Should you call out if...

Re: Should you call out if...

james herriot lied — Thu, 04 Jul 2013 23:47:40 GMT

That's a lovely piece of editing there, Gillian: you've cut and pasted to suggest that I'm arguing one situation as the only possible situation. Well done - much more powerful than a logical and considered rebuttal. You haven't answered any questions at all: are you perhaps failing to engage with the process here? In which case, I would have to conclude that you can't show that a fitting dog isn't suffering, in contradiction to your previous stance, and so you must lack compassion and empathy; I do, after all, have a precedent (RCVS vs Chikosi, 2013). If you're going to lay down a framework to which all others must adhere, at least have the grace to follow it yourself.

A propos of nothing:

[quote user="Gillian Mostyn"]

I wouldn't want to presume anything about a man I have never met and of whom I know nothing.

[/quote]

along with:

" I doubt he actually gives a s**t or he would have engaged in the process in the first place."

As neither of us would presume anything about a man [we] have never met, I'm sure you'll join me in condemning such an unqualified, emotive and unfair statement as this. Who would have written such a thing, Gillian?

Re: Should you call out if...

Evelyn Barbour-Hill — Thu, 04 Jul 2013 23:38:29 GMT

[quote user="james herriot lied"]As to engaging with the disciplinary process I'd expect the most contrite mitigation to come from the most manipulative individual.[/quote]

And never, ever, defend yourself robustly. That really condemned Joseph Holmes.

Re: Should you call out if...

Gillian Mostyn — Thu, 04 Jul 2013 23:22:34 GMT

[quote user="james herriot lied"]I still think a fitting dog has the capacity to suffer, and you seem to think that's a weakness on my part. What does that tell you?[/quote]

I have no intention of throwing anything at you - I have only expressed my opinion, nothing more. You are entitled to disagree.

[quote user="james herriot lied"]I'm happy to digress - we're not pushed for time and all of these threads are ostensibly about the same thing: there was a man, who would have given his right arm for the opportunities that you and I have had - all we had to do was pass a few exams. He managed to get through vet school in a country which was already going to the dogs, where merit counts for less than connections. He must REALLY have wanted to be a vet, because I'm told that being a vet in Zimbabwe doesn't carry a whole lot of clout. He then went through the rigours of MRCVS examination - and this isn't an easy option - in order to build himself a better life. He got a job - not, perhaps a job which he particularly wanted, but a foothold nonetheless, and something which he would have endured to get where he wanted to be. He then dropped an almighty b*ll*ck. Who knows, that hour in which he waited for back-up, believing that he was doing the right thing, might have been the longest hour of his life. He might have been utterly wretched and powerless. So much so that he went home in shame and felt unable to engage with any process, such were his feelings of guilt.[/quote]

No, the discussion is about a disciplinary committee hearing and subsequent decision. I wouldn't want to presume anything about a man I have never met and of whom I know nothing.

I also tried to lighten the mood with my final comment and smilie but it obviously didn't work. There is nothing new to add to the debate really and your recent posts have upset me with their tone so I will not be posting on Vetsurgeon about this subject.

Re: Should you call out if...

james herriot lied — Thu, 04 Jul 2013 22:52:40 GMT

[quote user="Gillian Mostyn"]

I'm guessing you don't like me much.

[/quote]

Ha ha ha.

The summation of your rebuttal is that I don't like you very much. Do you have any insights here? That perhaps don't relate to how being questioned makes you feel?

I'm happy to digress - we're not pushed for time and all of these threads are ostensibly about the same thing: there was a man, who would have given his right arm for the opportunities that you and I have had - all we had to do was pass a few exams. He managed to get through vet school in a country which was already going to the dogs, where merit counts for less than connections. He must REALLY have wanted to be a vet, because I'm told that being a vet in Zimbabwe doesn't carry a whole lot of clout. He then went through the rigours of MRCVS examination - and this isn't an easy option - in order to build himself a better life. He got a job - not, perhaps a job which he particularly wanted, but a foothold nonetheless, and something which he would have endured to get where he wanted to be. He then dropped an almighty b*ll*ck. Who knows, that hour in which he waited for back-up, believing that he was doing the right thing, might have been the longest hour of his life. He might have been utterly wretched and powerless. So much so that he went home in shame and felt unable to engage with any process, such were his feelings of guilt.

Or he might have been an *rse who couldn't see why everybody else disagreed with him, but who concluded that it was more likely that an entire group of his peers was wrong, than that he was missing the point entirely. Apparently it does happen that way sometimes.

Show me some evidence that a fitting dog isn't suffering. Explain to me why a client telling you, over the phone, that their dog is in status allows you to draw a conclusion that it isn't suffering, based on your preconceptions of the effects of a fit. Be honest, would you continue to use the argument that a fitting dog doesn't suffer if you somehow got dragged in front of the DC over it? It can now be used against you, you know. It can make the difference between a telling-off and a punishment.

As to engaging with the disciplinary process I'd expect the most contrite mitigation to come from the most manipulative individual. Why such contrition should be in any way helpful to the defendant is beyond me: it hasn't helped the dog any. Applying the argument that this would then lead you to mend your ways is a non sequitur: a proper carpeting in a quiet room is what would bring most people into line - the exception being, of course, the most manipulative individual, who has just learned that the DC can be, erm, manipulated. Tell me why you think that Mr Chikosi saying that he was really, really sorry should have had any influence over the outcome?

As an illustration, try this. Essntially 1.20 - 1.40. Are you seeing my point? No? Well, then just watch the whole thing and at least it will lighten the mood.

www.youtube.com/watch

But what would I know? I still think a fitting dog has the capacity to suffer, and you seem to think that's a weakness on my part. Happy for you to throw stuff at me as a result. What does that tell you?

Re: Should you call out if...

Rob Loxley — Thu, 04 Jul 2013 22:50:51 GMT

[quote user="Francisco Gomez"]

[quote user="Gillian Mostyn"]

[quote user="Francisco Gomez"]Under current legislation a fitting dog would require a visit.[/quote]

Please could you show me where this is written as a statement of fact.

[/quote]

http://www.rcvs.org.uk/advice-and-guidance/code-of-professional-conduct-for-veterinary-surgeons/supporting-guidance/24-hour-emergency-first-aid-and-pain-relief/

[/quote]

THIS IS NOT LEGISLATION!!!

Re: Should you call out if...

Gillian Mostyn — Thu, 04 Jul 2013 21:32:34 GMT

[quote user="Francisco Gomez"]I know you won't agree with me, I am just pointing out that not everything is as black and white as you put it.[/quote]

I don't see things in black and white at all - that's my point. There is no list of conditions or situations which makes a visit necessary - simply the professional judgement of the vet. You just need to be happy to defend your decision.

People keep talking about this case setting a precedent. There hasn't yet been a case where the vet has offered a perfectly sensible reason why they decided to not carry out/delay a visit and yet they were still disciplined. I'd be far more worried if that had happened.

Re: Should you call out if...

Gillian Mostyn — Thu, 04 Jul 2013 21:28:12 GMT

[quote user="Anthony Todd"]Perhaps not "legislation" or a "statement" or a "fact" but recent events would dictate that, if a vet wants to continue being employed as a vet, then, if any client demands a visit, then you gotta go, and quickly, or else![/quote]

I guess that is why our opinions differ so much - because I saw the details of this case completely differently to you. I did not come to the same conclusion at all.

Re: Should you call out if...

Francisco Gomez — Thu, 04 Jul 2013 21:27:14 GMT

[quote user="Gillian Mostyn"]

[quote user="Francisco Gomez"]Under current legislation a fitting dog would require a visit.[/quote]

Please could you show me where this is written as a statement of fact.

[/quote]

http://www.rcvs.org.uk/advice-and-guidance/code-of-professional-conduct-for-veterinary-surgeons/supporting-guidance/24-hour-emergency-first-aid-and-pain-relief/

'3.13 Clients may request attendance on a sick or injured animal away from the practice premises and, in some circumstances, it may be desirable to do so. On rare occasions, it may be necessary on clinical or welfare grounds. The decision to attend away from the practice is for the veterinary surgeon, having carefully balanced the needs of the animal against the safety implications of making the visit...'

Would the DC not interpret this as 'the visit to this dog may be necessary on clinical or welfare grounds since moving it by the client may injure the dog further due to their poor understanding of 'how to move a fitting dog''?

I know you won't agree with me, I am just pointing out that not everything is as black and white as you put it.

Re: Should you call out if...

Anthony Todd — Thu, 04 Jul 2013 21:24:56 GMT

[quote user="Gillian Mostyn"]

[quote user="Francisco Gomez"]Under current legislation a fitting dog would require a visit.[/quote]

Please could you show me where this is written as a statement of fact.

[/quote]

Perhaps not "legislation" or a "statement" or a "fact" but recent events would dictate that, if a vet wants to continue being employed as a vet, then, if any client demands a visit, then you gotta go, and quickly, or else!

And that's the rub.

Re: Should you call out if...

Gillian Mostyn — Thu, 04 Jul 2013 21:17:21 GMT

[quote user="Francisco Gomez"]Under current legislation a fitting dog would require a visit.[/quote]

Please could you show me where this is written as a statement of fact.

Re: Should you call out if...

Francisco Gomez — Thu, 04 Jul 2013 21:14:18 GMT

I think I'm about to get even more unpopular here but...

Not being conscious NOT SAME AS Not being in pain/suffering

My take in this is that a fitting dog is not only suffering but also at risk of further injury. Under current legislation a fitting dog would require a visit. Not only that, if you ask the owner to bring the dog to the surgery and the dog injure himself in the trip after you have denied a visit, you may be very well at fault. I.e. You could have avoided the dog injury if you have attended the visit in the first place.

- Hence why I would support slight changes in the profession current responsibilities.

Re: Should you call out if...

Gillian Mostyn — Thu, 04 Jul 2013 21:04:44 GMT

[quote user="james herriot lied"]Your statement is not fact; it's an opinion.[/quote]

[quote user="james herriot lied"]The statement that a fitting dog is not suffering is not fact, and in my opinion is also somewhat lacking in compassion. [/quote]

Please give me any evidence that a dog in status is conscious.

[quote user="james herriot lied"]Gillian: all week, you've been happy to sit in judgment on a man who was unable to be here to defend himself, on the basis that YOU felt he was in the wrong.[/quote]

No, I agreed with the DC decision to remove him from the register until he explains his decisions.

[quote user="james herriot lied"] You've also managed to imply that anybody who disagrees with you must automatically have a less enlightened view of patient care.[/quote]

[quote user="james herriot lied"] If calling me silly is as far as you can construct an argument, then clearly the irony of your current stance won't make a dent on you.[/quote]

I didn't - I said the argument was silly.

[quote user="james herriot lied"]What, I wonder, would one of your clients make of your statement? Would you be happy for them to read it? Would you be prepared to stand behind it in front of them? In front of the DC?[/quote]

I think my clients would be fine......I'd be the one visiting them when their dog has been squashed!

[quote user="james herriot lied"]If you don't think a fitting dog is somehow suffering, what's the point?[/quote]

I refer you to my last post. I was sticking to the subject of the thread. Are you?

I'm guessing you don't like me much.

Re: Should you call out if...

james herriot lied — Thu, 04 Jul 2013 20:55:38 GMT

[quote user="Gillian Mostyn"]

[quote user="james herriot lied"]Are you absolutely sure that the dog on the other end of the phone isn't suffering, Gillian? I'd like to think I wouldn't be taking that tack, for fear of causing unnecessary suffering......[/quote]

Please don't make my statement of fact into a silly argument to try to make a point. Unless you disagree?

[/quote]

Lovely.

Your statement is not fact; it's an opinion. As such, it's deeply flawed and demonstrates a lack of insight into what your patient might be going through. I'm going to entertain your bluster here, Gillian: all week, you've been happy to sit in judgment on a man who was unable to be here to defend himself, on the basis that YOU felt he was in the wrong. You've also managed to imply that anybody who disagrees with you must automatically have a less enlightened view of patient care. This is your prerogative, but don't expect to sit in such judgment without being, yourself, judged. You might also wish to reference glasshouses and black kettles.

The statement that a fitting dog is not suffering is not fact, and in my opinion is also somewhat lacking in compassion. If calling me silly is as far as you can construct an argument, then clearly the irony of your current stance won't make a dent on you. What, I wonder, would one of your clients make of your statement? Would you be happy for them to read it? Would you be prepared to stand behind it in front of them? In front of the DC?

If you don't think a fitting dog is somehow suffering, what's the point?

Re: Should you call out if...

Gillian Mostyn — Thu, 04 Jul 2013 20:53:24 GMT

[quote user="Anthony Todd"]

Arlo may have a first hand opinion on that but, if there is no suffering, then there is no urgency to visit surely?......

Animals I've seen coming out of fits never seemed to be too happy IMHO.

[/quote]

The animal is not suffering while in status. It is unconscious. Obviously it is an emergency and prognosis is improved dramatically by prompt treatment. But if we are still discussing the OP's question - which is what makes a visit necessary, and whether status needs a visit then the answer is no. We only have to visit if an animal's condition/welfare would be worsened if it were moved.

Re: Should you call out if...

Michael Woodhouse — Thu, 04 Jul 2013 18:59:04 GMT

We can only extrapolate from humans. I knew an epileptic lass and she was completely unaware when fitting, and very dazed and confused afterwards.

The urgency comes from hyperthermia. I have only had one dog fitting that died at the surgery. Anaesthetised with propofol, put on anaesthetic machine. Had a temperature off the upper scale of the thermometer. One and only time I have had that.

Glucose bottom end of normal. Managed about half a litre of fluids and got ice packs out when died.

Farm dog and hay time so farmer had been away all day. I'm guessing that had been going on for some time. Dog had an odd fit before but not under treatment.

Re: Should you call out if...

Anthony Todd — Thu, 04 Jul 2013 18:43:18 GMT

[quote user="Gillian Mostyn"]

[quote user="Anthony Todd"]What's the difference in "suffering" between a fit and severe trauma.....? [re Mr. C and sequelae][/quote]

An animal having a fit is unconscious, and is therefore not actually 'suffering'.

[/quote]

Arlo may have a first hand opinion on that but, if there is no suffering, then there is no urgency to visit surely?......

Animals I've seen coming out of fits never seemed to be too happy IMHO.

Re: Should you call out if...

mariette asselbergs — Thu, 04 Jul 2013 18:16:25 GMT

A fitting dog is unconscious, therefore not suffering. I agree, not suffering, but in danger. Fitting increases intracranial pressure tremendously and there is danger of the cerebellum being pressed onto the brainstem and death as a consequence. That makes it an emergency in my opinion.

Mariette

Re: Should you call out if...

Hannah Wynne Richards — Thu, 04 Jul 2013 18:14:01 GMT

John The animal is no more at risk in my car than it would be in the owners. Giving the owner a lift doesn't increase the insurence, any more than giving a friend a lift in your own car would. It only becomes a taxi if the owner is charged for their own carriage.I never was one for using 'elf and safety as a spurious excuse not todo my job

Wynne

Re: Should you call out if...

Gillian Mostyn — Thu, 04 Jul 2013 17:59:50 GMT

Please don't make my statement of fact into a silly argument to try to make a point. Unless you disagree?

Re: Should you call out if...

james herriot lied — Thu, 04 Jul 2013 17:57:06 GMT

[quote user="Gillian Mostyn"]

An animal having a fit is unconscious, and is therefore not actually 'suffering'.

[/quote]

Are you absolutely sure that the dog on the other end of the phone isn't suffering, Gillian? I'd like to think I wouldn't be taking that tack, for fear of causing unnecessary suffering......

Re: Should you call out if...

John Flynn — Thu, 04 Jul 2013 17:51:55 GMT

[quote user="Hannah Wynne Richards"]

Yet another problem with Vets Now Back in my days as an assistant-I was always provided with a practice car (as part of the package-could also use it for private use)-no insurence problems-so would put dog (and owner ) on back seat, and bring in

Wynne

[/quote]

I'm sure you had a suitable grill between back and front or similar to stop the dog hurtling forwards dangerously if accident etc, but I don't think just because someone who works at Vets Now has a car means it is in ANY way going to be suitable for transporting dogs safely, especially in an emergency setting - additionally I would thought insurance would be costly if you are ferrying owners around as well?

Rule 57:

"When in a vehicle make sure dogs or other animals are suitably restrained so they cannot distract you while you are driving or injure you, or themselves, if you stop quickly. A seat belt harness, pet carrier, dog cage or dog guard are ways of restraining animals in cars." (British Highway Code, https://www.gov.uk/rules-about-animals-47-to-58/other-animals-56-to-58)

Re: Should you call out if...

Gillian Mostyn — Thu, 04 Jul 2013 17:30:38 GMT

[quote user="Anthony Todd"]What's the difference in "suffering" between a fit and severe trauma.....? [re Mr. C and sequelae][/quote]

An animal having a fit is unconscious, and is therefore not actually 'suffering'.

Re: Should you call out if...

Anthony Todd — Thu, 04 Jul 2013 16:07:28 GMT

[quote user="Martin Atkinson"]

[quote user="Clive Ansell"]What do others do? I don't like Propofol for status epilepticus, I find its duration of activity far too short. prefer diazepam and barbiturates. [/quote] I've never found propofol useful for this either, maybe I've not been using it properly but I would go: Diazepam rectube; Diazepam I/V; Phenobarbitone i/v; sub-lethal dose of pentobarbitone I/V if that's failed top up on the pentobarb, in that order!

[/quote]

For once I agree with Martin... Pentobarb [Sagatal], now discontinued, worked fine for me, nicely progressive and titratable, around 30 mins on one I/V to stop the seizure, just then top up, I/V or even S/C if you want.

What's the difference in "suffering" between a fit and severe trauma.....? [re Mr. C and sequelae]

There's I/V phenobarb available for medicos but I haven't used it; should be even longer acting.

Re: Should you call out if...

Hannah Wynne Richards — Thu, 04 Jul 2013 15:59:31 GMT

Wynne

Re: Should you call out if...

Martin Atkinson — Thu, 04 Jul 2013 15:53:21 GMT