A weekly column for 25 years about vets and pets
I wrote my first column for this newspaper in April 1995, which means I’ve been writing it every week for twenty five years now.
So perhap it’s a suitable time to reflect on what we vets actually do when we go to our clinics every day to look after pets.
Diagnosis is the most critical area, and the main reason why vets need to go to college for five years. First, we need to learn all about normal health. Then we need to learn about the myriad ways that disease can affect normal health. And finally, we are taught how to work out what, precisely is wrong, and why it has gone wrong i.e. we need to make a diagnosis.
One recent case provides a good example of the importance of a diagnosis.
A dog was brought to me that had been coughing for a few weeks. The cough was getting worse, so this was an urgent case. In this era of trying to reduce physical contact, it was tempting to give the dog a general treatment for a cough: this might include an anti-lungworm dose, and antibiotics for an upper respiratory infection. However, I know from experience that there are many other causes of coughing that require a different approach, so I arranged to examine the dog. And as soon as I placed my stethoscope on the dog’s chest, I knew what was wrong. The dog had a loud heart murmur, and his heart was racing along far faster than normal. To complete the diagnosis, I had to take chest xrays and carry out an ultrasound examination to see a three-dimensional view of the heart beating, but the key fact remained: the dog’s cough was caused by leaky heart valves, and he needed specific medication to stop fluid building up in his lungs. Within 48 hours of starting the medication, his cough had completely cleared up. The case is a classic example of the importance of an accurate diagnosis: it would have been impossible to give him the correct treatment by just guessing what might be wrong.
Deciding the correct treatment is just about as important as making the correct diagnosis. I remember a case a few years ago of a dog that had been recently imported from Poland.
The dog had developed a high temperature and had stopped eating, and at the first visit to a vet, he had been diagnosed with anaemia. He had been given treatment for the most common causes of anaemia in Ireland but he wasn’t improving. When I saw him, something didn’t add up: why was this dog not responding in the usual way? An extra blood test, sent to a specialist laboratory, came up with the answer: the dog had an unusual form of anaemia caused by a tiny blood parasite carried by exotic ticks. And on close questioning, the owner responded by saying that yes, they had found a tick on their dog back in Poland. This blood parasite is never normally seen in Ireland, so it wasn’t easy to find the right treatment at short notice. In the end I had to use a cattle drug, given in a tiny dose. There was nothing else available, and the dog was worsening by the hour. So he had just one tenth of a teaspoonful of this particular treatment, injected into his vein on just one occasion. The effect was remarkable: within hours, he brightened up, became more active, and developed an appetite. Within just a few days, he was completely back to his normal cheerful self, and blood tests confirmed that his anaemia had responded, and his blood count was rapidly returning to normal. This case was a dramatic example of the absolute need to give the correct treatment.
Sometimes medical treatment is not needed, and a surgical approach has to be used instead. Again, it is critically important to use the correct surgery at the right time. These days, specialist surgery is only done by vets with years of extra training and finely honed skills. But I’ve been qualified for 35 years, and when I was younger, there were no specialist surgeons available. Vets with good general surgical training often had to do their best to care for their patients. I remember one particularly remarkable surgical case.
A ten year old terrier who developed severe heart failure: xrays showed that he had fluid gathering around his heart. The only way to save him was a technique called pericardectomy, where the membrane bag surrounding his heart was dissected out, so that fluid could no longer gather inside it. This was major surgery, opening into the dog’s chest, with all the risks that this entailed. However the dog was dying, and there were no surgical specialists available, so I had to do the operation. In the end, it went well, and the dog made an excellent recovery, with several more good years of life. These days, I would definitely refer a case like this, but it was a good example of the remarkable impact of the right surgery being done at the right time.
Diagnosis and treatment of disease are vets’ key skills. But there is one more area that’s equally important: the prevention of disease. This includes advice on breeding healthy young animals, using medication to prevent life threatening parasites, giving vaccines to prevent deadly viral infections, suggesting optimal nutrition to promote good health, and giving general lifestyle advice to keep pets fit and healthy.
Preventing, diagnosing, and treating disease in animals: that’s what the job of a vet involved 25 years ago, and it’s just the same today. Some things don’t change.