Reasonable Expectations Part II: Access to “The Back” of the Hospital

This is the second part of an ongoing series describing how people are developing new expectations when it comes to veterinary care for their pets.  Part one can be found at www.speakingforspot.com/blog

Care to tag along next time your pet is whisked to “the back” of the veterinary clinic for an injection, a diagnostic test, or a nail trim? Perhaps you are curious about what actually goes on “back” there. Maybe you believe that your best buddy will feel more secure if you are present.  Whatever the reason, know that  if you desire to go where your pet goes and see what your pet sees, this is a perfectly reasonable expectation in most circumstances.   Your request might be denied if: 

-Your pet is better behaved without you there (all vets have experienced aggressive patients in the exam room who become gentle as lambs when separated from their humans).

-There is something going on that is private (for example, a grieving client) or too graphic for you to see (trust your vet on this one).

-Your dog or cat will be in an area of the hospital that is off limits to humans. For example, in my hospital, in order to avoid radiation exposure, no one other than the patient is allowed in the room where X-rays are taken.  Gentle sand bags are used for restraint along with mild sedation if needed.

- The staff is aware that you have a lot to say and no one will be able to get anything done because they will be too busy responding to your questions. 

Admittedly, some vets simply don’t like having clients tag along.  If your doc falls into this camp, some patient persuading on your part may be necessary.  Provide reassurances that you will be on your best behavior and remind him or her that large animal vets do practically all of their work in front of their clients.  I happen to love when my clients wish to accompany me into the bowels of the hospital.  In fact, I find myself inviting them to follow more often than they think to ask.  I prefer they get a first hand look at what I am doing and seeing, rather than simply listening to my after-the-fact verbal description.  Admittedly, I’m proud of my facility and feel great when clients see our bustling staff, content patients in clean, comfy cages, and state of the art diagnostic and patient monitoring equipment. 

Before my clients step foot beyond the exam room, I gently coach them on the art of being unobtrusive- avoiding instructing nurses on how to restrain their pet and asking a bazillion questions while I am performing a procedure.  I always reserve the right to send clients back to the exam room if I perceive that their anxiety level is becoming contagious, and I describe in advance what they will be seeing.  This deters some, which is a good thing- nothing like a fainting or vomiting client to get the day off to an exciting start! 

Have you ever accompanied your dog or cat to “the back” of the hospital?  Was it a good experience for you?  How about for your pet?

Now, here’s wishing you and your four-legged family members abundant good health!

Nancy Kay, DVM
Diplomate, American College of Veterinary Internal Medicine
Recipient, American Animal Hospital Association 2009 Animal Welfare and Humane Ethics Award
Recipient, 2009 Dog Writers Association of America Award for Best Blog
Recipient, 2009 Eukanuba Canine Health Award
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Website: http://www.speakingforspot.com
Become a Fan of Speaking for Spot on Facebook

Please visit http://www.speakingforspot.com  to read excerpts from Speaking for Spot. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot is available at Amazon.com, local bookstores, or your favorite online book seller.

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20 Responses to “Reasonable Expectations Part II: Access to “The Back” of the Hospital”

  1. Laura Says:

    I have a background in shelter and volunteer rescue work, so I’ve been invited in the back more than the average client. I’ve never regretted going back there except in one respect. I can’t bear to leave euthanized pets at the vet to go to the freezer. I have to drive them to the pet cemetary/crematorium myself so I won’t picture them in bags at my vet’s. I don’t need that image the next time I go to the vet for a different pet.

    And believe me, I’ve never asked to go in the back of the crematorium!

  2. Elaine Says:

    I will always remember what a privilege and delight it was to be by my dog K.D.’s side as Dr. Kay performed an abdominal ultrasound several years ago. I also know that not all my dogs do best with me at their side during diagnostic procedures. My subsequent dog Will was calmer WITHOUT Mommy by his side (every dog reacts differently to being upside down in a foam “V”!). I thank Dr. Kay for giving me the option, and appreciate the ongoing teamwork it takes between client and doctor to determine when it’s good to be there, and when it’s not!

  3. Jan Says:

    Being asked or allowed is wonderful but there are times when the owner is very anxious about their pet and are a bundle of nerves. I’ve been just that person, and my dog has been better because I stayed behind waiting for them all the while working on calming myself down. Sometimes it is better for everyone and pet if the Vet can just do their job.

    I am very grateful for their skills.

  4. Sandy Mesmer Says:

    Another excellent post!

    I always prefer to go “in the back” with one of my dogs. As a matter of fact, if a vet insists that I can’t, I will not be returning to that vet.

    It’s only hard when it’s an emergency clinic in the middle of the night. I have to cross my fingers and hope they are doing a good job, as if they don’t let me in back I can’t very well go to a different vet.

    I applaud your empowerment of dog owners around their vets. Even more than human doctors, many vets act like the owners are ignoramuses with an IQ of 50. Thanks for your efforts.

    Best, Sandy

  5. Ingrid King Says:

    I worked in various facets of the veterinary profession for twelve years and did everything from cleaning cages to managing a practice. As someone who’s things from both sides of the fence, so to speak, it now serves as a red flag for me when a clinic refuses client access to “the back.” It makes me wonder whether they have something to hide. Of course there are situations where it may be inappropriate for a client to be in the hospital’s treatment areas, but this should be explained on a case by case basis, and the client should be given the option to wait until it’s okay for them to go back.

    Laura, I totally agree with you on not being able to leave euthanized pets at the vet. Even though they have always been treated with dignity in the practices I worked at, the idea of any pet’s body, whether it’s mine or a client’s, in a plastic bag in a freezer, never sat right with me. I always took my own to the crematorium, and for the last two, I actually stayed for what is called a witnessed cremation, so I have seen the back of a crematorium, and it’s not at all what I pictured – it was a very comforting experience (to me) to know beyond a doubt that the ashes that were returned to me where my own pet’s, because I accompanied her body all the way to the final destination.

  6. Kellie Roberts Says:

    I have noticed a general change in how things are done at the vet’s office — at least all of those that I have been to (several) in recent years.

    My experience had always been that the vaccines, blood draws for heart worm testing, etc., were done in the exam room with the client present, unless they chose to leave. Now, every vet examines my dogs and then takes them into the back room for everything. I don’t like it!

    Why this apparent change in protocol? When I was a tech and we did most everything in the exam room, it was rare that a client didn’t want to be present or was problematic in any way, so it doesn’t seem to me that these would be the reason for the change. Thoughts?

  7. Lesley Says:

    We are always allowed in the back and it is always offered to us. The O.R. has a window in the wall, and we even watch surgical procedures. Nothing in my vet clinic is hidden. We recently were in a clinic far from home for a surgical implant of frozen semen and again were invited to watch the entire procedure through a window. I do not trust any clinic which refuses this privilege. I makes on very suspicious.

  8. cookiekn Says:

    Yes, I have. I’ve been in the room for the ultra sound & then the modified colonoscopy – I’ve held my pups for everything from blood tests to injections; even held them in hospital with their IV tubes. I’m lucky; but, I do ASK – and we’ve known each other for so many years that Dr. Key knows me well enough to know I can handle it all.

  9. Cassandra Says:

    The article you posted in July on GDV came the day after I lost a standard poodle to bloat. This one addresses my experience at the emergency clinic at 4:30 AM. When another dog woke me and I found him I knew he was in bad shape and it was end of life so I rushed him to the clinic to end his suffering. The tech grabbed the leash and tried to take him to the back without letting me go with him, she insisted that I was not allowed. I’m not letting him out of my site at this point, I won’t abandon him when he’s in pain and I have no idea what her plans are.
    When I tell her that if I can’t go with him, I’ll call my vet and get him out of bed. She tells me “This is an emergency and he’s suffering!” to which I replied “Why do you think I’m here at 4:30 in the morning!” She then came up with the solution of putting us in a room and having the vet come in. The vet was wonderful and compassionate. I’ve been in dogs for over 25 years, breeding, showing and rescue and have spent more than my fair share in vet’s offices in the waiting room and in the back. “Speaking For Spot” helped me to stand my ground when I needed too.

  10. Mary K. Chelton Says:

    I walk my current nervous adopted rescue Vizsla to the door to the back when she has to go there, or she plants her feet and has to be carried or dragged. She is a pet store puppy mill dog and came to me at 1.5 years with a totally terrified view of the vet. Since a lot of vets around here make deals with puppy stores for 3 free visits included in the price of the puppy, who knows what happened to her, or prior to the pet store when her tail was docked improperly?

    When my old dog and first Vizsla died 4 days at home after 8 days there in intensive care, the staff were more than kind about letting me come and visit him and try to get him to eat, etc.

  11. Erin Says:

    I’m so glad to see a vet who encourages people to join their pets. Believe it or not my dogs are actually better with me there. They trust me and I have spent countless hours building that trust. My first vet did house visits so his clients held pets for shots and small procedures. More complex things happened in his clinic and I was well aware of what I could tolerate and when the procedure passed my limitations. Since he retired I have gone to a new clinic where they are much more comfortable with owners *not* accompanying their patients. For certain procedures I do insist on joining the activity. I have been told by the vet techs that my dogs are actually better with me there and I believe it because they do hold still when I am holding them. I wish more vets would allow those of us who are an asset to join in and make us all more comfortable with the caveat that we will be excused if we are in the way.

  12. Mary Says:

    I prefer to stay with my dogs at all times and I know for certain that they are much calmer and better behaved when I am there. I have been present for many procedures and know to stay quiet and out of the way. I don’t get anxious, faint, or ask a lot of questions.

    Yet I find it increasingly difficult to find a vet who will let me stay with my dogs. The excuse is always the same: our insurance won’t allow it, something could happen and you could sue us, etc.

    I’m currently looking for a new vet and this is a real stumbling block, as I need a vet who understands that my staying with my dogs is in their best interests, and who cares more about what’s best for my dogs than about their rules.

    I’m thinking about writing letters to several vets who have been recommended to me to explain my concern and ask if they would allow me this privilege (when I call, the receptionist just says clients aren’t allowed in the back). I can also offer to supply references from other vets (specialists, emergency, out of the area) who could vouch for my behavior. Does that sound like a good idea? Any other ideas on how to find a vet who will allow this? I’m in the San Francisco Bay Area, if that matters.

  13. Kathie Says:

    My very first vet (1979) was a solo practitioner and I was allowed to be with my Berner on many occasions and I really appreciated that, particularly as a newbie guardian. When he retired we moved to a larger practice and like others have mentioned he did the majority of procedures in the exam room with me present. The practice has grown now and almost everything is done “in the back” and there is little space to accommodate any additional people being present and/or visiting a pet who is hospitalized.

    In 2000 my Berner Kristie required major disk surgery and spent 11 days hospitalized at a specialty hospital about 30 minutes away. They welcomed visitors during her stay and at the time their visiting room (private) was “in the back” just off the hospital wards. I spent several hours with her each day. Because the room was “in the back” I could hear much of the conversation that went on “in the back”. What I heard warmed my heart and gave me a great sense of comfort that when I left each day Kristie was in the best and most caring of hands.

    I have returned to Animal Care Center since whenever we have required specialty care and/or diagnostic procedures, and since 2005 have had the good fortune to be under Dr. Kay’s care. Sometimes I sit in the waiting room and sometimes I go back but I know every request to go back will be accommodated if reasonably possible. In recent years I have accompanied Gretl at her ultrasound and also sat with her in her cubby for an entire morning before she went to surgery. It makes all the difference in the world.

  14. Dr. Nancy Kay Says:

    Hi there,

    I am pained to hear that some are experiencing a “brick wall” when attempting to stay with their pets. Mary, I read your concerns and strongly suggest that you bypass the receptionist and speak directly with the veterinarian about your wishes. What the vet really needs to hear is why it is you wish to stay with your dog- he or she needs to know that you are not coming from a place of mistrust or nosiness- rather you believe you are serving your dog’s best interests. If the hospital has a blanket policy of “no clients beyond the exam room” I would encourage finding another clinic- and there are plenty of them in the San Francisco bay area to choose from.

    Best wishes,

    Dr. Nancy Kay

  15. Natalie Says:

    I prefer to be allowed into the back with my dog whenever possible.

    Our diabetic dog did much better if I stayed with him, especially after he was blind. Most of the vets we dealt with were great about letting me go back with him.

    We did have to stand our ground one night at the Emergency Vet when we took him in for a very fast heart rate. The front desk didn’t want to let me go back with him. My husband told them to take a flying leap. So I asked them to just go ask the attending emergency vet if it would be okay – why couldn’t the reception staff have offered to just ask! – and the vet agreed. I absolutely was not willing to turn him over to strangers.

    With him, I observed blood draws, needle urine draws, blood pressure checks, ECGs, and abdominal and cardiac ultrasounds.

    The dog we have now has problems with fear aggression and he tends to inhibit the urge to attack what scares him in unfamiliar situations. So with him it is safest I think for the techs and vet if I let them take him back without me. But I sure don’t like it that way. And if we ever get into more serious procedures or it becomes important for me to go with him, that’s what I’ll do.

  16. Miria Yarden, B.Sc.,MS,APDT Says:

    To many clients and professionals like me, a blanket refusal to allow me to be with my companion is a red flag. Unfortunately, I have accounts from my clients that remind me of horror stories, although they are few and far between. Naturally, there are situations where the owner would be in the way, both physically and emotionally. On the whole, my pats are calmer when I am with them and all my veterinarians have been undetstanding and realized that I needed compassion as well as my animals.
    There was only one little gal I had, named Nefer, a Pharaoh Hound. If I stayed for her “pedicure” she raised the roof and people in the waiting room were sure we were pulling her nails, instead of clipping them. Then on one occasion I suggested to the doctor that I will not come in with her. Lo and behold! within minutes she was done, quiet, calm and relaxed. We do learn a lot from the animals themselves, don’t we? My sweet “Diva” taught me a lot that day.

  17. Jana Rade Says:

    Our vet does almost everything in the exam room (examinations, shots, taking out stitches …). He only takes the animals in the back for x-rays and such procedures. I have to say wanting to see behind the scenes never came to my mind in his case, I guess we just trust him that much.

  18. Susan Williams Says:

    With my dogs, and my regular vet clinic, I’m always allowed/invited back, and taught how to do things if one of the dogs will need something at home (bandaging for the ‘must chew off everything’ Corgi, injections for the cat with kidney problems, etc). Emergency vets have been a mixed bag, some letting me reassure, some making me wait outfront. Sspecialty hospitals have been places I’ve written off my list. I’d rather be with my pal, seeing and knowing the treatment is done with respect. The two specialty hospitals, who would not let me go in the back, returned creatures who came home frightened, aggressive and deeply changed.

  19. Natalie Says:

    I generally haven’t met as much resistance as it seems some people have. But then I haven’t asked that up front before I was an established client either. I tend more often to request it once I’m there with a pet. And to try to choose a veterinarian who is the type who would be comfortable with it – someone who sees me as part of the team – as that speaks volumes about the vet.

    Our diabetic dog’s pulses and veins were not easy to find and some vets worried the first time I was present for a blood draw that I would be upset if it took a couple of tries, as it often did with him.

    One last time I had to stand up for the right to be with him was the day we let him go. We were doing the euthanasia in the car but it was too awkward for them to put a line in there. So we took him inside briefly so they could do that. And the tech and vet on duty didn’t know me and didn’t want me to come in the back. I just told them the clinic owner was okay with it – we had had him in the back before when she was attending to him – and came in whether they liked it or not. That was the most crucial moment of all that I needed to be with him and no one would have been able to stop me. They tried a couple of times to get me to let him go with them but I refused and was adamant – I go where he goes. Pretty hard to argue too much with me under the circumstances…

    Once again, I think it was a case of not being familiar with us and also fear of how I would react to any difficulty getting a line in.

    But I think if the clinic owner had known about that, she would have been upset that it happened. The last time I’d had him there, I sat in the back while they examined him, gave him an IV injection, and drew urine with a needle. She knew I could handle it and that he did best with me there.

  20. Marlene Johnson Says:

    Thank you Dr. Kay for advocating the practice of allowing owners to stay with their pets if they wish to do so.
    When I was 15 years old we had to take my guinea pig to the vet on call because she seemed to have suffered a stroke, I always remembered how kind he was explaining to me that there was not much he could do to make her better and he seemed surprised when I said that I don’t want her to suffer and that putting her to sleep might be more humane, my only request was that I would be able to hold her myself so she would not be scared. He let me do that even when he seemed a bit hesitant at first. It meant a lot for me back then, and I still appreciate veterinarians who respect the bond I have with my animals and who understand that I don’t want them to be separated from me in a strange place and strange people if at all possible.
    I have come across offices where they totally denied me to be present for procedures and the reason given was either that it was their policy or that their insurance won’t allow it. I went looking for other vets and the two I use now allow me to be present for procedures, I have held my dogs until they are out when they are being sedated, recently even held my chicken for that. I also restrain my dogs myself, as I know my dogs best and I know just how much restraint each of them needs, usually not much anyway. Being present not only gives me information about how my dogs react in certain situations, it also helps to get the right procedures done, because the few times I wasn’t there, blood draws were done wrong (not enough blood, wrong tubes, wrong tests), wrong vaccine was given (kennel cough instead of 5 way shot for parvo etc. ). I have been there when my dog came out of spay surgery, my vet knows he can trust me with those things and at times when he is dealing with emergencies and his staff is tied up with that it helps them too if I stay with my animals.
    And yes, my large animal vet who comes to the farm expects me to lend him a hand and restrain my animals for him as he doesn’t bring anybody along for that.

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