Three days after my new puppy Cooper came home, he vomited blood. X-rays revealed a bowel obstruction. Cooper needed surgery. He was too unstable for surgery and spent the night in the puppy intensive care unit. The following morning, a large rock was removed from his intestine. My 8-week-old puppy had swallowed a rock the size of a ping pong ball.

Two weeks after Cooper’s surgery, I couldn’t find my house keys; terrified that Cooper had eaten them, I immediately visited my vet and demanded full-body X-rays. She obliged given that Cooper’s medical chart says: “rock eater.” No keys were found in Cooper’s digestive tract.

A week later, Cooper slept in until 7 am (his usual wake-up time was 5 am). I went to the vet. Convincing them that he was dehydrated because he slept in, Cooper received a 200-mL normal saline fluid bolus. 

A month later, Cooper woke up at 4 am vomiting bile. Clothed only in pajamas, I ran down the street signaling for a taxi. Seeing Cooper, the driver at first refused us a ride. I was irate: “My puppy may be dying; if he dies it’s your fault!” Even the crankiest cab driver won’t turn away a dying (albeit very well-appearing) puppy. In the emergency room, he had X-rays (rock eater) and lab work. All were normal. The following morning, he vomited again. I resisted the urge to go to the emergency room, but scheduled an appointment with the vet. Cooper’s diagnosis, a very common phenomenon, was “puppy bile vomit syndrome.” It is basically the equivalent of reflux in babies. Zantac and a biscuit before bedtime solved the problem.


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In less than a year, I had taken Cooper to the vet 15 times and emergency room 5 times. The complaints included rashes, coughing, sneezing, vomiting, acting scared, sleeping too much, being too skinny, and eating poop (to name a few). This was all normal puppy behavior. Cooper has his own patient profile at our local pharmacy including all his prescriptions: Zantac, Flagyl, doxycycline, Zofran, Augmentin, steroid cream, and puppy ibuprofen.

On my most recent vet visit, I brought Cooper in for evaluation because his poop smelled bad. My usual veterinarian was not available. The on-call vet said, “Natalie, you know you have a dog, right?

Four years of medical school and 3 years of residency had taught me volumes about sick children, but I knew nothing about puppies. I wanted to raise a healthy, intelligent, well-behaved puppy, and was afraid of failure. All my visits to the vet were driven by the need for reassurance that Cooper was healthy and that I was doing a good job. I suddenly had insight into the minds of first-time parents. What to me was normal baby behavior was completely foreign to most parents.

I have no children of my own, and up until getting Cooper, I had no responsibility except to myself. Early on in my residency, I would often brush over parents’ concerns, stating “Oh, that’s normal” or “You don’t need to worry about that.” When in reality, the families wanted more from me. They wanted the same reassurance that I wanted with my puppy, that they were doing a good job as parents.

As I walked home from the vet, I thought back to all the missed opportunities I had to really talk to families about their concerns and fears. One evening, a young couple came into the emergency room  at 2 am for evaluation of their 3-week-old baby. The chief complaint was “no stool in 8 hours.” Some of the emergency room residents wondered: “Why would you bring your baby in at 2 am when there is nothing wrong?” I went to see the family. Their baby had always pooped every 2 hours. The parents were very worried.

Instead of saying “Oh, that’s normal,” I talked at length with them about normal baby pooping patterns and reassured them that they had a beautiful, healthy newborn, and that they were doing a good job. At the end, they were embarrassed, having rushed to the emergency room so quickly.

I sat down next to them and said, “Let me tell you a story about my puppy Cooper and the time I rushed to the emergency room for reflux.”