What would you do?

Having returned from an equine visit, I clambered out of the car in the practice car park and started gathering some equipment that needed cleaning.

A few parking spaces over, one of our other vets was stood with her back to me, sporting a visor, deep in conversation with a client via a rolled down car window. A few months ago, this would have seemed absurd, but is now completely normal for consultations in the current climate.

I couldn’t hear what my colleague was discussing, but eventually the client replied: “What would you do if he was yours?”

On the spot

Even though I had no idea of the context, I knew that, in that moment, my colleague would be experiencing the all-too-frequent sinking feeling when faced with that question.

I don’t think clients ask the question to put you on the spot, but it always feels that way. It comes from a place of genuine concern, with them asking for your guidance and professional opinion rather than just the facts and options that you’ve already presented. But the truth is, it’s never an easy question to answer.

So many variables exist between cases, background, finances, and even species. The likelihood is I have never been, and will never be, in this exact situation – faced with this exact decision – for my own pet.

Cat woman

In simplest terms, I don’t have a dog, I have cats – and while I have dealt with all manner of bodily fluids in all manner of scenarios in a workplace environment, I can’t tell you whether I would be able to cope with an incontinent dog in my home, therefore it’s very hard for me to say what I would do if your old cancer-riddled dog who is bright in himself but lacked control of his bowels was my own.

If I am, however, asked what I would do on diagnosis of hyperthyroidism of a 13-year-old moggie, I could hand on heart say I would opt for radioactive iodine therapy. This is one of the reasons I insured my own cats.

Yet the client who asks the question may not have insurance, or be able to afford the up-front cost – in which case, again, we are not in the same situation and never would be, because I have that safety net for my own peace of mind.

A question of cost

Unfortunately, one of the biggest challenges of being a vet is that choices for treatment or diagnostic plans are often limited by finances. So, while I can advise what is probably the best option for your pet, taking into consideration the costs, I would not necessarily be faced with the same options were I treating my own.

While a wealthy equine client may be willing to throw money at a valuable colicking horse, I know I would struggle to justify the thousands of pounds required for colic surgery on my own horse.

Precautionary measures

But it isn’t always down to money. Sometimes the animal is insured or “money is no object”, but the owner and I have differences in opinion, or lifestyle, that ultimately affects the decision.

For example, if I had a bitch, I would neuter her at an appropriate age so I would never have to make a decision on whether to operate or try medical management of a pyometra (unless she had an unlucky first season pyo).

Likewise, I would keep a cat inside until she was neutered, so would never be faced with a decision of whether to spay my own pregnant cat.

Problem-solver

I do sometimes admit to clients that, being a vet, I naturally have a tendency towards problem-solving and “if he were mine”, I would want to do the tests, imaging (and so on) to find out what’s going on.

I back this up with the caveat that said tests may only confirm what we already know, or may not ultimately change the treatment plan or prognosis. Yes, I would do the investigation, but many clients just want to ensure their pets have a comfortable final few weeks or months.

The end

Probably the most difficult time we are asked the question is when presented with a very ill, complicated case of end-stage disease.

The honest answer is that I have the advantage of being a vet and would (hopefully) have noticed the signs of deterioration much earlier, and either intervened or opted for euthanasia much sooner than now. However, for the client, the initial consultation may be the first time they realise how truly unwell their pet is, and by this time the options are much more limited.

“What do you think is best in this case?” might be a fairer, and less emotionally-charged question – and, in reality, it’s this question I am probably answering most of the time.