Can you trust your vets? (A cautionary tale)

The obvious answer should be Yes! Veterinary is one of the caring professions, alongside with nursing and all varieties of medicine, human or animal. Practitioners of such professions are usually, by nature, caring people, who adhere to a code of conduct and are guided by strong ethics. When we have an injury or any health issue, we visit our GP, and we follow their advice because we trust them. In a very literal sense, we trust them with our life.

For many of us, our pets are not just animals. They are part of the family. We love them, we care for them and we want to do as much as we can to help them when they are ill or injured.  We take them to the vets and we have to trust that the vets know what they are doing, and that they are doing their best. Unfortunately, that is not always the case. When the standards that we expect from the vets are less than ideal, we are left with a sense of general distrust and a feel of having been treated unfairly.

I had an experience that made me question my trust in the vets. One of my cats, Essi, is a sweet, good-natured black and white shorthair, very good at finding a soft, warm and well-protected place for a nap, but she also likes to explore. On arriving home as a nine week old kitten, she was immediately confident, exploring all the rooms while her two sisters were taking things at a more relaxed pace. At the first opportunity, she went up the stairs to inspect the rest of the house, and when they finally were allowed in the garden, she decided that next-door’s thatched roof needed to be investigated. There she went: a little kitten running up the slope to the ridge of the roof and coming down again very proud of her achievement.  All three of them had great fun in the garden, going up a tall ash tree and playing in the branches, while we, “the humans”, wondered how they were going to come back down. We were there, ready to help, but there was no need: all three came down, some more gracefully than others did. After that, Essi started to venture further afield. Our garden opens onto a large village field surrounded by hedges. Children play there and people walk their dogs, but it is relatively quiet and safe for a cat. This was a magnet for Essi, perhaps hunting mice, or just because she likes finding new places, so of course she went to the field. One day she did not come back at dinnertime. We were worried and went out looking for her and calling her name, which she knows very well, but could not find her. When she did not appear the following day, we went out again calling her; we asked the neighbours and printed posters, but still no answer. Even with the good sense of direction cats are famous for, Essi might have simply got lost, we would never know, but eventually she returned as if nothing had happened.

All this love of exploring was pushing her luck. One night, when she was about five years old, she came back very late, all spooked. Sometimes other cats come into the garden and chase ours, so we did not think there was anything to worry about. We fed her, and after eating her food very quickly, she bolted upstairs. I followed her and found her hiding under a bed, making strange noises. I tried to calm her, but she just ran downstairs again and disappeared through the cat flap. We thought she just needed to go out and patrol her territory; however, she did not come back for three days. When she finally came on a Saturday evening, we noticed her right hind leg was bent at an unnatural angle, and she was clearly in distress. So we called the vets, who gave us an emergency appointment, and we took her immediately. The vet on duty, let’s call her Cathy, told us Essi needed an X-ray. There we were waiting patiently in the waiting area until she called us to explain the results of the X-ray and the options for treatment: Essi had a broken metatarsus (ankle), and we had four options: (1) Realign the bone, under general anaesthetic, and keep it in plaster for a few weeks. No guarantee that the bone would fuse, and in that case there was option (2) amputate the leg. Option (3) was to have the bone reconstructed by a specialist vet, using very high technology. This would give a secure bone in a shorter time, but it would cost big money (we do not have pet insurance). Option (4) was unthinkable: Put Essi to sleep.

Many years ago, when we lived in a house adjacent to a farm, one of our cats, Boots, got caught in a combine harvester. He managed to come back home, dragging a much mangled rear leg and clearly in shock. We took him immediately to the vets, expecting the worst, or at the very least coming back with a three-legged cat. However, the vet did an excellent job of realigning the various broken bones, stitching all the injuries, and immobilising the leg. After a few weeks, the leg was much better. The cast stayed in place throughout, until the leg healed enough to be supported by a simple bandage, and Boots could put weight on it. Little by little, he was allowed to move about, until he could walk, run and jump almost normally. Although the treatment was expensive, as expected for such an extensive injury, we thought it was fair.

By comparison, Essi’s injury seemed less dramatic, so we decided to go for the first option and hope that the treatment would work. Essi stayed overnight at the vets for her operation the following day. In the evening, she was ready to be collected. She had a temporary cast, that, according to Cathy, needed changing the following day. Also, Cathy told us the cast had to be changed weekly, so we needed to make weekly appointments indefinitely until she told us the leg was safe. The weekly changing of the cast was not required for Boots, so we wondered why it would be necessary in this case. It was going to be traumatic for Essi, who has never been happy to be put in the basket and transported to the vets, not to mention the expense, as each appointment had to be paid separately. Nonetheless, we had no option but to agree to the weekly appointments. We left the surgery with a traumatised cat and a massive bill. This included the emergency Saturday first visit, two X-rays (Cathy said that the first one did not show the injury very well, so a second one was needed), the overnight stay, the operation, and a bagful of antibiotics and painkillers. We took Essi back home and, as we knew she would need to be confined, we had improvised a cage using an upturned baby cot and tried to make her as comfortable as possible; on one end of the cage we put a soft blanket and bowls with food and water, and on the other end she had a litter tray. Essi was very sweet, although clearly uncomfortable and in pain, but she took to her cage as if she understood the need for it.

The following day it was back to the surgery, where Essi was fitted with a new, more permanent cast. One that was to last all of one week. We paid the bill and went back home with Essi crying all the way there and back. On our third visit, Cathy was not there, so Essi was seen by a junior vet. She was gentle, but unexperienced, going by the way she put the new cast. It was placed very high on the leg, making it impossible for Essi to do anything else but lie on her side. Also it was fitted too loosely, as compared to the previous cast. By the following morning, the cast was on one end of the cage and Essi on the other… so back to the vets. This time Cathy attached a new cast, to the leg and a protective cone went around her neck, to stop her biting off the cast, and she recommended more painkillers and some medication to calm Essi down. With an ever-increasing pile of bills, I decided to buy the medication online, from a reputable UK veterinarian pharmacy. This cost me just one third of the price charged by the vets, including postage, and the pills arrived the following day.

Several more trips to change casts followed weekly, with Essi increasingly distraught, not purring and looking uninterested. Finally, one day, after 14 changes, Cathy said that the leg appeared to be solid, but to be on the safe side, she recommended another X-ray. This would involve general anaesthesia and an overnight stay. So we decided against it, even though Cathy insisted strongly. So finally, Essi was discharged and we went to pay our final bill. On checking the bill we found that two X-rays had already been added (and then refunded when we explained we did not have them.) What made me uneasy was the fact that there were two X-rays listed, when the vet said one was needed. That reminded me of the first visit, when two X-rays were taken because “the first one did not show the injury very well, so a second one was taken”. Here, the same story was going to be repeated, even though there could not have been a need for a second x-ray since not even one was taken!

As it happened, Essi started looking much happier as soon as she could move more freely. In a very short time, she started moving more normally, then running and jumping, and she is now happy and completely back to normal. I, on the other hand, was left with the uneasy feeling that things did not add up. I cannot help but feeling that the treatment was an overkill. I felt enormous pressure to go for the weekly visits, the X-rays, the expensive medication (the alternative of buying the medication online was not even mentioned).

I still think that vets are caring professionals, and the vast majority, including Cathy, most likely love animals and want to help them.  The problem is that veterinary surgeries are businesses. They exist to make money and some vets may feel pressured into selling extra visits, prescribing the medication they stock without mentioning cheaper alternatives, and generally generating as much income for the surgery as possible. Pet owners, on the other hand, are a “captive audience”, wanting to do the best for their pet, and having to make quick decisions, often under stress. While I acknowledge that a veterinary surgery is a legitimate business, and the vets are professionals that need a decent salary, pet owners may or may not have the resources to pay for expensive treatments. Even having pet insurance may not guarantee that all the required treatments will be paid, as there are usually many exclusions, limits and requirements for extra payments. The business should not be in the way of the caring, but more importantly, we need to know that we can put all our trust in our vets, medically and financially.  My experience was not a pleasant one, and I would hope that it was a one off; unfortunately, I have heard other stories.

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