Recently, I was confronted with the worst of the worst. The know-it-all breeder. She brought in her brachycephalic breed puppy for sudden onset of neurological abnormalities and respiratory difficulties. The puppy was about 8 weeks old and looked very poorly bred.
After examining the puppy, I decided that chest xrays were the place to start. The presentation of the case was very strange - a previously very normal, active puppy that had suddenly declined over about 8 hours. He (Peter the puppy) began having trouble walking, he was staggering around, and he had started to have difficulty breathing. None of the other puppies were showing any symptoms. My initial thoughts were a type of pulmonary edema called non-cardiogenic. It can occur secondary to seizures, choking, electrocution, and head trauma. The owner reported that her very young (and VERY obnoxious, as evidenced by his behavior in the waiting room) son could possibly have dropped the puppy on its head.
Xrays showed an interesting pattern in the lungs that could be consistent with non-cardiogenic pulmonary edema. There are other differentials for this type of pattern, but NCPE is by far the most likely.
I went to speak with the owner. Said "breeder" had already informed me that she thought the puppy was either suffering pneumonia or head trauma. I explained my differentials to her. At that point, the conversation really started to go downhill.
Her: "I respectfully disagree with your diagnosis."
Me: "Ma'am, I have not made a definitive diagnosis. I have given you a list of possible diagnosis that are causing these signs and xray findings."
Her: "Can I look at the xrays? I've seen a lot of aspiration pneumonia."
Me: speechless. As if I - THE VETERINARIAN - have not seen a lot of pneumonia.
I showed her the xrays. She looked at them and clearly had no idea what she was doing. She then proceeds to tell me that the puppy is suffering aspiration pneumonia (there is NO evidence of this on xray) and requests Clavamox. I declined, stating that I generally start pneumonia puppies on enrofloxacin and doxycycline.
Her: "Are you a neonatology specialist?"
Me: "No, I'm an ER doctor, and I treat puppies and kittens ALL the time."
Her: "Well, my doctor is a specialist in this area."
Me: "Is your doctor available at this time?"
Her: "No, I don't think so."
Me: "Well, I am, and if you want my medical opinion, that's it."
Her: "You probably don't know that flat-faced breeds are prone to aspiration pneumonia. They do it all the time.
Finally, I looked at her and said, "ma'am, you obviously do not respect my opinion." Her response? "I've been doing this for 8 years (breeding)."
My response? "I've had teeth for 32 years. That doesn't make me a dentist."
In the end, I sent her out the door with Clavamox. I told her that it wasn't the best antibiotic for the pneumonia her dog didn't have and reiterated that her VERY sick puppy needed hospitalization and oxygen therapy (which she declined). The stupid breeder was supposed to see her veterinarian today for a recheck of the puppy, but when I called, she had never been seen.
This is why we hate breeders. I went to school for 8 years and have worked in ER for 4 years. I might - JUST MIGHT - have some clue what I'm talking about when I look at an xray.
Oh and FYI breeders, if you're just going to waste our time and tell us your uneducated diagnosis, please just do us a favor and stay home.