Dealing with grief and anger

Dear Dr. Forsythe: I have been reading your articles for several years now.  I’ve always enjoyed the way you give advice and appreciate your take on different pet problems.  Recently I went through something that has left me truly desperate for closure, so I thought I would ask for your opinion on what happened.

Several weeks ago our Golden Retriever “Rusty” got into some antifreeze that had spilled in my sister’s garage. The vet ran several tests and kept Rusty there in the hospital.  They even gave alcohol to him intravenously to combat the lethal affects of the toxin.

The next morning we got a call from the vet’s office that Rusty had complications overnight and was on a ventilator! Apparently while he was getting his treatments, he vomited and aspirated and had severe breathing problems and was in critical condition. Just the day before it seemed like the treatment Rusty needed was going to be rather routine.

After getting that terrible news, I went down to see him and I couldn’t believe that was the same dog I had taken in the day before.  He was hooked up to a machine and looked half dead.  Two different doctors told me he had a 50/50 chance of pulling through. In a daze, I  OK’d more treatments in order for him to have any chance of survival.

A few hours later a different doctor (who I had never met before) called with the news that my Rusty had died.  She was very serious on the phone, to the point, and didn’t even tell me she was sorry.  She also let me know that I owed over $2,000 for the treatments.

I later met with the first doctor who had admitted Rusty.  That primary doctor tried to explain that this was a complication of the treatment that needed to be done, and that there was no way to foresee that he might gag and breath in his vomit and develop serious breathing issues and die from complications. Again, I was presented with the bill, paid it, and was escorted quietly to the exit.

Dr. Forsythe, as the past few weeks have gone by I have been mulling the whole experience over in my head constantly.  I’m just not sure whether one of the vets  could have done something wrong that ultimately caused Rusty’s death. Everything seemed to go downhill so quickly, and I realize there are no guarantees in life, but it just seemed so cold to me that none of the doctors ever showed any emotion to me or even offered and condolences after he died in their hospital.  Now that the shock has worn off, I’m thinking of lodging a complaint or getting an attorney — and I’m not sure at all that I should have paid the bill they gave me.

Could you please let me know what you think about this situation?  Am I wasting my time?  Do you think something is fishy here?

Diane S.

Dear Diane: First I want to tell you how very sorry I am for your loss.  It sounds absolutely horrible to take your beautiful Golden into the vet in a timely fashion and think that the treatments are virtually guaranteed to remedy the problem, only to have disaster strike.  And then to be treated coldly is a bitter pill to swallow

I will say that Antifreeze poisoning is a serious and potentially lethal toxicosis. Very soon after exposure, the ethylene glycol molecules start to create crystals that plug up and cause irrevocable damage to the pet’s kidneys.  The standard treatment is administration of IV Vodka — I know this sounds crazy, but that is the antidote for the toxin. And it needs to be done in a timely fashion before kidney damage happens. Unfortunately, this alcohol infused directly into the pet’s vein causes drunkenness and so must be monitored VERY carefully. It sounds like Rusty had some vomiting and then probably aspirated (choked) on his vomit and developed a severe lung problem (perhaps even collapsed lungs).  This is when a “routine” emergency turned into a “life-threatening” complication.

While it is hard to assess negligence in a case like this, the profound element you have shared with me is the fact that nobody seemed to take the time and show you the kindness and caring necessary to help you cope with the magnitude of this complication and the subsequent loss.

I wasn’t there, so it’s impossible for me to really weigh in on this situation, but in my own experience and knowing how my colleagues in the profession treat such emergencies, I presume that the correct treatments were done and that Rusty had a negative reaction and a complication after getting the alcohol.  There are times when situations like this CAN happen through no actual fault, however I think a query into the details of what happened with Rusty is more than called for here.  It would be well within your rights to speak to the veterinarian on duty as well as the owner of the veterinary hospital about specific details that led to Rusty’s complication.  Was there a doctor or nurse supervising Rusty when he received the IV treatments?  After he vomited, what was done to prevent aspiration?  You should ask proper questions and have your curiosity about the case satisfied.  You are, after all, Rusty’s advocate.  If you had the feeling that you were being shuffled between veterinarians and did not receive a personal touch, I believe that you need to follow up more thoroughly until you feel there is closure.

I validate that veterinary hospitals can become very busy places, and I understand that especially in large metropolitan areas, staffs can be large and the number of doctors can be vast and less personal than in a small community such as Sonoma.  However, I live by the mantra that “nobody cares how much you know until they know how much you care”.  As you grieve, you are in search of answers, so I suggest you make a concerted effort to get them, so you can put this sad experience behind you.  Rusty would be glad you did.

My deep condolences, and please accept a nice big hug from me in your thoughts.

Love, Dr. F