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Vet 101 Q + A : Meet Dr. Letrisa Miller

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Dr. Letrisa Miller

Our regular Vet 101 contributor Dr.Letrisa Miller is a current finalist in America’s Favorite Veterinarian. She’s a favorite at Cat Wisdom 101 and we thought our readers might enjoy learning more about her and what’s it’s like to be a vet.

Q & A with Dr. Letrisa Miller DVM

Dr. Letrisa Miller dvm

LMW: You grew up on a farm in where cycles of life and death are accepted. What were your earliest experiences with animals and when and why did you decide to become a veterinarian?
LM: I grew up on a farm in Oregon. We had about 300 hogs, a herd of cows and a few horses as well as cats, dogs, and various birds. I started raising purebred dairy goats in Jr High School and had a herd of around 40 when I graduated from High School.
Most of my earliest memories involve animals. I have always loved my animal companions and sometimes I think I have identified more with my animal friends than with my human ones.
I think I decided that I wanted to be a veterinarian when I was around 10 years old. I always enjoyed caring for the sick animals on the farm and I was the one who was willing to get up in the middle of the night to check on them. My Mom started finding veterinarians who would let me observe when I was in grade school, and I liked what I saw. I did go through a period when I wasn’t sure about becoming a vet. That lead to me going to graduate school in microbiology before finally ending up in vet school.
LMW: In what way did these early experiences prepare you for the reality of veterinary college?
LM: All of the experiences on the farm were important in learning how to be a good vet. Birth, life, sickness, death, all were there to see and learn from. Each animal had its own personality and spirit and each shared some of the same needs while also having some different ones. Learning to understand what, when and how to provide for the needs of the animals around me went a long way toward preparing me for life as a veterinarian, and the discipline that I learned milking goats twice a day and caring for sick animals helped me with my studies.
LMW: What advice would you give a child thinking they might want to be a vet?
LM: Study hard in school and spend a lot of time studying both animal and human behavior. It is important to be involved in leadership group activities. Understand that what you see at a veterinarian’s as a pet owner is only a very small part of what happens at a clinic or hospital. The best way to start understanding what a job in veterinary medicine is like is to volunteer at a clinic or shadow a veterinarian.
One of the not so well kept secrets is that veterinarians don’t make a lot of money, but their education is very expensive, so if money is important, choose a different career.
LMW: What are the biggest changes in veterinary medicine you’ve experienced since beginning your career?
LM: Feline medicine is starting to be much better understood as cats become more popular pets. While the amount of research done in feline medicine is still far less than in canine medicine, more and more is being done. The most recent advances are related to using DNA. Some researchers are using DNA information to discover if there are markers for diseases and if DNA can be used to effect cures for diseases.
LMW: There are more women entering the field since you were a student. What kind of gender gap did you experience in veterinary college? Did you experience gender discrimination?
LM: My class in vet school had slightly more women than men. Now there have even been a few classes that have been 100% women.
There were some places, such as in large animal medicine where there was still a gender bias. I felt it a small amount in school, but was a bit overwhelmed by it out in practice. When I practiced mixed animal medicine I definitely found some clients that really didn’t like the thought of a female veterinarian working their cattle. I think that the situation there is changing, but slowly.
LMW: Have you noticed differences working in the Midwest vs. the East Coast (where you now practice) in terms of types of issues seen?
LM: There are always regional differences in infectious disease. In Oklahoma, I commonly saw a fungal disease called histoplasmosis that really doesn’t occur here as well as different tick borne diseases. Oklahoma didn’t have lyme disease (which I’m very glad that cats don’t get!), but did have cytauxzoonosis which was pretty awful. For some unknown reason, I have also seen more idiopathic hypercalcemia on the East Coast. So far, none of the experts in feline medicine can say why that might be, but I am trying to talk some people into studying the regional incidence of the disease so that we may start to understand it better and may be able to figure out the cause.
The most common diseases remain the same, however – inflammatory bowel disease, stress related lower urinary tract disease, and dental diseases – are all common in both regions.
LMW: When and why did you decide to focus on a feline-centered practice?
LM: Feline medicine sort of crept up on me. I always thought I wanted to practice like James Herriot and see whatever came my way, but in my second year of veterinary school I think I started to get hooked on feline medicine. That summer my queen had a litter of kittens and one of them had a major heart defect. When I started researching the disease, I started to realize that feline medicine was much more challenging than the medicine of other companion animals. So little was known and so few treatments were available. After that I decided on somewhat of a lark to do a preceptor rotation in a feline practice to see what it was like since I had never even seen one, much less been in one! I really enjoyed the time I spent there and felt very much at home.
After graduation, I started working in mixed animal practice and found that there was no way that I could practice the high quality medicine that I wanted to and know everything I wanted to know if I tried to keep up with all species. Cats were a natural choice for me because the medicine is always challenging and by focusing on a single species, I can stay up with all the new information in the field. Because I really want to be the best I can be at what I do, I decided to focus on cats after a couple of years of practice.
LMW: Statistically, cats receive less frequent vet visits than dogs. Why is that and what are your recommendations to improve vet wellness visit stats for cats?

LM: People who have a cat are very aware of what their cat likes and doesn’t like. Cats are very good at training us to provide what they want. Unfortunately, only the sickest cats are happy to go to the vet, and they let their humans know in no uncertain terms that going to the vet is not on their agenda. Cats are very territorial and really don’t like to go to places outside their own territory. If they don’t go out often for a ride, the car is very scary and overwhelming and the smells of other animals can send a cat into a panic. (Who is going to eat me in this unknown world??)

As a cat owner myself, I understand how hard it is to convince myself that I need to take one of my “kids” to the clinic. It is very difficult to face the accusation of your cat when you put them in a carrier and drive off to the vet, so many of us simply avoid the unpleasantness altogether and don’t take them.

Cats are also masters at appearing to be well even when they are very sick. Because of this, many people don’t perceive veterinary care as necessary or needed for cats. People may have the false belief that because cats are kept indoors, they don’t need veterinary care. While these cats may have a lower risk from injury and infectious diseases, they do still get sick (take for example dental disease) and do need care.

The best way to improve the stats for cats is to make vet visits as pleasant as possible. The more often the cat goes to the vet, the less stressful it is because they become desensitized and if a cat goes to a veterinary clinic or hospital that caters to cats, they usually have a less stressful visit.
The major reason that feline only clinics exist is to decrease the stress of vet visits for their patients. Less noise, fewer scary smells and people who understand cats make for much more pleasant visits.
Another thing that is needed to improve the stats is education of cat owners, particularly in the area of knowing what to look for to perceive illness in their cat. Education of cat keepers is vital to the health of cats! If people don’t know about the health of cats, they can’t recognize when there is a problem or what to do if there is.
LMW: What are your favorite and least favorite things about being a vet?
LM: As can be expected, seeing kittens is one of the best parts of my job, and conversely seeing death is one of the worst. It is wonderful to see a cat that was critically ill come back as a healthy patient as well.
The hardest thing for me, however, is knowing that a cat can be treated and being unable to treat them due to financial constraints or unwillingness of people to address the situation. It is heart breaking to see a cat suffering and not be able to help it. At my clinics we have always done the best we can with these cases and we keep a fund for deserving felines so that we can help as often as possible. Unfortunately, this is a fairly common problem and since most people don’t have insurance for their pets in the USA, many die because there isn’t enough money to treat them.
The other really difficult thing is not being able to comfort the people who lose their cats. Grief is a personal experience and it isn’t something that can be “fixed”. As hard as that is, we have to live with it.
LMW: Tell us about your own pets or clinic pets. Do your pets at home react to “clinic scent”. Other than washing your hands when you get home, what do you recommend pet parents do after touching pets outside the home?
LM: I have two cats at the clinic and two cats at home. Monster and Bella live at the clinic. Monster rules the downstairs at the clinic. He has just about every disease you can think of! He was a very sick kitten, but he had a very healthy middle life. Now a senior, he has many problems, but is very happy. We keep a close eye on him and he feels good on most days.
Bella rules the upstairs and has almost all of the clients wrapped around her little claw. She is a beautiful girl who I bottle fed along with her two siblings.
I still have one of her brothers who lives at my home. He is named Blondie after Clint Eastwood’s character in “The Good, the Bad, and the Ugly”. Wherever I go at home, he is sure to follow. My other home kitty is Hop-Along Cassidy. She is, as you might guess, a triped. She was also a bottle baby, as she was found in an alley when she was a few days old and she had lost one of her back legs when her umbilical cord cut off the circulation right after she was born. She is a very shy girl, but has learned in the last year to allow us to pick her up and loves to be petted. She will do almost anything for a freeze dried turkey treat!
My home cats don’t even take a sniff anymore when I come home. I guess they find the smells of the other cats boring now. When they were younger if would get a sniff down when I came home, but not anymore.
I safeguard their health by washing and disinfecting before going home and wearing an overcoat that stays at the clinic to be washed at the end of the day. If I have been around anything that is particularly worrying, I change my cloths and shoes in the laundry room and don’t allow my cats access to them until I am sure they have been adequately disinfected.
Most of the time, simple hand washing and leaving shoes where the cats aren’t going to come into contact with them is plenty of infection control. If, however, you have been at a shelter or feral colony, disinfectant and showering is probably in order because upper respiratory viruses which are common where there are groups of cats staying like to hitch rides on clothes and shoes and can live on clothes and a person’s body for at least several hours and up to a week or so.
Dr. Letrisa Miller practices veterinary medicine in Manchester, Conn. Connecticut Feline Medicine and Surgery LLC.


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