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Vet Talk

Dr. Google: Never Available for a Consultation
December 30, 2013 (published)
Wendy Smith Wilson, DVM


This unsourced chart - no one seems to know who created it - is found on several Internet sites, including this one: http://www.wiki-pet.com/health/dog/charts/medicine-chart.php. Numerous similar and also unsourced charts are easily found. We source all of them to the unlicensed Dr. Google.
Click here for larger view

As a veterinarian in a semi-rural part of the country, I see some pretty creative home remedies from clients. Our region has always been economically depressed, so things really didn’t change much with the recession; most folks around here just don’t like to take their pets (or themselves) to the doctor unless it’s something that causes them genuine alarm.

Because of that mindset, they tend to try to treat problems themselves. There are some that I’ve heard for years, starting long before everyone had computers in their pockets:

“He’s been limping for about a month — I’ve been giving him a baby aspirin every day. It’s been getting worse lately, though, so I thought I’d better have you check him out.”

“She has a tummy ache! That pink stuff on her fur is Pepto Bismol. She’s still hasn’t stopped vomiting, though.”

“He’s been really itchy. I’ve been giving him Benadryl, but it doesn’t help. Do you have something stronger?”

With the explosion of instant Internet availability, “Dr. Google” has given pet owners access to a litany of home remedies — some of which make your veterinarian shake his head, others which make him shudder. The problem with good old Dr. Google is that the sucker gives advice willy-nilly and without the benefit of a physical exam. Not cool, dude.

Charts like this one are easy to find; a friend emailed it and it's all over the Internet but we can't find out who created it. Honestly, it’s not all bad information, and there are many worse ones out there. However, some of the problems with using unsourced information like this begin when pet owners believe they’re treating constipation and their pets really have diarrhea (seriously, that happens a LOT!) or when an animal has a topical parasite, like scabies or fleas, and the owner is shoving in an antihistamine for the itching. Home remedies are not going to be effective in these sorts of situations, and sometimes they can be quite harmful.

Also, some charts out there have doses listed which are absolutely, completely, totally, irrevocably inappropriate, which increases the likelihood of serious consequences to the average Googler’s trusting pet. Once again, totally uncool.

An important fact to consider is that individual animals may have disease processes that make otherwise benign medications harmful. If your arthritic old dog has poor kidney function and you’re shoveling in aspirin (with the best of intentions!) for his chronic pain according to this or some other internet dosage chart, you can be doing much more harm than good—aspirin can cause his kidneys to fail. Aspirin isn’t particularly kind to the cartilage in the old fellow’s joints, either. Cartilage provides a cushiony surface on the ends of bones, so it’s pretty important to preserve it for as long as possible. Newer drugs have emerged in the last couple of decades for both pets AND people because they are safer and cause significantly less cartilage degeneration than aspirin.

Some of the medications on this list have a “DO NOT USE!” label . . . and those may not be accurate either. For that same old dog whose kidneys are beginning to fail, Tylenol (acetaminophen) might actually be a reasonable option at a specific dose and with careful monitoring for side effects. On the other hand, Tylenol can kill a cat quite effectively, so perhaps a stronger warning than “DO NOT USE” would be appropriate. Call me paranoid, but if death is a likely outcome, I’d like to see that listed a bit more emphatically.

There are some easily obtained over-the-counter (OTC) drugs on this chart that are listed for treatment of diarrhea. Unfortunately, Dr. Google hasn’t chatted with you to try to discover the underlying cause of the diarrhea, so while these doses might be “okay,” they won’t do a thing for a dog with whipworms or parvovirus or a cat with intestinal cancer (or any of a myriad of other causes of diarrhea in our pets).

Plus, even though you can find drug dosages posted all over the Internet, it's unethical and not allowed in most Practice Acts to provide dosage amounts for an animal that has not been seen by a veterinarian; Dr. Google doesn't give all the contraindications for a certain dose that a vet would know. That's why we don't provide dosages in Veterinary Partner.

Then there are the folks I mentioned earlier who believe their pets are constipated because they see them repeatedly straining to defecate with nothing coming out. Instead of calling their veterinarian, they search the internet for constipation treatment and may use the medications in this chart to try to give them relief. Unfortunately, most of the dogs that I see for “constipation” actually are straining because of intestinal cramping secondary to diarrhea, so anything used to loosen up the stool is going to make things worse. I’ve also seen more than one cat for “constipation” that instead had a life-threatening urinary tract obstruction. Fiddling around with an Internet search to treat these cats for constipation is going to delay seeking veterinary attention in a situation where prompt treatment will make the difference between life and death!

One OTC drug that is not on this particular chart is ivermectin, which is used in multiple species at VERY different doses to treat numerous types of internal and external parasites. It’s not always a “household” medication, but you’ll often find ivermectin on farms where it is used to treat horses and cattle for parasites. It is common practice in rural areas for hunters with kennels full of rabbit, raccoon and bear dogs to buy the cattle product from their local feed store and use it off-label (in other words, in a manner for which it is not intended) for heartworm prevention. These guys give a tremendously high dose—much more than is actually needed to prevent heartworms—and while the majority of those hunting dogs don’t even seem to blink, you’re going to kill a Collie breed with that same dose. I once had a client who gave his Collie a smidgen of ivermectin paste intended for his horses; the poor thing was suddenly unable to stand and completely blind. With good emergency and supportive care he actually stabilized over the next couple of weeks and we expected him to recover—until the day he went outside unsupervised and staggered into the owner’s pond and drowned. Totally not cool.

Unfortunately, Dr. Google is never available for consultations in regard to possible contraindications and side effects of the medications he recommends for our furry companions. He doesn't care if you follow his advice and harm to your pet results; there is no recourse when he misses the diagnosis. Please, please don’t take his word for anything! If you’re tempted to treat your pet with a home remedy, STOP and call your veterinarian first. It could be that it really is just a simple cough — or it could be congestive heart failure. There’s no way you can know just by looking at your pet. After all, if practicing veterinary medicine were that easy, there’d be no need for veterinarians!


 
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