How low can you go?

Re: How low can you go?

Anthony Dennison — Fri, 31 May 2013 22:18:51 GMT

[quote user="David Mills"]has anyone seen £18,000 spent on a cat?[/quote]

I've seen close to it, though it was at university and it was insured to the hilt. Tail-pull injury that would start to resolve then the cat would get blocked or the urethra would spasm. Think his longest spell in the cat ward was about 4-6 weeks?

Sadly he deteriorated and passed away, they have a photo of him up on the wall outside the cat ward now.

Re: How low can you go?

Hanna Bennett — Thu, 30 May 2013 20:17:27 GMT

+1 for the bloods, had one once which turned out to be diabetic as well as a pyo.

Re: How low can you go?

Martin Atkinson — Thu, 30 May 2013 19:20:26 GMT

[quote user="Evelyn Barbour-Hill"]Palpate?[/quote] I'm glad you raised that word Evelyn it seems a lot of people have lost the connection between their hands and their brains! I don't scan as I don't have ultrasound, X-ray if some doubt, high WBC count increases probability but if it is discharging pus from its vulva with the right signalment I get on with it however I would do a routine profile if they are sick and funds allowed so I can give a better prognosis - I've had the odd one die later of renal or hepatic failure.

Re: How low can you go?

Mark Hedberg — Thu, 30 May 2013 13:40:12 GMT

[quote user="Iain McAllister"]

Rhodium Standard Care anybody?

(the world's most expensive metal for the uninitiated...)

[/quote]

Plutonium Standard Care - I hear it gets glowing reviews!

Re: How low can you go?

Iain McAllister — Thu, 30 May 2013 12:57:38 GMT

Rhodium Standard Care anybody?

(the world's most expensive metal for the uninitiated...)

Re: How low can you go?

Cat Henstridge — Wed, 29 May 2013 11:16:09 GMT

[quote user="Mark Hedberg"]

[quote user="Thomas Johnson"]

I don't understand why this post, and Evelyn's before it, deserved red stars. I have given 5 stars to both to compensate.

[/quote]

Obviously it's because nobody wants to think about kissing Evelyn. (5 stars from me too!)

[/quote]

Or me perhaps?!

Re: How low can you go?

Mark Hedberg — Wed, 29 May 2013 09:53:20 GMT

[quote user="Thomas Johnson"]

I don't understand why this post, and Evelyn's before it, deserved red stars. I have given 5 stars to both to compensate.

[/quote]

Obviously it's because nobody wants to think about kissing Evelyn. (5 stars from me too!)

Re: How low can you go?

Thomas Johnson — Wed, 29 May 2013 09:19:06 GMT

[quote user="Cat Henstridge"]

[quote user="Evelyn Barbour-Hill"]

[quote user="Cat Henstridge"]I noticed in another thread you mentioned you weren't in the best of moods this morning (who is at 2am?), so I am chosing to ignore your insinuation I don't have empathy with my clients. [/quote]

Aaaah, thank you Cat.

[/quote]

You're welcome! And thankyou to you too!

[/quote]

I don't understand why this post, and Evelyn's before it, deserved red stars. I have given 5 stars to both to compensate.

Re: How low can you go?

Cat Henstridge — Tue, 28 May 2013 21:32:53 GMT

[quote user="Evelyn Barbour-Hill"]

Aaaah, thank you Cat.

[/quote]

You're welcome! And thankyou to you too!

Re: How low can you go?

Evelyn Barbour-Hill — Tue, 28 May 2013 20:00:10 GMT

Aaaah, thank you Cat.

Re: How low can you go?

Hannah Wynne Richards — Tue, 28 May 2013 18:47:14 GMT

My pet hate is "I don't want him tosuffer" which really means "I'm too mean to pay for heart/arthritis medication "

Wynne

Re: How low can you go?

Cat Henstridge — Tue, 28 May 2013 15:37:12 GMT

[quote user="Evelyn Barbour-Hill"]

[quote user="Cat Henstridge"] use the excuse 'I don't want her messed with' - agghh!)[/quote]

But sometimes - maybe more often than you think - they are not trying to find excuses, they really mean it. I've never known anyone refuse pain relief or other simple treatment on these grounds. Slow down, take longer consultations, talk, have sympathy or even empathy with your clients. (Well, most of 'em, anyway )

"Shoud we bother" is a completely different kettle of fish. I've rarely heard it in the last twenty-eight years. No sympathy with that one.

[/quote]

Actually, I find the 'messed with' quote is usually the first thing out of their mouths when you start a discussion about teeth/arthritis/bloods and, as you say, often once you have explained what you are proposing, most change their minds. It's the ones who aren't interested in helping their elderly pet and who think a penchant for soft food and sleeping all the time is 'normal' are the ones who wind me up.

I noticed in another thread you mentioned you weren't in the best of moods this morning (who is at 2am?), so I am chosing to ignore your insinuation I don't have empathy with my clients.

Re: How low can you go?

Martin Atkinson — Tue, 28 May 2013 15:27:54 GMT

I wonder which part of my last post red-star man didn't like, would he or she like to tell me. Or perhaps its just me.

Re: How low can you go?

Dagmar Steele — Tue, 28 May 2013 14:40:31 GMT

I've done a similar cesarian a couple of weeks ago and of course cat was unsupervised without collar, opened up wound, had to staple. Never came back to take the staples out, can't reach them. Hope cat can get them out itself somehow, poor thing. Yes, I've reported her....

Re: How low can you go?

Martin Atkinson — Tue, 28 May 2013 13:22:52 GMT

Client calls Thursday morning cat been in labour for 24 hrs told to come in but has no money, advised to go to Putney RSPCA hospital where she's been before with a dog. Turns up in the afternoon with no appointment, cat obviously poorly still no kittens. Clearly needs caesarian, agreed to spay under C4 charity spay scheme which gives me £55 for a very heavily pregnant spay. Found one dead kitten, deformed uterus with only one horn and no anatomical cervix, other ovary found with vestigial horn. Owner finds £15 towards it so looking up slightly. Comes in Saturday had been much better but temperature 103.5 F so given antibiotics- can't pay for them of course. Call 7.30pm Sunday cat really poorly. Can't get to Putney, no transport, no money for taxi. Turns up in friend's/relative's car. When asked why she can't take her to Putney replies, 'I haven't got time, I've got to go home to get dinner' (clearly is no concern that my Sunday dinner is now going cold at home and I'm not getting paid)!! Cat is now very dyspnoic as well as wound infection and has the death rattles and I'm losing patience so told will have to be PTS as no money for what would be very intensive treatment. Que floods of tears, cat PTS and owner takes home - well that a result at least she didn't expect me to have it cremated for nothing as well. Bank holiday Monday afternoon, phones my mobile even though I'm not on call now, her dog is fitting. I've finally lost my patience and told her to get her friend/neighbour and take it to Putney or call the OOH clinic which will no doubt tell her to do the same. Other cat booked in for spay today on C4 scheme, no-show, what a surprise. Don't you just love 'em? Its water off ducks back now for me but it still never ceases to amaze me the gall of some people.

Re: How low can you go?

Evelyn Barbour-Hill — Tue, 28 May 2013 02:06:45 GMT

[quote user="Cat Henstridge"] use the excuse 'I don't want her messed with' - agghh!)[/quote]

"Shoud we bother" is a completely different kettle of fish. I've rarely heard it in the last twenty-eight years. No sympathy with that one.

Re: How low can you go?

Evelyn Barbour-Hill — Tue, 28 May 2013 01:03:32 GMT

[quote user="Michael Woodhouse"]

[quote user="Evelyn Barbour-Hill"]Does anybody do Xrays and scans and "bloods" when it's a straightforward pyometra? [/quote]

I will almost always put the scanner on unless screamingly obvious and discharging. Suppose if you had no scanner you might radiograph.

Never bothered with bloods - they are going on fluids anyway.

[/quote]

Palpate?

Re: How low can you go?

Michael Woodhouse — Tue, 28 May 2013 00:44:07 GMT

[quote user="Evelyn Barbour-Hill"]Does anybody do Xrays and scans and "bloods" when it's a straightforward pyometra? [/quote]

I will almost always put the scanner on unless screamingly obvious and discharging. Suppose if you had no scanner you might radiograph.

Never bothered with bloods - they are going on fluids anyway.

Re: How low can you go?

Evelyn Barbour-Hill — Tue, 28 May 2013 00:38:01 GMT

[quote user="Dagmar Steele"] I sometimes will operate on a pyo without doing bloods and x-rays and scan beforehand.[/quote]

Does anybody do Xrays and scans and "bloods" when it's a straightforward pyometra?

Re: How low can you go?

Mark Hedberg — Mon, 27 May 2013 15:43:07 GMT

[quote user="Julie Innes"]

What does pee me off, however, is the client (I had last week) who has a 6 mth old puppy with symptoms of colitis- I think it is a dietary sensitivity and may need some time and patience to find a diet to suit. Owner isn't prepared to do that. "If you're telling me you can't fix this immediately, I'll have to get rid of him- I'm not having that in my house!" I've done faecal samples, but if they come back inconclusive (as I suspect they will) this poor dog will no doubt be on gumtree in a week :(

[/quote]try z/d ultra and a few days steroids, this should buy you time to work it up. Also a week of fenbendazole to kill any giardia lurking round tn there. Might not get an ideal dx, but at least the garden hose is turned off! :)

Re: How low can you go?

Dagmar Steele — Mon, 27 May 2013 10:11:03 GMT

[quote user="Cat Henstridge"]

On the subject of not treating diseases in older pets, this is a bug bear of mine and something I am quite passionate about. I cannot stand it when people say 'but she's old, should we bother' (or use the excuse 'I don't want her messed with' - agghh!) with their pet with a treatable problem which is causing suffering (arthritis/CRF/Hypert4 etc) and I am surprised when vets have this attitude as well. It shouldn't cost much to do a quick pre-op blds, a BP check and a T4 and simply giving NSAIDs (without bloods if necessary) will increase quality of life massively in older animals. Sure, some have more complex issues and I have no problem tailoring investigations to their budgets or wishes but there is never any excuse for not treating to some degree just because of age.

[/quote]

I've never said I wouldn't treat an animal just because it's old and I am fully with you, people saying "she's so old, we don't want to put her through this" and then declining pain medication or a pyo OP drive me up the wall. Or people not having their pet's teeth done because it's old! (I always ask myself and sometimes them if they wouldn't go to the dentists if they had severe toothache or take pain meds if they'd be heavily limping?) But I will prescribe NSAIDs and in some cases even combine them with steroids without doing bloods to help the animal as I sometimes will operate on a pyo without doing bloods and x-rays and scan beforehand. If the puss comes out of the back end and I can feel the uterus between my hand I don't necessarily need any more diagnostics.

Re: How low can you go?

Cat Henstridge — Mon, 27 May 2013 09:34:29 GMT

Only on Saturday I had a lady bring in a GSD pup for first vaccines, who then asked if she could split the cost. I had quite a serious chat about the on going costs of a dog of this size and in the end she signed up to the practice plan. Which in the short term was a lot cheaper but hopefully she will keep it up and the dog will get guarenteed on-going care.

Re: How low can you go?

Braden Collins — Mon, 27 May 2013 00:55:45 GMT

The clients that really annoy me are the ones we pay $2000 for a pure bred bulldog thinking they can make money off breeding them then don't want to pay for a consult because they think they've spent enough on the dog already. I really hate the cut price vaccine models. It makes it more expensive to treat an unwell animal, which doesn't do animal welfare any good.

Re: How low can you go?

Julie Innes — Sun, 26 May 2013 22:48:41 GMT

Of course I totally agree with many of the pp's- I will go through all the options for a pet, and let the owner decide which option they want/ can afford. Often it is about talking to the client and getting a feel for their circumstances, and not just financially. For example, an older cat presented for vaccination or another problem, that has been losing weight, possibly has signs of CRF/ hyperthyroidism, I will always give the owners the option of further investigation but won't push it too energetically. I discuss the "next stage" of each process- eg if they tell me categorically that there is no way they can give the cat tablets and would not consider surgery or the costs/ realities of radiotherapy, is there really much point in diagnosing the cat as hyperthyroid? as long as I have given them the options, I respect their right to make the decision for their 18 yo cat.

My issue with the corporates and such is not stack-em-high-sell-em-cheap- in my experience that isn't the case. Many of the corporates charge a much higher mark-up on drugs than most of us, and the pressure is on to sell food/ flea treatments/ wormings (at an inflated price) to people who really can't necessarily afford them- hence the reason they have gone for the cheap vaccine in the first place.

I am in the happy position of being able to have prices that my clients think "reasonable". The reason for this is that I keep overheads down, don't pay myself as much as I probably should and don't push my clients into lots of tests etc that they can't afford. I admit, there are certain clients who I deem "good" clients, in that they care very much for their pet, but who don't have much money, and I will always try and keep costs down for these guys (eg by choosing a cheaper antibiotic/ charging a reduced consult fee).

Re: How low can you go?

James Laidlaw — Sat, 25 May 2013 18:37:00 GMT

Agree with you completely John.