Second opinions via the Internet

I have posted on this once before, but I believe it bears re-visiting.  Lately I have had quite a few readers asking for advice on their personal pet’s problem.   These are folks who have been doing an internet search about their pet’s problem and accidentally arrived at my spot here.  I’m glad that they feel they have been helped enough by my information to ask for my opinion.  The thing is, I’m still limited to giving general advice and information; I still haven’t perfected the psychic abilities that would allow me reach out and get in touch with the problem over the ether.

This is a particularly difficult situation when I am asked to second-guess the doctor who is actually seeing the pet.  Chances are, he has some information about the case that I don’t have.  My goal would be to actually help the client and the pet’s regular doctor by opening a common ground for communication about the situation.

Pope If you’re reading this, you know that when you search the internet, you can find that your search expression will yield an awful lot of results.  It’s difficult to know which one to trust when they are in conflict.  What is it that makes a reliable site?  If I wanted to put up a site that says the Pope has three illegitimate children and won’t pay alimony, I could do it.  It would be utter rubbish, but you could "find it on the internet".  I can tell you that there many doctors who dread nothing more than "…I’ve been researching this on the internet."  People who are perfectly reasonable and intelligent in other respects will bring in a print-out that just makes no sense whatever and wave it about like a talisman.

I’m happy to answer your questions as best that I can.  If I’m not as specific as you would like me to be, at least you’ll have something that’s a discussion point for you and your pet’s doctor, and I don’t think it will make him/her crazy.  That is a positive point.  So keep reading, and keep those emails coming.

6 thoughts on “Second opinions via the Internet

  1. Karen regarding Garth says:

    I have a 15-year old yellow lab/husky mix. Back legs have been weak for last 3 years, but in mid-October, woke up to him not being able to get up (happened 3 years ago, briefly put on steriods, and he was back to normal, still tough to get up, but walking great for a “100-year old dog”). After 10 days in emergency care, tests revealed he had a degenerative myelopathy and liver results not “up to par” and put on prednisone (which we had asked for from the onset) and in 3 days he bounced back and was sent home on October 17. Had been doing great until an onset of diarrhea (no blood) this week – November 14. Now on day 5 (not constant, as I have given him pepto-bismal, rice, chicken – but as of this morning still diarrhea when he has a bowel movement – which is about 3-4 times day/night). Would any of these medications or a mix of them, suddenly cause diarrhea after being on them for over a month? Our vet couldn’t see any reason. . .
    Prednisone – 10mg 2x/day
    Tramadol – 50mg 2x/day
    Famotidine – 10 mg 1x/day
    Zentonil – 400 mg 1x/day
    Potassium Bromide – 1-1/2 ml 2x/day
    Thyro-tabs – .2mg 2x/day
    Baytril – 136mg 2 at 1x/day(was on for 1 week – finished on Nov. 8 – given because of stoma and possible infection with all the urinating due to prednisone)
    Regular food is Science Diet W/D – so his stool is usually alot (such the case with W/D)but always firm and solid.
    He is drinking and eating well (always has, both has never stopped over any period – hospital or home). Seemed weak during the onset of diarrhea, trouble getting up in the morning – definitely needs help, but once up walks,goes through dog door, and gets up on own during the day . . . How can I knock this thing out of him – I thought constipation was a possible side effect of tramadol, but now I am confused . .
    Any advice would be most appreciated. Thank you in advance from Garth and me.

  2. Doc says:

    This is a very challenging case. You already have come to grips with the fact that Garth has passed the first flush of youth. He also has a progressive degenerative disease for the treatment is palliative, not curative.

    Your doctor on the scene seems to be doing a very thorough job,

    I get the impression that Garth has been on this combination of meds for some time. While none of them are considered particularly bad about causing diarrhea, it is possible that somehow the combination is doing so. On the other hand, it is also possible that Garth has developed a new disease process.

    Pepto-Bismol inhibits bacterial growth and slows down the secretion of fluid. Thus, it should be helpful with a dog who has a fluid stool, but not necessarily frequent stools and straining. Imodium, by contrast, increases rhythmic segmentation of the bowel, basically slowing it down and relieveing cramping. Imodium would be better if you had emptied your colon but were still cramping and straining. From your description, the Pepto sounds more appropriate.

    You are already feeding a high fiber diet. Sometimes it helps to switch to a low-residue, more digestible diet like I/D and adding metamucil (1 tsp/20 pounds body weight per feeding) for the fiber.

    Non-specific treatment for colitis can also include metronidazole. This is an antibiotic that kills bacteria that thrive without oxygen, and it has an anti-inflammatory effect on the bowel wall.

    That being said, you do have to consider that there may be a new disease process that won’t be diagnosed without colonoscopy and biopsy. It also may be something that has to be managed, rather than cured.

    Again, your doctor on the scene seems to be doing a very thorough job, and I recommend that you share your concerns with him/her.

    This website has some handles and harnesses for helping these big old guys to get around:

    Good luck in helping your friend to have a good quality of life at this difficult time.

    Thanks for reading and writing.

  3. Doc says:

    Hello, Angela,
    Take a look at the posts on Aural Hematoma. I cannot really advise you as to how to treat a dog that I have not seen.

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