Saturday, December 13, 2008

Emergency!

One of the most horrible things any pet owner can face is a sick dog or cat who requires emergency treatment when their veterinary hospital is closed and they have to rely on an emergency hospital. It can be the best, or worst, experience of your pet-owning life.

One of my friends had a horribly sick cat. He was bleeding and it was impossible to tell why. Off she raced to a nearby emergency hospital. The cat went into shock as soon as he was taken back to be examined. It was ultimately discovered, on x-ray, that he had swallowed something. No one knew what it could be since my friend is very careful to keep everything locked away and out of reach of a curious kitty. When he finally passed it, it turned out to be a necklace lost in my friend’s house by a neighbor child. It had cut the cat up so badly inside that the veterinary internal medicine specialist was amazed that he had healed so well. Fortunately, he is home and recovering although I doubt as much can be said for my friend’s bank balance. But that was not her consideration when trying to save her beloved cat’s life.

Others have not fared as well.

One of my friends is a delivery room nurse at a major hospital. She’s a dog breeder with a good deal of experience and her education helps her with veterinary emergencies. Her veterinarian had moved to a new house and didn’t have phones in her bedroom yet when my friend had a litter due imminently. My friend had spoken with her in the early evening and they planned a c-section but it appeared that the little mother-to-be had gone to sleep. She woke up in full blown labor and my friend couldn’t reach her veterinarian so she brought the little dog to the emergency hospital and told them she needed a c-section. They said they’d be the judge of that and took her back to examine her. They said she was quiet and put her in a quiet, dark room. My friend asked if they’d ever seen that breed before. They hadn’t. She told them that she’d been breeding them for a number of years and she c-sectioned her dogs because, as a man-made breed, she knew the pelvis of the mother is usually too small to accommodate the large heads that these dogs have. She didn’t want to lose a puppy. She also told them that the girl’s mother and sister both had needed c-sections because the puppies wouldn’t fit through the pelvis. Amazingly enough, they argued with her! She said she wanted to see the attending. Incredibly, they said there wasn’t one in house. They determined the puppy was in the birth canal but said they wouldn’t guarantee the safety of the pup. They wanted to give her pitocin (to increase labor). My friend told them the head was too big for the pelvis and pitocin would only serve to ram the head into unyielding bones and not do anything except to exhaust the mother and injure, if not kill, the other pups.

My friend told them that she was a Labor and Delivery Room Nurse and they said that the human model is not the same as the canine one to which my friend replied that the basics are still the same: the passage, the passenger, and the forces.

My friend was very frustrated because she knew what had to be done and all they had done was argue with her for 3 ½ precious hours! Time was quickly slipping by when they finally said they’d take blood and call the attending at home with the results. She asked if they could call him and have him come in while the bloodwork was done. They said it wasn’t the policy. They’d give him the results before he came in. When he finally arrived, after they made her sign papers that she had refused pitocin, they did the C-Section and the puppy was dead. She asked if the puppy was the biggest in the litter. The attending said it was the smallest. She explained that if he, being the smallest, couldn’t fit through, could he imagine what would have happened to the other four larger puppies if the dam had pitocin? He stared over her head. My friend was relieved to get out of there with the mother and surviving puppies. I keep thinking of that other puppy who was dead as a result of the unyielding intern who was obviously inept and uninformed and claimed to be following policy. They are clearly responsible for that puppy’s death.

And then, in another part of the country is an owner who had two dogs die, separately, in an emergency hospital. Her Toy dog was sprayed by a poisonous Colorado Bull Toad, and she had to rush him to the hospital in the middle of the night. They gave him a drug not tested for poisoning in dogs and he died as a direct result of improper treatment. The drug is meant to stop car sickness and she questioned that since you are supposed to make a dog vomit up poisonous material, not stop him from getting it out of his system. An incorrectly administered drug that hadn’t even been tested for that purpose.

Her other dog died because the hospital was in violation of a State code: they didn’t have proper staff on duty with proper credentials. The State in which she resides requires that a 24 hour emergency hospital have a board certified emergency veterinarian in the building. Twice she has been there when there has only been an Intern in the hospital, a direct violation of the regulations. They also said they couldn’t treat the dog, they hadn’t so much as x-rayed him, and they insisted he be moved which is something that shouldn’t be done with a critically ill patient of any species. By the time he got to the next hospital, where he was x-rayed, his lungs had filled with fluid. Nothing could save him at that point, no matter how much money she was willing to spend. He died at the second hospital.

What has happened to each of these owners and their dogs is unconscionable. We must demand better treatment and competent staffing. There must be more than the almighty dollar of importance to these emergency hospitals. There has to be accountability. If they cannot operate properly and with proper staffing then they should not be allowed to operate.

Then where will owners go? Well, I have to wonder whether there’s any difference between no emergency hospital and one that does such a disservice to animals and their owners that the end result is a dead dog or cat, a heartbroken owner, and an outrageous veterinary bill. Perhaps for those facilities the bottom line is really all that matters.

8 comments:

Anne said...

This is such a great article on such a sad, sad issue. You know my feelings regarding the so-called emerency vet. Thank you for blogging about this. Its been nearly a year since my experince and thankfully, I followed my head and my heart and still have my little fur-baby!!

Montana said...

I am right here with you............this is a great post.

Anonymous said...

The almighty dollar...

I too believe these hospitals need to have proper staffing, but they run into one problem. Money. People are outraged at the costs of veterinary bills, but they are miniscule when compared to that of a human hospital. Who here has gone to the hospital for a scheduled c-section and come out with a $2500 bill? A c-section will cost you and the insurance company tens of thousands. How do you expect a veterinary clinic to have staff equivalent to a human hospital when there gross income is so much less?

Darlene said...

For Anonymous (I wish you'd signed your name): I believe everyone expects to spend more for Emergency care. What they also have a right to expect is quality care, regulations met, and respect for the owner.
You mentioned the c-section. The c-section was requested and cost was not an issue with that client. The doctor on duty refused and wouldn't even call in the attending. The puppy died. The owner is lucky the dam and the rest of the litter wasn't dead.
The case of the poisoned dog being given medication that was contraindicated in a facility that was required *by law* to have a boarded emergency veterinarian on the premesis was clearly a violation of State law, let alone bad medicine. And the hospital that didn't even try to treat the emergency but sent the client to another hospital with a critically ill dog was just, in my opinion, unconscionable. People will pay. Many of us pay more for our pets than we do for ourselves. But, in turn, they deserve quality care for their animals. It's that simple. I have a good idea of how much money many specialists earn. I think for that kind of money, they shouldn't have someone else speak to the client but should do so directly. Yes, I know of that happening as well. Emergency care should equal quality care, not shoddy care. And that is the point of my blog post.

Montana said...

Thank you Darlene for the real up front answer to the prior post.

What was even worse was they made the dog go to another hospital after keeping him 7 hours and letting him get critical.
The bottle of medicine clearly states that the drug has not been tested in dogs or cats that have ingested poison.
Anonymous should put a name with their comment.

Dr Jeannie said...

Darlene,

Thank you posting this article, it all so sadly true today....

So great to see you educating the public, I'll be back here to keep an eye on this blog. :-)

Dr Jeannie

1800petmeds coupon said...

I won't comment beyond saying that in a moderately similar situation I made it very clear to the people in charge that I was going to call a lawyer if something wasn't done in the next 10 minutes.. and I was dead serious... and something, the right thing, was done. I also made them realize how serious I was by asking every single employee their name and how long they had been working there and the ones who were snippy at first were met with my question of "How exactly do you want me to detail to my lawyer how your attitude was to me when I asked you a simple question?"

Darlene said...

For 1800PetMedscoupon, Thank you for sharing the way in which you handled the situation. It put them on notice. It's a shame it had to come down to that. I'm glad there was a good outcome for your companion.