I hope eventually to be able to post about what’s happening with my writing, with Barnum’s training now that his mouth is no longer hurting him, and my involvement in increasing disability access in my town. But first, I’m gonna bend your ear about Barnum’s health woes for the past two months.
Part of the reason I have not been posting is because writing is so much slower for me since I’ve had to use speech software due to my wrist problem. But another reason is that I kept waiting for this particular health issue of Barnum’s to be resolved before posting about it. I’m beginning to wonder if it will ever be resolved! In fact, I’ve been writing this post for so long that it’s turned into a novella. Therefore I’ve decided to break it up into more than one post.
Here is our story…
Part I: I Should Have Listened to My Gut
I’ve posted several times recently about my search for a diagnosis — and eventual treatment — of Barnum’s mouth problems. At one point, Barnum had an appointment to get dental x-rays with a local veterinarian, but I didn’t post about what happened there, mostly because I was utterly physically and emotionally wrecked in the aftermath of that wretched appointment. Then we finally went to Veterinary Dental Services, and I was focused on updating you on the fascinating developments of Barnum’s malocclusion diagnosis and surgery.
But before we ever made it to VDS, Barnum suffered an attack of medical care from which he has not yet recovered. In fact, he has been to the vet so many times in the past three months that he developed a fear of riding in the car. Whereas he used to love trips in the van, after one vet trip too many he started to show definite signs of stress in the van: panting; a quiet, desperate whine; a face filled with anxiety. So that’s given me a new behavior to work on. Oh joy. More about that another time.
* * *
Before I was disabled by chronic illness — about twenty years ago — I trusted doctors and expected them to have answers. However, after spending several years hopping from doctor to doctor trying to get a diagnosis for my increasingly severe medical problems and being met with, at best, earnest confusion, and at worst, condescension and hostility, I approached doctors much more warily.
At the same time, I was having excellent experiences with veterinarians. Every time I took my cats to the vet, I was praised for my concern with my cats’ health and thanked for taking such good care of them. I remember saying to my friends, “I wish I could have a veterinarian as my doctor. They’re so kind. They listen so well. I wish people doctors could be more like animal doctors.”
Looking back, I realize there was another major difference between me and my cats other than our species: I was sick, and my animals were healthy. During those golden years, getting health care for my animals was straightforward. I’d bring the animal to the vet, and something simple, sensible, and straightforward would occur — an exam, a treatment, a procedure. Then it would be over.
Things changed radically when my first service dog, Jersey, had her eye problem misdiagnosed repeatedly — including by emergency and specialist vets who should have known better. General practice vets also misdiagnosed her, but at least they were honest about their limitations. All of this culminated in the loss of Jersey’s eye to glaucoma and the eventual discovery that the veterinary ophthalmologist who had screwed up the worst had falsified Jersey’s medical records, presumably to protect herself against litigation.
Then, with Gadget, I was faced with the challenge of obtaining veterinary care for a dog with chemical sensitivities, food allergies, and bad reactions to vaccines, heartworm preventative, and many other standard veterinary medications. The vet who had been so wonderful with Jersey — even buying a tonometer so that she could get monthly eye-pressure checks without going to the specialty hospital — did not believe that Gadget’s seizures were caused by his heartworm medication. I did eventually find an excellent vet for Gadget, but then I moved to the town where I now live, two hours away from Gadget’s holistic vet, and I had to search for a new vet again.
For the last six years I’ve made the rounds of most of the vets in my area, trying to find someone knowledgeable, accommodating of my disabilities, kind and gentle to my dog, and above all, really, really competent. At first, it seemed a wasteland. For example, one of the vets that people have referred me to has had multiple dogs die while they were under anesthesia, including young, healthy dogs undergoing something as routine as neutering. I also tried out two area holistic vets who did no harm, but who charged huge sums to do practically nothing. I found a vet who seemed okay, and then he retired.
* * *
Finally, about a year ago, I found Dr. Piwonka. She is open-minded, knowledgeable, competent, thorough, yet honest about her limitations, and, while Barnum does not adore her, he seems to trust her more than he trusts most vets. She is a keeper! She was stumped by Barnum’s mouth mystery, but it was also she who first suggested that I take him to Veterinary Dental Services. I deeply regret that I did not follow that advice when she first gave it. Because instead…
I thought, “An hour-and-a-half away? I have to drive across the state just to get x-rays?” Before this, I hadn’t even known that vets needed a special dental x-ray machine that was different from a regular x-ray machine. And even after I learned that, I thought, “Someone around here must have a dental x-ray machine!”
The problem was that I was imagining that whatever was wrong with Barnum’s mouth would be something really obvious that would show up on an x-ray. I also did not comprehend the kind of expertise that is necessary to properly interpret x-rays or understand how a dog’s mouth should look — what their teeth and jaws should look like.
So, when I learned that a vet who is very close by, “Dr. L, ” had recently acquired a dental x-ray machine, I thought, “Perfect!” True, Barnum saw this vet when he was a puppy, and I didn’t stick with her as our vet because I found her too conventional and not as knowledgeable as I would’ve liked, however some of my friends used her as their primary care vet and were satisfied with her, and I hadn’t heard any horror stories about her. Plus, she only needed to take the x-rays and look at them, right? That was simple, right?
Wrong, wrong, terribly wrong. First of all, Barnum needed to see Dr. Piwonka for an exam, bloodwork, and a referral before we could even make an appointment for the dental x-rays. Then we needed to wait two weeks for an opening in Dr. L’s schedule. But finally on May 24, Betsy drove Barnum to Dr. L for dental x-rays and what I was confident would be his diagnosis and surgical treatment.
I’m not going to say that everything that could’ve gone wrong did. After all, Barnum didn’t die under anesthesia, and Dr. L didn’t misdiagnose him or perform unnecessary oral surgery. Other than that… Let’s just say I regret my decision to take him there. Things went badly from the first moment: when Betsy arrived to drop off Barnum, she learned from the very grouchy vet tech that Dr. L had never seen Dr. Piwonka’s exam notes and bloodwork from the previous week. I scrambled to have Dr. Piwonka fax them over.
Because I didn’t 100 percent trust Dr. L already (red flag that I ignored!), I also sent a note with Barnum, outlining his symptoms of the past few months, including which things had improved when he was on antibiotics. I also requested that while Barnum was under anesthesia his hind toenails be trimmed, but not to bother with his front toenails because they didn’t need trimming.
I waited anxiously all morning, and when I called to check in with the vet at noon, as I’d been instructed, the assistant told me that Barnum was still “being worked on.” I thought, “Wow, he must have really needed some serious surgery.” I waited anxiously for her call.
When at last Dr. L called, she said that the x-rays of the left side of Barnum’s mouth had shown no abnormalities, so we still didn’t know what had caused the problems. However, his beard — the hair around his lips — was gunky with food, which smelled bad, so they had cut it off.
I was stunned. I had expected an obvious structural cause for the infection that Barnum had been suffering with for so long, so it was a real blow to still be in the dark about what the problem was. I was also shocked that Dr. L only took x-rays of the left side of Barnum’s mouth because, although Dr. Piwonka and I both believed the problem to be on the left side, I had still expected that once Barnum was under general anesthesia Dr. L would do a complete set of dental x-rays. (I later learned that she only took x-rays of a small portion of the left side of his mouth, which did not even include his canine teeth that turned out to be the major cause of the problem.) I also thought that Dr. L was saying that the poor state of Barnum’s beard might be the problem — as if the only issue had been bad breath, and as if, as a three-time Bouvier owner, I wouldn’t know what a dirty beard smelled like! (I spoke with her a few days later and discovered that I had misunderstood some of this. So please hold off on judgments of this doctor until I got to tell the rest of the story.)
“But,” I said, “It’s not just an issue of smell! Barnum has been having pain, lethargy, excessive drinking!…”
Dr. L said maybe the antibiotic had taken care of those problems.
“No,” I said and reiterated a point I’d made in my note: just a couple of days earlier, Barnum had yelped in pain when he scratched the left side of his face. She said maybe he needed to be on a different antibiotic or a stronger one. I countered that the antibiotic was definitely working — his breath had improved greatly, his energy was better, and he was drinking a normal amount of water again — but that we still don’t know what had caused the infection. She suggested keeping him on antibiotics another two weeks, and I agreed, but that didn’t get me any closer to a diagnosis.
I was beside myself with frustration and helplessness because I couldn’t think how we were going to find out what the problem was. Also, it seemed I had just subjected Barnum to general anesthesia and spent over $200 for a beard trim. But it was actually worse than that.
Even though I’d been instructed to wait till the end of the day to pick Barnum up, he was still gorked out and anxious, both aftereffects of the anesthesia, which worried me. Plus, when he got in the car he smeared blood droplets on his dog bed with every step; apparently they trimmed all his toenails, including the ones that were already filed short, so he’d been quicked multiple times. Of course, he also reeked of fragrance, but I had expected that because the more time a dog spends in a veterinary office, the worse he will smell of chemical products.
When we got home, my PCA and I washed him with unscented dog shampoo and baking soda to try to get the smell out of his fur; he still reeked and therefore so did my bedroom, and the fumes made me pretty sick for the next several days. But I was still glad that he was home. He continued to smell so strongly of fragrance that the next day Betsy and I shaved him (hair absorbs and retains scent, so cutting it off usually helps a lot).
While we were clipping Barnum I noticed something strange: the fragrance smell was much stronger around his head. When I leaned over his head I got particularly sick. While I was clipping the fur on his ears, I found a wet, sticky, oily residue in his ears. At first I thought I must have gotten soapsuds or water in his ears when I’d washed him, but then I realized the intense fragrance was coming from the residue on my fingers. Someone at the vet had trimmed his ear fur and used liberal amounts of a scented ear cleaner!
This was the beginning of the nightmare.
Tune in tomorrow(ish) for the ear-raising next installment!…