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Wednesday, June 30, 2010

Yes, There Is A Real Reason

Today I saw a dog for a behavioral consultation, a particular interest of mine.  He was showing aggression towards the other dog in the house and the owner was concerned.  After a lengthy visit and asking many questions, I determined that besides changing some things in the household and doing behavioral therapy, he would likely benefit from medical therapy.

Whenever we're evaluating for a behavioral problem we want to rule out the possibility of an underlying medical disorder that is leading to the abnormal or unwanted behaviors.  So besides doing a thorough history and physical exam it's common to do routine lab tests, even if the pet otherwise appears healthy.  And when we are considering placing a pet on long-term medication we want to screen for any underlying problems that might make it dangerous to use these drugs.  For both of these reasons I recommended that we do a battery of tests on the dog. The client balked at the cost and was concerned about the necessity of the tests.  After explaining it again, she reluctantly agreed.

And it's a good thing we did, because we discovered a potentially serious liver disorder.  His liver values were significantly elevated on the blood tests (for my vet readers....ALT was 654, and normal range is 10-100; ALKP was also elevated at around 250).  First of all this meant that we couldn't start him on drug therapy because of the potential risk of of complications due to a liver problem.  Second, it meant that he would need to have even more tests, likely with a specialist, to discover what was causing the problems with the liver.  Now when the liver is abnormal, waste chemicals can build up in the blood stream and lead to neurological disorders.  Usually this includes seizures, incoordination, and lethargy, but can also include behavioral changes.  So there is a possibility that the dog's abnormal behaviors are related to a liver disorder.

Now you would think that someone might be glad that we didn't just put their pet on a drug that could end up being harmful, and that we had possibly figured out a reason for the aggression.  However, the owner seemed a little upset when she left and was pretty curt at the end of the visit.  She was probably thinking of how much more money she was going to have to spend getting his problem diagnosed, and not thinking of the potential severity of a liver disease.

This is exactly why vets want to run diagnostic tests.  To just look at the dog you would think he was very healthy, never knowing that there was a hidden problem.  If we had not run the tests and simply tried medication, we could have given him complications due to the drugs, or simply overlooked a serious problem and delayed a true diagnosis.  So when your vet makes recommendations for tests, please understand that it's for a real reason, even if it may not seem obvious to you.  We really do catch problems by practicing quality medicine.

1 comment:

  1. I just cannot understand some pet owners. I of course would not be happy hearing my pet is sick but I would be very grateful that I had such a good vet.

    Question for you. One of my dogs is very aggressive. When I first got her from a rescue a little dog (off leash) got in her face and she bit the dog. The dog died on the way to the hospital. (Severed artery).
    So I have discovered she is very aggressive to all animals. She goes bonkers when she sees another dog. Last week she caught a full grown ground hog. She carried it and shook it for a good 20 minutes.
    No matter what I did she would not let go.

    She is 125 lbs and my other dog Rock is 175 lbs so it is very hard to walk them together. Rock is fine but Molly can get very excited.
    I have been to two trainers and have done the work they suggested but she still remains very hyper when it comes to other dogs.

    She has had blood work done and she is fine.
    Do you think it might be helpful for her if I approach my vet about trying some SSRI's for her? Do you think they work on dogs? I have not heard too much about them with animals but it seems to be an over-looked drug fro behaviour or fear issues.

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