Educational tips for pet lovers

The dog sees the vet and goes into fits

Mrs Lee slid open the consultation room door carrying a Silkie with jaws clamping open and shut non-stop, body trembling violently and eyes looking very frightened, as if the dog had seen a ghost. Watery drops of saliva drooled onto the stainless steel top of the examination table. 

"I am sorry to intrude. This is an emergency." Mrs Lee said.  A dog having uncontrolled body shaking, like an epileptic person foaming in his mouth is frightening to anybody. Will the dog die of heart failure if treatment is delayed as the violent tremors showed no signs of abating?

I was completing my consultation on a dwarf hamster that was not eating.  Its owner, a ten-year-old girl was so shy that she would whisper her observations and her mother would ask her to repeat her answers.  This hamster could not eat because the lower front teeth had overgrown up and inwards into the roof of the mouth while its upper front teeth were missing. They left the room quickly.

Dogs in fits are an emergency.  The owner expected instant treatment. I broke open a vial of anti-fit drug, looked for the white spot which indicated the place to break the glass ampoule safely.  There it was but somehow, the broken top nicked my left fore finger, causing blood to ooze from the wound.  

Mrs Lee said, "My dog has bitten his tongue. How to stop him from biting his tongue?"  The lower muzzle was stained with bright red blood. There was no time to put something in his mouth to save the tongue. I injected the drug into his back muscle rather than injecting into his vein.  He was not the typical fits case and seemed to be frightened as well.  Therefore, finding his leg vein would delay the effect of the drug as he would struggle more. He was already five minutes into fits, I estimated. There was no time to take the history.

"Was he on anti-fit medication?" I asked Mrs Lee. This was the first time I had met her and I presumed this was not his first episode of fits.

"The other vet did not give such medication," she said. This meant that the dog did have fits before.

"The rectal temperature is 40.2 degrees celcius while the normal temperature should be less than 39.5 degrees."

Was the fever the cause of the fits?  The thermometer could not deceive. It would be a snap diagnosis of fever. Well fever was not the cause of fits. Since the complaint was skin disease, the dog would have been normal and the 'fever' would be caused by its muscular tremors over five minutes.

She had brought the dog for consultation of skin disease on his chest, the lower part called the sternum and the fits had just happened when the dog arrived at the surgery. She had seen the other vet twice in over 12 months but the condition had not improved. Some skin diseases require follow up veterinary examination a month later but the vast majority of Singapore owners do not do so.

"Maybe, your dog is frightened of vets or veterinary premises," I tried to lighten the situation with humour. This was a dog with frightened eyes in addition to fits. So far, there have been no reports of dogs going into fits on entering the veterinary premises.  All vets know of dogs refusing to enter the veterinary premises or running out quickly and biting the vets during examination to show their displeasure and their association with pain. This was a dog who became hysterical and actually developed fits on nearing the door of the surgery.   

"I brought the dog to see you as you have fewer patients," Mrs Lee said, comparing to a very busy practice. "The last two visits to the other vet resulted in my dog developing fits."

Yet, the dog developed fits here too and there were no long queues of dogs and cats. There was no dog or cat at the small waiting area to be seen on this overcast grey afternoon.  

There was a hamster inside the consultation room.  Two guinea pigs were waiting outside as all cases are made on appointment here. However, Singaporeans seldom are punctual in their half hourly/case appointments and the cases bunched up. No owners had strayed in for consultation. 

This Silkie would have seen only a couple who had a pair of guinea pigs inside two paper bags. Somehow he must have an acute sense of smell, the veterinary premises had a distinct smell and he could sense it from twenty feet away at the car park. The owner had parked her car forty feet only at the other row of car park as she had previous experiences of her dog behaviour. As she reached the front of the surgery, the fits developed.   

"We would need to remove this Silkie from the consultation room and go far away," I said. The drug had reduced the intensity of fits but the dog seemed to be worried and shaking. Mrs Lee took the dog ten shops away and the dog settled down.

"I would discuss the treatment of the skin disease with your son," I said. A tall strapping handsome man, around twenty five years old, towering over his mum whose slim figure would make a good advertisement for the various slimming saloon advertisers. Her chocolate brown face might mean she was an avid golfer.

Was this a new dog behaviourial condition not described in veterinary literature, a case of 'vet phobia?"

It was 3 o'clock in the afternoon and a storm was imminent.  Dark clouds blanketed the sky of this Deepavli public holiday, a festival of lights. The atmospheric pressure had changed and dogs have been reported to be frightened of lightning and thunderstorms. They would whine, hide, urinate, injure properties or themselves. They may run away from the house to escape from the forces of nature. This is known as storm phobia. There was no lightning today but this dog would sense the climate changes.  

Certainly the Silkie was frightened of being near the veterinary premises as he struggled to be examined outside the main door and injected. He flexed his head and I thought, he was going into fits again. After the injections, he was taken far away again.  
   
The skin disease on the sternum was an initial wound which got licked by the dog over twelve months. It had now extended into a size as big as the palm of the young man.

"The cream given by the vet is useless," Mrs Lee complained.
"Well," I said. "The dog keeps licking the cream off and therefore it could not work effectively."

Mrs Lee must have used an Elizabeth collar round the dog's neck as recommended by the other vet but had removed it as the dog must have objected to it.  So, the vet gets the blame for not producing results. 

The centre of the sternal skin was greyish due to long term licking. The edges showed that hair follicles had been infected by bacteria. 

"How did he become frightened of vets?" I asked. Certainly he was happy at the vet as a puppy and had received two vaccinations without any problem.

"Was there something traumatic at the veterinary premises?" I asked.  "This Silkie was castrated by the vet at six months of age." 

Mrs Lee remembered the event. Her dog was held overnight at the veterinary premises before castration the next day.  This could be the root of the problem. The Silkie might have developed 'separation anxiety', another behavioural problem in the dog. 

In going to the vet, the dog remembered its youthful experience of being abandoned all alone in a place with the barking of many dogs, the meowing of cats, the strange smells of disease and disinfectants in the veterinary premises. He felt he was going to be abandoned again. This triggered the fits. He knew he would be rewarded as his owner would quickly take him away from the veterinary premises.

"There is a need to follow up four weeks later,"  I said to Mrs Lee. "You will need house-calls.  This dog should never step into a veterinary premises as long as he lives."

"Do you make house-calls?" Mrs Lee asked.  "I seldom do, " I said. "It is much more difficult to treat a dog at the house. It can be aggressive or even run away." 

In retrospect, I should not have said not bringing the dog near the veterinary premises. What if the problem was also aggravated by the storm phobia as the short thunder storm was present at that time too.

House calls can be expensive and I don't know whether the dog will go into fits on smelling the veterinarian? If this happens, the owner will not be too happy to pay the house call charges. 

Like a small group of people, a small percentage of dogs do suffer from neurosis, commonly called behaviourial problems.  In this dog, the mental disorder resulted in a drastic change of personality whenever he is brought near the veterinary clinic. Could he be worried that he would be left all alone in the veterinary premises. His separation anxiety leads to fits and his owner will definitely reward him by taking him away from the veterinarian?  There was no thunder heard by me at that time but the dog could have heard the thunder. Some dogs do suffer from storm phobia or fear of thunder and lightning. The conditions of storm were present at that time and in fact, it was raining dogs and cats for the next half an hour.  

Is there a cure for this phobia?  In human medicine, the patient is slowly exposed to the source of phobia and learn how to overcome it.  If this dog is walked past the veterinary premises over a period of time, a long period of time, will his fear be decreased? It is not practical for Singaporeans who are time-pressed and scarcely have time for themselves, let alone, resolve a dog's behaviourial problem.

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