Everyone expects to make mistakes when learning but, fortunately for pets and their owners, not all veterinary mistakes end in bad outcomes. In many cases, the power of natural healing will see patients resurrected despite veterinary intervention. It’s important for all those treating disease, in man or animal, to question if they are responsible for a turn around, or whether the patient should take the credit.
Fresh out of 5 years training in a Sydney specialist hospital, and confident I’d seen most diseases at least once, I believed myself ready to take on casual locum work in more exotic locales. Sure there were some diseases we didn’t see in metropolitan Sydney, but I expected they wouldn’t be too difficult to recognise and master.
During my second week working in a hospital on the NSW northern rivers, a collapsed dog was presented to me. She was limp and ragdoll-like, with multiple firm nodular masses through her breast tissue, but was otherwise happy and eating ok. She didn’t have any of the respiratory symptoms characteristic of a tick-affected patient.
Having been involved in the treatment of a near identical case in Sydney only weeks before I made my bold assessment: paraneoplastic motor neuropathy secondary to mammary adenocarcinoma (transl: breast cancer causing muscle paralysis). I admit, it was a rare condition, but it fitted all the symptoms exactly. Given such diseases are usually mediated by the immune system, I immediately started immunosuppressive doses of the most inexpensive and accessible drug available: cortisone. The dog was discharged for home nursing to minimise hospitalisation costs, with a guarded prognosis.
Two days later I was greeted by a magnificent floral arrangement in the waiting room, delivered in gratitude for a miraculous treatment success. Within 24 hours of starting the cortisone the collapsed bitch was resurrected; able to rise, walk and even run. Choosing not to proceed with chest X-rays and mastectomy, the owner was simply thrilled to see her dog’s quality of life returned, albeit temporarily until the breast cancer finally claimed her.
I left work feeling good that day, reassured that my extensive training had served me well, and maybe even an air of conceit that I had pulled such a rare diagnosis and spectacular treatment success out of my hat.
Now, after many more years of experience working in the same region, I look back on that case with some embarrassment. Having now witnessed the many and varied presentations of snake bite victims, I am confident that dog was a such a case. The breast lumps undoubtedly cancerous, but coincidental, and the cortisone was of no therapeutic benefit, except perhaps as placebo to owner. The outcome was good for all parties but the credit clearly lays at the feet of natural healing.
- Pattern recognition, assuming that animals with near identical symptoms have the same disease, is a pitfall for both owners and vets. This is one of the reasons vets will refuse to make diagnoses on owner description rather than seeing the patient themselves.
- Many diseases and injuries, including seemingly catastrophic ones like snake bite or hit-by-car, may get better without treatment. Pet owners who give vitamin C, reiki or other therapies to their animal, like vets, should always question whether to take full credit for good outcomes.
- Local knowledge can be very important. While most diseases can arise in any animal, irrespective of location, some diseases vary by geographic region, venomous snakes and ticks being the obvious ones. The bigger a vet’s caseload with a particular disease or surgery, the better we become. Country practitioners may have better success rates treating local snake bite victims, while inner city vets may be more well honed in diagnosing lead poisoning.
- It’s important for clinicians to constantly reappraise past cases, in view of new information or experience. Failing to do so threatens to lock us in to loops of self-confirming bias.