Tuesday, October 4, 2011

Coda

I loved reading May B. Insane's previous post- it was a lot of fun bringing these wonderful dogs to their new sucker, er, person. I see both of them almost every day and continue to be amazed at the personality Maddie displays- hers is truly a complex psyche.

So Insane has been bugging me to blog recently. Since I now work in The Most Boring Job a Vet Can Have I don't really have much good blog fodder. I'm sorry, what can I blog? "Today I saw a few thousand dead pigs..." But as Insane's previous post relates, sometimes we do see or hear of good stories.

On a previous weekend I was in the town I used to practice in and ran into an old client. I had seen her old, geriatric Min Pin named Layla a few months after I started working at that practice in 2008. At that time Layla was about 12, diabetic, and was in end stage congestive heart failure. She had marked ascities, crackles, and exercise intolerance despite being on a high lasix dose, enalapril, and spironolactone. She would hardly lift up her head as I examined her one afternoon.

Now "The Book" calls for an echo to evaluate heart function before placing any animal on any kind of positive ionotropic medicine, and I agree with this. However, as so often in private practice, "The Book" comes up against "The Client Has No Money" and the client with a sick pet will always win. So, while warning Layla's owner about the dangers, I started her on Vetmedin, a veterinary only heart drug that is kind of a mixture of a positive ionotrope and something else I forget right now... (this is what happens when you don't use information- it floats away).

Two months later this dog was eating and barking again. Against all odds she had improved that much. Now, three years later she is 15 years old and on a cornucopia of medications daily but runs, barks, eats, plays with her sisters, and is a happy dog. I have Layla's owner much more time than she could ever hope for. Sometimes that's a nice feeling.

2 comments:

The Homeless Parrot said...

Vetmedin is a wonder drug! I start all ER CHF patients on it, echo be damned.

And for the record: it's a phosphodiesterase inhibitor that sensitizes the heart to calcium :)

Can'tSpell, DVM said...

LOL- Thanks! ;)