選擇獸醫的重要

因為狗主的無知,Whisky生病了。打從一次郊遊,從身上找到兩隻牛虱,Whisky開始食慾不振,面無血色,惡夢便開始。

起初基於方便,我們帶Whisky到荃灣獸醫診所求診,醫生為Whisky抽血,證實紅血球偏低,血濃度26%(正常指數為35-55%),有貧血跡象,被診斷為牛蜱熱(Tick Fever),打了三支針,分別是抗生素,消炎和補血針,由於針藥濃度高,平時不怕打針的Whisky,痛得哀鳴,我看在眼裡,很是難過。

Whisky隨即便開始吃抗生素(Doxycycline)和消炎藥(即皮質類固醇Pred),飽肚才服藥,由於Whisky沒有食慾,所以每天還要輔助餵食(force feed) 一罐Hills 的a/d罐頭處方食品(Presciption Diet),醫生吩咐,儘量多餵Whisky吃紅肉以補充鐵質。藥物傷胃,所以還要吃胃藥。

吃過藥後,Whisky第一個星期的情況的確有好轉。第二個星期覆診,沒有驗血,服用同一樣的藥方,Whisky的情況開始停滯不前,甚至出現倒退,開始極度虛弱。第三星期覆診,抽血發現血濃度只得22%,醫生著我們隔日帶Whisky回去打補血針,但眼看Whisky走起路來已經一拐一拐,我們覺得事情不妙,所以決定帶Whisky另覓醫生。

當天晚上心情七上八落,最是難熬。決定要轉醫生後,又不知應找哪一位,在一個討論區被奉為神醫的,往往在另一討論區可以遭踐踏蹂躪。最終知悉一間大圍珍禽異獸及動物醫院(Tai Wai Exotic and Small Animal Hospital)(下簡稱大圍寵物醫院),駐院的Dr Tiger,被譽為全港最優秀的白兔醫生,我有擔心過這動物醫院能否醫治狗狗,但想深一層,珍禽異獸也能醫,狗狗應該更容易吧!大圍寵物醫院的網頁,對牛蜱熱有詳細的描述(載於Care Sheets一欄),姑且就試試這一間吧!加上兩名創院人都曾在嘉道理農場及愛護動物協會工作,也就好像打了支強心針。

第一次到大圍寵物醫院,感覺非常好,木製的椅子,穿透的陽光,讓人心情也紓緩一些。醫生為Whisky作詳細檢查,發現牠有脫水的現象,另外驗血報告顯示血濃度只得18%,但醫生強調,這只是證實Whisky有貧血,並不能證實有牛蜱熱。要測試有沒有牛蜱熱,就要進行抹片檢查,看看在顯微鏡下有沒有牛蜱熱,由於血液樣本細小,這個測試的準確度並不高,所以如驗不出結果的話,便要使用漁濃處的高準確度測試,當然價錢也較貴。由於在顯微鏡下已發現到Whisky的血液帶有牛蜱熱寄生蟲,便無需再往漁農處化驗。Whisky即時入院,需要留院打鹽水針及抗生素。當我在傍晚返回醫院探望Whisky的時候,血濃度回升至20%,證明所用的針有效。原本Whisky要留醫一晚,但我知道牠在陌生地方不會睡得熟,加上醫院沒有人當值,我便要求把Whisky接回家。

到了第二天覆診,血濃度返回18%,醫生猜想是因為注射針的藥力已散去的緣故,她說Whisky可能是不幸地同時染上兩種牛蜱熱,所以單靠對付導致肌肉疼痛的寄生蟲的Doxycycline已不能治癒Whisky,我們要配專門對付破壞紅血球的寄生蟲的兩種藥水,有七至八成的治癒機會,不過費用昂貴,而且大圍寵物醫院並沒有存貨,其中Atovaquone Syrup要到大埔寶湖動物醫院購買,另一隻Azithromycin Syrup便要到旺角勝利道的藥房配。我們把Whisky送回家後,隨即展開勞累的尋藥之旅,後來查到西營盤的方舟動物醫院(BB在這裡渡過最後的歲月)同時有售兩種藥水,經過一輪確認和交涉後終於把藥賣給我們。

Wellvone這藥真的昂貴,只是二十毫升,便差不多要一千五百元,幸好Hithromax只需百多元便有交易。Wellvone是黃色稠糊的液體,好不奇怪的,我稱之為「滴滴金」。只是很多狗狗吃完都會嘔吐,所以有些醫生會建議開止嘔藥,以防浪費這個價錢比起白松露菌不惶多讓的昂貴藥物。不過,大圍寵物醫院的醫生解釋狗狗嘔吐可能是藥水太稠的關係,建議餵這藥後隨即餵其他食物(特別是狗狗平日最喜愛的食物)及開水,以沖淡藥水的味道,也可以省卻狗狗受苦多吃藥。結果為期十天的療程,Whisky從沒有因為滴滴金難吃而嘔吐過,也幸好因為Whisky屬於小型狗,一千五百元足一個療程用。

滴滴金這名稱真沒改錯,只吃了一劑,Whisky立即精神許多,耳朵的微絲血管也充了血,口腔也紅潤了。這令我們充滿希望。可是翌日覆診卻出乎我們的意料之外 ── 血濃度不升返跌,只剩下16%。只要跌至15%,Whisky便要接受輸血,那情況便很緊急。醫生說我們只好繼續觀察,一有什麼不對勁的話立即返回醫院。第二天再覆診的時候,帶著戰戰兢兢的心情等驗血報告,血濃度竟然上升至36%,是正常的紅血球指數!自這次之後,Whisky便再沒有驗血,因為看牠紅潤的樣子,相信牠的血濃度己經沒有問題。Whisky在用完十天療程後作最後覆診,Whisky只需完成剩餘的Doxycycline,整個治療便完成。

回想起來,如果我們一早把Whisky送進大圍寵物醫院,作出準確的診斷,牠便不需要受這麼多皮肉之苦,我們也不需要受這般的精神折磨。大圍寵物醫院的各位醫生都甚有醫德,看過Whisky的三位醫生,他們的著眼點都是希望能把狗狗的痛楚減至最低,同時也為狗主的經濟考慮,這點我是沒有想過的,因為當我首次預約,接待員告訴我診金是四百元的時候,我以為這裡只是另一所高檔動物醫院:給你一流的服務,也要你付上一流的價錢。你能想像荃灣獸醫診所收取五百大元的同一種簡單驗血報告,這裡只是收五十塊嗎?為求詳細,第一次診治時,大圍寵物醫院把血液樣本送往化驗所化驗,收費也只不過是百多二百元。荃灣賣廿一元一罐的a/d,這裡只賣十九元。在每天覆診驗血的階段,他們甚至連二百三十元的覆診金也不收,只收五十元的驗血費,好像非牟利團體一樣。是他們不懂做生意,還是市面的獸醫太沒良心?

圖一:由於要抽血的關係,所以要在頸項位置剃掉一撮毛,護士拿起電動剃刀,Whisky便已怕得不得了。剃毛後的Whisky,看起來憔悴了不少。
圖二:這罐頭食品好像pâté一樣香濃,理應很惹味,可是Whisky實在沒有胃口,熊掌於是變了砒霜。
圖三:百聞不如一見的滴滴金(右)。

註:被牛蜱叮過也不一定會患上牛蜱熱,要視乎該牛蜱的帶菌量而定,所以有些狗隻被多隻牛蜱叮著也沒事,有些只需被一隻牛蜱叮過也可以致命。藥物只能控制牛蜱熱寄生蟲的數量,並不能完全把它們清除。患過牛蜱熱的狗隻也可能在抵抗力弱的時候復發。因此,如果閣下經常帶狗狗到草叢,便要為牠打防疫針,同時也要定期使用Frontline。另外,因為香港沒有狗隻的血庫,最好結識一些身體健康的大狗,以防狗狗需要輸血。以上所述各項只是筆者的個人經驗,和針對Whisky個別情況使用的療程,如閣下懷疑狗狗患上牛蜱熱,請立即帶牠到可靠的獸醫求診。

19 thoughts on “選擇獸醫的重要

  1. whisky是不是已經完全好了?

    我覺得Frontline是否可以防止牛蜱上身也是一個疑問, 我覺得frontline呢類產品只是防止它們繁殖, 就算殺死它們也要咬了狗狗吸入有藥性的血液才能有效, 所以如果咬那一刻牛蜱有大量細菌, 也有機會患上牛蜱熱, 不知我這想法是對是錯!?

  2. 你的問題是雖然Frontline可以在若干小時內把牛蜱殺死,但假如一隻超毒牛蜱迅速地在牠死去之前已咬了狗狗,這也可能把寄生蟲傳給狗狗。

    我倒沒有問過獸醫,這個問題值得一問。我估計Frontline未必能百分之百預防牛蜱,但預防的能力也很高,所以似乎很多獸醫都推薦使用,而你所提的可能是機會率的問題。

    Whisky是復原了,牠已經完成所有藥物,可以自動製造紅血球。獸醫亦說Whisky可以懷孕。不過,正如文中所說,這病是可能在狗狗抵抗力弱時復發的。(另外,獸醫極力不鼓勵人們繁殖狗狗。)

  3. 聽到Whisky完全痊癒就安心了

    有機會我都會問一下獸醫這個問題

    對狗狗身體好, 應該早一點替牠們desex
    我三隻小狗也在5個月大的時候已經做了絕育手術

  4. 有關絕育的問題,我心中一直有個固執的疑問:

    我們的器官總存在著生病的風險,切掉某器官自然可避免那器官患病。特別是當我自己也沒有太大機會生育的時候,我也會比生育過的婦女較大機會患上女性病,那麼我又是否應該把我的器官割掉呢?我以前也養過一隻狗女,沒有做過絕育手術,亦不是因為狗女病而過世。為什麼要令狗狗受絕育手術帶來的痛苦呢?

    這個問題我也有問過獸醫,我而要找一些臨床的數字查證一下沒有絕育的狗女患病的機會。你有相關的資料嗎?

  5. 我從來沒有養過寵物。讀了你這篇文章後才知道原來香港有這樣的醫院,而我想像whisky躺在病床接受治療的痛苦樣子,應該和大部份的病人差不多。

    我想問狗狗輸的血是從哪裡來的?

  6. 如文中所說,香港是沒有狗隻血庫的,所以獸醫建議Whisky要認識大隻的狗友。否則,動物醫院便會徵用他們相熟的狗隻捐血。

    大概人和動物一樣,都需要一流的醫療服務。

  7. 好鍾意狗狗但唔敢養,想是責任太大怕承担不來吧 – 與養小孩都差不多。看過這篇,感受更深。

    Btw, 喜見Whisky健康活潑!

  8. 養狗狗大概與養小孩都能緩和家人的關係。不過相比起養小孩,養狗狗實在輕鬆得多呢。

    可是一個人自住的責任相對較大,因為我們總希望能減少狗狗自己在家的時間吧。

  9. pinkpandamary: Yes, I think so. And Whisky has been going there for regular check-ups.

  10. Oh, sorry, pinkpandamary, I misread your message – Whisky has been going to Tai Wai Hospital.As for Ark, my another dog went there, and I think that was ok too.

  11. Hello,I have some questions want to ask you about the Tai Wai Hospital. My dog has suffered from eczema for several years (in summer). She recovered after receiving one injection and some medicines given by the veterinarian nearby my home. However, her problem lasts more than 6 months this year, no improvement and getting worse. I bring her to Tai Wai Hospital after seeing the comments posting in the web. Up till now, 2 times visits, the doctor seemed no idea and no definite treatment plan to my dog. My dog’s problem is getting more and more worse, more hair loss, more rash, always tired and sleep. The doctor still gave the same medicines to her even I have told him the condition. I worry very much. So, I would like to seek your advice about the choice of doctor in Tai Wai Hospital. Is Dr. Tiger better to treat dog’s problem? Is it needed to tell the receptionist about the designated doctor I want during appointment making?Thank you very much!

  12. I’m sorry to hear about your dog’s situation. If you want to see Dr. Tiger in particular, I think you need to raise that to the receptionist. I heard that Dr. Tiger is more specialised in rabbits and she has a pretty full schedule.Did you bring your concern to the vet and ask what kind of treatment would your dog undergo and how long would it take?My dog has seen different vets there, and it seems they were all willing to answer questions.I hope your doggie will get well soon and please keep me posted. (I have eczema too, and I understand how painful it is.)

  13. Hello,Thank you for your suggestions. Today, I have contacted Tai Wai Hospital and made an appointment to Dr. Tiger. The appointment will be two weeks later.In view of seeking the second opinion to my dog’s problem, I have requested the previous vet clinic to send my dog’s record to Tai Wai Hospital before first visit. All the progress and the conditions must be clear to the vet there. The vet told me he agreed to the diagnosis made by the previous vet. That was skin allergy. Then, he prescribed steroid and antibiotics which were the same drug and dosage as before. My dog had taken the same steroid and antibiotics over six months. I did’t want the same prescription as no improvement could be seen and even worse. I asked the opinion and treatment plan to the vet in the first visit, he told me the duration in handling allergy was long and it could not be totally treated. It would recur in future. The medicines taken were correct and needed to continue. At that moment, I could do nothing, just followed his professional prescription and booked the next week appointment for following up the condition.In the second visit, he told me he was very disappointed to my dog’s condition. My dog had more and more hair loss and skin rash, but still playful. I asked the opinion and treatment plan again, he said the steroid dose needed to increase and took the anti-histamine also. Then, my dog needed to take high dose steroid, anti-histamine, antibiotics and ointment application. The nightmare starts, she always sleeps, not willingly to play and eat, twitches over body during sleep, restless all the time. I couldn’t tolerate till next appointment, I phoned to the hospital and told the condition after taking the high dose medicines to them today. Dr. Tiger replied me afterwards, she gave me some suggestions and changed the medicine dosage. To be truth, I totally agree all the staff there are very nice and patience. However, my concern is my dog’s problem. I want an effective treatment only. In fact, the VA in the previous vet clinic is mean, but the vet is nice. The main point is effective treatment, so I still choose there. I don’t know seeking second opinion in the other vet clinic is correct or not.By the way, I am very happy that you are willing to share your opinion to me.

  14. After reading your story, I think Whisky is ‘fortunate’ to have come under an illness which is curable by the available medicines.Perhaps no one can understand better than I how annoying skin disease can be, as I have been suffering from it for years. I’m really not sure if the medicines currently availabe can cure your doggie’s allergy or eczema, for I sometimes have doubts in western medicine for its unknown side-effects. Rather than purely relying on the steroid and antibiotics, have you ever look at the situation more holistically, e.g. your doggie’s diet, the environment (temperature and humidity) and other things (any chemicals in shampoo, the frequency of washing, the fabric of its bed)? Sorry I cannot offer you any concrete help on this because I don’t have much experience on treating dogs with skin disease (my previous dog did have allergy because I washed her too often). And as a human being, I’m still in search of the right kind of treatment for myself. (I just went to another traditional herbal doctor yesterday and I will share the adventurous treatment soon.) Don’t despair and I hope that your doggie will get well soon.Keep in touch.

  15. Hi,I have a good news want to tell you. My dog’s skin problem is subsided. She gains her energy again. The final vet I chose for my dog was me. In fact, I did not trust the Tai Wai Hospita any more. Thus, I used my knowledge to help my dog. As I guess my dog’s problem was eczema together with bacterial infection all over the body and fungal infection around the anus, so my prescriptions were: 1) stop all oral medicines 2) reserve the diet as before 3) omega 3 4)ointment 5) use antiseptic shampoo (i.e. iodine shampoo twice a week. On day 1 of the treatment, the swelling and redness subsided. On day 3, obviously no more hair loss. On day 5, new hair growth. On day 10, all problems disappear. In this event,I regret I did not stand on my opinion firmly and my response was too late. Luckily, the problem did not enter the irreversible stage. As the topic of your blog, the importance of choosing a vet. It’s really important. It would be grateful to share your experiences and comments for me. Thank You. Merry Christmas!!

  16. 看到Whisky的生病日記,作為主人的你一定很心痛吧?!她最後也痊癒了,實是不幸中之大幸!看Whisky的樣子就知道她是一頭乖狗狗,看到她生病我也很心痛哩.祝福她以後健康快樂~

  17. 小旦,多謝你。Whisky近日很好,依然饞嘴,依然愛玩。想不到這生病日記也成為許多愛狗人士的聚腳地。

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