Big Dog Little Dog, or why I want to stay in school forever

[Editorial note: The VBB collective is pleased to welcome our newest member, VSBB! That's VS for Veterinary Student. Try to keep up!]

You may not know that it's a common saying in Veterinary World that the "unluckiest" pets in the world belong to veterinary students. No pet gets ill as often as a future vet's pet. My cat seems to have read the book on behaving like a vet student's pet while I was at orientation, because she woke me up the Saturday after the first week of class with one of those this-is-not-going-to-get-better-on-its-own-but-it's-not-really-an-emergency problems. Sigh. I called the vet's office and they very kindly fit us in that morning's schedule.

We arrived for our appointment. I talked to the tech. The doctor did her thing. I headed to the front desk with medications and a slightly miffed cat.

As one receptionist presented me with the bill and took my payment, a couple walked into the lobby. They wanted to make an appointment for their maltese, who had been involved in what we like to call a Big Dog Little Dog altercation. No, they hadn't brought the dog with them. She was at home, because it was easier for them to come to the veterinary hospital to make an appointment than to call. Okaaaay. The other receptionist offered the couple some appointment times, they agreed to one, and the receptionist did what all good receptionists do: she let the clients know they needed to provide a vaccination history for the dog. If the dog wasn't current on her rabies vaccine, she would need to get one before being discharged, because it's a legal requirement. It's also a good idea in case the dog who bit her might be rabid, but the receptionist didn't get into that. I don't blame her, because:

Ready? Here's what these people said over the course of less than three minutes:

• You can't give her a rabies vaccine! It'll kill her!
• But she's old!
• You know, I think vaccines make them sick. My friend's dog got a vaccine and she got sick.
• Listen, she can't breathe well. You're going to have to kill her.
• Do you want me to go to a different veterinarian?
• How would I know her history? She's from Arkansas.
• How would I know if the other dog has been vaccinated?
• I don't want to talk to the veterinarian about it, I just want her to be seen! She needs stitches or something!
• I can find someone else who will care about this.
• She's 10 years old. She's going to have to die.

Let's ignore that this dog probably should have gone to the emergency room, or at least come along for the ride to make the appointment so the vet could see her promptly. Let's pretend that veterinary records can actually cross state lines via the magic of these things called mail, fax and email. Let's assume that it's totally acceptable to treat polite, professional receptionists with yelling, a bad attitude, and refusing to respond logically to what they say. Let's agree that 10 really isn't old for a small dog. We may also be able to agree that the average land shark maltese is far too mean to die young, but I don't want to make assumptions about what kind of dogs you've got at home.

How on earth is the staff of a veterinary hospital supposed to respond to people who seem to want a) proper, if delayed, treatment for their pet, b) to refuse proper, routine care for their pet, c) to threaten to take their business elsewhere, d) to talk nonsense, e) to deny that rabies is a public health issue that might become personally relevant via their own dog, and/or f) to insist that a receptionist kill a patient?

I was relieved to be able to walk out the door of the clinic before the resolution of this conversation. That I was relieved makes me so sad. Sure, I don't have to have these conversations while I'm in school, but I've got a career's worth waiting for me when I graduate. 

And you know what else? My cat may keep getting sick the whole time I'm in school, but she's not even close to the unluckiest pet out there. I may not have a ton of time, or a lot of money, but if she's in a Big Cat Little Cat incident, you can bet she's going straight to emergency. It just hurts my heart to think about that poor land shark maltese suffering at home while her owners wasted time and added more misery to the world. I'm going to school to argue with people who won't let me take care of their dog?

Is there a big black market for replacement chinchillas?

Yet another VBB sympathizer has graciously provided this guest post for our poor, neglected blog during this long hot summer. Thank you, Dr. C. Lanigera!

My story is from several years ago when I was an intern in avian and exotic pet medicine. The background on this story: One of the boarded specialists was taking call for me one evening so I could have a much needed night off. An emergency call came in regarding a chinchilla who had gotten his leg stuck in between the bars of his cage. When he arrived at the hospital, the leg was pretty much self-amputated mid-tibia, so my boss cut off the dangly bit, bandaged the leg, and admitted the chinchilla to the hospital for surgery the next day to perform a proper amputation at the level of the knee - any lower and you risk pressure/rubbing sores. This all went down around the same time as the ACVS conference and so we only had one surgeon available at the large referral hospital where this happened. Because of this, the chinchilla's surgery didn't take place until late afternoon the next day, making it necessary for him to spend an extra night with us in the hospital to recover. So to recap: Chinchilla presents in the wee hours between Weds and Thurs. Late Thurs afternoon, the Chinchilla has his surgery, and has to stay until Fri for release. On Fri, the fiancé of the owner comes to pick up said chinchilla. He is happy, understands the discharge instructions, greets the chinchilla warmly, and takes him home to heal. On the following Monday, the owner of this chinchilla, followed by her fiancé, marches into the lobby of our hospital with the chinchilla in one of those giant exercise balls and plops him, ball and all, down on the counter... 

...This is where the story gets good. 

She asks, quite sternly and accusingly "Where is my chinchilla?! THIS is NOT my chinchilla! I DEMAND my chinchilla RIGHT NOW!!!"

She then proceeds to whip out a yellow folder full of photographs of said chinchilla, holding them up next to the chinchilla in the exercise ball, and insisting that the fur pattern on the chinchilla in the ball is different than the pattern on the one in the photo. Our poor receptionist is just baffled and trying to keep this woman calm and keep her from making a scene in the middle of our busy lobby. She went to get the client coordinator and put her in a room. Unfortunately, the doctor who had overseen the whole case was off on Mondays and was not in the hospital. Our other boarded specialist was sent in to try and smooth things over. This woman would not budge on her story. She genuinely believed we had given her a different chinchilla. I was eventually asked to come into the room to talk to her, as I was also involved in the case. The witness to her crazy was unprecedented and 4 1/2 years later, it's still one of the oddest complaints I've ever been a part of. 

"This is NOT my chinchilla! He's not the same! Before surgery he ate mostly pellets, but THIS ONE wants to eat hay!"

I countered with us offering large amounts of hay in the hospital as it is better for their digestive tracts than pellets alone - maybe he liked the taste of hay once it was offered to him.

"But he's MEAN now! He used to never bite and all weekend he was nipping at us!"

"Ma'am, Your chinchilla just had SURGERY to amputate his LEG. He's been in a strange place for 2 days and experienced a significant amount of pain. We did what we could to control their pain before, during and after surgery and sent him home with oral pain relievers, but I'm sure his surgery site is still tender and he's getting used to walking around with only 1 hind leg. All this, I'm sure, is very scary to him. I can understand if he's a little cautious or aggressive." (BECAUSE OMG HE JUST HAD HIS LEG AMPUTATED is what I wanted to say)

"Look at this picture," she said, shoving a slightly grainy photo of a chinchilla printed on a piece of inkjet paper in my face, "TELL me this is the same chinchilla, because I think their fur patterns are different - you can see stripes in the fur pattern around THIS chinchilla's leg stump! My chinchilla didn't have those! SEE?!"
I told her I thought the two looked very similar and I couldn't really tell a difference. I could neither confirm nor deny this was the same chinchilla as the one in the exercise ball. I told her she probably is seeing the stripes in the fur pattern because the fur has been shaved short enough to see the nuances in the skin. This is typical of all grey chinchillas. 

This woman legitimately thought that something had happened to her chinchilla and it had died, so to save face, we had amputated the leg of a NEW chinchilla to give to her, AS IF SHE WOULDN'T NOTICE. Yes. Seriously. That's what she thought.

Her fiancé sat in the room with all of us the whole time, eyes wide with shame and embarrassment over the whole situation. I asked him, as the one picking up the chinchilla, if he had noticed a difference then. When he tried to speak, she cut him off stating HE wasn't the owner and wasn't qualified to make that determination. 

I told the woman that I was the doctor who took over her chinchilla's case the morning following his admit to the hospital. I arrived at 7:30 that morning. He had been admitted around 3am. There  was at most a 4 hour gap, in the middle of the night, where a "switch" could've happened. We had no other chinchillas in the hospital until after this one's leg had been amputated. There were cameras all over our building for security reasons. We told the woman, if she needed more proof, we could provide camera footage tracking the chinchilla's whereabouts during his entire stay with us. We had saved the original amputated leg, which we put on hold for a while, in case she came after us legally. Maybe we could use it as DNA evidence. It was absurd. 

Her defenses weakened, she said one more time, deflated, "I still think it's a different chinchilla..." ...and with that, she picked up her chinchilla in the ball, her stack of photos in their yellow folder, and her dejected fiancé meekly followed her as she marched back out of the hospital. 

At least I got a great story out of the whole thing! You can't make this stuff up, folks!

Clients behaving badly

I think this behavior is a little over the top. Your dog dies so you beat up your veterinarian? Really?

I remember when I was in school, we had a dog in our ICU who was hanging on by a thread pretty much during my entire ICU rotation. I don't recall specifically what was wrong with him, just that I had to check his vitals every 15 minutes all night for several nights in a row, and they were never good, and I frequently had to page my resident, which is never fun, and it didn't at the time seem to me that this dog had any real chance of going home.

At some point toward the end of my rotation, this dog started actively trying to die again. This time, for whatever reason, the owner of the dog got mad. Having received yet again a phone call from the supervising veterinarian asking him if he wanted full resuscitation or if we should euthanize or let the dog go, he apparently hung up the phone without answering, and arrived at the building moments later (he must have been on his way in for a visit or something). He stormed past the security desk and headed into the ICU and just started pushing and shoving and yelling and knocking over IV poles and basically clearing a path to the dog - in whose cage I was sitting, because I was bagging him at the time. Luckily the security team was right behind him and they had him out of there pretty fast, because all I could think at the time was how upset my mom was going to be if I was killed by some maniac client before I even graduated.

Anyone else ever find themselves on the wrong side of a client's fists? Officer Cynical, I'm not talking to you here :) (though I'm sure you can share plenty of fun stories) (and you should feel free to do so)

Skunk

Wanted to share what I found to be a particular giggly kind of day here at the VBB this week.

Had a really great client call in for an exam for his dog.  Just a wellness exam, no biggee.  But when he arrived at the clinic, my staff came running to me telling me we had to change the plans and have him go around back to the exam room we have for contagious animals.  I asked why, and they informed me that the dog had obviously been sprayed by a skunk and was really stinking up the lobby.  They had to open the windows to let some fresh air in!

So I said OK, and went around back into the room.   A little skunk spray isn't gonna kill me.  And my own dogs have been sprayed multiple times, so I wasn't too concerned.  I was, however, concerned about the dog's well being (direct hit skunk spray can cause harm) so I wanted to make sure we took good care of him.

Upon entering, I realized the dog was doing GREAT.  Bouncing around, happy, not squinting his eyes or anything that you often see when they take a direct hit to the face. 

So I bent down to check him out, when it "hit" me.

Doggy hadn't been sprayed by a skunk.   The owner hadn't been sprayed either.

Nope.  This wasn't that type of skunk.  This was THAT type of skunk.  You know, good ol' Mary Jane.  Doobage.  Reefer.  Happy Plant.

Yep, the owner was sooooo high on some really high quality marijuana that he literally reeked of it, and my staff didn't recognize the smell - it is called "skunk" for a reason.  And yes, it smells just like a skunk.

So after some really good laughs, and after a particularly lovely conversation with the extremely happy owner (he told me he looooooved me) I found the doggy to be fine and normal and no other problems were noted.  Thank god he wasn't sharing with the dog!   He wasn't, and all was well, and we sent them on their way.

I also realized at that point in time why someone else drove him.   :)