Friday, November 23, 2012

Why I say no to housecall euthanasias...usually

One the questions I am most often asked is "Do you do housecalls?", often with the question posed in reference to euthanasia. I usually respond with no, although I have done two housecall euthanasias in the past year. The main reason I don't do them is that I simply don't have time. Often I am asked by someone who is not near to the clinic where I practice, and, including travel time, it could easily take me 2-3 hours at the end of my day from start to finish. This would be outside office hours, as I need to be at the practice during my working hours to see other patients. Why so much time? Well, in order to have the right tools, I would need to be coming from work, or have planned it far enough in advance to have the right drugs and medical equipment with me. If we're using sedation first, I need to wait while that takes effect. The actual procedure is over in seconds once an injection is given into the vein, but finding a vein can take some time and is sometimes a struggle. To be practical, we need to find a way to keep patients from soiling the area after they have passed, and I don't like owners to see their beloved pet in a cadaver bag. I need to take the patient's remains back to the clinic to be stored until they are picked up by the cremation company. Preferably I have one of my veterinary technicians or assistants with me, to help me during the euthanasia, as well as with lifting the patient out of the car when we reach the clinic. Logistically, this can be difficult to arrange.
People believe that their pet will be less stressed at home, but often we can find ways to minimize stress at the clinic. Sometimes I come out to the client's vehicle to give sedation first (oral sedation is not reliable, and I only give injectable). Other times I do the entire procedure in the car. We have a quiet exam room that has a comfy couch (it's where I do most of my acupuncture appointments) and most dogs will settle in nicely there. The other advantage to being at the clinic, is that when things don't go according to plan (yes, even euthanasias sometimes require a Plan B), I have immediate access to more drugs, extra hands, and even gas anesthetic, in order to make my patient's passing the most peaceful possible.

Of the two housecall euthanasias I have done, both were very peaceful for the patient and as stress free as possible for their owners. I'm glad I was able to offer this for them, but when I am performing as many as seven euthanasias in a bad week, I can't accommodate everyone. So I maintain that we can do a "good death" in hospital, one that honors both the life of the patient and their bond with their humans, as we give them the final gift of a peaceful passing.

Tuesday, November 20, 2012

New Toy

My latest veterinary toy isn't actually a medical device. It's my new Google Chromebook.
On my way out the door this morning, I grabbed the Chromebook under one arm (sooooo light!) and set it up on my desk at work. It feels like the clinic has been crazy busy lately, but today was one of those Tuesdays where I hang around and wait for something to happen. I took advantage of the rare downtime to catch up on some projects. The first was to write a summary of a case where you could say I am an "expert witness", as my medical findings may be used in court. I wrote it as a document in my Google Drive. The second was to catch up with some continuing education on VIN which I left open on Google Chrome, to read between cases in the afternoon.
I guess the third is to write a blog post. The ability to type and compose easily was one of the main features that drew me to the Chromebook. I'm hoping this will get me into the habit of updating the blog more frequently!