feemandvm

I couldn't agree with you any more!

I really hope you mean pain medications only. There is no good reason to use antibiotics for a spay unless you are not using sterile technique or unless the uterus was infected or a dental was done at the same time. Pain medications should without question be prescribed with a spay as it is a painful procedure 100% of the time.

I would get the hound to Ohio State's Greyhound clinic ASAP!!! The dog likely needs a liver aspirate or biopsy to determine the cause so the most appropriate treatment can be started. They can call OSU at 614-292-3551.

As for actually filing for malpractice... this is a decision that you need to take very seriously. You will be jepordizing the vet's license (although if they did nothing wrong they won't lose their license) and you will likely be ending your relationship with this clinic. If a client of mind came in on emergency and saw one of my associates and received what I believed to be a good quality of care and there was a complication and the owner sued them... I would not see them myself again. If I felt that the care the animal received was not appropriate than obviously that would be a different situation. What about getting copies of your records from the vet that did the surgery and asking the vets at teh ER clinic to review them and find out from them if they think the "Standard of care" was used. They know how sick your dog was and with your records they'll know exactly what was done by the surgeon.

If she didn't enter into the intestines or stomach then systemic antibiotics are not indicated. For an infection to develop there either: 1. The underlying cause which resulted in his vomiting originally resulted in infection and was unrelated to surgery 2. A break in sterile technique occurred. If an incision was made into the stomach or intestines then systemic antibiotics are warranted as it can no longer be considered a "clean" surgery. I don't know how to interpret the "tear thing" as without seeing it I can't comment about it. Regarding antibiotics and dental cleanings. There are actually many board certified specialists that no longer recommend antibiotics following a routine dental cleaning. I still use them personally but the standard of care may be changing in that regard.

Share these abstracts with your vet. Also... send the sample to Michigan State's lab and request an interpretation. Personally I would avoid Hemopet. Thyroid Function Testing in Greyhounds Sm Anim Clin Endocrinol 12[1]:4 Jan-Apr'02 Review Article 0 Refs C.B. Chastain, DVM, MS, Dipl. ACVIM (Editor) & Dave Panciera, DVM, MS, Dipl. ACVIM (Assoc. Editor) Sm An Clin Endo Gaughan KR, Bruyette DS.; Am J Vet Res 2001; 62:1130-1133 BACKGROUND: Thyroid function tests are frequently evaluated in greyhounds because of alopecia, infertility, and poor race performance. In most cases, hypothyroidism is not present, despite the finding of decreased serum total thyroxine (T4) concentrations. Sight hounds, including greyhounds and Scottish deerhounds are known to have serum T4 concentrations lower than other breeds of dogs. This can result in an erroneous diagnosis of hypothyroidism. SUMMARY: Basal serum T4, free T4 (fT4), and the serum T4 and fT4 response to thyroid-stimulating hormone (TSH) administration were evaluated in a group of healthy pet dogs and in two groups of healthy greyhounds. All pet dogs and 56 greyhounds had serum T4 and fT4 response to thyrotropin-releasing hormone (TRH) administration evaluated. Serum concentration of endogenous canine TSH (cTSH) was measured in 18 pet dogs and 87 greyhounds. The pet dog group consisted of 19 dogs of various breeds (no greyhounds), with a mean age of 5.2 years. One group of greyhounds consisted of 37 female dogs with a mean age of 1.4 years that were actively racing and currently receiving testosterone for suppression of estrus. The second group of greyhounds consisted of 61 dogs with a mean age of 4.9 years that were not receiving testosterone. Greyhounds receiving testosterone were significantly younger than those not receiving testosterone and pet dogs. Of the greyhounds not receiving testosterone, none of the females (n = 35) were racing, while 10 of the 26 males were actively racing. No dog had received thyroid supplementation, glucocorticoids, or anabolic steroids with the exception of testosterone within 3 months of study. The mean basal serum T4 concentration was significantly lower in the greyhound groups than in the pet dog group. The mean basal serum fT4 concentration was significantly lower in the greyhound groups than in the pet dog group. The mean serum T4 response to TSH was significantly greater in pet dogs than in greyhounds either receiving testosterone or not. Greyhounds receiving testosterone had significantly higher serum T4 concentrations post-TSH than greyhounds not receiving testosterone. While there was no difference between the mean serum fT4 concentration after TSH administration in pet dogs and greyhounds receiving testosterone, the fT4 concentration in greyhounds not treated with testosterone was significantly less than the other groups. The mean serum T4 concentration in response to TRH administration was significantly lower in both groups of greyhounds than in pet dogs. The mean serum fT4 concentration after TRH administration was significantly lower in greyhounds not receiving testosterone than in greyhounds treated with testosterone or pet dogs. Mean serum cTSH concentrations were not significantly different between any of the three groups. The reference ranges for all greyhounds were established as basal concentrations of T4, fT4, and cTSH were 2.1 to 37 nmol/L, 1.3 to 32.2 pmol/L, and 0.03 to 1.3 ng/ml, respectively. The authors concluded that greyhounds have a lower reference range for serum T4 and fT4 concentrations than that of other breeds. CLINICAL IMPACT: This study shows that serum T4 and fT4 concentrations in greyhounds are considerably lower than in non-greyhound dogs and clearly demonstrates the difficulty in diagnosing hypothyroidism in this breed. The lower limit of the reference range for T4 and fT4 concentrations in greyhounds is near the lower sensitivity of the assays. Therefore, it may be impossible to establish a diagnosis of hypothyroidism based solely on these hormones. Because the serum TSH concentration was similar to that of other breeds, an elevated cTSH combined with T4 and fT4 concentrations at the low end of the reference range combined with appropriate clinical signs is necessary to diagnose hypothyroidism in greyhounds. Dynamic testing using TSH or TRH stimulation testing may also be useful, but less practical. Testing when appropriate clinical signs are present is of particular importance in greyhounds. Caudal thigh alopecia, common in greyhounds, is not caused by hypothyroidism, and infertility is likely to be only infrequently caused by hypothyroidism in female dogs. Exogenous testosterone used to suppress the estrous cycle does not appear to alter basal serum concentrations of T4, fT4, or c-TSH, but responses to TSH or TRH stimulation may be increased by testosterone administration. Thyroid function testing in Greyhounds. Am J Vet Res 62[7]:1130-3 2001 Jul Gaughan KR, Bruyette DS OBJECTIVE: To evaluate thyroid function in healthy Greyhounds, compared with healthy non-Greyhound pet dogs, and to establish appropriate reference range values for Greyhounds. ANIMALS: 98 clinically normal Greyhounds and 19 clinically normal non-Greyhounds. PROCEDURES: Greyhounds were in 2 groups as follows: those receiving testosterone for estrus suppression (T-group Greyhounds) and those not receiving estrus suppressive medication (NT-group Greyhounds). Serum thyroxine (T4) and free thyroxine (fT4) concentrations were determined before and after administration of thyroid-stimulating hormone (TSH) and thyroid-releasing hormone (TRH). Basal serum canine thyroid stimulating hormone (cTSH) concentrations were determined on available stored sera. RESULTS: Basal serum T4 and fT4 concentrations were significantly lower in Greyhounds than in non-Greyhounds. Serum T4 concentrations after TSH and TRH administration were significantly lower in Greyhounds than in non-Greyhounds. Serum fT4 concentrations after TSH and TRH administration were significantly lower in NT-group than T-group Greyhounds and non-Greyhounds. Mean cTSH concentrations were not different between Greyhounds and non-Greyhounds. CONCLUSIONS AND CLINICAL RELEVANCE: Previously established canine reference range values for basal serum T4 and fT4 may not be appropriate for use in Greyhounds. Greyhound-specific reference range values for basal serum T4 and fT4 concentrations should be applied when evaluating thyroid function in Greyhounds. Basal cTSH concentrations in Greyhounds are similar to non-Greyhound pet dogs.

What surgery was done? A spay is an abdominal surgery and if a vet is routinely sending home antibiotics with spays then I would question their sterile technique. Removal of the spleen is an abdominal surgery and again antibiotics are not inidicated unless sterile technique is broken. Now if the procedure involves entering an organ like the stomach, bladder, intestines, etc. then antibiotics would typically be indicated. Pain medications should ALWAYS be indicated in an abdominal surgery. However, I don't know if I could say that the "standard of care" wasn't met.... but I would like to think that our profession has progressed enough that we would be more proactive with pain management. Having said that, I know someone that emailed me about their dog and they were furious their vet sent home pain medication for "Just a spay". I told them to go thank their vet for taking good care of their dog. Feel free to email me if you have questions. Greyhounds have no specific requirements for additional antibiotics than other breeds but I do find that thorough pain management helps them in recovery a lot.

I don't scale my own dogs teeth. If they are bad enough that they need scaled... then they need cleaned properly under the gumline. What SusanP posted sounds reasonable to me if you are very careful not to scratch the teeth thus making it easier for more tartar to accumulate. However, if your pet needs thorough scaling... they need a real cleaning.

At this point I would honestly recommend Dasaquin. It is made by the same company but their research is showing that it is more effective than Cosequin which says a lot b/c Cosequin was the gold standard in the industry. An extra bonus is that it is actually cheaper than Cosequin!

The problem is because glucosamine is not tightly regulated by teh government... teh ingredient list may not actually reflect what is in teh product. : ( Here is an old thread: I would be very hesitant to use any product not on the Consumer Labs approval list. They will independently verify product analysis to show that the product contains what is listed on the label (many products fall short of their claims). I personally use and recommend Cosequin DS or Dasaquin. http://www.consumerlab.com/results/gluco.asp http://www.nutramaxlabs.com/products/anima...uin_dog_FAQ.asp Analysis of Glucosamine and Chondroitin Sulfate Content in Marketed Products and the Caco-2 Permeability of Chondroitin Sulfate Raw Materials JANA 3[1]:37-44 Spring'00 * Abimbola O. Adebowale, PhD, Donna S. Dox, MS, Zhongming Liang, MS, and Natalie D. Eddington, PhD * Pharmacokinetics-Biopharmaceutics Laboratory, Department of Pharmaceutical Sciences, School of Pharmacy, University of Maryland, Baltimore, Maryland Objective: The purpose of this report is to evaluate and present the results of analysis of actual contents of several products in the marketplace containing glucosamine and/or chondroitin sulfate and to determine if they significantly deviate from label claim. In addition, the study examined the intestinal transport of several marketed sources of chondroitin sulfate. Methods: A total of fourteen products containing glucosamine hydrochloride or sulfate and eleven products containing chondroitin sulfatewere evaluated using a UV-HPLC method. In addition, a total of 32 products containing chondrotiin sulfate were tested using a titration method. The permeability of various marketed sources of raw materials of chondroitin sulfate across Caco-2 cell monolayers were assessed. This analysis was an attempt to evaluate whether different suppliers of chondrointin sulfateuse different grades of material. Results and conclusions: The amounts of glucosamine and chondroitin found after analysis were significantly different from the label claim in some products, with deviations from label claims rangeing from as low as 0% to over 115%. Products with a retail price of less than or equal to one dollar per 1200 mg of chondroitin sulfate were found to be seriously deficient in meeting label claim (less than 10% of label claim). The permeability of different molecular weight chondroitin sulfates was found to be significantly different (P<0.05), with the permeability coefficient increasing with decreasing molecular weight. This suggests that molecular weight of chondroitin sulfate could be a possible predictor of permeability. More specifics: 26/32 products were found to contain less than 90% of the chondroitin sulfate stated on the label with 17 products containing less than 40% of the label claim. Only 5/32 products contained the labeled amount of chondroitin sulfate in the product. The industry standard allows for a 10% variance. An Analysis of Glucosamine and Chondroitin Sulfate Content in Oral Joint Supplement Products J Equine Vet Sci 22[3]:125-127 Mar'02 Review Article 12 Refs * David W. Ramey, DVM; Natalie Eddington, PhD; Eugene Thonar, PhD; Martin Lee, PhD * PO Box 5231, Glendale, CA 91221 Numerous dietary supplements containing glucosamine and/or chondroitin sulfate are marketed as a way to help support, improve or restore the health of their horse's joints. In humans, the glucosamine and chondroitin sulfate market has been estimated to be over 500 million dollars in retail sales between July 1998 and May 1999. While it is not clear that such products are actually effective in horses, the assessment of effectiveness might be skewed if the products did not contain content in amounts that matched label claims. Since they are considered nutritional supplements, oral joint supplements are not subject to the same stringent requirements for quality manufacturing as are pharmaceutical products. The quality of dietary supplements becomes a question because of the lack of regulatory provisions regarding the actual content of active ingredients contained in the jar, bucket or bottle. In fact, there is no practical way for veterinarians or horse owners to judge the quality of the products that they are purchasing. Independent analyses of a variety of supplement and herbal products designated for the human health market have shown that many products that have been tested, including calcium, St. Johns wort, ephedra and ginko biloba, have product content that fails to match label claims. Some even have zero active ingredients. Testing of glucosamine and chondroitin sulfate products intended for human use has also showed wide differences between published label amounts and the actual content of active ingredients. Even if oral joint supplement product were effective, the supplements would not be effective if the active ingredients were not included in the supplement product. This study analyzed 11 over-the-counter supplements intended for use in horses that contained chondroitin sulfate, glucosamine, or both.

http://www.VeterinaryPartner.com/Content.plx?P=A&A=2065

One option is you can see if your rescue group can order the drops at cost for you if they have a vet that orders medications for them. You can also write hte manufacturer of hte drug and see if they can provide a discount for your pet as I believe most of hte gluacoma medications are human medications that we just use in veterinary medicine. Are you sure that you are using "CoSopt" and not "Trusopt"? The reason I ask is that Cosopt is a combination of Trusopt + Timolol and you mentioned in your post you were giving Timolol and Cosopt. Xalatan is really the strongest drop that they have so it is concerning if the pressures are still elevated despite its use. Few thoughts: 1. Ask your vet about using Methazolamide. I know some specialists believe that it is unnecessary to use if you have them on a topical carbonic anhydrase inhibitor (Trusopt) but others will use both in conjunction and I've seen pressures improve with the addition of Methazolamide. If the vet says "I don't think ti will help." Ask them you'd like to try it unless they feel it would be likely to hurt. 2. Ask if they think trying Prednisone drops instead of TAB w/ Dexamehtasone may be of benefit. Probably not a big difference but can't hurt to ask. 3. Still pursue the 2nd opinion just for peace of mind. 4. Contact the manufacturer of Xalatan and see if they can work with you in anyway.

Seeing an ophthalmologist is the best thing which you have already done. If you are uncomfortable wtih this one... any chance you could see another? Maybe one at Tufts as someone else recommended? There are multiple causes and treatments for glaucoma but it will depend on the underlying cause. Most common treatments include: 1. Trusopt (topical eye drop) 2. Timolol (topical eye drop) 3. Methazolamide (oral medication) 4. Prednisone (topical and/or oral if inflammation is suspected) 5. Xalatan (topical eye drop; not indicated in every case of glaucoma) 6. Surgical or laser treatments performed by an ophthalmologist There are others but these are some of hte more common treatments. The Xalatan is REALLY expensive (about $1/drop) but is also probably the most potent. If you cannot control the pressures with medications/surgery/laser than the only other options are enucleation (removing the eye/eyes) or euthanasia. The pain associated with glaucoma is very intense. I would really consider the 2nd opinion at Tufts and try to get in ASAP so you really know all of your options. If you cannot get in to see the ophthalmologist due to no open scheduling... sometimes you can cheat the system and get seen on emergency and get worked in sooner. I hope you are able to get your pup more comfortable!!!

How low were the platelets? You really don't see bleeding problems unless they are below 25,000.

Remember a positive titer is NOT diagnostic for infection... it only diagnoses exposure. Certain levels can be highly suggestive of infection but only PCR testing is considered diagnostic b/c you are not looking for the dog's response to the organism but for the organism itself. Most dogs that are exposed to Lyme disease never will get sick a day in their life... with or without treatment. Treatment for B. canis is 2 injections fo Imidocarb 2 weeks apart but I would want to confirm diagnosis first. Imidocarb is NOT effective for B. gibsoni. I would sent a follow-up titer to North Carolina State (http://www.cvm.ncsu.edu/docs/ticklab.html). OSU has found several false positive titers at Protatek and so I no longer recommend or use them. Was basic bloodwork done as well?

There are 2 main options in using Artemisinin and OSU is researching them. 1. Give a low dose daily. 2. Give a mega-dose once weekly. I'm not sure if OSU has any results on which therapy has been more effective yet but I'm eager to find out. I would email OSU and see what they are recommending as they are doing active research: greyosu@osu.edu

Here is a key to remember. Although Greyhounds can have lower neutrophil counts... that doesn't mean EVERY Greyhound will have lower neutrophil counts. This goes for all of the Greyhound blood values. So maybe his own personal normal neutrophil count is 3400 and he is sick so now it is down to 1900. Or maybe his normal value is just 1900. The problem is by just looking at bloodwork you can't tell. That is where you look for other signs. If he is sick with a virus then you should be seeing some sort of sign: fever, lethargy, inappetance, etc. If he is completely healthy than it is hard to argue that it would likely be anything other than normal for a Greyhound. Make sense? If not, feel free to drop me an email.

Don't let the teeth be cleaned awake. Big mistake. Multiple posts on why not to if you do a search. Options: 1. Chews (you mentioned that he doesn't like raw meaty bones; consider other dental chewables that may be beneficial from Dentabones to Greenies to CET Hextra chews, etc.) 2. Water additives (Aquadent, Oxyfresh, Breathalyzer Plus) 3. Diet (there are prescription dental diets that can help; Royal canin, aka Waltham, probably has the best one but others are made by Purina and Hill's Science Diet) 4. Daily brushing

I personally have had ONE root canal done, and the endodontist should have told me that the tooth structure was such that a root canal was not justified. He took my $600 with a smile and thank you. I ended up paying my dentist $50 to pull it the next week. I'll never do THAT again, and that includes my dogs' oral issues as well. Pull it. Pupper will never miss it. I think you are making a mistake if you allow 1 bad experience to taint your entire opinion on a subject. It is ashame that your endodontist was not honest with you... but that doesn't mean that root canals are not good procedures, just that your endodontist was dishonest. I think people don't realize what a big deal it is to pull a canine tooth. The root of the tooth is actually larger than the part of the tooth that sticks out of the gum! They'll need an incision made into the gums, the gum lifted off of the bone of the jaw, bone drilled away from the jaw, then the root leveraged away from the bone, the resulting deficit is often packed and then sutured over. This isn't like having a small incisor pulled... it is a big deal. Will a dog with a pulled canine be scarred? No. 99.9% will do fine. Lower canine extractions run teh risk of having the tongue hang out fo the mouth but that is strictly cosmetic. However, if the difference in cost isn't an issue AND you have a dental specialist in teh area, I would personally pursue the root canal for my own dog. If the difference in cost was problematic financially... I would have no problem pulling the tooth. Again I'm not arguing against extraction as much as arguing against the idea that a root canal isn't better or justified.

The vaccine is the only option that is likely to significantly extend life so if it is an option financially for the owner, they should pursue it. 4 vaccines are given at 2 week intervals and then a booster is given every 6 months. Some dogs that only lived for an additional 8 weeks after diagnosis are now living for 1.5 years or more. It really is a miraculous product. It is not available to GPs and thus they will need to see an oncologist that and they will discuss possible side effects. Each vaccine including exam charges, charting fees, etc. will likely run $400-$600. Much like the dental vaccine, this product has an FDA approved conditional license so all the data isn't in yet. HOWEVER, given the extremely poor prognosis of the disease, I would use it at the drop of a hat with my own dog!!!

Don't use the liquid for a Grey... you'll need to give 2-4 teaspoons which is not very user friendly. Simply pick-up some tablets or capsules (most are 25mg). You can start with 1 tablet 2-3 times daily and easily increase to 2 tablets 2-3 times daily. You can basically dose it at 1mg/lbs as an easy cheat. Of course with any medication you should always verify with your vet if it is OK for your pet.

Kidney disease and low WBC counts are 2 of hte more common misdiagnoses that I'll see in Greyhound labwork. Of course the vet may absolutely be correct with his diagnosis... but those are 2 levels that are commonly misinterpretted. Here is an article that may help you with the kidney side of things: http://www.animalmedicalcentreofmedina.com...y%20Failure.pdf Others have posted many sites that discuss Greyhound bloodwork which you will want to share with your vet. What antibiotic was used? If it was Clavamox then that could account for a significant portion of your bill.

Would you feel the same if your own dentist recommended a root canal instead of extraction for your teeth? I can't see how recommending the best care is "taking you". If you felt the vet was dishonest or did a poor job then you need to find a new vet.

There really isn't a "defined dose" of fatty acids to treat arthritis (at least not a scientifically proven one). There is more information showing that 180mg of EPA per 10 lbs. of body weight is the ideal dose for allergies. It generally takes a higher dose than that to manage arthritis. Remember that when you are giving 1000mg capsules they are NOT 1000mg of EPA!!! Look on the package and 99% of the 1000mg capsules will have around 180mg of EPA. So for allergies you need to give 1 capsule per 10lbs. of body weight daily (8 capsules daily to an 80 lbs. dog isn't very practical... plus all the extra oil is more likely to result in GI upset). If you can find high potency capsules then it significantly reduces the number of capsules needed to reach your dose of EPA. If you just want a nice coat... any supplementation may help. If you are really wanting to help arthritis with fatty acids, the most ideal way to do this is with a prescription diet as they have actually shown that the levels and combinations they use are effective in managing arthritis. Most of the OTC joint diets do not contain high levels of fatty acids... they are termed joint diets b/c they contain glucosamine (what they don't tell you is at most they contain 1/3 of the therapeutic levels). The prescription diets also have low levels of glucosamine but the reason they work is due to the fatty acid content.

Yes you can use Compazine orally in dogs to help with nausea... works pretty well actually. You'll need to discuss dosing with your vet though.