Last night’s houseguest was not exactly sick; she was pregnant—somewhere between 64 and 70 days pregnant. Darn near overcooked, I’d say. And no nine-year-old, ten-pound Shih-Tzu deserves to be in such a predicament without expert attention. So I took her home for the night in case her overlong labor came to fruition in the wee hours of the morning.

I don’t know what percentage of vets engage in this kind of risky behavior but in our hospital (I like to think of ours as a kind of blend of home-style and high-tech vet care) we do it fairly often.

Risky, you ask? Definitely—especially in this legalistic day and age. I know several Miami hospitals currently dealing with legal crises. And taking pets home is rife with opportunities for escape, transportation-related crises and sudden death in a home environment devoid of crash cart and technical assistance. The last thing I need is a law suit—especially after going above and beyond to lend a personal touch to my practice.

Despite the risks, I flout Murphy’s law if only to feel human in how I practice medicine. Given the appropriate indications and safety considerations, it seems natural to want to care for a patient in one’s own home. But not every case lends itself to at-home care.

Here are my criteria:

• the pet needs to be observed by a knowledgeable person

or…

• the owner is uncomfortable watching their own pet for whatever reason

and…

• the owner has refused 24-hour hospital care (as documented in the pet’s record)

and …

• the pet’s needs are reasonably met in a scantily equipped home environment

and…

• the owner understands that the pet could theoretically die in the time it takes the caretaker (me) to transport the pet back to the hospital should an emergency arise

Only if all these requirements are met will I consider putting myself through a less-than restful night with a sick or observation-intensive case.

In Mimi’s case (the pregnant Shih-Tzu), several considerations came into play:

• a C-section was in the cards for this case given that natural birth was out of the question for a dog of her size, age and breed—not to mention the size of the Cocker spaniel-sired pups (how many do you see in this X-ray?)

• a late afternoon C-section (I had never even met Mimi until 5 o’clock yesterday afternoon) was out of the question for this high-risk patient—she’d have to be scheduled for the morning

• the owner was horrified by the prospect of her imminent labor (and had no earthly idea what to do if such a calamity should befall him)

• the owner was unwilling to take her to the 24-hour hospital, either for observation or emergency C-section (he’d had a terrible experience with another emergency facility a couple of weeks ago when they assured him that Mimi was indeed not pregnant—confirmed by blood test, not by ultrasound—and that she’d simply grown fat)

• Mimi was a very sweet, 100% friendly and non-dog aggressive little thing; she’d have no trouble sleeping on my bed all night

   

• the pups were apparently viable (moving like crazy) but Mimi did not look like she was in much danger of going into labor this evening (her temperature was not low as in the case of impending parturition)

Apart from a little loss of sleep and a bit of extra bowl-guarding courtesy of my slightly offended Frenchie, everything went according to plan. No labor. No midnight trip to the hospital for an emergency C-section. Nothing. Thank God.

“Accidental” pregnancy notwithstanding, everything today went 100% according to plan: four healthy pups and one healthy (if ouchy) mama. I even defied my own standard practice and spayed her at the same time (I normally don’t because it adds significantly to the discomfort). But as with the issue of at-home care, sometimes you just have to bend some rules to provide the best healthcare possible given the client-patient limitations.