The Mistakes Veterinarians Live that Make Us Paranoid. Or Kill Us.

There are reasons most competent veterinarians are paranoid. Now, I don't use "paranoia" as a compliment, but, I do say it is aptly fitting.

At some point in your veterinary career you accept your quirks and embrace them as the fabric that made you whole.

I am paranoid about a yards long list of things at work. Why would I be paranoid at work? and, why would I accept this as unchangeable? Because, the consequences of not being paranoid are too frightening.

Me and my girl Madeline

In the  last week I have seen real-life reasons why I know I am both supposed to, and, dead right to be, paranoid. Shit happens, really, really bad shit in the day to day real-life world of being a veterinarian.

Vet med is this crazy offshoot of a profession trying to live up to ridiculously lofty expectations we placed upon ourselves, whilst, trying to fit into the glass slipper-shoes and manifest the same medical miracles as our human counterparts do. Except, and this is like the biggest blaring Vegas-style neon asterisk ever, we get very little support from anyone else. Veterinarians don't have the ability to ask for a specialist to "pop-in for a looksie" and help guide a case. We haven't had years of a residency to help white glove us into the world that awaits us. We also, (in almost every single case), have some narrow, if not non-existent, budget to adhere to. No time, no money, and no calling a friend. Humans in their white coats have it so easy.. They have their shit together. They have to. They are watched. Part of a pack. They have insurance guidelines and protocols. We, well, we veterinarians are the equivalent of fortune seeking gypsies toting our wares across the plains to those who don't know better than to hope our elixir can "cure all that ails ya!"

SO, if this were your life complete with its bills, internal conflicts of ineptness and imposter-syndrome meanwhile attempting to maintain a neck abreast of the Jones's next door, you would learn what we have learned. If you are asked to do more with less you get creative. We do wacky shit like fill the appointment slots in 15 minutes versus 30,, (heck, simple math). Double your profits half your time allowance. What could go wrong here,,? Or, make room for time you don't have by offering services that seem "convenient." Like drop-offs, Owner Not Present services (and provide them cheaper. Wait?? what? See this story here). Owner Declines All .... (whatever,, people decline shit you cannot imagine they would.. like; pain meds.. what!?). Yep! happens.. I actually had to make pain meds for surgeries free so people wouldn't decline them. (If they did, I still give them away for free). It's the right thing to do do for your patients who you KNOW feel pain. (Just because you don't wanna pay for it doesn't mean it ain't there people!).

On top of my inherent paranoia for things like getting behind on my appointment schedule (with the White Rabbit muttering "I'm late! I'm late!" on repeat in my brain), is under estimating a surgery price. No matter how hard I  to be a clairvoyant who knows without being able to actually see how many rotten teeth are actually in that snarling mouth of garbage-smelling decay. Or, the paranoia  of having a client get bitten by their own pet because they refuse to stop getting in the way of their already nervous afraid pet who we know is going to bite first chance they get. Want to imagine what my insurance carrier says to me when a client is bitten because they were doing a technicians job. Not pleasant. I need my insurance, and clients need to understand this. Or, how to decline profanities when the client who has bled you for two grand can suddenly find the money for that private cremation, but, not have enough to pay their bill for trying to save their life. Or, having a lost pet be found with a microchip (all together now sing "hallelujah!") to find out we never registered it so we still don't know who they belong to. Or, you do knee surgery on the wrong knee, or mass removal on the wrong mass, or forget to pay attention to the patient alerts and your patient almost dies in front of you because you didn't. (I swear this is just the list from today, this list goes on and on!).

Here's the list of the paranoia building headline of this week.

Cat accidentally gets euthanized during vet visit.  A Houston-area woman is at a loss for words after she says her 8-year old cat, Sophie, was accidentally euthanized at Suburbia North Animal Hospital in Spring. "Every time I close my eyes, I see that look on her face and I just can't get it out of my head," Michelle Olson said. Olson and her husband had just picked up Sophie after taking her in for a routine checkup and to get a rabies vaccine when she got a call from the hospital. "It was the doctor herself calling saying, 'Please get Sophie back here immediately, we gave her euthanasia instead of a rabies vaccine,'" Olson recalled.
They quickly took Sophie back to the vet.

You think that this can't possibly happen? Well, it did. Want to know how? (Or at least how I see it could have happened).

So far I guess I should feel lucky. Up until today I hadn't even considered confusing euthanasia solution with a rabies vaccine on my paranoia list.

How could this happen??!! Well, let's discuss.

Here's my full on paranoid list of possible causes for euthanizing a cat who was just supposed to get a rabies vaccine;

1. The pet parent left the cat behind for treatment. I know lots of practices that plan their whole day around drop off appointments. You think, "It's just a simple rabies vaccine. Why wait for that? Let's hit up Target for detergent and pick up Fluffy after. Time is precious, detergent level is almost critical." Let's go back to the "creative" tactics of above. Ever think about how much time we could save if we didn't have to chat with you about you, or, Fluffy? LOTS! We don't get paid by the hour like lawyers do... (huh, possible hack for bucks). Would you leave your toddler at the doctors office for an exam and ya know, whatever else? NO! You wouldn't! Why? Because your kid needs you to watch over them. I used to, (like yesterday used to), let the techs pull up the vaccines. But, now I am adding this to my list of "no longer trusted to do" paranoia. If there is going to be a mistake Lord let it be mine to own).

2. The color of a rabies vaccine looks a lot like the color of beuthanasia. Red-vs-pink, it's the same color scale. Syringe next to syringe and most vets might not blink with query.

3. Volume. The volume of euthanasia solution to euthanize a cat is 1 ml, which is the same for inoculating for rabies. Oops! grabbed the wrong syringe in my rush to get the simple vaccine done!

4. How does a rabies vaccine differ from euthanasia solution? Other than what I have stated previously the delivery is very different. A rabies vaccine is given under the skin. What we call subcutaneously. A tiny pinch of the skin to find the space between haired outside and on top of the muscles space, draw back, make sure there is not a bloody "flash-back" and deliver. If you are me, I deliver a cats rabies vaccine in the tail. It's still SQ, (takes practice), but its the recommended site as published by the AAFP. But, euthanizing a patient is almost always done by delivery the overdose of the barbiturate into a vein. Quick, efficient, and reliable. Trying to kill a patient by the same means we give a rabies vaccine?Not quick, not effective (guessing here), and surely not reliable.

5. Trying to do too much in a cramped time frame. Oh, if I could get people/clients to understand this. How can I be everything to everyone at the same instant? People have set appointments, God forbid I get behind in appointments, people get pissed, or, God forbid you come home to find your beloved pup having trouble breathing, on the brink of expiring. Who do you call? Me, probably me, who is already drowning in appointments, and you need to be seen NOW! and really you prefer to be here with the people you know and trust than at that ER that overcharged you last time for a broken toenail. Paranoid? Yes, I am paranoid that you will come here, and, need to be there on oxygen and monitored for a day,, or more. And, I do not have the ability to provide oxygen 24/7 as I lack the 24 part.

Mistakes, this mishap of epic proportions which is both tragic and irreparable beyond imagination was a human error. Completely human. I promise that the drug companies making euthanasia solution did not mislabel it "rabies".

My big question is, I get that this was probably a similarly colored syringe with the exact amount of euthanasia solution indicated, but, how did it get in the wrong place? At my clinic we keep that bottle of pink death under lock and key, yes, 24/7. it is not left out. It is not to be drawn up by idle hands. It is not a paranoia I apologize for.

Whats the most troubling part of this story as a person who lives the motto "your worst fear will happen." We vets euthanize so many pets so often that the delivery and the process is as routine as a rabies vaccine. The same expectations for clients apply. Don't make us wait, don't ignore the emotional gravity of the situation, but, yes, be prepared to see the happy 4 month old new penny puppy next door, 30 seconds from now. And, then the guy who argues about why you are late, as you tried to squeeze a few more minutes in with the heartbroken tear-laden family you just left behind who has to go home without their child they love so much it has slept in bed with t hem every night since they adopted in a dozen years ago.

The healing powers of Serafina

Paranoia and personal strife sit with my conscious every waking moment of my working life.

Could this happen to me? Oh, Jeez I cannot answer honestly for fear it might drive me to hole up at home and just seek use of my license as an acupuncturist or peaceful passage parson.. the kind of vets who leave vet med with some form of PTSD that leaves us not taking chances with life and death and all the tiny tip-toes of minefields that lie there. Mistakes in medicine are well documented and accepted. Add the stress of timetables, ridiculous expectations to be every kind of doctor to every kind of pet parent with every imaginable budget and the mistakes are bound to happen with increased frequency and consequences.


More information on tail vaccines here.

AAFP,  American Association of Feline Practitioners Vaccine Guidelines here.

Full cat death story here;
https://www.msn.com/en-us/news/us/cat-accidentally-gets-euthanized-during-vet-visit-family-says/ar-BBZ4ywh?ocid=spartanntp&fbclid=IwAR0P56Jt1yySrb8AQfHhhPpN3Y6-ep4JmkNknkdWn9ueXqoR5TpeaTseOr8

Up next in the paranoia cornucopia is the clinic who accidentally places the tag for "communal" cremation instead of "private" cremation on the pets body. And, ya know, you find this out when the pet parent calls inquiring about the remains that they have never been called to come and pick up because ya know, you see this one coming, there are no remains to be picked up. What kind of apology can you give them? Yep, that's happened to me.. reason number 6,251 that I am paranoid.

Or, just as gut-wrenching, is the client who requests, may or may not have paid for, and then successfully gets that little wooden box of their beloved family members ashes returned to us for pick up, but, never comes to actually take home.. What do you do with that box? How long would you hold onto it? Some of them didn't really want them back if there was a bill outstanding, and some of them just forget I think? Maybe?

Of course, because you are already paranoid, you hold onto it for two years, (isn't that the statue of limitations for most crimes?) and, you finally bury it at home with your own deceased pets to keep company in their eternal slumber spot. And YEP! 3 months later they come with some equally tear gutting story about how they couldn't get to us because Wilson their only friend while on that deserted island wouldn't let that little wooden box replace him.. Yep, happened to me.

Story of the broken but yet still irresistibly adorable kitten is saved by an innocent bystander who "has no money, but  isn't she cute as can be!" and your staff begs you to take on this little broken life,, because "if anyone can save her we can!" turns out to have rabies. turns out you figure this piece of zoonotic lethal shit after that Cujo possessed lightening bolt bites half the staff, including your most senior tech who is in her third trimester of her first childs life. Sure, there's tons of credible data on vaccinating for rabies while very very pregnant. That's safe? right? (kill me,,, really,,,how does this stuff happen to me)?

I am a veterinarian. I attract crazy. I live life and death. I literally, and very openly consciously tell myself every day as I drive into work that I simply have "to do the best I can, and come home alive and able to do it again tomorrow." This is my life. The one I chose. The one I always aspired to be. BUT, I am paying the price of this. I have been hurt, shunned, hated, sanctioned, and vilified. I stand alone knowing I did what I thought was right even if it was going to cost me financially or professionally. I can be paranoid to protect my patients, but, I am not going to be paranoid to protect my ego, my pride, nor my staff. I can go down liking who I am even if no one else does. I see the stuff you think is Twilight Zone material,,, and through it all, over the decades I still get up, grab those big girl panties by their ever expanding saggy bottomed waistband and adorn my equally unsexy disposable scrubs (that are only going to get soiled with fluids and excrements you havens even imagined exist in your own nether-regions,, or "tween" spaces, I go on. Paranoid.

Want to hear more about these topics? Here are some great videos on the life of a veterinarian;
Bernard Rollins Plight Of Veterinary Medicine. YouTube.

Hear about Dr Shane Cotes Suicide Story. YouTube

Please remember your vet is a human. Maybe a human dealing with more than you ever imagined possible.. Here are the statistics for vet med;
One in every six veterinarians have considered suicide. That’s three times the national average.

Maybe paranoia isn't suicide? And maybe its a small part of why this job costs so many so much?

For more on this please see my other blogs;

Find What Breaks Your Heart And Change It.

Ethical Fatigue and the Crossroads Of Vet Med

The Problem In Vet Med and the Great Divide

Serafina.. The WHY in Who I AM

Don't Forget To Put Your Heart Into Every Euthanasia

More about Dr Magnifico and her mission here;

My clinic is Jarrettsville Veterinary Center in Jarrettsville Maryland.

My YouTube channel.

My off site information exchange network which offers free veterinary advice and case based stories of my real-life cases. Pawbly.com.

Best Veterinary Facebook Page ever; Jarrettsville Vet

My pups Frippie and Storm

Be well everyone. And wish it to the others in your life.

Human Vs Veterinary Medicine: Real-Life Case Meets the Dueling Ring. Who's Better and Why?

Growing old is the luxury of your ancestors mastering a wealth of tools. Modern medicine has become so highly specialized and advanced that it has extended life spans to triple what they were a hundred years ago. Technology has helped enable us to get real time information and share it almost anywhere in the world in the blink of an eye. We have medical innovations for every conceivable problem, and agricultural advancements guaranteeing us access to an abundance of food. A bazillion tiny steps in  our species history, a few millenniums later, and we now have an excellent chance of living past our thirties. We should all feel so blessed. We really do have it easy compared to three, (or more), generations before us.

my Frippie and one of her sacred socks.

When life presents us humans with a stumbling block in our health we have so many avenues available to ponder. We live in a country where access is available to miraculous options. If you have insurance the sky is almost the limit, and, you can be carried and cared for through the halls of medicine without ever being told "there is no hope," and/or, "there is nothing more we can do." If you don't have financial resources or health insurance you can walk into any ER and the hospital is still required to help you. On the contrary, in vet med although we can (should) at least be empathetic enough to always grant and garner hope, (although I fear we are not and do not), should you not be fortunate enough to be independently financially secure, or, have insurance that pays at time of service, or, a wealthy animal loving friend, or, good and available credit, when and if it comes to lacking funds for your pet care the doors to help for them unanimously and almost immediately close. Veterinarians are happy to help if you can pay for it with a full deposit to be left with your pet. If you cannot, we have decided to chorus our voices in unison to the anthem of finger pointing blame and deflection with chants about "pets being a privilege, not a right!" (What does this serve other than to humiliate a pet parents breaking heart being forced to part with love due to insolvent ability)? When same clowder of  veterinarians do have the opportunity (consent and financial stability) to treat our patients we are expected, and, have to do more, with less. Less available avenues, less access to needed specialists, and less insurance options to allow those necessary diagnostics to uncover correct treatment options, never mind pay for those miraculous medicines. We vets have to be everything to everyone who needs us right here and right now.  Never mind the too frequent impatient snarky comments like; "and, if you could be snappy about it I have other things to do with my day, and my time is valuable too." (Hint, hint, this is the wrong thing to say to your vet trying to tick all those possible boxes while flying solo). As you can see, being a veterinarian with the same hopes, fears, and often expectations to take care of your four-legged kids as your two legged kids, is a big ask, with a big bunch of obstacles.

As a veterinarian providing health care options for pets for over 15 years I can testify that we are far more skilled and versed in seeing cases through from start to finish than our human medical counterparts are. We have to. The patients that walk through our front door with a presenting complaint are cared for by us to the completion of care. We are expected to figure out the problem and provide the answer in one visit, and do so based on your budget for it. We are there as the guide for the whole journey. It makes us Sherpa's with invisible tool chests of unparalleled excellence.

We veterinarians have to be a "Jack of all medical trades" as we try to be the one stop medical shop.

I guess I always knew this, but this week I lived this.

This week my life has been a true display of the stark contrasts of veterinary versus human medicine.  Lack of full oversight, disjointed as it is too focused on specialized care and passing the buck was found ubiquitously on the human medicine side. This week, in one tumultuous day actually, I took my mom to one ER at 8 am for debilitating pain that left her incapacitated and bed ridden to come home at 2 pm to find my dad having trouble breathing. This led to another trip, with a brief visit to Patient First (different one in a different state), that kicked off an almost immediate transfer to the ER  for immediate admission.

Frippie and her shadow Jitterbug

Let's start with my moms story.

On Monday December 16, 2019 my mom had surgery. She had elected to do this after a newly discovered mass came back "suspicious" from a needle aspirate. Within days she was given numerous options. She decided to be as aggressive as possible. She is a 23 year previous cancer survivor. She had been aggressive in her treatment and care options decades ago and it had served her well. Her new oncology surgeon was her guide. She, like every other aspect of  my moms care came to her with the best medical training, a breadth of experience, and a gentle, compassionate hand. My mom believed she was very lucky to have her.

Surgery went very well. Her surgeon, as is the protocol, looked at the local lymph nodes and decided to take them all as they looked abnormal and she didn't want to leave anything she knew might be dangerous behind. Two days after her surgery my mom came home with a few drains, a new scar but a feeling of relief that this was once again behind her.

Fourteen of the sixteen lymph nodes came back positive for cancer. Her mass was also now able to be definitively labeled.

For this care she was seen by 10 doctors over 4 months, and 6 separate doctor visits. Cumulatively it accrued to about four full 24 hour days.

Magpie protector of the lair

If she had been my patient with the same condition and the same treatment plan it would have been two visits. Here's the breakdown of a veterinary practice patient flow for this;

The first visit would have been to discuss the history, examine the patient and the mass. From here we discuss a few things.

Important key and critical discussions need to include;

1. Here is what I think we are dealing with.
2. Here is what I think we should do about it.
3. What are the goals for the patient?

Every successful client-patient discussion should stay and be focused within these.

For all patients the discussion of where to go next is usually centered on;

What are the options?

A. Religious Bliss is usually option Number One; I refer to this as; Ignore it and hope. While there are some masses that might appear relatively benign, if you don't have a piece of it, and, if it isn't examined by a credible trained person it is always a "guess and hope" scenario. Some cancers give clear early obvious warning signs. My moms was one of those.

B. Fearful Sleeper; AKA Tiny Lil Poke, FNA., What we call a "fine needle aspirate." Quick, easy, no anesthesia required. I refrain from saying "cheap" because sending that slide of cells to a pathologist is the same price as sending a far more diagnostic large piece of tissue. Pathologists like big, (the bigger the better), pieces of tissue if they have to make a diagnosis and potentially change the life of the person who provided it. FNA's are problematic for multiple reasons. First, you have to poke the correct piece of tissue. Ever try to poke accurately repeatedly and perfectly an awake unhappily to be restrained dog who weighs as much as you do? And, you have to pass that needle through skin, fat, and then a mass covered in multiple layers of tissue? You get artifact along the way to the money shot. I tell clients that you can rely on that slide smear of that aspirate about 70% of the time. In many cases the pathologist has to say "non-diagnostic sample." And there goes your $200. If it comes back as "consistent" with xxx(scary)xxx. We have to recommend a biopsy to confirm, or, a surgery to remove.

C. One Shot Answer. Go for the best chance of getting your diagnosis now and go for the biopsy. If you chose this, and based on loads of factors I always vote to start here, please, oh goodness, please go for a one kill surgery. At my clinic, for my patients I always want "one and done!" One surgery to remove the mass,, diagnose the mass and be done with the mass. In rare cases this is not possible.. all of those cases are cases where people waited too long, or, its a tumor we had little hope of slaying to begin with.

But, lets go back to our heroine. My mom. Human medicine is about hoops... and liability. It would be inaccurate to not point out that these are wonderfully intelligent saviors working in a midst of corporate medically and ethically guided steps, but still slow and cumbersome. My mom had a pretty clear problem, with a very high indication of cancer suspicion. She also had a history to match her fears. She was the duck who looked, walked, and quacked. She also was ready, willing and able to be aggressive. She wasn't the ostrich with her head in the sand.

Storm. All adoration, very little calculation.

Here's where I would argue vet  med has it's incredible advantages.

If I think I have a patient that I fear has a cancer that needs tending to ASAP I can talk to you about it on the first visit. I can then discuss all of the options. We can then start down that road on day one visit one. Want an aspirate? BOOM! same day, (just give me 10 minutes to set up). Three days later = answer. Not sure you are ready for the road ahead? Let me take a chest x-ray and try to tell you if the Gods are in your favor? (Why because statistically IF there are "mets" (metastatic lesions which are an indication of the mass having spread to the lungs) the prognosis for surgery is the same as without surgery.

Now, lets stop here and take a second. What human medicine provides us and makes me cringe at as I am trying to be the expert of too many things to be anything other than the Queen of The Jack of all trades' is that we guess A -WHOLE-HECK of A LOT! Remember how we got here? We made a guess that this was cancer, and that this was a bad kind of cancer. Educated guess, sure, but we are guessing.

I suppose we should all take a second and reflect that if it is new and abnormal lets just assume it doesn't belong there and evict it. Right?

After the FNA is discussed and either returned as "inconclusive" or, "indicative of cancer" we then discuss getting that bigger piece of tissue. This is where my whole spiel about "anesthesia always has risks, and, a cost. Therefore we weigh the risk versus the benefit" happens. Biopsies need general anesthesia. This is not a decision we make blindly. The average veterinary FNA is about $300, the average biopsy is about $500-800, maybe more if I am going to be aggressive and attempt to remove cleanly. Which is always my goal, (and always should be yours too!).

If we follow my moms example we are now at the place where we have done our exam, done our FNA and now need surgery to confirm the FNA and remove the suspected cancerous mass.
My mom and my patients (almost all (wink-wink) of them) have pre-op blood work. You, me, us, the whole patient list, should have pre-op blood work. No sense going under anesthesia if we fear you won't wake up. (Next asterisk here: a GREAT vet provides help even if corners might be cut. I have done lots of  "no other viable choice" surgeries without any pre op diagnostics. I have done these surgeries with all invested parties knowing, thinking, fearing, believing that if we don't do this surgery the only other option is humane euthanasia. So, what do we have to lose? (Maybe the cost of a surgery that ends without a patient walking home? (Has happened maybe (?) once in 15 years of fear-free-trying.)). (See Spencer's Stories here). (Personal plea here, since I started shouldering the possibility of free last chance surgeries I have become full-happy-purpose driven. The more I give away, the more optimism and compassion I give the more I know this is the only way to practice medicine healthy and content). Try, always try. Encourage your clients to try. Be honest. Be a pet parent next to them. It's not about money, or privilege. It's about honoring life and all the desire we all have to keep living it with one more day in the sunshine.

Here's where I would have taken my mom on a different route. I would have looked for mets before scheduling, or doing surgery. The cost for three view chest x-rays at my clinic is $150. It is so helpful to know this. I also have to explain costs, (lucky MDs get to dodge this sticky step). Asking a client to spend likely $800 to $1500 for the mass removal binds me (my ethical opinion) to being completely open and honest.

My pups waiting for dinner

My mom had her surgery based on an FNA without anything else. Surgery, radical excision surgery was next.

She did great. It was the right choice.

A few days later she developed pain in her back. The pain over 4 days caused her to become bed ridden. I got a phone call at 8 am, "mom can't walk, she wants to talk to you," my dad sputtered.. He handed her the phone, inaudible crying... sputtered words. "Mom, call 911 or go to the ER."

Instead they called the office of their surgeon who suggested they go for an x-ray. My dad elected to go to an independent office that he had used before. He called to notify me. "WHAT! why would you go there?" stammered silence.

"Listen dad, medicine is all about preparing for worst case scenario  as you uncover the clues to your situation. Go where her doctor is. (An hour and a half in the opposite direction of his choice). What happens if her xray indicates a serious problem? (Yep, on your way there now aren't you? Or, she gets admitted to a place they don't know anything about her."

He turned around and headed to more recent, although less familiar territory.

Her xray was difficult to definitively diagnose. No broken bones, no abnormal chest patterns, more good news than bad, but, alas also, no answer.

Jitterbug admires himself

Two days later, after a prescription for ibuprofen (which sarcastic slightly annoyed me will remind you all is NOT a prescription) and she was screaming for help. Again.

This time they (over the phone) decided a CT might be a better diagnostic tool to assess her spine.. their next guess. (Pssst,, mom,, yeah, its me your vet daughter, tell them you need better pain meds. Ask for tramadol and robaxin? (cause, ya, know every doctor loves a back seat driver).

Four days later no answers, no referrals, this time they suggested she could "try the oxycodone she had post op and never took). Oh, and yes, she can have some tramadol.. (squeaky wheels get some relief).

Two days later, Friday morning (yes, yesterday Friday) after basically living at her house and not being able to ease any of her pain we decided at 4 am to go to the hospitals Urgent Care facility for orthopedics. At 8 am, the minute they opened we were there. She needed a wheelchair to get in the door. She could not sit up long enough to finish her paperwork. She was exhausted, beaten into accepting she might  never feel better, and so fragile I began to see the world as a matriarch that we weren't leaving without answers I accepted. They were about to meet me litmus test. (I went to a military academy, I am feared, I make no apologies for this. Fair, feared, ferocious, F*%$# 'em.).
Within a few minutes we had a doctor to see her. We went over her history, as garbled and complicated as it was. We all collectively answered questions, provided insight, and started chipping away at her problem instead of punting for diagnostics, waiting for experts, and getting worse.

Dr Dan did an exam with her laying on her back the only place where she was comfortable, and within 10 minutes of that we ruled out her worst case scenarios. She had severe muscle pain based on her history of spinal issues, her surgery past and present and her inability to respond to palpation of her spine. She had muscle pain!" WAIT? WHAT! We were preparing for spine surgery.

"Mom, did anyone examine you the last two times (everything previously had been without me present)?

"No, they just sent me for tests."

In my head, and I am sure a few words slipped out audibly, I thought, "Are you f'ing kidding me? No one touched you? It's been over a week of crying in excruciating pain in bed, and no one touched you. You would have had your answer immediately if someone had touched your spine versus your muscles on other side  of it!" In veterinary medicine if your pet sees a vet or any kind, shape, or flavor there is ALWAYS an exam,,, every,,, single,, time! It is malpractice if they do not.

We left with Robaxin and a steroid. She has been slowly improving since.

How can human medicines obsession with diagnostics to achieve a diagnosis be so blind to the  basics. On my side of the fence this is "malpractice."

Want to be a skilled doctor, start by being a good listener, a thorough diagnostician, use the tools that trained you (head, ears, nose, hands, and  yes, gut), and then tell your mute patients that you can figure it out on BOTH a budget AND without words.

I know pet care can be expensive, but, human care is waay more corporate profit based, waaay more inefficient, and waaay crazy pass the buck hot potato than vet med is.

Chemo is a whole different discussion. My mom has an excellent prognosis because she has a specialist to guide her. A few million previous victors to both benefit from their lessons learned, and outcomes favored, and a militia of determined men and women who all want to see the sunshine on their faces for many more days to come.

Ya know what, vet med has the same. Ya know whats even more amazing, as the  mom of two oncology patients they do far better with the treatments than humans do. I would never use the all too common excuse,"I don't want to put them through chemo." If they can benefit from it, live longer lives, see more sunny days, they will probably do far better with it than you think they will." That's dogs and cats. No fear, no apologies. Living today and loving the people they spend it with.

P.S. My mother waxed and waned in pain for four weeks. Four weeks, one of which was as an inpatient hospitalized patient until she had another MRI, and then a bone scan. The bone scan 6 weeks after her surgery revealed metastatic cancer in almost every bone in her body.

Want to know how much I know vet med surpasses human medicine?

Think it might have helped if every doctor she had met had examined her as they listened to her?

Think maybe that cancer in a 23 year post cancer patient wasn't on the top of the "feared" list every time she spoke to a medical professional?

Think that pain care options are doled out in pathetically paltry pieces? (It took 2 weeks to get access to an opioid, and 6 weeks to any kind of meaningful pain relief as every doctor discussed side effects and dependency. Turns out those opioids are her only hope at life long partial relief).

Think that I couldn't have and hadn't already known what she knew about a week after a surgery she sailed through? This was bad, really bad. It is the worst. Took the human MD's 6 weeks to figure it out.

Where is the silver lining in human care versus vet care. She has a better chance at some good time than most vets can offer advanced cancer patients in her same shoes.

There is frustration, of course, but she has a diagnosis now, and options, and yes,, she has what we all universally need, hope.

For more on vet med please see my other blogs. For information on my veterinary clinic see our Facebook Page, or, website JarrettsvilleVet.com.

For more help from me on your pets care please go to Pawbly.com and ask me. It is free to use.

For educational veterinary medicine videos see my YouTube channel here.

My video on her care and the maze of human medicine here;