THERE are plenty of things that keep me awake at night.

We all have issues that can occasionally prevent slumber, no matter how tired we might be.

But still, after all these years, the big one for me is a very simple question. And it’s this: "When is the right time?"

I am pretty sure decent veterinary surgeons everywhere will agree with me. This is the one you need to get right each and every time. The correct answer is repeatedly required for the benefit of your patient, your client and, indeed, your reputation.

Get it wrong and you can create misery and regret. Get it wrong and people never forget. Get it wrong and people will mutter about you. Get it wrong and some people will sue.

Get it right and, even though you are still often criticised, at least you can sleep easy. And it's very stressful because, for vets, 'When is the right time?’ is the question that is asked continually. Every day, over and over.

The most difficult is: ‘When is the right time to put my old pet to sleep?’ Much has to be considered. It may be impossible to properly assess quality of life within the artificial confines of a consulting room. Some patients get a burst of adrenaline that make them appear far more able than they actually are. Some do the opposite and sit dull and sullen, giving the impression that they couldn't care less about life.’ When is the right time?’

There far are too many other examples to list them all. When is the right time to castrate my dog? Spay my bitch? Decide to operate on a vomiting cat? X-ray or scan a dog that is losing weight? Swab a badly infected ear that is not responding to treatment? Refer an exasperating case? Attempt surgery on a badly damaged leg or opt for amputation? Remove that lump or leave it alone? ‘When, indeed, is the right time?’

And then there are the simple things that appear straightforward but have the potential for huge upset, misunderstanding and conflict.

Like: ‘When is the right time to ask for payment when a much loved pet has been put to sleep and sent for private cremation?’ Think about it. I do, every day.

Do you ask beforehand, so as to get the business bit out the way, or does that not seem right? Do you ask immediately after, so as to avoid a prolonged visit when the ashes are collected? Or does that seem inconsiderate? Do you wait until the client returns to collect the casket and present a bill at the same time? Seems harsh.

Or do you send an invoice at a later date, hoping that it will not serve as an ugly reminder, right at the point that people are finally getting over the sad event? ‘When is the right time?’

The great dilemma is, for some things, no matter how hard you try, there just isn't a right time. Or a right answer.