% \ LETTERS TO THE EDITOR
LETTRES A LA REDACTION
Standards of practice
Dear Sir:
I ran into a very disturbing situation lately on which
I would like some feedback from the profession. I was
telephoned by a client and friend one Saturday morn-
ing and he told me how a close acquaintance had
allowed a visiting veterinarian to spay her dog atop
her kitchen table. This lady was very proud of the fact
that she had paid a very reduced rate for this service.
Now, I admit I have no direct proof and I am not even
sure of the identity of the veterinarian, but I am sure
this did happen.
I live in an isolated community, and though I try
to match prices in the larger cities, there are always
a few clients who are sure I am taking advantage of
my isolation. I do not resent fair competition, but, as
PRACTITIONERS' CORNER
LE COIN DES PRATICIENS
Idiopathic trigeminal neuritis in a dog
Arden K. Powell
A five-year-old spayed Irish Setter-Golden Retriever
Across dog was presented with a history of anorexia
and polydipsia of 2-3 days duration. The medical his-
tory was unremarkable and vaccinations were current.
Significant findings on physical examination included
a hanging jaw, a mild decrease in mass of the masseter
muscles, and excessive drooling. The dog was unable
to close its mouth and, when offered food and water,
was unable to eat or drink. A detailed neurological
examination was normal except for the lack of jaw
tone. Serum chemistries (urea, creatinine, alkaline
phosphatase, alanine aminotransferase, sodium,
potassium, chloride), hemogram and urine analysis
were within normal limits. Based on the above find-
ings, a diagnosis of idiopathic trigeminal neuritis was
made. Daily caloric and water requirements were
calculated and force fed to the dog as liquified Canine
p/d (Hill's Science Diet).
The dog returned to the hospital on day 7 of the
disease with increased difficulty in eating and a non-
compliance to feed on the part of the owner.
A large bore pharyngostomy tube was placed to ease
alimentation. (1) The dog began to show voluntary jaw
Sardis Animal Hospital, 7236 Vedder Road, P.O. Box 128,
Sardis- BWC V2R lAS5
Can Vet J Volume 32, May 1991
we all know, if one dispenses with a few important
surgical standards, one can do surgery very cheaply
indeed.
I guess my question at this point is, hasn't veteri-
nary medicine progressed beyond this sort of penny-
ante nickel and dime nonsense? Since graduating four
years ago, I have seen veterinarians cut each other's
throats and practice truly bad medicine for the sake
of the almighty dollar. It is no wonder that so many
veterinarians leave the profession se very early in their
careers.
Bryce L Fleming, DVM
Midnight Sun Veterinary Services
409 Cook Street
Whitehorse, Yukon
YIA 2R2
movements by day 14. The pharyngostomy tube was
removed on day 17 and the dog began self-feeding.
There was a low grade localized infection at the
pharyngostomy site which resolved completely with
Amoxicillin 500 mg ql2h for seven days.
Idiopathic trigeminal neuritis (idiopathic bilateral
trigeminal palsy) is an apparent demyelination and
degeneration of the trigeminal nerve axons and gan-
glion. It is a self-limiting disease that can be episodic
throughout the life of the dog. There is no definitive
treatment; therapy is directed towards supportive fluid
and nutrient intake. A prime differential diagnosis to
include is rabies. Sufficient evidence to rule out rabies,
including vaccine history, history of exposure and
clinical signs, should be obtained and caution exercised
(2,3).
References
1. Kirk RW, Bistner SI. Handbook of Veterinary Procedures and
Emergency Treatment. Philadelphia: WB Saunders, 1985:
535-537.
2. Ettinger SJ. Textbook of Veterinary Internal Medicine. Diseases
of the Dog and Cat. Philadelphia: WB Saunders, 1983: 628.
3. Oliver JE, Lorenz MD. Handbook of Veterinary Neurologic
Diagnosis. Toronto: WB Saunders, 1983: 246.
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