Vet Stress So sorry—I left my tricorder on the Enterprise (unreasonable expectations in pet medicine)

How many times can I say it. I’m truly not trying to steal your money. It’s just that there’s no way I can tell you what’s wrong with your pet unless we probe a little more deeply. X-rays, bloodwork, urinalyses, ultrasound, CT scans and MRIs are but a few of the items on the menu. The one thing I can’t offer you? A tricorder eval.

Remember that device “Bones” used to determine what the heck was wrong with the characters on Star Trek? The tricorder?

Well, I ain’t got one.

Unless you let me test your pet with the tools we do have, I’m not likely to figure out the disease process your pet is suffering from—not without any certainty anyway. And even if I used every tool known to vet science, I could never promise that I’d ever locate the source of your pet’s illness. Some diseases are just that insidious.

That’s life and medicine as we know it now—for humans, too, in case you think we vets too backwoods to compete with a full arsenal of diagnostics.

Yet that’s not the expectation I’m frequently faced with. People want to know—now!—exactly what’s wrong with their Fluffy. And they can’t always pay for the job of figuring it out or are often too impatient to await the results.

Sure, I can make educated guesses (which we can agree to pursue without diagnostics on your pet’s behalf) but don’t blame me if things don’t go just right. Animals (and this includes humans, too) are just too complex for our simple brains. We need tools, techniques, reasoning (which can often be faulty by design) and an ability to put them all together.

Yesterday’s client was one of these: “What do you mean we have to sedate her for those X-rays?” After 10 minutes of struggling and stressing out a Pug to near asphyxiation, it was clear that we were correct in our initial assessment. This owner was not satisfied, despite my best efforts to explain the constraints this dog’s airway and anxiety provided.

Just beam me up, Scotty. Clearly I’m not capable of figuring this one out without my tricorder.

God knows I’d love one of these babies. Though it should have rendered the good Doc on the Enterprise a mere device-holder, even he still managed to keep his post in Starfleet after a trillion episodes. That alone should go a long way to proving that even the tricorder wouldn't be enough to satisfy the likes of some pet owners. Sigh.

January 26th, 2008

Add Comment17 Comments

Your post made me think of a cartoon, I just wish I could remember who published it. It might of been Gary Larson but I'm not sure.

Anyway, there is a dog laying on a exam room table and there's a cat walking around the dog. The dog owner asks what's up with the cat and vet says that he's doing a cat scan. DOH! LOL

Not a helpful or even insightful reply, but the next time a client complains about having to go through the process of elimination to figure out what's wrong with their pet, perhaps you'll think of the "cat scan".

Stacy January 26th, 2008 09:31:00 AM

Stacy: Then a black dog walks around the patient and the doc charges for the Labwork. That's a classic.

Dr. Patty Khuly January 26th, 2008 09:35:00 AM

Don't forget you're supposed to be able to diagnose over the phone too :)

Does your tricorder work over the telephone line?

Michelle Schwab January 26th, 2008 10:01:00 AM

Also via email.

Diana January 26th, 2008 11:11:00 AM

Hi - I just wanted to say that your post helped. I'm a moderator on a feline IBD forum and shared your link with the members here. One woman said it helped her cope with the recent loss of her beloved pet. I'm hoping she posts her response here - but wanted to let you know you made a difference.

Jenny January 26th, 2008 11:22:00 AM

Dear Dr. Patty,

I enjoy your blog very much and, as a nurse who works with the public, can easily empathize with your frustrations. But frustration with clients seems to be a recurrent theme in your posts and I'm wondering if a) your clients read your blog and b) if that influences their decision to move on to another vet...as you mentioned in an earlier post this week.

As health care professionals we have to give a measure of respect to our clients, whether they deserve it or not. That's one of the things which makes us "pros." Venting to coworkers, behind closed doors, is one thing. Venting on the internet, giving your name and the location of your practice, is quite another. Have you considered how your clients might feel on reading your posts?

I've had to make some hard decisions, sometimes based on finance, sometimes just because I disagreed with my vet about what's best for my dog. I have no doubt that my vet's thoughts occasionally ran towards frustration with my choices but if I read those frustrated thoughts on a public blog, I'd find myself another vet. No one, not even an idiot, wants to be called an idiot in public. My advice, given with great affection and for what it's worth, is tone down the snarkiness or blog anonymously.

Anne

Anne January 26th, 2008 04:04:00 PM

Well, I'm not one of Dr Khuly's patients, but I have occasionally been privy to some of my vet's more human observations about me and my animals and it makes me respect her more. As a reader of this blog, I'd have no problem bringing my animals to see Dr Khuly.

Juli January 26th, 2008 06:16:00 PM

I too am a nurse. I know what it's like to have to vent. It's a MUST!!! If no one will listen, the internet (and including dr. k's fans) will! Hell I'd do the same thing if I had the time and my own personal big blog too fill up. My stories would be a little more interesting though because I deal with mentally ill. I wish we had a tricorder too. It would make my job a lot easier when everyone says they're sick just to get more medicine or to try get high off cough syrup. While we're at it, let's get some truth serum into public facilities.

ashleigh January 26th, 2008 07:07:00 PM

Maybe it's just my sensitivity, but it's too often the stressful things that stay with us when we go home at night. I guess I consider it a tribute to the kind of pet owners reading this blog that I assume you'd know I'm not talking about you. I do have clients who read Dolittler
and they seem to be comfortable with it. In this case I didn't think I was insulting, but snarky is a good word. Thanks for your concern. Though I'm not sure toning it down appeals to my mission to bring you the real world of vet medicine in blog format, I will try to supply more positive posts. Check out tomorrow's.

Dr. Patty Khuly January 26th, 2008 07:23:00 PM

This to me doesn't read as snark...

"Yesterday’s client was one of these: “What do you mean we have to sedate her for those X-rays?” After 10 minutes of struggling and stressing out a Pug to near asphyxiation, it was clear that we were correct in our initial assessment. This owner was not satisfied, despite my best efforts to explain the constraints this dog’s airway and anxiety provided."

It says to me that the owner wasn't be told what he or she wanted to hear, so they subjected their dog to more stress because his or her hearing was shut off.

Anne- Be glad you don't bring your dog to my vet. If she thinks somebody is being a idiot about something, she tells them so. If somebody doesn't understand what they are being told, she will explain herself without the vet jargon, but if they continue to make a issue of it, she sends them on their way and wishes them the best with whatever they decide to do and where they decide to go.

Some people like bouncing from vet to vet just so they can be told what they want to hear. The same can be said about human medicine. I could come up with a list of people that insist that their weight issues are due to a thyroid problem. These people bounce from doctor to doctor to be tested and the test results always come back the same...everything is normal. It's their diet and need to sit on their butts for hours on end that's the problem, but to tell them that causes these people to become all teeth and claws.

If I were to move to Miami tomorow, I wouldn't hesitate to bring my crew to Dr.Patty. If she felt that I was being a idiot about something, I'd expect her to tell me so and explain why, but then again, I wouldn't be doing what some of her clients do to her on a regular basis either. Now whether she'd want to deal with my crew or not, that's a whole other story. LOL

Stacy January 26th, 2008 07:51:00 PM

Well, as I mentioned I shared this with the Feline IBD forum...and one person whose cat recently died was very touched by this post. She had been bitter that the vets couldn't figure things out - this post was very helpful for her. I also got another email from someone saying they really appreciated it...it is always so easy when you have a very sick pet to expect the vet to know everything, but it just isn't always that case. I appreciate your sharing your perspective.

Jenny January 26th, 2008 08:36:00 PM

You just can't please everyone all of the time. Don't change ONE iota of your posting Dr. K. It is educational, enlightening and just plain entertaining at times. I would give my right arm to be a client of yours EVEN if I were the topic of one of your posts. (Though I do LOVE my current vets.)

I'm willing to bet that the ones who might get offended by the post subjects aren't the ones reading blogs about pet health in the first place.

Let's also remember that things that don't vent are likely to explode. That wouldn't be good for anyone now would it?

Tail wags.

Marie January 26th, 2008 10:52:00 PM

Really do have to laugh.. We have the same thing going on in medicine.. with the private patients, and insurance companies.. Think my vet is relieved when I come in, and not harrass him with the cost factor.. even though he charges $5.00 more per visit.. ughhh
Barri

barri January 27th, 2008 11:01:00 AM

Dr. Patty, don't you have the standard issue veterinary crystal ball? I believe Merial makes one. Many great things have been said about the various version on one of the professional networks. A must have necessity for the diagnosis when your not allowed to do any diagnostic or the diagnosis over the phone/email!

Alli January 27th, 2008 04:38:00 PM

A tricorder....lol.....man, what I could achieve if I had one of those too........

Amy in Somerville January 28th, 2008 08:56:00 AM

I am always very happy to see my vet go through a diagnostic process rather than just do 20 expensive simultaneous tests like my current GP does :)

emily January 28th, 2008 09:23:00 AM

I would love a tricorder. Right after that I want a magic wand. This would be for my "magic wand patients". These are the ones where I know what they have and I know what they need to do but they don't want to do it. They want me to make it all better by boinking them with my magic wand. Give up smoking? Eat less excercise more? Come on doc, can't you just boink me with that magic wand?,

kate7047 January 29th, 2008 01:15:00 PM

Add Commment

Log In

E-Mail:
Password:
Register
Reset Password

E-Mail:

Virtual Vet Hospital

Got a sick pet? Visit our Virtual Vet Hospital and admit your own pets as patients in Dolittler's unique pet healthcare forum.

The Virtual Vet Hospital is temporarily unavailable as we transition to a new web site platform.

Careerists

Did you always want to be a vet or vet technician? Thinking about it? Working on it? Need some Help?

"The greatness of a nation can be judged by the way its animals are treated."

- Mohandas Gandhi