advice needed please

Re: advice needed please

Lindsey Edwards — Mon, 20 Oct 2014 18:06:05 GMT

+1 I wouldn't want to be arguing whether a compromised owner became exposed before or after clinic admitted dog or how rapidly treatment cleared all risk in a condition recognised for causing chronic shedding. No contact, no risk. At home or after discharge we can advise but can't eliminate risk.

Re: advice needed please

Lindsey Edwards — Mon, 20 Oct 2014 17:57:59 GMT

Matt I agree, clinic is exposing itself, by permitting contact. Obviously risk is lowered by treatment but whilst in our care it's our problem. Accept risk was higher in home environment prior to treatment but I wouldn't want to be the one defending the idea as to when an owner may or may not have contracted a potentially life threatening disease, ie before or after it had been hospitalised and presumably still sick if still admitted!

Re: advice needed please

Matt Hilary — Mon, 20 Oct 2014 14:19:27 GMT

[quote user="Rob Davis"]

I don't know off the top of my head how high the risks of contracting lepto from the dog would be (presumably he has already had significant contact with the dog and presumbably your staff are also exposed to the same risk), BUT [quote user="An On MRCVS"]I believe he is on immunosuppressive therapy himself[/quote] makes the situation a little more worrying... I would speak to the VDS ASAP for advice on how to word a disclaimer if he is insitant on visiting. Would it be possible to speak to his doctor to discuss the risks in the light of his medication?

[/quote]

This. Are we not (at least in part) legally responsible for the owner while on our premises?

Re: advice needed please

Hannah Wynne Richards — Mon, 20 Oct 2014 09:52:08 GMT

Well I don't think anyone has ever accused me of being politically correct.

Wynne

Re: advice needed please

Evelyn Barbour-Hill — Sun, 19 Oct 2014 18:56:00 GMT

[quote user="Colin Thomson"]From the red gold keep thy finger;[/quote]

Well, we're all doing that.

Re: advice needed please

Gillian Mostyn — Sun, 19 Oct 2014 18:38:16 GMT

I know....all this politically correct tip-toeing around that Wynne does gets really annoying. You wish she'd just get on with saying what she means....

Re: advice needed please

Glenn Hodgson — Sun, 19 Oct 2014 18:35:44 GMT

[quote user="Hannah Wynne Richards"]

For goodness sake! You are the dog's veterinary surgeon - not the owner's nanny. Get him to sign a disclaimer if that makes you feel legally safer. After that, he's an adult - so has the legalright to take whatever risks he wants to take - smoke, go swimming from a polluted beach, etc

Wynne

[/quote]

Haha.

You shouldjust say it how it is.

Re: advice needed please

Hannah Wynne Richards — Sun, 19 Oct 2014 16:55:45 GMT

Wynne

Re: advice needed please

An On MRCVS — Sun, 19 Oct 2014 12:02:36 GMT

Thanks for all your thoughts . In the end I let the chap in wearing gloves after signing a short disclaimer saying I had explained the risks . Appreciate the feed back .

Re: advice needed please

Colin Thomson — Sat, 18 Oct 2014 23:04:46 GMT

My original comment was a bit of an off the cuff remark to what I considered to be an overreaction to the chap wanting to see his dog. I've been in a grumpy mood most of the afternoon.

But let's look at the relative risks here. If the dog is in hospital with lepto, I suspect its being treated with antibiotics. These are usually pretty effective at killing lepto, so its not unreasonable to suppose the level of lepto shedding is lower since the treatment started than it was before. That should greatly reduce the risk of any human getting the disease. Its unlikely the dog only started shedding lepto after it became hospitalised. In fact it probably shed MORE lepto before it was hospitalised than it is doing now whilst being treated. Where was the dog before it came into the vets? In the care of the owner, I suspect. If he didn't catch lepto before the dog was hospitalised, he's far less likely to catch it with suitable precautions after its been on treatment.

Let the man see his dog. Stop being so "nanny state" about it all.

Reminds me of this quote from "The Bride of Lammermoor"

"Look not thou on beauty's charming,
Sit thou still when kings are arming,
Taste not when the wine-cup glistens,
Speak not when the people listens,
Stop thine ear against the singer,
From the red gold keep thy finger;
Vacant heart and hand and eye,
Easy live and quiet die."

Its bad enough if you choose to live your life like this, but forcing others into it is a lot worse, IMO.

Colin

Re: advice needed please

Lindsey Edwards — Sat, 18 Oct 2014 22:14:56 GMT

I share your concern, especially as o indicated he is on immunosuppressive drugs and therefore compromised. As far as I am aware, risk of transmission is low but as we were always lectured 'all secretions and excretions' any immunocompromised person would potentially be at risk handling the patient. Given leptospires can theoretically cross mucosal surfaces (mouth/eye splashes) and intact skin if wet/macerated/injured and once in our care as vets we are 'responsible' for patient I'd be reluctant to 'permit contact' between a susceptible person and an animal demonstrating signs of a transmissable/zoonotic condition...once discharged we can only advise but in our care it is our problem? If it were a staff member receiving treatment or pregnant would you be permitting/condoning they handle the patient?

Re: advice needed please

Glenn Hodgson — Sat, 18 Oct 2014 22:04:03 GMT

I would tell him if he catches leptospirosis he might die, advise best to look and not touch as you have done, record this in my notes. Then iover to him, would let him pat his dog if he wanted to. I think he would have to get his dogs.. "fluids" in his mouth to have a problem..

Re: advice needed please

Gillian Mostyn — Sat, 18 Oct 2014 16:19:22 GMT

Pair of latex gloves should do it.... I would be happy for the bloke to see his own dog. I would only hospitalise if it were very poorly- as it seems to be in this case- otherwise it would have gone home anyway.

Re: advice needed please

Michael Woodhouse — Sat, 18 Oct 2014 15:58:30 GMT

It's his dog. Explain the risks but I agree with Colin. You have no right to forbid this chap from seeing his own dog.

Re: advice needed please

Colin Thomson — Sat, 18 Oct 2014 15:16:08 GMT

Don't let the dog urinate on him and he'll be fine, surely. Pair of gloves at the most.

Or has leptospirosis now gained the ability to leave the body through the fur and jump across the airgap to those in attendance?

Colin

Re: advice needed please

Rob Davis — Sat, 18 Oct 2014 14:23:53 GMT