1352. Sunday April 7,2013's interesting case. A vet's heavy responsibility

Death of a beloved dog is very emotional for the owner. After 5 days of IV drip and twice daily visits from the owner with his other Jack Russell (wired-haired), the sick Jack Russell (smooth-haired) passed away on Sunday morning. This case was treated by Dr Daniel.

Blood test had revealed extremely high serum urea and creatinine and high total white cell count in this vomiting anorexic dog of around 5 years of age. The owner was aware of the poor prognosis and came to visit daily with his other Jack Russell to let the latter know that his friend is very ill. As I worked from 9 am to 8 pm most days during week days, I would see him. He would talk to the sick Jack Russell as a friend and his wire-haired Jack Russell would see that the sick patient, sometimes lying down, at other days sitting up but with not much response.

The dog vomited in the first 2 days of hospitalisation and was maintained alive on IV drips and antibiotics. He was breathing heavily on Saturday and passed away overnight. Dr Daniel does not start work till 12 noon, but this was his case. I am very strict on such cases. The attending vet must inform the owner of the death as that is his or her responsibility. No other vet should do it. Owners will feel better if the attending vet does it. It is plain common sense but I believe that younger vets who are off duty deem that it is their private time - the "work-life balance" so much advocated nowadays.

In matters of death of a sick dog, there is no such thing as "work-life balance." I told Dr Daniel to phone him to inform him about the death even though he was off-duty on this Sunday morning at 9 am. I texted to him the owner's phone number. He texted back to say the owner's handphone was switched off. He had texted messaged. I reviewed the case record. There was the owner's residence tel number. I texted him to phone this number and some family member responded. I told Dr Daniel he was to come to the Surgery immediately before the owner arrived.

Death of a sick pet requires a vet to be present when the owner arrives. This should be the correct way. This is a vet's heavy responsibility although he or she is not working. The owner was already emotionally upset that his younger Jack Russell had become seriously ill without "cause".

I had explained to him that blood test did show a bacterial infection and the bacteria could be from the grass when his Jack Russell was exercised. "The other Jack Russell is healthy," he had said to me. "It is like dengue fever in a family. Not every family member is infected although they may be bitten by mosquitoes." Singapore has a spike in dengue fever in the last 3 months of so. He accepted the explanation. He knew the poor prognosis as Dr Daniel had told him.

Yet in the end, it was very emotional for him. Much less than for a woman. He brought his wire-haired Jack Russell to see the dead companion. "Say goodbye to him one more time," he brought the Jack Russell to see the dog again. Dr Daniel was present when he came and spoke to him. Cremation arrangements were made.

I expressed my condolences to him as he left. He took my hands to shake and wished me well. It was a very sad sunshine Sunday morning for me. It was good that the owner was satisfied with the care given to his dog. There should be no delay in informing the owner of his pet's death, before he arrives to visit as much unhappiness arise if this is not done as death is a very highly emotional issue.  Some owners would be very angry saying "Why don't you inform me when the dog dies."

Abuse of health care workers in human medicine are on the increase in Singapore, according to a Straits Times report I read recently. Some vet practices have put on written notices saying that pet owners who abuse the frontline staff will not be accepted.             

In any case, it is a vet's heavy responsibility to inform the owner when his pet dies. He should not have this mindset that he should not be disturbed during his time off, to achieve the "work-life" balance. A beloved pet's life has passed away. The vet should be responsible to the very end of the sick dog's life. 

P.S. In another similar case of high total white cell count, the Jack Russell of a similar age developed high fever and had stiff legs and extended neck and panting. He was on intensive IV drip. He cried non-stop on Day 2 and I thought euthanasia would have been an option to stop his pain. I tried various sedatives and pain-killers in addition to the usual medication and IV drip. Yet he recovered on Day 3 (Blog: A miracle on Good Friday case study). He is much better now.