Because I promised this post on the event of Pepper’s death:
I’m a high maintenance client for veterinarians. Most of them probably want to pick a bone with me. 😉 I’m cool with that, because with the exception of discussing euthanasia, I ask nothing of them I didn’t ask of myself in medicine. To be clear, I expect a vet to:
- 1. Possess informational and technical competency.
- 2. Educate me about the choices my pet and I face, including cost and the option of euthanasia, where reasonable.
- 3. Revisit #2 whenever the pet’s health changes or new information arises.
- 4. “First do no harm” – avoid investigation or treatment that cause suffering unless the benefits outweigh the risks.
- 5. Demonstrate compassion to my animals and family.
Unfortunately, with one noticeable exception, I feel failed time and again on #2-4. At times, even #5 has been in jeopardy.
Let me provide an example that’s less fresh than Pepper’s:
Four years ago, when our cocker spaniel, Buddy, ate garbage and got sick, we took him to the emergency clinic recommended by our vet. We felt responsible and somewhat sheepish, and the solution seemed straightforward; he’d receive IV fluids and have his stomach pumped.
Three days later, despite maximal treatment, he hadn’t improved. The reason? Ultrasound confirmed an infected biliary tree and gallstones, which is rare in seven year-old dogs, I’m told. To survive, Buddy would need surgery and IV antibiotics for at least another 10 days.
P and I told the vet to go for it. We’d already invested so much emotionally and financially, it seemed foolhardy to quit. Then I got call from the vet tech as Buddy was getting prepped for OR. She wanted me to authorize a platelet and plasma transfusion.
I suspect most people wouldn’t understand this to be an ominous sign, but fortunately I did. Although it felt like I extracted the relevant information syllable by syllable, I asked a ton of questions that meant the vet had to come on the line. I learned Buddy’s blood was clotting within his veins. He was at high risk of bleeding out on the table, and his odds for survival were less than 10%.
Now maybe that wouldn’t make a difference to you folks, but it did to us. We drove as a family to the clinic, said goodbye, and we had our sweet mutt put to sleep.
I left the hospital, peeps, not only missing my dog, but minus a sense of innocence. What had gone wrong? Had someone simply dropped the information baton during the frequent shift changes? Because we’d always before agreed to aggressive treatment, had the staff assumed we always would? Had profit been a factor?
I don’t know the answer. I hated that the last question even entered my brain. But the lack of communication, coupled with the $3000 bill, when no cost had been discussed — ever — without me being the initiator, made everything suspect and tawdry.
Anyway, I promised myself I’d become a better advocate for my pets’ interests. I’d ask better questions.
Since then, I’m sorry to say I’ve seen this pattern emerge with other species, other veterinarian clinics, even other people in the role of client. To this observer, it seems as though veterinarian medicine operates on these default assumptions and principles:
- That by bringing in a pet for help, treatment will be all-out until we say “enough”.
- With the exception of one vet one time, I will have to be the one to bring up the subject of euthanasia, even if it’s a logical choice. Even then, it’s spoken of in hushed tones, as if it’s a shameful, dirty secret.
- Risk/benefit ratios of procedures are not explained unless expressly requested.
- Information is not presented in an accessible manner, so that one requires a medical background to understand its ramifications.
- Cost isn’t mentioned unless initiated by the client.
Now if we agree the ideal vet behaviors are what I’ve listed at the top of this post, why the discrepancy between that dream and execution? For some vets in some clinics, money might be a factor. But this cannot explain it all. Even in my most recent encounter with Pepper’s vet — a woman who didn’t so much as ask for a credit card imprint or ID until the end of my last visit; a woman whose eyes shone with compassion for Pepper and I — the pattern held. Since I believe the majority of vets I’ve met have a good heart and operate from good intentions, I have a few questions:
- Is this a function of poor luck? In other words, have I just not stumbled upon my ideal vet?
- Maybe I’m weird in what I want, and current practices would satisfy 99% of the population. If so, please tell me. I’m weird in other things, too. That’s okay. 😉
- If we agree most vets operate from right intention, what do you think stops them from acting in an ideal manner?
- Is it their training, which may emphasize the science of animal medical practice over the art of animal medical practice?
- Are they so constrained by financial worries it clouds their judgement?
- Is it a time issue?
- Are they so bonded to the animals, they believe maximal intervention is the best and kindest practice?
The point is, I do not know. I have no friends or family within the animal healthcare industry, so I’m at a loss and would love any insight you can provide. Please note, I expect you to refrain from vet-bashing in your comments. And if you work as a vet or as their assistant, please contribute. I will spay or neuter anyone who abuses you.