Some things you just can't make up.
Our clinic has been seeing a 10 year old Boston Terrier. He has had some hair loss and skin issues, so we started working up the case. His overall blood tests were good, but his thyroid level was low. We started him on a supplement and brought the thyroid level within normal range, but his skin didn't get much better. We had already ruled out bacterial and fungal diseases and he wasn't itchy so we didn't think that allergies were a likely cause. I had become a bit stumped and had recommended that they take him to a local veterinary dermatology specialist.
That was back in early May.
Today the wife comes in and asks about whether or not the disorder could be mange. For those non-vets reading this, let me explain a few things. There are two kinds of mange we commonly see in dogs: Demodex and Sarcoptes ("Scabies"). Sarcoptes can affect any dog at any time and causes significant itchiness. Demodex occurs when the immune system is immature or suppressed and we almost exclusively see it in dogs less than a year old. An adult dog shouldn't have Demodex unless there was a real problem with their immune system and other signs of illness. This particular dog wasn't itchy, didn't have the signs of scabies, and was overall healthy. Could it have been Demodex? Actually, yes. However, that was certainly not our first thought in a 10 year old dog with confirmed hypothyroidism and no other signs of illness.
So why did the client ask about mange? When my receptionist, Christina, was asking me about it my first thought was that the client consulted "Dr. Google" in an internet search. But Christina said "oh, it gets better." I cringed. "She was talking to the guy at the tire shop where she was getting new tires, and he said that he had a dog with mange that looked exactly the same. So she was asking if it could be mange."
We had to spend some time explaining that mange in a dog that age was extremely unlikely, that we had absolutely confirmed hypothyroidism, and that there were no other signs of health problems to suggest an immune system disorder. Even so, I don't know that she was completely convinced that I was right and the tire guy was wrong.
I don't mind my clients looking things up online. It often stimulates good conversations and I like clients to be well educated. However, I always ask my clients to discuss things with me before taking "Dr. Google" as the ultimate source. Heck, I always tell you readers to check with your own vet! Any vet on the internet is handicapped by not being able to see and examine a patient, and you should never rely on such advice as the sole voice of diagnosis and treatment. If you're merely searching by symptoms you don't have the clinical judgement and ability to take a list of findings and appropriately tie them to a proper diagnosis.
But you should never listen to a non-veterinarian over a vet.
Sure, talk to friends, co-workers, and random people to see what they might suggest about your pet's illness. But when you then talk to your vet, realize that they have the training, knowledge, and skills to make a proper diagnosis. When it comes down to who you believe, give your vet the edge.
We had to spend some time explaining that mange in a dog that age was extremely unlikely, that we had absolutely confirmed hypothyroidism, and that there were no other signs of health problems to suggest an immune system disorder. Even so, I don't know that she was completely convinced that I was right and the tire guy was wrong.
I don't mind my clients looking things up online. It often stimulates good conversations and I like clients to be well educated. However, I always ask my clients to discuss things with me before taking "Dr. Google" as the ultimate source. Heck, I always tell you readers to check with your own vet! Any vet on the internet is handicapped by not being able to see and examine a patient, and you should never rely on such advice as the sole voice of diagnosis and treatment. If you're merely searching by symptoms you don't have the clinical judgement and ability to take a list of findings and appropriately tie them to a proper diagnosis.
But you should never listen to a non-veterinarian over a vet.
Sure, talk to friends, co-workers, and random people to see what they might suggest about your pet's illness. But when you then talk to your vet, realize that they have the training, knowledge, and skills to make a proper diagnosis. When it comes down to who you believe, give your vet the edge.
