Pawcurious Vet Blog: Pet help, stories, and information with Dr. V

Yesterday my receptionist came out of the restroom with the most perplexed look on her face. Imagine her surprise when she entered the washroom, only to be greeted with this:

For those who can’t read graffiti scratches, it says, “(name of our clinic) bitches are ugly”.

Aside from the annoyance of having graffiti in our bathroom that we now have to deal with, it’s an odd choice of insult. Our staff is, all things considered, quite attractive, so it’s not much of a blow.

Are they instead referring to the female dog clientele? They are pretty cute too.

I’m baffled. If someone really wanted to hurt us, they could have taken to yelp to complain to the larger general audience out in cyberspace, instead of lashing out in the relatively private confines of a restroom facility via Sharpie.

Mostly I’m disappointed in the lack of creativity. I mourn for today’s youth. What happened to “Your clinic is the rotting pestilence of a thousand carnivorous tsetse flies”, or “This clinic stinks like an abscessed anal gland”? At least I would have respected them, despite disagreeing. Or maybe they could have embraced the double meaning of bitch instead of just going for the popular definition. How common. The same concept with a bit more verve: “My bitch is cuter than these bitches!” Not the greatest, but still, this is up there with yo mamma jokes and “Oh yeah? Well, you’re a STUPIDHEAD!” in terms of gut-crushing impact. I went back over the day, trying to remember any surly 12 year olds I may have inadvertently upset, but none come to mind.

I wonder if James Herriot ever had someone graffiti his truck and tell him he was ugly.

I’ve spent a couple of entries deconstructing pet food, but I wanted to take a moment to specifically mention a brand that has done something really good.

When we suspect a pet of having a food allergy, it can be very difficult to get to the root of the problem. Pets can be allergic to anything, but usually they have a reaction to one specific protein or carbohydrate. Trying to figure out what it is- fish, beef, chicken, wheat, corn- can be difficult. If you read the labels on your pet food (which you should!) even those foods marked “sensitive stomach” or “sensitive skin” tend to have a variety of ingredients including some of the most common allergens.

Up until recently, pet owners have had two choices: home cooking, or prescription diets. A food allergy elimination diet typically entails eliminating all the major allergen sources, and providing a diet that has one single novel protein source and one single novel carbohydrate source (one the pet hasn’t been exposed to before.) The diets therefore have odd ingredients: venison, duck, peas, hydrolyzed soy (the latter being a protein that is broken down to the point that the immune system no longer recognizes it as an antigen.)

While some unlucky allergic pets react even to the prescription diets, most food allergic pets respond quite nicely. They are very effective. And, being a prescription diet, they are also pretty pricey. Unlike other prescription diets, such as the renal disease diets and the heart failure diets, there isn’t a nutritional imbalance that would make it a poor choice for your average healthy pet, so it’s fine to use long term. There’s no reason a similar diet couldn’t be produced for over the counter use, aside from the fact that the ingredients are more expensive.

Dick van Patten’s Natural Balance has responded to the need with a great over the counter line of Limited Ingredient Diets. They have one protein source and one carbohydrate source, and the ingredients are very similar to those of the prescription diets. I used their vegetarian formula with good success when I needed a lower-fat, lower-protein low allergen diet for Mulan (who was allergic to the prescription renal diets.) I know the prescription diet manufacturers are extremely strict about their processing of the allergy diets (as in, they do not share equipment with other types of pet foods), and I can’t say how this brand’s manufacturing compares. That being said, for pets with a mild to moderate allergy that is suspected to be food related in origin, this could be a nice alternative to at least try out. In this economy we all appreciate saving where we can, right?

The line is available for dogs and cats, in canned and dry forms.

I had a client complain about me this week.

To back up a bit, he had come in a month ago with his dog, whose left side of her head was swollen to about twice its normal size. “It’s an abscess,” he told me, and wanted me to ’stick something in it and drain it.’

I do what I always do, and come up with my list of differentials- all the things it might be. You just can’t assume it’s the most likely thing, even though it probably is, because sometimes it’s not, and if you aren’t keeping all the possibilities in your head you make mistakes. I was thinking of abscesses, cancers, foreign bodies, rattlesnake bites, all sorts of things.

I took a little peek in the dog’s mouth, but with her head as swollen as it was, I couldn’t mess with it too much. So my plan was to do the following: sedate the dog, which would make her more comfortable and allow me to do a full exam; and go from there. The next steps might be, depending on what I saw: remove a rotten tooth, drain an abscess, do some x-rays if it looked like a mass.

The owner was very upset I didn’t know the problem right off the bat. He asked me several times, incredulously, why I couldn’t tell if there was cancer by looking at the outside of the dog. There’s a planet Krypton joke in there somewhere, I just know it.

So he stormed out, then called Doc Good Ole Boy down the road, who, according to the owner, diagnosed a tooth root abscess over the phone based on his description. He passed on some rather uncharitable things the other vet supposedly said about my experience level (and this is a person I have never met). He went on and on to my office manager about my incompetence.

“Well, what exactly did Doc Good Ole Boy do?” my office manager asked.

“He gave her a pain med, then he pulled the rotten tooth.”

“OK,” said my office manager, “So he did exactly what our doctor suggested we might need to do, then?”

“Well, yes,” he conceded. “But he knew right away without all that other hooey. He stuck his fingers right in there and knew.”

“OK,” said my office manager. “So you’re mad my doctor didn’t put her fingers in a painful dog’s mouth and force her jaw open? Because I wouldn’t do that either. Aside from the risk, that’s a very painful thing to do to pet.”

“Well,” the man scoffed, “You shouldn’t be working with dogs if you’re scared of them.” As if overconfidence is the key to not getting bit. Actually, I would say the key to not getting bit is sedation and pain control, but that’s just me, Doc-who-likes-her-face-and-hands-intact.

I wonder how many fingers Doc Good Ole Boy still has. I found out his name and was debating whether or not to call him and see if he really said the things this person claims he did, but my tech very correctly pointed out that it wouldn’t really accomplish anything. I try very hard not to throw other vets under the bus, because most of the time the client’s side of the story is about 30% correct compared to what really happened, so it bothers me when others do it to me. This is the part where I take solace in my superior pain management, alone in my self righteous indignation.

It’s amazing the weird, innovative, useless, and useful you can find on the internet when you actually look. I’m not sure what category this one falls into:

The Porch Potty, a self-contained patch of grass that waters itself. A mini yard for your mini dachshund. Emmett would destroy that with one big pee, so clearly this is intended more for the toy chihuahua apartment dwellers.

If I lived on the 5th floor of a walkup in Manhattan, this would seem a very viable alternative to schlepping a 4 pound dog downstairs in the middle of a snowstorm. It’s small enough to fit on a little balcony and self-contained enough for crummy gardeners such as myself to probably manage to keep alive for a bit. My sister, who lives in an apartment in an area with some extreme weather, has pee pads in her foyer for her shih tzu- I’d imagine this would be a little less smelly and labor intensive. She has a birthday coming up, but I imagine if I present her with a box of grass she’s going to wonder if I’ve finally snapped.

Emmett is in remission!

He’s in his third week of chemotherapy. He will continue the weekly regimen until about 8-12 weeks, when it starts to decrease in frequency. After 16 weeks it is done once a month, hopefully for a long, long time.

We also typed his lymphoma. There are 2 types, B cell and T cell. I remember learning in school that B=Bad and T=Terrible, as in, neither one is good, but T is the worse kind to have. The median survival times are markedly less for T cell lymphoma.

And Emmett has B cell. It sounds strange to say, “I’m so glad Emmett has B cell lymphoma,” but you know what I mean.

Here’s a helpful tip for everyone:

1. If you have a brachycephalic breed dog (pug, bulldog, Boston terrier, etc) you need to be very careful with their eyeballs since they are particularly susceptible to eye injury.

2. This means, you probably shouldn’t let them roll around in the sandbox.

3. If they do roll around in the sandbox, and you notice a ton of sand in their eye, instead of wiping it out and thus dragging it all over the eyeball, rinse it out with saline. Better yet, call your vet.

4. When that eye puffs up, swells shut, and turns white, waiting a few days will not improve the situation. Ouch!

Just a friendly reminder from your corneal ulceration specialists here at pawcurious.