Wednesday, June 8, 2011

When the Vet Becomes the Client

I recently was forced to diagnose and treat my own Pomeranian, Joey. The panic of the owner within my heart battled the sensible veterinarian in my mind. My big tough Italian husband, Guy, loved his little fluff-ball to pieces! I couldn't stand to break his heart with any bad news. I spent twice as much money on tests trying to convince myself that my dog wasn't sick, instead of just accepting the facts. I then went on to spend just as much money trying to identify the cause of the illness, when just like a lot of clients, no specific cause could be found. It was frustrating and scary. I was annoyed that my dog, the veterinarian's dog, was seriously ill.

Guy and Joey on his 1st birthday!







Joey was diagnosed with a potentially fatal condition called "immune mediated thrombocytopenia." This is where his body destroys his own platelets, the components in blood that prevent and stop bleeding. They are the main components in blood clots and scabs. Without enough platelets, a dog can bleed to death. He was only two years old at the time. I performed pre-anesthetic bloodwork to have his teeth cleaned. The platelets came back low, very low. I ran three more platelets tests with even lower numbers before I decided that the numbers were real. He didn't act sick!! He still chased the cat, had a great appetite, loved to go on walks; everything was completely normal!

The good news is, Joey has responded wonderfully to treatment and his platelet counts soared back up to normal before any complications arose. The bad news is, his medications have side effects, very noticeable side effects. For those of you with dogs with allergies or immune diseases, you've likely already had the unfortunate pleasure of meeting prednisone. I know the side effects, but I also know the benefits. It saved my dog's life! I always weigh the risks versus the benefits before prescribing or taking medications. In this case, the benefit hugely outweighed any risk or any side effect.

I have had owners tell me over and over again about how their dog is drinking more and urinating more, they won't stop panting and he seems so hungry while on prednisone! Well, yeah, those are the most common side effects of prednisone. They are pretty benign side effects medically speaking but can be very disturbing to the owner taking care of the pet. I experienced first hand what some of my clients had already shared with me. Joey was on a very high dose of prednisone. Because of that, he would wake me up 3-4 times a night to go outside. He would try to snag food out of my hands he was so hungry. He didn't want to go for walks and he didn't want to play with his cat anymore. Even though I saw him appear more sick on the medication than I saw him before the diagnosis, I had evidence in the bloodwork that the medicine was actually helping and not hurting. It was saving his life! That was worth a little interruption in my sleep and a pup that was a little less active. Medicines serve a purpose. And as long as we use them carefully within the boundaries, it's a good thing.

Granted, I have lots of patients who never experience these side effects on the low doses that are prescribed with the common allergy or inflammatory situation. But, because of Joey, I have been more emotionally conscience of the side effects of common medications rather than just medically conscience.

Joey is doing well. He's on a lower dose of prednisone for maintenance purposes. He's back to playing with is kitty, taking long walks and never asks to go out in the middle of the night anymore.  He will be on prednisone for 2 more months before I can try to take him off. Even at that, if his blood levels drop again, I'll just have to put him back on the medicine. It's a battle that we'll be fighting for a long time, but in the end, we will be victorious.


Sarasota Animal Hospital

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