Dear Dr. Forsythe: My cat has an ugly sore on his upper lip that looks like a herpes sore. It has been there for over a year and he gets treated with steroids, but they don’t really seem to help that much. I feel like his lip is so sore that he is miserable. I am considering putting him to sleep but since the rest of him is OK, that seems extreme. I just wish there was something I could do to make this go away.
Lumpy Lip
Dear Lumpy: Those “lumpy” lips on cats are usually eosinophilic granuloma complex (EGC), which are a nasty looking and uncomfortable chronic inflammatory sore that grow and fester on the mouth and lips of cats. But unlike Uncle “Fester” from the Addams Family, these icky sores are neither funny, pleasant nor witty to behold. Fortunately, until recently most doctors have simply given injections of prednisolone or depo-medrol to try and curtail the nastiness of the sores. If it hasn’t been done already, it would be good to get a sample of the diseased part of the lip and send it into the lab to confirm the diagnosis. Fortunately, there is a fairly successful medication that may help EGC made by Novartis. I’d tell you to “ask your doctor about …” but when I hear that being said on a commercial I want to push a chopstick through my ear. So I’ll just tell you the medication is called Atopica and it is being used very successfully in veterinary medicine. Assuming that your pet indeed has this particular granuloma lesion you described, Atopica may really help. I hope that you can soon have a cat whose “leprosy” lip will soon look as clean as a whistle. Good luck.
Dr. F
Dear Dr. Forsythe: I recently moved to the area and had an interesting experience I wanted to share with you that happened while I was at my previous vet getting a health certificate for travel to San Francisco (from our previous residence in Arizona). The doctor had stepped out of the room to take an important call that couldn’t wait, and I made the mistake of thumbing through my pet’s chart to see what was written in it. I was shocked to see that there were doodles and scribbling and even little drawings of me in the column of the lab work sheet that had my pets name on it. I could understand if there were medical comments but these were X-rated doodles! I was so shocked I left the exam room and when the doctor approached me in the waiting room I asked for a copy of my chart. He informed me that the practice was “paperless” and I left it at that. Could you please let me know what might have been going on?
Shocked and not laughing
Dear Shocked: It sounds like something fishy was going on. Many “paperless” practices still keep a hard copy of lab work and some brief notes in patient files as a type of backup. Those “scribbles” were no doubt insulting, inappropriate, and unprofessional. Whoever created them violated the practice act, and leaving the chart out so you had access to it turned out to be insulting and hurtful. The fact that your chart was carelessly left in your presence shows a lack of thoughtfulness, which obviously followed bad judgment and behavior in the first place. While I understand your decision to “leave it at that” I do believe that you have some recourse to request – or demand – a hard copy of any notes in your hard file if you feel so compelled. This is the first time I have ever heard of such a story, and it is hard for me to believe any veterinarian would be so stupid and so thoughtless as to subject a client to this. Perhaps you should send a note to this nut-case in order to feel some closure and also let him know how his impact affected you. And good luck – I’m sure this was an isolated incident.
Dr. F
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