So when some­one walks into an ani­mal emer­gency room with a sick and lethar­gic dog or cat, and the own­ers’ men­tion she is not spayed, why do we cringe? Is it because we are super hard-core spay/neuter pronates? Well yes, but not for the rea­son you are prob­a­bly think­ing. We are more con­cerned that we have a 4-year-old female that is brew­ing a hor­ri­ble and fatal infec­tion in her uterus. It is a called a pyome­tra, and this is a true emergency!

A pyome­tra lit­er­ally means “pus filled uterus”, nasty right? The way ani­mals are built, they are more pre­dis­posed to this con­di­tion, but it seems most com­mon in dogs. Because ani­mals walk on all fours and can­not prop­erly drain any infec­tion, it just stays in the uterus. That is why humans don’t typ­i­cally have this issue. Experts still don’t know why some ani­mals suf­fer from a pyome­tra, and some go their whole life with­out. There are some the­o­ries that the nor­mal cycle of prog­es­terone leaves the uter­ine lin­ing sus­cep­ti­ble to infec­tion (acvs.org). E.coli seems to be the most com­mon bac­te­ria found in these infec­tions, so ascend­ing infec­tions from the vagina or anus might be the cul­prit  (acvs.org).

(Veterinarypartner.com)

Antibi­otics due not typ­i­cally work to fix the prob­lem, and surgery really is the only option. If it goes untreated the ani­mal can become extremely sick, and the uterus make even per­fo­rate caus­ing sep­tic peri­toni­tis. If this hap­pens, all the infec­tion con­tained in the uterus spreads through­out the body, and the prog­no­sis is grim. This illus­tra­tion shows a nor­mal size canine uterus on the left and a com­par­i­son to an infected uterus on the right.

If you do decide not to spay your female, then are some things you should be aware of:

These infec­tions are most com­mon in dogs 4 years old and up, but can hap­pen at any age.

Keep a record of your females heat cycle, since they tend to hap­pen in dogs 4–8 wks after estrus, and in cats 1–4 wks (acvs.org).

Symp­toms include (acvs.org):

• Lethargy
• Depres­sion
• Anorexia
• Exces­sive water intake
• Exces­sive urination
• Pale gums
• Vom­it­ing and diarrhea
• Weight loss
• Enlarged abdomen
• Sub­nor­mal tem­per­a­ture (Nor­mal is 100–102.5°F)
• Inflamed eyes
• A small per­cent may only have dis­charge from the vulva and no other symp­toms. Some don’t have any dis­charge (called a closed pyometra).

If you see any of these symp­toms take your pet to a vet imme­di­ately! Ignor­ing the­ses symp­toms can cause kid­ney dam­age, sep­sis, and death.

If your pet does need surgery, and you catch it early, most patients do very well. They usu­ally need to be hos­pi­tal­ized for at least 24 hours to start treat­ing the infec­tion, pain man­age­ment, nor­mal­ize hydra­tion sta­tus, and to watch for any fur­ther com­pli­ca­tions. After­care is usu­ally the same if you have your pet spayed; avoid­ing extreme activ­ity for 2 weeks, antibi­otics and pain management.

So that is why we REALLY want you to spay your females if you are not a breeder, or after you have retired your female. We don’t want to see your pre­cious lit­tle girl suf­fer a more extreme surgery, than a sim­ple spay.

I chose to write this blog entry after I had recently cared for a  patient that passed away from a pyome­tra. She was only 4 years old, and the own­ers had no idea this was a side effect from keep­ing an intact female. This is an all too com­mon sce­nario, and I thought for Tippy I would try to make the pub­lic more aware. Hope this gave some insight and another rea­son to please spay/neuter your pets.

Here are more web­sites for the owner and vet­eri­nary pro­fes­sional to peruse:

http://www.acvs.org/AnimalOwners/HealthConditions/SmallAnimalTopics/PyometrainDogsCats/

http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/112009.htm

http://www.veterinarypartner.com/Content.plx?P=A&A=603

https://www.vetlearn.com/standards-of-care/septic-peritonitis

This is a great video, ignore the sales pitch for his book at the end:

WARNING GRAPHIC

http://youtu.be/H7o611VAiB0

Works Cited:

Kennedy, Shawn DVM. “Pyome­tra in Dogs & Cats.” Amer­i­can Col­lege of Veterinary

Sur­geons. 01 Oct. 2011. Web. 23 Feb. 2012. <http://www.acvs.org/AnimalOwners/HealthConditions/SmallAnimalTopics/PyometrainDogsCats/>.

Brooks, Wendy C DVM. “Pyome­tra.” Vet­eri­nary Part­ner. 20 Aug. 2007. Web. 23 Feb.

2012. http://www.veterinarypartner.com/Content.plx?P=A&A=603

Bloat… The MOTHER of all Emergencies

by Mylissa Cor­lew, LVT

Fido is doing well these days.  Play­ing out­side, going for walks, and enjoy­ing all the events in a dog’s day.  He was just given a clean bill of health at his veterinarian’s office a few days ago.   Despite his aging, he seems to be look­ing like the gold stan­dard for his large breed.

Then it happens…  

Fido is visu­ally bloated, attempt­ing to vomit with­out suc­cess, rest­less, pac­ing, and cry­ing out in pain.  You run to your clos­est ani­mal hos­pi­tal to find that Fido has just been diag­nosed with a life threat­en­ing con­di­tion known as GDV!

What the H*** is GDV?!?

Gas­tric Dilatation-Volvulus (GDV), com­monly called bloat, is an emer­gency med­ical con­di­tion that is seen most com­monly in large and giant breed dogs. Fido’s event IS life threat­en­ing.  GDV occurs when a gas filled stom­ach expands and rotates, twist­ing off it’s own blood sup­ply and the blood sup­ply to the spleen as well.   Build­ing gases pro­duced from the nor­mal diges­tion of food con­tin­ues to expand the stom­ach with no hope for escape from the esoph­a­gus (*burp*) or into the small intestines (*fart*).   As pres­sure in the stom­ach builds up, the trapped gas con­tin­u­ally builds pres­sure on the stom­ach walls caus­ing the stom­ach tis­sue to stretch and in time…die.

The pos­si­bil­ity of stom­ach rup­ture is preva­lent.   The ever expand­ing stom­ach causes pres­sure on the diaphragm which has a seri­ous effect on the heart and lungs.  This cas­cade causes dif­fi­culty breath­ing and abnor­mal heart rhythm. Most dogs will go into shock soon after the signs of GDV are seen. Death can occur within a mat­ter of hours (or less).

How did they get THAT diagnosis?

Your vet­eri­nar­ian can typ­i­cally visu­al­ize a bloat when it walks in the door. A dead give-away are phys­i­cal symp­toms that look like this…

• Dis­tended (bloated) abdomen
• Unpro­duc­tive retch­ing / heaving
• Extreme lethargy
• Excess sali­va­tion
• Heavy pant­ing
• Rest­less­ness / pacing
• Pale gums

A truly defin­i­tive diag­no­sis is deter­mined by a radi­ograph or x-ray.  A char­ac­ter­is­tic “box­ing glove” appear­ance is a sure sign that GDV is the dirty cul­prit of Fido’s funk.   Check out the diag­nos­tic radi­ograph below…

See the resem­blance… Looks like a box­ing glove, right?!?

So, we have the bad news… now what?

Fido needs emer­gency cor­rec­tive surgery.  Period.

The only way to ensure that Fido is not going to repeat this hor­rific event is to sur­gi­cally cor­rect it.  He will have to have his stom­ach “tacked” or attached to the abdom­i­nal wall.  This ensures that the stom­ach will not rotate again.  Although he may bloat again…

Mean­while, back at the ranch…

You’re pac­ing in the wait­ing room of the ani­mal hos­pi­tal and the ded­i­cated tech­ni­cians and vet­eri­nar­ian are rac­ing against time to save your beloved Fido’s life.

First things first.

Fido needs some pain con­trol med­ica­tion.  Imag­ine if you had a stom­ach full of gas that you could not relieve. Bloat hurts!   OUCH!  Next, an IV catheter, blood work, and a diag­nos­tic radi­ograph will be per­formed.  Blood work, includ­ing a CBC, Serum chem­istry, elec­trolyte panel and a pos­si­ble lac­tate read­ing are all indi­cated.  This will allow your vet­eri­nary team to deter­mine how treat­able Fido’s bruised and pos­si­bly necrotic stom­ach is. It is also an indi­ca­tion of how well Fido will do dur­ing anes­the­sia and how quickly his recov­ery will be.

Fido (and pos­si­bly your­self) need to be treated for shock.  Fido’s shock can be treated with the imme­di­ate infu­sion of IV flu­ids and ther­a­peu­tic drugs. Your shock, on the other hand, will have to be left in the wait­ing room with you.

Next, Fido’s stom­ach will be decom­pressed.  This pro­ce­dure occurs out­side the sur­gi­cal suite to buy a lit­tle time.  Using asep­tic tech­nique, a large bore catheter is inserted through the abdom­i­nal wall into the stom­ach.  The main focus of this is to allow some of the abdom­i­nal gas to escape there­fore reliev­ing pres­sure.  A stom­ach tube place­ment may also be attempted to relieve some gas.

Get­ting Fido’s stom­ach decom­pressed and revers­ing shock is only half the bat­tle… now the fun starts!   Fido is pre­pared for sur­gi­cal intervention…

The fancy med­ical term for Fido’s surgery is called a gas­tropexy (fancy, huh!).  A gas­tropexy sur­gi­cally con­nects the stom­ach to the abdom­i­nal wall to ensure that it stays in its nat­ural posi­tion. With­out this surgery, the pos­si­bil­ity of Fido being in this same sit­u­a­tion is as high as 75%! Surgery also allows your vet­eri­nar­ian to deter­mine how bad it looks in that abdomen (how bruised Fido’s stom­ach is and if his spleen needs to be removed).

After surgery, a lot of care and mon­i­tor­ing is imper­a­tive. Fido will have to stay in the hos­pi­tal for about 36 hours before he can be released to heal at home.  You may have to mod­ify his diet and behav­iors to ensure his health.

Check this out…..

Although we still don’t know the true cause of bloat, it is impor­tant to rec­og­nize its symp­toms and sever­ity.  If you are able to iden­tify it early, you have a bet­ter chance of sav­ing man’s best friend.

To fin­ish this story…After a long recov­ery, Fido is back to his dog park lov­ing, shoe chew­ing, and floor poop­ing self.

The End.

Will Maisy Ever Learn?

By Jodi Novak, DVM

It started as a typ­i­cal evening. Maisy ate her din­ner one early April evening along with Ban­dit, the other house­hold dog.  Sent out­side to the back­yard after din­ner, both dogs instead darted off into the woods together. Real­iz­ing Maisy and Ban­dit were gone, her owner began to feel a famil­iar dread.  That con­cern was jus­ti­fied as just a short while later, pant­ing Maisy appeared in the door­way adorned with a face full of por­cu­pine quills.  Gath­er­ing the leash, her owner called Maisy and headed for the car…

This sce­nario becomes more and more com­mon with the pass­ing of win­ter and arrival of spring and warmer weather.  Despite a com­mon mis­con­cep­tion, por­cu­pines do not hiber­nate over the win­ter.  Instead, they find a hol­low tree, decay­ing log or other suit­able den and sub­sist on the inner tree bark (prefer­ably pine). The por­cu­pine will stay in or very close to the den dur­ing the cold win­ter months.  As the weather warms they then increase their range for­ag­ing for a more var­ied diet of buds, leaves, berries, etc.  Once of the largest North Amer­i­can rodents, por­cu­pines are gen­er­ally noc­tur­nal her­bi­vores.  Big and cum­ber­some and nois­ily root­ing around in the brush at night, they become such tempt­ing tar­gets for your curi­ous canine friend.

Mag­ni­fied Por­cu­pine Quill pic­ture, avail­able at http://www.mos.org/sin/sem/quill.html 1996

The North Amer­ica Por­cu­pine is armored with roughly 30,000 quills. The quills, essen­tially mod­i­fied stiff hol­low hair, can grow 3–4 inches in length. Each quill con­tains sev­eral lay­ers of small back­ward fac­ing barbs.  Not only is easy removal dif­fi­cult, the quill may begin migrat­ing into deeper tis­sues.  This migra­tion can occur sur­pris­ingly quick, espe­cially if the quill has pen­e­trated com­pletely through the skin.  Addi­tion­ally, the quill absorbs mois­ture, soft­en­ing and expand­ing the quill, facil­i­tat­ing fur­ther migra­tion into the for­eign tis­sue.  Unlike pop­u­lar belief, por­cu­pines are inca­pable of shoot­ing their quills.  Instead, they have mus­cles sur­round­ing the base of each quill that can more eas­ily dis­lodge the quill upon con­tact.  When threat­ened, the por­cu­pine will also deftly swipe its tail, swat­ting the attacker.

Very painful, these embed­ded barbed spines are extremely dif­fi­cult to remove.  Occa­sion­ally, some excep­tion­ally stoic dogs will let you pull some of the quills at home.  Before con­sid­er­ing this at home, please under­stand that deeply anchored quills can be ago­niz­ing for your pet and your safety is para­mount. Even nor­mally sweet tem­pered dogs may bite dur­ing times of pain and distress.

If only a few quills are present and you elect to attempt quill removal at home, you will need a sturdy pair of pli­ers.  Grasp the quill squarely at the base, next to the skin, and pull firmly.  The most effec­tive way to remove the entire quill and not leave a buried tip is to pull in a motion oppo­site to its direc­tion on entry.

More often, as in Maisy’s case, numer­ous quills are painfully lodged and you will be unable to safely remove them at home. Fran­tic to get the quills out, many dogs will begin paw­ing at their mouth and face — not only stick­ing their paws with the quills, but also exac­er­bat­ing the dam­age by break­ing the quills and mak­ing their removal even more prob­lem­atic.  In these cases, quill removal is greatly assisted with the ben­e­fit of pain med­ica­tion, seda­tion, and even gen­eral anes­the­sia if necessary.

Often times, com­pletely buried quills, or bro­ken pieces, can be felt under­neath the skin and a small skin inci­sion may be needed to retrieve them.  In other cases, quills evade detec­tion; so deeply embed­ded that they can not be felt or seen.  Migrat­ing quills can be found exit­ing the dog’s skin for sev­eral weeks — even months — fol­low­ing the episode.  In most cases, the quills will soften and even­tu­ally pass with­out a prob­lem.  How­ever, on rare occa­sion, migrat­ing quills can become a seri­ous or even fatal threat if they pen­e­trate vital organs such as the lung, heart or major ves­sels.  For this rea­son, remov­ing quills over­ly­ing the chest, ribcage and abdomen should take pri­or­ity.  Also, if your dog has quills over­ly­ing their chest or ribs, it is very impor­tant to min­i­mize activ­ity until they have been removed.

Depend­ing on the extent of por­cu­pine quills, pain med­ica­tion and antibi­otics may be advised.  For those dogs unlucky enough to receive a mouth­ful of quills, soft­ened food should be offered over the next sev­eral days fol­low­ing quill removal.

 So, how did Maisy do?  With the help of some pain med­ica­tion and seda­tion, her quills were removed unevent­fully.  Her owner reports that one small quill was found and gen­tly removed the fol­low­ing week.  Unfor­tu­nately for Maisy and her owner, it wasn’t her sec­ond encounter with a por­cu­pine that night…it was her FIFTH!  No, in fact her fourth time was just three weeks prior.  Her owner finally relin­quished the hope that Maisy will ever learn her les­son and leave the por­cu­pines alone. She now brings Maisy on long leash walks faith­fully every morn­ing and evening.  On final report one month later: Maisy has had no repeat run-ins with the por­cu­pine; her owner is four pounds lighter.

We wish them and your dog a won­der­ful porcupine-free summer!

Heat Stroke,  A Hot Weather Dan­ger For Your Dog.  By Whit­ney Friedrich, LVT

  Warm weather brings fun in the sun for every­one. When our fam­i­lies have par­ties, sport­ing events, and pic­nics our pets are included. This means more run­ning, hik­ing, ball chas­ing and a greater poten­tial for heat stroke to occur. Heat stroke is a seri­ous and life threat­en­ing prob­lem that occurs when a dog’s core body tem­per­a­ture is ele­vated to greater than 104.0 F. Nor­mal rec­tal body tem­per­a­ture can range from 99.0 F to 102.5 F.

Although there can be other fac­tors that cause a dog to have heat stroke, envi­ron­men­tal con­di­tions are the most com­mon cause for your pets inabil­ity to keep their tem­per­a­ture nor­mal.  What does this mean exactly? It means that when the tem­per­a­ture and humid­ity is ele­vated out­side you pets are at a higher risk.  Sum­mer time can be the most dan­ger­ous sea­son for this poten­tially fatal danger.

There are some other fac­tors some other fac­tors as well to con­sider that also cause heat stroke.  Dogs that are over­weight or obese cer­tainly are more at risk than nor­mal weighted ani­mals.  Pre­ex­ist­ing con­di­tions such as heart dis­ease, lung dis­ease, or laryn­geal paral­y­sis may put your pets at a greater risk.  Dehy­dra­tion and advanced are can con­tribute to poten­tial heat stroke.  There are also cer­tain breeds that are prone to heat stroke as well, see exam­ples below.

Brachy­cephalic Breeds (Squished faced dogs)

• Pugs
• Bull­dogs (Espe­cially English)

Dou­ble Coated Breeds

• Golden Retriev­ers
• Chow Chows

Dogs Bred for Cold Climate

• Huskies
• Great Pyre­nees
• Samoyed

There are sev­eral pre­cau­tions that we as pet own­ers can take to reduce the risk and avoid this cri­sis for our pets.  They can still be part of our daily activ­i­ties; how­ever, we just need to use com­mon sense to avoid the dan­gers of heat stroke.

• Never leave your dogs unat­tended in the car, espe­cially in the sum­mer time. Even if it feels cool or it is over­cast it can still cause the dogs in that car to overheat
• Avoid vig­or­ous exer­cise or long walks in very hot weather
• Have cool drink­ing water avail­able at all times in hot weather
• Use shade, fans, and air con­di­tion­ers to aid in keep­ing our pets cool.

Being care­ful with your pets on a hot day could save their lives.  There are signs you can watch for that may help you iden­tify pos­si­ble heat stroke:

• Heavy pant­ing
• Dark red or pur­ple gum color
• Thick saliva
• Dry or tacky gums
• Col­lapse or loss of consciousness
• Ataxia (stum­bling or drunken gate) or disorientation

Being aware of this poten­tial dan­ger and avoid­ing dan­ger­ous sit­u­a­tions can make a dif­fer­ence.  If you notice any of these signs it is VERY impor­tant to seek imme­di­ate med­ical atten­tion for your pet.  You can take your pets tem­per­a­ture at home rec­tally (remem­ber a nor­mal tem­per­a­ture is 99.0 to 102.5 F), and if the temp is above nor­mal call your vet­eri­nar­ian for advise.  If you have a friend or fam­ily mem­bers with pets it is very impor­tant to edu­cate them on the dan­gers of heat stroke.

Please have a safe and happy sum­mer season!!

The tra­di­tional Easter lily makes a beau­ti­ful spring time Easter arrange­ment or cen­ter­piece. How­ever, cat own­ers should be aware that Easter lilies along with many other lily vari­eties pose a poten­tial health haz­ard to their pets. With the Easter Hol­i­day approach­ing, this is a guide to learn the dan­gers of the Lily plant and how to keep your cats safe.

The vast major­ity of the pub­lic are not aware of the toxic dan­gers that lilies pose to cats, and that cats have been shown to be extremely sen­si­tive to all parts of the many vari­eties of lily and lily hybrid plants. It is impor­tant for cat own­ers to learn the toxic dan­gers that they cause and how to cor­rectly iden­tify a lily to avoid bring­ing it into their home. Some lilies are so dan­ger­ous that as lit­tle as nib­bling on 2 leaves or on a sin­gle flower can be fatal for the unsus­pect­ing kitty. The exact amount, or toxic dose of the plant to cause symp­toms is not known, but we do know that there is a quick onset of clin­i­cal signs that points to a rapid absorp­tion rate. It has been reported that symp­toms can start within 30 min­utes of ingest­ing leaves or flow­ers. What does this mean for the cat owner; if you even remotely sus­pect that your cat has been nib­bling on a lily plant, you need to con­tact your vet­eri­nar­ian immediately.

The major organ sys­tem that is affected by the inges­tion of lilies is the kid­neys and renal sys­tem. The renal tubu­lar epithe­lium, or the cells lin­ing the kid­ney, seems to be the main tar­get of the plant’s poi­so­nous affects. Once ingested you may see signs which include exces­sive sali­va­tion, vom­it­ing,
anorexia, severe depres­sion and dehy­dra­tion. Once these symp­toms are noticed and lily inges­tion is the sus­pected cause, acute renal fail­ure can progress rapidly if aggres­sive treat­ment is not started right away.

The main­stay of treat­ment con­sists of aggres­sive intra­venous fluid ther­apy to flush out the kid­neys as much as pos­si­ble to pre­vent poten­tially life-threatening anuric renal fail­ure (kid­neys com­pletely shut down and pet is no longer able to pro­duce urine). If it is known that the cat ingested the plant the vet­eri­nar­ian may have the option of induc­ing vom­it­ing or pump out the stom­ach to bring up any of the plant that remains undi­gested. This along with admin­is­ter­ing acti­vated char­coal will help slow down any fur­ther absorp­tion and help neu­tral­ize the toxin into the renal sys­tem. You should antic­i­pate your cat to be in the hos­pi­tal under close obser­va­tion for at least 24 to 48 hours while intra­venous flu­ids are admin­is­tered. Blood work, such as serum chem­istry pro­files will likely be per­formed every 12 to 24 hours to eval­u­ate kid­ney func­tion and to gauge the effec­tive­ness of the fluid treat­ment. If kid­ney fail­ure has already occurred then the only hope for recov­ery may be renal dial­y­sis and the prog­no­sis is poor.

In addi­tion to the fluid ther­apy to sup­port the kid­neys other symp­to­matic sup­port­ive care will be given as well. This could include gastro-protectants such as famo­ti­dine which inhibits stom­ach acid pro­duc­tion or any other antiemetic which will decrease vom­it­ing or nau­sea that may be present. Once the kitty is feel­ing bet­ter, no longer vom­it­ing, and well hydrated the goal will focus on mak­ing sure he starts eat­ing again. If he does not eat after 24 hours of no vom­it­ing then an appetite stim­u­lant may need to be given.

Although this type of tox­i­co­sis is life-threatening and the treat­ment can be daunt­ing and expen­sive for any pet owner, it is impor­tant to know that recov­ery is pos­si­ble and can hap­pen with care­ful mon­i­tor­ing. If may take weeks if not months for the kid­neys to return to com­plete nor­mal func­tion. If emp­ty­ing the stom­ach and admin­is­ter­ing med­ica­tions to pre­vent absorp­tion of the toxin are effec­tive, the prog­no­sis for recov­ery is excel­lent. How­ever, if enough toxin is absorbed to lead to acute kid­ney fail­ure, then the prog­no­sis is guarded to poor, and the mor­tal­ity rate is high. This makes it essen­tial to seek emer­gency care imme­di­ately after inges­tion of the lily plant.

Know­ing the dan­gers of lily plants can hope­fully poten­tially save the life of your cat if he tends to be mis­chie­vous and nib­ble on plants around the house. Even one lit­tle nib­ble can mean a death sen­tence for even the most inno­cent kitty. Although the Easter lily makes for beau­ti­ful arrange­ments dur­ing the Easter hol­i­day it is best to choose a plant that offers an attrac­tive non-toxic alternative.