How the Doctor Almost Killed Her Dog (article)

[lei325]

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http://well.blogs.nytimes.com/2011/01/20/how-the-doctor-almost-killed-her-dog/?hp


"The bottom line is that while your domesticated pets may act like small children and your children may, at times, act like wild animals, when it comes to health care, they should always be considered different species."

Interesting blog article. I've seen it when I was a vet tech, where MDs think they know what's right, and then they don't understand why the dog is going into renal failure. MD≠DVM.

 

[LetItSnow]

Interesting blog article. I've seen it when I was a vet tech, where MDs think they know what's right, and then they don't understand why the dog is going into renal failure. MD≠DVM.

There's a lesson for people in the vet world, though, too, and that's that it's just as true going the other direction (DVM≠MD).

 

[Bigcatlover]

Great post. I think all pet owners should have access to a more extensive list of what is poisonous for cats and dogs.

 

[sumstorm]

There's a lesson for people in the vet world, though, too, and that's that it's just as true going the other direction (DVM≠MD).

At least in our vet school, we hear again and again that we can't treat humans (especially in parasitology). not sure if that is true at other schools, but technically, if you are the owner, you can treat your own pet, and my friends that graduated med schools insist they were never told that they shouldn't apply thier knowledge to animals.

 

[VeganSoprano]

I have a humorous story that I've used with clients to illustrate this principle: a vet I know was having an allergic reaction of some sort and decided to take diphenhydramine. The instructions on the box said to take one tablet (50 mg, a standard dose for adult humans). The standard dose for dogs and cats is 1 mg per pound of body weight. So this guy looked at the label and thought "that doesn't make sense, I weigh a lot more than 50#"...and proceeded to take 3 tablets. In the end, it was pretty much a miracle he was able to drive home safely and he was nicknamed Rip Van Winkle for some time afterward.

 

[Trilt]

I once came back from a 10-hour shift to see an email from my mother that said "I gave Slurpee [my family dog] some ibuprofen because he was limping. Is that okay?" dated seven hours ago. Cue minor heart attack.

Luckily, she didn't give enough to cause any problems (my boy's a pretty big dog), but I told her in the future to call or email me first.

 

[Whyevernot55]

I have a humorous story that I've used with clients to illustrate this principle: a vet I know was having an allergic reaction of some sort and decided to take diphenhydramine. The instructions on the box said to take one tablet (50 mg, a standard dose for adult humans). The standard dose for dogs and cats is 1 mg per pound of body weight. So this guy looked at the label and thought "that doesn't make sense, I weigh a lot more than 50#"...and proceeded to take 3 tablets. In the end, it was pretty much a miracle he was able to drive home safely and he was nicknamed Rip Van Winkle for some time afterward.

Oh my, I know a vet assistant who did that once. He was like "well, we give the DOGS three, so I took three!" 😱 He was very, very sleepy. 😴 It was actually kind of hilarious.

 

[cowgirla]

I have a humorous story that I've used with clients to illustrate this principle: a vet I know was having an allergic reaction of some sort and decided to take diphenhydramine. The instructions on the box said to take one tablet (50 mg, a standard dose for adult humans). The standard dose for dogs and cats is 1 mg per pound of body weight. So this guy looked at the label and thought "that doesn't make sense, I weigh a lot more than 50#"...and proceeded to take 3 tablets. In the end, it was pretty much a miracle he was able to drive home safely and he was nicknamed Rip Van Winkle for some time afterward.

Last time I took one 25mg benadryl, I started shaking like crazy, heart was racing and irregular, and started hallucinating. I can only imagine that I might have done if I had taken 150 mg....probably jumped off a roof or run naked into traffic or something. Who needs LSD when you can pop some diphenhydramine!

 

[Willowhand]

A foolish mistake, but the MD more than redeemed herself in my eyes by admitting her error and using the episode to help educate others. Kudos to her!

 

[LivestockDoc]

Who needs LSD when you can pop some diphenhydramine!

Hey, I'm still useful for some things! 😛

 

[Willowhand]

On the diphenhydramine tangent, I was once in the ER for an allergic reaction and the Doc gave me 250 mg (I weigh 120lb and 50 mg is usually enough to knock me out). He also had me on prednisone, which seemed to cause insomnia. The allergic reaction was controlled, but I spent the rest of the day as a drowsy, twitchy, jello-brained lunatic

 

[WhtsThFrequency]

There's a lesson for people in the vet world, though, too, and that's that it's just as true going the other direction (DVM≠MD).

True, but vets are much less likely to try and diagnose/treat other humans a) other humans wouldn't let them and b) human life is more expensive/valued than animal life, so we're too cautious.

I don't think the veterinary world needs a lesson - we know all too well we can't treat people. MDs (and the general public) are all about trying to treat animals themselves with limited knowledge. An animal can't say "no, don't treat me, you don't have the right knowledge" like a human can, and they are considered less valuable so people tend not to be quite as cautious when applying medical treatment. I see it all the time.

 

[DVMDream]

True, but vets are much less likely to try and diagnose/treat other humans a) other humans wouldn't let them and

Actually, I have had a few clients ask questions to the vet about themselves and ask if the vet will tell them what it is/give some meds. Funny story: Yesterday some guy called and stated that he had been waiting in the ER for the past 3 hours with a spider bite that had abscessed and he wanted to come in to us so that the vet could lance it, drain it and give him some antibiotics because he didn't feel like waiting anymore. There are some crazy people out there. 🙄

 

[Dsmoody23]

A foolish mistake, but the MD more than redeemed herself in my eyes by admitting her error and using the episode to help educate others. Kudos to her!

Agreed.

Pretty ballsy move to go to the New York Times and publish your mistakes.

I definitely respect that, and wish we'd see that kind of humility more often.

 

[spicykimchi]

She's brave to put her neck out to the world like that and admit that even MDs can make huge mistakes.

 

[LetItSnow]

Agreed.

Pretty ballsy move to go to the New York Times and publish your mistakes.

I definitely respect that, and wish we'd see that kind of humility more often.

That's why it's so discouraging when people are nasty to someone like that (the comments on that page were filled with "what a *****" type of comments). Sure it was a stupid move, but hey - the author already admitted that.

People need to consider the outcome: the author made one dumb move and put one dog at risk, but by being so public about it s/he probably prevented 10? 100? 1000? dogs from being put in the same position down the road. In my book that more than makes up for it.

 

[david594]

Your veterinarian may recommend a medicine called Rimadyl, a nonsteroidal anti-inflammatoy drug that works in dogs but, wouldn’t you know, is toxic for people.

I'm still lost on where they came up with this statement. Since when did carprofen become toxic to people?

 

[EllieGirl89]

I'm still lost on where they came up with this statement. Since when did carprofen become toxic to people?

If taken in great enough quantities it results in liver damage and subsequent jaundice. That's why they stopped using it for people.

Someone correct me if I'm wrong but I'm pretty sure that's right.

 

[DrYoda]

I'm still lost on where they came up with this statement. Since when did carprofen become toxic to people?

It's not, its adverse effects are similar to other NSAIDs in humans. It was voluntarily pulled from the human market and according to my pharm book (katzung 10th ed) still available for humans in some countries.

If taken in great enough quantities it results in liver damage and subsequent jaundice. That's why they stopped using it for people.

Someone correct me if I'm wrong but I'm pretty sure that's right.

Many drugs are bad if taken in great enough quantities. It's the therapeutic index type measurements (LD50/ED50) that are important when telling if a drug is safe or not.

 

[laitmanvet]

Independently of this post, I found/read this article. My first reaction was: at least she admitted her mistake and then wrote about it in a way so other people don't make that mistake. It was gutsy I suppose.
But I sorta agree with some of the comments on this piece. Why didn't she google?
Also, I can't think of one medication I would give my cat out of my medicine cabinet. Not only do I know my cat digests things differently than me but he also weighs significantly less than me. Even with, say antibiotics, I'd be afraid of mis-dosing him. There are even very few foods out of my fridge I would feed the cat.
I don't in any way think this makes her a bad human doctor, as many of the commenters on the NYT website said....but perhaps she was a tad facetious here.

 

[Willowhand]

But I sorta agree with some of the comments on this piece. Why didn't she google?

She probably would have found the answer easily enough in this case, but what about any number of other situations? I've been in vet school for less than year, and already I've seen the ugly aftermath of Dr. Internet's prescriptions. I'm all for clients who like to be well-informed and do their research with reliable sources, but deciding to medicate your animal (or yourself, for that matter) based on the results of a google search just seems like a bad idea.

 

[Jakesmom]

My aunt just sent me a message on facebook saying her dog was limping and asked what I thought she should do. I told her to make an appt to see her vet. Since today is Saturday, she said she'd do it on Monday and asked if she could give the dog some ibuprofen until then. Of course I responded with a resounding NO!!!!!!!!!!, but it's just so common for people, MD or not, to think they can give human meds to their animal. Anything that can be done to bring awareness to the subject is 👍👍 in my book, so I say big thanks to her for helping educate our future clients.

 

[Lubeckd]

I kind of want to go into vet medicine through pharmacy though. Because I always have a soft spot for cats and dogs <3

 

[david594]

I kind of want to go into vet medicine through pharmacy though. Because I always have a soft spot for cats and dogs <3

There are a decent number of pharmacists in the US that work in the veterinary profession. I'm pretty sure most teaching hospitals employ a couple(we have 2 here), and I know a of some very large private practices that have had pharmacists on staff.

 

[BeagleOne]

[QUOTE my friends that graduated med schools insist they were never told that they shouldn't apply thier knowledge to animals.[/QUOTE]

One would think that if they are intelligent enough to get through medical school that they would also be intelligent enough to figure this out on their own.

 

[scb44f]

One would think that if they are intelligent enough to get through medical school that they would also be intelligent enough to figure this out on their own.

The problem is since some of them learned anatomy/physiology using animals in college, and all of them know that the results of research on animals is often applied to humans, they (yes, generalizing) figure it's all the same. I've seen this in my own SO who's an M1, who I have to remind over and over (and over again) that it's not that simple.

 

[katryn]

Having nitpicked MD clients about this before, one of them put it in perspective for me. Vets are taught comparative anatomy/physio from day one. It's beaten in to us that dogs, cows, cats, horses, pigs, etc are NOT the same. However, MD's are taught human medicine. Not only are they taught human medicine only, but that it is the "right" answer, because for them, there is no other answer. And unfortunately intelligence does not equal common sense. Some MD's simply never think to consider that animals may be different.