vet response - does this seem reasonable?

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cm2581

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Something happened to my terrier when I was out riding this afternoon. Not sure but all of a sudden he was lying screaming in the grass verge. My immediate thought was horse stood on him, although that now seems unlikely according to vet as no Obv swelling or soft tissue injury to the hurt leg. Her thought was some sort of twisting injury as no reaction to pressing leg but very sure to rotate. So she gave him metacam and morphine injection and if not better in morn to get xrays. Took him home and left him with other half while I went to finish horses. when I got back he seemed in much more distress and I phoned vet again who said bring straight in. When I got there they just said to leave him in overnight and they would give him some more painkillers and xray in the morning. when I left him he was so sore he was just lying crying and he's not a whimp- tough as boots wee terrier Who is always happy. so original vet visit 4.30, second 6.45. Dog clearly in a lot of distress. Is this normal to just leave him to suffer till the morning? If I had a suspected broken leg or my horse no one would be leaving till the morning!!!
 
Just had phone call from vets. Fractured radius and ulna in the same place so I think he must've been stood on. Poor wee guy! Hopefully it will heal ok without the need for surgery. At least they were quick off the mark this morning!
 
Poor little soul.

Personally I wouldn't be too happy. I would have wanted x-rays done there and then at the first appointment. That's what the practice where I work would have done. Everyone does things differently though so not to say where I work are right - but you would not have had to pay 2 consultation fees AND had to pay for an overnight stay :rolleyes:
 
Oh for god sake!! I keep posting the wrong thing in the wrong thread!! Hopefully he'll be ok but think I may be changing vets after this or at least making inquiries as to how it would've been handled elsewhere.
 
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Hollycatt said:
Poor little soul.

Personally I wouldn't be too happy. I would have wanted x-rays done there and then at the first appointment. That's what the practice where I work would have done. Everyone does things differently though so not to say where I work are right - but you would not have had to pay 2 consultation fees AND had to pay for an overnight stay :rolleyes:
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In this country that would need a big specialist night time referal establishment.Caesereans, bloat etc would be dealt with as an emergency night call out by most vets ,but fractures would get the treatment issued. That is..dog made comfortable till morning. There is such a one in Battersea,run by the PDSA which take over a usual practice for night time hours..so the day vets get some SLEEP.
 
That is one reason I love my vets - they are a 24 hour 'hospital' so can (and have) do x-rays at all hours.
 
I agree with Harebell, EK that it sounds reasonable. Yes, some vets may well have x-rayed at night, but would it actually have changed the treatment plan? In this case, your dog was made comfortable and x-rayed the next morning; as opposed to being x-rayed, then given pain meds to make him comfortable til morning. As far as the dog is concerned, he has received the same treatment presumably. Even with fractures that need surgical stabilisation, I am sure that previous studies have shown better outcomes when a surgery is delayed til morning to allow a full team of nurses to be present and a vet who isn't tired.

As there was no obvious soft tissue injury it is a little unfair to expect the vet to jump straight to a broken leg. I'm sure there are plenty of owners out there who would say that if a vet wanted to x-ray a dog with no soft tissue damage then they were just after the money. I think sometimes vets can't win - either they want to do too many tests, or they don't do tests quick enough.

Hope your little guy is feeling better soon and makes a speedy recovery.
 
Harebell said:
Yes, it does seem perfectly reasonable. My vets can (and have) x-rayed at any time of day or night, and they are not a "specialist night time referral establishment" as EastKent suggests, but in this case the initial assessment by the vet suggested that a fracture was not immediately obvious? Therefore I would think it was totally reasonable to wait and see what happened, and to x-ray the following morning if required.

The fact that your dog appeared to be in more pain later that evening was not something the vet could have foreseen, so I am not sure why you feel it is necessary to change vets now :confused:
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She has lost faith, I understand that, the dog had a lot of pain initially, with a suspect broken leg [horse standing on it!!!] it was likely that pain would increase in a few hours, but she was sent away and then had to leave it overnight with the vets, she could just as easily have kept it at home, armed with more painkillers, as an experienced animal owner it would have had more monitoring.
In view of the circumstances, I think I would look to go somewhere else, but this is because my friend had a dog that was transported from one surgery to another then another! and eventually and painfully died, 18 hours after being taken in [regularly swallowed stones] it actually needed immediate surgery, just because it was in the wrong place and the wrong time of day, it died in pain. I no longer use that vets practice.
 
The reason I was a bit put out at him just being left till the morning was the timings as per OP. At 6.45, there were still vets, nurses and reception staff in till at least 7.30 as there is an open surgery till then - as in, if your in by 7.30 you will be seen and it was quiet. Sedate, xray and apply a robert jones banagage does not take long. Instead, he was left in a kennel with an unstabilised fracture. The bill is currently not large (~£150) and it does not appear that I have been charged for the overnight stay. It is not about the money. It is as I said, he was just left. Had it been 11pm I could understand but not at the times I took him in. Having said that, they have been very good apart from that. So I will reserve judgment on whether or not to change vets.
 
Harebell said:
The OP stated she didnt actually know whether the horse had trodden on the dog? And why was it "likely" that the pain would increase, when the vet had already adminstered painkillers?

However losing faith is a subjective matter, so if that makes the OP wish to chose another vet then that is his/her personal choice.
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I have had several leg issues, and the pain increased over a few hours, due to swelling I suppose, painkiller did work for about four hours, but then I needed to repeat the dose, OK human painkillers may be different, but i assume that the swelling and pain would be the same.
The dog had a sudden injury with no signs of laceration so probably a pulled ligament which would swell up, or a fracture, which would also swell up.
 
Harebell said:
Since I own sighthounds I have had numerous examples of leg problems, so I can understand where you are coming from? However I dont understand how the vet was meant to predict that from the initial assessment, I have had a couple of instances where a fracture was not initially diagnosed until the pain increased and the situation did not get better :(
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Just to confirm here - my issue was not with the initial visit but the return visit at 6.45. That is the time that I'm unhappy about him being left. I agreed with the vet at the first visit. He was not visibly in distress at that time but became much worse to a degree which I considered a welfare issue to be left till the morning. As I said, 11pm different story. But 6.45 was my issue.
 
cm2581 said:
The reason I was a bit put out at him just being left till the morning was the timings as per OP. At 6.45, there were still vets, nurses and reception staff in till at least 7.30 as there is an open surgery till then - as in, if your in by 7.30 you will be seen and it was quiet. Sedate, xray and apply a robert jones banagage does not take long. Instead, he was left in a kennel with an unstabilised fracture. The bill is currently not large (~£150) and it does not appear that I have been charged for the overnight stay. It is not about the money. It is as I said, he was just left. Had it been 11pm I could understand but not at the times I took him in. Having said that, they have been very good apart from that. So I will reserve judgment on whether or not to change vets.
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I can see where you're coming from, especially given there was a late surgery on, so I can understand you feeling a bit annoyed about him being left. Having said that, hindsight is a wonderful thing, and if at the time the vet felt it was unlikely to be a fracture then leaving him overnight may well have seemed like the sensible option. Unfortunately there is a fine line between diagnosing a problem quickly, and not jumping in too fast with unnecessary tests. Hopefully your vets will continue to deal with your dog well, but if you do feel that you've lost faith in them then its better to change than to be in a situation where you don't want to call the vet because you don't trust them.
 
My main issue with these things - as a lawyer and and vet student - is choice. I want the choice to be mine and to be treated like an intelligent human being and given the facts.

If the practice doesn't have experienced enough staff or the time to do an x-ray until morning - tell me. Don't just bullshit a bit, leave it and hope for the best. Its my choice if I then stick with you and wait and see how the situation develops or go to the largest local vet hospital/vet university that CAN provide the treatment I want. I have more respect with people that are open and honest and give me that facts so I can make an informed choice.

My animals are my life. If they are injured cost doesn't come into it. if there is a clinical reason not to x-ray - fine - explain it to me. If not - explain it to me and let ME deceide whats best for MY animal. I personally feel too often vets put their own fees and business before whats best for the animal and owner. Will I feel the differently when I qualify and am lining my own pocket - I hope not!
 
Hollycatt said:
My main issue with these things - as a lawyer and and vet student - is choice. I want the choice to be mine and to be treated like an intelligent human being and given the facts.

If the practice doesn't have experienced enough staff or the time to do an x-ray until morning - tell me. Don't just bullshit a bit, leave it and hope for the best. Its my choice if I then stick with you and wait and see how the situation develops or go to the largest local vet hospital/vet university that CAN provide the treatment I want. I have more respect with people that are open and honest and give me that facts so I can make an informed choice.

My animals are my life. If they are injured cost doesn't come into it. if there is a clinical reason not to x-ray - fine - explain it to me. If not - explain it to me and let ME deceide whats best for MY animal. I personally feel too often vets put their own fees and business before whats best for the animal and owner. Will I feel the differently when I qualify and am lining my own pocket - I hope not!
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WOW.... Hollycat, that is how the vets used to operate in the UK in the 1970's, but now they spend a lot of time on a non confrontational approach, as a client, I fell in to the trap myself, being so pleased that the cat could be injected for worms rather than a tablet, turned out it was Health and Safety as cats might injure the vet, of course I still had to hold my mini Tiger, but that was not the issue!
 
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I dont think I would be angry in this circumstance tbh, the vet has acted how they see fit at the time, without any clear sign of fracture you would probably have been rather annoyed if they had insisted on xrays and there and then and there was no fracture. It would have cost you more money to xray in the middle of the night too. Also had they discovered a complex fracture requiring surgery they still wouldnt have operated until the next morning so would have been in exactly the same boat. I'm not really sure I see the issue. Had the dog gone in with severe abdominal distress or something then they would have xrayed and operated on their findings in the middle of the night, costing a small fortune because thats a geniune emergency that cant wait until morning. A fractured leg is perfectly acceptable to control overnight with pain meds and sort in the morning. I know you took in earlier in the day as well but realistically if they insisted on xraying every single dog that went in with some sort of pain in a leg as soon as it went in they would have an awful lot of very angry clients feeling ripped off and it would be a total waste of their time as they see loads of dogs like that every week, most of which havn't done anything sinister at all and are fine after some anti inflams and a few days rest.
 
I have re read and still stand by what I'm saying, if they had no real reason to suspect a fracture I think its reasonable to keep controlled with pain meds over night and re asses in the morning. Had they knocked him out to xray and then discovered him needing an op they would have run out of time to operate that day, therefore he would have needed a second knocking out the following morning.
 
Blimey ..injected a CAT for worms,not with Dectomax I hope. One local vet got struck off for doing exactly that.It is not licensed for cats (or dogs actually) and can prove fatal,for instance to border collies.
 
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