Lost In The Sea Of Need. When the Vet Needs the Advice.
Hello Everyone,
While my usual blog posts are about my veterinary life's stories and experiences in an effort to educate and inform the public about the pet needs I see as imperative to overall pet health and welfare this post is different.
In this post I am asking for YOUR advice. Hard as I have tried I don't seem to have figured out how to come to peace with how to not feel compelled to help those pets and their parents in need.
The phone rings and someone on the other end of the line is desperately pleading for help for their pets condition that they cannot afford to treat elsewhere. We have gotten calls from across the country, the Big Apple (where everything is astronomically expensive), to around the globe (these are especially puzzling. How do I help you in South Africa?), to our own backyard.
Whenever possible we offer the following;
1. Come in for an exam and assessment. We will give you an honest opinion and reasonable prices. We are also full-service which implies we can do the work-up and surgery on premises. It is the whole reason we publish prices and cases.
2. We offer options. Options come in all sizes, shapes and scenarios. They can be life-saving and/or life changing.
3. A chance. Often we just offer a chance.
Some of these cases involve an ambiguous undefined disease process that after a quick exam are deemed "lost cause-leading to pro bono euthanasia". It may sound cold and cruel BUT life can be exactly that. We see cases that are so progressed and difficult the prognosis is grave and eminent. This is suffering without tangible hope to improve. These are the cases where mercy was overlooked at the last rest stop. These are the cases I feel compelled to intervene as the last option for empathy to provide peace. Even with these too-little-too-late cases; a client without resources, a pet dying in front of us, and no real way to provide even the most bare-boned plan for any chance at remission or cure, even then, SOME of these cases are not provided a consensual to euthanasia. If you think suffering is bad, dying without hope, or, hospice care, is worse. Despair is unavoidable, but, the crippling inability to relieve suffering is cruel and criminal. It is as unsettling as the suffering you know is occurring. It is where my words need to be concise, direct, and well-intentioned. For these cases clients have to step outside of their grief, their blame and their denial. These cases call for real-life intervention. They are not frequent but they do happen. I don't need advice for resolving these cases. I need advice for how to notify clients to avoid them in the first place.
We, the whole lot of us in veterinary medicine, need help in providing guidance so that too late isn't when we are sought to begin.
What is the most basic tidbit of advice I can give them?
Don't assume that you don't have any options, OR, wait so long that you don't have any left.
Here is a real-life example.,,
We received an email asking to help a dog with a suspected pyometra who was living in the DC area. The dog belonged to an older woman who didn't realize how sick her dog was. Her daughter was visiting and on inquiry was told that the dog hadn't eaten or gotten up in days. She rushed the dog to the local vet to be told it was likely a pyo and the cost would be upwards of $2,000. They, like many of us, couldn't afford this. They went online looking for affordable help. They found me, via this blog, and called the clinic looking for help. This was on a Friday. We offered to see them but explained that we don't do surgeries on Saturday or Sunday and urged that they call every shelter, rescue, and vet they could asking for a quicker surgery and a way to afford it.
The next time we heard from them was Monday morning. We saw them on Monday night. By this time the dog was almost in a coma. She couldn't stand, walk, or lift her head. Her color was purple-blue knocking on deaths door. She was labored to just try to breathe. They had $300.
I made myself a promise many years ago to never walk away from a pyo or a parvo. Two savable conditions that never survive with a death syringe, but often surprise you with skill and time.
The conversation with the owners went like this...
"I'm sorry." Anything and everything that could be said after was irrelevant and shaded with unneeded character references.
The conversation with the staff and associate vet seeing them was that they couldn't afford even the most pared down treatment plan. Three hundred dollars wouldn't get us past anesthesia and antibiotics. They needed a $500 surgery on top of these to remove the rotting uterus festering inside of her. Even if we offered to use the Good Sam Fund (overlooking that fact that they aren't a client) this dog needed to go to the ER after and that was going to cost at least $500. The ER isn't going to admit a dog without a deposit. If I had to guess I gave her a less than 10% chance of making it through surgery even if they had enough money for the intensive care she needed to provide any real chance at survival. It is not about the money, it is about what is fair for everyone involved. I didn't even think she would survive surgery and I felt that it wasn't right or fair to them to take the little money they did have for a patient who wouldn't survive.
When I explained this to the client she said she wanted to take her dog home.
While I had elected to withhold my previous chatter to spare the client from feeling any more sadness than they already did, it was time to be the advocate for the patient.
"What can you do for her at home? She needs medical and surgical help that you haven't been able to find elsewhere. I am afraid she will die on the way home, and even if she does make it home she will probably not make it through the night. How are you going to feel if that happens? What do you think you would want if you were in her position? She is dying and she is suffering."
After 30 minutes of deliberating they put her down. Everyone felt better after. It is something we don't often admit, but, peace can come after death.
The next scenario is the more common one...
The phone call goes like this...
Related Blogs;
Jarrettsville Veterinary Center For Clients With Financial Constraints blog.
Affordable Options Are Everyone's Right.
Rescue Economics. When The Expense Costs You Your Ability To Care.
While my usual blog posts are about my veterinary life's stories and experiences in an effort to educate and inform the public about the pet needs I see as imperative to overall pet health and welfare this post is different.
In this post I am asking for YOUR advice. Hard as I have tried I don't seem to have figured out how to come to peace with how to not feel compelled to help those pets and their parents in need.
 |
| Weasely's Story |
Here's the typical scenario...
Whenever possible we offer the following;
1. Come in for an exam and assessment. We will give you an honest opinion and reasonable prices. We are also full-service which implies we can do the work-up and surgery on premises. It is the whole reason we publish prices and cases.
2. We offer options. Options come in all sizes, shapes and scenarios. They can be life-saving and/or life changing.
3. A chance. Often we just offer a chance.
Some of these cases involve an ambiguous undefined disease process that after a quick exam are deemed "lost cause-leading to pro bono euthanasia". It may sound cold and cruel BUT life can be exactly that. We see cases that are so progressed and difficult the prognosis is grave and eminent. This is suffering without tangible hope to improve. These are the cases where mercy was overlooked at the last rest stop. These are the cases I feel compelled to intervene as the last option for empathy to provide peace. Even with these too-little-too-late cases; a client without resources, a pet dying in front of us, and no real way to provide even the most bare-boned plan for any chance at remission or cure, even then, SOME of these cases are not provided a consensual to euthanasia. If you think suffering is bad, dying without hope, or, hospice care, is worse. Despair is unavoidable, but, the crippling inability to relieve suffering is cruel and criminal. It is as unsettling as the suffering you know is occurring. It is where my words need to be concise, direct, and well-intentioned. For these cases clients have to step outside of their grief, their blame and their denial. These cases call for real-life intervention. They are not frequent but they do happen. I don't need advice for resolving these cases. I need advice for how to notify clients to avoid them in the first place.
 |
| One of the pets who needed us. |
We, the whole lot of us in veterinary medicine, need help in providing guidance so that too late isn't when we are sought to begin.
What is the most basic tidbit of advice I can give them?
Don't assume that you don't have any options, OR, wait so long that you don't have any left.
I need help in spreading this message!
 |
| Tammy |
We received an email asking to help a dog with a suspected pyometra who was living in the DC area. The dog belonged to an older woman who didn't realize how sick her dog was. Her daughter was visiting and on inquiry was told that the dog hadn't eaten or gotten up in days. She rushed the dog to the local vet to be told it was likely a pyo and the cost would be upwards of $2,000. They, like many of us, couldn't afford this. They went online looking for affordable help. They found me, via this blog, and called the clinic looking for help. This was on a Friday. We offered to see them but explained that we don't do surgeries on Saturday or Sunday and urged that they call every shelter, rescue, and vet they could asking for a quicker surgery and a way to afford it.
The next time we heard from them was Monday morning. We saw them on Monday night. By this time the dog was almost in a coma. She couldn't stand, walk, or lift her head. Her color was purple-blue knocking on deaths door. She was labored to just try to breathe. They had $300.
I made myself a promise many years ago to never walk away from a pyo or a parvo. Two savable conditions that never survive with a death syringe, but often surprise you with skill and time.
The conversation with the owners went like this...
"I'm sorry." Anything and everything that could be said after was irrelevant and shaded with unneeded character references.
The conversation with the staff and associate vet seeing them was that they couldn't afford even the most pared down treatment plan. Three hundred dollars wouldn't get us past anesthesia and antibiotics. They needed a $500 surgery on top of these to remove the rotting uterus festering inside of her. Even if we offered to use the Good Sam Fund (overlooking that fact that they aren't a client) this dog needed to go to the ER after and that was going to cost at least $500. The ER isn't going to admit a dog without a deposit. If I had to guess I gave her a less than 10% chance of making it through surgery even if they had enough money for the intensive care she needed to provide any real chance at survival. It is not about the money, it is about what is fair for everyone involved. I didn't even think she would survive surgery and I felt that it wasn't right or fair to them to take the little money they did have for a patient who wouldn't survive.
When I explained this to the client she said she wanted to take her dog home.
While I had elected to withhold my previous chatter to spare the client from feeling any more sadness than they already did, it was time to be the advocate for the patient.
"What can you do for her at home? She needs medical and surgical help that you haven't been able to find elsewhere. I am afraid she will die on the way home, and even if she does make it home she will probably not make it through the night. How are you going to feel if that happens? What do you think you would want if you were in her position? She is dying and she is suffering."
After 30 minutes of deliberating they put her down. Everyone felt better after. It is something we don't often admit, but, peace can come after death.
 |
| Sweet Baby Rae.. mom needed in patient help Baby Rae needs a home. |
I need help in figuring out how to not get cases at this point.
The next scenario is the more common one...
The phone call goes like this...
"The shelter/the vet I go to/my friend told me to call you and that you could help my pet...."
Nothing (yes, NOTHING!!) burns my butt like my neighboring vets referring cases to us that they can do, but don't want to do because the client lacks the money up front. These are YOUR clients and YOUR patients... Shouldn't they be YOUR responsibility? Or, do you just help those who can pay upfront? Take a note from our play book. Use CareCredit! Offer third party billing! OR, ask for help from your compassionate clients who WILL HELP IF YOU ASK! Heck, you might even get more Facebook likes and more clients because you CARE.Yes, these clients often have little to no available money, BUT, they all have desperate and dying pets. They all also have DEAD pets if someone who can help doesn't step in.
 |
| When one of our patients is surrendered at a shelter we go and get them. Beignette,, she needs a home too. What might happen if you surrender your pet at a shelter. |
So my friends,,
WHAT SHOULD WE DO? How do we make an impactful, meaningful difference for these pets?
For those of you who aren't familair with how we extend our help to our clients in need, here is a review of our policy;
1. We do not deny care to our patients when they are in need. Emergencies may need to be referred on a case by case basis, but, we will assist the pet if it is safe to do so.
2. We do not offer "economic euthanasia" (euthanasia as a means of treating due to financial constraints).
3. We provide multiple ways to pay for needed care.
4. We provide the option of signing over a pet to one of our affiliated rescues if the burden is more than the client can or will provide for.
5. The vet has the option of providing pro bono care IF they want to, IF the case has a reasonable chance of survival, and IF we believe the client can follow through with the after care needed to insure successful resolution.
6. We don't treat a good paying client's pet any differently than a struggling financially client. Their pets have exactly the same diseases, conditions, and needs. Financial profiling should be so distaseful and shameful that the profession should take a stand AND do something about it! WHAT ARE WE WAITING FOR? A MUTINY? A competitor to figure this out (P.S. It is my dream to have PAWBLY be that meaningful change for these animals).
 |
| Extension outreach foster family |
Here's where I need help!
- What should we do so that we can provide meaningful timely help?
- How do we extend that reach to people who aren't local?
- Can we convince other animal care facilities to be both the business and the provider when the situation is complicated and resources are tight? If we haven't been able to do it on the human side can we do it on the veterinary side?
- The rescues think the vets are the problem (we have priced ourselves out of accessibility AND we don't care), and the vets think it is the public's problem (after all if you cannot afford a pet you shouldn't have one). Meanwhile pet is sick and dying.. don't argue when the need is in front of your face.
- What does your vet do? Have you ever asked "what would happen if your pet needed something that you couldn't afford?" Are you prepared for the answer?
Thanks everyone for reading and contemplating. I am all ears.. let the ideas fly!
 |
| One of our TNR friends. |
Jarrettsville Veterinary Center For Clients With Financial Constraints blog.
Affordable Options Are Everyone's Right.
Rescue Economics. When The Expense Costs You Your Ability To Care.
If you want to help pets please reach out to me. Leave a comment here, join me on Pawbly.com, or find me at the clinic Jarrettsville Veterinary Center, Facebook at Jarrettsville Vet, Twitter @FreePetAdvice, or YouTube.
Together we can save lives! It is who we are and at the heart of every pet parent and animal lover.
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