Dog Days of Summer

  

I love summer, I really do.  What I don’t like about summer is having to leave Drago at home sometimes because it is too hot outside for him.  Drago lives for the outdoors.  He loves car rides too, and appears to enjoy people-watching from the car while I grocery shop.  Today, in Pennsylvania it was over 90 degrees farenheit.  Drago wanted so badly to be outside but I only let him outside for about 15 minutes at a time.  He seemed disappointed when I ran an errand  and didn’t take him with me.

However, maybe he doesn’t mind not being outside too much.  As I type this post, he’s laying upside down on the love-seat in front of the airconditioner.  Every now and then his toes and tail twitch as if he’s dreaming about chasing a squirrel.  Maybe he’s outside in his dreams. ūüôā  We’ll have to take a nice walk in the wee hours of the morning tomorrow before it gets hot again.  There are always lots of squirrels out at that time too…

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Mystery Dinner

Dogs, and cats for that matter, eat all kinds of weird things.   Some eat foods, some eat toys, some eat poop (ew!)…the list goes on and on.  Being a veterinarian, we get to see some really intresting cases of weird things eaten.  In my post  Pet Poison Hotline I mentioned what happens when pets eat toxins but what about when a dog eats inanimate objects? Toys? Strings? Bones?  This condition is known as dietary indescretion.

When your pet eats an inanimate object only three things can happen:

  1. Nothing – it passes.  You may or may not see it pass as a present in the yard.  If you don’t find it eventually you begin to wonder if he ever actually ate it.  OR, you consider the possibility that it may still be inside.
  2. She makes a mess – by vomiting it back up, along with the rest of the contents of the stomach.  Then, to make matters worse, diarrhea develops too.
  3. Bad news bears – it gets stuck.  This also can cause vomiting or diarrhea or worse if not dealt with in a timely manner. 

Our physical examination and diagnostics like blood work and x-rays can help us determine if something is stuck.   Sometimes on x-ray you can see a stuck object.  Other times, you see large dilated airfilled intestines and stomach as gas backs up from the obstruction.

Check out the following x-ray for a dog presenting for vomiting and diarrhea with straining.  He has a history of getting into the trash can and did so a few days ago before all this started.  Do you see anything?

     Do you known what his diagnosis is? It’s a foreign body…in the stomach.  If you don’t see it, the following reproduction of the image with overlays points out the foreign body/bodies (green circle) in the stomach and a small amount of gas (blue arrow) in the intestine.  In this case, the gas amount is normal, it’s just the foreign body that showed up on x-rays that is abnormal.

  
 Okay, hopefully you see it now.  Now the fun part comes…what is it?  This pup had surgery and we pulled the foreign body out of his stomach.  When we went in, we were thinking we would be retrieving some rib-bones that had been in the trash can and were still stuck together.  However, this was not the case, and I should have known seeing as these two things look so identical in shape and length.   Do you know what it is yet?

  
Pacifiers!  Crazy right? Surgery went well and he recovered uneventfully.  The owners, when shown what was collected from his stomach were astounded.  Apparently, these pacifiers were missing for a full week!

It can sometimes be fun to try to guess what may be the culprit of an obstruction.  However, it is much more fun to see you smiling and not worrying over your pet as they undergo surgery to relieve an obstruction.  Be mindful of what your pet’s habits are.  Some pets will eat these things, others could care less.  Learn to know your pet and what objects or foods need to be kept away…this way, I won’t have to open up their gi tract to find out just what mystery dinner Fido had a few days ago.

Frankie

Last week I posted about the TNR group I work with. I mentioned how it’s nifty when I get to see cats they pulled off the streets and adopted out to clients who eventually come to my primary care practice, Animal Health Care Center of Hershey. Sometimes, we see them for illnesses before they are adopted out. Meet Frankie. Frankie must have been abandoned because what Flame-point Siamese is a bonafide stray? Frankie was taken in by PAWS. He was thin, under-conditioned and un-neutered. He was given lots of groceries and love. Last week, he developed vomiting and diarrhea. So much so that the pound he gained since being taken in had vanished. PAWs brought him into AHCC. One of our doctors attended to his care while he was hospitalized for a few days. He was diagnosed with inflammatory bowel disease. Medications to help reset his system were given and a dietary change was made. He went “home” to PAWS on Thursday.  I had another TNR clinic on Saturday at PAWS’ headquarters and got to see Frankie running around the great room. It is so good to see your patients feeling better and back to health. Assuming he continues to do well and gains his weight back, I’ll be neutering Frankie and cleaning up his teeth later this month. Clearly he doesn’t know these plans or I doubt he would have taken the following selfie of the both of us… ūüėČ
 

Smile!
 

Pet Poison Helpline

Have you ever had your cat eat something she shouldn’t have? What about dropping one of your birth control pills on the floor and that quick Fido swallows it? ¬†Or maybe Fluffy got into the batch of brownies you just baked?FullSizeRender¬† Chances are you ended up at the veterinary hospital after such an event. ¬†As veterinarians, we get asked all kinds of questions as to possible toxicities. It is difficult to have all the answers sometimes, especially with more obscure medication ingestion. ¬†We turn to a service called “Pet Poison Helpline”. ¬†Pet Poison Helpline (http://www.petpoisonhelpline.com/) is a wonderful service offered to any pet owner or veterinarian for a small fee of $49 per case. ¬†They have toxicologists available 24/7 to help owners and vets determine if an ingestion was toxic, what clinical signs may show up, and how to treat and monitor the patient through their toxicity.

Tonight, we utilized this service. ¬†Sneaky Sandra came into our office on emergency basis after ingesting her owners’ medications. ¬†Sandra slurped 4 different pills off of the table while her owner was grabbing a glass of water. ¬†A little while later, Sneaky Sandra had vomited and began to tremble. ¬†Her owners did the right thing in bringing her in to be seen. ¬†We examined Sandra and called Pet Poison Helpline on behalf of the owners. ¬†Sandra’s toxicity case was entered into their database. ¬†A veterinary toxicologist then led our veterinary team through determining if a poisoning had occurred, what treatments are necessary, and signs to watch for. ¬†Luckily, Sneaky Sandra ingested 4 different medications that were ALL basically benign since she only ate one of each medication. ¬†The toxicologist determined Sandra had not been poisoned more than possible having some excitement followed by sedation.

As a veterinarian, I really appreciate the help Pet Poison Helpline’s toxicologists can give us. ¬†Poisonings are so different from patient to patient that it is hard to know all the details about each one. ¬†Also, if not treated correctly from start to finish, they can be deadly. ¬†Another good thing about Pet Poison Helpline is that as an owner, if your cat eats a plant at 4am in the morning, you can call and talk with a toxicologist to determine if you need to hop in the car to the emergency veterinarian. ¬†Let’s hope as a pet owner you never have to use it, but if you do…please know Pet Poison Helpline:¬†855-764-7661 is always available for your assistance.

Sick pet puzzles

It is difficult when your pet is sick. Unlike people, our pet’s cannot talk to us to let us know what is wrong, they have to let their ailments show us the clinical signs. These clinical signs are important to note when you end up taking your sick cat to the vet.  Hopefully, I’ll be able to shed some light on what goes through a vet’s mind when you bring your pet in to be seen for a sickness.

You know all those pesky questions the technicians ask you? Did she eat? Has he been coughing? Did she vomit? She did!?!, what did is look like? (Yes, we go there…not all vomit is the same. Vomiting food means something different than vomiting phlegm.) All of these questions constitute what we call a history. Knowing what your pet is doing at home starts to give us a few pieces of the puzzle.  

 More puzzle pieces fall into place once your vet has had a chance to perform a physical examination. This step helps us determine if your vomiting dog is painful in the abdomen, has a mass in the abdomen, or if the coughing dog’s lungs sound harsh. If you sit back and really pay attention to your vet performing the physical examination you should see that it is very thorough. It is easy to miss what all we do because many times we vets are asking you, the pet owner, more in-depth questions while we are performing the physical exam. The steps we take in a physical examination are usually quite methodical and almost second nature to most vets. I usually start with the lymph nodes of the chin and then go on to the ears. In fact, it is so second nature to me that when checking my own dog’s ears for wax I sometimes begin to continue on with the next step in the physical exam!

After the history and exam, some conditions are obvious and do not immediately need further diagnostics. For example, let’s take a look at Brogan. Brogan is a 4 year old lab who has been vomiting for half a day and just before his appointment he had his first bout of diarrhea.  Other than his vomiting, he has been bright, alert, and is still playing like usual. On physical examination Brogan’s temperature and vitals were normal. Palpating of his abdomen was unremarkable – no masses, thickenings, or pain noticed. He has a good appetite, but just can’t keep food down currently. My approach as a vet is to look at Brogan’s scenario and develop a list of possibilities to his illness…upset stomach, parasites, obstruction, infectious causes, and a few more.  Then I look at the likelihood of these possibilities.  If Brogan was really down and out, I usually recommend either x-rays or bloodwork.  These too, give us another, and hopefully the final piece of the puzzle. In some cases, as well Brogan, I would likely discuss with the owners that Brogan appears to be otherwise healthy and we can try to treat empirically first.  This means Brogan would receive medications for vomiting and diarrhea and if he did not improve, we then would see him back again to perform the diagnostics.

  
There are many different causes to illnesses.  As described, getting information from you, the pet’s examination, and sometimes diagnostics as well is the best way to put the pet illness puzzle together.  As veterinarians, our job is to take all of this information, figure out what is related and important to the current case, and decide the best course of action.  While these puzzles can be frustrating at times, it is one part of veterinary medicine that keeps me entertained, learning, and challenged.  There is nothing better than figuring out the correct puzzle and helping Fluffy get back to enjoying playing ball.