First-hand experience makes for a good vet

Dear Dr. Forsythe: I’m a second year veterinary student at UC Davis, and I’m very worried about my dog.  My small dog has been coughing recently and was diagnosed with a heart condition.  He is going to be put into a study at my school (which will save me money with his treatment) but I am worried about how long he is going to live.  Many of the teachers I’ve spoken with are very careful not to tell me anything about the prognosis.  They did say that he has a grade five out of six murmur and that his condition was serious, but nobody seems to want to tell me how long I can expect him to live.  Why do you think they are being so vague? – UCD vet student

Dear Student: Cardiac disease encompasses many complex and varied components.  Even when a pet receives excellent diagnostics such as X-rays and ultrasound to determine the exact cause of a heart murmur and the severity of his heart disease, it is almost impossible to say how long a pet will survive.  So many factors are at play:  how advanced was the disease when the diagnosis was made?  Which medications are being given and how well are they working?  Is the pet showing signs of improvement?  Congestive heart failure in pets is a serious and progressive condition.  In veterinary medicine we can treat the condition with various medications that decrease the workload of the heart and often patients seem to feel better for extended periods of time.  In your pet’s case, however, the doctors are probably hesitant to promise you certain survival time because the murmur is very loud and the disease may be severe.  A grade 5/6 murmur is just about as severe as it can get—so it is important to treat this condition aggressively and be realistic that your little dog is suffering from a serious and life-threatening condition.  In my experience I would counsel a client like you to enjoy every moment with your dog but be ready to say goodbye sooner rather than later because of what you’ve described as very advanced disease.  The good news is that your pet is in excellent hands and the medications available are affordable and can help make your dog feel more comfortable and live longer despite heart disease.  My best thoughts are with you and I hope you are able to use this difficult time with your wonderful little dog as a valuable learning tool in your education.  You are gaining first hand knowledge about cardiac medicine and learning about the importance of communicating well with clients who are concerned and need clarity during a worrisome time.  You’ll probably make one hell of a good veterinarian.  – Dr. F.

Dear Dr. Forsythe: With the holidays coming up, I was hoping you can give me some tips on symptoms of food poisoning in dogs.  When does an “upset” tummy warrant a visit to the vet?  I’ve noticed stray pieces of chocolate dropped on the sidewalk here and there, and of course Sonoma offers the unique challenge of dried up grapes left over from the harvest.

Can you give me some guidance on the symptoms that mean my dog needs professional attention right away?  I suspect different poisons cause different reactions, but are there any general tips to keep in mind?  Thank you. – M.M., Sonoma

Dear M.M. A really good rule of thumb is that if your pet has been vomiting or had diarrhea for more than a day, it is time to seek veterinary help.  I also tell clients that severe lethargy, inappetence or trouble breathing is also a sign of an emergency.  If a pet has bloody vomit or stool, this is a medical emergency.  In terms of toxins, anytime you see a pet ingest a known toxin (drugs, chocolate, antifreeze, toxic plants) a visit to the veterinarian is warranted.  However, if an excited pet regurgitates after eating three doggie biscuits and then isn’t hungry for dinner—common sense would dictate monitoring this pet for a day or so before making an appointment with your veterinarian.  It really comes down to knowing your pet and using the power of intuition.  I always tell my clients “if you’re worried, I’m worried.”  But the general tips of blood, difficulty breathing, or something lasting more than 24 hours are the most important ones to keep in mind.  I developed this rule of thumb for emergency visits after a very sweet, but very intrusive client dialed my emergency number last New Year’s Eve and in a very drunken state told me about her dog’s fleas and wanted to come down to the office, pick up some Advantage, and give me a kiss at midnight.  – Dr. F