Mega-e new members, please read!

[Admin]

Getting the most out of your relationship with your DVM and our group so
that you can be the most informed and up to speed for your dog's
comfort, health and longevity:

A word about the practice of veterinary (and any other) practice of
medicine and your role of being either an advocate for the patient or
being the patient yourself. Obviously, education, experience and the
exercise of the best judgment under the circumstances are key for your
DVM. So much so, that these three factors are essentially the guiding
factors in analysis of potential medical malpractice cases (which I
defended as a lawyer for many years). But this discussion is about
understanding our roles in the partnership with our veterinarians (and
of course, their staff) in the furtherance of our dogs' health and comfort.

Our role is to observe keenly, to record important details, and to
report clearly to our pets' health care providers so that they can do
their part. The tech's job is to know what information to obtain and to
communicate that to the DVM. The DVM's job is to sift through
information from you and from the exam, to know or to do necessary
research, and to advise you of choices on what comes next. The outcome
of this for the patient depends on the whole of its parts.

This is pointing out the obvious to some extent, but it should
clarify why we insist that you read, read, discuss and read some more.
We can't give a shortcut to this by feeding you all you need to know,
but we can, of course, give you the basics to assist you in your steep
learning curve at first. That part is often made more difficult by how
any of us deal with the panic and fear of loss that comes with the
shocking diagnosis. You have to take a deep breath and begin your
education. Most dogs will begin do much better than they were doing
before you found out what is wrong, and before you started taking charge.

From here, you need to learn how to help educate your DVM on some
of what we've learned on the day to day management, and you must learn
what any good DVM needs from you: interest, clear questions, and good
communication so that the TWO of you (and other friends or family
members involved with the care) can reach understanding sufficient to
make the right decisions.

Easier said than done. A few things come to mind here to assist
you. We suggest you keep a log on your dog's days for awhile, and keep
a page for questions. Vets are busy, but they'll give you the time you
need if you are prepared.

Questions to think about:

1. What signs or symptoms should alert me to take my pet to the DVM or
emergency clinic immediately?

2. What medications will help my pet cope with this
problem/diagnosis/symptom?

3. What are the side effects of the medication or supplement? What
should I do if I observe any of them?

4. If there are risks inherent in using or not using a medication (or
supplement!), are they outweighed by the likely benefits?

5. Is there any maintenance involved with treatment? Note: lab work
is often VERY important. You must return to have it done when necessary,
or speak to vet staff about a postponement.

6. What can happen if I choose NOT to treat this problem/illness/symptom?

SOMETIMES A TREATMENT OR PROCEDURE OFFERED HAS KNOWN RISKS -- severe
ones, even -- WHAT SHOULD YOU DO, THEN?

Talk, talk, and talk some more to the DVM, until you know why this
should be done or used. But make sure your questions are answered. You
NEED to understand fully. There are often many reasons why an exception
to the rule is the best thing for your dog, but only you can make those
hard decisions. If you haven't had your questions answered, or if you
have and you are still not sure, then go for a second opinion. Many
times your DVM will be happy that you want a second opinion, and will
suggest a referral to a specialist. Two professional heads are often
better than one, and it probably will be appreciated by her or him,
especially if there is a bit of risk involved with the treatment.

When the DVM offers or requests to do laboratory work - blood, urine,
x-rays, endoscopy, fluoroscopy, ultrasound, or even surgery:

1. "Please help me understand why this is needed." Put another way,
"What information will we glean from it?

2. Is the information from the test(s) needed for a decision on a
prescription or next step for treatment? If the treatment is not going
to depend on the outcome of tests, you may be able to postpone or avoid
the expense. What is meant here is that sometimes it is easier or less
costly to begin a treatment regime. How the treatment works on the
symptoms can tell the doctor the diagnosis. For example, there may be
tests for helicobacter pylori (a bacteria that causes gastrointestinal
distress, ulcers, and sometimes vomiting in humans or dogs). Our dogs
tend to be prone to some similar bacterial overgrowth that affects them
by causing a marked increase in regurgitation and sometimes vomiting.
When all other, more serious causes are ruled out, you can test for it,
or you can start the treatment regime. If the bacteria is the problem,
and it often is (!), the dog will be much better in 3-4 days with the
treatment (but you have to complete the three medications). This is
"diagnosis by treatment", and sometimes diagnosis by a positive response
to treatment is a possibility.

Holistic medicine may also be a great adjunct to traditional treatments.
But don't try to just add stuff, helter skelter. Holistic veterinary
medicine is as much an art and science as the mainstream is. Get a
consultation from a trained holistic DVM. Often treatments, including
acupuncture, can boost the immune system.

One last thought - and I might add more later -- but I wanted to address
how to get the most out of being here with our group. One caveat: IF
YOUR DOG IS NOT LOOKING QUITE RIGHT, HAS GONE OFF HER FOOD, OR YOU THINK
SOMETHING IS WRONG, GO TO THE DVM OR EMERGENCY CLINIC. Don't wasteprecious time
by firing off a post and waiting for an answer, sometimes for hours! If you
suspect aspiration pneumonia, or bloat, (especially bloat and torsion) get your
pet to the doctor quickly. With pneumonia,hours are very important. Waiting to
see how he is tomorrow is a horrible idea! By then you have lost so much time
and your dog is likely to need hospitalization, rather than just oral
antibiotics and nebulizing at home. With bloat and torsion, MINUTES COUNT. Go!

1. PLEASE READ all you can in our resource section: our Files section,
links, pictures. It's there to help you understand all we can help you
with. If you don't understand something, ASK us. Or ask your DVM or
his/her staff.

2. Be as specific as you can with your questions. We also need to know
as much as you can tell us about your dog.

3. WE ARE NOT HERE TO GIVE VETERINARY ADVICE. Don't ask us for that.
You'd get less than what it costs you - nothing. Sometimes the
difference between tips or ideas and vet advice is not all that clear.
"Should I give my dog Prilosec?" calls for something close to veterinary
advice. "Why is Prilosec [or other acid inhibitors] used for
megaesophagus?" I don't mean to suggest that you have to worry about
how you ask � the words you use, but be prepared for our sharing what works for
our dogs, for discussion on generally what most find helpful, and that sort of
thing.

4. WE WANT YOU TO TAKE OUR SUGGESTIONS/IDEAS/TIPS/INFORMATION TO DISCUSS WITH
YOUR DVM! That partnership is what is going to best help your dog. We are a
resource. We bridge the gap of the doctor who probably has never had to figure
out the day to day stuff that makes living with megaesophagus much easier, but
who knows some of the principles of treating the disease and some related ones,
and you, the newbie, who is probably still panicked and worried.

5. PLEASE DON'T BE LAZY WITH THE SUBJECT LINE OF YOUR POSTS. Before
you hit that "reply" button, can you think about whether the subject
line is still accurate, please? Your moderators and many other active
members get about a hundred emails a day. We want to get to the ones
that really need us. Eventually, we delete everything. Be specific in
your subject line, and when the discussion morphs to something else,
start a new subject line, AND IF YOU ARE JUST NOW CHATTING with another
member, be courteous. Go offline!

6. If you are sharing something that works for your dog, and it is
non-traditional, please be sensitive to the fact that we have newbies
all the time. If you think it might be helpful to another who can't
seem to make things work, and if you decide to share it, please mention
that it is not traditional and may be risky to try. Example: soaked
kibble (pieces can stick to esophageal wall and cause regurgitation);
cage bottles for water (if your dog has no movement in that enlarged
esophagus and must eat in vertical position, why would you think water
is going to fare any better? Drinking water while he is on his four
paws is really a bad idea!) But some can get away with doing a little
of that, even if not for many years. If you suggest something like
this, help protect the newly diagnosed dog and either keep it to
yourself, or if you must mention it, mention that this is risky for most
dogs with megaesophagus.

7. Lastly - a word about off topic stuff. We are pretty loosely
structured, and we don't generally moderate the list. That means - if
the list is not too busy, such as on the weekends, sometimes it is fine
to post that silly dog story, or to respond with "I know how you feel"
or something not terribly urgent. We are like a family, and some of
that is good. If it is really off topic, like something about your
other dog, your cat passed away, that's fine - share it. Use good
judgment. But if really off, put "O/T" in the subject line. If you
have a question about whether it is ok to post, ask one of your
moderators. And - no advertising. Not here, please.

Let us know how we can be of some help to your and your dog!

Donna and Bailey (12 years thriving with megaesophagus)