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
http://www.thevetschoice.com/
www.CrawfordDogandCatHospital.com

A Veterinary Rant

Up until now, I have tried to keep my posts educational, non-opinionated, and free of controversy. But... all good things must come to an end. I need to ventilate about one of my pet peeves, breeders that think they are veterinarians.

Now, when I started practicing, I was more easily intimidated by breeders. I mean, they would say things like my breed can't do X, or my breed needs Y. They would tell the people that they sold to puppies to that they had been breeding all their lives and veterinarians don't really know anything about (fill in the blank for the breed). I was a baby vet, never mind that I had been in school for longer than most of these breeders had been in business, but it can be difficult to convince a new pet owner that the wizened old breeder that sold them Fluffy the maltipoodoodle has had no medical training and is talking out of a hole other than their mouths. So for years I would just nod and let it drop.

Now there is a new axe to grind. I have been practicing medicine for 25 years, the last 21 as a small animal veterinarian on Long Island and I know what I am talking about most of the time. If not, I refer to a specialist that will cover the rest of the time. My Ivy League education and years of experience should count for something.

That is why I am starting to loose it every time a new puppy owner comes in and tells me that their breeder said the dog can't have a leptospirosis vaccine or it will explode or something. I know that historically, this vaccine has caused more reactions than other vaccines. But hey, every vaccine that I ever got caused at least some reaction. Ever had a painless tetanus shot? Also, in our area, leptospirosis is a real problem, made worse by the wet summer that we have had. We have had several cases of lepto this year. I know dogs that have died of leptospirosis. Oh yeah, Mr. and Mrs. Breeder, it is contagious to people as well. So let's not vaccinate these dogs and let them bring a disease into the homes of these nice people that you sold this puppy to and make everyone sick. You know I only recommend these vaccines to make money anyway, or so I've been told.

So people, pick a veterinarian you trust and follow his or her recommendations. Get your information from a reliable source that has done some research, or read some research, or at least knows what they are talking about. Don't just take my word for it, here is what the CDC says about leptospirosis. They have some idea of what they are talking about, unless you think they are part of the greater government conspiracy to over vaccinate your dog. Your veterinarian is also a good source of information. They spent at least 8 years in school learning to take care of your pet and untold hours of continuing education since graduation honing their knowledge. The years that they have spent practicing have not been for naught, they actually have learned something over the years. If you don't trust your veterinarian and think that he or she is an idiot because the breeder told you so, find a different veterinarian, or a different breeder, or you will get what you deserve in the end. Unfortunately, your pet may be the one to suffer along the way.

Keith Niesenbuam, VMD
http://www.thevetschoice.com/