Last night we received a call from a frantic pet owner. Her 4 year old dachshund was no longer able to walk. The most likely all-to-common and devastating condition was intevertebral disc disease, and is notorious amongst the breed.
She arrived, and a physical exam confirmed my suspicions.
Tearfully, the client explained to me that her dog was "her child" and she'd do anything for him. I explained to her that her dog needed a hemilaminectomy, a detailed and complex surgery near the spinal cord to relieve the problem and allow her pet to (most likely) recovery completely. The surgery is typically only performed by surgical or neurological specialists, given the difficulty of operating near the spinal cord.
Without surgery, his prognosis to walk again was significantly worse, meaning he might end up paralyzed or need a cart in the future.
"What! The surgery costs WHAT? There's no WAY I'd spend more than $300 on this dog! It's just a dog!"
.....?
Glad I'm not your kid.
Thursday, January 31, 2013
Tuesday, January 1, 2013
Doctor google
Today I saw a young female puppy for the symptoms of bloody urine, straining to urinate, and small frequent urinations. In a female dog, these signs typically indicate lower urinary tract disease; such as a urinary tract infection, bladder stones, or other causes.
I recommended a urinalysis, a simple test to look at the urine under a microscope to look for bacteria, crystals, or cells indicating the cause. The clients and I talked about the likelihood of their puppy having a recessed vulva (a poor conformation), resulting in an easier pathway for bacteria to reach the bladder. Other possible causes included ectopic ureters, which may require surgical correction in the future. Read more about that here.
Pending test results, I recommended starting amoxicillin, the most common first line urinary tract antibiotic, as it actually is excreted in the urine, making it an exceptionally effective choice for UTIs. A typical course of therapy for an uncomplicated UTI is 7 days. (Many other reasons may indicate longer therapy).
The clients called a technician into their room.
"We looked on google, and we read that amoxicillin is a bad choice for UTIs", they said. "We want cephalexin for now, and a 30 day supply of baytril to go home just in case."
Oh GOOD! You read google for 5 minutes, so you are DEFINITELY more qualified to choose antibiotics than a doctor who spent 10 years training to do this job.
I tried to be patient and explain that cephalexin is typically a choice for skin, based upon the properties of the drug. Baytril is reserved for more serious or resistant infections, and is avoided in puppies because it may have a risk of cartilage damage in puppies under a specific age.
The clients didn't argue any more, but you could tell they weren't happy. I just CAN'T understand this mentality. Of course it's not the first time this has happened - I've had people diagnose their dogs with many, many ailments based upon google, only to find out that they've diagnosed their dog with a disease that doesn't even occur in our area. (Or similar. You get my point). Google search is an amazing tool, but is NOT even close to a substitute for medical training, testing, and experience.
I recommended a urinalysis, a simple test to look at the urine under a microscope to look for bacteria, crystals, or cells indicating the cause. The clients and I talked about the likelihood of their puppy having a recessed vulva (a poor conformation), resulting in an easier pathway for bacteria to reach the bladder. Other possible causes included ectopic ureters, which may require surgical correction in the future. Read more about that here.
Pending test results, I recommended starting amoxicillin, the most common first line urinary tract antibiotic, as it actually is excreted in the urine, making it an exceptionally effective choice for UTIs. A typical course of therapy for an uncomplicated UTI is 7 days. (Many other reasons may indicate longer therapy).
The clients called a technician into their room.
"We looked on google, and we read that amoxicillin is a bad choice for UTIs", they said. "We want cephalexin for now, and a 30 day supply of baytril to go home just in case."
Oh GOOD! You read google for 5 minutes, so you are DEFINITELY more qualified to choose antibiotics than a doctor who spent 10 years training to do this job.
I tried to be patient and explain that cephalexin is typically a choice for skin, based upon the properties of the drug. Baytril is reserved for more serious or resistant infections, and is avoided in puppies because it may have a risk of cartilage damage in puppies under a specific age.
The clients didn't argue any more, but you could tell they weren't happy. I just CAN'T understand this mentality. Of course it's not the first time this has happened - I've had people diagnose their dogs with many, many ailments based upon google, only to find out that they've diagnosed their dog with a disease that doesn't even occur in our area. (Or similar. You get my point). Google search is an amazing tool, but is NOT even close to a substitute for medical training, testing, and experience.
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