Dognapping or misunderstood vet?

In My Humble Opinion
1

Here’s the sitch:

My wife and I and our four-month-old puppy were at my sister’s house out in the country this weekend (we’re going to be moving there in a month, so we’re getting it ready).

Puppy’s been really good all weekend, so we decide to start training her to not wander off when we let her off the leash. She does really well with us on the back deck, so we have her walk back to the barn/garage with us.

We’re al hanging out in the barn. My wife and I are getting tools, puppy’s sniffing around. Then she get very agitated, starts running back and forth and trying to vomit. We think maybe she’s been bitten by a spider. She vomits up breakfast, won’t let us look into her mouth, and repeatedly tries to crawl into a corner and hide. She’s whimpering and repeatedly swallowing.

This is 60 miles from our current home, so, not knowing what to do, we go through the yellow pages for an animal hospital. We find one that’s 15 miles away, and open on Sunday at noon, and we rush the dog to the vet. It will be $100 for a consult, they say. OK.

We get there, vet’s kind of a jolly smartass. Not a bad sort. Deflates my wife’s hysterical panic over our whimpering dog with some jokes, etc. Clearly overworked (we’re the 3rd emergency of the morning, he’s the only one there). Dog won’t let him examine her mouth, so he sedates her and tells us he’ll need to keep her for a bit to examine her. (This will likely cost more than $100, we presume, but that’s OK.) Call at 2PM, he says, and don’t worry–the dog will live, this is a young, active, responsive dog coming in under her own power w/o major breathing difficulty, not some 12-year-old hound who’s gone into anaphylactic shock and needs to be carried in.

We go back to the house, pace a lot. Call at 2 PM, answering service (his wife) pages him, no reply. Call back at 3PM, she pages him again, says he’s prob. just busy in surgery, etc., just wait. Around 4PM, he calls us back, says she had swallowed some wood splinters or small plant seed pod burrs, etc., and he removed four or five of them that were stuck in the rear of her throat. Throat is very raw, still, and, just in case it was a plant burr and the dog has some allergic reaction to it, he wants to keep her overnight for observation and keep her on a fast IV to help flush any toxins out of her system. We should call at 11 AM the next morning. (Definitely going to cost more than $100, we think.)

OK. We go home last night (nearly a 1.5 hour drive from the vet’s office). This morning, at 11 AM, my wife calls the vet. He says he wants to disinfect the rear of her throat one more time before he lets her go. Call back at 5PM. My wife complains that she’ll have to drive more than an hour to get there. He says, call at 4PM, and I’ll probably tell you to come get her at 5PM.

Wife unhappy, but I tell her to be patient, he’s probably overworked, he said he was going to be in surgery most of the day, etc. She reluctantly agrees, then calls our home vet on an unrelated matter (had to schedule an appt. for one of our ferrets). As she’s talking with them, she lets them know what’s going on with our dog. The vet’s assistant (nurse? tech? don’t know what her title is) says, that sounds really strange–we don’t even keep dogs in overnight for a spay/neuter. It sounds like that vet might be trying to keep her there longer than necessary, to fleece more money out of you. My wife calls me back, and we agree that she should return and get our dog released.

My wife’s already gone up there–vet left a sign on the door that he’ll be out 'til 4PM; answering service was very rude to her, she reports. She’ll be going back at 4PM.

My question (after this huge setup): Whaddaya think?

Is the vet prolonging her stay so as to get more money out of us?

Is he being overly cautious? (This seems unlikely, since he went out of his way to tell us that this was a minor issue, the dog would be fine, etc.)

Or is he just overworked, and used to a slower country pace (something my sister attests is usual out in that neck of the woods–not much hurrying going on), and doesn’t think it’s unusual to wait the whole day to get around to doing a followup check on a minor ailment (when, presumably, patients with more life-threatening situations may also be in the queue)?

2

Well up until your vet’s assitant busted out with that I was more inclined to give him the benefit of the doubt.

Now my guess is he is just an ol’ country Doc, and was waiting with the dog at 4.

What happened?

3

I’ve having my dog spayed tomorrow as it happens, and they’re keeping her overnight. I’m taking her in first thing in the morning (Tuesday), she’ll have the operation then, and come home Wednesday afternoon.
We checked around a bit (we were looking for a new vet) and they all said she’d stay overnight for spay surgery, so that’s not all that uncommon.

Your situation is a bit different, of course, but maybe he was just being cautious. Maybe he was really busy and wasn’t able to follow-up with her? Maybe her throat was worse off than he originally thought and wanted it to have more time to heal up?

4

Well, we got the dog back. My wife went to the office at 4PM and picked her up, w/ only some trouble. Dog was just fine, cost was not killer ($480ish–though he made an exceedingly unfunny joke that it was going to be $1500 at first). The doc seemed to recognize that my wife was upset with the office’s handling of the situation, but he didn’t seem to have the right social skills for such an interaction. Our final assessment: He appears to be (a) overworked and the office understaffed and (b) he is not really concerned about timeframes or about customer service. He does things his way, in his own time, and doesn’t really know how to deal with customers. The situation would likely have been greatly ameliorated if he had one vet assistant and a full-time receptionist. But oh well.

5

The Vet in the country most likely was overworked, extremely busy and was trying to do the best for your dog by keeping it for observation. He may not have handled it the best but in that situation sometimes it’s difficult to put in a lot of time talking to the owners when you are trying to care for the pets.

The person who was way out of line was the person who answered the phone at your Vet’s office. If she did indeed suggest that this other Vet may have been trying to “fleece” you that was very unprofessional. Many Vets may not keep spay/neuters overnight but other’s do and there is nothing wrong with that, it’s just an extra precaution. As for keeping an animal overnight after an emergency situation, that’s generally a good practice, especially if there are possibilities of complications.

6

Whoever you spoke to on the phone (most likely a receptionist, rather than a tech) is an idiot. She’s playing a fool’s game for a lot of reasons–she’s trying to make a diagnosis over the phone, she’s making determinations that she is not qualified to make about whether or not the dog needed to stay overnight, and she’s breaching professional ethics by badmouthing this other vet.

First thing they’ll tell you when you start in this field (usually before they even show you where the bathroom is) is that it is impossible to diagnose anything over the phone. You cannot determine an appropriate course of treatment for a problem you’ve never seen. It’s just not possible. This is usually a precursor to the first rule of your job–don’t give estimates over the phone, because you don’t know what we’re going to need to do. It also leads to the second rule of the job–don’t suggest treatments for problems we haven’t seen, because you could make the situation worse. What it sounds like over the phone isn’t always what’s actually going on. Just last night I had a woman come in because her cat had been chewing on a box of rat poison a few days ago and now had rectal bleeding. That description was right in line with a case of anticoagulant rodenticide toxicity, which would probably kill the cat by morning. Turns out the blood was from the vulva, not the rectum. She just had a UTI, thank god. Still, we would never have known if we hadn’t actually examined the cat.

And let’s face it, techs are NOT vets. No matter how skilled and well-educated we are, there are a lot of determinations we’re just not qualified to make. We don’t get to decide what kind of fluids a patient will be on, how much KCl to give a hypokalemic patient, which antibiotic to use, or whether an animal needs to stay overnight or can be discharged. Those kinds of decisions are beyond the scope of our training. We’re simply not able to determine whether your dog needed to stay or not. The chick at your regular vet, unless she has DVM after her name, is seriously overstepping herself and her qualifications.

Even if she was a vet, she had no business making a comment like that. None whatsoever. You never, ever, under any circumstances, criticize a vet to a client. You might mention that you would have maybe treated the case differently, or say that you usually refer patients to thusandsuch, but you do NOT insult a colleague. It’s a breach of professional ethics. Your vet needs to know what the staff is saying to the clients, because it reflects very badly on the practice.

As far as the case itself, my armchair diagnosis (even though it’s a fool’s game) is that he’s not done a thing in the world wrong. It sounds like she had a mild/moderate allergic reaction, and was at risk for a more serious one. With her throat already being raw (and probably a bit swollen from the irritation), worsening of the reaction could have made her choke to death. If it were my dog, I’d have wanted fluids and observation for her, and we often recommend exactly this for allergic reactions. (Allergic reactions that haven’t yet peaked aren’t stable, whereas most post-spay patients are, and if the woman you spoke to is too stupid to know that, she really has no business passing judgement on someone else’s treatments.) His treatment plan sounds fairly appropriate to me, based on the limited information available.

In any case, he made his recommendations, and you agreed to follow them. You were perfectly free to take her home Sunday night, or to decline the further treatment Monday and come get her that morning. He gave you options, and you chose to do what he thought was best for your dog.