The following are true stories. *Names have been changed to protect the furry and innocent.
The past few months have brought up a few emotional challenges as a veterinarian. But none more difficult than those cases and patients whose problems could have been avoided. On more than one occasion, technicians that I work with and myself have surrounded a patient as we said goodbye and more than a few tears were shed. It’s not only the situation that was disheartening, but also the circumstances of how we got there.
Maggie* was middle to older aged shepherd cross who was brought in to the clinic for vaginal discharge. The next question is always the crucial one…is she spayed? In her case, the answer was “no” and the diagnosis became much more suspicious for a pyometra. She was an otherwise healthy dog. Financial costs were a concern for Maggie’s family. Diagnostics were not an option, but more importantly, neither was treatment. Every attempt was made to find a financial solution that would work. Even a payment plan was offered of which the terms of could not be met by her family. Sadly, euthanasia was elected.
Gertie* was another patient who presented with vaginal discharge. She was a middle aged English Bulldog who had not been feeling well for a few days prior to her examination and her family needed to figure out finances. During surgery, I came across a significantly enlarged ovarian mass which was closely attached to the kidney. I was able to remove it, explore the rest of her abdomen, and finish the surgery.
Gertie took much longer to recover than we expected. We began to worry and ultimately went back into surgery only to discover an abdomen full of blood & clots. All of the ligatures were in place and we could not find the cause of the bleeding. Given the appearance of the ovary earlier, we were suspicious of a malignant tumor which may have weakened tissues or spread to other organs. With the constant flow of blood and no way to stop it, her family made the decision to let her go. I felt a sickness and surge of emotion as her heart stopped and the monitors went silent.
Two dogs and two different situations. In both cases, pets’ lives ended and the bond with their family broken prematurely. And patients like Maggie and Gertie are not the only ones; this happens almost daily within the veterinary profession. Myself and the rest of the veterinary team hate this part of our jobs. The knowledge that we can save lives and help animals, but in some circumstances fail to achieve that goal, is gut wrenching. A simple ovariohysterectomy years earlier could have avoided both of these incidents. Month after month, we end up euthanizing patients for potentially preventable issues. So where did we go wrong?
Oftentimes, the weakest link in this chain of events may be our communication. Many times, the discussion goes along the lines of “you should spay your dog and this is why” and it’s a very simple conversation sometimes. Perhaps we need to be more serious and real about it. As veterinarians & technicians, it is our job to advocate for the animals. It doesn’t mean we have to be the “bad guy” but we should be more stern about why preventative care is so important; and this goes for any disease or condition. Another thing to consider, is that we don’t bring it up as seriously as we should because we’re afraid to discuss costs and the lingering fear that clients will think we’re just “in it for the money.” Well, if that were the case, we would never recommend vaccinations, spay/neuter surgeries, or parasite prevention! We need to turn that perception around and at the same time help our clients in whatever way we can.
Many communities have low cost spay/neuter programs or vouchers that many clients don’t know about. More hospitals are starting “angel funds” to help subsidize pet care at the discretion of the clinic…so maybe that’s what we need more of. One suggestion I give to clients is to start a savings account for their pet. If an owner were to save just $10, $20, $25, etc. from each paycheck, it would help to get started on diagnosing and treating their pet in an emergency. This is not meant to be a knock on pet insurance but a savings option may put owners more at ease that they are still in control of how their hard earned money is spent.
I don’t have all the answers and maybe it’s a different solution for each clinic. The first step though begins with having that honest discussion with your clients. Aim for those preventative care steps to help avoid that unexpected heartbreak when you know you could have saved that pet. Pull up that chair and have a conversation, not a lecture. Don’t make it scary; let it come from the heart. Remember, lives and a bond are at stake.
About the Author
Dr. Ryan Llera is a small animal veterinarian at the Kingston Veterinary Clinic in Kingston, Ontario. Though originally from Florida, he married a Canadian (who is also a vet!) and they share their home with 3 cats, 2 dogs, 2 horses and a pet rat named Sherman. Ryan is also a regular guest writer for the Ontario SPCA blog. You can find more of his writing at www.drryanllera.com or see what else he is up to on Facebook & Instagram.