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Bob Brown offers a firsthand look inside a hospital-based emergency room for animals. The report focuses on two specialists in the field of veterinary science whose amazing medical work impacts the lives of so many pet owners.
Monday, March 29, 1999
CONNIE CHUNG, ABCNEWS Youíve seen it countless times on TVóthe lifeóandódeath pace of the emergency room. Automatic doors fly open. The patient rolls in on a gurney. Doctors and nurses shout instructions at each other. Every second counts as they try to save a life. But in this story, the patients are, shall we say, different. As Bob Brown takes you to this busy trauma center, you may find yourself wondering where you could get the kind of treatment these patients get.
BOB BROWN, ABCNEWS (VO) An emergency patient is in critical condition.
ANNEóMARIE MANNING, ER VETERINARIAN Sheís closed.
BOB BROWN (VO) The patient is a cat whose lungs and chest cavity are filled with fluids. It dies on the operating table.
ANNEóMARIE MANNING OK, go ahead. Sheís gone. One cc, epi ...
BOB BROWN (VO) Then, with a fast and coordinated response from the doctor and emergency staff, it is brought back to life with many of the same techniques THAT would have been used on a human.
ANNEóMARIE MANNING OK, we got a heartbeat.
BOB BROWN (VO) This was one out of more than 80 cases a day that are seen at this animal emergency clinic at Angell Memorial Hospital in Boston, one of the biggest animal hospitals in the world.
MALE VETERINARIAN Whatís his name?
DOG OWNER His nameís Duke.
MALE VETERINARIAN Duke.
BOB BROWN (VO) The patients range from the humble to the exotic. From a hamster with skin disease that started after he hid in the wall behind a washing machine ...
HAMSTERíS OWNER I donít know if he has picked up something there or if he has some kind of infection or ...
BOB BROWN (VO) ... to a blue heron with a bloody wing brought in by a park ranger. And at the center of this 24óhour, highóstress operation are two women, Lisa Moses and AnneóMarie Manning, the coódirectors of emergency services at Angell who may not have much time left for a life, but who do enjoy one particular kind of luxury.
LISA MOSES Itís the absolute luxury that we have that we can become very attached to our patients. And thatís why I wouldnít trade my job for one as an MD for anything. Because thatís what makes it worth it is that we develop real relationships with our patients.
BOB BROWN (VO) And the patientsóMimi is here for a checkup on her pregnancy ...
FEMALE VETERINARIAN You still have three babies.
BOB BROWN (VO) ... are allowed to return the affection.
ANNEóMARIE MANNING We get to come in and hug them and kiss them, and nobody looks at us weird.
LISA MOSES Right.
BOB BROWN (VO) Lisa and AnneóMarie are two of the most prominent specialists in a field of veterinary service that was virtually unheard of when they were kidsóhospital and clinicóbased emergency care. In the last 20 years, the number of animal emergency clinics has grown from a dozen in a few major cities to more than 400 around the country.
ANNEóMARIE MANNING Anything can come through the door. On a given night, I might see an animal in congestive heart failure. Iím going to take him right back to the ICU, OK? I might see an animal who threw a disc out in their back or got hit by a car and has a broken leg.
BOB BROWN (VO) Survival rates have improved dramatically because of 24óhour monitoring and increasingly sophisticated technology. Here, theyíre using an endoscope, an instrument with a miniature camera, to help them insert a feeding tube into this cat. Lisa will use ultrasound on a Springer Spaniel named Libby to discover what appears to be a cancer on her liver.
LISA MOSES Oh, I donít like that.
BOB BROWN (VO) What they like best are cases like Sophieís. She was brought to Angell all the way from Nantucket by Mike Feeney (ph), who was afraid she might have cervical cancer. There are 30 specialists at Angell, ranging from cardiologists to a plastic surgeon who rebuilds jaws or limbs disfigured by cancer. Mike Feeney felt it was worth the five and a half hour trip in bad weather.
MIKE FEENEY, SOPHIEíS OWNER Itís a real hospital, you know. Itís huge. Itís big, and they have a lot of great doctors here. And they have all the stateóofótheóart equipment. Theyíre able to deal with the problems that veterinarians, say, on like Nantucket canít.
BOB BROWN (VO) In Sophieís case, it was a gynecological problem. The day after she was admitted to the emergency room, she underwent a hysterectomy. Two days later, emergency over, she and her doctor were enjoying a walk together. And before the week was out, Sophie was back in Nantucket. The bill was $2,600. Feeney was prepared to pay, but pet owners are often surprised at the expense of animal emergency care. And owners rarely have insurance to cover the costs. Each night in the ICU is $200, aside from any additional treatment. Xórays are $100. Blood tests add another $80. And the cost of treatment can quickly escalate because so much more can be done.
ANNIEóMARIE MANNING We need oxygen and a catheter.
BOB BROWN (VO) Surgeons here can perform hip replacements on animals whose cases might once have been considered hopeless. This dog, Max, had his pelvis rebuilt after being crushed by a car.
ANNEóMARIE MANNING So weíre going to estimate four to five days in the hospital for cuddles.
BOB BROWN (VO) But doctors here must always raise the financial issues involved before proceeding, even when the only alternative may be euthanasia.
LINDA REID, TAFFYíS OWNER This is a nightmare. This is a nightmare.
ANNEóMARIE MANNING We donít want somebody to put their animal to sleep because of finances, but we also want them to be able to put dinner on the table for their children. And if treating their pet to the tune of several thousand dollars means they canít do that, then thatís not the right thing for them to do. We need to know how youíd like us to proceed. Thatís extremely difficult for us to reconcile. But ...
LISA MOSES We canít make that decision for them. They have to make that decision.
ANNEóMARIE MANNING And we have to help them.
LINDA REID I donít want him to suffer. Excuse me.
ANNEóMARIE MANNING Itís OK. Take your time.
BOB BROWN (VO) In this case, AnneóMarie has shown Linda and George Reid Xórays of their cat Taffyís enlarged heart.
ANNEóMARIE MANNING Her heart is extremely large. Normally their heart would be probably like that size. So weíre talking about a ...
BOB BROWN (VO) The question is whether the ICU should place a ďdo not resuscitateĒ order on Taffy if she stops breathing. The Reids chose to try treatment. AnneóMarie placed Taffy on medication that controlled the problems associated with her heart, and the decision paid off. Taffy was able to return home after five days.
LINDA REID Say, ďAll I know is I want to come home.Ē
BOB BROWN (VO) In cases where the potential for recovery exists, the hospital may offer financial assistance and will always work out a payment plan. But if thereís little or no chance of a successful treatment and the animal will suffer, Lisa and AnneóMarie are often called on to be sensitive but direct in their recommendations. Eightóyearóold Josh Smolowicz (ph) came in with his mother, knowing that their dog Ranger was unlikely to survive much longer.
MRS SMOLOWICZ Heís a 15 1/2óyearóold dog. And, you know, there could be several things wrong with him. He means a lot to us. Heís a very, very special dog.
BOB BROWN (VO) And although the emotional blow of making a lifeóandódeath decision is numbing, Joshís mother had talked carefully with him. And Lisa believes the understanding he showed is an example of why the details of such a case should never be hidden from children.
LISA MOSES I have so many clients who come into the exam room and tell me that the thing that they remember from their childhood most of all is that they came home and their dog was gone. And nobody told them what happened. Or they told them something that was a madeóup story, and they found out 10 years later. And they donít want to repeat it with their own kids.
BOB BROWN (VO) Because of pancreas and kidney trouble that couldnít be treated, Ranger was euthanized four days later.
LISA MOSES I try really hard to validate whatever decision they make. So I feel like we have to be their advocate at all times.
ANNEóMARIE MANNING But sometimes itís so busy that youíve just euthanized an animal and another emergency just rolled through the door.
LISA MOSES Right, you have to run right back out there.
ANNEóMARIE MANNING And you have to go right off to that, and you donít have time to settle your emotions over what youíve just done. So, you know, even if a client sees us in the exam room putting their animal to sleep, and we donít look like weíre having a difficult time, we are.
LISA MOSES Yeah.
ANNEóMARIE MANNING Yeah, thatís definitely a hard thing.
LISA MOSES And there are weeks that it really takes its toll on us. And thereís times when Iíve been particularly emotionally attached that I canít euthanize the animal. And I have to come and get AnneóMarie to help me.
ANNEóMARIE MANNING Right. Weíve done that for each other.
BOB BROWN (VO) Both Lisa and AnneóMarie have pets of their own, and as you might imagine, some they grew attached to from their work. Lisa has one pit bull named Dora, a former patient of Lisaís who was abandoned in the hospital. And another named Paloma, who came to Angell Memorial as a cruelty case. She chose pit bulls because they are the least likely to be adopted by people searching for pets. AnneóMarie adopted a cat, Gracie, brought into the hospital as a stray. And she has a Husky named Nishka. She is 33 years old and lives with her mother because most of her life is taken up by her 60óhour work week, and starting relationships is difficult.
ANNEóMARIE MANNING Itís hard. I mean, thereís no single guys. I mean, the veterinary profession is becoming more and more women, and thereís fewer men in veterinary medicine. But where thereís a will, thereís a way.
LISA MOSES Yeah, right.
BOB BROWN (VO) And although there is luxury in having relationships with animals, those contacts are always governed by relationships with the people who bring them in. Kathy and Richard Santos (ph) showed up on a Saturday in early January with Lewis, a Golden Retriever, who was too weak to walk or lift his head.
RICHARD SANTOS, LEWISíS OWNER You know, the average life expectancy of a Golden is 12 years, and here he is, 17.
ANNEóMARIE MANNING His heart rateís very fast.
RICHARD SANTOS I was reluctant to bring him here because I just had the notion that we wouldnít be going home with him.
BOB BROWN (VO) Itís possible that Lewis, who has arthritis, might have been mishandled inadvertently by a dog groomer, who could have placed a strain on a back condition that already existed. The problem is Lewis canít tell them exactly when the pain started and where it hurts worst.
LISA MOSES I liken it to pediatric medicine a lot of the time. Because youíre dealing with a patient who canít verbalize for you what hurts and what the problem is. And you have people that are bringing that patient in to you that are very attached and very emotional about whatís going on.
ANNEóMARIE MANNING Just sit with him so he wonít feel scared.
BOB BROWN (VO) The Santos agreed to have Lewis placed in the hospitalís intensive care unit for the night. AnneóMarie started him on pain medication and IV fluids to overcome dehydration. And when he saw Kathy and Richard walk away, he did have the energy to protest.
KATHY SANTOS He hates it when we leave him anywhere.
ANNEóMARIE MANNING Heíll get lots of attention.
KATHY SANTOS I mean, he was telling me that he didnít want us to leave him here. He could even rally. Heís rallied before.
BOB BROWN (VO) Because of his age, 17, AnneóMarie chose not to put him through any batteries of tests. The next day, Lewis felt so much better that he was discharged. The treatment had mainly overcome his symptoms.
ANNEóMARIE MANNING That probably feels good to him. Give like a little massage. Yeah, you like that, huh?
BOB BROWN (VO) She showed the Santos how to help keep him comfortable, and they headed back home. In this environment, where time is often measured in the seconds of a crisis, the weeks or months that can be bought to maintain the quality of life for an animal and extend a relationship can be priceless. And life has many ways of asserting itself hereóa critical case, rushed in the door one moment, a mother whose pups, it is feared, have died in the womb, is turned, an hour later, into a photo album picture. Following an induced labor, the pups arrived alive and well. And, like all the creatures here, ready for a place in the family.
LISA MOSES Any client who brings in their pet to us, itís not just an animal to them. Otherwise, they wouldnít have come to us in the first place. Miss Pfeiffer (ph), Iím going to take you into the room.
ANNEóMARIE MANNING The impact that I have on the lives of the people that bring these animals in, itís huge. And I take that very seriously.
PET OWNER Hello, baby.
ANNEóMARIE MANNING Itóitís really important to me that I donít underestimate how big of a deal that is to people.
LISA MOSES Yeah, I think being rewarded with seeing an animal go out the door that came in really bad shape, this is what makes me happy.
CONNIE CHUNG Charlie, do you know how much is spent on medical costs on pets a year?
CHARLES GIBSON I have no idea, but I would presume itís in the billions?
CONNIE CHUNG Thatís rightó$12 billion, according to the Veterinary Medical Association.
CHARLES GIBSON Itís extraordinary to see how those emergency rooms treat animals in much the same way human are treated when they come into the emergency room. There is a cable operation called Animal Planet that now has a show, very popular, called ďEmergency Vet,Ē although I think they ought to call it ďEV.Ē Get big ratings.
U M M A R Y
In the last 20 years, the number of animal emergency clinics has grown from a dozen in a few major cities to more than 400 around the country.
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