Asking Doctor Dolittle to Do a Little More

Mature male vet talking to male owner holding dog on lead in surgery

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: 

  1. Is this a function of poor luck? In other words, have I just not stumbled upon my ideal vet? 
  2. 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. 😉
  3. 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.

24 thoughts on “Asking Doctor Dolittle to Do a Little More

  1. I’m not an expert on vets. I’ve only used two in a lifetime, and no emergency room yet. I’m definitely going to be more guarded in the future while looking out for my pets.

  2. As a multipet owner, I know that finding a vet that I’m comfortable with as well as my animals is very important. Right now, I am very happy with my present vet who has gone above and beyond in keeping me informed of all options.

    I have a youngish cat with kidney disease and towards the end of the year her body began rejecting the treatments. My vet was very up front with me that unless I wanted to take risky heroic measures, I was probably going to have to prepare myself to say goodbye. I’m happy to say that since then the cat has made something of a recovery and is doing fine, but I appreciate my vet’s honesty at that time, and actually dread moving as it will mean finding a new vet.

  3. Medeia, it can be work to get communication in place, but IMHO, it’s so worth it. I hope you’ll fall into the right place for you when it’s required.

    Alissa, that’s an encouraging story. I’d hang onto that vet, too! Maybe he/she could refer you to a colleague in your new location?

  4. Having read this, I realise that I’ve always been very, very lucky with vets, no more so than with our current veterinary practice.

    We live in a poor, small town and our vet is very aware of the financial burden of veterinary care. She is one of those vets who puts the welfare and comfort of her patients above anything else. She’s been known to take sick animals home with her to give them constant care. With every problem we’ve presented to her, she and her associates have been like a dog with the proverbial bone trying to find a diagnosis.

    WARNING: Jan, this may make you cry. 🙁

    When Maggie fell ill, Audie and the other vets in the practice were very methodical with the testing. Not only that but they took the trouble to explain what they were doing and why. They worked their way through all the possibilities and provided us with medication to ease Maggie’s discomfort until they found out what was wrong. When Audie made the diagnosis that Maggie’s lungs were full of fluid, she put the x-ray up, showed us the extent of the problem and explained the options. Yes, she could’ve drained the fluid but Maggie was old and the procedure would’ve been tough on her. We decided that Maggie had been through enough, that she’d had a good life and it was time to let her go. There was no hanging around waiting for another appointment to have that done. She offered me some time to say goodbye, there was no rush. We were taken into a little room at the back. Audie explained how it would all work, that Maggie would experience some discomfort when the needle went into her leg. Audie’s husband held Maggie down, cradling her in his arm, Audie gave her the injection and it was over. Everyone was wonderfully sympathetic. We weren’t given the bill, just told to come in and pay it when we were ready. Audie hugged me before we left. The way everything was handled made a very sad situation bearable.
    A few days later, we received a sympathy card in the mail signed by everyone at the practice.
    I honestly can’t speak highly enough of our vets.

    There are good vets out there. I think it’s a case of pure luck in finding the right one.

  5. Well, I’m not an expert by any means. All I have to offer is experience as a teen-age volunteer in one vet’s office, but I was the sort that shut up and listened in the hopes of getting a head-start towards a veterinary career (funny how things change over time).

    Anyway, as far as monetary concerns, I would say just about every vet (except maybe hollywood ones) has them, no matter how much they wish they didn’t. Yes, vet care is expensive, but comparatively little of that actually makes it into the vet’s pocket. So, I’d say even the best vets have to worry about their bottom line, and perhaps especially the best ones, because they are more inclined to help animals regardless if payment is likely to be forthcoming.
    Second, I suspect a lot of vets do not bring up euthanasia because entirely to often it is not the choice of last resort, when there is little else to do for an animal, and the kindest thing is truly to put it out of its misery. Very often it is the first resort of lazy or parsimonious pet owners who view animals not as friends and companions but as accessories, and it is absolutely heart-breaking from the view-point of those working in a vet’s office, particularly when they are certain that the animal can be saved. Ergo, they try not bring it up until the last minute, because not all pet owners are compassionate and dedicated, and it is difficult to tell who will be which sort from the beginning.

    Jan, for your particular dilemma I would say finding a good vet is a little bit of luck, but it is also about building the relationship with the staff over time. A vet’s office is a little bit like an emergency room, every day there are horrors that come through the doors, and the best you can do is try to keep the tide from overwhelming you.

    Anyway, that’s just what my few years experience have shown me. Hopefully you’ll find your ideal vet.
    ~Lia

  6. I have three stories that are relevant here, and they get progressively more promising in their implications for the quality of vets I’ve been picking.

    Story # 1 (Timmo):

    I had adopted a feral cat, Timmo, who was (and will always be) the best pet in the world. He genuinely looked and acted as though I was the most wonderful of all God’s creatures. Unfortunately, he got sick around age 4 and started demonstrating signs I interpreted as preparations for dying. I took him to the vet in Albany, NY I thought would be best, primarily because he was the son of my family’s (justifiably well-respected) vet 20 miles away. Unfortunately, it didn’t go well. First “Junior” palpated Timmo and advised exploratory surgery. I found out later that Junior had felt tumors on Timmo’s kidneys and even suspected it was cancer as a result of FIV. I wasn’t informed of any of that, and as a result, Timmo had invasive surgery with very little chance of it helping him. All it did was make him miserable and maybe extend his life by two weeks. I wrote a stern letter to the dad, and switched vets.

    Story #2 (Linus):

    Brit Hub 1.0 and I adopted litter-mate kitties Linus and Polly when they were about 4 months old. Linus got sick one Sunday morning, vomiting and clearly in distress. We took him to the emergency room at the University of Pennsylvania vet school. He was examined by a student, then by a professor. The professor explained that normally this would be caused by something wrapped around the cat’s tongue, but there wasn’t anything, so they’d need to do an ultrasound. Results showed there was a blockage and so they would have to operate. We were told the estimate for the surgery, approved the treatment plan and paid 30% up front.

    Turned out — the vet student had missed a clear nylon filament wrapped around Linus’s tongue. They apologized and we actually got a refund! (No one ever said, but I assume they figured all the diagnostic tests, including the ultrasound, would have been necessary anyway, so we paid for those but not for the hefty cost of surgery.) And I can’t feel too bad about Linus having surgery, as he recovered brilliantly, and it led to Brit Hub 1.0’s best pun ever. Linus was wearing the huge post-surgical collar — which we called The Cone of Silence — when he climbed into the dishwasher. Brit Hub 1.0 called out to me that this was happening. I didn’t see how he could fit with the collar on, so I said, “You’re kidding. Cone and all?” “Yes – – Sir Arthur Cone And All.”

    Story #3 (Mimi):

    Brit Hub 2.0 and I adopted Mimi, a Rhodesian Ridgeback mix, shortly after our wedding in North Yorkshire. Brit Hub 1.0’s wedding present for us was to pay for all three of us to go to Alaska for a cruise. (People tease me and say my first husband went on our honeymoon, but of course that’s silly. It wasn’t our honeymoon.) The day we were to drive Mimi to the boarding kennels before the cruise, Mimi started limping. Our vet here in the country met with us and was baffled. But there was a new practice opened up nearby with an veterinary orthopedist. They had an opening and off we went. He was great — x-rays confirmed his suspicion, namely that Mimi’s days as a doggy gymnast were over because we couldn’t let her do back flips anymore. She’d pulled a muscle in her back. We got prescription steroids, drove her to the kennel and our trip was saved. (It was probably a good thing she was in the kennel while she recovered; we’d have had a hard time keeping her quiet.)

    The bottom line is that I have had good vet experiences and I’ve had bad ones. I believe animals are saner about death than we humans are, so I’ve never had a problem euthanizing a pet when it’s been the right time. I do expect a vet to understand that, but they always assume I’ll wail & gnash my teeth.

  7. Wow. I was a little trepidatious about doing this post, both in terms of opening some recent wounds for myself, and because I feared it would turn into a vet-bash. I’m so glad I did this.

    Sue, if I had your Audie, I’d hang onto her. I wonder how she’s managed to retain her sense of mission and hope despite the very-real barriers Lia’s delineated below. If you get the chance, would you ask her and pass on the information to me?

    Lia, I’m so grateful for your comments. If this is the reality the vets in our city face, no wonder so many of them react as they have. I know how it used to affect me when I’d see kids who suffered because their parents lacked fundamental skills. To have to deal with that day in and out… I’m going to make a point to respond with more understanding to their plight, even while doing the best I can by my pets.

    I agree with your point about the protective nature of a long-term relationship. Unfortunately, all our crises that require hard decisions have occurred during the evenings or weekends, when our choice of providers is limited to one of two hospitals, with one vet on call at each. We had one occur in the day, too, when our regular vet couldn’t fit us in. In other words, thus far we haven’t managed to maintain any continuity of care. I agree that would be ideal.

    Magdalen, LMAO about the Cone of Silence and All.

    Thank you for all three of your stories. It was your last paragraph, though, that hit the mark for me. Perhaps their hesitation about mentioning euthanasia is a misguided attempt to protect me from reality. Maybe my medical training and outlook makes me more sanguine about hard choices than their typical client.

    Lots to think about here.

  8. Interesting post, Jan. And actually, I’ve found the opposite to be true–and equally frustrating.

    Let me explain. I’m also a high maintenance client–probably because I’ve worked in a vet’s office as head of canine rehab, have been involved in dogs and researched health-related articles extensively for over 15 years, and am on our national breed club’s Health and Genetics Committee. I probably know more than the typical pet owner. I’ve found that some vets don’t like this. They don’t LIKE for you to request extra tests, or suggest discussing x treatment.

    We were once ridiculed by a vet for insisting our dog get tested for letpo. In fact, it was like pulling teeth. He thought we were nuts–just because our dog went off her food and drank a tiny bit more water, so what? Luckily, we knew our dog, knew her not eating was paramount with disaster, knew lepto was a concern, and insisted not only on the test, but a prophylactic treatment with antibiotics. Guess what? She was positive. Early treatment for lepto can make the diference between life and death.

    Luckily, our vet now is AWESOME. And actually, their policy (as was the one where I worked before) is to always give the owner an estimate of costs prior to performing any services. A good thing, I think.

  9. I haven’t thought this through so it’s mushy coming out of my head but I think there might be some correlation between pediatricians and vets – both of your patients are basically unable to articulate verbally what’s wrong with them and yet the ‘parents’ expect everything to be explained in real words. Personally, as a parent and former pet owner I don’t think this is unreasonable:) But clearly it might cause some difficulties.
    I do think that doctors – of all types and persuasions – need to do a better job of explaning issues, costs, prevention, etc in real words. Jan – your example of the platelet test is illuminating and shows that only with specialized knowledge were you able to understand underlying issues involved in Buddy’s situation. Personally, I’d want to be informed of all of these issues so I could decide what was important or not in my own context. That goes for the vet, the pediatrician, my own GP, the woman who cuts my hair, the car mechanic, etc . Sure it makes me a control freak but if I don’t have the information I don’t know what questions I need ask. I can be a pain in the butt now and become a better educated customer or I can go somewhere else, right?

  10. I think I can answer for Audie, I’ve known her for 8 years.

    Apart from the practice, she and her husband also have a small ranch and make some income from that;

    Secondly, this is the only practice in a 10 mile radius. She has an overwhelming number of clients to keep the practice humming along. They do large animals as well as pets. Plus, they’re geared up run quite a few of the tests in-house, rather than send samples off elsewhere, which up costs quite a bit. That even applies to prescription drugs. We had one of our dogs on Valley Fever meds for a while. Her staff would go on line and search the online pharmacies for the one that offered the meds at the lowest price.

    Thirdly, depending on the illness/problem, she starts with the cheapest diagnostics first. She pretty much makes that clear right from the start;

    Fourth, she’s extremely driven. There’s not enough hours in the day for her. She’s definitely one of those vets who puts her patients first. For a while, we thought we were going to loose her because she had health issues that were wearing her down. She was having trouble finding another vet to buy into the practice. Now she has two part time vets, one who’s retired from his own practice and another who has a practice elsewhere, but spends a couple of days a week up here.

    Finally, she has very strong religious beliefs (Scient010gy) and she draws great strength from that. Plus, she is extremely strong-minded and determined. To her, it really is about animal welfare and a love of what she does.

    I’ve had pets for 30 years, hubby worked with racehorses for 25 years. We’ve both dealt with numerous vets over the years and we both agree that Audie is the best vet we’ve ever had. We realise we’re very lucky and we wouldn’t dream of taking our pets anywhere else.

  11. That’s one of the things I worry most about with the move to a new state. Our last vet office was wonderful. Baldrick didn’t always see the same vet (all the staff, with exception of a couple of interns over the years, were female. Not that it matters, but I always found it interesting)but they were always very sweet to him, and patient with us. We hauled that dog in for every little thing. But they seemed a good mix of pragmatic and compassionate.

    Baldrick hates the vet, he shakes the whole time–in fact, I’m fairly certian that when he does go, it’ll be because he stroked out at a routine check-up–he also doesn’t cry or anything when he’s hurt. It’s normal reaction for animals not to act wounded, but it also makes it hard to figure out what’s wrong.
    “He was limping earlier…”
    “See?! I’m fine!!”

    Anyway, so we dragged him in for every little thing, and sometimes he just got rimadyl or tramadol for pain, and take it easy, and just watch it. Other times, he had to have emergency surgery to remove a bladder stone from his ureter (and the rest of the stones) and got a nifty titatium rod in a back leg from one of the most amazing specialists ever. His offices were immediately indicative of his attitude, and my boy was running like a mad dog again within weeks.

    But we’ve been going to the same vet for ten years. The dog is 13. Just at the time in his life when things are going to start falling off, and he (more to the point, we) needs extra-special care, we’ve moved to a place where no one knows him, and I don’t know how to even start looking for a good vet. If it takes several tries, though, we’re very willing to do that.

    I think it just depends on the vet, the size of the practice, and any number of other factors. There are wonderful ones out there, and then there’s the kind I grew up with, who cluck their tongues when you “assign human emotions to an animal.” I think it does take some luck to find the right one for you and your pet, but yeah, so far we’ve had great luck and wonderful vets. *knock wood*

  12. My experience with vets has been about the same as my experience with doctors. Some of them are magnificent, compassionate people who do well at communicating and at negotiating a treatment plan that is good for both pet and owner. Others are just minimally competent technicians doing a job. And while one those minimally competent technicians saved my cat’s life with emergency bladder surgery, I don’t use her as my regular vet.

  13. Debra, yes, I think you probably know more than the typical pet owner. I would bet some vets would find that intimidating, at least until you’ve both figured out the power dynamics in the relationship.

    One of the things I learned in practice was to listen to parents. We caught a case of meningitis unusually because I had a mom who *knew* her baby was sick long before I would have picked it up. Kudos to you for listening to your instincts, and good for them for going along with you, even if they required a little…encouragement. 😉

    Steph, I couldn’t agree more about the need for respectful communication. Funny, but as I wrote this post, thinking perhaps some vets were more comfortable with the technician part of their jobs than the human side of the equation, I thought of my expectations about a mechanic.

    Sue, so your Audie works hard, smart, at something she feels passionately about, and that presumably she sees as her calling. Thanks for that perspective. I always like to know how some people thrive under adverse conditions.

    Clovia, aw, your pup sounds so sweet. (Love his name, BTW. :)) I wonder if your old vet could give you a referral. Failing that, usually worth-of-mouth is the best way to find all professionals, although you can see that hasn’t worked out super for me. Wishing your Baldrick can stay well until you find the write one!

    Bryn, as usual you use half the words I would to encapsulate the paradigm. 😉 Even less-than-ideal professionals do awesome work sometimes. (And mostly-awesome professionals can perform below their usual standards on bad days.)

    1. His full name is actually S. Baldrick 🙂

      If you’ve never watch the series Blackadder, with Rowan Atkinson (Mr. Bean) then that’s probably means nothing to you. If you have, then my Baldrick looked very much like Blackadder’s dogsbody, Baldrick, when we got him at the pound. Scabby, filthy, infected and disgusting. He’s feeling much better now 🙂

      1. I heart Rowan Atkinson, and Blackadder. I don’t heart my spelling. Sorry for goofing up your pup’s name. As for that image of your boy…um, yeah. 😉 Glad he’s better now.

  14. There are so many good points here! I am saying ditto to all the great points that have been made. I am probably going to ramble a bit as well….

    I am a high maintenance client as well. I have worked with animals over the years and gained a lot of medical understanding when my youngest son was diagnosed with cancer as a child. Plus I am really good at research, so I usually walk in the door armed with a good deal of information.

    I agree with your list of qualities for a vet but would probably allow for a looser interpretation of #4 – because animal patients can’t talk, sometimes the testing needed can really depend on the situation and the pet.

    Several years ago we had to change vets, even though our vet and the hospital staff were personal friends because we had serious questions about the quality of care our pets were receiving. Some of the treatment was not consistent with current best practices in the field. When it got to the point that we had concerns about our pets’ safety, we switched doctors. Our new vet immediately diagnosed a problem with my labradorable that I had been asking the previous vet about for months.

    I still get choked up even thinking about my chow mix that we lost to cancer last year at age thirteen. Not ready to tell that story just yet….

    Jan, your experience at the emergency vet sounds just horrible! Here, it is a crap shoot as well. There is only one emergency vet for the entire area that all the vets recommend. Since it covers a large geographical area, it is 35 minutes from my house. Since it is only open at night and on weekends, the vets rotate and range, in my opinion, from from barely competent to good. When I have called the office for advice, I have NEVER been given correct veterinary advice. And they are awfully expensive –an average visit is between 300 – 500 dollars. But they have provided valuable medical care that my animals needed on more than one occasion.

    Our present vet is a wonderful woman. Everybody in the practice is, actually.. I think the important things is to realize it is the entire package – the doctor, the techs, even the receptionist – that really makes a practice great. She came through a recommendation from a friend. Ultimately, I think that’s the best way to find someone who is great for you and your pet.

  15. I think your expectations are absolutely reasonable, but I’m somewhat shocked you’ve encountered what you have. I wonder if you being an MD is working against you (money source $$kaching$$) even where that may not be true. I also wonder if there are regional differences. I’ve had pets in two places–Portland, Oregon and Ann Arbor, Michigan. YES, they recommend some things we just can’t justify (the teeth scraping thing for $600 every other year or something–I just CAN’T.) and maybe my refusal on the expensive preventative tells them I also am going to be financially concerned with other treatments–we DO pay for the heartworm stuff and shots, but they KNOW money is an issue.

    But maybe ALSO, living in places where most of the population is very educated (here)- or OREGON where euthanasia is even available for PEOPLE (sort of) I may just be lucky that the culture has extended into veterinary medicine.

    I think it may just be a need of training. Some people might be truly and deeply offended by a vet saying, ‘so we could put your pet to sleep’–but approaching it from a risk benefit: “you know, even with the $3000 surgery, only 20% of pets recover from this, and it will probably only add a year or two to their life. Is it something you want to pursue?”–the right language makes it easier, and might open the dialog.

  16. Yikes, Glinda, you’ve been through a lot. I assume your youngest is young and healthy today?

    I should explain a bit about point #4 with an example. When the vet found Pepper’s abdominal mass on exam, I refused to authorize an automatic needle biopsy. I carry a cell phone. We had blood and urine tests pending, and I’d want to discuss those results and the information gleaned during the ultrasound itself before a decision.

    Pretty simple expectation, I think, yet I had to repeat it twice: when I signed the consent for the ultrasound, and again when they found the mass.

    The results of that conversation: if we did the needle biopsy, I would be committing Pep to IV fluids and antibiotics (including hospitalization) for several days before we’d know the cytological diagnosis of an almost-certain cancer I wouldn’t treat. This against a backdrop of a kidney stone and acute renal failure.

    When I laid out the holistic view of Pep’s treatment choices, as above, and asked if I’d understood the situation correctly (I had), it was as if the vet finally put all the pieces together herself. She looked at me with fresh respect, on top of her compassion. She understood what I knew – only because of my background – that what appeared to be a fairly painless, simple procedure was actually a commitment to an entire treatment plan.

    Anyway, that’s how my brain works. It’s exhausting and odd and intensely irritating to others. 😉

    Hart, I wish it was as simple as my background being an issue, either in terms of assumptions about what I’ll understand or finances. My sister went through two comparable situations with her pets, and she has no medical training.

    I wondered about regional differences, too, which likely goes to training. When I went through med school, other than excellent modelling and a few lectures about the doctor-patient relationship from other family doctors, we had no formal courses on communication. Before I left the University, even during the first non-clinical year, we were designing entire modules around that subject.

  17. Jan, my youngest is indeed alive and still eating too much junk food! (This is the son who lives in New Mexico and plays in a band.)

    My remarks about #4 were not meant in any way as a criticism. I think it really varies from situation to situation (or at least it has with my animals). Doing a biopsy without blood work results doesn’t seem to smart to me, either. And several days for a biopsy result? Seems way too long!

    Many of the vets in Northwest Indiana trained at Purdue University downstate which has a well known veterinary school. Yet their attitudes seem very different in dealing with the animals and their owners. So, I am not sure how much where a vet trains makes a difference, at least in this area. 🙂

  18. I’ve had great people for my pets. I did have one incident with my previous dog, Dingo. He loved everybody, even cats, and showed affection to the vet. During one visit she was out of vaccine but offered to bring it to my place the following day. Dingo was so happy to see her he offered her his ball. He was less thrilled when we held him still so she could give him the injection. She had to laugh when he started giving her dirty looks while she updated the records.

    We had a different vet by the time he had to be put down. They were very understanding and went so far as to send a sympathy card.

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