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All Posts Tagged: Pet Emergencies

Hemorrhagic Gastroenteritis in Dogs — Severe Bloody Diarrhea

Recently we’ve had quite a few cases of hemorrhagic gastroenteritis (HGE) at Greenbrier Emergency Animal Hospital. The good news with HGE is that, seeing blood in their dog’s stool, many owners will bring them in immediately, allowing us to start treatment right away, greatly improving the survival rate and minimizing hospitalization time. HGE sometimes can be mistaken for colitis, an inflammation of the colon that presents with mucousy, blood-tinged stool. Patients with colitis — which we also see a lot of at Greenbrier — usually are bright and alert and can be treated as outpatients. Dogs with HGE, however, usually present with lethargy and very bloody, watery or mucoid diarrhea, and in severe cases can present in shock from dehydration. The diarrhea in cases of HGE has often been described as “strawberry jam-like”. Occasionally HGE causes vomiting as well.

The etiology or cause of hemorrhagic gastroenteritis is unknown but is thought to involve any one of the following: allergy, stress, parasites, or bacteria. Small breed dogs are affected most often, but any dog can get HGE. It is believed that when the condition is present, the permeability of the GI tract is increased, allowing protein and plasma to leak into the bowels and causing the dog to become severely dehydrated. The diagnosis usually is made based on the description of the diarrhea and a simple blood test that looks at the levels of protein and red blood cells. A very high level of red blood cells, low levels of protein and very bloody diarrhea is diagnostic for hemorrhagic gastroenteritis.

We treat HGE with high levels of IV fluids. Occasionally, dogs with low protein will need an additional type of IV fluid to boost the protein level. Other treatments might include antibiotics (since one theory holds that hemorrhagic gastroenteritis is caused by Clostridium, a form of bacteria), GI protectants, and antiemetics or antinausea medication. If untreated, HGE can be a life-threatening disease. Once placed on IV fluids, most dogs will need to be hospitalized for 1-3 days and then will be fine. But it is extremely important to seek veterinary care immediately if your dog has a bloody stool.

© 2011 Greenbrier Emergency Animal Hospital. All rights reserved.

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PODCAST: Pets and Snake Bites — Act Quickly!

During the warm-weather months, our slithery, venomous snake friends become more active. And snake bites are a very common problem in the summertime. Our pets are very curious creatures and tend to lead with their noses and their front limbs, so that’s where we see the most bites (on the face and front legs). These bites often cause extreme pain, swelling and bruising, and that’s typically what you as an owner will notice first, if you don’t happen to see the snake itself. You may also see puncture marks that may be bleeding or oozing.

© 2011 Greenbrier Emergency Animal Hospital. All rights reserved.

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PODCAST: Heat Stroke in Dogs

As the heat and humidity of the summer months are approaching quickly here in Central Virginia, pet owners should be aware of the dangers of heat stroke, one of the more common summer pet emergencies in dogs. Heat stroke is a situation in which a pet’s body temperature has risen way above normal and needs immediate veterinary attention. Unfortunately, our domestic pets don’t sweat the way we do to dissipate excess heat, so they aren’t as efficient at cooling their bodies as we are — and heat stroke can result. The condition can become fatal rapidly if left untreated, but is easily preventable with some common-sense measures.

© 2011 Greenbrier Emergency Animal Hospital. All rights reserved.

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Addison’s Disease in Dogs and Cats

Does your pet have good days and bad, or “waxing and waning of clinical signs,” as we like to call it in the vet world? Does your pet have some lethargic days and some days where he or she just won’t eat? Has your pet experienced any weight loss? Is your pet having gastrointestinal signs such as vomiting or diarrhea, or is your pet urinating more and drinking more water? If these symptoms sound familiar, your pet may have Addison’s Disease, or hypoadrenocorticism, a medical condition in which an animal’s body fails to produce an adequate level of steroids. Addison’s Disease is most often seen in middle-aged female dogs, but can be seen in any dog or cat. With this condition, occasionally your pet’s electrolytes will show up abnormal on in-house blood work — sometimes so abnormal that he or she will require immediate emergency medical attention. Your veterinarian can perform a specific test to evaluate for this disease.

Treatment for Addison’s Disease often includes oral steroids, and sometimes injections. Most patients will need to remain on medication for life, but most pets do very well with proper care and can still enjoy long, happy lives. If you suspect your pet may suffer from this disease, visit your veterinarian as soon as possible for testing.

IMPORTANT NOTE: If your pet is on steroids (including prednisone), it’s important to avoid taking a pet off the medication suddenly and instead to taper the dose down gradually. If your pet has been on steroids over a long period and you suddenly stop the medication, you can actually induce Addison’s disease, and your pet may require emergency medical attention as a result.

© 2011 Greenbrier Emergency Animal Hospital. All rights reserved.

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PODCAST: Common Household Pet Toxins

Our first podcast — and many more to come! This first podcast focuses on common household pet toxins — we’ll identify these toxins and briefly discuss treatments and outcomes. There are some tasty treats that you might never suspect are toxic to your pets.

© 2011 Greenbrier Emergency Animal Hospital. All rights reserved.

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Laryngeal Paralysis or “Lar Par” in Dogs

The larynx, which is the opening through which outside air flows into a dog’s lungs, allows for vocalization and prevents food inhalation (aspiration) — both of which are important functions. Paralysis of the larynx, otherwise known as laryngeal paralysis or “lar par” for short, means that either one or both of the vocal folds does not fully open during breathing. The condition can occur in cats but is more common in dogs, and specifically in large-breed dogs. It can be hereditary in Bouviers, Huskies, Bull Terriers, Dalmatians and Rotweillers and is also commonly seen (but not necessarily hereditary) in Labs, Goldens, St. Bernards and Newfoundlands.

The first thing you might notice if your dog is suffering from lar par is a change in his or her bark, which might sound more hoarse, because the vocal folds are not moving as they once did. Due to the importance of panting, which is essentially moving air through the larynx, as a cooling function in dogs, you might also find that your dog has exercise intolerance and/or might breathe very noisily or heavily in warm weather. As well, when paralyzed, the larynx might not be able to protect the lungs from aspiration, so your dog may experience coughing, gagging and/or retching. In extreme situations, you may even notice respiratory distress or heat stroke. The clinical signs usually correlate with the degree of paralysis.

To diagnose laryngeal paralysis, your veterinarian will need to do a sedated exam and watch the larynx move as your dog breathes. Because the larynx is so deep in the throat, it is not possible to get a good look at it without sedation. A workup for lar par might also include blood work on thyroid levels, since up to 10 percent of dogs with lar par also have concurrent low thyroid. Chest x-rays may also be taken if your vet suspects aspiration pneumonia, which commonly happens with laryngeal paralysis.

The only treatment for laryngeal paralysis is a surgical procedure to tie back the laryngeal folds. This procedure, actually quite common with race horses, is called a “tie back” and is usually performed by a surgery specialist — so your primary vet may refer you to a specialty practice. The surgery can only be performed on a stable patient, so If your dog has a lar par complication such as pneumonia, he or she will likely be hospitalized until stable enough for anesthesia and surgery. The major risk of the surgery is an increased likelihood of aspiration pneumonia, since the folds will no no longer able to completely close and protect the lungs.

Lar par is a disease that can range in seriousness from minimal clinical signs to severe respiratory distress and even death. If you notice any of the hallmark signs, such as a change in bark, increased respiratory noise, or exercise or heat intolerance, please bring this to the attention of your veterinarian. It is very important to note that dogs with this condition can overheat easily, so they should be kept in an air-conditioned environment and have limited exercise until they can be examined and/or have surgery. The good news is that after tie back surgery, dogs usually do quite well.

© 2011 Greenbrier Emergency Animal Hospital. All rights reserved.

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Pet First Aid: Responding to Pet Emergencies at Home

Working in emergency medicine, we get numerous calls from people wondering what they can do with their pet in an emergency prior to coming in to the office. While the majority of treatments on your pet should be done by a veterinarian or a member of a veterinary staff, there are some things you can do to help your pet prior to transport.

Preparing to Transport Your Pet
The most important thing to remember is that you should never do anything to assist your pet that will cause harm to yourself. Even the most gentle pet, when in pain, may try to bite and/or scratch you. The most frequent occurrence of this situation is after a pet is hit by a car — we often see clients who have been bitten by their pets while trying to tend to them and transport them. For dogs, placing a large blanket or towel over the head, with room for them to breathe, can help prevent injury to yourself. You can also use a towel with cats, and it’s a great idea to put on sturdy work gloves and a long-sleeved shirt prior to picking them up.

With an animal that has been hit by a car, it’s also helpful to slide the animal gently onto a board, blanket or sturdy piece of cardboard — this will help protect against possible trauma to their spinal cord or neck. It’s also important, especially in patients that are having trouble breathing, to keep your pet sitting up on their sternum (chest) — that will help them aerate both sides of their lungs and breathe more easily. You can place thick towels on either side of them to help keep them propped up in this position.

Getting Bleeding Under Control
When it comes to pet injuries, a bleeding pet typically leads to a frantic owner, so it’s important to stay calm and focus on helping your pet. To be prepared for such an event, having a first aid kit on hand for your pet — including gauze and materials needed to make a bandage — is a very good idea. One important initial word of advice is that if there is foreign material sticking out of the wound, do not try to remove it yourself. The foreign object could be pressing up against a blood vessel or penetrating an organ, and removing it could cause more harm than good. This includes foreign material sticking out of the eye.

For penetrating wounds (such as bites) and wounds that are bleeding heavily, apply firm pressure and place a firm pressure bandage over the wound. If the bleeding is on a limb, you can also try to raise that limb above the level of your pet’s heart to help slow the bleeding. For nose bleeding, apply ice to the bridge of the nose to slow it down, and try to keep your pet laying on their sternum (chest), as we discussed above.

One of the most common bleeding problems we see on an emergency basis is a bleeding toenail, which includes a toenail that has broken or has pulled out. This kind of injury can bleed profusely and run all over a floor or rug (I refer to this as “crime scene bleeding”). To help bring the bleeding under control at home, you can place the bleeding toe in some corn starch, a bar of soap or a stick of underarm deodorant containing zinc.

Dealing with Toxicities
Toxicities are also a common emergency we deal with here at Greenbrier Emergency. With so many different substances toxic to pets — and many substances you might otherwise not think of as toxic — always call a veterinarian if you suspect that your pet has gotten into something. In this kind of situation, many people consider trying to make their pet vomit to remove the toxic substance. But with some household products and medications, inducing vomiting in a pet can cause more harm than good. Your pet, if poisoned, may not be able to swallow correctly and end up inhaling some of its vomit, creating a whole new problem known as aspiration pneumonia. Also, some products can cause more irritation to the esophagus and mouth on the way back up than on the way down.

Because so many common plants are toxic to pets, I usually recommend that people keep a list of the types of plants they have in and around their house. Telling your vet, “they got into a big green one,” doesn’t help us pinpoint the exact toxic agent and resolve the problem.

For other common toxic household substances like rat poison, try to keep them stored in a place that is inaccessible to your pet. And if you smoke, don’t throw your used filters outside — nicotine is a toxic agent to pets, and any remaining tobacco, eaten by your pet in large enough quantities, can cause serious problems.

Call Ahead!
If you ever do have an emergency situation with your pet, if possible, please call a veterinarian or Greenbrier Emergency to let them know you’re on your way. That will help them get set up and be prepared to handle your pet’s specific problem and treat them as quickly and effectively as possible.

© 2010 Greenbrier Emergency Animal Hospital. All rights reserved.

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Parvovirus: Make sure your dog is protected!

A lot of you have probably heard of parvovirus, commonly referred to as just “parvo.” This disease is characterized by weakness, vomiting and extreme diarrhea (often with blood in it). Parvo is mostly found in young dogs, aged 6 weeks to 6 months, but it can be found in older adult dogs as well. Younger dogs are often more severely affected. Predisposed breeds include Rottweilers, Labradors, American Staffordshire Terriers and “pit bulls,” although any dog can be affected (I diagnosed this disease in a Shih Tzu earlier this year). Parvo is shed in the stool and has fecal-oral transmission — meaning that dogs become infected by eating infected substances (e.g., feces or grass with feces on it) or grooming other dogs with feces on their rears. And this little virus is hard to get rid of — once it is in your yard, it can last for up to a year.

What effects does Parvo have on your dog? In addition to the above-mentioned lethargy, vomiting and extreme diarrhea, this virus can do some truly awful things to your pup. Parvo is so debilitating that many pets have to be hospitalized for several days — if not weeks — with intravenous fluid support, antibiotics, anti-nausea injections, antacid injections and plasma transfusions. The virus can also severely decrease your pet’s white blood cell count and protein levels. And in rare instances, Parvo can even have effects on your pet’s heart or can create an obstruction in your pet’s intestines, causing the intestines to “fold in on themselves” and close off — an obstruction that requires surgery to fix. Although not all pets are this severely affected and some can be managed on an outpatient basis, some pets do die from this disease.

So what can you do to prevent this disease in your pet? Vaccines are available and are, for the most part, very effective. Occasionally a vaccinated pet can still get parvo, but in those cases the disease is often less severe than if they had not received the vaccine. Talk to your veterinarian about when to vaccinate and how many vaccines your pet needs — predisposed breeds often need more vaccines than other breeds. Also, do not take your pet to a place where there has been parvovirus within the last year. And if you yourself come into contact with a dog that has parvovirus, take care not to become a “fomite” &mash; when exposed, people can act as carriers and spread the disease to their own pets. After contact with an infected dog, Parvo can be found on your hands, clothes or shoes — so wash your hands, change your clothes and take off your shoes to help avoid bringing this disease home to your pet. Bleach in a 1:30 dilution with water can kill parvovirus on your floor and other surfaces, if you allow the solution to sit for approximately 10 minutes.

If you suspect your dog may have parvovirus, keep him/her away from all other dogs and take your pet to a veterinarian as soon as possible. Your veterinarian can perform a “snap test” to check for the virus. If your dog has been diagnosed with this disease, be sure to clean up all of his/her stool immediately, do not allow your pet to be around other dogs, and do not introduce another dog into your house without consulting your veterinarian first.

© 2010 Greenbrier Emergency Animal Hospital. All rights reserved.

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Grape toxicity and pets: Delicious but deadly

Grapes may be one of people’s favorite fruit-based snacks, but they are not a safe snack for our pets. While grapes don’t cause humans any harm, they can cause acute kidney failure in dogs, and even possibly in cats. Despite recent research, the exact agent in grapes that causes the toxicity is still unknown. It was previously thought that perhaps something related to pesticides or heavy metals in grapes was causing the problem, but that hypothesis has since been disproven. Current theories suggest that the fleshy portion of the grape, rather than the seed, is the toxic culprit. Thompson seedless grapes, the common green ones from the supermarket, statistically seem to create the highest number of problems in animals — however, this could just be because that variety of grape is the most commonly purchased. Other products made from real grapes, such as raisins, grape juice and grape jelly, have also shown to cause problems. And heated and fermented grape products, like those used in baked cookies and cakes with raisins, can also be toxic to pets. One notable exception is grape seed extract, which is found in some pet products and synthetic grape-flavored medications, and is not currently thought to be a pet hazard.

One of the most frustrating things for owners is just how small an amount of grape ingestion can be toxic. I have had people tell me, “Well, he only ate 2 or 3 grapes,” or “Well, he got into some trail mix with raisins, but there weren’t many in it.” Unfortunately, any known grape ingestion — regardless of the amount — could potentially cause a problem.

People also tell me, “I have been giving my pet grapes for years without a problem.” Regardless of what you may have given your pet in the past, that doesn’t ensure that your pooch won’t react badly to grapes in the future. In fact, some dogs that have eaten grapes in the past with no signs of toxicity ultimately may run into trouble with them. The consequences of grape toxicity can be severe, so why take the risk? To avoid these kinds of problems, we highly recommend not giving your pet grapes in any amount.

Like many other products that are toxic to animals, your pet may appear normal for up to 24 hours after they eat grapes or a grape product. Within 24 hours or so, you might start seeing them not wanting to eat, vomiting, acting like their abdomen is in pain or experiencing diarrhea. Within 48 hours after ingestion, they can start experiencing more serious problems, such as showing a decrease in the amount of urine they produce — or not producing urine at all. These are some of the signs of acute kidney failure.

And just like any toxicity, early treatment is the key. If you suspect your pet has eaten grapes, raisins or products containing them, bring your pet to Greenbrier Emergency Animal Hospital or to your regular vet as quickly as possible. Grapes can sit in the stomach for hours after being ingested, so your vet will most likely give your pet an injection to make them vomit. They may also be given what is known as activated charcoal to help bind up any additional grape products in the GI tract. Your pet will also likely be placed on intravenous fluids for 48 hours and have their kidney function checked daily for 72 hours via a blood test. The prognosis of any given case usually corresponds with how soon you realize that your pet has eaten the grapes — and how fast you react to get them the proper treatment.

© 2010 Greenbrier Emergency Animal Hospital. All rights reserved.

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Winter Hazards for your Pet

Now that the holidays are upon us, I thought it would be a good time to remind pet owners of the many common household items that can be hazards to pets during the winter season. I’ll start with a list of common food items that can present serious problems for pets. Many of these items have their very own blog entries, so please search our blog after you read this post if you’d like more detail. I am constantly surprised by how many people aren’t aware that these foods are potentially toxic to pets, so I don’t think we can list them too often.

Foods
Yeast bread dough: converts to alcohol, causes bloating
Moldy foods: contain toxins that can cause tremors
Macadamia nuts: can lead to weakness, depression, vomiting
Chocolate: GI and cardiac signs, can make pets hyper excitable
Onions, garlic, leeks, onion powder: can lead to anemia
Xylitol (contained in sugarless gum): causes low blood sugar, liver toxicity and blood clotting disorders
Grapes/raisins: can lead to kidney failure. For some dogs, it only takes a few.
Fatty foods: can cause pancreatitis

Plants
The following plants are toxic to pets:
Lilies: can cause kidney failure in cats
Holly: can cause gastrointestinal problems, lethargy
Mistletoe: can cause gastrointestinal problems and is a cardiotoxin
Poinsettia: can cause irritation to the mouth and gastrointestinal problems and is a mild toxin

Holiday-related items
Since many of the items below only come out seasonally, they can be a novelty — especially for those curious cats or puppies. Take care to pet-proof your holiday decorations!
Christmas tree water: can be laden with bacteria and/or pesticides; causes gastrointestinal signs
Ribbons/tinsel: cats especially love these, and they can cause linear foreign bodies requiring surgery
Liquid potpourri: can cause severe oral, ocular and dermal damage
Electric cords: can lead to electrocution, fluid in lungs

Other toxic items
Antifreeze: Extremely toxic to animals!! Lethargy, “drunk” behavior, kidney failure
Ice melt: irritating to skin, paws and mouth

Please keep your pets safe this holiday season. If you think your pet has ingested any of the above, please seek veterinary attention immediately. Many of these toxins can be mitigated with early veterinary intervention.

Dr. Elvira Hoskins

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