Unfortunately, in my line of work, I see a lot of grieving people from all different causes; unexpected tragic losses to expected but not quite ready long term cancer patients. I am extremely sympathetic, as I love my own pets dearly and know what it feels like to be on the other side of the exam table.
I am no psychologist, but from experience, I can tell you that there are many variations of normal grief. Some people hide their tears and break down once they walk out of the room, others cry openly and accept my condolences and even a hug after their pet has passed. Others do not talk, and some are even slightly rude with the reception staff at the counter. 99% of my clients grieving, even given the most extreme circumstances, thank me for helping their pet at their final minutes, and are courteous and kind.
Yesterday, I had the misfortune of dealing with someone who could not control herself, and took it out on me and my staff.
"Sissy" was her cat, a 14 year old domestic longhaired cat with extreme difficulty breathing. At triage, my technicians immediately recognized the urgency and placed Sissy on oxygen. The client had stated that an asthma attack was the cat's presenting complaint, that she had had this before, and she had been trying to wait for her veterinarian to open (in another 24 hours). Sissy was cyanotic (blue gums), and very pale. She was open mouth breathing and fluid was coming from her nose, and she had a low body temperature. When I listened to her chest, I heart a high heart rate and moist lung sounds, or "crackles" that often occur when fluid builds up. The most likely causes of these findings is congestive heart failure, however other possible diagnoses (or 'differential diagnoses' in medical terminology) include pneumonia, neoplasia, or asthma. These differentials were much less likely given the picture as a whole, but none of the possibilities can be completely ruled out without testing, like chest radiographs (x-rays) or an echocardiogram (ultrasound of the heart).
I went into the exam room. I inquired further about the history; it turns out that Sissy had never had any testing to confirm asthma, furthermore she had not had any treatment or flare-ups in 4 years. This is not consistent with asthma, and certainly my physical exam findings were not consistent with asthma as the most likely diagnosis. I recommended oxygen, chest radiographs, and hospitalization with medications to be determined based on imaging. The client refused any testing and screamed at me. "JUST GIVE HER A STEROID SHOT! ALL SHE NEEDS IS A STEROID SHOT!!"
Steroids are a prime treatment for asthma, however can worsen heart failure. I explained this to the client, as well as the findings that did not go along with asthma. I discussed that we could try medications alone, but that Sissy might decline. I also discussed that given her critical condition, even with all diagnostics and no limitations, she was at risk for sudden death or respiratory failure. I have pulled cats back from this condition before, but there are no guarantees in medicine. Further complicating the issue was that the client did not want to spend any of her own money on her cat.
The client screamed at me again. She then put her hand up in my face, dialed her phone, and called someone. I excused myself to go check on her cat, as well as to give her time to make her call, despite her rude behavior.
Five minutes later, I came back into the room. Her sister had joined her and was also hysterical. "CAN'T YOU JUST FIX HER? FIX HER! WHY CAN'T YOU JUST FIX HER?!" Calmly, I explained the medical situation again, and that I could definitely try to fix their cat, but ultimately, the clients decided upon euthanasia.
"NOW what's going to happen!?" She screamed. "I want my cat right now!"
Sissy had been resting in our oxygen-enriched incubator, where she was still struggling to breathe, but had more comfort than the room air environment. I explained this to the client. I offered for her to come sit with Sissy while we provided oxygen via a face mask to help her stay comfortable.
I brought the client to the treatment area, and an assistant placed Sissy in her arms with a blanket. I brought over an oxygen mask, and told the client "This oxygen will help Sissy to breathe easier while you spend time with her." I slowly moved the mask into place, and the client screamed at the top of her lungs in a tone that could have fightened a demon;
"WHAT IS THAT!!!!!!!!!!!!!!!!!! WHAT ARE YOU GIVING HER?!?!?!??!!!!!!"
Somewhat dumbfounded, I replied "Ma'am, this is OXYGEN to help Sissy breathe while you hold her." (What did she think it was? Poisonous gas we were going to make her and her cat breathe?)
When the clients were ready, and amongst screaming, yelling, and swearing, I administered the euthanasia solution. Sissy stopped struggling to breathe, and passed peacefully. I knew we had done the right thing, despite the drama associated with the decision.
As sad as the loss of a pet is, there's no reason to treat the veterinarian like an enemy!
Tuesday, January 24, 2012
Friday, January 13, 2012
The full moon.
Wow.
I woke up this morning after finally getting a night of sleep. Work this week has been outrageous, and actually this entire winter has been busier than usual. To give you some idea of my schedule this week, it went something like this:
Wake up in the afternoon/early evening, shower, get ready for work. Feed my pets. Stumble around the house for awhile, trying to figure out what day it is and get rid of my sleep-deprivation headache. Leave for work, drive somewhere to find food (since there's no groceries or time to go to the store while on 15 hour shifts), arrive at work. Eat my dinner at the staff break table. Clock in, put on lab coat and stethoscope. Run around like a mad-woman for 14-15 hours dealing with situations like the one below. Try to maintain patience, poise, and make sound medical judgements. Finish shift, clock out. Drive home (trying not to fall asleep at the wheel), crash into bed, try to sleep (it's been sunnier than usual this winter, so I've been having a hard time with the sleep part, and additionally, we just moved, so it's even more difficult with everything askew). Repeat. No time for household tasks, cooking, eating, or other such silly things. Needless to say, I'm exhausted.
So after arriving at work one night this week, it was blessedly quiet. Nothing hospitalized, no patients waiting to be seen when I arrived. I got a few things done that have been waiting for weeks, and enjoyed a few hours of peace and quiet. We took a few phone calls, but none of the callers would agree to come in.
The night looked golden - usually after about midnight, the caseload drops off as most people are asleep and not able to know what their pet is or isn't doing. Unfortunately, that wasn't the case this night.
Four clients, three of them disasters, all arrived within 15 minutes of each other.
Client #1 - Young, otherwise healthy dog who had had his first seizure. Fortunately, this patient was stable. Unfortunately, the clients were ridiculous. I spent about 20 minutes talking to them about the most likely diagnosis, epilepsy, and the usual therapy for their pet. As their cute young dog tried to get me to throw his toy so he could fetch it, these clients actually asked me to euthanize their dog. Again, I explained that their pet was stable, that he may never seizure again, and even if he did, it was (usually) manageable with medications. In the middle of my third go-around explaining, I was pulled away for the next client.
Client #2 - 1 year old pomeranian, Sid, presenting for "just not being himself." She stated that this had just happened in the last hour or so. "Just not himself" was a ridiculous understatement - Sid was laterally recumbent and nearly comatose, dripping blood from his penis and definitely critical. The client was acting bizarre, attempted to leave several times, and stated that she had no money to spend to help Sid.
She refused to apply for CareCredit to help herself help Sid. She contacted 3 or 4 relatives, who then each separately called our hospital multiple times.
While I waited for the client to sort out her drama, I tried to help Sid, regardless of the fact that she couldn't pay for services. I passed a urinary catheter, and found that he had multiple bladder stones, including some stuck in his urethra. My technician inquired again about symptoms, and the client changed her story - now stating that she had been holding him all day and that the bloody urine had started that morning. In truth, poor Sid probably had been unable to urinate for several days, and probably had kidney damage as a result.
I went in to speak with her. Any normal human could see that this dog was suffering. It didn't take doctor status to be able to look at the poor thing, unable to move, body temperature falling, dribbling bloody urine and nearly in a coma to make that decision. I gently explained the situation to her. She made multiple more phone calls, gave me way too much information regarding her multiple estranged husbands/baby's daddy/boyfriends, and finally agreed to euthanasia, TWO HOURS after her arrival. She refused treatment for Sid, and without treatment, she knew, even in her drug-altered state, that he would continue to suffer and eventually die. I thought we had resolution of this awful situation.
Client #3 had been waiting in an exam room for much of this time. This client had been calling our office multiple times with a 1 year old chihuahua having difficulty with labor. The dog had one stillborn puppy, and 8 hours had gone by with no further puppies. Green discharge was now coming from her vulva. This is BAD - the remaining fetuses are probably either near dead or already dead, and if the fetuses aren't removed from the uterus, they can decompose and make the bitch very, very sick.
Unfortunately, these clients were complete morons. (You may think I'm being harsh, but just wait and see for yourself). They refused an exam by a doctor (so why did they come in?), they refused to apply for CareCredit (the only payment plan that is available). My technician got vitals on the bitch, who thankfully appeared stable at this time, and recommended they see a low - cost spay/neuter clinic as soon as they opened in the morning, about 7 hours' wait. He explained to them that the wait was not ideal, and she could be very, very sick quickly based on their poor decisions. We gave them contact information for the most affordable low-income spay clinic in our area. The next day, they continued to call, had NOT taken the bitch to be spayed, and her symptoms were worsening. By 5pm, when the spay clinic closes for the day, they never made any sort of arrangements for her care and continued to call us. The spay clinic is subsidized by donors and local government and is able to perform spays well below cost, therefore the cost of a spay at this clinic is actually LESS than our exam fee ALONE. We gave them the tools to save their dog at a VERY low price (we're talking less than $100), and they did nothing. I feel bad for their poor, poor dog, but I feel nothing but contempt for the humans.
Client #4 had also been waiting a very long time to speak with me. I was so happy to walk into the exam room and find a normal person, a friendly dog, and a minor problem which I remedied quickly. The client was friendly, asked good questions, and genuinely loved her pet. I apologized for her long wait and she thanked me for my care of her pet.
Back to client #2
Despite signing the paperwork for euthanasia, which we were performing for free, and was the only right thing to do for her poor dog, the client continued to call family members. Her estranged baby's-daddy-creepy-douchbag-ex-husband came down to the clinic after hour number two of this drama, and refused to let us euthanize the dog.
I argued with him for an hour, but he was completely irrational (and probably on drugs). He said really smart things, including that he had a dog with this problem before who he had fixed by giving it yogurt. Oh, right, yogurt totally clears up KIDNEY FAILURE and bladder stones. Sorry, I forgot when they taught that in EIGHT YEARS of school. My bad.
After the fourth hour of this saga, my patience was completely gone. I informed this man that he needed to put his feelings aside and do the right thing for his pet. He refused. I then told him that he either needed to authorize treatment, to euthanize his dog, or he needed to leave. If he chose to leave, it would be against medical advice and I would contact the animal control authorities and report him for cruelty.
He chose to leave, and signed against medical advice paperwork.
So incredibly infuriating. I contacted the authorities the next morning, and they will be doing a full investigation. I hope they throw the book at him.
I woke up this morning after finally getting a night of sleep. Work this week has been outrageous, and actually this entire winter has been busier than usual. To give you some idea of my schedule this week, it went something like this:
Wake up in the afternoon/early evening, shower, get ready for work. Feed my pets. Stumble around the house for awhile, trying to figure out what day it is and get rid of my sleep-deprivation headache. Leave for work, drive somewhere to find food (since there's no groceries or time to go to the store while on 15 hour shifts), arrive at work. Eat my dinner at the staff break table. Clock in, put on lab coat and stethoscope. Run around like a mad-woman for 14-15 hours dealing with situations like the one below. Try to maintain patience, poise, and make sound medical judgements. Finish shift, clock out. Drive home (trying not to fall asleep at the wheel), crash into bed, try to sleep (it's been sunnier than usual this winter, so I've been having a hard time with the sleep part, and additionally, we just moved, so it's even more difficult with everything askew). Repeat. No time for household tasks, cooking, eating, or other such silly things. Needless to say, I'm exhausted.
So after arriving at work one night this week, it was blessedly quiet. Nothing hospitalized, no patients waiting to be seen when I arrived. I got a few things done that have been waiting for weeks, and enjoyed a few hours of peace and quiet. We took a few phone calls, but none of the callers would agree to come in.
The night looked golden - usually after about midnight, the caseload drops off as most people are asleep and not able to know what their pet is or isn't doing. Unfortunately, that wasn't the case this night.
Four clients, three of them disasters, all arrived within 15 minutes of each other.
Client #1 - Young, otherwise healthy dog who had had his first seizure. Fortunately, this patient was stable. Unfortunately, the clients were ridiculous. I spent about 20 minutes talking to them about the most likely diagnosis, epilepsy, and the usual therapy for their pet. As their cute young dog tried to get me to throw his toy so he could fetch it, these clients actually asked me to euthanize their dog. Again, I explained that their pet was stable, that he may never seizure again, and even if he did, it was (usually) manageable with medications. In the middle of my third go-around explaining, I was pulled away for the next client.
Client #2 - 1 year old pomeranian, Sid, presenting for "just not being himself." She stated that this had just happened in the last hour or so. "Just not himself" was a ridiculous understatement - Sid was laterally recumbent and nearly comatose, dripping blood from his penis and definitely critical. The client was acting bizarre, attempted to leave several times, and stated that she had no money to spend to help Sid.
She refused to apply for CareCredit to help herself help Sid. She contacted 3 or 4 relatives, who then each separately called our hospital multiple times.
While I waited for the client to sort out her drama, I tried to help Sid, regardless of the fact that she couldn't pay for services. I passed a urinary catheter, and found that he had multiple bladder stones, including some stuck in his urethra. My technician inquired again about symptoms, and the client changed her story - now stating that she had been holding him all day and that the bloody urine had started that morning. In truth, poor Sid probably had been unable to urinate for several days, and probably had kidney damage as a result.
I went in to speak with her. Any normal human could see that this dog was suffering. It didn't take doctor status to be able to look at the poor thing, unable to move, body temperature falling, dribbling bloody urine and nearly in a coma to make that decision. I gently explained the situation to her. She made multiple more phone calls, gave me way too much information regarding her multiple estranged husbands/baby's daddy/boyfriends, and finally agreed to euthanasia, TWO HOURS after her arrival. She refused treatment for Sid, and without treatment, she knew, even in her drug-altered state, that he would continue to suffer and eventually die. I thought we had resolution of this awful situation.
Client #3 had been waiting in an exam room for much of this time. This client had been calling our office multiple times with a 1 year old chihuahua having difficulty with labor. The dog had one stillborn puppy, and 8 hours had gone by with no further puppies. Green discharge was now coming from her vulva. This is BAD - the remaining fetuses are probably either near dead or already dead, and if the fetuses aren't removed from the uterus, they can decompose and make the bitch very, very sick.
Unfortunately, these clients were complete morons. (You may think I'm being harsh, but just wait and see for yourself). They refused an exam by a doctor (so why did they come in?), they refused to apply for CareCredit (the only payment plan that is available). My technician got vitals on the bitch, who thankfully appeared stable at this time, and recommended they see a low - cost spay/neuter clinic as soon as they opened in the morning, about 7 hours' wait. He explained to them that the wait was not ideal, and she could be very, very sick quickly based on their poor decisions. We gave them contact information for the most affordable low-income spay clinic in our area. The next day, they continued to call, had NOT taken the bitch to be spayed, and her symptoms were worsening. By 5pm, when the spay clinic closes for the day, they never made any sort of arrangements for her care and continued to call us. The spay clinic is subsidized by donors and local government and is able to perform spays well below cost, therefore the cost of a spay at this clinic is actually LESS than our exam fee ALONE. We gave them the tools to save their dog at a VERY low price (we're talking less than $100), and they did nothing. I feel bad for their poor, poor dog, but I feel nothing but contempt for the humans.
Client #4 had also been waiting a very long time to speak with me. I was so happy to walk into the exam room and find a normal person, a friendly dog, and a minor problem which I remedied quickly. The client was friendly, asked good questions, and genuinely loved her pet. I apologized for her long wait and she thanked me for my care of her pet.
Back to client #2
Despite signing the paperwork for euthanasia, which we were performing for free, and was the only right thing to do for her poor dog, the client continued to call family members. Her estranged baby's-daddy-creepy-douchbag-ex-husband came down to the clinic after hour number two of this drama, and refused to let us euthanize the dog.
I argued with him for an hour, but he was completely irrational (and probably on drugs). He said really smart things, including that he had a dog with this problem before who he had fixed by giving it yogurt. Oh, right, yogurt totally clears up KIDNEY FAILURE and bladder stones. Sorry, I forgot when they taught that in EIGHT YEARS of school. My bad.
After the fourth hour of this saga, my patience was completely gone. I informed this man that he needed to put his feelings aside and do the right thing for his pet. He refused. I then told him that he either needed to authorize treatment, to euthanize his dog, or he needed to leave. If he chose to leave, it would be against medical advice and I would contact the animal control authorities and report him for cruelty.
He chose to leave, and signed against medical advice paperwork.
So incredibly infuriating. I contacted the authorities the next morning, and they will be doing a full investigation. I hope they throw the book at him.
Thursday, January 12, 2012
MIA
Hey readers,
I apologize for my long absence. Work has been unusually busy this winter, and I'm struggling to stay caught up. I'll try to get back into the swing of things soon.
~Er doc
I apologize for my long absence. Work has been unusually busy this winter, and I'm struggling to stay caught up. I'll try to get back into the swing of things soon.
~Er doc
Sunday, December 18, 2011
Um..................... really?
Today, an older female client arrived at the front counter. She did not have a pet with her.
"I'd like to report a lost dog," the client stated. My receptionist gathered the form necessary to record this information and assist the woman in finding her dog.
"Okay, where did you last see him?" The receptionist asked.
"He's lost INSIDE my house," she stated plainly. "I've looked everywhere for him, and I just can't find him. I've looked under the beds, under the couch, and he's nowhere. I know he's in the house because I haven't left today and he slept on the bed with me."
"..... Ma'am, I'm not going to be able to help you find the dog inside your house - Lost dog reports only work if someone else finds your dog. If your dog is in your house, nobody else is going to find him. Can you have someone come over and help you? Have you tried shaking his food dish?"
....
Really? You lost your dog INSIDE YOUR HOUSE and you came in to report him lost?
"I'd like to report a lost dog," the client stated. My receptionist gathered the form necessary to record this information and assist the woman in finding her dog.
"Okay, where did you last see him?" The receptionist asked.
"He's lost INSIDE my house," she stated plainly. "I've looked everywhere for him, and I just can't find him. I've looked under the beds, under the couch, and he's nowhere. I know he's in the house because I haven't left today and he slept on the bed with me."
"..... Ma'am, I'm not going to be able to help you find the dog inside your house - Lost dog reports only work if someone else finds your dog. If your dog is in your house, nobody else is going to find him. Can you have someone come over and help you? Have you tried shaking his food dish?"
....
Really? You lost your dog INSIDE YOUR HOUSE and you came in to report him lost?
Monday, November 28, 2011
Trauma drama
5am, Thanksgiving morning.
A phone call comes through from a client. "Two of my dogs were shot! We're on the way!" She's too upset to give us any more details about their condition.
Immediately, I wonder -- how in the heck do not one but TWO of your pets get shot?
My technician and I start preparing for arrival of two potentially serious, potentially life-threatening injuries. Gunshots can result in any bad trauma you can think of; bleeding, penetrated bowels, ruptured bladder, spinal paralysis, pneumothorax, instant death, infection....
The first pet arrives and walks into the clinic under his own power, which is a surprise. My tech receives permission for initial treatment and diagnostics. He has two entry wounds on one side of his chest, but no exit wounds. He is experiencing mild shock, and is exceptionally painful, but for a gunshot wound, appears moderately stable.
We start pain medications, IV fluids, oxygen, and antibiotics. I walk up to the lobby to speak with the client who is understandably hysterical. Hysterical, however, slows down my ability to do my job.
"Hi, I'm ERdoc. Your pet is in fair condition, and is already receiving pain medicine, oxygen and IV fluids."
"TELL ME SOMETHING ABOUT MY DOG!" She screams.
"Ma'am, I understand you're upset, this is a very scary situation. You have to realize that we're working as fast as we can, and if you just take a deep breath and calm down a bit, we'll be able to help you more quickly. Now is there any major medical history I should know about ? How did this happen?"
The client calms a bit, and I get a history. The pets had escaped out the front door, and it was suspected that a neighbor shot them for being on their property. Cruel, but actually not illegal since the dogs were at large.
The second dog arrives and actually looks better than the first. He has a thru and thru gunshot wound so close to his spine that it's frightening.
Amazingly, both patients recovered well and were sent home with their (very) thankful families the next day.
Despite the high stress, extreme potential for disaster, and emotionally charged situation, we were able to provide happy outcomes for both of these patients!
A phone call comes through from a client. "Two of my dogs were shot! We're on the way!" She's too upset to give us any more details about their condition.
Immediately, I wonder -- how in the heck do not one but TWO of your pets get shot?
My technician and I start preparing for arrival of two potentially serious, potentially life-threatening injuries. Gunshots can result in any bad trauma you can think of; bleeding, penetrated bowels, ruptured bladder, spinal paralysis, pneumothorax, instant death, infection....
The first pet arrives and walks into the clinic under his own power, which is a surprise. My tech receives permission for initial treatment and diagnostics. He has two entry wounds on one side of his chest, but no exit wounds. He is experiencing mild shock, and is exceptionally painful, but for a gunshot wound, appears moderately stable.
We start pain medications, IV fluids, oxygen, and antibiotics. I walk up to the lobby to speak with the client who is understandably hysterical. Hysterical, however, slows down my ability to do my job.
"Hi, I'm ERdoc. Your pet is in fair condition, and is already receiving pain medicine, oxygen and IV fluids."
"TELL ME SOMETHING ABOUT MY DOG!" She screams.
"Ma'am, I understand you're upset, this is a very scary situation. You have to realize that we're working as fast as we can, and if you just take a deep breath and calm down a bit, we'll be able to help you more quickly. Now is there any major medical history I should know about ? How did this happen?"
The client calms a bit, and I get a history. The pets had escaped out the front door, and it was suspected that a neighbor shot them for being on their property. Cruel, but actually not illegal since the dogs were at large.
The second dog arrives and actually looks better than the first. He has a thru and thru gunshot wound so close to his spine that it's frightening.
Amazingly, both patients recovered well and were sent home with their (very) thankful families the next day.
Despite the high stress, extreme potential for disaster, and emotionally charged situation, we were able to provide happy outcomes for both of these patients!
Thankful for the boys in blue.
What a crazy weekend.
One of my most extreme situations ever occurred this weekend, and I'm very proud of my determination in preventing animal suffering.
I arrived at work in the morning and received patient rounds from the overnight doctor. One of the patients was a young, large beautiful cat who had arrived at 1am. The client found this cat tragically injured after being caught in a bear trap. As the cat entered the clinic, my colleague described that he was absolutely howling in pain. She quickly administered pain medication, despite the client's lack of ability to pay. The cat was injured nearly beyond repair. Both hind limbs were broken, in several locations, including the feet, ankles, and tibias bilaterally. Both hind limbs had severe degloving injuries; meaning that the skin was pulled away from the muscles, bone and tendons underneath. Both hind legs had the pads removed, and the tissue appeared very unhealthy due to lack of blood flow and overwhelming infection setting in. In order to try fixing this kitty's injuries, it would require far more than most veterinarians or clients are capable of - the repair would take months and months of dedicated treatment, daily bandage changes for much of that time, multiple surgeries, as well as thousands and thousands of dollars. My heart bled for this poor, poor cat.
If the cat was a human, amputation would probably be performed, however, a human has the ability to use a wheelchair, have assistance, and understands what is happening to them. A cat without hind limbs would be bordering on inhumane.
Unfortunately, the client was out of her mind crazy. She also had not a penny to contribute towards any sort of care. Let me reiterate that this was not a "give him some medicine and he'll be okay" situation. If this cat had been my own, I don't think that even I would have chosen to try to treat him. His injuries were massive.
The client had spent 5-6 hours trying to obtain any sort of financial assistance. By the time I arrived, the cat had been suffering for far too long.
I stepped in to her exam room. Immediately, I knew that something was off. The client could not sit still, could not make eye contact, and was agitated. She did not answer any questions or respond to my comments, she instead spoke to herself and rocked back and forth. In my experience with 'crazy' clients, she looked like a typical methamphetamine addict.
Then the unthinkable happened. The client demanded to take her cat home, without treatment.
I was stunned. Nobody in their right mind would think of doing that to a poor, innocent cat. Of course, this woman was definitely NOT in her right mind.
I stated plainly - "I will not allow you to take this cat home without treatment. This is cruel, and definitely classifies as animal neglect. I will report you to animal control and the authorities if you try to leave the building with your cat. I know that it is a very sad situation, but your cat is suffering and it is my job to make sure that all my patients are relieved of suffering. Even if you had a million dollars, I honestly can't guarantee that this could be fixed. "
She didn't get it. She tried to walk out of the building with her cat, and could not listen to reason. I had had enough and could not stand to watch the cat writhing in pain for one second more.
I contacted our local police department and asked them to assist in enforcing animal cruelty laws, as I do not have the authority to confiscate a pet.
The police arrived and dealt with the crazy woman for about an hour and a half. She screamed, yelled, and threw things. She lied to the police and made up a story about another clinic doing thousands of dollars of treatment "for free." She made up crazy stories and eventually, the police told her that she could either agree to treat her cat (and present the funds necessary to do so), could agree to euthanize her cat, or she would be thrown in jail for animal cruelty. The cops prepared for a battle as the woman kicked, screamed, spit and was a all-around psycho as they escorted her from the building.
We couldn't thank the police officers enough for helping us to prevent this poor, sweet cat from suffering for one minute more. We pet him, told him what a good kitty he was, and teared up as I euthanized him.
For readers who have never experienced this sort of situation, I realize that it may sound odd that I fought for the ability to euthanize this cat. If left untreated, this cat would have died after days or weeks of suffering incredible pain, being unable to move, and having massive infection take over his wounds. The veterinary oath demands that I will use my skills for the "prevention and relief of animal suffering". There was truly no chance for healing and I couldn't allow this crazy person to torture an innocent pet.
Tough day. More stories to come.
~ERdoc
One of my most extreme situations ever occurred this weekend, and I'm very proud of my determination in preventing animal suffering.
I arrived at work in the morning and received patient rounds from the overnight doctor. One of the patients was a young, large beautiful cat who had arrived at 1am. The client found this cat tragically injured after being caught in a bear trap. As the cat entered the clinic, my colleague described that he was absolutely howling in pain. She quickly administered pain medication, despite the client's lack of ability to pay. The cat was injured nearly beyond repair. Both hind limbs were broken, in several locations, including the feet, ankles, and tibias bilaterally. Both hind limbs had severe degloving injuries; meaning that the skin was pulled away from the muscles, bone and tendons underneath. Both hind legs had the pads removed, and the tissue appeared very unhealthy due to lack of blood flow and overwhelming infection setting in. In order to try fixing this kitty's injuries, it would require far more than most veterinarians or clients are capable of - the repair would take months and months of dedicated treatment, daily bandage changes for much of that time, multiple surgeries, as well as thousands and thousands of dollars. My heart bled for this poor, poor cat.
If the cat was a human, amputation would probably be performed, however, a human has the ability to use a wheelchair, have assistance, and understands what is happening to them. A cat without hind limbs would be bordering on inhumane.
Unfortunately, the client was out of her mind crazy. She also had not a penny to contribute towards any sort of care. Let me reiterate that this was not a "give him some medicine and he'll be okay" situation. If this cat had been my own, I don't think that even I would have chosen to try to treat him. His injuries were massive.
The client had spent 5-6 hours trying to obtain any sort of financial assistance. By the time I arrived, the cat had been suffering for far too long.
I stepped in to her exam room. Immediately, I knew that something was off. The client could not sit still, could not make eye contact, and was agitated. She did not answer any questions or respond to my comments, she instead spoke to herself and rocked back and forth. In my experience with 'crazy' clients, she looked like a typical methamphetamine addict.
Then the unthinkable happened. The client demanded to take her cat home, without treatment.
I was stunned. Nobody in their right mind would think of doing that to a poor, innocent cat. Of course, this woman was definitely NOT in her right mind.
I stated plainly - "I will not allow you to take this cat home without treatment. This is cruel, and definitely classifies as animal neglect. I will report you to animal control and the authorities if you try to leave the building with your cat. I know that it is a very sad situation, but your cat is suffering and it is my job to make sure that all my patients are relieved of suffering. Even if you had a million dollars, I honestly can't guarantee that this could be fixed. "
She didn't get it. She tried to walk out of the building with her cat, and could not listen to reason. I had had enough and could not stand to watch the cat writhing in pain for one second more.
I contacted our local police department and asked them to assist in enforcing animal cruelty laws, as I do not have the authority to confiscate a pet.
The police arrived and dealt with the crazy woman for about an hour and a half. She screamed, yelled, and threw things. She lied to the police and made up a story about another clinic doing thousands of dollars of treatment "for free." She made up crazy stories and eventually, the police told her that she could either agree to treat her cat (and present the funds necessary to do so), could agree to euthanize her cat, or she would be thrown in jail for animal cruelty. The cops prepared for a battle as the woman kicked, screamed, spit and was a all-around psycho as they escorted her from the building.
We couldn't thank the police officers enough for helping us to prevent this poor, sweet cat from suffering for one minute more. We pet him, told him what a good kitty he was, and teared up as I euthanized him.
For readers who have never experienced this sort of situation, I realize that it may sound odd that I fought for the ability to euthanize this cat. If left untreated, this cat would have died after days or weeks of suffering incredible pain, being unable to move, and having massive infection take over his wounds. The veterinary oath demands that I will use my skills for the "prevention and relief of animal suffering". There was truly no chance for healing and I couldn't allow this crazy person to torture an innocent pet.
Tough day. More stories to come.
~ERdoc
Monday, November 21, 2011
Triage is the name of the game!
Last weekend was extremely busy at the ER. Multiple critical cases, mostly with positive outcomes, but of course some sad ones came through, too.
Out of all the chaos, the one call that I just can't understand -
The phone rings. My technician answers -
Caller: "Hi, I have a dog who's acting wierd. I need you to guarantee me that if I come in right now, I will be seen immediately."
Tech: "Well, sir, we'd be happy to take a look. We are an emergency room, and we're experiencing very high case loads right now, so a wait time does exist. When you arrive, a technician will triage your pet, obtain vitals, and if your pet is deemed stable, they will have to wait in line. The most critical cases have to be seen first, just like the human ER."
Caller: "NO!!! I demand that if I come in to see you, I WILL BE SEEN RIGHT AWAY!"
Tech: "Sir, what symptoms is your dog experiencing?"
Caller: "He's just acting weird, and I... I can't explain it. He's still eating and drinking normally."
Tech: "Has there been any vomiting or diarrhea?"
Caller: "No. But I WILL NOT WAIT! If I come, you have to promise me I'll be seen without waiting!"
Tech: "I'm sorry sir, but there's no way I can tell you that. Your dog sounds stable, but we are happy to take a look. If your pet is stable, you'll have to wait your turn to see the doctor. There are several people here waiting right now."
Caller: "FINE! YOU DON'T CARE ABOUT ANIMALS!"
**Hangs up.
WTF?
Out of all the chaos, the one call that I just can't understand -
The phone rings. My technician answers -
Caller: "Hi, I have a dog who's acting wierd. I need you to guarantee me that if I come in right now, I will be seen immediately."
Tech: "Well, sir, we'd be happy to take a look. We are an emergency room, and we're experiencing very high case loads right now, so a wait time does exist. When you arrive, a technician will triage your pet, obtain vitals, and if your pet is deemed stable, they will have to wait in line. The most critical cases have to be seen first, just like the human ER."
Caller: "NO!!! I demand that if I come in to see you, I WILL BE SEEN RIGHT AWAY!"
Tech: "Sir, what symptoms is your dog experiencing?"
Caller: "He's just acting weird, and I... I can't explain it. He's still eating and drinking normally."
Tech: "Has there been any vomiting or diarrhea?"
Caller: "No. But I WILL NOT WAIT! If I come, you have to promise me I'll be seen without waiting!"
Tech: "I'm sorry sir, but there's no way I can tell you that. Your dog sounds stable, but we are happy to take a look. If your pet is stable, you'll have to wait your turn to see the doctor. There are several people here waiting right now."
Caller: "FINE! YOU DON'T CARE ABOUT ANIMALS!"
**Hangs up.
WTF?
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