Sunday, October 11, 2009

Change of heart

I got a request to refill a medication on a dog we haven't seen for two years. Legally, they must be seen within the last year to fulfill to maintain the doctor-patient-client relationship, so I refused. The dog showed up in the afternoon for an appointment, also overdue for vaccines and heartworm testing.

The dog was nice enough, although nervous and unruly. "She drives me crazy," the owner said. "She can't be around other dogs, so I can't take her on walks, because what if she sees another dog? And she goes nuts when my parents' dogs come to visit. So she doesn't go anywhere but the house and the backyard." I mentioned the dog was overweight, and she said, "Well, that's because she doesn't get any exercise. But I can't take her anywhere. She drives me crazy. And look at this shedding." I tried to let all the complaints about her dog roll of my back. She even complained about fitting the cost of the appointment into her budget. At least she wasn't complaining about having to make the appointment.

At the end of my exam, I said, "Unfortunately, her heartworm test came up positive." "What?" the owner said, "I can't believe it!" She got very quiet. I talked about the process for treating the worms, starting with chest Xrays and labtests, ending with a series of intramuscular injections. It is expensive, especially for such a big dog. "I'm so stunned," she said. Well, we weren't; her dog had been off preventative for over a year. We don't prescribe it just for fun in Texas. Even at my high-compliance practice, we treat about one dog per week. I offered to get started today, or we could schedule in the future if she couldn't afford to start now. "No, I'll have to reschedule. But I'll definitely save up. I don't want her to die! I just can't believe this."

Funny how she changed her tune, but I'm glad to know she really does care about her dog.


Anonymous said...

Jennifer! what on earth is a heart worm test?? sounds quite scary(shudder)...We have kept Jessy's injections up year after year..if you have a Dog/Pet then you are obliged to look after it properly surely? You do a great job,Jenn. and in about 4 years time we shall have another Niece Kara in Florida (who is also studying to be a Vet.) to be proud of.x


Emily said...

As I was reading, I was afraid that she was just going to say you should put the dog down. I'm glad she wants to treat the heartworms.

Anonymous said...

Are these Heart worms real worms then? We have never heard of them..Noel thinks it might be something that is just in Texas..


Vetmommy said...

Auntie Norma, yes, heartworms are real. They are spread from dog to dog from mosquitos, which we have plenty of here in Texas. It used to be a disease seen mostly in the Southern US but has spread to all the states, though still worse in the South.

The adult heartworms live in the right side of the dog's heart and the pulmonary vessels. They lay baby worms that are circulated in the blood; these are picked up by the mosquito and transmitted to the next dog, completing the lifecycle. If they are not treated, they can cause heart failure.

Heartworms are easy to prevent with a once-a-month pill. We run a heartworm test every year at the time of the dog's annual vaccinations and exam. The test is a simple blood test, only takes a few drops of blood and 8 minutes. The treatment is long and expensive... which is why an ounce of prevention is worth a pound of cure!

Anonymous said...

..Thank-you Jennifer,for your reply.We do have 'mozzys' in England and especially in our garden when it's a bit too wet..what an awful pest that is! xx