On December 13, 2008 I posted about the Emergency Clinic experiences of three different pet owners. Of the three, only the cat owner had what seemed like a really good outcome. At least her cat was still alive which was more than could be said of two dogs and one puppy belonging to the other two pet owners. Sadly, more has come to light about the cat owner's experience and I can't decide if I'm sickened or just furious. Here's what transpired. There will be no names mentioned, nor will I say where it occurred. It could happen anywhere, to any pet owner.
The pet owner in question is a medical professional so she's not an uninformed individual. She also adores her cats and dogs and has done a good deal of rescue work. Her health, of late, has not been what it should have been which has meant that she could only drive when she felt she could do so safely. (A recent surgery should have resolved that issue.) She had brought the cat to the Emergency Hospital as reported earlier, where it was discovered that he had ingested a piece of jewelry dropped by a neighbor's child, that had cut him up internally. You already know that he survived that episode but here's the short version of what I have discovered since then.
Complete bloodwork was done, hence, it should have been analyzed. He also had an upper respiratory problem. They would only look at one thing even though she had his care transferred to a specialist who specialized in respiratory issues. Not only did that specialist not check for that issue but the owner was told she'd have to make a separate appointment with the specialist at her practice for that. Nor did the specialist at any time talk with the owner on the phone. Further, they did not do a complete enough workup, despite having complete bloodwork, to tell her if there were something else going on besides the issue with the swallowed item.
Not being able to travel to the hospital each day, but calling many times around the clock, the hospital staff implied that she was a bad owner for not being at the hospital! Nothing could be further from the truth. She desperately wanted to be there but couldn't drive and there was no one to take her there. A friend who is an experienced cat owner and also has health problems, said she'd go visit the cat in the hospital. The owner made arrangements, calling to give permission. When the woman traveled all the way across town to the hospital, they refused her admittance to see the cat. The owner had never denied any tests or treatment, despite the cost. She was well aware of the fact that Emergency hospitals are expensive. She wanted the best care for her cat. And they would not allow a friend to visit in her stead to reassure her that she had seen the cat and spent some quality time with him.
You may be thinking that all of these things are trivial since the cat survived but there's more. The records were to be sent to her regular veterinarian so that he could follow up and would have the bloodwork. When the cat got sick again, becoming quite lethargic, she discovered that the records had never been sent to her veterinarian from the Emergency hospital. He had no opportunity to see the results of the lab work.
She took the cat to another specialty hospital to see a well-respected respiratory specialist along with another of her cats who was displaying respiratory symptoms. The older cat's problem is the result of something structural but she's essentially fine. She thought the younger cat's problem was his respiratory issue which seemed to be worse and wasn't responding to antibiotics
More bloodwork was done on the young cat at the referral hospital. The little guy had to stay to be rehydrated and he needed more tests to try to determine what was at the root of his problem. The resulting bloodwork showed that the young cat was in kidney failure! That should have been discovered at the Emergency hospital, had they properly interpreted the bloodwork. If they had sent the records to her regular veterinarian, he could have discovered the kidney problem and the little guy could have been started on subcutaneous fluids immediately at home to prevent exactly the dehydration and lethargy that resulted from lack of diagnosis.
Frankly, I call this bad medicine. I believe that it is important for veterinarians to look at the entire animal. Yes, treat the emergency for which he was admitted but if the bloodwork tells you that something else is going on, then tell the client that there's another problem as well. First Do No Harm. And why didn't they follow through by sending the records to the client's veterinarian? Why did they repeatedly infer that the owner is a bad owner? Why did they refuse to allow the owner's friend to see the cat when the owner had called specifically to give permission?
That hospital saved the cat from one problem but allowed his kidney problem to go undiagnosed when they had all of the information in their hands and added further to their mistake by not sending a copy of the records to the client's veterinarian. They allowed the cat to suffer because they missed the diagnosis or didn't care enough to properly interpret the bloodwork.
How many other Emergency Hospitals function this way? How many clients are mistreated? How many diagnoses are missed when the information is in the bloodwork results that are right in front of them? This could have happened anywhere. To anyone. This isn't a story. This is real. It happened.
My heart aches for this owner, this cat, and for all of those others who may have suffered from a similar experience.
By and large, veterinarians are excellent practitioners. Be sure you have fully investigated all Emergency options before you need emergency care. Ask questions. If the State Board keeps records of formal complaints, ask if there are any against that hospital or any specific veterinarians who practice there. Sadly, too few people report these issues. Caveat emptor: let the buyer beware.
Yes, the one "good" Emergency hospital in my previous blog post wasn't so "good" after all.
Showing posts with label Emergency hospitals. Show all posts
Showing posts with label Emergency hospitals. Show all posts
Saturday, February 28, 2009
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.
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.
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