I first met Farkle two months ago.  Farkle was in for her annuals: her vaccines and tests that we recommend every year. 

Farkle’s heartworm, Lyme, Ehrlicia, Anaplasmosis and stool sample were negative.  The owners noticed that the skin was turning black and Farkle was scratching all the time. Signs of a mild allergy, I took a deep breath, smiled and walked in the exam room to meet new clients and Farkle.

Farkle was adorable!  A cute little pug, she panted all over the exam room.  The staff had already alerted me that the owner had Farkle on a ‘grain-free’ diet.  FDA had come out with their list of foods that had been related to hypertrophic cardiomyopathy and heart failure.  Most of the ‘grain-free’ diets were on the list.  We have never recommended a grain free diet, because it did not make sense.  When I worked on my Master of Science in Parasitology, I worked with wild coyotes, foxes and cougars. None of the wildlife I necopsied were eating grain free.  I saw lots of corn, grain, persimmons and other items in stomachs of the dead carnivores.  Finally, FDA had enough research to come out with a statement that recommended not feeding grain free.

As I was teaching Farkle’s mom, I could see that she was skeptical.  She finally said that the other vet had recommended it.

I explained the FDA’s statement, my experience and moved on to the exam. Especially, if I was never going to see Farkle again, I wanted to do a good exam. On the table, I might have gotten a kiss as I started my exam.  I always start with the head.  Farkle had a condition called stenotic nares.  When we started breeding for the cute little smushed in faces, the bones were shortened, but the tissue for a long nosed dog was still present.  That means there is extra tissue at the nose, in the back of the soft palate and in the laryngeal pockets.  Farkle’s was bad enough that she had trouble breathing. I drew a picture in the chart to show the owner how surgery would make Farkle breathe better. I also noted that I would not do surgery until Farkle was off the grain free diet.  I do not want to be blamed for a diet related cardiac death with my anesthesia.

“Why didn’t my other vet say something about it?”

“I don’t know. Maybe it was not as bad when they saw Farkle.  This is what I see today.” I could see Farkle’s mom was a tad less trusting of me now.

Deep breath.

“Farkle has an allergic condition.  That is why the fur is a little sparse and coarse here and the black in her groin and axillary areas.” I then recommended flea control instead of medicine.  I could tell the trust was not strong at all now. Obviously, medicine would have gotten me more credibility, but I thought it would clear up without it.  Farkle’s mom asked good questions, picked put my recommended treatment and scheduled her recheck.

As I left the room, I didn’t know if I would see Farkle again, but a week later, Farkle was back.  The skin was better, not great, but good for a pug.  The itching was gone.  And Farkle’s mom had been on the internet.  Seems FDA did come out with a statement.  Seems I was right.  And when could she do the surgery?

Even with the diet change, I recommended that we wait a couple of months.  So Thursday, I saw Farkle for a presurgical exam. This time, I noticed that Farkle had a couple of deciduous baby teeth that had not come out.  The incisors kept the permanent incisors from being in the right place.  I suggested that we address that while Farkle was under anesthesia.  Her mom quickly agreed.  I explained that we would take dental x-rays, clean the teeth and it would help Farkle not have heart disease later in life.  Of course, Farkle is wiggling all around and I can’t see much of her mouth.

Farkle’s mom was scared about the anesthesia but put on a brave face. I am certain I saw a few tears. I reminded her that she didn’t have to do the surgery, but she acknowledged that Farkle would do better, so she wanted to.

Farkle’s blood work was good.  The nares reconstruction went well.  I took tissue out of both sides of the nares and then took some of the center.  Farkle could breathe better right away.  The dental exam and cleaning was not as routine. The extra incisors were relatively easy to get out, but the first premolars were missing.  We found them on the radiograph. Instead of growing straight up, they were completely sideways.  One was pushing the second premolar backwards instead allowing the premolar to be straight.  The periodontal ligament was enlarged, which meant that the tooth was causing a reaction that was altering the bone.  If left in place a dental cyst could form and fracture the jaw.

Suddenly, my easy dental of the day, became my hardest.  I had to drill through bone to a place seen on the radiographs, but not seen in the mouth to remove the misplaced teeth. Did I mention that they were tiny teeth?  Teeth that might have been missed if we did not have the newest dental radiology sensor. We had just replaced it after Rusty had allowed our last sensor to get broken and need replacing. Friday when I found the tiny teeth and successfully removed them and prevented a serious problem, I forgave Rusty. I’m still not thrilled with the five digit cost, but I am glad we were able to fix Farkle.

I last saw Farkle today when her mom picked up.  Her mom had tears again, but this time it was tears of joy.  She was happy that Farkle could breath and we had found and fixed another problem.