Saturday, December 14, 2013

Rigby's Broken Toe -- The Whole Story

That day in January when Rigby broke her toe was one of the most stressful days I ever spent at a vet's office with my dogs.  I didn't tell the whole story at that time because there were matters that needed to be addressed with the veterinary clinic, but at this point I think it's best that the real facts of what happened that day be told if, for no other reason, than to educate others about what can happen when you take your dog to a vet with all good intentions.

When I brought Rigby home I wanted to give her every chance to live a healthy life, so I decided to use a veterinarian who has the reputation of being the best doctor for Weimaraners in Western Pennsylvania.  Because there are special vaccination protocols for Weim puppies that are very important and even though the trip to the vet's office was an almost 80-mile round trip, I felt it was worth the effort to get optimal care for my young pup.  Some of you may have heard of this vet as he is known by Dr. Mike and has a Saturday morning radio show where he answers callers' questions.  His veterinary clinic is known as Animal General and Rigby became a patient of his office, although she was never actually seen by Dr. Mike Hutchinson himself.

The following is a chronology of what happened that day and the week following:

Shortly after 8:00 a.m., Tuesday, January 22, 2013, I called Animal General (AG) to see if I could get Rigby seen for an injury to her right front leg.  Arrangements were made for me to drop her off to be seen by a veterinarian and then to pick her up later in the day, after I attended a business appointment.  

Around 9:30 a.m. I arrived at the AG office with Rigby and, shortly thereafter, we were taken into an exam room by Dr. Marc (that's how he introduced himself to me).  Rigby’s temperature was taken and found to be normal. 

I explained to Dr. Marc that she had been fine until about midnight the night before when I was taking her out for the last time of the night.  I said that she had run down the basement steps ahead of me and when I got to the bottom of the steps she was limping.  I also voiced the opinion that I was worried that she might have caught a toenail in the carpeting on the steps.

Her leg was examined and she was found to have pain in her foot area.  She voiced her discomfort with a “scream” of pain.  Dr. Marc said he would need to do x-rays and I signed the paperwork necessary to have this done.  I left Rigby at the AG office and headed for home to get ready to go to my business appointment.

Shortly after I arrived home, around 11:00 a.m., I received a phone call from Dr. Marc.  He told me that no fracture was shown on the x-ray.  

He then told me that they had done the x-ray of both of her legs so that they could compare her right and left legs to get a better idea of what might be going on.  Dr. Marc told me that by the evidence he saw on the x-ray that there were two possible diagnoses and that they are both associated with growing pains, hypertrophic osteodystrophy (HOD) or panosteitis (pano).  He explained that pano is more often seen in males and, well, Rigby is a female.  He also said that Rigby fell into the correct age range to have either of these problems.  I asked him a couple questions about the causes of both of these conditions and we discussed treatment options.  He suggested putting Rigby on an NSAID and limited activity.  I gave him permission to give her the first dose of the NSAID and said I would be back later in the day to pick up Rigby.

Realizing that HOD is a recognized health problem in Weimaraners that can have serious consequences if not treated in a timely manner, I contacted Rigby’s breeder and co-owner, Linda Hartheimer, to ask for advice on what my next steps should be.  First and foremost, we wanted to get a definitive diagnosis and get Rigby started on the treatment protocol if she did have HOD.  Secondly, we knew that we wanted to have her included in the research being done on HOD in Weimaraners by Noa Safra, DVM PhD at the University of California at Davis. Because Dr. Safra is a friend of Linda’s, Linda called her to give her a heads up that we would be in touch with her and sending x-rays and blood work.

Around 1:30 p.m., since my business appointment had been cancelled, I was able to get back to the AG office.  By this time I was pretty emotional, very worried about the future of my young pup.  When Dr. Marc had time to see me he took me into an exam room and showed me the x-ray and pointed out the area that he said showed the evidence of the two possible diagnoses he had voiced earlier.

I told Dr. Marc about the research being done on HOD in Weims and told him that Dr. Safra had been contacted and was willing to speak with him.  I told him that there was a treatment protocol that needed to be followed to properly treat a Weim with HOD to get the best results and that I would want to send blood samples and the x-ray to Dr. Safra in California. 

At this point Dr. Marc began to waiver on his diagnosis, saying that the x-ray wasn’t that clear because the pup had not been sedated for the x-ray and that now he couldn’t give a definitive diagnosis from the x-ray.  He also suggested that I wait a month and bring Rigby back to have x-rays done then, since what he was seeing on the x-ray was very mild.

Knowing that time is of the essence in treating HOD in Weims, I was quite surprised that a suggestion to wait a month would be made.  It was at this time that I really began to have serious questions about Dr. Marc and what he was saying, and I knew that I had to take whatever steps were necessary to get a true, definitive diagnosis for Rigby.

The AG office staff obtained Dr. Safra’s phone number from the Weimaraner Club of America website for me and I went to my car to call her to get more information on what x-rays she needed and how the blood needed to be labeled and shipped.  Dr. Safra was not available and I left a message and waited for her to call back. 

I also spoke with Linda, the breeder, and told her how the doctor was changing his opinion about the x-ray once I informed him about the HOD study and wanting to have someone else look at the x-rays.

I went back into the AG offices and waited for the phone call from Dr. Safra, which came about 40 minutes later.  She told me she could email the information about the x-rays and the blood she needed to the AG office, along with some documents that needed to be filled out by myself and the vet.  I obtained Dr. Marc’s email address from the office staff and passed it on to Dr. Safra.  I assumed the email was received by Dr. Marc, as he told me the prices of having the additional x-ray done and the blood drawn and I was given the paperwork to fill out.

Later Rigby was brought out to me, along with the x-rays, the blood that was drawn and the items I had left to keep Rigby comfortable while she was kenneled at the AG office.  I paid for the x-rays, NSAIDs and all the services that had been rendered for Rigby and left.

Because it was of utmost importance to me to find out as quickly as possible if my puppy was suffering from HOD and to start treatment as soon as possible if she was, on the way home I stopped at a Fed-Ex office on Route 19 to ship the x-rays, blood and paperwork to Dr. Safra in California.  I chose to have them delivered overnight, at a cost of $143.44.

The next day I received an email from Dr. Safra saying that she saw no evidence of HOD on the 
x-rays, but that she would have the radiologist involved in the HOD study look at them when he returned from a meeting.  I was relieved to get this news, but still did not know why Rigby was limping.

On Thursday, January 24, I started Rigby on the NSAIDs that had been sent home with us by AG, assuming that she must have pano, since that was the only other diagnosis offered to me.  I also continued to keep her on limited activity, doing what I could to help her heal.

On Tuesday, January 29 I received another email from Dr. Safra informing me that the radiologist had viewed the films of Rigby’s leg and that he agreed there was no HOD.  He also said that Rigby’s first toe on her right foot was broken, explaining her lameness and pain.

I was so relieved that there was a simple explanation for the pain my puppy was experiencing and so happy that she did not have one of the serious conditions that Dr. Marc claimed to have seen evidence of on the x-rays.

I was not, however, pleased about the misdiagnosis and the money that was wasted because of the failings of an apparently uneducated veterinarian.  A visit to the vet that should have cost about $150 grew to a cost of over $300 and then there were the fees for overnighting the radiographs and blood work to California.

I've always treated the vets of my horses and dogs with respect, been timely for appointments with my animals ready for whatever procedure was scheduled, followed their directions and paid their invoices on receipt of services.  My step-daughter is a veterinarian, so I've heard stories of how some owners can irritate and frustrate vets, and I've always made an effort not to be one of those people.

In turn, I do expect professional services and proper diagnosis and treatment of my animals.  This was not given in Rigby's case due to arrogance, neglect and/or a lack of knowledge.  

Over the years, as my knowledge has increased, I have learned not to blindly trust the explanations or opinions of all vets, and that day in January proved to take my lack of trust to new heights.

With the most serious of maladies my animals have suffered, including Dalton's EPM and Rocky's wobblers, I've consistently heard from my vets, oh, you caught this early, or, most people wouldn't have even noticed this yet, proof once again that an alert, informed owner is a pet's best friend.

I have since switched vets for Rigby and had a very good experience with the new vet clinic when she needed emergency surgery for pyometra.  I hope that I will have a lengthy and strong relationship with these new vets, but I will be asking many questions and doing my best to be a well-informed pet owner to ensure that my dogs get the care they deserve.

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