hypothetical situations

[verbal_kint]

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1. A client pulls up with a hit by car dog that will die without immediate medical attention. They only have $50. The short term costs for caring for the animal will be much more than that, not to mention the long term costs. What do you do?

2. Two black cats come into the clinic. One is supposed to be euthanized. You euthanize the WRONG cat. What do you do?

3. A breeder brings two puppies to your clinic. He will not be able to sell those puppies because they deviate somewhat from the breed requirements, but they are healthy. He asks you to euthanize them.
-what would you do?
-this breeder is one of your top clients, would you be willing to lose him over this?
- the breeder tells you that he'll just go home and drown them, what would you do?

 

[HeartSong]

1) I would have in place already a pool of money from people who donate to cases where a client cannot pay the costs. I would work out a payment plan for the client to pay of the cost. I would ask the client to release the dog into my custody until they were able to pay off a certain percentage of the bill or after a set amount of time. If they did not pay off the bill, then the dog would remain in my custody.

2) No choice really. Have to tell the owner of the euthanized cat what happened and make a plan to pay off the lawsuit that is sure to ensue. And also euthanize the right cat.

3) Offer to buy them. Not for the amount that a perfect quality pup would go for, but say $50 each or work out a price. If he is one of those snotty breeders who just wants them dead because he can't stand "imperfect" pups running around that came from his dogs, then I have no problem losing him as a client. I would recommend him to another vet that would be willing to euthanize them. If he did not accept this recommendation, I would say that since he told me that he was going to drown the puppies I would have to report him to the authorities who would charge him with animal abuse.

Of course I say all these without ever having been a vet. Though I have seen situations like this and worse as a vet assistant. One of many reasons why I'm going into behavior instead of medicine.

Some real situations I've seen. I worked for a vet who didn't have vet techs, only assistants and volunteers. She had two kittens in to be spayed. She asked one of the volunteers to anesthetize them. The volunteer used dog anesthetic on them and they never woke up. The vet just shrugged and said "they were just shelter kittens anyway." I don't know what she would have done if they had belonged to someone.

A client brought in a dog to see if she was pregnant. Not only was she pregnant, she was due in 1-3 days. The dog was a zero of the fat scale and was a pointer. The vet told the owner that the dog needed food and to not be worked for a while until the puppies were weaned. He said, "no, can't do that. Have a trial the day after tomorrow that she has to compete in." I never saw the client or dog after that but I despised the vet from that moment on.

 

[Iain]

1. A client pulls up with a hit by car dog that will die without immediate medical attention. They only have $50. The short term costs for caring for the animal will be much more than that, not to mention the long term costs. What do you do?

Take care of the animal and then worry about the money. The problem with veterinary medicine is too many people expect favors which makes it hard to where to draw the line on helping an animal that needs your help, and a person taking advantage of you.

2. Two black cats come into the clinic. One is supposed to be euthanized. You euthanize the WRONG cat. What do you do?

This should not happen - no need to even speculate over it.

3. A breeder brings two puppies to your clinic. He will not be able to sell those puppies because they deviate somewhat from the breed requirements, but they are healthy. He asks you to euthanize them.

Unfortunately one of the realities of veterinary medicine is that some animals have a task or job to perform, if they are unable to do this, or more likely in a pet setting a family is no longer able to support the animal a decision has to be made.

I would definitely suggest the idea of adoption families, and I would hope that someone who is that involved with animals would be welcome a suggestion. If he did not accept this, the reality is the puppies will be destroyed either by another vet, or by himself, and I would much rather ensure it is done properly, and in a pain free manner and do it myself.

 

[mammalmama]

In answer to the third hypothetical question, this was my experience with it. Although this does not concern puppies, it does concern an adult dog that could not be taken care of anymore. This dog comes into our clinic with a broken leg. One of the doctors splints the leg and sends the dog home. Two weeks later, the dog comes back in having torn off the splint. The doctor that splinted the leg was not on duty that Saturday so a different doctor took the case. She tried to resplint the leg but the leg swelled up so there was no way that we could have splinted the leg. She called the owners and told them what happened and the owners said that they would just take the dog home and shoot it. The doctor offered to euthanise the dog so at least the dog would die humanely. The owners agreed to the euthanasia and to the charge for it. The doctor didn't euthanize the dog. She decided that she needed to practice leg amputations. She amputated the leg and put the dog up for adoption on one of the local German Shepherd rescue websites in our area. The owners got charged for the euthanasia and think their dog is dead, when it is still alive and has been adopted. This to me seems incredibly wrong. I can see suggesting to the owner, to release the dog to the hospital and we'll take care of the leg and put her up for adoption. But you don't charge someone for a euthanasia and then don't do it, let alone put that dog up for adoption. That seems completely unethical and wrong.

 

[HeartSong]

The doctor didn't euthanize the dog. She decided that she needed to practice leg amputations. She amputated the leg and put the dog up for adoption on one of the local German Shepherd rescue websites in our area. The owners got charged for the euthanasia and think their dog is dead,

This is soooo wrong and one of the reasons more and more doctors and vets are being sued. Though in this case I think very much that the vet should be sued, or better yet her license to practise be revoked. Could she not offer the option of amputation to the owner? How dare she charge him . . . grrr, I honestly don't understand some doctors.

 

[VeganSoprano]

1. A client pulls up with a hit by car dog that will die without immediate medical attention. They only have $50. The short term costs for caring for the animal will be much more than that, not to mention the long term costs. What do you do?

Treat the animal, then worry about a payment plan. Explain that the animal will remain in my custody until payment is made per agreement. Suggest ways they can pay for tx, such as special funds through rescue organizations. If client can present sufficient evidence of true financial hardship, offer a discount on bill (waive exam fees, etc)

2. Two black cats come into the clinic. One is supposed to be euthanized. You euthanize the WRONG cat. What do you do?

I tell the truth and do what needs to be done to fend off the inevitable lawsuit. But this is a situation that would never happen. I would be the one euthanizing, and I would verify with certainty that this is the right animal. If the animal were generic-looking, as would be the case with a black cat, I would triple and quadruple check. A mistake like that would not happen.

3. A breeder brings two puppies to your clinic. He will not be able to sell those puppies because they deviate somewhat from the breed requirements, but they are healthy. He asks you to euthanize them.
-what would you do?
-this breeder is one of your top clients, would you be willing to lose him over this?
- the breeder tells you that he'll just go home and drown them, what would you do?

Well, for one thing, this wouldn't happen. Many if not most puppies do not turn out to be perfect according to breed standard. These animals are sold as pets - no problem at all.

I would not euthanize a healthy animal for any reason, ever. I would offer to take the animals off the breeder's hands for no charge (a good deal since the breeder will not have to pay for either the OV or euth).

There is no way an unethical breeder would ever be a top client of mine because frankly, I'm just not that good at keeping my big yapper shut! Really, though, I would have no problem losing this person as a client. Money isn't everything. I will be a doctor for the animals, not the cash.

If the breeder tells me he will take the puppies home and drown them, I will tell him that he has threatened to commit an illegal act of animal cruelty and I have no problem reporting him to the appropriate authorities. I will not be blackmailed.

 

[verbal_kint]

For #1, would anyone ask the owner to opt for euthanasia? Since the owners cannot pay for the short term, and prob not the long term, would euthanasia be a considerable option?

also, the ER clinic I work in does not do ANY billing of any kind. They always take the low end of the estimate as a deposit. In critical cases, we have owners sign an approval for critical care and take a deposit of $350 before any major stuff is done. Many clinics who do billing end up never seeing the money. Owners rack up a bill at one clinic and to avoid paying, they'll go to a different clinic. It doesn't seem too unusual to hear someone say "Oh, I don't want to go to Clinic A, they won't treat my animal until I pay off my bill."

 

[VeganSoprano]

As a doctor, I would not consider euthanasia to be an option for an animal that has a reasonable chance of recovery.

I think holding the animal until the bill is paid is reasonable. I hate the thought of holding a living creature as collateral, but things have to be done.

 

[HeartSong]

I also think that holding the dog until payment is made is reasonable, though I wasn't sure if there were any laws or regulations concerning this. That's why I would ask the owner to agree to release the dog into my custody until such time as the bill is paid off at least to a certain percentage, then I would know that I had full legal right to hold the dog.

If the client did not agree to these terms, that is when I would offer to euthanize.

 

[Alysheba]

Not to be a cynic...

but what are you going to do with a dog in your custody that almost certainly will be left there after the owner doesn't pay? State law will require you to file legal paperwork etc. in a process taking weeks to months (depending on the state) before you can adopt the animal out. In the meantime you are using valuble cage space, paying for treatments, yada, yada, yada. Also, is this animal adoptable? Or are you willing to care for it for the rest of its life? What if this is a weekly occurance? (Can't/won't pay the bill happens daily in a large practice). Will you keep all of them?

Despite the fact that most veterinarians picked this career because of a love of animals, most of us are not independently wealthy and cannot afford to become a non-kill shelter for people to dump animals on.

There is no right or wrong answer to this question, but in all honesty, I would most likely euthanize this animal. My committment to all animals is to "ease animal suffering". By euthanizing an animal that requires heroic tretment that the owner cannot pay for, I have prevented that animal from suffering any further. I understand the other viewpoints expressed here though, and probably felt the same way until I'd been in practice for a couple of years.

 

[HeartSong]

I would probably keep the dog as my own if the client didn't pay the bill. I'm going to have many dogs and cats, there's no avoiding that. Even though I won't be in a situation like this, I will be taking in a lot of stray and unwanted animals (I have done this all my life with the help of my mom). There won't be any problems with me adopting out the dog if I decide that route instead because as I've said before, I would only agree to do this if the owner has already essential 'sold' the dog to me so that I'm the legal owner of it.

Now the idea of this happening often would be a different hypothetical situation and would change what I would do. Though I would never want to own or be a vet at a clinic that was big enough to see cases like this daily or weekly. I would consider the history of the client and look at how much money is available from the donation pool and make decisions from there.

I'm not saying that I wouldn't euthanize the dog for anything, but I would consider ALL other options first.

 

[mammalmama]

The thing with my situation was that the owner did not want to pay for further treatment. They were going to take the dog home and shoot it. I guess the owners did not want a three-legged dog. I think the doctor's heart was in the right place, but her ethics were not. I certainly think that she should be punished for what she did. You don't charge a client for something you don't do. I did meet the dog. She was very sweet, and completely adoptable. I would have adopted her if I didn't have two dog's already.

 

[muttmommy]

1. A client pulls up with a hit by car dog that will die without immediate medical attention. They only have $50. The short term costs for caring for the animal will be much more than that, not to mention the long term costs. What do you do?
Sorry - but I would take care of the dog and worry about expenses and fees later. That is the job of the vet - to help sick and injured animals - period.

2. Two black cats come into the clinic. One is supposed to be euthanized. You euthanize the WRONG cat. What do you do?
Be honest and confess - then fork out the money for the lawsuit and hopefully learn not to do it again.

3. A breeder brings two puppies to your clinic. He will not be able to sell those puppies because they deviate somewhat from the breed requirements, but they are healthy. He asks you to euthanize them.
-what would you do?
-this breeder is one of your top clients, would you be willing to lose him over this?
- the breeder tells you that he'll just go home and drown them, what would you do?

I also support the idea of adoption and fostering - UNLESS there is something that is so wrong with the puppies that they are unable to enjoy quality of life. Otherwise, I would offer adoption first as an option. Then go from there.

Did I really just say all that without the help of caffeine??? Wow. I'm definitely moving up in the world!!

 

[southerncomfort]

I would probably keep the dog as my own if the client didn't pay the bill. I'm going to have many dogs and cats, there's no avoiding that. Even though I won't be in a situation like this, I will be taking in a lot of stray and unwanted animals (I have done this all my life with the help of my mom). There won't be any problems with me adopting out the dog if I decide that route instead because as I've said before, I would only agree to do this if the owner has already essential 'sold' the dog to me so that I'm the legal owner of it.

Now the idea of this happening often would be a different hypothetical situation and would change what I would do. Though I would never want to own or be a vet at a clinic that was big enough to see cases like this daily or weekly. I would consider the history of the client and look at how much money is available from the donation pool and make decisions from there.

I'm not saying that I wouldn't euthanize the dog for anything, but I would consider ALL other options first.

It doesn't matter how large your clinic is, you WILL get cases like that on a very regular basis. Chances are, half the time they will just show up at the clinic door with a half-dead beastie--they're not regular clients, don't have any regular vet, do their own care, etc.

When I worked emergency (granted, that is an extreme setting), we would easily have two such cases per shift! That is not an exaggeration--there were files full of billed and payment plan cases that were never paid in full, if at all. I know--at the start of the each month, we got to make the phone calls and send out the statements.

And, unfortunately, in most areas, a donation pool to cover such expenses would be depleted very quickly. 🙁

Remember, these are the questions they ask at interviews. They want to know that you really know what you're getting into, and the answer is never "because you love animals". These are scenarios you will face in the real world of practice.

 

[HeartSong]

In reality, I won't run into this situation ever because I'm going into behavior not medicine. However, I have worked for three veterinary clinics so I do have some experience in what different clinics experience. The first I worked for was a country vet, she would operate on an animal without upfront payment and let the client take the animal back. But wouldn't see a client if there was debt on their bill. She did have a lot of money owed to her but I believe that she thought it was worth it.

The next vet I worked for was the second largest clinic in town. I believe the policy there was that all money had to be paid up front. If a client came in with a situation like we are talking about, the vets wouldn't even know about it. The secretaries would explain to them the policy, give them their options, and tell them where the next clinic was closest to them. It made since because of the size of their clinic.

The third vet I worked from was a small clinic in a big city. There are about 3 other clinics within a 2 min drive of it and 7 within a 10 min drive. There is a 24 hour emergency vet clinic within 5 mins of it. We hardly had any emergency cases there. When we did, the vets would operate and work out a payment plan. Animals had also been dumped there and there were always dogs and kittens at the clinic up for adoption. It was my favorite clinic to work at though I didn't like one of the vets very much (she has be fired since the time I stopped working there.)

So really, the question does depend on a lot more variables than just what is presented. BUT, in the hypothetical question given, it doesn't mention that this happens often. I assumed from the question that it is a rare occurance, otherwise the hypothetical situation would start out something like "for the fifth time this week . . . "

No, my answer will never be "because I love animals," but it will also never be "because I love money." It will be more "whatever I can do to meet the needs of the animal and my need to make a living." Balance is important in everything.

 

[southerncomfort]

No, my answer will never be "because I love animals," but it will also never be "because I love money." It will be more "whatever I can do to meet the needs of the animal and my need to make a living." Balance is important in everything.[/QUOTE]

That's the hard part--not many vets are turning these people away because they love money, but rather because they have to make a living.

I wasn't trying to harp on you or anything (honest!). Some of the replies here though are more emotional than practical.

 

[theunraveler]

1. A client pulls up with a hit by car dog that will die without immediate medical attention. They only have $50. The short term costs for caring for the animal will be much more than that, not to mention the long term costs. What do you do?

2. Two black cats come into the clinic. One is supposed to be euthanized. You euthanize the WRONG cat. What do you do?

3. A breeder brings two puppies to your clinic. He will not be able to sell those puppies because they deviate somewhat from the breed requirements, but they are healthy. He asks you to euthanize them.
-what would you do?
-this breeder is one of your top clients, would you be willing to lose him over this?
- the breeder tells you that he'll just go home and drown them, what would you do?

1) can it be saved? if can i will forgo the initial charges and save the dog. as a vet my monthly income will be more than enuff to cover the charges needed to save the dog.

2) my first reaction will be "**** that sux" then proceed to weave some fanciful tale to get myself off the hook then euthanise the cat that was mark for euthanasia. i bet the average joe wouldnt know how the cat died...

3) offer to adopt the 2 puppies

 

[Iain]

1) can it be saved? if can i will forgo the initial charges and save the dog. as a vet my monthly income will be more than enuff to cover the charges needed to save the dog.

Starting salary is beer and peanuts, vets are not particularly well paid.

 

[verbal_kint]

2) my first reaction will be "**** that sux" then proceed to weave some fanciful tale to get myself off the hook then euthanise the cat that was mark for euthanasia. i bet the average joe wouldnt know how the cat died...

you should think about being an author of children's books.

 

[Iain]

you should think about being an author of children's books.

JK Rowling is now the richest lady in the UK - that income could suppliment animals whose owners can not afford to provide care for them, it would get much further then a vets income.

 

[theunraveler]

you should think about being an author of children's books.

thx, i'd keep that in mind 😀

 

[theunraveler]

Starting salary is beer and peanuts, vets are not particularly well paid.

in my country, starting pay for a govt vet is around 2.5k which is quite substantial (at least to me) compared to 1.7k for a graduate in degree in business or arts

 

[cudvm2005]

"In reality, I won't run into this situation ever because I'm going into behavior not medicine."

What are you going to do with the owners who want to euthanize their pets because of behavior problems? You WILL run into these situations. They come up day in and day out. Obviously as was stated before, there is no right and wrong answer to these dilemmas. Saying that in the case of a HBC you would waive fees or adopt the dog is maybe feasible a few times, but if you are an associate veterinarian in a clinic you can believe me that this will not fly with your boss all too often. HBC cases can be thousands of thousands of dollars to "repair" and not always with the best prognosis or best outcome for the patient. There is no way that an associate can adopt every stray or every pet from an owner who can't afford payment. As we all know, or at least those of us who have actually worked in private practice know, payment plans do not work. Clients would do better to obtain Care Credit or another credit card. And those of us who have worked out there know all too often a person will come in and say "do everything to save my dog" and you do and run up a huge bill that is never paid and the animal is never picked up.
Regarding euthanizing the wrong animal, it is foolish to think that this does not go on in the real world. In fact, I was just discussing this with a resident at my vet school yesterday and she told me it happened during her internship last year at a very elite private practice referral place in Florida. There is no excuse for it, but it does happen. I don't think it's common for a situation where a perfectly healthy pet is euthanized in place of a sick one. The one being euthanized by mistake is probably very ill as well. And sure things should be double, triple, or more checked. But the reality is that it happens. If this were an interview question you would not be wise to answer "that would never happen to me' because it very well could
Regarding breeders, this scenario will happen as well. Yes you could try and adopt out the puppies or buy them from the breeder or whatever, but are you as the veterinarian going to offer free spays and neuters for those pups as well? Are you going to eat the cost of that plus buying the dogs? Because I think it's unethical to send those puppies out intact and able to breed on their own.
I don't know if people on this board have practical experience working in the veterinary field, but if you don't I would suggest getting out there and really making sure that you are able to handle the ethical and moral dilemmas that come up each and every day. Sure it's noble to say you are not in this for the money. And that's the right attitude to have. And no, I don't want to be cynical and say that everything has to be euthanized or that the picture is very grim. But to think that as an associate, or even a practice owner that you will be able to save every living thing that comes through the door (including those that are savable with no money) is completely unrealistic. You may spend thousands of your clinics dollars to save one dog, when you could have donated that money or time to a shelter and helped dozens of other animals. Things are not black and white and if you continue to have that attitude while in vet school, you will not only be disappointed and angry, but you will become bitter and jaded very quickly.

 

[Alysheba]

CUDVM2005 - Congrats on your impending graduation! Next year (internship or first year in practice) will be your toughest, most interesting and exciting year yet. Enjoy it. 😀

Alysheba
Cornell University
College of Veterinary Medicine
Class of 2000

 

[cudvm2005]

CUDVM2005 - Congrats on your impending graduation! Next year (internship or first year in practice) will be your toughest, most interesting and exciting year yet. Enjoy it. 😀

Thanks! I've applied for internships in the NYC area (I'll definitely be moving back there after graduation.) We'll see how the match pans out. Just took the NAVLE on Friday. Hopefully that went well! I'm excited to be finishing up, but nervous at the same time. More excited though. I will be great to be finally done with school!

 

[VeganSoprano]

as a vet my monthly income will be more than enuff to cover the charges needed to save the dog.

Um, not quite. Most vets start at around $50,000/yr in major urban areas, but also have about $100,000 in student loan debt to pay off.

Granted, you will be waiving your own fees (for exams and stuff), so that will help...but you can waive those fees for anyone if you want.

 

[theunraveler]

well for those lucky enuff to born with a silver spoon, they can go on Papa-Mama scholarship. for those who are financially not so well off, the AVA provides a scholarship with a bond for 6 yrs... so it aint too bad

 

[laurafinn]

My answers to the hypothetical questions.

1. I would recommend euthanasia.

2. Be honest and apologize to owner of mistakenly euthanized cat. (BTW--Recent studies have suggested that heartfelt apologies reduce chances of medical malpractice suits -- not that that would be my primary motivation for saying I'm sorry.)

3. I would refer the breeder to another veterinarian. The threat of him taking his (substantial) business elsewhere or drowning the pups would not sway me.

Question #3 is the most difficult. I would feel terrible euthanizing healthy and temperamentally sound puppies simply because the breeder is too lazy, proud and/or greedy to spay/neuter them and place them in pet homes. At the same time, I would not offer to place the puppies myself -- that would be letting the breeder off the hook for what is essentially his responsibility. As for drowning vs. lethal injection, for my own sanity, I would have to foist that ethical/moral burden back on the breeder. Just say no to emotional blackmail. 🙁

 

[CoffeeCrazy]

I agree that a lot of people need more real-world experience in the veterinary world before applying to vet school and answering the above hypothetical questions. In an ideal world, there'd be enough money to refuse to follow a client's wishes or treat pets whose owners won't pay up. But it's not ideal, and all the sympathy and moral indignity I read above is the reason why 1/3 of private practices fail. School don't want to hear that you'll take in every animal without a home. Especially the midwestern schools - they are looking for practical, business sense in their students.

A vet clinic is a business. You don't have insurance companies covering bills. Where's your money going to come from? Situations like the above do happen, unfortunately. One of my professors who used to be in private practice told us about a man who asked for some perfectly healthy puppies to be euthanized. The clinic refused and offered to adopt them out instead. But he didn't want them to live. He took the box of puppies outside, placed them behind his truck, and ran them over on his way out of the parking lot. At least stupid clients like that can be turned in to the police. But it does happen.

You can't help an animal without incurring costs, and if the cost is you going out of business and being unable to help any other animals, you need to rethink how you prioritize.

I'm really not that cynical, but I like to think that I'm a realist. There's no perfect answer to any of the questions, but a vet does need to stay in business to help animals.

 

[laurafinn]

While I agree with CoffeeCrazy for the most part, I do think the hypothetical situations that were outlined do not occur with equal frequency. For instance, you will run into a ton of HBC cases and others where the client cannot pay for adequate care. It's important to realize that as a vet you will be euthanizing a lot of animals for solely financial reasons.

Situations like #2 will happen, although hopefully not with such grave consequences.

I see situation #3 as a very specific case that just happens to press my buttons. It seems like fewer US dog breeders are culling these days (admittedly, this is based on anecdotal evidence). Frankly, I feel comfortable providing a referral in this case because I don't believe being asked to cull healthy puppies with poor conformation prospects is as common as the other situations that were mentioned. I am generally not inclined to deny a client's request for euthanasia. For instance, if someone came in with a litter of puppies that were of breeds/mixes suffering from overpopulation problems, such as pits, Rotts or GSDs, I would euthanize. Same with puppies with genetic/health problems, such as double merle Aussies.

If people want above all to find homes for dogs, maybe their true vocation is humane society director or outreach coordinator, rather than veterinarian. There's certainly no shame in that, and it's best to figure out it now, rather than after several expensive years of schooling. This society needs many different kinds of animal advocates.