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Stewardship

January 11, 2022

At what cost? And is the problem fixable? I need more information and information costs too, both time and money. And what do we do with that information?

I need to intervene, whether it's surgery or medication, hospitalization, or, in animals, euthanasia. And what is the right decision? This is medicine, a weighing of the odds, an art, and a science. Compounded by personal experience, preconceived notions, preferences, and convictions about stewardship. What is right? When it is $3,000 less for a vacation or $3,000 needed to feed a family- the cost still costs, but it isn't the same. As veterinarians, it's not our burden to bear, but we bear it anyway. What is the least amount of testing to get the information we need to make a better-educated decision? And response or lack thereof to treatment is a diagnostic test… And animals aren't people, but they are family members just the same.

And there is the cost that is not only financial- it is the fear of an unfixable problem, the trying and failing (arguably worthwhile for the peace of knowing one has tried), it is the emotional toll, the time-intensive care, a care-givers burden, the murky waters of medicine and heavy conversations with kids-too-young to really understand. We bear that too, as what is "right" for one family may be the opposite decision for the other.

The loss was more than they could bear, especially after recently recovering from the navigation of intense surgical complications with a different pet. Which, in early hindsight, they may not have chosen to endure. Sushi is certainly appreciative that they brought Otto through everything because Otto (the dog) is Sushi's (the cat) best friend. So when Sushi became so sick shortly after all this, it was a hard hit. All the questions. All the cost. All the unknowns. We, even as veterinarians, consider the 'what-ifs" and "would I's." It's a question frequently posed and one easier (not easy, but easier) to consider as a spectator. And it teaches you quickly not to cast judgment. His family loved him enough to euthanize him, but they didn't have to!

Our purpose for pets and people is the same- to make lives better through the practice of veterinary medicine. Through the All-Star foundation, we had the privilege of this. Few things can compare to the joy this brings, especially experienced so tangibly! The memory of the tearful and joyful reunion of Sushi with his family continues to inspire me.

I wish I could explain why animals eat things. While it is my favorite surgery- an adventurous surprise to identify what does not belong in the GI tract -it really seems like an unnecessary expense. Sushi loves three things:

  1. Otto the dog
  2. His 12-year-old two-legged brother
  3. Dinosaurs

It seems so appropriate that this 1.5-year-old, goofy orange tabby had an intestinal obstruction with half of a rubber dinosaur toy- he wouldn't tell me where the other half was, but I think his purr said he wouldn't do it again.

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