Practice Of Veterinary Medicine Is Sometimes Frustrating

Reader Robert began writing to me Sunday, the 19th, with questions about his seriously-ill dog:
Help please!  My 1 year old German Shepherd stopped eating 3 days ago.  2 days ago she had terrible diarrhea (no blood but mucous), and vomiting all day until she vomited yellow bile.  I took her to my veterinarian.  He felt her abdomen and she yelped.  He did bloodwork and a stool test and gave her subcutaneous fluids along with B-vitamin injection and an anti-vomiting injection.  He sent us home with carafate and Cerenia.  He called next morning with blood/stool results and said he found no organ damage and no worms so he said he “assumes it’s a gut bacterial infection”.  My dog refused food, refused carafate and Cerenia so I returned to the veterinarian.  They took an x-ray and determined there was a lot of gas in her belly and her spleen was quite enlarged.  They gave her an injection of Convenia and a fentanyl patch on her skin.  I took her home.  She still wont eat or drink.  It has been about 10 hours since the Convenia injection.   Should I  take her to an emergency care clinic for IV fluids tomorrow if she still hasn’t drunk anything? Thanks!
I advised Robert that there were too many variables for me to even begin to make suggestions, especially without access to the laboratory test results, and that she should defintely go for more diagnostics if these signs persisted.
UPDATE 1:  Dog is in emergency care facility for past 9 hours undergoing barium xrays to check for blockage(s).  So far, no blockage detected and barium is 1/2 thru intestines.  Will call in 3 hours for status report and I’m told if no blockage is detected, they will keep her overnight and try to feed her.  Until they detect blockage (likely necessitating surgery?) or she eats on her own if no blockage is found, they will keep her there on IV fluids.
P.S. so far the bill is $2,200 and they still don’t know what’s wrong and she still wont eat or drink on her own.
UPDATE 2:  The barium moved through to her colon over 6 hours.  They described this as “slow, but no clear indication of an obstruction.”  I brought her home and she is resting.    Basically, 3 days, $2,200 and many injections and stressful trauma to her later?  They still don’t know anything definitive as to a cause.  I’m beside myself and inclined to keep her home for awhile longer to see if she improves/develops any appetite.  VERY heartbreaking/frustrating.

Robert, welcome to the world of practice.  You are frustrated, and we understand that.  Imagine how frustrated your veterinarian is.  Not that the focus is on us, because the focus is directly on your pet.  Still, this doctor has done a lot of work, performed all the right tests and has given all of the right treatments, yet your pooch is still not well.  You may be certain that he feels the pressure to get her well just as strongly as you feel the heartache of wanting her well.

Her case illustrates a factor we deal with daily in veterinary medicine that is very different from the practice of human medicine:  cost.  Robert has spent $2200.00 so far and that may not be the end of treatment and diagnostics.
She may still need an exploratory surgery of her abdomenNo disease has a price tagNowhere is it written that your pet will become well if $”x” are spent.  Some conditions are made better for $100.00.  Some cost thousands or even thousands and thousands.  Some never get better no matter how much you spend.  Some don’t have $2200.00 to spend on a pet.  Some don’t even have $100.00 for unexpected pet problems, it may be all they can do to maintain regular monthly and annual wellness care.
Sometimes sad decisions must be made when owners cannot afford care that is needed for their pets.  Unfortunately, unless you live within driving distance of a charity veterinary hospital, that is where some pet owners find themselves.
The practice of veterinary medicine is sometimes very, very frustrating.
See you tomorrow, Dr. Randolph.
covenia, convina, convinia, covinia

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