Fit to be tied.... (issue resolved, chemo finished for now)

texsuze
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Fit to be tied.... (issue resolved, chemo finished for now)

Postby texsuze » Tue Nov 27, 2018 5:48 pm

Another rant, if you will. Bear with me....

My oldster has spent the last 8 days boarded at an equine clinic (2 hours away) so he could receive chemo ointment on his eye (squamous cell ca) and be monitored by the vets there (see my thread in the Veterinary forum). The vet ophthalmologist (who rotates between his own clinic, this clinic, and one other) set a protocol for 5-F ointment 4x/day for 2 weeks, then, assess the eye. He typically recommends horses be boarded at this clinic so owners aren't exposed to the chemo, and so he can check on the patient if the vets need a consult.

During the past week I asked more than once about the timing of chemo application throughout the day, etc. I was told the treatment was 2x/day. Why had the protocol changed? No one could answer. Yesterday I spoke with a coordinator at the ophthalmologist's own clinic, telling her about the chemo regime. She was evasive about 2x vs. 4x/day chemo, saying "...I can't comment because I wasn't present during the initial examination..." Alarm bells ringing louder now.

I think the coordinator must have alerted the ophthalmologist about the situation. A vet from the equine clinic where my horse is staying phoned this a.m. to say ".... there was a miscommunication about the treatment...." so my horse is now back on the original 4x/day treatment regime for the remaining 7 days of his stay. She said the lesion looked to be responding (despite the under-dosing) during the last week and feels things are going well. She did not apologize for the screw up.

I'm so livid I'm shaking. I took my horse to this clinic because they had an eye specialist available, but now a week has been wasted on a sub-therapeutic dose of chemotherapy. Adding insult to injury, I've been making the 4 hour round trip out to check on him every other day and have found his general care to be substandard: skanky water in trough, manure left in paddock for days (from previous occupants) and my horse's sheet attached in a ramshackle manner (surcingles NOT crossed under him, chest closure half-buckled, leg straps looped incorrectly---dangerous). I told two vets and one 'barn help' gal about the crap care.

The clinic owner also phoned this morning, to apologize for the management problems. I told him my horse was not the only one there subjected to lax care (horse standing with front leg in an empty water trough--kicking), that my horse had been getting suboptimal veterinary care, and that I'll need to assess the situation...

I'm shredded with guilt and not sure where to go with all this. One more week of chemo still to go. I just want my horse to be cured and home with me. I just needed spill my guts here to folks who understand.
Last edited by texsuze on Sat Dec 22, 2018 6:39 pm, edited 2 times in total.

PaulaO
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Re: Fit to be tied.... (long, get ready)

Postby PaulaO » Tue Nov 27, 2018 5:57 pm

I would be madder than hell about the under-dosing. You put your guy there so treatment protocol would be followed and it wasn't. The clinic should give you a free week of additional treatment (if necessary per the eye vet). I would definitely let the eye vet know about the sub-optimal care at a clinic where he works.

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Re: Fit to be tied.... (long, get ready)

Postby Josette » Tue Nov 27, 2018 6:15 pm

I would be furious too. Maybe take photos of these conditions and document with dates these problems and substandard care. Before you pay final bill (when you are bringing your guy home) - submit these grievances and request compensation on your bill. The poor communication is a major concern regarding the chemo treatments plus it appears to have extended his stay there. I probably would have done some major verbal assault - so good that you some how kept your head on.

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Re: Fit to be tied.... (long, get ready)

Postby StraightForward » Tue Nov 27, 2018 6:20 pm

Ridiculous - they should comp you for the time they screwed up, not to mention getting the care issues corrected.

I can't imagine a vet putting a horse in a soiled stall/pen. :eek:
Keep calm and canter on.

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Re: Fit to be tied.... (long, get ready)

Postby Rockabilly » Tue Nov 27, 2018 6:28 pm

I get it. I really get it. I STILL don't like the girl who put Billy's medication in his feed dish. I told her please don't put any medication in his feed dish because he won't eat it. I looked to see if he had eaten and there were pills laying about in the feed dish. I dislike her intensely because of it and I have not forgotten 6 years later so yeah I get it!

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Re: Fit to be tied.... (long, get ready)

Postby heddylamar » Tue Nov 27, 2018 7:09 pm

Wow. What the hell?! You have every reason to be furious. That's not acceptable care for a medical facility. They should be reimbursing you for the unused meds and charges for medicating the other 2x/day. If your guy needs to stay longer, because of the underdosing, I presume they'll be comping his care?

I'm so sorry.

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Re: Fit to be tied.... (long, get ready)

Postby piedmontfields » Wed Nov 28, 2018 1:13 am

Really sub-par. I'm sorry, Sue. I hope your fellow continues to improve.

I agree with the comments about finish the care and contest the charges/inadequate performance.

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Re: Fit to be tied.... (long, get ready)

Postby KathyK » Wed Nov 28, 2018 3:00 am

Chiming in to agree with everyone else. You have every right to be upset. I hope your horse comes home soon with a clean bill of health.

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Re: Fit to be tied.... (long, get ready)

Postby Ryeissa » Wed Nov 28, 2018 1:04 pm

I'm so sorry! this makes a hard situation so much harder.........................

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Re: Fit to be tied.... (long, get ready)

Postby exvet » Wed Nov 28, 2018 1:44 pm

I would be upset as well. Substandard care is simply not acceptable. I also feel you should not have to pay the full board if what was expected was not being done. If they cannot come to an amenable solution, you can always file a complaint with the state board. This is not something I mention on a whim for I would in no way want to have the same happen to me (be reported to the board); but, inappropriate dosages/dosing regimen is an egregious error. I am going to guess that the facility is/was understaffed, perhaps due to the holiday; but, then I'm afraid in such situations the owner(s) have to suck it up and do it themselves or only take in cases that they can adequately care for properly. I remember cleaning stalls at an equine clinic where I was staffed as a practitioner because there was no one else to do it and I wasn't going to hospitalize horses in a pig sty. If they cannot staff and care for their facility appropriately then they shouldn't be accepting in-patients for hospitalization.

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Re: Fit to be tied.... (long, get ready)

Postby acheyarcher » Wed Nov 28, 2018 2:18 pm

I would wonder if the Rx vet packaged the eye ointment and if so if the directions were written on the package as required by law.

I work with 5FU and a whole lot of other chemos far more potent. I dont buy that it is a hazard outside the skill set of the average owner. Anyone trained at universal precaution should also be reading labels and charting meds. Someone should have had the brain power to notice. If not I dont buy that their skill and handling is safer than yours would have been

None of this is acceptable in a facility calling itself a vet clinic. The manure and food/water issue particularly. I too would file a complaint with the state board. Yes I use to work vet clinical. Never saw a vet come in and do work over the holiday, it was usually myself.

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Re: Fit to be tied.... (long, get ready)

Postby exvet » Wed Nov 28, 2018 2:43 pm

I can promise you that more than one vet has worked a holiday whether it's coming into the clinic or off the truck. Some of us do it because we're scheduled that way but many also do it because we own the business and there are hospitalized animals to care for which require a doctor checking on their status at least once if not more than once a day, holiday or no.

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Re: Fit to be tied.... (long, get ready)

Postby khall » Wed Nov 28, 2018 8:43 pm

That is just so unacceptable in so many ways. I would be hopping mad too.

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Re: Fit to be tied.... (long, get ready)

Postby Tuddy » Thu Nov 29, 2018 2:14 pm

Agree with what has been said here. Start taking pictures of your horse when you arrive. I would also be discussing some financial compensation for the time period of being underdosed. You should not have to pay the board bill as they were not keeping their end of the deal.

Good luck, hope your horse gets well soon! Sorry this happened to you.

Please keep us posted.

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Re: Fit to be tied.... (long, get ready)

Postby Rockabilly » Thu Nov 29, 2018 2:56 pm

So many comments about reimbursing, but I think it's more about the quality of care. Reimbursing is not the first thing I think of here. It's the care or lack of for her horse.

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Re: Fit to be tied.... (long, get ready)

Postby acheyarcher » Thu Nov 29, 2018 3:07 pm

exvet I am not saying no vet works holidays and weekends, but many years in the clinic, in the three I worked in, never happened. Perhaps a difference between small and large.

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Re: Fit to be tied.... (long, get ready)

Postby texsuze » Thu Nov 29, 2018 5:05 pm

Thanks for all the input and support. I went to see my guy yesterday. He seems depressed, understandably. We walked around the clinic grounds, did some grooming, feet care, treats. I told him the chickens said 'hi' and that we are all ready for him to come home, and to hang in there for a little while longer.

Wonder of wonders, manure was gone from the paddock and I could look into his water trough and see through to the bottom! He was still wearing his sheet (another gripe about the care) but it was attached more or less correctly. The barn help was skulking around in the shadows; I hope they've been shat on royally.

Ophthalmologist vet left a voicemail late yesterday in response to my morning phone call to him. I wanted to make certain he knew that my guy had not been getting the chemo treatment that he'd had prescribed. He said he'd received some photos of the lesion from the clinic and said it "....looks awesome." I take that to mean reduced in size but not sure. Early next week, at the end of the scheduled two-week chemo regime, he is supposed to examine my horse and make his assessment. I will be there, with my trailer, along with DH. If further chemo is required I'll apply it myself with my horse at home.

Since two different clinics, their staff and vets are involved, I'm seeing lots of cracks for things to slip through, my case in point. I doubt I'll ever discover where the ball was dropped--receptionist who placed the chemo rx order with Wedgewood Pharmacy? Ophthalmologist's office to communicate the path report and subsequent treatment protocol? Veterinarian interns at the clinic? Who is driving the bus? I want to get my hands on a tube of the 5F ointment to read the label, if one was put on.

I've said nothing yet to anyone about compensation, reimbursement, etc. Silence tends to make guilty parties squirm, since everyone is waiting for the ax to fall. I hope they are squirming. After next week's exam is complete and I know about my guy's prognosis and the plan going forward, I'll see what the clinic has to say on the subject. Before I load my horse into the trailer, I'll get that issue finalized to my satisfaction. As RB mentioned, good care and a cure are paramount for me. A huge source of frustration is never knowing how/if the chemo treatment screw-up negatively affected the chance for complete cure of the SCC.

I always keep a detailed, written log on every single thing, mainly so I can remember. The treatment protocol prescribed by the ophthalmologist was clearly outlined on a Laboratory Result Communique' he generated (which I have) after he got the biopsy results, back at the beginning of the month. So I have that in writing, too.

I'd like to somehow emphasize to both clinics the need for a written system of checks and balances (if one doesn't already exist) for both general care of hospitalized horses, and for any therapies they are receiving. Weekend, weekday, holiday, every day. If they have one already, it is faulty and needs to be reinforced and tweaked. By being the squeaky wheel this time, maybe the clinic will get a kick up the a$$ so other horses won't suffer with crap care and management.

Thanks for lending your ears and for your jingles, please. It ain't over yet.

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Re: Fit to be tied.... (long, get ready)

Postby Josette » Thu Nov 29, 2018 5:37 pm

Sounds like you have a plan in place. I would not leave with simply a verbal scolding to them and minimal compensation. All involved personnel need to be held accountable to fix this communication problem, incorrect treatments given and lastly the unsanitary incompetent care provided at this facility. Otherwise, they will not be forced to address these problems to make corrections for future clients. I totally agree to give a kick up the a$$.

Sending jingles for a speedy recovery for your guy and to come home soon!

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Re: Fit to be tied.... (long, get ready)

Postby StraightForward » Fri Nov 30, 2018 2:58 am

Rockabilly wrote:So many comments about reimbursing, but I think it's more about the quality of care. Reimbursing is not the first thing I think of here. It's the care or lack of for her horse.


Yes but, what's done is done, and the clinic should be falling over themselves to make it right. Just like a restaurant comping a bad meal, cutting things off the bill here is one of the main ways the clinic can demonstrate their desire to correct the mistakes. Plus, cutting into the bottom line is strong motivation for any business to get its act together.
Keep calm and canter on.

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Re: Fit to be tied.... (long, get ready)

Postby Ryeissa » Fri Nov 30, 2018 7:12 pm

StraightForward wrote:
Rockabilly wrote:So many comments about reimbursing, but I think it's more about the quality of care. Reimbursing is not the first thing I think of here. It's the care or lack of for her horse.


Yes but, what's done is done, and the clinic should be falling over themselves to make it right. Just like a restaurant comping a bad meal, cutting things off the bill here is one of the main ways the clinic can demonstrate their desire to correct the mistakes. Plus, cutting into the bottom line is strong motivation for any business to get its act together.


yes, money means something to the business. I agree with Rockabiliy that for *me* my main concern is my horse, of course, but one way we "vote" is with payment. Also, its stupid to have to pay for something you never received!

I always tend to me more passive with confrontation and just let it go, but I try to also think if the next person who I would hope doesn't have to go through the same thing.

I get it, my mare's cremation was screwed up by a vet and I was very upset, I asked for her body to be cremated. I had very little recourse at that time. that is in addition to poor choices vets have made. Since I didn't actually spend money on that, I had no recourse.

texsuze
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Re: Fit to be tied.... (issue resolved?)

Postby texsuze » Mon Dec 10, 2018 6:29 pm

It has been a week since I brought my oldster home from being boarded while getting his chemo for SCC. He had his post-chemo exam from the vet ophthalmologist right before we trailered home, and vet was pleased with the results of treatment. A second round of chemo (to be administered by me, here at home) scheduled to begin in about 8 days, perhaps just 'belt and suspenders' towards a complete cure.

Today I received an email from one of the veterinarian owners of the equine clinic where we boarded. He had originally phoned me when we were about a week into this situation at the clinic, and at that time I had (calmly) described the problems with the under-dosing of chemo rx. and the manure management/water/blanketing issues. In his email today he apologized for the all problems that occurred, and stated the clinic has given me 100% discount on the bill, which was over $1100.

I'll compose a simple 'thank you' response to the owner's email, and hope like heck they will continue to monitor and review their management practices, both for therapy and general care. That's the best I can hope for on that issue--the most important issue. DH and I now have a pretty good idea about where the "miscommunication" about the chemo dosing took place. We won't ever know if/how that screw-up might have impacted getting the lesion nuked. Only time will tell, and my guy is still set to have his next round of chemo soon.

Going forward: keeping my oldster comfortable, successfully completing Round 2 of his chemo, and jingles for a complete cure.

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Re: Fit to be tied.... (issue resolved?)

Postby Tuddy » Mon Dec 10, 2018 7:21 pm

Wow! Good for them for owning it! Onward and upward for your guy!

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Re: Fit to be tied.... (issue resolved?)

Postby piedmontfields » Tue Dec 11, 2018 12:15 am

I'm glad the clinic did this, and like you hope they learn.

Keep us posted on how your fellow does with the next round!

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Re: Fit to be tied.... (issue resolved?)

Postby Sunshine2Me » Tue Dec 11, 2018 3:18 pm

Sending you ~~jingles~~ for your oldster!

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Re: Fit to be tied.... (issue resolved?)

Postby Rockabilly » Tue Dec 11, 2018 4:56 pm

It really takes the owner to be the "squeaky wheel" and advocate for their horse. You are my kind of person because you care so much.

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Re: Fit to be tied.... (issue resolved?)

Postby LeoApp » Tue Dec 11, 2018 7:25 pm

At least they tried to make it right.
Jingles for your old man!!

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Re: Fit to be tied.... (issue resolved, chemo finished for now)

Postby texsuze » Sat Dec 22, 2018 6:40 pm

Thanks for all the jingles. I've posted a (hopefully) final update in the Veterinary forum.


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