Cushing Veterinary Clinic, in my opinion, is the main hub of our cute little town. We’re like the Central Perk in Friends, the bar in Cheers or Arnold’s in Happy Days. I see people of all walks of life and animals of all shapes and sizes. I never know what is going to come through the door. Some days are filled with highly intense cases and other days we see cute little puppies needing vaccines. I like the cute little puppy days!
This past June, I had a patient come in that was not your typical case. Scout was a 14-month-old German Shepherd, fully vaccinated and on heartworm preventative and flea/tick preventative. Basically, his owners take exceptional care of Scout. The owner said that Scout was not feeling well, had not eaten in the last 24 hours and was just not himself. He was not vomiting, didn’t have diarrhea, and was still very bright and alert. Hmmm…cases with such vague symptoms are always tough. After a thorough physical exam, I opted to treat for a simple gastritis (upset belly) and treat with a broad spectrum de-wormer (gets all those bad bugs!). I told the client that if Scout was not better in a few days, we would do some blood work.
I called to check on Scout the next day and he was eating and doing well. Yay!
But a week later, Scout was back in the clinic.
We drew his blood, but the results were normal and didn’t provide any clues as to what was happening with Scout who was now starting to lose weight.
Scout started to lose weight
During Scout’s numerous visits to the clinic throughout June, I maintained a very open conversation with Scout’s owner. It is very important to me to always communicate why I’m making the exam, diagnostic or treatment decisions that I am. It is also very important to me to always be truthful and when I don’t know something, I let the owner know. In Scout’s case, I was stumped. Being a young veterinarian, I gave Scout’s owner referral options if they wanted a more experienced veterinarian. But they chose to keep him in my care. The fact that they trusted me so much with their precious Scout made me think and research even harder to find out what was wrong.
At this point, I decided to do a series of radiographs (x-rays) to try to see if there were issues in Scout’s abdomen. Being a veterinarian can be a lot like being a private investigator. Unfortunately, animals can’t tell us exactly what’s wrong, so we have to use all the clues we can to make a diagnosis. But if you keep digging sometimes you stumble upon an answer. It also helps when you have clients that trust you.
The radiograph did reveal a new clue, but it wasn’t on the abdomen. The radiograph I took showed a glimpse of the lungs, but something didn’t look right, so I took some chest radiographs to get a better look. His lungs looked very splotchy. A differential diagnosis popped into my head. FUNGAL! I ran into my office and started to look up all the symptoms of Histoplasmosis. This is a common fungal infection found in dogs, especially in Oklahoma.
By golly I think I had it. To be sure, I sent in a urine test. The results came back a few days later and it was indeed Histoplasmosis.
I could have danced, so I did…until my staff made me stop.
Beginning of treatment
We started Scout on anti-fungals right away. But we still weren’t out of the woods. He was still in a lot of pain, not eating very well and losing a lot of weight. We even discussed his quality of life, but before losing all hope, we changed up his pain medication, and Scout finally took a turn for the better! Hooray!
This entire process took a little over a month to diagnose and manage treatment.
I want to thank Scout’s owners for putting so much faith and trust in me. It isn’t easy to keep going, especially with the same veterinarian, when things aren’t getting better. It took faith for them to stick with me, and I’m so thankful Scout is doing great now.
Scout came in last Saturday for his check-up. He has gained his weight back and looks fantastic!