Thursday, November 25, 2010

Oh come on! Someone step up here...

First night back was fun, of course. Isn't it always?

I'm in a room talking to a client about her dog's impending surgery when I hear my name yelped out by a technician in the ICU. I exited the exam room in a hurry to find my technicians working frantically on a hit by car dog.

Said dog weighed about 15 pounds, and her pelvis was on backwards. In less silly terms, she obviously had fractured her spine, as she was completely limp from the waist down. She had bright red blood coming out of her vulva and was in severe shock. Her condition was extremely critical, and my technicians had already placed oxygen by face mask and an IV catheter.

There were FOUR adults with this dog. FOUR. The owner was in another state. Presenting the dog were the owner's father, her brother, a sister, and possibly a sister-in-law. We told them $500 to get started on stabilization and diagnostics. They declined. No money, they cried.

"Fine," I replied. "Please have whoever is making the financial and medical decisions come back here so that I can discuss the situation while monitoring the dog" (who got a whopping dose of pain medications at that point, despite the financial situation). My tech went to get someone. Minutes passed. No one came. The door alarm rang multiple times as the 4 people rushed in and out, making phone calls, standing around discussing. They consulted. No one would fill out the required paperwork, and no one would come talk to me. I stood there, tied to the patient, because my other tech was in isolation caring for 2 very sick parvovirus dogs.

Finally, the owner's brother came back. "Uh, yeah, we're going to take her (the dog) to another vet up the road in X town."

My reply, "uh, no sir, you're not. He is closed for the holiday. There are no other veterinarians open at this hour and on a holiday eve. This dog is severely injured with a guarded to grave prognosis. You either need to commit to diagnostics and treatment (what treatment options there are) or euthanasia. This dog is NOT leaving the clinic."

He mumbled, "my dad is making the decisions." I politely requested that he get his father.

More minutes pass. It has now been almost an hour since the dog presented. I have 3 patients with paying owners that are waiting for their IV catheters, fluids, and further testing that cannot be attended to because these people are running in and out of the front door, making a scene, and basically throwing a huge wrench into the flow of our small clinic. I spend another 10 minutes waiting.

Finally, I march out the front door, furious. They are all standing around. "I need you," I say firmly and point to the father. He trails me reluctantly to the ICU where I give him the same talk. He says his daughter (in Florida) is hysterical and cannot make a decision. I tell him the decision is clear if finances are a concern. It may be clear even if they have a million dollars.

"I have to talk to my daughter," he says, and out the door he moseys.

At this point, I am purple. The dog is suffering, needs to be euthanized, and not one - not A SINGLE FREAKING ONE - of these adults will step up to the plate, procure a small amount of money for me to do the humane thing (or a larger amount to do some diagnostics and confirm my suspicions).

At this point, it has been over an hour and 15 minutes, and I am sick and tired of my paying clients that need care being ignored. I march back out front and tell the whole group they need to make a decision. The sister-in-law says, "Why can't we just take her home and let her die there?"

My gut response was this, "If you were hit by a car, broken practically in two, and in shock, would it be ok if your family took you home to let you die??????" I was horrified, but I did not actually say this. I sort of wish I had.

In the end, I euthanized the dog for free. I had no intentions of leaving it to suffer, whatever the owners financial situation. They paid the exam room fee and nothing else, despite the treatment we initiated. Then...oh THEN...they had the gall to try and request private cremation afterwards - which costs $200! I told them in no uncertain terms that before we could proceed with private cremation, they would need to pay for the IV catheter, pain medications, oxygen, and fluids we had already administered to their dog to ease its pain and treat its shock.

Oh, the backpedaling that occurred then. The dog was taken home to be buried.

Seriously?? Look, I understand not wanting to plunk down $500 on someone else's dog, but for the love of God, between 4 adults ranging in ages from 32 to 75, you cannot produce $200 to do the right thing for your daughter's/sister's pet??

It was not a good start to the night. Thankfully, while we stayed busy last night, we had no other real "excitement."


MTWaggin said...

Consider this...same 4 ADULTS (I use the term loosely) that let the dog get hit by a car to begin with! No surprise.

Holly said...

MTWaggin....sometimes things happen. With 4 adults and who knows how many kids or visitors ....stuff happens. Some might not know the dog is there, or might be paying attention to someone else coming in or whatever...leaving the door open just a few seconds longer and the dog is out.

That said, I cannot understand the fact that these people do not see the gravity of the situation. I saw it from the internet.

Thank God for vets like the blog author....who have the compassion to do what needs to be done IN SPITE of the less than adequate decision making abilities of the other people involved.

HP, how does your clinic stay in business???? With another $200 (or plus) loss on the books, I am amazed that the clinic stays in the black.

Also, thank you very much for the comment on Puzzle at my blog. She's a dear little cat that both Courtney and I try to do many things with in order to enrich her life. Part of the reason I take her places is so that she also will recognize home, should she escape. I want her to know her neighborhood because as I stated above "stuff happens". Yesterday, she had fun AND when we got home she trotted right up to the front door, so I think she knows "her" house.

Elizabeth said...

OMG - idiots .. the poor dog.
Thankfullu HP you were able to stop its suffering.

I know stuff happens and I try to be prepared when I go away. I leave signed letters with my petsitter giving my Vet and the clinic ( 24 hr er )the power to treat my animals and to make all medical decisons on their behalf if I cannot be reached.. My credit card number is on file.
I do this for two reasons, first my petsitter does not have to be the one to make the decision (not fair) and I trust that my vet and clinic to make the best decisions for my pets in my absence. Whatever that decision turns out to be I know they have the best interest of my pets at heart.

Holly said...

Oooo, Elizabeth that is such a good idea. When I head out to the NRHA futurity, I am going to leave that information with my clinic.

Thank you!

Life in vet school said...

Elizabeth, I do the same thing you do. I've gotten a couple of funny looks and snickers when someone pulls my dog's file and sees the note on top, but I'm perfectly fine being "that crazy dog lady" if it means my kids get the best care. :)

HP, some people just do not deserve to live.

Michelle said...

My heart goes out to you. What a horrible position to be put in. You did a gracious thing by not charging for the euthenasia. I believe I would have wanted to strangle one or all of the bunch, that together, couldn't muster up enough brains to do the right thing by the dog.

Hope you had a blessed Thanksgiving.

C. Todd Dolen, DVM said...

Enjoyed reading your blog! Thanks for stopping by and checking out mine. Nice to know there's another UT blogger vet out there. Hope you're having a great holiday.


The Homeless Parrot said...

Holly: MT has an unfortunate point. While accidents certainly happen to the best of us (even me) - the vast majority for the hit-by-cars I see did not slip a leash or run out an unattended door or gate. They are free-roaming dogs that have bad luck - especially in our area. It's sad and frustrating because it's so preventable.

With respect to running in the black as an ER - you might be surprised (or not) to hear that our profit margin is very, very slim. We are owned by a board of local veterinarians. Our function is to handle their emergencies so that they can have quality of life. That is basically all they care about. While it's lovely that we do actually run in the black, that is only a recent development - courtesy of our amazing OM. She has been running the place for 5 years. Prior to that, the clinic was losing a large, large amount of money.

The place I did my internship ran in the red year after year. It likely still does. I have no idea how they manage to stay in business (it was a total mystery), but it's not uncommon for ERs to be unprofitable.

People who come in and cry poor or complain just don't understand that we have no subsidization. We rely totally on payment for services rendered. There is no government to help us, no insurance companies (well, very, very few), and no Medicare for dogs.

The Homeless Parrot said...

Elizabeth and HT: I think that is an excellent idea, and I would never snicker or think you were crazy for providing that information for your pets. That is absolutely wise. I can't tell you how many times I have been presented with a critically ill or injured animal by a petsitter, the owners are unreachable, and the petsitter doesn't have $500-1000 to plunk down for treatment. It's a terrible situation to be stuck in, and I wish all owners thought ahead and planned accordingly.

When I go out of town, my petsitter/tech has 6 or more phone numbers and knows that she is authorized to take any of our pets to work as needed (or the birds to the avian vet 1 town over).

The Homeless Parrot said...

Michelle: Thanks. I worked, but it wasn't a bad day!

Holly said...

Ooooo, I must not have been clear.

I believe you HP that most hit-by-cars are free roaming dogs. I just thought this must have been a house pet that escaped because of the # of adults in your waiting room. That can happen to anyone (tho, I purposely train door behaviors for that very reason).

As a very experienced dog trainer said once, training holds when management fails (leashed get dropped, doors left open, attention waivers). This is what I was thinking when I posted.