PAYOH VETS PTE LTD
Blk 1002, Toa Payoh Lor 8, 01-1477,
Singapore 319074. Tel: +65
MORAL ETHICS VERSUS ECONOMIC
CARNASSIAL TOOTH ABSCESS IN AN OLD DOG
Case study written in 2010
Dr Sing Kong Yuen, BVMS (Glasgow)
When told of a high risk anaesthetic death on the operating table, many owners opt out of surgery. The dog's health deteriorate as there is infection and loss of appetite. Eventually, most owners must decide on two choices. A prolonged painful death from malnutrition and infection. Or a possible death from cardiac failure arising from anaesthesia while the dog is having dental work on the operating table.
Vets are not Gods. It is foolish for the vet to say that the dog has a high percentage of survival when the dog is in poor health. Well, if the dog has a poor chance of survival, some owners think: "This vet must be no good".
Advise the owner to seek second opinions rather than continue conservative medical treatment for several months
Is it morally ethical to milk
the owner as a cash cow knowing that surgery will cure but the risk of
anaesthetic death on the operating table is extremely high?
Economic reality may override the moral ethics in a private practice with so much competition and high overheads. The staff and associate vets see what you do if you are the leader in the practice. Do the right thing by asking the owner to seek treatment elsewhere once the owner has had lost the trust in the veterinary-client relationship with the vet.
Vets are not Gods. Deaths on the operating table will present themselves to every practising vet. Bad-mouthing do spread like wild fire when you handle high- risk anaesthetic cases in old dogs as there will always be owners who delay treatment or ignore veterinary advices till they have no choice except surgery.
In this carnassial tooth case recorded here, I did not phone Vet 1 as to why medical treatment and cleaning of the facial wound were performed for one year for "sinusitis" owing to a yellowish nasal discharge from the left nostril for one year. The owner had confirmed that Vet 1 had diagnosed correctly the condition. "He just would not operate on the dog." This was the point of view of the owner whose mother was the one in contact with Vet 1.
The mother would have to
visit him many times to seek a cure. Finally, the son took the high
anaesthetic risk to get the dog operated at Toa Payoh Vets.
These were the pluses but
still one cannot be too complacent.
Only 11 out of 42 teeth existed and they were loose ones with tartar built
up over the years. Vet 1 had done one dental scaling some years ago. So,
there was a good veterinarian-client relationship with the owner's mother.
But now he would not risk his professional reputation to do any
anaesthesia on this old Chihuahua.
|The family vet prescribed antibiotics for the past 12 months as he did not want to risk his professional reputation. This old runny nose Chihuahua might die on the operating table during anaesthesia to extract the carnassial tooth abscess. However, extraction of this tooth would stop the purulent discharge from this abscess within 7 days. No more stress in the household as the mother sees the dog soiling her face and the apartment daily for 12 months.|
|Refer the case to other vets if you don't want to risk your professional reputation of anaesthetic deaths in high-risk ill patients with respiratory infections as the social media bad mouthing of such deaths is prevalent.|
|At 7 months, I saw this beloved old Chihuahua. Her left face was clean and has no oro-nasal wounds.|