The context of the following conversation is Alex's dog needed to go to the vet so she took the dog to the car.:
Alex says My poor puppy has a tummy issue again!.
The friend responds Oh no, again? That's the third time!.
Alex responds Fourth, actually. I didn't tell you about the other one. This time I knew she'd have to go to the vet right away. She needed meds!.
The friend responds Did she struggle to get in the car again?.
Alex responds Yeah, it was quite the ordeal. She was howling the whole way. I felt so bad..
The friend responds Aww, poor dog. I hope she feels better after getting those meds..