Tag Archives: veterinary medicine

Firing my vet…

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To put the bottom line up front, I’m going to have to fire my current vet.

Given how often I find myself in need of veterinary services, I feel like that’s a statement that probably deserves some follow up. The fact is, I like my current vet. They’ve got a beautiful new facility. The docs and staff are consistently good to work with during appointments.

Unfortunately, it’s getting those appointments in the first palace that’s causing the trouble. I called yesterday afternoon, wanting to get an appointment for Jorah. He’s got a lot of the classic signs of an ear infection. It’s one of those things that’s not going to trigger a high speed run to the emergency vet, but that should get treated sooner rather than later. After I explained his symptoms, the receptionist offered me a choice of appointments on July 9th or 11th. I’m sorry. What? I’m sure some people will let their animals linger, in pain and possibly getting worse for the better part of three weeks for an appointment, but I’m not one of them.

They didn’t offer the option of a drop off appointment or even ask if I wanted to get on the cancellation list.

I’m not putting their name on blast here, because I know the veterinary industry is currently under a phenomenal amount of pressure and doing it while perennially understaffed. Although I understand the overall issue, that’s not going to get in the way of me using every resource I can bring to bear to get Jorah, Anya, Cordelia, or George the treatment they need in a timely manner.

In any case, I do want to voice my appreciation for Middletown Veterinary Hospital for getting Jorah scheduled for an appointment – as a new patient – in less than 48 hours from the time I called. They’re the place that did Cordy’s spay last week since my current vet of record was scheduling those out into August and September.

Based on the sum total of experiences getting this menagerie of mine vetted over the last few months, the only logical thing to do is start the process of getting the three furry ones transferred over to Middletown while I’m there tomorrow. Getting all their files transferred will be a hassle. It’s going to add 20 minutes to every trip to the vet. Unfortunately, it can’t be helped. The vet I’m firing was awfully promising, but all the promise in the world is wasted when it takes the better part of a month to get basic care.

On the limit of post-operative instructions…

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When you leave the vet’s office after one of your little furballs has surgery, they send you home with a post-op care sheet. In theory, this paperwork will tell you what to do, what issues to be on the lookout for, and how to handle some basic situations if they crop up. The post-op sheet isn’t and can’t be an exhaustive reference.

The reason I know this is because it doesn’t address, in any way, the scenario I was faced with this morning. By yesterday evening, Cordelia seems to have overcome her post-surgery lethargy. I’ve seen her eating, drinking, and eliminating – all the things you’re supposed to monitor as your patient recovers.

I don’t suppose any read ahead material really prepares you for starting the day to realize that sometime during the night, the kitten has gone head first into her food dish and smeared food around the circumference of the cone. She also managed to get the edge of the cone into her litter and had that clumped to the cone.

Under normal circumstances (or perhaps with a normal kitten), you might be tempted to think I’d just remove the cone, clean it up, and then put it back on her. The thing is, Cordy remains what I politely like to call selectively feral. She’ll accept being touched on her terms, but when I initiate it, she’s off like a rocket to the nearest available hiding place. She simply will not be “handled.” Thanks to her slight build, those places are most often under things like the bed or dresser and therefore bloody inconvenient places from which to try extracting her.

This leaves me in a bit of a conundrum. I don’t want to put her in a position where she can defile her sutures, but overall, I wonder which is better, removing the cone, cleaning it, and most likely being unable to put her back in it, or leaving her to wander the house for the next week with a crud encrusted cone?

Yeah, there are definitely things the post-op instructions don’t cover.

Still better than the average Tuesday…

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Anya had her first checkup with her regular vet this morning. It was about as successful a visit to the vet as one can reasonably expect from a cat. They caught her up on shots and gave her a once over. Aside from the eye, they didn’t find any areas of concern. She’ll go back in late May for her spay surgery. It was nice to talk to the vet about “normal cat stuff” instead of emergent situations needing immediate and decisive intervention. 

After that, it was a quick trip home to drop Anya off and reset a bit before running off to a couple of appointments of my own. There, we largely talked about things I already know since there were no appreciable changed to anything since the last time I was there. Checking in periodically seems to keep the sawbones at least reasonably satisfied. Plus, it’s nice to get an occasional confirmation that my innards are still plugging along in spite of what I’ve done to them. 

I knocked a few other things off the list while in transit. It wasn’t a particularly restful day off, but it was full of stuff that needed doing. Then again, even if the whole thing had been pissing away time on stuff that didn’t need doing, it would still have been time better spent than the average Tuesday in the office. And on that happy note, the week drives on.

Credit where it’s due…

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I spend a lot of time on this blog bitching and complaining about things. No apologies. It’s just who I am as a person. However, when credit is due, I like to think I cover those bases too. So, with that said, here’s the credit due this week:

1. Summit Bridge Veterinary Hospital. As soon as I found Hershel on Sunday morning, I was on the phone immediately to Summit Bridge. The fact that on a Sunday morning, they were open and immediately available for an emergency phone consult put them steps above just about any other practice I’ve used. Assessing that the situation was likely beyond their capabilities, they immediately referred me to two local emergency vet options. Quick, professional, and focused, they’re a solid recommend in my book if you have veterinary service needs in the local area.

2. BluePearl Pet Hospital – Christiana. BluePearl, like a lot of the other large chain veterinary practices get a lot of guff. I suspect that’s at least in part because of the prices involved when it comes to emergency or specialty vet medicine. I get it. However, everyone I worked with there on Sunday morning was fantastic. Hershel was in triage within 45 seconds of walking through the doors and the receptionist seeing his condition. Fifteen minutes later, the emergency vet was providing a detailed breakdown of his condition, pros and cons of treatment, and likely outcomes. She was compassionate and responsive to questions throughout our conversation. The tech who walked me though options for cremation or other arrangements was incredibly professional. The vet and tech tending to the actual euthanasia somehow managed to be a physical presence and yet disappeared in plain sight, allowing as much time as I wanted both before and after administering the final drug cocktail. From start to finish, the team at BluePearl displayed competence, professionalism, and compassion both for Hershel and for me. I don’t regret a nickel of their fee.

3. Jorah. This sweet, slightly neurotic boy has been unfailingly happy through what has felt like a very long couple of days. After sniffing around a bit Sunday night, he settled in to his own routine of snoozing in the living room, barking at the squirrels, and chasing the birds from the back yard. I honestly don’t know what I’d have done if he hadn’t been here when I got home with an empty crate on Sunday afternoon.

A very good girl…

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I remember the day I brought Maggie home like it was yesterday. I wasn’t even looking to add another dog at that point. It was a few weeks before Christmas and I didn’t want the inevitable headache of taking a puppy on a 1600-mile round trip drive. Then a friend at the office put up a “free puppies” sign. Mama had died giving birth and the large litter was eating the family out of house and home. It was a fire sale – everything must go – before they were dropped off at the shelter. Surely there wasn’t any harm in going to take a look. As I recall, people from our office ended up taking some if not all of that litter.

I came back after lunch that day with a sleepy chocolate lab snuggled down inside my coat. For the next almost 14 years, she was my shadow. Through the successes and failures of life, tens of thousands of road miles, changes of jobs, changes of houses, there she was with a wagging tail and a smile on her face. Maggie was one of the most consistently happy dogs I’ve ever had the privilege of knowing.

For the last few years, though, Maggie was also a very sick dog. Sometimes it felt like we were keeping her together with bubblegum and bailing twine, but she was always game for another trip to the vet and eager to greet everyone there. As long as she was up for pressing on, there wasn’t a test or procedure I was unwilling to try or a specialist I wasn’t willing to meet. Over the last week, despite some new meds, I watched that old spark slowly fade away. 

There’s more we could have done. The vet would have pumped her full of more meds if I’d have asked for them. It would have been so easy to go down the road of calling for extraordinary measures, but she deserved better. She deserved to meet the end walking in under her own power and while she still had some of the old nobility about her.

I couldn’t ask her to suffer so I didn’t have to – not after so long together, not when she’s done everything I’ve ever asked of her and so much more. 

From start to finish Maggie was a very good girl – a once in a lifetime dog. 

My life was incalculably better because she was part of it and is now the darker for her absence. I’m going to miss her terribly.

Another vetting…

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Yesterday Maggie and I swung by the vet so they could pull another urine sample. I’m expecting the culture to tell us one of two things: 1) Maggie’s UTI has cleared and the infection wasn’t what has been causing her wildly increased drinking and peeing or 2) Six weeks of progressively more aggressive antibiotics have failed to overcome the infection.

If it’s the former, the consulting internal medicine doc we saw last month has already proposed a preliminary course of action based on treatment to roll back a worsening of Cushing’s symptoms that isn’t indicated by the basic test of cortisol levels. I expect at least another trip to Malvern if that’s the result. If it’s the latter, well, we’ll have to see what’s left in the options box if this particular infection is truly uncontrollable with antibiotics.

I’m in the rather odd position of actively hoping that her Cushing’s has gotten worse. It’s at least the enemy I know – one that we’ve had good success wrestling into an uneasy truce if not submission over the last couple of years. It’s at least a fighting chance for some improvement. The same doesn’t seem to be true if we’re dealing with an unchecked infection.

There’s not much to do now until we see what we’re dealing with. It’s one of those rare times when I wish I was just a little more low strung and zen.

Schlepping across Pennsylvania…

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Almost two months ago I noticed that Maggie had started drinking approximately an Olympic sized swimming pool’s volume of water every day. I assumed it was a return of some of the symptoms that led us to her Cushing’s diagnosis. Several rounds of testing more or less proved that wasn’t the case. Her Cushing’s remains controlled, but there was bacterial growth in her urine sample – diagnosis: urinary tract or kidney infection.

After the first week of antibiotics there wasn’t much improvement, so they changed up the prescription to something a little more powerful. Two weeks of that showed some vague signs of at least getting her seemingly endless thirst under control. We’re almost through the second two-week round of antibiotics – for a total of five weeks under treatment.

Overall, she seems far better than she was two months ago. She’s not draining off a gallon of water every time I refill the bowl. She’s not struggling to get her feet under her to stand up and her back legs aren’t apt to fall out from under her every time she tries making a turn on an even remotely slick floor.

When we were in the worst of it, I scheduled an appointment with an internal medicine specialist – basically what I expected was a hail Mary play to find out if there was anything that the rest of us had missed and provide a fresh set of eyes to look over an increasingly thick medical record.

Having a dog that drinks non-stop in and of itself isn’t a huge deal when I’m mostly working from home. All that water has to end up somewhere, but it’s not hard to open the door every hour or two or even to get up in the middle of the night for a trip outside. Starting back to work in the office on a more regular basis created a bit of an issue. As much of a dog lover as I am, living with a critter that can’t help but pee all over the house or whatever room you’ve tried to waterproof isn’t a realistic option… and have you even looked at what getting a dog walked two or three times a day would cost?

I kept the appointment with internal medicine – knowing that if I cancelled and there was any backsliding, it would take a month or longer to get another appointment. I still want a set of fresh eyes to give her the once over and either confirm that we’re getting after the right problem or find out if there’s anything that can reasonably be done to coax a little more quality of life out of the situation. Maybe it’s overkill for a 13-year-old lab, but it’s why I went schlepping across Pennsylvania today.

Nobody expects…

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Maggie’s test results were not what either her doctor or I were expecting. We were both more or less convinced that her Cushing’s had advanced a bit and her meds would need to be dialed in a bit to correct for that. What two days worth of testing showed, though, was that her Cushing’s is well controlled and those numbers are almost exactly where they were a year ago.

Her tests did reveal a higher than expected number of white blood cells in her urine sample. The cause, ultimately, is unknown… but we’re treating it as a persistent, low grade urinary tract infection since that’s the most likely suspect. Maybe we’re on to something, because she has perked up a bit since we started her on mountains of antibiotics twice a day. Nobody expects the Spanish Inquisition, I suppose.

My poor old girl is still drinking copious amounts of water – maybe slightly less than a week ago – but she’s getting a round a bit better so for now I’m willing to call this at least a temporary win. We’ll see how things look in two weeks when the last of the pills runs out and we’re back to her normal maintenance meds.

This is definitely one of those times where I’m exceedingly happy I never had an interest in having kids… their basic care and feeding, wanting to go to college, or getting married would have eaten into my “Medical Care, Veterinary” annual budget line to an unacceptable degree.

Sickly or otherwise…

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I dropped my dear, sweet, elderly chocolate lab off for her next round of tests this morning. A series of x-rays shows that the swelling in her front leg is almost certainly a very large and somewhat inexplicable hygroma – basically her leg holding a whole lot of fluid. It seems to be disappearing as quickly as it came on. It’s looking far better this morning than it did on Friday afternoon.

The other test for today, the ACHT stimulation test, should optimally confirm what we suspect – that her body has built up a tolerance to the current dosage of Vetoryl that’s been holding the symptoms of Cushing’s at bay for the last year or so. If that’s the case, we should be able to adjust the dosage upwards and buy her some more time. That’s what passes for a best-case result with her these days.

At almost 13, fighting this kind of rear-guard action is probably as much as we can hope for. How it ends, of course, is inevitable for all of us, but as long as she’s in control of her mental and physical capacities – and not in pain – I’ll clear the decks to give her the quality life that she’s earned from our long years together.

Maggie is the kind of happy go lucky dog that will follow anyone anywhere. Hand over her leash and off she’ll go. Normally she goes without so much as a second look. This morning, while the tech was leading her back the hall to her room for the morning, my girl gave me a look over her shoulder, making sure I was still there. My breath caught and in that brief moment, I had “all the feels” watching her disappear into the back room.

I haven’t always been that maudlin. I suspect the endless flow of years continues to give me an enhanced perspective on just how quickly things can change regardless of how much time, money, or expertise you pour out. 

We should have results from the stim test tomorrow. For now, sickly or otherwise, I’m just awfully happy to have her home.

On the day after…

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Maggie has been home from her adventure at the emergency vet’s office for a little more than 24 hours now. She’s sleepy after a day of being poked and prodded on top of not feeling well – and I think she wishes Jorah would leave her alone to rest quietly, but she’s even putting up with his periodic efforts to annoy her. I think she’s reached the point in her recovery where the biggest issue is her obvious disgust at how little boiled chicken and rice is put in her bowl at meal time. 

After loads of bloodwork, a few x-rays, and plenty of diagnostic back and forth with the vets, it seems the final reason for violent sickness is going to be “unknown.” Off the record, both the vets and I agree that the most likely cause is having found and devoured something tasty, but moderately toxic while patrolling the yard. If you’ve ever had the opportunity to live with a Labrador, you’ll understand that “she probably ate something” is a perfectly reasonable rationale for illness. 

I never rest well when any of these fuzzy little bastards is sick, so hopefully this one is well and truly on the mend… again.