Case 1. 17-year-old Jack Russel goes home today. He could stand up and had eaten most of the canned food for the past 2 days. I advised going home as very old dogs are better with family at home so as to spend time with family. This is an unusual case of bradycardia. Financial considerations mean no ECG or any tests to be done to practise evidence-based medicine.
Jan 17, 2014. Emergency clinic. 8.30pm. Can't stand, fainting, drooling. Vet said glucose at 3.4 ml was normal. Owner did not want blood test at all. Heart rate was very "slow" at 40/minute.
Jan 18, 2014. Toa Payoh Vets. Dog was recumbent, 4.8 kg, 38.2C. Owner said blood test was done 1.5 years ago and was OK. Did not want blood test. "Has he any fits recently?" I asked. "Yes, a few days ago."
Treated with IV drips, heart disease medication and antibiotics. Dog able to stand, eat and went home. I strongly advised dental extraction of the rotten canine with exposed roots and other rotten teeth. "The bacteria inside the rotten teeth will return and the toxins damage the heart and lower the immune system."
Such advices may fall on death ears as the dog was 17 years old and the baby-boomer generation owner probably does not to incur more medical costs. This old dog was really old and had the decayed teeth been extracted, would have been in a better health. Fits could be caused by an extremely painful mouth and the dog would not eat if he was toxic. No blood test was permitted and so the health status of the blood, kidneys and liver cannot be known.
Case 2. At least 10 years old. The complaint was lameness in front paws. Swelling of lower paws and dampness due to paw licking.
The Doberman Pinscher strongly objected to me opening his mouth for examination. Few teeth remains. Once I managed to open, he pawed his mouth so vigorously and bad breath filled the room. My intern videoed this behaviour.
"It is not a lameness problem although it appears to be so," I said to the owners. The dog has terrible tooth ache and uses his front paws to try to relieve his pain by rubbing and rubbing. Dental extraction will cure this problem."
The old dog was not particularly lame and was limping now and then. His back paw pads were dry and scaly but the front were wet and swollen due to licking or mouthing. Dental clean up will enable him to live a much better quality of life.
"No more bad breath after your dental work ?" the two senior citizens ask me.
"No more," I guaranteed.
"Any discount?" the senior citizen asked. "The package of $300 is low," I explained. "There is general anaesthesia and dental extraction to be done and the cost is usually more."
I gave an antibiotic injection 24 hours before dental work. At 20th hour, I examined the dog. Her mouth was not so painful as she permitted me to open the mouth without getting worried as you compare the video below with the one above (before baytril antibiotic injection).