I didn’t mean to go AWOL on everyone. In fact, I was halfway through an entry yesterday, one that will keep, when I paused to take a cat to a veterinarian in an encounter that just put me off for the rest of the day.
Over a year ago, while waiting in a dermatologist’s outer room (remember back when people actually had to drive to see doctors and meet with them face to face?), I was reading a waiting-room magazine with an article by Malcolm Gladwell, talking about establishing a doctor-patient relationship in the five-ish minutes allotted to the interaction in an exam room — a particularly fraught process if the doctor has to focus on taking notes as well. (The dermatologist solved that part of the problem by bringing in an assistant who did the note-taking.)
Yesterday with a new veterinarian that doctor-patient relationship proved to be an epic fail, and I spent the rest of the day mad at myself for failing to recognize it as it happened and then trying to decide what to do about it. In the meantime, Na Ki’o is not well, and he did not get the help he clearly needs, so this morning’s decision is what to do about that while avoiding a repeat of yesterday, where we spent a lot of money to get lectured about how poorly we’re managing his diabetes. Which we are not, and which did not do a dang thing to help Ki’o.
I used one clinic exclusively from its founding through multiple changes in ownership and vets up until late in my dog Reprieve’s years when for assorted long-winded reasons it seemed best to go to whichever vet(s) could meet her needs, regardless of where they practiced. That’s why one clinic sees Marrakesh all the time and Oz most of the time, while another clinic serves Ki’o and sometimes Oz. At one point these two clinics were each staffed by one vet, so they were sharing emergency calls, which meant any animal could end up at either clinic.
Both clinics now have more vets on staff, although none of them at one clinic seem to last longer than a year. And on top of this there’s a pandemic (have you heard?), which has taken all conversations out of the relative comfort of an exam room and moved them to the parking lot, where the emphasis seems to be on speed rather than substance, especially in colder weather.
Sometime before lunch on Wednesday Ki’o stopped moving and when he did take a step or two, he was limping badly and coming to a stop. Yesterday morning I called his clinic first thing, and I guess I shouldn’t have been surprised to learn that a new vet was on hand. Dr. Johnson, who has been Ki’o’s primary caregiver for much of Ki’o’s time with us, is working part-time, possibly contemplating retirement.
The Gladwell moment with the new vet didn’t go gladly, although I didn’t realize how bad it was until I unpacked it over many hours. We didn’t start auspiciously, when yet another new vet tech mistook Oz for Ki’o.
Here are Ki’o’s chronic health issues: diabetes, pancreatitis, asthma. He is overweight, although well below the 23 pounds he may have been when the Animal Welfare League assumed care for him.
He weighed 15ish when he came to stay with us; he ballooned to 19 last year when his sugar skyrocketed and he put on weight and two vets at two clinics couldn’t find the problem. It turned out to be an extremely food-motivated cat sneaking behind the washing machine to break into the dog food supply, stowed in the drawer under the washer.
Trying to explain all of that in a parking lot encounter with a vet tech who doesn’t know the difference between a dog and a cat (that’s unkind, but that’s where I am this morning), who then relays this to a vet who has never met Na Ki’o . . . well, it didn’t go well. Instead of focusing on his limp, the new vet heard “lethargic,” which is not a word I used, and recommended blood tests. I agreed to this, and I suppose it doesn’t matter, because before they renew his prescription for his asthma steroid, they will want this information anyway.
But this vet, who in hindsight didn’t listen to anything I said about the limp, quickly dismissed that as “arthritis” and focused on our diabetes management. Somehow she decided we are undisciplined caregivers who do not keep our cat on any sort of schedule.
I didn’t answer questions very well; I have to fully embrace my own culpability in this interaction. Instead of saying, firmly, “This is about his limp, which is new and doesn’t really seem related to the hirple he manifested in early January,” I went down the diabetes rabbit hole with her.
We test Ki’o’s sugar before every shot, and adjust his dose of insulin accordingly, much like humans treat their own diabetes. This drives veterinarians nuts. I get it: a percentage of pet owners would rather euthanize their pet than learn to inject insulin twice daily, so vets get used to making it as easy as possible for their clients.
But we are over-monitoring our cat, according to this vet, who one minute recommended going without any blood-sugar readings for two weeks and then in the next breath suggested putting a sensor on him to get real-time readings.
She seems like a very nice, knowledgeable person, even though she can’t be a day over 12, but what it comes down to is that she gave my cat very short shrift over the issue at hand — he is barely moving — to take us to task for our “haphazard” diabetic maintenance that is in fact the exact opposite.
For whatever reason, we were not in sync yesterday, and it left me very upset all day and most of the night. I debated calling her back; I debated asking for one of the other two vets at the clinic; I contemplated calling the other clinic, where one vet has seen him before but the two new ones have not, and with a 67 percent chance of having to start all over again, I’m not liking the odds.
I think where I’ve landed, this morning, is with yet another new vet, one who may not have the diagnostic capabilities of the clinics but who comes to you. The thought of putting Ki’o back in his carrier to get the thorough physical exam he should have received yesterday isn’t inspirational, particularly since he went for musculoskeletal issues in January and this could be a new on-going happenstance. On her website, the vet who comes to your home (she only treats geriatric and hospice pets) emphasizes the importance of getting to know you, your pet and its routine. That’s what I want, and I’m never going to get that in five minutes in a parking lot.
Garbanzo Beans for Breakfast 