Does a vet's absolute honesty save fewer pet lives?

Patty Khuly, DVM
Updated: September 09, 2010
Published: March 04, 2009
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There’s no better example to prove veterinary medicine can be an art as well a science than that of the interchange between veterinarian and pet owner in the face of a crisis. 

How a veterinarian handles these crucial moments can mean everything to how the patient is ultimately treated––or not. Typically, it all comes down to 1) how well these parties know each other, 2) the trust the pet owner places in their professional and 3) the veterinarian’s interpersonal skills. 

This last point is affected by a complex mix of so many tiny variables that it’s no stretch to say that mundane issues like a veterinarian’s caffeine intake, time pressures, too-small breakfast and a million other small stresses can affect the outcome of an interaction. 

But that wasn’t my problem during one of last week’s stressful client visits. It was more the fact of not having yet earned the trust of a brand new client––and realizing that I knew this client not so very well.

Here’s the story:

Though I’ve always urged Dolittler readers to seek second opinions from specialists, I see more than my fair share of second-go-round cases. In this case, however, no specialist was needed. 

This was a geriatric male dog whose severe skin disease had led to a horrible gnawing injury of his tail. Exposed bone, ligaments and nerves at the middle of his long tail had been crudely (but effectively) bandaged by his owner. 

Upon removing the bandage and revealing the injury, I thought his owner might hit the floor. She was so distraught over the situation I was somewhat at a loss to know how to effectively calm her. 

  • Perhaps I made more of the injury than I should have, intent as I was on explaining every detail of its lengthy and possibly ineffective treatment (tails heal poorly, especially in dogs whose underlying skin conditions might take weeks to resolve). 
  • Perhaps I was too quick to recommend amputation of the tail as a better solution than the slow, stressful, questionable recovery of a mangled tail. 
  • Perhaps I overwhelmed her with my explanation of the dog’s self-traumatizing condition as a potentially devastating behavior that might necessitate an e-collar for weeks or longer.
  • Perhaps I frightened her with my explanation that we had yet to address the dog’s skin and any other physical concerns, especially his advanced orthopedic issues––not to mention the internal issues we might find, as this dog had never had comprehensive labwork done.

In any case, when the owner’s tears finally brimmed over at the end of this discussion, I knew I’d gone way too far. This sensitive owner had required more delicate handling than I had anticipated. Next thing I knew, she was talking euthanasia. 

I was suddenly very confused, not having realized I’d hit her over the head so hard with all my cold, hard facts. I had advanced all my points carefully and optimistically, I’d thought. After all, this dog’s last veterinarian had left me with a clean slate, one I could do so much with that I was excited to get started on fixing this dog.

But instead, I’d left her feeling like all the work that would be required might be too much for her thirteen year-old dog. Somehow, my enthusiasm for healing her dog had fallen flat. I’d over-burdened her with my extreme honesty and lengthy discussion, something I guess her dog’s former vet had never done. 

At first I thought it was the money. Yet after explaining that everything would come in at well under a thousand dollars she assured me that the monetary concerns were incidental. She was simply concerned that her dog would have to suffer...perhaps for nothing. 

That’s when I changed my tack and backpedaled as hard as I could, assuring her that we didn’t have to make any snap decisions. Let’s clean up the wound, bandage it, go home on some Rimadyl and antibiotics and we’ll talk about it after the weekend. I even invited her to Dolittler so she could get to know the kinds of recommendations and discussions most vets now enter into. 

And, yes, the story has a happy ending. Though still reluctant to amputate the tail, she’s an ace at bandaging it. She understands it may take months and that it may still need to come off, but she’s more comfortable with the concept. 

So why the sudden change of heart? I’d like to think it comes down to Dolittler but I don’t think I can take the credit. A weekend on pain medication convinced this owner that her dog can still play at the park and enjoy life. Chalk it up to the life-saving power of very basic healthcare...despite the brutal honesty.

Sometimes it takes a powerful dose of this stuff...and sometimes we need to dial it down a few dozen decibels. Honesty may be the best medicine in some cases, but I’m now convinced it can also kill.