The Fourth of July was my very first weekend on call as a brand spanking new veterinarian. I had a guy call first thing in the morning on Sunday.
Me: Hi this is DocMac.
Guy: My dog's acting kind of lethargic and I'd like you to look at him if you have time.
Me: How long has he been lethargic?
Guy: He seemed okay yesterday. We had a party and he ate a bunch of hotdogs.
(Alarm bells started going off in my brain. Bunches of people food, especially things like hotdogs can cause pancreatitis)
Me: Has he had any vomiting or diarrhea?
Guy: I don't know. He's an outside dog. He runs in the yard and plays in his pool. I found him in the pool this morning.
(And now I'm worried about heat stroke)
Me: I'll meet you at the clinic.
Oh my God! My first emergency!
Guy brings in a middle aged labrador and the poor thing is half dead. He can barely raise his head, his gums are white and his heart rate is slow. I'm like, holy crap! All the guy said over the phone was his dog was a little lethargic!
Sadly, this dog died about 15 minutes after presentation, I believe it was heat stroke. The previous day had been in the upper 80's with high humidity. The party had probably made him more active than usual and he pushed past his limits.
What I can't get over his how calm this man sounded the entire time. Even looking back with the wisdom of experience, this guy must have had ice water in his veins. I'll admit that I was freaking out a little bit through the process of trying to save this dog. It was my first emergency on my own and I had only been graduated from vet school for four weeks.
Monday, August 31, 2015
Friday, August 28, 2015
Don't Believe the Owner, Part 1
Being on call for emergencies is usually a pain in the ass. Nine times out of ten, it's not a real emergency and could totally wait until the next day. But sometimes it's hard to determine what's a real emergency and what can really wait until the next day because all I have to go on is the owner's description. Sometimes it's accurate. Often it's not.
Phone call on emergency. The woman on the phone is frantic. Says her german shorthair pointer is bloating. Bloat is an extremely dire emergency that often needs immediate surgery.
Frantic Woman: He's bloating, he's bloating. I've got to get him in!
Me: What exactly is he doing right now.
FW: He's laying there painting. He's breathing hard!
Me: Has he vomited?
FW: He's bloating! His stomach is big!
Me: Has he tried to vomit?
FW: No, he'd feel better if he did!
Me: How long has he not been himself?
FW: Since my stupid brother fed him! I've got to get him in!
Me: If he's bloating you need to take him to the emergency practice in (large city about 45 min away). I don't have the staff and supplies to do the surgery that he might need.
FW: He's bloating, I've got to get him in!
Me: You need to take him to the emergency practice because if he IS bloating, I'm just going to send you there and that will have wasted time that he doesn't have. Go to the emergency clinic!
FW: He's bloating, I've got to get him in!
Me: Fine, bring him in.
I meet them at the clinic. The dog jumps out of her car and bounds into the clinic. Dogs that are bloating have a hugely distended abdomens and are usually retching, drooling and in serious distress. This dog was so not bloating. He was acting completely normal. A thorough exam and bloodwork turned up absolutely nothing. Turns out the woman's brother had fed the dog twice his normal amount of food and she had panicked.
At this point she asks me if we can get her dog's vaccinations up to date since she hasn't had him in in a while. Hell no, I'm not giving your dog vaccinations during an emergency visit! That is not what I'm on call for! You can schedule yourself an appointment during regular business hours for that, Mrs. Lazy Crazy.
Phone call on emergency. The woman on the phone is frantic. Says her german shorthair pointer is bloating. Bloat is an extremely dire emergency that often needs immediate surgery.
Frantic Woman: He's bloating, he's bloating. I've got to get him in!
Me: What exactly is he doing right now.
FW: He's laying there painting. He's breathing hard!
Me: Has he vomited?
FW: He's bloating! His stomach is big!
Me: Has he tried to vomit?
FW: No, he'd feel better if he did!
Me: How long has he not been himself?
FW: Since my stupid brother fed him! I've got to get him in!
Me: If he's bloating you need to take him to the emergency practice in (large city about 45 min away). I don't have the staff and supplies to do the surgery that he might need.
FW: He's bloating, I've got to get him in!
Me: You need to take him to the emergency practice because if he IS bloating, I'm just going to send you there and that will have wasted time that he doesn't have. Go to the emergency clinic!
FW: He's bloating, I've got to get him in!
Me: Fine, bring him in.
I meet them at the clinic. The dog jumps out of her car and bounds into the clinic. Dogs that are bloating have a hugely distended abdomens and are usually retching, drooling and in serious distress. This dog was so not bloating. He was acting completely normal. A thorough exam and bloodwork turned up absolutely nothing. Turns out the woman's brother had fed the dog twice his normal amount of food and she had panicked.
At this point she asks me if we can get her dog's vaccinations up to date since she hasn't had him in in a while. Hell no, I'm not giving your dog vaccinations during an emergency visit! That is not what I'm on call for! You can schedule yourself an appointment during regular business hours for that, Mrs. Lazy Crazy.
Thursday, August 27, 2015
Two Kittens, Sketchy Information
The other day a friendly older lady brought two new kittens in for checkups. The receptionist went through the usual questions.
Receptionist: Are they boys or girls?
Lady with Kittens: I don't know. I'm hoping for girls
R: Okay. How old are they?
LwK: I don't know. The guy at the barn said they were born a couple days apart.
R: Okay. Did he deworm or vaccinate them?
LwK: I don't know. He didn't say anything.
At this point they come to my exam room so I could figure out the answers to all these basic questions. They were two cute, healthy looking girls, both about 9 weeks old. I vaccinated and dewormed them and gave LwK the usual go home instructions (feed kitten food, booster vaccinations in 3-4 weeks, give next dose of dewormer in two weeks, etc.)
LwK: Can I use clumping cat litter?
Me: Um. Yeah, that's fine.
LwK: Good because I didn't want to use the clay stuff.
Me: *Perplexed frown*
LwK: The guy at the barn said clumping cat litter kills cats.
Me (trying to keep my mouth from hanging open): I have never heard of that.
LwK: Yeah, he said they eat it and it clumps up their insides.
Me: I have never heard of a cat eating cat litter, so I think you're safe.
That was a new one for me. Guy at the barn didn't know gender, age, doesn't say anything about care of kittens except that clumping cat litter kills cats. Seriously. I'm just glad LwK had enough sense to question that kind of advice!
Receptionist: Are they boys or girls?
Lady with Kittens: I don't know. I'm hoping for girls
R: Okay. How old are they?
LwK: I don't know. The guy at the barn said they were born a couple days apart.
R: Okay. Did he deworm or vaccinate them?
LwK: I don't know. He didn't say anything.
At this point they come to my exam room so I could figure out the answers to all these basic questions. They were two cute, healthy looking girls, both about 9 weeks old. I vaccinated and dewormed them and gave LwK the usual go home instructions (feed kitten food, booster vaccinations in 3-4 weeks, give next dose of dewormer in two weeks, etc.)
LwK: Can I use clumping cat litter?
Me: Um. Yeah, that's fine.
LwK: Good because I didn't want to use the clay stuff.
Me: *Perplexed frown*
LwK: The guy at the barn said clumping cat litter kills cats.
Me (trying to keep my mouth from hanging open): I have never heard of that.
LwK: Yeah, he said they eat it and it clumps up their insides.
Me: I have never heard of a cat eating cat litter, so I think you're safe.
That was a new one for me. Guy at the barn didn't know gender, age, doesn't say anything about care of kittens except that clumping cat litter kills cats. Seriously. I'm just glad LwK had enough sense to question that kind of advice!
Wednesday, August 26, 2015
My Crazy Life: Louie
Welcome to my crazy life. I'm a veterinarian. I also have a husband, two year old daughter, three dogs and three cats, although the exact number of dogs and cats varies day to day.
The newest addition to the household is Louie, a nine month old Pit Bull.
Louie came into the clinic as a drop off. History was hit by car yesterday. I'm like really, HBC yesterday? Either he's not very bad off or the owner has no $$. Louie walked back to the treatment area on three legs, wagging his tail and licking everyone he passed. The owner had authorized x-rays (thank God!). Too bad that Murphy's law of veterinarians states that nice young dogs have to have bad things. I was hoping for a pelvic fracture that would heal with cage rest. But no, this is what I found instead.
That is a proximal femoral fracture that requires surgery to the tune of ~$3,000. Talked it over with the owner. Owner tried to get financing, but was not able to.
Next option: leg amputation. It would keep Louie from living with a painful, non-healing fracture. Dogs are born with three legs and a spare, after all.
Owner was unable to afford the several hundred dollar cost of leg amputation. I could hear in his voice that he knew where this conversation was going. We couldn't let Louie live with that amount of pain for the rest of his life.
This is where people start hating on veterinarians. Why don't you just do it an let him pay later? Or make payments? Or just do the surgery for free? Don't you love animals?
I've let people make payment arrangements before. It doesn't work. 95% of them are never seen again and we never see a dime in payment from them. Another 4.9% now believe that they can charge anything they need and end up increasing the amount they owe faster than they are paying on it. And every once in a while, a rare person actually pays off their bill in a reasonable amount of time.
I'll clue everyone in on another fact. Veterinary clinics are SMALL BUSINESSES! We have to bring in enough $$ to keep the staff paid, the lights on and pay for supplies. Payment plans do not do this! Neither does doing expensive surgeries for free!
You can walk into an ER and get treated for free because Medicaid (aka the government with our tax dollars) picks up the bill. Medicaid does not pick up the bill for your pet to be treated for free. Too many unpaid bills = vet clinic out of business.
I'll get off my soapbox now.
Anyway, I hate it when men cry. The owner didn't break down or anything, but I could hear the tears in his voice. And sometimes I'm a sucker. Certain dogs and cats just tug at my heartstrings. The owner ended up signing Louie over to the clinic and I took Louie home with me. A veterinarian friend of mine placed a pin and wires (not the ideal treatment, but I don't do any orthopedic surgery and I draw the line at $3000 surgeries on rescue dogs).
Now we cross our fingers and pray it works. If it doesn't, well, dogs are born with three legs and a spare. :-)
The newest addition to the household is Louie, a nine month old Pit Bull.
Louie came into the clinic as a drop off. History was hit by car yesterday. I'm like really, HBC yesterday? Either he's not very bad off or the owner has no $$. Louie walked back to the treatment area on three legs, wagging his tail and licking everyone he passed. The owner had authorized x-rays (thank God!). Too bad that Murphy's law of veterinarians states that nice young dogs have to have bad things. I was hoping for a pelvic fracture that would heal with cage rest. But no, this is what I found instead.
That is a proximal femoral fracture that requires surgery to the tune of ~$3,000. Talked it over with the owner. Owner tried to get financing, but was not able to.
Next option: leg amputation. It would keep Louie from living with a painful, non-healing fracture. Dogs are born with three legs and a spare, after all.
Owner was unable to afford the several hundred dollar cost of leg amputation. I could hear in his voice that he knew where this conversation was going. We couldn't let Louie live with that amount of pain for the rest of his life.
This is where people start hating on veterinarians. Why don't you just do it an let him pay later? Or make payments? Or just do the surgery for free? Don't you love animals?
I've let people make payment arrangements before. It doesn't work. 95% of them are never seen again and we never see a dime in payment from them. Another 4.9% now believe that they can charge anything they need and end up increasing the amount they owe faster than they are paying on it. And every once in a while, a rare person actually pays off their bill in a reasonable amount of time.
I'll clue everyone in on another fact. Veterinary clinics are SMALL BUSINESSES! We have to bring in enough $$ to keep the staff paid, the lights on and pay for supplies. Payment plans do not do this! Neither does doing expensive surgeries for free!
You can walk into an ER and get treated for free because Medicaid (aka the government with our tax dollars) picks up the bill. Medicaid does not pick up the bill for your pet to be treated for free. Too many unpaid bills = vet clinic out of business.
I'll get off my soapbox now.
Anyway, I hate it when men cry. The owner didn't break down or anything, but I could hear the tears in his voice. And sometimes I'm a sucker. Certain dogs and cats just tug at my heartstrings. The owner ended up signing Louie over to the clinic and I took Louie home with me. A veterinarian friend of mine placed a pin and wires (not the ideal treatment, but I don't do any orthopedic surgery and I draw the line at $3000 surgeries on rescue dogs).
Now we cross our fingers and pray it works. If it doesn't, well, dogs are born with three legs and a spare. :-)
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