MAGGIE: the dog who changed my life

MAGGIE: the dog who changed my life
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Friday, June 19, 2009

Advocate for Your Pet: Misdiagnosis Happens!

Let me start by saying that my dog, Maddie, is the picture of health, except for some environmental allergies that manifest as itching. But in the past seven months Maddie was misdiagnosed twice with two different serious health problems, by two different well-meaning veterinarians.

Maddie's allergies were bad last summer and fall, and I was trying to avoid giving her Prednisone. In addition to diet changes, I took her to the Dermatology department at Colorado State University and reluctantly began Maddie on allergy shots, which I gave under the skin in the back of her neck.

Now one lesson I learned the hard way with Maggie, our previous black lab, was to always bring my intuition to the table when obtaining the advice of an expert, such as a veterinarian, regarding her health. With each allergy injection I gave Maddie, I noticed my incongruence. I didn't feel this was the way for her. But I wasn't sure what else to do right then.

About one month into the allergy injection regime, Maddie barked one day and immediately screamed in pain. I was shocked and frightened. I thought she must have a stick lodged in the back of her throat, or an infected tooth. I also noticed her hesitancy to yawn fully. To our vet we went, a man I really like. When I explained her symptoms, he nodded, told me I wouldn't like what he was about to do, and opened Maddie's mouth wide. Of course, she wailed, and I held her close to comfort her.

"Maddie has immune-mediated masticular myositis, an inflammation in the muscles of the jaw that go up into her head," he told us apologetically. "That's why opening her mouth is so painful. Her response to my opening her mouth is classic for this disease. We can also do a blood test which will be positive if she has it."

I ached to hear this. "How do you treat it? Will it return?" I asked anxiously.

"With massive doses of prednisone, tapering over 6 months." Her best chance to be out of pain was to get the inflammation down. Our vet wouldn't say it would definitely return even if brought under control, but indicated it sure was a likely possibility, and I knew chances were it would if it were truly an immune-mediated disease.

He knew how I'd resisted treating Maddie's allergies with Prednisone, and how much I'd hate this treatment plan. But I couldn't let her be in pain.

"Is there any chance this was brought on by the allergy shots?" My feeling was that this is what had precipitated this "attack" on Maddie's muscles.

"No," he said without a trace of doubt.

My gut told me otherwise. My gut knew we needed to stop the allergy injections. We left with the dreaded Prednisone & began it immediately. I also made an appointment with another vet who does an energy treatment called Bicom, and left for Texas soon after Maddie was treated. This vet did think, as I did, that it was likely that Maddie's myositis was due to the allergy injections.

The bottom line is that Maddie was only on Prednisone for 12 days in total, including the wean. I threw the injection vials in the garabage & Maddie never received another shot. (I never heard back from CSU when I left a message in the Dermatology department asking if this reaction ever occurred with allergy injections). I believe the Bicom helped Maddie's allergies and her rapid healing from the myositis tremendously, (the climate change helped alleviate her itching, too).

Oh, and Maddie's test for immune mediated masticular myositis came back negative.

Please don't think I'm advocating to not give your dog allergy injections. They do work for some dogs, and most dogs will probably never have the reaction Maddie did. What I am encouraging is that you tune in to your intuition regarding your own pets, and whether a diagnosis and/or treatment feels right to you for that pet at that point in time.

Life continues to show me with my animals how important it is to advocate for our pets with their veterinarians, especially when our gut tell us something different is happening. Our animals can't talk, which makes a veterinarian's job tough. Vets are human, and we need to keep in mind that our close bond with our animals may allow for information to pass between us at a sixth sense level that the vet may not have access to. If a diagnosis regarding your pet doesn't make sense or feel right to you, don't hesitate to speak up and ask questions. Let your vet be yours and your animal's partner in health, while you remain your animal's top advocate. Remember, no one knows your precious animal souls like you do!

Stay tuned for Maddie misdiagnosis #2 in an upcoming blog post.

Posted By:

Dawn Kairns
Author of MAGGIE: the dog who changed my life


Ingrid King said...

I'm so glad you followed your intuition when it came to Maddie's diagnosis, and that you're sharing your story. It can be really difficult for a lot of pet parents to do this when faced with the presumably expert advice of a veterinarian.

I ran into this when I had to take Buckley to an emergency clinic. You'll find the full story in "Buckley's Story - Lessons from a Feline Master Teacher,", but for the purpose of this comment, the short version is that she had been lethargic all day, I couldn't get a hold of her regular vet, her gums were pale towards the end of the day, which of course, was a Friday (I think there's a law that says all animal emergencies happen on Friday nights or on weekends!), so against my better judgment, I took her to the ER. By the time we got there, she seemed better and was very vocal about protesting the blooddraw that, given her presentation, made total sense.

However, the results did not. The vet told me she had a dangerously low platelet count and was at risk for bleeding out and that I should leave her at the ER over the weekend until she could be worked up by their internal medicine department on Monday. When I asked what they would do for her over the weekend, I was told they would simply observe her. I knew with every fiber of my being that not only was this diagnosis wrong, but that leaving my little cat at the ER all weekend long was the wrong thing for her. I checked her out AMA - a lengthy process that involved being told repeatedly that Buckley could die at any moment, followed by having to sign a multitude of release forms before we were finally allowed to leave.

Diagnostics with her regular vet on Monday followed by a cardiac ultrasound later in the week showed that she was in congestive heart failure. Even though it made for a worrisome weekend, I never regretted my decision to follow my intuition and take her home with me that weekend - and she lived another happy seven months after this episode.

We are the ones who know our pets best, and to me, the measure of a great veterinarian is one who doesn't dismiss these intuitive hits from pet parents. I've been fortunate that all my regular vets have been open to listening to me, even when my intuition seemed to run counter to what seemed medically appropriate. We are our pets' best advocates!

retriever farm said...

Poor Maddie. I have used allergy injections on a very limited basis in my office, never seen a reaction like that, good to know I'll keep it in my thoughts. Sometimes it is hard to get the vets to be more open minded. I feel that way about foods and spaying and neutering. I have seen some sides effects from these things, but for most people commercial easy dog foods and definately spaying and neutering are the way to go for most people. However not all those things ring true for my animals. Trust your gut, you know your dog better than anyone else.

Dawn Kairns said...

I'm so glad you followed your intuition with Buckley, also, Ingrid. I agree that it can be difficult for pet parents to do so when faced with veterinarian advice. I've been there...

Were Buckley's platelets low because of the heart failure? I sure understand your choice to take her to the ER -- I'd have done the same.

Asking, as you did, what they'd do for Buckley if you left her, was great to do -- some folks just don't think to ask the questions that can help them make a better decision, and place the trust outside of themselves. I did that once with Cinnamon and really regretted it. Bless all those fibers in your being that knew what to do! Now you can hopefully look back more peacefully because of your choice to follow your gut and keep Buckley with you.

Thanks for sharing your story with Buckley so folks will know what lengths they may have to go to to go against medical advice.

I'm sure her congestive heart failure diagnosis broke your heart, but I bet you made those last seven months with Buckley the best ones of your lives together.

I so agree that the measure of a great veterinarian is one who doesn't dismiss our intuitive hits.

Dawn Kairns said...

Thanks for your compassion for Maddie. She has been through a lot in her 3 years with us!

I know my vet hadn't seen this before, either. It just makes you realize each animal may have adifferent response, just like humans.

Thanks for staying open to this reaction in your office! I have my feelings re: commercial pet foods which I'll probably share on my blog at some point. I'm a big believer in spay and neuter, unless, of course, you are a good breeder like yourself, and are promoting the best in our wonderful retrievers!

Thanks for sharing with us!

Ingrid King said...

Dawn, Buckley's platelets were never low - it was lab equipment error. I was fortunate to know that this particular test is hard to run and often comes back with inaccurate results, especially on the type of equipment veterinary clinics have at their disposal. When the test was run at a major lab a day later, it came back normal.

Buckley had had a history of heart disease prior to this ER episode, which made the misdiagnosis even more upsetting at the time.

Dawn Kairns said...

Wow, that's an eye opener that Buckley's platelets were never low-- glad you knew that re: the equipment, Ingrid. You sure didn't need that concern along with dealing with her heart disease diagnosis. I'm so sorry you had to go through that. I know you still miss her very much.