Saturday, June 17, 2017

Top Veterinary Articles of the Week: Low Platelet Counts, Preventing Summertime Dehydration, and more ...

Low Platelet Counts Are Big Trouble for Dogs

Dr. Marty Becker

"Does your dog have black school or bruises or other marks on his skin? This could be a lights and sirens emergency, and definitely requires a fast trip to the vet." ~Dr. Marty Becker

One thing about blood is that it's a well-designed, carefully regulated concoction of life-sustaining bits. One of those are platelets. The principal function of platelets is to prevent bleeding. If platelet count drops low enough, not only it would result in uncontrolled bleeding for any wound but it can even lead to spontaneous bleeding anywhere in the body. Such situation is life-threatening and a dog can die from internal bleeding.

The while cute "guys" are platelets. Photo Thrombocyte

During her drug-induced hyperthermia, Jasmine's platelets got destroyed in large numbers. Among other fallout from the event, bruises started appearing on her tongue and elsewhere on her body. When the teaching hospital's emergency veterinarians also discovered a large abscess in Jasmine's abdomen, they could not operate until her platelets got high enough to do the surgery safely. While the abscess was a high-risk ticking bomb, we did have to wait for the platelet numbers to rise. If the abscess ruptured, it could have killed Jasmine. But surgery without enough platelets to prevent profuse blood loss would kill her also.

A dog with insufficient platelets needs emergency care and the cause of platelet loss needs to be figured out.

Read Dr. Becker's article about the signs and dangers of low platelet count.


Preventing Summertime Dehydration

Dr. Nancy Kay/Spot Speaks


80% of a dog's body mass consists of water. That should tell you how important water is for life. There is water in the blood, there is water in the cells and surrounding tissues. Water is involved in every function the body performs. Water and its properties is what makes life possible.

"An adequate amount of water within the body is essential for maintaining normal blood pressure, circulation, and bodily functions." ~Dr. Nancy Kay

Dehydration happens when the loss of water is higher than intake. This can happen with diarrhea, vomiting, kidney failure, or increased panting when the loss isn't matched by supply.

On a hot day, particularly with physical activity, a lot of water is lost through panting. Panting is how dogs expel excess body heat but it comes at a price of higher water loss. If a dog doesn't have access to sufficient amount of water to drink, or they are too busy having fun to remember to drink, they can get dehydrated quickly.

Make no mistake, dehydration is a common emergency and can be life-threatening.

First signs of dehydration include saliva pooling on the tongue in little foamy streaks. Next signs are dry, sticky gums, lack of skin elasticity, dark, concentrated urine, followed by delay in capillary refill time, lethargy and other serious signs.

Learn more about summertime dehydration and how to prevent it in Dr. Kay's article.


Protein-Losing Enteropathy (PLE) – When Protein Passes in the Poop

Dr. Christopher Byers/CriticalCareDVM

At one point, protein-losing enteropathy was on the board as a differential diagnosis for some of Jasmine's issues. Rottweilers are one of the breeds highly susceptible to this problem. I was glad to have it ruled out.

What is protein-losing enteropathy?

Firstly, it's not just any protein that is being lost, it is a particular one, called albumin. Albumin is one of the two main functional proteins in the blood. It is partnered with globulins. Globulins are blood proteins involved with immune function. Albumin is a transporting protein and plays a major role in keeping fluids where they belong, such as inside the blood vessels. Without enough albumin the blood, fluid goes where it pleases and accumulates in places where it doesn't belong.

You can check out My Brown Newfies blog for a real-life story on how all hell can break lose when all these things happen.

Potential causes of this condition include infectious diseases, inflammatory bowel disease (IBD) such as in Leroy's case and as we temporarily figured in Jasmine's case ... Believe it or not, those are the better ones from the potential diagnoses.

Check out Dr. Byer's comprehensive article about PLE.


Medical Cannabis and Its Impact on Pets

Dr. Jean Dodds

To cannabis or not to cannabis? That is the question. I see more products out there, now even to treat anxiety. I was asked whether I'd use it for my dog(s). Like with anything else, it depends. If there wasn't any other effective way to treat something, I'd consider anything that could work. That's for sure.

Dr. Dodds, however, points out risks other than issues of legality or potential toxicity. For example, what about regulations about pesticides, fungicides, chemicals and other toxins or impurities in medical cannabis?

Check out Dr. Dodds' thoughts.

Thursday, June 15, 2017

Dog Medical Emergencies Survey: Are Bug Stings an Emergency?

27.78% survey participants checked bug stings as being an emergency.


Our guys got their share of bee stings. While painful and distressing, most bug stings indeed are not an emergency.

Because the hornet stung Cookie on the face, we kept the key in the ignition and watched carefully. I gave Benadryl immediately and the swelling started going down in couple of hours. If it got any worse, we'd gone to a vet.

Last time when Cookie stepped on a bee, she was very unimpressed. She was limping, shaking her foot, I could see it hurt a lot. Typically, I give Benadryl, but because Cookie was showing major signs of pain, I also gave her one Deramaxx. (As much as I am not a fan, I keep renewing my stash, so I have some dog-appropriate NSAID on hand when needed.) That time it didn't even swell much, though some other times it did, such as when she got stung by a hornet it did swell up.

I tried and ice pack too, but Cookie hates it. I didn't want to traumatize her more in the attempt to help her.

Half an hour later she seemed back to normal. I was watching her carefully, though.

There are times when bee or hornet stings can be an emergency.


Just like with people, in some cases, a sting can cause a violent allergic reaction and even anaphylaxis. Fortunately, this is rare, but it could happen.

Swelling itself can lead to an emergency if severe and/or mouth or throat are involved.

If my dog showed any further signs beyond initial pain and moderate local swelling at the site, I'd see a vet quickly.


Allergic reactions to stings can range from mild to severe and life-threatening.

Mild reactions can include fever, loss of appetite, and mild lethargy. A moderate reaction can present with hives or swelling and redness of the lips, around the eyes and neck, This can progress to anaphylaxis. Would you want to take a chance?

A severe reaction, then, is the anaphylaxis itself. A dire emergency.

I should note that crawling insects can be even more dangerous.


A sting may or may not lead to major trouble. Spider bites, on the other hand, depending on the species, can be a major disaster depending on the species living in your area.

Be diligent, don't take chances.



Related articles:
Dog Medical Emergencies Survey
Dog Medical Emergencies Survey Results
Is Unproductive Retching an Emergency?
Is Difficulty Breathing an Emergency?
Is Panting an Emergency?
Is Severe Pain an Emergency?
Is Limping an Emergency?
Is Vomiting Bile in the Morning an Emergency?
Is Profuse Vomiting an Emergency?
Are Convulsions or Seizures an Emergency?
Is Loss of Appetite an Emergency?
Is Reduced Activity an Emergency?
Is Severe Lethargy an Emergency?
Is Inability to Stand an Emergency?
Is Inability to Urinate an Emergency?
Are Cuts and Abrasions an Emergency?
Is Bleeding an Emergency?
Is Blood in Vomit an Emergency?
Is Fresh Blood in Stool an Emergency?
Is Black, Tarry Stool an Emergency?
Are Pale Gums an Emergency?
Is an Unresponsive Dog an Emergency?
Is Coughing an Emergency?
Is Choking an Emergency?
Is Head Pressing and Emergency?



Symptoms to Watch for in Your Dog now available in paperback and Kindle. Each chapter includes notes on when it is an emergency.

Tuesday, June 13, 2017

Damaged Ear Tip: Meiko's Story

by Krista Magnifico, DVM

Mieko is a 3-year-old Boxer who lives in a household of rough play and constant activity.


One afternoon Meiko's dad arrived home from work to find the melee had proven too much for him.

The result of the day's playtime was a painful, red, bleeding, sore ear. 


Meiko did what all pets with painful ears do, he shook his head, a lot. Head shaking causes the ear pinna (ear flaps) to hit the side of the face and top of the head and this flailing motion ruptures the blood vessels in the ear and causes the ear tips to bleed.

When you come home from work, not expecting more than a happy wagging pup to greet you and instead find yourself in the midst of a CSI gunshot victim scene the amount of splatter blood can catch you by surprise, never mind flat out alarm you.

Meiko and his dad arrived at the clinic a few minutes later. Head holding and ear shaking were met with firm discouraging "No's!"

Meiko's dad wanted two things:


  1. Stop the bleeding
  2. Close the wound that was causing the bleeding.


Perfectly understandable when the tiny blood splatter was flying around the room, walls, floors, ceilings, it was a perfect F=ma equation.

Those tiny micro-droplets can soar great distances with just the right trajectory and acceleration.

There are moments in some examinations where the few seconds of collecting data require a few paused moments to gently break bad news.

There I stood holding Meiko's face, gazed at his dads, and broke the news. 


These can be frustrating. He provided me a slightly sarcastic glance and I'm pretty sure he silently said, "don't tell me something I don't want to hear."

It is difficult to treat these wounds. 


The more they shake the quicker they bleed.

If you can't stop the head shaking the wound can't allow a blood clot to form and therefore it continues to bleed. Every head shake dislodges the clot and there it goes again bleeding.


The ear needs a few days of rest to let the wound heal.


Suturing it almost never works. It requires anesthesia, further trauma to the pinna edge and one hard head shake and you are back to square one.

So here's what we did for Meiko;

This is a two person job.

Assistant number one holds the dog. As you can see my technician is holding him in a sit position and holding the head still.

The treatment person does the following:



  • We cleaned the ear edge. Warm surgical cleaner (or warm water with a tiny bit of soap is also fine) for a few minutes was soaked on the open bleeding wound.
  • I then took a non-stick absorbent pad with triple antibiotic ointment and folded it around the ear edge.
  • Next, I wrapped the ear to the top of his head with a self-stick bandage (we use Vetwrap, the veterinarian's favorite bandage).
  • Lastly, an e-collar to keep the feet and face rubbing from removing the bandage.


Important points:



  • Do not apply the bandage too tight.
  • Do not cut it off and cut the ear hidden underneath.
  • Treat the underlying cause of the ear bleed. For Meiko, the cause was rough play, but some dogs shake their heads due to allergies, ear infection, or foreign bodies in the ear.


Within about 3 days the bandage should be able to be removed and the ear should finish healing over the next 10-14 days.


Related Blogs: Living with Bleeding on the Edge, Ear Tip Dilemmas

***

If you have a pet in need, you can find a community of helpful people at Pawbly.com. Pawbly is free to use and open to anyone who loves their pet and wants to help them.

I am also available for personal consults at Jarrettsville Veterinary Center in Jarrettsville Maryland. Or find me on YouTube or Twitter @FreePetAdvice.


Articles by Dr. Magnifico:
Don't Make This Mistake: Ruby's Death To Heat Stroke 
Parvo: Cora's Story 
Jake's Laryngeal Paralysis
The Tip Of The Iceberg: The Unexpected Dental Dilemma
The Ear Ache That Wasn't Going Away: Tootsie's Story
Cody's Eyelid Tumor
Ruger's Mysterious Illness
The Day The Heart Stood Still: Timber's Story 
Different Definition Of Comfort Food: Levi's Story 
Savannah's Pancreatitis  
Histiocytoma: Rio's Mysterious Bump
Von Willebrand's Disease: Greta's Story 
Alice's Heart Murmur  
Jekyll Loses His Tail Mo-Jo 
Pale Gums Are An Emergency: Bailey's Story 
To Amputate Or Not To Amputate: Heidi's Story
Lessons From A Real-Life Veterinarian 
Charlie's Life-Saving Lipoma Surgery  
Understanding and Diagnosing The Limping Dog, Why To Probe The Paw 
Angus' Dog Fight And The Consequences
When To Induce Vomiting And When It's Not A Good Idea  
Abby's Survived Being Run Over By Car But Succumbed To A Mammary Tumor 
Palmer's Hemoabdomen: Nearly An Unnecessary Death Sentence
A Puppy That Doesn't Want To Eat Or Play Is An Emergency: Aurora's Story
Does Your Dog Like Chewing Sticks? Hank's Story  
Lexi's Bump 
Pyometra: Happy Ending for Pheonix 
Never Give Up: Bella's New Legs 
How Losing His Spleen Saved Buddy's Life 
Pyometra Emergency: Saving Chloe  
Limping Dog Checklist (part I): Did You Check the Toenails?
Limping Dog Checklist (part II): Did You Check between the Toes?
Limping Dog Checklist (part III): Foot Pads
Limping Dog Checklist (part IV): Broken Bones  
Limping Dog Checklist (part V): Joint Injuries
IVDD: Recovery, Post-Op Problems And How To Conquer Them All
Has Your Vet Given Up On Your Pet? Or You? Would You Even Recognize It If They Had?
Cervical Disc Disease: Hank's Story of Hope
Retained Testicles: Diesel's Story
Ear Tip Bleeds: Domino's Story
Leroy's Battle with Cancer
Winnie's Vitiligo
Foreign Bodies and Levi's Story

Monday, June 12, 2017

Adoption Monday: Lee, Labrador Retriever, Page, AZ

Lee came in with a horrible wound around his neck. The wound was caused by a collar that was never removed or loosened as he grew. After a round of antibiotics, a good diet, and much love, his neck has healed up and only minor scar tissue is left.


Lee has put the past behind him. He is neutered and now is looking for an active and loving home.

Lee is very smart and he wants to learn. He is also a great dog on the leash, in the car, and a great love bug. Lee likes to play with other dogs but is not a fan of kitties.


Lee is house-trained and current on vaccinations.

***

Page Animal Adoption Agency is a 501c3 nonprofit organization that provides animal adoption, education, and low-cost spay and neuter services to Page, Arizona, and the surrounding communities.

Page Animal Adoption Agency began about four years ago as a small group of people who wanted to reduce the number of unwanted pets being euthanized in the city shelter. Now, they are in the process of renovating a building donated by the city to turn it into an Adoption Center of which Page can be proud. Through fundraising efforts and generous donations, that goal gets closer every month.

Saturday, June 10, 2017

Top Veterinary Articles of the Week: Masticatory Myositis, At-Home Euthanasia, Reverse Sneezing, and more ...

Masticatory Myositis in Dogs – When Chewing Hurts!

Dr. Christopher Byers/CriticalCareDVM

Masticatory myositis is a fancy term for inflammation of chewing muscles. Can you imagine that? Eating should not hurt but that's what happens if a dog suffers from this condition. It's a type of auto-immune disease and it sucks. With Jasmine, at one time the vet suspected she had this. It turned out, however, that she had arthritis in her jaws instead. That poor girl had arthritis everywhere.

Jasmine fit the bill, including being one of the susceptible breeds. I was glad that diagnosis was eventually ruled out; arthritis was easier to deal with.

If you want to learn more about this condition, read Dr. Byers' insightful article.


Euthanasia Outside of the Veterinary Hospital

Dr. Nancy Kay/Spot Speaks

"More and more veterinarians are dedicating their house-call practices to providing an in-home euthanasia service." ~Dr. Nancy Kay


There was a time when one couldn't even dream of having their dog euthanized at home. When the time came, you had to take your dog to a vet, period. Over time, this is changing.

When we realized we weren't going to put Jasmine through any more suffering, home euthanasia was what I wanted to do. This wasn't my original plan; all along I sought for Jasmine to be able to spend her last moments where she was the happiest - some place in the woods. I was sure that her vet would be willing to go along with that. However, that fateful day, everything conspired against Jasmine. Not only her own body but even the elements. It was mid-April, but we had freezing rain. Every inch outside was covered with ice. If she was just nonambulatory, we could have driven her to the woods and carried her to a beautiful place. That, however, was not an option in the weather we had that day.

My second best option would have been letting her go at home. But for the same reasons, it was too dangerous for her vet to drive all the way to our place; not that he wouldn't. We had no choice than driving Jasmine to the closest vet hospital. Fortunately, she was familiar with that place also, because she was getting her physical therapy there. She passed peacefully, but it was not at all what I wanted for her last moments.

Dr. Kay has many profound thoughts and comments on at-home euthanasia. I encourage you to read her article.


What Dog Owners Need to Know about Reverse Sneezing

Dr. Marty Becker

Episodes or reverse sneezing can be very scary when you don't know what is going on. When Jasmine had it for the first time, I was freaking out. Once you learn what it is, it's not as scary anymore.

Reverse sneezing is a result of irritation of soft palate. This can be caused by many things. However, if it is severe or ongoing, I'd want to make sure nothing sinister behind the irritation.

In his article, Dr. Becker explains what it is and what it looks like.


How to Examine Your Dog at Home (and When to See a Vet)

petMD


This article describes some routine things everybody should be doing for their dog regularly. Looking for lumps, bumps, and irritations (and don't forget ticks!), checking inside the mouth, monitoring body weight, and checking vital signs. At least every now and then one should practice checking vital signs just to know how it's done as well as having a baseline for when things are not the way they should be.

This, of course, does not substitute regular wellness exams with a veterinarian; there is so much more they can learn from a thorough physical exam alone. But it is a good habit to keep. It also helps your dog get used to being handled, an advantage for veterinary appointments.


Care of Hair in a Shih Tzu Dog

Dr. Krista Magnifico

Thursday, June 8, 2017

Dog Medical Emergencies Survey: Is Pressing Head into Corners an Emergency?

80.56% survey participants checked choking as being an emergency.


Ok, I  concede this sounds quite weird and more like a trick question than something that could be an emergency situation. Surely this sounds harmless enough?

Not so fast.


Head pressing indicates damage to the nervous system. The potential causes you're looking at are damage to the forebrain and thalamus, brain inflammation, stroke,  brain tumor, an infection of the nervous system, toxins, liver shunt, stroke or acute head trauma.



Does that change your mind about whether or not head pressing is an emergency?


Accompanying symptoms can include issues with balance, disorientation, vision problems and seizures.




Pressing head into corners or against objects should be treated as an emergency.



Related articles:
Dog Medical Emergencies Survey
Dog Medical Emergencies Survey Results
Is Unproductive Retching an Emergency?
Is Difficulty Breathing an Emergency?
Is Panting an Emergency?
Is Severe Pain an Emergency?
Is Limping an Emergency?
Is Vomiting Bile in the Morning an Emergency?
Is Profuse Vomiting an Emergency?
Are Convulsions or Seizures an Emergency?
Is Loss of Appetite an Emergency?
Is Reduced Activity an Emergency?
Is Severe Lethargy an Emergency?
Is Inability to Stand an Emergency?
Is Inability to Urinate an Emergency?
Are Cuts and Abrasions an Emergency?
Is Bleeding an Emergency?
Is Blood in Vomit an Emergency?
Is Fresh Blood in Stool an Emergency?
Is Black, Tarry Stool an Emergency?
Are Pale Gums an Emergency?
Is an Unresponsive Dog an Emergency?
Is Coughing an Emergency?
Is Choking an Emergency?



Symptoms to Watch for in Your Dog now available in paperback and Kindle. Each chapter includes notes on when it is an emergency.
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