Second opinion: Read the Rx label!

I recently was stopped by a couple riding their bicycles in my neighborhood. My reputation as a veterinarian who gives advice hit a fever pitch in my community during the pandemic.

Mr. and Mrs. Snowbird just came back from their home in upstate New York. They, like so many people, adopted a pet during the pandemic and drove their new dog Rascal, a one-year-old Corgi, down last weekend.

Prior to traveling to Florida, they brought Rascal to their veterinarian because they thought he had allergies. Rascal was shaking his head a lot and vocalized when you touched his ear.

The question that they had for me referenced back to their other dog, Ruby, a 14-year-old Schnauzer who had terrible allergies. She constantly licked her paws, scratched all the time, and rubbed her face. I recommended that they talk to their local veterinarian about Apoquel or Cytopoint allergy treatments.

The schnauzer was a happy dog after starting the medication. They were hopeful that Rascal didn’t have allergies because the medication was expensive, but Rascal seemed very uncomfortable.

I asked them about the working diagnosis. They told me that their New York veterinarian thought that Rascal had an ear infection. Two weeks ago, Rascal’s ears were red, inflamed, and painful. The veterinarian took a sample from the ear to look under the microscope and sent it out for culture.

The doctor started Rascal on an ear cleaner and pain medication and told the couple they would start treatment once the culture results came back.

The couple told me the technician at the hospital called and told them that Rascal had a bacterial ear infection and the vet wanted to start him on antibiotics. They also told them to clean his ears once a day and to continue him on the pain medications if he was still uncomfortable.

After two weeks of medication, ear cleaning, and pain medications I told them that Rascal should be feeling and looking better. They said he wasn’t and wanted to know if I could look.

As we walked to their house, Mr. Snowbird said that Rascal is not clinically better. He doesn’t seem to be in as much pain, but the veterinarian said that he would only need the medication for a few days, and he is still on them.

Rascal also hates it when Mr. Snowbird puts the medication in his ear. He mentioned that it seemed kind of cruel to put cold ear medication in an ear but what does he know. I was puzzled because I don’t know any ear medication that needs to be refrigerated, but maybe the medication was compounded specifically for Rascal.

Rascal is a sweet Corgi. He jumped up on me when I entered the house and, true to form, he smelled sour. When I investigated his ear, it was inflamed and sensitive and full of white material.

I was hoping it wasn’t pus. Mrs. Snowbird brought me the medication and it was Clavamox, an amoxicillin product that was meant to be refrigerated and given orally. I asked them if they are giving the medication orally or putting it into the ear.

I have never seen such finger pointing towards each other. Obviously, someone didn’t read the label. Mrs. Snowbird laughed and told me at least I had a funny story to tell people. Little did they know that I write articles.

Something about him was familiar

Best Christmas story or nightmare. You choose.

One day I had a new client come in with a 7-year-old Bernese mountain dog. Chewy presented with a lack of appetite, diarrhea, and vomiting. When the clients came in, I immediately recognized their dog. He had an unusual white stripe on the forehead. The puppy I remembered had the same color pattern and white stripe as Chewy. So, I asked my technician to leave the room and look up Bernese mountain dogs that I have seen over the past 7 years.

I asked another technician to come in to help me perform the physical examination on Chewy. Chewy was clinically dehydrated, his abdomen was tense, the fur on his face smelled like vomit, and his rear end had remnants of diarrhea still on the fur. I told the clients that we would need to start with some blood work and x-rays, and my technicians recruited some help to pick up this 135-pound beast onto the x-ray table. I went back into the exam room and started to talk about the other Bernese mountain dog with similar markings.

Looking back, it was about 7 years ago when a young couple bought a puppy from a breeder. It was in December and the young couple went away for Christmas and left the puppy with their friend and my client. They didn’t leave a cage or toys and the young woman who took care of the puppy left him in a spare bedroom where the puppy did tremendous damage.

One day the puppy got out of the bedroom and destroyed their Christmas tree. He knocked it over, ripped open presents, chewed up ornaments, and ate the stockings. I remember informing the young woman when she brought him in that I was going to have to perform surgery to retrieve all the things that he ate. It ended up being a problem because we couldn’t communicate with the owners based on their travel, but the surgery was an emergency. I ended up performing the surgery which went without complications. The friend ended up paying for the surgery and I found out later that the whole ordeal ended their friendship.

My technician who was doing the deep dive into the research came in and told me that my instincts were correct and it was the same dog. His name was John. When the new owners found out that his name was John they asked if the original owner’s name was Hortensia. It was.

Same dog, similar situation. I ended up telling the new owner my history with John. They adopted John about a year ago, hated the name and call him Chewy because he always has something in this mouth.

My technicians came back in with Chewy and we put the radiographs on the examination computer and we could see the problem right away. Chewy had  about 9 pacifiers in his stomach. I asked the owners if they have a child and they did. Each parent thought it was the other one that got rid of the pacifiers, but it was Chewy. I told them that Chewy needed surgery. The fact that there are 9 pacifiers means that they are not passing. I thought it was fortunate for them that when they adopted John the previous owners transferred the insurance to them, and they never canceled it. And I told them that they never will. Best holiday news ever. Love, Chewy.