Two weeks ago there was an appointment on the schedule for a dog whose owner reported "masses of ear mites crawling out of the dog's ears and burrowing under the skin." Ok-several problems here. 1-ear mites are microscopic. 2-they don't generally crawl out of the ears in droves. 3-they don't burrow under this skin. So this was shaping up to be an interesting appointment.
The dog arrives, has no mites, but does have a yeast infection in her ears. The owner is not impressed with this diagnosis as he was pointing out "mites" running all over the dog and burrowing into the skin during the whole exam. We tried to ignore this behavior as he was clearly under the influence of some illegal substance and informed him that the medication we were sending home would kill any mites as well as the yeast she did have. That was not the end of it.
He continued to call and complain that the dog still had mites, they were everywhere and she was just infested with bugs. He claimed if he poured alcohol on her then the mites would just go crazy and run everywhere. We suggested he bring in some of the mites for us to see. So in comes a baggie with some sort of skin flakes or scabs he has picked off the dog, but no mites.
So he comes in for a recheck appointment (with another baggie of whatever he has recently picked off the dog) and insists now that the dog has "sex crabs" and they are all over him and the house as well. Dog still has no bugs of any kind on her and I also tried to explain that "sex crabs" don't live on dogs or carpets. We let him pour alcohol on the dog so he could show us the bugs (mites, sex crabs, whatever they may be...) running around. All we saw was dead skin flakes turn into wet dead skin flakes. I informed him that all we were seeing was dry skin which was probably dry because he kept pouring alcohol on her. He insisted that he was a)not on drugs b)not hallucinating and c)even though they look like skin they are bugs he was just sure. So we took some to look at under the microscope and sure enough-skin flakes. We finally told him we could do one of two things. Treat the dog with a broad spectrum drug for common ectoparasites (mites, lice, etc) and have him call an exterminator for the house or refer him to a dermatologist. He decided to treat the dog and leave it to be boarded while he went to the hospital. I'm not sure what he was going for but hopefully for some mental help or detox (did I mention the sores on his arm he has from picking bugs off himself?). Oh, and on the way to the hospital he dropped off another baggie with something he picked up off the carpet-still not a bug.
The dog, who did not itch or shake her head the whole time she was with us was probably glad to have a break from all the alcohol pouring and picking.
We have not heard from him this week but I think it will soon be time for him to seek a second opinion.