Friday, December 17, 2010

Want some wine with that cheese?

The last 2 nights have been significantly less than stellar. SIGNIFICANTLY.

7:00pm Wednesday night, an owner calls. Her large breed dog has had 2 puppies, both dead. The third one was born alive, but the bitch accidentally eviscerated the puppy while chewing the umbilical cord. Further, the bitch has stopped pushing and produced no more puppies in over 8 hours.

My technician recommends bringing BOTH mom and the eviscerated puppy in ASAP. The owner declines to do so and hangs up. At 11:30pm, she calls back. The puppy with its intestines hanging out is dead (there's a real shocker), and the bitch has not been pushing. Should she bring her in? My technician counsels her AGAIN that bringing in the dog is imperative. The owner demures.

1:15am, I am dog tired. Owner shows up with a ONE HUNDRED AND TWO POUND dog in tow. No puppies. Owner doesn't have finances...but she's been breeding for 20 years, and she knows all about it. She coughs up the money for xrays and an ultrasound. I see 5 puppies, 3 definitely alive on ultrasound. There is no obvious cause of fetal obstruction, so I recommend trying oxytocin to stimulate labor.

It starts to go downhill at that point. The owner complains that she doesn't want to sit around for 3 hours and wait to see if numerous doses of oxytocin work. She has to be up at 5am. However, she doesn't have money for c-section. She's not worried about live puppies. She asks me if she can get one shot of oxytocin and take the dog home. I tell her she can do that, however I would strongly advise against it. She whines some more, then she asks me what I would do.


It takes her an hour of more wasted time to decide to try oxytocin. Another puppy is born, but it is dead. I call to give her the news. She suddenly becomes extremely worried about the other puppies (previously she said she was not concerned with live puppies). I recommend c-section if she wants any live puppies (although I tell her that the chances of any surviving at this point are slim). She wants another ultrasound to see if any are still alive.

I'm rapidly losing my patience. Another u/s reveals live puppies still. Mom suddenly comes up with enough money to do a c-section, so to surgery we go. It is now 4:30am. Surgery is bloody, as all c-sections are. It is not routine in any fashion. The puppies are absolutely enormous. There are 4 left. The owner - OF COURSE - did not want the dog spayed, despite the fact that she was SIX YEARS old and well past good breeding age. Unfortunately, I had to make 4 uterine incisions (when normally I make ONE). The uterus was friable and tore. In the end, I had my technician call and tell her that the uterus needed to come out. I was afraid to leave it in, as I was seriously concerned about healing.

Then it got really interesting. For no discernible reason (and believe me, we exhausted the possibilities), the dog went into complete cardiac arrest. We started CPR in the operating room. Her heartbeat came back. I continued surgery. She died again. We got her back. I continued surgery. Repeat 2 more times.

Yes, she died 4 times in surgery. Amazingly, she pulled through and recovered from anesthesia. I suspect occult heart disease contributed to her cardiac arrest. We removed four puppies from the uterus, 2 alive, 2 dead. One was so huge that I realized surgery was necessitated from the start. There was no way that puppy was coming out.

I didn't leave work until well past 9am, collapsed into bed around 10am, only to get up and do it all over again last night. Last night was also a nightmare. One of my techs called in sick; the receptionist called in sick, too. So we were staffed with 2 techs and myself. Further, Everyone had a problem with money last night.

We had one couple who signed an estimate for their very ill cat, agreed to payment, then threw a fit at the register when they realized that we run our checks electronically. They accused our technician of lying to them over the phone about taking checks. It got ugly. Then there was the young, well-to-do looking lady with her 2 little dogs that ate a bottle of Rimadyl. We decontaminated them, treated them with activated charcoal. Then the perfectly nice looking young lady threw a fit (literal) that her bill was $300. She protested that she was quoted $92 for the first dog and $46 for the second (our exam fees). When we explained (again) that those were the exam room fees, she stated that since she was not told the price for treatment, she should have to pay nothing. I didn't let her get away with that.

Then there was the nice young guy with his beautiful dog that somehow managed to badly break its leg in the backyard. He had the $92 to be seen and nothing else. We discussed options: amputation, orthopedic surgery, or long-term cage rest and pain medications with questionable return of function to the leg. He could do NONE of those things. His wife hated the dog and wanted him to get rid of it. The dog was euthanized while the man held it in his arms and sobbed.

After all this, one of the only 2 technicians I had melted down in the ICU. She had been in surgery with me the night before, dealt with the stupid, thoughtless owners who were only concerned with breeding and producing puppies to sell, she'd dealt with the owners that night complaining about money, and then had to assist with euthanizing the dog with the broken leg. So, she lost it in the middle of the ICU - sobbing hysterically, asking me "why, why?? Why are people such idiots? Why do people breed? Why is it our fault that we can't fix them for free?" - tears streaming down her face.

I had to resist the urge to run screaming and crying from the building myself, but I kept it together. Thank god I have the night off.


Shannon said...

I don't blame your tech for her break down nor would I have blamed you if you had run screaming from the building. It scares me how horrendously people treat their animals and how horrendously people treat those that are charged with caring for them in a medical emergency.
It says a lot about our society that we regard pets as disposable as pop cans and value the lives of those that we say we love to the tune of $96.
I'm sorry you had to go through that.

MTWaggin said...

How any vets or vet techs do their job is beyond me (shelter staff also gets kudos). I ADORE animals but I cannot deal with STUPID PEOPLE! Therefore I stick with computers for a living and love my animals in all ways!

Okay so here is a requests (you were taking those recently yes), can you post us with an uplifting Christmas gift of a story where the owner wasn't stupid and....?

:) PS I can't blame a tired tech or vet for having a breakdown after all that. You all amaze me!

The Homeless Parrot said...

Thanks for the support guys. :)

MTWaggin, it made me really sad this morning because I am STILL wracking my brains to figure out a good, really happy Christmas story. I'll post as soon as I do.

Elizabeth said...

It makes me so angry to hear about these thoughtless people.
I have a friend right now who rescued a beautiful Bernese Moutain dog about 7 months old and is fighting so hard to keep him alive. He suffered terrible abuse. His back was broken and set without any Veterinary care and it looks like there is infection. He is in terrible pain today and I think his pain may be ending today and I am so sad. It is so not fair because no amount of money is helping this poor boy now..

sarahMTSBB said...

poor things- you, the techs, and the pets! THAT is why i'm a medical technologist instead...i'm strongly encouraged to help keep the patients alive and no longer sob over that kind of stuff. i hope that your clients bake for you at least!

Holly said...

I am so sorry for such a crappy couple of days. I am sorry for your tech, I am sorry for you, and I am sorry for the animals that had such careless, stupid owners.

In memory of the Broken Leg Dog, I will hand out extra treats to my pack tonight and I will snuggle up them for an extra few minutes.

For YOU and your techs...I am sending calorie free cyber chocolate of which ever decadent variety you choose. Help yourself.

I'm with MTWaggin...I don't know how you do what you do, but I'm glad you do!

Anonymous said...

Oy, I have to give you kudos for being an emergency vet! Even I don't think I'd be able to muster up the energy to stay calm and deal with those clients. I hope you get well-needed rest and have a good holiday!

GuitarGirlRN said...

I'm always amazed at how people expect vets to treat animals for free. I'm an ER nurse, and one of my colleagues was talking about some pet-related thing, like an annual checkup. She was talking about how expensive it was, and I said what, vets are in business and they expect to be paid for the expert services they provide. She said,"I know, but they shouldn't be GREEDY! They should be in it for the ANIMALS!" to which I said, "you're paid a salary to be here and do your job, right? Or should you do it for free fir the PATIENTS??"

Mary said...

What percentage of clients have trouble paying/make comments, etc.? (Obviously, nothing exact, but wondering if it's like 20%/50%/80%?)

Luckily have only had one experience at the emergency vet -- about a year ago. I thought the cost would be way more than $1000 and was very pleasantly surprised when it was less than $500.

I just cannot imagine pulling the kids of tricks your clients try to pull all of the time!

Mary said...

Oops -- *kinds* of tricks

At the parrot rescue where I volunteer, I once had a woman who'd just talked about buying an expensive puppy (over $1200) try to talk me into giving her a parrot for free because she couldn't afford the adoption fee (around $200 for a bird that would cost at least $600 from a breeder and probably over $1000 in a pet store).

Frustrated me to no end, for many reasons.

belovedparrot said...

Here's the solution to your money problems: Hire a BIG mean looking dude who doesn't talk much. When it's time to present the bill, have him do it. When a client starts complaining, have him come in to "listen" to the complaints, cracking his knuckles as their whining goes on. His presence will make them understand they're not dealing with some wishy-washy bleeding heart vet who "should" do all this for free!

belovedparrot said...

I think it's horrible what you have to put up with. I know there are bad apples in every industry, but when it comes to animals and children my understanding starts to run out. Please take very good care of yourself, okay?