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  1. #1

    Question Unresponsive Vet; What Would You Do?

    My two year filly came home from a month at a well known trainer's barn with a dry cough and slight runny nose. We were told that while there at the trainer's barn she received two antibodic injections for cough/upper respitory infection. After being home for a couple of weeks, she still had the cough and the runny nose has become more profuse. I called my farm vet who has treated my horses for 6 or 7 years. He gave her penicillian (powder form) for five days or so. The infection still hasn't cleared up, and the runny nose is worse and yellowish in color. I called him on Friday when another one of my horses starting coughing and he said he would be out the next morning. No show or call from my vet until Sunday early evening when he showed up unexpectedly. He suspected a gutteral pouch infection and said he "hoped it wasn't stangles". My vet was unable to scope her as he didn't have his scope with him. He was going out of town the next day and said that he would scope her later in the week. After doing some research on the web and comparing my filly's symptoms to those on the Merck Vet website, I was fairly certain that my filly had a gutteral pouch infection that was most likely caused by strangles (or strep). This morning I called my vet first thing in the morning and asked when he could come out and scope my horse. He replied "sometime later in the week" and when I pressed him for a more specific day and time, he said he had to take another call and basically hung up on me (really professional behavior!). Given that I have 5 horses at my farm who all could have been exposed to strangles, and a two year filly whose condition wasn't getting any better (in fact, the nasal discharge was worse) I called the vet clinic that had treated her when she was with the trainer and asked if they could examine her and scope her if necessary. I made an appointment for later that morning and loaded up my sick filly. About two hours later while driving to the vet clinic, my farm vet phones and says that he could come out later in the afternoon to scope her. I told him that it wasn't necessary as I was taking her to XYZ equine veterinary clinic since he was unable to give me a definitive day and time when he could come out and examine my horse. My farm vet went balistic, claimed I was over reacting, that her condition wasn't that serious, etc. and that I shouldn't believe what I read on ther internet. I told him that he was the person who suggested that she could have a gutteral pouch infection that was quite posssibly caused by strangles and that I wasn't willing to just let it go until he could fit me into his schedule. The vet clinic scoped her and confirmed that she does have a gutteral pouch infection and most likely has strangles, although we are waiting on the lab results to confirm it.
    My farm vet did call me later to apologize for his angry outburst but is still insisting that I was over reacting. Personally, I feel four days from my initial call is more than enough time to expect a farm call unless it is for routine vaccinations, etc.

    I have always had a good relationship with my regular vet and have been a loyal client for 8 years or more. I have spent thousands (probably tens of thousands) of dollars on the veterinary care of my horses. I am, however, more than annoyed at his unprofessional outburst and more importantly, his attitude that my horse's health condition "wasn't life threatening" so waiting another day or two wasn't a big deal. My question is what would you do in this situation? Would you find another vet for farm calls? What would you do in this situation?



  2. #2
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    Who knows if he was having a bad day or what, however, I would have a hard time getting over the outburst and would change vets.



  3. #3
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    He called back to appologize? that would mean a lot to me. If you have had a good relationship with him in the past, then I would likely forgive this uncharacteristic behaviour and chalk it up to stress/over work or something else going on in his life that is affecting his work. vets have stressful jobs, particularly in the spring.

    Keep the other clinic as your back up if you were happy with them.

    Or if you can't forgive your old vet, then make the switch. Up to you.



  4. #4
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    I've been going through something much the same but my vet has been great. I have chosen my vet because he has been such a comfort for me in tough times-he even reassured me that my toddler was going to be fine after eating an entire bowl of cat food many years ago. Sometimes it is not just the message but how it is delivered that matters most.



  5. #5
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    Personally, I would be outraged at my vet for treating me in such a manner... and would have a serious conversation about it with him. Perhaps he had a family emergency that would in my mind take precedence. On the other hand, he verbally gave you a diagnosis, that was correct,Yes?.And if you did your research you will know that antibiotics for strangles are not recommended. It can lead to Bastard strangles. I would think, (I am not a vet , but in my experience) that a gluttoral pouch infection would be a secondary issue until the strangles has run its course.Unles the course of action is only to flush pouch. If this was the same vet that gave the first 2 doses of injectable antibiotics, what was the diagnosis for that treatment? and why only 2 doses? unless perhaps they realized it was strangles then? and if so, why was horse not quarantined to trainers barn? Those would be questions I would ask. Strangles happen...is it a PITA? Indeed! can it be serious?yes! but it is what it is, and proper protocol should be followed to prevent outbreaks. Just my thoughts...



  6. #6
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    Yikes. I'd be ready to officially move on to a new vet. Since you've had a good relationship for so long and he did call to apologize, I would discuss the matter with him to see where you stand. "Dr. X, you know I respect and value your knowledge and skills. This incident has really bothered me and I'm now questioning if we're still a good fit. What do you think?" I have to wonder if he's got something else going on in his life. In my admittedly limited experience, possible strangles ranks pretty high on a list of things that need to be addressed immediately. If he's having business or personal problems that distracted him from providing what you feel to be acceptable care, then consider continuing with him. But if you feel that your trust in him is irreparably damaged, then move on.



  7. #7
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    Quote Originally Posted by Equsrider View Post
    Personally, I would be outraged at my vet for treating me in such a manner... and would have a serious conversation about it with him. Perhaps he had a family emergency that would in my mind take precedence. On the other hand, he verbally gave you a diagnosis, that was correct,Yes?.And if you did your research you will know that antibiotics for strangles are not recommended. It can lead to Bastard strangles. I would think, (I am not a vet , but in my experience) that a gluttoral pouch infection would be a secondary issue until the strangles has run its course.Unles the course of action is only to flush pouch. If this was the same vet that gave the first 2 doses of injectable antibiotics, what was the diagnosis for that treatment? and why only 2 doses? unless perhaps they realized it was strangles then? and if so, why was horse not quarantined to trainers barn? Those would be questions I would ask. Strangles happen...is it a PITA? Indeed! can it be serious?yes! but it is what it is, and proper protocol should be followed to prevent outbreaks. Just my thoughts...
    Good questions, We were never told that our filly could have been exposed to strangles at the trainer's barn, only that she had a cough/cold. The antibiotics she was given while at the trainre's barn was Exceed, which is a long acting antibiotic. Better question is if horses at the trainer's barn had strangles, why wasn't the barn quarantined? We were kept totally in the dark by the trainer other than the fact that she had a cough and had been given Exceed. The vet clinic flushed the pouch and kept her overnight so that they can flush it again tomorrow. The also administered a jell antibotic that is applied directly into the gutteral pouch. If she does in fact have strangles I am about 100% that she picked it up at the trainer's barn since none of my other horses had any symptoms until two or three weeks after she came home. She has never been off the farm except for a short stay at the same vet clinic over a year ago.



  8. #8
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    PTR~ I feel your concern for your horse, well all your horses now...and wish them a uneventful recovery. As caring stewards of our horses we become anxious to find all the answers quickly, so we may heal them quickly. Unfortunately, some things in nature happen and have to run their course on its own timetable. It is frustrating and worrisome for the horse owner.Cheers to you for being such a great advocate for your horses welfare, jingles to your filly and others....keep us updated on the culture results



  9. #9
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    I just have to say, read my post about caring for a wound. There are many other elements out there that can infect a horse.



  10. #10
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    Although you had a positive relationship with your vet in the past, it doesn't excuse his behavior. If he had been so negligent to not return calls and not take a possible strangles case serious then how would he react to a REAL emergency? There may be things going on with his practice that would cause such behavior. He may be Sooo busy or business failing. I'm guessing failing caused his confrontational phone call.
    Unless you have no choice but to use him, I suggest switching vets.
    His behavior was completely unethical and apparently your 8 years of loyalty meant nothing. Vets have to be some of the most compassionate people who genuinely care about your animals. If a vet has lost that feeling then they should get a new job.
    I love my vets! It could have been years since an injury and they will always ask how it's healing etc. The front desk pages the vets and I get a call back almost immediately from the vet. There is always an emergency vet on hand and they don't spare any time ensuring an accurate diagnosis and treatment.
    I wouldn't expect anything less and neither should you.



  11. #11
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    What I would be doing is finding another trainer. I would jackbooting the person at the training barn that gave your filly two doses of an antibiotic. What person did this, under who's orders, what did they think they were treating and what antibiotic were they treating her with- one that is long acting and only needs two doses or a short acting one that needs days of dosing?? If the filly was TRYING to develop strangles then they just supressed the disease and made it worse, creating a perfect storm for bastard strangles.

    Sounds like your regular vet is in solo practice and those guys have to work extra hard to meet the needs of their clients. In the end, your regular guy made you a priority though, as written, the dialoge was touchy. Sounds like his hunch about strangles might also be right. Since you brought a sick horse back to your farm you probably have it isolated it (you did isolate the horse???) so the chance of spreading any disease will be lessened.

    Your problem happened back at the trainers farm and not in discussion with your regular vet, IMO.



  12. #12
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    If my vet acted in that manner I would consider it out of character and ignore it, though my feelings would probably be slightly hurt. If it happened again I'd just get mad and find a new vet if possible.

    I am surprised that you brought a sick horse home. I had one at the Amish trainer for what was supposed to be about 2 months. She got some kind of upper respiratory ailment (but not even close to stangles) a couple weeks before I was to bring her home. Since I have a barn full at home, I didn't want to take any chances and left her there another month or so for him to treat (he's an excellent horseman and uses the same vet I do when necessary) until she was well over whatever it was.



  13. #13
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    Quote Originally Posted by stolen virtue View Post
    I just have to say, read my post about caring for a wound. There are many other elements out there that can infect a horse.
    She didn't have a wound, she developed a dry cough while at the trainer's barn. She left our farm perfectly healthy.
    As far as bringing her home and possibly infecting the rest of the barn, the trainer told us that she had developed a cough and had called the vet clinic that we have used previously and where she is now and that the vet had given a shot of Exceed antibotics (as it turns out, it was 2 injections over a couple of weeks time). About the only think I could have done differently was to have called the vet clinic that treated her at the trainer's barn and asked a few more questions. At the time, the trainer presented it as a "no big deal" cough. When we brought her home she had a dry cough and a slight clear nasal discharge. When her condition didn't improve after a couple of weeks I called my regular vet who prescribed five days of a powder antibiotic. I called my regular vet again last week when another one of my horses had developed a dry cough and the filly's nasal discharge was more profuse and yellowish in color. At that point my regular vet observed that her gutteral puch was probably infected and hoped that she "didn't have strangles." That was on Sunday evening. I still don't have confirmation that she does have strangles until we get the culture results back, but the vet clinic has said that it certainly looks like strangles and to disinfect my trailer and barn as if it is strangles.



  14. #14
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    Quote Originally Posted by SLW View Post
    ....

    Sounds like your regular vet is in solo practice and those guys have to work extra hard to meet the needs of their clients. ...
    Good point about the solo practice. When the solo vet I had been quite happy with was unable to show up for not just 1 but 2 emergencies, I decided to switch to a practice where SOMEONE would be on call. Yes, it's more expensive, but I have much more confidence in actually being able to get care in an emergency.

    BTW: I'm in Los Angeles county near Orange County; not exactly out in the boonies.



  15. #15
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    Quote Originally Posted by SLW View Post
    What I would be doing is finding another trainer. I would jackbooting the person at the training barn that gave your filly two doses of an antibiotic. What person did this, under who's orders, what did they think they were treating and what antibiotic were they treating her with- one that is long acting and only needs two doses or a short acting one that needs days of dosing?? If the filly was TRYING to develop strangles then they just supressed the disease and made it worse, creating a perfect storm for bastard strangles.

    Sounds like your regular vet is in solo practice and those guys have to work extra hard to meet the needs of their clients. In the end, your regular guy made you a priority though, as written, the dialoge was touchy. Sounds like his hunch about strangles might also be right. Since you brought a sick horse back to your farm you probably have it isolated it (you did isolate the horse???) so the chance of spreading any disease will be lessened.

    Your problem happened back at the trainers farm and not in discussion with your regular vet, IMO.
    FYI: Untrue about bastard strangles and antibiotics.

    Here is one site talking about its myth, but just google it. That is just plain untrue.

    http://www.montanaequine.com/docs/pres_strep.pdf



  16. #16
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    Actually, that is one of the problerms with using my farm vet. He's a solo practioner, and when he's out of town or otherwise unavailable I've either had to deal with the problem myself (OK for small stuff) or haul my horse to the vet clinic where she currently is being treated. The vet clinic has 24 emergency care and a board certified surgeon. I've used them in the past for emergencies that my farm vet either couldn't handle or when he has been unavailable. The problem is that they are 45 minutes away. My practice in the past has been to call my farm vet first, and if he's unavailable, to haul to the clinic. I'm OK with that arrangement, however, it seems like my vet isn't unless it's a life threatening emergency. My problem is when it isn't a life threatening emergency but serious enough in my judgement to require timely vet care (i.e. not routine vacinations, injections, my horse seems a little off, etc.) and my vet isn't able to come over in a reasonable period of time (24 to 48 hours) and I made the decision to take my sick horse to the XYZ vet clinic, my regular farm vet got upset with me for doing so. He's lost a number of good clients in the area due to his lack of back-up. I've been loyal and stuck with him despite having to deal with his not having a back up vet on call when there is an emergency. My horse have lived at home for 5 years, so I have no one else to rely on other than my husband in case of a sick/injured horse. At the end of the day, I have to make the call to haul to the clinic if he isn't available. I tend not to over react and have treated many a colic myself, diagnosed a laminitis case, etc.



  17. #17
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    First off, let me send some Jingles for your filly and for the rest of the horses in your barn.

    I had a similar experience, my horse was colicking, called the vet, left the message with the service (it of course was after hours), and when he didn't call back in an hour, I started calling other vets in the area. I had no sooner hung up with one that said he would come out, when my regular vet finally called back. And he too went ballistic when I told him that Vet Y was coming out, and I told him in no uncertain terms that I did NOT appreciate being yelled at when I had a critically ill horse. He then apologized, and said he would be out, and I called Vet Y back and told him that I didn't need him. Vet Y was very professional and understanding.

    Turns out that the paging service had the wrong on-call vet in the log, and that vet didn't return the page because it was not his turn to be on call.

    I did tell my vet again when he got to the barn that I felt his outburst was uncalled for, and he agreed.

    We managed to put it behind us and had a good professional relationship after that.

    I do want to add that it was a small practice, only two vets, and they were very busy, so I did understand that for non-emergency type situations, that it might take a day or two for them to get to me, but if it had been a case like yours, they would have been there same day.

    And there were plenty of times that they had to reschedule my regular set appointments due to other emergencies, and I totally understood that.

    My current vet works out of the third largest private equine hospital in the nation, so I know I can always get a vet out here if I need one, if she is not available.
    There are friends and faces that may be forgotten, but there are horses that never will be. - Andy Adams



  18. #18
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    I agree with what others have said. Another thought that I had is that our vets are who we need to be able to count on when things go wrong. The routine calls need to be done, but to me, the most important quality in my vet is dependability. When my vet goes away (rare) or has a weekend off, she always has another single practice vet as her back up. They trade off for each other. She also makes herself available even when away if the back up vet has questions. I am not left without a vet to ask questions and come out on an emergency call. If I feel its of pressing nature, she comes out. Even if that means at 11pm when she is done her last emergency. She also has a connection with the closest vet clinic, and coordinates with them if I need to go there. I in no way expect her to be available to me at all times, but I feel safe with her protocol when she isn't.
    You have a long relationship with your vet. If other important issues/emergencies have been handled well by your vet, imo talk it out. We all have a bad string of days here and there. Vets are human too. If the outburst was bad enough and beyond what you are comfortable with, find a new vet. The last thing you need to worry about in an emergency or stressful situation is how your vet will respond.
    Think about the trainer, how the issue was handled there, how you handled it upon her return too. Don't know enough about that situation, but sounds like that needs some thought as well.
    Jingles to your horses, I hope its not strangles, but if it is, a speedy recovery for all.



  19. #19
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    I lost Aisha to a vet who placed her care on the back burner. He felt that because she was OLD, she wasn't worth all the measures and procedures I told him to do to find out how bad her laminitis was, despite the signed document the BO had detailing the care for my two horses (basically up to $2000 in procedures on the filly, on anything with better than 75% survival; no financial limit on Aisha, anything with 35% survival rate). I was at the academy at the time, and I had to call and ORDER him to x-ray her feet a second time, a week after I had asked him to do it and the BO called and told me he never showed.

    I didn't know until afterward, but he and my Mom (horsie guardian if I was unreachable) got into a yelling match on the phone with him saying she was too old to whip out all the lifesaving measures and my Mom saying "you don't understand, this horse is everything to her!"

    Aisha waited until two weeks after I graduated to tell me it was time. I hate that man with every fiber of my being, and not only do I not use him, but I won't even mention him if someone asks for a recommendation. I mention an elderly cow vet over him.
    COTH's official mini-donk enabler

    "I am all for reaching out, but in some situations it needs to be done with a rolled up news paper." Alagirl



  20. #20
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    So, he apologized but still insists you were overracting to yellow snots, a cough and a fever???? Bzzzzt. I'd make other arrangements.

    Oh, take it easy on that training barn, I doubt they were hiding rampant strangles. All kinds of horses in and out of those places and the younger ones can pick stuff up from horses coming back from shows pretty easy. Even in the cleanest and best managed barns.

    Most of the training barns also will administer routine meds if their vet deems it appropriate and the boarding contract has wording to that effect. Was your horse vaccinated for Strangles before it went there???? Many active show barns now require it. And it may be an independent infection not associated with Strangles.

    But get another primary care vet. It may cost more but look what this could cost you in additional meds and lost training time and condition because vet thought you were overreacting.
    When opportunity knocks it's wearing overalls and looks like work.

    The horse world. Two people. Three opinions.



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