Don’t get me wrong. I am MORE than happy to answer the questions that I can for readers and subscribers of MyPetsDoctor.com, but it disturbs me when owners are left with questions after a visit to your pet’s doctor.
Here are some suggestions to help you get all you need when your dog or cat makes a trip to a veterinarian.
MAKE A LIST
I am the world’s most forgetful person. When I was a little boy and my Aunt Polly would send my Uncle Sam and me to town, she always gave us a list and we never came home with everything on the list. Can you imagine how badly we would have performed without a list?
Even today, as I approach my sixtieth birthday, I’m an avid fan of lists. When I need to go to a physician I start a list as soon as I recognize the need, so that I won’t forget to tell him everything historical that pertains to my medical complaint.
That’s the first part of my list.
The second part has questions about treatment. What are the side effects of treatment? How long will I be on medication? Are there alternative forms of treatment? What are the pros and cons of the alternatives?
These same questions apply to your pet’s visit. If he is suffering from an acute-onset problem you might not have much time to make a list, but difficulties that arise slowly, such as skin problems, behavioral problem, a chronic and/or recurring cough, these are cases that give you plenty of time to make an in-depth list.
DON’T BE SHY
In thirty years of practice I’ve been unable to develop the skill to read minds and have yet to hire a staff member who can. We don’t know what your questions are, so you have to ask them. We try to explain things in terminology and at a pace everyone can retain. We try to be complete with our explanations, but you may have questions we haven’t thought of.
Many veterinarians will finish an office visit with an inquiry of their own: “Do you have any questions?” Don’t be too quick to say no; this is your opportunity to ask.
I always like to add one more step to this final examination-room inquiry: “If you think of questions later, call us! That’s what we’re here for!” We don’t want you getting your answers from an unreliable source, especially the Internet, where 64% of the medical information is either outdated or outright wrong.
You may think of something after you’re at the cashier’s desk, and the doctor has already moved on to his next patient. That’s OK. Ask the employee to take the question to the doctor and bring you back an answer. You may have to wait until he is finished with that patient, or he may have to call you later. Be patient. You have a question and you deserve an answer.
CALL BACK LATER
It’s not unusual for questions to arise after you get home with your pet, maybe even a day or two into your pet’s treatment. Perhaps you didn’t have any questions until side effects showed up, or your pet wasn’t getting well as fast as you thought he should. These are valid questions. I’m not shy about calling my physician back when I have followup questions, and neither should you be shy about calling your veterinarian under those circumstances.
Again, patience and understanding are necessary. Your veterinarian may not have time to call you back, and he may have to relay the needed information through a staff member. He may be having a day like we’re having today (emergency surgery and nonstop phone calls leading to appointment after appointment). Some calls I simply won’t be able to return until tonight after closing or tomorrow between appointments.
Now, let’s cover the unpleasant side of this topic. What if your veterinarian refuses to call you back? What if he won’t answer your questions? Assuming you haven’t put yourself into the “pest” category with unreasonable requests or excessive inquiring phone calls, you deserve an answer to your questions. In my mind, refusal to answer your questions is sufficient reason to find another veterinarian.
The practice of medicine is complicated. The more we learn about practice, the more complicated it gets! Likewise, having a good understanding of what’s wrong with your pet, why it’s doing what it’s doing and why he needs the medicine he needs all get more complicated, too. All this complexity leads to more questions and your pet’s doctor wants, and needs, you to understand. Your better understanding leads to better compliance with therapy, which leads to a higher rate of healing and a lower rate of relapse.
See you tomorrow, Dr. Randolph
MMASK
My dog (Cheweenie 4yrs old) was diagnosed with a Shunted Liver in 2021. She began having seizures 3 months ago. She was just put on Kepra (still having seizures & head pressing) Blood work is not good.
ALT-930
AST-453
ALKP-282
Platelets-157.
I am not sure what to do at this point. Vet wants to try Hills L/D and Denamarin
Do you believe it’s worth trying or am I prolonging the inevitable.
I am heartbroken. I don’t know what the right answer is
Denamarin is certainly indicated. You might ask for a referral to a board-certified internist, too. Thanks for reading, Dr. Randolph.
I and the veterinarian cannot find a specialists, because almost all of the blood test values are almost normal.
Only the BUN values were the tripple of the normal level. (“Mild kidney failure”)
My cat was given a booster vaccine shot one year ago. After that, pododermatitis appeared on the paws. I went back to the veterinarian, but she could not help me. She had never seen such kind of illness before. She remommended me another veterinarian. He prescribed cortisone ointment, hypoallergenic cat food was given him, but nothing changed. I found another veterinarian, a dermatologist. He sent blood samples to different labs.
The creatinine level was at the maximum of the normal level.
The liver enzyme values are normal.
The white blood cells was 17.6 G/L (normal: 6-15 G/L), the next value was 14.2 G/l.
Eosinophil (Advia 120) 2.3 (normal 0.06-2.21), but “aesinophilia has not been confirmed by other examinations”.
Hemoglobin 82 G/l (normal: 90-150), the next value was 100 G/l.
Albumin 22.9 g/L (normal: 25-45)
fructosamine 433 umol/L (normal: 221-241)
Phosphate 3.7 mmol/L (normal: 0.9-2.2)
The other parameters were in the normal ranges.
Bacterial or fungal infections has not been confirmed by tissue examination from the paws.
Immunochemical examinations were also performed:
A/G ratio 0.9 (normal 57-94)
alpha-1 globulin 6.5 (normal: 4 – 14 %)
alpha-2 globulin 15.4 (normal 7 – 12 %)
beta-globulin 12.4 (normal: 16 – 31 %)
gamma-globulin 19.5
“The elevated alpha-2 globulin level could be the consequence of an inflamation”
FIV, FeLV tests are negative.
Summary: Mild kidney failure, and mild (?) inflamation.
Convenia shot was for the possible inflamation.
I have read that Convenia is effective for E. coli infections, so it could decrease the appetite.
I have been feeding him with pure meat (boiled chicken chest) for two days, and his body weight slightly increases. It is 6.4 lb today.
I think it is not a good solution, because of the elevated BUN values, but I have no other choice.
I cannot find any information about the normal gamma-globulin levels. I asked the veterinarian to perform an IgE test, but only gamma-globulin level has been given by the lab. I have read that autoimmune reactions could occure after repeated vaccination, and it is suspected to contribute to kidney failure of dogs.
Convenia was given to my 3 year old tomcat. His body weight was 7.3 lb before the shot. Three days after the shot he lost his appetite and the gums turned to white. The gums are not white now (8 days after the shot), but his body weight decreased to 6 lb. I have read that the effect of this antibiotic lasts about 2 weeks. What can I do? He will die of hunger. His illnes cannot be diagnosed, the antibiotic shot was a pure guess. Slightly elevated BUN value, normal creatinine level, weight loss and pododermatitis were observed a year ego. His body weight was 10 lb or more before the illness. Thanks for your help.
Roger, I feel for your grief as you watch your kitty waste away. The likelihood that Convenia is at fault in his illness is extremely low. Your kitty lost at least 27% of his body weight from the pre-illness weight of 10#. He had evidence of uremia a year ago, what are his BUN, creatinine and liver enzyme values now? In some cases general practitioners need the help of specialists, and referral to a board-certified internist may be the answer to finding the underlying causes of your kitty’s problems. I am going to say a prayer for your comfort and your cat’s illness and would like for you to write back when you know more so that we may stay updated on his progress. Best wishes, Dr. Randolph.
We took her to the veterinarian the 8/7/10 (last Saturday) but by then she wasn’t acting like that. She started acting weird the next day we took her to the veterinarian. The veterinarian told us that everything was ok. But my MaltiPoo is very aggressive towards others and it was hard for the veterinarian to check her. The veterinarian gave her a shot in her leg and gave her medicine to see if she has parasites. I called the veterinarian yesterday and told her what was happening and she said to stop giving her the medicine and that she is maybe acting like that because she is traumatized from her visit. But I don’t think she may be traumatized because after the veterinarian we took her to the park and she was acting normal. My guess is that maybe she’s acting like that because of the medicine or fleas that are attacking her or maybe she has hip problems. I also noticed that she likes going for walks, only eats if I feed her (doesn’t eat her own food), only poos if I take her out for a walk, doesn’t want to sleep in her bed anymore (only under my bed) and gets scared easily. She goes in circles smelling her tail and then runs away or sometimes while she is sitting down she gets up and runs away giving a loud cry. Also, I can pet her anywhere but if I touch her tail or somewhere near her tail she looks at me and then smells it. I have seen fleas on her though so I’m hoping the cause of this is fleas and that she may be scared of them. I think that may be it because while she was smelling near her tail I checked and a flea jumped. But we can’t give her medicine for fleas until August 18.
-Olivia
Good for you, Olivia! It’s important when pets are acting as strangely as yours did that you have her to the doctor as soon as possible. IF her only problem is fleas you can use Capstar prior to her next regular, monthly whole-body flea treatment. You can read about Capstar here: http://www.mypetsdoctor.com/capstar-for-flea-control. If you’re seeing a significant number of fleas despite proper flea control ON the pet, you will need to treat the house and yard. Read this article (in toto or you can just scroll down to IN THE HOUSE and IN THE YARD). http://www.mypetsdoctor.com/flea-control-flea-prevention-dog . On the other hand, there IS the possibility of an allergy problem or even a psychosis that is causing this behavior, so more followup may be needed. One “trick” I’ve used extensively is to have owners record video of behavior that a pet won’t exhibit in the clinic. In this case the quality doesn’t have to be excellent, so you can even use your phone if you don’t have a videocamera. Keep us posted, this is a very interesting case, Dr. Randolph.
My 3 year old MaltiPoo has been acting strange during the last few days. She smells her tail and runs away. Some times she cries like she’s in pain. She can’t stay still because she’s always running away and hiding. She doesn’t want to go for walks, eat, or play anymore. She just wants to be under the bed or be by my side. She trembles and seems sad and scared. I’m worried because she lost interest in things she liked to do. She has been scratching, trembling, crying, has red skin, and smelling her parts. I’m scared. HELP!
At the risk of stating the obvious, Olivia, your MaltiPoo needs to see a veterinarian IMMEDIATELY. There is no reason for your pet to suffer when this might be easily treated and fixed. Please write back and let us know what the doctor finds. Best wishes, Dr. Randolph.