I had a client complain about me this week.
To back up a bit, he had come in a month ago with his dog, whose left side of her head was swollen to about twice its normal size. “It’s an abscess,” he told me, and wanted me to ‘stick something in it and drain it.’
I do what I always do, and come up with my list of differentials- all the things it might be. You just can’t assume it’s the most likely thing, even though it probably is, because sometimes it’s not, and if you aren’t keeping all the possibilities in your head you make mistakes. I was thinking of abscesses, cancers, foreign bodies, rattlesnake bites, all sorts of things.
I took a little peek in the dog’s mouth, but with her head as swollen as it was, I couldn’t mess with it too much. So my plan was to do the following: sedate the dog, which would make her more comfortable and allow me to do a full exam; and go from there. The next steps might be, depending on what I saw: remove a rotten tooth, drain an abscess, do some x-rays if it looked like a mass.
The owner was very upset I didn’t know the problem right off the bat. He asked me several times, incredulously, why I couldn’t tell if there was cancer by looking at the outside of the dog. There’s a planet Krypton joke in there somewhere, I just know it.
So he stormed out, then called Doc Good Ole Boy down the road, who, according to the owner, diagnosed a tooth root abscess over the phone based on his description. He passed on some rather uncharitable things the other vet supposedly said about my experience level (and this is a person I have never met). He went on and on to my office manager about my incompetence.
“Well, what exactly did Doc Good Ole Boy do?” my office manager asked.
“He gave her a pain med, then he pulled the rotten tooth.”
“OK,” said my office manager, “So he did exactly what our doctor suggested we might need to do, then?”
“Well, yes,” he conceded. “But he knew right away without all that other hooey. He stuck his fingers right in there and knew.”
“OK,” said my office manager. “So you’re mad my doctor didn’t put her fingers in a painful dog’s mouth and force her jaw open? Because I wouldn’t do that either. Aside from the risk, that’s a very painful thing to do to pet.”
“Well,” the man scoffed, “You shouldn’t be working with dogs if you’re scared of them.” As if overconfidence is the key to not getting bit. Actually, I would say the key to not getting bit is sedation and pain control, but that’s just me, Doc-who-likes-her-face-and-hands-intact.
I wonder how many fingers Doc Good Ole Boy still has. I found out his name and was debating whether or not to call him and see if he really said the things this person claims he did, but my tech very correctly pointed out that it wouldn’t really accomplish anything. I try very hard not to throw other vets under the bus, because most of the time the client’s side of the story is about 30% correct compared to what really happened, so it bothers me when others do it to me. This is the part where I take solace in my superior pain management, alone in my self righteous indignation.
kelly says
Oooh – I mad for you. What a jerk owner! What did he get out of passing on the rotten things Doc Good Ole Boy might have said?
Kristie says
Back after DD was born, I reread my collection of James Herriot for no good reason other than it came in short vignettes and I didn’t have the brain power to follow long plots while I was spending hours on the couch nursing.
Anyway, I think it was in Every Living Thing that he dealt with this exact scenario. It’s kind of amusing to see that while time and place may be different, some things never change. :-p
Jaime says
Way to take the high road! This guy obviously was in a rush and didn’t care enough to get a thorough examination done. I feel bad for his dog, imagine how he treats his dog if that’s how he treats other people…
Jaime
Lisa says
You have so much more tact than I would have had! I would have started poking back at him, ’Do you consider yourself a good pet owner? Well then what kind of pet owner lets their pet’s teeth get so bad that they need surgery for an abscess?’
Swelling doesn’t automatically indicate an abscess. My schnauzer had one side of his jaw and neck swell up. Xrays didn’t indicate a problem, teeth were in good shape. The vet and I decided that I’d put warm compresses on the area a few times a day with the hope that there was a gland that was blocked. It worked. After a day or so of the compresses, the swelling was gone.