Yesterday was not exactly the kind of day we dream of as we file into our classroom on that first day of vet school. Nametag-adorned first year vet students live with another sort of fantasy—one of animal service provided lovingly for grateful parents and their beloved pets.
Yesterday it just wasn’t meant to be. It was one of those rare days when I had to practice colleague-free—an unexpected, unscheduled departure from normal that left me double-booked with four surgeries to manage along with a lunchtime meeting.
And so I started the day with a simple query: Will there be enough hours in the day to accommodate everyone? What if a serious emergency comes in? Should I cancel some of these appointments?
I had no time to muse further on the day’s banquet of cases: they were already walking through the door in droves. Get moving, Dr. Stress, and forget about what’s coming. (I talk to myself thus. Is this normal?)
My first case of the day? A foundling kitten adopted by this client’s elderly father weeks ago. Much loved, it had been sleeping nestled in his arms as he’d nursed it back from a state of emaciation. Unfortunately, this ten-week-old little female had not yet seen a vet. She had an upper respiratory infection, mange, ear mites, intestinal parasites—the works. But it was only when the FIV (feline AIDS) test turned a telltale shade of cobalt blue that I knew we were headed for seriously stormy weather.
One [extremely tearful] phone call later and the decision had been made—no way could they keep this sick, FIV-positive kitten. There were other cats in the household to consider. The FIV-positive households (to whom I occasionally appeal for placement of such cases pending further testing) were full-up. The kitten was euthanized.
Next up, rechecks on two of the three Yorkies from earlier this week. Pneumonia-boy was doing well, despite his slacker-client`s patent inability (unwillingness?) to medicate him properly. Discussions on dosing techniques followed, with the strong recommendation to hospitalize until we were past the critical period where antibiotics were crucial to successful treatment. Declined.
Renal failure-girl was eating but her owner had ignored recommendations to feed the low protein diet I’d prescribed or the list of lower protein baby foods I’d suggested. Vitamins and phosphate binders? (But she’s eating! Do I still need to do that?) More of the same explanations I’d offered two days ago seemed lost in the [very dark] space between her ears. This one’s not going to make it for very long, I conceded.
A stack of simple cases, four straightforward surgeries and one lunch meeting later I got hit with another doozy: a second opinion from another hospital. Though necessary in many cases, I dread them. Too often they involve uncomfortable bad-mouthing of other vets and a lot of dickering over prices. Most complicated cases, I believe, deserve second opinions from specialists, not from little old me. Nonetheless, I faced this new client with an open mind.
A geriatric, obese cat with a huge ear hematoma was plopped unceremoniously onto the exam room table. Just look at that ear! The other vet drained it three times and shot it up full of drugs and it still looks like hell. (Yep, it looks like hell. Let’s fix it so we can treat the ear infection that caused it.) But I want you to do it without anesthesia, Doc. (Um…I don’t think we can do that. The ear is extremely painful at this point and nerve blocks don’t work well in that area.) Well, I can’t spend a fortune. I mean, he’s already fourteen!
Twenty more minutes of explanation and wrangling and the cat was installed in a kitty-condo getting prepped for surgery tomorrow.
After another train-wreck geriatric cat in desperate need of serious dental work, I was forced to deal with the worst case of the day: a convenience euthanasia double-header. Mom had died. The daughter-client had brought Mom`s pets in to tie up loose ends after her passing. One obese kitty (nine or ten) and one geriatric Cocker Spaniel were looking at me warily from their opposite locations in the exam room.
I couldn’t do it, I explained. But my colleague, who had been a good friend to this client for many years, had promised he would. She begged. He was out sick and would likely be out all week. What am I supposed to do? How can I kill two animals like this? Overwhelmed by my frustrating position, I conceded.
I can’t tell you how upset I am at myself for caving like this. I had too many other patients to think about and took the easy way out. This is not what I went to vet school for.
Days like this will pass. But my actions will last forever. Contrite as I am I know I’m forgiven. Nevertheless, when I look back to my wide-eyed idealism on my first day of vet school I can’t help feeling I`ve been chasing windmills all this time. But I know this too shall pass. There`s no doubt—today will be better.
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I can’t tell you how upset I am at myself for caving like this. I had too many other patients to think about and took the easy way out. This is not what I went to vet school for.>>>>
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Dr. Patty-
I really feel for you. You were in a bad spot, and did what you had to do. I am sorry you had to do it. Maybe you can think about an action plan if this ever happens again. Take care, and don't blame yourself!
Judi
Judi December 8th, 2006 03:32:00 PM
I noticed over at Fat Doctor she had your blog listed. I can tell you that I stayed up wayyy too late last night reading through it! Sounds like quite a day and that you handled it like a trouper! Don't beat yourself up for the "convenience" euthenasia. I imagine that they would have ended up in shelter and porbably not adopted for their age and then euthanised. Not the ideal end for them either! In the end you may have protected them! I hope that doesn't sound bad. Thanks for sharing!
Mandi December 8th, 2006 08:28:00 PM
You shouldn't fell bad. The daughter is the one who should be having guilt pangs. At least they left this world in the company of a caring and compassionate vet. I'm sure you told them YOU loved them as they went to heaven. Now they can be with their owner. I hope the daughter is kept awake nights bothered by what she did. At least now there is no danger of those poor pets being mistreated.
Lori December 9th, 2006 03:53:00 AM
This truly sounds like an awful day, and I'm so sorry that you -- and the animals -- had to go through it! I agree with the comment that suggested brainstorming ways to handle the convenience-euthanasia issue if it comes up again in the future; I also agree that those animals probably had a kinder end from you than they'd have had from a shelter.
I once had a stint ofgoing to our local shelter, every day for eight weeks, to look for a missing cat (never found him: he probably became dinner for a coyote . . . we keep our cats indoors, but he'd knock screens out of windows to get out). Of course we adopted a new kitten from the shelter, but I saw terrible things when I was there: people bringing pets in for very trivial reasons even when staff explained that the pets would probably wind up being euthanized rather than adopted. Some of the staff there told me that their job really makes them hate people.
At least you're in a setting where most of your clients care about their pets -- enough to pay for vet care, even if they haggle about the price. But I imagine that's small comfort after a day like this one!
Susan December 9th, 2006 12:53:00 PM
Thanks for the comments. My colleague and I actually discussed the issue yesterday. He confessed that one of his recent cases left him sleepless after he realized that he`d mistakenly conceded to the client`s demand for premature euthanasia. The dog was ill but not deathly so. This owner just couldn`t handle the stress in her family for a variety of other reasons and this seemed like the easiest way out for her. He and I talked about what we should do about these cases in the future and agreed to always run them past each other and never undertake them without weighing in with each other first. We`re considering a waiting period alternative as well. Thanks for your suggestions they helped. Hopefully we`ll have a more complete policy with appropriate protocols soon.
Dr. Patty Khuly December 10th, 2006 10:42:00 AM
Can't you refuse? Lots of older pets find homes, maybe you should work with a rescue. I am fostering a 10 y.o diabetic cat right now who is an evil owner giveaway. That woman would turn over in her grave if she knew what her children were doing to her beloved pets. Bet the animals were closer to her than the kids were in her later years, otherwise, they couldn't do something like that. I don't know a child can betray a dead parent in that fashion.
Stefani January 1st, 2007 08:04:00 PM
my mother's trust office set up everything to be taken care of when she dies. closing and selling the house, selling off her belongings, and putting her 2 cats to sleep. my mom was reluctant to agree but decided that it was easiest and most convenient for all (except the cats!) i talked her into letting me take them home with me (to michigan from arizona) when the time came. she was greatly relieved. she really loves her "kids" but didn't want to be a bother even after she was gone.
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