Sometimes the most important lessons come from the cases you wish you’d never seen.

The patterns you can’t unsee

When you work in emergency medicine long enough, patterns start to emerge.

The diabetic cat whose owner didn’t recognize the early warning signs. The dog with advanced kidney disease who had never had routine bloodwork. The pet suffering from a preventable toxicity caused by an unvetted supplement bought online.

Again and again, I saw animals facing serious — sometimes life-threatening — conditions that might have been caught earlier. Managed better. Maybe even prevented entirely.

These weren’t cases of pet parents who didn’t care. They were deeply devoted owners who simply didn’t have clear guidance, trusted resources, or access to the right tools.

And that stayed with me.

Learning the hard way

I didn’t start out in emergency medicine. I spent my first eight years in general practice, and honestly? I felt stuck. Underwhelmed. Like I was going through the motions.

Then I picked up relief shifts at a local emergency clinic — and everything changed.

Emergency medicine doesn’t ease you in. You’re thrown straight into high-stakes situations where decisions have to be made in minutes, not days. Sometimes seconds.

I’ll never forget my first GDV — or “bloat.” It’s a life-threatening emergency where a dog’s stomach fills with gas and twists, cutting off blood supply. These dogs can die very quickly.

That night, I stabilized the patient and got approval for surgery. When we called the on-call surgeon at 1 a.m., the answer was simple: I can’t do that surgery. You’re on your own.

So there I was — textbook open, a critically ill dog on the table, and a nurse managing anesthesia while I coached and operated at the same time.

The dog didn’t survive. Not because of inexperience — the damage was already too severe.

I wouldn’t recommend learning this way.

But it lit something in me. I knew I wanted to be the person who could say yes at 1 a.m. The one who could step in when everything felt impossible. The one who could offer hope when families were terrified they were about to lose their pet.

the cost of pushing through

I threw myself fully into emergency medicine. I worked general practice during the week and picked up ER shifts whenever I could. Some weekends blurred into back-to-back shifts with barely any rest.

I loved the work. When I became pregnant with my first daughter, I left general practice and went full-time in emergency care. As the hospital grew, I helped build its critical care program alongside some incredible nurses.

But here’s the part we don’t talk about enough: living on adrenaline eventually catches up with you.

After my daughter was born, something felt off. The exhaustion was overwhelming. The brain fog was frightening.

One day, a dog came in with vomiting — a case I’d managed countless times. And my brain just… slowed down. I figured it out, but it took far longer than it should have.

That moment scared me.

I was in my thirties. I had a newborn at home. I needed my mind and body to function — and they weren’t.

the shift that changed everything

What I eventually realized is something that goes against how we’re trained in emergency medicine:

You can’t fight your way to healing.

In the ER, we act. We intervene. We fix. And that saves lives.

But healing — real, lasting healing — often comes from slowing down. From working with the body instead of constantly pushing against it. From catching issues early, before they turn into emergencies.

And that’s just as true for our pets.

what animals have taught me

After 14 years in the ER, one thing is crystal clear to me: animals have an incredible ability to heal.

They don’t overthink. They don’t resist their bodies. They don’t carry the stress we do.

When given the right support — quality nutrition, appropriate supplements, consistent preventive care — they respond. Sometimes in ways that still take my breath away.

The hardest cases are the ones where that support comes too late. When the first time I meet a pet is under bright ER lights, fighting for their life.

Why prevention matters so much

This is why I built Paw & Pestle.

Not because emergency medicine failed me — it saved countless lives.

But because I couldn’t shake the feeling that we could do better before crisis hits. That we could support wellness between vet visits. That pet parents deserved access to the same vetted, science-backed products their veterinarians trust — without having to navigate confusing online marketplaces.

Pet parents want to be proactive. Veterinarians want to guide them.

But vets are stretched thin. Pet parents are overwhelmed. And trust gets lost in the middle.

Paw & Pestle exists to bring that trust back.

the lessons i carry forward

Here’s what 14 years in emergency medicine has taught me:

1. Prevention isn’t extra — it’s foundational. The best emergency is the one that never happens.
   
2. Timing, quality, and guidance matter. Small interventions early can change everything.
   
3. The vet–pet parent relationship is sacred. When that trust is strong, pets thrive.
   
4. Access matters. Too many pets suffer not because help doesn’t exist, but because it feels out of reach.
   

That last lesson is why we’re building the Paw & Pestle Angel Fund — to help families access emergency care when cost would otherwise stand in the way.

Because love should never be the thing that isn’t enough.

From crisis to wellness

I still love emergency medicine. I always will.

But today, I’m just as passionate about keeping pets out of the ER whenever possible.

Because veterinary medicine, at its best, isn’t just about treating illness.

It’s about building wellness — together.

With compassion and care, always,

Dr. Elena Shockman, VMD