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kennel cough

My Golden Retriever Confronts the Medical Juggernaut

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Recently, our golden retriever, Bailey, got kennel cough. She hasn’t been in a kennel in years, but that’s what they called it: kennel cough.

Please forgive my ignorance in the matter. You see, I’m just a people-doctor. I’m not a veterinarian like, say, Pfizer CEO Albert Bourla. I can’t claim to be an expert on kennel cough.

But as far as I can tell, “kennel cough” appears to be vet-speak for a nonspecific respiratory tract infection in dogs. It seems to be a term veterinarians use much as I would “bronchitis.”

Do you know what a golden retriever with kennel cough sounds like? After all, people-doctors have historically described kids diagnosed with croup as having a “barking” cough.

Well, based on my limited experience, a golden retriever with kennel cough sounds like a Canada goose. Bailey was repeatedly emitting a medium-pitched grunt/honk, lower in register than a duck’s quack but higher than one of those old-fashioned ah-oo-ga automobile horns.

It’s kind of a Honk! Honk! Honk! with the H’s partially dropped. It’s actually quite alarming. Trust me, you don’t want to hear your golden retriever sounding like something it retrieved.

Now, Bailey is a good girl, and I love her dearly. But my wife loves that dog more than life itself. Sometimes I wonder if she’d donate her own liver if it were necessary to save her.

So my wife calls Bailey’s veterinarian, and she tells them about her symptoms.

I should mention that my wife is a doctor, too. Just a people-doctor like me, mind you, not an expert on kennel cough like Albert Bourla. But a medical case presentation is a medical case presentation, and she knows how to present a case.

So what did Bailey’s Primary Care Provider tell my wife after hearing the medical history from a fellow medical professional? Well, they told her that it sounds like kennel cough, and that they can see Bailey in 2 or 3 weeks.

Incidentally, this veterinary practice – I am not making this up – had recently been bought out by some kind of veterinary investment firm which, over the past couple of years, also bought multiple other practices in the area, including the only veterinary emergency room in town. Soon after those acquisitions, they closed down the emergency room.

My wife says to them, “2 or 3 weeks? Bailey will either be fully recovered or dead by then.”

“Well, we’ve been chronically short-staffed,” they replied. “We’re blocked up for urgent appointments…etc., etc.”

A brief, polite back-and-forth ensued, but ultimately Bailey’s “provider” didn’t offer an urgent appointment.

In their defense, this veterinary group knows what really is important. A couple of months earlier, at Bailey’s routine checkup, her doctor noted concerning “plaque buildup” on her teeth.

Do you know what Bailey’s doctor recommended? Doggie dental cleaning. Under general anesthesia. Seven hundred dollars, cash on the barrelhead.

They also have never delayed care when it comes to Bailey’s vaccines.

You see, according to the American Animal Hospital Association Guidelines (generously supported by Boehringer Ingelheim Animal Health, Elanco Animal Health, Merck Animal Health and Zoetis Petcare), all dogs should be vaccinated for:

  • Distemper
  • Adenovirus
  • Parvovirus
  • Parainfluenza
  • Rabies

while many or most dogs, depending on “lifestyle and risk”, should be vaccinated for

  • Leptospirosis
  • Lyme disease
  • Bordetella 
  • Canine influenza

and some should even be inoculated with Rattlesnake Toxoid.

I will add, these vaccines are not one-and-done shots. Most of them are recommended to be boosted annually, or at minimum every 3 years.

But again, the experts know what is really important. For example, while Bailey has fortunately avoided any major orthopedic problems to date, we know at least one golden retriever who has had both ACLs reconstructed, and other dogs who have had total hip replacements. Advanced orthopedic surgeries, while admittedly costly, are an essential component of the golden retriever’s healthcare armamentarium.

(This probably sounds selfish, but I just hope and pray Bailey doesn’t develop gender dysphoria. I don’t think we can afford to take her down to Cornell to have them surgically construct a neophallus for her.)

Whew. Let’s step back and review. As I said, I’m no expert on these matters, like Albert Bourla. I want to make sure I’ve got all this correct.

Our golden retriever must navigate a healthcare system that cares so much for her health and well-being that it’s willing to intubate and anesthetize her for a tooth cleaning. Cha-ching!

In the name of vaccination, it will repeatedly inject her with numerous inoculations, up to and potentially including rattlesnake toxoid. Cha-ching!

It offers any number of extensive and expensive Orthopedic surgeries – as long as Bailey’s owner pays. Cha-ching!

And yet, when she gets sick with an acute respiratory infection, it tells her to stay home and wait, offers no treatment, and refuses to see her. Even though, should she become severely ill, her emergency health care system has been decimated by corporate profiteers.

Do I paint an accurate picture, or do I exaggerate?

Fortunately, Bailey’s story has a happy ending.

As so many other concerned patients and family members do, we consulted Dr. Internet. I know, I know, patients are supposed to trust the experts, and refrain from doing their own research – but you’ll have to forgive us. After all, it’s the family dog we’re talking about here. And we did discover some interesting information.

According to our research, the most common first-line treatment for kennel cough is doxycycline, an inexpensive, generic, people-antibiotic that’s been around since the 1960’s. The primary purpose of prescribing it here is to treat against Bordetella, the most common bacterial cause of the disease.

Incidentally, Bailey is up to date on all her recommended vaccines, so the fact that she got kennel cough in the first place raises its own set of questions. I won’t head down that rabbit hole here, except to ask:

If a disease doesn’t merit the patient being seen, assessed, and treated when they contract it, why is obsessive vaccination against it so necessary?

My wife called back, and in her very polite but insistent way, explained that if they weren’t going to see Bailey, we were ‘requesting’ a prescription, which in the end they wrote. I half expected them to say, “Doxycycline, but that’s human paste!” To their credit, they didn’t.

You’ll be glad to hear that after commencing empirical, early treatment with a cheap, decades-old, repurposed drug, Bailey improved almost immediately. Whether this was due to the doxycycline, her own immune system (God gave her one too, we must not forget), or both, we cannot be certain. Anyway, the goose honk is gone, her appetite is back, and she’s got the frequent zoomies again.

But the whole episode left me with a lingering, uneasy, even unhealthy feeling. It’s not exactly déjà vu, but rather the sensation that I’d been through something very similar – and similarly unpleasant – before. 

Whatever could that be?



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Author

  • Clayton J. Baker, MD

    C.J. Baker, M.D. is an internal medicine physician with a quarter century in clinical practice. He has held numerous academic medical appointments, and his work has appeared in many journals, including the Journal of the American Medical Association and the New England Journal of Medicine. From 2012 to 2018 he was Clinical Associate Professor of Medical Humanities and Bioethics at the University of Rochester.

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