This week: Difficult diagnosis
Was that really a seizure or are you just happy to see me? A regular client of mine came running into my consultation room the other day with her little terrier crying: 'My dog just had a seizure. It yelped and then urinated uncontrollably and fell over. Is he going to die?' All the while her little terrier, named Jelly, was staring rather quizzically at me. He was probably wandering what all the fuss was about. She was so sure it was a seizure it was almost convincing. But I doubted her story.
Clients and their ill pets' symptoms are always out to trick me. I need to be on full alert when dealing with them. And seizures can be a very tricky symptom.
I didn't go out and insult the woman by saying she was wrong. I said: 'I think there is more going on than meets the eye.' A superficial examination failed to reveal anything obvious, so I asked the owner what Jelly was doing before the 'seizure'.
She answered: 'Nothing much. I just got home from work and she was happy to see me and while she was jumping up and down and barking, she just started seizuring.' I made a note that the dog would have a 'seizure' when excited. I listened carefully to the heart and lungs and noted nothing audibly abnormal. I went as far as to conduct an electrocardiogram, more commonly known as an ECG, on Jelly to see if there were any electrical conduction problems with the heart but again, there were no signs of anything out of the ordinary.
I further asked in detail about the actual seizure and Jelly's owner said: 'One moment she was bouncy and the next she just yelped and fell over. Her body was soft to the touch and there wasn't any struggling. It lasted a few seconds and then she was up again but was a little tired looking.' I noted from this that there was no involuntary muscle movement commonly associated with a seizure. It really didn't sound like a seizure to me. At this stage in the old days I would have asked the client if she could capture the seizure on film to help me differentiate between a seizure or something else, but nowadays I have a new trick up my sleeve.
Most tech-savvy people in Hong Kong would know about Bluetooth. It's a technology that allows wireless communication between two machines. What has that got to do with veterinary medicine? Some clever sod has invented a Bluetooth-enabled ECG. With the old-fashioned ECG, the dog had to be attached via various wires to the machine and that meant I could do an ECG only in the confines of a table. With the Bluetooth version I can have the dog running around the client with the ECG strapped safely on its back and allow me to monitor an exercising dog's electrocardiogram. This can reveal much about the heart's conductivity.