Ear update

[meeciegeezer]

So I started researching and calling local vets this morning, and got an appointment with the 3rd clinic I called (yes, yes, I REALLY should have done research earlier, but yeah, school, busy, since the move).

I did like the vet. An older, Indian guy who did all his initial training in India, and got a PhD here in the states before he went back to get his license. In fact, he did some reproductive endocrinology work just up the hill from where I work at U of Michigan. I'm not sure why he's in private practice again, but I'd give it a guess that it has to do with the same reasons I'm looking to leave research...

But anyway, he was very good. Riley handled having her bandage cut off just fine, and he didn't want to re-bandage her. He said just to leave the cone on, especially if the ear drains at all (it'll cut down on the splatter), but other than that, I can just put a bit of stockinette over he head babushka style if she gets antsy about rubbing or scratching it.

I talked with him about the anesthesia issue, and he went through the record very carefully, and asked me if the emergency center vet was young. Riley was, in fact, overdosed on butorphenol, not the stand-alone dose, but in combination with dexdomitor. And that likely caused the extreme bradycardia and apnea. So, I'm still thinking about how to handle that, whether I should send a letter to the emergency clinic so they don't actually kill some other person's dog.

And possibly the most concerning: he was worried that since Riley didn't have an ear infection and hadn't been doing much head-shaking that I'd seen that this may have been caused by an underlying autoimmune disorder. So I guess I have some research to do, and she has a pred course and taper now on top of the antibiotics and pain meds. 

Comments

[talesofmyboys.livejournal.com]

That is very scary about the anesthesia... I recently had to talk to one of our vets at work about something I witnessed during a procedure that wasn't right. I wish I had spoken up earlier because something similar did happen again, and now I feel guilty about that. And I feel bad for having to have the talk. Can't win... I hope you can figure out what the cause of Riley's ear issue is. Poor girl.

[meecie.livejournal.com]

I think you're right. I should let them know, just in case. Thing is, he didn't charge me for the additional anesthesia, so I have this suspicion that he knows anyway, you know? But just in case....

[ozdobe.livejournal.com]

I am sorry to hear that it was a mistake with the dosage, but that is better than Riley having a reaction for no other reason.

Dobermans get more hematomas because of vWD than many breeds.

[meecie.livejournal.com]

Yeah, I agree completely. I'm pretty sure Riley doesn't have a clotting disorder (you'd think I'd know by now?), but it certainly makes sense that dogs who had it would get a lot more issue with hematomas. They also have that super-fragile ear cartalige, yes? So more prone to injury for the double whammy.

[dinahprincedaly.livejournal.com]

Man oh man dogs can be so complicated. I had no idea... Yes write the letter. Feel better Riley

[meecie.livejournal.com]

Yes indeed. She's doing a lot better now.

[penichops.livejournal.com]

Urggg, not sure if I like news like that about the dosage of Riley. Sometimes I wonder about how things like that happen.

Any I secretly hope you have to put stocking on her head because the photos of that will quite funny :)

[meecie.livejournal.com]

Hahaha, she really does look cute in a babushka.

To be honest, I'm with ozdobe, it's a relief that it was a dosing mistake, and not some crazy sensitivity my dog has that will make her a high risk under future anesthesia/sedation. I won't ever trust that e-vet again (I'll be looking at other clinics), but still,a relief.

[nosemovie.livejournal.com]

this new vet guy sounds pretty good. I'm happy he listened and worked with you to explain what might have happened and that you werent' imagining stuff. Really good vets who will REALLY LISTEN seem to be few..

[meecie.livejournal.com]

Agreed. And I liked his manner with Riley, a lot, she's really never been good at the vet, but she did fine with him. That's always a plus.

[moodypdx.livejournal.com]

Sorry I did not get back to you sooner;( I have not had full access to my computer and I really dislike answering e-mails on my phone. We use dex/torb a lot when we just want sedation, we rarely ever use it as a pre-anesthetic, and I cannot think of any negative incidents we have had with it. So sorry you and Riley had that experience, but very glad everything has worked out. I would certainly e-mail your concerns to the hospital manager while cc'ing the veterinarian. These things can be just mistakes, or they actually do not know they gave too high a dose, both are very scary things. You might be saving another person's dog.

On a side note we also do not quilt ears or treat aural hematomas with surgery. We drain the hematomas and inject steroids into the pocket. It usually takes care of the problem, with one, sometimes two steroid injections. Many times the dogs do not even need to be sedated for the procedure. Lots of ways to deal with hematomas, but we have found this one to be the easiest.

I am very glad you and Riley have found a doctor you like and trust, it can be really hard. Good luck and I hope the come comes off soon.

Also, sometimes aural hematomas can be from an injury, maybe one you did not see happen. I'm hoping there is no underlying issue. Lots of healing love to Riley.

[meecie.livejournal.com]

Thank you! And no worries on the timing at all.

I am not following instructions, and I took the cone off Riley pretty much completely. Every time she moved, the cone was bonking her sore ear, and it just hurt to even watch. If I have to leave her and can't watch her for scratching/shaking, I'll think about putting it back on, but for now, she's far more comfortable. I have kept treating her with pain meds.

I actually found that technique online when I was researching, and I wish one of my vets had tried it or offered it as a suggestion, it looks like the success rate is really good. But all is done now. All the vets I've worked for (and all the ones I've gone to since this happened) have been ear-quilters, so it's just what I'm familiar with, but draining + steroids seems like a good technique.

My only beef with this Doctor is he's yet another one still pushing for yearly vaccines, ugh. I really don't understand this reluctance to change, despite the literature and national/AAHA recommendations.

[sarahmichigan.livejournal.com]

Poor kiddo. Glad you like/trust the new vet, though.