Wednesday, August 12, 2009

That's What I'm Talking About

Not that I want to gloat, but I would like to follow up on my last post about following recommendations of people that may not know what they are talking about.

I saw a dog last week as a second opinion. It was one of those cases where the first opinion wasn't wrong, the people just had a sick dog and wanted someone else to have a look at it. As a matter of fact, while I was having a look at it the first opinion veterinarian called the owner on their cell phone and actually suggested that they do a test that turned out to be the absolute correct test to do, but I jump ahead.

These nice people own a nice dog that went to their regular veterinarian because it wasn't feeling well. Turns out it wasn't feeling well because it was in liver failure. The vet diagnosed this and told them the dog had hepatitis (inflammation of the liver) Their friends said that if this dog is so sick you need to take him to see Niesenbaum (bless their souls). I examined the dog, and the blood tests the other vet had done, and looked at the x rays the other vet had taken. I also noticed a large bruise on the dog's chest. I suggested that we repeat the blood tests since things seemed to be getting worse. I added a clotting profile and a leptospirosis titer. (Link to previous post that I mentioned) First vet called and suggested we do a lepto titer (see above line). The blood count showed almost no platelets. An ultrasound showed mild to moderate liver disease and the rest of the clotting profile and the lepto titer were pending.

I started treating for the low platelet count (thrombocytopenia) and put the dog on antibiotics that would cover the possibility of leptospirosis. The dog stabilized and there was no more bruising. Guess what?? The lepto titer came back today and it was positive.

So all you pet owners that live in areas where your veterinarian tells you that there is a risk of catching leptospirosis VACCINATE YOUR DOGS! This dog almost died. It is not out of the woods yet. It exposed the staff at the previous vet hospital as well as my staff, and the family that owns this pet to a potentially dangerous disease.

Boo hoo, if it had been vaccinated it might, I mean might, have had a reaction. Most likely not and if it did, most likely very mild. It would have saved the owners thousands of dollars between the two hospitalizations. It would have kept dozens of people from getting exposed to a zoonotic disease. It would have prevented me from ranting about this topic twice in a week.

Keith Niesenbaum, VMD


SchoolPsyc said...

I sure do love vets willing to stand up for their convictions. I do not fear side effects as much as the fact that some vaccinations will not actually help due to multiple strains. You know, similar to what happens with flu vaccinations.

I just read this about this disease:

There are vaccines available, but usually only for one or two of the more common strains. Unfortunately, vaccination against one strain does not protect against the other strains. The current canine vaccines protect against the serovars canicola and icterohaemorrhagiae. These two serovars have been decreasing in total number of infections, but unfortunately, other serovars that infect dogs such as grippotyphosa, pomona, and bratislava have increased.

Keith Niesenbaum, VMD said...

This is a serious disease and one that is not difficult to protect against. The older vacciens were only 2 serovars but there are now two companies making 4 serovar vaccines. Unfortunately, there are 6 prevelent serovars and only limited cross protection against the two that are not in the vaccine. In addtion, the vaccine does not give 100% protection, but it's all we got so I vaccinate at risk dogs.

Companion Animal Solutions said...

I have a really good veterinarian who I trust very much. She's committed, caring, and up to date on the latest veterinary information and procedures. She recommended vaccinating my two Australian Shepherds for leptospirosis, so I asked her questions about this disease. As usual, she took the time to explain to me the importance of the vaccine and the dire consequences that could occur if either of my boys came down with it. She even took the precaution of using two different injection sites (they were getting updates on all of their shots) so if a problem occurred, we'd have a better idea of which shot caused the problem.

I stress with my clients daily how important it is to find a vet with not only the latest technical skills and knowledge, but someone willing to take the time to educate owners.

Thanks for being one of the veterinarians with the experience and skill, but more importantly, the passion for educating owners both in your office and your blog.