Tuesday, January 06, 2009

Do you practice what you preach?

My best friend asked me an interesting question yesterday, after getting the response to the standard question "what did you do today?". She asked, "how often do you actually do what you tell your clients to do?"

Well, frankly... not often. You see, I know better. What I tell my clients is what I need to tell them to give them the best chance to get through a circumstance that I don't necessarily know the outcome to. This presumes that they don't know what an infection looks like, that they are going to let their animals go play at an off-leash dog park after major surgery, that they don't recognize subtle pain in their pets, and all sorts of things that I know that I won't do. But I don't know that you won't do them.

So yes, I neutered my cat on a whim, not fasting him the night before. My logic - he's 9 weeks old, I wouldn't have fasted him for more than an hour or two anyway due to his age. Granted, the time and situation was dictated by boredom rather than careful planning ahead, but surgery is surgery. I had time, space, material, and help while doing it, which is all I ask for.

I didn't give him as much anesthesia as I would have given a client's cat in the same circumstances. I give my patients the amount of anesthesia that they need so that I can be positive that they will not wake up during the procedure, that they won't remember it, or feel any pain. In my own cat, I gave just barely enough to finish the procedure - knowing that he would wake up faster and that I would be on hand to monitor his recovery and pain levels very closely. Is this hypocritical? Maybe. Is this something that was in Alexander's best interest? Yes, he recovered quickly, he was a known quantity to me, and I ensured that his pain was well controlled. Is this something that I should be maybe doing with all my clients' pets? Should I be using the lowest possible dose of anesthesia so that they have fast recoveries? Probably not. In this situation, I was not going to be leaving Alexander overnight at the clinic, he'd have to be awake and alert that evening at home. 99% of our surgeries stay overnight, and they are able to have a slow recovery in an enclosed area where their pain and mobility is managed. I don't think that I would *trust* most of my clients to have a pet home that night - what if the pet fell down the stairs, started bleeding, started chewing at the incision, etc. I know what to do and have the resources to deal with it - others don't.

I took Xander home the same night, letting him even play with my older cat. Again - I was able to gauge his level of alertness, and recognized if I'd gotten him in over his head. If he hadn't been able to hold his own at home, he would have been restricted to a single room or a crate to recover without interference. Would I trust my clients to make this same assessment and decision... no.

I guess what it comes down to is that I assume the lowest common denominator for my clientele. And while I've often been pleasantly surprised to find out that they are more competent, observant, or rational than the average person, as often as not I find out that people are making decisions that aren't in the best interest of their pet.

Also, I'm one of the biggest culprits for telling people to bring their pet to the veterinarian. I cannot diagnose things over the phone - god knows I've tried. In fact, yesterday I diagnosed constipation over the phone. Today, after having set up all the materials needed for the 9:30 appointment and enema... there was no stool in the colon. At all. Boy, did I feel silly. I have best guesses and gut feelings. But unless you have had the opportunity to at least hear about a possible diagnosis, if not have seen it or treated it yourself, it's very difficult for you to look at something and know that it is or isn't something that needs medical treatment.

I'm starting to realize why veterinary school is shaped the way it is. It's a fun feeling.


Anonymous said...

Thanks for leaving a comment on my sight. I can't find your email address to respond to your comment, so I came here.

Cushings is the first thing our vet suggested but was ruled out by a blood test. From what I've read of the disease online, it seems to fit. They did a T4, too, and his thyroid was fine.

Thanks for stopping by and offering suggestions. I really appreciate it!

Anonymous said...

...got any suggestions on the constipation thing? My kitty's 10 and I think his gut may just be giving out on him. He had an enema on Monday and it doesn't look like he's pooped since then! Despite the oil I've been giving him every night, like the vet told me to!

Kat said...


There are a whole bunch of reasons that cats can be constipated, including kidney disease, other metabolic disease (diabetes, hyperthyroidism), dehydration, hypomotile colon, etc. I'd recommend sucking it up and asking the vet for the full workup (all the bloodwork) and asking them for an honest prognosis on how this is most likely to play out based on their experience. The more information you have, the better you can decide how to proceed with treatment and maintain his quality of life.

Junior said...

Thanks for visiting Junior's blog he loves all things animal so will be very impressed that you are a vet.
I was looking for an email to send you his contact info but couldn't find one. our email is hjoythom@yahoo.com