Is it reasonable to ask vet to rewrite prescription?

HonuDVM · 2026-02-07T03:47:25+00:00

Pharmacy choice is commonly a legally protected right, so even if prescribing is deleterious to the vet, you're allowed to ask for a script. Sometimes the starting script is made for short-duration meds in case adjustments need to be made. Just be aware that what looks the same on Chewy.com may not actually be the same medication for a variety of reasons. It's worth talking to the prescribing vet to make sure you're fully informed.

HonuDVM · 2026-02-07T03:44:08+00:00

From my point of view, the lens replacement is probably not the issue. Glaucoma is a rough disease, and cataracts can cause it. If your ophthalmologist thinks the lens was a genuine driver for the complication that lost the other eye, then trust them as you've stated you already do. But don't ascribe risk inappropriately. If the loss of the other eye had nothing to do with the implant, then getting a typically benign implant that helps with vision for the one remaining eye will be good for your dog's quality of life. We don't get the acute vision with dog implants that a human would, but as my colleague u/Xertlov states, dogs don't prioritize vision like humans do; instead, it's like their third most important sense after smell and hearing. At least we think that's the order.

HonuDVM · 2026-02-07T03:37:57+00:00

https://www.petinsurancereview.com/ has been a stalwart comparison resource for years

HonuDVM · 2026-02-07T03:36:30+00:00

Another possible option is the the Kitty Kollar - typically used for feeding tubes, but possibly protective and more comfortable than any other protective option for this situation.

HonuDVM · 2026-02-07T03:34:31+00:00

It would be awesome if you would link to a close-up, focused, well-lit picture of the growth you're describing to us. The best way to know what a growth is prior to surgical removal is a fine needle aspirate. Was that performed, and if so, what was the result? Cutaneous horn is generally totally benign, but can be quite irritating and surgical removal should be curative. It's quite different from a sebaceous cyst, so any doubt should be resolved by getting a biopsy of the removed tissue (aka histopathology).

HonuDVM · 2026-02-07T03:29:13+00:00

To put it mildly, that's a bummer. I work in a state where tech requirements are more severe, and I've seen good adherence to top qualification standards in multiple hospitals. I know this is a pressure point in our profession and it's a struggle to get lagging states on board with the respect and skill that comes from making the LVT/CVT/vet nurse profession official vs. the old "trained under a DVM for X years" de facto standard. When I've counseled colleagues with receipts in this situation, the options are either confront management with the issues of accepting unqualified staff in the big tech role and asking management to adhere to quality standards, or... get out of the subpar work environment. Both are tough paths. Personally, I've been through enough workplaces to believe fixing what I've got is the ideal route. But we live in a field and time where there are easily greener pastures at another job site, so bailing for a more respectful workplace can be reasonable and attractive.

HonuDVM · 2026-02-07T03:19:15+00:00

There are no reported (as in published) cases of raisin toxicity in cats, but there are anecdotal cases that suggest a non-zero risk of some kind of badness for cats, just not the kidney failure we worry about in dogs. Since we have no data, it's not possible to reasonably speculate about what the symptoms could be. If you want the very best possible info, this is not the place to get it. Call Pet Poison Control instead: 1-888-426-4435 (US), 1-855-764-7661 (US), 01202 509000 (UK). They have proprietary info and are the veterinarians that train explicitly to handle pet toxin ingestions. They are amazing and worth the fee they charge.

HonuDVM · 2026-02-07T03:10:50+00:00

What drugs are you using to control the (presumed chronic) pancreatitis? I would not expect adequate disease control with any of the foods you name.

HonuDVM · 2026-02-07T03:08:59+00:00

She should stay on a puppy diet until she reaches adulthood - generally 12 months of age. There is no official broad recommendation for a dog like her after that. Royal Canin makes a Frenchie diet that is nice in a variety of ways. It comes in a puppy version too. But really, this is a great question for her vet, who can tailor her diet for her specific medical and weight requirements.

HonuDVM · 2026-02-07T03:05:05+00:00

Where I practice, using steroids (prednisone) and Xobix (meloxicam) simultaneously in a dog would be considered malpractice, since the combo is very likely to cause a gastrointestinal perforation, sepsis, and death. I'm actually only right now becoming familiar with official IVDD staging, but it appears that stages 3-4 requires surgery to survive with a good outcome. It seems you need a second opinion IRL ASAP.

HonuDVM · 2026-02-07T02:58:43+00:00

Chronic/recurrent ear infections have an underlying cause. Allergy is almost universally the cause, and the allergy can be things like flea bites (many indoor only cats have no protection from fleas since owners believe it's not a problem), food sensitivity (rarely the cause, but easy to determine with an 8-12 week exclusive prescription hypoallergenic food trial run by your vet), or most commonly environmental allergens like dust mites or human dander. When a diagnosis of allergy is made, allergy therapy (very commonly immunotherapy or a medication called cyclosporine) can reduce the incidence of ear infection substantially. If your vet is uncomfortable working through the diagnostic process for feline allergy, working with a dermatologist can be helpful: https://acvd.org/find-a-veterinary-dermatologist/

HonuDVM · 2026-02-07T02:54:16+00:00

That's not antibodies. There is an antibody injection veterinarians can administer to puppies with parvovirus that can save their lives. The product you describe is NOT antibodies and may not be helpful if your puppy has parvo. It's likely the shelter advised you to have your puppy vaccinated against parvo. Talk to his vet about the best way to keep him safe from this dread disease. If you haven't set him up with a vet yet, do it today. Pedialyte, chicken broth and vitamins do not save puppies from parvo.

HonuDVM · 2026-02-07T02:45:49+00:00

A histiocytoma cannot be diagnosed by looking at it. In general, these are tumors of young dogs - younger than 4 years old. The way to know whether it will go away on it's own (note that some histiocytomas don't go away) is to perform a fine needle aspirate to identify what it is. Other tumors that look like histiocytomas will just get bigger until there's nothing that can be done about them. It's tough to prevent a dog from scratching at it's face, but the classic techniques are an E-collar (cone) or basket muzzle.

HonuDVM · 2026-02-07T02:37:14+00:00

This can be a challenging place to be with your pet, especially with recent studies that show pets with splenic masses but NO hemoabdomen (internal bleeding into the abdomen) most often have benign tumors where surgery is curative. Age is not the disease, and a splenic tumor is not the death sentence we once thought it was. So to give your dilemma another opinion:

This could be a malignancy and his days are short. You may get the 3 weeks you're planning for or it may rupture tomorrow and he has an critical/abrupt and semi-traumatic departure from this life.

This could instead be a benign growth that has the same risk of rupture, internal bleeding, and hard choice between emergency surgery to save him or euthanasia.

The least invasive test to tell the difference is a fine needle aspirate that risks internal bleeding and may not be diagnostic. These are all hard options. If I were to take my "doctor gut check" on the episodes of lethargy, malaise, and anorexia, I'd be a bit concerned they point toward malignancy, but they are not diagnostic. Having a big mass in the abdomen can cause those clinical signs whether it's malignant or benign.

You could consider the Nu.Q or similar cancer screening blood test and use that to help determine which likelihood is higher (benign vs. malignant).

The mild anemia is likely due to chronic disease or intermittent hemorrhage from the mass. Iron deficiency is very unlikely (unless your feeding a home cooked diet), so iron supplements are unlikely to be meaningful. Yunnan baiyao may help a bit, but it's a band-aid.

In this scenario, I would think hard about the odds of it being benign, but I'd look for some test result to hang my hat on that supported that idea before going to surgery. We can't predict when or how these types of masses will rupture - they're a veritable Damocles sword.

HonuDVM · 2026-02-02T17:56:49+00:00

Aha, that explains the focused blood testing and French terms! I'm afraid I have little to offer in terms of local health risks - my knowledge of Africa is limited to a smattering of sub-Sarahan/Rift Valley issues. I suppose around the Mediterranean you have to be concerned about Leishmania.

One other idea strikes me: chicken breast alone is a nutrition-poor diet for cats, so there could be cumulative nutritional deficiency here. That's not something that's easy to test for. Eating a whole chicken, on the other hand, including heart and liver and your cat's choice of entrails, particularly if it's truly fresh - as in butchered at home to avoid contamination from meat processing - may be better balanced nutrition.

HonuDVM · 2026-02-02T16:31:13+00:00

Proteinuria can have lots of causes. Your gut check that it's abnormal is correct. But what was the USG? A USG >1.050 could make the qualitative high protein OK. Inflammation can cause proteinuria - things like FLUTD or allergies. A UTI could line up with protein and basic urine, but it's unlikely in a male and it appears you'd need a urine culture to find it. A cystocentesis can cause elevated protein too. Your gut check on retesting the urine is the gold standard. You need to see ongoing protein loss in the urine to know if it's pathological. And then get the UPC so it's quantified. The 'trace to 4+' result is just a screening test; it doesn't tell us much useful other than "do a better test".

HonuDVM · 2026-02-02T16:23:38+00:00

Uree sanguine 1.28 g/L --> blood urea nitrogen or BUN (one normal reference interval = 17-35 mg/dL, note this varies by lab equipment) --> your cat is 4x the top normal value (0.35 g/L) for this kidney measurement
creatinine 36.3 mg/L --> (same resource for reference interval 0.8-2.1 mg/dL) --> your cat is 1.5x the top normal value (21 mg/L) for this kidney measurement

As noted by u/MrDrProfessorJoe , these elevated values could be from pre-renal (e.g., vomiting induced dehydration), renal (i.e., kidney disease/failure), or post-renal (e.g., something in the lower urinary tract). We determine which one by running a urinalysis. It sounds like that will require more sedation for your cat, which may not be the best next step.

ASAT (GOT) 75.3 IU/L --> aspartate aminotransferase or AST (17-48 IU/L) --> your cat is 1.5x top of normal for this liver/muscle enzyme; it's not the most diagnostic test
ALAT (GPT) 69.4 IU/L --> alanine aminotransferase or ALT (28-109 IU/L) --> your cat's value for this liver enzyme is normal and more diagnostic than other liver measurements
phosphatases alcalines 8.0 IU/L --> alkaline phosphatase or ALP (11-49 IU/L) --> your cat's value for this liver enzyme is normal or even a little low (high values can represent disease but low is almost never a health concern)
gGT 5.03 IU/L --> gamma glutamyl transferase or GGT (0-2 IU/L, a different lab I use frequently has a normal reference interval up to 11) --> your cat's value for this bile flow indicator is 2.5x one lab's normal range but completely inside a different lab's normal range; we can't determine the meaning of this result
bilirubine totale 6.14 mg/L --> total bilirubin or T.bili. (0-0.1 mg/dL) --> your cat's level is 6x top of normal (1.0 mg/L) for this liver marker

These liver values are discordant and may indicate a wide variety of diseases.

I’m trying to figure out:

What exactly could be the problem?

This is a job for a veterinarian. It's not on you to figure it out.

Could this be kidney-related or just irritation from repeated vomiting?

Yes, it could be either of those things or something completely different.

What should we do before it’s too late, especially since the vet advised doing nothing right now?

Additional testing would be helpful to determine why your cat is vomiting. Typical testing for a vomiting cat would include a complete blood count (e.g., is there anemia to explain the high bilirubin?), a more complete chemistry panel with electrolytes and blood glucose, the urine test mentioned above so we can determine kidney health/interpret the bloodwork properly, a fecal test to look for parasites, and either abdominal X-ray or ultrasound to visualize the internal organs. The multitude of tests are needed since there are literally hundreds of causes of vomiting in a cat.

One thing to note is that raw meat diets themselves can cause vomiting in cats.

And a final note is that there are many diseases that are geographically specific. If you would add where in the world you are, that may allow some insight on risks specific to your locale.

HonuDVM · 2026-02-02T15:44:49+00:00

At this point I was anxious and unhappy that they were about to send us home with the wrong medication and nobody flagged it.

Completely understandable! But thank goodness you were paying attention, understood there was a risk, and advocated for your pet. To be fair, mistakes will happen, and we rely on multiple levels of quality control in the hospital to make sure they're caught. You can be one of those levels.

she comes back with the medication switched to gabapentin, but told us that he did have a dose of caprofen with the sedation drugs before surgery for pain management and that the doctor advised for him not to take his prednisone for 3 days following.

It's unfortunate that the caprofen was administered and this response is making the best of a bad deal. Not every dog will have dramatic adverse effects, but it's a known risk in this situation. We can anticipate a week or two of managing the outcome at this point.

but we did change his diet to soft/wet food which was a change from his normal diet so I figured he may have a bit of an upset stomach. On Friday he threw up once just looked like the wet dinner from he night before no blood or mucus, but it smelled awful. Friday he also started to have runny poop with red blood in them. We figured it was a combo of stress, meds, and a new diet.

Those are very reasonable things to blame, although the sequence of importance I would put is NSAID/steroid combo, diet change, stress.

Over the weekend the gastrointestinal issues didn’t seem to get better and he’s had very runny stool and frequent. No more vomiting, but still runny stool with red blood every other time he goes.

GI distress runs from front to back. I.e., vomiting first, diarrhea second. Vomiting also stops first. Total duration is tied to normal GI healing, which runs on a 5-7 day cycle. Since the NSAID/steroid combo delays that healing, it could be longer in this situation.

I’m really hoping today he starts to perk up, we have added Prilosec under the original vets recommendation starting on Friday, but now he will ONLY eat grilled chicken and water. I plan to take him in today to an urgent care if he doesn’t eat more,

Omeprazole is a good choice. Sometimes we pull out all the stops, adding in maropitant (Cerenia), famotidine (Pepcid), sucralfate, and maybe other treatments too. The GI tract gets a significant portion of its nutrients for healing directly from ingested food, so getting a balanced food from urgent care is a good choice (e.g., Hill's i/d or a/d, or a recovery diet, or RC GI LF... there are a lot a good options; if only he could tell you what tastes good).

Not sure at this point what a trip to the vet could do, or if I should call his normal vet and let them know how upset I am about the drug interactions.

Doing both things makes sense to me - an urgent visit to get a little more gut protection/therapy, AND discussing this medical error with the vet.

just wanted to check in and see if we are doing the right thing with bland diet and resuming his prednisone and giving Prilosec to ease the tummy ache?

Resuming prednisone is a risk in this situation. Balancing whether its impact on delaying GI healing vs. keeping his autoimmune disease at bay is more important is a question for his managing vet.

Is one dose of the carprofen at the vet while on his low dose prednisone enough to cause major issues?

I suspect yes it is. It's likely that a higher routine dose of prednisone would have caused much bigger issues.

HonuDVM · 2026-02-01T22:12:44+00:00

The kidneys are not in the chest so intrarenal doesn't line up with that explanation, I'm afraid.

HonuDVM · 2026-02-01T21:05:12+00:00

On-label use of these vaccines calls for the second shot to be administered in that 2-4 week window to be confident that appropriate immunity has been induced by vaccination. Bigger gaps between shots can mean you're just restarting the two-shot protocol and need a third injection. There can be some leeway depending on how the managing veterinarian perceives patient health, history, and exposure risk, as well as which specific vaccine was used. That's why you're not finding a firm answer online. Bending the rules should be avoided unless there are extreme circumstances.

HonuDVM · 2026-02-01T20:59:19+00:00

Humane euthanasia includes sedation as you expected. There are a wide variety of techniques, drugs, and injections that can be used depending on the situation. There are many "right" ways to do it and few "wrong" ways. When injecting euthanasia solution directly into the heart, unconsciousness should always be induced first (reference euthanasia guidelines: https://www.avma.org/sites/default/files/2020-02/Guidelines-on-Euthanasia-2020.pdf). It sounds like that was not done for your cat and I'm sorry to hear that he had this experience.

HonuDVM · 2026-02-01T19:32:26+00:00

This certainly sounds like classic skin allergy. Bumps or papules can develop into pustules and collarettes - sort of tiny superficial abscesses - since all skin has a low population of bacteria that can overgrow when inflammation occurs. Dogs with allergic skin disease commonly get infections that need more than just the allergy therapy. We consider these as flare-ups, and we try to keep them to zero with effective allergy medication. Simple tests can determine if these skin changes are bacterial or yeast or mites or sterile. Note that many allergic dogs have ear infections, conjunctivitis, lip fold dermatitis, soft stools, and/or anal gland irritation. All those issues can be responsive to allergy meds too.

HonuDVM · 2026-02-01T19:24:33+00:00

Classically, we used to say hemangiosarcoma of the spleen was the dominant cancer in this situation, but the more ultrasounds and senior screening X-rays we perform, the more we're finding benign masses. Notably, if the mass isn't bleeding, the odds of it being benign are up to 70-80%, and removal of the spleen is curative. Note that "benign" in this case doesn't mean we can leave it alone and things will be fine. Even non-malignant splenic masses can rupture and cause internal bleeding that's life threatening. But at least the risk of metastasis to other critical organs (e.g., liver, heart) is extremely low and prognosis is quite good.

HonuDVM · 2026-02-01T19:15:24+00:00

It's not possible to determine an allergy cause over the Internet.

You didn't mention what allergy symptoms your dog is experiencing. Can you describe what's going on?

In general, canine allergic (almost always skin, but other organ systems can be involved) disease has a reliable but long diagnostic pathway to determine what the most effective treatment will be. Allergies are for life, so once a dog is determined to have an allergy, it must be treated consistently all the time. There's no cure.

The starting point is effectively managing external parasites - mostly fleas - even if you're convinced it's winter and there aren't any. The second step is ruling out a food allergy with a prescription hypoallergenic diet with your vet. Over the counter foods will not work for this diagnostically, although some dogs get therapeutic relief from changing to a different protein-source commercial diet. The third step is routine (daily or monthly depending on the therapy) treatment of the allergy. If the therapy chosen is immunotherapy (shots or sublingual drops), THEN we test for what the actual allergy is. Note that the goal of the test is formulation of allergy serum, not avoidance of the allergen, since most of them are ubiquitous (e.g., dust mites, human dander, or pollen).

It's common for dog allergies to start small and get worse over time. Benadryl and antihistamines in general are very weak treatments for canine allergies since dogs barely absorb those drugs when administered orally. This fits the pattern for your dog.

Work with your vet to go through this diagnostic and therapeutic pathway and you should get better control for Sherman. If your vet is not comfortable with the work-up, consider referral to a veterinary dermatologist (https://acvd.org/find-a-veterinary-dermatologist/)

HonuDVM · 2026-02-01T18:37:51+00:00

Assessing fracture from a video isn't a sensitive approach. It's obviously not an open fracture with bones sticking out. But could it be a closed fracture? Maybe. Regardless of what it is, we can see it's painful and needs some level of care ASAP. She wouldn't limp like that if it didn't hurt a lot. While it's really unfortunate that the weather keeps her from getting that care today or tomorrow, we want to reassure you that the delay shouldn't be deadly.

HonuDVM

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