News: Guest Posts
In the ER: Veterinarians are sleuths
Are you sure Dozer did not swallow any dog toys or clothing?” I asked.
“No, we keep the yard cleaned up so there is nothing for the dogs to get into,” Dozer’s owners replied. Thus began the search for the cause of vomiting in an 8-year-old Alaskan Malamute.
There are at least 63 causes of vomiting in dogs, which is probably why we see so many cases at our emergency hospital. If the cause is not apparent after a thorough physical exam and history-taking, sometimes we perform diagnostic tests, such as X-Rays and blood tests to narrowing down the possibilities. A few dogs need an even more sophisticated level of diagnostic workup, such as an adrenal gland function test or abdominal ultrasound.
At eight, it seemed unlikely that “dietary indiscretion” would cause of Dozer’s gastrointestinal problems. Much higher on the list were conditions, such as cancer, immune-system disease, pancreatitis, liver failure or kidney failure.
Dozer seemed uncomfortable and somewhat tense when I palpated his abdomen, but did not appear overtly pained. “Let’s do some radiographs to see what things look like,” I suggested. (My X-Ray vision was not up to par that day.)
When the digital images appeared on the screen, the nurses could tell something was abnormal. We all gathered around to throw our two cents in. Dozer’s intestines were very distended with gas in certain areas. There was a strange density in the cranial (toward the head) part of his abdomen. We kept looking.
In one of my finest moments of X-Ray reading history, I suddenly saw it: “It’s a rubber ducky!” I almost hollered. Squinting at the images and moving closer, we asked each other, “How (and why) does a dog swallow a rubber ducky whole?”
Two hours of surgery later, the naughty duck sat like a proud trophy outside Dozer’s run. It was somewhat blackened after the journey through his intestines, but probably still quite capable of floating, if required. The owners explained, “It used to be Dozer’s favorite toy. He probably buried it months or years ago. He may have been mad at us for leaving him behind for a few days when we went out of town last week, and decided to dig it up and swallow it to get back at us.”
Would a dog do that?
News: Guest Posts
FDA issues a “health alert” for Merrick Beef Filet Squares Dog Treats
The U.S. Food and Drug Administration (FDA) issued a warning to consumers not to use Merrick Beef Filet Squares for dogs distributed by Merrick Pet Care with a package date of “Best By 111911” because the product may be contaminated with Salmonella. This is not the same as a recall. The report says: “Although no illnesses associated with these products have been reported, the FDA is advising consumers in possession of these products not to handle or feed them to their pets.” Read the complete advisory for additional information on Salmonella infection.
Dog's Life: Lifestyle
FDA takes months to notify vets about drug recall
Pet food recalls have been all too common in recent years, causing controversy with bad communication and lack of precedent. Unfortunately, this danger isn’t limited to the food industry.
Last July, the FDA shut down Teva Animal Health’s operations, the largest American producer of generic veterinary medications, after inspections found several manufacturing violations between 2007 and 2009. On September 4, two of Teva’s products were recalled, ketamine hydrochloride (an anesthetic agent used in spay/neuters, teeth clearning, and other everyday procedures) and butorphanol (a pain reducer).
These drugs are given to hundreds of animals each day, making the recall a potentially catastrophic situation. However, the recall notice was sent only to distributors and stated that there was no obligation to notify their customers (veterinarians) about the recall.
Most veterinarians didn’t find out about the ketamine recall until the end of December, but by then it was too late. On December 21, the FDA finally issued a public recall notice following the questionable deaths of five cats while under undergoing anesthesia with ketamine.
As if matters weren’t bad enough, a week later the FDA issued a second notice extending the recall to ketamine manufactured by Teva but sold under seven brand names. An article for SF Gate reports that “drugs made by Company A and sold under the label of Company B can legally bear the label ‘Manufactured for Company B,’” making it difficult for veterinarians to know whether a drug was made by Teva.
It’s alarming that it took almost four months to notify veterinarians about the drug recall, not to mention that there still has been no public notice sent about the second drug, butorphanol. There was also no information on the FDA’s Pet Health and Safety Widget. After this recall, how can veterinarians trust the medications that they prescribe? And how can we trust that our veterinarians have the right information?
Hopefully this situation will prompt action to change the protocol for recalled veterinary drugs, but it only adds to a growing list of potential problems. Tainted pet food, toxic dog toys, unsafe medicine, what’s next?
News: Guest Posts
Tales from a Colorado ER
We used to have sign in our lobby that said “Any unsupervised children will get a cup of espresso and a free puppy.” We took it down after one of the clients asked what kind of puppy. We now have self-serve coffee in the lobby, and it’s not uncommon to see a kid trying to short-circuit the coffee maker.
Which brings us to the case of Tonsi, a seven-year-old, hyperactive Australian Shepherd who tore into the 50-pound sack of coffee beans his mom brought back from Nicaragua. Fortunately, he was discovered before he devoured the entire sack (which certainly would have resulted in his demise), but he did manage to scarf down several pounds.
Our staff has the routine down for toxin-ingestion cases: an injection of apomorphine to cause vomiting (it always works), followed by some charcoal to absorb any toxin from the intestines, then possibly IV fluids for 12 to 24 hours, depending on the ingested substance. To be honest, these indiscriminate dogs seem to keep our ER in business. Tonsi vomited up a large amount of undigested coffee beans soon after getting his apomorphine, but apparently there was a lot more caffeine on board, as we were soon to find out.
Tonsi’s heart continued to race at 180 to 200 beats per minute (normal should be around 80 to 90.) He was amped up and wired to the gills, jumping straight up in superman-like attempts to leap over the eight-foot tall run walls in a single bound. He gave all of us the jitters; it was almost as if Starbucks had spiked our water. I have to admit, equally enthused and irritated by Tonsi, I had been imbibing more than my share of coffee during the shift.
One of our nurses suggested giving Tonsi a beta blocker, which would help slow down his heart, but we did not have any stocked on the shelves. At this opportune time, enter (stage left) Corky, a six-year-old Cockapoo, who had just ingested his owner’s vial of medication, which included (guess what?) a beta blocker.
One more dose of apomorphine, and I found myself sifting through more vomitus. I spotted a small red tablet, perhaps the ingested beta blocker? Tonsi continued to wildly leap in his run, barking crazily. As I slid the red tablet out of the bilious slime with a tongue depressor, an idea crept into my over-caffeinated, somewhat deranged mind: Do I dare?
News: Guest Posts
New York case is the first
A dog in New York has tested positive for the 2009 H1N1 influenza virus, IDEXX Laboratories confirmed December 21, which is the first time a dog has been diagnosed with this strain of influenza in the United States.
According to IDEXX Laboratories, the 13-year-old mixed breed dog, who has recovered, was taken to an emergency veterinarian in Westchester County, New York, after not responding to of antibiotics and anti-inflammatories prescribed by his regular doc. The dog had a dry cough was lethargic and not eating. He is believed to have caught the virus from his owner, who tested positive with H1N1 earlier in the week. There are no indications that the dog passed the virus on to any other animals or people.
The 2009 H1N1 influenza virus has also been found in humans, cats, pigs, birds and ferrets. There have been no confirmed cases of pets passing the virus back to people. The AVMA is actively tracking all instances of H1N1 in animals and posting updates on its website.
News: Guest Posts
Do you or don’t you?
Earlier this week, The Wall Street Journal ran a short piece on pet insurance. Mostly, it’s a primer on how to shop for policies. In a Bark story last summer, Nancy Kay, DVM, recommended considering pet health insurance as one of ten strategies for stretching your vet dollars (More Bark for Your Buck, May/Jun 2009). Everyone seems to think it’s the coming wave, even though only about one million pets in the U.S. are currently insured.
But I’m not onboard. I haven’t invested in pet insurance for my dogs, and I’m not entirely sure what’s stopping me since I figure I’d willingly mortgage the farm to treat anything that might ail them. Part of my problem is an uncomfortable feeling about pet insurance turning into the convoluted nightmare that is our current health insurance setup. As treatment for dogs and cats becomes more advanced, specialized and expensive, it’s easy to imagine that pet insurance will distort costs and decisions. If I only pay for 20 percent of my dogs’ treatment (a pretty common coverage level), won’t I demand more care? Won’t that drive up costs overall? And what will more treatment mean to my dogs, especially late in life? Medical interventions to extend a dog’s life, such as surgery and drugs, aren’t without risks, side effects and pain all born by an animal who can’t understand why he or she is being subjected to these measures. And I haven’t even raised the specter of HMOs—but once pet insurance is firmly entrenched, won’t the industry push back and attempt to dictate treatment? After all, there’s a precedent.
Of course, I know the argument on the other side—an unexpectedly sick or injured pet with a good prognosis, plenty of quality life ahead but owners’ with no money to pay for care. I haven’t stood in their shoes, and probably if I had, I’d be writing my check to VPI right this minute. How are Bark readers making this decision?
News: Guest Posts
Confirmed cases of H1N1 being passed from humans to dogs and cats
A couple weeks ago, my otherwise healthy 12-year-old Catahoula, Desoto, had a bad case of diarrhea--the kind that required running to the back door with him in the middle of the night. It lasted for 10 messy days (we couldn't always make it outside). I tried not to worry too much since his appetite was as big as ever. But it got me thinking about how the most wonderful time of the year overlaps with the sickest time of the year. Lately, I've had more students and their dogs call in sick to class. Is it possible for people to pass on their illness to pets?
When it comes to the H1N1 virus or “swine flu,” the answer is yes. Two Chinese dogs were confirmed to have contracted the infamous virus from humans. Closer to home, an indoor cat in Iowa caught H1N1 from its owner. Since then, four more American cats came down with the illness, two of whom died.
This is not to be confused with H3N8 or CIV (canine influenza virus), which was originally passed on to dogs from horses. The symptoms of both viruses are similar: loss of appetite, lethargy, fever, runny nose, coughing and labored breathing. There is a CIV vaccine that veterinarians recommend for dogs who spend a lot of time with other dogs, such as at doggie daycares or shows.
For the latest info on public health and your pets, go to the American Veterinary Medical Association website.
News: Guest Posts
Tales from a Colorado ER.
Frank loved to eat things. As a stout one-year-old Lab, eating is what he lived for. Sharing a home with a family that included six-year-old quadruplets supplied him with plenty of objects of his desire. His family reported finding lost clothing, toys and other random items in his stool. Frank avoided any serious issues with his indiscriminate eating habits until one night last month, when he decided to swallow a Beanie Baby unicorn.
After vomiting for 24 hours, and losing his famous appetite, Frank’s owners knew something was wrong. X-rays at our emergency hospital showed a strange bulge in his intestine, with a triangular object encircling it. Large pockets of gas upstream from the blockage confirmed that he had a surgical problem, and off to surgery he went.
Our emergency veterinarians opened up a piece of Frank’s intestines, and found the Beanie Baby unicorn without even a tooth mark on it. Frank must have wolfed it down as if it was a cocktail wiener. Wrapped around the unicorn—perhaps substituting for a piece of bacon—was a rubber band, which is what showed up as a triangle on the X-ray.
Frank had about a foot of his intestines removed, and then the remaining ends were sutured back together. The next day, as Frank recovered from his surgery, we discussed strategies for preventing future recurrences.
“How about a cage muzzle?” I suggested, and the owner agreed it would be a good idea, considering the chaos that usually ruled at his house. With five children running around, the availability of a pair of stray socks, underwear or even another Beanie Baby, was inevitable. The Frankster went home the next day with his owner, the intact Beanie Baby cutely enclosed in a plastic baggie, perhaps destined for display on the fireplace mantle.
We did not expect to see Frank back at our hospital, but one week later he was sick again. He was lethargic and not eating, and one look into his eyes would tell you he was not feeling well. He was clearly, please excuse the expression, “sick as a dog.” Repeat X-rays were suspicious for another blockage, and ultrasound confirmed it the next day. Frank went back to surgery at his regular veterinarian’s clinic, where a large wad of impacted grass and more intestines were removed. Apparently, he had been grazing in the yard, despite the cage muzzle.
Hopefully, we have seen the last of Frank. He doesn’t have much in the way of intestines to spare. Every time dogs undergo repeat surgery, adhesions can form on the surface of their intestines, causing them to stick together. Any previous surgery site can shrink down into a stricture, creating the risk of future blockages. Frank’s family will have to be diligent about keeping his cage muzzle on, and ensure that all he eats is dog food. This should help guarantee that the family’s remaining Beanie Bay collection remains intact. Maybe Frank’s owners could sell it to cover some veterinary bills.
News: Guest Posts
Pig ears and beef hooves recalled for salmonella.
The U.S. Food and Drug Administration (FDA) issued a health alert, last week, warning consumers not to use pig ears or beef hooves pet treats manufactured by Pet Carousel because they may be contaminated with salmonella. It sounds like these treats could be for sale just about anywhere—they were distributed nationwide and to chain stores. Brands to look out for include Doggie Delight and Pet Carousel for ears and hooves, plus Choo Hooves and Dentley’s for hooves only.
According the FDA no illness has been associated with the products. The presence of salmonella was detected during routine testing by the agency in September 2009. Read more about the recall, handling and symptoms in humans and pets.
According to the PETCO Scoop, that company has removed all Pet Carousel hooves from its shelves and has issued a statement that it does not carry pigs ears from the company. As of yesterday, PetSmart has voluntarily pulled 14 hoof products off its shelves.
Dog's Life: Lifestyle
Life-threatening illness requires treatment.
Salmon poisoning is a rare but serious condition in dogs. If not treated, around 90 percent of the dogs with this malady will not survive it. The cause of the disease is a bacteria that lives within a fluke that is a parasite of fish. Dogs ingest the fluke parasite and the bacteria inside it when they eat raw fish. The life cycle of the parasite involves both fish and snail hosts.
Salmon poisoning is not well known, perhaps because it only affects a few species, including dogs, and only salmon seem to be carriers of the parasite that contains the dangerous bacteria. In addition, the whole system of hosts, parasites, and bacteria occurs in a relatively isolated geographic area—west of the Cascade Mountain Range in Oregon, Washington, California and British Columbia.
Symptoms of the disease include severe intestinal upset, fever and swollen lymph nodes. If your dog has eaten raw fish in this region of the world, especially if any of these symptoms are present, veterinary treatment is essential. Be sure to tell your veterinarian if your dog may have been exposed to this disease.
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