Thursday, June 11, 2009

Where the MU Vet Hospital Goes Wrong

I have an old dog. Eleven and a half; okay, 11 and 3/4. She is beloved this dog. The best dog I have ever owned or probably ever will. A part of my life and my soul, I have always felt honored and humble that I have been allowed to share her life. And like many old dogs, she has become such a part of me that she is an extension of my thought. We understand each other, though the slightest gesture or flick of the eye.

If you have ever had a beloved dog, maybe you'll understand why I am so angry at the vet school. Maybe not. Nonetheless, I'm furious, and after years of similar stories, both personally and from friends, I'm like that guy on the old movie from the 1970s called "Network." I'm mad a hell and I'm not going to take it any more.

Last weekend, my normally very fit and capable dog, who looks more like she's six than nearing 12, suddenly got very weak and began to look a bit pot-bellied. This morning found me with a 9:45 appointment at the vet school for an abdominal ultrasound. Extensive testing through the week is drawing us toward a probably inescapable cancer diagnosis. I went to MUVTH armed with multiple xrays and extensive bloodwork results from my GP Vet, the capable Dr. Wendy Forbes of Rock Bridge Animal Hospital. She and I had been working on this through the week. The ultrasound was to show us more clearly what's going on in Viva's abdomen. A mass is almost certain, the question being whether it's splenic or kidney or even something else.

And that's really all I want to know. I'm not planning dramatic intervention. She's a dog who has had a fantastic quality of life and to me, quality is far more important than quantity. So the reason I was referred, the only reason I was there, was to get an ultrasound.

I was escorted in fairly quickly by the student, who gave Viva a somewhat cursory exam, then disappeared to get the attending. And we waited. And waited. Me on the hard bench plank, Viva on the ice cold linoleum floor. For an hour. Finally a Resident appeared, and began to give Viva another exam. "Oh honey," she said to Viva, "you're shivering!" And I replied, "Ya think? She's been laying on this cold floor for an hour." I mean, come on. They left an old, sick dog in a breed with very little coat for an hour on a cold floor, why shouldn't she be shivering?

The resident, in her best "I'm the pro and you're an idiot" voice, started to explain to me some of the tests they would like to do.

[ETA: The resident actually told me what they wanted to do before she even looked at Viva. She examined Viva after she outlined what they wanted, then outlined what they wanted again after the exam.]

"Well, we'd like to do another CBC. And of course, depending on what the ultrasound finds, we'd like to do a fine needle aspirate (and I had to stop her from explaining what that is, I *know* what it is), though with her platelets so low that might be a bit iffy, then we'd like to do a bone marrow tap."

"I really just want the ultrasound."

"Oh. Well, okay, let's see. We'll need to take some xrays too."

"You have x-rays." (her hand was on them for God's sake.)

"Well, we may need to take some more."

"Why? You have xrays."

"Xrays would probably be required if you want an ultrasound."

"Then forget it, I won't do the ultrasound."

(she's looking at me like I've sprouted two heads, because I won't go along with her 'Doctor knows best, let's charge everything we possibly can' scenario.)

"Well let me see, let's see what it would be without xrays." (cogitating ensues, in which the student points out they don't have a price structure for ultrasound without xrays, which is ludicrous, because a) they have her xrays and b) you really DON'T need xrays when you do an ultrasound)

"Okay, it'll be about $300."

They wanted $300 freaking dollars to wave a wand around on my dog's belly for a few minutes. Further, I was informed that no, of course I couldn't stay with my dog and it would take two hours "or so." I told them I couldn't afford $300, so they looked at each other again with that look of 'how dare she not fall into line like a sheep' look and said they would consult. They left the room. I promptly called the other place in town that does ultrasounds, which we hadn't chosen first because they couldn't get me in till this afternoon. Their price was almost half less than MU's. So when they came back in and said, brightly, "oh, we can reduce it to $260!" I said thanks, I'm leaving.

"Oh, um, well, we think from her bloods she might have a rectal bleed so we want to test that and see if we can give you some meds for it." (they do a digital exam and say, somewhat regretfully, they can't find anything).

For all that, for having to wait an hour to be seen, and for the privilege of them doing absolutely nothing for my dog, I paid $92.

And maybe I shouldn't be so furious. But let me tell you the things that infuriate me about MUVTH.

First, I should not have to wait an hour to be seen, especially with a sick dog.

Second, I feel the vet school grossly overcharges and deliberately adds on unneeded tests in an attempt to get fees up. In the past, I have been lectured and yelled at for not going with the most expensive treatment possible.

Third, and this is a big one, is not being able to stay with my dog. They take your dog away and do whatever they want. I've had my dogs used as student guinea pigs before, including a dog who came back so bruised from a liver biopsy that his entire belly turned completely black. I think medicine "behind closed doors" is an extremely poor way of doing business. If, indeed, the departments are set up in such a way that there isn't room for owners, then that should be remedied. This is supposed to be a state of the art facility. Owners do deserve to be in on what's going on.

Which brings me to my last point. I never felt (and have never felt when taking any dog to the teaching hospital) that my views or knowledge were in any way respected or even considered. I have always felt condescended to, ignored, and sometimes as if I was just an extra to be gotten away from the dog as soon as possible, so stupid that anything I said was dismissed on its face. It's completely infuriating and always gets my back up so yep, I tend to get surly.

Yes, some owners are pretty clueless. But it doesn't follow that all are, and even those who are deserve respect and someone really listening to what they are saying. Which I never seem to get at MU, where my knowledge in some areas probably way outstrips that of most of the staff.

Some of us have been trying to address these pervasive problems with the vet school for years. I could tell you almost a dozen horror stories, all dogs I know or have owned personally. But the administration is patently uninterested in listening to us, and certainly not in making any sort of change to the way it does things. I bet it brings in a lot of money from the unsuspecting dog owners who don't know better. It's sad, and it needs to end.

Meanwhile, my old dog and I are home. She'll have her ultrasound this afternoon, and I'll be right in the room with her so that I too can see what's going on and help keep her calm.

[ETA: Viva had her ultrasound yesterday afternoon at The Pet Center, with Dr. Miller. They got me right in. I was able to stay with Viva, which helped a lot to keep her calm. We looked at her for about 15 minutes while Dr. Miller very patiently explained what he was seeing. I was able to see her organs right along with him which was extremely interesting and educational. This is how veterinary medicine should be practiced. Thank you Pet Center!]

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