Client refused dog from Dog's Trust because of my reference

RE: Client refused dog from Dog's Trust because of my reference

Clive Ansell — Wed, 08 Feb 2017 10:10:40 GMT

[quote user="Martin Atkinson"]And there is still no excuse for finally showing when the animal is emaciated/cachectic/sarcopenic, moribund and clearly been lying in its own excreta.[/quote]

That's the crux of it; the terrible state the animal was in and the length of time left without seeking veterinary attention. Many reasons/excuses are being put forward here, can't give the tablets, won't eat the diet, got no money, 3rd cousin 10 times removed has died again, etc etc etc. It remains a fact that the owners are responsible for the welfare of their pet (enshrined in law) and could have telephoned for further advice. Their negligence entirely.

RE: Client refused dog from Dog's Trust because of my reference

Dagmar Steele — Wed, 08 Feb 2017 10:03:25 GMT

I am trying to incorporate call backs by the nurses into my regime. It usually goes down well with the clients, shows we care and helps the odd one out to come back sooner. Not yet firmly implemented but on the way. I find this a generally good thing to do.

RE: Client refused dog from Dog's Trust because of my reference

Martin Atkinson — Wed, 08 Feb 2017 09:48:55 GMT

[quote user="Kate Richardson"] Maybe a follow up phone call after a month or 2 would have helped? I've seen many a hyperthyroid cat started on treatment, then it ran out and 6 months later re presented for the same symptoms and the owners didn't understand the treatment is long term. [/quote]Is this something that you would routinely do? How many clients, apart from your regulars, after you've seen them stick in you mind that they have not been back when you've only seen them once so you would then think to call them? We do have a reminder system in place for routine recalls for follow-ups but that was not triggered in this case. I'm too busy to remember every random client/pet who didn't come back when instructed but they would have had a vaccine reminder which they chose to ignore anyway. And there is still no excuse for finally showing when the animal is emaciated/cachectic/sarcopenic, moribund and clearly been lying in its own excreta.

The owner (husband) phoned me again yesterday and I explained the reasons why I felt their care had been less than ideal. He was far less emotional than the wife and son had been and he thanked me for my honesty. I suspect that they were in denial as clients often are as they know they have neglected their pets and want to displace the guilt.

RE: Client refused dog from Dog's Trust because of my reference

Kate Richardson — Tue, 07 Feb 2017 21:08:29 GMT

I'm not advocating their actions (or lack of) but one has to ask why did they not come back for follow ups? Finances? Lack of understanding of the disease process and the need for ongoing treatment/managament? Lack of trust of vets? (this is not a dig at you Martin). Maybe a follow up phone call after a month or 2 would have helped? I've seen many a hyperthyroid cat started on treatment, then it ran out and 6 months later re presented for the same symptoms and the owners didn't understand the treatment is long term. I know the responsibility to care for pets lies with the owners, but better education and support goes a long way. Particularly with hyperthyroidism, how many of us have seen terminal emaciated cats that are still eating??? See the thread WTAF related to pets owned by doctors, if they can do it/ignore it/accept it, what hope has joe public? Owners think a pet is ok if it still eats. Simples. Better education. Animals don't lose weight from age alone. Its the diseases of old age that cause weight loss. Sorry. Rant over

RE: Client refused dog from Dog's Trust because of my reference

Clive Ansell — Tue, 07 Feb 2017 20:44:06 GMT

[quote user="mariette asselbergs"] I would like to try to take the opportunity to explain WHY in your judgment their end of life care was not good. They may not have been able to give the tablets, their cat might have refused the kidney diet, they might not have appreciated or understood the link between hyperthyroidism and CKF, etc.[/quote]

and, from the OP

until April 2015 when it was diagnosed with hyperthyroidism and early renal failure. It was put on Felimazole and they were advised to give renal diet and would have been told to come back for a repeat T4 3 weeks later. That was the last we saw of them until September 2016 when it was brought in emaciated (BS 1/10), moribund and soaked in its own urine which they said had only happened in the last 24 hrs

They were advised a recheck after 3 weeks, then left the cat 17 months until it was in extremis. If they were unable to medicate they should have sought further advice, or gone elsewhere for another opinion. I would have given them a bad/no reference too.

RE: Client refused dog from Dog's Trust because of my reference

mariette asselbergs — Tue, 07 Feb 2017 20:27:06 GMT

[quote user="Martin Atkinson"]

The client is now demanding to know why I was not happy.

A) should I tell them the truth or just say I'm not prepared to give my reasons? - I'm pretty sure they won't come back here so I'm not scared of losing them as clients.

B) should I make a complaint to the Dogs Trust that they have breached client/vet confidentiality by telling the client what I told them?

[/quote]

About your question a) Depending on what kind of clients they are, what mood they will be in etc. I would like to try to take the opportunity to explain WHY in your judgment their end of life care was not good. They may not have been able to give the tablets, their cat might have refused the kidney diet, they might not have appreciated or understood the link between hyperthyroidism and CKF, etc. The euthanasia event was not a good opportunity to discuss these things, but now it might be and it might end into a better understanding of each other. Many people think that cats going thinner and thinner etc it simply a sign of aging and getting to the end. Like "going off their legs" for dogs. But obviously if these are unreasonable clients then a discussion like this would be useless.

Mariette

RE: Client refused dog from Dog's Trust because of my reference

J G Wray — Mon, 06 Feb 2017 20:07:00 GMT

[quote user="Martin Atkinson"]The words I used in a private conversation with someone at the Dog's Trust was that client's end of life care for the previous pet was not good without going into detail of why. I fail to see how that is a discussion of the client's behaviour[/quote]

Really?

[quote user="Martin Atkinson"]The person I spoke to at the VDS said that was a reasonable comment[/quote]

Then you can rely on them

[quote user="Martin Atkinson"]The nurse who was with me when we euthanased the cat will corroborate the disgraceful condition the cat was in.[/quote]

Well, a witness to likely fact is no problem, it's just that opinion bit.

RE: Client refused dog from Dog's Trust because of my reference

Martin Atkinson — Mon, 06 Feb 2017 16:18:19 GMT

[quote user="J G Wray"]Discuss the clinical records does not mean discuss the owner's behaviour or character. Therein lies the professional behaviour issue.[/quote]The words I used in a private conversation with someone at the Dog's Trust was that client's end of life care for the previous pet was not good without going into detail of why. I fail to see how that is a discussion of the client's behaviour or character. The person I spoke to at the VDS said that was a reasonable comment, if I'd put they were 'buggers' (her words) in the clinical notes that would be different. The nurse who was with me when we euthanased the cat will corroborate the disgraceful condition the cat was in.

RE: Client refused dog from Dog's Trust because of my reference

J G Wray — Sat, 04 Feb 2017 10:09:19 GMT

[quote user="Clive Ansell"]"spoken to VDS and as I suspected they confirmed that if the client has given the Dogs Trust my details there is an implicit permission for me to discuss the clinical records"[/quote]

Discuss the clinical records does not mean discuss the owner's behaviour or character. Therein lies the professional behaviour issue.

RE: Client refused dog from Dog's Trust because of my reference

Nicola Cole — Fri, 03 Feb 2017 20:01:19 GMT

[quote user="Martin Atkinson"]

[/quote]

I would certainly take that as permission as well-sorry, just checking!

In that case I would explain to the owner what was poor about the care they provided for their pet in the hope that they would treat any future pets better.

RE: Client refused dog from Dog's Trust because of my reference

grumpyoldman — Fri, 03 Feb 2017 19:45:23 GMT

It maybe better to just stick to the known facts about the animals you have seen ,when you saw them and let them draw their own conclusions rather that colour things in for them. After all they may just be looking to ensure that people will eventually consult a vet rather than just leaving something to die under its own steam??.

RE: Client refused dog from Dog's Trust because of my reference

Clive Ansell — Fri, 03 Feb 2017 17:57:55 GMT

How would this become a misconduct issue?

A colleague has given a truthful opinion as to his perceived suitability of a client to be a responsible pet owner, with animal welfare the overriding concern. If I remember correctly, part of our professional oath is to uphold and promote animal welfare - so should be a gold star from the RCVS, and not the dusty bin prize.

and

"spoken to VDS and as I suspected they confirmed that if the client has given the Dogs Trust my details there is an implicit permission for me to discuss the clinical records"

RE: Client refused dog from Dog's Trust because of my reference

J G Wray — Fri, 03 Feb 2017 14:49:12 GMT

What will the position be if this turns into a complaint of serious professional misconduct to RCVS?

I can see how passing the clinical notes has implied consent, but voicing the opinion as to character of the owners and suitability as future dog owners hmmmm. Is that noble, even courageous and justified in the sense of protecting future pets from past behaviours - we're assuming the owners have learned nothing - or is it poor judgement, loss of control and driven by frustration at lack of control of previous adoptions? Does anyone think RCVS would distinguish?

Would we be having this discussion if the history had been handed over for DT to draw their own conclusions?

And, imagine the opportunity there would have been to educate the owners with their new dog.

Only a complete misanthrope believes there is no hope for starting again and getting it right this time with the appropriate help, from a professional.

RE: Client refused dog from Dog's Trust because of my reference

Clive Ansell — Fri, 03 Feb 2017 14:02:04 GMT

[quote user="Nicola M"]Did the client give you permission to discuss their previous pets with the Dogs Trust? If not, then as far as I'm aware you've broken client confidentiality and the client has a reason to be upset[/quote]

One would not be discussing previous pets clinical histories or client information in detail, just passing an opinion as to whether or not they would be suitable pet owners, based on how they cared for previous pets.

In Martin's OP these clients clearly would not be, and in the interests of animal welfare, to say otherwise would be wrong. They should thank their lucky stars they are not being prosecuted.

RE: Client refused dog from Dog's Trust because of my reference

Martin Atkinson — Fri, 03 Feb 2017 13:56:54 GMT

[quote user="robloxley"]What made you believe that the results of your conversation would be confidential?[/quote]Maybe I'm being naive then but I would expect a private conversation between myself and a member of staff at the Dogs Trust should remain just that - private, as I'd already explained I was not prepared to provide a reference. In addition when I spoke to someone at the Dogs Trust who had responded to my complaint she said that they would never reveal the results of private conversations and that they respect the confidentiality of information given to them by vets. Someone clearly has not listened to the rules.

As another poster has already suggested in this thread we should all be aware that when we say what we believe may be in confidence that cannot be guaranteed. But what is worse; just a blank refusal to give a reference with implied criticism or telling the truth regardless?

RE: Client refused dog from Dog's Trust because of my reference

Rob Loxley — Fri, 03 Feb 2017 13:32:28 GMT

[quote user="Martin Atkinson"]It seems the Dogs Trust have broken that confidentiality and although they deny it[/quote]

What made you believe that the results of your conversation would be confidential? Whether it be a job reference or rehoming reference, I'd expect my reference to be open to all parties concerned.

RE: Client refused dog from Dog's Trust because of my reference

Arlo Guthrie — Fri, 03 Feb 2017 11:13:22 GMT

[quote user="Martin Atkinson"]A) should I tell them the truth or just say I'm not prepared to give my reasons? - I'm pretty sure they won't come back here so I'm not scared of losing them as clients.[/quote]

Well of course, it's just me and whaddoIknow, but I was going to say yes, tell them.

a) because not telling them (leaving it to their imagination), is just corrosive.

b) they should be told their animal husbandry fell below the standards required by the Animal Welfare Act, if for no other reason than it might cause them to pull their socks up next time.

RE: Client refused dog from Dog's Trust because of my reference

Martin Atkinson — Fri, 03 Feb 2017 10:26:12 GMT

[quote user="Jill Butterworth"]What a nightmare,[/quote]No nightmare its just a pain having to tell the client the truth that they neglected their cat. I've spoken to VDS and as I suspected they confirmed that if the client has given the Dogs Trust my details there is an implicit permission for me to discuss the clinical records. Also in a case like this my concern for animal welfare trumps everything. At least there is nothing contentious in the clinical notes if the client demands them just stating the facts it was emaciated, cachectic, moribund and soaked in its own urine with the obvious time gap that they'd not brought it in for 15 months since its hyperthyroidsim was diagnosed and treatment started.

RE: Client refused dog from Dog's Trust because of my reference

Gillian Mostyn — Fri, 03 Feb 2017 10:02:51 GMT

[quote user="Jill Butterworth"]What a nightmare, but sleep easy that you have the moral high ground here.[/quote]

Couldn't agree more. Your actions were purely in consideration of animal welfare and there would be no personal gain. If these people want their dirty laundry aired in public, tell them to bring it on Martin! . It is far too easy for us all to run away from awkward situations because of the worry of making our own lives more difficult. I've certainly done it myself, and regretted it later.

If your actions have prevented these owners from neglecting another pet, then you were absolutely right. And if they report you, go get 'em!

(I think Wynne is whispering in my ear today! )

RE: Client refused dog from Dog's Trust because of my reference

Bob Russell — Fri, 03 Feb 2017 10:00:52 GMT

We have had numerous similar requests, often from people we have not seen in years. I stick to the facts.

If not regularly vaccinated/parasite treated I note "nothing on records".

Never had to do one for someone that deserved a truly bad reference but would provide a reference that is accurate in my opinion.

The owners accept that a reference is going to be sought, pet may be conditional on it and have nominated you as the veterinary practice. Permission therefore granted IMO.

May not suit RCVS and just might concern VDS but since when did the RCVS give real guidance on confidentiality?

RE: Client refused dog from Dog's Trust because of my reference

Jill Butterworth — Fri, 03 Feb 2017 09:37:36 GMT

What a nightmare, but sleep easy that you have the moral high ground here. In hind sight, if you had known how this might go, and for the rest of us as a warning that OUR confidentiality could be breached, you could have refused to give a reference, as with a poor employee. I have euthanised animals where I have been very upset/angry over the animal's care at the end with the misguided paralysis and neglect which occurs when people probably wish the animal would die in it's sleep. Not a good excuse, though.

I suppose photographs/video are the way to go, in future. I wonder if one day we will wear bodycams...

RE: Client refused dog from Dog's Trust because of my reference

Martin Atkinson — Fri, 03 Feb 2017 08:59:00 GMT

[quote user="Nicola M"]Did the client give you permission to discuss their previous pets with the Dogs Trust? [/quote]There is an implicit permission in that they presented us with a form to sign which nominates us as their veterinary surgeon and that they have given Dogs Trust our details as the previous/current vet in order for the Dogs Trust to obtain a reference from us to determine their suitability to re-home a dog. This is AFAIA much the same as a contract with an insurance company allows the company to obtain clinical history from the attending veterinary surgeon. In this case no clinical history has been released, only an off-the-record and hopefully confidential comment to a junior member of the Dogs Trust team that the owners end of life care for their previous pet was poor. It seems the Dogs Trust have broken that confidentiality and although they deny it, it seems rather suspicious that the client used those exact words when relaying back to me what they'd been told.

I think I may pass this by the VDS before I comment further to the client.

RE: Client refused dog from Dog's Trust because of my reference

Nicola Cole — Thu, 02 Feb 2017 21:13:15 GMT

Did the client give you permission to discuss their previous pets with the Dogs Trust? If not, then as far as I'm aware you've broken client confidentiality and the client has a reason to be upset. If they gave permission then there's nothing they can do about it and personally I would tell them the info the decision was based on.

RE: Client refused dog from Dog's Trust because of my reference

Dagmar Steele — Thu, 02 Feb 2017 19:25:03 GMT

I guessed as much.

RE: Client refused dog from Dog's Trust because of my reference

Martin Atkinson — Thu, 02 Feb 2017 18:22:38 GMT

[quote user="Dagmar Steele"]All that comes out of it is you might not do it again, right?[/quote]I had already refused to give a reference to them for this owner as previously they have still re-homed dogs to clients I have given poor references. They phoned me and extracted the statement out of me that I was not happy with the client's end of life care for the cat but I did not reveal why. This is a lose-lose situation but the result is that I will certainly not give them any references for any clients again in future.