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Vet Talk

ADR: Learning from History
March 16, 2015 (published)


Photo by Dr. Teri Ann Oursler

“Well, Doc, y’know...he just ain’t doin’ right.”

And thus, one of the most colorful acronyms in veterinary medicine is born. ADR: Ain’t Doin’ Right.

The conversation between the client and receptionist usually goes something like this:

Client: “I need a vet to come take a look at my sick Heffalump.”
Receptionist (trying to get an idea of how long an appointment to schedule, what supplies the vet may need, etc.) “Certainly. What’s been going on with your Heffalump?”
Client: “Well, I dunno. He’s just...off.”
Receptionist: “Off in what way? Is he eating? Does he have a fever?”
Client: “Well, he just ain’t doin’ right.”
The conversation continues when the vet arrives to examine the heffalump.
Client: “Hi, Doc! I’m glad you’re here. Something’s up with Pinky.”
Vet: “What seems to be wrong with Pinky?”
Client: “Well, that’s why you’re here, isn’t it?”
Vet (remembering why her dentist keeps recommending a mouth guard): “I mean, what sort of symptoms have you noticed?”
Client: “Well, he just ain’t doin’ right.”


We can probably all agree that a large part of the success of medicine involves “finding out.” The first step toward reaching a diagnosis (i.e., finding out what’s wrong) is taking a history.

The word history has sailed to us across the oceans of time and space by way of Latin-speaking Rome from the Ancient Greeks, who called a wise man “histōr” and the act of finding out, or narrative, “historia."

The history comes from that long, annoying, and even intrusive-feeling list of questions the veterinary technician and/or veterinarian ask you at the beginning of each appointment. These questions really aren’t designed to ruin your day, try your patience, or delve into the details you (and we!) would prefer stayed private.

We want to stand a chance of getting home to dinner too, so when we follow “Have you given him any medications?” with a seemingly endless list of things with which someone in the family or neighborhood might possibly have thought to dose your cat, it isn’t that we’re trying to prolong the appointment. It just means that at some point almost every one of those items has come up in a last minute “Oh, we did give him just a little bit of XYZ. Does that count?” It counts. Trust us.

We don’t care what you keep in that drawer in your nightstand unless you left it open and the dog ate one of those toys you keep hidden from the kids. Then we really do need to know. We won’t judge. Promise. Won’t even giggle.

You can help streamline this process before you even get to the clinic (or before the vet pulls onto your ranch). Check with EVERYONE who is involved in your animal’s care and prepare answers for the following (some of these are only relevant if your pet hasn’t been to this particular veterinarian before).

Age: yes, I know that doesn’t seem like something you should need to research, but you’d be surprised by how many “he’s about 15” year old horses I’ve seen that were actually much closer to 30.

Vaccination status: This means exactly which vaccines were given when. “Up to date on everything” doesn’t actually give any useful information as to which diseases your animal is protected against.

Parasite prevention: This includes flea control, heartworm prevention, and any preventives against internal parasites. Again, “He’s covered” isn’t a real answer. Make a habit of recording what your pet is given when.

Medications: This includes prescription meds from a vet, over the counter meds, vitamins, supplements, topical ointments/sprays/whatnots, and your grandmother’s medical marijuana that your brother thought the dog could use. Tell the vet EVERY non-food item that your pet has consumed, rolled in, been bathed in, or had injected. Holding back information because you’re embarrassed or worried about narcotics enforcement is dangerous to your pet. Quite frankly, your vet could not care less what you drop, roll, smoke, or shoot in your spare time. We just care about your animal.

Past medical history: Try to keep this to relevant or ongoing conditions. The fact that your dog had a torn nail three years ago probably doesn’t relate to his current vomiting. On the other hand, if he’s had a history of pancreatitis, that’s pretty darn relevant.

Current signs/symptoms: Get the story straight between all members of the family BEFORE your appointment. Listening to “It started a couple days ago.” “No, it was last week at the same time as Sissy’s concert.” “No, it wasn’t, because Grandma was here then and we put her on the iceberg on Sunday” doesn’t clear up the picture for the vet. Give a clear list of signs, whether they have changed over time, and when each started.

Providing something more descriptive than “He just ain’t doin’ right” may sound like a lot of work, but it’s really just a matter of being observant and organizing those observations. A clear history will not only make it much easier for the veterinarian to get to the bottom of your animal’s medical condition, it will also make the ancient Greeks bow to your wisdom.


 
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