My head: 0 Wall: 1

At 7:30am on Thursday morning, 30 minutes before I left for my week of relaxing, camping, football, and good friends, a woman rolled through the front door with her large breed (>60 pounds) male dog that had been neutered the day before at the local El Cheapo spay/neuter clinic.

The dog's empty scrotum was about the size of a cantaloupe or maybe a small melon. It was bruised, and blood was leaking from the incision site. This is a somewhat common post-operative complication of big dogs that are neutered later in life. It's called a scrotal hematoma - when there is marked hemorrhage at the incision site after surgery, and the scrotum fills up with blood. It looks downright horrifying but is rarely life-threatening. Treatment is usually strict cage rest, cold compresses, an e-collar to prevent self-trauma, sedation, and anti-inflammatory therapy (prednisone often).

In this case, the dog did not have a cone of shame on, and he removed his stitches for us. As a result, I had to sedate him to clean the incision site and re-suture it. She had the neuter done for $20! At our ER, sedating a big dog and sewing up an incision costs about $300. Of course, she didn't have it. After an hour of running in and out of the front doors, calling people, and applying for CareCredit, she finally procured the money. I gave her the option, since it was ALREADY 8am at this point, of waiting to see her veterinarian (who might be able to work with her financially) or going back to the spay/neuter clinic. She did not want to wait. She was very slow, and the sight of her dog bleeding sent her into near hysterics. No amount of explaining that her dog was going to be just fine could convince her to wait a half hour.

I sedated the dog, removed the chewed out sutures, placed new ones, cold compressed the scrotum, and administered anti-inflammatory medications. The dog recovered rapidly. Afterwards, I carefully went over his care with the owner - explaining that the incision would likely still ooze blood for a while, that cage rest was important, that the scrotum would remain swollen for anywhere from 5 days to 3 weeks. I also explained that RARELY, a scrotal ablation (complete removal of the scrotum) is needed if the sac becomes over-stretched. This is a last ditch approach due to the bleeding and the need for complete anesthesia again.

2 days ago, the incision was still oozing. The owner took the dog to her veterinarian. He advised her that the blood was old, the hematoma was healing, and she should go home and not fret too much. She called our office, demanding a refund yesterday because we "didn't do anything for her dog."

Really?

No, really?

I didn't sedate your dog and replace all the stitches he had torn out? Must have been somebody else at another clinic. Perhaps I was sleeping and dreamed that I repaired your dog's surgical site. But that doesn't really constitute doing anything, right?