Before I begin this brief venting session, please let me be clear that I love [good]children and truly see them as a miracle, a notion that is substantiated in the fact that my wife is expecting our first child in what has been a very planned pregnancy. That aside, one of the biggest aggravations I have to deal with as a veterinarian in recent years is children that are out of control in my waiting room and in my exam room!
On a daily basis, often multiple times a day, I have to contend with much more than than the interpretation of a non-talking patient's history, clinical signs, occasional unwillingness, and the release of unexpected gas or excrement. In addition to this challenging work, I often find myself confronted with a far more sinister problem: the little devil children of the clients!
While their parents sit by idly, these children tamper with my valuable and fragile scopes, go through exam room drawers, harass the already scared or even aggressive patient, jump all over my extremely expensive lift tables, and even crawl over my back as I examine the patient. As I try to explain the potential problems the animal may have, necessary diagnostics, and potential treatments, I find myself frequently having to yell over their screams, or blatant interruptions as they ask me their own pointless questions or babble nonsensical stories. In my waiting room, children often are allowed to damage food and treat bags for sale, throw magazines all over the place, scream at the top of their lungs, and run around like they are in some kind of playground or reckroom.
In order to get the job done, I sometimes find myself in the awkward and uncomfortable position where I have to correct the children myself and order them to leave the equipment alone, step away from the pet that they are upsetting, or allow me the space I need to perform my examination. In some cases, I even have to tell the parent that I cannot continue the examination unless the children are either restrained or made to wait out in the waiting room. Just yesterday, a child even stole an item from the waiting room, and when the receptionist ran outside to inform the parent of the theft, rather than reprimand the child and make the child give the item back, the parent simply paid for it!
Having graduated veterinary school in 2001, I have seen this trend of unruly children get increasingly more prevalent with each year of practice. That tells me that as time goes on, an ever increasing number of parents seem to be losing the ability to raise disciplined, well adjusted, respectful children, a fact that is rather alarming. Not only are these unruly children very unpleasant to be around, but what kind of adults will they one day make? How do they treat the animals at home? Well, regardless of whatever kinds of future criminals they want to raise, here is a message from me to all parents with children like this: I WENT MANY YEARS OF SCHOOL TO PRACTICE VETERINARY MEDICINE, NOT TO BABYSIT YOUR LITTLE MONSTERS!
What in the world happened to the principles that I was raised with: do not interrupt adults when they are talking, respect your elders, do not tamper with or damage other people's property, do not steal, etc., etc., etc.? When I went to the vet with one of my parents, I would not dare act in the manner in which many children of today behave. I would not interrupt the vet when he spoke, in fact, I would not speak at all unless the vet spoke to me directly.
Is this because I was a special child? Well, maybe a little (just kidding!). It because my parents demanded that I respect them, and my respect for them meant that my embarrassing them in public would ultimately be just as embarrassing to me.
Roger L. Welton, DVM
Founder, Web-DVM
Thursday, March 20, 2008
Thursday, March 6, 2008
You Never Know
Tuesday afternoon, I was presented with a very sick and rapidly deteriorating 13 year old, male, German Shepherd, that ended up with a grim diagnosis of severe chronic renal failure (kidney failure). This left me in the always uncomfortable but necessary position of having to inform the owners who love this dog dearly of their beloved pet's bleak circumstances.
When presented with a patient's diagnosis, my job is to objectively explain to the owners the nature of the disease and its implications, treatment options, risk of treatment versus benefit of treatment, odds of success, and of course cost of treatment. Based on all of this information, it is left to the client(s) to decide on how they wish to have their pet treated or not treated, or to elect euthanasia. While I provide the medically impartial information, it lies solely with the owners to apply their individual feelings about how much to put an animal through and how much they are willing and able to spend, given the probability of of a successful outcome.
In this German Shepherd's renal failure case, the labwork indicated that the likelihood of success with even aggressive treatment was very low. I explained to the owners that out of 10 cases that may present with this patient's set of clinical signs, combined with labwork that indicated severely advanced disease, at best, 2 would yield a favorable result. I then explained that treatment for this disease is not very invasive or painful, and carried no other risk than a more than fair likelihood that it would not work.
At this point, with little hope of success, many owners would elect euthanasia not wanting to prolong their pet's suffering, not willing or able to spend the money for treatment, or combinations of all of these sentiments. Whether this is right or wrong is a very personal decision, not for me to judge or convince them otherwise, but to respect and offer my services to implement their decision.
The owners of this German Shepherd were determined that as long as there were ANY chance, albeit a long shot, they had to at least let me try. Again, whether this was right or wrong is a very personal decision, not for me to judge or convince them otherwise, but to respect and offer my services to implement their decision.
After 2 days of aggressive treatment, the patient's condition has taken a remarkable turn for the better. His vomiting has abated, his spunk has returned, and his appetite fully restored. His follow up labwork indicates kidney values that were back within the normal range. He will likely go home tomorrow, and needless to say, his owners (two very nice ladies), are overjoyed.
In this case, it is easy to look back and say that the owners made the right decision to have the dog treated. In hindsight, it would have been premature to put this dog to sleep. While he is still is in kidney failure with his longevity uncertain, fed a kidney sparing prescription diet, he may hold on for days, weeks, or months to come.
Let me be clear, however, that the moral of this story is not to convince my readers that, given poor prognosis with treatment, that owners should cling to that small bit of hope and always elect treatment. Let us not forget the 8 out of 10 dogs that may present in exact same state as this German Shepherd that would have spent the last 3 days of their lives in a hospital, only to die or be put to sleep anyway.
I offered this little tale instead to simply remind you that when you and your beloved pet are faced one day with similar circumstances, you never know.
Roger L. Welton, DVM
Founder Web-DVM
When presented with a patient's diagnosis, my job is to objectively explain to the owners the nature of the disease and its implications, treatment options, risk of treatment versus benefit of treatment, odds of success, and of course cost of treatment. Based on all of this information, it is left to the client(s) to decide on how they wish to have their pet treated or not treated, or to elect euthanasia. While I provide the medically impartial information, it lies solely with the owners to apply their individual feelings about how much to put an animal through and how much they are willing and able to spend, given the probability of of a successful outcome.
In this German Shepherd's renal failure case, the labwork indicated that the likelihood of success with even aggressive treatment was very low. I explained to the owners that out of 10 cases that may present with this patient's set of clinical signs, combined with labwork that indicated severely advanced disease, at best, 2 would yield a favorable result. I then explained that treatment for this disease is not very invasive or painful, and carried no other risk than a more than fair likelihood that it would not work.
At this point, with little hope of success, many owners would elect euthanasia not wanting to prolong their pet's suffering, not willing or able to spend the money for treatment, or combinations of all of these sentiments. Whether this is right or wrong is a very personal decision, not for me to judge or convince them otherwise, but to respect and offer my services to implement their decision.
The owners of this German Shepherd were determined that as long as there were ANY chance, albeit a long shot, they had to at least let me try. Again, whether this was right or wrong is a very personal decision, not for me to judge or convince them otherwise, but to respect and offer my services to implement their decision.
After 2 days of aggressive treatment, the patient's condition has taken a remarkable turn for the better. His vomiting has abated, his spunk has returned, and his appetite fully restored. His follow up labwork indicates kidney values that were back within the normal range. He will likely go home tomorrow, and needless to say, his owners (two very nice ladies), are overjoyed.
In this case, it is easy to look back and say that the owners made the right decision to have the dog treated. In hindsight, it would have been premature to put this dog to sleep. While he is still is in kidney failure with his longevity uncertain, fed a kidney sparing prescription diet, he may hold on for days, weeks, or months to come.
Let me be clear, however, that the moral of this story is not to convince my readers that, given poor prognosis with treatment, that owners should cling to that small bit of hope and always elect treatment. Let us not forget the 8 out of 10 dogs that may present in exact same state as this German Shepherd that would have spent the last 3 days of their lives in a hospital, only to die or be put to sleep anyway.
I offered this little tale instead to simply remind you that when you and your beloved pet are faced one day with similar circumstances, you never know.
Roger L. Welton, DVM
Founder Web-DVM
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