Dr. Risser's Column: June 2008

Dr. Risser's Column: June 2008

We hope that you and your animal pals are enjoying a wonderful summer. It has been a terrific summer here at Fall Creek Veterinary, with the chance to see a lot of new faces (many attached to adorable puppies and kittens). A new (human) face on our staff here is Colleen Grafton, a student at Mount Vernon High School, who is enjoying her job caring for our boarders and hospitalized patients.

A Sunday trip to the "Dental ER" with my 5-year old son last week (following a spectacular trip over his bicycle handlebars and a lost baby tooth) offered me a reminder about the importance of available emergency medical services, and the value of planning ahead for the hopefully unnecessary but often inevitable veterinary ER visit your pet may experience. We are fortunate (both as pet owners and busy veterinarians) to have 24-hour hospitals on Indianapolis's north side. During the early days in this practice, I would often work a shift or two at one of them myself. The popular Discovery Channel show Emergency Vets has give a lot of people a look into the world of animal emergency clinics (alas, minus the tense narration and dramatic music of the show; many a time I would have loved that backdrop versus explaining a case to worried families, with instead only old Duran Duran songs playing on the speakers ovehead).

It used to be typical for veterinarians to "cover call" and see weekend/ holiday/ late night emergencies on their own. In rural areas, this is often still the case. But as regular hours of operation for many practices have expanded to accomodate busy people who work or have children active in activities, the level of general practitioners to be on-call "24/7," mentally sharp, and not grouchy with family and staff has gotten challenging. I did it myself for the first 14 years I practiced, until realizing that my patients may not get the optimal level of care if I show up at the office, alone at 3:15 AM, compared to seeing a veterinarian at a fully-staffed emergency clinic. We are also fortunate to now have board-certified criticalists here, which raises the standard of care even more. These are smart people (I consult with them relentlessly), and are certainly good at navigating difficult emergency cases and, often, improving the outcome in the critical initial stages of care.

Some common questions about veterinary emergencies:

1. When is it an emergency that needs to be seen and when am I just being paranoid?
Sometimes, the answer is clear. A dog hit by a car that is in shock and bleeding clearly needs care. A cat is a life-threatening asthmatic crisis is the same. Most of the rest lies within a gray area. For some people, anything that has them concerned enough to make them think about going to the emergency clinic will benefit from, at least, the peace-of-mind that comes from an exam. Significant pain that seems unable to be controlled at home, or pets that are showing quick deterioration from whatever symptoms they are showing are best off being seen sooner rather than later. If you think there may be a possible problem while our office is still open, phone or e-mail us to clarify if and when you may need emergency care after hours. Finally, some of the listing on our "Links" page (among them healthypet.com and veterinarypartner.com) have some good advice as well, that may help you decide if immediate care or "wait-and-see" is more appropriate for your pet.

2. Where should I go?
At face value, this would seem an easy answer: Go to the closest emergency clinic. We have listings of up to 5 locations within 15 to 30 minutes of most of our clients. But what if the closest location has an emergency surgical patient on the table and 5 other animals in the lobby waiting to be seen? It then would seem, for all but the most life-threatening acute emergencies, that an additional 15-minute drive, where there may be no such wait makes more sense; calling ahead to see what the wait could be (as well as preparing the staff for your arrival) is a good idea. For what it's worth, I would be happy to give you my own personal take on the local emergency options, to see what might be the best match for your pet. A lot of factors come into play, going beyond the scope of this newsletter. I would recommend keeping the phone number of one or two emergency clinics easily accessible (we can give you a handy refrigerator magnet if you want, too).

3. Do I have the option to transfer care when Fall Creek's office reopens?
Absolutely. If your pet requires additional hospitalized care, and your pet is stable enough for transport, you should have the option to transfer him or her back to our office. Please contact me if you want to know if this is a good option. In some cases, it may be appropriate to continue care with one of the specialists affiliated with the emergency clinic. But remember, the option is always yours when it comes to your pet's care.

4. Why are Emergency clinics so *#%! expensive?
Several answers fit here. Among them, emergency clinics have a lot of overhead expenses, including equipment for intensive care and in-house lab testing (outside labs close on weekends and holidays), high staff costs (try hiring for positions that include overnights, weekends, and holidays), and maintaining a facility that may see a zillion emergencies or nothing at all on any given day. Also, there is the old-fashioned economics of supply and demand, meaning that prices can be higher when you're the only show in town. That said, we do have more than one option in town, and having a bit of friendly competition is a good thing. For the increasing number of our clients that have been purchasing pet insurance policies, since all medical and veterinary costs seem to grow rapidly, it is important to know the level of coverage provided for emergency care. This can make a huge difference if your pet requires emergency care.

As always, please get in touch with us with any questions or comments. Have a wonderful, "emergency-free" rest of your summer!