Home diagnosis: always a train wreck for veterinarians

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Watch out for veterinary clients who think they know better than you.

Mr. Mortis was in a state of sheer panic. "Something has gone terribly wrong, Doc! Riggy is curled up under the sofa. He won't move and his pupils are dilated. I'm afraid he may be dead!" Riggy Mortis had been discharged from my clinic just three hours earlier. Phone calls like this one are often just as upsetting for me as they are for the client.

"I don't know what may have gone wrong," I told the client. "Can you bring him right over to the clinic so I can see what happened?"

"No way, Doc. I tried to reach under there just now and he darn near took a piece out of my hand."

Based on that, I was able to glean that Mr. Mortis was a bit premature in his determination that Riggy was dead. In fact, home diagnoses are wrong most of the time, and the home remedies that often follow are equally misguided. In Riggy's case, the next logical step would have been burial, which, to say the least, was inappropriate.

ILLUSTRATION BY RYAN OSTRANDER

You see, strange things can happen when our clients try to diagnose on their own. Mrs. Downer is a great example. She was aghast concerning my postoperative instructions for her dog, Dozey.

"What? You aren't going to put him on pain medicine! That's outrageous! He just had real surgery with stitches and everything. When I had surgery I was on Narcoset for a month. Dozey is very sensitive. I think he needs pills."

I assured her that Dozey's one-stitch surgery did not call for analgesics and sent her home. Of course, she was back the next day.

"This dog was perfectly healthy when I brought him in here. Now all he does is mope around. My neighbor says that you should have known better than to use anesthesia on a sensitive dog like him. He's still groggy from your anesthesia. I ought to sue you!" (FYI, the surgery was done with local analgesia.)

I checked him out. Dozey seemed fine but acted groggy. Mrs. Downer's next words clued me in. "You don't think it could be the drugs, do you, Doctor? You see, you weren't going to give him anything for the pain, so I gave him a few aspirin when we got home. Then I remembered hearing somewhere that aspirin isn't good for dogs. So I gave him one of those Narcosets that I had left over from my surgery. I threw in a Somnium tablet to help him sleep also."

How was this pooch still conscious?

Mrs. Downer was one of those people who fail to heed my advice then are quick to blame me for the results of their own stupidity. I set her straight and after a stern lecture from me, the bowwow recovered uneventfully.

My usual preferred order of events is as follows: I diagnose. I prescribe. Client cooperates. I hate it when the order is mangled, as it was in another case.

"Hello, Doctor. This is Mrs. Rage. Hemo cut his foot and needs stitches right now. It's really bleeding. Can I bring him over for stitches? I know he needs them."

I told her to bring him in so I could take a look.

"I don't want to waste a trip if all you're going to do is look at it or bandage it. I have to know that you'll stitch it right away."

I politely informed Mrs. Rage about who makes the surgical decisions and told her to come over. You guessed it. It turned out to be just a broken toenail.

Unfortunately, once our clients arrive at a home diagnosis, they are prepared to defend their judgment no matter how idiotic. Take, for example, Mrs. Blueprint.

"Doctor, Mimik is the best dog ever. I hope you can save him. He's been limping for two days. I'm afraid that we could lose him."

Just a little lame? Why the panic?

"Do you think you can fix my poor dog before all his hair falls out?"

My curiosity was aroused at that point. Lameness leading to alopecia? Since when? I asked Mrs. Blueprint for an explanation.

"My neighbor's pet had this exact same thing. It all started with a limp. After that got better, he seemed OK. Then a few weeks later he died. The thing is, Doctor, before Polly died, all his feathers fell out."

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