12 Pros and Cons of the Veterinary House Calls

My staff and I were trading favorite house call stories this week.

• “Remember the house call when you fell in the grave that was just dug for ol’ Bandit?”
• “How about that pug that used to sit at the dining room table and eat with the owner?”
• “No, I wasn’t ready for that euthanasia I had to do with the co-owner watching on Skype.”
• “Eek! What about the house call for the cat who had already passed away a few days ago? The owner wanted to know if the cat would be okay.”

Indeed, house calls provide lots of stories — some sad, some worrisome, some bizarre. Many times, a house call seems more like a scene out of an indie film than part of my job.

Here are some pros and cons of house call veterinary visits. (Dr. Deb Bias Alert: I prefer to do my medicine in the office.)

Pros of Making Veterinary House Calls

1. Convenience, plain and simple. If you have difficulty getting about, or if your pet is a senior, is handicapped or difficult to transport for any number of reasons, a house call vet may be a life saver.
2. Less Stress on the Pet. Some animals hate the animal hospital. They begin shaking when you turn that corner, or pull into the parking lot. The cat begins screaming before, during and after you get him home. A house call might be the answer.
3. Observing the pet in their own environment. For a confusing medical case or for a behavior consult, a home visit can be invaluable. No matter how honest the owners might think they are being when giving a medical history, a home visit can be very informative. Walking into a house thick with cigarette smoke, being overcome with the smell of cat urine, or watching a dog being manhandled by a bunch of kids might give you some insight into a pet’s problems.
4. Home Euthanasias. In many situations, this can be a comfort to pet and owner alike. Enough said.
5. Personal Relationships. Even if you don’t sit down to a full-course meal with your vet, having your veterinarian visit your home can strengthen mutual trust and compassion.
6. Multiple Pets. If you are not quite a “collector” but have a gaggle of dogs and your friends are beginning to call you “the cat lady,” a house call may be in order!

Cons of Making Veterinary House Calls

1. Less Thorough Exams. Paying a call to Mrs. Fatigue in her recliner, who says Fluffy might be under one of four beds upstairs, but she wouldn’t know because she hasn’t seen the cat in a day or two, doesn’t start my visit out right. If you don’t have a helpful owner, or are in a challenging environment that is dirty, with poor lighting, you’re not going to be able to do a good exam. It seems that many people don’t think vets need light or tables!
2. Expense. There has to be a fee for house calls. House call vets see far fewer patients in a day than does a vet in a hospital. Think about how much a locksmith charges to come to your house! The last time I checked, locksmith school didn’t cost $200,000.
3. Fewer Diagnostics and Treatments are usually performed in the home setting. Often, an X-ray is essential for a diagnosis; clipping up a severe hot spot may require the help of two technicians; a fractious cat simply might not be manageable at home. You can’t look at ear smears (don’t think of spreading cream cheese right now), skin scrapes or fecal samples under the microscope immediately. Blood work can’t be run stat. It may not be safe to tranquilize an animal at home. Some traveling vets have fully equipped hospital vans, making more services possible. Many, however, can only offer bare bones exams.
4. Scheduling. Simply because of the ground some house call vets cover, you may not be able to get your vet to your house in a timely fashion. This may mean going to an unfamiliar vet. I see a lot of house call patients at my hospital because the house call vet simply wasn’t available.
5. Time Management. I hate to sound antisocial, but house calls take a lot of time even if all goes smoothly. Many people seem to think it’s a social call as well. The age of James Herriot and sitting about for a spot of tea, with just a smidge of veterinary medicine on the side, is not a great business model.
6. Referrals. Make sure your traveling vet works closely with a referral center or a veterinary hospital that will willingly admit/work up his or her patients. You don’t want to hear from your house call vet that your animal must get to a full-service hospital immediately, and not know where to go.

The Music Never Stopped

My house call days have provided me with some of my funniest and most poignant animal memories, my own “All Things Bright and Beautiful” novel, so to speak.

Euthanasias can be the most emotional house calls, and sometimes the most bizarre. Suffice to say, expect the unexpected. Here’s one memorable tale.

I was called out for Sadie, a very old, sweet dog whose time had come. The steep, icy driveway was a difficult ride even for my four-wheel-drive vehicle. When I got to the house at the top, there were lots of cars, always a sign that I may be walking into an event with a long guest list, a full cast of characters.

Sadie was lying in the middle of what looked like a sea of old mattresses. There were candles everywhere. Several women were on the mattresses with Sadie. I think music was playing. Maybe there was singing. Why was I thinking of the Grateful Dead? Must have been the incense and Indian print pillows. I began to think about how well, or how freaky, this would go.

• How long am I going to be here?
• Is there room for me on a mattress?
• Will there be a lot of keening and crying?
• Can they bring a light over into the mattress pile?

You get the idea.

Suffice to say, I was able to wade through the women on the funeral pyre, and find my way to Sadie. My technician did not have as easy a time. Her presence seemed an imposition to the funeral participants, and I had to explain that I needed my technician to help me.

My tech looked quite strange, extending her hand through the mourners to hold off Sadie’s vein, her butt far up in the air, looking like she was a participant in an advanced yoga class.

Everything was ready, in my opinion. Sadie was relaxed and sleepy. I simply had to place the needle in Sadie’s vein, and inject the euthanasia drug. “Wait,” a voice stammered. The owner announced that all the guests had not yet arrived. Oh boy.

We waited a bit. I kept a straight and compassionate face. The straggling mourner arrived. Sadie’s last moments were peaceful and serene, surrounded by a small village of her closest friends. I slipped out of the home during the first song, relieved that my part of the ceremony had gone well, thinking it all belonged on the Sundance Channel.

If life in the clinic ever seems like it’s becoming trite, maybe I’ll do more house calls.

This pet health content was written by a veterinarian.