new name!

spacer

Behavior

Cliff Diving through a Cloud of Expectations
February 19, 2013 (published)
Phyllis DeGioia, editor Veterinary Partner and ANIMALicious

Clients’ expectations of a visit to the vet sometimes differ from what a vet expects. It’s possible this is never more true than in an emergency.

A couple of years I ago I watched my 42-pound English setter get into jumping position and then take a swan dive off a 9-foot retaining wall onto a cement driveway. He hit the ground with a hideous thud, the splatty kind of landing that physicists could use as a teaching example of mass and acceleration due to gravity.

Dodger got up and ran off to play. A few minutes later we were putting ice and topical antibiotic on his scraped chin. He spent the next few hours running at bred-for-field-trials speed.

Not only did Dodger run, he didn’t display a single sign of distress. He moved well, eyes and breathing were normal, blood didn’t come out of any orifices, and gums, temperature and temperament were normal. He could lie down in multiple positions without discomfort. A front leg sported a swollen spot that was gone less than 48 hours later.

Obviously he had to go to the ER after that splatty landing, but first I would have to stop him from playing, so I phoned. The veterinarian I spoke to said it sounded unnecessary to take him to the ER unless something changed.

Dodger went to our regular vet on Monday because I was still certain that some internal part of his body had to be injured. The vet said “well, he has some tartar on his teeth.” You’d think the velocity alone have blown the tartar off.

Shouldn’t that have been a fatal fall, much less one without injury? Shouldn’t he have, at the very least, broken a leg, if not his neck or back, or possibly ruptured a few internal organs? It made no sense to me that he could just get up and walk away from a fall that would have seriously injured any human.

I asked my friend Dr. Becky Lundgren of VIN about it via instant message.

Me: Shouldn’t he be dead?
Becky: Only animals with brains tense up for the landing.
Me: Vet said something about how his solid musculature may have helped him.
Becky: Probably translated the force through the muscles, thus spreading it out like a big rubber ball.
Me: Wouldn’t you think an internal organ would go splat?
Becky: Ribs are springy. Brainless wonders are often lucky.

I wasn’t getting what I wanted to hear. I was lucky that I work with enough veterinarians that I could keep asking until I was satisfied with an explanation.

I IMed an ER vet, our own Dr. Tony Johnson.
Me: Shouldn’t he be dead?
Tony: Empty skull
Me: Seriously, explain this to me
Tony: I think he rolled with it – like a drunk
Me: But how does that work?
Tony: Did not fight the impact – was loose. If he was tense he would have broken something. This is why most drunks who fall down don’t get hurt. Has saved me many times.
Me: Is that because impact is able to be spread out instead of absorbed in one place?
Tony: Yes. And I think a healthy dose of luck was in the mix, too!
Me: Is it more about landing “loose” or more about what shape the dog is in?
Tony: Too many factors, including chance, to consider.
Me: What about weight? What about the Great Pyrenees that live there?
Tony: The fur would save them, and one of the dewclaws would catch on something and stop the fall.
Me: He could have died, right? What could have happened?
Tony: You got an hour? TBI, collapsed lung, ruptured bladder or spleen
Me: TBI?
Tony: Traumatic brain injury but that requires a brain to be present.

Poor Dodger… He thinks his theme song is “I Like to Move it” from “Madagascar.” I think it’s “If I Only Had a Brain” from the “Wizard of Oz.”

But although all of the veterinarians offered answers, they were not what I expected. Even days later, I was still panicked over the nightmare vision of my dog flying to the driveway, graceful as a cat. Why was no vet concerned?

I decided to pull out all the stops and use a media request. I talked to Dr. Louise Murray, Vice President of the ASPCA Bergh Memorial Animal in New York City. If anybody could explain this clearly to me, it would be an ER vet in Manhattan. This hospital sees a feline high rise fall once a week (more in nice weather) and a canine case about once a month.

Dr. Murray did not disappoint.

“We just don’t know if more relaxed animals survive than tense animals,” said Dr. Murray. “In cat studies, cats who fall mid-range heights between two and six stories had worse trauma than cats who fell from over six stories. In mid-range they don’t have time to position themselves. For dogs, they did worse when it was over three stories. There is no data for dogs falling from over six stories, probably because they all died.” She said there is a huge variety of injuries that can result from falling from heights.

One story has 12 feet, so Dodger’s 9-foot fall was less than one piffling story.

Did his medium size and significant muscle tone help him walk away? I still wasn’t grasping the whole “it’s like drunks who fall down and don’t get hurt” theory.

“They analyzed what condition the dog was in after the fall. The reason they fell did not affect it, weight didn’t matter, why they fell didn’t matter, surface didn’t matter – just height mattered,” she said.

Studies have been done of high rise falls in cats and in dogs, and film has been taken of cats as they’re falling. Studies are retrospective, and they take data after the animal comes into the hospital. But it’s impossible to do a retrospective study on whether muscles are loose.

“There is speculation, but we don’t know,” she said. “We don’t know if the more tensed cat falls differently than one who isn’t. In animals we have no idea because that would be impossible to analyze without doing very harmful research to animals so I would rather remain mystified.”

But what about that loose vs. tensed muscle question?

“We don’t know anything about emotions in this situation,” said Dr. Murray, “but if pets aren’t flailing, they’re getting ready to land. You’d rather fall with the weight evenly distributed. In my mind, panicking and flailing will make you land on one focal area because you’re not positioning yourself. Say a dog jumps over a high wall: they’re not flailing, they’re in position.”

And my silly, wildly hyper dog who jumped out of sheer excitement?

“Dodger is not unusual,” she said. “It doesn’t surprise me. Here we fairly regularly see dogs that have fallen a story, and they’re okay, maybe a little bit banged up.”

My real lesson in all of this had nothing to do with the physics of mass and acceleration due to gravity, although that was the only part on which I was focusing. I assumed he had internal injuries, and expected recognition of my fear, whereas the vets looked at the medical facts. Most likely one of their concerns was dealing with a panicky owner. Learning how to work with clients' expectations is not taught at vet school. That's a skill born from experience, and it's particularly valuable when dealing with a panicky client- especially one whose job is all about preparing educational material for pet owners.

Being fraught with expectations set me up for dissatisfaction when there was no need to feel that way. I am, sometimes, my own worst enemy. There is enough trouble in the world without borrowing it.

Unless Dodger jumps off a higher cliff, of course.

3 Comments

Hugo - CommunityVet 
February 28, 2013

Thank you for your kind words. I learned (the hard way, not in the classroom) that the best way to know about client expectations is to simply ask them directly. Knowing exactly what a client's expectations are helps you achieve or adjust them. And a clients body language, verbal tone and cues sometimes aren't enough. Nothing like proper verbalization to increase empathy! That's why I love to hear about client stories told by themselves, like the one you posted. I always learn something important!


Phyllis DeGioia 
February 27, 2013

Hi Dr. Hugo, Four stories? Hard for me to imagine that even now. I appreciate your response to your client more than I can say. You understand better than I did about what I was looking for - someone to meet my worries (what a perfect phrase). Wish I'd had you and your response rather than "well, he has tartar on his teeth" (funny now but not very helpful at the time). It was nearly impossible for me to believe he was not injured internally because it just doesn't seem possible. You read in client education material that if your dog gets even bumped by a moving car that you should take the dog in to rule out internal injuries. I love your thinking on their names - Goliath (what a great name for a Rott!) and Dodger are appropriate names for wild flying boys who cheat death. thanks for writing - you made my day!

Hugo - CommunityVet 
February 26, 2013

I once saw a Rott chasing a cat that jumped over a wall and fell to a highway tunnel. It was a fall well over 4 stories high. He got up gracefully and dodged (sic!) the coming traffic with the ease of a football player. The owner couldn't believe that nothing had happened (neither did I). Should't he have died, she asked me. I proceeded with all the answers you heard, and she reacted with the same disbelief and anguish you must have felt too. She only relaxed and smiled when I told her that I could keep him overnight just to make sure no internal damage would develop unnoticed during the night. So, her expectation was finally met - she was not only looking for someone who cared, but also someone who shared her disbelief and met her worries. The dogs name was Goliath. I think the explanation for both Goliath and Dodger cheating death lies in their names... ;).



 
Home
Loading


Browse by categories


About us



Connect with us

Twitter Find us on Facebook RSS feed

VetzInsight
Powered By VIN