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.


  1. I diagnosed myself with a UTI this summer using google. I was working in rural Canada and wanted to make sure that the hour long drive to the nearest emergency room would be worth it. When I arrived I told the nurse doing the assessment that I thought I had a UTI and he said "Because you had one before?" and I embarrassingly admitted it was because of Dr Google.

  2. There is a difference between trying to get some information, and arguing with your doctor about what the diagnosis is based upon Dr. Google :)

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  4. Exactly. Did you tell them how much a 30 day supply of Baytril would cost? lol I'm surprised they even came in-they could have just submitted a pet meds request right ;)

  5. Nicki, I didn't tell them, but we laughed over the cost of that medicine for them - they had a giant breed dog! If I had truly been in it for the money I would have just sold them the $600 of antibiotics that weren't necessary. But I care about my patients AND doing the right thing!

  6. We've actually been hoping to find a good veterinarian in Salt Lake City. What's the best way to find one? We're very new to this, thanks for the help.

  7. Great questions. The best way is to ask people you trust for their recommendations. From there, go into a few clinics that are close to you, and check out the lobby. Are the receptionist friendly? Look at the clinic's website. Do they offer modern diagnostics (such as ultrasound, blood testing, and endoscopy)? Ask the staff where complicated cases are referred (and if they say they don't ever refer, run away!). After you find a place you're comfortable with, schedule a well-pet check up. If you like the doctor, you're done! If you don't, keep looking. It is really important to match you and your veterinarian's style/beliefs and expectations. Some people treat their pets like children, others treat them like livestock. Make sure you get what feels right.

  8. Okay, I am 99.99% with you. However, at one time I had a very ill dog that continued to slip until she died, and no one was ever able to diagnose what was wrong. Because I could not let it go, I read non-stop for weeks until I came across a possible cause, which might have been treatable.
    Certainly, I do not have the training. But my vet did not have the time available to spend weeks reading and searching for just one dog.
    And if my vet ever prescribes something that I wonder about, I hope that he will forgive me if I tell him that I've read something and want clarification.
    Plus, I think it helps me to recognize important symptoms that I might not have mentioned otherwise.

  9. Again, there's nothing wrong with reading and trying to get information - it's when you start TELLING your veterinarian or M.D. what drugs you want, what diagnosis it is, etc that it's a problem. Sure, there's some great information online; but there's also lots of wrong information. It takes more than a google search to correctly diagnose ANYTHING. Especially be careful reading about drugs online; I'm pretty sure there's a website for every common drug saying STAY AWAY THIS DRUG KILLS. Obviously that's not true - but if you can read information and try to remember your veterinarian is the professional, it's mutually beneficial.

  10. This is defenetly not the first or the last time that people try to diagnose themself/someone else by medical information through google. I really understand and respect the will to explore and learn about medical information, but I will never understand people, which are actually arguing with their doctor about it.
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  11. Thanks for this article. I enjoy reading about what to do in case certain situations present themselves with my dogs. A vet in Edmonton used to give me great insights every visit and I've used many of them throughout the years.