On a frosty November morning, three large dogs took off across a field after an orange barn cat named Ernie. Too far from the safety of the barn loft to return, Ernie scampered down toward a nearby ditch, which was running full of icy Colorado runoff. Trapped at waters edge as the pack approached, Ernie plunged into the frigid waters, but the dogs followed. The three of them surrounded Ernie in the ditch, biting at his body and shaking it in turn, as Ernie desperately struggled to get free.
A neighbor spotted the fracas from their kitchen window, and rushed outside to run the dogs off. Ernie struggled to claw his way out of the ditch, using only his front legs to scrabble onto dry ground. There he collapsed, barely moving.
The cat I saw that was rushed into the treatment room of our emergency hospital appeared to be dead.. Barely breathing, frigid to the touch and hair coat soaked to the bone, he felt like a cold, wet rag. “How old is he?” I asked, surprised to find out he was only five. With his sunken eyes and battered face, he appeared to be closer to 15.
Ernie’s body temperature did not register on our thermometer, but probably was close to 85 degrees. Our nurses rushed to warm him up and treat him for shock. A surgical air warmer blew hot air into a blanket under his body. Warm bags of IV fluids were packed around his torso. An IV pump pushed another bag of warm saline into a catheter in his front legs. An IV drip of pain killer and antibiotics was started.
Four hours later, Ernie’s body temperature finally registered at 92 degrees F., still 10 degrees below normal. He finally raised his head and slowly looked around, as if saying to himself, “I’m still alive?” He may have considered himself in kitty heaven with warming air blanket and fluid bottles, along with the doting attention of the veterinary nurses.
Although Ernie had minimal use of his back legs, he gently kneaded his front toes when he was scratched along his back. At this point, I sensed he was going to be OK, despite his apparent rear leg paralysis and the large bite wound in his flank.
By the next morning, Ernie could walk, he was eating, and, although he was moving very slowly, he was ready to go home. With some TLC, pain meds and antibiotics, he would enjoy a week at home before returning to his mouse-hunting haunts in the barn.
In considering Ernie’s astounding recovery from the attack of three dogs in a freezing ditch of water, I suspect that the icy cold water created a hypothermic response that was protective. As his body systems slowed down, to a semi-hibernation state, blood flow to critical organs like his kidney and brain was preserved. Eventually, as he warmed up, his heart was gradually able to restore his circulation, giving him back use of his rear legs.
Cats like Ernie continue to amaze me at their ability to survive the most dire of circumstances. As veterinarians, we can provide the basic supportive care, but it is grit and tenacity, mostly, that carries these tough felines through.
Tuesday, September 29, 2009
Sunday, September 6, 2009
Make My Day: What Would You Do?
Many emergency veterinarians enjoy the challenge of gunshot wound cases, especially when we have a good outcome. It’s not very often, however, that a dog comes into our ER in critical condition from a gunshot wound, and survives, and the dog’s owner ends up dead from the very same thing. That is exactly what happened on the afternoon of November 2, 2003.
Mojo was a 3 year old Miniature Pinscher, but did not deserve the “land shark” label that many of these MinPins end up with, as he normally was affectionate and friendly. He did like to bark, however, and that tendency would end up leading to the demise of his master.
Just before Mojo arrived at our emergency room with his owners, Diane and Richard, he had been found collapsed in their yard, struggling to breath. His gums were pale, and he had a wound on the left side of his chest. As he got oxygen to help him breathe, a quick XRay showed two bullets lodged in his chest. One bullet was lodged right next to his spine in his chest cavity, and the other one was down near the bottom of his chest.
As soon as Richard, Mojo’s owner, realized what had happened, he left the emergency clinic and said he was going home. He appeared calm at the time, but his wife noted a look of determination in his eyes she had not seen before. After Richard left, our team of emergency vets and techs continued to work on Mojo, administering IV fluids, pain meds and more oxygen.
When Richard arrived back at his home in the rural town of Ault, Colorado, he grabbed a stick of lumber and immediately went next door to confront his neighbor. He knew immediately where the bullet had come from, because his neighbor sometimes complained about Mojo’s barking. The neighbor also ran a jewelry business out of his home, and bragged about the collection of guns he kept for security.
Richard’s neighbor was waiting for him, apparently sitting in a chair in his living room with a shotgun laying across his lap. When Richard knocked on the door, he shouted at the neighbor to come outside. Threats were yelled back and forth. When the neighbor refused to come outside, Richard broke the small view window in the top of the door.
A shotgun blast tore through the open window and hit Richard in the middle of his chest, and the wounds proved to be fatal. The shooter of Richard, and Mojo, was released from County Jail 9 days later under the Colorado “Make My Day” law, where deadly force can be used to protect one’s self, family and property if they are threatened. The issue of why he could shoot Mojo without penalty was never addressed.
Meanwhile, efforts to save Mojo continued, and proved successful. He was taken off of oxygen, moved out of intensive care, and started on oral pain meds and antibiotics. Our success in reviving him provided some solace to Diane, Richard’s widow.
Several months later, Diane moved with Mojo to another state to try and put their nightmare behind them. As far as I know, they are getting along OK.
Further investigation revealed that the second bullet in Mojo’s chest was from a previous gunshot, and multiple pellets were also found in the side of the house where Mojo used to roam the yard and bark. He had been used as target practice by the neighbor, whose intolerance of Mojo’s barking proved to test the limits of the law and human civility.
Mojo was a 3 year old Miniature Pinscher, but did not deserve the “land shark” label that many of these MinPins end up with, as he normally was affectionate and friendly. He did like to bark, however, and that tendency would end up leading to the demise of his master.
Just before Mojo arrived at our emergency room with his owners, Diane and Richard, he had been found collapsed in their yard, struggling to breath. His gums were pale, and he had a wound on the left side of his chest. As he got oxygen to help him breathe, a quick XRay showed two bullets lodged in his chest. One bullet was lodged right next to his spine in his chest cavity, and the other one was down near the bottom of his chest.
As soon as Richard, Mojo’s owner, realized what had happened, he left the emergency clinic and said he was going home. He appeared calm at the time, but his wife noted a look of determination in his eyes she had not seen before. After Richard left, our team of emergency vets and techs continued to work on Mojo, administering IV fluids, pain meds and more oxygen.
When Richard arrived back at his home in the rural town of Ault, Colorado, he grabbed a stick of lumber and immediately went next door to confront his neighbor. He knew immediately where the bullet had come from, because his neighbor sometimes complained about Mojo’s barking. The neighbor also ran a jewelry business out of his home, and bragged about the collection of guns he kept for security.
Richard’s neighbor was waiting for him, apparently sitting in a chair in his living room with a shotgun laying across his lap. When Richard knocked on the door, he shouted at the neighbor to come outside. Threats were yelled back and forth. When the neighbor refused to come outside, Richard broke the small view window in the top of the door.
A shotgun blast tore through the open window and hit Richard in the middle of his chest, and the wounds proved to be fatal. The shooter of Richard, and Mojo, was released from County Jail 9 days later under the Colorado “Make My Day” law, where deadly force can be used to protect one’s self, family and property if they are threatened. The issue of why he could shoot Mojo without penalty was never addressed.
Meanwhile, efforts to save Mojo continued, and proved successful. He was taken off of oxygen, moved out of intensive care, and started on oral pain meds and antibiotics. Our success in reviving him provided some solace to Diane, Richard’s widow.
Several months later, Diane moved with Mojo to another state to try and put their nightmare behind them. As far as I know, they are getting along OK.
Further investigation revealed that the second bullet in Mojo’s chest was from a previous gunshot, and multiple pellets were also found in the side of the house where Mojo used to roam the yard and bark. He had been used as target practice by the neighbor, whose intolerance of Mojo’s barking proved to test the limits of the law and human civility.
Tuesday, August 18, 2009
HIgh Rise Syndrome: Sky diving cats
Several weeks ago, a kitten came into our emergency clinic that had fallen 50 feet out of a tree. Amazingly, the owner had caught the falling feline just before it hit the ground, but on the way down the kitten hit a large branch. His back leg was clearly broken, and after giving some pain meds we talked to the owner about his two options: Fix the broken leg, or amputate. Three legged cats, or "tripods" as they are affectionately known, have become quite the designer pet as of late. Thankfully, so far, Paris Hilton et all have not discovered this trend. Unfortunately, this kitten owner was cash-strapped, and was forced to elect a third option: humane euthanasia due to lack of funds. The owner signed a euthanasia and cremation form, and the Siamese-mix kitten sat in a cage awaiting his fate. As the doctor on shift, it was my job to perform the euthanasia, but I stalled. After all, pain meds were on board. My procrastination had its reward an hour later when one of our vet-student nurses came to work. She took one look at the kitten and proclaimed her willingness to take over its care if the previous owner was willing to surrender him. One phone call later, and with the help of another veterinarian skilled at fixing bones, and Thomas' (his new name) broken leg was pinned together. Cats have an amazing ability to survive large falls. In New York City, a veterinary study showed that if a cat fell more than 7 stories, it was much less likely to be injured than a cat that falls just a few floors. With the occasional absence or removal of window screens, it is not unusual for cats to find their way onto window ledges and airborne danger. What usually happens when they fall is that they slowly try to right themselves (by this time they have fallen 3-4 stories), and once righted, float down, parachute-like, to land on their feet. If they land before they are righted and relaxed, there are usually severe injuries because they are tense and flailing. As I write this Blog, Thomas is curled up in my lap (occasionally introducing some typos on the keyboard), because our technician could not keep him after his leg was fixed, and she was trying to find a new home for him, and no one else would take him and well...here he is.
Izzy's Repreive
Can 4 drops of Rescue Remedy cause a dog to become gravely ill? Izzy is a 4 yr old Chihuahua mix that came into our emergency clinic last weekend with bloody diarrhea and vomiting. Her owner had put 4 drops of Rescue Remedy, a homeopathic flower extract, into some water and Izzie drank all of it. The next day, she was lethargic, not eating, and started to have severe bloody diarrhea. She was so weak when she got to our clinic she could not stand up.
Poor Izzie’s owner was racked with guilt. She was convinced she had poisoned her dog, and unfortunately another veterinarian had told her that Rescue Remedy could be fatal. Well, it turns out you could probably give multiple bottles of the product to one dog without causing any harm, because it only contains microscopic amounts of plant extract. Of more serious concern is the alcohol base that the plant extracts are in. It is probably questionable whether products like Rescue Remedy have any beneficial effect at all with dogs, but that is my own skepticism getting in the way of an open mind.
Izzie’s blood work showed that her blood was way more concentrated than it should be (PCV=66% if you like lab numbers), and much of the fluid had leaked out into her intestines. This is typical of a disease syndrome in dogs known as HGE (hemorrhagic gastroenteritis), which may have many different causes including bacterial infection, stress or dietary indiscretion (ie eating a dead animal).
The treatment for HGE is IV fluids and IV antibiotics, and that is what Izzy got. Most likely, her bloody diarrhea was due to the stress that prompted her owner to give her the herbal product in the first place. At our hospital, we have seen many animals get better with IV fluids and treatment, even if the diagnosis was unknown. We have an almost religious faith in the ability of IV fluids to help heal any condition; maybe we could start a new religion?
In any event, 48 hours of fluids did the trick for Izzie, and home she went. I am pretty sure that her owner will not give her any more Rescue Remedy the next time Izzie gets stressed. I wonder if it would work for me???
Poor Izzie’s owner was racked with guilt. She was convinced she had poisoned her dog, and unfortunately another veterinarian had told her that Rescue Remedy could be fatal. Well, it turns out you could probably give multiple bottles of the product to one dog without causing any harm, because it only contains microscopic amounts of plant extract. Of more serious concern is the alcohol base that the plant extracts are in. It is probably questionable whether products like Rescue Remedy have any beneficial effect at all with dogs, but that is my own skepticism getting in the way of an open mind.
Izzie’s blood work showed that her blood was way more concentrated than it should be (PCV=66% if you like lab numbers), and much of the fluid had leaked out into her intestines. This is typical of a disease syndrome in dogs known as HGE (hemorrhagic gastroenteritis), which may have many different causes including bacterial infection, stress or dietary indiscretion (ie eating a dead animal).
The treatment for HGE is IV fluids and IV antibiotics, and that is what Izzy got. Most likely, her bloody diarrhea was due to the stress that prompted her owner to give her the herbal product in the first place. At our hospital, we have seen many animals get better with IV fluids and treatment, even if the diagnosis was unknown. We have an almost religious faith in the ability of IV fluids to help heal any condition; maybe we could start a new religion?
In any event, 48 hours of fluids did the trick for Izzie, and home she went. I am pretty sure that her owner will not give her any more Rescue Remedy the next time Izzie gets stressed. I wonder if it would work for me???
Deuce is wild, or Why You Need Pet Health Insurance
Should you get pet health insurance for your dog? Ask the owners of Deuce, a 2 year old, 80 pound black Labrador Retriever, who lives up a mountain canyon in Colorado.
Deuce arrived at our emergency clinic on July 27th, with a very swollen leg, the result of a rattlesnake bite. Fortunately, rattlesnakes in our part of Colorado do not have very potent venom, and most patients survive. However, in a few cases, the venom can wreak havoc in the bloodstream, leading to unstoppable bleeding, kidney failure, sloughing of skin or other systemic illness. The basic treatment for a rattlesnake bite is IV fluids, an injection of an antihistamine, anti-inflammatory medication, and pain meds. Sometimes antibiotics are added if the bite wound appears infected. Whenever possible, it is ideal to give antivenin, to counteract the negative affects of the snake venom on kidneys and platelets (clotting portion of the blood). Unfortunately, antivenin is very expensive, costing close to $600 per vial. Of course, when you consider that the average human snake bite victim may get 10 vials which cost upwards of $2,000 per vial, the veterinary version seems like a bargain. The average dog gets one to two vials when the owner can afford it, but many can not and most dogs will survive regardless. Deuce got the standard treatment, without antivenin, and recovered over the next 3- 4 days.
On July 30, we got a call saying Deuce was coming back. The assumption was there was some complication related to the snake bite wound. No, said the owners, this time he appears to be coughing. It turns out Deuce had been shot by a neighbor with a shotgun when Deuce escaped from the yard and started chasing the neighbor’s chickens. XRays showed multiple pellets throughout Deuce’s chest and abdomen. (See below)
The treatment was déjà vu: IV fluids, some pain meds and more antibiotics. When it comes to shotgun pellets, they are usually left alone (ask Dick Chaney and some of his hunting buddies), as long as they are not causing a problem with a vital organ. Although some of the pellets in Deuce’s chest were irritating his airway, he stopped coughing and went home the next morning.
No doubt when Deuce’s owners were checking out for the second time, 4 days after the rattlesnake bite, they may have inspected one of the brochures for Pet Health Insurance that was sitting on our counter. Of course, at that time, the horse was already out of the barn, so to speak.
Deuce arrived at our emergency clinic on July 27th, with a very swollen leg, the result of a rattlesnake bite. Fortunately, rattlesnakes in our part of Colorado do not have very potent venom, and most patients survive. However, in a few cases, the venom can wreak havoc in the bloodstream, leading to unstoppable bleeding, kidney failure, sloughing of skin or other systemic illness. The basic treatment for a rattlesnake bite is IV fluids, an injection of an antihistamine, anti-inflammatory medication, and pain meds. Sometimes antibiotics are added if the bite wound appears infected. Whenever possible, it is ideal to give antivenin, to counteract the negative affects of the snake venom on kidneys and platelets (clotting portion of the blood). Unfortunately, antivenin is very expensive, costing close to $600 per vial. Of course, when you consider that the average human snake bite victim may get 10 vials which cost upwards of $2,000 per vial, the veterinary version seems like a bargain. The average dog gets one to two vials when the owner can afford it, but many can not and most dogs will survive regardless. Deuce got the standard treatment, without antivenin, and recovered over the next 3- 4 days.
On July 30, we got a call saying Deuce was coming back. The assumption was there was some complication related to the snake bite wound. No, said the owners, this time he appears to be coughing. It turns out Deuce had been shot by a neighbor with a shotgun when Deuce escaped from the yard and started chasing the neighbor’s chickens. XRays showed multiple pellets throughout Deuce’s chest and abdomen. (See below)
The treatment was déjà vu: IV fluids, some pain meds and more antibiotics. When it comes to shotgun pellets, they are usually left alone (ask Dick Chaney and some of his hunting buddies), as long as they are not causing a problem with a vital organ. Although some of the pellets in Deuce’s chest were irritating his airway, he stopped coughing and went home the next morning.
No doubt when Deuce’s owners were checking out for the second time, 4 days after the rattlesnake bite, they may have inspected one of the brochures for Pet Health Insurance that was sitting on our counter. Of course, at that time, the horse was already out of the barn, so to speak.
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