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Vet Talk

Patience, Grasshopper: Let's Not Jump to Conclusions
May 9, 2016 (published)

lick granuloma Foil

A lick granuloma. Photo by Dr. Carol Foil
I recently received a text message from a childhood friend who grew up to be a dog trainer. His clients trust him and often ask his advice regarding their pets’ medical issues; he always tells them that while he is a good dog trainer, he is not a doctor, and that they need to contact a veterinarian for health concerns. (Which is an absolutely perfect and appropriate response!)

In this case, his client’s young German shepherd mix had an infected wound. This dog owner told him that the veterinarian who saw the dog for the injury mentioned that he might be self-traumatizing due to anxiety. The owner asked her trainer if he thought medication was needed to manage that anxiety. That’s when my old pal got in touch with me.

On the surface, it seems pretty obvious, right? The dog has a wound, and he’s licking and chewing at it. While he’s a mixed breed dog, he’s obviously mixed with a breed known for its tendency toward anxious behavior. No-brainer, right? Give him something to calm him down. Doggie Prozac.

Not so fast! Jumping from A to B should be more involved than an assumption.

I’m really glad my friend the trainer got in touch with me. He’s a smart guy; he knew he was being asked to give veterinary advice and wanted to tell this client the right thing. He didn’t want to refuse to help and just send them back to the vet; he wanted to be able to discuss the situation and help steer them in the right direction, and give them confidence in their next steps. Good for him! We had a text message chat about what to do.

From the veterinary perspective, we need to rule out physical causes before jumping to the conclusion that the dog has wounded himself out of anxiety. I’m just guessing here, but knowing how these things often go, I suspect that he had a course of antibiotics (may not even have finished them yet) and that the vet mentioned anxiety as a possibility during that first visit simply because of the breed. There are still many steps to go, though, before we can say that anxiety is the root of the problem!

Let's look at some basic questions.

First, has there been enough time allowed for the treatment to work? The wound is not going to get better after one dose, nor will it remain better if the dog only gets the antibiotics for half the time he's supposed to get it. If they’ve given all the medication as prescribed and that infected wound hasn’t responded to the antibiotic, then maybe it’s a resistant type of bacteria that needs a different drug. Maybe there’s a fungal infection. Maybe there’s a problem with the bone underlying the wound (fracture, tumor) that’s preventing healing.

There are TONS of possibilities here before assuming that the dog has gone off its rocker and is trying to devour a body part. Let’s do a biopsy. Let’s culture the wound and see what offending microbes might grow. Let’s take an x-ray to see what’s going on inside: maybe there’s a foreign body inside the wound, maybe there’s a problem with the bone beneath the surface. For that matter, let's wait to see if our treatment works or the problem resolves on its own! If we do all that and still can’t find a physical cause, only then does it become reasonable to consider self-mutilation as the sole cause of the injury.

That leap from A to B is a long one, and whether it's correct or not is a good question. In this example, a dog could end up on a medication for the rest of his life without needing it.

The moral of the story is this: if you know a trainer, groomer, dog walker, or pet store employee who gives you medical advice, stop and consider the value of that advice. These folks mean well, but typically they don't have any medical training, much less the necessary stuff. Sure, some folks know a little bit more about dogs than others, like my trainer friend, but they are not doctors. If the first trip to the vet doesn’t resolve your pet’s problem, then talk to your vet again before jumping to conclusions or assuming that what you were told was wrong. Not every problem is simple, and the only people out there with the appropriate education and experience to diagnose and work up a serious medical problem are veterinarians.

And if your trainer tells you to go to the vet, don’t be mad. Instead, thank him for knowing his boundaries and having your pet’s best interest at heart!

1 Comment

Dr. Meow
May 10, 2016

Not to mention that GI disease can cause dogs to lick their paws.  May want to do blood work and a B12 level, too!  Just to add one more layer to the complexity that is veterinary medicine!



 
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