An epitaph for Cotton

The phone call had brought us rushing back from lunch, and now my associate and I were standing over our patient: a small young dog, emaciated and comatose, oxygen and monitors hooked to her almost-lifeless body. Except for the slow chest rise and the steady ECG, she was still as stone. Our technicians already had IV fluids running and ice bags around her damp body.

Craig Woloshyn, DVM

"What's her temp?" I asked.

"108."

"Can't be. Check it again."

The technician shook her head. "I tried three different thermometers. They all stop at 108, so I don't know what the temperature really is. She came in seizing."

While my associate tended to the dog, the receptionist brought me a fax of the records from the dog's regular clinic. Nothing unusual. A wellness panel a year ago. A bunch of vaccines. Heartworm prevention. My anger rose, and I steeled myself for a confrontation with the neglectful owner. Another patient that would probably die because her owners had delayed seeking care.

The exam room held a distraught family. As I described the pet's condition, the tears came. A bit late now, I thought. My associate called me out of the room. As we watched, the petechia spread over the patient's body, faster than anything I'd ever seen. Returning to the room I asked about the dog's history, wanting to find some blame for the owner to shoulder.

"We took her to our regular doctor last year," the owner said. "Cotton was always thin. They did some tests and said they didn't know what it was. She was just thin." Again I went to the records. A chemistry panel and CBC. No further tests, no more investigation. "They said she would be all right. And she was until an hour ago, when she fell over and started shaking."

My eyebrows rose. "You waited an hour while she was having a seizure?"

Tearfully the wife explained. "As soon as it started we went right away to our regular doctor by our house, but they said they couldn't see her now and to check somewhere else. We started driving and stopped at another clinic, but they said they were too busy. So we kept driving, and someone at another clinic told us to go to the emergency clinic across the street from you."

It was noon. The emergency clinic would be closed, of course, and every veterinarian in the county knew that.

The woman continued. "They told us no one would be there, but that was the best they could do. Your number was on the door, and we called you."

"Where do you live?"

She told me. A 45-minute drive past five other clinics.

We talked a while longer, and I explained DIC and the grave prognosis. The family hugged, cried, and said goodbye to their pet, who only a few hours before had been a vital family member, a companion to the children and a comfort to the parents. Now she lay lifeless, abandoned by doctors who had sworn to take care of her, turned away by a profession dedicated to compassion and caring.

I sat, my anger drained, overwhelmed by a sodden cloud of disillusionment, black and thick.

Cotton, we failed you.

Dr. Craig Woloshyn, a Veterinary Economics Editorial Advisory Board member, owns Animal Medical Clinic in Spring Hill, Fla. He shares advice through Sun Dog Veterinary Consulting. Please send questions or comments to ve@advanstar.com