Veterinary consult

As always life has been busy, but it got out of control recently in my case. The uni workload has increased as we approached to the end of the year. I seemed have hit my mental burnout, and felt quite depressed, but it appeared to be a common and "normal" thing among students in my year. After rejuvenating over one weekend with decent coffees and food, I felt much better once more. I really live on good food mentally and physiologically, ain't I? Hopefully, I will have more time for social life and this blog after my exams in late November.

Right, back to the topic. Veterinary consultation - hmm, I have little experiences with consults to be frank. The whole thing isn't very appealing for me personally, though some owners are quite sweet and lovely to chat to. Much like any other jobs dealing with people, servicepersons are bound have something to gossip about behind scene at the end of the day. In our case, it is behind the consult door and far away from the ears and eyes teaching staff/clinicians. Certainly, doing such deed is un-professional, and it is a breach of confidentiality, but we can't help being humans. Of course, no name or anything specific that may identify the clients is mentioned.

Anything in there?

How often you know that people aren't be honest outright. Well, that occurs frequently in veterinary consults. Owners sometimes tell us what they think we want to hear, but not the truth. Figuring out what is wrong with our little furry mates is much like doing jigsaw puzzles and detective work - integrating relevant information to make some sense or list differential diagnoses ie. likely causes/underlying pathology. When the truth is not given, our life is much harder and it's our friend who suffers consequently - well, our friend will then have an increaesd chance of becoming my customer on a PM table as a wrong diagnose can be proven fatal.

We were told of a case of a Labrador, responsible by the ER/critical care head vet. The dog was presented with pollakiuria (increased frequency of urination), hypersensitive sound (very hysterical even to being called its name) and hallucinated (it seemed to be chasing invisible flies in the consult). As usual, interesting and exciting things happen on Friday night. There was a little wine party at the owner's, and the dog became like so after the party.  She sedated the dog, did a thorough physical exmaination, checked the mouth and found bits of chocolate brownies. First thing cholcolate is toxic to animals, but they don't show neurological signs like these (chocolate toxicity will be posted at a later time).  Second thing is the brownies were no mere baked goods in this case. With her experience, common thing occurs commonly. She had seen way too many marijuana toxicities, and she believed that the dog munched on hash/weed brownies. She asked the owner explicitly to confirm if there is anything special in the brownies, and the owner did not say anything about the recreation drug. She then proceeded to explain the clinical picture and most appropriate treatments. The dog was induced to vomit, and she found some grass like materials with partially digested brownies. Thinking about probability the dog could have been poisoned from other source, but given the clincial signs and history of party, ingestion of brownies, it is most likely that special brownies were made for the gathering, and the dog (being a Labrador) managed to get some bites. I would say that vets with less experience and knowledge in critical care and toxicology, would not have figured that out right, and the patient's health could have been compromised as appropriate treatment was not provided promptly.

Like I said before, veterinarians are not in the consult to judge. We just want to do our jobs quickly and finish the session within the time limit (usually, 15 minutes). But, some owners just love talking on and on about their life, sometimes including private detail that we don't want to know. Consult charge is per 15 minutes, and some do not realise that they pay for us to listen to them talking. I guess it's better if they see a psychologist for this purpose.

An ideal consult would be a client come in with a calm and relaxed patient, facts provided, quick exmination, diagnostic process/work-up/tests, confirm the diagnosis, advise about the disease, management and treatment options. Fitting all of these in 15 minutes is challenging. Even though this is what majority of the profession are doing, sometimes it is not ideal since proper discussion of the disease and management are often left out. Many vets just reach for treatments eg. corticosteriods, antibiotics or NSAID, and tell owners to give the drug(s) to their pet without telling why. Consults are pretty much the balance between medicine and business. With the skills and experience I have right now, I would take ages to do a proper consult. Practice makes perfection, I guess.