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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.

 

Uncommitted clients make for half-a---- care

February 20, 2007 / (7) comments


Sorry for the mild profanity but nothing makes me crazier than clients who can’t figure out whether or not they want their pet to live…to receive treatment…or even to go to the vet in the first place.

I have a beautiful little calico in hospital who used to be a beautiful big calico about three or four weeks ago. 'Round about that time she decided to consume many small pieces of cellophane tape—approximately half a stomach-full. So every time she ate, Kitty threw up most of her food.

It shouldn’t have taken too long for her owner to figure out that Kitty was in some sort of distress. I mean, she’d been vomiting after every meal. That’s sort of a clue, right? And how about the weight loss? From fifteen to ten pounds? What would your friends say if you lost 33% of your body weight in three weeks?

And then there was the issue of the bright yellow skin…and gums…and tongue. How do you miss that?

But Kitty’s owner hadn’t overlooked it. In fact, she was able to provide a detailed history of what had transpired, down to the possibility that she had seen her consume the plastic. No, this owner just hadn’t decided whether or not she cared enough to bring the kitty to the vet. Or maybe she was just in denial. Or perhaps she kept expecting kitty to get better the very next day. Who knows?

All I do know is that I’m the one who has to sit and watch the kitty, day after day, puke her guts up (only occasionally bringing up some tape) without the possibility of performing a surgical retrieval of the tape until her liver chills out.

Because Kitty’s liver is a mess. When she lost weight (read: fat) so precipitously, her liver became overwhelmed with the lipids its job it was to process. The disease is called hepatic lipidosis, lovingly known in our profession as “fatty liver disease.”

The upshot? This two year-old cat is essentially dying of liver failure because her owner failed to seek medical attention in time. The process may or may not be reversible. But the owner may or may not put up the money for it. And after three days without contact with her, she may or may not be planning to come back to pick up her cat. And by the time she decides, there may or may not be a kitty to pick up.

In the meantime this kitty could use some different treatments—like a nasogastric tube. But that can’t happen unless the owner picks up the phone when we call so she can authorize them. Honestly, though, I don’t think it would make a difference. This owner can’t afford a higher level of care anyway.

Somehow, some way, this kind of situation has to change. It’s so frustrating to know you could provide so much more care if only…(fill in the blank).

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COMMENTS (7)
1
by on 03/13/2009 02:09am

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I actually rescued my calico from "fatty live disease" for $30. 


FYI:  only for very dedicated owners, very worth it if you love your pet but not for the faint of heart. 


When we adopted Cleo she lived for a little over a week under our bed (she's shy but lovely to those she trusts), a few years later, when we adopted our other cat Toby, Cleo caught an upper respiratory infection (which we treated with antibiotics from our vet) but she retreated to under the bed again and refused to eat.   I chalked it up to her adjusting to Toby and the forced antibiotics and hoped she would come out eventually.  By the next week, I was very concerned and took her to the vet.  She was jaundiced around the lips and losing weight rapidly.  Our vet recommended keeping her at the vet for $200/day (for at least a week).  I'm not sure if we will ever have a spare $1000 but we most definitely did not have it then and our veterinarian was not very positive about her outcome even with the vet stay.   I asked the vet what was involved in the treatment and whether I could do it at home and although he was reluctant he eventually agreed.  Two weeks of home treatment, multiple (and I mean 6-8 times/day, too much and they vomit it back up again) syringe-forced feedings of blended wet cat food, (which filled us with horrible guilt, I mean we weren't sure if these were our last moments with her and we were basically torturing her to get calories into her) daily IV fluids, and eventually a shave to cleanup her long haired coat that was starting to mat with cat food.  All this right before Christmas, we ended up flying to our parents house (they bought the tickets) with our new baby and a "dying cat," as our relatives called her.  At the airport our bag was lost with the IV needles in it (the food and IV bag was in our carry on thankfully), and we ended up at the Hospital in the Emergency ward begging for needles at 11:00pm at night for our cat (they thought it was funny, we were distraught).  By the end my husband and I had divided the duties, he force fed (I became too guilty and nauseous at the smell of the food), and I administered the IV (having previous experience with horses, I wasn't squeamish).  Soon after we returned to Vancouver, she started to eat again and slowly went back to her shy happy self.  If I had it to do all over again, I'd do it in a heartbeat but it’s been three years and hopefully I won’t have to. 


 

2
by on 02/23/2007 09:12am

Vasha: Your situation is truly scary. Did you consider pet insurance? Many will cover you without considering "plastic eating" a pre-existing. For twenty bucks a month I bet you could have slept a lot better.

And, by the way, Kitty is still yellow but is looking better. Her owner groaned the other day when I mentioned her bill was at $750. If she only kew what a break I was giving her due to her unfortunate circumstances she might take the time to be thankful. Sometimes I think the kinder you try to be the more you get screwed in the end. But this is what lets me sleep at night.

3
by on 02/22/2007 04:51am

Oh, boy... Your story of the calico cat touches a nerve for me, brings up a nightmare scenario. I am a person of limited finances, living with a charming cat who's irresistibly attracted to all sorts of plastic (grocery bags, bubble wrap, tape, scrubbing sponges, and on and on). Somehow, he periodically manages to find and eat something of the sort, no matter how I try to hide them away -- for instance, I recently left the door of a closet unlatched for just moments, and returned to find him inside it, ripping off and swallowing pieces of bubble wrap with avidity.

So far, he's only once swallowed something he couldn't pass. That time, he spent several days in the hospital having it surgically removed. The bill was horrifyingly high; I put it on a credit card, and spent a long time paying it off. But after he came back from the hospital, I knew that if he did this again, I just wouldn't be able to pay for surgery a second time. So I worried greatly, knowing that if I had to take him to the hospital, I would find myself pleading for someone else to adopt him and pay for his care -- I wouldn't be able to authorize any care unless someone else would guarantee the bill. Would I have to have him euthanized because I couldn't pay? The only alternative I could imagine to that was to have him (and his sister) adopted by someone else -- I'd lose my cats, but they'd be alive -- but it's not likely I could find this person, is it?. So you can tell that I fretted a lot and watched my cat, who showed no diminution in his appetite for plastic, closely. Luckily, this scenario didn't come true.

But the behavior of the people you describe, not willing to even make <i>any</i> decision, is beyond me. I wouldn't be able to see a cat in that state and not do anything -- even if I didn't have a penny, I'd at least try really hard to find some solution.

4
by on 02/21/2007 09:18pm

Amen, georg!

To the people who still think that their pets are property, I generally ask 'Do you have a car?' and when they say 'yeah, duh!' I ask 'Well, you give your car routine maintenence, don't you? Why would a pet be any different? They're both your property."

This seems like a no-brainer. But obviously it's still a huge problem.

And while I tend to fight against being my dog's legal guardian (just like I believe a parent should be a /parent/, not a friend) nevertheless I am still responsible for the little life that shares my space. It's my responsibility to give them the best care I can, in all ways. And if I can't do that, then I shouldn't have a pet.

My dog ~is~ my property -- there's no denying that. I paid for her, she's licensed to me, it's my responsibility to keep her physically healthy, emotionally stable, and as happy as a dog can be. That's well maintaining my property! However, Roxie is also my friend and a companion, and she's a LOT more than just an inanimate object. So I give her a LOT more than routine maintenence.

She deserves it!

Whitewater

5
by on 02/21/2007 11:09am

Legislating to guardians won't do much to fix the fundamental root of the problem. Nor would paving the streets with money. Too many people still believe that pets are property and not in need of maintennance and proper medical care. Nor does legislating guardians eliminate flat out rudeness. Insert rant here about the loss of manners in the current society.

What we all need is more education and a better sense of responsiblity for manners and pet care. Unfortunately, closed ears aren't learning.

6
by on 02/20/2007 08:23pm

(erase "paid", replace it with "paved"...)

7
by on 02/20/2007 08:22pm

So fill in the blank. If only we had "guardians" instead of owners? If only she'd sign over the cat and turn fixing it into your financial problem and moral obligation? If only the streets were paid with money?

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About fully vetted

Patty Khuly, VMD, MBA

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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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