84. Sunday case - 2nd opinion and feedback

Sunday 30th May 2010

The lady wanted a second opinion. Vet 1 said that her 5-year-old Chihuahua had heart disease and had prescribed a cough mixture (on the first visit) and heart drugs (Fortekor 5mg and a white capsule) on the second visit. The owner does not know what the white capsules were for.

It was a beautiful Sunday morning. One entrepreneur had opened a small office at Peninsula Plaza and I had dropped by at 9.30 am to congratulate her. Then I rushed back to the Surgery for this second opinion.

I put the stethoscope on the dog's chest on the right and left. "I confirm that your dog has a serious heart disease. Is he still coughing?"

"Well, he did cough 2 days ago, but not today."

"Your heart drugs need to be given regularly and listen to the coughing period. Your dog must not be permitted to be too active."

"I can give him the cough mixture when he coughs," the lady in her late 40s said.

"In heart disease, there will be water in the lungs. The dog wants to cough up the water from the lungs. If you give the cough mixture to prevent coughing, your dog will "drown" with excessive water inside the lungs."

Fortunately she did not self-medicate or her dog would have had died. She sought a second opinion and that was good for her dog.

"I must tell you that your dog will not live to a ripe old age of 15 years unlike some Chihuahuas," I had to give the owner the prognosis. "If you are careful with the heart drugs and monitor him closely for coughing or other signs, he may live longer. He may need more dosage over time or other drugs. I don't expect him to live more than 1-2 years."

The owner held back her tears. I checked my records as this dog had dental scaling and teeth extraction done by me one year ago. He was OK.

"Coughing at night started one month ago," the owner said.

"Why did you consult Vet 1?" I asked for feedback to improve my services. Was something lacking in this case? Well, Vet 1's surgery was much nearer to her apartment and that would be the main reason.

"Vet 1 does not need appointments," the lady said. "She is very busy as there is a big crowd of patients. I had to wait one and a half hours to see her."

This feedback is important to me. No appointments mean more business perhaps? Dog owners in Singapore dislike appointments or are there more factors for owners to switch loyalty? I am sure the causes are many. I am glad that this owner got a second opinion. I asked her to check with Vet 1 what the white capsules were for and to keep in touch.

P.S It is deadly to give cough mixture to dogs with heart disease. Try and get proper veterinary advices.