Yesterday I saw one case with Dr Daniel. The owner had been my old client for at least 18 years since his chihuahua is 18 years old.
WHAT IS WORRYING THE CLIENT?
This is the crux of the matter. I spoke to him. He said: "My dog was whining and crying the whole night. She couldn't sleep and therefore I couldn't sleep. She had constipation."
The dog was limping and had pain on the right limb. During X-rays, on extension of the limb, the dog bit the handlers. So, there was no problem with the cause of pain.
Now, prescribing Rimadyrl tablets. This is standard practice. "But this is an 18-year old dog," I said to Dr Daniel. "She is equivalent to a 100-year-old man. Rimadyrl has side effects on kidneys."
"Side effects of Rimadyrl occur only after taking the medication for some time," Dr Daniel said. "Not overnight."
"In Australia, the dog owners you saw practice with other vets, usually bring in their dogs for Rimadyrl earlier than 18 years old and so the side effects of long-term medication can be seen over time. This Chihuahua is 18 years old and has come in for the first time. In Singapore, many owners don't see the vet till a crisis happens. In fact, the owner said that the dog had no problems other than constipation. What if the dog dies when the owner gives Rimadyrl over the next 3 days? His kidneys and livers may not be that great at 18 years of age. Blood tests would show but why take the risk?"
I said: "What if the dog has an adverse reaction to Rimadyrl and die soon after consultation at Toa Payoh Vets? You will be accountable for the death from oral Rimadryl as this will be what the owner will say."
It is best not to prescribe NSAID orally for hip arthritis till the blood test results come in. Even then, pred would be safer.
Many new graduates think that pred should be avoided in all situations. So NSAIDs but in this case, it is better to be safe than have a dead dog dying of kidney failure due to Rimadyrl. Each vet has his or her own prescriptions and if you consult 3 vets, you may get 3 ways to treat your dog for "constipation:.