Field/specialties with the least amount of euthanasia?

[Sciencenerd10]

Have you ever watched a person or animal die "naturally"?

Unfortunately, yes.

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[DVMDream]

Unfortunately, yes.

It's horrible. Euthanasia is peaceful. I guess I don't understand why you're wanting animals to die naturally if you know how horrible that is.

 

[Sciencenerd10]

I guess I don't understand why you're wanting animals to die naturally if you know how horrible that is.

I wanted to know if there were certain ways to give an animal adequate pain relief so they could be with their loved ones as long as possible. So that the passing process could be made natural and peaceful. I wasn't aware that there isn't a pain medication that can provide this.

 

[DVMDream]

I didn't know if they would offer free pain medication since the owner didn't want to euthanize. Like another person mentioned their office offered free euthanasia to the puppy with parvo because the owner didn't have the money.

There's a massive difference between offering a one time free service for a puppy that is in the process of dying and providing possibly months worth of medication to an owner.

 

[Minnerbelle]

I didn't know if they would offer free pain medication since the owner didn't want to euthanize. Like another person mentioned their office offered free euthanasia to the puppy with parvo because the owner didn't have the money.

1 ml of pain medication for a kitty in this situation costs $40, maybe 2 ml for $60 or something like that. That lasts maybe less than a week.

I only lose out on like $40 total for euthanizing for free.

 

[Minnerbelle]

And back to this comment...How am I putting on an impression that my "ignorant perceived ideas" about the profession are more legit than the advice given by vets on this forum? When I ask about where the information they are providing comes from or if they have worked in that specialty themselves, it is not to imply they aren't giving legitimate advice or that my ideas are "more legit". I ask these questions because if they did work in that specialty I would PM them asking for more details about their experience in that field. I am not trying to step on toes here...I am genuinely trying to learn as much as I can about this profession.

How about the times where you totally dismissed how multiple veterinarians have said euthanasia is a reason very very few people in the profession get burned out, and your comment was that well, it's true for all the vets you know (I somehow doubt that, and think you're probably projecting your own feelings onto what their saying, but whatever). Or when people all with experiences with zoos (dude, don't worry, I'm sure someone who's responded with the least experience with zoos likely has more experience in it than you) say that yes euthanasias aren't uncommon in zoo med, your response is no, it probably isn't (or not enough to bother you or whatever). You said you feel like you understand pathology as a specialty because of wtf has shared, but what she's shared here really doesn't describe what she does at all. If you were to describe her job, her training, and what her career aspirations were, I'm sure it will not look anything like what it actually is.

You keep saying that you're spending a year to figure out what you want to do because you don't understand the profession, but keep insisting that a core component of the profession (i.e. euthanasia) is not something you can stand. How do you know when you have so little experience? From the things you've said, it's clear you really don't get it. So why don't you actually investigate that more before you start going off on random niches of vet med that are extremely competitive and unlikely attainable for you as your only viable options?

 

[WhtsThFrequency]

I wanted to know if there were certain ways to give an animal adequate pain relief so they could be with their loved ones as long as possible. So that the passing process could be made natural and peaceful. I wasn't aware that there isn't a pain medication that can provide this.

There are some that may help the severe cases we are discussing (morphine and morphine-related drugs etc) but they are beyond the bounds of a clinic to be able to provide for free, and it sets a dangerous precedent that anyone who refuses euthanasia can get free meds (and who knows if they will even actually use said meds for their pets - drug seekers are no strangers to vet clinics). The idea of a sedated, pain-free animal dying peacefully in their sleep at home is a romantic one that is not grounded in reality. It does not happen except in extraordinarily rare circumstances. You want calm and peaceful? Euthanasia. Those are the drugs to make the passing easy and pain-free.

Another aside - animals also, in general, do not want to be with their "loved ones" when they die. There is a deep biological urge to separate themselves and die alone.

 

[Sciencenerd10]

How about the times where you totally dismissed how multiple veterinarians have said euthanasia is a reason very very few people in the profession get burned out, and your comment was that well, it's true for all the vets you know (I somehow doubt that, and think you're probably projecting your own feelings onto what their saying, but whatever).

I said it was what the vets I have spoken to said. I wasn't dismissing that this isn't the case for everyone. I find it interesting to hear that it is not the case for several people on here. I am not dismissing that.

Or when people all with experiences with zoos (dude, don't worry, I'm sure someone who's responded with the least experience with zoos likely has more experience in it than you) say that yes euthanasias aren't uncommon in zoo med, your response is no, it probably isn't (or not enough to bother you or whatever).

My comment was that I would think it is still less than GP and I asked if others would agree. That was me trying to get confirmation that it is indeed less than GP.

You said you feel like you understand pathology as a specialty because of wtf has shared, but what she's shared here really doesn't describe what she does at all. If you were to describe her job, her training, and what her career aspirations were, I'm sure it will not look anything like what it actually is.

I feel like I understand pathology better than I did before. I was saying that I was hoping others could talk about their experiences in their specialty. WTF explained how the emotions of pathology for her becomes about the science and how she enjoys doing less euthanasia in this field. So yes, I do understand pathology better now. I am not saying I am some expert. Geez.

You keep saying that you're spending a year to figure out what you want to do because you don't understand the profession, but keep insisting that a core component of the profession (i.e. euthanasia) is not something you can stand. How do you know when you have so little experience? From the things you've said, it's clear you really don't get it.

I didn't say I can't stand euthanasia. I am expressing my hesitancy because of the financial/ economical euthanasia and I wanted to hear about some first hand opinions and experiences with this.

So why don't you actually investigate that more before you start going off on random niches of vet med that are extremely competitive and unlikely attainable for you as your only viable options?

A part of making an informed decision would be research. Before I choose any career I want to know the diversity of it and what my options are. So why wouldn't I ask about the field I would probably enjoy more?

 

[CalliopeDVM]

Another question for everyone. Say you do have a patient that has cancer, and their owner can't afford chemo. Are there other options besides euthanasia? Can you send the patient home with pain medication to make them comfortable, and they pass on naturally like some humans do?

In cases like this where the client doesn't want euthanasia, do you ever provide pain medications at no cost to help the animal so they don't suffer?

Options other than chemo? It depends on the cancer and the severity at the time of diagnosis. In some cases, palliative care will alleviate the pet's pain and suffering for a while; in other cases, it won't help. And, no, we don't provide free analgesia; if the owner can't afford to keep their pet comfortable (assuming that we've not gone beyond that stage already), then euthanasia is the only other option. We can't give out free medication - whether it's chemotherapy drugs, antibiotics, or pain relief. If the client doesn't want euthanasia but also won't otherwise accept (and pay for) any other options to relieve their suffering, I tell them that their refusal is causing their pet to suffer, and I will report them to Animal Control for abuse. And I will (and have). It is not acceptable to refuse to alleviate your pet's suffering, one way or another, and surrendering a pet for euthanasia is almost always an available option.

That is really sad. Are there no oral pain medications that can be given to a pet with cancer or other conditions? Are they just not a good option?

Again, it depends on the type and location of cancer, the stage of the disease, and the individual animal. In some cases, transdermal and oral pain meds are enough, in some cases they're not. At the stage when home-medication and treatment is not sufficient, that's the time to euthanize because otherwise the pet will continue to suffer.

 

[WhtsThFrequency]

If the client doesn't want euthanasia but also won't otherwise accept (and pay for) any other options to relieve their suffering, I tell them that their refusal is causing their pet to suffer, and I will report them to Animal Control for abuse. And I will (and have). It is not acceptable to refuse to alleviate your pet's suffering, one way or another, and surrendering a pet for euthanasia is almost always an available option.

That's really interesting @CalliopeDVM. I didn't even consider that option. What was the outcome in those circumstances?

 

[dyachei]

If you are interning for zoo med would that be the only place you intern? Or would they send you through several other fields of vet med during this intern year?

You are right, having a mentor straight out of school would be better before jumping right into private practice. I would want to start my own fairly soon though if I stayed in GP. The vets I have spoken to in person said they felt like they were not respected as doctors working in offices as associates. They wanted more freedom to do things their way.

No you usually need a small animal and large animal internship

 

[CalliopeDVM]

I didn't say I can't stand euthanasia. I am expressing my hesitancy because of the financial/ economical euthanasia and I wanted to hear about some first hand opinions and experiences with this.

Economic euthanasias happen all the time, and I am glad there is that option rather than having "economic suffering" instead (i.e. suffering for economic reasons).

One very, very important thing you will need to know if you are considering clinical veterinary medicine: we can do nothing - nothing - without the owners' consent. It's not even about money: even if we weren't going to charge them, we still need their consent to do anything. We can't test them, we can't treat them, we can't keep them in the hospital unless the owner allows us to do it. So even if there are lots of treatment options available, unless the owner agrees to purchase those options from us (treatments, medications, hospitalization) we can't do them, regardless of how much the pet needs them.

 

[DVMDream]

If the client doesn't want euthanasia but also won't otherwise accept (and pay for) any other options to relieve their suffering, I tell them that their refusal is causing their pet to suffer, and I will report them to Animal Control for abuse. And I will (and have). It is not acceptable to refuse to alleviate your pet's suffering, one way or another, and surrendering a pet for euthanasia is almost always an available option.

And we did exactly this with the parvo puppy case I describe earlier. We even eliminated economic reasons for her and she still refused to alleviate suffering. Of course, nothing came from it. They did a welfare check the next day but "no one was home." But at least we tried and did what we could. Sometimes, that is all that you can do.

 

[CalliopeDVM]

That's really interesting @CalliopeDVM. I didn't even consider that option. What was the outcome in those circumstances?

I have only had to report once, and (as I recall) animal control confiscated the animal and it was euthanized. More often, simply threatening owners with the call drives home the importance of the situation and the fact that I'm not overstating the severity of the situation. Maybe it cuts through the haze of their denial, or maybe it tells them that I'm not trying to oversell them on something when it isn't necessary, but that what I told them Dakota needs (say, a GDV surgery) is really a life-or-death necessity. I tell them there are only 2 options: treat (at least palliative care) or euthanize......of course I only do that when the patient is really suffering.

 

[CalliopeDVM]

Of course, nothing came from it. They did a welfare check the next day but "no one was home." But at least we tried and did what we could. Sometimes, that is all that you can do.

Yeah, a lot depends on the quality of your local Animal Control organization and individual officers. But, at least you have to try.

 

[Sciencenerd10]

Economic euthanasias happen all the time, and I am glad there is that option rather than having "economic suffering" instead (i.e. suffering for economic reasons).

One very, very important thing you will need to know if you are considering clinical veterinary medicine: we can do nothing - nothing - without the owners' consent. It's not even about money: even if we weren't going to charge them, we still need their consent to do anything. We can't test them, we can't treat them, we can't keep them in the hospital unless the owner allows us to do it. So even if there are lots of treatment options available, unless the owner agrees to purchase those options from us (treatments, medications, hospitalization) we can't do them, regardless of how much the pet needs them.

Is this one of the reasons some vets become burnt out? The fact that a lot of the power lands within the clients hands even when you know what is best medically for the patient?

Did you ever go through a period where you blamed yourself for not treating an animal when the owner couldn't afford it. I have heard that some owners will actually blame the vet and say their pet is dying because the vet is money hungry. Which of course isn't true. Has that ever happened to you? And if so how did you deal with the guilt?

 

[Minnerbelle]

That's really interesting @CalliopeDVM. I didn't even consider that option. What was the outcome in those circumstances?

In my state it's mandatory reporting. It pisses people off, but it happens.

 

[Minnerbelle]

I have heard that some owners will actually blame the vet and say their pet is dying because the vet is money hungry. Which of course isn't true. Has that ever happened to you? And if so how did you deal with the guilt?

All the time. I feel no guilt, as none of it is my fault. Why should I feel guilty? I feel a host of other emotions, but guilt is not one of them.

 

[Sciencenerd10]

All the time. I feel no guilt, as none of it is my fault. Why should I feel guilty? I feel a host of other emotions, but guilt is not one of them.

I feel like I would blame myself personally because technically I could treat the animal with skills and resources. So although it wouldn't be my fault I would probably blame myself.

 

[WhtsThFrequency]

Is this one of the reasons some vets become burnt out? The fact that a lot of the power lands within the clients hands even when you know what is best medically for the patient?

Yes, it absolutely is. Much more so than the actual number of euthanasias we have to do.

Did you ever go through a period where you blamed yourself for not treating an animal when the owner couldn't afford it. I have heard that some owners will actually blame the vet and say their pet is dying because the vet is money hungry. Which of course isn't true. Has that ever happened to you? And if so how did you deal with the guilt?

And yes, there are a lot of money-hungry accusation levelling at vets. How heartless we must be because we won't treat them for free. Etc. Everyone has their own ways and rationalization to not let it get to them, I don't think there is a clear cut answer.

I feel like I would blame myself personally because technically I could treat the animal with skills and resources. So although it wouldn't be my fault I would probably blame myself.

I think this is the crux of the matter here.

Instead of just cowing to these feelings and trying to tailor your career in veterinary medicine, (which has a lot of euthanasia associated with it as a field no matter what specialty you are in), in order to avoid it, you need to critically evaluate why you feel this way and attempt to change it if you want to succeed. Feeling guilty about things beyond your control is not a healthy emotion no matter what field you are in. And you know, people have been tough with you in this thread, perhaps undeservedly so in a few instances given your experiences, but I think you have hit the nail on the head with your own feelings here. It sounds like isn't the euthanasia per se that bothers you - it is the feeling of powerlessness. And sadly, it is something you'll feel a lot of in vet med.

There is also a difference betweeen guilt and shame. Guilt is realizing you messed something up, seeing a clear path to correct these actions in the future, and pursuing that path. Shame is a different emotion. Shame is feeling bad about something, whether it is your doing or not, and letting it get to your own self esteem when you start blaming yourself as a person with no solution in sight. Guilt is a healthy emotion, shame is not.

 

[Sciencenerd10]

I think this is the crux of the matter here.

Instead of just cowing to these feelings and trying to tailor your career in veterinary medicine, (which has a lot of euthanasia associated with it as a field no matter what specialty you are in), in order to avoid it, you need to critically evaluate why you feel this way and attempt to change it if you want to succeed. Feeling guilty about things beyond your control is not a healthy emotion no matter what field you are in. And you know, people have been tough with you in this thread, perhaps undeservedly so in a few instances given your experiences, but I think you have hit the nail on the head with your own feelings here. It sounds like isn't the euthanasia per se that bothers you - it is the feeling of powerlessness. And sadly, it is something you'll feel a lot of in vet med.

There is also a difference betweeen guilt and shame. Guilt is realizing you messed something up, seeing a clear path to correct these actions in the future, and pursuing that path. Shame is a different emotion. Shame is feeling bad about something, whether it is your doing or not, and letting it get to your own self esteem when you start blaming yourself as a person with no solution in sight. Guilt is a healthy emotion, shame is not. Take it from me, I am the Little Engine That Could when it comes to shame,

I have always felt guilty over things that I probably shouldn't. I tend to take on the responsibility and blame myself for things. I honestly don't know how to overcome this though. Did you ever blame yourself or feel guilty/shameful in any situation of euthanasia? And if so, how did you overcome it?

 

[WhtsThFrequency]

I have always felt guilty over things that I probably shouldn't. I tend to take on the responsibility and blame myself for things. I honestly don't know how to overcome this though. Did you ever blame yourself or feel guilty/shameful in any situation of euthanasia? And if so, how did you overcome it?

Nope, I haven't felt guilt really. Then again I have never done general practice. The only times I euthanized anything was in my fourth year of vet school. The reason I feel like I am not as good at dealing with it as some of my peers doesn't have to do with feeling guilt over anything, it is just I get too sad over the actual process. Like seeing life leave a body makes me sad. I'm in research right now and I have to do it to mice quite a bit. I love the meeces. Those guys are such troopers; I probably care too much about them. I don't think I could do animal model research as a primary career because of that, though. But I know feeling sadness over their loss of life has nothing to do with me as a person, my abilities, etc, hence why I don't feel guilty per se.

I am very similar to you actually - historically I have been awful at taking on more responsibility than I should and blaming myself for everything. It led to.....bad consequences for my health and mental state down the road. It actually took therapy to get me to stop (or at least get better at it).

 

[Sciencenerd10]

Nope, I haven't felt guilt really. Then again I have never done general practice. The only times I euthanized anything was in my fourth year of vet school. The reason I feel like I am not as good at dealing with it as some of my peers doesn't have to do with feeling guilt over anything, it is just I get too sad over the actual process. Like seeing life leave a body makes me sad. I'm in research right now and I have to do it to mice quite a bit. I love the meeces. Those guys are such troopers; I probably care too much about them. I don't think I could do animal model research as a primary career because of that, though. But I know feeling sadness over their loss of life has nothing to do with me as a person, my abilities, etc, hence why I don't feel guilty per se.

I am very similar to you actually - historically I have been awful at taking on more responsibility than I should and blaming myself for everything. It led to.....bad consequences for my health and mental state down the road. It actually took therapy to get me to stop (or at least get better at it).

Did you ever think that euthanasia would make you feel as sad as it does before you entered vet school? Did you ever think prior to choosing vet school that you would probably go into a specialty that required euthanasia less because of this? How did you feel when you witnessed your first euthanasia before choosing vet school?

Is it required to euthanize in vet school?
How did you end up in pathology without doing some sort of internship and rotating through ER and GP?

Sorry that was like a million questions in one post.

I too have had some bad consequences from this blaming myself for everything. It surely isn't healthy. I think I will focus on this a bit more within myself.

Thank you for being understanding.

 

[WhtsThFrequency]

Did you ever think that euthanasia would make you feel as sad as it does before you entered vet school? Did you ever think prior to choosing vet school that you would probably go into a specialty that required euthanasia less because of this? How did you feel when you witnessed your first euthanasia before choosing vet school?

Is it required to euthanize in vet school?
How did you end up in pathology without doing some sort of internship and rotating through ER and GP?

Sorry that was like a million questions in one post.

I too have had some bad consequences from this blaming myself for everything. It surely isn't healthy. I think I will focus on this a bit more within myself.

Thank you for being understanding.

I actually was very detached from euthanasia before vet school. Sidenote, I heavily considered going into food animal medicine as well in vet school. And there is a lot of euthanasia there. Really it's just dogs. I have problems euthanizing dogs - likely because I'm too attached to my own.

The first euthanasia I witnessed was a cat and the clinic I worked at. I was actually kind of...excited? in a weird way because I had never seen a euthanasia (heck, I'd never actually seen anything really die before). If that sounds weird, eh, I'm just being honest. And the process itself was very smooth and honestly quite nice. I felt no guilt at all afterwards. Then in fourth year there was s sweet old hound dog with neuro problems that had to go. He wasn't even on my service but I had seen him around. I cried over that because I love hounds. But I never felt bad or guilty, because I knew it was for the best. If it had been a financial or convenience thing, I don't know how I would have reacted. Likely worse.

I don't know if it is required in school per se, but you are doing yourself a disservice if you try to to out of ever euthanazing anything. I personally had to inject a huge goat who had had chronic spinal cord disease. I remember him; nice goat although being a buck he stunk like hell and therefore I did also for days. The owner was an old timer who really liked him and had kept him comfortable.

Pathology as a specialty generally does not require a rotating internship because the things you learn in GP/ER are not applicable to what you will be focusing on in pathology. There's really no point. E.g. being able to place a catheter like a boss will not help you in path. However, this ups the ante in terms of application and you generally need a lot of experience in path via externships to be competitive.

 

[CalliopeDVM]

I have always felt guilty over things that I probably shouldn't. I tend to take on the responsibility and blame myself for things. I honestly don't know how to overcome this though. Did you ever blame yourself or feel guilty/shameful in any situation of euthanasia? And if so, how did you overcome it?

You do really need to address that issue, or it will hobble you no matter where you go in life. I have never felt guilt or shame because an animal was euthanized, even in cases where I told the owners it was the best or only option. I believe there are worse things that being dead, so I am not ashamed of offering it as an option, nor do I feel guilty about carrying it out. Honestly, that concept is an odd one to me; I can't imagine it. I have felt kind of ashamed on a few occasions where I messed up the euthanasia and as a result it did not go as smoothly as I would have liked -- the animal was out and unaware but it was tougher on the owners than I would have wanted, and I feel badly that I put them through that. I consider euthanizing a pet one of the most important things I do, and I feel badly on those few occasions when I don't do as good a job as I usually do.


(edited for spelling error)

 

[dyachei]

Did you ever think that euthanasia would make you feel as sad as it does before you entered vet school? Did you ever think prior to choosing vet school that you would probably go into a specialty that required euthanasia less because of this? How did you feel when you witnessed your first euthanasia before choosing vet school?

Is it required to euthanize in vet school?
How did you end up in pathology without doing some sort of internship and rotating through ER and GP?

Sorry that was like a million questions in one post.

I too have had some bad consequences from this blaming myself for everything. It surely isn't healthy. I think I will focus on this a bit more within myself.

Thank you for being understanding.

Euthanasia hardly affects me negatively. It truly is a gift we can offer suffering patients. There have been a few where I felt profound loss of a long time patient or friend's animal, but even that is a healthy emotion. 2 cases stick out at me. One was a very young, blocked cat. The owner couldn't afford a thing else and the cat was in a lot of pain. They just couldn't afford to unblock, hospitalize and treat. I later had the owner as one of my tech students and she was profoundly thankful he didn't have to suffer. The other was a 3 year old cat that would violently attack it's owner in her sleep. She was fearful for her toddler. He was otherwise healthy.

Before vet school, my experiences with euthanasia were very positive. I never wanted to avoid it. I've seen far too many situations where people suffered unnecessarily because we don't have that option for humans.

It's essentially required in school. It isn't written in stone, but you will have at least 1 case where you will be a participant.

 

[Sciencenerd10]

Thanks everyone for your replies.

I think at this point the best thing for me to do is continue shadowing at various offices to get a good feel of the profession. I am keeping several of your tips and information in mind. I appreciate everyone participating in this thread. I feel like I was able to sit down and talk to a group of veterinarians about tough issues and get honest answers from them. So thank you to those of you who kept an open mind and didn't get offended by my questions. I am only trying to learn as much as I can about this profession and the conversation has been very insightful.

On that note, I have one last question. Do you have any advice on the types of offices I should definitely expose myself to before choosing vet med? I know we mentioned a few through this thread. I have heard that I shouldn't spend most of my time in an "old school" vet office. Why is that? How can you tell if an office is old school?

 

[CalliopeDVM]

On that note, I have one last question. Do you have any advice on the types of offices I should definitely expose myself to before choosing vet med? I know we mentioned a few through this thread. I have heard that I shouldn't spend most of my time in an "old school" vet office. Why is that? How can you tell if an office is old school?

What you will see in a truly "old school" clinic will be no accredited technicians, no computer integration (for anything), and very little veterinary technology beyond what is required by law (anesthesia, surgery, radiology). Often there will be expired drugs and supplies still on the shelves and still used. However, there are a lot of clinics that are "old school" in some ways, but not in others. A vet with state of the art orthopedic surgical equipment and a complete pharmacy, but no computer integration for even the appointments or preparing prescription labels, for instance. Or a clinic that has great staff, good computer integration (including electronic medical records), and all the bells and whistles of equipment, but doesn't use appropriate surgical suite protocols (no mask/gloves/gowns, open windows, etc). Or a clinic where the vet is up to day on surgical techniques and protocols, has appropriate equipment and good staff, but still uses old and inappropriate medical care, such as not using analgesia or inappropriate steroid use. That last one will be the hardest for you to spot, as you won't be understanding the actual treatments. I've worked in over 5 dozen different clinics, and I've seen maybe 3 or 4 that are not "old school" in some way - and that's OK. Old does not mean inappropriate or obsolete, and there are advantages to doing some things the "old school" way.

I think the only one you really need to avoid is the first - the one that is really "old school" in almost every way. Why? 1) most clinics aren't like that, and it will give you an unrealistic view of the profession and 2) Vets who run their business and professional life like that will probably not be giving you realistic and current advice about a veterinary career. And 3) you may get in to bad habits before vet school, but I'm not sure that's a big deal when you're just shadowing and you realize academia is a different animal.

 

[Sciencenerd10]

Great insight CalliopeDVM! I have definitely shadowed at an old school clinic by the looks of it. It was not totally old school, but it definitely had some of the qualities listed.

 

[lailanni]

Great insight CalliopeDVM! I have definitely shadowed at an old school clinic by the looks of it. It was not totally old school, but it definitely had some of the qualities listed.

You might enjoy a large referral hospital. They have many doctors on staff - a handful may be boarded in different specialties. Usually there's at least one surgeon and a radiologist. These centers also usually see emergency cases just because the crazy stuff from other clinics gets sent over there. You might not like the ER aspect, but it'd be a good way to meet some specialists, lots of doctors, and see a bunch at once. I'm not sure where you're located, but if you're near a larger city there's probably one around.

A nice referral hospital will have better technology (even an MRI in swanky ones) and chances are you'll see some more modern medicine.

 

[lailanni]

Is this one of the reasons some vets become burnt out? The fact that a lot of the power lands within the clients hands even when you know what is best medically for the patient?

Did you ever go through a period where you blamed yourself for not treating an animal when the owner couldn't afford it. I have heard that some owners will actually blame the vet and say their pet is dying because the vet is money hungry. Which of course isn't true. Has that ever happened to you? And if so how did you deal with the guilt?

There are lots of reasons vets become burnt out and it's largely dependent on individual personality and area of work. Something that may really wear one person down could be just an annoyance or a non-issue for another. But is is frustrating when clients decline treatment.

I don't feel guilt over euthanasia. I say ditto to CalliopeDVM's sentiment above. I'll feel bad when I'm not having a good vein day or an animal has a bumpy euthanasia, but I don't feel bad about the euthanasia itself.

Euthanasias don't wear me out. It's dealing with crap clients. That's what I could skip.

 

[lailanni]

OP, just out of curiosity have you considered human medicine?

There's not really euthanasia. And excluding the cases where people personally refuse treatment, I'm under the impression that diagnostics and advanced treatment options are pursued regularly. You don't hear "well, if we don't come up with X dollars, we'll just have to put grandma down."

You'd get to practice medicine and would sidestep this euthanasia issue. Plus you wouldn't have a crushing student debt:income ratio. And you could still help animals in your spare time.

 

[CalliopeDVM]

Great insight CalliopeDVM! I have definitely shadowed at an old school clinic by the looks of it. It was not totally old school, but it definitely had some of the qualities listed.

The flip side is that you don't necessarily want a clinic with all the bells and whistles either - at least not a clinic like that exclusively. Just like a fully "old school" practice will give you an unrealistic expectation of what real life clinical medicine is, a fancy referral clinic without financial limits having all the bells and whistle (and clients prepared to accept everything and without cost concerns) is also an unrealistic view of clinical medicine.

Actually, best would be not to shadow or work at a single practice (or practice type) if you can -- get a look at a lot of different styles of clinics, medicine, and doctors.

 

[CalliopeDVM]

OP, just out of curiosity have you considered human medicine?

There's not really euthanasia. And excluding the cases where people personally refuse treatment, I'm under the impression that diagnostics and advanced treatment options are pursued regularly. You don't hear "well, if we don't come up with X dollars, we'll just have to put grandma down."

You'd get to practice medicine and would sidestep this euthanasia issue. Plus you wouldn't have a crushing student debt:income ratio. And you could still help animals in your spare time.

Great idea!

 

[LetItSnow]

On the whole, I have had more cases where I've been sitting there saying to my staff "I wish they would let me euthanize this animal" than I've had cases where I'm sitting there saying "This is ridiculous that they're euthanizing this animal."

I have plenty of euthanasias where I wish they'd let me treat, but not usually very often where I feel like euthanasia is an *unreasonable* option (but then, I'm pretty tolerant of people having different value systems for pets. If you're the type of person who can't wrap your head around someone feeling differently about animals than you, you may find a lot more euthanasias to be frustrating).

But, I also work in a situation where if I don't want to euthanize an animal because I feel it isn't appropriate, I have the freedom to decline to perform the procedure. I'm not sure if that's true (in a practical sense) for most vets, especially associates, or if more often than not they'd feel extreme pressure to do it against their will. Not sure.

If someone brought me their pet and there was some sort of accident and the pet needed treatment to survive but the only thing getting in the way of treatment was money, I would feel terrible euthanizing that animal. I am afraid that the guilt would follow me around everywhere.

So would you feel better sending the pet home to continue suffering?

A new grad still has a lot of learning to do, and working alone isn't a good way to do that (all those options are still doing GP work).

Hahahahahahahahahahahahahaha.

Sorry. It was the "working alone" part that got me, since I work alone usually.

(Actually, I really do like my situation - I work alone the majority of the time, but since we have 6 other facilities there are at least 6 other doctors just a phone call away who can review my case and talk it through if I'm in over my head. It's sorta the best of both worlds: forced to deal with it, but have a little bit of a safety net. And I have called in another doctor three times for surgical procedures I hadn't done and felt it best to have some over-the-shoulder guidance.)

Another question for everyone. Say you do have a patient that has cancer, and their owner can't afford chemo. Are there other options besides euthanasia? Can you send the patient home with pain medication to make them comfortable, and they pass on naturally like some humans do?

Of course you can. Plenty of vets do hospice care.

But a couple points: First, it's not as simple as "here's some pain meds, have a nice day." Controlling pain, especially in very sick patients, can be a complex task. And often, one where you can't fully achieve the goal and still have a conscious, interactive pet. And if you don't have a conscious, interactive pet - what's the point?

That's true in humans, too. Spend any time with hospice patients and you'll find out their quality of life can really, really suck. Just laying there so drugged up that they're not mentally present .... drooling and unable to eat because they're so nauseous ....

I would be very, very cautious about romanticizing "pass on naturally like some humans do". I'm not sure that's what you're doing, but it kinda sounds like you're saying that's a "better" way to go. As if you just sorta slowly decline, smiling the entire time, and then - click - you're dead and it was a comfortable, peaceful thing.

That's not how it usually happens, in both people or animals. I've witnessed plenty of death, and for my money I'd <personally> prefer to be euthanized. Give me a bloop of propofol and then some euthasol any day.

I feel like I would blame myself personally because technically I could treat the animal with skills and resources. So although it wouldn't be my fault I would probably blame myself.

Technically you can't treat the animal without the owner's consent. You're looking at it as if having the skills and resources are the only thing you need, but that's a fiction you created in your head. In reality, you need skills, resources, and permission. No ifs, ands, or buts. The permission matters every bit as much as the skills and resources. So no, technically you can't 'treat the animal' just because you have the skills and resources.

Final comment in my catch-all reply ......

..... the majority of "thank you" cards I get from owners are for cases I euthanized. And that's in a setting where I don't even know the owners (I don't have long-time relationships with them like a GP position would.). I get the occasional "thanks for saving my dog with that awesome FB or GDV surgery" card, but at least 75% of the follow-up thank you's I've gotten have been euthanasia cases.

Euthanasia is a great chance to make a very positive impact on a pet owner's life. Yeah, there are tough ones. But rather than think about it as the dirty little corner of vet med you don't want to go to, think of it as a treatment we offer that removes suffering from the animal and, if done compassionately, can make a huge difference to an owner.

 

[CalliopeDVM]

Hahahahahahahahahahahahahaha.

Sorry. It was the "working alone" part that got me, since I work alone usually.

(Actually, I really do like my situation - I work alone the majority of the time, but since we have 6 other facilities there are at least 6 other doctors just a phone call away who can review my case and talk it through if I'm in over my head. It's sorta the best of both worlds: forced to deal with it, but have a little bit of a safety net. And I have called in another doctor three times for surgical procedures I hadn't done and felt it best to have some over-the-shoulder guidance.)

I worked alone as a new grad for almost a year. I survived and my patients survived, but it really wasn't a good situation for either of us (myself or my patients) and I wish a) I hadn't been put in the position of doing that and b) I'd known enough to know it wasn't the right thing to do. Even having another vet in the building (not working with me, just working nearby) would have been better. Not just for the tough cases or surgeries, but even for the atypical normals. While I learned a lot, I thank God I had good technicians and a lot of luck to keep my patients safe. A lot could have gone wrong, too. There are much better ways to learn.

 

[LetItSnow]

I worked alone as a new grad for almost a year. I survived and my patients survived, but it really wasn't a good situation for either of us (myself or my patients) and I wish a) I hadn't been put in the position of doing that and b) I'd known enough to know it wasn't the right thing to do. Even having another vet in the building (not working with me, just working nearby) would have been better. Not just for the tough cases or surgeries, but even for the atypical normals. While I learned a lot, I thank God I had good technicians and a lot of luck to keep my patients safe. A lot could have gone wrong, too. There are much better ways to learn.

Yeah, I can see that perspective. I dunno. Maybe a few years from now I'll look back and wish I hadn't been alone, but at the moment it feels like I sorta have the best of both worlds: autonomy to force me to buck up and deal with things, but other docs with access to my records just a phone call away, and at least one colleague who is always willing to come in if I truly feel like I need 'immediate' help. Dunno. I've never really felt 'alone' even though I might be the only doctor in the facility.

 

[Coquette22]

I'm another newbie who is regularly alone, but have a safety net in that I can call the other docs. I'm alone when I work Saturdays and on my regular Thursday evenings (though Thursdays are usually just vaccs/wellness) and for any emergencies while I'm on-call. I'm with LIS; I like being forced to handle things on my own but I like knowing that I can call back-up if I need it. And like LIS, maybe I'll look back and think it was a bad idea, but for now, I feel like it's beneficial.

 

[CalliopeDVM]

Yup, hindsight is 20/20........looking back after 15 years.

 

[Minnerbelle]

When I did the overnight solo ER thing out of school, I felt pretty confident for the most part. Like I don't remember any particularly bad outcomes except maybe for a likely tension pneumo that I may have potentially have been able to save had I been a little quicker or if a boarded ECC or very experienced ER doc been the one in charge (though I wasn't even the only vet on that one and I'm not sure how much I can blame myself if difference between life/death was literally 1 min. You know, the holy **** she's dying she's dying. Oh she's dead.). For the vast majority of cases, the patients were treated appropriately, and I'm not sure others would have done any different. I always had someone to call.

But then, something really changed around oct/nov or so. Not sure how much of it was my ****ty employer, but I came to the realization that any pet that I cared about (my own or friends' pet), I would absolutely prefer being treated at a vet school or highly reputable referral hospital like angell that has highly trained or at least mentored interns. I wouldn't want my own pet at a hospital with a new grad all alone at night. I spend a good amount of time in an academic environment now, and also come in contact with a lot of new grads, and even only being a year ahead of them, I notice how much I've grown since. Even those new grads who are highly competent are very very green still. I would not send my sick patient to them. I also have been able to work with many specialists and every time, I realize how much more I have to grow. And I don't consider myself a shoddy vet. When I switched jobs 6 months out, even as essentially a new grad, none of my techs (who have been working 10+ years in this multi doctor practice and have seen multiple doctors come and go) had any idea. They were flabbergasted when they asked me what year I graduated a few months after I started. In fact I think I'm ****ing awesome, but even then I don't think being by myself right out of school was a good thing. Even now, I don't think it would be a good idea for me to go back to solo ER. I don't think I can deny that good internship training results in better trained ER vets (and I'm talking about the good ones, because some of them really suck and I don't trust them at all).

I felt pretty okay/good at the time, and actually really enjoyed how much I was learning everyday. But even just a year later, i get a little anxious just thinking about how that may not have been the best plan. And I'm glad nothing disasterous happened.

 

[CalliopeDVM]

I felt pretty okay/good at the time, and actually really enjoyed how much I was learning everyday. But even just a year later, i get a little anxious just thinking about how that may not have been the best plan. And I'm glad nothing disasterous happened.

Yes, I enjoyed it at the time. Felt fine, felt confident, was not nervous (except surgeries - that took more years to feel confident at). That's what youth and inexperience can do for you (and I wasn't even young at the time - I was almost 40).

 

[shortnsweet]

I'll admit it...euthanasias have affected me negatively before. There was one week in particular last year when I had to put down 10 horses. Equine medicine in the academic world also means you put down donations. During the last euthanasia, I broke down. The thought of doing one more was terrible. My senior clinican did the next because she recognized I was struggling.

There are so many times where I know euthanasia is necessary, and I am glad we have that as an option for our patients...but it can affect you.

And as for the chemo question above from the OP....correct me if i'm wrong smallies vets, but onco in the vet world is not the same as human medicine. So many owners don't go through with it because it may only prolong a pet's life for a few months. Where is the QOL in that situation? I would never judge an owner for not wanting to spend the money on chemo.

 

[CalliopeDVM]

And as for the chemo question above from the OP....correct me if i'm wrong smallies vets, but onco in the vet world is not the same as human medicine. So many owners don't go through with it because it may only prolong a pet's life for a few months. Where is the QOL in that situation? I would never judge an owner for not wanting to spend the money on chemo.

Usually that's true, and I find it very rare that I have a client elect chemotherapy. On the other hand, chemo in the vet world is often not as intense as in human medicine, so the side effects are considerably less, and the rare pets I see on chemo are not suffering the side effects (intractable nausea, weakness, hair loss) like most human chemo patients do.

 

[dyachei]

I guess i feel like there is a first for everyone and how else are people supposed to learn? It's all well and good to want someone with more experience, but you don't know that the fresh out of school vet is any worse than the 15 year experience vet. For all you know, they haven't kept up to date on that one type of case or haven't seen that one type of case before and mismanage it worse than a new vet.

 

[SocialStigma]

And as for the chemo question above from the OP....correct me if i'm wrong smallies vets, but onco in the vet world is not the same as human medicine. So many owners don't go through with it because it may only prolong a pet's life for a few months. Where is the QOL in that situation? I would never judge an owner for not wanting to spend the money on chemo.

I work at a large SA ER and referral center where we actually see a lot of chemo patients. We're actually having an oncologist start within the next few months because of that. I'm a new grad but from what I've seen so far, most clients pursue chemo when presented with that option. I'm also located in a large urban city though. Dogs and cats seem to tolerate chemo much better than humans and most of the chemo rechecks that I've seen so far have very little side effects (maybe 1 in every 5 patients will have vomiting/diarrhea).

 

[Coquette22]

As a small animal GP in private practice in a very small city in an economically depressed area, very few of my clients are willing to go for chemotherapy. That said, the animals who do undergo chemo have a pretty good quality of life during treatment.

 

[Sciencenerd10]

You might enjoy a large referral hospital. They have many doctors on staff - a handful may be boarded in different specialties.

This is such a good idea. I could probably get exposure to a lot more in a place like this.

OP, just out of curiosity have you considered human medicine?

I have considered human medicine. I love that in human medicine if someone doesn't have the money, they still get treatment. I wish it could be that way in veterinarian medicine.

I am more interested in vet medicine than I am human medicine. Both fields are great and both have their ups and downs. Veterinarian medicine has been a childhood dream for me though. I don't get the excited, passionate feeling about being a physician like I do when thinking of becoming a DVM.

Technically you can't treat the animal without the owner's consent. You're looking at it as if having the skills and resources are the only thing you need, but that's a fiction you created in your head. In reality, you need skills, resources, and permission. No ifs, ands, or buts. The permission matters every bit as much as the skills and resources. So no, technically you can't 'treat the animal' just because you have the skills and resources.

I am thinking more of a situation where the owner is begging me to treat their animal, and money is the only thing in the way. It is this type of situation where I would want so badly to treat at no cost because I would have the skills and the resources, as well as permission from the owner. It is in this type of situation I feel like I would be flooded with guilt.

I think I really need a lot more exposure to the field.

Regardless of what I choose, I really want to do something to work with/help animals. If any of you have any ideas of how that can be implemented into life somehow I am eager to hear about it. I know as veterinarians you probably work closely with individuals who work with animals in other ways.

 

[Sciencenerd10]

I'll admit it...euthanasias have affected me negatively before. There was one week in particular last year when I had to put down 10 horses. Equine medicine in the academic world also means you put down donations. During the last euthanasia, I broke down. The thought of doing one more was terrible. My senior clinican did the next because she recognized I was struggling.

10 horses? Why?

Like I have heard on this forum as well as from a veterinarian whom I adore "The day euthanasia no longer effects you, you should retire from vet med"

 

[Lab Vet]

This is such a good idea. I could probably get exposure to a lot more in a place like this.



I have considered human medicine. I love that in human medicine if someone doesn't have the money, they still get treatment. I wish it could be that way in veterinarian medicine.

Be careful about this statement. Yes, it's true that if an individual walks into an emergency room and can't afford to pay, he or she will not be denied life saving treatment. Beyond that, however, economics certainly play a role in the quality of care a person will receive. With [the option of] nationalized health care, this situation has somewhat improved, but the difference in treatment options between the 'haves' and the 'have nots' is wildly different. Before coming to veterinary school, I worked for the director of (human) cardiothoracic surgery at a prestigious academic medical center. I once asked him what the most difficult part of his job was. I thought he would say the hours. This individual is probably the most hard working person I've met in my life. He easily worked 80 hour weeks, performed complicated transplant surgeries (often at ungodly hours of the day and night), had an active NIH basic science grant, and was involved in more clinical trials than I could count. Nope- his answer had nothing to do with the workload. He told me the most difficult aspect of his job was arguing with insurance companies over 'the worth of a life.' That's right- who's 'worth' saving- the 20 year old, with his whole life ahead of him, or the 70 year old, with a few co-morbidities, who may be entering their twilight years? I can't even imagine dealing with that type of stress. At least in vet med, the client is making the decision about the treatment for the animal in question. In human medicine, it's a third party driving many of those decisions, from diagnostic tests made available, to the treatment portfolio presented. Life in this world can be very cold and harsh.

 

[Minnerbelle]

I guess i feel like there is a first for everyone and how else are people supposed to learn? It's all well and good to want someone with more experience, but you don't know that the fresh out of school vet is any worse than the 15 year experience vet. For all you know, they haven't kept up to date on that one type of case or haven't seen that one type of case before and mismanage it worse than a new vet.

That's exactly how I justified it to myself, really. There are plenty of ****ty veterinarians out there. As an ER vet you see tons of cases managed by other people, and boy are there some doozies out there (I mean yes, you can't truly judge unless you were there and everyone makes mistakes, but there are some totally inexcusable cases and some repeat offenders that make you really wonder). After seeing a lot of those, particularly if I were being extra hard on myself, I would feel like... You know what, I'm doing okay. There are a couple of ERs in the state I avoid sending patients to because their older vets suck just as much as if not possibly more than their newbies. Even though ERs tend to have higher turnover in general, the places that have their **** together that I trust more tend to be much more stable, and partly it's because or maybe it's the reason that they don't hire new grads.