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Dr. Coates is a veterinarian based in the other “Sunshine State” – that's Colorado to the rest of you – where she lives and plays with a varied range of animals. She shares her professional and personal experiences, Monday through Friday, here on petMD's blog, the Fully Vetted. Log in for your daily dose of her insight and wisdom.

 

Boiling blood transfusions (another rant on severe client misbehavior)

August 23, 2007 / (16) comments


Remember Dingleberry? He’s the cat who arrived crawling with so many fleas that his clumps of matted fur appeared to move with singular purpose: Get us off this animal, they might have said. He’s almost dead anyway.

I minced my words in my last post in deference to the owner’s ignorance (as opposed to what others labeled outright neglect). This post, however, is a no-holds-barred indictment of the client’s behavior. Why? Two reasons:

1. Dingleberry came back for his recheck last week loaded with a fresh batch of fleas. The owner was again, unaware of the problem and oblivious to the obvious solution I had recommended. For the record, she only came back because she wanted the cat’s unsightly mats shaved off—not to recheck his anemia.

2. This week she had the gall to call her credit card to dispute $300 in blood transfusion charges. She claims I did not secure her permission before embarking on this life saving procedure.

Dingle would have been dead but for his blood transfusion. I’d spoken to his two owners that day (by telephone) about the need for a blood transfusion and its expense. Neither denied that I should undertake such a procedure in light of its clear necessity. Without it he would have been stone cold dead within 24 hours—no doubt about it considering his severe depletion of red blood cells due to the active blood-sucking of his hundreds of fleas.

As usual, I documented the owner’s approval of all procedures. Yet none of that means anything to the credit card company. They’re there to protect their precious cardholder from evil vets like me who seek to indiscriminately appropriate their clients’ funds.

The day I saved Dingleberry’s life I went out of my way to drive to the specialists’ hospital and pick up the necessary unit of blood myself. I stayed late to make sure Dingle had no reaction to his transfusion. I nursed him back to health over the next couple of days.

But the owner claims she was happy to pay for all of his care—minus the transfusion. She swears that under no circumstances would she have paid an extra $300 to save her cat’s life.

When I got on the phone with her earlier this week I was all sugar—though my blood was boiling. She pleaded her case with the indignation of someone who had been taken advantage of by an unethical merchant. What could I do? I couldn’t lose it on the phone with her. My only recourse was to describe my feelings at being told my care was unwanted and unworthy of compensation.

The receptionists who overheard the conversation were aghast: Why didn’t you tell her you were going to call Animal Control for animal neglect if she didn’t pay? Why didn’t you threaten to sue her for theft of services?

I could have done all that—and more. Instead, I’ll just refuse to see her next time. I’ll have her sit in the waiting room for half an hour. I’ll wait until the room is packed with clients. Then I’ll come out and explain that we will not be seeing her today or ever due to our inability to provide the kind of service her cat needs.

I’ll miss Dingle, though. Who knows? I might just suck it up and care for Dingle to the end—just because all other alternatives in this case seem so inadequate. And because the sins of the mother should not be suffered by her children, feline though they may be.

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COMMENTS (16)
1
by on 08/26/2007 09:54am

Thank God, for every client thats a _____________,there are 50 other clients who really love and care.

2
by on 08/25/2007 08:55am

Barb: Our prices are ridiculously low on some items. For the effort and expense of raw materials involved, $300's a steal.

3
by on 08/24/2007 09:38pm

For what it's worth, $300 for a blood transfusion sounds extremely reasonable (the word "cheap" can have bad connotations, but in this case it's a GOOD thing <g>). If that's the going rate in your part of the country, that stupid client has no idea how good she's got it!!

Hang in there!

4
by on 08/24/2007 12:41pm

This is a tough situation for you as care giver. If you offend the customer she will tell 10 others of how 'badly' she was treated. Word gets around fast. If you make a stand out in the customer waiting area then all those folks see you berating a customer. This is a no win situation for you.
The poor cat is a victim no doubt.
I think you have 2 options.
1. Next time you have this client in your exam room require her to sign off on all the procedures to prevent any mis-understandings and never work with her over the phone again.
2. Your front desk people could very politely encourage her to seek appointments elsewhere. No questions asked. Maybe someone else in the area can make a dent in her carelessness toward her pets.
Just my two cents worth.

5
by on 08/23/2007 08:06pm

Hi Dr. Patty-
If you refuse to see her next time, she might not get her cat any vet care at all (at least she has some sort of relationship with you). Better to report her to Animal Care for neglect--maybe they'll remove the cat and find it a new home.

6
by on 08/23/2007 06:18pm

in Las Vegas our laws regarding reporting animal abuse are pretty much: blind eye/turn the other cheek.

in the grooming salon where i work we see some horrendous cases of animal abuse and neglect. i have seen more severely matted cases in a week that have OWNERS than i did in an entire MONTH of volunteering at the animal shelter.

we're talking a pinch collar embedded in a dog's throat, choke collars that require pliers to cut off (yes, the salon had to pay for that collar), foxtails embedded in pawpads/genitals/armpits/ears/everywhere, a pretty 4 year old poodle that has had a severely infected dewclaw for the past 6 months that i've been grooming her, and, my most matted case: an 11 month old poodle puppy whose owners had supposedly 'lost' him for a week and brought him in for grooming the day they found him. this poor baby was so severely matted that his head was cocked to the left slightly and he was limping when he walked. his fur came off in one unbroken piece. he actually had to step out of his fur as i peeled it off. the second he was free of his coat, he jumped up and kissed me.i was near tears.

the worst story i ever heard was from my manager. she was grooming an 8 month old bichon in similar matted state as the aforementioned puppy. all puppies are wriggly, especially the first timers, so she thought nothing of it when the puppy started whimpering as she began slowly releasing one of his back legs from its matted cocoon. about halfway through the puppy let out a shriek and went into shock... they rushed him to the instore vet and called the owners. the vet discovered that the puppy had broken his leg awhile back but the severe matting had managed to hold the bones in place. the owners scratched their heads and said "we wondered why he was limping!". my manager said they never saw that puppy again.

in vegas we're not legally able to report cases such as these to the authorities because "at least they're getting their dog groomed now". i guess the idea is, they could have just let their pet continue to be miserable... at least they cared enough to bring them in for grooming at all.

i've learned to just get that poor dog out of his miserable condition and show him lots of love before giving him back to his owner who will (invariably) turn down my suggestion they return in 4-8 weeks for a bath and brush or full service groom so we can "maintain the coat so we never have to shave him bald again". the owners shake their heads and grunt something like "no way. you just charged us $64 to make our dog look like a rat. why would we ever want to bring him back here?". never mind that it would have been at least $20 less if they would just come in more than twice a year...

7
by on 08/23/2007 02:04pm

Don't relinquish the cat unless the owner pays you in CASH....

8
by on 08/23/2007 01:48pm

Dr Patty: One of my close friends is a dentist and its the same thing. The people who owe tons of money are the ones complaining when the dentist won't fit them in, or when they are asked to pay in advance for future work. And the really galling thing is that these are not working stiffs who may be strapped for $. Its always the wealthy patients who think nothing of spending thousands on non-essentials that don't think they have to pay for their dental care.

I just wrote a check for over $100 to my dentist for the stuff my wonderful dental insurance didn't cover. I don't like that I have to do that but I understand that he has rent to pay, staff to pay, equipment to pay for, etc.

9
by on 08/23/2007 12:42pm

Heather#2: I wish our Animal Control were that helpful. I often rely on police for what AC should be doing--usually because AC can't be bothered to answer the phone.

M: I agree with your approach but my last attempt to get this policy adopted by our hospital severely tested my "change management" skills. The clients rose up and successfully challenged my bosses: "How could you be so cold!...so legal!" Many of these clients owe us thousands of dollars, btw. Oh well...it's not my money, just my headaches.

10
by on 08/23/2007 12:38pm

I love the biblical capstone to your column, Dr. Khuly.

You rock.

It's hard to be in the position--as many doctors are--of dealing with neglectful owners, parents, and legal guardians who aren't serving those in their care. What do you do? Because there's no EASY answer--there are lots of answers--I love when both sides are laid out and nothing's decided. That's like life.

11
by on 08/23/2007 11:55am

I do rescue, TNR, and volunteer for a no-kill shelter in my town in California. I often rely on advice and assistance from county animal control. Recently I found a tame outdoor cat in need of medical attention not being cared for by her family (foxtail in the eye). The family would not take her to the vet. Animal control advised me to explain to the family that they would be wise to relinquish the cat to me so that my organization could provide medical care and rehome the cat. Otherwise, animal control would take the cat, provide medical care, send the bill to these people, charge them with neglect, and still rehome the cat.

Would this same type of thing work in Florida? If you aren't able to do this as a vet, is there a local rescue that one of your staff can tip off?

Good luck! How sad and frustrating.

12
by on 08/23/2007 11:35am

This is the kind of situation that could be easily avoided with long consent forms and hefty deposits demanded up front. Everyone is quick to condemn this owner as a turd for behaving this way, but the same people may find the alternative leaves them cold. No one likes having to sign a ream of legal forms and pay up front when they only want their pet to be saved. But without those measures, us vets get driven to compassion fatigue, burn out and (all too often) to commit suicide. Clients should think about that the next time a receptionist slides that onerous consent form across the counter for their signature, and tells them nothing will be done until their credit card clears. Its not just about the money. Its about getting all aspects of the client/veterinarian/patient relationship spelled out clearly in order to avoid "misunderstandings".

13
by on 08/23/2007 11:18am

That is so sad and I applaud you for not going through the phone and taking her head off.

14
by on 08/23/2007 11:07am

2CatMom: That's not a bad idea...

15
by on 08/23/2007 10:47am

I think you should report the owner for neglect. The cat obviously continues to be neglected. And since you don't want the owner to continue to be a client (who would frankly) you have nothing to lose, do you?

If she brings the cat back and its reinfested, can you legally hold the cat and call the animal cops?

16
by on 08/23/2007 10:41am

That's why I couldn't be a vet-I'd be in jail for clubbing that owner with a very large stick.

Poor Dingleberry. I hate to say it but if that's the (non)care he's going to get, maybe death isn't that bad.

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About fully vetted

Patty Khuly, VMD, MBA

Photo of Dr Khuly

Dr. Khuly is a former petMD blogger and small animal veterinarian in Miami, Florida, where she practices medicine at Sunset Animal Clinic and serves on the board of the South Florida Veterinary Medical Association. She is a graduate of Wellesley College, the University of Pennsylvania School of Veterinary Medicine, and The Wharton School of Business.

As a significant sideline, she writes...a lot. She authors pet health columns for USA Today, The Miami Herald and Vetstreet. She also writes a popular monthly column for Veterinary Practice News and serves as regular contributor to Veterinary Economics, The Bark, and the Veterinary News Network.

Dr. Khuly lives in South Miami with her brood of hens, goats, dogs, cats...and humans.

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