Reasonable Expectations Part III: Access to Round-the-Clock Care

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

If your dog is sick enough to require hospitalization or has just undergone a major surgical procedure, how will he or she be cared for overnight and on weekends?  As much as the mere thought of this makes me cringe I must advise you that even though your dog or cat is “hospitalized”, in some veterinary clinics this will involve no supervision whatsoever from closing time at night (perhaps 6:00 PM) until early morning when the first employees arrive back at the hospital.  What if your dog manages to slip out of his Elizabethan collar and chews open his surgical incision? What if your kitty begins experiencing pain during the night?  What if your dog vomits and aspirates the material into his lungs? All these “what if’s” are what make me crazy whenever I think about a hospitalized animal left alone for 8 to 12 hours at a time.  And here’s what makes me even crazier- some people don’t think to even ask how their beloved family member will be supervised when the clinic is closed, likely because they cannot fathom the possibility that adequate supervision would not be provided.

Please know that it is perfectly reasonable for you to expect that your hospitalized family member receive round-the-clock care.  There are a few different ways this can happen.  While a 24-hour hospital staffed with a veterinarian is ideal, this simply does not exist in all communities (but if it does exist in your neck of the woods, by all means take advantage!).  Here are some other viable options:

-A veterinarian comes into the clinic multiple times during the night and on weekends to check on the hospitalized patients (some vets prefer to take their patients home with them to help make monitoring and supervision more convenient).

-A skilled veterinary nurse (technician) comes into the clinic multiple times during the night and on weekends to check on the hospitalized patients and has access to contacting the vet should the need arise.

-Your dog or cat comes home with you, but only after you receive thorough monitoring instructions along with a way to reach your vet should questions or concerns arise.  As scary as this might sound, this remains a better option than leaving your best little buddy left completely unsupervised overnight.  Just imagine how you would feel lying in a hospital bed, hooked up to intravenous fluids, and no one entering your room to check on you for twelve long hours!

How would your dog or cat be cared for overnight and on weekends should the need arise?  Please do tell.  And if you’re not sure, no time like the present to find out.

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

Nancy Kay, DVM
Diplomate, American College of Veterinary Internal Medicine
Author of  Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
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
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, and your favorite online book seller.

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17 Responses to “Reasonable Expectations Part III: Access to Round-the-Clock Care”

  1. Lesley Says:

    I was a nurse in a former life, and I will NOT leave my dogs overnight in a clinic which is unattended. They come home with me, and sleep in my room. I.V. therapy–no problem—-nausea—no problem—-pain—we fix it. I put white towels or sheets on the floor so that I can easily measure any bleeding or discharge and know the color etc..

    My vet feels perfectly comfortable with this situation and well she should. Dogs feel better too.

  2. Debbie Jacobs Says:

    I am so glad to have what I often thought, confirmed. I always prefer to bring my dogs home, even if it means I’ll have a sleepless night. Sorry to miss you at Blog Paws BTW.

  3. Elizabeth and The Lab Crew Says:

    This is a big pet peeve of mine.. for my pets no overnight care means my pets do not stay overnight. PERIOD no exceptions. They are much better off at home with me getting 24 hr care ( and they do get it ) then alone on a cage in an empty clinic. That seems like such a no brainer to me but apparently not to some Vets. At a previous clinic when I took my female in for a spay appointment and they informed me that I could pick her up the “next” afternoon, I asked who would be looking after her overnight. They said, “no one, but it is quiet and she needs rest.”. When I asked what would happen if there was a complication they looked at me like I had two heads. Their answer was “nothing will happen, she will be fine.” I said fine then I will take her home with me after the surgery but they informed me that was not their policy and again tolde nothing would happen to her. I replied, you are right nothing will happen because she is not having the surgery and I took her home and had the surgery done at a clinic with 24 hr care.

  4. Donna P. Wilson Says:

    My dog ate approx 40-75mg rimadyl while I was out of town. My son picked me up @ the airport approx 10 hrs later saying \but don’t worry, he seems just fine.\ I took him to the emergency Vet immediately where they put him on IV’s 24/7. I suggested taking him to my vet in the morning and they said \fine but you know they don’t have 24 hr supervision.\ I had forgotten, so of course I left him there at the much higher rate. I was thankful for there existance. It was a rough 3 weeks but 6 months later he seems just fine.

  5. Kristin Boggs Says:

    When my senior dog Maggie, age 14, had to have an adrenalectomy (to remove her adrenal gland due to a tumor causing Cushing’s symptoms), I made sure her surgical facility had 24 hour monitoring. They had an overnight nurse I could call at any time during the night for an update, which I did. This gave me tremendous peace of mind. It was a complicated surgery for a 14 year old dog, and so many things could have gone wrong if she were left unattended post surgery.

  6. Jana Rade Says:

    This really is an important issue to consider. When Jasmine was to be hospitalized for the first time I was very worried about what happens at night.

    Our vet check up on hospitalized patients every two hours (himself or the vet tech).

    I couldn’t say I felt that was enough, though probably in those cases it was/as well as it turned out to be.

    I know that her vet has his patient’s well being deeply in heart and wouldn’t do anything to put them in any danger. I would still prefer somebody being there round the clock of course, though I appreciate that it is not possible for most clinics.

    When she was at the teaching hospital, there is somebody on premises at all times, but with the number of patients I don’t think they get to check on them substantially more frequently with exception of critical cases.

    I think that next time I will just get a cage of my own and stay there with her 🙂

    BTW, got the book! Just started reading it, but I think that every pet owner should have this book on their shelf!

  7. J Says:

    I will only overnight my dog where there is 24 hour care. In addition, I will hospitalize my dog at that facility only if I have 24 hour visiting rights. We all know that there is scientific evidence that the presence of a loved one expedites healing.

  8. Laurel Says:

    Thanks Nancy, for bringing up this topic. I’ve learned to ask, “Do you have a night nurse?” Years ago, Chester was scheduled for abdominal surgery just before a holiday weekend. Had I not pressed the vet as to how he was going to be supervised post-op with the clinic closed, Chester would have been alone, after major surgery and still on IVs, for hours. The only option the vet could offer was to transfer him to the emergency clinic, where I found Chester sitting up in his tiny cage as it was too painful to lie down. I’ve also had to suggest that the dog receive a pain patch post-op. I’d like to see you address that topic. Thankfully, the vet I now use allows, and even encourages visits to pets in the ICU, will provide pain patches, and has a night nurse.
    Laurel, celebrating the love of dogs at http://laurelhuntbooks.com

  9. Mary Says:

    I’m currently struggling to find a new vet (I posted about my problems finding one who will allow me “in the back”). Two of the four vets who have been recommended to me by other vets and whom I’ve checked out told me that they keep dogs overnight after a spay, even though no one is there to monitor them.

    Even though I could insist that my dogs never stay overnight, my confidence in a vet who would want to do this is shaken. I keep debating whether or not this is a “rule out” for those two vets, or whether I should give them a chance.

    The third vet gave my dog a cortisone injection without asking me the first time I went there (to be fair, it wasn’t the clinic owner who I would see on a more regular basis, but it still makes me wonder about their philosophy).

    The only negative on the fourth so far is that they are closed on weekends (the others are open Saturday mornings). That increases the amount of time that something might go wrong and I wouldn’t have access to my regular vet.

    Changing vets is so stressful! I wish you were in my area, since you don’t think that what I want is unreasonable.

  10. Susan Williams Says:

    We are lucky enough to have an Emergency Vet Hospital within 30 miles. My vet has always been clear about the services/staffing at his office, and has advised when it would be best to transport the dog to the 24-hour facility. He has also instructed me how to care for the injured animal at home. Depending on the situation, and comfort level with bodily fluids and function, it is easier for the my dogs if they are at home, knowing I’m a whine away. They lounge in the crate with an IV, instead of the unsupervised ripping it out the IV, tearing off the bandage, and being a bad patient. Not that much different from cranky folks who don’t want to be in the hospital either.

  11. Spirit Jerry, Wyatt Ray, Jim & Rene Says:

    Dr. Kay, you are so right. Thank you for bringing this up. We have seen lots of parents leave their dogs at vet facilities without overnight care after just going through amputation, and it worries us to no end. Many people just don’t think to ask.

    And, on Tripawds we’ve sadly learned about some dogs who did great during amputation surgery but died sometime during the night, of various causes. Pawrents were just devastated when getting that phone call in the morning. We can’t help but feel that their deaths were avoidable if the vet clinic had some kind of overnight care.

    Thanks for this important insight, we’ll be sharing it with our members.

  12. Natalie Says:

    I have always hated the idea of leaving a dog or cat overnight in an unstaffed hospital. Fortunately it’s not something we have had to contemplate for a long time. I wouldn’t do it now but have in the past when I was a less assertive caretaker.

    More fortunately, we live in a fairly urban area where we have a choice of three or four 24-hour facilities, more if we want to drive farther. Though we haven’t had to leave a pet overnight, we have made ample use of emergency care over the years.

    Twice our diabetic dog Chris collapsed and couldn’t get up – always on a weekend of course. And we were immediately in the car and headed straight for the 24-hour hospital.

    One thing we did that I think helps is spending time to get to know the 24-hour care facility so you are comfortable with it before you wind up having to leave a beloved pet there. As it happens, our nearest 24-hour hospital also was home to our dog’s dermatologist so we visited a number of times for appointments and they were familiar with us and had some of his records. That made the emergency trips a lot less stressful. I was able to immediately go into the back with him, for example.

    Whereas at another emergency hospital where they didn’t know us, I had to fight to be able to go back with him at a point when he was very stressed and blind. (We went there because it was a heart issue and his cardiologist worked at that hospital at the time.)

    So we knew it was a clean, professionally run facility, what their attitude toward clients was, some of the vets, the support staff. And exactly how to get there as fast as possible! Which was important a few times.

  13. speakingforspot Says:

    Thanks for all the responses. Please, all of you struggling to not leave your animals unsupervised overnight, please, please stick to your guns. Your intuition is right on.

    Best wishes,

    Dr. Kay

  14. Amy Says:

    When my Karly had massive mammary tumor removal & spay at the same time I asked my vet if I could take her home that day and he said no, that he’d come in and check on her. I was so anxious for her to have the surgery (b/c her diabetes was affected) I went along with it. In hindsight, I wish I had waited a week and set up a surgery with a specialist hospital with 24-hour staff. She had a complication the next day (bleeding) and an even more serious one several days later, so I wound up spending a lot of extra money anyway, and things could have gone very wrong.

  15. Amy Says:

    p.s. in case you’re not already aware of “Betsy’s Law” http://www.nj.com/news/index.ssf/2010/06/new_law_states_nj_animal_hospi.html

  16. Diane Blackman, CPDT-KA Says:

    I guess I’m lucky. As a professional dog trainer, I have a great relationship with my vet and they know they are priority #1 for me. They understand that when I have a dog coming home from surgery that my entire evening will be spent monitoring the dog (I actually bring the dog up with me on the couch and we watch TV…. I DON’T try to multi-task that evening). I’m also lucky that my vet is available by email and/or cell during off hours. There’s no one better to watch my dog than me. I know my dogs better than anybody else — including my vet. Case in point, when my golden had pyrometra last year, I caught it so early that her white blood count wasn’t even elevated yet when I got her into the vet’s office.

  17. blessedsilence Says:

    One more comment! I don’t know if my vet has full 24 hr care but someone was there late enough to call my vet at 2230 when my senior bluetick coonhound started waking up from his sedation and bleeding into his lungs. My vet stopped in on her way back from a function and tracked me down while I was working night shift at my hospital; his platelet count had been 2, yes, TWO! We had sedated him hoping his treatment with steroids would help stop his bleeding (am not sure what else we used – it was a couple years back). My vet wanted to put him down as he was terrified and was drowning in his own blood. I said absolutely! The staff on my floor saw me weeping, found out the story, someone covered my shift and I met my vet at her clinic – she was half expecting me. She took me back and showed me what had happened. I have been allowed back into surgeries, trying to keep my nurse mouth shut and to see a pound dog who we had hoped would come into my rescue not doing well – making the decision to send her to heaven :(. She was a year old. Anyway, my vets work very closely with me and I with them. Thank you for this series. It is very important for both vet and human patients to feel comfortable with their medical practitioners, never to be afraid to ask questions and always act on behalf of their loved one.

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