Moment of brilliance

I try not to brag here about the things that I do that sometimes astound even myself, but I have kicked some serious a** before - surgically and medically. It's ok to pat myself on the back once in a while, right (so much for NO ego in my writing:)?

Case in point: last weekend I came in to take over the night shift from my day shift colleague. She had just admitted an 8 year old dog with vomiting, bloody diarrhea, anorexia, and severe depression. Bloodwork showed a low white blood cell count and hypoglycemia (low blood sugar) at 43 (normal 80-100). In other words, the patient was showing signs of sepsis. My colleague suspected something intra-abdominal - a foreign body, possibly a perforated GI tract. She prepared the owner for possible exploratory surgery.

When I came in, she handed me the chart and asked for my thoughts. I skimmed everything, then reviewed the xrays - which were utterly unremarkable other than mild ileus (ileus = GI tract is not moving). We discussed differentials for this case. As we stepped out of xray, I asked offhand "have you tested for parvo?" She shook her head and told me the dog was vaccinated.

There are several problems with the vaccinated response. The first is that the definition of "vaccinated" in our area is decidedly loose. Many people vaccinate their own dogs with Tractor Supply vaccines, administer them wrong or store them incorrectly, and their dogs wind up with parvo. I see it every day. Secondly, vaccines are not 100%, although we fall into the trap of thinking they are. A vaccinated dog can still - although it is VERY unlikely - contract disease.

I flipped the chart open to where the owner marks vaccine status and saw that the dog was indeed vaccinated - for RABIES. Nothing else.

The parvo test was screamingly positive. When I called the owner to relay the news, she was stunned. However, after some prodding, she told me that they'd recently adopted a puppy that had developed vomiting and diarrhea for a couple of days and then gotten better. Wanna guess where the 8 year old dog probably got the parvo? Also, the poor dog had never gotten a parvo vaccine - not once in its life. Mom was astounded and couldn't wrap her head around the fact that her adult dog had parvo.

See, we DO recommend those vaccines for a reason - and not just to make money.