Veterinarians vs. the Internet
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What do you believe?
By Peri Norman
On a Friday night, about nine days after the start of a dog show weekend, one of my dogs refused her dinner. For many of us with major league chow hounds, this is a huge red flag. Others, used to more discriminating eaters, probably would not even bat an eyelash. Just heave a sigh of resignation and put the untouched bowl in the refrigerator until the next mealtime. Laurel had been in good spirits all day. She had eaten her breakfast with gusto and played exuberantly with her buddies. She does, however, fall in the group of dogs that refusing food is a big deal, so I took her temperature; 102.7. Then she coughed a couple of times and gagged. At 10 o’clock on a Friday night, I called Veterinary Medical and Surgical Group, a 24 hour facility, where Laurel is an active patient. There was an appointment with internist Dr. Melissa Herrera for 11 o’clock the next day. I took it. So, why the rush?
The very first thing I learned in my 4-H Veterinary Science project as a teenager was how to take the dog’s temperature. I can’t remember if we did it every day for a week, or once a month for a year, but the lesson was clear. It is important to know what is normal for your individual animal. If you only have one or two dogs, you might be able to store that information in your brain. I’m way too far gone for that! So I have a green folder where I keep track of things like my dogs’ temperatures, any vomiting or abnormal stools, coughing or anything out of the ordinary. This is also a useful place to keep track of flea and heartworm meds, vaccinations, estrus cycles and breeding dates. I know many people do all that on the computer. That’s fine, too! The more you know about your individual dog, the better decisions you can make about providing good care, without breaking the bank. Laurel’s evening temperature ranges from about 100.6 to 101.2. Temperatures up to 102.5 are considered within acceptable range for the average dog. At 102.7, Laurel was only .2 degrees above the average range, but she was 1.5 degrees above her high normal.
Learning what is normal for each dog is a good first step, but then how does one go about determining the next step. Dr. Suzanne Hennessey of Pismo Beach Veterinary Clinic tells me that fully 50% of young to middle-aged adult dogs she sees in her practice could have been treated successfully for significantly less money if they had been brought in to see her just 48 hours sooner. While that is just one veterinarian’s commentary, it puts a pretty interesting spin on heading to the vet promptly. Dr. Hennessey’s input boils down to 50/50 odds that “wait and see” is going to cost you more money than hopping into the car now!
Why take the vet’s word for it? Why don’t we take a look on the internet to see if the dog really needs to go to the vet? I checked four different sites’ “symptom checker” programs. None of them allowed for me to put in all the symptoms Laurel was displaying. You would think that they would be pretty straightforward; loss of appetite, elevated temperature and coughing. Only one site came up with the correct answer. The worst one could accommodate only one of Laurel’s symptoms, reduced appetite and offered suggestions including craniomandibular osteopathy and myeloproliferative disorders! Yet a third site offered the right answer along with alternative differential diagnoses of blastomycosis, cardiomyopathy and cleft palate! Thankfully, I know what the right answer is because I went to the vet and had the appropriate diagnostic tests done.
Another possible internet alternative might involve posting in a chat group. Many of you belong to chat groups on various topics including breed club-related groups or groups for particular show or trialing interests. How many of you think that questions posed in those forums get uniformly useful and correct answers? Well, I’m just saying that when you don’t know the answer, any place on the internet can give you multiple choices, but there is a reason our veterinarians spent many years in school and internships; so they can give you a correct diagnosis and appropriate treatment for what ails your dog.
Lest you think that I am anti-internet, let me tell you about how the internet can help you to take better care of your furry friend. It seems that the longer I am in dogs, the more awareness there is about health concerns that affect our pets. There are situations where the internet can be of tremendous service to you and the health of your dog.
Those chat lists I dismissed in the two paragraphs ago… well, most of them do have a couple people who have been around the block more than once. While internet conversations should never be an excuse to skip diagnosis and treatment by a competent veterinarian, much conversation on breed specific lists revolves around conditions common to your breed, or even the not so common ones that are cause for major concern. It is a good practice to be familiar with diseases that frequently affect your breed. Sport lists may have information about injuries or threats (think rattlesnakes on a field trial list) that you should be familiar with preventing and treating. The best place, if you have a breeder who has one, is a “family-group” list where people with related dogs share family news. Those are the places where our puppy people can ask us questions about vaccine schedules or other health issues and get a response from a breeder who knows things about their dog no veterinarian would know. For example, generally speaking, dogs from my line do not tolerate cephalexin (keflex) well. It tends to upset their stomachs within just a day or two. All of the other common antibiotics are fine. Dogs from my line also can have negative reactions to leptospirosis vaccines, so puppy buyers are advised to follow their veterinarian’s advice, but delay the vaccine until the immune system is mature after 16 weeks. Administering the vaccine at an early appointment so if an adverse reaction occurs, your dog’s veterinarian will be prepared and ready to handle the situation is also recommended.
There is a saying in medicine, “When you hear hoof beats, think of horses, not zebras.” While exotic diagnoses make for great television shows, the reality is that most often the correct diagnosis is the most common one, not the weird one. So when might you suspect the zebra instead of the horse? Well, perhaps you have learned on your breed specific chat list that your breed is prone to gastric carcinoma. Then if you have dog in the appropriate age range with GI symptoms, the zebra (gastric carcinoma) might be added to your list of possibilities more quickly than might otherwise indicated. Or maybe your dog is diagnosed with a chronic condition, like cardiomyopathy or epilepsy. The internet can be a wealth of information and support for owners whose dogs have chronic conditions that require on-going management. The first stop for up-to-date information on canine disease is the AKC Canine Health Foundation website. They provide excellent information to all dog owners. They are motivated by our concerns and supported by our donations. Many veterinary hospitals and canine pharmacies have a wealth of information about various diseases on their websites. For those who are more scientific in orientation, Pub Med or PLOS (Public Library of Science) can supply in-depth information about treatment and inheritability about many diseases, even the zebras.
The reality is that excellent care from a competent veterinarian and internet research are not mutually exclusive. They both have much to offer. One just needs to be discerning about using each of them properly. For the record, Laurel is fine. She had kennel cough!
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