Comments on: The Art of Delivering Bad News: What I Wish I’d Known

By: Patricia

Patricia — Sat, 23 Jan 2010 22:49:05 +0000

I am really grateful to an emergency vet who leveled with me about the condition of my cat. I think my regular vet didn’t level with me a day earlier because it was obvious I was clueless about how serious my cat’s kidney failure was and he knew me well enough to know it would be a shock. One of my earlier cats had kidney failure for 2 1/2 years and that’s what I expected. It never occurred to me that a cat could reach an end stage in 6 months. I took him in for fluids and when I was ready to go the vet tech said I should stay as the vet wanted to talk to me. When he entered the room, he looked at his feet a lot and then said I would probably want to bring my cat back in a couple of days to have more fluids. But on Sunday morning my cat looked terrible so I decided not to wait and took him to an emergency vet for fluids. She picked him up, cuddled him, kissed him, and said “It’s so hard to say good-bye to these old timers but I think that’s what you should do. Let me show you your cat.” And she showed me ulcers in his eyes, his throat, had me smell his breath which smelled like urine, and explained the course of the disease. Her compassion and her directness punctured my expectation he would live for a couple more years like my other cat. She made it clear my cat was suffering and for that I am grateful. She wanted to know if I wanted to talk this over with my husband and I said yes. After telling my husband I would not be bringing Travis home, she put him down. Even now I cry thinking about this event. But I admire her directness and professionalism in helping me to spare my cat any more suffering. Your guidelines are the way this vet handled me in helping me to understand the condition of my cat. Years later I am still grateful to her.

By: welso

welso — Sat, 23 Jan 2010 21:10:55 +0000

Another tip: When it comes to potentially fatal diagnoses, don’t think out loud. Don’t say anything until you’re sure.

A 4-week-old kitten I had just adopted developed breathing problems. The vet did x-rays, thought they showed fluid in the abdomen and blithely pronounced that my cat had FIP. Death sentence delivered.

As I was getting things together to go home, tears welling up in my eyes as I was trying to wrap my head around what was happening, the vet came back and suggested we send the films to a radiologist who was experienced with tiny kittens. Turns out, what the vet interpreted as abnormal fluid was actually normal physiology for such a young kitten. The kitten did have some kind of lung infection, but it cleared up quickly with medication, and the kitten is now a happy, healthy adult.

By: Barbara A. Albright

Barbara A. Albright — Sat, 23 Jan 2010 19:45:34 +0000

Be honest and forthright.

I am not a fan of the question “What would you do if he was your pet?”

Neither am I, simply because he/she isn’t your pet. And what you may be able to do or not do may not match our ethics, emotions, and capabilities.

It also may play guilt into the situation, by convincing an owner to do something they do not believe in. period.

Honest & to the point, no maybe this maybe that.

Thanks for the post.

By: Wayne A. Miller, RPh

Wayne A. Miller, RPh — Sat, 23 Jan 2010 14:37:00 +0000

Dr. Koehl,

I am most impressed with your frank discussion on delivering bad news to patients and caregivers. You offer great advice the both veterinarian and medical providers alike.