Dog experts: Good visit or second opinion?

[LisaR]

I took my dog to a new vet today. The staff was wonderful and the vet was nice. However, the vet didn't do a whole heck of a lot, IMO. Maybe I'm wrong, though, so I would like some other opinions.

Here is the history I gave to the vet. Recently, he seems to trip over his front paws when walking. There isn't any pain when we move his legs and there aren't any lumps. He had a day this week when he couldn't jump up on the furniture like he normally does. He would just walk over to the sofa and whine until we picked him up. One day last week, DH picked him up and he made a horrible yelping sound. We rubbed him all over and moved every body part and couldn't find the source. He seems to lay in funny positions lately. He is eating fine, bathroom habits haven't changed, and nothing else seems noticeably out of the ordinary. He has lost two to three pounds (depending on the scale) over the past few months. We have changed up his food so that could be the reason but I don't know.

The vet looked in his eyes and ears and listened to his heart. He was panting and she said his teeth need to be clean. They do but she didn't actually open his mouth or check his gums except to view what she could while he was panting.

She only recommended blood work because it was mandatory for teeth cleaning. I got the impression she wouldn't have run it otherwise.

It came back with a slightly elevated BUN (34) and creatinine (1.5). She said that those numbers are only slightly elevated so she isn't worried about kidney problems at this point but wants him to go on kidney prescription food just in case. They sell it there are the vet.

In addition, she said he has arthritis that is starting to set in. This was apparently determined from his history because she never felt his body for any lumps or painful areas and she didn't order any x-rays. She did recommend three different arthritis medications that they happen to sell right there are the vet.

$170 later and I'm not really sure my dog received a good check-up or the correct diagnosis. Does this sound like a typical exam for a dog with the issues I described? I really hate to plunk down more money for the same opinion. I don't think arthritis is out of the question but I just thought she might do something more to determine that.

 

[minkydog]

Gosh, that wouldn't have reassured me either. I think I might want a second opinion before I started him on a bunch of meds. See if you can get a copy of the bloodwork too, so it doesn't have to be redone.

 

[BearcatsFan]

ITA. Get a second opinion. Of COURSE they sell the food there at the vet, so naturally they want you to put your dog on it ... just in case.

I'd get a copy of that bloodwork and march my dog to another vet.

 

[daughter_of_amid_chaos]

My cat was diagnosed with stage 2 kidney failure about a month ago. My vet made sure I knew every test that was being done and what he thought it probably was (diabetes). He spent over 30 minutes with me and the cat going over everything as he checked her out.
After the test came back with kidney failure, he spent about 15 minutes with me on the phone telling me what needed to be done and had me bring her to the vet asap for further testing. A few days after that testing I got another call from my vet going over everything again and asking if I have any questions.

So I would say definitely get a second opinion. Kidneys are not something you want to mess around with and if your gut is telling you that the vet didn't do enough, follow that instinct. You know your pet better than anyone else and can tell when something is off. My instinct of that is the reason my cat's kidney failure was caught so early.

I hope everything works out for you and your doggy!

 

[Pea-n-Me]

What kind of dog is he and how old?

 

[LisaR]

What kind of dog is he and how old?

Miniature schnauzer and 9.5 y/o.

 

[Pea-n-Me]

Why did you see a new vet? I would say it wasn't a great visit because you seem mistrustful of the vet.

I think the kidney issue is something to be concerned about. Older dogs are prone, and so are Mini Schnauzers. According to the International Renal Interest Society Classification of Stages of Kidney Disease, your dog is in Mild Renal Azotemia if those numbers are correct.

TABLE 02: International Renal Interest Society Classification of Stages of Kidney Disease

Stage I II III IV Creatinine (mg/dL)

Stage I Nonazotemic Kidney Disease <1.4

Stage II Mild Renal Azotemia 1.4-2.0

Stage III Moderate Renal Azotemia 2.1-5.0

Stage IV Severe Renal Azotemia >5.0

creatinine (1.5)

Since it is still early stage, I'd see what steps you may be able to take now to help slow the progression of the disease. But I'd do it with another vet and have those numbers repeated in another month or so.

More info: http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/130603.htm

BTW, I saw this also but lost the link. It could help explain some of the things you've seen with your dog. (But arthritis could be partly to blame as well, and he could be laying in different positions if he's in pain.) Anyway, something to learn more about and keep an eye on.

If you dog is suffering from canine kidney disease, he will show a variety of symptoms. The most common include dehydration, increased water consumption, and frequent urination. Your dog may also have discolored teeth and a loss of appetite. Other symptoms of canine kidney disease are muscle weakness, mouth ulcers, shivering, and diarrhea.

If you decide to give this vet another chance, have her talk more to you about kidney disease, like daughter_of_amid_chaos's vet did. If not, find someone else who will be more attentive to it and will help educate you.

I sort of don't mind the vet selling me products because mine's not pushy in any way and I figure he's doing me a favor having them there available for me to buy if I need them. (I used to have to get prescription food for one of my dogs.) Otherwise it would be more work for me trying to either make special food or find it somewhere else, kwim? Same with medications.

 

[LisaR]

Thanks for the info, Pea-n-Me! Very interesting.

The vet we have been using retired. They have a new person and my friend went to him and said he had a terrible bedside manner so I decided to try a completely different place.

It wasn't that I didn't like the vet. She was really nice and the people working there were beyond nice. I thought she jumped to the arthritis conclusion without any testing. I didn't get any justification for giving him 3 different pills multiple times a day. I thought an X-ray would be pretty standard and I at least thought she would move his limbs around a bit and make it look like she was checking for arthritis.

 

[calypso726]

Get a copy of your dog's bloodwork and I would immediately switch vets.

 

[LuvsDragonflies]

I would take the dog to another vet, get all the workups and history they have. SOunds like she's in the business of selling. It's a big deal, they make a LOT of their money having you buy the crap they sell.

 

[Pea-n-Me]

The vet we have been using retired. They have a new person and my friend went to him and said he had a terrible bedside manner so I decided to try a completely different place.

It wasn't that I didn't like the vet. She was really nice and the people working there were beyond nice. I thought she jumped to the arthritis conclusion without any testing. I didn't get any justification for giving him 3 different pills multiple times a day. I thought an X-ray would be pretty standard and I at least thought she would move his limbs around a bit and make it look like she was checking for arthritis.

Ah, ok. I am dreading the day my vet retires! We have had a great relationship for over 20 years. The old-school vet we had prior to him wouldn't allow us to stay in the room while our dog was put to sleep so we had to find a new vet at what was a very stressful time, i.e. in the very late stage of bone cancer. We subsequently found a nice, young vet to come to the house but later, when we got a new puppy, he was gone. (Apparently a moonlighter.) So I went searching again.

The first question I asked our new vet (which must have seemed pretty strange with a puppy in my arms) was what his policy was about putting dogs to sleep. He replied that 90% of his house calls were for euthanization, and he's even put animals to sleep in the back of cars if that's what was best for the animal. That told me a lot about him right there, i.e. that he was open and not rigid like our last guy had been. I like open. I know not everyone is like that and I was fortunate to have found someone that I was able to work well with. Yet I've met others who don't like him...

My point? I'd say give the vet who took over from your vet a chance. Don't go by someone else saying his bedside manner stunk. They might have just had a personality clash, or maybe he was having a bad day, etc. It could be that you and the new vet get along famously. At minimum, your records are there and your dog is used to going there. (Which is huge, imho.) Consider letting him see you through these last years with your current dog. If it turns out your really dislike him, it gives you time to talk to people and research other vets in the meantime. Of course, once you meet him if you decide it's not going to work, you can still always make a change.

 

[Pea-n-Me]

Arthritis in the veterinary world is sort of like the sore throat in the pediatric world, or GERD in the human adult world. Very common.

Vets with experience become intuitive about it, just like pediatricians and primary care physicians do. Vets also have the added complication of people having to pay out of pocket for care and testing, and many don't want to do but the bare minimum for their pets, something they always have to consider.

My experience in having 6 dogs with arthritis through the years, is that they don't always do a lot of poking and prodding, or radiographs for arthritis. Arthritis on XRay is often one of those things that come up when they're looking for something else.

There comes a time in a dog's life when you just know that arthritis is setting in, given the age, size, description of the problem and such. Trying out a medication is fairly common because if it helps, it kind of verifies the diagnosis, and it solves the problem of avoiding expensive testing and exposing the pet to radiation, etc. If it doesn't help, then you move on to looking for other causes.

Pets today are fortunate to have some of the medications today available for them that weren't available years ago. There is still a hesitation about using them for a variety of reasons - they can cause other problems, they're expensive, misunderstanding about pain, etc.

XRays don't always tell the whole story. (It's too bad our pets can't talk to tell us what's wrong.) I recently had XRays for hip pain and was diagnosed with arthritis myself. Funny thing, though, the pain is greater on the right side (and gets absolutely horrible with rain coming or full moon cycles ) yet my XRays showed more arthritis on the left, which really doesn't bother me. I also have days when I have little to no pain at all. Go figure. All I can say is THANK GOD FOR MOTRIN when the pain is bad!!!

I think that many of us think of arthritis as a disease of the elderly, but in reality, it starts in mid-life - for some more than others. It's one of those things that you can't appreciate how painful it is unless you have it yourself.

I don't know why 3 medications were recommended for your dog (unless it was something like glucosamine/chondroitin along with an NSAID) but I would give it a try. You may see a big difference in your dog. I buy the G/C at Trader Joes, which makes chewables for dogs. You might see how the prices compare.

 

[rascooby]

I would start the dog on Cosequin for arthritis. It's not preseciption and if you shop around, you can get a pretty good price. You can get it at Petsmart too, just not for super cheap. Our Sheltie got really crabby as he got older, and I finally realized it might be pain. The Cosequin helped so much. He was like himself again. I also used it for our Great Dane and it worked well for him too.

I would probably have the bloodwork done again in a month or so. I don't like vets who push their products, so I'd probably look for another one.

 

[Soldier's*Sweeties]

Arthritis in the veterinary world is sort of like the sore throat in the pediatric world, or GERD in the human adult world. Very common.

Vets with experience become intuitive about it, just like pediatricians and primary care physicians do. Vets also have the added complication of people having to pay out of pocket for care and testing, and many don't want to do but the bare minimum for their pets, something they always have to consider.

My experience in having 6 dogs with arthritis through the years, is that they don't always do a lot of poking and prodding, or radiographs for arthritis. Arthritis on XRay is often one of those things that come up when they're looking for something else.

There comes a time in a dog's life when you just know that arthritis is setting in, given the age, size, description of the problem and such. Trying out a medication is fairly common because if it helps, it kind of verifies the diagnosis, and it solves the problem of avoiding expensive testing and exposing the pet to radiation, etc. If it doesn't help, then you move on to looking for other causes.

Pets today are fortunate to have some of the medications today available for them that weren't available years ago. There is still a hesitation about using them for a variety of reasons - they can cause other problems, they're expensive, misunderstanding about pain, etc.

XRays don't always tell the whole story. (It's too bad our pets can't talk to tell us what's wrong.) I recently had XRays for hip pain and was diagnosed with arthritis myself. Funny thing, though, the pain is greater on the right side (and gets absolutely horrible with rain coming or full moon cycles ) yet my XRays showed more arthritis on the left, which really doesn't bother me. I also have days when I have little to no pain at all. Go figure. All I can say is THANK GOD FOR MOTRIN when the pain is bad!!!

I think that many of us think of arthritis as a disease of the elderly, but in reality, it starts in mid-life - for some more than others. It's one of those things that you can't appreciate how painful it is unless you have it yourself.

I don't know why 3 medications were recommended for your dog (unless it was something like glucosamine/chondroitin along with an NSAID) but I would give it a try. You may see a big difference in your dog. I buy the G/C at Trader Joes, which makes chewables for dogs. You might see how the prices compare.

I agree...If it is a vet who has been in work for a while she may have the experience to dx the dog without much testing.

I work for a vet and most of our patients are there for arthritis and dental cleaning!

But, just like with anything else, if you're not satisfied, get a second opinion. Best of luck and I hope your doggie feels better soon!

 

[LisaR]

Pea-n-Me, thanks for all the great information! You have given me a lot to think about. My first step is to pick up a copy of the blood work just so I have it for my records. I want to look it over and make sure I didn't misunderstand the numbers. In talking to my DH, he suggested I call around and just talk to a few other vet practices in our area and see what kind of vibe I get. I need to find a place I have confidence in since this dog is older and will obviously have some health issues we will have to deal with. Plus, I have a spunky 3 y/o that has a long life in front of her unless I strangle her before then.

I'm also going to go dog bed shopping this weekend. My dogs don't really have one. We have a small one where we throw their toys to get them out of the way and we have big fluffy blankets in a crate that the younger one uses at night and the older one can use during the day but rarely does. When he couldn't get up on the sofa last week, I took a cushion off and put it on the floor so he could lay on it while I was out. Time for a nice dog bed.

 

[Soldier's*Sweeties]

Pea-n-Me, thanks for all the great information! You have given me a lot to think about. My first step is to pick up a copy of the blood work just so I have it for my records. I want to look it over and make sure I didn't misunderstand the numbers. In talking to my DH, he suggested I call around and just talk to a few other vet practices in our area and see what kind of vibe I get. I need to find a place I have confidence in since this dog is older and will obviously have some health issues we will have to deal with. Plus, I have a spunky 3 y/o that has a long life in front of her unless I strangle her before then.

I'm also going to go dog bed shopping this weekend. My dogs don't really have one. We have a small one where we throw their toys to get them out of their way and we have big fluffy blankets in a crate that the younger one uses at night and the older one can use during the day but rarely does. When he could get up on the sofa last week, I took a cushion off and put it on the floor so he could lay on it while I was out. Time for a nice dog bed.

A good bed can make a world of difference to an arthritic dog. Just like with a human, a well made bad can take pressure of of the joints. For the little guy I would say ground level is fine. If your other dog is a larger one(sorry I didn't see what breed) I would think about a slightly raised be. Not high enough where he's jumping, but at a level where he doesn't have to lift himself from floor level.

They also have heated ones now(I wouldn't use a regluar heating pad).