Tuesday, July 21, 2015

Pyometra: Happy Ending for Pheonix

by  Krista Magnifico, DVM

The story is so consistently the same that I almost gag repeating it. A middle aged dog walks into the clinic with the presenting complaint of  "not eating and lethargic."

Patient has not been to the vet in years and the dog is not spayed.

That's all I need to know....
The diagnosis is always the same;

This dog has a uterine infection and she is dying of internal infection. She has a pyometra.

She needs:
  • Surgery (usually) immediately.
  • IV fluids,
  • IV antibiotics,
  • about a day in the hospital, and
  • antibiotics for about 2 weeks after surgery.
The problem is always two-fold.

The dog is dying in front of you and the client hasn't had their dog spayed for a reason; they never could afford to.

So, now their $250 spay is a $1,000 (plus) emergency surgery.

And so it was with Pheonix.

I dare not even think how many dogs die simply because their owners couldn't afford, or didn't realize the importance of spaying, and then felt compelled to euthanize because the cost to treat was too great.

Pheonix should have had her pyometra surgery the evening that she  presented to us. 

She should have gone to the emergency clinic nearby and had the festering infection that used to be her reproductive system removed. The estimate for her surgery there was over $2,000. A $200 spay was now priced at a $2,000 life or death investment.

Pheonix returned the next morning and had what I call a "bare bones last ditch" effort to eradicate her of the uterus she never needed and now was rebelling against her.

An ultrasound to confirm our suspicions.. a distended angry uterus takes center stage.

Diagnostics are nice. They provide answers to questions and little fearful voices in veterinarians heads. They are also considered "standard of care." Our nice politically correct way of saying "in the best interest of our patient they should be done." Another line item on an invoice that inflates a clients bill. There are many line items in this disease, hence, the hefty price tag. If Pheonix's owners couldn't afford the $200 spay, they definitely can't afford the $2,000 pyo surgery.

Veterinarians tend to feel angry that clients get themselves into this dilemma.

We recommend spaying at 6 months old. But, the client doesn't follow our advice providing excuses like:
  • it was too costly to spay her,
  • I forgot to do it,
  • time got away from me,
  • I was always planning on breeding  her,
  • etc.

Clients find themselves at the ER or vets office with a quick diagnosis and an expensive treatment plan. 

This disease has no time to wait for the scrambling of finding funds amongst friends.

Pheonix got help from us because we have two things in place:

I have a back up plan for back up plans. 

For those clients who do not have pet insurance, or a pet savings plan in place (my favorite option), there is Care Credit. Most people don't have insurance (like 95% of our clients), most don't have pet emergency funds (like 80%), and most cannot qualify for Care Credit (like 80%). That leaves the huge majority of clients with a dying dog, a huge vet bill, and no options.

I know this. I am prepared for this. I have the most generous friends and clients in the world. If I ask for help they help. It is a point of pride I hold dearest to my own abilities to help a pet in need. We do not turn away a pet in need I can only say this and do this because I have help.

I also have Vet Billing. Every client who is denied Care Credit is sent through Vet Billing. They provide us with third party billing for the clinic. No longer do I have to act like the bank, the creditor and the bitter nag begging for reimbursement months after I have bailed our butt out of a disaster.

There are happy endings if you work a little harder than  you have to, and care a little more than you are expected to. 

Pheonix's bill was about $1400 when she left us. About $1000 for her surgery alone. She spent three days in the hospital (at her families request) and is expected to have a full recovery.

If your dog has is diagnosed with this disease please know this:
  1. It is treatable. I will know vets have to hedge and be cautious, but trying might save your dog, and giving up will not.
  2. Discuss every single possible option to getting your pet the emergency surgery they need. Cut every corner, decline every elective and make it happen. Max your credit card, get a cash loan, pawn your stuff, go to GoFundMe.com, PetChance.org, your faily, friends, VetBilling is through your vet (click here to see which hospitals participate), CareCredit.com, your vet, every vet in the state, whoever, where ever, and find a vet who will help you.

I have unrealistic expectations. I will admit it.

I will not let a treatable dog be denied care based on cost. 

It is not a widely held opinion. I am not alone with this opinion in this profession, but I would rather be ostracized by my peers than neglect my purpose. If you were provided the means and guidance to help I believe it is your responsibility to do so.

I saw a Facebook post the other day from a very well respected veterinarian and friend who posted, "I hate it when a dog has to be euthanized over such a preventable disease." I don't know the particulars of the case, but I don't ever agree with the statement, "has to be euthanized." Why is there a "has to be?" because we are the all-knowing and there is no chance?

There is ALWAYS a chance!

Please do not euthanize over this disease.
Get your dog help!

To read the full story with photos visit Diary of a Real-Life Veterinarian.

Pawbly.com is a resource for pet people to ask questions, share information and help pets find the help and resources their parents need. It is free to join, use, and open to everyone who loves pets. Please visit us and share your pet stories, experiences, and lend a hand to a pet in need.

If you need help from me you can find me at the clinic, Jarrettsville Vet, or on Twitter @FreePetAdvice.


Krista Magnifico, DVM owns a small animal hospital in northern Maryland, where she practices everyday. She wants to make quality veterinary care available to everyone, everywhere at any time; trying to save the world 1 wet nose @ a time.  Her blog is a diary of he day-to-day life & the animals and people she meets. 

Dr. Krista is also the founder of pawbly.com, free pet advice and assistance.

To contact her, you may leave a comment on her blog, email her or catch her on Twitter or Facebook.

Articles by Dr. Magnifico:
Don't Make This Mistake: Ruby's Death To Heat Stroke 
Parvo: Cora's Story 
Jake's Laryngeal Paralysis
The Tip Of The Iceberg: The Unexpected Dental Dilemma
The Ear Ache That Wasn't Going Away: Tottsie's Story
Cody's Eyelid Tumor
Ruger's Mysterious Illness
The Day The Heart Stood Still: Timber's Story 
Different Definition Of Comfort Food: Levi's Story 
Savannah's Pancreatitis  
Histiocytoma: Rio's Mysterious Bump
Von Willebrand's Disease: Greta's Story 
Alice's Heart Murmur  
Jekyll Loses His Tail Mo-Jo 
Pale Gums Are An Emergency: Bailey's Story 
To Amputate Or Not To Amputate: Heidi's Story
Lessons From A Real-Life Veterinarian 
Charlie's Life Saving Lipoma Surgery  
Understanding and Diagnosing The Limping Dog, Why To Probe The Paw 
Angus' Dog Fight And The Consequences
When To Induce Vomiting And When It's Not A Good Idea  
Abby's Survived Being Run Over By Car But Sucumbed To A Mammary Tumor 
Palmer's Hemoabdomen: Nearly An Unnecessary Death Sentence
A Puppy That Doesn't Want To Eat Or Play Is An Emergency: Aurora's Story
Does Your Dog Like Chewing Sticks? Hank's Story  
Lexi's Bump 

Do you have a story to share?

Your story can help others, maybe even save a life!

What were the first signs you noticed? How did you dog get diagnosed? What treatment did/didn't work for you? What was your experience with your vet(s)? How did you cope with the challenges?

Email me, I'll be happy to hear from yo

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