I've come for a jab - refusing treatment

Re: I've come for a jab - refusing treatment

Gillian Mostyn — Fri, 01 Apr 2011 14:42:07 GMT

Ah - just your opinion then. Glad we cleared that up.

Re: I've come for a jab - refusing treatment

Hannah Wynne Richards — Fri, 01 Apr 2011 13:39:25 GMT

I would put the optimum time any time between 10 days post blleding and 20 days post mating, ie when season had finished,therefore preventing the problem of needing to treat more than 1 misalliance per season, and the 20 day period when problems could arise during the abortion

Wynne

Re: I've come for a jab - refusing treatment

Gillian Mostyn — Fri, 01 Apr 2011 12:17:52 GMT

[quote user="Hannah Wynne Richards"]I would have told the owner-tarmac layer or not to come back at the optimum time[/quote]#

which is?

I can't find any reference to an optimum time in the datasheets. The only reference to time seems to be:

In bitches treated beyond the twentieth day of gestation, abortion may be accompanied by the physiological signs of parturition, i.e. foetal expulsion, slight anorexia and mammary congestion.

which I would personally assume is best avoided.

Is there some more information somewhere that I haven't seen?

Re: I've come for a jab - refusing treatment

Hannah Wynne Richards — Fri, 01 Apr 2011 11:08:26 GMT

I'm with Jonathan and Chris on this one-use all drugs in the safest , most effective way-after al the reason they are POM-V is that we are trusted to have the knowledge to make these decisions-the owners are'nt-so I would have told the owner-tarmac layer or not to come back at the optimum time

Wynne

Re: I've come for a jab - refusing treatment

Chris Barker — Fri, 01 Apr 2011 09:03:04 GMT

[quote user="Busybee"]

[quote user="Chris Barker"]The effectiveness of Alizin approaches 100% up to 20d post-mating,dropping to 95% effectiveness by 45 d. [/quote]

Is there a paper about this? Just never heard of it's action explained in this way!

[/quote]

It's a multicentre trial quoted in the Virbac Reproduction Control product support material d0 to d22 - 100% effectiveness in original trial, 99% in field use d23-d45 4.3% failure rate If you really need chapter and verse as your Virbac rep

Chris B

Re: I've come for a jab - refusing treatment

Gillian Mostyn — Thu, 31 Mar 2011 22:26:17 GMT

[quote user="J G Wray"]

[quote user="Gillian Mostyn"]Do you refuse to use delvosteron too because you can wait and see if it gets pregnant instead?[/quote]

Now, now we both know there are certain risks associated with Delvo and these need to be discussed.

[/quote]

Yes. But if the owner is willing to take those risks, do you let them?

[quote user="J G Wray"]To go off at a tangent, err Mr Main didn't say no and look where that got 'im. Following orders as in " I was just following the client's order" is historically speaking, fraught.[/quote]

That is even beneath you. This client asked you to use a licensed drug for its own specific indication in a relevant case. Hardly comparable to Mr Main's issues.

[quote user="J G Wray"]PS I'm not all that worried about pissing people off.[/quote]

I knew that already.

Re: I've come for a jab - refusing treatment

Busybee — Thu, 31 Mar 2011 22:15:25 GMT

[quote user="Chris Barker"]The effectiveness of Alizin approaches 100% up to 20d post-mating,dropping to 95% effectiveness by 45 d. [/quote]

Is there a paper about this? Just never heard of it's action explained in this way!

Re: I've come for a jab - refusing treatment

Mark Holmes — Thu, 31 Mar 2011 10:53:23 GMT

I don't disagree, I normally suggest waiting particularly if mating wasn't observed and either giving the injection post oestrus or at d28 when I suggest spay as an alternative if necessary. Just in this case I would have given the injection. I try to keep life simple and providing the dog is not endangered would do as the client requested to avoid a headache. Its also ensures the consult fee is paid!

As Groucho Marx once said "Those are my principles. If you don't like them I have others!"

Re: I've come for a jab - refusing treatment

Gerry Henry — Thu, 31 Mar 2011 10:44:29 GMT

They seem to come in two flavours, the good ones are very good, knowledgeable and look after their animals reasonably well. They're good payers too. One used always to ask me into his (spotless) caravan for tea, served by a stream of dark eyed lovelies (his daughters) all of which he repeatedly told me were unmarried (I was young in those days). Nice man.

The others, like the shower that infested the local site at Echline are revolting; litter, excrement (human), toxic fires, scrap, petty crime. The site when vacated had to be seen to be believed; after clearing it was ploughed, only way to dispose of the ...

Re: I've come for a jab - refusing treatment

Laurence Webb — Thu, 31 Mar 2011 10:39:29 GMT

[quote user="Gerry Henry"]But I still don't get the 'wait until 30 day' routine because, 1) If you miss a single pup (not difficult at day 30) its a VDS job and 2) If you give Alizin at day 30 its messy, so why wait? [/quote]I wouldn't wait til day 30 for the above reasons, but I do advise to give Alizin once the season has finished in case another mating occurs. One memorable client managed 3 matings in the same season. Her reasoning was that it was the bitch's brother so they (they dogs) should have known better.

Re: I've come for a jab - refusing treatment

Chris Barker — Thu, 31 Mar 2011 10:37:46 GMT

JGW can well defend himself, but I thought I'd add some support anyway. Given the scenario (bitch mated 2-3d ago) I wouldn't have injected the bitch either The effectiveness of Alizin approaches 100% up to 20d post-mating,dropping to 95% effectiveness by 45 d. Providing the owner is sufficiently open with our receptionist when making the appointment, we don't even bother getting the dog in for at least 7-10d post mating. Then there is no chance of re-mating as oestrus will have finished. If they come in immediately post-mating we politely turn them away. We happen not to charge them at that visit - but that is personal choice - a professional opinion has been sought and offered. We also make sure they sign a specific misalliance consent form on which they acknowledge that they have been given various options, have had the statistics explained, AND that they understand the need for the second jab to be 24hrs later +/- 3 hours. This we see as our protection should the injections fail and complaint ensue

Chris B

Re: I've come for a jab - refusing treatment

Martin Atkinson — Thu, 31 Mar 2011 10:27:02 GMT

Having a Pikie camp nearby I threw my political sensitivity cap away a long time ago. Lets get this straight we are not talking about Romany Gypsies who nevertheless don't have a good reputation in their homelands but Irish tinkers. We have this sort of thing all the time and the rule is no treatment without payment up front, be honest they're are hardly going to report you to the RVC for refusing treatment. The national census made me laugh with the bit which asks for ethnic group and one option was for this lot. My observation is: a) they're not an ethnic group it is a lifestyle choice b) they are hardly likely to complete a census because they can't read and if they could they live outside the normal boundaries of civilised society so are hardly likely to want to be counted. And just in case someone thinks I'm a rascist bore 3 Pikie woman with kids came in yesterday with a 'stray' dog they dumped on us (it was obviously their own) and while our attention was diverted stole one of my nurses' mobile phone off the reception desk. Fortunately she discovered the loss within a couple of minutes and we jumped in the car and hot-footed it after them. When we caught up with them they at first denied all knowledege of course but when I started to call the police the phone suddenly appeared. A better result than usual: dog warden came for the dog and nurse got her phone back.

Re: I've come for a jab - refusing treatment

Rob Loxley — Wed, 30 Mar 2011 23:57:57 GMT

[quote user="J G Wray"]PS I'm not all that worried about pissing people off[/quote]

You surprise me

Re: I've come for a jab - refusing treatment

Jillian Hall — Wed, 30 Mar 2011 23:11:50 GMT

Just had a situation where I would love to have been given the opportunity to give Alizin a few weeks ago. So much simpler.

A 9ish year old bitch thats had been in labour nearly 24hours with nothing being producedand had stopped contractions. Tried Oxytocin but still nothing. The owner than asked "Do I sound heartless if I say just put her to sleep? She's and old dog and I don't really want these pups. I've got another 3 at home which I didn't really want in the first place." I could only think of one answer to his question. When discussing the cost of a potential cesarian he went on to say that "to be honest, I can think of better things to spend the money on".

(He can't even remember how many litters she's had in the past. He doesn't want these pups as he assumes they are cross-bred from the daughters dog visiting. The bitch in question does live with an entire male but it can't be him because the owner is sure he's firing blanks. )

Re: I've come for a jab - refusing treatment

J G Wray — Wed, 30 Mar 2011 23:06:12 GMT

[quote user="Gillian Mostyn"]Humans can be prescribed emergency contraception with less questionning than this!!!![/quote]

Funny old world eh?

[quote user="Gillian Mostyn"]I would rather prevent a pregnancy if one is possible (even though it isn't confirmed) - and would feel that this owner is actually being responsible (eventually) and would encourage this[/quote]

You are entitled to your opinion

[quote user="Gillian Mostyn"]Do you refuse to use delvosteron too because you can wait and see if it gets pregnant instead?[/quote]

Now, now we both know there are certain risks associated with Delvo and these need to be discussed.

[quote user="Gillian Mostyn"]I just think that in this case he may have just been p*****d off with yo[/quote]

Possibly, or, and I think this because he didn't decompensate in front of a waiting room full of people, he was trying it on knowing he was going to do a runner anyway.He ain't the first. I've said no on a number of occasions to clients. It's a good idea sometimes. Try it.

To go off at a tangent, err Mr Main didn't say no and look where that got 'im. Following orders as in " I was just following the client's order" is historically speaking, fraught.

JGW

PS I'm not all that worried about pissing people off.

Re: I've come for a jab - refusing treatment

Andre Escudeiro-Vieites — Wed, 30 Mar 2011 23:00:31 GMT

Maybe this is a different thread, but what I tend to do is: when somenoe phones telling the story of an unwanted mating, I book the alizin injections about 10 days later. If the mating has occurred then the oestrus phase has already started, and I assume that it CAN happen again as long as the bitch is in oestrus. After that lengh of time she is unlikely to accept the mating. At this point the alizin injections are very likely to be fully effective. I came up with this "protocol" myself. I guess it would be wiser to phone Virbac.

Re: I've come for a jab - refusing treatment

vs0u — Wed, 30 Mar 2011 22:10:09 GMT

[quote user="Gillian Mostyn"]

Forgive me if I misunderstood you but it seems to me that:

- the client rang to ask for a mis-mate injection. This was always what they wanted. They came in for that service. They were not told that you will not do the injection at the stage the dog was at. If this is always your policy, regardless of the client, surely the receptionist could be made aware of that?

- You went through all the details of possible options with them and they still wanted a mis-mate injection.

- you refused to administer this injection at that time for your own reasons, despite it being liscensed for precisely this use.

- you expected them to pay for your advice even though you refused to carry out their wishes having been given all the options. This is despite those wishes being perfectly reasonable.

- you expected them not to pay but didn't actually ascertain whether they would pay up-front if given the chance.

-you're now surprised that they were a bit reluctant to pay you for your advice.

Sorry - am I wrong????

[/quote]

This is exactly what I thought when I read it!

Re: I've come for a jab - refusing treatment

Gillian Mostyn — Wed, 30 Mar 2011 22:04:01 GMT

[quote user="J G Wray"]I'm not in the habit of injecting or prescribing prescription drugs of any kind on that sort of basis. Are you?I prefer to think a bit harder.[/quote]

Humans can be prescribed emergency contraception with less questionning than this!!!!

I would rather prevent a pregnancy if one is possible (even though it isn't confirmed) - and would feel that this owner is actually being responsible (eventually) and would encourage this.

[quote user="J G Wray"]I also did no harm, which is a pretty sound way of getting through practice life.[/quote]

Depends which way you look at it.

Do you refuse to use delvosteron too because you can wait and see if it gets pregnant instead?

[quote user="J G Wray"]PS I was after all musing on the plausibility of this character, their neck and my own naivety. [/quote]

The point I was making is that you have condemned this man for his actions, whereas I feel you have to take some of the blame for them. I look at the situation a little differently. He came for your advice, which you gave freely (but not for free, obviously). I assume you made him aware of all his options (and possible complications) and he still made the decision that he wanted the bitch injecting. You then refused to do this because it contradicts your own opinion. To be honest I am not at all surprised that he refused to pay for your advice under these circumstances.

As far as whether he would have been willing to pay for the service he actually requested, had it been offered - who knows?

I have also had bad experiences with travellers and 'tarmac men'. I am less trusting than I used to be and do expect to receive some money up front. I don't think you were naive. I just think that in this case he may have just been p*****d off with you!

Re: I've come for a jab - refusing treatment

Michael Woodhouse — Wed, 30 Mar 2011 21:45:02 GMT

You must either have a very high mark-up on the Alizin or charge not a lot for the scan and or vaginal swab.

The true 'gypsies' are honest people. I have looked at their horses and dogs on a number of occasions [we are on a direct route to Appleby Horse Fair] and always got payment from the obligatory roll of twenties.

Re: I've come for a jab - refusing treatment

Anonymous — Wed, 30 Mar 2011 20:54:26 GMT

Has become quite in vogue not to give misalliance drugs jsut because the owner thinks has been mated without some further questioning. In the event that has not been seen mated (i.e. tied to a dog), I don't tend to inject misalliance drugs, but leave until 21-25 days to ultrasound. Also if presents just after the said mis-mating, I tend to do a vaginal swab and see if any chance could actually have been mated and possibly conceive (often turn out to be in early oestrus and still bleeding), as well as spot any sperm kicking around that might suggest mating had actually occurred. If the owners aren't wishing to be mated at all, I frequently recommend spaying after season ended rather than spending the money on Alizin and then getting neutered.

I got some of these wacky ideas from a UK Vet article and have been pleasantly surprised to date that I've not yet encountered any unexpected pups when spaying or pregnancy checking these 'mismated' bitches after 3 weeks where mating hasn't actually been witnessed. Also I think (though would have to spend more time looking at figures on PMS than could be bothered) that has overall worked out more economical approach than simply injecting Alizin into everything presenting for a 'misalliance'.

Update on pregnancy termination in the bitch

McLauchlan Gerard, Ramsey Ian

Companion Animal - Volume 13 - Issue 8

Re: I've come for a jab - refusing treatment

Busybee — Wed, 30 Mar 2011 20:50:06 GMT

[quote user="J G Wray"]My preferred option is to wait until 25-30 days post mating then have another discussion. Lots of options to check for pregnancy at that time. Alizin licensed up to day 45.[/quote]

I was always under the impression that yes, it is licensed for up to 45d post mating, but if you give after day 20, the bitch can experience signs of parturition, which in my (limited) experience can be problematic.

I have to agree with the group that say treat rather than wait.

Re: I've come for a jab - refusing treatment

Wren — Wed, 30 Mar 2011 20:17:09 GMT

[quote user="Clive Ansell"]

If they are Gypos they have no intention of paying - end of!

[/quote]

They always pay me when I look at their horses. Usually I have no idea what the exact price of the colic exam plus Xmls of A and Ymls of B come to but I'm fully aware that it's a case of 'think of a figure quick then wait while they peel the notes from the proverbial wad of twenties'.

Whilst we're on the subject my next favourite call to go to is the 'could you check over my new horse please, I've just 'rescued' her from the gypsies'. Umm did you part with money to 'rescue' the horse? Yes? Then you bought her. There's a difference. And by the way it's 3 years old, not 8. Oh, and fairly well in foal by the looks of it.

Re: I've come for a jab - refusing treatment

J G Wray — Wed, 30 Mar 2011 20:16:45 GMT

[quote user="Gillian Mostyn"]Forgive me if I misunderstood[/quote]

Certainly

[quote user="Gillian Mostyn"]

the client rang to ask for a mis-mate injection. ...

etc

[/quote]

The client was vague and the mating not witnessed.

I'm not in the habit of injecting or prescribing prescription drugs of any kind on that sort of basis. Are you?I prefer to think a bit harder.

I also did no harm, which is a pretty sound way of getting through practice life.

If you deem my actions a SIn then it is one of Omission rather than Commission and on the whole a shedload less accountable.

JGW

PS I was after all musing on the plausibility of this character, their neck and my own naivety.

Re: I've come for a jab - refusing treatment

Rachael Winder — Wed, 30 Mar 2011 20:15:50 GMT

Neatly side stepping the original discussion, Virbac themselves recommend waiting until a bitch is out of season ( despite the licensing stuff) and I am fed up with dealing with the idiots who despite all appropriate warnings, manage to get the dog mismated again within 5days! Makes it all very complicated...

Re: I've come for a jab - refusing treatment

Clive Ansell — Wed, 30 Mar 2011 19:50:06 GMT

If they are Gypos they have no intention of paying - end of!