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Wednesday, April 30, 2014

Are You Afraid of Your Vet?



Hershey, at 14 years old.
He struggled with severe hip dysplasia and osteoarthritis.
Note his thin very straight back legs, thickened elbows and still his adorable sweet gentle smile.
What is normal for me, is not the normal for others. Surely, we are all guilty of this? In my profession I am conditioned to the sight of blood, the smell of vomit, poop, and intestines that are dying. I can diagnose almost as much with my eyes closed and my nose sniffing as with just my hands. But for those of you who are on the other side of the exam table I have to remind myself every single day to keep my veterinary lingo to a cool comfortable limited amount. To not lose or overwhelm a client with my big audacious words and demeanor.

If I can't convince you that I am here for the simple sake of helping your pet I have lost my purpose and strayed from helping both you AND your pet.

It was with this in mind that I provided my response to a friend's daughter when she wrote me asking for help with her elderly lab.

Hey Krista,

My lab - my love - is 12 and has arthritis and dysplasia very bad. More days than not, he has to be carried out to use the bathroom. I know if I take him to the vet, they will tell me to put him down, especially since he can't walk.

However, his mind is still good, and I just don't think he's ready. I make his meals, and give him meds, but now he has developed some sort of skin condition that is causing him to lose his hair very bad on his back end and stomach. It's almost yellowish and scaly on his stomach and his back end is just raw. Is there something I can do to ease this or should I take him in and hope for the best??
I'm sorry to bother you, but would truly appreciate any of your expertise.
Thank you!!!

My reply,

Hello,

The skin could be too many things for me to be able to guess without an exam and blood work. I would guess it's related to his overall health and would check blood work and any evidence of disease or immune system status. Most importantly you should never feel reluctant to go to the vet. It is not our place to judge you or make a decision for you. It is our job to help you understand what is happening to your pet with a diagnosis and offer you treatment options. In some cases I do think that a pet is suffering and that there are limited treatment options, so I will state this. But as long as my client has their pets best interest in mind, and the pet can eat drink pee and poop I offer pain management and extend a hand to help. Hospice is an option for all creatures and should always be offered. Whereas, euthanasia should never be a matter of convenience nor should it be the only option we provide.

There are lots of options for older dogs who struggle to get up and have pain, like injectable joint supplements, NSAIDs, glucosamine/chondroitin, physical therapy, water therapy, acupuncture and an orthopedic specialist, to name a few.

Go to your vet and explain everything that you told me. They can and will help. If they don't go elsewhere and remind that vet that they have failed you both. 

That's your job, to look for help for your dog. It's our responsibility to be your pets advocate and help you both. 

The answers are out there, but you have to find someone locally to start. I wish you the very best of luck.

Sincerely,

Krista

I saw my friend later that day and told her that I had replied to her daughters question. I also confessed to feeling saddened by her fears of being "reluctant to seek veterinary help because she believed that she would be forced to put her dog to sleep."

She replied, "Yes, we grew up in an area where our vet said to us, "Your dog is 12, why spend $300 to fix her? It's my recommendation that you put her down."" she paused. "It still upsets me to this day that we used to take their advice."

Another pause,, she started again,

"To which I would now reply, "Well, maybe we do."" She had changed her perception of what her role in taking care of her pet was. But that fear of not knowing what her options were, and what her dog was worth were still burnt into her memory. To her that dog was a family member, to their vet she was a commodity.

This is where my sailor mouth came out,,, and my passion lies..

"What the.. Do vets really say that?" I suppose they do?..may you all feel the burden of a heart bearing the burden of guilt of those who thought that euthanasia was their only option..



Dr. McCadden, our resident acupuncturist has an elderly dog with very weak back legs. We were talking about the options for him..I suggested trying to build him a cart.

Here is the labor of her husband's dog love..a cart from Home Depot stock that she says cost them abut $60.

Where there is a will there is always a way.



If you think that your pet is in need of help go look for someone who shares your view. Never settle for a lazy, uncaring, unwilling anyone..ever. There are some amazing rock star vets out there, knock on as many doors as you need to, one will open the door and help you, I promise.

If you have a pet question, a vet fear, or just need a shoulder to lean on, you can find me and a bunch of other animal rock stars at Pawbly.com. Pawbly is a place for all things animal related. If you have a question you can ask the community, or, if you take so many photos if your pets that you are fearing being labeled a "crazy cat/dog/ferret/horse/pig...whatever..person" you can post like mad on Pawbly. After all, we are all a little crazy when it comes to our pets!!, Why not join a group of people who embrace you for your pet passions?. And best yet, Pawbly is free for everyone to use.

Or find me on Twitter @FreePetAdvice,  or at the best clinic on planet earth (I am totally biased!), Jarrettsville Veterinary Center, in Jarrettsville Maryland.

Magpie sleeps.

3 comments:

  1. I don't know if you'll see this as I'm commenting on a post that's a couple years old, but if you do see this...

    I have heard of vets who, when presented with an actively dying animal and determining that nothing can save the pet, and being told the owner wishes to take the pet home to pass, will respond that that isn't an option and if the owner insists, the vet threatens to report to authorities for animal cruelty. No offer of how to make sure the pet is comfortable in its final hours as the dying process unfolds. Kinda hard in that situation to seek help elsewhere since you've just been informed that if you leave with your pet alive you risk a visit from the authorities and possible cruelty charges.

    Just in case you'd like to see what I'm talking about...
    https://www.reddit.com/r/veterinarians/comments/3h0eyx/new_grad_with_frustration_over_end_of_life_issues/
    I'd actually commented there from the client perspective. Thankfully my vet worked with me when I found myself in that situation, and I hope my story got at least one vet thinking. But basically vets were on board with "if they take the pet home report for cruelty". One did say they give opioids and send home pain meds if they can't convince the owner to euthanize. Yet another implied a suggestion to euthanize under the guise of giving vitamins or fluids. I guess basically, "here let me give Fluffy some fluids to make her feel better...oops! I'm sorry to inform you that Fluffy passed away while we were giving her the fluids".

    People see their pets as akin to children. Not wanting to get into the human euthanasia debate, even those who think it should be legal, I'm sure, would have difficulty consenting if, after rushing their child to the hospital, they are told "little Johnny has just hours to live. It's kindest if we give him an injection and end it within minutes." Imagine how the grief would be compounded if, after declining euthanasia, instead of being offered comfort care, the doctor replied with "if you won't let me put Johnny down, I will just have to report you to CPS."

    The comparison may seem silly, after all human hospice is a well established field, and human euthanasia illegal. But since people see their pets as children, I think the emotions involved would be similar.

    While the dog in your story was obviously not that close to death, and while I'm happy to have a vet who will work with me and not make me feel judged and I hope your friend's daughter was able to find the same, it sadly seems as if there are vets who give good reason why one might fear taking their Ill, elderly per to the vet.

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    1. I agree that each patient and each client needs to be treated as their own unique case. I strongly believe that clients should have options for every step in their pets care. I also believe that hospice (dying at home) is every clients right. BUT, there has to be some form of palliative care. Some form of pain management and attention to making sure a pet isn't suffering. There are times where i have reported people for cruelty and neglect. These cases involved people who were being selfish and not thinking of how they were going to be able to care for their pets.These have always been pets in terrible accidents and clients who refused to provide emergency care in even the most basic form of pain control. I wish you the best in getting the compassion you are seeking. I understand and encourage you to keep demanding it.

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    2. Oh definitely. Certainly palliative care is a must. For human or animal, hospice isn't just sitting around waiting for the patient to die without making sure care is provided to prevent discomfort and actively work to alleviate it when it occurs. I would hope those who wish their pets to pass without euthanasia would make sure they're able to provide whatever care is necessary and that those who refuse pain control are in a minority.

      Just curious, do you believe there is always a way to ensure comfort (ability of owner to provide such care aside for a moment)? Say an owner has no barriers to providing the needed care. Money is no object. Time is no object. They have the emotional and physical wherewithall to see it through. They are ready willing and able to hospice their pet all the way to the end. Any palliative measure you offer, they'll undertake. Given all that, are there conditions which may not be so conducive to a hospice assisted natural death? Any diseases or conditions where you would be concerned that best efforts may not achieve an adequate level of comfort for the pet?

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