They don’t call it the art of medicine for nothing. It’s sometimes an art,  and not an exact science, so every patient, family, friend, who goes with a loved one or accompanies anyone into a doctor’s office should know one really important thing! Just because a doctor gave you a diagnosis or prescribed a particular medication it does not mean that it’s the CORRECT diagnosis or the RIGHT medicine to take.

When you enter a medical professional’s office don’t leave your greatest asset, your mind, at the door. Many of us may someday get caught up in the doctor “fixing” an illness. We may mistakenly think that our physicians know the right answers to help heal ourselves and our family members. Especially during those times when we are not feeling well,  or perhaps have been stricken with an illness. But doctors, my friends, don’t always have the right answers. In fact, sometimes they aren’t even close. This is Part II of the Initial Story of a Medical Tip I Learned from My Dog.

Ihowdoghelpedwithmedical n the first installment we discussed how my dog and I had visited Vet #1 and Vet #2 in trying to identify the medical problem that was making my dog feel ill. We talked about how Vet #1 was initially going to do nothing, but then performed blood work when prompted to do so,  and finally diagnosed my dog with kidney insufficiency.   After the kidney diagnosis I spent the next several weeks thinking that my dog’s decline was due to an almost certain outcome that was not looking good. Since dogs can’t do dialysis the only real “treatment” is a kidney friendly diet, and a watchful eye from the owner. There is no “recovery” from kidney disease in dogs, only managing the symptoms, so this was not good news to hear and I tried to hope for the best and prepare myself for the worst.

When the diet didn’t seem to help, and my dog got worse, I consulted Vet #2. Something about the rapid decline in my dog’s health didn’t quite seem right and and so the story goes that Vet #2 after analyzing a urine sample, told me my dog had a urinary tract infection and prescribed a long course of antibiotics. Initially my dog seemed better but then after about three weeks following the last dose of antibiotics she seemed kind of “off” again. Not as bad perhaps as the initial events of the recent past, but not really herself. So I called Vet #2 and was told to bring in another urine sample for testing. I did, and brought in the first urine sample of the day and then immediately drove it to Vet #2’s office so that they could test it.

A few hours later Vet #2’s office calls and says we have bad news.  Your dog still has a urinary tract infection and we want to put her on another, big gun type of antibiotics.

“Hold on there, Miss Vet Technician,”, I said.    Notice the vet didn’t call, just the vet technician.  “Wait just a second I have some questions for you,”  I heard myself saying.    “Go ahead”,  said Miss Vet Technician. The following is an excerpt of our conversation:

My Questions for the Vet’s Office

Question #1) “What type of big gun antibiotic do you want to put her on? What’s the name?”

Miss Vet Technician gives me the name of the medication which I jot down for further research later. I’m not about to give myself, my dog, or anyone in my family any type of medication without researching it first.

Question #2) “So why would you just put her on an antibiotic without…………” my voice trailed off a bit as I was gathering my thoughts.

Miss Vet Technician cheerily answered… “you mean culture and sensitivity testing”?

“Yes, yes”, I answered. Shouldn’t we find out which antibiotic will work before we just go throwing another medication at her?”

Sure enough Miss Vet Technician agreed, and said they would send off the culture and sensitivity off to another lab and that would cost another $175.00.

Ok, I answered, at least we’ll know exactly what type of infection she has and more importantly, how to treat it. I knew I still had more questions before I was going to give any additional medication to my dog, so we moved onto my next question.

Question #3: “Let’s think about this a minute please. “This is a dog that is now in what would be called her senior years. She’s a large breed, so they age quicker than the smaller sized dogs.  Why do you think she’s now, for the first time in her life, getting these urinary tract infections?” “Could there be some type of blockage or something causing this?”

“Well, said Miss Vet Technician, we were wondering that also. So an option for you would be to do an ultrasound and an X-Ray to see if there’s something we can see that could be contributing to this problem. “

“I see,” I answered. And silently wondered why I was having to do all the “work” in thinking about all possible options. Wasn’t this something I was supposed to pay the veterinarian for?

“Well, do you have the equipment necessary to do these exams in your office?”, I said.   Previous years of having “big dogs” gave me a little bit of an extra knowledge base. I knew that most smaller veterinary hospitals do not have either the technical expertise in terms of the staff nor the equipment in house to perform certain kinds of diagnostic tests. So I asked this question and waited for the answer.

“We’d have to call in an ultrasound tech to come into our office for the ultrasound exam,”  chirped Miss Vet Technician.  “But we could do the X-Ray in our office and we have the machine here.”

I immediately changed course, and then asked if I could have a referral to the Internist that Vet #1 had initially refused several weeks ago. I explained to Miss Vet Technician that I was very selective about testing, equipment, and where things were done and I’d just feel more comfortable going to the specialist veterinary hospital where they had all the equipment in house, and a staff equipped to handle testing of very big dogs.

To Vet #2’s credit, Miss Vet Technician immediately said that would be fine, and said she would call me back in five minutes once she had the referral for me.  And five minutes later, like magic, we had a referral to the Internist’s office.

The Next Morning we visited with Vet #3:

I knew immediately upon walking into the office that I  had made a good decision. The office was impeccably clean, the staff attentive and organized, and there were multiple specialists all in one building. In fact, the office where I took my dog was known as the “Mayo Clinic for Dogs” and I could see why.

Vet #3, came out and ushered us into the exam room after we filled out yet another set of  new client forms, and then proceeded to take my dog’s history. So after the long story of her symptoms, and Vet #1 and Vet #2’s handling of my pet’s medical condition, Vet #3, says, “So at this point, you still don’t really know what’s going on?”   Yes, I agreed. “That’s why I asked for the referral here.” Initially after the first course of antibiotics she seemed to be getting better, but then she seemed a little “off” again, and then when I was told to give the “heavy guns” antibiotics I thought I should check this out further.

Note: giving antibiotics when you “think” it will help can be a dangerous thing for humans and animals. It’s like throwing a dart on the wall to see if it sticks.  There are three  big rules of thumbs for all of us to remember when it comes to antibiotics:

Three (3) Rules of Thumb When Dealing with Antibiotics

1) Only take them when you are sure you have an infection
2) Make sure the antibiotic you are taking is going to work against the type of infection you have (this is done through culture and sensitivity testing)
3) Once you start on antibiotics take the entire course of them. Don’t quit midway through your prescribed dose even if you feel better. This can make matters worse
Back to my dog’s veterinary story. So Vet #3, told us that first, she would do a “sterile” urine specimen, meaning that instead of catching my dog’s urine in a pan, in which case, it could be contaminated with bacteria from the skin or hair, she would insert a small tube into her urethra and obtain a sterile sample of urine. This way, we’d know for sure if she indeed had a urinary tract infection or not.

Part B of Vet #3’s plan was to do an abdominal ultrasound as well just to make sure there wasn’t a blockage or some cancer that had not been detected. And finally, part C of Vet #3’s plan was to draw all new blood work but instead of having the local veterinary hospital process it, she would send it out overnight to the specialty lab which was more accurate in terms of getting good results from blood work.

So, I apologize dear readers, I digress once more.  Anytime you, your pets and family members get medical testing there are three things you must know.
The accuracy of the results that you get back depend on three (3) important factors!

This is important, so you may want to write these down:

Accurate Medical Results When Doing/Participating in Medical Testing Involve the Following Three (3) Factors:

1. Quality of the Equipment: Remember in house is most always better than mobile units brought in from somewhere else.
2. Quality/Competency of the Person whose actually performing the Test.
3. Quality/Competency of the Person whose reading the results

I get it, so you thought this medical stuff was a piece of cake and that your doctor was always right? See how many different factors are in play, when you or your pets are trying to get properly diagnosed?

And once again, readers, we return to my dogs visit with Vet #3:  The Internist had done a very thorough physical exam and had drawn the blood, performed the ultrasound and then met with us later that afternoon to report the good news that the ultrasound was clear, and that she couldn’t find anything remarkably wrong with my dog.  Her labs would be back the next day so we were asked to hold off on giving her the “top gun” antibiotic that Vet #2 had prescribed.

The next day Vet #3 calls me back and says that my dog does not have a urinary tract infection. The sterile specimen had no bacteria in it, and so giving her antibiotics would be pointless. She also tells me that her kidney functions again came back within normal limits, and so for now, she did not have an issue that was showing up on lab tests as a kidney problem.

Vet #3, suspected that my dog’s issue could be a gastrointestinal issue since the first episode involved some strangeness with eating  her dog food (commercial dog food that she was eating at the time when she initially became ill) and some strangeness with her drinking habits.

It was ironic that Vet #3 had said this because on my initial visit with Vet #2, I had asked him if it would be possible that my dog had an inflamed bowel perhaps from the new bag of dog food that we had just opened when her symptoms started. Even though he said that was a possibility, he nixed my idea of putting her on a diet that was more healing to the bowel and just suggested we go the route of the antibiotics instead.

Since antibiotics were definitely contraindicated in this case, Vet #2 and I discussed methods of removing wheat products from my dog’s now home cooked food. I then came up with different food choices for my dog to eat that were all wheat and gluten free. And I’m happy to report that my dog’s health has improved, and she’s now sleeping through the night without any issues. The vomiting has stopped.  And my dog is back to her normal, albeit somewhat goofy self.  I’m now the recipient of lots of doggy kisses throughout the day and night—she’s showing her appreciation for the new diet and menu choices!

The wheat products and the rice that was also initially prescribed for her “tummy” troubles was actually making a bad situation worse. By eliminating the wheat and gluten from her diet, she was able to  rest comfortably, keep down the food that she ate, and give her gastrointestinal system nutrients that were healing, not inflammatory.

What I learned from my dog through this ordeal, is that once again, it is not always the best advice to take the advice of only one physician, whether human or animal. Sometimes getting a second opinion is not only a good idea, but a necessity. And getting “answers” doesn’t mean you’ll get the right ones, from any physician or veterinarian.

Even if a medication is prescribed, it doesn’t mean that you should take it or give it. This is not to suggest that you not take medications that are needed, simply a warning that you should ask lots of questions from your doctor and health care team before accepting every diagnosis or every medication offered. There are obviously situations, medical conditions, or even medical emergencies where you may need to immediately fill a prescription and begin taking medication right away.  Just always inform yourself, or have a trusted friend or relative who can help you investigate medications. Your best defense is always a good offense. And when it comes to your health, your best offensive stance is to become an informed consumer.

Important Medical/Health Tips My Dog Taught Me:

A: Don’t assume that your vet knows the right answer
B: If your animal isn’t getting better, ask more questions and/or get a 2nd opinion
C: If antibiotics are prescribed, ask if your vet has done a culture and sensitivity testing to see which antibiotics will be effective
D: You may consider asking for a sterile urine culture to be drawn if your pet is diagnosed with a Urinary Tract Infection (UTI) to make sure you’re not treating bacteria on the skin instead of a true UTI
E: If testing is required, ask your vet if they have the specialty testing equipment on site, and if so, how many procedures they do each day with that type of testing. If the number is small, and/or you have a large animal, you may want to ask for a referral to a higher level care animal hospital that is more experienced in that type of testing
F: You should personally research any medication that is prescribed.
G: Utilize your pharmacist as a resource and ask questions of both your doctor and pharmacist about medications, side effects and alternatives
G: Ask  the veterinarian specifically what the side effects of any prescription medication are.
Then ask what other options, including non prescription medications may also be possibilities

As my mother used to say. Use your noodle!  Taking the time to leave your thinking cap on during all your medical visits in the future, could not only be life enhancing, it could potentially save your pet’s, your children’s or even your own life!