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Don’t Ignore ADR

In veterinary medicine, with patients that cannot articulate how they may be feeling, we do not always get a clear and concise history from the owner, as the owner is often uncertain where the specific problem may be coming from.  It is one thing if there are definitive observations that the owner of the sick pet conveys to us – limping, coughing, sneezing, vomiting, diarrhea, seizure, etc. – but another matter altogether when the pet is just not acting itself but the owner cannot put his or her finger on exactly where the issue may be emanating from.  These are the cases we refer to as “ain’t doing right,” or ADR.

As rudimentary and poor diction as ADR may seem, this is a term we are not only taught in medicine course work in veterinary school, but also a term we readily used in rounds while rotating through the teaching hospital on our way to become doctors.  Interns, residents, and clinicians all commonly use the ADR medical history description, so it logically follows that as practitioners we use the same terminology.

Whatever one may think of ADR, it is a common history that we get from the owners who are so in tune with their pets’ every nuance, that even though there may not be a specific clinical sign to report, they just know in their hearts that something is just amiss with their pets.  And in the vast majority of cases, they are proven most correct.  In addition, when owners go against their instinct that something may be wrong but dismiss it as their own tendency to be neurotic about their pet getting the best of them and subsequently do not have the pet seen, serious or deadly consequences can result.

Last week, a lady brought her boxer in because she just was not herself; she was eating, defecating, and urinating normally, just generally dull and less perky.  This boxer’s very nice owner was being self-deprecating, telling me that he was likely just being an over-protective, neurotic mom.  It was a classic ADR case, where she had nothing to tell me other than her dog was just not herself.

On examination, I noted distension in the abdomen that concerned me.  2 x-rays and an ultrasound later, we discovered that the dog had a large tumor on her spleen.  The next morning, we performed surgery to remove the spleen and the dog recovered without incident.  The mass turned out to be a blood vessel based tumor that is very aggressive and very prone to bursting and hemorrhaging, a circumstance that could lead to death within minutes.  Having brought her dog in on her ADR hunch saved her dog’s life.

As animals, our furry children’s innate instinct is to hide signs of pain and illness to keep from showing weakness.  In the wild, weakness displayed gives other animals the opening to try to steal food or encroach on territory.  Taken in combination with the inability to articulate in words how they are feeling, sometimes as pet owners, all we have to go on is that there is something off about our pet.  If in doubt, have your pet seen by a veterinarian, as taking action based on ADR can often be the difference between life or death for our patients.

Dr. Roger Welton is the President of Maybeck Animal Hospital and CEO/Chief Editor of the veterinary information and blog online community, Web-DVM.

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