Finding Nothing on a Routine Exam

A lady brings her 3 year old mixed dog into the hospital for an annual exam. I perform the exam and ask her the normal relevant questions that should be involved in the process. I ask her if her pet is having any problems at all.

She says “Well, she does shake her leg sometimes…like when she is just standing there.”

And I reply while examining the dog, “Your dog is displaying somewhat of a fear response at the moment. Her twisting, turning, and shaking are signs of that. It may not be obvious to you, but that is why she is currently shaking.”

“Oh, okay.”

“So, when she is doing the shaking at home is there anything, anything at all in the environment, that might produce such a fear response at that time? Noises or people or any reason at all that you can think of?”

“No. It’s just like she’s standing there with her legs extended” and the client completely extends both of her forearms out to show me, “and one leg turns a little and begins to shake. That’s all.”

“The reason I am asking is because if there is no fear response at home generating that behavior, it would logically follow that pain is the next most likely cause and that would indicate a need for us to take some x-rays of her hips to see if she has arthritis or some hip dysplasia.”

“I don’t think she’s painful. She just turns her leg a little and shakes.” The clients forearms are extended again with her left arm rotated slightly internally.

“Is it like a person who is walking down the sidewalk in a normal fashion stopping abruptly and beginning to shake one of their legs for no apparent reason?”

“Yeah, I guess, something like that.”

“Well, that’s an indication of pain or discomfort…..assuming again it is not related to a fear response.”

“I don’t think she’s painful. She doesn’t seem painful. She just turns her leg a little and begins to shake.”

“Okay. I understand completely. Ya know, it’s probably nothing….I think it’s completely normal.”

And the client smiles in return to my last response. An extremely happy, content, satisfied, blissful expression extends from her smile throughout her entire posture.

So it goes. (to borrow one from Vonnegut)

Cribb          2013

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