D. E. Larsen, DVM
Mrs. Dannele stood at the front counter with Dixie in her arms. Well over six feet tall and muscular. She was a large and very proper lady. My guess is she was descended from some good pioneer stock.
Dixie was a black and white Boston terrier in a pink harness. Dixie was excited and squirming in Mrs. Dannele’s arm. But Mrs. Dannele had her locked in the crook of her left elbow, and she didn’t even notice Dixie’s struggles as she filled out the new client sheet with one hand.
“We were Dr. Campbell’s patients before he died,” Mrs. Dannele explained to Sandy.
I did not get a chance to meet Dr. Campbell before his recent sudden death, but I had heard stories of him. He was well-liked and well known, even to my clients in Sweet Home. Veterinarians who die while they are in practice always seem to walk on water for many years following their death. I knew that from the stories about Dr. Story, who practiced in Lebanon and died several years before I arrived.
I did have dinner with the young veterinarian who assumed his practice. At least more youthful than me, he was young, well educated, brash, and felt that he knew everything. In the dinner at a local veterinarian association event, I learned everything I needed to know about the guy. And none of what I learned impressed me. On the way home that evening, I had told Sandy that he would have trouble filling Dr. Campbell’s shoes.
“Dixie is having some chronic diarrhea, and the new doctor that took over for Dr. Campbell has not been able to solve the problem,” Mrs. Dannele said. “We have heard good things about Dr. Larsen and would like him to look at her.”
“We were sorry to hear of Dr. Campbell’s death,” Sandy said. “We never had a chance to meet him, but we have heard nothing but good things about him.”
“Yes, he was a super veterinarian and a good man,” Mrs. Dannele said. “Dixie loved him, and so did we.”
“Let’s get you into an exam room, and Dr. Larsen can get a look at Dixie.”
When I entered the exam room, Mrs. Dannele was quick to take command of the conversation.
“Good morning, Dr. Larsen, I am Mrs. Dannele, and this is Dixie. Our daughter gave us Dixie because she thought I needed some companionship when I was away from home on business. That was a good thought, but she might be more than I want to deal with away from the house.”
“I understand that Dixie is having some diarrhea problems,” I said as I laid my hand on Dixie’s head and rubbed it a little.
Dixie was wiggling all over the table. And trying to jump up to lick my face.
“We were Dr. Campbell’s clients, and we loved him. This young doctor who took over his practice is a world apart from Dr. Campbell. We just don’t know what our options are at this point.”
“You don’t have any commitment to the new doctor,” I said. “You are free to go where you would like.”
“That makes me feel better,” Mrs. Dannele said. “We almost felt like we were sneaking behind his back when we came here today.”
“There are many factors that go into a selection of a veterinarian, or any professional, for that matter. Actually, location, or proximity, is the number one factor. But it is important for you to feel comfortable with the relationship. And you should not feel guilty about making a change. People do that all the time.”
“But let’s get a look at Dixie,” I said. “Is she eating okay?”
“Yes, everything is fine except for her nasty diarrhea, and it doesn’t go away. We have changed diets, and he has given us a lot of different medications. And now he wants to do some testing to check her pancreas.”
“Will, the pancreas is sometimes a problem, but that is pretty rare,” I said. “I was always taught that when you out around a barn and you hear hoofbeats, you should look for a horse, not a zebra.”
I worked through a clinical exam and found nothing out of order except for diarrhea. There was a large drop of loose stool on the thermometer when it was removed from Dixie’s rectum. I placed that on a microscope slide.
“I am going to get a real quick look at this under the microscope,” I said. “And then we can talk about what we can do for Dixie.”
Taking the slide to the microscope, I placed a couple of drops of floatation solution on the small sample. I mixed it a little before dropping a coverslip on the liquid.
When I focused the microscope on the sample, the field of view was covered with roundworm eggs. I would expect to see a few, maybe, but nothing like these numbers on a simple smear. Dixie had a massive roundworm infestation.
“Mrs. Dannele, when was Dixie dewormed last,” I asked?
“I don’t know for sure, probably when she got her puppy shots.”
“She has a massive roundworm infestation. If we deworm her, it will undoubtedly solve her diarrhea problem.”
“Now, why didn’t he find that? It only took you a couple of minutes,” Mrs. Dannele asked?
“That is the difference between looking for a horse instead of a zebra.”
“What do we do now?”
“We will send you home with some liquid worm medicine,” I said. “You will see Dixie pass a surprising number of roundworms. It will gross you out, I am sure. It might cause her a little distress, but it will be for a short duration. I would expect her to have a normal stool in a day or two. When her stool is back to normal, we should check a sample to make sure she doesn’t have some other parasite. The medicine we give her will take care of roundworms and hookworms, but there are other worms and parasites, and we need to check to make sure she doesn’t have those.”
“Is she going to take this medicine at home,” Mrs. Dannele asked? “Maybe you should give it here.”
“This stuff most dogs will lick off the spoon,” I said. “The deal is, Dixie has a massive number of roundworms. On that microscope slide of a tiny sample, there must be a hundred roundworm eggs. That type of sample is generally not a good way to make a diagnosis. I might expect to see an egg or two in a puppy with a heavy infestation. I am afraid that if we give Dixie medication here, you might have her passing worms before you get home. There is a possibility that she will vomit worms also. You don’t want that going on in the car.”
“We will take the medicine home and give it there,” Mrs. Dannele said.
“We will give you a call in a couple of days. I expect Dixie to have a normal stool by then, and we will ask you to bring a sample in to have it checked.”
When Sandy called, Dixie was back to normal. Mrs. Dannele was already on her way with a sample.
“We are so pleased, and Dixie is pleased also,” Mrs. Dannele said. “Now, we would like to know what we have to do to move Dixie to your clinic.”
“From our view, it is done. You may want to call the other clinic and have them send her records. There is nothing more you have to do.”
“I think something should be said to the new doctor,” Mrs. Dannele said. “He needs to know that he missed a simple diagnosis.”
“You could make a statement to the receptionist when you ask for the records to be sent. The doctor would get the message.”
“Do you think that would be enough or appropriate,” Mrs. Dannele asked?
“It is appropriate, but to be honest with you, I have met this young doctor, and he is well educated. His problem is he thinks he knows all there is to know. I doubt there is anything you or I could say that would teach him anything.”
“Thank you for your honesty. We will just leave it at that. We are going to be far happier here.”