kinds of drugs and its side effects

The Frankie Diaries, 9/26: Petside Manner & Hospice Care

stethoscopeI’m just back from the vet, where I went after a weekend panic. On Friday night, Frankie did a weird thing with his back legs when he was outside,  kind of kicking them out like many dogs (but not generally Frankie) do after they poop or pee to stir up dirt. But Frankie didn’t seem quite in control of his movements.

I examined his feet but could find nothing that would have caused him any discomfort, nothing that he was trying to dislodge. It happened only a couple of times, and then Frankie was fine.

It happened again on Saturday evening, again with a quick recovery.

Then on Sunday, Frankie fell inside the house, suddenly losing his balance.

I panicked. I thought about taking him to the emergency vet and called several friends to ask their opinions. We all agreed that since he didn’t have any other symptoms — no vomiting, diarrhea, loss of appetite — and recovered quickly from the incidents, I could wait until the following day.

Which I did, on pins and needles.

The WTF Vet

I called the veterinary office on Monday morning and was told that the first available vet was Dr. M. She would not have been my first choice, and not because I think she lacks medical skill.  What she lacks is petside manner. I don’t expect warm and fuzzy, but I could live without rude; among other things, she once said that Frankie was “weird.” For that reason, I much prefer the equally competent and much kinder Dr. E, who never insults Frankie  (at least not to his — and my — face).

Sure enough, when she came in to the room where we were waiting for her, Dr. M said, “Geez, every time I see Frankie he looks ten years older.”

WTF?  Don’t they teach you in veterinary school — come to think of it, in the human universe — never to say stuff like that?

The Diagnosis

At that point, I was so worried about Frankie that the comment rolled off my back. I was focused on the exam. The ears looked good, so Dr. M.  didn’t think it was a balance issue. And the neurological response tests were normal.

The likely cause of the problem, she decided: arthritis stiffness and pain. The prescription: Metacam.

Whew.

That wasn’t quite all, however. Dr M. said that Frankie’s bottom two teeth look bad. She suggested I get them pulled. But, she said, a regular dental “might break his jaw,” so she advised a veterinary specialist dentist.

That’s general anesthesia and more than $1,000 to treat a dog with CCD? I looked aghast. Dr. M. said yes, I wouldn’t do it either, but it’s my job to  mention it.

You’re Not Sending Frankie Away, Are You?

Mention it, yes — but it would have been nice to mention it in the context of “I wouldn’t necessarily advise it.”  So… “Your dog looks really old, but you might want to subject him to major dental surgery.” Talk about mixed messages.

Again, WTF?

It was clear that there was no way I was going to have Frankie’s teeth pulled, but when I got home it still bothered me. Although Frankie doesn’t have a problem eating, I felt I wasn’t doing all I could for him.

Then I realized that, whether I put a name to it or not, I am engaging in a different type of care: Hospice.  Perhaps a better name is palliative care — making sure your pet is not suffering but not taking extreme measures.

In human cases, hospice sometimes means home care, but more often it means a separate facility with full time nursing care. Not so with pets. As the American Animal Hospital Association puts it:

Hospice is focused on giving pets a safe, caring, intimate end-of-life experience in their familiar environment. As such, it is not geared toward curing a pet’s disease, but rather toward keeping the disease from causing the pet any discomfort. Hospice care focuses primarily on providing pain control and physical and emotional comfort to the pet. To prevent the anxiety of hospital visits and to allow pets and owners the maximum amount of time together, pet owners provide as much care as possible at home.

Frankie is not suffering from a terminal illness in any conventional sense. And, as my panic this past weekend showed, I’m not ready to say good-bye yet. But somehow putting a name on this phase of my life with Frankie, calling it a form of care rather than a form of giving up, made me feel better.

Now if only I can avoid future visits to Dr. WTF…

Update: I realize I am being rather unfair. Dr. M. is more than merely competent; she is very gentle with Frankie and she follows up with me assiduously, calling me in NYC, for example, to discuss a problem that arose while I was away. I’m a slow burn kind of person; it would have been better if I had responded to her insensitivity on the spot. Instead, I’m here venting.

 

Posted in Dog Health Care | Tagged , , | 32 Comments