After finishing and overnight shift, I made a stop by a client’s home on my way home for what it thought would be a quick appointment.  It was a Sunday morning and the client had requested a nail trim for his two dogs and cat.  I was feeling particularly charitable with my time and it was an easy procedure, so why not.

There were 3 pets: two Rat Terriers and a Persian Cat.  Each pet has 4 paws with 5 toes on each and subsequently 5 nails on each paw for a total of 20 nails. So  3 pets with 4 paws, 5 toes and nails per paw, 20 nails per pet comes to a total of 60 nails to trim. None of the three pets had their nails timed recently, so they were all a bit over grown.  When nails are over grown, the quick, a nourishing vein which grows in the middle of the nail is extended.  You have to take care to not cut into the quick during the nail trim to prevent bleeding.  All part of nail trimming 101.  I proceeded to do the nail trim and all was going well. That was until I got to the 3rd pet and the 60th nail.  I cut the nail a bit close and hit the quick.  59 salon perfectly trimmed nails out of 60 is not bad, but 60 of 60 is better.

My client and I were I having a conversation about this, that, and the other when I noticed a very small smear of blood on the white tile floor.  I pointed it out to the client and then the situation escalated.  The sight of blood can be a strange thing to some people.  In practically all cases, any amount of blood looks like a lot more blood than in actuality.  The nail was not frankly bleeding, but oozing. The client became concerned and a cascade of question ensued: Oh, she is bleeding! Will it stop? It is going to get infected isn’t it? Why is it bleeding? Is she in pain?  That has to hurt, is she in pain? What are we going to do?  As the client became more excited, so did the pet, which increases blood pressure and activity, which in turn tends to keep the bleeding going, impeding the resolution of a very minor problem.  I opted to apply a bandage to apply compression to the bleeding surface of the nail, facilitating the development of a clot, and stopping the bleeding.  I also figured the excitement level would normalize without my being present. I departed with instructions to remove the bandage in a couple of hours and if there were problems or concerns, to give me a call.  I knew the call was coming, it was just a matter of when.

I was awakened from a sound sleep two hours later by the expected call.  The client stated his dog had removed the bandage and was still bleeding.   The cascade of questions began again. I interrupted and told him I was coming over and would cauterize the nail to stop the bleeding. He expressed concerns that cauterizing would be painful and he did not want to cause his pet pain.  I explained the difference between pain and discomfort and how the very minor procedure was necessary. I was back at my client’s home in 15 minutes. As I suspected, the pet was no longer bleeding and the compression bandage had worked as planned. As a precaution, I did cauterized the nail with a septic stick. The pet didn’t react to the procedure, but the stick slipped form the nail and dug into the side of my thumb.  The resulting chemical burn did hurt, but I grinned and took it to prevent a rekindling of the excitement cascade.

Over the years, I have come to realize that clients, just as any other person, are as different as chalk and cheese.  You have to learn to accept and meet them where they are in their life’s journey, just as you would hope they would you in your journey.  A friend of mine who was a dentist told me if someone tells you they are in pain, accept their concern and act accordingly.  I have extrapolated that advice to if a client expresses a concern, you accept and address that concern. I knew the oozing nail would resolve itself in short order, even if my treatment consisted of benign neglect, but my client didn’t. One of the universal needs we all have is to be heard and acknowledged.   Throughout my personal and professional life, the times I have kept that in mind and responded in kind, things have worked out well… the times I haven’t, not so good.

The case of the bleeding toe nail worked out well.  The pet is ok, the client is happy, and I have a standing invitation from my client for a French toast breakfast.

Dr. Pierre Bland is a small animal practitioner who offers office and house call appointments to his clients.  His offices are located at 3225 N. Andrews Avenue, Ft. Lauderdale, FL and can be reached at 954 673-8579.