Looking at the whole picture… again

In yesterday’s post I talked about the importance of looking at the whole patient, regardless of what the client believes is the most pressing problem.  Talk about karma. 

Matrix_muzzle__2_ Today, little Matrix here was scheduled for an exam and evaluation because he had been having seizures.  When a patient has had episodes that we suspect could be a seizure disorder, we start with a careful history.  What did the episodes look like, what else was going on, how long did they last, how long did it take to recover?  Then a physical examination is in order to check for any problems that might bear on the situation.  Next we do some screening blood tests to look for obvious problems in liver function, kidney function, blood sugar or any other area that might be contributing to the problem.

You might think from the picture that Matrix was hard to deal with and that’s why he’s wearing the cute little red muzzle.  You’d be wrong, though.    In the process of his physical exam, I found that his left mandible was fractured.  He had a broken jaw and his owners didn’t even know it.  They had noticed that he was a little touchy in that area for the last week or so. (They have several big dogs, one of which probably is the author of the injury).

After consulting with a veterinary dental specialist, our best option proved to be limiting the jaw mobility by wearing a loose-fitting muzzle (and eating a liquid diet).

I can tell you that dealing with a fractured jaw is not usually part of a seizure-disorder evaluation.  Amazingly enough, this is another example of how we get behind schedule.

By the way, the bloodwork was normal, but he really is having seizures.  We’ve started him on medication to suppress the seizures…liquid medication.

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