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Angry Hippo
May 12, 2004

by Nyc_Tattoo
Worried about my doggie. Took him to the emergency vet and my worries aren't much better.

Worth noting: Doggie is a 6 year old 10KG/22LB terrier mix that received rabies (paperwork listed as injection site "RS") and and 5-in-1 DA2HPPV (listed injection site as "LS"). I assume that means left and right shoulder. Dog has never reacted poorly to those vaccines in the past.

Date of vaccination was 3-10-19.

On Sunday (3-17-19) I noted a large bump on his right side behind the shoulder. It's more than an inch wide and several inches long. It is not inflamed, doesn't seem warm to the touch. No redness or any other discoloration. Doggie doesn't seem to be licking or scratching at it.

It didn't seem to be causing him any discomfort and we went on a long walk (several miles) on Sunday afternoon. He was dragging behind a bit though now that I think of it. I thought it was because he didn't like walking in the mud/snow but now realize maybe it was his shoulder.

Today (3-18-19) doggie was hanging out with me at work and didn't seem to have any problems (although he was mostly chillin). We went for a walk and less than a mile in he started limping HEAVILY and seemed extremely distressed walking. Thats when I decided to take him to the ER based on how big the bump was (on a small doggie) and how much it seemed to be affecting his mobility.

I took him to the local VCA 24 hr and they saw him. The vet tech told me seemed to think the bump was part of the muscle and not the skin or fatty layer.

The Doctor, bless them, seemed like they were quite young and didn't seem to know precisely what it was either. They checked the mobility on his leg that was having issues and felt up the bump. They were able to press 'really hard' on it without my dog showing any discomfort. They noted the bump was a little bit squishy but somewhat firm and that they could move it around.

They kind of said... well... since they just got vaccines it could be a delayed reaction. They said the distemper vaccine is usually put in the right shoulder (and the rabies in the left hind quarter) - my VetCo vaccination paperwork doesn't reflect that though. They said it could be a reaction to the vaccine or maybe it's cancer.

They offered as possible treatment benadyrl, painkillers and a biopsy/aspirate of the lump to ensure it wasn't cancer.

My question was, "Is it consistent with a bad reaction from a vaccine" to which they replied, "yes".

I told them since he doesn't seem to be in any major pain that perhaps the painkillers weren't necessary (to which the vet seemed okay with).

I also questioned them about the 'cancer/other growth' angle and they told me they couldn't be sure without doing the tests.

I then said them, "I'm kind of getting the vibe perhaps a wait and see approach is best. Is it ethical to just give my dog benadryl and take a 'monitor closely' stance, with an understanding to come back if it gets worse?"

And they told me yes it would be ethical as my bank account breathed a sigh of relief.


Anyways, long story short I'm 130 dollars poorer but don't feel any better about my doggie. Can anyone reassure me things are going to be okay or share an experience of a similar reaction to a vaccine?

Part of me thinks maybe it was carelessly administered by the VetCo people. The Vet arrived late and didn't seem to be super professional. One of the oral vaccines was administered so carelessy it went all over the arm of the vet tech holding my dog.

). I initially called them when doggie had problems and they were like 'gently caress if we know, we recommend you take him to a vet'.

They did tell me that if it was found he had a bad reaction to call them back so they could do some follow up on their part.... what would that follow up entail? Blowing a bunch of smoke up my rear end? Or maybe a refund and apology?

Am I a bad person for not paying hundreds more to make sure my doggie doesn't have cancer? If my dog did have cancer (at only 6 years old for a small breed) would it even be ethical to treat it beyond palliative care? I have wrestled with whether I would even undergo chemo-therapy myself, I can't imagine giving it to my dog.

Unfuck my head, por favor!

Angry Hippo fucked around with this message at 05:41 on Mar 19, 2019

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Crooked Booty
Apr 2, 2009
arrr
There are no strict rules about where dog vaccines are administered so the rabies was probably given in the right shoulder. Local reactions (i.e. a lump at the injection site) to rabies vaccines are extremely common. Getting a local reaction to a vaccine has nothing to do with your vet being careless; it just has to do with how your dog responds to vaccines. No one owes you an apology or a refund. Most lumps from rabies vaccines are pea-sized to golfball-sized, but bigger is possible. They usually show up a couple days to a week after the injection. They usually go away within a few weeks. Typically these lumps aren’t painful (and neither is cancer), so your dog’s limping may have nothing to do with the the lump, or the lump may be something else like an abscess. If you are super worried then have your primary vet aspirate the lump and see what it is. There is no way to know what it is otherwise. If you don’t want to spend money then I guess chill out and see if it goes away or not.

Angry Hippo posted:

I told them since he doesn't seem to be in any major pain that perhaps the painkillers weren't necessary
When your dog is “limping HEAVILY” and seems “extremely distressed” he is absolutely in pain, even if he doesn’t scream when the vet presses on his lump or whatever.

Crooked Booty fucked around with this message at 10:33 on Mar 19, 2019

Angry Hippo
May 12, 2004

by Nyc_Tattoo

Crooked Booty posted:

There are no strict rules about where dog vaccines are administered so the rabies was probably given in the right shoulder. Local reactions (i.e. a lump at the injection site) to rabies vaccines are extremely common. Getting a local reaction to a vaccine has nothing to do with your vet being careless; it just has to do with how your dog responds to vaccines. No one owes you an apology or a refund. Most lumps from rabies vaccines are pea-sized to golfball-sized, but bigger is possible. They usually show up a couple days to a week after the injection. They usually go away within a few weeks. Typically these lumps aren’t painful (and neither is cancer), so your dog’s limping may have nothing to do with the the lump, or the lump may be something else like an abscess. If you are super worried then have your primary vet aspirate the lump and see what it is. There is no way to know what it is otherwise. If you don’t want to spend money then I guess chill out and see if it goes away or not.

When your dog is “limping HEAVILY” and seems “extremely distressed” he is absolutely in pain, even if he doesn’t scream when the vet presses on his lump or whatever.

To be fair, the vet tech (not a doctor) strongly implied that a reaction in deep muscle tissues could be caused by a vaccine not appropriately administered in the correct way. That combined with the lack of professionalism found in the vet I originally visited for vaccines gave rise to those thoughts. Is the vet tech incorrect? I mean obviously reactions can occur without any malpractice... but certainly malpractice could also be afoot? Or am I off base here? The vet tech assisting the vet at the time of vaccination had this "WTF is this lady doing" look on his face the entire time.

I've often felt it's a fine line between procedures being medically advisable or appropriate and what is medically necessary. I've got the opinion that not all services recommended are really necessary and that some vets offices engage in bill padding.

Example: Doggie ripped his dew claw several years ago. Had him taken in and the vet patched him up and recommended both take home oral anti-biotics and an injection simply as a preventative measure. He kind of spooked me into it. I have to question if a one-hundred dollar injection was really necessary on a dog showing no signs of infection who was promptly treated with oral anti-biotics. Even though it was unquestionably 'reasonable' treatment, a part of me thinks that the injection on top of the oral anti-biotics was just overkill and 'bill padding'. In any case he got both injected and oral anti-biotics.

"This is probably just a reaction to a vaccine and his symptoms/timing are consistent with such, but MAYBE CANCER - we can do all these expensive tests to rule it out" seems like a classic case of 'medically appropriate, not medically necessary' efforts to pad the bill for services of questionable value.

As far as doggies pain... It appeared really bad on the walk (although no whining or yelping) but seemed to clear up almost entirely at the vet's office. Since he wasn't visibly distressed at the time of the visit or under light activity no pain meds seemed like a reasonable course of action. I know l said I told the doctor I didn't think painkillers were necessary, but It was more like I asked their permission not to give them to him. from the vet. My thinking being that maybe an acute condition would benefit more from rest than medication. I certainly don't want my dog to be in any unnecessary pain, but all drugs/treatments have risks of potentially serious side effects. I also suspected that the medication was offered just to "do something" like the doc who placates a sick patient with a script for anti-biotics even though they probably have a viral cold or flu.

I specifically asked if the planned course of treatment (benadryl, no pain killers, wait and see) was ethical to which they replied, 'yes' without hesitation or any reservations, even though it was not their first treatment plan. To me, that kind of says that the other stuff was appropriate to recommend but not medically necessary.

I love my dog and would pay an obscene amount of money to keep him healthy and happy. With that said, I also don't like flushing money down the toilet.

Can anyone touch on more broadly whether my assessment of some vets billing/treatment practices is correct? Or am I being unduly harsh? I'll admit that at least in the two examples I gave that they were based on providing the absolute best outcome for my dog and leaving little to chance - but is it necessary? It doesn't seem to just happen with vets either. On the human side, my last visit to the doctor was as a healthy 20 something going in for basically a checkup. The doctor says, "you are healthy and all seems well, but lets run a battery of blood tests... cause you haven't had them before" it seems like a case of perhaps being medically appropriate but far from medically necessary and 'bill padding'. I didn't get the tests because even though it was "free"(/covered) it seemed unnecessarily intrusive and of questionable value. Decade later with no intervention and I'm still alive. Tests weren't needed.

What about the ethics of treating/not treating a doggie cancer? I imagine it becomes a balancing act of "quality of life vs extending life".

Suppose doggie had a huge cancerous growth on it's side affecting mobility. Is it ethical to put the dog through the difficulties of surgery if another growth is likely/certain? How many tumors do you cut out? Do you keep doing it until one is finally inoperable? At what point do you become a butcher slicing up your bow-wow for your own sake instead of for his best interests?

Angry Hippo fucked around with this message at 15:57 on Mar 19, 2019

Slugworth
Feb 18, 2001

If two grown men can't make a pervert happy for a few minutes in order to watch a film about zombies, then maybe we should all just move to Iran!
In any group of people, there will be shady folks, so yes, technically somewhere out there is a vet recommending unnecessary stuff. However, it's far from the norm, and both of your examples (with the possible exception of the dual antibiotics, but I may be missing part of the whole story of course) are both very reasonable, as is your human medicine story. Bloodwork and other diagnostics exist to catch what can't possibly be caught by a simple exam. It's literally the whole point.

More directly, your veterinarian is obligated to act as your pet's advocate, since the animal cannot advocate for itself. This involves suggesting the best medicine at any moment, and then allowing the owner to make decisions based on their own finances. If a vet has ever made you feel lovely about limited expenses, then that's not cool, but saying "It looks like a bump. That's genuinely all I can tell you without diagnostics because nobody on this planet can diagnose a bump with 100% certainty without aspirating it" isn't them trying to pad a bill, its them informing you of the situation, giving you the best medical course of action, and then allowing you to decide how to proceed.

The best general advice I can give you is this - Vets spend as much time and money on school as human doctors. Techs spend as much on school as a lot of nurses (to be fair, 4 year degrees are becoming more the norm in human nursing, so the gap is widening). Feel free to google average doctor/nurse pay vs average vet/tech pay. There's not a person on this planet who decided to get into veterinary medicine to get rich. We do the same work as those on the human side for much less money. We are there to help animals. We would do it for free if we could afford to, I swear to you.

roomforthetuna
Mar 22, 2005

I don't need to know anything about virii! My CUSTOM PROGRAM keeps me protected! It's not like they'll try to come in through the Internet or something!

Angry Hippo posted:

Decade later with no intervention and I'm still alive. Tests weren't needed.
It sounds like your view of medical intervention in general is similar to mine, but you have a slightly more paranoid view of it as bill padding, where I think it's more somewhere between rear end-covering and offering the best possible care. It's unfortunate that that sort of thing often comes across as a recommendation rather than as an offer, but I can see that it's tricky (especially with the general public) to be clear like "there's about a 2% chance that its cancer, a 3% chance that it's something else that needs treatment, and a 95% chance that it'll be fine if you leave it alone, the tests will cost $X and have a Y% chance of themselves causing additional complications, and in the event that the test reveals it's cancer there's a Z% chance that it's a false positive, and the cost of treatment for cancer is $Q, and the chance of spontaneous remission if it's cancer is P, and cancer left alone averages X discomfort and Y lifespan while cancer treated averages Q discomfort and V lifespan, etc. etc. etc."

People already see weather forecasts like 80% chance of rain, then if it doesn't rain they're like "ha, the forecast was wrong again!"

I doubt doctors/vets even know these numbers, let alone have the ability to present them meaningfully to a layperson, especially not taking into account surrounding circumstances (ie. what are the odds that a bump shortly after a vaccine at that location is cancer? How are the numbers impacted by age?)

(Now I wonder if pet insurance has stats like these - actuaries seem to be a much better source of this kind of detail than medical people, but I don't know if they have pet actuaries!)

Angry Hippo
May 12, 2004

by Nyc_Tattoo
Update:

Dog is still alive. Bump seems to be reduced in size substantially. It went from almost being the size of a ballpark frank on his ribs to being a nearly imperceptible bump.
Glad I didn't drop 300 bucks on all those crazy tests.

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WrongThreadFred
Dec 19, 2020

by Fluffdaddy
e:wrong thread, sorry

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