This one takes the biscuit

Re: This one takes the biscuit

Wren — Thu, 11 Aug 2011 17:02:38 GMT

And once when the boot was on the other foot I had my husband in A&E to get his face stitched up (stitched his arm up myself once, but drew the line at his face!), his cut was through the lip/skin junction and they decided they needed the Maxillofacial surgeon in to do it (prompted partly by my imaginative husband who told them he was a model ). They eventually got her out of her bed and not only was she younger than me - and I was pretty newly qualified at the time - but she said that she'd rather have been a vet but she wasn't clever enough .

Re: This one takes the biscuit

Robin Grimmer — Thu, 11 Aug 2011 16:57:01 GMT

Most of the GPs I've had to deal with clients have been a pleasure to deal with.

Re: This one takes the biscuit

Tim Cheyne — Thu, 11 Aug 2011 16:49:08 GMT

I have given up with GPs and even specialists when it comes to zoonoses. There is widespread brucellosis in the goats and possibly less in the cattle and good evidence of seroconversion to West Nile virus in a significant number of horses on a bird migratory route but talk to the medics about them and they are not interested.

As far as they are concerned the TB is brought in by the immigrants who present with it (despite them having been screened within a few days of arrival) and the disease in cattle is a myth. Brucellosis is tested for sporadically but for abortus not the prevalent strain of melitensis. West Nile Fever?,,"No we never see any cases." "Do you test for it?" (long pause) "Well, no, I don't think that we do."

Tim.

Re: This one takes the biscuit

Tanya Fielding — Thu, 11 Aug 2011 16:07:03 GMT

we had a GP let his bitch get pregnant then wanted home visit to put them all down at a day old. More recently daschund belonginig to GP had surgery for slipped disc but could not be bothered to go for hydro or physio, would see how it went. We also have someone that works in a doctors surgery who will not buy tramadol from us as she just takes it off the self at work, I have no control over quantities or re checks.

Re: This one takes the biscuit

Simon Neuhoff — Thu, 11 Aug 2011 13:27:46 GMT

On the note of GP as clients - some make excellent ones, where you can chat to them on your level, they understand everything and are compliant etc. Others are nightmares! I have recently had a second opinion on a hyperthyroid cat that has not had ANY meds since last year - and the GP owner had been using human neomercazole prior to this (against the previous vets advice). In my locum days I did a house visit to put to sleep a dog in congestive heart failure - and had to explain to the GP owner why the dog was on diurectic and how diurectic helped animals in heart failure! He was a locum GP (who qualified outisde the country) and I had seen him previously as a patient of his - did not inspire confidence!

Re: This one takes the biscuit

Simon Neuhoff — Thu, 11 Aug 2011 13:23:34 GMT

[quote user="Clive Ansell"]

An interesting point.

I have a client in one of my regular practices who refuses point blank to pay for licenced frusemide and an ace inhibitor drug for her CKCS in congestive heart failure. she is an NHS nurse and "gets" generic enalapril and frusemide from work. I always advise that she should be using licenced veterinary drugs. It is an objection to the paying for the drugs, not an overall cost issue as she doesn't mind paying for consult or lab fees. Incidentally, the dog is fine and recent 6 monthly bloods showed no signs of organ dysfunction.

I cannot stop her of course (I'm not the illegal drugs use police!), but am I right in giving her the required doses? I have given the doses, as I feel it is better for animal welfare if she uses the correct ones than just guesses or uses human ones.

If it were my practice, I feel I would dismiss her, taking the line that we either play by the rules or you go elsewhere.

[/quote]

A difficult one. I think really that if you DO give clients doseages for human meds you are implying that you are in favour of what they are doing - you are in fact party to the crime! So I discourage this heavily though I confess I have crumbled on rare occasions when the owners have emotionally blackmailed me. Usually pointing out that it is illegal is enough.

Re: This one takes the biscuit

Claire Fisher — Wed, 10 Aug 2011 20:47:08 GMT

[quote user="Richard Carter"]

[quote user="Claire Fisher"]whose GP had told her to ring us for advice on what to do to avoid Toxoplasma [/quote]

No - you really do know more about toxo than the GP. We still have a couple of GPs in my area that advise rehoming the cats on hearing the happy news.....Doesn't seem to make much difference to the GPs when you tell the now distraught owners that the risks from an adult cat are minimal to non-existent and that as the cat predates the pregnancy, any exposure in future will be similar to exposure already occurred, just be careful etc etc

[/quote]

I'm sure I do know more than the GP when it comes to Toxo and I did tell her about undercooked meat/gardening but felt I should point out that anything not related to the cat should be checked with a human medical professional (butt covering I suppose!)

Even the BMJ found owning a cat was not associated with an increased risk of Toxoplasmosis so maybe next time I'll tell her to give her GP the reference!

http://www.bmj.com/content/321/7254/142.full

Re: This one takes the biscuit

Bob Russell — Wed, 10 Aug 2011 17:20:01 GMT

These GP's seem to be a bit of a pain! Get the nurse to sign a disclaimer confirming she understands that she is using unlicensed products in contravention to cascade. Also you cannot be responsible for complications arising from such use. Once done you can treat away knowing you have some defence if the illegal drugs Police do come your way!

The nurse is acting illegally unless she is entitled to write a prescription for these drugs. I am not sure if any nurses are allowed to prescribe cardiac medication. There is a limited list that some nurses are allowed to prescribe but I would be amazed if benazepril is on that list!

Re: This one takes the biscuit

bob lehner — Wed, 10 Aug 2011 16:51:28 GMT

A long time ago, my own GP was also a client - but he didn't like forking out for vets' bills.

When his spaniel developed an aural haematoma he decided on a bit of DIY surgery and stuck a scalpel blade in it. The dog bit him. Very gratifying.

Re: This one takes the biscuit

Bob Russell — Wed, 10 Aug 2011 16:44:27 GMT

[quote user="Camilla Edwards"]

http://www.legislation.gov.uk/ukpga/1966/36/crossheading/restriction-of-practice-of-veterinary-surgery

Veterinary surgeons act 1966

19 Restriction of practice of veterinary surgery by unqualified persons.

(1) Subject to the following provisions of this section, no individual shall practise, or hold himself out as practising or as being prepared to practise, veterinary surgery unless he is registered in the register of veterinary surgeons or the supplementary veterinary register, and an individual who acts in contravention of this subsection shall be liable—

(a)on summary conviction to a fine not exceeding £100;

(b)on conviction on indictment to a fine.

(4) (d) the carrying out or performance of any treatment, test or operation by a registered medical practitioner or a registered dentist at the request of a person registered in the register of veterinary surgeons or the supplementary veterinary register;

i.e. a GP would have to be under the guidance of a vet advising which treatment to give.

[/quote]

This allows a vet to authorise a medical practitioner to carry out a treatment on behalf of the vet. No vet was involved so this is not relevant. Does it make it illegal for the GP to act in this way? Not so sure as the pet is his own property.

Possession of unprescribed POM's is illegal but doctor has a get out of jail free card on that one. He/she is not supplying so clear on that one too. GP has made a diagnosis so in trouble there as not legally qualified for that!

[SCHEDULE 3
EXEMPTIONS FROM RESTRICTIONS ON PRACTICE OF VETERINARY SURGERY]
[Part I
Treatment and Operations which may be given or Carried Out by Unqualified
Persons]
[1
Any minor medical treatment given to an animal by its owner, by another member of the
household of which the owner is a member or by a person in the employment of the owner.

We start to get into what constitutes minor medical treatment! I strongly suspect a GP will try to use this as a defence and I have a suspicion that it would be accepted.

I still suspect nobody will take on a GP for this unless it is under the Welfare of Animals Act. From what has been stated I would find the GP guilty and as a hang-em up high judge would make sure they did not see blue sky again for years!

Re: This one takes the biscuit

Clive Ansell — Wed, 10 Aug 2011 13:32:05 GMT

An interesting point.

If it were my practice, I feel I would dismiss her, taking the line that we either play by the rules or you go elsewhere.

Re: This one takes the biscuit

patrick murphy — Wed, 10 Aug 2011 13:29:48 GMT

also went to truama having been savaged by a patient, and they had to look up in a book what antibiotic would suitable, I did point out that I have treated a few over my career.

Re: This one takes the biscuit

patrick murphy — Wed, 10 Aug 2011 13:28:12 GMT

at a lecture in USA, the god of endocrinology said his first cushings in Berkeley was in a dog being treated for diabletes by its owner who was also an endocrinologist

Re: This one takes the biscuit

Camilla Edwards — Wed, 10 Aug 2011 13:27:15 GMT

http://www.legislation.gov.uk/ukpga/1966/36/crossheading/restriction-of-practice-of-veterinary-surgery

Veterinary surgeons act 1966

19 Restriction of practice of veterinary surgery by unqualified persons.

i.e. a GP would have to be under the guidance of a vet advising which treatment to give.

Re: This one takes the biscuit

Bob Russell — Wed, 10 Aug 2011 12:41:23 GMT

I am interested in the legislation that makes it illegal to administer a POM unless acting under a VS. The regulations are more interested in controlling how we chose and dispense/supply medication.

If a GP supplies medicines to someone else this comes under the regs but giving random POM's from his or her bag to their own pet does not seem to apply. I would agree with the possibility of accusations of theft from the NHS but doctors do still get 'samples' so this may be hard to prove.

There is a great difference between what should be done and what can legally be got away with.

I am more than happy to be corrected if I am wrong on a point of law.

These GP's are not worth bothering with generally as the authorities are unlikely to consider it serious enough for disciplinary action unless actual suffering has been caused or allowed to continue. It seems obvious that this is the case here but the RSPCA tend to fight shy of taking on professionals.

There was a horrendous case of child abuse recently where social services failed to act despite all the warning signals because adopting parents were both GP's. At least one is in prison now!

Re: This one takes the biscuit

Hannah Wynne Richards — Wed, 10 Aug 2011 12:24:17 GMT

Bob I'm carefully avoiding getting embroiled in controversy over treatment of ex-wives, and also children, but you're wrong on the legality of owners treating animals.It's illegal for anyone to administer a POM drug to an animal unless acting under the direction of a veterinary surgeon,whose responsibility for care for the animal must be real. It's OK for one of us todispense POMs to a groupof animals with vague instructions such as "use after difficult lambing " but not to just hand out on demand

In this case the animalwas not under the care of a veterinary surgeon, so the owner was breaking the law. She was also doing so byusing Augmentin which does not have a veterinary license-and I strongly suspect was stealing from the NHS as well, so that's 3 charges to put her in front of the magistrates on

Wynne

Re: This one takes the biscuit

Bob Russell — Wed, 10 Aug 2011 11:13:17 GMT

One of my ex-wives phoned me for advice because she had injected herself with pig vaccine (near the knee!). She had spoken to the GP and been told to phone the vet!

I did my dutiful bit and referred her back to the GP armed with the correct advice.

No advantage to me to have her pop her clogs now as both children are over 18 and demand ransom money in their own right!

Re: This one takes the biscuit

Martin Atkinson — Wed, 10 Aug 2011 10:06:06 GMT

[quote user="Richard Carter"]

[quote user="Claire Fisher"]whose GP had told her to ring us for advice on what to do to avoid Toxoplasma [/quote]

[/quote]

....Plus they are likely to have antibodies with prior exposure and they are far more at risk eating undercooked meat and gardening without gloves where the neighbour's cats have crapped in your garden!

I read an article somewhere about cats being banned as pets in Iceland as a means of controlling toxoplasmosis in humans. It made no difference to the incidence,

Re: This one takes the biscuit

Richard Carter — Wed, 10 Aug 2011 09:43:00 GMT

[quote user="Claire Fisher"]whose GP had told her to ring us for advice on what to do to avoid Toxoplasma [/quote]

Re: This one takes the biscuit

Gina Dungworth — Wed, 10 Aug 2011 08:26:03 GMT

In my first job in practice I had a GP that was convinced his PUPD elderly bitch had a behaviour problem causing inappropriate urination (I think he went as far as calling it attention seeking) rather than a medical problem exacerbated by being lefty alone all day and so nowhere to urinate except in the house.

On a cheerier note (for certain values of cheery) a GP in a different part of the country once called me as I ate my breakfast to say "Timmy has come unzipped" (cat being treated by a colleague after a massive degloving injury and well known to everyone in the practice). I offered to run down to the surgery straight away, but she just wanted me to know that she'd be dropping him off at our surgery on the way to her surgery. One quick phone call from me to the person most likely to be opening up, and we were all ready to admit the cat for surgery as soon as he turned up (he did very well eventually).

Re: This one takes the biscuit

Louise6732 — Tue, 09 Aug 2011 23:58:02 GMT

[quote user="James Laidlaw"]

Client tonight.

20 minutes late for appointment.

No animal with them.

Same problem as 3 months ago (skin) but "in a different place".

Baffled as to why I didn't give them the convenia and dexafort injections it had last time to give at home themself...

[/quote]

Bloody hell!

Re: This one takes the biscuit

James Laidlaw — Tue, 09 Aug 2011 23:31:07 GMT

Client tonight.

20 minutes late for appointment.

No animal with them.

Same problem as 3 months ago (skin) but "in a different place".

Baffled as to why I didn't give them the convenia and dexafort injections it had last time to give at home themself...

Re: This one takes the biscuit

Amanda Nicholls — Tue, 09 Aug 2011 23:07:11 GMT

I remember seeing a dog a few years ago with grotty teeth, I tried to book it in for treatment and talked about starting tooth brushing post op. The owner was reluctant to do much until the child (about 7 or 8 years old) piped up that daddy should know how to look after the dog's teeth as he is a dentist! The dog was booked in for a scale and polish without further discussion!

On the subject of doctors, I saw a poor cat last monday evening surgery that had sat in one spot for 2 days not eating or drinking, I could feel the crepitus so took an x-ray straight away - fractured pelvis! His response when asked why he hadn't done something sooner - "it was the weekend and then I had to go to work today" I would hate to be one of his patients.

Re: This one takes the biscuit

Claire Fisher — Tue, 09 Aug 2011 22:43:48 GMT

[quote user="macflea"]

had a case where a lady rang me , concerned her enfant had being eating dog poo and was concerned her child may catch worms from the poo , she said she rang her doctor to discuss it ie did she need to give the child any medication or what should she do , doctor told that it was some thing she should discussed with her vet . i have to tell her we dont treat children at our veterinary clinic and really doctor should have spoken to her about her concerns.

[/quote]

I spoke to a pregnant woman last week whose GP had told her to ring us for advice on what to do to avoid Toxoplasma - advised to have someone else clean the litter tray but I also pointed out that there were several other risk factors that she really needed to discuss with the GP!

Re: This one takes the biscuit

Vet2Vet — Tue, 09 Aug 2011 22:34:54 GMT

[quote user="macflea"]

[/quote] Loving it !