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Friday, May 29, 2009

I can...but should I?

I have been thinking about my job lot lately. Thinking about how our business is growing in one direction and personally I am growing in another direction. All the messages I receive are to practice the best medicine possible. This comes from continuing education, journals, personal communications, etc. We all strive to do our personal best and I am no exception. But more and more 'best medicine' seems to be synonymous with 'spend big money'. I do tend to watch out for my clients pocketbooks above my own, so perhaps this is just my own hang-up about money rearing its ugly head.
More and more people (especially in the more urban of the two clinics) see their pets as little people. I might be better off working with livestock, fewer messy emotions. No internal deliberations on my part...she just lost her job, can't afford to pay rent and here I am telling her her cat NEEDS a dental -its the best medicine I can provide. I don't like laying guilt trips on people, hmmm maybe another hang-up of my own as i am exquisitely sensitive to guilt trips.
I think it was easier (on me) when I could say -your cat is yellow and has lost 1/2 its body weight-you need to put her to sleep. Now I am legally obligated to say I MIGHT be able to save her with xyz diagnostics and hospitalization and it will cost about $1000. If this was a nice heifer and it made financial sense to try to save her -great. But this is a cat -how do you measure up the benefits of companionship and the affection you feel for her? The human-pet bond is an amazing thing but when it goes bad it just tears me up.


ChristyACB said...

I didn't know there was a legal obligation to give the other recommendations.

3 of my 4 cats have passed since January of 2007, including one in November of 08 and then in April 09. All were very old and 2 had been with me since bottle feeding them as rescues. The last I got after she already had mammary cancer (though she lasted more than 2 years which is amazing).

It is super hard after being with an animal so long to lose them, but after the new-car price of 3 weeks of treatment for the first one, only to have her on 3 machines that would keep her alive temporarily, I learned a lesson. I do more treatment at more expense than most, true, but I lost a lot of trust for my vets. They seemed far too invested in survival vice happiness.

I finally had to tell my vet that living in horror such that all that was left was that, rather than the wonderful life up to that point is not what I would want and I don't think they would. Even then she was reluctant to put her to sleep. (She was eaten up with cancer at this point, had to be force fed and needed a tube, required sub q fluids, hard time breathing due to lung cancer and no balance or ability to walk due to weakness and low o2). How hard is it to say to a client who is in obvious pain that they aren't gone far enough yet to justify putting them to sleep? Horrible. Horrible.

And seriously, this is after 2 years of me daily following every surgery and every treatment and ever chemo like clockwork so it wasn't like I was trying to ditch her.

And now my old man beagle has melanoma on his eye. I love his soulful brown eyes so off to the specialist for lasering we go! Argh!

But, like you said, they are more than just animals to most people. For me they are fast friends. Been with me longer than the kids and they are out of the house now! They've traveled the world with me on vacations and for our job. They've put up with being drooled on by babies and ignored by moody teens. Yet they always are there with a purr and a snuggle at the end of the day. Who can beat that?

Vets are in a terrible spot, I think. Specialists are often so eager to get a paper out of something that they give slightly inflated ideas about surgery that is totally experimental (such as complete bowel removal and supposedly a cat can survive?) and GPs are often torn by the pity of an owner who wants to help but just can't. So money is spent wrongly...too much on a lost cause and not enough on one that might survive.

I don't envy you that job. Not at all! It is a hard one full of heartbreak and hard choices and even harder recommendations.

hickchick said...

Thanks Christy-its good to hear from a pet 'Mom'. It's called informed consent and is driven from a need to cover your ass. The information age means the 'standard of care' is the same for the sticks as it is in a very affluent urban setting. just another symptom of my burn-out that i let it get to me instead of rolling with the changes. :)

Meadowlark said...

We had this issue just the other day. I felt like the meanest person in the world when I told the vet to put our 14-year old dog down. He'd had a stroke and couldn't move his back legs, and call me mean, but what the hell kind of life is that?

I understand that pets are like family to many, but they are not people. I've seen people go to more effort to help a stray pet then they do a homeless kid. It just frustrates me. Rant over. Sorry.

Sue said...

I had a cat named Alex-16 years old. He started declining. I took him to the vet. I was given different options.....of course I made the "effort" to prolong his life. I LOVED my cat. The vet tried many different things, but lets face it-Alex was SIXTEEN. After 3 weeks of varying "treatments" (at a cost of over $300 we didn't have), my husband finally "put him down"....while I was in town grocery shopping. Frankly, all I was left with was the feeling the vet was a money-grubber. I truly do not mean offense......this was just my feeling at the time. I guess I never saw the other side-that maybe the vet really cared. But, in hindsight, I also know I would NEVER go through all those treatments again. So, another viewpoint.

Ruralrose said...

Wow I certainly don't envy you your position. Probably started out wanting to help animals and now your job has turned into caring for the needs of people. I love my animals too but I join in with Meadowlark about how we sometimes treat pets better than people. Catch 22 and irony all at once. Your tender heart and powerful compassion are telling you something is amiss and the constant work pressure to keeping you from acknowledging it properly. Times they are a changin' . . . and that can be a very good thing. So wonderful a kind woman like you is a vet, hope you feel better about things today, peace

livinginalocalzone said...

I have never had a pet or tended for an animal in another way, but what you describe is one of the hardest parts I can imagine whenever I start considering having an animal to care for. I don't know what to say, its just rough.

hickchick said...

Not having pets myself (yeah like the contractor whose house is never finished) I tend to look at pets in a very rational way. That is where the conflict comes from. Our business is shifting away from that. Thanks for all the feedback, this gives me alot of things to think about! Kris

Gina said...

I was in this field for many years too and left it for many of the reasons you mention.

I also found myself overly attached to animals in my life to a point I was being cruel to keep someone living past their quality of life (my 16 yo dog who like Meadowlark's had a stroke).

I never thanked you for your supportive comments when I had to make the decision to put down the two young livestock killers. I have to say it was the hardest decision I have ever made and if the vet had given me other options (ours supported our decision) besides euthanasia, the decision would have been harder to make.

I agree with the others that it is good a kind person like you are in the field.