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— July 10, 2012 —

Should we go to the vet for that?
by Daniel McElroy Jr.

Sometimes, we run into the question of whether an injury or illness is serious or not. This week, I’d like to discuss my criteria for when a dog needs to be seen by a vet.

Let’s say your dog is sick. He hasn’t eaten for a few days, he threw up and now has diarrhea. Does he need to go to the vet? Is it an emergency, or can it wait until next available appointment?

What about the dog that is limping? What if he has a cough? He got into a fight and has a cut/scratch. Do I need to get him antibiotics? All of these questions may or may not require a vet visit.

Before I go any further, I must say this. “I am not a doctor, nor do I play one on T.V.” Use this information combined with good judgement and common sense. My general attitude towards medical issues is to be conservative when I can. I don’t run my dog the the vet for every scratch or upset stomach, but when there is a real problem, I want to be as aggressive with treatment as possible. Generally speaking, if I wouldn’t go to the doctor myself for a condition, I don’t take my dog to the vet. That being said, here a few guidelines that I use to determine whether a dog needs to go to a vet.
Throwing up/refusing to eat:
A very serious symptom, that may be misunderstood is when a dog is vomiting or refusing to eat. I know some dogs are less food motivated, but if your dog is usually a good eater and refuses food, pay close attention to him. When it comes to G.I. symptoms (vomiting, lack of appetite, diarrhea-with or without blood present) I tell people that any two symptoms at the same time is a cause for a vet visit. Also, any one symptom that goes on for a couple of days requires a trip to the vet. My male Rottweiler will vomit bile if he doesn’t get fed regularly. An empty stomach for him equals an upset stomach, but he will eat right away. A few months back, however, Gunnar our 10 year old pit mix seemed a little lethargic and refused to eat a couple of meals in a row. There were no MAJOR symptoms, but this was very unusual for him. We took him straight to the vet. Turns out it was caused by hepatitis, which can be fatal if left untreated. Other causes of refusing to eat may be blocked intestines, infection (parvo, distemper, etc), gastric torsion (flipped stomach) and other serious illness like cancer. All of these are very serious and a vet can help you figure out what the problem is.

Coughing is a tough one. Puppies will often develop “puppy cough” when they are first exposed to other dogs. This is analogous to the kid who goes to daycare and catches a cold. There are many germs that will make a puppy cough. Bordetella is the one most people know about. Generally it is not dangerous unless it develops into a secondary infection like pneumonia. The bordetella vaccine can reduce the severity of the infection, but it is not effective in preventing it entirely. Other germs, like distemper also cause coughing. The distemper infection is usually fatal, but fortunately the vaccine is very effective. So a cough by itself, in a well vaccinated puppy or young dog needs to be watched. If the dog develops any other symptoms (discharge from the nose, lethargy, lack of appetite) he should see a vet right away. Also, any puppy that is coughing is very contagious. Please do not bring him around any other dogs until the symptoms are completely gone. In an adult dog, coughing can be anything from “kennel cough” to allergies or a serious heart condition. Coughing for more than a couple of days requires a trip to the vet.

Cut or bite wound:
As a rule, I do not put my dogs under anesthesia or give them antibiotics unless absolutely necessary. If a dog has been in a fight, first check the dog over for injuries. Injuries can range from superficial scratches (wounds that do not puncture completely through the skin) to shallow punctured to deep punctures. Deep punctures should be seen by a vet. If you can see the layers under the skin, or if a wound doesn’t stay closed, that would be what I am describing. Obviously, bleeding that can’t be stopped would require a vet visit. The main reason for seeing a vet with deep punctures is the potential for serious infections and abscess development. The vet will often surgically implant a drainage tube to prevent this. This will require the dog to be sedated. Sedation has it’s own risks, so I have to be certain a wound is severe enough to put my dog under anesthesia. (While anesthesia is safer than ever, we have had more than one client have their dog sedated for elective procedures with the dog not waking up from anesthesia. Anesthesia must be viewed as a serious issue.)

Superficial wounds are things I describe like a skinned knee. They are caused by the outer layers of skin being scraped off, but without penetrating through it. With these types of wounds there is no need for stitches, because there is nothing to close. With superficial wounds, I clean with diluted iodine or peroxide (peroxide is controversial-never use it on a deep puncture) and let the wound air dry. If the dog has a long coat, clipping some hair around the wound will help keep it clean. A topical cream can be used, but is usually not necessary. Once the scab has formed, don’t mess with it. This is nature’s bandage. It will fall off when it is no longer needed. Again, if the skin is completely punctured, it doesn’t fall into this category. I would personally take my dog to the vet for a superficial wound only if it develops an infection. Swelling, increased redness or pain, development of pus are signs of infection. Pink tissue around the edges of a wound and scabbing are part of the normal healing process.

The use of antibiotics is a topic I would like to briefly discuss here. The human medical field has long recognized that the overuse of antibiotics as a very serious problem. Regularly now, we hear about a new “drug resistant” super-germ that is defeating modern antibiotics. The reason these germs exist is mainly due to improper antibiotic usage. When we go to the doctor, we expect to get a pill of some sort to magically cure us. Often times, a wound is not actually infected, or a condition is viral. In both of those situations, antibiotics are not necessary. Fortunately, human doctors have learned to not prescribe antibiotics unless they are actually needed. Some vets are still catching up. I routinely hear of vets prescribing antibiotics “just in case”. THIS IS A BAD IDEA (Please see: http://www.aafp.org/fpr/20000300/01.html for an article about the risk of overusing antibiotics). A vet may have two reasons to give antibiotics when they are not actually needed. They want to keep their clients happy and its easier to just give a drug than educate the client. The other reason is that they are selling these medications and there is a profit motive. Like I said, I try to work with good honest vets who do the right thing but there are some out there who don’t. If your vet wants to prescribe antibiotics “just in case” I would question them to decide if it’s really necessary.

A dog that is limping can be serious or minor. If your dog refuses to put any weight on a limb following an accident or injury, there may be a serious injury. Obviously any deformity would call for a trip to the emergency vet. If he will walk on it, and there wasn’t an injury or incident, give him a few minutes. Often, arthritis will cause a dog to limp right after getting up from resting. If this is the case, anti inflammatory drugs can help. DO NOT give your dog over the counter human medications like ibuprofen. Tylenol and Ibuprofen are very toxic to dogs. Aspirin is generally safe, but you should look for a dog-specific one at a pet store to make sure you give the correct dosage. If your pet is aging and over the counter medicines don’t relieve his pain, a vet may be able to provide you with something more effective. If you have a senior dog with arthritis, I would recommend looking into cold laser therapy and acupuncture. While acupuncture has done some good, we have had truly amazing results with cold laser therapy. Integrative Pet Care in Chicago provides these services and we recommend them highly.

As I said earlier, this is not meant to be an all-encompasing article on when your dog should go to the vet, but a general guide. Next time your pet refuses to eat, or has a cough, hopefully this will help you decide how to proceed.