Pivotal Moments: The Case That Changed My Life and Career

Do you know those cases that change your perspective on life and how you practice veterinary medicine? This is one of those.

I wrote this story about six months ago and have hesitated to share it. I am not sure why. Perhaps I wanted to see if it still resonated with me, or maybe because there was such a profound emotional impact, I wanted to safeguard it.

In any case, I think there is value in sending a gentle reminder to all RVTs and veterinary staff to be kind, compassionate and caring. You never know someone else's battle.

And, if you are privileged enough for someone to trust you, to let down their guard, open that door, and let you in, respect that. Hold that safe. And please, do not ever take it for granted.

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I typically have a “To Do” list a mile long, and while I strive to get things checked off promptly, I often find myself adding more tasks than what I remove. It’s a two-steps forward, three-steps back sort of process. That said, I have had forward movement, so I suppose it’s a good thing.

When I sat down at my computer this morning to start working on the proverbial “frog” of the day, I found I could not focus. I was stuck. In fact, my brain has been stuck on a particular case that occurred at work in the past few weeks. It is occupying a lot of space in my head.

I want to share it with you.

A client came in for an exam with a 12-year-old, intact female Husky, who was lethargic, inappetent for a week, PU/PD, had significant vulvar discharge and was otherwise “off”.

Oh, and she also got into a box of Laura Secord dark chocolates a week and a half ago and ate an undetermined amount. She had diarrhea for three days.

As we are still doing curbside medicine/triage, I had a lengthy conversation with the client about the importance of doing bloodwork to assess kidney function because of the chocolate, but more pressing, I was very concerned about the dog having a possible pyometra.

I discussed the usual diagnostics, treatment, and surgical options due to the nature of the situation; all the while, the client maintained a stoic, defensive, and stand-offish air.

The client maintained that they did not want the dog to suffer and that they are a hospice worker and see death daily. Sure, a pragmatic approach, but why did they not bring the dog in last week when signs first began and they were concerned? Why wait? The dog was obviously suffering, which contradicts their intent.

After this conversation and reviewing a detailed estimate, the decision was to do an exam and run bloodwork due to financial constraints. All further diagnostics were declined, and funding options were exhausted.

Financial constraints are NOT an uncommon roadblock that many clients face. I am sure you are all familiar with weighing the pros and cons and determining which diagnostic test to run over another to fit into a budget.

Our practice also happens to be in an area with some very low-income and poverty-stricken individuals and families.

In discussing the case with the DVM, the consensus, based on previous interactions over the years with the client (I had only met them once before), was that they are notoriously unreliable and non-compliant.

There have also been many discussions with the client about their other dog at home, as he has gone after and bit several people.

The story thus far is likely, not much different than many cases you encounter regularly.

After completing the exam and bloodwork (WBC count was through the roof, and ALP, ALT, globulin, and electrolytes were all out of whack), I went back outside to confirm the original suspicion of a pyometra.

I go through the usual…you have a very sick dog…surgery is the best option…antibiotics…radiographs…cost…quality of life…risks of being a senior dog…etc.

Again, the client reiterates how she does not want the dog to suffer, that she owes the dog everything, and while she is avoiding the word “euthanasia”, I can tell that that’s where her headspace is.

She tells me she cannot afford surgery and that she works seven days a week as a self-employed hospice worker to support three aging parents, two adult children, and three grandchildren. She is the only provider.

She was silent for a minute…she seemed to be struggling with her finances in her head to determine if she could pull money from any one particular area to scrape together enough for surgery.

She closed her eyes and sighed. She looked defeated.

Like life kept piling on more and more, and it finally reached a breaking point.

She looked me in the eyes, pleading almost, for me to make the situation better, to have a different answer, or to make her dog better. I am not sure. But I could see her start to unravel.

She started to cry, but not a gentle, my dog is sick, cry. A panicked, almost hysterical quiet cry, where she told me the dogs saved her life.

Saved her life…not in a philosophical way, but literally saved her life.

With her voice shaking and tears falling, she told me how her ex-husband beat her so severely that he broke her jaw and her orbital bones, and then tried to throw her off a third-floor balcony.

He had locked the dogs up in a different room, but hearing the fight and her screaming, they managed to get out.

The female dog stood over her while she lay on the floor, almost unconscious, and the male dog went after her ex-husband. Neither dog allowed him to get near her again.

Seeing that he could not get past the dogs, her ex-husband left the house.

He left her broken, bleeding, and dying on the floor.

I stood there in complete shock.

With my hand over my mouth and silent tears rolling down my cheeks, I listened to her painfully recount what her dogs meant to her, understanding that she does, in fact, owe them her life.

These dogs are her guardians. They mean everything to her.

All I managed to say was, “I am so sorry”. I could not think of anything more appropriate.

She composed herself, wiped her eyes, stood up straighter and took a deep breath.

She told me that he went to jail for attempted murder and several other charges but was released 16 months later due to a technicality.

That technicality? A typo that he and his lawyer found in the police documents.

She said she constantly feared he would come after her again, as an acquaintance advised that he was living in the area. She expressed how grateful she was that the dogs lived with her.

She further explained that she could not afford surgery for her dog due to the $34,000 she had paid out of pocket for reconstructive surgery on her jaw and orbital bones over the last two years.

Her most recent surgery was on December 1st when she had her remaining teeth pulled to allow for a complete set of dental implants.

Through tears, she pulled down her mask, flashed me a smile, and with a slight chuckle, said, “at least I have beautiful teeth now!”.

Again, I apologized for all she had been through and agreed she had a beautiful smile.

She reiterated that she does not want the dog to suffer, that she has helped her through so much, saved her life, and that she owes her respect and kindness even if that means saying goodbye.

The hesitancy in bringing the dog to us was now clear. The fear of loss was palpable.

The decision was made to treat the dog with antibiotics and pain control to see if she could turn the corner over the next few days. If not, we would schedule her euthanasia.

While she initially improved with treatment, that inevitable day came about ten days later.

I placed a catheter, provided pain control and sedation, and we humanely euthanized, a process I have been through hundreds of times.

This one was different.

I knew that this woman’s life would change forever. She is not simply saying goodbye to “a dog”.

The DVM left the room, and I sat on the floor with this woman, her hands and voice shaking as she gently stroked her beloved companion and saviour and, while painfully saying goodbye, recounted stories of their time together.

We sat like that for around half an hour; we cried, talked, and shared stories.

Before she left, she thanked me for listening to her. She thanked me for taking the time to understand her and what happened. She stated that most people are cruel, judge harshly, and condemn without reason.

I thanked her for sharing her story with me.

I walked out of that room with a vastly different perspective on life, people, and my role as an RVT.

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Lessons come to us at the most unlikely of times. Through what seemed to be a complacent, non-compliant, uncaring owner was a profound and startling reminder of the tenacity and strength of the human spirit and the deep connection between man and dog…or woman and dog.

It is not our place as RVTs to judge our clients. It is our place to advocate for our patients, give them a voice, and to explain things thoroughly, present all options, and in trying moments, provide a safe space for our clients to express themselves.

We are all doing the best we can with the information we have, the resources available to us, and the circumstances in our lives.

Remember that.

You never know what someone is going through, and a surface-level judgment on behaviour can cause more damage than you think.

All cases occupy space in our heads, what varies is the length of time in which they stay.

Some are over and done with, almost as fast as their 15min vaccine appointment, and some remain with you for years, and the pivotal ones, the rest of your life.

This case will be with me for life.