Treating the Treatable: Turning Failures into Lessons
In a world where technology oftentimes reigns supreme, Michael Schaer, DVM, opts for a low-budget hands-on approach to emergency veterinary cases whenever possible.
“I don’t need fancy tests, I’ve got the dog and the dog tells me what’s wrong” through signs and symptoms, he said. Schaer encouraged professionals to stay alert to every medical possibility, examine patients every day while in the hospital, and recognize that common things – like allergic bronchitis and heartworms – do occur frequently.
Talking to a packed room of professionals at the CVC last month, Schaer listed some of Mikey’s Maxims, 10 lessons gleaned “from my failures. Don’t let them be yours,” he said.
Emphasizing basic medicine and the power of astute observation, Schaer reminded colleagues that “nothing is routine. If you don’t think of a disease you’ll never identify it.” For pets that cannot be healed, “always do a necropsy if you have the body,” he said. “It’s the only trial by jury that you have at your disposal. And it answers the questions.”
Working with students at the University of Florida has kept Schaer on his toes. He told colleagues about an intern who begged him “not to abandon a patient” that had not responded to treatment. As a result of her plea, Schaer reexamined the pet, tried an alternative that worked and allowed him to send the cocker spaniel home.
“Every day is a new day,” he said. “Examine your patients every day. You will pick up things that you missed the day before.” As an example, Schaer showed x-rays from a dog that presented with kidney stones that had been treated but the symptoms persisted. Upon careful examination of the slides, Schaer discovered a larger mass that had been missed by doctors who diagnosed the stones.
In addition to examinations, Schaer warned colleagues to question cytology tests and other “definitive” reports when a pet’s symptoms do not match – or contradict – a record. As an example, Schaer told audiences about a nine-month-old cat that presented with a distended uterus. The pet’s records showed that she had been spayed, yet her uterus was intact. “Always interpret everything within the context of presentation,” he said.