This is a PodTalk independent production created in conjunction with the Meta and Walkley Foundation Public Interest Journalism Fund. Before we get started, this podcast includes conversations about suicide, mental health, euthanasia and descriptions of surgical procedures. Please take care when listening.
Next left, the destination is on your left. Here we go arrive, Adelaide Animal Emergency Referral Centre this is home for the next few hours. I'm not good with illness and I'm terrible with the sight of blood. So spending a night in an animal emergency hospital is daunting to say the least. To be completely honest, I'm nervous and I'm feeling just a little nauseous. Hi, how are you going? My name is Caroline. I'm here to see Diane. Diane Whatling is the business manager here at the Adelaide animal emergency referral centre. It's a specialist and emergency practice that runs 24/7. She takes me through to the high risk part of the hospital. That's the part dog owners like me rarely see. It smells like disinfectant as you'd probably expect. There are bright fluro lights overhead and a big digital screen with details and vitals about each patient. I've watched on as vets and vet nurses go from one to the next patient, adjusting their drips, taking blood and reading their charts. There's blood from somewhere. There's a bird and a cat and about half a dozen dogs been seen too tonight. I can see from the big screen that Roxy the Maltese Cross has abdominal pain and hypothyroidism in the room or cage next door. There's Benson the Schnoodle he's got diarrhoea and dehydration. And down the end is stumpy a Parsons Russell terrier, whose tricky has been stitched up after a dog attack. Just as I'm getting to know the patients, a black curly haired dog is dropped off by a stranger who found her wandering in the street. She doesn't have a collar, and she's shaking. It's now up to the doctors and the nurses to find out just what happened to her.
She's probably been hit by a car because when they get hit by a car, they often gets really scuffed nails so the ends of their nails are torn almost
take a quick photo just to show that
This is a typical night in emergency. And I'm just at the start of my four hours here. And the emotional roller coaster is about to begin.
I'm Caroline Winter, a journalist and dog lover and you're listening to Sick As A Dog, Episode three - In Their Shoes. This podcast is shining a light on a crisis that's making the people who care for our animals very sick. It's burning them out, forcing many to leave their jobs. And in some cases, it's killing them. This series is about finding answers to some very complex questions that affect us all and can't be ignored any longer.
Vet Sophie Putland loved the challenge of complex animal medicine. Her dad told us so earlier in the series, and she's definitely not alone. Vets and vet nurses thrive on this stuff. It's where they can put all their training and years of experience to work. They want nothing more than for a patient to come through the door who's an interesting case as some have termed it with an ailment that needs some problem solving. And in an emergency hospital. That can be a dime a dozen.
Tonight, I'm spending my time with the vet staff in the thick of it. First I wanted to meet some pet owners who were waiting for news. So I wandered back out into the waiting room.
My name is Zoe.
So I head over and say hello to Zoe she looks like she's in her maybe mid teens and she's with her dad. And we just started chatting when she sees her Staffy Zeus groggily stumbling towards her
He's a bit dazed, look how he's walking. He's not just drunk.
So yeah, this has held together quite nicely because we did this... that's alright darling.
I met Zeus in the hospital out the back when he just had one side of his face stitched up after being in a dog attack. The operation will cost Zoe's dad $1,300 that he couldn't be happier with the service and the care from the Vet's here. And of course, the fact that Zeus is going to be just fine.
They're amazing. Amazing. I know, when you come in, especially the love. I've been to vets where you're just a number And been to vets who care about the dog. Amazing.
It's a happy ending for this family. And also for Dr. Sloane Abraham. She hadn't long started her 4:30pm to 2am shift. When she stitched up Zeus,
I literally just did the procedure, and my colleague did everything else. So most of the time, you know, we do follow I in cases through, but then, you know, if you're busy and you haven't had a chance to eat, someone may pick up something for you, as we'll try and help each other out where we can.
Dr. Sloane graduated from vet school at the end of 2020. And after a short stint in a mixed practice with small and large animals, she landed her dream job right here in emergency
love, it would not go back to GP. What I do love though, is you know, you see the ones that come in and they're quite sick, and they're quite critical. The ones that do recover, they go home with a wagging tail, and they see that owners, you know, they're pretty much on death's door, and now we've saved that dog and we're sending it home. I guess every case doesn't turn out that way. But those are the ones that, you know, I find the best part of the job.
This animal doctor is Young has a good sense of humour. And she's pragmatic. And tonight she's one of the ER consulting bits, meaning she'll see patients as they come into the hospital. By the time I speak to her, she's been at work a couple of hours. And aside from stitching up Zeus, she's seen a cat with a large blood clot who the owners decided to put down and she's now treating church, a 15 year old Pomeranian, who has diarrhoea and vomiting, a sore belly and is finding it hard to breathe.
I think the owners are thinking that if there's anything serious going on, I think they are in that stage where they may say goodbye to little one from the vibes that I'm getting from them, the whole family has presented, there's quite a lot of crying going on. So I think they're they haven't fully made that decision yet. But I think you know, if something bad comes up on the Bloods, I think they might call it there. But in you know, in saying that you never know what people are going to do until you have that next conversation with them.
And we talk while she waits for blood tests to come back. Sloane tells me about what it was like at the practice she worked out previously. And it sounds very familiar. There was a culture of overbooking clients, meaning she missed out on breaks, there were super long days and an expectation she'd front up to work after being on call the night before. She described it as a we just need to get people through the door kind of attitude. But she says she's well supported here. And as found her happy place,
I love working. Whenever there's a shift available, and I'm free, I always am willing to pick it up all the my senior vets because I'm still very junior baby vet. So I do find that I do rely on my senior vets quite a bit. You know, if I'm here by myself for a few hours with the shift change overs, I know that, you know, I can call any of them and they're always more than willing to help me over the phone. And you know, if I need to FaceTime then they're happy to answer my video calls as well. And if I need them to come in, they always come in to support me as well. So I feel like I get a lot of support. I plan on being in the industry for a long time. I haven't had any of those thoughts of leaving, you know, I've got plans, you know, to loop them around and travel while I work because we can do that. But you know, I don't plan on leaving the industry anytime soon. But I might just be one of the lucky ones that have found somewhere I love working.
I need to put a catheter in and get some blood from
The blood work for Chooch is back.
Next step would be to admit this one, chest X rays, and then ultrasound hopefully tomorrow and do ketones as well and then treat it appropriately. So not missing anything. Awesome. I'll go have a chat with them.
Dr. Sloane disappears into the consult room.
Hey guys, so I haven't a look at the bloods here. Our glucose is quite high. So whether we've got a bit of diabetes going on, and then potentially something called DKA, which can be due to the diabetes as well. We've got high...
While she talks through the options with the family. Amy is draining fluid from Stumpy's throat wound.
It's filling up with air as I push the air out. Oh my goodness. Yeah. So it was a dogfight. Yeah. So we just keep pushing that air out to look forward to seal and then you'll be all good again. A bit more normal.
Amy's been a vet nurse for more than 20 years and for most of that time, she's been here at the Adelaide Animal Emergency Referral Centre.
You either love it or you hate it. Like er, it's, it's better when it's busy, that's for sure. For me, I love the variety and the kind of the pace you never know what's coming through the door. I like being on my toes and sort of having that kind of unknown, but I like being busy. So for me it's the busyness and the satisfaction of sending them home and they're better
Vet nurses like Amy are vital to the industry. In fact, it frankly couldn't run without them. They do everything from helping to treat animals and support vets during surgery, to monitoring patients providing grief support to clients, and reception duties. She says the job has changed a lot over the years. And for the better,
We've got a lot more freedom to do stuff. Now, when I first started nursing, you were just literally almost like a glorified cleaner. And you'd hold the animal and the vet would do all the work. Whereas now we can face the IV catheters and we can set up all the fluids and run all the drugs and we really are a lot more hands on now. So I've certainly noticed that as a change, which has been great for us because you feel more empowered and more responsibility, which is good. Yeah, definitely. It's changed a lot over the years. That's vomiting and diarrhoea that was so it was just a bit dehydrated.
The focus is more often than not on veterinarians. But there are 12 and a half 1000 vet nurses in Australia, who make up 45% of the almost 28,000 Strong veterinary services workforce. And vet nurses are also very prone to high levels of burnout, poor mental health, and suicide. To cope with the long hours, stress and continual exposure to the trauma and pain of animals, and the low pay. Amy also works at a pet store to mix things up.
I love my job. I absolutely love my job. But for what we do, the pay is absolute crap. Really. We do anaesthetics, we monitor patients, we clean floors, we do reception, you know, we're basically everything in the clinic, I'm not just a nurse. So for what we have to know, I mean, I get the same money working at Petstock than I do here. Put it that way. So I can work in retail behind the counter just saying, Do you want fries with that? Or I can bust my butt here running around like a crazy person for eight hours and get the same pay. So I think in that sense, yeah, it's a bit demeaning in that sense, you feel a bit worthless for what you're doing. But the satisfaction that you get from the job kind of makes up for it.
The staff here are working their butts off. If they're not trading an animal, they're running tests, they're cleaning something or they're doing some admin. No one sits down for more than 10 minutes in the tea room. They also chat and laugh a lot. from an outsider's perspective. It's a nice atmosphere.
I'm thinking about Sophie Putland again. And I wonder if it was this kind of fast paced, challenging, yet supportive and friendly workplace that she enjoyed so much. Well, that's what I said. My thoughts are interrupted, as Dr. Sloane returns with news on Chooch, the Pomeranian, there's been a lot of back and forth with the family, understandably.
So I said, let's do this test. And that may help us, you know, decide whether we're gonna go with treatment, but he may be in hospital for four or five days, there may be a chance he he may still pass in that time. I'm sorry, buddy, you can't go home.
The doctors run another test to see if Chooch has gone into diabetic ketoacidosis. It's a potentially life threatening complication of diabetes.
Well, at this stage, half the family have already decided on euthanasia, half of them haven't. So I said, Why don't we do this test, which will then help us, you know, go down that pathway? Because I think some of them just need that answer that they're not doing the wrong thing. I've already explained to them, you know, it's a reasonable decision at this stage.
And so now that that test has been done yet go back down and say, yep,
So I'll go back and tell them that he, he is in DKA. So the diabetic ketoacidosis. And then I would say most likely he is going to go up to Jesus tonight. You're a very cute thing. I go speak to people.
These are the tough conversations that vets have to have with clients every day. There's emotion, heartbreak and finances all at play. Sloane tells me this is the most difficult euthanasia that she's had.
I don't want her to tell me. You guys can be with him the whole time as well.
The family's distraught, they're arguing with each other about what to do. And it's part of her job to keep them calm and bring it back to what's best for her patient.
I know it's not an easy decision to make.
Let's just do we have to just live with the fees. It's not bad. Boy, no.
I want to know how he's feeling he doesn't have to do that.
I'm in tears while I listen. The family then makes their decision and Dr. Sloane Abraham talks them through what to expect.
He's not going to close his eyes like a lot of people expect. what he'll do is he'll sort of his head will go down. What they can have after is a few little muscle twitches, and it can look like they're releasing some air so it can look like they are taking a few blood. Once I get the IV catheter in, I'll bring him back in here. You guys can then spend some more time with him. If you guys all want to be present, you're welcome to hold him put him on the ground. I'll work around you guys okay.
Later that night, the paperwork is signed, and Chooch is put to sleep
I take a walk through the building, which is much bigger than just the hospital space where I've spent most of the night. The Adelaide Animal Emergency and Referral Centre is part of the corporate chain Green Cross, Australia's largest pet care company. It's one of four emergency and specialist services in Adelaide. It's also where other vets refer their patients for more advanced procedures. Alright, so in here, Business Manager Diane Whatling, and the emergency departments Clinical Director Dr. Helen Palm showing me around
This is the sterilisation room in which all instruments are sterilised and clean, we're just about to take receipt of an instrument washer. But it's a huge cost, not this machine alone would be worth probably $120,000 Plus, then it needs to be maintained. And then there's all a myriad of orthopaedic equipment, a myriad of surgical equipment.
I hadn't actually thought myself just how advanced animal medicine and equipment needed.
This, so he so this is like a human. Yeah, it is the same thing.
So along with dozens of emergency vets and nurses, the centre has surgeons, dentists, and medicine specialists, all who deal with complex conditions like cancer and neurological diseases.
These vets and nurses are high achievers, I think the vets that we attract to specialists in emergency especially the specialist, high achievers, obviously, they've gone above and beyond. But I also think that you have to be a special kind of person to work, you know, within the emergency service, because it's it's fast paced, it's quick thinking, it's knowledge, and it's been able to multitask.
Even from what I've seen tonight, it's a high energy, sometimes stressful, challenging environment, being mindful of how it might affect the mental health of this staff. Dr. Helen Palm tells me that she focuses on supporting and mentoring young vets like Sloane Abraham, what I try to do
With them is be supportive and kind and friendly, as a basis for then being able to really talk about what you're doing medically and help you with a certain case or come back to you with suggestions of how to improve or, or that general mentoring aspect of it's something I really enjoy. But I think also traditionally vets being that high achieving group of young people leaving university and going through a really complex and long study and coming out with such high expectations of themselves and reasonably unforgiving of themselves as well unforgiving of themselves on an academic sense, but then you add in the emotion and the euthanasia and, and that finances and all of that and it's a potent mix for for people really putting themselves selves down and feeling bad about themselves. But as a profession if we can be more open to that and more supportive and more able to talk about cases that went well, or cases that went bad or decisions that were good or decisions that were perhaps not so good. And we have to be really It sounds glib to say kind, but you're working at a high level, but you have to be kind to each other and supportive of the decisions you've made, so that nobody's going home, feeling bad.
We heard previously about the type of workplace culture that can make or break of it. So how they treat each other inside of course, is one thing. It's what comes out from outside that Helen and Diane say is much harder to deal with.
We try not to read our Google reviews and often they're very, very good, but people can be vicious and horrible. And that is one of the things that comes through in reviews, online reviews or trolling is often they're just in it to make money, or call themselves animal lovers, but it costs so much or call themselves animal lovers, they wouldn't do it for free or my dog was suffering, but they still wouldn't do it. Nobody else works for free. We do a lot of work for free.
And we often will look, we will often chat about an account and we'll say, Oh, we won't charge them from that, or we will cap the bill here. We know it's going to get better. Just give it another 12 hours, and we won't charge them for that 12 hours of monitoring that goes on all the
time. And yet, no one expects to go to hospital for free or to have grandma treated for free or you know, broke a hip, but we'll you know, we'll do it for free. There is an expectation that if you love animals, then you should always provide
There's never been a focus on how much does it truly cost to run a vet clinic? How much does it truly mean to pay a professional based on the cost of a business?
I don't know the answers to those questions, but I'm pretty sure it's a lot. A big chunk of this whole complex mess is about the cost of care. What hasn't been said yet is that vet practices, clinics and centres like this one are all private businesses. Some are corporate chains, others are small groups. And then there are some independence. They set their fees how they want, they pay their staff how they want and invest in their practices how they want. Effectively, they provide a service like a dry cleaner, or a crash repairer or any other as pet owners, you and I are free to use or to not use their service, and we can go somewhere else if we're not happy. We discovered last episode, the vast majority of vets don't earn a lot. And if they own a practice, most aren't driving to their beach houses in Ferraris. I certainly know mine isn't. But they do have to cover the costs of running a business to stay viable. They get kicked, bitten spat on, and some spend their days with their arms up and animals bomb. They do what they do to treat and save animals. If it was about the money, many say they'd be doing something else. When I take Harvey to my vet, and he discounts my bill, which he does do and I tell him off for it that comes out of his pocket his bottom line. Now if he does that, for all his family and friends, you know shaves a bit off here and there, what's leftover, and where's the money to upgrade equipment or buy medication or pay for his staff when he can get staff then add in the stray animals and the wildlife that vets treat because they've been brought in off the street. They don't get paid for that either. And yet, there's still this backlash because people argue that the fees are too high, and they want to discount, it's just not sustainable. The average household spends $617 on vet bills for their dog, and $717 for their cat each year. care costs money, and it can be expensive. And the cost varies depending on whether it's a general checkup around vaccinations or something more serious. A standard dog or cat vet check could sit around the 50 to $100 mark. A vaccination will set you back 80 or $90 each year for an adult animal and a couple of $100 for puppies and kittens. Well, a teeth clean could cost anywhere from four to $500. And if you need to take a trip to emergency well, that can be in the 1000s
We've cut straight to the nitty gritty of why high end veterinary medicine these days is such a difficult field to work in because you can't foresee if you if you have a dog that's come in it's been hit by a car and it's badly injured, multiple factors, lung contusions, maybe some head trauma. There are all possibilities that we can treat these days. But you can't foresee at the beginning whether that's going to be two days and one surgery or five days and three surgeries and financially for people. That's that's a huge range but medically it's also a huge range that you can't predict. So it's it's really managing the medical aspect but the people's expectations and their finances every step of the way.
It's right about now that I want to bring Harvey back into the picture. Because what Helen Palm just described was pretty much our situation
Six weeks after Harvey was hit by a car and three vet visits and X ray pain meds and a lot of bruising later. We now know he's going denied surgery, he tore the cranial cruciate ligament in his left back leg, like our ACL, the bit that stabilises the knee. And the procedure is going to cost us about $6,000. Yep. $6,000 These are the moments when bill shock kicks in, understandably, of course, and I've heard many times while making this podcast, it's also the moment things can turn ugly.
There's nothing that gets people more emotional than finances and high emotion together. I mean, it's a volatile mixture of things. We do try very hard to have medical solutions that still maintain the animal's best interests, but make it possible for the owner. And that's that's really hard often, because you can't, there's many situations you can't compromise on the medical treatment. But trying to find a solution is one thing we do. Being patient and giving the owners time to work out what they can and want to do while still keeping their their pet safe. And there's the situation sometimes, if animals are gravely ill or very, very badly injured, and there isn't a safe medical compromise that we can make, and the people aren't able to follow the best solution that we can offer medically, having some heartfelt conversations with them and supporting them and acknowledging that that is still also an appropriate or acceptable responsible solution is to sometimes say goodbye.
I'll note here Harvey isn't a patient of the AAERC but Helen's sentiment is spot on. You and I are used to having really good medical care for ourselves. And we expect that for our pet as well. But unlike us, there's no Medicare for pets or PBS. It's not subsidised. It's a private industry. So we probably don't realise what it actually costs. And the care versus cost equation is something Diane Whatling is acutely aware of also that they're not just treating the patient, but managing the owner too.
We can't sustain you know, debt rates of, of high debt rates. And we don't hear that's one of the things that we've worked quite hard harder, we try to provide detailed estimates of procedures updates, every time we speak to a client often will get the comment, it's all about money. But it's not all about money. It's it's an app, it's all about communication to a client of what we're doing for that patient. And this is the cost because we don't get any government subsidy, we don't get any any, you know, handout from anybody. And so it's really a user pays system. And it's very difficult at times for clients to be able to afford that.
Now, I'm not saying all vets are saints, it's up to individual clinics to set their fees. And I'm sure there are some who overcharge some who order tests and procedures that aren't needed and the like. But they're in the minority, the majority just want to send home a healthy dog, cat, goat, or guinea pig or horse. So one part of the answer to solving the vet crisis is a greater understanding by pet owners and the community about the cost of care to be reminded, as if you needed to, not to flip out and deliver a tirade of abuse to a vet, to bail them up against a wall or troll them on social media, or which happens way too frequently. And in that moment of emotional turmoil, to realise that they want what you want to make your pet better. And they'll try and figure out a way to do that in the best way they can while still keeping their business afloat.
Treat us like you would your doctor, your GP, or the paramedic who picks you up, or your physiotherapist or your home care nurse, we do actually belong to that group, believe that we are actually trying to do the best for you and your pet. Even if you don't agree with us, that's that's our job is to look out for the welfare of your pet. And we can only do that by looking out for your welfare. At the same time financial as well as emotional, we need you to make sound decisions. So we are actually trying to communicate really well with you. So just simply being respectful of the job we're doing.
Next time on sick as a dog critical shortage.
There's days where we have to say look sorry, we cannot see you we've already dealing with three or four or five other critical cases and we don't have the staff for the space or the availability to get you in.
The endless struggle to fill jobs in regional and rural areas, leaving wide open the risk to animal welfare and biosecurity.
If that outbreak is to happen, there are not enough government vets certainly in Queensland to provide the level of work that would be required.
Regional clinics are crying out for VET So what's been done to get grads to do this and go Bush,
I grew up on a farm so large animals is an interest of mine and that tends to lend itself to more regional practice.
Sick As A Dog is written, produced, edited and presented by me Caroline Winter for PodTalk on the lands of the Kaurna people, and additional support from Drew Radford. You can support this podcast by subscribing wherever you get your podcasts, share it with others or post about it on social media, and you can find out more online at sickasadogpodcast.com.au
