Lupin21

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I actually forgot the cat wasn't vaccinated when I agreed to it, so now I feel like I can't go back on what I told him. :(
ugh. Yeah, I haven't had much time to go through history at times we are so busy some days. I hate looking unprepared when I ask the clients some questions, but dem's da breaks.
 
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DVMDream

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I actually have a client right now that refuses all vaccines and he's got an aggressive cat that he wants groomed. Cat also has a murmur, so I tried to pass them off to a cardiologist. Cardio can't see them for at least a month and I got a call saying they don't think the cat will last that long. In the end it turns out all they really want is for the cat to be sedated and groomed. I agreed, but we also need blood work and chest rads while sedated. I wish I had told him I'd only do it if the cat was vaccinated for rabies. I think I will tell him this is the only time we will do this without a rabies vaccine. He also got grumpy with me and told me he could tell I didn't want to get to close to the cat. No, I don't want to get bitten by your aggressive unvaccinated cat! And I don't want to put my nurses at risk either! He tried to tell me how sweet the cat was, but even the wife said the cat wasn't friendly at home either.
Yeah, agree with TRH, and you surely can call him up and tell him that the cat is getting vaccinated for rabies while there and being groomed, otherwise it isn't happening. Your safety and your staff are much more important than one dingus and an aggressive cat. If you do it "this once" he will expect it again and again and again and become more irate when you say you can't do it without x, y, z in the future. Stick your ground and don't waver. It takes time to build that confidence, but you are right, the cat needs certain things, you are the Dr and the owner can either consent or piss off.

I piss off a lot of people like this that come in with "I only want this and nothing else". I tell them this isn't a buffet and you don't get to pick and choose how/what we do. This is medicine and I am going to do what is best for the patient and for staff safety. If they don't like that, the can exit the building where they entered.

Did he actually agree to blood work and rads or did he decline those as well?
 

vetmedhead

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I just don’t get people who are hesitant to vaccinate. Not anti-vaxxers who are against every vaccine entirely. I obviously disagree, but I know that they take a stance that any vaccine is bad. I can understand their thought process, no matter how wrong it might be. But I see people come in frequently who are hesitant to vaccinate and will reluctantly do DA2PP, but fight tooth and nail against rabies. Then they’ll do bordetella and not really care because it’s oral and not a shot. It’s like, how did you form these beliefs and misunderstanding of how vaccines work? You’ve never heard of injection site sarcomas so that’s not the reason. Your pet has never personally had a reaction to an injection or an oral/intranasal vaccine so that’s not the reason. And no matter what we do we can’t convince you that your logic is flawed. And while DA2PP is a core vaccine, Lyme is actually a more prevalent disease in my area. You’d think these people would only do the vaccines that their pet is most at risk for. But there’s no rhyme or reason, and I can’t understand that.
I think there's a lot of interesting psychology about vaccines. In my experience most people feel better about oral or nasal vaccines because they perceive them to be less "invasive" since they don't involve any needles. I also think more people are concerned about rabies vaccines because of extensive lore about how terrible they are for people (lots of people are still afraid of the painful stomach shots nowadays even though that's not really done anymore) and lots of anecdotal talk about how hard that particular vaccine is on animals. I've especially encountered client reluctance to rabies vaccinate their animals as they get older, with many saying they didn't want to put their pets through it or suffer a reaction (which, for many clients, includes preventing the patient from being lethargic after the vaccine).
At least here, rabies is require by law and I tell people that, haha. I also remind them the fine and required quarantine protocols if they’re caught and the $30 vaccine doesn’t seem so bad...
Was going to bring this up as well. Nobody likes the $$$ rodeo that is involved when unvaccinated animals bite someone, or worse (from a $$$ perspective) come into contact with a rabies positive animal. I'm most familiar with rabies control in TX, which is Rabies Vector Mecca, and that stuff is taken very seriously and clients will regret it if their pets aren't current.
 
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ajs513

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I think there's a lot of interesting psychology about vaccines. In my experience most people feel better about oral or nasal vaccines because they perceive them to be less "invasive" since they don't involve any needles. I also think more people are concerned about rabies vaccines because of extensive lore about how terrible they are for people (lots of people are still afraid of the painful stomach shots nowadays even though that's not really done anymore) and lots of anecdotal talk about how hard that particular vaccine is on animals. I've especially encountered client reluctance to rabies vaccinate their animals as they get older, with many saying they didn't want to put their pets through it or suffer a reaction (which, for many clients, includes preventing the patient from being lethargic after the vaccine).
And this is why I try to make vaccines sound like not a big deal to every client I take a history from. Basically just saying “alright sounds like we’re just due for a couple shots and a heartworm test. Should be a nice easy visit today.”

There is one thing though that I feel sort of strongly about, and I’d like people’s take on it. My hospital does callbacks for most of our patients, basically if they’ve had anything done other than a nail trim, recheck, or something like that. My one coworker feels strongly that we should do callbacks even for patients who only came in for shots that they’ve had in years past. So if a dog comes in for an annual visit and gets DA2PP and bordetella she wants to call and check on them the next day. While I do think clients appreciate being checked on, I think it implants the idea that things can go wrong after shots, which is something I never want a client to think. We tell them the day of the visit that their pet may be a little tired that day and to call if they have any concerns or if their pet has repeated vomiting, facial swelling, etc. But I feel like excessively checking on the pet when the owner hasn’t called with any concerns plants that seed of worry over something that shouldn’t be concerning. Thoughts?
 

vetmedhead

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And this is why I try to make vaccines sound like not a big deal to every client I take a history from. Basically just saying “alright sounds like we’re just due for a couple shots and a heartworm test. Should be a nice easy visit today.”

There is one thing though that I feel sort of strongly about, and I’d like people’s take on it. My hospital does callbacks for most of our patients, basically if they’ve had anything done other than a nail trim, recheck, or something like that. My one coworker feels strongly that we should do callbacks even for patients who only came in for shots that they’ve had in years past. So if a dog comes in for an annual visit and gets DA2PP and bordetella she wants to call and check on them the next day. While I do think clients appreciate being checked on, I think it implants the idea that things can go wrong after shots, which is something I never want a client to think. We tell them the day of the visit that their pet may be a little tired that day and to call if they have any concerns or if their pet has repeated vomiting, facial swelling, etc. But I feel like excessively checking on the pet when the owner hasn’t called with any concerns plants that seed of worry over something that shouldn’t be concerning. Thoughts?
To be fair, things can go wrong after shots, and it can be beneficial to check in on that proactively rather than relying on clients to report when they may not have always caught mild reactions on previous vaccinations and "suddenly" deal with a serious reaction that there may have been some preludes to previously. I think it's important as well since many animals often show allergic reactions differently from how humans show them, and they can be easy for clients to misinterpret or miss even with education on what to look for when they head home. This is also a good time to identify common vaccine side effects and talk the client through them rather than having the client assume something went wrong (an example I can think of would be a cat being sneezy or having runny eyes after receiving the nasal FVCRP vaccine - this is super common and doesn't mean the vaccine made the cat sick, which can be a good thing to remind clients of in a follow up call).

I also don't know that it's always a bad thing to follow up with clients irrespective of the purpose of the visit - it can be a good way to develop trust with the client and increase compliance and office visits in the future. Sort of a not-so-sneaky way to get them to like you and come back again, if you will.
 

vetmedhead

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Some of this also goes back to the idea that things that are routine are not the same as things that are benign. There are absolutely risks that can be associated with vaccination, but for most patients and for most vaccines they do not outweigh the risks of not being vaccinated. Vaccination is and should be routine, but it isn't benign and things can happen.
 

batsenecal

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I also don't know that it's always a bad thing to follow up with clients irrespective of the purpose of the visit - it can be a good way to develop trust with the client and increase compliance and office visits in the future. Sort of a not-so-sneaky way to get them to like you and come back again, if you will.
This is why I would do the call back and make it sound as if it is a part of every visit, regardless of the purpose. If you do it for everything as policy, it doesn't make any one particular procedure seem any more scary than another.
 

JaynaAli

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In addition to what's already been said, callbacks are also a way to cover your butt, liability wise. Client comes back saying that your vaccine killed the dog, but if you do callbacks it will be documented that they said the patient was doing okay at that point, as least. Or if there are concerns you can tell them how to address it/come in/etc. Also it's fairly common for the spouse who came to the appointment to forget something the spouse that didn't come wanted addressed, so I think callbacks are a good point to check back in and see if there are other concerns that need addressed that weren't done at the appointment. Yes, they're annoying for the techs to do and take time, but I think they are important. And I agree with bats that if it's part of the routine people won't overthink it and think callbacks are scary...they'll hopefully think of you as caring.
 

finnickthedog

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I think callbacks for vaccines are a good idea. My cat had a vaccine reaction and I could see a different owner either missing it entirely or not thinking it was a big deal. And I don't know what (if anything tbh, maybe it would have passed?) would have happened if I didn't know something was wrong and call them myself.
 

WildZoo

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Now I’m trying to responsibly dispose of random meds that I’ve found while packing and it’s way harder than it should be. Went to a CVS and they said they don’t dispose of meds. Went to a Walgreens, they said the same thing and that the closest Walgreens that does take meds for disposal is 2 miles away (not THAT far, but far enough that it’s pretty out of the way).
I’m trying to do the responsible thing here, esp since one of the meds I’m trying to dispose of is a topical antibiotic and another is hydrocodone, but I’m getting reallll close to throwing them in the trash.
...2 miles? :p
 

WildZoo

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When I’m running a million other errands the day before moving and it’s literally 2 miles in the opposite direction I’m going, then yes, it’s too far. Normally no, yesterday yes.
Just seemed easier/simpler than most of the other suggestions tbh. Or since you're driving anyway, to just take em with you and figure it out when you get there.

Though I realize I'm late to the conversation.
 
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Skimble

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Yeah, agree with TRH, and you surely can call him up and tell him that the cat is getting vaccinated for rabies while there and being groomed, otherwise it isn't happening. Your safety and your staff are much more important than one dingus and an aggressive cat. If you do it "this once" he will expect it again and again and again and become more irate when you say you can't do it without x, y, z in the future. Stick your ground and don't waver. It takes time to build that confidence, but you are right, the cat needs certain things, you are the Dr and the owner can either consent or piss off.

I piss off a lot of people like this that come in with "I only want this and nothing else". I tell them this isn't a buffet and you don't get to pick and choose how/what we do. This is medicine and I am going to do what is best for the patient and for staff safety. If they don't like that, the can exit the building where they entered.

Did he actually agree to blood work and rads or did he decline those as well?
I've been thinking about calling tomorrow and saying something like, hey, sorry, I didn't remember when we were on the phone that your cat isn't vaccinated, we can't sedate/treat/groom the cat unless it is vaccinated for at least rabies. Then see what he says, I know he'll be PISSED.

He did agree to BW & rads, but the appointment isn't until Monday, so not sure what he will agree to at drop off. Oh, and he's uncomfortable dropping off, he'd rather stay even though he knows it will be a few hours.
 

grebes4lyfe

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Just seemed easier/simpler than most of the other suggestions tbh. Or since you're driving anyway, to just take em with you and figure it out when you get there.

Though I realize I'm late to the conversation.
Yeah. But I was over everything yesterday. It was almost 5pm and I still had other errands to run since I’d been waiting for UPS all day and had to cram all of my errands into 90 minutes and also had to drive an hour into LA for dinner with my vet so that I could see her before I left. I poured my roommates coffee grounds into them this morning.
Again, normally not a big deal. 2 miles in the wrong direction in rush hour LA traffic the day before I drive cross country? Not gonna happen

I also didn’t want them in my car for the drive since they were unlabelled narcotics. Just in case I got pulled over. Utah has scary laws.
 

that redhead

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And this is why I try to make vaccines sound like not a big deal to every client I take a history from. Basically just saying “alright sounds like we’re just due for a couple shots and a heartworm test. Should be a nice easy visit today.”

There is one thing though that I feel sort of strongly about, and I’d like people’s take on it. My hospital does callbacks for most of our patients, basically if they’ve had anything done other than a nail trim, recheck, or something like that. My one coworker feels strongly that we should do callbacks even for patients who only came in for shots that they’ve had in years past. So if a dog comes in for an annual visit and gets DA2PP and bordetella she wants to call and check on them the next day. While I do think clients appreciate being checked on, I think it implants the idea that things can go wrong after shots, which is something I never want a client to think. We tell them the day of the visit that their pet may be a little tired that day and to call if they have any concerns or if their pet has repeated vomiting, facial swelling, etc. But I feel like excessively checking on the pet when the owner hasn’t called with any concerns plants that seed of worry over something that shouldn’t be concerning. Thoughts?
My clinic has a dedicated call back person who calls every appointment the next day or two (minus tech appointments haha). I think of it more in the customer service way than reinforcing that something is expected to go wrong. Just a little, “how did fluffy do after their visit yesterday?” People are always really appreciative of a call. I also give people the reaction school which saves us a lot of calls on “fluffy is tired!!”
 

that redhead

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I've been thinking about calling tomorrow and saying something like, hey, sorry, I didn't remember when we were on the phone that your cat isn't vaccinated, we can't sedate/treat/groom the cat unless it is vaccinated for at least rabies. Then see what he says, I know he'll be PISSED.

He did agree to BW & rads, but the appointment isn't until Monday, so not sure what he will agree to at drop off. Oh, and he's uncomfortable dropping off, he'd rather stay even though he knows it will be a few hours.
“Hello Mr Dingus! As I was reviewing Witchy’s file in preparation for her grooming appointment on Monday, I noticed that she is not current on her rabies vaccine. As you know, this is required by law and there are some hefty fines for unvaccinated animals. We’ll make sure we get that vaccine up to date for her at her visit. Please let me know if you have further questions or concerns!”
 

killerleaf

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When I first got Max, I joined a forum for Chinese Crested. They, as a breed, have issues. Badly bred ones have more. :) I learned a lot on that forum, tho, and I will say that he is a happy boy at almost 12. Yes, he still has acne, and yes, we watch him like a hawk for a few days after any vaccine. I wish we could do what some areas are allowed, with a vaccine one year, then run titers for the next two. But that is just because he stresses so badly after shots. I understand why we can't in our area, and I keep him up to date. I do not want him to have to fight something that I could have prevented with a vaccine. I just wish that there was one that did not have to be yearly.
 

WildZoo

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Yeah. But I was over everything yesterday. It was almost 5pm and I still had other errands to run since I’d been waiting for UPS all day and had to cram all of my errands into 90 minutes and also had to drive an hour into LA for dinner with my vet so that I could see her before I left. I poured my roommates coffee grounds into them this morning.
Again, normally not a big deal. 2 miles in the wrong direction in rush hour LA traffic the day before I drive cross country? Not gonna happen

I also didn’t want them in my car for the drive since they were unlabelled narcotics. Just in case I got pulled over. Utah has scary laws.
Forgot you were in the LA area :) i'd probably never drive anywhere lol
 

Stroganoff

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Stroganoff

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Forgot you were in the LA area :) i'd probably never drive anywhere lol
I read this as Large Animal. Pre-vet has twisted my brain. :(
 

Elkhart

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I'm sorry, I know these posts were a couple pages back; I’m just now getting to them.

Hun, you need to be gentle to yourself. You’re not dumb. You’re not a loser. I know how hard it is, but you need to tell those thoughts to **** off when they happen. They’re not true. **** happens and it sucks, and I’m so sorry you’re still struggling with this, I can’t imagine how hard it is. But mistakes don’t define you.
As much as this may sound weird, have you considered unfollowing for a while? It doesn't have to be permanent, but it would be like taking a break from something that is becoming consuming in your life. There is definitely nothing wrong with it in my opinion. I mean, I gave up WW because I have no self control when I play and needed to focus on the next chapter of my life. haha
Seconded. Sometimes the best way to be okay with those things is to stop seeing them altogether for a while. You don’t need to unfriending these people on Facebook. Just unfollow. Or even take a short hiatus from social media (excluding SDN since it seems like this is a great stress reliever for you). It’s gives you a chance to fully heal before seeing those things again.
Thanks for the encouragement and advice, all. I'm actually feeling a little bit better now and I've just sort of accepted that I am going to get upset sometimes and that's okay, even though it's no use because it isn't like I can't go back in time and change the outcome. Even if I could, and I did make through school and became a vet, who is to say that I'd really actually be any happier? I wish I wouldn't have gone through seven years of education and $120k+ of student loans for nothing, but hey... that's just how things went.

Life should hopefully get better soon. I made my last rent payment for the IA apartment last week and am hoping to move back out of my parents' house soon, and I'm currently looking to make a career move into something a bit more lucrative than the barely above minimum wage work I'm currently doing. It'll take time and it'll require me to stockpile some funds for startup + moving costs, but I'm determined to make it happen and I think it is ultimately the best move for me.

There are certainly days and weeks when I still feel worthless and stupid and inadequate and aimless (though the meds are helping), but then I remember how far I've come since December 2017 when I was dismissed and... I don't know. I feel terrible and boastful for saying it, but I'm almost proud of myself for making it through it all. I couldn't see myself still managing to survive and be alright, all things considered, past that month when everything went down, let alone nearly two years later. I do owe a fair bit of that to SDN, though, for providing such great support. I'm hoping to continue to pay it forward to others who are struggling academically and/or psychologically/emotionally in vet school.
 

Squeaksmom

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Not terrible or boastful @Elkhart . You deserve to be proud, and I'm glad you are!