ER What to Expect Part 2
|February 5, 2021||Posted by Melinda under Uncategorized|
If you are just joining us, read the first part for explanations & disclaimers, important & not-so-important notes, and the philosophy of this post (because if you don’t, and you troll this post, don’t come whining to me when I don’t approve your comment.)
Last time we covered exotics that are probably going to die, exotics that are probably going to make it, a lot of vomit, and the random ear infections (with a nail trim of course).
If my squirrel brain can possibly handle it,*
this post will cover the last five from the list.
*Turns out my squirrel brain can absolutely NOT handle doing the last five. I managed the first part of the first one on the list……I’ll get to all of these, I promise. And maybe even some after that because you, my Dear Reader, seem to really really like these posts judging by the number of you who have emailed me.
- Geriatric dogs that: a) have been “perfectly healthy” up until today and never needed vet treatment, but come in with a list of a gazillion old dog problems and the owner wants to know “what’s causing all this.”
b) OR geriatric dog has various well managed health issues that has one specific problem that needs to be checked out. c) OR Geriatric patients that are crashing and burning before my eyes and Jesus ain’t letting go of that wheel this time. Sometimes they are coming in for euthanasia and sometimes they are coming in because the owner needs to hear there is nothing else they can do. Trauma. These are the fun ones, don’t judge me. There are apparently some people that get excited over internal medicine cases, which make me want to drive ice picks through my eye sockets. Trauma? YES PLEASE. They range from “I came home to this and I have no idea,” to hit by car, to dog fights (don’t bring your dog over to your friend’s or relatives’ house. Don’t dismiss continually household fighting as “playing rough.”) There’s also broken legs for all sorts of reasons. The really weird zebras. The dog that ate chocolate. The mystery ailment that will go away as soon as you decide to make the drive.
- Geriatric dogs in all their forms
It is true there are old dogs that are perfectly healthy until they are not, and go to the ER because they are suddenly Not Fine. They do exist.
Unfortunately, I don’t get to see those as often because apparently I’m a magnet for the small, old dog dumpster fires.
Old dogs with a single problem usually fit into category 1b (You really do have an old dog with just one problem – it’s usually cancer), or category 3 (Zebras and the answer is usually cancer, but not always). We will get there.
What I see far more commonly is the old dog that has NOT been perfectly fine, and has many undiagnosed problems. I know this because after assuring me that the dog has been perfect healthy and never been to the vet, the owners will go on to give me a long list of ailments that have been going on for various lengths of time.
She acts like she can’t see! And has fallen off the bed twice! Been healthy as a horse every day of her 14 years until two days ago. By the way, can you also take a look at her ears? For the last year there has been a discharge and a smell. Also, her teeth are bad. Oh, that cloudiness in her eye? Don’t worry about that – it happened 6 months ago but she didn’t stop eating or drinking and seems to be fine now. She’s a picky eater, I can’t get her to eat dog food so I feed her chicken broth and bits of carrot, do you think you can check that out tonight too? Nope, not on any medications currently, didn’t you hear me? She’s been absolutely fine until 2 days ago. What do you mean, “what are my priorities” tonight? I WANT TO KNOW WHAT IS WRONG WITH MY DOG AND WHAT IS CAUSING ALL OF THIS.
Here’s a truth. Just because a medical problem hasn’t been diagnosed doesn’t mean it doesn’t exist. This is true for your own health, and your dog’s health. It is not breathed into existence when it is named like some magical spell. Whether your pet has diabetes, hepatitis, or chronic kidney disease at any particular moment does not depend on getting an official diagnosis.
There may a lot of different reasons that your old dog hasn’t seen the vet. He has problems but they didn’t seem that bad. He’s getting older and problems are to be expected, that’s just life. Your family never were much for taking animals to the vet for “every little thing.” But tonight is different. You can’t stand it anymore. You are making the leap. You don’t know how much it’s going to cost and your resources aren’t unlimited.
A mixture of fear of judgement or that something is really wrong this time, guilt, uncertainty about the process and finances, and a million other emotions may be bubbling together.
Here’s what I need you to understand.
I’m not going to be able to fix your dog tonight, because they didn’t get sick tonight. Your dog has multiple problems, not just one, that have been developing over time. That one thing you are seeing that made you finally worried enough to bring him in tonight is likely the consequence of some other problem. One that will probably take some time to diagnose and treat.
What we need to do tonight is prioritize his problems. How do we stabilize and make him comfortable tonight? What diagnostics do we need to do tonight start the investigation into what this is (and what this isn’t) and help guide us on what needs to be tonight to make him stable and comfortable. Yes, you most certainly will need to follow up with your regular vet or a different center in ASAP. Just maybe when I run bloodwork or take an xray, like sunbeams from heaven the definitive cause of all our woes will be illuminated for all to see.
But while we are speaking of bloodwork and X-rays, I want you to remember something.
I have not yet been issued my crystal ball.
It is practically impossible for me to give you a firm answer of what is wrong unless I can run some tests. Physical exams and a history are incredibly important and when I make my list of “things that might be causing this,” the eventual diagnosis is usually on that initial list. But unless we are going to slap some bandaids on the symptoms and hope for the best, I really do need to run some tests.
It’s like speculating on who is going to win the superbowl three minutes before the game starts. We can make some good guesses, but sometimes you gotta just watch the game.
Coming soon: Geriatric dogs parts b and c, and the rest of the list. Probably in multiple parts. Because aren’t shorter posts more often a lot more fun?