Tuesday, August 17, 2010

Exercise in frustration

Nothing - absolutely nothing - is as frustrating as the failure to communicate with an owner. That feeling of wanting to knock your head against the wall repeatedly until blood spills out of your ears is never a good one.

Last week, we were presented with a THIRTY POUND miniature dachshund. In case you aren't familiar with breed standards, a mini dach female should weigh in at about 11 pounds. This dog was morbidly obese. She had also developed diabetic ketoacidosis, a nightmare to treat under the most ideal circumstances and with all the finances in the world.

These were not ideal circumstances at all - a terribly obese dog with a mentally handicapped owner that had serious financial limitations.

The referring veterinarian that diagnosed the dog tried to talk them out of treatment and heavily recommended considering euthanasia. The owners refused, then changed vets the next day (after starting treatment at the original vet). The dog came to us on ER for overnight care. We discussed again that this disease is often fatal, usually recurs, and can cost upwards of $3000 to effectively treat.

The owners wanted to continue despite our heavy caution. Over the next 3 days, the situation deteriorated. Financially, the owners could not accept the burden. They maxed out their CareCredit, pawned their wedding rings to get more money, and they were considering selling their car on the last day that I saw the dog. She did not noticeably improve over her 4 days in the hospital, although her blood glucose became more manageable.

Over the course of 3 nights, I knocked about $200 off the bill. And the dog still did not get better. She was eventually discharged by the referring veterinarian and sent home on injectable insulin, although she was nowhere near ready. The finances were just too tight.

In the end, no one feels good in that situation. We WANTED to help the owners, but they were absolutely stubborn in their refusal to understand the big picture. This dog WILL be back in 2-12 months with a recurrence of DKA. They are already feeding her tuna in heavy oil at home - AGAIN (she also had pancreatitis). They are obsessively checking her blood glucose and adjusting her insulin based on the results (a big no-no!), crushing up human glucose tablets and administering them, and basically screwing up everything the vet is trying to accomplish in regulating her diabetes.

It's a shame when communication fails. No one wins in that situation.


Michelle said...

My heart goes out to you. It must be enormously frustrating for a vet to come up against these obstacles.
I had a cat with diabetes on insulin. He was fifteen when diagnosed. We followed directions very carefully and even then it was costly and difficult. Jake just passed away this year, at age eighteen.
I am disabled, however, it does not impare my judgement on how to treat or end treatment on my animals. You are up against tough odds on this case with the daschund.
I will pray that all parties involved come to a mutual agreement. I know the heartache of limited financial funds, and have seen the toll that poor owner judgement has on the vets caring for the animal.
Blessing to you for your caring heart.


The Homeless Parrot said...

Michelle: He was mentally handicapped, an injured veteran - which made it all the harder. I admit, I was frustrated with him and his wife, but I also felt terribly sorry for them. They have no children and regard this dog as such. Obviously, in their house, food is love...