Bulldog whelping

Re: Bulldog whelping

Claire Godfrey — Tue, 24 Jan 2012 17:14:48 GMT

[quote user="Joyce Whitehead"] I hate it when owners of pet bitches think it will be an easy way to make money, and am inclined to tell them that it may not be a bad idea, but to bear in mind that they might need to have hundreds of pounds available for a caeser and any other complications, and that in the worst case scenario some bitches may not survive, or they may end up with a caeser and one pup, not very profitable at all. [/quote]

Discussing spaying a clients Staffie bitch at her 6month health check, when he revealed his master plan. "I thought I'd have a litter, then I can use the money from the pups for her spay"

Think I managed to convince him otherwise!!

Re: Bulldog whelping

Cat Henstridge — Tue, 24 Jan 2012 16:26:00 GMT

[quote user="Kate Richardson"]Again, not excusing the owners in the slightest, but is there enough public education on these matters? Another ideal public campaign that could be run- educating people on what can happen if all goes wrong with a pregnancy and costs involved. Might help to cut down unnecessary and excessive breeding. I know some people will go ahead with it regardless, but even if were to stop a proportion from thinking breeding was all plain sailing, it would be a good thing. A lot of these people probably only contact a vet when things go wrong, ie once the horse has bolted, rather than before they embark on a pregnancy. Hilight the options available should your bitch get mated 'accidentally'[/quote]

My thoughts exactly! This thread would make an excellent subject for Arlo's vet survey website idea, a pretty much clear, concise message from the profession and an interesting/controversial enough subject to catch the eye of journalists, not to mention the welfare benefits to bitches if people act on the messge (one can but hope! )

The questions could go something like; Have you ever performed an elective casearian on a bitch? Do you think a bitch who requires a caesarian should be spayed at the same time? How much is the cost of a caesarian at your clinic? Have you ever dealth with owner's who haven't considered the need for a caesar or were unprepared for the cost? Stick in a couple of quotes from vets and maybe some stats from the KC about the percentage of bull bitches need to be caesared to get the pups out and hey presto, press release!

Cat

Re: Bulldog whelping

Utlendigur — Mon, 23 Jan 2012 22:13:07 GMT

[quote user="Joyce Whitehead"]I am not against people breeding, but can't bear it when they feel no need to do any research or reading at all, then phone up to get advice when the bitch is about to whelp.[/quote]

We had one owner who was under the impresssion that once the bitch got near whelping the normal course of action was to simply drop her off at the surgery, and collect her and litter once she had finished, with a vet providing constant monitoring for however long she took (too much watching One Born Every Minute?). She was quite shocked and panicky when she realised that she was expected to have the bitch whelp at home!

Re: Bulldog whelping

Joyce Whitehead — Mon, 23 Jan 2012 21:18:21 GMT

I do feel that there should be some publicity of the fact that breeding from your bitch is not an automatic way to make money, and if you do it well, you may make nothing (ie good feeding and puppy care). I hate it when owners of pet bitches think it will be an easy way to make money, and am inclined to tell them that it may not be a bad idea, but to bear in mind that they might need to have hundreds of pounds available for a caeser and any other complications, and that in the worst case scenario some bitches may not survive, or they may end up with a caeser and one pup, not very profitable at all.

Of course then there is always the bitch that hates the pups.....

I am not against people breeding, but can't bear it when they feel no need to do any research or reading at all, then phone up to get advice when the bitch is about to whelp. I certainly agree that euthanasing a healthy bitch due to money concerns would haunt me, but then I feel that about any condition which is easily treatable.

Re: Bulldog whelping

Kate Richardson — Mon, 23 Jan 2012 21:07:53 GMT

[quote user="Clive Ansell"]Yes, and of course, the Bulldogs owners have had a minimum of 9 weeks to plan for and mobilise necessary funds for a possible, almost inevitable, OOH C-section. If a accidental mating they have had plenty of time to arrange mismating injections, termination of pregnancy or getting the bitch speyed during pregnancy. The RTA cat owners do not have any notice. [/quote]

Again, not excusing the owners in the slightest, but is there enough public education on these matters? Another ideal public campaign that could be run- educating people on what can happen if all goes wrong with a pregnancy and costs involved. Might help to cut down unnecessary and excessive breeding. I know some people will go ahead with it regardless, but even if were to stop a proportion from thinking breeding was all plain sailing, it would be a good thing. A lot of these people probably only contact a vet when things go wrong, ie once the horse has bolted, rather than before they embark on a pregnancy. Hilight the options available should your bitch get mated 'accidentally'

Re: Bulldog whelping

Clive Ansell — Mon, 23 Jan 2012 20:55:42 GMT

[quote user="alison howell"]

The main difference between the whelping bulldog and the RTA cat mentioned above is that the bulldog breeders are going to make 1,000s out of the pups therefore they will most likely come up with the money if pressed whereas the cat owners won't.

[/quote]

Yes, and of course, the Bulldogs owners have had a minimum of 9 weeks to plan for and mobilise necessary funds for a possible, almost inevitable, OOH C-section. If a accidental mating they have had plenty of time to arrange mismating injections, termination of pregnancy or getting the bitch speyed during pregnancy. The RTA cat owners do not have any notice.

Re: Bulldog whelping

Malcolm Ness — Mon, 23 Jan 2012 20:42:35 GMT

[quote user="Virginia Campbell"]I wonder if the scenario could have been something like this...[/quote]

Could have been, but it wasn't.

Re: Bulldog whelping

vs0u — Mon, 23 Jan 2012 20:32:27 GMT

I've seen one where the owner of a whelping staffie claimed to have no money, begged and pleaded and pretended to phone friends etc, and when euthanasia was threatened eventually, produced £500 in cash from a back pocket and paid the lot.

These people are just trying it on!

Re: Bulldog whelping

Virginia Campbell — Mon, 23 Jan 2012 18:34:54 GMT

[quote user="Malcolm Ness"]The bitch spent several hours in the care of a well known veterinary charity before it was realised/reported to the owner that "they didn't qualify as clients" of that particular charity. They were sent in search of a private veterinary practice[/quote]

I only have experience of one well known vet charity clinic, and their support staff are always absolutely 100% cystal clear on the phone and in person to the owner, what qualifies them as clients. I wonder if the scenario could have been something like this...

Owner rocks up at charity clinic unannounced.

"My bulldog bitch is whelping and, shockingly, appears to need a Caesar. I have no money. Operate on her for free"

"Right you need evidence of XYZ benefits"

"Umm...hmm...right...I just need to go outside to ring my partner". *disappears*

Charity clinic left with sick whelping bitch. Eventually realise that owner has not come back. Gives pain relief +/- drip Eventually owner comes back, sans documentation, told not eligible, faffs about in reception for hours whinging down the phone at everyone they know, then eventually brings the dog to you. Just one possible scenario.

Re: Bulldog whelping

Clive Ansell — Sun, 22 Jan 2012 16:14:20 GMT

Do any of you offer credit plans through a finance company to pay for treatments, where usually a deposit is paid and the remainder is paid off over any number of months by direct debit?. My dentist operates such a scheme, he charges a deposit to the client, and gets the remainder from the financier. The client then makes monthly payments to the financier. It can be arranged on the spot with a 5 minute phone call where the client is credit scored.

I know several practices that allow monthly payments, and get the client to sign a practice made agreement, but it seems many just renege on the payments, and I am not sure how legally binding they are?

It is always a last resort, but where clients cannot or will not pay for treatment PTS always remains an option. I accept it as part of my job and part of veterinary life that we sometimes have to euthanase healthy animals with treatable conditions. I had to PTS a young otherwise healthy cat on Friday that had been in an RTA 24 hours previous and suffered an acetabular fracture with very little displacement, but had not yet urinated or defaecated. Clients were not eligible for charity assistance, and were totally unwilling to accept or pay for any ongoing treatment or hospitalisation, or for transfer to OOH clinic for the weekend, so they requested PTS. In fact this case is not dissimilar to the OP; clients initially turned up at the local PDSA, not eligible, so triaged, given vetergesic, metacam and amox and told to find a PVS. All these clients have done so far is moan and find fault, they expect someone else to take responsibility and pick up the tab - in the end it is their responsibility to provide funds or take out insurance, it is not the fault or a failing of the veterinary profession or of the animals charities.

Re: Bulldog whelping

katja wagner — Sun, 22 Jan 2012 14:53:17 GMT

I like phips idea about the disclaimer,at least a way to cover your a... and keep some controll about what happens once they leave your practice, also my degree of sympathy with such clients became close to zero over the years,unfortunately there is still an animal attached;

also agree that there is not really any difference to pts an otherwise healthy animal with treatable condition and that's why i feel the s...always ends up at our door.

signing over to practice and rehome later is a good option and i have done this in the past but as an employee you might not be able to do this depending on practice policy.

katja

Re: Bulldog whelping

Lorna McHardy — Sun, 22 Jan 2012 12:17:38 GMT

[quote user="Clive Ansell"]

Don't know all the details, but in this case the charity maybe should have told the clients to find a PVS in the first instance. I support the charity in that their almoning rules need to be satisied before carrying out a C-section, it is not the job of charity clinics to provide a free service to breeders of pedigree dogs.

[/quote]

None of us are obliged to do that, charity or not and I don't think anyone would disagree - I certainly don't. It's just the small matter of the difference between theory and practice, and how you deal with it. Your proposed approach is totally logical and impossible to argue with based on rationality alone, but hey, we're human, and I'm sure none of us became vets expecting to kill healthy animals for logistical reasons - and it's not just whelpings, after all. We all have a cut off point somewhere. What price the mental health of members of the profession?

Thankfully, as several people have pointed out, it's actually quite rare that people claiming no money no friends no family no nothing are genuinely unable to come up with something that will at least cover the costs.

I also agree fully with Kate - the bigger charities are in a fantastic position to push responsible pet ownership and combat the notion that it's a right people can expect somebody else to fund; and they should be doing this a lot more. I actually asked somebody once "So who do you think should pay for your dog's treatment?" and they looked sheepish and came up with the money. But they could just as well have kicked up a major fuss and made a complaint to everyone and his wife, and my life very difficult.

There'll always be some who will chance their luck and try to play the system; a small proportion of parasites is an inevitable part of any welfare system. But that isn't the animal's fault and in the end, it's the animal that suffers most. Your average vet is mostly going to be firefighting, dealing with each individual case. The big charities could be doing preventive educational things in a much bigger way than they do; tie it in with other issues. It's not just about vet bills, after all.

All of which brings us back to the Voice of the Profession stuff.... it would be nice to see more 'you are responsible for your pet's care and that includes paying for necessary treatment' and less 'the vets are all ripping us off so they can pay for their holiday homes in Mallorca' in the media.

Re: Bulldog whelping

Clive Ansell — Sun, 22 Jan 2012 10:30:10 GMT

[quote user="phipps"]

Translation for those of us working in private practice:

"How can you "recognise ineligibilty" (ineligibility = can't/won't pay the bill) for goodness sake! You're a far better person than I if you can tell who qualifies (who will pay the bill) just by looking at a client, and I'm sure the private practice would be extremely keen to employ you! The client turns up, claims to be eligible (that they will pay the bill) - the only way for them to prove it and register is to produce their money. If they don't have the required monies, they have to take a withdrawal form to the local bank to make a withdrawal (or contact a relative to borrow some money etc etc). Despite placing great stress on the importance of returning the money ASAP to clients (which we do!), it doesn't guarantee the client will comply in a timely fashion. Meanwhile, the bitch has to wait - not ideal, but the only way of ensuring everyone walking in off the street cannot access the 'free' treatment provided."

So, An On MRCVS, after reading this translation can you see why it is impossible to take this approach in private practice without breaching the G to PC? I cannot see how taking this approach is any less "wrong" in terms of the G to PC when applied by charity clinics. And this is the point of this whole thread:

[/quote]

Not ideal I agree, but a client could contact home, phone a friend, or walk/drive to a local cash point in a matter of minutes to arrange funds. I have had cases in OOH clinics where the client has phoned a friend to arrange an over the phone credit card payment while the patient is being preped for surgery.

[quote user="phipps"]

On the face of it, the actions taken by the charity clinic under discussion in this thread were wrong and indeed, disgraceful. The explanation provided above by An On MRCVS is no excuse, just as it would be no excuse in private practice. Charity clinics in general, if this is their excuse, need to rethink this approach (or at the very least their justification for this approach), with reference to the G to PC.

[/quote]

Re: Bulldog whelping

Glen McIntosh — Sun, 22 Jan 2012 04:55:48 GMT

[quote user="An On MRCVS"]How can you 'recognise ineligibility' for goodness sake! You're a far better person than I if you can tell who qualifies just by looking at a client, and I'm sure the charity would be extremely keen to employ you! The client turns up, claims to be eligible - the only way for them to prove it and register is to produce their documents. If they don't have the required documents, they have to take a form to the local HB/CTB offices to be stamped. Despite placing great stress on the importance of returning the form ASAP to clients (which we do!), it doesn't guarantee the client will comply in a timely fashion. Meanwhile, the bitch has to wait - not ideal, but the only way of ensuring everyone walking in off the street cannot access the 'free' treatment provided.[/quote]

Translation for those of us working in private practice:

[quote user="Malcolm Ness"]It seems that when it comes to rules, there's one set for them and another set for us.[/quote]

But I agree with this:

[quote user="Clive Ansell"]the rules are the same. the GtoPC applies to all of us.[/quote]

Re: Bulldog whelping

Glen McIntosh — Sun, 22 Jan 2012 03:30:11 GMT

[quote user="katja wagner"]i wonder if a private practice is allowed to have the same policy as a charity to perform caesarian only including spey?[/quote]

In theory I don't see why not - for clients that can't pay the bill and you are willing to perform the caesarian without payment then you could make that a condition. If they don't like it then they need to take the dog elsewhere and try their luck, or pay the full fee....

[quote user="katja wagner"]and how can a charity proof it was accidental mating?[/quote]

Good question.

[quote user="katja wagner"]also would like to know what happens if you decline to operate without payment,pts refused by client and they bugger off promising to find another vet ,never find or even look for one and bitch and pups die at home?[/quote]

If I was in the situation where the options of either 1. Full payment upfront for caesarian, or 2. euthanasia, were refused by the client and they said they wanted to take the dog to another vet's I would get them to sign a disclaimer, or "treatment waiver" form that stated my treatment reccomendations and that the client had declined them and that they accepted the risk to their dog by declining, and that they confirmed that they had undertaken to take the dog to another vet. I would also inform the client that this was an animal welfare issue and that I would be contacting the RSPCA to advise then of a potential animal welfare law breach if I did not get a request for my case notes for this dog from the next vet within 1 hour. I would warn the clients that an RSPCA inspector would visit their house to check on the animal and may prosecute them if they found the animal in distress.

This has worked for me in the past in similar situations. In one or two cases where the owners haven't followed my reccomendations and haven't taken the animal to another vets, the visit from the RSPCA ALWAYS compels them to do the right thing. I have found that the RSPCA get pretty serious about these types of situations. I am afraid that I am not persuaded by the RCVS's mealy mouthed guidance regarding client confidentiality in this situation and would have been happy to have been a test case should it amount to a disciplinary hearing.

While I agree with you, Katja, that I do not want to euthanase an otherwise healthy bitch and pups because the owner cant afford to pay the bill for a caesarian, I have told clients on several occasions that euthanasia was the only option I could offer them if they couldn't pay the bill. They all came up with the money.

But the longer I've been doing this job the less sympathy I have for clients in this situation, and the more inclined I am to follow through with the threat of euthanasia. Why is caesarian any different to the young, otherwise healthy animal with a simple fracture that has an excellent prognosis with surgery, but is euthanased because the client can't afford the cost of surgery?

Would there be any merit in the 3rd option, which is sometimes provided by us in cases like the animal with the simple fracture which the client cannot afford to pay for and would be otherwise euthanased - that is: signing the dog (and pups) over to the practice for rehoming (or even on-sale)?

Re: Bulldog whelping

katja wagner — Sun, 22 Jan 2012 00:52:01 GMT

i guess most private practices wont have unlimited resources either and have to put up with bad debs,yes i know,there is always pts as cheeper alternative but again,i would not want to do this.

i wonder if a private practice is allowed to have the same policy as a charity to perform caesarian only including spey?

and how can a charity proof it was accidental mating?

also would like to know what happens if you decline to operate without payment,pts refused by client and they bugger off promising to find another vet ,never find or even look for one and bitch and pups die at home?

katja

Re: Bulldog whelping

Hanna Bennett — Sat, 21 Jan 2012 21:00:10 GMT

While I agree with you in principle that we are only obliged to provide first aid/welfare treatment I'm with those of us who fear for their sanity if they euthanased a healthy bitch in labour. However would you let this dog leave the building if they refused euthanasia and still had no money at all and no charity clinic option available to them? Once it is 'in my care' unless I have assured myself it is going directly to another vets who will perform the surgery (not likely) then I feel that I am responsible for that dog's welfare.

Only time I've ever seriously used the threat to euthanase was to a client who was a previous bad debt, had CCJs against him and literally not a penny to his name. Our 'local' PDSA (outside their catchment area) refused to help at all, and pretty much told me i was obliged to do the surgery if the owner requested it. Owner also phoned our not local PDSA (40 miles away) who agreed to see her as a 'special' case, and expressed complete understanding of why we couldn't set a precedent in our local area by effectively performing a completely free caesarian. Did wonder how we stood on the whole 'fit to transport' theory but gave her some terbutaline and sent her on her way with a sigh of relief. Those of us without charity clinics really are over a barrel in these circumstances - still remember the then head of the RCVS telling a lecture that the way to deal with people with no funding was welfare tx and send to a charity clinic then being thoroughly bemused by my response of 'but we have no charity clinic (sorry we do - us!)'. That caesar was actually the most understanding owner I've had in that situation who actually took my offer to euthanase his dog to mean that he had to seriously look for an alternative which he acheived. Most of them just turn on the tears and deny having anyone in the world who could help them out financially.

Re: Bulldog whelping

Clive Ansell — Sat, 21 Jan 2012 20:16:04 GMT

[quote user="katja wagner"]

I wonder what would happen if a private practice sends a bitch in need of caesarian away to find a different practice willing to operate without payment.as soon as you check her she is under your care and your responsibility but there seem to be different rules for private and charity vets?!

katja

[/quote]

No, the rules are the same. the GtoPC applies to all of us. None of us are under any obligation to provide £100's of surgery and not be paid for it. It is entirely the responsibility of the client to have the necessary funds. We have to offer emergency care to relieve pain, suffering or distress, which may be PTS.

I work in both private practices and 2 charity clinic in the same area. I have never come across a case of a patient needing a C-section that has been "sent away" without being at least triaged and treatment or pts offered. What usually happens is that clients choose to go elsewhere because they don't like the options on offer, namely they are offered PTS when they have no money. Many just turn up at the charity clinics, but if not eligible they are bounced right back.

Charities have strict almoning rules, they have finite resources that have to be spent wisely (debatable with the RSPCA I know). if clients do not satisfy the eligibility criteria they are turned away, apart from any immediately necessary emergency care. They certainly are not there for breeders', or people who would rather not pay fees. In the case of C-sections these are carried out only as necessary and only for eligible clients, in the event of accidental matings only, to save the life of the bitch (not the puppies), and speying at the same time is mandatory and non negotiable.

Re: Bulldog whelping

Lorna McHardy — Sat, 21 Jan 2012 19:51:25 GMT

[quote user="Kate Richardson"]

For most people having a pet is a luxury, but there are also obvious health and social benefits to having a pet, but they need to be suitable pets. I have no problem with an elderly or disadvantaged person or a sick person or a lonely depressed person having a pet, there are enormous benefits to having a reason to get up each day. These people deser ve the assistance that they can get from a charity clinic.

[/quote]

Given the known benefits of pet ownership in terms of health and mental well-being, I reckon there's a good argument for pets and petcare being available on the NHS

Re: Bulldog whelping

Kate Richardson — Sat, 21 Jan 2012 18:51:27 GMT

[quote user="Clive Ansell"]Maybe as a profession we should be euthanasing more of these; the message that needs sending out is "if you don't take responsibility and have the necessary funds, you dog could be PTS"?[/quote]

Maybe that's a message the RSPCA could be sending out rather than creating adverts with cute puppies saying please give us some more money to help feed me. Shutting the door after the horse has bolted. They are in a position where they could do so much more to PREVENT cruelty and suffering- adverts highlighting the cost of having a pet, the costs of multiple pets, the costs of different sizes of dog, examples of vets fees, campaigns to promote pet insurance, anything to promote the fact that owners need to be responsible for their pets. For most people having a pet is a luxury, but there are also obvious health and social benefits to having a pet, but they need to be suitable pets. I have no problem with an elderly or disadvantaged person or a sick person or a lonely depressed person having a pet, there are enormous benefits to having a reason to get up each day. These people deser ve the assistance that they can get from a charity clinic.

Re: Bulldog whelping

Kate Richardson — Sat, 21 Jan 2012 18:35:32 GMT

Maybe Malcolm can supply some further details as to whether they had the required documents or were sent away to find them etc etc. The OP stated that she was a sick bitch. If she was sick, and I have no reason to disbelieve the OP, then surely time was a factor in her being sicker at the point of surgery than she was say 6 hours earlier.

You are right in that I have never worked in a charity clinic, and I don't have a full understanding of how they operate, but I do have an understanding of animal suffering so if you don't think a sick whelping bitch is suffering, to say nothing of the foetal stress (yes, I know they all survived...so far) then we will have to agree to disagree. And as regards parturition not being a clinical emergency, then if there are signs of dystocia, then I am sorry but I also disagree- I have always believed that that was one of the true emergencies. Minutes matter. Not saying that this was the case here, but in some cases of dystocia, every minute counts. I'm not playing down the owner's responsibility here, I am talking in more general terms, and of course I think the owners are the ones at fault but how does that help the bitch at that particular point in time?

And I don't understand why you feel the need to post anon

Re: Bulldog whelping

katja wagner — Sat, 21 Jan 2012 17:06:23 GMT

the bitch may not have suffered but she was under the care of the charity who then passed the ball on to a private practice leaving them to deal with the this problem.

great for the poor sod who did the op and then stands in front of his ,hers boss explaining lack of payment. sure alternative would have been pts but i for my part can totally understand why a vet would not want to do this.

of course in the first place its the client's duty to have the financial means to care for their animals needs but the s... ends always on the vets door step.

and i too would rather charge breeders more then give them a discount and the right to pester the staff!

katja

Re: Bulldog whelping

Clive Ansell — Sat, 21 Jan 2012 16:27:16 GMT

Of course the clients could have taken their bitch to a PVS elsewhere in the first place or much sooner had they so wished. Maybe they were trying to pull a fast one and bag a free c-section?

I with An on MRCVS on this one; the clients are not eligible until the necessary paper work is completed, apart from emergency life saving treatment. Parturition is not a clinical emergency.

If there is anyone at fault here it is the client; they are responsible for making sure there are the funds and the means in place to provide treatment for their animal. They have had 9 weeks to prepare for the almost inevitable C-section, given it is a Bulldog. I would go as far as saying that clients who cannot provide for their animal should face prosecution under the animal welfare act.

Maybe as a profession we should be euthanasing more of these; the message that needs sending out is "if you don't take responsibility and have the necessary funds, you dog could be PTS"?

Re: Bulldog whelping

An On MRCVS — Sat, 21 Jan 2012 16:10:48 GMT

How can you 'recognise ineligibility' for goodness sake! You're a far better person than I if you can tell who qualifies just by looking at a client, and I'm sure the charity would be extremely keen to employ you! The client turns up, claims to be eligible - the only way for them to prove it and register is to produce their documents. If they don't have the required documents, they have to take a form to the local HB/CTB offices to be stamped. Despite placing great stress on the importance of returning the form ASAP to clients (which we do!), it doesn't guarantee the client will comply in a timely fashion. Meanwhile, the bitch has to wait - not ideal, but the only way of ensuring everyone walking in off the street cannot access the 'free' treatment provided.

Considering the bitch now has a large litter of healthy pups, I'd say your understanding of the 'bitch being made to suffer further' is as misguided as your understanding of how charity practices operate.

Re: Bulldog whelping

Kate Richardson — Sat, 21 Jan 2012 14:20:11 GMT

[quote user="An On MRCVS"]Owners frequently just turn up at said charity and claim they are eligible for treatment - they are then issued a form to take to the council offices to get stamped to prove it. Not the charity's fault or cruelty on their part, they can't treat anyone and everyone who claims eligibility! The owner had 9 weeks to make arrangements in case of whelping problems - caesarians are never 'emergencies'. Having worked for this charity, the owner would have been offered euthanasia of the bitch to prevent suffering - not the clinic's fault the owner declined - nothing to do with all the ££££ inside the bitch at all....[/quote]

That's not what I take issue with. It's the fact that the bitch spent several hours at the clinic before being turned away. If it had been turned away within the first hour that would be different. Ok, the clients made the mistake of thinking/assuming/hoping they could get treatment there, and they are equally at fault here for allowing themselves to get into this situation in the first place, but the clinic made a mistake in their delay to recognise the ineligibilty of these clients and the bitch was thus made to suffer further.