Anaemic dog that was kicked in abdomen

RE: Anaemic dog that was kicked in abdomen

Clare Tapsfield-Wright — Fri, 08 Apr 2016 16:43:45 GMT

[quote user="Martin Atkinson"]

[quote user="Stigen"]the more i bother listening to their rants(without agreeing or disagreeing) the more they like me, which I find to often be the case when I try to pick up girls as well. [/quote]Good tactic: girls like sympathetic, gentle men who don't try too hard, you then become a challenge for them. I've rarely had to chat girls up, they come after me. Doesn't work if you're a minger mind you!

Is that a tangent? Well this thread has run its course anyway. Can I have a red star please?

[/quote] no red star but I am starting to feel a little nauseous

RE: Anaemic dog that was kicked in abdomen

Martin Atkinson — Fri, 08 Apr 2016 09:47:45 GMT

[quote user="Bob Russell"]Those that start praising you to the high heavens tend to become the most spiteful on Facebook later![/quote]Are you talking about clients or girls here Bob?

RE: Anaemic dog that was kicked in abdomen

Bob Russell — Fri, 08 Apr 2016 09:11:35 GMT

What are girls?

Those that start praising you to the high heavens tend to become the most spiteful on Facebook later!

RE: Anaemic dog that was kicked in abdomen

Martin Atkinson — Fri, 08 Apr 2016 08:57:04 GMT

Is that a tangent? Well this thread has run its course anyway. Can I have a red star please?

RE: Anaemic dog that was kicked in abdomen

Braden Collins — Fri, 08 Apr 2016 06:53:16 GMT

I tend to find the ones that come in ranting about another clinic always seems to love us at first. then as soon as we say "no" to them about anything, they turn against us as well. If you have got them out the door, I would consider you very lucky. I would be inclined to follow it up with a "don't come back" letter. Gently worded, of course.

RE: Anaemic dog that was kicked in abdomen

Stigen — Thu, 07 Apr 2016 22:14:25 GMT

It seems to work out now. I spent half my day at work today talking on the phone with all the other surgeries in the area. She seems to have stirred some emotions with everyone, and complained about them all, but she seems to have taken a liking to me(thus far). With these sort of clients I find that the more i bother listening to their rants(without agreeing or disagreeing) the more they like me, which I find to often be the case when I try to pick up girls as well.

For reasons unknown to me one of the other vets has called her and offered to do the surgery for free(incidentally the same one that had the lethal threats). He`s a bit of a character. The other option I offered her is to go to a referral clinic with a soft tissue surgeon(that has also seen this patient before) and have her,and me, do the surgery, at a fair enough price. I advised her to take the free surgery, that`s a pretty sweet deal.

RE: Anaemic dog that was kicked in abdomen

Dagmar Steele — Thu, 07 Apr 2016 09:40:36 GMT

[quote user="Stigen"]

Also she is very low in funds.
I might try to tell her that this is a special surgery that should be done by a referral centre.

[/quote]

Why am I not surprised???? Of course there will be no money, and I bet if you investigate further the first vet will probably tell you they tried to ex-lap or tap but she declined. Again, don't touch it, there is nothing but trouble ahead. As you've already seen her, tell her this goes way beyond your abilities (I know that's a blatant lie ;-) ) and if she wants the dog to survive she has to take it to the referral center. There are taxis where she lives, right?

RE: Anaemic dog that was kicked in abdomen

Robin Grimmer — Thu, 07 Apr 2016 08:39:07 GMT

[quote user="J G Wray"]

Once upon a time, not so very long ago, a relation of an occasional contributor to this forum, a veterinary surgeon, was told by RCVS that they had to provide veterinary services to a farm client who had threatened them with a shotgun. This was because there was no other vet on the island.

At that time RCVS, bless them, suggested requesting a police escort to the farm. There was no irony in this suggestion. So , why don't you give RCVS a call, tell them what you know of her behaviour, threatening colleagues and shifting practices and see what they say in 2016?

Whilst slightly tangential I'm interested to know if online registration and appointment making is a strong enough entreaty so as to commit you to providing a service. RCVS has always been a little vague on when a contract to provide services is formed, in a legal sense.

[/quote]

I don't think the OP practises in the UK. I think he's in Norway IIRC.

RE: Anaemic dog that was kicked in abdomen

Hannah Wynne Richards — Thu, 07 Apr 2016 08:33:07 GMT

If you do an ex-lap, find a splenic tumour which has metastasised, then you'll be in real trouble. That would be a case which I would consider merited true euthanasia - in fact, allowing it to wake up would constitute a criminal offence. That's the sort of owner who will either refuse permission for euthanasia, or will go around the district telling everybody that you "killed it during an operation".

Contact the police now, so they're aware of the situation, and if you ex-lap it, tell them the time of the operation. They do have the legal right to authorise emergency euthanasia if an animal is suffering.

Wynne

RE: Anaemic dog that was kicked in abdomen

Nhombokisheni — Thu, 07 Apr 2016 02:09:04 GMT

Is she aware that you have spoken to the other vets.........maybe just mentioning the ones she had threatened might get her to seek help where she is not known. If shops can turn your credit application down based on your history......then surely you can politely inform her that she is not welcome. There is no legal obligation to explain any further OR give reasons as far as I am aware.

Maybe it's time we created a database blacklisting such clients....that way they can't hope around the entire U.K.....a veterinary version of Experian...and yes such people can be banned from owning pets.....oh is this just me dreaming away???????

RE: Anaemic dog that was kicked in abdomen

Braden Collins — Wed, 06 Apr 2016 23:36:24 GMT

As almost everyone else has said, run. This client will cause you so much grief. If you ex-lap it (I think that would be my approach) and find nothing, I don't think the client will be understanding.

RE: Anaemic dog that was kicked in abdomen

J G Wray — Wed, 06 Apr 2016 23:25:06 GMT

RE: Anaemic dog that was kicked in abdomen

Utlendigur — Wed, 06 Apr 2016 23:05:06 GMT

[quote user="Stigen"]the other vets have been calling me to tell me to stay away from her, that she is crazy, and that she posted pictures with a gun threatening to kill one of them. [/quote]

Sounds like a phone call to the police is the next step - they could at least take the gun off her!

RE: Anaemic dog that was kicked in abdomen

Stigen — Wed, 06 Apr 2016 22:48:56 GMT

I agree with all of you! She booked the appointment online, and with all the stuff she wrote about all the vets she`d been too, and all her google differentials, I told my assistent to tell her that we were all booked, and refer her back to the last clinic she visited. That did`nt work, she claims to have no car, and lives close to our surgery, so I reluctantly had to see it. Then as I have been emailing other surgeries the other vets have been calling me to tell me to stay away from her, that she is crazy, and that she posted pictures with a gun threatening to kill one of them.

[quote user="Eilidh Corr"]To be fair, I don't understand why this dog wasn't opened up in the first instance - unless the owner refused, it is very odd that a dog with those bloods and that history waited a week for a work up. But as you say, you don't have the full story[/quote]

I was thinking the same thing. It was acutely anaemic after a kick to the belly...I would want to check for a ruptured spleen, or at least do a tap.

So I am in a slight pickle now. She has a sick dog, that probably should have a risky surgery, by my hands, and the owner is a crazy woman posting death threats to vets. And all the vets in a 25 mile radius refuse to see her Also she is very low in funds.
I might try to tell her that this is a special surgery that should be done by a referral centre.

RE: Anaemic dog that was kicked in abdomen

Joyce Whitehead — Wed, 06 Apr 2016 22:31:34 GMT

I agree these are never going to be good clients and need to be shipped off, either to a previous practice or a referral who can work it up fully. But I'd suggest that maybe this dog has an underlying chronic anaemia problem and the kick was the issue that caused it to collapse and therefore be worked up? Some of these dogs with chronic issues cope amazingly well with a very low HCT, so the kick may be a red herring.

RE: Anaemic dog that was kicked in abdomen

Gillian Mostyn — Wed, 06 Apr 2016 21:46:55 GMT

We had a client last year who was 'practice hopping' - we were number 3. They left to go to a local 'not for profit' practice who 'was going to be cheaper'

I put a note on the client record stating that we would not accept them back. When they came in last week to book an appointment (saw that coming) they were refused. Very satisfying!

Sometimes it just isn't worth the hassle!

RE: Anaemic dog that was kicked in abdomen

Eilidh Corr — Wed, 06 Apr 2016 21:11:25 GMT

To be fair, I don't understand why this dog wasn't opened up in the first instance - unless the owner refused, it is very odd that a dog with those bloods and that history waited a week for a work up. But as you say, you don't have the full story.

I agree - I would, in your shoes, politely explain the value of building a relationship with one practice, offer to phone that practice to discuss the case so that there's continuity, and edge her towards the door. If that's not an option (it is always an option!) then the above suggestion of abdo tap, check clotting then ex lap would be my next move.

RE: Anaemic dog that was kicked in abdomen

Robin Grimmer — Wed, 06 Apr 2016 20:24:19 GMT

Have you tried an abdo tap to see if there's blood in the abdomen? Will confrim that you need to ex lap.

And I would like to give the person that kicked the dog a damn good kick in and see how they like it. It wasn't the client was it? She sounds a bit mental. Sounds like it could be a case of Munchausen syndrome by proxy.

RE: Anaemic dog that was kicked in abdomen

Hannah Wynne Richards — Wed, 06 Apr 2016 19:36:29 GMT

I agree with everybody else. I'd point out to her how good all the veterinary surgeons she has already been to are, and would say that I couldn't possibly do better.

Wynne

RE: Anaemic dog that was kicked in abdomen

Dagmar Steele — Wed, 06 Apr 2016 19:01:27 GMT

I wouldn't touch it either! I am confessing now that with these I usually tell them to get a complete history and take it to the big referral center where they can examine and do everything. If owners are unhappy with one or two vets it may be the vet's fault, if owners are unhappy with five vets they are the clients from hell and I'll do everything to make sure they'll not become my clients!

RE: Anaemic dog that was kicked in abdomen

Martin Atkinson — Wed, 06 Apr 2016 18:44:47 GMT

Sounds so much like the client from hell I wonder if this is a wind up! I would politely tell them that you are not able to help them and they are better sticking with one of the other vets. If they don't take the hint just tell them you are not prepared to accept them as clients. Even if you do everything right if it doesn't go according to their expectations they will be the first to refuse to pay/sue you/report you to the RCVS probably in the order. As they say in East Enders, it 'aint wurf it. I would not touch it with a barge pole.

RE: Anaemic dog that was kicked in abdomen

Gerry Henry — Wed, 06 Apr 2016 18:04:58 GMT

Ex lap, uterus or spleen, maybe both.

RE: Anaemic dog that was kicked in abdomen

Lindsey Edwards — Wed, 06 Apr 2016 17:24:44 GMT

Difficult case to manage but ongoing regen anaemia without improvement in pcv would suggest ongoing loss or destruction? Increasing bun post prandial or gastrointestinal haemorrhage? Imha, ongoing bleed or side effects of possible steroids? Return case to sender or discuss in person with vet to cross check all?

RE: Anaemic dog that was kicked in abdomen

Gillian Mostyn — Wed, 06 Apr 2016 16:51:19 GMT

Agree with Rob. You're on a loser here. I suspect the owner is moving vets hoping to find one who says what she wants to hear, not necessarily what is right.

From what you've said, I'd be checking clotting with a view to an exlap.

RE: Anaemic dog that was kicked in abdomen

Rob Davis — Wed, 06 Apr 2016 16:46:14 GMT

This owner is not doing the dog any favours by bouncing between different vets and playing them off against each other. The history you have is incomplete and the owner sounds like a nightmare. I would politely suggest that she needs to stick with one vet and allow them to work up the case properly. If she does insist on seeing you, then I wouldn't want to do anything until I had complete histories from all the other vets who have been managing the case, and ideally spoken to them in person too.