Vets-right diagnosis & decisions after death of pup
 

I'm sorry this is so long...

I recently posted about the loss of my little Harley. I am having such a hard time accepting his death and whether anything else could have been done to save his life. I plan to get another Yorkie soon but don't know if I need to use the same vet or try another one. His death has me wondering if this vet is the right one. This may be a crazy question but how do you know if you have a good vet? I just can't help but wonder if the vet could have done more for Harley or maybe if he had went to a different vet the outcome would have been different... Is it normal to think this way after a loss or am I loosing it? I am still to this day doing research on the internet of symptoms and diagnosis to see if my vet did everything he could. I just need some closure and also want to make sure I make the right decision for my next pup.

I actually chose this vet because one of the vet techs use to live next door to me so I felt comfortable with her. His office has a very laid back (and somewhat unprofessional atmosphere) but after I met the vet I really liked him. His fees seem real reasonable and he is always concerned about running your bill up. He never wants to perform tests or anything unless he thinks it is absolutely necessary. Harley was actually hospitalized with this vet 3 times over a 3 week period for his illness. He had ingested a large amount of NSAIDS and had drug toxicity (terrible accident). My vet said that the drugs had caused stomach ulcers and that's what he was treating him for. His bloodwork showed his liver and kidneys had not been affected. Harley had been throwing up blood and as soon as that ceased the vet thought we were out of the woods and he was going to be fine. However, Harley developed some other symptoms when he came home from the hospital and I called the vet and they told me to take him off all of the meds that had given him immediately. They thought he was having a reaction to the meds. He was pacing back and forth, restless, tremers, curling up in a ball like he was in pain and even had some whining.They wanted to see how he done off of the meds and recheck him that Monday. At this point he was still vomitting but with no appearance of blood. He got worse and I had to take him to an emergency vet that Friday night and the emergency vet gave me a different diagnosis of Gastritis. The emergency vets treatment didn't work either after paying $950 and Harley's health kept declining. By Sunday I had to call the emergency vet again and he wanted to charge me more outrageous fees. My husband is not working right now due to an injury so I couldn't come up with that kind of money again. My regular vet doesn't take emergency calls but I didn't know what else to do so I called the vet tech I knew. She was able to get in touch with my vet and he surprisely came in for me. I was really appreciative of that because he really went out of his way. He ended up doing a blood transfusion on Harley due to anemia but he passed away Monday during the night. Both vets had told me that they were sure he was going to recover so I was shocked to see his health keep declining. I guess I'm torn because of the 2 different diagnosis. I don't know if more test needed to be performed or what. I really don't have a cause of death besides my vet thinks that an ulcer ruptured and he was having more internal bleeding (he was still vomitting but with no appearence of blood). It's hard to get closure and know that EVERYTHING possible was done. My dogs life was in his hands so how do I know all the right decisions were made???

I am very sorry you can't seem to get closure on the loss of Harley.
Having eaten large amount's of poison, which NSAIDS are to dogs,
especially small ones, that should be enough to realize your vet did
everything he could but I do understand there always be a question
about it being enough done for Harley. Somethings we just have
to accept. I am sorry your little one suffered for a couple
of weeks before passing, that must have been very hard to go
through. If I felt like you I would most certainly look for a new vet
because I don't think you will ever be comfortable and trust this one.
Ask your friends for referrals. Check out other local vet's web sites.
I hope you find one your comfortable with.
I am, once again sorry for your loss of Harley,


Hugs,

I am sorry, I know this is heartbreaking but unless you had done a neocropsy on your pup you will never know why he died and got a second opinion.

Your vet sounds like he was very concerned and "first did no harm" which is very important to me. A vet that just starts throwing stuff at a dog is a hugh concern to me so I like your vets approach.

I wish you could have closure but I just am not sure you can unless you do a lot of research on the internet to see if they followed the correct protical.

Hi, I am so sorry for your loss and all the pain and suffering you and Harley have gone through. I wish there were words that would help but I know there aren't any. When I read your post, I had to look over to your profile to see where you were from because my first reaction was wow she is talking about my vet!! We have had the same vet for 20+ years. They way you described your vet fits ours to a T. I like him because the dollar isn't the most important thing to him. His costs are so much less then other vets around here. Maybe his office isn't as "high class" as some and not as professional or fancy as alot of others but he still has done a great job taking care of our pets over the years. On the other hand, we have never had a really serious situation with life threatning decissions and treatments. I have often wondered what we would do in that situation. Would we run to the really expensive vets with the belief that they might know more or be able to do more for our little one??? Hard question! I guess we would have to go with our gutt instinct at the time. In a wonderful world we could all go to the best and have the money to do it but there are alot of us that don't have that choice. If you have a vet that you have been happy with and trusted before, maybe you could just try to focus on healing and getting through this difficult time before you decide on changing your vet. My prayers are with you. Debbie

That's not really a different diagnosis--gastritis is just a fancy way of saying stomach upset. It sounds to me like everything was done for your poor baby.

I want to say how sorry I am at the sadness you feel over the death of your boy, Harley. It sounds like he was a precious little man for you and your family.
I am prefacing this by saying I'm not a vet but I am a nurse and also had a husband that died from pancreatic cancer that spread to his liver and I became more knowledgeable about the liver than I would have been other wise.
I want to share a perspective about Harley's death although I don't want you to take it as a negative judgment. Most of us know that accidents happen and sometimes the consequences are very hard. NSAIDS ingested are hard on the liver and kidneys especially in an overdose situation as it was with your little guy. When presented to your vet with this situation they deal with what's in front of them. Unfortunately, there is the possibility that the situation in May of last year when Harley ate the sugarfree gum that had Xylitol in it and your vet didn't think it was anything to worry about may have damaged the liver to the point where his little body couldn't clot the blood. One of the functions of the liver deals with blood clotting. Only a necropsy would have told you exactly what caused his death and in hind sight it's really only second guessing but it seems to me that with the documented information out there on the dangers of Xylitol, you were blessed to have had 8 1/2 extra months of Harley in your life. I don't know, he may have lived a long life and never had any problems from his liver but it seems to me your vet may have made all the right decisions in the NSAIDS situation but all the wrong decisions back in May with the Xylitol. I know there are things in life that I look back at and try to learn from as well as having had animals (mainly my alpacas) die as a result of ignorance (my own and my vets) and the learning curve of life and I look at how my vet handles it. It doesn't make the loss any easier but if my vet were to take the information learned and use it so no one in their care is hurt by that thing again, then I feel a little better knowing they learned something. I'm not sure you were ever able to talk to your vet about the Xylitol dangers. If he was still ignorant of this and blissfully thinking sugarfree gum is ok as long as he passes it, than he wouldn't know to add that possible liver damage to the situation of the NSAIDS. Maybe your boy would have survived one or the other alone but again it's really just a guess without a necropsy.

I don't think it was anything related to his liver. He had bloodwork done with both my vet and the emergency vet and they both told me his liver and kidneys were functioning great. I know hindsight is 20/20 and if my husband could go back to that day he would not have put his prescription on the bedside table. He had doctors orders to stay in bed and put it there because that's where he could reach it. Any other time Harley would have been closed off from that room but because my husband was home that day he was free to roam in the bedroom. There's alot of IFS but too bad I can't turn back time. I wasn't home that day to protect him.

THIS IS EXACTLY WHY I AM NOT A BIG FAN OF NSAIDS - nsaids can perforate a human bowel and if given with steroids or given on empty stomach it can cause alot of intestinal damage - ulcers, ruptures etc. I only use this if absolutely necessary.

what nsaid was given and was it prescribed by vet or did he get into some meds at home. I am so sorry this happened

I always go to specialists when it gets serious as they have further education and training

here is some info on nsaids

Advice to Dog Owners Whose Pets Take NSAIDs

I constantly educate myself and work with vets and specialists as a team effort as I feel no one person knows everything about everything.

the way you know if an ulcer is coffee ground stuff in vomit or diarrhea as it is dried blood from the intestines.

here is some info on ulcers

Gastrointestinal Ulcerations in Dogs

what meds was your dog prescribed by vet after having an ulcer

accidents happen as sad as it is :( we try so hard to keep them safe but sometimes things happen - you cannot beat yourself up over it as what is done is done and he knows you did not hurt him on purpose - all we can do is once we know better we do better

sounds like vet did plasma transfusion and that is the best thing to do to flush toxins out of the body when poisoned - my dex had that when he had severe pancreatitis and i believe it saved his life. The only thing is maybe he could have done that in the beginning if it was a toxic poisoning but i think he tried to do everything he could think of and plasma is fairly new in the vet profession - i can only say next time if it is something this serious get to know an internal medicine specialist as that is where i took dex and she saved his life - had i left him with the vet i think he would have died.

I am assuming your pup took human doses of NSAIDs? Based on what you are saying it was an accident....so that is what I am thinking.

I dropped one Ibuprofen tablet on the floor about a month ago, and one of my pups grabbed it and swallowed it. I called the vet and they said to come in immediately. They got him to vomit, but never saw the pill. (maybe he had not swallowed it...but not sure where else it could have been). They treated him anyway because this is a dangerous thing and can cause ulcerations of any part of the GI tract. He had activated charcoal....and for two weeks was on medication. He took Pepcid and Carafate.

Large doses of that medication is deadly for a pup. NSAIDS do have their purpose for dogs and humans, but in moderation and used carefully. It sounds to me like this was not prescribed, but an accident.

I really think that if it had already been in his system long enough the damage may have already been done and perhaps the end result would have been what it was.

I am just terribly sorry for your loss of Harley. I don't know the full story, so I cannot give an opinion about your vet. It does sound like he cares.

yeah i do not think the liver or kidneys were affected if blood work was ok but i do think he my have had a perforated bowel from the nsaid damage. Nsaids damage the intestines and if they get past that then they can damage the kidneys and liver - sounds like it damaged the intestines and internal bleeding to me :(

Thank you for saying that because I have been beating myself up over this..at first I beat my husband up over it because it was his medication that was left out. I know he wouldn't do anything to hurt Harley because he loved him just as much as I did but I was angry with him for a while. The medication was mobic...it was prescribed to my husband. He had fractured a disc in his back and the broken piece was lodged against a nerve so his movement was very limited. The doctor had put him on bed rest until he could have the surgery. There was no one there to take care of him so he decided to put everything he needed (medication included) on the nightstand beside the bed so he would be able to reach it and not have to get up. It was a bad idea but he was also on pain meds so he probably wasn't thinking clearly. Thank goodness when it happened my teenagers had already got home from school. My husband got up to go to the restroom and a few minutes later my daughter heard Harley playing with something so she went to check on him and discovered he had the bottle of pills. He chewed it enough that they fell out. They called the vet and were told to induce vomitting. They induced vomitting but didn't see any pills. The first time he was hospitalized he was in for one night and they said that he was doing so well they were sending him home. The vet couldn't believe how well he was doing. The only signs he had at first was vomitting and he laid around a little more. The vomit didn't look like coffee grounds but it was dark and sometimes you could see small blood clots in it. After about the first week he was just about back to normal...playing and everything but was still vomitting. So he was hospitalized again because of his vomitting. The vet told me at that time that his gums were pale and he had low platelets but he wanted to keep an eye on him because he didn't think he was to the point of needing a transfusion at that time but if he kept bleeding he would. He was at the hospital 5 days so they could keep a close eye on him. He was doing so well they decided to go ahead and send him home. He still had some vomitting but it had slowed down and it was clear...didn't show any signs of blood. He was on Cimetidine, calcium and one other medication (I can't think of the name of it and don't have my paperwork with me.) It was after the 2nd hospitalization that he started going downhill.
Dwerten...thanks for all of the information and for being so kind. I was really scared to post all of this information because I didn't want to get beat up over it...believe me I am doing enough of that myself. I just wanted to get some other opinions. You may be right about the perforated intestines...I'll have to read a little more on that. The last time I took him to the vet that Sunday I had noticed that day that his stomach was swollen and I know he didn't have a bowel movement from the time he went to the emergency vet on Friday until he went to my vet on Sunday. Thanks again!