Blood results am I being unreasonble

setterlover

setterlover

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I have a 25 year old Arab X (retired) who has always been a very good doer but I am finding it harder to keep his weight down despite my best efforts and restricted grazing .
On getting jabs done I spoke to the vet about testing him (Ems and Cushing's) especially as we are moving and need to look at management at the new place.
I'm sure he isn't Cushings but worth doing as bloods taken.
Vet took the blood on Wednesday testing all done in house and told would ring the results through on Thursday no call
Rang Friday yes results there but only a vet can give them and would definitely ring Friday.Rang at 3 pm yes vet would definitely ring between 4 pm and 6 pm I explained we are in the process of selling up and buying another property and I had urgent paperwork that needed to be posted ,( 7 miles round trip) but I waited in No phone call .Had to go off this morning to post the documents.
I know vets are busy but life at present is stressful enough with the house move.
Part of the reason for testing is to get a clear picture of what I am dealing with and think about setting up management of him at the new place.Givrn his age I doubt I would medicate but would just manage.
I feel quite cross guess there will be nothing until Monday now.
With all the stress of moving maybe I'm just grumpy and stressed.
 
This happened to me once i was really stressed out about it as my horse was getting really footsore for no apparent reason, i just kept ringing them every couple of hours till they sorted it out. It took about a week to get results back which were positive 🙄
 
Yes and no. I do agree that if you promise then you should try to deliver. To be honest they probably shouldn't have promised next day results! It was probably ambitious. If their practice is anything like ours we are absolutely flat to the boards at the moment. I can have every intention of being in the office to ring people between 4 and 6pm, but then an extra 3 or 4 calls get added to the day's schedule, and all of a sudden it's after 7pm before you're back at the office. You might get a couple of people rung, but not necessarily all of them (I might take 5 or 6 sets of bloods a day, so that's 5 or 6 people to ring with results every day, plus yesterday's people you couldn't get hold of, plus the people who want to speak to you with other queries). At yhe moment this is every single day. If you're also on call that night then you may have to drop it all and head out to emergencies, and if you're not on call there are times you actually do need to go home (childcare, other non-moveable commitments). I do my very very best for all of my clients, but I have not left work before 7.30pm for the last couple of weeks - and my contracted finish time is 5pm! It just isn't always possible to get everything done. If I'd known you had personal reasons for needing what is essentially a non-urgent result quickly I'd have moved you up the queue, but often these don't make it past reception, so if time is limited the urgent/sick cases get prioritised with result reporting.

I totally understand that none of this is good customer service, and it does massively bother me, but we have tried all sorts of things. We are advertising madly for more vets - most practices are very short-handed at the moment, particularly in the summer when people take AL etc. We have tried reporting results whilst driving, but a) this isn't massively ideal from a H&S perspective and b) I certainly find I need the case records in front of me, and definitely need to record what was discussed/prescribed on the notes. We are trying to delegate 'simpler' results (eg. negative WECs or strangles tests) to non-vets to report, which helps with a few, but even with negative results clients often have questikns which necessitate a call from a vet anyway.

So, long story short, you should probably have had better service, and the above isn't an excuse, but merely an explanation of why it sometimes isn't possible to call at the discussed time.

I would definitely ring on Monday and express your frustrations, but in reality you had a non-urgent (although I appreciate your personal need for urgency) test taken 3 days ago, so I definitely wouldn't go in guns blazing at this stage. Hopefully you'll get your answers on Monday.
 
I think the stress of the blood results just adds to all the other stress . Paperwork drops through the letter box or in my email to do with the house sale/purchase and they all need to be dealt with NOW and posted back urgently which always involves driving in to the nearest village we don't want any delays at this point! plus stuff needs to be sorted the other end quotes on re- fencing the paddock etc so I need to know what I am dealing with regarding the Arab's management.
Trying to manage everything all at once makes it even more stressful.Im surprised they couldn't email or text the results to me and speak to a vet later it's not knowing that makes it difficult.
Will contact the vets Monday morning to see if I can get any joy
 
I had the same thing with mine, wasn't under any other stress so no big deal really and a few more days wait for her to start treatment really didn't make much difference so it didn't bother me too much, odd thing was though that I was dealing with a clients horse who was registered with a different vet and I'd asked for a cushings test, been told results in 2 days at the latest, not heard anything so called them and they put me through to the lab who emailed me the test results, still had to ask for a vet to call me to arrange to have the prascend put up for me though but very strange they were willing to send me test results when another practice won't.
 
SEL said:
@Gamebird is there any reason vets won't email them? I'm educated on blood results (10 years of managing my pssm / EMS mare) & I'd rather have them speedily than wait for my over-worked young vet to ring.

Practice rules are they just ring apparently
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I am happy to email them out, but not in isolation, only after a discussion. I can only think of a tiny number of cases where the number on the page doesn't need some interpretation, even if it's very minor (eg. negative WECs - but even them I do still like to remind clients of the scope of tbe test, and that they don't detect tapeworms/cyathostomes). The lab pathologist's comments also are easy for owners to misinterpret - the pathologist hasn't seen the horse and hasn't got the full clinical details, so sometimes they make comments or suggestions which are irrelevant or inappropriate for a particular case, and this can cause some difficult situations with clients who read then without having had the reasoning for them not applying being explained first.

I'd say you sound like you may be the exception, but that would be very very rare, and I'd always prefer to have the discussion. Also have you seen how often blood results get posted on social media by owners asking the internet for advice? I'd definitely like to have at least got my (qualified and case-specific) advice in first, and documented in the notes!
 
Gamebird said:
I'd say you sound like you may be the exception, but that would be very very rare, and I'd always prefer to have the discussion. Also have you seen how often blood results get posted on social media by owners asking the internet for advice? I'd definitely like to have at least got my (qualified and case-specific) advice in first, and documented in the notes!
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exception only for the stuff I'm familiar with! Generally I'll test her CK/AST and sometimes insulin if her crest is up. I like to get those results promptly because they drive my action plan. But yes, the pssm sites have many, many blood tests posted for the general public to interpret and sometimes the lab print outs aren't that easy to read let alone deduce what's going on.

My GP on the other hand posts them all on my medical account and never speaks to me even when a call would be very helpful.
 
And an addendum:
I do think that veterinary input for interpretation is really important. Although 'normal' ranges are documented alongside results, it's important to view these with veterinary knowledge. For example with the normal range used for PCVs most perfectly normal ponies/cobs would be flagged up as anaemic - however the normal range was developed in fit TBs and it is absolutely normal for ponies/cobs etc. to come out lower. In some cases with other markers it would actually be of concern if it was eg. high end of the normal range (but not flagged as raised) - dependent on case and clinical presentation. Some tests can read up to a hundred or more units above the 'normal' and not be of concern at that point, others are indicative of serious pathology if they are only raised by a handful of units.

Individual animal factors are also relevant. I could get a result of 40 for an ACTH for two different horses and be totally happy with that for one, but be wanting to carry out a TRH or assess response to treatment in another.
 
Seems to be common now. The vets say they will call you and then never do. This was never the case prior to being Vet Partners, the difference in approach is very noticeable and unfortunately it's not for the better.
 
SEL said:
@Gamebird is there any reason vets won't email them? I'm educated on blood results (10 years of managing my pssm / EMS mare) & I'd rather have them speedily than wait for my over-worked young vet to ring.

Practice rules are they just ring apparently
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I always ask my horse vets, before they are leaving, to give permission to the clerical staff to send the results on to me as soon as received. That will be a copy of the lab results. Could you try doing that?

We have usually had discussion in detail whilst drawing the blood and then I get to see them before we have another discussion if needed. That way I have more idea of any questions I need to ask and time to think of the way forward.
I have never had any problem with that. I have never asked for interpretation on SM. That would be silly.
I also find it difficult for my vet to phone when they happen to be free because I am on a landline and rarely at home and I cannot sit by the phone forever.

My small animal vet blood tested my cat to try and find her problem, I didn't ask the conclusion just collected the meds. I didn't ask for them but when I got home the blood test results were waiting in an e mail. That always happens with that vet.
 
paddy555 said:
I always ask my horse vets, before they are leaving, to give permission to the clerical staff to send the results on to me as soon as received. That will be a copy of the lab results. Could you try doing that?

We have usually had discussion in detail whilst drawing the blood and then I get to see them before we have another discussion if needed. That way I have more idea of any questions I need to ask and time to think of the way forward.
I have never had any problem with that. I have never asked for interpretation on SM. That would be silly.
I also find it difficult for my vet to phone when they happen to be free because I am on a landline and rarely at home and I cannot sit by the phone forever.

My small animal vet blood tested my cat to try and find her problem, I didn't ask the conclusion just collected the meds. I didn't ask for them but when I got home the blood test results were waiting in an e mail. That always happens with that vet.
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I did ask if she (vet) could arrange for them to be emailed because she tries to phone at 6pm when I'm in a field with no signal! Unfortunately it's company policy.

In all honesty I'm better placed to judge the results given 10 years of owning the horse. Vets can get worried about her CK being over 500 whereas I shrug that off!
 
We had a long conversation when we discussed taking the bloods .I told them I have had a Cushing's horse before ( medicated for 5 years ) and a borderline Ems horse who I managed for a couple of years so it's not new to me .I explained that as I was moving and need to set up our new paddocks I felt I wanted to know exactly what I was dealing with .I also explained that given his age mid 20's and the fact he has COPD as well I probably wouldn't medicate just deal with it by management so they knew what I wanted to achieve.I don't want him to have zero quality of life .
 
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Update Phoned this morning the vet dealing with this has now gone on leave for 2 weeks.They are now trying to find a different vet to talk to me
I have to go out the afternoon at 2pm for an important appointment so have told them this and I'll just wait!!
 
I am feeling similarly to you OP about my vets at the moment, they are usually fab but I am dealing with Vet A who is a lameness expert and who was actually in the surgery with Dex observing.
Vet A wasn't there on discharge, so Vet B did a 30 second hand over, I got told the bare minimum details of 2 weeks in hand walking on box rest, then 3 weeks incrementally more hand walking still on box rest then from week 6 turnout.

I don't know when the dressing can come off, how far he can walk to in hand graze, how long for, what the signs of infection are, the best way to reintroduce turnout, Vet A's thoughts on his prognosis, why suddenly 5 weeks box rest rather than the initial 2 week estimate, how long to hand walk for, when he can have the farrier, whether he even has any soft tissue/ligament damage that they found while in there..

I then emailed the Tuesday I brought him home and said I realise Vet A is a busy man, but please can you pass on these questions I have to him (5 questions similar to the above, not OTT) - nothing, not even a response from the office to say queries received. I then called Friday and said no response, please he get back to me and office said they'd text him to call me, waited all day and nothing. He is then on annual leave this week, and next week he is doing a clinic week so also won't be the one coming out to remove his stitches so can't even talk to him then (practice 20 mins from my yard, so why an exception cannot be made I don't understand).

Considering he's just had surgery and how little it would take to seriously affect his recovery/prognosis, and considering I have paid a hell of a lot of money for the treatment, I am really cheesed off.
 
setterlover said:
Update Phoned this morning the vet dealing with this has now gone on leave for 2 weeks.They are now trying to find a different vet to talk to me
I have to go out the afternoon at 2pm for an important appointment so have told them this and I'll just wait!!
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I'm usually one for trying to be understanding but that is terrible service. Have you tried just refusing to come off the line until a vet is summoned to read you the results? I understand companies have policies, etc etc, but it's an incredibly simple thing that you're needing!
 
Widgeon said:
I'm usually one for trying to be understanding but that is terrible service. Have you tried just refusing to come off the line until a vet is summoned to read you the results? I understand companies have policies, etc etc, but it's an incredibly simple thing that you're needing!
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I would go into the surgery, explain to the receptionist that you need a 5 min chat with a qualified vet and that you will wait until they find one.
 
Unfortunately we are very rural and it is the Veterinary hospital that covers our area..It is a 40 mile round trip to the hospital so I guess I'll just have to wait.
It was only after long conversations with my farrier and with the vet that I opted to test.As we are in the throws of selling up and purchasing a new house it seemed like a good idea to get a base line and know what I'm working with to set up the new paddock as it will need work on the fencing anyway might as well know what would be best.
Life is never easy and I find I am constantly waiting for people to get back to me . relocating and buying and selling of houses is so stressful.
 
setterlover said:
Unfortunately we are very rural and it is the Veterinary hospital that covers our area..It is a 40 mile round trip to the hospital so I guess I'll just have to wait.
It was only after long conversations with my farrier and with the vet that I opted to test.As we are in the throws of selling up and purchasing a new house it seemed like a good idea to get a base line and know what I'm working with to set up the new paddock as it will need work on the fencing anyway might as well know what would be best.
Life is never easy and I find I am constantly waiting for people to get back to me . relocating and buying and selling of houses is so stressful.
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I feel you on this too! I am currently in the final throws of a house purchase, as in everyone in the chain is ready, and the estate agent casually drops into conversation that my vendors don't yet have a mortgage offer.... It never rains but it pours!
 
I’ve started texting normal results now. Not the numbers, just my interpretation). Playing phone tag is a massive waste of time. My Gp is the same as others- just gets the lab to send me my results doesn’t ring.
If I am running them in-house and think there will be abnormalities I get the client to wait then I can talk face to face. Obviously not doable for on property visits.
The number of clients that don’t answer the phone is very high.
 
Finally got the results
He as tested as Ems and his Cushing's is 39 so a bit high
Very pushy vet immediately wanted to get him on medication and shut him on a dirt paddock with very little to eat.
I can't even think straight at the moment.
Other than difficulty keeping his weight down he is cantering around showing no signs of any discomfort farrier out last week thought his feet looked great absolutely no sign of pulses or bruising
At 25 he needs to have quality of life !!!
In a turmoil don't know what to do
 
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setterlover said:
Finally got the results
He is Ems his Cushing's is 39 so a bit high
Very pushy vet immediately wanted to get him on medication and shut him on a dirt paddock with very little to eat.
I can't even think straight at the moment.
Other than difficulty keeping his weight down he is cantering around showing no signs of any discomfort farrier out last week thought his feet looked great absolutely no sign of pulses or bruising
At 25 he needs to have quality of life !!!
In a turmoil don't know what to do
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Mine measured at 160 before she went on meds (in January!) and I won't put her in a dirt paddock - she's retired and needs quality of life. While the grass is like this she's muzzled so she can nibble but not gorge. She's on steglatro for the summer months only.

Never been footsore just gets a huge crest.

With 39 I'd be careful about grass access but I wouldn't go overboard tbh.
 
I can empathise with this. My little one does now have half a tablet a day but in terms of other management he’s treated exactly as he always has been (i.e. sensibly) but the list of things the young vet wanted me to do just weren’t practical or what I considered quality of life.

I felt like the initial vet thought I was making excuses, but for example muzzling, I might get a muzzle on him once but I sure as hell wouldn’t get on one him a second time! He goes feral when it suits him…
I didn’t want him to be stuck in a stable 22 hours a day (mine live out). Vet essentially told me mine could never set foot on grass again. He has a restricted paddock in summer with hay, but I wasn’t prepared for him to be in a small mud paddock in winter. They’re at home and I work full time so again, no fetching in at 10am doesn’t work!

I get it, the vet has to give me the textbook answer else I’d be complaining when he comes down with lami. But I also had a chat with one of the more seasoned vets and they were much happier having a sensible and practical conversation about it.

So mine essentially spends April - October on restricted grass with hay, and then October - March out with my other on normal grass. I let it get to almost standing hay, it’s not rich pasture.

What I’m trying to say is I would manage him as you are doing, be sensible and vigilant and I know people have differing views on the meds but I’d give them a go.

The day mine can no longer tolerate a “normal” enough quality of life will be the day I let him go.
 
Thanks 94lunagem the vet just seemed to be bullying me to give him no quality of life stuck on a dirt paddock .Already I do restricted grazing in summer with low calorie haylege ( he has COPD to add to the mix) and from the end of October he and his companion go onto a bigger area with very long grass.He is strongly bonded with his field companion so they both have the same routine.He is a dear little soul and if he can't cope with this routine at his age (25) I would sooner let him go than make him a prisoner on a dirt paddock .Like you I absolutely hate muzzles not that one would stay on for longer than ,10 minutes!
When I called them tonight they both came galloping over to me squealing with joy for a handful of low calorie treats he deserves that sort of life.
The only reason I tested was because we are moving and I need to sort out management at the new place.
 
My vet leaves me a WhatsApp just to say good or bad. If the latter, it'll be a voice message to say what to do, and we'll talk in depth later. The actual blood results tend to come with the end of month accounts. I get that vets are busy people, but leaving a voice text takes less than a minute
 
setterlover said:
Thanks 94lunagem the vet just seemed to be bullying me to give him no quality of life stuck on a dirt paddock .Already I do restricted grazing in summer with low calorie haylege ( he has COPD to add to the mix) and from the end of October he and his companion go onto a bigger area with very long grass.He is strongly bonded with his field companion so they both have the same routine.He is a dear little soul and if he can't cope with this routine at his age (25) I would sooner let him go than make him a prisoner on a dirt paddock .Like you I absolutely hate muzzles not that one would stay on for longer than ,10 minutes!
When I called them tonight they both came galloping over to me squealing with joy for a handful of low calorie treats he deserves that sort of life.
The only reason I tested was because we are moving and I need to sort out management at the new place.
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I doubt the vet is ‘bullying', they are just advising best practice to prevent further problems whilst you get the horse on medication, and in a system where you can manage the weight well. Imagine if they said 'it's fine, carry on as you are' and the horse developed laminitis- that would be mis-management by the vet and you'd be in a much worse situation.
 
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