Page 14 - Autumn 21

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Gertie
A 7-month-old female Hungarian Vizla was presented with an extensive list of severe conditions and a distraught owner that compounded the tension of the consultation. These two beings were severely sleep deprived over many months and my nerves felt shot soon after they arrived. The owner was so addled that she barely knew where to begin and also disappointed and upset that no other veterinarian was prepared to listen to her concerns over Gertie.
The dog was so agitated here, pacing, irritable and whining that I had to settle it immediately with Bowen and Australian Bush Emergency essence before I could even think where to begin my assessment.
I harken back to my study days in homeopathy where we often discussed the feeling of the medicines. This was not the true hysteria of Ignatia and had not the anger of Chamomilla, it was primarily one of complete dissatisfaction and frustration. Within a few minutes of timeline notation it also became clear that the medicine would be principally for gut, liver and nervous system. The dog was putting my teeth on edge with her whining and her constant restlessness was nerve wracking.
Background
This little dog was a travelling companion for the owners who decided to escape lockdown and travel around Australia this year to whatever areas opened to them along the way.
Travelling largely through the North of Australia they were advised by their Veterinarian to put Gertie on to Nexgard (afoxolaner/isoxazoline) for tick prevention. I have treated a few cases of severe toxicity in dogs from this drug and the owner came to me especially because I was able to validate her own suspicions in this regard. I have also found that the most severe cases have been in young dogs that have gut
symptoms prior to administration and consider that mucosal inflammation or liver stasis predisposes these animals to more severe disease.
I was dealing with a case of toxicity here and it was hard to see the dog through the disease.
The timeline
The timeline was the key to discovering the link with the drug and is also useful for miasmatic identification. I would then see what medicine could link to all the symptoms and also how it makes me feel. I had the fall-back option of treating the dog on a detox program with Nux and Carduus failing a good prescription. Timeline in this case goes like this. Vaccine at 6 weeks, picked up at 8 weeks from the breeder, by 9 weeks of age she was on Flagyl (metronidazole) for gut upset, 12 weeks another vaccine,
13 weeks another course of Flagyl and this was the day before they left to go away.
By 17 weeks of age Gertie had been given her first Nexgard and was vomiting every day. She was cranky and irritable with diarrhoea. She had vaginitis the whole time and at 6 months of age was given Cytopoint for severe skin pustules and wheals which started another bout of illness culminating in acute renal failure with oliguria and frank haemorrhage from the urinary tract. She still has some blood in stools after recovering from this ordeal in intensive care. Gertie had Nexgard every month for 4 months during this whole time because the owners did not know any better and were getting more and more addled from sleep deprivation being kept awake almost all night with ten minutely need to toilet or settle Gertie.
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