the euthanasia impasse

RE: the euthanasia impasse

Virginia Campbell — Fri, 11 Dec 2015 14:06:57 GMT

[quote user="Anthony Todd"]"Can't you give it an injection" [/quote]

Oh, I've heard this lots of times. So far have managed to avoid blurting out in frustration , "Yes. A blue one".

RE: the euthanasia impasse

Martin Atkinson — Thu, 10 Dec 2015 10:58:13 GMT

[quote user="grumpyoldman"] I guess we are just tougher than them . [/quote]Notwithstanding 'them' sounds a bit rascist, I think its not about being tougher its a cultural thing. Northern Europeans, especially us Brits, are just less impulsive, openly emotional and expressive. Whether this is nature or nurture I'm not sure. Just look at the difference in the quiet dignity of the French after the Paris massacre and compare it to the weeping and wailing/self flagellation of the relatives of those lost in a middle eastern suicide bombing.

RE: the euthanasia impasse

Mark Hedberg — Thu, 10 Dec 2015 10:15:18 GMT

[quote user="Kate Richardson"]

Interestingly, I am watching some webinars on bereavement at the moment, and the '5 stages' of grieving aren't thought to be valid now- I haven't finished watching them yet so will post more info once I've finished if anyone is interested?

[/quote]

Very much so, I always did think it was a bit simplistic - keep us in the loop, please!

RE: the euthanasia impasse

Kate Richardson — Thu, 10 Dec 2015 10:05:18 GMT

[quote user="Thomas Johnson"]I've had a few clients who have told me that they've been more upset over the loss of a pet than the loss of a parent...[/quote]

That may be because they didn't grieve properly for their parent in the first place, sometimes the pet is an attachment to another family member.

RE: the euthanasia impasse

Thomas Johnson — Thu, 10 Dec 2015 09:07:35 GMT

[quote user="grumpyoldman"]

You do look at them sometimes and think what the hell are you going to do when your mother/husband dies ? I guess we are just tougher than them .

[/quote]

I've had a few clients who have told me that they've been more upset over the loss of a pet than the loss of a parent...

RE: the euthanasia impasse

Anthony Todd — Thu, 10 Dec 2015 08:31:39 GMT

[quote user="grumpyoldman"]I think the Doc Martin approach is the best followed by ,an invitation to seek a second opinion .[/quote]

+1, it gives the owner time to accept the inevitable and also confirm the bolt-from-the-blue shocking diagnosis and recommendation.

"Can't you give it an injection" [therapeutic!] is often the request.

As most of these are well advanced I can't see that another 24 hours is too cruel and owners' acceptance is part of the process.

Mind you ,even in the most obvious of cases the "second opinion" usually involves every test under the sun, at vast expense, when the prognosis is obvious.

RE: the euthanasia impasse

David Mills — Thu, 10 Dec 2015 06:07:51 GMT

[quote user="Martin Atkinson"]I am as well but not everyone has that luxury if they are employees and working for an employer who has one rule for themselves and one for the employees.[/quote]

Quite so. We are privileged in a way as we have no need to promote client loyalty - they come because it's cheap, not as a choice, and every interaction costs us money. I find it bemusing that other vet charities are so big on 'customer service' these days.

RE: the euthanasia impasse

grumpyoldman — Wed, 09 Dec 2015 22:43:39 GMT

I think the Doc Martin approach is the best followed by ,an invitation to seek a second opinion . You can lead a horse to water but you cannot make it drink. Not sure about people from the med ,but they are generally child substitute pets with childless couples .all parents and grandparents still alive , never seen anything or anyone die , so can't cope with it. You do look at them sometimes and think what the hell are you going to do when your mother/husband dies ? I guess we are just tougher than them .

RE: the euthanasia impasse

Virginia Campbell — Wed, 09 Dec 2015 21:12:01 GMT

[quote user="Clive Ansell"]

[quote user="Virginia Campbell"]both of which took 1/2 - 3/4 hour of gentle discussion for the owners to get to the finish line of a decision and ten minutes of actual sedate and euth.[/quote]

[quote user="Virginia Campbell"]I once spent 2 hours with a non client whose dog had been diagnosed 2 weeks earlier at a good practice elsewhere with splenic haemangiosarc with liver mets[/quote]

[/quote]

The first two had been scheduled 3/4 hour (known rather intense client but very good client who took great care of her cat) and half an hour (lovely couple I'd never met, been loyal to the practice for 40 years) respectively- both during normal office hours. Once I sedated the pet I nipped into the next consult room to do a short consult, then back to euth. They still knocked me behind a bit so I didn't get a break during that consulting session. Bit of a PITA as I'm nearly 6 months pregnant and could have done with a cup of tea! We're a bit more expensive than the average practice here and thankfully our routine appointment slot is 15mins rather than 10. We also have the occasional blank catchup slot booked so not too many people were kept waiting that session.

The haemangiosarc was while I was locuming and the last client of the day. I was paid till 1pm, there till about 2.30pm, didn't charge the practice the extra time so my loss not the practice. Although we didn't get paid at all as when the situation that the previous vets predicted spoton befall the dog, the client was so surprised and panicked by the completely predictable emergency that - after I'd finally euth'd it - she declared that she had run out of the house without bringing any money. O decided on private crem, dog spent a week in the freezer, no money forthcoming, went for group crem. If that one had been at all send-homable I would have done so about an hour and a half earlier, but it was one of the situations where I suspect it could have spent several hours panicking for oxygen before dying.

RE: the euthanasia impasse

Martin Atkinson — Wed, 09 Dec 2015 18:52:55 GMT

[quote user="David Mills"]Happens fairly frequently here - usually once a week.[/quote]Being as you're the last resort for the bottom feeders who have neglected their animals to the extent they've reached this point it doesn't surprise me - there's probably a few passed on by all of us.

[quote user="David Mills"] It's much easier for us to involve our inspectors obviously,[/quote]I was going to say that.

[quote user="David Mills"]I've no patience with these clients, and am usually blunt to Doc Martin levels,[/quote]I am as well but not everyone has that luxury if they are employees and working for an employer who has one rule for themselves and one for the employees.

RE: the euthanasia impasse

Francisco Gomez — Wed, 09 Dec 2015 18:08:56 GMT

[quote user="David Mills"]

hospital haven't time to hold their hand and feed their guilt/drama queen tendencies (always seems to be Mediterranean women IME

[/quote]

Given what I say I advocate at the top of the thread, that seems excruatingly funny

RE: the euthanasia impasse

David Mills — Wed, 09 Dec 2015 17:38:57 GMT

Happens fairly frequently here - usually once a week. Vast majority are chronic cases where owners have made all the right noises about PTS when time, then refuse when it is. If its hospitalised it's easier but we have had clients take their animals against advice - in which case they sign a disclaimer saying they're going against vet advice and may be liable to prosecution unless they seek tx elsewhere. It's much easier for us to involve our inspectors obviously, and we've had a few prosecutions from this. Funnily enough the fact the owner has sought vet care (even if they've completely ignored advice) works in their favour in the courts.

I have a problem with passing responsibility in these cases to the inspectorate - whilst you can satisfy yourself something will be done it doesn't solve the immediate welfare problem. Those saying they will admit and do everything and then bill the client - cloud cuckoo land, good luck. As a halfway house (in some cases) admitting the animal and relieving pain and suffering as far as practical is the best thing to do but it does come with the risk of the animal improving and the client accusing you of wanting to kill it etc. You have to obviosuly choose your cases - bleeders and the dyspnoeic are out.

I've no patience with these clients, and am usually blunt to Doc Martin levels, but equally we as a hospital haven't time to hold their hand and feed their guilt/drama queen tendencies (always seems to be Mediterranean women IME, surrounded by fawning family, histrionics and the full screaming) by 'persuading' them. In these cases, ethically, I have no problem with doing or saying whatever necessary to achieve the right result.

RE: the euthanasia impasse

Bob Russell — Wed, 09 Dec 2015 17:03:11 GMT

Got close a few times in 30 years. Once all reasoning has stopped my last resort plan would be to make an appointment with another practice for a further 'independent' opinion or a call to the RSPCA.

Never had to go the whole way yet as good sense eventually prevails!

RE: the euthanasia impasse

Hannah Wynne Richards — Wed, 09 Dec 2015 16:51:52 GMT

See my other thread - euthanasia without consent could land you in very hot water! That's where the threat of RSPCA to obtain a signature comes in useful

Wynne

RE: the euthanasia impasse

Clive Ansell — Wed, 09 Dec 2015 16:48:01 GMT

[quote user="Virginia Campbell"]both of which took 1/2 - 3/4 hour of gentle discussion for the owners to get to the finish line of a decision and ten minutes of actual sedate and euth.[/quote]

[quote user="Virginia Campbell"]I once spent 2 hours with a non client whose dog had been diagnosed 2 weeks earlier at a good practice elsewhere with splenic haemangiosarc with liver mets[/quote]

How do you find the time to do that? where I am working at the moment surgeries are 10 minute appointments and almost always fully booked plus extras - tonight is fully booked 1700-1840 + 3 extras already. I physically would not have the time, it just isn't there.

[quote user="Virginia Campbell"]how many times in their career other people have resorted to the RSPCA threat, and whether it worked to get the consent form signed?Has anyone ever just gone ahead and proceeded with the euth in the presence of the owner who can't/won't nod or mumble OK or scrawl their signature on the paper?[/quote]

Would never euthanase without consent, unless a severely ill or injured case that is brought in as a stray and cannot be identified.

Have never threatened RSPCA either. Usually able to persuade people to agree to PTS, sometimes takes a day or two though.

I was once involved with a case brought in by the RSPCA; elderly icteric, fitting SBT with abdominal mass size of a football. Owners flatly refused PTS. RSPCA, VDS, RCVS and their lawyers involved, independent vet from another practice had to come and examine the dog, then it was PTS on welfare grounds with RSPCA signing consent form (I refused unless signed consent)

RE: the euthanasia impasse

Martin Atkinson — Wed, 09 Dec 2015 16:33:17 GMT

As you say this situation is very rare and I can't honestly remember when I've reached total impasse with someone who genuinely cares for their pet. While diplomacy and bedside manner is not my strong suit I do try to be as empathetic as possible. But there has come a point at which I've just have to be hard hearted and put the cat back in it basket/dog in their arms and tell them to go away and come back when they've made a decision. That actually usually works because they do understand that euthanasia is necessary and the realisation that they've got to take it home again only to come back another day forces the decision. With the odd hardcase who has point blank refused to do any treatment or euthanase I would report to the RSPCA. But I've never euthanased anything while the owner was present without their consent.