It’s a common request. “Good afternoon, this is Mrs. Jones. Dr. Smith sees my Yorkie, Grey, and he has the same thing he always gets and he needs ‘the shot.’”
“OK, Mrs. Jones, Dr. Smith will need to examine Grey to be sure if it’s actually ‘the same thing’ or not. Many conditions look the same, but aren’t,” says Sheila, Dr. Smith’s receptionist. “I see that Dr. Smith has treated Grey for bladder infection, ear infection, a variety of skin conditions and most recently a cough. Which same thing is he suffering with today?”
“Oh, it’s his skin. It’s acting up again. It’s the same thing he always gets.”
“Actually,” Sheila explains, Grey has been seen for several different skin conditions.”
“I’m in a hurry, my dog is uncomfortable and I’m going out of town today at 3, he just needs ‘the shot.’”
“Let me check the schedule and run this by Dr. Smith. He’s in surgery right now but I can speak with him over the intercom.”
Sheila explains the situation to Dr. Smith. He replies to Sheila, “When I finish this surgery I have five more to do today. I can see Grey at 6 PM or I can see him tomorrow, but I’ll need to examine him. It’s always something different with him and every thing he gets is treated differently.”
“Oh, Sheila added, “I forgot to mention she’s leaving town today at 3:00 PM on a business trip.”
“It’s against my better judgment, but have him come in at 1:30 sharp and I’ll give him‘the shot’ between this surgery and the next one and hope that’s what he needs. There’s no way for me to know without examining him and I won’t be able to examine Grey between surgeries.”
Three weeks pass and Mrs. Jones is back on the phone. “Hi, Sheila, this is Mrs. Jones. We spoke a few weeks ago when I was headed out of town and Grey was having his usual problem. I came in between Dr. Smith’s surgeries that day and got a shot, but he’s back to scratching again. I need an appointment to bring him in so he can examine him.
“We can see Grey at 2:00 PM today.”
Grey arrives as you see him in the photos. The skin is inflamed, infected and itchy. “Grey just became a ‘poster child,’ Mrs. Jones,” Dr. Smith relates. “It’s cases exactly like his that are why we insist on an examination before administering medication. Do you see these lesions on his tummy and under his anus? This is all bacterial infection. These lesions under his throat and in his axillae may be bacterial or yeast or both. I’ll need to perform DuroTak cytology on those to know what treatment he needs.”
“You say he’s been urinating in the house and asking to go out a lot more lately? He needs blood and urine tests for that, so I’ll keep him overnight and fast him to get accurate results.”
“The injection we gave three weeks ago wasn’t ‘wrong,’ it just wasn’t appropriate for the conditions he has. That explains why he is still scratching. Without the examination, the most important part of every visit, we weren’t able to know what all of his problems were.”
“We will get started on his testing right now, and make an appointment for tomorrow for me to discuss all of our findings with you.”
See you tomorrow, Dr. Randolph.