by Dr. Robert Foley, DVM
A wonderful client of mine brought her 12-year-old Boxer to see me.
Last night, the dog had his first seizure and the owners found themselves at a local 24-hour veterinary facility because we were closed. They were in today to see me to discuss what had happened last night, to have me examine their pet, and to get my opinion as to what was the next step to take.
I typically subdivide my seizure dogs into one of three categories based on age.
A three-month-old puppy, for example, that starts having seizures typically has a congenital malformation (liver shunt, hydrocephalus etc.).
A middle-aged dog, let’s say 3 to 5 years old, who begins having seizures is typically your epileptic patient. Epileptics are simply animals predisposed to having seizures with no identifiable cause other than genetics. We all have a seizure threshold, an accumulation of neuronal stimulation where the brain will have seizure activity. Epileptics have a lower threshold and thus seize more readily.
The third category, unfortunately, the one poor Winston fell into, is the older patient that begins to seize.
This, unfortunately, is usually due to an intracranial lesion ( a lesion like a tumor in and invading or surrounding and compressing the brain). As an added clue, this patient is a Boxer, a breed that is notoriously known for developing cancer ANYWHERE. Of course, there is the outlying infectious disease that can infect an animal of any age and cause seizures but let’s dismiss them for the moment as they are certainly rare.
The reason that I am giving you this background is to provide a perspective on the “treatments” that were given to Winston at the emergency hospital.
They ran some baseline tests (appropriate) and some other tests (that were aggressive) without discussing options to the owner (the words MRI, neurology consult, cancer, or guarded or poor prognosis were never mentioned).
Then they proceeded to dispense Amoxicillin to treat possible pancreatitis (the dog demonstrated no signs of pancreatitis and Amoxicillin would not be the treatment if he had). They gave the dog multiple pain medications (notice I didn’t say anti-seizure medications or sedatives but pain meds).
Then the kicker. They VACCINATED the dog!
To the unfortunate and unknowing pet owner, the illusion of care and compassion was provided; to the knowing and discriminating veterinarian, this is criminal.
Treatments (some unnecessary and some downright dangerous) and tests were performed simply to pad the client’s bill. The client received no education and no options.
They simply were gouged then “shipped”.
A little secret…we never really started Angryvet because we were “angry”. It was a catchy name that would hopefully draw people to our site to help bring attention to some issues that we felt warranted more study and more accessibility to pet owners. I never intended to be a whistle-blower or to bad-mouth veterinarians. Today, in this post, I will skip the obligatory qualification that most vets are good, honest, and educated people. Today, I am angry. Really.
Dishonesty and price gouging are not unique to veterinarians by any means.
If someone goes to any professional to seek advice on something with which they are not educated or familiar, they run the risk of encountering a dishonest person. I am not well-versed at all with construction or auto mechanics and have definitely been taken for a ride or two over the years.
Am I angry with humanity? Why do we do this to each other? Is money that important? Is it too difficult to take pride in an honest day’s work and to receive an honest day’s pay? Do the pressures of making money and surviving the stress and pace of life cause some of us to forget ethics and decency?
Am I angry with veterinarians in particular? Should we be held up to a higher standard? Did we not take an oath that includes the words “Primum non nocere” , or “First do no harm?” Do we have an unwritten code amongst veterinarians to not blow the whistle on another veterinarian when they are acting unethically or is it our responsibility to the client who may not understand what is being done to them to do just that?
Once again, as I often state, I don’t have all of the answers. Today, I feel good because I not only explained all of this to my valued client but because I have a following of people who actually are out there to listen to what I have to say.
I just wish I had a better story of humanity to share.
***
A wonderful client of mine brought her 12-year-old Boxer to see me.
Last night, the dog had his first seizure and the owners found themselves at a local 24-hour veterinary facility because we were closed. They were in today to see me to discuss what had happened last night, to have me examine their pet, and to get my opinion as to what was the next step to take.
I typically subdivide my seizure dogs into one of three categories based on age.
A three-month-old puppy, for example, that starts having seizures typically has a congenital malformation (liver shunt, hydrocephalus etc.).
A middle-aged dog, let’s say 3 to 5 years old, who begins having seizures is typically your epileptic patient. Epileptics are simply animals predisposed to having seizures with no identifiable cause other than genetics. We all have a seizure threshold, an accumulation of neuronal stimulation where the brain will have seizure activity. Epileptics have a lower threshold and thus seize more readily.
The third category, unfortunately, the one poor Winston fell into, is the older patient that begins to seize.
This, unfortunately, is usually due to an intracranial lesion ( a lesion like a tumor in and invading or surrounding and compressing the brain). As an added clue, this patient is a Boxer, a breed that is notoriously known for developing cancer ANYWHERE. Of course, there is the outlying infectious disease that can infect an animal of any age and cause seizures but let’s dismiss them for the moment as they are certainly rare.
The reason that I am giving you this background is to provide a perspective on the “treatments” that were given to Winston at the emergency hospital.
They ran some baseline tests (appropriate) and some other tests (that were aggressive) without discussing options to the owner (the words MRI, neurology consult, cancer, or guarded or poor prognosis were never mentioned).
Then they proceeded to dispense Amoxicillin to treat possible pancreatitis (the dog demonstrated no signs of pancreatitis and Amoxicillin would not be the treatment if he had). They gave the dog multiple pain medications (notice I didn’t say anti-seizure medications or sedatives but pain meds).
Then the kicker. They VACCINATED the dog!
To the unfortunate and unknowing pet owner, the illusion of care and compassion was provided; to the knowing and discriminating veterinarian, this is criminal.
Treatments (some unnecessary and some downright dangerous) and tests were performed simply to pad the client’s bill. The client received no education and no options.
They simply were gouged then “shipped”.
A little secret…we never really started Angryvet because we were “angry”. It was a catchy name that would hopefully draw people to our site to help bring attention to some issues that we felt warranted more study and more accessibility to pet owners. I never intended to be a whistle-blower or to bad-mouth veterinarians. Today, in this post, I will skip the obligatory qualification that most vets are good, honest, and educated people. Today, I am angry. Really.
Dishonesty and price gouging are not unique to veterinarians by any means.
If someone goes to any professional to seek advice on something with which they are not educated or familiar, they run the risk of encountering a dishonest person. I am not well-versed at all with construction or auto mechanics and have definitely been taken for a ride or two over the years.
Am I angry with humanity? Why do we do this to each other? Is money that important? Is it too difficult to take pride in an honest day’s work and to receive an honest day’s pay? Do the pressures of making money and surviving the stress and pace of life cause some of us to forget ethics and decency?
Am I angry with veterinarians in particular? Should we be held up to a higher standard? Did we not take an oath that includes the words “Primum non nocere” , or “First do no harm?” Do we have an unwritten code amongst veterinarians to not blow the whistle on another veterinarian when they are acting unethically or is it our responsibility to the client who may not understand what is being done to them to do just that?
Once again, as I often state, I don’t have all of the answers. Today, I feel good because I not only explained all of this to my valued client but because I have a following of people who actually are out there to listen to what I have to say.
I just wish I had a better story of humanity to share.
***
I was really pissed with that story when I read it on Angry Vet a few months back. It's quite an unfortunate tale since it reinforces the stereotype that emergency vets are just there to rip you off. I've been around enough boxers to know that an elderly dog having seizures is almost always a brain tumor. They knew it, too. Shame on that clinic!!
ReplyDeleteYeah, pretty unreal to me. We had a very bad experience with emergency vet also but I was hoping that it was simply incompetence. Though it's not clear what's worse.
ReplyDeleteGetting second opinion at the teaching hospital saved Jasmine's life; they wanted us to put her down! All we got was $800 of total misdiagnosis.
In this case, to me it's likely both. If they wanted to pad their bill, they still could have given the right treatment at the end at least!
What an awful story. This is exactly the kind of thing that makes me angry. The vet my sister uses pulls the same kind of crap. I took her puppy in while she was out of town due to some tummy trouble. I went in for a stool microscopy (he had recently guzzled water from a river that frequently has giardia+ tests). They wanted to run 9 different tests which had NOTHING to do with tummy troubles. They assumed (that like my sister) I was clueless about canine health and possible treatments. A less educated owner would have spent $800 when what they needed was a $20 stool sampling.
ReplyDeleteWell, I don't object diligence ... but our experience with ER vet was not good at all either. Still ought to write about that.
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