My Favorite Clients

Last week, I got to meet two of my favorite types of clients.

On Friday, during appointments, I saw a lab that had been vomiting all night. He looked like he felt like shit, his back was slightly arched but showed no other signs of stomach pain and discomfort. He still wagged his tail. He was minorly dehydrated. Normally, I'm uber-conservative when it comes to GI upset. Dogs vomit. End of story. Being a lab, you know that it is possible that he ate something he shouldn't have though the owner didn't think so. Because of the dehydration, I admited him to the hospital for IV fluids and medication to stop the vomiting.
Saturday morning, the vomiting had stopped but the dog was regurgitating. So we took some x-rays and the only thing that looked abnormal was the fact that his stomach seemed a little large. His attitude was unchanged and he showed no more signs of discomfort than he did the day before. So I sent him home. (And I was out of injectable medications anyway.)
Sunday moring, I'm woken up by the owner calling. The dog did well overnight but now was regurgitating uncontrolably. So I met him at the clinic after an hour or so and readmitted the dog for fluids again. We took another x-ray and some things had changed slightly but nothing jumped out at me. Since we were out of injectable medications, I had to figure out how to get them. I called up the local human hospital's pharmacy and put in an order. Then I went and got the medications. Oddly enough, I was told to come in the back door because it would be easier. So I did. There was no security, no anyone and I snuck into the hospital and back out. By mid-day, I had pretty much decided after lots of consultations, that I needed to do a barium study. Barium studies are when you give a large volume of contrast (half a liter in this dog's case) and then take a series of x-rays over set amounts of time. My tech and I fought to give this dog the barium and at one point stopped for a chest x-ray because I wasn't sure the dog was actually swallowing the contrast. We finish and take the first couple of x-rays 15 minutes apart and sure enough things are looking good. The stomach is filled and already the contrast is moving into the small intestine. We take the third set and then an hour later (two hours after giving the barium) the fourth set. There was no change between the two sets. Hmm... I call the owners and let them know that in two hours, I'm repeating the rads and at that time they will need to make a decision about the next step. So repeat the rads in two hours. No change. Okay, now we go to surgery, keep the dog on fluids and cross our fingers or euthanize. They elect to keep the dog on fluids. The next morning, the dog hasn't changed. The x-ray show that the barium hasn't moved; if anything, its backed up into the stomach even more. Ugh. Now the decision is clear-surgery NOW or euthanasia.
So the owners, wanting to do everything possible for their dog, make the difficult decision to take the dog to surgery. We go to surgery and when we roll the dog over, he regurgs lime green fluid-barium and bile mixed together. When I start cutting, pretty much right away, I pull up small intestine with something in it. Eventually, we have it out-1 1/2 inch piece of corncob. I get the intestine closed and close up the dog. Yea! Everything looks good right now. I hope its going to keep going that way.
Oh, where was I going with this? Why do I love these clients? No questions (or minimally at least) asked, they did what they needed to do for their pet even when I couldn't make any promises that it would turn out okay.

On Friday night, after 9, I get a call from the office that an emergency is coming in. Its a dog with a puncture wound in its elbow. I take a look at the dog, make an estimate and tell the owners (two young guys) that I would need a good faith deposit of like $70-90. We x-ray the dog to make sure that the puncture hasn't broken anything. The tech goes up to get the deposit so we can sedate the dog and close up the wound. These guys ran out of the house with no money. They have $6. Ugh. We're probably not going to get paid anything I think. Can they call home and get a credit card number? Okay. No wait, that card doesn't have any money on it. We can do a held check we tell them. They tell us that we'll get paid tomorrow. Sure, I think. We work on the dog and then in the morning, we get a phone call. The owners want to know how much the bill is. We tell them and then they tell us that they will get the dog in the afternoon. One of the techs fell in love with the dog and found a bunch of half used rolls of bandages to give to the owners. In the afternoon, they owners came back in to pick up the dog. They had worked all day long to come up with the money for the dog. Unfortuately, it wasn't enough. They were about $20 short. But you know what? It didn't matter. They worked for what they owed. They didn't ask for credit. They didn't ask if they could do payments. They accepted that a service had been performed and now they owed for it. I figured that since they paid the bulk of the bill, we wouldn't see them again for the recheck nor would we see the $20 they owed us. Oh well, its almost worth it since they had paid for most of it. BUT NO! They came in this week, paid the balence and I guess, set up the recheck. I love people that can accept responsiblity.