The Pet Doctor's Shoes: True Tales from the Trenches of Veterinary Medicine

By Phil Caldwell

Have you ever wondered what it's like to be a veterinarian? From the challenges of being called into work at 3am, to surprise riddled house calls— this book exposes it all!

Dr. Phil Caldwell has been a veterinarian for over 25 years and has some well worn shoes to prove it. He covers all aspects of small animal veterinary medicine including surgery, aggressive pets, steep invoices, house calls and why working with humans is sometimes more difficult than working with animals.

"The Pet Doctor's Shoes" is a book for animal lovers, veterinary students or anyone who has ever had a childhood dream of helping pets who can't help themselves.

• Language: English
• Publisher: BookBaby
• Release date: Aug 1, 2021
• ISBN: 9781098357160

Book preview

It Can't All

Be Good News...

Before I was even accepted into veterinary school, I volunteered at a local small animal clinic. Essentially, I was an unpaid kennel attendant, so I did my fair share of scooping poop and cleaning up pee. This is the part of the drudge work that seems to be required for anyone interested in getting into vet school. I suppose its purpose is to weed out those applicants that have certain types of aversions. If you can’t tolerate the sight of animal waste, then don’t bother applying. Animals produce both feces and urine in large quantities, sometimes very unexpectedly, and it’s better to find this out sooner rather than later.

Occasionally, if everything had been cleaned up and the dogs had been walked and the litter boxes had been scooped, I was allowed to observe a surgery. This was my favorite thing to do, and even the simplest procedure was exciting. On one of those days, I was asked if I wanted to witness the removal of a feline’s testicles and, of course, I said yes. Hell yes! Watching a cat be de-balled seemed like a great way to spend some time for an eager veterinarian-to-be, and I was sure it would be great dinner conversation with my parents when I got home.

I watched as the technician set up the surgical area and premedicated the victim (I mean, Blackie), and soon after, the doctor arrived. The tech and the doc gave an injection and Blackie fell limp. I’ll spare you the gruesome details, but suffice it to say that it was bloodless and very quick. A minute later and the doctor had finished. She took some time to explain everything that happened, but it was over in less time than it took to clean up afterwards. Blackie was put back in the cage, and a few minutes later, the technician went over to check on him. Something wasn’t right. His stare was fixed and still. He wasn’t breathing.

In one second, the entire mood of the day was turned on its head. Blackie was pulled out and put on the prep table. The doctor was called and she came rushing over. Syringes were grabbed, medication was pulled out of drawers, and a tube was inserted down the kitty’s throat. I stepped back, not understanding much of anything that was going on. After a brief listen with a stethoscope, the doctor started pushing on the cat’s chest as if she were trying to break it. Her face was worried and tense. Medication was injected, a couple of swear words were tossed around and more chest pumping. I looked over at the ECG, and although there was some sort of rhythm, the pattern didn’t look like anything I had seen on those TV medical shows. Another drug was injected. More pumping. The technician was breathing for Blackie with rapid shallow squeezes of the ventilator bag. Nobody said anything. After another minute, the ECG must have looked better because the doctor’s faced relaxed a little, and I may have even seen her take a breath for the first time since the cat hadn’t. The doctor looked up at me.

This isn’t good.

Half an hour later, Blackie was moving around and lifting her head. I was amazed. Not that long ago, I had just assumed the cat was a goner but now it was responding to voices and touch. There truly was something to the old adage that cats have nine lives, and at that point, I just assumed that everything was going to be fine. Unfortunately, the doctor wasn’t as optimistic. She shone a light into Blackie’s eyes. They were wide and black and not responding to anything the doctor did. This was more bad news. It was possible, the doctor explained, that Blackie would be blind because of what he had gone through. Blackie’s brain had been deprived of oxygen long enough that it may have affected his retinas, a very sensitive part of the cat’s neurological system.

It was time to call the owner.

I still remember the doctor walking into her office with the weariness of someone dreading what had to be done. She picked up the phone. I happened to be standing in the treatment room, just outside the office entrance when she called out to me.

One day you will have to do this, and it will be one of the worst days of your life.

Then she told me to shut the door.

For me, there is nothing worse than giving bad news. I’m an optimist at heart and I want things to work out. I want to be the one who says it’s going to be a great day. And tomorrow will be great too. And maybe the day after that. Of course, that’s an absurd hope in veterinary medicine. People come to me with seventeen-year-old cats who weigh five pounds that haven’t seen a vet in sixteen years. And they want reassurance that their cat will live another year. Because it’s Christmas. Or because they heard that their friend’s cat lived till it was twenty-three. Or because this cat, this skinny little shell of an animal, is the ONLY thing they have left in the world. When I give this type of news, I’m tearing at the sacred bond that some people have with their animals, and in many cases, I’m breaking the bond completely. Having lived with and lost several pets over the years, I know exactly how painful this broken bond can be.

Blackie’s doctor was right: I would someday have to give an owner terrible unexpected news. Many years later, a puppy died as a result of a routine neuter. This was a very well-loved puppy that was, at least in my mind, in perfect health prior to the surgery. He arrested while I was doing the final sutures and, with two doctors and three technicians working on him, we were able to bring back a very unstable heartbeat. Even after twenty minutes, he wasn’t breathing on his own and his eyes had a cold fixed stare. His body lay lifeless except for our mechanical ventilation that forced a breath into him. It was apparent that he had suffered brain damage due to prolonged oxygen deprivation.

I can’t describe in words the feeling of having to call an owner about a surgical complication. Yes, they sign a paper at drop-off saying that ANYTHING can happen, including death, and I think everyone intrinsically knows that it is possible, but most people don’t want to think about it. And most people don’t expect it. The owner of the puppy had been very worried that morning. She had asked me if everything was going to be okay, and I reassured her nothing bad was going to happen. A simple procedure, I added as if removing body parts was as simple as giving an injection. Looking back, what else should I have said? Yes, we will take great care of Dusty, but keep in mind that shit happens so you just never know? I picked up the phone (I told everyone to get out of the office first and closed the door), and I made the call. I can’t remember exactly what I said, but it wasn’t long before both the client and I were sobbing so hard, it was difficult to have a conversation. In fact, I think I was crying more than the owner and she started to console ME, which in retrospect was a little embarrassing. I told her that Dusty was still alive, but there was a very good chance that he wasn’t going to survive. The client told me that she was going to come down with her family and make a decision.

As it turned out, Dusty was later euthanized. He was taken to an emergency facility, but despite their efforts, he was in a coma and still not breathing on his own. If he were a human, everything possible would have been done, but in this case, the prognosis was grave. It was the obvious choice to say goodbye.

Bad news comes in other forms and if it’s not about the health (or rather un-health) of a pet, it’s about the cost of medical care. I don’t understand how, as I write this in 2020, we still have to do blood work and X-rays, as I’m pretty sure that movies and televisions have promised us that we would have one gadget that does it all by now, BUT such a gadget does not exist and we have to rely on expensive testing. And after the expensive testing comes the expensive treatment. And, if your total budget for veterinary care for the entire year is $50, then you’re not going to be too happy when presented with a bill for $1500 or especially $5000. And, wait for it, if your dog slips a disc and is paralyzed, then expect a bill to go above $10,000 if you want to have a surgery done.

In Los Angeles, lots of people are broke (even if they have a Mercedes), but most people have some sort of reserve they can tap into if push comes to shove. At the very least, they know how to GoFundMe and make up a story if things are really bad. In Las Vegas, almost everyone is broke, and many people have used up all of their reserves so, unless they themselves are dying and the doctor is okay with a kidney donation as a form of payment, they are really stuck. This can have some very sad consequences. Many years ago, I was presented with a younger dog who had been attacked by another dog in the household and his eyeball had popped out. Not all the way, mind you, like some sort of veterinary cartoon but out far enough that it definitely needed surgery, and it wasn’t going to be cheap. I can’t remember exactly how much the estimate was, but it must have been a couple hundred dollars. Back in the day, this was a fair amount of money, especially when the office visit fee was only twenty-five dollars.

It was a very sad little dog but an even sadder owner. She started to cry after I told her how much it was going to cost. There was no way she was going to be able to afford it. No credit cards, no checking account, and apparently, not even any cash reserves. The incident causing the eye injury happened very quickly—the bigger dog was eating at the food bowl and the smaller dog came up to it. Bigger dog didn’t like that approach, and with one chomp, it was an unexpected disaster. With no money and the dog in a lot of pain, I gave the owner the choice of saying goodbye. I know she carefully considered her lack of options and she didn’t blame me. Instead she thanked me for being so frank. She cried and I stood there. I told her I was deeply sorry.

I ended up doing what I certainly regret now; I euthanized the dog. At that time, it seemed like the only solution. Yes, I could have had the owner surrender the dog. Or we could have set up a payment plan BUT, and this was the big BUT, we had been stuck with animals that the owners had surrendered, and it had taken weeks or longer to find them a home. I had also been burned by many clients who had promised that they would pay the full bill only to find out that they hadn’t even turned in a minimum monthly payment. My boss had told me repeatedly that we were a business and not a no-kill shelter and if nobody else was willing to loan a client money, why should he? I wished I had saved that little dog. The owner really seemed to love it and if it weren’t for the money, it would have been an easy fix.

Having your veterinarian tell you that you should kill your pet because you lack the funds to treat is the number one way a vet can ruin your day. But I have other fun ways of doing it. Telling a client that their pet has parasites comes a really close second—at least for some people. I had a long-term client bring in three of her dogs because she thought they all had dandruff. On closer inspection, I suspected that they had lice and I confirmed it by taking some of the dandruff and putting it under a microscope. I returned to the room and told Mrs. Irwin that Mini, Mighty, and Mo had pediculosis.

What’s that? she asked innocently.

All your dogs have lice.

It was as if I had told her that flesh-eating bacteria had attacked her sweet pooches, and the only solution was to firebomb them all immediately.

Telling her that the lice did not want to live on her didn’t dampen her hysterics. She cried, she wrung her hands, she went through the five stages of grief. The appointment turned into psychotherapy for Mrs. Irwin and dragged on well past the allotted time. I told her that the condition was very treatable, and after repeating this statement a tenth time, she calmed down and decided that she was going to treat them rather than immediately drop them off at the shelter.

I’ve had similar reactions when I tell owners their pets have fleas. Fleas aren’t so bad. Yes, they are a little gross, and I’m sure the pets don’t appreciate them, but they are nothing to stress over—but that’s the vet perspective. To some people, your pet has fleas is interpreted as you are the dirtiest, most disgusting person in the world and you are probably a filthy hoarder. This can lead to denial in some cases, and I have had people insist marauding clinic fleas jumped on their pet while they were waiting for me to come into the room. When I ask them if their pet is current on flea control, I have been told that certain breeds of dogs do not get fleas. I should know this. I am a veterinarian and I know everything.

Are vets ever at the receiving end of bad news? Yes, it happens, but then it goes back to the owner—like a gift that keeps on giving. On THREE occasions (I’m embarrassed to admit), a pet has gone into heat AFTER I had spayed it. This is not supposed to happen, but the reason it does is because the doctor (in this case, me) mistakenly left a piece of the ovary inside the pet during the spay procedure.

I remember the phone call I received from the young owner of one of these animals.

My cat is acting very horny and I don’t think it is supposed to act like that after it has been spayed, right?

Well, no, I replied. That is a problem if your cat is indeed acting like that.

Being a professional, I try to avoid using words like horny. I also try to avoid phrases like I think your doctor f*@ked up.

If the owners are postmenopausal and using estrogen cream on their skin and then petting their pets, it is possible that the pets can go into heat because of that. But alas, all these owners with their horny pets were either men or premenopausal so I had to go back into the abdomens to look for the remaining remnant of the ovaries. In all three cases, I managed to find what I should have taken out previously. Thankfully, all these owners took the news quite well, and they were pleased that there wasn’t a charge for the re-surgery. I have since modified the way I do spays and (fingers crossed), I haven’t had another problem.

Bad news is just a part of a veterinarian’s job. I’ve had to accept it just like I’ve had to accept the fact that I can’t express anal glands without getting them all over my jacket and shirt. And it hasn’t gotten any easier giving or receiving unwanted news. People (at least the more sympathetic ones) have told me that I care too much. If I didn’t care, this job would be a lot easier.

You need to euthanize your dog because it’s peeing on the carpet and it’s coming up to holiday season? What time can we book you in?

Who goes into veterinary medicine and DOESN’T care? I suppose there are some people who care less the further down this road they go, but I don’t think they start out this way. And the more stubborn ones, such as myself, still care a lot over twenty-five years later.

Chapter 2

Bad Behavior

In the final year of veterinary school, everyone must write an examination affectionately called the National Boards. When I was writing them years ago, there were two parts. Part one was a multiple-choice trivial pursuit and assessed our general medical and surgical knowledge of everything from cows to fish to birds. Part two was much more interesting and fun. They gave us a certain scenario such as a jaundiced dog who comes into your clinic, and with a MAGIC pen, you made choices how to handle the case and your consequences were revealed with the MAGIC pen. This was a little nerve-wracking because it was easy to go down the wrong road (just like in real life), and if there was an abrupt end to the choices, then you likely just killed your virtual patient. They didn’t say, You’re an idiot. You just killed Samson and the young family is devastated! but it was definitely inferred. Next question, young Grasshopper!

There isn’t a third part to the examinations, but there should be. This third part would determine if you are suited to small animal practice which so many people erroneously think they are. A sample question would be:

If a client answers his cell phone while you are trying to listen to a dog’s heart, do you:

Put down your stethoscope and start writing up the records? Wait till the client’s conversation is over before listening to the heart again?

Politely remind the client that it is not allowed to answer a cell phone in the examination room? Go back to listening to the heart? Ignore expression on owner’s face?

Give the client an icy glare and say Are you going to get that? while daring him with your eyes?

Stomp out of the room and say, I’ll be back when you’re finished?

Snatch the cell phone out of his hand and shove it down the client’s throat?

If you are going to be a small animal veterinarian, the correct answer is A. There are some people that would argue that B is also a correct answer, but I would beg to differ. Any veterinarian must deal with an incredible amount of bullshit, so if you don’t have a high tolerance for it, then maybe you should consider a job doing meat inspection because at least the meat won’t talk back.

Bad behavior. It’s an everyday occurrence and I think I have survived in this business because I roll with it. A client who answers a cell phone during an office visit doesn’t really bother me. If he or she really wants to take that call, despite office rules and basic social considerations, then they are obviously rude and no amount of counseling on my part is going to change their parental upbringing. Eventually, the call will be over and we can get back to business. Kids, on the other hand, can be far more challenging, and there have been several instances where I have bitten my lip so hard that I tasted blood. Why are kids so challenging, you ask? Well, let me list the reasons.

Let’s start with the kids who use the vet clinic as their personal romper room. These kids jump on the weight scale, run through the halls, climb on the stools, and want to sit on the examination table. Usually, this joyful behavior is accompanied by screeching and yelling which makes even the most docile dog or cat fear that the world is coming to an end. Invariably, the kid hurts himself or herself, usually by tripping or banging their head on the table, and then the torrent of tears and the wailing begins. If there is blood, then it means a trip to the bathroom. At this