'They were fine last week...'

Re: 'They were fine last week...'

Gillian Mostyn — Tue, 04 Dec 2012 14:15:27 GMT

I had one this morning - 15 year old dog that came for unrelated issue but had obvious (due to smell) dental disease. Just a very quick inspection showed a draining sinus above an upper carnassial! The owner said 'do you think it is worth treating in a 15 year old?' My answer? Would you rather be left in pain if you got a tooth root abscess at 90 years old? He looked a bit shocked at my blunt reply - but certainly got the message.

I guess I just wasn't in the mood to deal with a moron today...

Re: 'They were fine last week...'

Jon Bray — Mon, 03 Dec 2012 23:38:53 GMT

[quote user="Mark Holmes"]

I ask if they had a molar abscess what would be the worse scenario death under ga or a chronic untreated abscess.

[/quote]

Good idea: I've recently taken to pointing out (when necessary) that the animal is suffering and it is illegal not to take action to relieve this - and although there may be a slight risk of losing an animal under anaesthetic it is a hell of a lot less than losing it during a euthanasia which is the only other humane option. I can't recall not getting my way on that one yet.

Re: 'They were fine last week...'

Hannah Wynne Richards — Mon, 26 Nov 2012 16:46:47 GMT

Hear hear

Wynne

Re: 'They were fine last week...'

Nixthevet — Mon, 26 Nov 2012 16:42:13 GMT

I think that whilst we now have the added protection of the AWA we probably feel unsure about actually enforcing it. Perhaps the RCVS professional conduct department ought to be a 24hr service in order to give more back up ( currently only available during office hours).

I have threatened clients with the RSPCA/prosecution on several occasions...and followed up by reporting them to the RSPCA if they failed to take me advice on getting treatment. Once they have been informed that you will have no choice but to take action ( and it's recorded and witnessed) then my view is that professional confidentiality no longer applies and we should get in touch with the authorities to take some action.

Re: 'They were fine last week...'

Jo Cobbett — Mon, 26 Nov 2012 13:20:25 GMT

[quote user="Martin Atkinson"]

[quote user="Jo Jones"]And people wonder why their dog's ear infection keeps coming back and is really difficult to get rid of![/quote] It can be easy to be glib about this but how pedantic were you about making a correct diagnosis, educating the owner in how to use the drops and emphasising the need to come back for a check up. You may be very conscientious about this Jo but IME most vets aren't. I will make a tentative diagnosis, take a swab for slide or culture if necessary, show them how to apply the drops and get them to demonstrate to me them doing it and emphasise they come back in a week better or not, then if they're better they're sent home with ear cleaning drops and told to collect some more when they run out as this is for the long term, if they're not better we investigate and re-treat until they are. Result - very few recurrent ear problems. Sounds simple but so many vets don't emphasise this enough. If you do all this then I agree with you and if they didn't come back then your clients are dicks.

[/quote]

I agree entirely. Poorly managed ongoing otitis cases are one of my biggest frustrations, so I always drum in into the owners how important follow up is. I didn't see the dog for it's OE last year, so I can't comment on what was said then. But I always impress on owners that we need to follow up on the dog's ears until we are 100% convinced that the problem has settled (in the cases where there is a chance of cure as there doesn't seem to be an underlying problem), as otitis will turn into a chronic ongoing painful problem for their dog if not managed correctly. For those with likely underlying causes (most of them) I discuss that further, including work up and long term management. And if I have cases that I know need following up and suspect the owners won't bring the dog back, I write the dog's name in my diary for a week's time and if they haven't come in I ring them to remind them that they need a check up. (I also do this with weight checks when I've discussed weight at vaccinations etc - I'll ring them a month later to remind them that the dog/cat is due a weight check. They usually then come in, and we can check that things are going ok. If you don't ring them, they never come in, and the dog is even fatter at the next vaccination!)

Re: 'They were fine last week...'

Hannah Wynne Richards — Mon, 26 Nov 2012 12:31:18 GMT

No money for veterinary fees yet money for drink???????????????????????

What a waste of space!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Scum like this aren't short of money-they spend it (probably ours if the truth be known ) on the wrong things

Wynne

Re: 'They were fine last week...'

james herriot lied — Mon, 26 Nov 2012 08:41:44 GMT

Cases like these are learning curves, Anthony. I suspect next time, you'd be more likely to give the dog a shot of something at the point of examination, without discussion of money. And then explain what you've done, how long it would last for and what the guy would be required to do to get further help.

Not the dog's fault; nor, I suspect, yours. I think both of you would have slept more soundly if some analgesia had been slipped in before too much discussion.

You might also find that once the guy straightens out, he gets some great advice from Dr Google about vets' obligations to treat emergencies. The problem with that is that the most scumbaggy owners are often the most strident when it comes down to their 'rights' and entitlements.

Re: 'They were fine last week...'

Anthony Dennison — Sun, 25 Nov 2012 23:12:55 GMT

Micheal, I did look at the dog - sorry I guess it came across that I didn't even let the guy through the door. It was fine apart from a damaged hock, either ligamentous damage or a fracture. In fact, it could have been older than that as there were 2 grazes on the lateral aspect of the hock that seemed to be quite old, starting to heal.

Told the guy to go pick up some tramadol the next day when he could get some money together.

Re: 'They were fine last week...'

Mark Hedberg — Sun, 25 Nov 2012 22:24:13 GMT

[quote user="Evelyn Barbour-Hill"]

One of my nurses is extremely severe with drunks and sometimes I let her loose and retreat out of earshot.

[/quote]

Don't you mean "Out of the line of fire"?

Re: 'They were fine last week...'

Michael Woodhouse — Sun, 25 Nov 2012 21:06:37 GMT

Anthony - I wasn't having a 'dig' at you. Usually in these situations I will put the money aside and have a look at the dog. That often gives the people the chance to calm down and for me to make as assessment whether it's just bloody sore and will cope with some cheap and cheerful PBZ/Pardale V or needs euthanasia due to a #. Then it gives you chance to have 'the conversation'.

Re: 'They were fine last week...'

James Laidlaw — Sun, 25 Nov 2012 20:25:12 GMT

Well, yes. Any NORMAL person would.

Re: 'They were fine last week...'

Anthony Dennison — Sun, 25 Nov 2012 18:44:45 GMT

[quote user="Michael Woodhouse"]

[quote user="Anthony Dennison"]but I couldn't treat the dog without payment - it's an offence to get goods or service without having the means to pay,[/quote]

I'd have still given pain relief/euthanasia. At my own expense if I had to.

[/quote]

Tried to, as I said... guy got aggressive and walked out. I was trying to suggest hospitalisation, the closest I got was getting him to agree to pick up oral analgesia the next day when he could get some money together. The thing that frustrated me the most is that the guy should have got treatment for the dog but didn't give a toss until it was suitable for him to sort something out. And he waited until he'd woken up from his drunken stupor to get help.

He kept repeating that he didn't call the vets straight away as he 'wasn't thinking straight' etc, but wouldn't any normal person get in contact with a vet for at least advice soon after it happened?

Re: 'They were fine last week...'

Malcolm Ness — Sun, 25 Nov 2012 17:26:43 GMT

[quote user="Anthony Dennison"]I open the door and the first words out of his mouth were 'I haven't got any money to pay for this, just thought I'd be up front.'[/quote]

Drunk or not, I think there is a possibility that your man is an experienced and knowledgable crook (or a lawyer - but that is splitting hairs)

The crime is "Gaining goods or services by deception"

If he has told you that he has no money then he can't be guilty of deception and no matter what was or wasn't said subsequently, if pressed for payment or threatened with prosecution the one thing that he will remember is that his very first words to you were ................. and you have to prove his intention to deceive "beyond reasonable doubt".

Bitter experience!!

Re: 'They were fine last week...'

Evelyn Barbour-Hill — Sun, 25 Nov 2012 17:00:48 GMT

[quote user="Anthony Dennison"] it's an offence to get goods or service without having the means to pay,[/quote]

Not exactly. Not if the provider of goods or services agrees.

[quote user="Michael Woodhouse"]I'd have still given pain relief/euthanasia. At my own expense if I had to.[/quote]

It reads to me as if Anthony too would have done that but wasn't given the chance.

[quote user="Anthony Dennison"]

I open the door and the first words out of his mouth were 'I haven't got any money to pay for this, just thought I'd be up front.' The dog had been hit by a car at 10pm THE NIGHT BEFORE, was 10/10 lame on it's left hind and looking miserable. He didn't want to go to the other practice in the area (probably had a bad debt) and didn't have our number to ring us as he'd lost the card with the number on.... despite the fact we'd been open since 9.30am he only just arrived.

He absolutely stank of alcohol,

[/quote]

This sort of thing is a regular, if now infrequent, occurrence for me. I deal with it as seems best at the time, with no fixed protocol. But that's the joy of being self-employed single-handed.

One of my nurses is extremely severe with drunks and sometimes I let her loose and retreat out of earshot.

Re: 'They were fine last week...'

Michael Woodhouse — Sun, 25 Nov 2012 14:16:54 GMT

[quote user="Anthony Dennison"]but I couldn't treat the dog without payment - it's an offence to get goods or service without having the means to pay,[/quote]

I'd have still given pain relief/euthanasia. At my own expense if I had to.

Re: 'They were fine last week...'

Anthony Dennison — Sun, 25 Nov 2012 12:01:31 GMT

Had another good one on Friday; bloke knocking on the door of the branch practice I was at during the hour we were closed for lunch. Politely told him that we were closed and open again at 2. 'But me dog's been run over'

He absolutely stank of alcohol, politely told him the dog was in pain and needed treatment but I couldn't treat the dog without payment - it's an offence to get goods or service without having the means to pay, so we would have to hospitalise the dog and treat until he paid, or as the dog's welfare was compromised euthanasia was also an option. Bloke got aggressive, accused me of trying to take the dog off him, picked the dog up and walked out.

Couldn't exactly block the door could I? Dog warden went round to check the dog and he said he'd be going to the other practice he told me he refused to go to.... Dog warden is going back on Monday to see what happened over the weekend.

Re: 'They were fine last week...'

vs0u — Fri, 23 Nov 2012 18:28:27 GMT

[quote user="Evelyn Barbour-Hill"]Ah, now that's the sort of situation where I occasionally have had a rant. I have this special act I put on where I stride up and down, throw my hands up in despair, walk out of the room "because I need to calm down" and so on. [/quote]

That sounds fab - any chance could you put a video of you doing it on here?

Re: 'They were fine last week...'

Martin Atkinson — Fri, 23 Nov 2012 17:37:23 GMT

Re: 'They were fine last week...'

KMurphy — Fri, 23 Nov 2012 17:05:08 GMT

[quote user="Jo Jones"] The owner told me "last time he was in was for his ears, and they're still not right". Last time he was in was October.[/quote]

I can beat this! I had a dog in for its vaccinations in August and the owner reported that the dog still gets an awful lot of ticks despite that very expensive treatment we sold her. No, she didn't want any more - she still had three pipettes left in the box at home. Checking her records I could see she had taken a box of Advantix at the dog's booster 3 years ago!! I politely explained that of course it won't work unless you actually apply it to the dog but she remains unconvinced...

Re: 'They were fine last week...'

Utlendigur — Fri, 23 Nov 2012 16:44:03 GMT

And today's offering "found suddenly collapsed", never had much wrong before. Was beyond moribund - uraemic as hell, extreme uraemic stomatitis, anaemic, so dehydrated and cold it was verging on freeze dried, no hope of a vein but expired with a smidgen of sedation and a whiff of iso. I kept checking it for ages after pts to make sure as there wasn't much difference between the "before" and "after"

Re: 'They were fine last week...'

Jo Cobbett — Fri, 23 Nov 2012 16:09:07 GMT

Just seen a dog for its booster. The owner told me "last time he was in was for his ears, and they're still not right". Last time he was in was October. Last year. And people wonder why their dog's ear infection keeps coming back and is really difficult to get rid of!

Re: 'They were fine last week...'

Hannah Wynne Richards — Fri, 23 Nov 2012 14:04:28 GMT

Slight variation Rescue cattery-overcrowded Owner means well but can't see that putting cats from different sources in the same run spreads disease On the plus side-she rehomes a lot who would otherwise be PTSed Downside some become ill I don't think it's deliberate lying-more that she has so many she doesn't notice until they are dire

Wynne

Re: 'They were fine last week...'

Evelyn Barbour-Hill — Thu, 22 Nov 2012 16:16:45 GMT

A good few years ago my nurse was so upset by the Christmas Clearout requests she penned a little festive poem. Perhaps not brilliant, but I pinned it up in the waiting room anyway:

Christmas is coming, the goose is getting fat,

now is the time to put down the old cat.

If you haven't got a cat, any dog will do,

and while you're about it bring them kittens too.

Re: 'They were fine last week...'

Mark Hedberg — Thu, 22 Nov 2012 15:29:51 GMT

A colleague of mine was an emotional wreck by one monday; she'd done 24 over the weekend and she just had enough. (old dogs, dying cats, rta's, dying/dead cases...bad weekend.)

Re: 'They were fine last week...'

Anthony Dennison — Thu, 22 Nov 2012 15:19:00 GMT

My first weekend on call had a body count of 14