Communication and Second Opinions Save Lives
Hello everyone. I’m excited to be here at Fully Vetted and hope that at least a few of you have stuck around after Dr. Khuly’s departure! I’ve got some big shoes to fill; feel free to let me know how I’m doing.
Did you read the Q & A between Dr. K and me? If so, you might remember that I touched upon the importance of communication between veterinarians and pet owners. Veterinary medicine has become so complex, with so many options at so many price points, that the only way to make sure that pets receive the care they need at a price their owners can afford is … you guessed it, communication.
I had a case recently that really drove this point home for me. I was scheduled for a house call euthanasia appointment on a 4-year-old Red Heeler; I’ll call her Annie. Annie had been attacked by two dogs, receiving multiple bite wounds and extensive soft-tissue bruising, just about what you’d expect from a mid-range dog fight. Unfortunately, her owners did not immediately take her to the veterinary office but waited several days until infection had set in and an abscess ruptured. Seeing the pus and blood pooling on the floor was the kick in the pants they needed to finally get her in.
As is usually the case, this crisis occurred after hours, so they took Annie in to a nearby referral/emergency center, and received an estimate of $2,000 to $3,000 for sedation and wound management (to be performed multiple times over the next few days), hospitalization, medications, eventual surgery, etc. The owners explained that they simply didn’t have access to this kind of money, and asked if there were any other options. "No," they were told. They applied for a type of credit account that can be used for health emergencies but were declined.
After being told that no other options existed, they decided the best thing they could do for their dog was to euthanize her and called my practice to set up the house call. When I arrived at Annie’s house, I was greeted by a tearful owner and a slightly depressed dog who was obviously uncomfortable (she was on Tramadol for her pain) but was certainly not on death’s doorstep. I asked Annie’s owner if he would be willing to let me sedate her so that I could shave the fur from around her wounds to get a better idea of what we were dealing with (this had not been done at her last vet visit, which made me wonder how the doctors could accurately describe the extent of her injuries). If the damage was overwhelming, we could proceed with euthanasia. If things were not quite as bad as he had been told, maybe I could come up with a Plan B. Annie’s owner jumped at the chance to help his dog.
After Annie was sleeping comfortably, I shaved away a lot of fur and found three major punctures that had infections involving deeper tissues, and multiple, less serious scrapes, bruises, etc. After talking it over, her owner and I decided that some "old school" treatment was worth a shot. So I flushed Annie’s wounds as best I could while she lay on the garage floor, prescribed a whopping dose of a broad spectrum antibiotic (for the geeks out there, 20 mg/kg amoxicillin-clavulonic acid every eight hours), and crossed my fingers.
Long story short, at her first recheck (three days after the above), Annie was looking much better — infections resolving, wounds starting to heal, and she was a much happier, brighter dog. Still no guarantees, but I’m optimistic that in another week or so, she’ll be out of the woods.
Why do I tell you this story? Simply because in all but the most grave cases, options do exist. The Plan B’s out there don’t always work (I warned Annie’s owners that we could spend their money and still have to euthanize), but if you’re ever presented with a veterinarian who fails at two-way communication and essentially says, "It’s my way or the highway," get a second opinion.
Dr. Jennifer Coates