elle

24/7 care is NOT an AAHA standard, FYI.


The reason for overnight stays after routine surgical procedures is actually for the animal's benefit, not the vet's wallet -- in most cases, with proper anesthetic/surgical protocols, there is not a very high risk of complications once the animals is awake and mobile.

The reason for the overnight stay is to avoid the risks associated with sending a pet home. Being away from home, undergoing a surgical procedure, etc is stressful for the animal. No doubt when they see their owners, they get very excited, when they get home, they get very excited. Staying at the clinic - confined in a cage with little stimulation - most pets will curl up and sleep through the night after surgery, allowing their bodies to heal.


My experiences:
I've worked as a tech in multiple day practices that performed routine procedures and left animals overnight alone afterwards. Other than kinked lines on IV catheters or soiled cages, I haven't seen any other complications in post-surgical patients left alone overnight.

I also work in the regional 24/7 emergency clinic. The majority of the spay/neuter complications we see are in pets that had surgery in the last 24 hours and did not stay overnight at the clinic where the surgery was performed. Most of the complications are: internal bleeding caused by too much activity too soon (how many people with cats really keep them confined to a cage overnight when that is what i recommend to them?!) or owners thinking the animal was groggy from surgery and thus not heeding the advice to keep the e-collar on at all times so animals come in with wide-open incisions with all kinds of organs hanging out.


For any surgical patient in day practice -- the patient is always observed through the day and evaluated before we leave for the night. If anything about the case was not strictly routine or the patient is overly anxious or the patient is not recovering as well as hoped or any number of other red flags, we ALWAYS call the owner to inform them that the patient should NOT stay in our hospital overnight. We tell them what is going on, that we recommend continued monitoring at a 24 hour facility, etc. If they absolutely refuse to transfer, we send the pet home with strict discharge instructions and a card for the closest emergency clinic.



BackInBlack - in reference to taking pets in the back treatment area: The day practice I work in is much more accommodating to people that do not want to leave their animals. If it is slow, we'll allow you to come back to the treatment area, if its busy, we'll do our best to do whatever we can in the room. The exceptions are: owners are NEVER allowed in surgery, dental, or radiology.
The ER I work in however, has a very strict employees only in the treatment areas policy. The one exception we will make is if we have an animal that is so critically ill (ie it is intubated and someone is manually breathing for it, it is anesthetized/unconscious and hooked up to monitoring equipment, etc) that it cannot be transfered into an exam room for the owners to be present during euthanasia or it cannot be removed from an oxygen cage for a visit. However, the employees only policy is for the safety of all involved... You never know when we could be working with fractious animals, and people just love to walk up to the table and pet fluffy while we are drawing blood, etc. We routinely have sterile fields set up in the treatment area (IV caths, U-caths, laceration repairs, etc) and we cannot allow owners to be milling around and potentially jeopardize other patient's quality of care, etc. We're not torturing your pets back there -- I don't get paid enough to do this job for any other reason than pure love of doing it. And to top it off, you never know when an owner is going to freak out at what they see --- It really helped when we had a GSD that was hit by a car and rushed in without warning to have some owners standing with kitty in our back tx area (new vet, didn't know policy)... The GSD started vomiting gallons of frank blood down the front of my scrubs... One owner nearly passed out and the other started vomiting in the trash can! Both in the way while I'm trying to start an IV, get fluids and a transfusion started, stabilize open fractures, etc.

And again, we have policies because like everyone here generalizing about the people that work in veterinary medicine, we have to generalize about this country's pet owning population. And by and far, most of them are not nearly as intelligent or educated as the people on this forum. Our policies are designed to keep owners safe (we do live in quite a litigious society, afterall), to give us the opportunity to do our jobs unimpeded so that we can give your pets the highest quality care possible.

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Lydia & Bowie's Under Pressure, CD RA CGC

doberkim

And I will reiterate, after almost singlehandedly (with the help of a few select techs, elle being one of them) getting my hospital through our AAHA certification on the FIRST TRY thank you very much yesterday!!!!!!!!!, I can assure you that 24/7 care is NOT a mandatory standard for AAHA - what you need to have is the ability to REFER for 24 hour care, which we have.

Lydia pretty much stated everything else, and I Have to get on my way to a private ob lesson

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Kris L. Christine

My Meadow was a one-person dog, he always had to be near me, or he panicked. When he went to a veterinary surgical specialist for a major cancer operation, they wanted him to stay overnight -- they did have 24/7 coverage. Knowing him and how stressed he'd get at veterinary clinics, I insisted on staying overnight next to him and brought my sleeping bag along.

At around 10:00 at night, they relented and let me bring him home. He was much calmer and more comfortable sleeping on his own bed next to me in a quiet environment with the constant attention and comfort of his family.

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Kris L. Christine
Founder, Co-Trustee
THE RABIES CHALLENGE FUND
www.RabiesChallengeFund.org

tranquility

I'm sure the majority (hopefully) are good vets, but I've only had bad experiences. This one vet said that I should be 'firm' with my bunny as if she was a dog. Proceed to pawn all these stupid vaccine shots when I have a housebunny and didn't secure her when he gave the shot. Of course my bunny jumped about. He proceeded to grab her w/ one hand and hold her in the air as he thought that will calm her. (stupid) Broke her foot on the ensuing release back onto the exam table. Garbage vet. Can't believe he owns 3 dogs. What a joke.

If one cannot love animals, get the hell out of the practice. Totally ignorant about rabbits.

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Striving to become the most educated future 'yellow eyebrow dog' (aka Doberman) owner.

DP807

Elle - maybe things have changed as it has been 10+ years since I worked at a vet hospital. I don't mean to mislead anyone.

I don't think anyone here suggested that an overnight stay after surgery is only done to fatten a vet's wallet! It is for the animal's benefit.

BackInBlack

To the vet that I went to, it was not about the money either. He charges the same amount of money whether they stay overnight or not. I understand that vets have to make a living also, and I am okay with that. I am NOT okay with leaving my dogs overnight unsupervised after surgery though. It is just a personal thing for me, and I wouldn't do it. If for some reason they had to stay overnight with a catheter, or whatever...I would want them transported to a 24 hour emergency clinic, or somewhere where they had overnight care. Once again, MY PERSONAL feelings....

I understand that the "general" public is not dog/cat savvy and I think I understand why vets do what they do....... However, I want to be an active part of my dogs care, I want to know what your doing, why you are doing it, and what the benifits/risks are. I have had everything from vets who won't sit and discuss things with me just wanted to poke my dogs with this or that, to vet's who would sit with me for an hour or more and even send me home with reading material or websites to reference at home. I am not saying that their practices are bad, or that they have bad intentions....once again, it is just something that I am not comfortable with, and it might not be the vet for MY dogs. There is no shame in that.

I am not saying that I am not a pain in the arse I am sure I can be. But I would never let a human doctor just poke, prod and medicate me without understanding fully what they were doing, and I would never let them do it to my animals either.

Having a good vet is something that is a huge priority for me. It took me awhile to find what *I* consider a good one. She has probably paid for her suburban off my dogs, and those of my friends that I have sent or brought there, but she is 100% worth every penny. I am really sad to leave her in a few months.

I hope that none of the vets/techs on our forum have taken what I said in the wrong way. I am sure I am *that* owner that you all hate but it is just........well.........is what it is.

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robinb

I totally agree with BIB and would never leave any animal unsupervised at night. My vet clinic does both my horses and dogs and has no problem with sending a dog home even with a catheter. It's pretty common practice in the horse world for owner's to run fliuds overnight.

I don't even leave healthy horses or dogs unattended overnight. If I'm gone someone with animal experience stays here.

However, I've been a client of the same vet for over 30 years and that does help.

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gazoo02

I agree too!! Working in the human medical field, I couldn't fathom leaving a running IV in an animal overnight or post surgical patient with zero supervision. Even with the most benign maintenance fluid, damage can be done if the catheter infiltrates and is left to run all night long. Or an animal could develop complications and no one is there to notice.

I get the point about people in the way during emergent situations, people not capable of handling the situation, or interfering with care; but I think every situation has to be taken on a case by case situation. Working in a Trauma ICU, there has been a lot research on whether or not family should be allowed to visit the patient at any hour or be present for codes (trust me, this has met much resistance). The thought process is, when people are sick; that is when they need their family the most. Why should we hold patients "hostage" and restrict visitations during this critical time. Also, we find if a family is present for a code (and capable of handling it) it brings closure. It lets them know we did everything we could or helps them to make a decision on withdrawing care.

My point is, I think if a dog is considered too sick to go home after a surgery; than I don't understand how it can be rationalized that they are well enough to stay alone in an unfamiliar environment. My dogs are most comfortable with me and at my house. So I would insist on them coming back home before I would ever leave my dog unsupervised.

Also, I wouldn't be afraid to let the owners see the ugliness of situation either, because that may help them decide on how to proceed with their animal's care.

I don't think dogs should be taken in the "back" for minor procedures without the owners. My last vet attempted this, but quickly returned to get me when my dog got nasty about being poked. Once I came back, she was a little peach and let them do whatever they wanted.

I agree not all people are capable of handling situations, following directions with post surgical care, or staying out of the way during the delivery of care. But when talking to people, you can usually get a sense how capable they are of following directions and base your decision from there. I just don't think it should be a hard and fast rule when it comes to this stuff.

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Tori

robinb

Good Post Tori!!!!

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RedFawnRising

Ditto, well said, Tori.

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