Question from layperson re: refusing treatment in an emergency situation

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Kittenmommy

Kittenmommy

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This is something I've thought about a lot. It might seem strange to you guys, but I'm a Crazy Cat Lady, so please bear with me. ;)

I've often thought about what would happen if I were in a car accident and I had a cat (or cats) with me. Could I refuse treatment until the cat(s) got treatment? In a situation like that, s/he/they would be my priority. Can a person even refuse treatment in an emergency situation?

I know it sounds insane, but please advise.
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What do you think you're going to do for your cats if you have a crushed chest or whatever other injury?? In a true emergency, you're not capable of transporting your cat to the vet, so keep them in crates and have emergency contacts in your cell phone.
 
Of course you have the right to get up and walk out of the ER at anytime.

That is a perfect outcome from the ER stand-point. We bill you for the evaluation and get an easy disposition in record time.

I've been well trained in treating severely injured cats... trans-cortical lead therapy is a true panacea. It is usually pretty cheap, depending on how often you offer the treatment.
 
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Jarabacoa said:
I've been well trained in treating severely injured cats... trans-cortical lead therapy is a true panacea. It is usually pretty cheap, depending on how often you offer the treatment.
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:laugh:
 
Yes Kittenmommy assuming you are not under the influence, under arrest, and speaking in your right mind you can refuse care.
 
Take you cats to the vet instead of yourself to the ED....when you pass out on the floor from a occult head injury and do not feed them, they will begin to eat you. Do yourself a favor and get a large potato sack, a roll of duct tape and cold river. Cat problem solved.
 
In all seriousness there was an article awhile back about how some EMS agencies were identifying vets in their area that could deal with injured pets and setting up a plan with the appropriate agency to transport the animals there if they were injuried during a car accident (ie animal control, sheriff, etc). So if you are really worried about this you could work with your local EMS agency to ensure that they have a plan for dealing with injured pets so it doesn't delay patient care. And if the pets aren't injured then they should be fine for a few hours until you get check out at the ED and arrangements can be made.
 
If the paramedic on the scene has no reason to believe you lack the capacity to understand the consequences of your actions (the potential for death, inability to have sex or wipe your own butt), you absolutely have the right to refuse treatment or transport.

You might think that your cats would do the same for you.

You'd be wrong, of course. Those cats you've lived with for years probably couldn't pick you out of a line up, assuming they cared enough to try. Which I sort of doubt. All us bipedal food-dispensers sort of look alike to them.

Jaracoba and Speed have offered several solutions to the cat problem. Unfortunately, they've raised several questions in the process. For example,

What can you do with a dead cat?

Fortunately, Amazon has a suggestion: http://www.amazon.com/101-Uses-Dead-Simon-Bond/dp/0517545160/ref=sr_1_1?ie=UTF8&s=books&qid=1250861119&sr=8-1

Take care,
Jeff

BTW, General... don't sell yourself short. I have faith that your up to the task.
 
Kittenmommy,

Contrary to what it appears, there are lots of emergency personnel who actually like cats (and dogs, and horses, and ferrets) and will do their best to help them out. The best way for you to help your cats in an accident is to tend to your own needs first (y'know, a variant of 'put your own oxygen mask on first, then help children'). Nobody loves your pets like you do, and if you deny yourself urgent or emergent care you're likely to take that away from them. The next best thing is to keep them in a carrier, with collars and ID tags, if you're driving with them. Emergency personnel will take your animals to the appropriate place: emergency vet hospitals if they're injured, and a shelter if they aren't. After you're better equipped to move about in the world you can retrieve them and go back to being a great Kittenmommy. Having said that, yes, you can refuse treatment if you are otherwise alert and oriented. That would not be a good idea for you or your cats.

Spoken as a) a cat lover, b) the spouse of a pet-lovin' EMT, and c) a former tech at an emergency vet hospital.
 
Here are a few good uses...
 

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I actually had a call like that once. Middle aged woman was rear ended at a stop light by another car traveling about 25 mph. The cat lady's car was then pushed into the car in front of her. Moderate damage to her rear bumper, minor damage to her front bumper. The guy who caused the accident was transported with neck pain, the girl in front had no complaints and refused transport. The cat lady was ambulatory at the scene but c/o neck pain. Manual immobilization was initiated in the standing position but she wanted to refuse treatment because her cat was in the back seat. Luckily for the cat, the cat was in its carrier and the lady had strapped a seat belt over the carrier. She kept hemming and hawing about refusing or going because she didn't know what was going to happen to the cat. Finally, one of the cops agreed to drive the cat to the vet which was just on the other side of town. I think the only reason he decided to take the cat was we had the lane blocked off and he wanted to get traffic moving. Its amazing what cops will do to keep traffic moving.
 
Since we're talking about hypotheticals to some degree here let me bring up an unpleasent point. I think that there are many EMTs and docs and cops who would question the capacity of someone who is placing the welfare of their pets above their own.

One can easily imagine reading the run sheet of a call where "The patient was fixated on her cats and seemed to have no understanding of her own situation or the risks involved in her refusal of care consequently we restrained the patient and..."

Since the OP here is trying to figure out a way to refuse care in such a situation I would note that voicing understanding of one's risks and having a reasonable plan goes a long way. A patient who says "There's nothing wring with me. I'll be fine. I'm taking my cats to the vet even though my car is totalled and I have no way to get there." is not convincing. A patient who says "I don't think I am hurt that badly but I understand that I am risking my health and life by refusing medical care. I am going to get a cab and take my cats to the vet and then I will go to the hospital after that." may fare better. Remember that EMTs are particularly reluctant to let patients refuse care AMA (Against Medical Advice) because there is a lot of liability associated with it. The more calm, lucid and rational you appear the more likely you are to be allowed to refuse.
 
docB said:
Since we're talking about hypotheticals to some degree here let me bring up an unpleasent point. I think that there are many EMTs and docs and cops who would question the capacity of someone who is placing the welfare of their pets above their own.

One can easily imagine reading the run sheet of a call where "The patient was fixated on her cats and seemed to have no understanding of her own situation or the risks involved in her refusal of care consequently we restrained the patient and..."

Since the OP here is trying to figure out a way to refuse care in such a situation I would note that voicing understanding of one's risks and having a reasonable plan goes a long way. A patient who says "There's nothing wring with me. I'll be fine. I'm taking my cats to the vet even though my car is totalled and I have no way to get there." is not convincing. A patient who says "I don't think I am hurt that badly but I understand that I am risking my health and life by refusing medical care. I am going to get a cab and take my cats to the vet and then I will go to the hospital after that." may fare better. Remember that EMTs are particularly reluctant to let patients refuse care AMA (Against Medical Advice) because there is a lot of liability associated with it. The more calm, lucid and rational you appear the more likely you are to be allowed to refuse.
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I never took sole responsibility for a refusal. I always contacted medical control and ran it by them. Often they would actually speak to the patient as well.
 
Lady, I'm going to put you on a 5150, Legal 2000, or whatever qualifies as a psychiatric hold in your state, and keep you medicated with increasing doses of Haldol until whatever psychotic delusions you have about your cats (and your wholly imaginary relationship with them) disappear and you are fit for formal evaluation.
 
I think a key distinction needs to be made here - you absolutely have the right to REFUSE treatment if you are able to understand the risks and benefits and able to express your refusal. You are NOT entitled to manipulate your provider into caring for a species we are not trained to care for in order for the privelege of caring for you. I think most reasonable providers would spend at least a moment trying to work with you to find a solution, but threatening to refuse care so that your cat can be prioritized will get you one of two responses (neither of which you want). Either you will be restrained against your will and cared for, or you will considered to be AMA, and the provider will leave.
 
If I had to put my money on who is going to do better in a car accident, a cat or a human, my money is on the cat. I mean, take a human and throw them off a 30 foot cliff, and they've got serious problems. Take a cat and throw them off the same cliff, 90% of the time, they'll land on their feet completely unscathed. Factor in the relative much longer fall compared to height ratio that this involves and you realize that they are very resilient animals. Looking at pound for pound strength and agility, cats are to humans what Usain Bolt is to a toddler. Now, if you sat on the cat, then the injuries are proportional to the amount of your mass. This ratio reverses as you get very overweight, as the fat rolls tend to be rather protective at really high BMI's.

If your cat has life-threatening injuries, I imagine that there is not much that can be done for the thing, I mean, it is a cat. Do you want a chest tube put in for a pneumothorax? In the average ER, there is no way that we are going to be able to get a vet to come in and take a look at the animal. Few ERs have the staff available to run an injured cat over to a vet's office. You might find a compassionate cop here and there that would take it upon themselves to care for the cat.

If the cat's injuries truly are emergently life threatening, the thing needs to be put down. I'm sorry, I just don't see ICU-type treatment for a cat being warranted. The thing is suffering, put it out of its misery. It is selfish to want to prolong an animals suffering, just so you have your companion.
 
Jarabacoa said:
If I had to put my money on who is going to do better in a car accident, a cat or a human, my money is on the cat.
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Before making that bet I would just want to know what the tooth:tattoo ratio of the human was.
 
I'll be honest, if I were in an accident and had my dog with me (I'm not much of a cat person) I would be more concerned for the dog than myself. I get were she's coming from. I can't tell if a lot of the posts are sarcasm but if not I am a little shocked that many of you are surprised by her desire to take care of her cats before herself. I don't know if its just where I'm from but there are many people who care for their pets as if they were children.
 
atkinsje said:
I can't tell if a lot of the posts are sarcasm but if not I am a little shocked that many of you are surprised by her desire to take care of her cats before herself.
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A little hint on the background of this forum. It used to be called the Inglorious Smart Asses of Emergency Medicine forum but someone became offended so we shortened it to Emergency Medicine.

Yes, the vast majority of posts here are sarcasm. It's an occupational hazard of our specialty.

Take care,
Jeff

BTW, Veers... So that's where 5150 came from? As a Van Halen fan from Texas, I was completely in the dark.
 
my first reaction (and there are others much more experienced than me..) was:

No matter how hard you try to refuse treatment, if you have serious, possibly life-threatening injuries following MVA, you are most likely (and should) be treated regardless of how much you protest. Anyone who says "don't take care of my massive controllable hemorrhage" or closing airway and insists on getting her cats cared for is going to be looked on as not in their right mind, sedated, and cared for. That's the way it should be imo. Think about the situation where the EMT/EM doc DIDN'T take measures to prevent long-term damage and rather took care of your cats. The court is 100% of the time going to ask, "Did you really think she was in her right mind when she refused treatment directly after she had suffered major trauma?" and the EM doc would lose their license not to mention be involved in massive litigation.
 
atkinsje said:
I'll be honest, if I were in an accident and had my dog with me (I'm not much of a cat person) I would be more concerned for the dog than myself.
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Dogs are a different story altogether. If a dog and a human are in a MVA, it's the tattoo-to-tick ratio that determines who EMS transports first.

* Greyfriars Bobby, a Skye Terrier in Edinburgh, Scotland, was loyal to his master long after his master's death in 1858. Until Bobby's death 14 years later, he reportedly spent every night at his master's grave.[14] A statue in memorial of Greyfriars Bobby was erected near the graveyard.
* Hachikō, an Akita who became a symbol of loyalty in Japan, is now honored by a statue in Tokyo. Hachikō is famous for his loyalty to his long dead master.[15]
* Heidi, a Jack Russell Terrier from Scotland, made her way down a 500 foot vertical drop to get to the body of her owner (after he fell to his death while hiking) and stood guard over his body for days in 2001.[16]
* Gelert is the name of a legendary dog associated with the village of Beddgelert.
* Old Shep, a Border Collie, who - after seeing the coffin of his master loaded onto a train in Fort Benton, Montana in 1936 - maintained a vigil at the station for six years.[17]
* Bobbie, the Wonder Dog, after accidental abandonment on a cross-country trip, Bobbie made his way back over 2800 miles to his family's home.
* Old Drum, an American Foxhound whose death at the hands of a neighbor was the subject of a lawsuit and George Graham Vest's famous closing argument "Eulogy to a Dog."
 
Jeff698 said:
A little hint on the background of this forum. It used to be called the Inglorious Smart Asses of Emergency Medicine forum but someone became offended so we shortened it to Emergency Medicine.

Yes, the vast majority of posts here are sarcasm. It's an occupational hazard of our specialty.

Take care,
Jeff

BTW, Veers... So that's where 5150 came from? As a Van Halen fan from Texas, I was completely in the dark.
Click to expand...

This was my initial assumption, however the internet can be tricky...
 
My own beliefs about pets and animals are heavily colored by my own upbringing. My parents got a siamese cat and then a stray came along and they started reproducing. We lived in the middle of nowhere and the cats soon out-numbered us. At one point, we had over 10 cats running around. We didn't feed them, and they thrived until I imagine the food supply ran out and they took off for greener pastures (there was also an incident involving a lawn-mower... bad place for a cat to nap, and a couple of losses to car fan belts). A mother cat that just had a litter of kittens died and my dad had to decide on letting the kittens starve gradually, or ending it quickly with a .22.

We had an old arthritic dog that went after a year old pup and nearly killed him. We realized the two dogs couldn't live together, so we dug a hole out back in the desert and walked the old decrepit dog there and put him down. It is economics in the country, a 2 cent bullet versus a vet bill for hundreds of dollars. Each are equally humane.

People who want to seem more compassionate spend more time making a show of loving their pets "I'm not getting treatment until you take care of the cat!" It just sounds like a cliche hollywood World War II script transformed into a lame cat-lover movie.
 
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coldweatherblue said:
my first reaction (and there are others much more experienced than me..) was:

No matter how hard you try to refuse treatment, if you have serious, possibly life-threatening injuries following MVA, you are most likely (and should) be treated regardless of how much you protest. Anyone who says "don't take care of my massive controllable hemorrhage" or closing airway and insists on getting her cats cared for is going to be looked on as not in their right mind, sedated, and cared for. That's the way it should be imo. Think about the situation where the EMT/EM doc DIDN'T take measures to prevent long-term damage and rather took care of your cats. The court is 100% of the time going to ask, "Did you really think she was in her right mind when she refused treatment directly after she had suffered major trauma?" and the EM doc would lose their license not to mention be involved in massive litigation.
Click to expand...

I disagree. The courts are leaning more and more heavily toward supporting patient autonomy. We are being placed under an ever increasing burden to justify why we thought someone lacked the capacity to make decisions. Of note the ABEM LLSA program (if you don't know what it is search it) includes articles this year and next year (what, I'm the only one who'se looked at next year's reading list?) on capacity and AMA.

Also, while you may get sued you are unlikely to lose your license over a case like this unless you've done something really egregious.
 
docB: thanks for your reply and information. :thumbup: I'd like to think that under all emergent circumstances everything possible should be done to preserve life, but this is based on ideals and not real-world experience (naivety of a medical student..). Good to be aware of the attitudes of the court towards these situations.
 
Having browsed here for a fair amount of time, I declare Jeff my favorite poster. Congratulations on your meaningless award.

Take care,
love
 
Jeff698 said:
A little hint on the background of this forum. It used to be called the Inglorious Smart Asses of Emergency Medicine forum but someone became offended so we shortened it to Emergency Medicine.

Yes, the vast majority of posts here are sarcasm. It's an occupational hazard of our specialty.

.
Click to expand...


:laugh::laugh::laugh::laugh::laugh:
 
atkinsje said:
I'll be honest, if I were in an accident and had my dog with me (I'm not much of a cat person) I would be more concerned for the dog than myself. I get were she's coming from. I can't tell if a lot of the posts are sarcasm but if not I am a little shocked that many of you are surprised by her desire to take care of her cats before herself. I don't know if its just where I'm from but there are many people who care for their pets as if they were children.
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I don't know how uncommon it is but my local volly fire dept. that i am a member of carries non-rebreathers for dogs. :rolleyes:

I have never had to use it but thought it was interesting we have those.

In my short time as an emt I have already seen one dog in an mva but it was not injured.
 
There's a funny video of a firefighter giving mouth-to-mouth to a cat. Apparently this "saved" the cat, according to the expert medical opinion of the news journalist, that is. :rolleyes:
 
leviathan said:
There's a funny video of a firefighter giving mouth-to-mouth to a cat. Apparently this "saved" the cat, according to the expert medical opinion of the news journalist, that is. :rolleyes:
Click to expand...

Supported by science or not, you just can't buy better PR for the department, though.

Take care,
Jeff
 
leviathan said:
There's a funny video of a firefighter giving mouth-to-mouth to a cat. Apparently this "saved" the cat, according to the expert medical opinion of the news journalist, that is. :rolleyes:
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I guess no one here has seen the "Green Mile"?
 
I must have forgotten to subscribe to my own thread, because I had no idea anyone had replied to my post until I came back here to post something else! Whoops!

TyrKinase said:
Google comes the rescue yet again: Cat seatbelts -- http://www.secureapetinc.com/store/product_info.php?products_id=68
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That looks like a great product! We have a cat carrier that straps into the car (the seatbelt goes through two loops on the back, securing it to the seat). The seatbelt you posted is probably even better.

jbar said:
In all seriousness there was an article awhile back about how some EMS agencies were identifying vets in their area that could deal with injured pets and setting up a plan with the appropriate agency to transport the animals there if they were injuried during a car accident (ie animal control, sheriff, etc). So if you are really worried about this you could work with your local EMS agency to ensure that they have a plan for dealing with injured pets so it doesn't delay patient care. And if the pets aren't injured then they should be fine for a few hours until you get check out at the ED and arrangements can be made.
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Thank you! I will definitely look into that.


Phledge said:
Kittenmommy,

Contrary to what it appears, there are lots of emergency personnel who actually like cats (and dogs, and horses, and ferrets) and will do their best to help them out. The best way for you to help your cats in an accident is to tend to your own needs first (y'know, a variant of 'put your own oxygen mask on first, then help children'). Nobody loves your pets like you do, and if you deny yourself urgent or emergent care you're likely to take that away from them. The next best thing is to keep them in a carrier, with collars and ID tags, if you're driving with them. Emergency personnel will take your animals to the appropriate place: emergency vet hospitals if they're injured, and a shelter if they aren't. After you're better equipped to move about in the world you can retrieve them and go back to being a great Kittenmommy. Having said that, yes, you can refuse treatment if you are otherwise alert and oriented. That would not be a good idea for you or your cats.

Spoken as a) a cat lover, b) the spouse of a pet-lovin' EMT, and c) a former tech at an emergency vet hospital.
Click to expand...

You're right, the flight attendants always say that in the event of an emergency, you should secure your own oxygen mask before trying to help anyone else. It makes sense, and I'd never thought of applying the same idea in my hypothetical situation. If I'm injured, I may not be lucid enough to make good decisions regarding my cat's care anyway.

Flopotomist said:
I think a key distinction needs to be made here - you absolutely have the right to REFUSE treatment if you are able to understand the risks and benefits and able to express your refusal. You are NOT entitled to manipulate your provider into caring for a species we are not trained to care for in order for the privelege of caring for you.
Click to expand...

That's a good point too. EMTs probably don't know much about animal first aid/care besides stuff that would be common sense for patients of any species (i.e. blood gushing out of the head is bad, etc.).

Jarabacoa said:
If your cat has life-threatening injuries, I imagine that there is not much that can be done for the thing, I mean, it is a cat. Do you want a chest tube put in for a pneumothorax? In the average ER, there is no way that we are going to be able to get a vet to come in and take a look at the animal. Few ERs have the staff available to run an injured cat over to a vet's office. You might find a compassionate cop here and there that would take it upon themselves to care for the cat.
Click to expand...

That would actually be preferable to me. I know MDs don't know much about treating animals, aside from what I said above (things that would be common sense).

Jarabacoa said:
If the cat's injuries truly are emergently life threatening, the thing needs to be put down. I'm sorry, I just don't see ICU-type treatment for a cat being warranted. The thing is suffering, put it out of its misery. It is selfish to want to prolong an animals suffering, just so you have your companion.
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I would never, ever prolong an animal's suffering for my own selfish reasons. Several times now, I've held our cats as our vet did the last compassionate thing for them, because there was no hope. I watched my mother die of cancer, and I've often said that we're far more compassionate to our animals than we are to our fellow humans.

However, I won't let go prematurely. If there's a good chance that my cat will recover with proper treatment and go on to live a long, healthy, happy life, then I'll tell the vet to go for it.

greytmedic said:
Before making that bet I would just want to know what the tooth:tattoo ratio of the human was.
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LOL. I have no tattoos. I have all of my teeth, including one wisdom tooth that came in just dandy. And I even have an extra tooth that showed up out of the blue from God knows where. ;)

leviathan said:
There's a funny video of a firefighter giving mouth-to-mouth to a cat. Apparently this "saved" the cat, according to the expert medical opinion of the news journalist, that is. :rolleyes:
Click to expand...

I have seen CPR performed on a cat (one of my cats, actually). He had feline HCM, and arrested as we were getting ready to take him home from the hospital. He literally died in my arms. They rushed him back to the back and did CPR, but they said they weren't getting any results and so Kittendaddy and I told them to stop, because he was already gone. :(

Thank you, everyone who gave me thoughtful answers to my question. You've given me a lot to think about and I'm reconsidering how I'd handle an emergency situation involving my cat(s) if (God forbid!) I'm ever in one. I really do appreciate it!
 
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Jeff698 said:
Proof that there are intelligent newbies out there! :)

Take care,
Jeff
Click to expand...

I'm not exactly a "newbie", here or anywhere else. And I'm also not a fish, so don't expect me to swallow bait! ;)
 
I mean said:
I just had to comment on this in your example the cat would probably be rather injured likely broken jaw, legs, pelvis, chest injuries. Oddly enough falling from greater height (more then 70 feet) gives the cat a better prognosis as they have more time to orient and land flexed to let their whole body dissipate the impact as they land. I realize you are probably not really interested in this but in case the article is here: Am Vet Med Assoc.1987 Dec 1;191(11):1399-403

Enjoy!
Click to expand...
 
Jeff698 said:
.

Yes, the vast majority of posts here are sarcasm. It's an occupational hazard of our specialty.
Click to expand...

Maybe for you. Some of us don't have time for such nonsense.
 
Oh contraire angelo, I'm fascinated.

Wikipedia (below) has a reference that challenges the theory that cats have higher survival from higher heights due to selection bias (the higher the fall, the fewer, but more spectacular and well-published the survivors).

http://en.wikipedia.org/wiki/High-rise_syndrome

(From Wikipedia)

Studies done on cats that have fallen from 2 to 32 stories, and still alive when brought to a veterinarian clinic, show that the overall survival rate is 90 percent of those treated.[1] In a study performed in 1987 it was reported that cats who fall from less than 6 stories, and are still alive, have greater injuries than cats who fall from higher than 6 stories.[2][3] It has been proposed that this might happen because cats reach terminal velocity after righting themselves (see below) at about 5 stories, and after this point they relax, leading to less severe injuries in cats who have fallen over 6 stories.[4] Another possible explanation for this phenomenon would be the fact that cats who die in falls are less likely to be brought to a veterinarian than injured cats, and thus many of the cats killed in falls from higher buildings are not reported in studies of the subject.[5] In a more recent study it has rather been observed that cats falling from higher places would also suffer more severe injuries.[6]
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What fun studies to conduct! "OK, lets go up 5 floors and chuck a few more off!"

I've been enlightened by studying this subject. Most of my knowledge is from anecdotal information. I didn't know there was peer-reviewed research on it!
 
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One of our cats somehow loosened the screen in our bedroom window and jumped/fell out (second floor) and she (luckily!) didn't have a scratch on her. We didn't even know what had happened until she showed up at the back door, meowing to be let in! :eek:
 
Through the years I have compiled my own randomized, retrospective evaluation of psychiatric patients and the correlation to the number of pets they own. Specifically felines. I call it the CAT scale (Correlating Anxiety/Abstract Thought).

In my intensive lab-based research facility, I have noticed a near linear relationship between the number of felines owned and the predictability of oon (out-of norm) behavior of their owners. Current research has also revealed that the co-owership, or even sole-owership, of "atypical household pets" also adds to the predicability of oon behavior. Below, published now for the first time, are the results of these findings:


1 cat - likely normal mental status and train of thought, capable of informed consent.

2 cats - Patient may exhibit borderline anxiety toward basic medical procedures. There is a high likelihood of allergy to adhesive tape or fruits and nuts. Likely to have excessive jewelry (useful to consider when ordering head CT scans).

3 cats - History of borderline personality and documented anxiety disorders are likely. Facial hirsutism and concomitant PCOS are potential co-morbidities. Patients likely to wear purple. Likely allergies include (in addition to above) Haldol (5-8%), Amytriptyline (4-6%), and Normal Saline (1-2%). Drug-seeking behavior can be apparent.

4 or more cats - High likelihood of emergency psychiatric holding (Baker Act, 5150, etc). Low likelihood of true medical illness. Typically unable to rationalize or give informed consent. Allergies to common painkillers and antibiotics are frequent ("That drug that starts with 'D' makes me itch").

ADDITIONAL PET OWNERSHIP:

Reptiles - female patients owning 1 or more reptile start at cat scale 2. Additional cats increase overall score. Male patients start at cat scale 1.

Birds - All owners of a pet bird are automatically scored at a cat scale 2. Patients who own both birds and cats start at cat scale 3. Add one point for each additional cat owned.

The Niner institute is frequently searching for young investigators to broaden our research and expand our contribution to the medical world. If you are interested, feel free to check out our website at:

http://www.funnyordie.com/videos/b5e66d4b58/play-helen-and-hall-oates-off-keyboard-cat.
 
LOL, Niner! :D

My husband and I have nine cats and a beagle. All hope of sanity is lost, and I'm OK with that. ;)
 
Kittenmommy said:
LOL. I have no tattoos. I have all of my teeth, including one wisdom tooth that came in just dandy. And I even have an extra tooth that showed up out of the blue from God knows where. ;)
Click to expand...

If that's the case, this is a moot question anyway... because even if you were in a 5mph rear-end collision... you are most likely doomed.

You better go out and get a tattoo just in case... hey... it could be of a cat (or all nine of them... that would be more protective...):laugh:
 
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