How to proceed....

Re: How to proceed....

Michael Woodhouse — Sat, 09 Feb 2013 11:39:28 GMT

Tmac - I was not criticising what you did in any way. I am maybe a little more 'gung ho' and if the dog not clinically dehydrated then a single shot of NSAID doesn't seem to do any harm. The medics have an IV paracetamol that would have occasional uses in cases like these where we might want to avoid a conventional NSAID. I also appreciate that the antibiotics are unlikely to 'cure' the dog but they would be indicated in a prostate or even pancreatitis and might have made the dog better. [I see it a bit like giving steroids to derm cases, might mess up an investigation, but it doesn't sound like this chap is going to come back tomorrow cap in hand looking for gold standard treatment - sometimes you do have to compromise and do what you can within the constraints of the client or budget].

I hate cases like that. I'd rather there was no money than the owner was an arsehole.

Re: How to proceed....

Tmac — Sat, 09 Feb 2013 10:50:21 GMT

I didn't want to give NSAID given dog's abdominal signs and possibility of dehydration.....which if the owner is now to believed, is a likelihood. They point blank refused fluids. I did wonder about the antibiotics but was worried about masking anything short term and the dog's temp was normal. The second vet felt they would just go round the houses trying to hear what they wanted. We did offer euthanasia as they were so adamant they didn't want anything done. The usual story of spending hundreds on an operation in the past but never made any difference to another dog! They did take taxis too and fro to our surgery and presumably the second one as it is further from them and have paid twice for a vet to tell the same thing.......

Re: How to proceed....

Michael Woodhouse — Sat, 09 Feb 2013 10:37:36 GMT

You did what you reasonably could. I may have given NSAID|/Methadone & some antibiotic cover too, to see if you could improve any of your differentials.

Pleased that you have your husband there to take some of the conflict away from you.

Never beat yourself up about these cretins.

Re: How to proceed....

Nicola Lawlor — Sat, 09 Feb 2013 10:06:44 GMT

Sounds to me like you did what you could in the circumstances. The patient is now the responsibility of the other practice and it is between them and the client to deal with the poor dog. I honestly don't know what you can do beyond this though I completely understand your frustration and worry about how the poor dog is getting on and whether the owner will ensure the dog receives appropriate care. Your notes are fully up to date with regard to what was advised and declined so you have your defence properly in place if this does blow up into anything more - though I suspect the client will continue to have issues with everyone he sees but probably realise he doesn't have a leg to stand on if he doesn't follow advice given and things go wrong.

If only we had a magic wand.....