I brought my six-year old lab mix in last week for a yeast infection in her ear. The doctor prescribed Tri-Otic ointment, which is a mix of three active ingredients: Gentamicin Sulfate, Betamethasone ... Read More
I brought my six-year old lab mix in last week for a yeast infection in her ear. The doctor prescribed Tri-Otic ointment, which is a mix of three active ingredients: Gentamicin Sulfate, Betamethasone Valerate, and Clotrimazole. From what I understand it is a common enough treatment, though it was not what we were prescribed last time we had this issue (I think the idea was to "knock it out once and for all" by prescribing something a little stronger this time). Two or three days later my dog started getting bad diarrhea. Uncontrollable, to the point where she was having accidents in the house at night. This is very unusual for her -- she had had something similar two or three times before in her life, each time associated with stress (my being away, moving houses, etc.). We waited out the weekend and the diarrhea didn't go away. I left a message through the Riverdale Park Animal Hospital e-mail scheduling system Sunday night. Monday morning I called and was told I would have to make a new appointment. I asked whether that was entirely fair, since according to the literature included with the bottle it was possible that the ear medicine (specifically the Betamethasone) had caused the diarrhea. The receptionist told me curtly "it wasn't the ear medicine." This was when I began to become suspicious that the practice, if not Dr. Sundar himself, might be more concerned with extracting money from me than with providing me with due treatment. Monday at 2:30 we had our appointment. My dog hates, absolutely hates, the rectal exam, so we usually forego it, as we were able to do this time. I was told, however, that she would need a rectal probe to obtain a stool sample. When I asked why they didn't simply ask me to bring a sample along with me, they were patronizing and tendentious, obviously because they didn't have a good answer.I was told that my dog would have to be tested for giardia, and that there had been "a lot" of that going around lately. Later the doctor mentioned that they had seen "one case," but perhaps that qualifies as "a lot" in this circumstance, I'm not sure. He said that she had probably gotten into some bad water or ingested something else that had infected her. I protested that I keep a close watch on her, and would know if she had gotten into something, and that she had not. I suggested that it might have been the ear medicine, since that was the only change in habit that had occurred in the past week. My suggestion was met with a rather patronizing response that whatever the literature included with the medicine might say, diarrhea was not a possible side effect of the medicine. I agreed, very reluctantly, to the giardia test, which involved obtaining a stool sample via a rectal probe. Predictably, given her behavior in the past, my dog let out a loud, long yelpy moan, and tried to hide behind the chair when the probe was over. The giardia test was negative. The doctor told me that she had an imbalance of bacteria in her gut, the kind of imbalance that could be caused by an antibiotic like the ear medicine she'd been taking. Still, he disavowed all responsibility. She must have "gotten into something," despite the fact that she had never "gotten into anything" before, that I walk her and so I can see what she does and does not get into, and that, at least anecdotally, she is not the kind of dog to go and eat or drink from unknown sources. The doctor was unable to offer any explanation beyond that. He maintained that there was no way the ear medicine had caused the imbalance. In another breath, he said in passing "probably you're right," but he was almost certainly patronizing me. When I asked what he would have prescribed if the giardia test had been positive, he told me that it would have been the same antibiotic he was prescribing in the light of the negative test result. To my incredulity, he responded that he "could also" have prescribed another antibiotic to go along with it. By then I was becoming convinced that the giardia test was more about the $55 it cost than any concern for the well-being of my dog. I should also mention that his opinion regarding the possibility that the ear medicine had caused the diarrhea seemed to change once the giardia test had been performed (NOT simply after the results came back negative). Before the test, was "statistically irrelevant"; immediately on the test's having been done, he conceded that, yes, this is the kind of problem that an antibiotic might cause because it could upset the balance of gut bacteria. I found his change in opinion disconcerting, as it suggested that he would be willing to listen to the notion that the ear medicine may have played some role only AFTER he was sure the test would be going on the bill. I am sorry to say this, but I think this place pressures owners into doing more than is medically necessary, fails to give due weight to their observations and that its concern is for profits first, pets second. Read Less