Have you ever had to leave your pet at the vet’s overnight? Did you wonder how often they would be checked? Did you ask the vet about this? If you knew that there would be no one in the practice building overnight whilst your pet was hospitalised, would you leave them there? Or had you assumed that overnight vet care is just like the NHS? Always someone around with all the necessary kit to hand?
Most owners probably assume that, when they leave their pet at the vets overnight, they will be checked at least 3-4 hourly, if not more often1. In reality, the monitoring of hospitalised veterinary patients is much more variable, with patients left unsupervised for more extended periods. Here we explain why it is vital to know the out-of-hours provision for inpatients at your vets and the questions you should be asking.
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When it comes to overnight inpatient care, all veterinary practices are not equal
Pets need to be kept in hospital for many reasons, from acute trauma to complications associated with diabetes, and supportive treatment to post-operative recovery. The thing all these reasons have in common is that the animal can receive a level of monitoring and treatment that would not be possible at home. The best 24-hour veterinary care for inpatients is when veterinary care is provided seamlessly, whether it is during regular opening hours or overnight. Much as happens in human hospitals.
The reality is that veterinary practices vary hugely in overnight treatment and monitoring they can provide for inpatients. At one end of the spectrum, there are the large veterinary hospitals and dedicated out of hours services, who have all the equipment in place to care for very sick pets. Crucially, they have a team of veterinary staff (vets or qualified nurses) who work only nights and are onsite continuously throughout the night.
The next level of care is when one vet or nurse is present for part of the night. However, they will also be working the day shift and need to get some sleep at some point (either going home or staying onsite and bedding down in an empty kennel!). This means the inpatients will not be monitored for some part of the night. This is the typical set-up at the main branches of general practice vets.
The other end of the spectrum is those clinics where no one is onsite once the clinic locks up until the following day and is most commonly seen at the small branch clinic. Some vets might use tech, such as webcams, to monitor inpatients remotely.
It’s all a question of clinical judgement.
Your vet will use their clinical judgement and experience to decide how much monitoring your pet needs overnight. The level of overnight supervision required for a hospitalised pet will be determined by your vet. A vet will look at factors like the severity of illness, how stable the patient is and how intensive the treatment required is. They then decide if the pet can go home, stay at the clinic or be referred to another practice with the necessary facilities and expertise for the very unstable and sick patients. There are some categories of patients that need continuous monitoring, such as those in a diabetic coma, with respiratory distress or unstable epileptics for whom overnight care in a 24 -hour hospital is the only option.
Then there are those patients who are stable but still need to stay in hospital for treatment, such as intravenous fluids or post-operative pain relief. These pets don’t need continuous monitoring and can safely be kept overnight without constant checks. However, there is a risk of reduced care quality if, for example, the drip line stops and is not picked up until the following day.
As more and more first opinion practices rely on dedicated out of hours providers to provide emergency care for their patients, the transfer of hospitalised patients to those providers overnight is necessary before being brought back the next morning. Sometimes this round trip needs to be done for several consecutive days. Occasionally the clinic will arrange this, but it is often the owner’s responsibility to arrange transport.
We need to talk about overnight inpatient veterinary care
In a perfect world, every veterinary clinic would have comprehensive overnight inpatient care. Vets are aware that owners would overwhelmingly prefer overnight care to be done “in house “2. But, as we all know, the world is not perfect and, with the cost of equipment and staffing, for many practices, is it simply not economically feasible. For that reason, vets are not obligated to provide this level of care. Still, the professional guidelines state that vets ensure adequate care is available elsewhere, if necessary. And crucially, vets are supposed to make sure that owners are aware of the level of monitoring their pets will receive.
It is essential that you are clear in your own mind what level of care your pet has if they are kept overnight at the vets. Would it bother you if, once the vet has determined it was safe to do so, that no-one checked on your pet from 8 pm to 8 am? If your pet needed it, would you have difficulties transporting your pet to another clinic for overnight care and then bringing them back to your usual vets in the morning, possibly for several days in a row?
Neither response is right or wrong but should guide you in your choice of veterinary practice. If your answer is yes to both the above, then you would be strongly advised to consider choosing a veterinary hospital as your provider of veterinary care, even if this is less appealing in terms of distance from your home, say, or cost. And it goes without saying that the more intensive the overnight care is, the more expensive the hospitalisation will be.
Ask the right questions
So, how do you find out about inpatient care in practice? The veterinary practice should make this clear when you register your pet with them. It also must be explained to you if your pet is admitted to the hospital overnight as part of informed consent. The problem is there are likely to be fewer things further from your mind when looking for a vet. The best time to find out about inpatient overnight care is when you choose a practice for your pet.
Questions to ask include: there someone onsite all night? How often are patients checked? Where do they usually send pets for next-level care, and who is responsible for the transport? This ensures that there are no surprises regarding your pet’s overnight care on the night in question.
You may also be interested in;
- Canning E. The ethical, legal and professional implications of the frequency of inpatients checks during out of hours hospitalization. Vet Nurse. 2012;3(8). doi:10.12968/vetn.2012.3.8.517
- Why out-of-hours services may not be such good news for owners. The Vet Record. 2020;187(12):502. doi:10.1136/vr.m4890