to Remove a Stuck Eyecap on a Snake


Recently, my meanest snake, Selma, the king rat snake (elaphe carinata), had a stuck eyecap.  I knew this because one of her eyes were still opaque when the rest of her body had shed.

Stuck eyecaps are serious issues if they are not removed in time.  The snake can end up blind!

As such, I took to removing it.  This one was a bit finicky.  At first I used a damp Q-tip and gently rubbed it over the eye, but it wouldn’t come off.  Then, I tried the tweezer tactic.  I sanitized, cleaned, and dried the tweezers.  Then I gently tried to coax the eyecap off but it was still stuck enough where it would be dangerous if I tried to force it.  Next, I put her in a nice bath with Shed-Ease Reptile Bath and let her soak for about thirty minutes.  When I removed her from the bath, I tried the Q-tip again and it wiggled off enough.  I followed up with the tweezer to pluck it out now that it was loose.

Here is the eyecap (sorry for the cell phone quality!):

Stuck Eyecap Removal from Elaphe Carinata (King Rat Snake)

We used a variety of method to get this one stuck eyecap off, including tweezers, Q-tips, and a soak in Shed-Ease

Stuck Eyecap Removal on Elaphe Carinata (King Rat Snake)

Different angle of the stuck eyecap

There are many ways to remove an eyecap.  Over at the Reptile-Parrots Forum (yes, you should join!) we had a discussion here on how to remove eyecaps.  Here are some of the many methods that we came up with (note: you may have to use a combination of methods):

-Using a damp Q-tip and gently rubbing it off.

-Using a tweezer to gently pull it off (very risky if you are inexperienced).

-Putting the snake in a slightly damp pillow case so that while he moves inside of the pillow case he will rub up against the material (suggestion courtesy of Wildheart at Reptile-Parrots).

-Soaking in warm water with Shed-Ease.  For smaller snakes, I use a critter keeper with a top to keep the snake in the container.  They are very useful.  For larger snake, like my jungle carpet python, I will use a large Rubbermaid 50 gallon or higher with holes in the top for airflow.

If you have more suggestion please contribute them in the comment section below.  I’d love to hear them.  Also, you can join the discussion at Reptile-Parrots here .

Please note that only experienced caretakers should attempt to remove difficult severely stuck eyecaps.  If you are having trouble removing one, seek the assistance of an experienced herp vet.

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How Doctors Die


Ren the Ferret

Ren the Ferret

The following is a reprint from an article a friend of mine recently posted on Facebook. For the sake of simplicity I have left a link to the original post “How Doctors Die” by Ken Murray.  The subject may or may not be controversial to pet owners but I think it is something that must be broached, especially for Ash and myself as we take care of so many pets.

Case in point is Magic, my stray cat whom I saved from imminent death from a shelter over a decade ago when I saw an ad to save her – even though I already knew that she was an older cat and not a “cute as a button kitten” that so many people go for.  In the past few years, the doctors had been treating Magic who came down with hyperthyroidism.  The suggested treatment for Magic was a one time radiation (radio iodine) treatment or oral medications for the rest of Magic’s life. Not being able to afford the $2,000 for radiation treatment we opted to go for the Methimazole (tapazole) pill which was a lifelong treatment in which a pet owner has to administer a tiny pill to their cat twice a day everyday forever.

We did so for almost two years, but I really question if it was the right choice or not. At that point Magic had already lived well beyond the life that she was supposed to and she lived in a grand fashion.  Meaning the first half of Magic’s life from when she entered mine, I happened to be single and she was  my only pet. That said I spoiled her rotten, she ate what I ate and the whole nine yards. And when Ash came into my life none of that changed.

Fast forward ten years and being diagnosed with hyperthyroidism and constantly being treated with medication: her personality changed and she preferred to be alone in some dark corner most of the time, Magic’s heart was still beating at a rapid rate, she was still skinny and overate, she was both lethargic and hyperactive at the same time seemingly, she farted more often, had constant diahrrea and peed excessively. Yet we kept her treatment up to keep her a live longer because she was a beloved pet and the doctors SAID that she could live many more years. However in contrast I think her last few years sucked and she didn’t live very well. She seemed uncomfortable and upset all the time.

This is where I think its most cruel and potentially inhumane to treat a gravely ill animal is it worth it all to extend their life a few years?  I never anticipated owning so many pets after we bought our house, but I also didn’t realize how quickly time flies and that inevitably our animals will get old like us and die as well. For animals like ferrets and cats who have fairly short lives sometimes their natural life can come to an end rather quickly much like one’s teens or twenties or thirties even.

We as caretakers of our animals really need to think hard and long about what our actions will be when its time or near time for our pet to pass. Will we have the courage to think about the animal and not ourselves?

Are we really keeping this animal alive via treatment to improve and extend the animal’s life or are we doing so because we aren’t prepared for the consequence of not having this pet anymore in our life.

IN REALITY DOES THEIR LIFE WITH TREATMENT STILL SUCK? as compared to when they weren’t sick at all? In the latter case are we making our pet needlessly suffer because we can’t let go or think we are doing the right thing?

Its something that I have asked myself often the past two years as I watched Magic waste away. One of our ferrets died this year as well as our Mean Snake. Our other ferret is inevitably going to pass in the next years and I question whether or not he is living a good life right now. His adrenal diseases which you can thank Marshall’s for seems like a crappy disease to have even with treatment.

In either case of our first ferret and the Mean Snake the decision to put them down were clear-cut.  Ren, our ferret was already very old as far as ferrets go and even with proper shots and daily oral meds she went quickly. She became paralyzed from the waist down and could not walk.  Our King Rat (Mean Snake) lost its battle to septicemia and the disease had opened up her skin right to the stomach cavity. The last month of treatments and injections were all for nought, we felt better that we fought so hard to save his life but I don’t know if we should have now that we have 20/20 hindsight.

With these losses this year in 2011, it has forced me to ask myself if the time comes again for another one of our beloved pets to pass what will we do and which of us (Ash and/or myself), if at all, will  champion for the animal that is sick or dying. I ask myself if we will do the right thing and just let the animal pass. For

Ash and myself sometimes I ask if we are cowards? The reason being is that we have provided clear instructions to one another for if we somehow ended up in a vegetative state or some other fatal or unfathomable condition we have instructed one another to not seek further medical attention to keep us alive.  Very similar to what the doctors in this article wanted for themselves. But I ask myself, why we didn’t or couldn’t grant that same amount of humanity and grace to our animals and forced them to fight for their lives. Maybe it’s because we didn’t and can’t know for certain what they desire and I’m afraid I’m not able to read their minds and make a decision without inputting my own feelings into the equation.  I know that looking back in all three cases it would have been better for the animals if we had put them down immediately yet we didn’t.  If I had done that to Ash if she were gravely ill, it would have been against her instructions to me and unconscionable so why is it ok for us to seek treatments for our animals that only prolong the inevitable to extend their lives for an arguably short period time? I don’t have an answer for this yet, but I hope that at least you will think about this subject as well. Euthanasia whether in humans or animals can be a hard subject to talk about but I feel that we need to.

With our animals, we are very much their caretakers, they did not choose a life in captivity and cannot tell us what they desire.  If we say oh look he looks like he has a will to live, I can’t say for certain if we are humanizing and expressing a part of our own feelings and injecting that into the equation for seeking treatment for a gravely ill animal. Each of us must make the hard decisionwhen the time comes to see one of our pets go and it must be dealt with in a mature and humane manner.

http://zocalopublicsquare.org/thepublicsquare/2011/11/30/how-doctors-die/read/nexus/

How Doctors Die

It’s Not Like the Rest of Us, But It Should Be

Years ago, Charlie, a highly respected orthopedist and a mentor of mine, found a lump in his stomach. He had a surgeon explore the area, and the diagnosis was pancreatic cancer. This surgeon was one of the best in the country. He had even invented a new procedure for this exact cancer that could triple a patient’s five-year-survival odds—from 5 percent to 15 percent—albeit with a poor quality of life. Charlie was uninterested. He went home the next day, closed his practice, and never set foot in a hospital again. He focused on spending time with family and feeling as good as possible. Several months later, he died at home. He got no chemotherapy, radiation, or surgical treatment. Medicare didn’t spend much on him.

It’s not a frequent topic of discussion, but doctors die, too. And they don’t die like the rest of us. What’s unusual about them is not how much treatment they get compared to most Americans, but how little. For all the time they spend fending off the deaths of others, they tend to be fairly serene when faced with death themselves. They know exactly what is going to happen, they know the choices, and they generally have access to any sort of medical care they could want. But they go gently.

Of course, doctors don’t want to die; they want to live. But they know enough about modern medicine to know its limits. And they know enough about death to know what all people fear most: dying in pain, and dying alone. They’ve talked about this with their families. They want to be sure, when the time comes, that no heroic measures will happen—that they will never experience, during their last moments on earth, someone breaking their ribs in an attempt to resuscitate them with CPR (that’s what happens if CPR is done right).

Almost all medical professionals have seen what we call “futile care” being performed on people. That’s when doctors bring the cutting edge of technology to bear on a grievously ill person near the end of life. The patient will get cut open, perforated with tubes, hooked up to machines, and assaulted with drugs. All of this occurs in the Intensive Care Unit at a cost of tens of thousands of dollars a day. What it buys is misery we would not inflict on a terrorist. I cannot count the number of times fellow physicians have told me, in words that vary only slightly, “Promise me if you find me like this that you’ll kill me.” They mean it. Some medical personnel wear medallions stamped “NO CODE” to tell physicians not to perform CPR on them. I have even seen it as a tattoo.

To administer medical care that makes people suffer is anguishing. Physicians are trained to gather information without revealing any of their own feelings, but in private, among fellow doctors, they’ll vent. “How can anyone do that to their family members?” they’ll ask. I suspect it’s one reason physicians have higher rates of alcohol abuse and depression than professionals in most other fields. I know it’s one reason I stopped participating in hospital care for the last 10 years of my practice.

How has it come to this—that doctors administer so much care that they wouldn’t want for themselves? The simple, or not-so-simple, answer is this: patients, doctors, and the system.

To see how patients play a role, imagine a scenario in which someone has lost consciousness and been admitted to an emergency room. As is so often the case, no one has made a plan for this situation, and shocked and scared family members find themselves caught up in a maze of choices. They’re overwhelmed. When doctors ask if they want “everything” done, they answer yes. Then the nightmare begins. Sometimes, a family really means “do everything,” but often they just mean “do everything that’s reasonable.” The problem is that they may not know what’s reasonable, nor, in their confusion and sorrow, will they ask about it or hear what a physician may be telling them. For their part, doctors told to do “everything” will do it, whether it is reasonable or not.

The above scenario is a common one. Feeding into the problem are unrealistic expectations of what doctors can accomplish. Many people think of CPR as a reliable lifesaver when, in fact, the results are usually poor. I’ve had hundreds of people brought to me in the emergency room after getting CPR. Exactly one, a healthy man who’d had no heart troubles (for those who want specifics, he had a “tension pneumothorax”), walked out of the hospital. If a patient suffers from severe illness, old age, or a terminal disease, the odds of a good outcome from CPR are infinitesimal, while the odds of suffering are overwhelming. Poor knowledge and misguided expectations lead to a lot of bad decisions.

But of course it’s not just patients making these things happen. Doctors play an enabling role, too. The trouble is that even doctors who hate to administer futile care must find a way to address the wishes of patients and families. Imagine, once again, the emergency room with those grieving, possibly hysterical, family members. They do not know the doctor. Establishing trust and confidence under such circumstances is a very delicate thing. People are prepared to think the doctor is acting out of base motives, trying to save time, or money, or effort, especially if the doctor is advising against further treatment.

Some doctors are stronger communicators than others, and some doctors are more adamant, but the pressures they all face are similar. When I faced circumstances involving end-of-life choices, I adopted the approach of laying out only the options that I thought were reasonable (as I would in any situation) as early in the process as possible. When patients or families brought up unreasonable choices, I would discuss the issue in layman’s terms that portrayed the downsides clearly. If patients or families still insisted on treatments I considered pointless or harmful, I would offer to transfer their care to another doctor or hospital.

Should I have been more forceful at times? I know that some of those transfers still haunt me. One of the patients of whom I was most fond was an attorney from a famous political family. She had severe diabetes and terrible circulation, and, at one point, she developed a painful sore on her foot. Knowing the hazards of hospitals, I did everything I could to keep her from resorting to surgery. Still, she sought out outside experts with whom I had no relationship. Not knowing as much about her as I did, they decided to perform bypass surgery on her chronically clogged blood vessels in both legs. This didn’t restore her circulation, and the surgical wounds wouldn’t heal. Her feet became gangrenous, and she endured bilateral leg amputations. Two weeks later, in the famous medical center in which all this had occurred, she died.

It’s easy to find fault with both doctors and patients in such stories, but in many ways all the parties are simply victims of a larger system that encourages excessive treatment. In some unfortunate cases, doctors use the fee-for-service model to do everything they can, no matter how pointless, to make money. More commonly, though, doctors are fearful of litigation and do whatever they’re asked, with little feedback, to avoid getting in trouble.

Even when the right preparations have been made, the system can still swallow people up. One of my patients was a man named Jack, a 78-year-old who had been ill for years and undergone about 15 major surgical procedures. He explained to me that he never, under any circumstances, wanted to be placed on life support machines again. One Saturday, however, Jack suffered a massive stroke and got admitted to the emergency room unconscious, without his wife. Doctors did everything possible to resuscitate him and put him on life support in the ICU. This was Jack’s worst nightmare. When I arrived at the hospital and took over Jack’s care, I spoke to his wife and to hospital staff, bringing in my office notes with his care preferences. Then I turned off the life support machines and sat with him. He died two hours later.

Even with all his wishes documented, Jack hadn’t died as he’d hoped. The system had intervened. One of the nurses, I later found out, even reported my unplugging of Jack to the authorities as a possible homicide. Nothing came of it, of course; Jack’s wishes had been spelled out explicitly, and he’d left the paperwork to prove it. But the prospect of a police investigation is terrifying for any physician. I could far more easily have left Jack on life support against his stated wishes, prolonging his life, and his suffering, a few more weeks. I would even have made a little more money, and Medicare would have ended up with an additional $500,000 bill. It’s no wonder many doctors err on the side of overtreatment.

But doctors still don’t over-treat themselves. They see the consequences of this constantly. Almost anyone can find a way to die in peace at home, and pain can be managed better than ever. Hospice care, which focuses on providing terminally ill patients with comfort and dignity rather than on futile cures, provides most people with much better final days. Amazingly, studies have found that people placed in hospice care often live longer than people with the same disease who are seeking active cures. I was struck to hear on the radio recently that the famous reporter Tom Wicker had “died peacefully at home, surrounded by his family.” Such stories are, thankfully, increasingly common.

Several years ago, my older cousin Torch (born at home by the light of a flashlight—or torch) had a seizure that turned out to be the result of lung cancer that had gone to his brain. I arranged for him to see various specialists, and we learned that with aggressive treatment of his condition, including three to five hospital visits a week for chemotherapy, he would live perhaps four months. Ultimately, Torch decided against any treatment and simply took pills for brain swelling. He moved in with me.

We spent the next eight months doing a bunch of things that he enjoyed, having fun together like we hadn’t had in decades. We went to Disneyland, his first time. We’d hang out at home. Torch was a sports nut, and he was very happy to watch sports and eat my cooking. He even gained a bit of weight, eating his favorite foods rather than hospital foods. He had no serious pain, and he remained high-spirited. One day, he didn’t wake up. He spent the next three days in a coma-like sleep and then died. The cost of his medical care for those eight months, for the one drug he was taking, was about $20.

Torch was no doctor, but he knew he wanted a life of quality, not just quantity. Don’t most of us? If there is a state of the art of end-of-life care, it is this: death with dignity. As for me, my physician has my choices. They were easy to make, as they are for most physicians. There will be no heroics, and I will go gentle into that good night. Like my mentor Charlie. Like my cousin Torch. Like my fellow doctors.

Ken Murray, MD, is Clinical Assistant Professor of Family Medicine at USC.