Dnalsi Gnol is Long Island spelled backwards.

Posted June 15th, 2010 by Dennis Leon, DVM

Lap ovh web1You would think that one of the wealthiest counties in the country would also be home to the best of the best veterinary hospitals in America.  You would think that the pet owners of this wealthy county would demand the most modern and cutting edge care for their companions.  Yes, you could think those things …and you’d be wrong.  Sure there are a good handful of very good veterinarians here -doctors who I am proud to call my colleagues -but we are surrounded by a sea of veterinarians who still give annual Rabies vaccinations to dogs, think that blood testing before major surgery should be optional, and think that pain management consists of sending home some pills after the owner stays up all night with a crying patient.

A conversation with an administrator at a local animal shelter the other day reminded me just how un-progressive veterinary medicine is here on Long Island.  First, a little background information: A couple of years ago, I agreed to perform some spays and neuters for the town shelter at a reduced rate.  Basically, we were doing them for free.  Our monetary compensation for these surgeries barely covered the costs of all the administrative paperwork that goes along with any operation.  Since I refused to lower my standards of care for the shelter animals, I ended up eating the cost of pre-anesthetic blood testing, pain killers and intravenous fluids for every single shelter dog and cat that ever came through here.  In my mind (at the time) it was a small price to pay for doing the right thing.  The real payoff, however, was the prospect of gaining a new patient/client.  The new adoptive owners would come to the hospital to pick up their freshly neutered pet and realize how wonderful our facility was compared to their current animal hospital of choice.

So how well did that pan out?  Not so well.  It turned out that more than 75% of the animals we received from the shelter did not have an owner yet.  The shelter wanted to get the animals spayed and neutered before adopting them out.  So we never had an opportunity to meet or speak with most of these new owners.  In the end, we performed several hundred surgeries (costing us tens of thousands of dollars in labor, medication and supplies) and gained …about eight new clients.  It was not a mutually beneficial arrangement, so we stopped receiving these dogs and cats from the shelter.

Fast forward to 2010.  I met with a shelter administrator who want to know if I would be interested in renewing my contract with the county.  Here is how our conversation went:

“Actually, I may want to do some dog spays for you this summer.  I’m learning how to do laparoscopic spays at the University of Georgia and…”
“Let me stop you right there.  Another veterinarian approached us with the same thing last week. We’re just not interested.”
“What do you mean?”
“We just don’t want to get involved with something so new.”
“Minimally invasive surgery is hardly new.  This is the new standard of care in humans and some veterinarians have been doing it like this for years.”
“We just don’t want to get involved.”
“So you’re turning down an opportunity to get a more progressive, more expensive, less invasive, less painful surgery done at …at the same price to you?”
“Well, what’s involved? Do you still remove the ovaries?”

At this point it be came very apparent that judgment had been passed on the procedure without knowing a single thing about it.

“Yes, both ovaries are still removed.  That’s what makes a spay a spay.  Typically, the uterus is left in.  This can be done with two or sometimes one small incision.”
“OK. I see… Well, we talked to our other veterinarians and they all said that laparoscopic spays were not a good idea for our dogs here.”
“Which veterinarians said this?”
“I’m not at liberty to say specifically.  Just the veterinarians who do our spays for us.”
“They’re wrong. This is just another glaring example of how backwards veterinarians are around here!”

Yup, I said that out loud.  What I managed to hold back were my thoughts of how many swollen, infected and painful surgery sites I have seen on patients spayed via the shelter over the past few years.  A shameful display of high-volume, low-cost negligence.

“Well maybe we’ll change our minds.  Things may change in six months if everyone starts to jump on the bandwagon with this laparoscopic stuff…”
“Unfortunately that will never happen.  You don’t just decide one day to start doing laparoscopic surgery.  You need to get sufficient training, then you need to invest in $10-30,000 of equipment.”
“So you just wanted to practice on some shelter dogs?”
“For lack of a better word, yes. Every dog I spay for you has a greater than 50% chance of being euthanized once you bring her back to the shelter.  I figured you might want to do whatever it takes to get them up and ready for adoption as quickly as possible.”
“Yeah, well …we just can’t let you do that.”

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3 Responses to “Dnalsi Gnol is Long Island spelled backwards.”

  1. Mark Nunez

    This is sad, but not schocking. Just as “the standard of care” for spays and neuters for dogs and cats that are brought in by owners. ANY animals undergoing anesthesia should have some preanesthetic work-up and IV catherter and fluids, and I commend you for upholding that standard of care despite the fact that you lost a lot of money doing so. However, this is NOT routinely done. Why is that? Why would people who know better not do these things that would be considered malpractice if skipped on a human? Because of money, that’s why. I cannot get my employers to get on board with this because other clinics in the area (some, not all) are not doing it and if a client calls to shop the price, they will go where it’s cheaper. Or at least that’s the reason given. The problem is two fold, veterinarians caving to the pressure to keep costs down at the expense of the patient AND owners who do not care enough to consider the consequences of these omissions.

    But, I’m getting a little off topic. I think that it is rediculous for the shelter to deny you the right to choose how you will perform the spays, because guess what, EVERY veterinarian has “practiced” on plenty of dogs immediately out of vet school. I performed ONE spay in veterinary school. ONE! Then I graduated and started practicing medicine/surgery. We are all still practicing, that’s why it’s called a practice. It’s just that some of us practice better than others, and practice doesn’t make perfect. Perfect practice makes perfect. :-)

  2. DancesWithCats

    The feline-only clinic where I work doesn’t do laparoscopic surgeries, but a pre-anesthetic panel, IV fluids, pain control, vital monitoring, etc. are all part of our surgery package. (A lot of clients decline the blood work, but if during the exam we suspect the cat isn’t healthy enough for surgery, we insist on it.)

    The problem is, we’re widely viewed as the most expensive clinic in town. You try to explain to clients exactly what the cost covers, itemized down to the cost of autoclaving equipment, but they just don’t get it. “If this stuff is so important, how come Dr. So-and-So doesn’t do it?”

    Very frustrating.

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