Let me tell you about a case I saw at the vet cinic last week. My shift ended at 6 and I was supposed to go to a kayaking class at REI at 6:30. At 4:30, my receptionist asked me if I could see a dog with bloody diarrhea. Since most of these cases are pretty quick appointments, I said sure. So we added Sassy to our already full schedule.
Sassy and her family arrived at 4:45, just like they said they would. I had seen her once before, although we aren't their regular clinic. The tech called me right into the room because Sassy did not look good. She was so weak she couldn't stand, her gums were pale, and her hear rate was elevated. This dog needed hospitalization and a relatively extensive work up. We rushed her back and started an IV right away. I then presented an estimate for about $600-700 for initial diagnostics and stabilization at our clinic, but I made it clear that she would then need to be transferred to a 24 hours facility for further care, at an additional expense. The owner ok'd the estimate and we got to work. This dog had multiple problems, including elevated liver and pancreas values, messed up electrolytes, and an extremely high white blood cell count. She was breathig rapidly and had a very painful abdomen.
After going through all of this with the owner, we decided to transfer her to the U of MN. However, after I called in the referral, the owner wanted to talk again. Turns out she was having second thoughts about going to the U. The dog was old(er) and they didn't have a lot of money. I managed to talk them in to at least going there for overnight hospitalization, as I really did not want to send this dog home. On occasion, I have eed known to bring sick patients home on IV's and house them in our bathtub, but this pet was too sick even for that.
During all of this, I had to see my routinely scheduled appointments as well. And wouldn't you know, I didn't get out of there until almost 7, too late to make my kayaking class.
A few hours later, the doc at the U of MN called me with an update. After spending several hours going back and forth, the owners decided to take the dog home against medical advice. They were really nice about it, but they told her they didn't have enough money for even the basic care. Shoot, if they'd been up front with me in the first place, I maybe wiould have taken the dog home after all. A night in the bathtub on IV fluids is better than a night at home with no fluids.
So of course I lost a little sleep over that one. Sassy was due to come in at 8 am the next morning for a recheck. What woould I walk into when I got to work? Would she make it through the night? Would she be in worse shape than before?
Pleasant surprise - Sassy was doing better! Not 100%, mind you, but maybe 50% better. I gave the owners yet another estimate. Actually, two estimates. One for another day in the hospital, and the second for outpatient treatment, which would be cheaper. Guess which one the owners chose? Yes, the first plan!
So she stayed in the hospital on IV fluids, pain meds, and antibiotics. I discharged her Friday night and saw her again for a recheck Saturday morning - she was almost back to her old self. She's having repeat blood work tomorrow. I would guess that the owners spent $1300 at my clinic, plus whatever her trip to the U cost.
I don't know why they declined treatment at the U, but let me do whatever the next day. Maybe it's because the dog was getting better and they were more willing to spend more money with a better prognosis. Maybe they just had a change of heart. All I know is that I wish they had been more honest with their limitations (although in the end there didn't seem to be that many) at the beginning of treatment. The U of MN vet felt really bad that she had to send her home that first night. If I had known the owners wouldn't have admitted her, I would have offered up my bathtub. I already missed my class, so I had the evening free after all.
At least the story has a happy ending. The dog is better, the owners are happy, and I got paid (which doesn't always happen in this business either - but that's for another post). I feel pretty good about all that.
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