So--to all 2 people who read this blog, what do you think about vets selling drugs?
Perhaps this is more of problem in the equine part of the industry, but commonly I am asked to sell drugs to people who like to "play" veterinarian. They are diagnosing and treating their own horses. One guy today was injecting his own joints! He wanted me to sell him all the necessary drugs, sedation, and syringes for him to do it. Maybe I'm just being a prick, but if I'm going to do that, then I'm going to inject the joint too-- then at least I know it's being done correctly, humanely, and cleanly. Furthermore, if there are complications (let's say at 12am, because they're never at normal times), do I have any obligation to help these people? I feel sorry for the horse, but that puts me in a tough position.
Sorry, but I paid $130,000 to learn how to do that, I'm not going to sell you drugs so that you can do it on your own. Don't chastise me for being "young" and "scared". Don't misinterpret it--I'm just being ETHICAL.
Tuesday, April 24, 2012
Tuesday, April 17, 2012
Wowza
With the sudden increase in appointments seen, also comes a sudden increase in "What the heck?!" moments; sometimes I have multiples a day even. Here are just a collection of short rants to my most favorite people:
1) No you can't be seen today. Especially when you call at 3:00pm demanding your horse be vaccinated before 5:00pm. Please don't give me attitude when I schedule you for the next day and tell you your Coggins won't come back for a week unless you pay double to have it overnighted. You have a YEAR to get these things done. It's not my emergency when you wait until the day before you need them.
2) Don't call my personal cell phone 5+ times then leave a message saying "So sorry to bother you, but..." You ARE bothering me. You're calling my personal cell phone. You're calling my personal cell phone 5 or more times.
3) When you page a veterinarian for an emergency at 12:05am, please do not keep me on the phone for 30 minutes talking about your chronically foundered horse's life story. He's foundered again because you gave him unlimited access to green grass. Yes I am sure. No I do not want to come out at 12:30am to come see him. I can put you on the schedule for tomorrow morning (or is it this morning?). No, you don't want that?? Ok. Then why'd you call the other vet in the practice the next day saying you'd "rather have a male vet" while giggling like a total creep. Wow.
4) I can only get to emergencies as fast as I can drive. When I say that I'll be there in 30 minutes, don't say "That's not fast enough!" Would you like me to jump in my personal helicopter?? Lord knows I'd much rather be sleeping than seeing your horse at 11pm on a Wednesday, but I'm still doing it. Don't be a total jerk.
5) When I see your downed horse that is a BCS of 2/9 and is so dehydrated that its eyes are sunk in, don't waste your breath trying to convince me that you take care of it. Obviously, you don't.
Among these righteous, annoying, and downright rude people, there are plenty of clients who are polite, kind, and altogether wonderful. Thank God for those people, otherwise I'd be quite bitter towards the world in about 3-4 workings days.
1) No you can't be seen today. Especially when you call at 3:00pm demanding your horse be vaccinated before 5:00pm. Please don't give me attitude when I schedule you for the next day and tell you your Coggins won't come back for a week unless you pay double to have it overnighted. You have a YEAR to get these things done. It's not my emergency when you wait until the day before you need them.
2) Don't call my personal cell phone 5+ times then leave a message saying "So sorry to bother you, but..." You ARE bothering me. You're calling my personal cell phone. You're calling my personal cell phone 5 or more times.
3) When you page a veterinarian for an emergency at 12:05am, please do not keep me on the phone for 30 minutes talking about your chronically foundered horse's life story. He's foundered again because you gave him unlimited access to green grass. Yes I am sure. No I do not want to come out at 12:30am to come see him. I can put you on the schedule for tomorrow morning (or is it this morning?). No, you don't want that?? Ok. Then why'd you call the other vet in the practice the next day saying you'd "rather have a male vet" while giggling like a total creep. Wow.
4) I can only get to emergencies as fast as I can drive. When I say that I'll be there in 30 minutes, don't say "That's not fast enough!" Would you like me to jump in my personal helicopter?? Lord knows I'd much rather be sleeping than seeing your horse at 11pm on a Wednesday, but I'm still doing it. Don't be a total jerk.
5) When I see your downed horse that is a BCS of 2/9 and is so dehydrated that its eyes are sunk in, don't waste your breath trying to convince me that you take care of it. Obviously, you don't.
Among these righteous, annoying, and downright rude people, there are plenty of clients who are polite, kind, and altogether wonderful. Thank God for those people, otherwise I'd be quite bitter towards the world in about 3-4 workings days.
Monday, April 16, 2012
Sorry!
Sorry for the slow posts. Spring time has hit in full force and without warning. We went from being kind of busy to full-tilt busy. I have been compiling a long post in my head-- so that will be coming soon. It will be a long rant...I will be back soon; albeit, probably not as often as previously. Since I've eaten my Ramen noodles, onward to finish the last half of the day!
Wednesday, March 28, 2012
Heart Wrenchers
Sometimes you have cases that disturb you so much that they literally alter your attitude, happiness, and frame of mind for 24 hours or sometimes even more. Unfortunately, I had one of these last night.
I'm not sure why this one bothered me so much. I have performed plenty of euthanasias. Sometimes they make me sad, other times, I'm relieved that the suffering of the animal and humans can finally be finished. This euthanasia was no different. The horse was suffering, and there was no doubt that it needed to be done.
Perhaps it was because these clients have had the worst horse luck of anyone I've known in the last year. They're incredibly nice people who are trying to do things right, have decent facilities, nice horses, and genuinely care and love their animals. In the last year, they've had to put two horses asleep (now three), and have had two of the nastiest lacerations that I've ever seen. I just want something to go right for these people!
Their horse had looked as though it got tangled up in the fence. However after some detective work, it appeared that it got kicked (a strong blow that broke its olecranon and possibly its humerus too) and then fell into the fence. Of course, the horse was young, extremely gentle, and trustworthy. It broke my heart to have to euthanize that horse. It was in extreme pain and unable to move the broken leg. I hate acute injuries that are just "bad luck" and nothing else. "Bad luck" is the story of this poor client's life.
That heart-ache has bled over into today. Some days it can be hard to just get up and do it all over again. Being a veterinarian isn't all puppies, kittens, and happiness.
I'm not sure why this one bothered me so much. I have performed plenty of euthanasias. Sometimes they make me sad, other times, I'm relieved that the suffering of the animal and humans can finally be finished. This euthanasia was no different. The horse was suffering, and there was no doubt that it needed to be done.
Perhaps it was because these clients have had the worst horse luck of anyone I've known in the last year. They're incredibly nice people who are trying to do things right, have decent facilities, nice horses, and genuinely care and love their animals. In the last year, they've had to put two horses asleep (now three), and have had two of the nastiest lacerations that I've ever seen. I just want something to go right for these people!
Their horse had looked as though it got tangled up in the fence. However after some detective work, it appeared that it got kicked (a strong blow that broke its olecranon and possibly its humerus too) and then fell into the fence. Of course, the horse was young, extremely gentle, and trustworthy. It broke my heart to have to euthanize that horse. It was in extreme pain and unable to move the broken leg. I hate acute injuries that are just "bad luck" and nothing else. "Bad luck" is the story of this poor client's life.
That heart-ache has bled over into today. Some days it can be hard to just get up and do it all over again. Being a veterinarian isn't all puppies, kittens, and happiness.
Wednesday, March 21, 2012
May-rch!
This week has been a whirlwind so far. I have no idea how it's only Wednesday since each day has lasted 12-14 hours. It has also been in the low 80s which is unseasonably warm for the area. Because of this everyone remembers that they have horses; horses to vaccinate and horses that have been lame, oozing pus, lacerated etc. I have been sweating way more than I should, and I'm getting cranky.
Onward to three on-call weekends in a row. This means I'll be on call for 26 straight days. Hizzah!! I will probably have some good blogging material. Stay tuned...
Onward to three on-call weekends in a row. This means I'll be on call for 26 straight days. Hizzah!! I will probably have some good blogging material. Stay tuned...
Saturday, March 17, 2012
Writing Letters
Even in my short career, there have been many times people have asked me to write a letter: to describe a prepurchase exam, to describe something to a farrier, to state the condition of humane cases, etc. So when a client called our practice wanting us to write a letter, it didn't throw up any red flags. However when I arrived on the farm, it was clear to me that this was something different...
As the first order of business, the owner wanted me to palpate a mare that was VERY pregnant. They decided that she was not in fact pregnant because she "shoulda had it by now". Ok. Not the soundest logic, but whatever. I stuck my arm in about wrist deep and confirmed that she was indeed very pregnant. (The fetus was large to say the least.) What was the most striking about the mare is that she was extremely thin. (2-3/9 BCS). This is what they wanted me to write a letter about. Apparently someone had called the Humane Society about this mare due to her condition. They wanted me to write a letter stating she was healthy. I told them I'd write them a letter, but it would not say what they probably wanted it to say.
After talking with them, I found out that this mare (a small Quarter Horse type mare) was bred to a Percheron "by accident". They apparently rescued (I use this term loosely) this stallion as a weanling; it is now 7 years old. They were unaware that it was a stallion and put the mare in the same pasture with it. Apparently they thought the testicles of stallions just fell off at some point during their young life; thus, magically rendering them sterile.
So writing this all down is filling me with rage all over again. At any rate, we had a long discussion about proper feeding, how much hay is adequate, improper breeding, and the birds and the bees of the horse world. These people were just plain ignorant, and unfortunately not interested in learning anymore.
Needless to say, I didn't write any letter. It's better that way.
As the first order of business, the owner wanted me to palpate a mare that was VERY pregnant. They decided that she was not in fact pregnant because she "shoulda had it by now". Ok. Not the soundest logic, but whatever. I stuck my arm in about wrist deep and confirmed that she was indeed very pregnant. (The fetus was large to say the least.) What was the most striking about the mare is that she was extremely thin. (2-3/9 BCS). This is what they wanted me to write a letter about. Apparently someone had called the Humane Society about this mare due to her condition. They wanted me to write a letter stating she was healthy. I told them I'd write them a letter, but it would not say what they probably wanted it to say.
After talking with them, I found out that this mare (a small Quarter Horse type mare) was bred to a Percheron "by accident". They apparently rescued (I use this term loosely) this stallion as a weanling; it is now 7 years old. They were unaware that it was a stallion and put the mare in the same pasture with it. Apparently they thought the testicles of stallions just fell off at some point during their young life; thus, magically rendering them sterile.
So writing this all down is filling me with rage all over again. At any rate, we had a long discussion about proper feeding, how much hay is adequate, improper breeding, and the birds and the bees of the horse world. These people were just plain ignorant, and unfortunately not interested in learning anymore.
Needless to say, I didn't write any letter. It's better that way.
Monday, March 12, 2012
Old Timers
It's been over a week since I last posted. This was mostly because Blogspot wasn't cooperating with my Internet Explorer, and I was always too rush to figured out how to make it work. This morning I finally buckled down and made it work.
Last week I ran into a common frustration many of us young, whipper-snapper vets run into. The old timers. We all learn many things for those people who have been in the profession for 40, 50, even 60 years. However, sometimes the standards they set us up for just, well, suck. Last week I was having a conversation about the cost of vaccination. The client had 5 horses they wanted to vaccinate. Vaccinating a horse isn't cheap-- even our cost for vaccines has sky rocketed in the last 3-4 years. To make matters worse, these people have no business owning 5 horses. At any rate, I quoted them a price (well over $500) and they were shocked. They tried to reason with me, "But Dr. Old Timey used to let us use vaccine by weight and we split the dose of vaccine three ways for the ponies. Then in half for the horses. And he only charged $6 for each dose." *Facepalm* Obviously, if you know anything basic immunology, you can't split a full dose of vaccine 2-3 ways and expect it to be protective. Furthermore, I have no clue what he was selling these people for $6. There are no vaccines that are even close to that price, even at our cost.
To make a semi-long story short, I tried to talk to this clueless lady about some theory of immunology to explain why we couldn't do this now. (Dr. Old Timey unfortunately suffered a stroke last summer and is no longer practicing. Because of this we are picking up quite a few of his clients. So stories like this are becoming more common). Not surprisingly, the people didn't make an appointment to vaccinate their horses, even for the minimum of vaccinations.
While I respect these old timers, I think it is also important to maintain a CURRENT idea of science and medicine. That's your job. From friends and my own experiences, I've heard stories about different old timers doing things like re-sterilizing single use disposable needles and disposable surgical gloves (and treating post-surgical infections routinely); charting medical cases with a date then describing the patient's visit with a simple check mark for notes; treating a severe colic with a shot of penicillin and leaving the horse to die instead of recommending euthanasia. I'm sure all of these things are well meaning. It just makes it really hard for other vets to come in and do the right thing when the preexisting standards for care and cost were set in the 1950s and haven't changed since.
Last week I ran into a common frustration many of us young, whipper-snapper vets run into. The old timers. We all learn many things for those people who have been in the profession for 40, 50, even 60 years. However, sometimes the standards they set us up for just, well, suck. Last week I was having a conversation about the cost of vaccination. The client had 5 horses they wanted to vaccinate. Vaccinating a horse isn't cheap-- even our cost for vaccines has sky rocketed in the last 3-4 years. To make matters worse, these people have no business owning 5 horses. At any rate, I quoted them a price (well over $500) and they were shocked. They tried to reason with me, "But Dr. Old Timey used to let us use vaccine by weight and we split the dose of vaccine three ways for the ponies. Then in half for the horses. And he only charged $6 for each dose." *Facepalm* Obviously, if you know anything basic immunology, you can't split a full dose of vaccine 2-3 ways and expect it to be protective. Furthermore, I have no clue what he was selling these people for $6. There are no vaccines that are even close to that price, even at our cost.
To make a semi-long story short, I tried to talk to this clueless lady about some theory of immunology to explain why we couldn't do this now. (Dr. Old Timey unfortunately suffered a stroke last summer and is no longer practicing. Because of this we are picking up quite a few of his clients. So stories like this are becoming more common). Not surprisingly, the people didn't make an appointment to vaccinate their horses, even for the minimum of vaccinations.
While I respect these old timers, I think it is also important to maintain a CURRENT idea of science and medicine. That's your job. From friends and my own experiences, I've heard stories about different old timers doing things like re-sterilizing single use disposable needles and disposable surgical gloves (and treating post-surgical infections routinely); charting medical cases with a date then describing the patient's visit with a simple check mark for notes; treating a severe colic with a shot of penicillin and leaving the horse to die instead of recommending euthanasia. I'm sure all of these things are well meaning. It just makes it really hard for other vets to come in and do the right thing when the preexisting standards for care and cost were set in the 1950s and haven't changed since.
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