Are you patient?

Are you patient?

Losing it' with clients can be costly
Oct 01, 2007

Donna was 30 minutes late but finally made it into the exam room with her new puppy, Rudy.

She scanned the charts and colorful images adorning the walls, courtesy of various unfamiliar drug companies. There was a dank, musty odor of too many animals in too small a place.

The new pup was restlessly circling the room. It stopped occasionally to deposit a small but not insignificant amount of urine on the floor. Donna Ryan repeatedly adjusted her skirt and unwound the leash attached to her new pup. The urine remained.

Dr. Alfred Bain walked into the exam room. Before him was a new "Schnoodle" puppy.

"Good morning, Mrs. Ryan, I am Dr. Bain," he intoned.

"Hello, doctor, I'm Donna Ryan and this is Rudy."

Dr. Bain reached for the pup and pulled the paper chart closer. With the chart were several papers Mrs. Ryan had brought from the breeder.

"The breeder told me he would need his distemperament shot and provo shot today. She said that was all he needed. Rudy is a designer dog, Dr. Bain — half Poodle and half Schnauzer."

The doctor tried to ignore the inanity and looked down at the "medical history" provided by "Pam's Pampered Puppies."

It appeared Rudy had been given a de-wormer on six occasions and had been given a DHLPP vaccination starting at 10 days of age and every 10 days thereafter until he was picked up yesterday at the tender age of 9 weeks. Dr. Bain also noted that Rudy had been on sulfadimethoxine, flagyl and centrine for diarrhea.

Donna continued:

"Doctor, Pam told me that ordinarily she wouldn't recommend any more shots for him, but thought one more in one week would be a good thing since he was the runt."

Dr. Bain looked through the rest of the history, then turned the pup over in time to see several large and engorged fleas "heading for tall timber" laterally into the haired regions of the flanks.

"Mrs. Ryan, it appears the breeder has given Rudy ivermectin on three occasions and an application of a topical flea medication at 10 days and then every two weeks. She also gave some on the day that you adopted Rudy. ... The question is, have you seen any fleas?"

"I haven't noticed any scratching, but Pam said that an occasional flea is normal."

Dr. Bain for the first time noticed the small bottle present near all the paper work. He moved over and read the label: "Give three drops monthly for heartworms."

"Mrs. Ryan, where did you get this medication?"

"Oh, Pam told me she has this very friendly veterinarian that she uses. He gives her bulk medications and helps her figure out how to save money on her kennel. She told me to try him first, but he really is too far away. She told me her doctor would send me medication in the mail if I need it. She also said there's a lot of medication I can get on the Internet if 'normal' vets are too expensive.

"But Dr. Bain, you are nearby — I'd prefer to buy that kind of stuff from you," Donna said.

Dr. Bain rolled his eyes almost imperceptibly.

He looked the puppy over very closely. The upper incisors were a full 14-mm behind the lower incisors. At the south end, tapeworm segments were visible. The puppy was small and had an obvious mitral valvular regurgitation.

The room became quiet.

Suddenly, Dr. Bain's seemingly quiet demeanor and countenance changed. His portly frame and balding head framed by red curly hair seemed to swell. His face became beet-red and his breathing rate accelerated. His right hand trembled.

"Mrs. Ryan, why are you here?"