“$150,” the woman insisted.
I squinted at her. “Really?”
“In Italy,” she said. “Full mouth extraction on my cat.” She paused. “And the vet didn’t even use anesthesia.”
Now I was extremely skeptical. How do you pull every tooth in a cat’s mouth without anesthesia? “They were falling out anyway,” she added helpfully. “He just kind of twisted and out they came.”
“OK, so that is pretty end-stage disease,” I told her. “I’d like to try and avoid that in this cat-” gesturing to the current patient, who had the beginnings of stomatitis, a very painful dental disease. “But it will be more than $150.”
“That’s OK,” she said, and leaned in. “I like you a whole lot better than that other vet. I’ll never go back.” She proceeded to tell me about her bad experience at another hospital. “I had a blocked cat, and all I had was $200. And they euthanized him!” She paused, and started to tear up. “I begged them to try something, to just try and drain his bladder or something, and they wouldn’t do it.”
“You know, I think they were just trying-” I started, but she wouldn’t let me finish. “I just wanted him to have a chance.”
It was an interesting thing to hear, given my week. A few days ago, I had a client who brought me a blocked cat. He was already beaten down by not being able to afford the emergency hospital estimate, and wanted to know what I could do for, ironically, $200.
The problem with blocked tomcats is, you really can’t do anything for $200. At the very least, they need a couple days in the hospital. This doesn’t include catheters, IV fluids, medications, radiographs, and the distinct possibility that despite all this they might still need surgery. It’s a bear to fix. I’ve been there, I’ve been that ER doctor, and I know because of my experience that sometimes euthanasia is the best option. It’s a terrible way to suffer.
But this client was tearful, and desperate to try something, so I told him against my better judgment I would at least try to empty the bladder. He knew it was a long shot, a very long shot, but it would at least give him time to try and figure out if he could work out a way to treat the cat properly. “And if not,” I told him very bluntly, “you should euthanize him.”
We kept the cat all day, and when he showed up that night he hadn’t done anything to try and find money for more care. “I hoped this would work,” he told me. We pulled the catheter. An hour later he called, and said the cat re-blocked.
So he euthanized him. And he thanked me for trying.
I didn’t get it, and I guess some part of me still doesn’t, because I’m looking at it from the cat’s point of view. I knew what was going to happen, I knew it was futile, and I felt bad putting the cat through it for no good reason. But then I had this woman today, who was so upset that she wasn’t given the choice, and it got me to thinking about Emmett and the hours writing prescriptions for chemo drugs and aspirating nodes for the same reason. There is always hope. And while I can gently try to guide people to reality, it’s not really my place to force them to stop hoping when they aren’t quite ready.
Hope is the only thing that many pet owners have at that time. You’re an awesome vet, Jess. I hope you know that.
Dr. V says
It’s hard. It is a hard job. I wish I were perfect at it.
That is so true– just being given the choice and then being able to come to the realization when you are ready to face it. I’m glad that guy followed your advice.
Your post made me think again about going through bone cancer with Shaq and what we did and didn’t do. Money wasn’t the issue. I just couldn’t put him through amputation at his age and with his arthritis issues. I know lots of dogs do fine with it. I just couldn’t. I did, however, do radiation. That did not help one bit. I know the oncology vet didn’t tried to guide me to reality by telling me if I wasn’t going to amp, the radiation wouldn’t do anything but possibly prolong the time before the pain wasn’t managable. Looking back, was I doing that for me or for him? When the only benefit is to prolong the inevitable (in other words, to “give it a try”), are we really doing the best for our pets? They don’t see the world through our eyes. They aren’t holding out for one more holiday with family, etc. They basically live the same day over and over throughout their lives. Yet, if we don’t give it a try and hold out hope for them, we feel we have failed them.
Very thought-provoking topic. Thanks for posting it. And thanks for helping me look at it through the pet’s eyes.
Dr. V says
And for every person I steer one way, there is that person who held onto hope when I had none, who came in a month later with a pet who truly did have a miraculous recovery and of course never wanted to see me again. There is no right or wrong, even from our perspective, just best guesses.