Monday, October 14, 2013

The Cat and The Line In The Sand.

Most vets go into veterinary medicine because they “love animals.” Those two words are on every vet school application and every job application I see. Don’t get me wrong it is a very important part of this job, but it is equally as important as “works well others,” and “wants to help people.”

It is a hard combination to find. Most of us vets like animals more than we like people. Turns out you need to have people bring in their pets into you AND then you have to be able to talk to them. They don’t teach you that in vet school..You have to learn that on your own. This one skill alone has been the kiss of death to many a vet. It is a big incentive to become a surgeon. Your people skills have a very limited time allotment, and you get to spend the majority of your time with your patients in a quiet permissive state.

My biggest single challenge has been this. When you are trying to save every possible pet that you can you are going to run into people who don’t feel exactly as you do. For some people pets are possessions of convenience. No one wants to admit this, but it is true.

I came to Jarrettsville Veterinary Center over 8 years ago. JVC was exactly the place I was looking for. A nice combination of country but for the sake of a descent cappuccino, suburbia was a stone’s throw away.  I inherited a clinic that practiced exemplary medicine from a congenial man who had been a vet for 40 plus years. He was loved by everyone and I had big shoes to fill.

I was a die hard dog and cat girl taking over for a man who had been doing this for a long time and had done every part of veterinary medicine along his way. Where he had cow, horse, goat, chicken, and every other species, with every possible ailment to back them up, I just had a pile of brand new textbooks and a “domestic dog and cats only, please” provision.

Every James Herriott story written served as the back drop for every dream I had in my teens and twenties. I wanted to live that life and be the American post-modern heroine who spun tales out of the people, places, and pets I met along the way, (but without all of the dirt, manure, and excrement).

Unfortunately, reality is never quite as easy and dreamy as the visions in your head want it to be is it?

I arrived at JVC as a shiny brand new vet school graduate ready to live some tales, eager to save some lives, and begging the bank to lend me more money than I ever thought I could pay back. (If I get to leave myself some advice in my next life I would say to be a little more patient, and stop jumping in the poison ivy in an effort to pull out the weeds. But I hardly listen to myself now either).

During my first month at JVC I witnessed the owner that I bought JVC from euthanize an 8 month old pure bred German Shepherd (that the owners had paid thousands of dollars for as an 8 week old) because he had terrible hips. I remember getting into an argument with him over it after he had put the puppy down. I was heartbroken for that puppy and decided I couldn't work in a practice where this was allowed to happen. In an outburst of complete unprofessional candor I told him that one of us had to go. We mutually agreed that once I had the reigns I could run JVC how I wanted to, and in the interim he would continue to run JVC how he saw best. The staff (god bless them) shielded me from anything they knew would upset me, and I endured the ignominy of the remaining days as “associate vet.”

When the reigns were turned over to me I announced to the staff that JVC would not provide “convenience euthanasia’s” and that in the future when clients called to schedule a euthanasia the staff was to tell the owner that euthanasia’s were scheduled as examinations and after the veterinarian had seen the pet and discussed the condition with the owner then, and only then, would a euthanasia be performed.” I know there were some clients who went elsewhere when they were told this. I decided before I issued the policy revision that I was OK with that.

A long time client came in with her cat one day requesting euthanasia. She explained that The Cat was “old, sick, and aggressive,” and for these reasons she wanted him put down. As I reviewed the chart I was concerned about a few things. First he was 10. Ten in cat years is about 45 in human years. She was clearly over 45. I don’t think she would have referred to herself as old, (nor do I for the record). He was underweight and scrappy looking. He also hadn't been seen by a vet in about 5 years.

I examined him and became concerned that some of his alleged violations might be medically explainable. I asked if we could try to figure out if some of these clinical signs might be disease related and I was met by a forceful, stern, uncompromising “No.” She had made up her mind and come to me for a euthanasia and nothing more.

It was her way and her wishes or nothing. Ask any Italian you know what happens when they are given an ultimatum and I would bet they will all say the same thing. “we are stubborn.” (I know I am stubborn. I am working on it, it's not a fast nor quick process, don't hold your breathe).

I tried to offer some compromises as I delivered my line in the sand. I, as politely as I could, tried to explain that ”I was not able to euthanize a pet that I thought might be treatable.” To the staff I explain it as “my conscience isn't for sale.”

After a few tension filled moments of unyielding wills, she signed The Cat's care over to us and left without a bill and in great palpable disgust. That was about 7 years ago.

One day many months ago the phones were ringing like the town was on fire. At these times the standard operating procedure is “that if you hear the phone ring more than 3 times everyone who is able is expected to answer.” Because the phones all seem to ring at once there are times that I answer. I answered a phone call with the sub-standard greeting of “Hello, Jarrettsville Vet.”

 I was met by a “Hello, I need to bring my dog in tonight so the vet can look at a wound that hasn't healed in a week.”

 “OK, I have an appointment open tonight at 5.” I said.

“Who’s on tonight? I won’t see Dr. Magestic.” (The name was wrong, but it was close enough to know she was referring to me).

“Well, that would be me, and I’m the only doctor on tonight.” I replied.

“OH! Sorry, I’ll call back later.” Click.

I sent a card the next day to her saying, “ I apologize if I have offended you, as I seem to have, and signed it K.Magnifico, DVM.

I got a two page reply a week later, that said the following;

“Dr. Magnifico,
I appreciate your personal note and the apology regarding my decision to not see you as a veterinarian. I think that I owe you an explanation of why I made that decision.
Since 1990 I have brought my pets to Jarrettsville Veterinary Clinic. In the past 22 years, the staff at the clinic has provided care to 4 cats and 5 dogs, all of which have been taken into our home as strays or rescue animals. I have always felt that the staff at the clinic respected me and partnered with me to make decisions regarding care/euthanization of my pets. I have previously had animals euthanized by Dr. X, Y, and Z. They were all caring, sensitive and understanding and supportive of the tough decision that I had to make for each of the animals.
When I brought The Cat in 2007, he was a sick 10 year old cat that attacked other animals and the occasional human. It was not easy to make the decision and I was stunned to be treated by you like a “bad pet owner.” I understand you professional ethics that prevent you from “euthanizing a pet just because the owner doesn’t want it anymore.” I cant understand, though, your complete lack of compassion for the animal, who was clearly sick, and the owner. I had more than one guest in my home offer to “put the animal out of its misery” but I thought that euthanization by a vet was most compassionate.
                I came home, after surrendering the cat to the clinic, in tears, and my husband and I agreed that we would never allow you to do this to us again. The only reason that we did not leave Jarrettsville vet Clinic is Dr. Z, who has provided exemplary care for our pets.
                You are, no doubt, an excellent vet as well, but I need a vet for my pets that respects me as an owner.
                                                                Sincerely, XXX

I have evolved a little over the years. There were examinations with pets whose owners requested euthanasia’s for such atrocities as “doesn't match furniture anymore,” to “not using litter box” (vets get this one A LOT!), to “whining excessively,” “moving,” “divorcing,” “new ___friend doesn't like pet,” to my personal favorite, “got new puppy.”  I have learned that pet care is a mutual process, where we both help the pet live a better life, or help end it’s suffering if there is nothing else we can do. I also better understand what I can and can’t do for both a pet and an owner. And I have drawn my line in the sand often enough to not feel pressured, bullied, or threatened into doing something I am not comfortable with. Saying “no” is a whole lot harder than saying “yes” but in the end I really only care about how I see myself when I look in the mirror. If I don’t like or respect who I have become than I will move on.

Here are my thoughts on her letter. A “caring, sensitive, understanding, and supportive  vet” shouldn't be a vet who lets you do what you want and doesn't offer to help you understand your pets needs. That’s what shelters are for. If you don’t want your pet, and you don’t want to help understand your pets needs I am not the vet for you. BUT I am caring and sensitive, maybe just more to your pet than to you. But I already confessed this flaw in the first paragraph.

The Cat was signed over to JVC and his first (and only ever) blood work panel revealed that he had hyperthyroid disease. Which explains ALL of his ailments AND his behavioral aggression. He began twice daily pills and became a docile affectionate cat. He was adopted by a family who spent the next 6 years revolving their lives around any and all of his needs. Cat was the nucleus of their family. We received postcards at every holiday, all from Cat, and he was brought to every Pets With Santa. When he passed away his family sent the most emotionally moving Thank-You card I am sure we will ever receive. Cat made their lives richer, fuller and deeper. He brought incredible joy to them, and I know for as much gratitude as Cat had for them, they had just as much for him.

I sent a reply to Cat’s former owner thanking her for taking the time to write and explain her thoughts. I also admitted that I will be the first to admit and self-scrutinize. My intention was two-fold, to try to help Cat and to try to end each day and my professional life without sacrificing my soul along the way. It is not an easy task, and I understand that I have lost clients along the way. I explained that I continue to try to help both my clients and their pets to anyone who asks.  I closed with saying that “thus far every pet that has been turned over to JVC, save for 1, has been adopted to a loving home.”

The one cat I put down was left to us by a client I loved dearly who died. Their cat was very, very, ill and as hard as I tried to get her well I was never able to. She was put down because she would no longer eat, and she was starving to death. Out of love and compassion for both them and Baby (their cat) I put her down. I still feel remorse for Baby, because I feel as if I failed her.

As for Cat's original mom, she called a few weeks ago requesting her records be transferred.

The worst advice I ever got as a vet was from another vet who told me "you can't ever care more about a pet than their owners do." My reply, "If I start to care less then who will take care of the rest of the world?"

If you have any pet related questions you can find me at, or on Twitter


  1. This was an encouraging article which leave me, with not my own words, but from those who are wiser than I.

    If you’re not giving the world the best you have, what world are you saving it for? – Anonymous

    I expect to pass through this world but once. Any good therefore that I can do, or any kindness or abilities that I can show to any fellow creature, let me do it now. Let me not defer it or neglect it, for I shall not pass this way again. – William Penn

    “Life is life – whether in a cat, or dog or man. There is no difference there between a cat or a man. The idea of difference is a human conception for man’s own advantage.” – Sri Aurobindo (1872–1950)

  2. I love your reply, "If I start to care less then who will take care of the rest of the world?" it's so true. There needs to be more veterinarians like you. I've had a few dogs over the years and it is heartbreaking to put one of them down. We've only had to do it once, and there was nothing we could do for her, but it was heartbreaking all the same. My friend used to work at a emergency pet clinic when I lived in Dillsburg and she would come home crying some days because it was so hard for her to put down dogs. Thank you for being sensitive to the emotions of the pets and their owners.

  3. thanx now i have the link which i was looking for my research.
    Dog health | My pet diary

  4. Dear, dear Dr.M:

    I followed your link in the reply to dr wagnon's recent post on a client who wrote a devastating note to her - in the same type of circumstances listed above. I have the pleasure and luck to work side by side with Dr. Wagnon at my clinic in Washington state. And I've had the same disgust thrown at me in similar situations.

    I feel fortunate to have discovered such a like minded vet as you, and just as fortunate to work side by side with Dr. Nicole (Wagnon).

    compassionate, understanding hugs.