If it were your pet what would you do?

One of the most dreaded questions veterinarians face: "If this were your [dog, cat, horse, cow, etc.] what would you do?" It's an innocent and reasonable question. I regularly find myself asking the same sort of question of the experts in my life--my mechanic, financial planner, hair stylist...

The question of "what would you do?" is a good one. It indicates trust and partnership in the veterinarian-client relationship. Why it makes me cringe is because it is so darned hard to answer sometimes!

Rarely do medical conditions have predictable black-and-white outcomes. As the veterinarian, each set of test results presents a complex algorithm. An algorithm is a flowchart of "if this, then that" scenarios that help us reach a diagnosis, plan treatment and assign a prognosis (i.e., outcome). For example, if the pet's kidney values are markedly elevated and the red blood cells are decreased and the pet is severely dehydrated, then the expected outcome of treatment is much different than if the kidney value elevation is the only abnormality. Sometimes, just as importantly, the algorithm for deciding a pet's care also includes financial considerations: if one has a big piggy bank, then one might choose to do a certain diagnostic test or treatment.

When asked to place myself in my clients' shoes, I want to give an honest answer. The trouble is, how I believe I would act if faced with the same predicament is not necessarily how I will act when the time comes. Considering the situation from the client's point of view works because I can share my personal rather than clinical take on the situation. But I often feel as though I'm not being entirely truthful. Can I really begin to guess what I would do if it were my pet?

This past Thursday I was faced with the worst choice my clients have to make. Our surly spaniel GrrrD, limping and crying for several days despite a thorough workup and aggressive pain management, became terribly lethargic. An x-ray of her suddenly distended abdomen showed several abnormalities which may or may not respond to surgical intervention. So, for this 13-year-old dog with multiple, seemingly unrelated symptoms and obviously suffering...what should I do?

I did what my clients do. I asked a veterinarian, my dear friend and collegue Dr. Trisha Fasse, for advice. We talked for some time about GrrrD's symptoms, her age, her test results and my feelings. My inner debate raged on. GrrrD the Snerd was my husband's puppy since college. She was a steady part of countless apartments and homes. She was our "kid" before we had kids. How could I not do everything and anything possible for her now?

Resolution finally came when Dr. Fasse reversed the age old question and asked me, "What would you do if it was your client's pet?" It became clear. The Snerd was suffering. She had inexplicable symptoms. She was not responding to pain medications. The likelihood of extending the length and quality of her life through exploratory abdominal surgery was highly questionable. Surgery in her condition was risky and I expected a difficult recovery. And just because we could do everything medically possible doesn't mean we should.

We will reflect on the many wonderful
 memories we share of GrrrD the Snerd.

Difficult as it was to let GrrrD go, my family decided it was best to alleviate her suffering. I have cried during and after numerous pet euthanasias with clients. Still it took me by surprise the strength of my emotions as I euthanized my own pet surrounded by my family. We all miss her, but we wanted to do what was best for her. I'm grateful for the advice I was offered by my veterinarian friend when making the decision, and now I understand even better why my clients ask me.

In Tribute to Tuffy

Children and pets may keep us young at heart, but their aging is a dramatic indicator of the passage of time. It seems like just yesterday GrrrD and her Canadian brother Tuffy posed in these pre-wedding photographs with their college buddy owners. That was over six years ago. Both men now have established careers and several children apiece. GrrrD is a crotchety senior spaniel, and sadly, Tuffy has passed away.

Tuffy's recent death has been a topic of much reflection in my home this week. He was a beautiful and funny dog, and he touched many lives--internationally!

The strength and endurance of the sibling bond between Tuffy and GrrrD was enchanting. GrrrD (aka "the Snerd") has always been a persnickety female dog. Around other dogs she typically remains aloof, protesting loudly and viciously when another canine crowds her space (luckily she is all bark and no bite). But she loved Tuffy. And amazingly she never forgot him!

On two occasions GrrrD accompanied my husband, oldest son and me to Manitoba to visit our dear Canadian friends and their dog Tuffy. Both times we watched in wonder as GrrrD leapt from the car after the long drive, exchanged a civil sniff with her black-and-white brother and immediately fell into crazy "puppy" play. It was unusually friendly behavior for GrrrD on any account. What makes it even more amazing is that it had been years since the littermates had last seen each other!

The bond between these spaniel siblings was special but not unique. As a veterinarian I've had more than one pet anxiously watch me examine its pal, showing more trepidation than the animal under inspection. I've met numerous dogs and cats who have grieved the loss of a fellow housemate (I don't think they necessarily grasp the concept of death, but loss they certainly do). I find these demonstrations of animal empathy and loyalty remarkable! The relationship between Tuffy and GrrrD has shown me that animal fondness can withstand separation by both miles and years.

Good dog, Tuffy.

This is Garbage Gut

EdGrrr pilfers a cantalope rind

It may seem like a matter of semantics but vomiting and diarrhea are not normal in a dog. They may be common (depending on the dog), but they are not a normal and simply over-lookable occurrence.

Vomiting and diarrhea are common and vague symptoms of illness in dogs (and cats!). Sometimes, like in people, these problems are mild and self-limiting. The causes of innocent short term GI upset range from non-threatening viruses to eating something that "disagrees" with the pet. On the other hand, vomiting and diarrhea can also signal more serious problems such parasite infestation, pain, infection, organ failure, intestinal blockage and cancer!

The good news is that these latter causes are far less common than the former! Dogs, especially those that enjoy moderate levels of freedom in their day-to-day activities, very frequently ingest things that make them barf. To most dogs, edible is an all encompassing descriptive term that includes decomposing animals, poop from just about any other living thing, and refuse--among other things.

Many times, "dietary indiscretion" results in a short bout of decreased appetite, soft stool, and possibly vomiting. But sometimes "garbage gut" produces such severe gastrointestinal discomfort that dogs require veterinary intervention and medications. In the worst case scenarios, a dog's dining habits may result in life threatening pancreatitis or surgery to remove a foreign body!

What do you do if your dog starts having soft stools, vomits or rejects his dog food? You know your dog best. I find that owners are often a good judge of the severity of their pet's illness (denial is, of course, a powerful and detrimental part of medical cases and can unfortunately delay treatment of serious problems). If you are not sure, it's never a bad idea to call your veterinarian and describe your dog's symptoms.

A Happy Ending for a Blind Dog

This past winter I had Lasik eye surgery to correct my terrible vision. Without glasses or contacts I was legally blind. Swimming and sports were a hassle. Staying up too late made my eyeballs scratchy. Since the surgery I have enjoyed the freedom of perfect vision.

Because we humans are so dependent on our sense of sight, we often forget that other animals are not as reliant on it and therefore do not miss it much when it is gone. I recently had the honor of examining a sweet blind Golden/Lab mix named Nellie.* Nellie has Progressive Retinal Atrophy (PRA), a genetic form of progressive blindness that can affect a number of breeds, including Labrador Retrievers. Although only 3 years old, Nellie was nearly euthanized because she could no longer be a decent hunting dog. Fortunately Nellie was sent to a blind dog rescue group and was recently adopted by some dear clients.

A blind Golden/Labrador mix like Nellie

Although Nellie is completely blind, she is attentive, obedient and gentle. In a strange place, she gingerly picks her way around the room and occasionally bumps into objects. Once she has settled in, though, Nellie (like many other blind dogs and cats) will easily maneuver through familiar surroundings as confidently as a seeing animal. When explaining a diagnosis of blindness I often reassure clients that their pet will adapt quite well "as long as you don't move the furniture around." Compared to humans, dogs have poor vision at the best of times. They use their heightened senses of smell and hearing to understand and respond to their environment. Therefore, blindness to a dog is not a complete tragedy.

I have no doubt Nellie will adapt to her new home and be a fine companion for her human family. The real tragedy in this story is that PRA and many other hereditary diseases can be avoided with careful breeding programs. There is a DNA blood test available to determine if potential doggie parents carry the genes for PRA. Most dogs should also undergo Canine Eye Registration Foundation (CERF) examination by a certified veterinary ophthalmologist prior to breeding.

This recommendation comes from personal experience. I nearly made the mistake of breeding our English Springer Spaniel GrrrD. She was a lovely hunting dog, free of obvious defect, and it seemed like a good idea to allow her to procreate! During my veterinary school training, my faithful "guinea pig" GrrrD was diagnosed with retinal dysplasia. Even though GrrrD had adequate vision, any future pups could have been blind. With that knowledge in hand, it was an easy decision to spay her.

Hereditary blindness is dramatic, but thankfully not that common. There are many other more painful and difficult conditions that can be avoided through informed decision making at the time of breeding. Ask your veterinarian for information before breeding. Future pet owners will thank you for your diligence.

*Name changed to protect privacy.