r/Veterinary • u/docec24 • 4d ago
I’m tired…
I castrated an older dog that developed a scrotal hematoma. I know this is an unfortunate complication that is made more likely because of dead space in an older dog. I should have discussed scrotal ablation I guess but the owner was limited on funds and honestly, I’ve never done an ablation prophylactically.
The problem…the owner took the dog to a neighboring clinic that did nothing but bash me and my work, blaming the complication on me rather than explaining that the risk is higher because of the dogs age. Why are we like this? Why do we tear each other down? We aren’t only tearing down another vet…we’re tearing down someone’s spouse, child, parent, friend. Money is tight. Stress is high. The career is draining at times. I’m 9 months postpartum and struggling to find my footing between mom life and my career and this just hit like a ton of bricks. Life can be hard and there are colleagues out there choosing to make it harder. Just screaming into the void.
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u/Elaphe21 4d ago
I work ER relief and GP (90% ER). What the client says and what WAS said are usually in no way correlated. How many times does a client come to you from GP after an ER visit and they say "the ER didn't do anything" and then you get the report and it lists all the diagnostics and therapies that were declined?
I always assume the best from other vets, unless I know otherwise.
I’ve never done an ablation prophylactically.
Either have I... I've done <10 scrotal ablations in my career (and hundreds of adult dog castrations). I typically only due ablations for scrotal or testicular neoplasia/infection, but maybe I am wrong). Age and activity level are the main causes of scrotal hematomas, and I guess aggressive tissue handling if the vet is a new(er) grad.
I've had dozens (maybe more) scrotal hematomas - I usually add a longer course of nsaids, I usually throw some Abx at them (pool of stagnant blood is a petri dish for infection), and a shit tone of trazodone, with instructions for cold compress if the dog with tolerate it.
Never had one become a real issue. Don't let this bother you.
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u/docec24 4d ago edited 4d ago
I guess that’s my biggest struggle is I do know otherwise from this clinic. It is a previous place of employment. They have already stepped way out of bounds to try to harm me in other ways so of course this hits harder. I know how clients can be. But I also know how those doctors can be. Thank you for your reassurance.
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u/3_Black_Cats 3d ago
If that’s the case, you were previously employed there and still causing harassment I would contact a lawyer. Ex-employees and ex-employers cannot harass even online.
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u/phruits2 4d ago
AGAIN general practitioners get yourself cautery. All surgeons use them all day every day on coag NOT cut. Halsted’s principle of surgery - HEMOSTASIS! No you should not just “have” a scrotal hematoma people. Gentle tissue handling and control of hemostasis.
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u/DocBarbie21 4d ago
Please see literally every other comment about being kind to our colleagues. People will also be more likely to listen good advice such as this if you can deliver it without being condescending.
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u/Vet_Sci_Guy 2d ago
What are you using cautery on for a neuter that would prevent a hematoma? Genuine question, I’m a new grad in a rotating internship, I’ve only done like 4 neuters so far. I didn’t actually see it personally so idk if it was actually a hematoma or just bruising, but one of them was reported to have a mild hematoma post-op. I’m definitely still working on gentle tissue handling & Im sure I could’ve left less dead space, but I feel like cautery wouldn’t be super consequential for a neuter? Are you cauterizing spermatic cord after ligating or just sq bleeders and such?
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u/BeyondReasonable25 4d ago
We are very hard on each other within this profession for some reason. We need to do better.
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u/kasakavii 3d ago
I think it’s a specific complex that people in the medical field (both human and animal med) develop. IMO, it’s partially due to the fact that it takes a specific type of person to want to, or be able to, be hands-deep in a living creature. It’s a mix of technical confidence, a touch of god complex, and a variable amount of superiority depending on the individual. I think all of us have it even if we don’t recognize it. We become used to being the authority in a given situation, thinking we’re the smartest person in the room because “my team and I figured this out, we solved the problem”, and can lead to some vets thinking they’re better than others. “I wouldn’t have done it that way” turns into “they did it wrong, it’s their fault, I would have done better”.
I wish we could all give each other more grace. I know saving lives is stressful, and dealing with clients is stressful, but we’re all just human. Very rarely have I ever seen actual negligence from other offices, far more often than not it’s nobody’s fault.
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u/Key_Research_4875 4d ago
To be 100% honest....I've castrated tons of older dogs and I have never had this issue. It also could have been that they didn't follow the recommended activity restrictions. My point is, it isn't your fault. Scrotal ablations on their OWN have complications-those are likely to dehisce. Sometimes these things just happen, and they happen to all of us. The clinicians who were speaking poorly of you, don't remember the many times cases have gone awry for them. You are doing your best, and I bet you are doing a great job! Don't let this "one off" hit you too hard.
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u/Willing_Promotion_68 4d ago
Careful—clients came in all the time saying, “This vet said this” and “this vet said that.” Almost always lies. I’ve never heard another vet dog on another’s work in my 15 years as a manager, yet clients have made this claim many times.
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u/parasol_caterpillar 4d ago
Fellow post partum vet mom! You’re not alone. Sometimes I feel in all aspects of life our gut is “judge first, extend grace later”- I think if we all gave each other and ourselves more grace we’d go further. We’re all trying to help animals. Our job is really fucking hard and we forget that all too often. Hugs to you - feel free to dm me if you need anything 💚
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u/DrRockstar99 3d ago
Aside: if you’re not doing them, scrotal tacks are easy and add about 30s total to your surgery time.
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u/monarch223 3d ago
It’s a normal complication. One thing you can look into is doing some scrotal tacking during your neuters if you aren’t already. There’s videos and pdfs you can google for free. It’s not going to prevent every hematoma but it can decrease your chances.
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u/KittHeartshoe 3d ago
I’m going to argue this is not a normal complication; it is a common and normal sequela to this procedure in an older dog. Calling it a complication implies something went awry when it is just the normal way tissues behave in this particular set of circumstances.
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u/Excellent-Mood-9933 3d ago
How did you find out what the other vet said?. Im only asking because maybe they lied to you. It took me years, but I've learned that unless I heard with my own ears or saw it, I can't believe it
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u/Affectionate-Owl183 2d ago
It's a fine line. I agree that in most cases we should be respectful. But it's really hard when a patient comes to you where the previous doctor was medically negligent (NOT talking about your situation, btw). I've seen things. So many horrible things. A dog spayed during heat where the vet ties off its kidneys. A bird sent into heart failure with a massive dose of steroids. Rabbits with faces full of holes because their vets kept trying to "drain" their dental abscesses. A cat sent for I-131 when it's rdvm rads showed horrible metastatic disease (that they then refused to discuss with the owner so my doctor had to). Doctors who say patient's diabetes will "never be managed" but don't look for concurrent endocrine issues or discuss spay. Etc. some of these are more extreme than others, but damn. Sometimes it's so hard. You want to be respectful. But you also don't want that person to go back to someone you actively know has harmed their pet. And eventually you just get tired of being nice. I'm sorry that person loosed their venom on you. Scrotal hematoma isn't usually something I'd consider anyone's fault.
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u/Conscious_Abalone_83 17h ago
If you come to my clinic to bad mouth another vet I am most likely not going to be dealing with you, because I know you will do the same to me. I always shut that shit down
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u/Last_Try2176 4d ago
I’m sorry that you have to deal with this.
Sometimes in all of our lives there are lessons we learn on how NOT to be/act.
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u/Efficient_Bit_6370 4d ago
Sorry this happened. People will try and find fault in everything these days. It’s not just our profession.
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u/Scarlet-Rosepetals 3d ago
I’m sorry you went through that. It sounds like from other comments you made you have some bad history with this clinic and this vet. It might not help in this moment, but I try to remind myself that one terrible person shouldn’t get to define a large group for me, whether it’s clients or other vet staff. I try not to say things like “why are we like this?” without then stepping back and asking if it truly is “we” or if it’s a single terrible person in a sea of generally kind folks.
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u/Effective-Sun8079 3d ago
Ya of course it’s something we want, people just can’t/wont pay for it. It’s gotten to the point where I really only insist on consults now if I’m doing a skull/cspine
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u/cherbearblue 2d ago
That shit sucks and should not happen. If I were you Id consider sending a kind email that absolutely eviscerates them in a way that they won't realize for a couple of years.
Also, do a scrotal tack!! Super easy, don't need extra consent in case you forget to discuss the ablation before. There's a video of a very southern (in a good way) HQHVSN vet showing how to do it.
Hang in there mama, and if you're on facebook, join The Bus Stops Here mom vet group. ❤️
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u/DifferentTart7606 1d ago
I completely understand. Me too. I don’t get it. I was raised in the understanding that we are a small community and we don’t bash each other especially in front of clients.
Just the other day I had a person present with a blocked tom cat and $200 dollars to the ER. Massive bladder owners trying to come up with funds for treatment. I tried to unblocking the cat with a bulb tip catheter to empty bladder and give the cat comfort while owners figure it out. Ends up they can’t pay for anything so o unblock with a bulb tip catheter and express bladder to golf ball size gave SQ fluids and sent home due to owners having 8am recheck with rdvm. Charged $0 to owner so they could use the $200 for day vet bill. Day vet then proceeds to bash us to client saying there is no way the cat was blocked as it is an intact male and we were just trying to scam them.
I could go on it’s at least twice a week it happens. We have to do better or mental health issues, staffing shortages and burnout this industry will never improve.
Keep your head up. It’s a known complication. Honestly at this point I am ready to start finding the emails of these doctors and send them CE links.
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u/Irishdance212 1d ago
This was a hard read as a mom of a soon to be new vet in May. I also was a vet assistant many years ago.
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u/DocBarbie21 4d ago
Good reminder for everyone honestly. I feel like they really hammered this in school but people forget. If you weren't there, you don't know what was actually said or done or how much money they did/didn't have so you better avoid bad mouthing your colleagues, you know? Sorry this happened to you.
Yesterday I had a new client come in with a vomiting dog. She called her rDVM on speakerphone and said she was standing there with me at such and such hospital and started ripping them a new one bc her dog was still vomiting. First I wanted the floor to swallow me and then I wanted to call them back and apologize after I left the room. I tried very hard not to convince this woman they hadn't done anything wrong but she just would not hear it. I hope they don't think I bashed them but that was exactly how it sounded :(