Wow

This weekend was a busy one in the ER. 14 hours on Saturday and 13 hours today. It's very difficult to manage gestational diabetes with a schedule like I work. Saturday wasn't so bad that I couldn't eat my snacks and lunch on time. My wonderful husband got up at 7am on Saturday and fixed me breakfast to ensure that I ate prior to work. The day balanced fairly well and my numbers were ones I was happy with. Sunday was a different story. The husband made breakfast again and packed me lunch. I never got a chance to eat it, as I was running from the moment I hit the door. It was exhausting, and I never really caught myself up with the food. Hopefully, I'll do better next week.

I had a horrible case on Saturday that left me shaking in anger when all was said and done. When trying to sleep on Saturday night, it kept coming back to haunt me.

An older couple presented with their morbidly (and I mean MORBIDLY) obese Labrador (140+ pounds). He'd been locked in their car for 3 hours in the 90 degree heat. When he presented to us, he was laterally recumbent with petechiae forming on his skin. He was also having diarrhea and vomiting - all bad signs.

The owners were asked for the $500 critical care/triage deposit to get started. They flipped out - claiming that was too much money. Before things got heated, I brought the owners back to ICU - thinking that I could discuss heat stroke with them, their dog's prognosis, and give them a better idea of what to expect.

Nope, the owners were adamant - $500 was too much to treat (and that was just to start - a dog this large with a heat stroke would probably run into the $2000 range). I commiserated slightly about the cost in my best soothing doctor voice and recommended euthanasia, given the dog's dire situation.

That's when things got ugly. The female owner refused to make eye contact with me.

"I don't want him to die here!" she semi-yelled. "I want him to die on MY terms." She then said, "we're not putting him down, that's not an option." Bewildered, I tried to again explain sepsis, DIC, and acute renal failure. The owners would not listen. They wanted to take him home - to live or die there. Finally, I looked straight at the husband and said, "your dog is going to die a horrible death if you take him home in this condition."

The owner patted the dog and said, "We think he'll live."

My mouth was hanging open.It is exceedingly rare that I will tell an owner that they are being cruel, but I told these owners in no uncertain terms that what they were doing was inhumane. I almost mentioned that the dog WOULD die on "their terms" - as their terms had included leaving him in a boiling car for 3 hours.

It all fell on deaf ears. They signed an against medical advice form and left, putting their vomiting, laterally recumbent, petechiated Labrador into the back of their SUV and driving off. I felt sick. I still do. Especially because today - we saw a dog that had a heat stroke yesterday. The owners did not seek treatment and now the dog is vomiting pure blood, oozing from every venipuncture site, and dying. Just like the Labrador is probably doing in some backwoods shed someplace.