Your Pet's Best Friend

Eclampsia revisited

I just recently posted on eclampsia.  I bet I hadn't seen a case in six months, maybe a year.  Tonight I had the third case in two weeks, and all of them pretty good sized dogs. This kid is supposed to be a Chihuahua, but she weighed fifteen pounds.  Of course, maybe five pounds of that was a killer set of jugs. At least she had the decency (luck) to have her crisis during office hours.

This is Minnie, tonight's star attraction.  She looks like she's mostly Dachshund, but fortunately she has longer legs, so it was easier to start her I.V.

Minnie is sporting a big rack, as well.  She was eating mostly table food, and mostly meat, at that.  Meat: it's high in phosphorus (which pulls calcium) and zero in calcium.  I'm not saying she would have avoided this problem by eating a good puppy food, but she might have.   

The real question is, how do I avoid this problem?  I've got stuff I need to do at home... like sleep.

On my honor...

I've posted on this before, but two things happened this week to bring it to mind.  The first was a meeting with ten new Scouts (and five older ones).   As usual, my question "What is your honor?" was met with blank stares.  As usual, I was dismayed (but no longer surprised).  A few boys essayed an answer, but none had a clue.  Thirty minutes later, I think maybe they had a glimmer of this currently unfashionable concept -- a concept that was part of the universal consciousness perhaps a generation or two ago.

The second thing was an article in today's Wall Street Journal:  "Girl Scouts Seek an Image Makeover".   "The Girl Scouts was started in 1912 as a way to give girls more opportunities outside the home.  It has since focused more on helping girls work together in groups and develop leadership skills.  The Girl Scouts has long offered programs on everything from running a business to mountain climbing."  They see their problem as an old-fashioned image that isn't reaching tech-savvy teenage girls who are "non-joiners".  They've added programs on topics such as managing busy schedules and on-line bullying to better reflect current issues.

I have to wonder if they'll be successful.  I hope they attract girls to the traditional values, rather than adapting the organization's image to the currently popular values (if "values" is the right word).  I think that's the goal, and it's a great organization.

My own feeling is that there are lots of places (even the internet) to learn this or that.  There aren't many places to have fun while learning those old-fashioned values that mold character.  Character is what you do when nobody's looking.  Too many people today don't think that's important.

Intussussception

Maddie sort of "fell through the cracks".  That's just a figure of speech, though here she looks thin enough to fall through a crack.  The "crack" she fell through was the one that formed when the marriage split.   She's really Mom's dog, but she liked to go down to the farm shop and hang out around Dad, who was pretty busy on the farm.  So Mom didn't get to see her just every day.  A couple of weeks earlier she noticed that Maddie didn't look just right, but she looked a lot better than this.  We're talking about a beautiful Golden Retriever who's only about a year old, and she looks like she's dying of some terrible disease.

Maddie's attitude was surprisingly good when you consider her emaciated condition.  Her bloodwork was pretty normal, except for the abnormalities you'd expect in a starving dog (anemic, low albumin, etc.).  Of course, she had plenty of food available, so why would she be starving?  Her abdominal X-ray did appear really abnormal, so it looked like an exploratory surgery was in order (after 24 hours on I.V. fluids, that is; she was pretty dehydrated).

This is what we found inside.  And what might this be, you ask?  Uh, the title of the post is "Intussussception", so that would be a pretty good guess.  Right... so what is an intussussception? I mean, besides a really long word that's hard to say?

Here is a diagrammatic representation of what you see in the photograph, minus the blood and stuff.  For unknown reasons, a section of intestine folds inside of another section of intestine, the way the old pirate's telescope collapses as the sections slip inside one another.   This produces a nearly complete blockage.  Liquids can pass through, but solids can't make it.  A slow starvation like this is one presentation, but some individuals get very ill, very suddenly.  Sometimes it happens when a dog has a whipworm infestation.  Sometimes it happens after a bad intestinal infection with lots of cramping (I've seen it as a complication in puppies with parvovirus -- a fatal complication in those cases).  Lots of times we just don't have any idea why it happened.

Here's a cross-sectional view.  Doesn't it look like a telescope?  I mean a floppy, pink, gooey telescope that's full of crap instead of stars?  Sure, it does.  What may not be obvious to you is that the part that's inside has its blood supply pulled around a 180 degree corner.  That pretty much crimps it shut, meaning no blood supply for the "inside part", meaning it dies. SO, even though it looks like we could just pull on the ends and open up the telescope, that doesn't work.  You have to cut out the whole mess and join the rest of the intestine back together again (what we surgeons refer to as "intestinal  resection and anastomosis" -- this post is just full of big words, isn't it?).

Here's Maddie just 10 days later when we took out her stitches.  She's gained 8 pounds, up to 52.  Not back to her fighting weight, but on the right track.  The surgery must have gone okay.

And here she is at a contented 73 pounds, which is about right (maybe even a little chubby).  I love a happy ending (especially when you've taken 18 inches out of the middle).

A beautiful day for a much-needed ride.

Sometimes you don't realize how much you needed something until you get it.  In my case, what I needed was some fresh air and open space.  I've either been working or going to meetings or working the little league basketball games for Kiwanis, or going to funerals or just about anything except riding my motorcycle.  Thursday is my "afternoon off".  I don't schedule appointments, but I usually have at least an hour of paperwork, plus errands to run, plus visit my CASA kid, plus patients in the hospital.  Today we had three emergencies in the morning, including the second case of eclampsia this week.   When you start the eleven o'clock surgery at 12:30, it's hard to finish by noon.  When I ordered supplies, it was the telephone rep's first day.  I ordered triple-antibiotic eye ointment and she asked me how to spell it.  "Eye? Ointment? Antibiotic? Triple? I - T ?"  It's two o'clock and I haven't had lunch yet, and yes, we've more errands to do. Hey, isn't it time to take the income tax stuff to the accountant?

Then, I went outside and found the beautiful weather.  Serendipitously, the foster family for my CASA kid were on their way out of town for the weekend.  Suddenly, I had time for a ride.

We saw many flooded fields, ditches lapping at their banks, and the St.Francis River spread even farther into its bayous than usual -- as in places you can usually drive to are under water today.  Of course, one of the plus-points of living in a flat delta devoid of scenery is that floods tend to be miles wide and two inches deep.  You folks with your pretty hills and valleys have floods that are fast and deep and dangerous.  We just get soggy down here. 

Mostly what I needed today was some space.  Man, do I feel better now!

Eclampsia, aka "Milk Fever", aka Post-partum hypocalcemia

The phone rang at 3:00AM.  This is never good: I am not pretty and I need my beauty sleep. "Do you make house-calls?"  It turns out the guy got up to use the bathroom and found his dog stiff and twitching uncontrollably. "Is this a female dog?" Yes.  "Has she had puppies recently?" Two weeks ago. "What kind of dog is it?" Part Rat-terrier and part Feist [I thought those were two different names for the same breed. In fact, I still think that.]  She needs an intravenous calcium injection, and I'm going to work... at three o'clock in the morning.  I'll be discombobulated for days.

So here she is.  You can't see her rigidity, her shaking, her fever. 

What you can see are the hardest-working glands in show-business.  This gal is running a do-it-yourself dairy, but she failed to read that little disclaimer about "professional driver, closed course, do not attempt".   She didn't see the asterisk: "Results not typical".

This dog is actually not the typical eclampsia sufferer.  While I have seen Beagles and even larger dogs with the condition, the typical patient is a very small dog like a Chihuahua.  She's milking heavily.  While it might occur even before birth, or at any time during nursing, seven to fourteen days after birth is pretty typical.  The bitch cannot cope with the demands of putting so much calcium in the mammary pipelines, and her blood calcium levels get low.  When this happens, the nerve-muscle electrical function gets screwy, resulting in uncontrollable muscle contractions.  This, like shivering, causes a rise in temperature (though to much higher, even dangerous levels, as high as 107 degrees).  Convulsions result and the combination of seizures and high temperature will prove fatal if not treated.

The longer this goes on, the more difficult it is to treat.  In early stages, one can almost always achieve a rapid reversal of signs by giving a slow intravenous injection of calcium gluconate.  It is miraculous to see the dog return to normal.  In more advanced and severe cases, intravenous fluids may be needed to support and cool the patient, and anti-convulsant sedatives may be needed for the seizures, but most can be saved.

We used to think these dogs didn't have enough calcium in their diets (which certainly wouldn't help anything).  Breeders used to give the bitches calcium supplements.  This turns out to be of little help.  It is a good idea to feed a high-quality puppy food during the last half of pregnancy and nursing.  This provides the extra protein, calories, vitamins and minerals needed for gestation and nursing.  However, there are plenty of dogs who have crummy diets and they don't get eclampsia.  The dogs that get it just can't handle the metabolic stress of nursing, and it doesn't seem to matter what you feed them. 

Since being "milked out" is what stimulates more milk production, you have to quit milking the dog.  In other words, the puppies get moved from the mama to the bottle -- no more nursing.  Since this condition appears to stem from a flaw in mama's metabolism, she needs to get out of the mommy business.  If she has another litter, you can count on another emergency call.

This is really my least favorite emergency, as I can't be self-righteous about it.  It's not due to neglect or bad judgment.  It's not like letting the dog run loose, or feeding it garbage, or forgetting that you left rat-poison behind the couch.  It is a true emergency, in that it just emerges, springing out like Athena from the head of Zeus.  Not only that, if I don't go treat it, the dog will die.  It really can't wait.  The only thing the owner could really do to prepare would be to get informed about the problem when the dog gets pregnant, and keep some Calsorb on hand (a rapidly absorbed oral calcium supplement) for emergency treatment at home.  Speaking of getting informed, here's a link to a great article on birthing puppies from Veterinary Partner.

The prodigal Great Dane returns.

In December, Pepper was purchased from a kennel as a 2-year-old.  She wasn't a family pet, but she seemed friendly enough.  Her new family took her home and she was fine on the ride.  Then they opened the car door and she bolted away.  They couldn't get within six feet of her, and she disappeared.  For weeks, she seemed to have dropped off the face of the earth.  Then she reappeared and Animal Control received at least one call per week (sometimes several per day) about her.  She led a furtive and feral existence, sometimes coming up to be fed, but always wary of being caught.  "Nessie" might have been a better name, as she was so often sighted, but never corralled.

The Animal Control officers tried feeding her, and tried feeding her baits with tranquilizers. They tried darting her with the capture gun.  She sailed over six-foot fences with ease.  On Saturday they finally succeeded in bringing her back alive -- after only three months.  She looks pretty sad in the kennel here.  She looked pretty scary in the official truck with the control pole around her neck and a look in her eye that reminded you of the miner in "The Shooting of Dan McGrew".  "He looked like a man with a foot in the grave, and scarcely the strength of a louse..."

She doesn't look much better up close while she's still full of tranquilizer, covered with dirt and scars and fleas, mighty thin.  We put her up for the night with a big bowl of food and water.  I must confess that I had some concerns about handling her when she woke up.  I think that's what prompted my having a dream of purchasing two horses and a black leopard without any adequate place to put them.  That or the manicotti I had for super... I don't know.

This morning she's feeling much better, has a great appetite, and is not unfriendly, despite her long and difficult adventures.  In addition to another big bowl of Science Diet, I fed her some balls of canned food, most of which had a pill inside: some Capstar for the fleas, de-wormer, Rimadyl for pain, and some antibiotics for the hole in her leg and the ripped-off toenail. 

I don't know that we're exactly "friends" yet, but we're not enemies.  With any luck, she'll be going home tomorrow.

In Memoriam: Martha Locke Wallace-Masters

I have heard it said that "...if you want a big funeral, be sure to die young: before  you've outlived all your friends."  The other approach would be to live a long and full life, and keep making new friends as you go.  That's what filled the church for Martha's memorial service.

I didn't get to know her until after she had risen, phoenix-like, from the ashes of her personal demons.  I only knew her as intelligent, gracious, kind, and fun.  I knew her as my client, my church family, and my friend.

It's okay to out-live your friends if that means you're getting more out of life than they are.  Of course, you only get more out of life if you put more into it, and Martha was much admired for that.

Dum vivimus, vivamus.

The worst pitfall in pet adoption.

Old Yeller Alert

In a previous post, I discussed many of the problems one might encounter in adopting a pet of uncertain origin.  In an attempt to be warm, fuzzy, and make the idea attractive, I pretty much glossed over the worst case scenario.

The problem is that these animals are not brought to the shelter or rescue agency because people have been loving and caring for them.  They are brought because people want to get rid of them.  "Give me your  tired, your poor..."  Sometimes they are already carrying a disease.  Sometimes they are so stressed that they don't have any resistance when they are exposed.  That same level of stress can also prevent them from responding to the vaccines given by the rescue folks.

This puppy looks really cute.  What you cannot see are the white gums, bloody stool, prolapsed rectum, subnormal body temperature (room temperature) and severe dehydration produced by her parvovirus infection.   Her new owners adopted her less than a week ago.  The Animal Rescue had given her first puppy vaccines and dewormed her for hookworms and roundworms less than 10 days ago.  If you showed me her paperwork, I would have asked you to bring her in for a quick check-up and a stool exam.  On paper, she ought to be okay, and last night she still looked okay.  She wasn't, though, and today she crashed.  She was exposed to the parvovirus before her body could respond to the vaccines.  It is as though somebody started machine-gunning you with live ammo while you were training on a paint-ball course -- you are not prepared to fight back.

SO, part of you says, "Don't get an animal like this; it's such a crap-shoot.  They could become seriously ill and die just about the time you get attached to them."  Then there's the part of you that says, "If we don't adopt these guys, they will ALL die."  You're between a rock and a hard place, with that "No good deed goes unpunished" feeling.  Somehow, a "money-back guarantee" just doesn't make you feel that much better. 

Does it happen that often?  Not really.  Very seldom, in fact.  That's just a pretty small consolation when it happens to you.  We keep doing it anyway, partly because we feel it's the right thing to do, and partly because we tell ourselves that nothing bad is going to happen to us.  Sort of the same way I justify getting on the motorcycle.  You pays your money and you takes your choice.

Sometimes you have to stay late.

This is one of those posts that could easily stray from the warm-fuzzy image we'd like to project.  Sometimes a patient is not in a life-threatening situation, yet you feel that his condition is something that just can't wait.  I'm not even going to define paraphimosis (much less post a picture), but that's what the puppy had.  When his owner noticed it early in the morning, he opened the pen to minister to him.  Unfortunately, the puppy ran past him and could not be found again and corralled until nearly five PM. 

That's why it was after five when they showed up at KVC without calling first for an appointment.  I had places to go, and people to see, and miles to go before I sleep, but I decided it just couldn't wait.  When you see the results of something delicate being dragged through the sand all day, it's a little difficult to think about the kid getting no relief for another 18 hours.  So we stayed late, did surgery, and fixed him up.  It messed up my schedule, but it made me feel a lot better, just thinking about him feeling better.

There's no business like snow business.

No snow all winter, beautiful weather last weekend, and global warming... and six inches of snow fell last night.  Actually, it started yesterday afternoon, and by five PM, it was really accumulating.  As the snow increased, the client traffic decreased.  The phones got quiet as people who don't know snow became immersed in it, some running out to play, and others getting ready to snuggle in for the night and hibernate.  That was my plan; I wasn't expecting any calls, which just goes to show how wrong you can be.

The first call was for the Lab puppy who had been let out to romp in the snow... in the un-fenced yard...and then in the street... and then under the car.  Lots of wound cleaning, and a little sewing, and a lot of pain medicine, and she'll be okay.

While I was finishing with her, the second case was seeping blood through the home-made bandage on his paw.  At home, these folks have that green metal edging around the flower beds.  When Max can see it, he just jumps over it, but he couldn't see it under the snow.  The cut wasn't big, but it was deep and severed a big blood vessel.  A little tying-off, a little sewing, pain medicine and a bandage, and he'll be okay.

Number three was a little Pomeranian whose back had gone out.  I guess he could have waited until the next morning, but I was already at the clinic and the owner was willing to brave the storm.  I'm glad we got started with his pain meds as soon as possible (though he had to wait for over 3 hours while the other guys got sewed up).

I worked steadily from 6:30 to 10:30 last night in the snow-storm (not OUT in it, thank goodness, like in the old days when I was doing cattle work in Pocahontas, Arkansas).  This morning, we have a bright, sun-shiny day, though the streets are a bit icy.  No clients, though.  Only two folks showed up.  My receptionist called to check on them and while only one actually asked, "Are you crazy?!", they pretty much all conveyed the same idea (in a more polite way). [And so what if she is? We want to know if you're going to show up for your appointment.]

Yeah, I figured that "snow business" would be "no business", but last night sure fooled me.