draggonlaady: (Default)
Cracked called, and spoke to Receptionist1 on Friday of last week (at quarter til 5, of course--she lives about an hour's drive away). Receptionist1 tells her that from what she's describing, the dog is most likely either 1: pregnant/whelping, 2: having a false pregnancy, or 3: has a uterine infection (pyometra). She explains that we cannot tell the difference between these over the phone unless the dog starts pushing out puppies. She strongly recommends bringing the dog in the next day to be looked at, or taking it to the Pet Emergency Clinic (because nobody in their right mind wants to deal with her alone after hours here!). Cracked is shocked that a dog as old as this bitch (giant breed, 7 yrs old) could even get pregnant--don't they go through menopause? Receptionist1 explains that dogs don't have menopause, and any dog that's still having heat cycles can probably get pregnant. Cracked then relates that Bitch did "tie" with Evil about 2 months ago. Repeat discussion of possibilities and options. Cracked wants to go take Bitch's temperature and then call back. Repeat discussion of possibilities and options, and that we CANNOT DIAGNOSE OVER THE PHONE. Taking her temperature won't change those options.
Cracked calls back and speaks to Receptionist2, who once more repeats the "cannot diagnose over phone" and options conversation. Cracked decides to watch and see if Bitch has pups overnight. If not, she will come in first thing Saturday morning.

On Saturday, Cracked calls. No puppies, but she can't bring the dog in because she has to go get snow tires on her car. WHAT?!? It's December; winter happens every year by this time! If you need snow tires, why didn't you get them a month ago? And if you've managed to drive this long without them, why do you need them NOW? Repeat conversation of options, with caveat that if Bitch has not produced pups by now, she obviously isn't going to do so--she either has a stuck puppy, or she has a pyometra, both of which are life threatening situations that should be addressed right now (or she is having a false pregnancy, which is not life-threatening but if it was your dog, would you take the chance when 2 of the 3 options might mean she dies?)

On Monday, Cracked calls. Repeat above conversations, I'm too tired of it to type them out.

TODAY, Cracked finally brings Bitch in. Bitch has a raging pyometra with several dead/decomposing pups. Really, truly, impressive in an ohmygod way (dead puppies aren't much fun...). I shit you not, her uterus was as big around as my thigh. This, sadly, means it was so distended/stretched that it was leaking pus into the abdomen through several small tears. So now, on top of the pyometra, she has a peritonitis. Dr M spayed her, flushed her abdomen, and started her on massive quantities of antibiotics, and she was recovering as well as can be expected when I left, but she could just as easily have died (and still may, despite surgery and medications!) because the owner didn't bring her in 3 or 4 days ago, when the uterus would have been much smaller, and we would most likely have not had to deal with the peritonitis and potential sepsis issues.


Previous encounters:

http://draggonlaady.livejournal.com/60430.html
http://draggonlaady.livejournal.com/61451.html
http://draggonlaady.livejournal.com/62833.html
http://draggonlaady.livejournal.com/68458.html
draggonlaady: (Grinding Bones)
Well, the woman with the "very sick puppy" never called or showed up today. Color me surprised.

BUT I did get to deal with one of my very favoritest repeat customers. She was mentioned briefly in this entry http://draggonlaady.livejournal.com/64637.html but I hadn't given her a name yet... she was the one that washed the dog in Pine-Sol.
She and her hubby are back yard breeders of Golden Retrievers. I shall call them Mr. and Mrs. Miller. I first saw them last fall when one of their "best" breeding bitches decided (apparently without provocation) to kill and eat their daughter's spaniel (who I shall henceforth refer to as Chew Toy). She was prevented from accomplishing this goal only by the combined efforts of Mr, Mrs, and another gent--possibly a son? who tackled her and pried her jaws open with a rifle. Presumably, if the prying had failed they were going to shoot her.
Anyhoo...Chew Toy survived the patch him back together surgery, and Millers REBRED THE FUCKING BITCH. Great plan, that. But moving along...

Mrs Miller calls this afternoon. Seems that Chew Toy is constipated. I explain that dogs rarely get constipated, it's much more common that they have diarrhea and the irritation makes them strain when they have no feces to pass. She wants to know why the dog has diarrhea. I have no clue, there are only about three hundred things that might cause diarrhea in a dog. I'd have to see the dog to give her any more specific idea. She wants to know if it could be something he ate. Well, yes it could. But I won't know if it IS that without seeing him. But he's not one that usually eats things...Well then, maybe that's not what's causing it. BUT I WON'T KNOW WITHOUT SEEING HIM! After discussion of possible work-up including x-rays and bloodwork, she says she'll talk it over with Mr. and maybe bring him in.

Mrs Miller calls back about 20 minutes later and goes through basically the same conversation with the receptionist, except this time the dog maybe ate some chicken bones from the garbage and could he be constipated from that? again with the recommending to bring in, possible x-rays, bloodwork, etc. Again with the maybe.

Finally, at 3:15, Mrs Miller calls and says she'll bring the dog in. Since she lives almost an hour's drive away, Receptionist tells her to come straight away, as we will need time to do a thorough work up, what with the x-rays and blood work and all that we'll most likely be doing, and the clinic closes at 5.

They show up, you guessed it, at 4:40. Guess that's better than 4:50. The really frustrating part about this is that she's done the same fucking thing to me 3 times now. She KNOWS how long it takes to do this work up because we've done it on other dogs... So I didn't leave until almost 6 tonight. The story had changed again by the time they got here too. Seems that now she's remembered the dog had diarrhea day before yesterday, and nobody's seen it eat for 2 days. Oh, and it vomited day before yesterday and again today--that's why they called. (Um...what? you called because you thought the dog was constipated.) So x-rays, fecal, bloodwork later... As expected, no signs of constipation. I go through the x-rays with her, point out the interesting things, explain that there's very little in the intestines, no signs of obstruction, etc.
After which she asks me...so does it look like he's very constipated? Um. no....I guess bad on me for poor communication? Never assume that people actually pay attention to you when you're talking to them, I suppose.

Oh, and by the way...Is it ok if I come back on the 15th and write you a check then? (she drops this on me at the last minute, as I'm tallying her bill because the receptionist went home an hour ago). No. No, that's not ok. You can write me a check now, and we'll hold it until the 15th, but as with every other business in town, and as it clearly says on the placard at the front desk, payment is expected at time of services.

And updates on other things...
Cracked's limping Beast is doing better now that she's actually giving him the treatments we recommended.

Beeotch and the pregnant chihuahuah: we have still not gotten payment for her emergency call the beginning of November. The phone number we had for her, the one listed in the phone book, and the one given by 411 (all different) are all no longer in service or belong to someone else. The address we had for her is unknown per the post office. The address she gave us when she picked the chihuahua and pups up was different--and apparently has belonged to a different client of ours (who doesn't know her) for the last FIVE YEARS. So the nice, polite letter I sent telling her she's fired (and the warning notice that she's being sent to collections) never got to her. Ah well. Maybe the collections agency can hunt her skanky butt down.

The ringworm/fleas/lice/earmites scraggly rescue kitten is doing much better, but apparently spread ringworm to most of the household. Oops. Good thing I stressed the part about it being zoonotic and they should contact their doctor...

And apparently, my Cowardly Lion was the final straw that broke up the relationship between Local Breeder and Fila Woman. Hurray! So the dogs that are worth any money are being demanded back by Fila Woman, and the rest of them are staying with Local Breeder and getting fixed... she's already started scheduling spays.

Updates

Dec. 7th, 2006 07:57 pm
draggonlaady: (Grinding Bones)
For those few of you who are following some of my cases:

The hydrocephalus-is-not-caused-by-worms folks have not called back in. I don't know if the pup died on its own or is still around. (http://draggonlaady.livejournal.com/71971.html)

Procrastinating Bloke and his coughing puppy--I've got lab results back from WSU, but I can't tell them that, because the house phone is never answered, the cel number they gave me gets me a men's clothing store in Spokane, and nobody has responded the message I left at the message number (his ex-wife, apparently). Since I can't get in touch with them, I don't know how this dog is doing either. (http://draggonlaady.livejournal.com/70967.html)

I've called several times to try to get an update on the dog who'd been shot. Have left messages on the machine 2 or 3 times. Have not been called back. (http://draggonlaady.livejournal.com/69291.html)

Broken-femur dog that the owners wouldn't allow surgery on is apparently doing "as well as can be expected." (http://draggonlaady.livejournal.com/69007.html)

Cracked has not called back with any updates as to how Evil Beast Dog is walking, or whether she's able to get his medication down him. (http://draggonlaady.livejournal.com/68458.html, http://draggonlaady.livejournal.com/62833.html, http://draggonlaady.livejournal.com/60430.html)

(Are you all sensing a trend here yet?)

But I'm ignoring all the incommunicado people and focusing on the cat from August, (amputated a leg, sent him to WSU for a transfusion and feeding tube, and who later had a large patch of skin die and slough off--jnau, you remember him, even if nobody else does) is doing good. Racing all over the house, jumping up on the chair and climbing into the bed unassisted. Skin is slowly growing back.
draggonlaady: (Grinding Bones)
Got to work this morning and turns out the boss-man has the ill, so instead of having the afternoon off today, I sent him home and stayed. And here I thought I was going to avoid the week's crazies. *sigh*

Ya'll remember Cracked and her evil Beast dog, right? She FINALLY brought him (and the two bitches) back in today. Happily, since I wasn't scheduled to be in this afternoon, they were set for Dr. S to see. So I only had to deal with Cracked in small doses. Seems that Beast has pretty advanced arthritis in his elbow, which I guess is better than osteosarc...but Cracked was at her bestest most annoying today--she had her reference text with her and argued EVERYTHING that Dr. S or I tried to tell her. Apparently her book lists "everything that Newfoundlands get" and she's "been researching" their problems...which of course leads to her asking if I think the dog's problem is hip dysplasia. Well, since the dog's limping on his FRONT leg, I really doubt that. She can't get him to take the pain meds or the joint supplements, and apparently can't be bothered to try putting them in a hot dog or dunking them in butter, because whenever we try to suggest these things, she either ignores us or changes the subject. So whatever.

Got to see another of my favorite clients this afternoon too--The Crazy Sisters breed dachshunds. Says a lot for their sanity right there, I think. They also recently had the wonderful experience of our receptionist threatening to call the prosecutor down on them if they didn't pay their bill--they'd bounced 3 checks in a row. They are currently on the "you will give us cash or credit card BEFORE your appointment" payment plan.
Today they bring in 10 puppies for their first vaccines and check ups. 2 have inquinal hernias--I KNOW I've lectured them before on repeating breedings that throw hernias, but here they go again. Both pups from the same litter, of course. I think I'd be spaying that female but apparently selling the puppies is too important to them. (Not that we ever see the money they get from these sales!) All the pups have ear mites, and I had to explain three times how they get spread and that they should treat the adult dogs too, since apparently all the parents have been scratching and shaking and had waxy goopy ears...not that they've bothered to bring any of the adults in to have that checked. They all have roundworms too, so I explain about worming the adults (which I've done before, but they apparently forgot that) as well as the pups.
And they provided a fine example of "do you understand the words that are coming out of my mouth!?" I was taking the pups and giving the shots while my tech did the paperwork behind me--so she couldn't see the pups through me. She asked what color the pup I'd just been handed was, and the younger of the Crazy Sisters started in about how mom was red and dad was a dapple. I explained that we don't need to know that--we don't put the parent's information down on the paperwork, we just need enough of a description of the puppy that we can tell what record goes with which pup. "oh, ok" she says. Hands me the next pup. THE VERY NEXT PUP. Not 30 seconds after "oh, ok". And when Tech asks what color it is... "mom was a dapple."

And the last thing of the day was the absolute best. Just after 5pm (so technically we're closed, though we haven't managed to escape the building yet), I get a call from a gent who sounds like he's having difficulty forming the words through the pot-haze. The whole conversation felt like moving in slow-motion. Seems his dog has been hit by a car and her leg's very swollen but he doesn't think it's broken. When did she get hit? "The other day." When. did. she. get. hit?! Sunday. SUNDAY! but he can't be bothered to call until after closing on Tuesday. Bastard obviously really loves the dog. Wants to know if there's anything he can do at home because the leg just keeps swelling. So he gets the whole canned lecture about can't diagnose over the phone, need to see the dog, probably need x-rays, he can ice it and give aspirin (no tylenol, no ibuprofen, no aleve!), really should bring the dog in, blah blah blah. He says he might call tomorrow, has to see if he can "fit it in around his work schedule." I managed to not call him nasty names while explaining that he could drop the dog off and give us a phone number to call him at--we can examine the dog while he's working.

Ok. I'm gonna go find dinner.
draggonlaady: (Teddy)
You all remember Cracked, right? With the 3 huge, completely untrained dogs? Well, it seems that the dog I looked at for limping is still limping. So she sent me a cd with a video of the dog on it. Receptionist told her before I watched the video that very likely all I'll get from it is confirmation of which leg he's limping on, and that if she wants to know what's wrong with the dog, we need to see him back--not on drugs this time, so I stand a chance of getting a reasonable pain response when I examine him.

Just got the video in the mail today. Watched it tonight, and between the dog being on the other side of a railing, spending 1/3 of the video laying down or urinating on something, and the owner trying to get the dog to move by 1) throwing frisbees at him, and 2) baby talking in a most annoying voice, guess what I could tell? You got it--he's limping on the right front leg. But I knew that last time I saw the dog (23rd of last month), when he'd been limping on it for 2 weeks already.

So I guess I get to see the dog again on Friday--with any luck, I'll even be able to convince Cracked to leave the 2 bitches in the car again. But I'm not betting on that.
draggonlaady: (Default)
Cracked called in on Wednesday. Says the dog's still limping, and she wants to bring him in on Friday so we can look at him again. Receptionist sets up the appointment, but during the conversation discovers that Cracked has not been giving the dog his pain medication, nor has she been cleaning the sore on the bottom of his foot. Receptionist convinces Cracked that she really should try the treatment recommended before deciding that said treatment doesn't work. Suggests several ways to get pills down dogs.
Today, Cracked calls back and cancels the appointment. Seems pain meds help afterall.

BUT to cancel that out...

Last night, I got a call on the emergency line. Woman, we'll call her Redneck, explains that her dog just hit her jeep (please note the wording there--the dog is completely at fault in this incident, according to her) and hurt her back leg (wait, what? BACK leg? oookaay... I can see head, neck, front legs from having run into something. But back leg? I'm skeptical). Wants to know if she can bring the dog in. Sure, no problem. It'll take her about half an hour to get here. That's fine.

15 minutes later, Redneck calls back. Can't get the dog in the jeep. Doesn't know what to do... dog (we'll call her Whimpy) jumped right in the jeep before, and rode up to the house here just fine. (So why'd you let her OUT of the jeep? Wouldn't it be easier on all involved, and especially on the injuries to NOT jump in and out repeatedly?) But now she's just laying there and won't get up. And she must weigh 100 pounds and Redneck just can't pick her up! Can she give her an aspirin? (Good god I begin to hate that question!) Sure, she can have one plain aspirin, no tylenol, no ibuprofen. But if she's got a broken leg or internal bleeding, it's not really going to help. Oh, well, pretty sure it's just her leg, and there's no bones sticking out or anything...

So today, guess who comes in? That's right, you got it in one! Redneck gets her daughter to help load Whimpy up and they come on into town. Unfortunately they can only come in at 1pm, and I'm booked solid until 3pm (I'm the only doctor in today, my boss is at a conference enduring wonderfully entertaining lectures on legal issues pertaining to veterinary medicine and other such topics). So they drop the dog off, and ok radiographs and whatever else we feel the dog needs. Please call her at home when we're done.

When I get a minute, I send a tech back to get Whimpy--and as they come around the corner into the room, the first thing I notice is that Whimpy has her entire front end shifted so far to the left that she's practically leaning on the tech's leg to avoid putting weight on her right. Yup, the FRONT leg--but that can't be right, the owner told me it was just one back leg, yes? Hmm. Whimpy comes the rest of the way into the room, and she's just almost as lame on the right back as she is on the right front. One exam, some pain meds and sedative, a few radiographs, and a clip-and-scrub-the-open-wounds later, I sit down to call the owner. I get a very nice elderly-sounding lady who is not only not Redneck, but doesn't even know who she is. She complains that she sure gets a lot of calls for her though...so either I've got a very old number, or Redneck's giving out someone else's number.

I have a solution though--I dig through the "received calls" list on the emergency cel. Call the number that Redneck called me from...and get Redneck's mother. Who really isn't that interested in what's wrong with the dog, but tells me she'll send us a check next week. What? no--we would really rather someone pays THIS week... none of the old "I'll gladly pay you Tuesday for a hamburger today" routine.

And we wait. Redneck and daughter show up to get Whimpy about 20 minutes before closing. We go over everything, what drugs we're sending home and how to treat the wounds, and I turn her over to Receptionist for final paperwork and bill. And the shit hits the fan. Redneck thinks she'll just make a $20 payment today and mom'll send a check next week. Receptionist says we'll gladly take the payment and hold a check for up to 2 weeks. Redneck says she only has $20 on her, and doesn't have a checking account. We take credit cards. Redneck has none. Daughter has no checking account. Redneck goes through her wallet and comes up with $40. Receptionist explains that we are open tomorrow morning, and we can keep the dog here for the night for no additional charge; you can can bring a check tomorrow for the rest of the bill.

I swear, we need to post a sign at the front door that says "We are not a loan agency. Don't ask us for credit, that's what US Bank and Visa are for."
draggonlaady: (Teddy)
This is the return of a woman I've had the misfortune to deal with on several occassions, though I don't think I've written to you about her yet. We shall call her Cracked. Because she is. Cracked has several very large, completely untrained Newfoundlands, which she is incapable of controlling. She is also apparently incapable of understanding why this would frustrate the people around her. In her credit, she's recently found new homes for some of the dogs, and is down to 3--an older, evil, intact male, and 2 bitches.

Yesterday, she showed up immediately after lunch (no appointment), let all three dogs out of the car (no leashes on any of them of course!) herds the whole lot into the lobby (without bothering to check for other clients and smaller beasties first). With the help of a technician, she rodeos the chaos into an exam room. Now, I want to point out that this level of chaos was only attainable by SEDATING THE FUCK OUT OF ALL THREE DOGS BEFORE BRINGING THEM IN. She'd given all of them a heavy dose of acepromazine so that they could be groomed that morning. Usually when she shows up, she turns the dogs loose and they run in different directions--towards other clients, towards the highway, towards other people's cars, etc. Well no, I suppose i don't really mean usually--she does this EVERY TIME she comes in.

Anyway. I'm supposed to be evaluating the male for a lameness. So I walk into the exam room to talk to Cracked. Seems that Evil has been limping for 2 weeks now, and the groomer pulled a big wad of "like hair, but hard, I mean completely solid" stuff out from between the "hoof parts of the foot" he's been limping on. (Hoof parts? when did dogs get hooves?) And now he's walking a lot better, but the owner doesn't think that was why he was limping. Because he's still limping, you see. "And it's not a... what do you call it? Chick weed?" "Cheat grass." "Yeah...that... it's not that because the groomer didn't find any in his feet." Right. Your dog runs loose on 100 acres of dirt and trees and he's never come in contact with cheat grass. Yup, I believe that.

Evil has already been fitted with a muzzle before I entered the room. But when I bend over to look at him, the OTHER dogs growl at me. So I ask Cracked to put the other dogs back in the car so that we only have to deal with the one that's got the problem. "Well, he won't like that--it'll upset him to be apart from them." He's drugged, lady. So're they. And I'm going to upset him a whole lot more by poking and prodding at his sore foot. And it's going to upset ME a LOT MORE THAN THAT if one of those other dogs bites me for doing it. So put them back in the car. And for once, she actually does it. Hurray.

So I try to see what lameness she's talking about. I ask her to walk the dog in a straight line across the lobby and back so I can watch him walk. She goes three steps out and comes back. I ask her to go all the way across the lobby, in a straight line. She goes in a circle, with herself between me and the dog. In 5 minutes of trying to get her to understand the concept of "walk the dog away from me, turn around, walk back towards me in a sraight line" I probably actually see the dog take 3 steps. At this point, I give up. Too much risk with having this dog (who's still not on a leash--we've discovered in the past that if we give Cracked leashes for the dogs, she simply puts the leashes on and then drops them, letting the dogs run around dragging the leash) loose in the lobby with other clients potentially arriving and people walking through is not worth the effort. So I round up the technician (the only one--the receptionist is at lunch and the other technician's sick), and we take the dog and Cracked into the back room to put him up on the table. I lower the hydraulic table (yay! I don't have to lift the 200+ pound dog!), and tell her that I want him on the table, pointing "this way" (which was punctuated with body language to indicate that i want the dog facing me). She looks at the non-hydraulic table--"You want us to lift him clear up there?" No. No, I want you to lead him onto THIS table, (which is 4" off the ground) and face him into the room. "Oh. Which way do you want him facing?"

Right. Skipping the rest of that--we eventually get the dog on the table, facing the correct direction, raise the table and lay him over on his side. Dog growls at me several times, but Cracked is much more concerned about the cat in the kennel behind her who's quite cranky while waking up from anesthetic. She goes off on a diatribe about how the cat has a bad attitude and her dog is so sweet and well behaved. I do my best to ignore her while looking at the dog. So then she asks the technician about "what do you call it? Chick weed?" To which the technician replies "Cheat grass". "Right. That. What's it look like, anyway?" Technician points to the seeds I'm collecting from between the dog's toes. "It looks just like that." I remove several cheat grass seeds and several small matts from the dog's feet. (I'm not dissing on the groomer here--I'm sure the feet were much worse before she got to them, and that she did her best with the evil beast and only Cracked to hold him still for her.) Show the owner where the bottom of one of his feet has a sore on it, which is probably where the groomer pulled the matt from earlier. Cracked wanders off on a verbal tangent, redescribing the matt and speculating on what it was (probably hair and pitch, which I've told her 3 times already at this point), and NOW she thinks that might be why the dog's been limping. But she doesn't decide that until after I go through the analogy of having a rock in your shoe and how your foot is still bruised after you take the rock out...

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