Hello Dr. Kraemer

Jack is a French bulldog rescue puppy that I am fostering.  He was doing great with me, just a normal perfect little healthy puppy, until he had a seizure last evening.

fr bulldog rescue puppy seizure

He had another near midnight and one again this morning at 5 am. They last two minutes or so. I have been gently petting/rubbing/holding him to draw him out of it while making sure he isn’t choking on mucus.

Here’s the recording of the one near midnight and the follow-up once he’s recovering.

Warm regards,
Forest

24H FR BULLDOG RESCUE SEIZURE UPDATE:

I took him to the nearby neurology center, where a litany of tests were conducted approaching $6k.

I just wanted to let you know you were correct about your prognosis and application of the “most common malady first” solution. The Phenobarbital worked, and Jack is back to being a vibrant, happy little Frenchy puppy.

Were all those $$$$ tests required and justified?

 

1 Answers
Dr. Roy Kraemer Staff answered 3 weeks ago

Answer for Was My Bulldog Vet Bill Justified?

Dear Forst,

First, I can’t thank you enough for your years of dedication to Fr. Bulldog Rescue, caring for the neediest cases, and providing unconditional love and support. 🙏 ❤️ 🐾

French bulldog rescue

Besides addressing this specific case of seizures, which I write about extensively in my prevent & treat article, the large vet bill mentioned and its respective value to the pet and the pet owner is a topic worth sharing with our community.

Below is the short answer I emailed Forst before being admitted to the neuro center.

Dr. Kraemer’s Siezure Answer

I am sorry to hear about Jack and the frightening episode, the good news is his young age since seizure dogs under the age of five usually suffer from the idiopathic type that is treatable and carries a good prognosis.

French bulldog puppy

BULLDOG IDIOPATHIC SEIZURES:

For simplicity, we can divide them into bulldogs 5 and older and those under the age of five.

Epileptic idiopathic type is the most common cause of seizures in younger dogs. Others, such as viral, trauma, and toxic causes, can usually be ruled out during the exam and history gathering.

Fr. bulldog puppy exam

SEIZURES TESTING:

Puppies should be screened for abnormal blood glucose, liver enzymes, and liver function. A simple blood chemistry, urine, and bile acid test,  should be included to help rule out low blood sugar, a liver shunt (PSS), and eclampsia (lactating bulldogs).

If required the doctor can proceed with treatment once the essential due diligence listed above is completed.

bulldog pre anesthesia lab tests

EPILEPSY TREATMENT

  • Phenobarbital: The most commonly used drug for puppy epilepsy. It requires blood level monitoring, is inexpensive, has minimal side effects, and is relatively safe.
  • Potassium Bromide: This can be used with or without phenobarbital, but there is a loading dosage period that also requires blood level monitoring. It has good safety, minimal side effects, and is inexpensive.
  • Levetiracetam (Keppra): Used to be costly, but the generic is reasonably priced. It requires no monitoring tests and is safe.
  • Other: Zonisamide, Gabapentin

To learn more about bulldog seizures, epilepsy, prevention, and care, click HERE

Is the Cost of Veterinary Services Justified

Dr. Kraemer, did the 6000 dollar bill and associated testing truly needed in Jack’s case? 

Forest, I truly understand your concerns, I will only provide a brief answer though I admit that this deserves a separate article that is dedicated to that topic as I am sure our community would find it highly valuable.

THE STATE OF VETERINARY MEDICINE TODAY

The state of veterinary medicine is very different from 30 years ago when I began my career. The landscape has dramatically changed, much like your local grocery store,  local community bank, and family doctor, who once had personal relationships with you, your parents, and your grandparents. Nowadays, many hospitals are owned by large corporations run by non-veterinarian Wall Street executives. Its the natural progression of many industries including medicine for better and worse

The emphasis is often on revenues and sales, leading to pressure to meet quotas.

This may lead to an unhealthy push to sell services, diagnostic tests, procedures, and medications regardless of their merits and necessity.

THE STATE OF OUR  VETERINARY GRADUATES

In many cases, the new generation of veterinary graduates prefers non-committed positions, relief work, and short working hours over ownership. Combined with the potential wrath of social media, rating sites, and lawsuits, many prefer to refer cases and surgeries to referral centers rather than deal with the challenges in-house.

The outcome is:

  1. TIME WASTE: a waste of the pet owner’s valuable time
  2. INCREASE COST: an increased cost of veterinary care.
  3. DIMINISHED SKILLS: diminished skills and expertise at the level of the general practice practitioner.
  4. DIMINISHED TRUST: this erodes the traditional relationship between the pet owner and his or her local vet

QUALITY REPLACED BY MARKETING

Some corporations staff their hospital with new graduates with limited experience and lure customers with marketing and promotion campaigns such as “low-cost wellness plans” that often include unnecessary services and treatments yet are short on expertise and experience.

EXAMPLE: An “In-House Wellness Plan” that packages unnecessary vaccinations and lab work, resulting in poor use of the pet owner’s resources.

STATE OF VETERINARY REFERRAL HOSPITALS

Specialization in veterinary medicine has its advantages but also has its limitations. Specialist carry high overhead and are limited by their range of services. They rarely see you long-term as they are required to send you back to the local referring vet, therefore, they are not invested in their relationship with you.

An example would be a dermatologist who is medically treating a bulldog ear over months and years when it is clearly in an irreversible painful end-stage state, with a TECA as the only worthy option (considering cost, risks, and pain). Since the dermatologist is not a surgeon they often treat for much longer than they should have.

French bulldog post total ear canal resection TECA

BULLDOG AND FR. BULLDOG EXPERTISE

There is also a lack of breed expertise. Bulldogs are one of the most popular breeds in the US and are known to have breed-specific problems yet, unfortunately, there are very few veterinarians who dedicated their career to the breed specialization needs, I have seen too many unfortunate and at times tragic errors that could have been prevented or better treated by a medical team familiar with the breeds.

Eng bulldog wellness

IMPORTANT WARNING:

More is not always better, and “do no harm” safety first must be abided by.

DIAGNOSTIC TEST WARNING

Tests are not without risk; some as in Jack’s case will require sedation or anesthesia (MRI, CT,), which puts your bulldogs at risk. A spinal tap also has an element of risk.

oxygen mask fr bulldog

VACCINATION WARNING

Besides the core vaccines, most non-core are not beneficial for most bulldogs (e.g., leptospirosis, rattlesnake) and are not without risks. Also, most should not be given annually as in the past but only every 3 years.

PRESCRIPTION MEDICATION WARNING

Nowadays many doctors prescribe drugs defensive drugs to placate the owners or as protection from lawsuits despite the potential side effects, especially with prolonged usage.

MICROBIOME (PROBIOTICS & DIGESTIVE ENZYMES):

Many drugs will adversely affect the gut, mouth, and skin microbiome (probiotics), which are critical to bulldog health. Overuse of antibiotics can lead to superbugs and multidrug resistance.

probiotics for french bulldog megaesophagus and GERD

IMMUNITY:

Other drugs will suppress your bulldog’s immune system. These are just a few examples of the risks your medical team and you must discuss.

Immune Bundle - Ultimate

Saving Money and Saving Lives Must-Do

Here is a short list of must-do that every bulldog owner should adhere to.

1. PET OWNER DUE DILIGENCE:

Educate yourself, especially as it relates to the breed. Our site is an excellent reference combining 20 years of experience, tips, warnings, how-to’s, and Q&A. You can also sign up for our newsletter and join our Facebook, Instagram, and YouTube community. Don’t be afraid to challenge your vet or refer them to our site. If needed, seek a second opinion.

2. PREVENTIVE CARE SAVINGS:

There are countless preventive measures you can take, including basic wellness.

MEDICAL PREVENTION

  • core vaccines
  • flea and heartworm prevention
  • microchip
  • pet insurance
  •  screening tests for aging bulldog

HOUSEHOLD PREVENTION

Within your household, preventive measures can be taken such as

  • stress reduction
  • weight control
  • exercise and play
  • balanced nutritious diet
  • bullly therapeutic supplements: can help boost the immune system, improve joint health, reduce inflammation and stress, improve comfort, and support the gut microbiome.
  • bully therapeutic topicals: are safe, low-cost, easy to implement, and effective. They include medicated shampoos, gels, skinfold wipes, conditioners, etc.

Yeasty Bulldog Antiseptic Bundle - Ultimate

SURGICAL PREVENTION

This includes eliminating brachycephalic syndrome conditions such as stenotic nares and elongated palate.

Spaying and neutering can also be considered to help prevent prostate disease, prolapse urethra, etc in males and pyometra, unwanted pregnancies, and mammary gland tumors in females.

3. BULLDOG SPECIALTY:

Seek a veterinary team that you trust and is familiar with the breed.

Veterinary Care Cost Saving Summery

  1. Owner-Vet relationship:
    1. competent dedicated vet
    2. trust
    3. owner compliance
  2. Dog compliance (some dogs are difficult to treat, so once-a-day or twice-a-week treatments might work better)
  3. Owner’s due diligence and compliance
  4. Proper diagnosis, proper prevention, and proper monitoring.

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The information provided on this platform is for general informational purposes only. It is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your veterinarian regarding any medical condition. It's important to always consider professional medical advice promptly and not to delay seeking it based on information you've read on this platform. Any reliance on the information provided here is entirely at your discretion.

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