One of my favorite client recommendations involves the use of a small, spiral-bound notebook (or a handy PDA, depending on your taste) and a pencil (or a set of quick thumbs). Keeping a log is so simple...and bears such magnificent fruit when carefully employed.
In case your veterinarian has never suggested it, you should know that many chronic, episodic or as yet undiagnosed pet diseases are amenable to the invaluable assistance offered by the low-tech tool that is journal-keeping.
- Diabetes (all varieties)
- Cushing’s disease
- Allergic skin disease
- Seizure disorders
- Inflammatory bowel disease
- Addison’s disease
- Cardiac diseases
The list would be longer if it wasn’t so early in the morning, but these are the most common disorders for which I strongly recommend my clients keep a log.
It’s a bit different for each individual disease but the basics are the same. In your journal you report on...
- Medication doses and frequency
- Feeding or other home care details
- Symptom presence, duration and description
- Veterinary visits, findings and recommendations
All this is recorded by date, of course, with some disorders requiring specific times of day.
Here’s where your veterinarian comes in. Your job is first to ask your veterinarian which details are most important to record. For example, seizure disorder pets may require the observation and recording of the different phases of the seizure and their timing. Diabetics will most definitely require details on insulin doses, blood glucose measurements, etc.
Next up is the issue of how to present your findings. Some of you will anally graph and chart your findings. Others will simply ensure it’s legible and easily digestible by your veterinarian (doesn’t count if no one can understand your scribblings, right?). Doesn’t have to be pretty––just needs to be understandably organized and basically intelligible.
See how easy it is?
Believe it or not, this simple task will help your veterinarian immeasurably. It’ll help guide a diagnosis, if the disorder’s provenance is as yet undetermined. It’ll make medication dosing more targeted and efficient. It may even save your pet’s life.
Oh, and one more thing...it’ll definitely endear you to your veterinarian.
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My Labrador has Primary/Typical Addison's and I started keeping a journal at the recommendation of the Addison Dogs Yahoo group the same week my boy was diagnosed. I keep it in an excel spreadsheet and print it out and put it in a binder every so often so it is up to date if I need to take it to the Vet with me. I keep meds/dosages, results of med changes, lytes results, symptoms, vet visits, treatment and outcome. It took me 3 or 4 months to get the nerve up to show it to my vet, I thought she would be insulted but she LOVES it. She told me she has given up asking people to keep journals because no one follows through. If I take Raider to the Vet and for some reason my Vet isn't there the spreadsheet is extremely helpful to that other person. They can see at a glance everything they need to know. I have been keeping it more than 2 yrs now and every med/every blood test he has had is listed.
7 months after he was diagnosed when he had reached the point of taking 22 tablets of florinef a day I was able to use the spreadsheet to make a case for switching Raider to percorten ( a drug that is not easily gotten in Canada and is expensive). The spreadsheet made all his symptoms stand right out and you could easily see where his lytes were when he was feeling great which was not often.
I continued to use it to chart his dose reduction ( not increases ) with percorten and prednisone and he is now a healthy and happy dog... He can do anything that his brother and sister do... The journal is a wonderful tool..
Elizabeth - from Nova Scotia February 28th, 2009 04:24:50 AM
I love your story, Miss Nova Scotia! Yeah, I sometimes get bored of asking my clients to do this (so few follow through) but for every ten you ask, one at least makes the effort. I think it's worth it--and your vet probably does too now that she's seen your success.
Dr. Patty Khuly February 28th, 2009 04:42:11 AM
One other thing that can help, specifically with dogs who have seizures (confirmed epilepsy or not), is to use the video feature of a cellphone to capture just what they look like while it's going on. Most people never think about this the first time it happens (they're freaked out too much, understandably), but it can let the vet see what they saw and get a better idea than from a vague description.
KateH February 28th, 2009 05:18:44 AM
I've both used the video method (our behaviorist loved it) as well as the diary.
Another suggestion is in regards to sending home medications. Give them a "log". Amoxitabs, 400 mg, BID, 14 days. Have a spreadsheet with 14 days, 2 spots for each day, the animals name, the drug and directions.
I can't remember the number of times I've resorted to counting pills to determine if I gave a drug that day or not, but this works every time. For chronic medications, suggest the use of a "pet calendar". I give immuran every other day, I have on each day he's supposed to receive it, a capital A in the lower left hand of the calendar day. When I give the medication, I put a line through it with a red pen.
It works great!
Jackson February 28th, 2009 05:50:12 AM
"Some of you will anally graph and chart . . ."
Did anyone else skimming this post initially think an "anal graph" was a way to record something really frightening?
Larry February 28th, 2009 06:59:21 AM
Only you, Larry...
Dr. Patty Khuly February 28th, 2009 07:11:04 AM
I am also a fan of logging. I have two cats (littermates) who, from the time I brought them home, scratched and scratched and scratched... It took nine months to get their symptoms under control, working first with my regular vet and then with a dermatologist. The diagnosis was a slow process of elimination (for example, they cultured positive for ringworm although they had no circular lesions, so we spent months getting rid of that; tested for mange and mites; tried various different diets; etc.) After the first couple of frustrating months, I started writing down every time I saw them scratch, as well as where. This showed a clear pattern of location (face and ears, often; neck and back of head, occasionally; elsewhere, never) and also just how much the changes of diet and ringworm treatments were not helping -- it's one thing to say, "I think he's about the same as he was last month", and another to have a graph showing that the cat is continuing to scratch the same number of times per day.
On the other hand, the graph showed a dramatic effect when the dermatologist finally started them on antihistamines -- the amount of scratching immediately went way down, and slowly declined further over the next couple of weeks. The conclusion is that they must be allergic to something in the environment, but I've never been able to figure out what -- the symptoms seem to be partly seasonal but not entirely, and have persisted in spite of moving halfway across the country. It's been seven years since then, and controlling their symptoms has been an ongoing problem, but they've never been anything like as bad as they were at the beginning. Keeping a log of doses and symptoms has helped me maintain my sanity through various attempts to reduce or stop the antihistamines -- the longest they've ever gone unmedicated was four months. It's allowed me to find out the minimum dose needed to stop the itch. I still feel like I'm fumbling in the dark, but at least I have a flashlight.
T.T. February 28th, 2009 08:45:45 AM
Right about when we decided the cocker's occasional diarrhea was a recurring problem and the vet suggested keeping a journal of symptoms/anything unusual before recurrences...it stopped. Hey, great. I'm still noting things like when he gets meds (his daily meds, his heartworm, and we decided to try deworming him for whipworm just in case), but hey, no problem symptoms to journalize.
I do keep a headache log as we're trying to pinpoint the exact cause and best treatments, and it's been helpful. Logs are so useful when you have an unknown problem; of course, sometimes the problem may be recording all the relevant data, or even knowing what's relevant. (Is it an action? Is it diet? Is it a habit? Is it pollen? Is it weather? Is it related to the phases of the moon? What needs to be recorded so we can get the most accurate picture?)
Galadriel February 28th, 2009 08:47:50 AM
Lynda: Sure, logging (and blogging) are best for the OCD-inclined (I include myself in this category, of course), but it's a far more constructive outlet than, let's say, drinking. Are you a knitter, too? I find that knitters have the OCD thing down--in a constructive way, of course.
Dr. Patty Khuly February 28th, 2009 09:01:41 AM
We've always kept detailed logs for various treatments. That way we can provide our Vet with clean, clear, definite information which makes treatment more effective. If we go off schedule due to circumstances beyond our control we just say it. We don't lie. When we got to know our vet we just told her "we want to learn".
We're now about as close to being Vet Techs as a pet parent could ever hope to be without formal schooling. There has been times when our Vet had to prescribe minor things like ear cleanings or eye drops what have you and says. . ."you know the routine".
Evet February 28th, 2009 10:27:35 AM
I've kept a log on my cats for 5-6 years now. I started because I once brought them in during a hurricane watch (my vet has one of those bunker-like buildings). I'm not sure what the confusion was, possibly not all the charts could be found, the place was busy, and everyone ended up getting a full series of vaccines even though they had received all the vaccines just a few months before. It wasn't the cost I minded so much, it was the unnecessary meds.
Since then I have notes for every vet visit with reason for visit, weight (including which scale was used - there are two), any vaccines or other meds given, any procedures. If the animal is sick, I make notes of the meds given and the progress at home. This is why my IBD cat got treated before he lost a lot of weight. Even though everyone said he "looked great," my records indicated that every time he was seen, he weighed a little less. He had no other obvious symptoms (like diarrhea or vomiting). My weight records also helped us get him on what finally seems to be an effective medication regimen (visit next week, keeping fingers crossed, but his appetite is much better). Now I have a chart for all his meds - more for my benefit, really, so I can keep the once daily, twice daily and every-other-day schedule straight.
silkenpaw February 28th, 2009 10:32:05 AM
I would have loved to be a Vet but I'm way to weak when it comes to shots, poking and prodding let alone surgery.
Evet February 28th, 2009 10:53:05 AM
An excellent suggestion & topic!Makes sense for any caretaker to keep track in a journal, whether human or pet! More than once, my Dad pulled out his journal to answer a question with specifics & date, particularly medication additions/deletions/change in quantity. I was rather proud of his perseverance and patience for 5 years.
I can think of numerous advantages: to fill in med record gaps, discover a trend, and even looking back for something/situation, long after the fact.
Barbara A. Albright/NH
Pocket's Story from NH February 28th, 2009 01:50:21 PM
I agree that home monitoring and logs are very useful for disease management.
I wish it was true that all vets found this endearing.
Many folks over on the feline diabetes message board start out with vets who actively discourage home blood sugar monitoring of cats, directing their clients instead to "shoot blind" and hospitalize the cats for "curves." Some of these same vets base dose adjustments on fructosamine test results, a very dangerous thing to do.
Some vets have told clients their cat might "bleed" too much from the ear prick, or it would stress them out, or be worthless info, which it definitely is not. Anyway, not all vets have appreciated the detailed blood sugar monitoring logs owners bring in. They usually go find a vet who does, though . . .
Which I guess underscores the point: If your vet isn't one of those who enthusiastically welcome this, may be time to look elsewhere.
Stefani February 28th, 2009 02:45:48 PM
My Addisonian/calcium oxylate stone forming/antibiotic responsive diahrrhea standard poodle loooooooooooooooves it when I write things in his home-chart, but his vet took a while to appreciate the data mining I do for him. After 7 years he now knows I want the numbers, not conclusions, because sometimes I might just know more than he does about the clinical realties of an f'ed up standard poodle.
I love my vet - and I have no doubt he loves that that know my dog.
Miki February 28th, 2009 06:38:13 PM
I came in here to say what was already said about blogging -- it can be a great opportunity to log things. The other thing that I do is keep a chart on the wall with "how many days since" an event last happened. How many days since my anxious dog peed his crate. How many days since my aggressive dog bit or snapped at another dog. It's in the form of, in my house, a "XX days since EVENT" sign like you'd see in a warehouse or industrial setting.
I blog over here: http://dogs.katzke.net
... And me? OCD? Nah: http://flickr.com/photos/karlkatzke/3189234655/
Karl Katzke February 28th, 2009 09:34:26 PM
Yeah, yeah, yeah, Somebody taught you how to chart Dr. K so you think it's "easy" and besides that you're clearly a left brain AND right brain person. :) Now for the rest of us not so adept, forms, charts, examples pretty please. Often failure of a patient to comply is not having a clue and being to embarassed to ask how to do what someone else clearly thinks is "easy".
PS: Afraid my brain went somewhere close to where Larry's went :) and I prefer crocheting. Need to get back to that, might get my own OCD tendencies a little better back onto the constructive track. Oh my, it's getting late. <G>
PJBoosinger February 28th, 2009 09:48:18 PM
Charting is good, charting is great. Now, as a vet student, I wish I could remember to give my female dog her every-other-day drugs. Because if I have a hard time with it, I wonder how clients manage. It certainly might work better if I actually wrote it down...but where? On what? How not to lose it?
I just had a thought for every-other-day drugs: Evens and odds. As in, if the first day she's due for a dose in that month is even, ie, the 2nd, then give it every even day. If it's an odd number, give it every odd numbered day. Brilliant (for me and my oddly nerdy brain anyhow).
lindabcs February 28th, 2009 11:38:50 PM
lindabcs - An easy way to help you remember is to get the little pill containers with the days of the week marked on them and mark one, week one and the other week two. Put the pills in them and then at least all it takes is a quick look to see if today is the day... You can also setup a reminder if you have something like Yahoo email, sent directly to your email..
<p>I use the pill containers to give daily meds and then there is never any question of whether I gave the meds or not. I just need to look. Or a quick call home for someone else to check if I think I have forgotten.
Elizabeth - from Nova Scotia March 1st, 2009 03:51:33 AM
I also recommend date-labeled containers. But my favorite, cannot-forget spot? Still the fridge. Sure, mine is stainless and nothing sticks but my daily tea-cupboard is a must-see spot. Everyone has one, right?
Dr. Patty Khuly March 1st, 2009 06:07:01 AM
I second the dated pill containers. Initially, I tried marking everything off on a dry-erase board, but I found that I never remembered to keep up with it. (I am uber-ADD, and my skills in the organizational department are minimal at best.) The pill box is much more my style.. and it's great when I'm boarding Thomas, because I don't have to worry about medication errors. (He's on a lot of meds.) I just split everything and ration it out ahead of time, and all the staff have to do is open the appropriate box and make sure he takes whatever's in there.
It's also cut down on the number of last-minute med runs. I am so bad about not realizing I'm running low until the bottle is pretty much empty. Using the box, the pill bottle comes up empty 7 days before it otherwise would have, giving me fair warning that I need to go buy more before it's an emergency situation.
Ramen Connoisseur March 1st, 2009 08:38:34 AM
In addition to working at a zoo, I teach dog training classes. We recommend keeping a log to help with potty training. People who follow through often find a trend for "accidents" so they can take steps to fix the problems.
teri March 2nd, 2009 12:05:49 PM
This is for Elizabeth in Nova Scotia - I'm GLAD you found the Percorten V! My "Sugar" was diagnosed with Addison's. She's hyper active and one day was just dragging. It took a few days and relapses for the vet to diagnose and then stabalize her. She was given Percorten SUBQUE vs. IM and sent home sans prednisilone. She was fine for 2-days and then absolutely tanked again on Day #3. Her bloodwork showed she was right back at her starting point the week prior when she was so ill! The vet wanted me to get the prescription filled you had your dog on. Thankfully he also consulted a specialist at MVS (Dr. K's fave experts) who said NOT to put her on that but give her pred and the Percorten V via IM. That did the trick. Now, two years later, she's weaned from the pred 100% and requires slightly less than the recommended Percorten V dosage per shot. (She's 65 lbs. and gets 1cc 25 mgs every 30-days.) I don't keep a journala as it's a 1/x month shot and she's doing fantastic on it. All her bloodwork and tests are together in her vet file should I need it, and if she worsens as she ages I'll keep the idea of journaling her health as a good tip!
Lee March 8th, 2009 09:45:29 AM
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