Friday, October 07, 2005

Nature vs Medical Science

I saw a client who is into homeopathy. I'd seen her before, but she usually sees an "all natural" vet in town, who was not available until mid-November. So, she settled for me again.

Now, I believe in Western medicine, but I also believe in "do no harm," and I don't prescribe antibiotics for viral infections, or just in case, or just to give the client something to walk out the door with.

What I believe more is my job more than anything else is to relieve animal suffering. So, I recommend lots of preventative stuff, and prescribe lots of pain relief.

This client is nice enough, and she loves her dog, but she is convinced everything not "natural" is going to harm her dog. She feeds a homemade diet. I have no problem with people feeding a homemade diet as long as they have done the research and take the time to make it balanced. And, you have got to cook all the meat.

She doesn't cook the meat. The protein sources she uses are mostly ground turkey, but sometimes tofu, eggs, and beef. She says, "We just want to make it as natural as possible, and so far we've been lucky and haven't had any problems."

I smiled and said, "Boy, I wish that was my experience. I have seen cases of salmonella, e. coli, and campylobacter from dogs fed raw meat diets. In fact, there was a puppy this spring that died of campylobacter; I couldn't save him."

I continued, "I know you want to feed your dog a natural food, but in the wild your dog would kill a deer or a turkey and eat it immediately. The turkey that you are buying was grown on a mass farm and processed with hundreds of other turkeys. The chance of contamination is high. You can feed a homemade diet, but please cook the turkey."

Then we discussed heartworm prevention. The owner claims everytime she gives a heartgard, her dog gets sick. She gave it last Sunday, and on Monday he wouldn't eat, on Tuesday he had diarrhea. I suggested trying a different kind of prevention, either a different drug orally or a topical drug. She said, "You know, we haven't had many mosquitoes this year, and we keep him inside during the high mosquito times, you know - dusk and dawn, and he just reacts so severely I'd rather wait."

I took a deep breath and said, "Unfortunately, we see lots of heartworm disease here. This summer, we treated 1-2 cases per week. It only takes one mosquito getting into your house and biting your dog, and he'll be infected."

She said she wanted to wait on bloodwork results. She was paying about $200 for a complete blood work up, as well as titers for distemper and parvo (to see if he needed vaccination or if she could skip it). Obviously, it was not saving money that was motivating her.

Then we came to the dog's skin. He was suffering from allergies, and had thin hair, pink skin, and scabs on his legs and chest. "Why don't we try a topical cortisone spray?" I suggested. "It will just work locally on the skin, won't be absorbed systemically, and would make him feel a lot better." Her eyes grew wide with fear. She refused any antihistamines, also, and preferred to just give fatty acids in the food.

I know she is just motivated to do what's best for her dog. But nature isn't benign. In nature, its a claws-and-teeth selfish fight for survival. Chemicals don't just come in a plastic bottle of pesticide. Organisms use chemicals (called toxins) to subdue and conquer other organisms, whether they are rattlesnakes or staphylococcus bacteria. Our own bodies use chemicals (hormones) to regulate all our processes, from reproduction to digestion to locomotion. Natural chemicals can get out of balance, by natural causes, causing disease (allergies, cancer, diabetes, etc). If we can intervene with proven chemicals to improve quality of life, for people or pets, I'm all for it. Not medicating for the sake of medicating, but for a specific proved benefit.

I called her with her bloodwork results. Everything was normal except for a high eosinophil count, a white blood cell that is elevated during allergic reactions. They have lots of histamine in them, causing lots of itchy misery. "I'd really like you to think about trying another heartworm prevention," I said. "I just want to protect his heart."

"OK, I know you are a good doctor and have his best interests in mind," she said, "I'll think about it."


paula said...

You know Jenn, I really couldn't agree with you more. This is something I feel so strongly about, I hate to see animals suffering unnecessarily just because the owners have strong beliefs about medicine and diet. I think if you truly love an animal you should go with what is best for it not what you think is the right thing to do based on little more than (a)what the paper said that week or (b) what the neighbour reckons is right. Unfortunately I have witnessed these things on a few occasions and the poor animal always ends up coming off worse. I had to look after a yorkshire terrier on a few occasions for a friend's mum. Both times it ended up with me taking it to the vet with a distended and very tender stomach. It was fed exclusively on liver and milk!!! I refused to feed it this crap and gave it dog food (wet and dry) and water. It went back much healthier and happier. I have known people who take their animal to the vet with pre-conceived ideas about what is wrong, the vet gives best advice and medication, they go away refusing to believe what they are told, medication goes in the bin and then they complain that the animal is still sick!! Please move to Runcorn and set up practice!!!

Leigh-Ann said...

We've got a "pound puppy", a shih-tzu, who was on her last day on death row when we adopted her. She had been deemed "unadoptable" by the local SPCA, despite being a popular breed, because her eyes were glued shut with infection, her ears were both infected, and she had numerous bald patches all over her body. We were warned by the shelter vet that she would need numerous, expensive, daily medications and that her life would be miserable, so it was kindest just to allow her to be put to sleep.

You know, the shelter vet wasn't exactly wrong about the fact she'd need daily medication, but he was completely wrong about what she'd need medication for! All the problems she exhibited in the shelter were the result of allegeries, mostly an allergy to corn. We cut that out of her diet and added in allergy shots for a few other things beyond our control, and she's being doing great for years. We supplement the allergy shots with prednisone as needed for her comfort. In addition, she has a couple of kinds of eyedrops, and meds for bladder crystals (she can't eat the medicated food because it contains corn). She's also got a bit of a thyroid problem.

So yeah, our dog takes a handful of unnatural medications every day, but she's happy. She's playful and loving and the most contented dog I've ever met. While the meds she's on might shorten her lifespan in the long run (we keep a close eye on her liver functions), they've already bought her 6 years she wouldn't have had if we'd left her at the shelter.

I truly understand wanting to do the right thing for your pet, but I don't always think there's one right answer. I'd personally rather ensure that my pet is comfortable, even if it requires medication, and even if it will eventually have consequences. I'd rather our dog have 10 wonderful years of fun than 15 absolutely miserable and itchy ones.

Aunty Norma. said...

You did well,Dr.Jennifer!!how you kept your cool I don't know..I am sorry to say this in public but that woman should not be allowed to keep a Dog!!! why on earth did she come to see you if she didn't intend to follow your good advice??? my Heart (yet again):o) bleeds for that poor Dog..and to feed it RAW meat..well she wants shooting!! ooo you got my mad up now,Jenn. xx

Anonymous said...

So will you hate me if I tell you that I have fed my dogs raw meat? But only from really, REALLY good sources.

Anyway, I was reading through your blog tonight - have to agree on the cystotomies as best surgery. And the tick post made me laugh. We had an insane office manager who wanted to sell more Frontline, so she would wander through our waiting room screeching, "Lyme disease is falling from the sky!" Yeah, she got fired.


Aunty Norma said...

We use Frontline on Jessy..and it really works am glad to say :o)When are you moving to Weaverham to open up? :o) don't go to Runcorn ..we appreciate Veterinary people here (sorry,Paula):-)actually,Jenn. there is a vets. practice just closed..had to open a larger place in the next Village 'cos the Pracice got too big.x

The Lioness said...

Came via Christine (Rabbit Lived) and am DELIGHTED to have found you. I am in vet school and hope to be finished in 3 years if I don't throw myself in the river first, I am absolutely loathing it.

Anyway, you have a Katrina animal link, I do as well, I'm fairly sure I'll like you loads. I wish I could test my hypothesis now but Bacteriology beckons (aren't you envious?).

paula said...

We are Advantage or on the odd occasion Stronghold people!!! Our three cats just know to run and hide when they hear the blister's being cracked open on the pack (mad animals!!).

Lisa said...

Reading about this silly woman made me so mad! She doesn't deserve to have a pet. With all the health problems her dog has, this could be seen as animal abuse.

Plus, it makes me crazy when people misrepresent and misuse the "natural." Hemlock is natural. Poison ivy is natural. So is snake venom. But that doesn't mean they're good for us! Or our pets.

Julie said...

Wow--that dog should be taken away from her. I can understand, though not agree with, the desire to have an "all-natural" lifestyle, but come on. It doesn't sound like her dog likes it much!

I have to confess to feeding my dog raw meat as well--but my excuse is that I didn't know any better. :( Now I do, and I won't. Learn something new everyday, thanks!