Your Pet's Best Friend

Diagnostic Workup Success - that almost wasn't.

This is Molly.  A few days ago she was presented for an examination.  She had been limping a little the night before and just didn't feel well.

There was no lameness when she came in, but she didn't have much mojo.  She didn't seem in any distress really, just no energy.  She also had not wanted to eat much.  There was no fever, nothing seemed swollen or out of place, and I couldn't find a sore spot anywhere.

She lives in a fenced yard, so trauma didn't seem likely, even though she shares it with another pretty big dog.   There just wasn't really anything to put your finger on, but you could tell she was unhappy.

I was about to send her home with some anti-inflammatory medicine, thinking she might have slipped and made a bad landing in the mud the night before.  Then her owner said, "You know she usually chews on everything, but she doesn't want anything today."  I asked, "Everything, as in a lot of things that aren't food?"  She replied in the affirmative.

With that piece of information, I thought of all the dogs with foreign body intestinal blockages I have seen who had no specific outward signs -- they just didn't feel good. "Let's take an X-ray of that belly. We probably won't see anything, but I'd hate to miss a ridiculously obvious foreign object."  Okay, let's do it.

The abdominal X-ray looked normal, but there was a little bit of the chest on the film, too.  When I looked at the whole film, the chest part looked "funny" (funny-strange, not funny-haha).  We took pictures of the chest.

There was what appeared to be a significant amount of fluid in the chest.  That will make you feel bad.  We tapped her chest - it was blood.  Internal bleeding will also make you feel bad.  In your chest, it will squish your lungs and eventually keep you from breathing, even if you don't go into shock first.

Even though there was no history of exposure to rat-poison, we filled her full of vitamin-K (the antidote).  That stuff makes the dog a free bleeder, and bleeding into the chest (hemothorax) is not uncommon.  Since my associate is pretty knowledgeable in Chinese medicine, we also started the herbal preparation called Yunnan Baiyao, as it helps to get the body's own clotting mechanisms into high gear.

The alternatives to rat-poison were not happy ones: a bleeding tumor, some other abnormal structure that had begun to bleed, or some other heretofore unnoticed bleeding disorder in the dog.  All of those have a terrible prognosis, not to mention that referral to a surgical specialist was not in the cards.

Thankfully, Molly has responded well to treatment and seems about normal now.   Who takes a full set of X-rays every time a patient just "doesn't feel good"?  Nobody.  A chance remark, a look at the wrong place, and we got an accidental look at the right place.  And I almost sent her home with some pain-killers.  Serendipity, it's called.

Snake-bites and Facial Swelling

Most of the snakebites that I have to deal with here are from copperheads.  We do have cotton-mouth water moccasins, but most of my patients are not in the water so much.   Usually you just see some facial swelling, as dogs typically go in nose first, and the snake bites them on the lip.   You treat them for pain, for inflammation, and give antibiotics, as the puncture wounds from a snake bite can get infected, just a like a dog-bite wound.  Puncture wounds are deeper than they are wide, so you can't really wash them.  The snake's mouth is dirty, just like your own (well maybe not JUST like, but everybody's mouth is full of germs), so the bite wound can get infected.

So, you have a Pit Bull, and his face swells up until he looks like a Shar Pei (at least his upper lips do).  Use your imagination, or Google up some Shar Pei pictures.

Then there is today's case.  This is the worst case of post-snake-bite swelling I have ever seen.  The owner says that this is actually reduced from the night before when the dog grabbed the snake.  This dog usually looks like the Pit Bull on the left here.  Now he looks like a Neapolitan Mastiff.

My patient on the left, a Neapoloitan Mastiff on the right. I think he will be fine, but he has some mongo swelling.

Pet Food Recall

KROGER RECALLS PET FOODS DUE TO POSSIBLE HEALTH RISK

CINCINNATI, Ohio, December 18, 2010 – The Kroger Co. said today it is recalling select packages of pet food sold in some of its retail stores because the products may contain aflatoxin, which poses a health risk to pets.

Kroger stores in the following states are included in this recall: Alabama, Arkansas, Georgia, Illinois, Indiana, Kentucky, Louisiana, Michigan, Mississippi, Missouri, North Carolina, Ohio, South Carolina, Tennessee, Texas, Virginia and West Virginia.

The recall also includes Dillons and Gerbes stores in Kansas and Missouri; Baker’s stores in Nebraska; Food 4 Less stores in Nebraska, Illinois and Indiana (Chicago area); and Jay C, Hilander, Owen’s, Pay Less and Scott’s stores in Illinois and Indiana.

Stores the company operates under the following names are not included in this recall: Ralphs, Fred Meyer, Fry’s, King Soopers, Smith’s, QFC, City Market, Foods Co., and Food 4 Less stores in California and Nevada.

Kroger is recalling the following items: Pet Pride Cat Food sold in 3.5 lb. packages with a sell by date of OCT 23 11 DP and OCT 24 11 DP under the following UPC code: 1111088128 Pet Pride Cat Food sold in 18 lb. packages with a sell by date of OCT 23 11 DP and OCT 24 11 DP under the following UPC code: 1111071357 Pet Pride Tasty Blend Poultry & Seafood Cat Food sold in 3.5 lb. packages with a sell by date of OCT 23 11 DP and OCT 24 11 DP under the following UPC code: 1111088152 Pet Pride Tasty Blend Poultry & Seafood Cat Food sold in 18 lb. packages with a sell by date of OCT 23 11 DP and OCT 24 11 DP under the following UPC code: 1111074580 Pet Pride Kitten Formula Food sold in 3.5 lb. packages with a sell by date of OCT 23 11 DP and OCT 24 11 DP under the following UPC code: 1111071903

Old Yeller Chunk Dog Food sold in 22 lb. packages with a sell by date of OCT 23 11 DP and OCT 24 11 DP under the following UPC code: 1111074566 Old Yeller Chunk Dog Food sold in 50 lb. packages with a sell by date of OCT 23 11 DP and OCT 24 11 DP under the following UPC code: 1111074563 Kroger Value Cat Food sold in 3 lb. packages with a sell by date of OCT 23 11 DP and OCT 24 11 DP under the following UPC code: 1111000018 Kroger Value Chunk Dog Food sold in 15 lb. packages with a sell by date of OCT 23 11 DP and OCT 24 11 DP under the following UPC code: 1111071559

Kroger Value Chunk Dog Food sold in 50 lb. packages with a sell by date of OCT 23 11 DP and OCT 24 11 DP under the following UPC code:1111000108

Aflatoxin is a naturally-occurring toxic chemical by-product from the growth of the fungus Aspergillus flavus on corn and other crops. If your pet shows any symptoms of illness, including sluggishness or lethargy combined with a reluctance to eat, yellowish tint to the eyes and/or gums, and severe or bloody diarrhea, please consult your veterinarian immediately.

The safety of our customers and their pets is important to Kroger. The company is using its Customer Recall Notification system to alert customers who may have purchased these recalled products through register receipt tape messages and automated phone calls. Customers who have purchased a recalled item should not use it and should return it to a store for a full refund or replacement.
Customers who have questions about this recall may contact Kroger toll-free at (800) 632-6900. For more information, please visit www.kroger.com/recalls.

My dog has been poisoned!

When the phone call starts that way, I am often skeptical.  People often blame poisoning for everything from cancer to parvovirus diarrhea.  How do you know it's been poisoned?  Did you leave poison out where your dog could get it?  Did you see him eat it?   Before I could ask any of my questions, the owner told me that another dog had died with the same symptoms two weeks ago. "He's drooling like crazy, and having convulsions. He has vomited and passed diarrhea.  He can't get up and I think he's dying."  You know how in old Westerns they used to say "Shoot first and ask questions afterward"?  At this point I'm thinking, let's get him into the hospital and ask questions afterward.

So here's Brutus.  He's pretty much just lying there, except for the constant severe muscle tremors that you can't see in a still picture. Those tremors are why his temperature is 106.   He certainly has all the signs of exposure to a toxin affecting the nervous system.  It's not carbamates or organophosphates because his pupils are dilated.  Could be permethrin or something similar, maybe slug bait.  No way to tell really, so it's on to supportive care.  I. V. fluids, atropine for the salivation, and plenty of valium for the seizures and tremors. 

Once we got him calmed down and quasi-stable, further questioning revealed that Brutus had escaped the yard, allegedly in search of romance.  When the owner caught up with him, he was down and out.  Turns out his deceased buddy had also escaped the yard prior to his demise.  I'm thinking that would have put me to work some overtime on the fence situation, but now we've got to worry about what we're going to do after the fact.

Brutus got relatively quiet, though his muscles were still quivering like a sack of snakes.  At the risk of having it vomited all over me, I administered good old Toxiban + Sorbitol.  This is as close to the "universal antidote" as we have.  First of all, we really don't know for sure what Brutus got into, and for a lot of toxins there really is no specific antidote.  This stuff is activated charcoal, which acts like a "chemical sponge" to catch toxins that are still in the gut. This should keep more from getting into his bloodstream and making things worse.  The sorbitol is a cathartic, to shoot the stuff on through and get rid of it.  A little messy, to be sure, but "a man's gotta do what a man's gotta do".

In the hospital, it's not that much of a problem, but if you send somebody home full of this, you have to warn the people that he's either going to vomit "black paint" or possibly have diarrhea like "black paint".  It will darn sure ruin clothing or carpet.  Inexplicably, some people don't take this warning seriously and destruction ensues.

Anyhow, I spent all Sunday morning with Brutus, missed church, missed Sunday luncheon, too.  By noonish he was getting pretty stable.  By evening he didn't look great, but he was holding his head up and looking like he might get over it. Evidently, he didn't get enough poison to kill him outright, and we got the rest of it flushed out.  His body's natural defenses came through (with some help from me).

Today he's looking good and going home... hopefully to an enhanced fence.

Rat Poison Scare

Why is this dog squinting?  Well, I'll tell you about that.  It seems that she and old Dad were out in the garage and somehow a box of rat-bait got knocked over.  They knew how many chunks of bait were in the box and when they picked them up, they were short a chunk.  Of course, with that kind of confusion, a dog has to be right in the middle of it.   The natural assumption would be that the dog had scarfed up one of the baits.  So, it's rush, rush, rush over to the veterinarian.

Now, when you look at this thing, it's about the size of two ping-pong balls end to end, weighs an ounce, and is pretty rough and rigid.  It doesn't look like something you'd want to swallow, but you are not a dog.  I well recall one of my "stupid hall of fame" dog patients who ate a brillo pad... twice.  Just because it doesn't look like food is certainly no guarantee that a dog wouldn't eat it.  Far from it.  So, we add a missing bait and a big dog and the sum could certainly include "dog ate it".

Which brings us to the squinty eye.  One of the most effective emetic drugs is apomorphine.  One of the simplest ways to give it is to put a little under the eyelid.  It absorbs through the mucous membrane and gets in the bloodstream rapidly.  In just a few minutes, Voila! you're puking.  Squinting, too.

In this case, you're puking up chicken [It looked like chicken; did it taste like chicken? Everything does, so I didn't have to check that.].  Then, some more chicken.  Then some more chicken. Then bile.  Then more bile.  No rat bait.

So, Dad went home and made a dismounted reconnaisance and found the missing bait.  Whoops, all that vomiting for (maybe) nothing.  Just to be on the safe side, we sent home vitamin K.   We cleaned up her eye, too.

One thing that I forgot to mention in a previous post on rat poison is that most of these rodent baits have a brilliant blue-green dye added to them.  That way you might notice a brightly colored poop and realize that something was amiss before the dog began to hemorrhage.  This stuff is pretty drab.  I must say that I prefer my environmental hazards to be more decorative.

Pet Food Recall - "Special Kitty" is special in a new way.

Yes, Wal-Mart's house brand of cat food (manufactured by Mars, makers of fine candy and pet food -- a winning combination, but don't get confused on Halloween) has a little Salmonella prolem.  Salmonella, famous for food poisoning, not for salmon.  Here's a link to the full info.  Supposedly these bags are all way out east of Missouri, but you might just check your serial number.

Pet Food Recall rises from the dead.

This time it's not the dreaded Chinese melamine. Apparently they are keeping that at home to put in their baby formula. It doesn't seem to be working any better for their babies than it did in the dog food here.

This recall concerns possible contamination with Salmonella (can you say "food poisoning"?).

Here's the website with all the information, positive spin and all.  They also list the recalled products and lot numbers, so don't get discouraged when you read about what great folks they are for doing the voluntary recall when maybe their food doesn't even have anything wrong with it.  Just keep reading... or scrolling down.

Pet food recall, but not such a big one.

This little recall (big if you're the company, I guess) only affects one size bag (20-pounds) of one product: PEDIGREE(R) Complete Nutrition Small Crunchy Bites.  It's also in a limited market area, i.e. a long way away from me: Albertsons stores in Southern California and Las Vegas, Nevada.

The pet food is being voluntarily recalled because of potential contamination with Salmonella. There have been no complaints or reports of injury resulting from consumption or handling of the recalled product.  I guess they just found somebody eating the stuff in the back room.  Or maybe they found somebody using the dog-food bags for a toilet.  Or maybe somebody's pet turtle was found in the feed room.  All turtles are potential carriers of Salmonella.  Don't put turtles in your mouth.

So here's a link to more information on the recalled food.

And here's a link to more information on handling contaminated food.  If it says "Contaminated", you know it's bad.  Also, never buy pet food with a skull and crossbones on the label.

Lead paint in dog toys.

This is nothing to lose sleep over.  While it is certainly true that lead is toxic and you shouldn't eat it, the potential hazards of the involved toys have been way overblown.

So, some toy tennis balls like this have lead paint in the pawprints.  How much of this would your dog have to actually eat in order to have a problem?  Here is what Sharon Gwaltney-Brant DVM, PhD, DABVT, DABT of the ASPCA Animal Poison Control Center says:

"So let's calculate a toxic dose for a 10 kg (22 pounds) dog. Assuming worst case scenario, we know that chronic toxicosis is induced at 3-30 mg/kg/day; we'll use the 3. For a 10 kg dog, that's 30 mg of lead per day times 90 days (3 month subchronic study) for a total lead dose of 2700 mg. Let's also assume that somehow the dog manages to eat 1/2 oz (15 gm, 0.015 kg) of leaded paint (at 30 ppm) off of these toys every day (unlikely there's even that much total paint on a toy, but we'll call this worst case scenario). So every day the dog is eating 0.45 mg of lead; it'll take 6000 days to get to the chronic toxic dose of 2700 mg of lead. That's 16.4 years. So, if the dog, every day, scrapes off 1/2 oz (1 tablespoon) of paint from toys/bowls whose paint contains 30 ppm of lead, the dog might finally develop lead toxicosis when it hits 16 years of age. Very very unlikely. Allowable levels for humans should be fine for dogs, especially since dogs don't live as long as we do (risk assessments for humans have to take into account our long life span). "

My brothers and I have laughed about the concerns with children's toys and lead paint.  Certainly it wouldn't be funny for children to be poisoned by eating their toys, but we had toys made out of lead. In fact, we made them ourselves, in our room, without adult supervision, when our ages were 4, 7 and 11.   First, you coat the cast-iron molds with soot by using the open flame of a candle.  Then the two halves of the mold are clamped together.  In the meantime, the lead has been heating up until it is all melted, its liquid surface shimmering like silver.

Now, while we inhale the acrid fumes, the cauldron of molten lead is tipped carefully to pour the mold full, making some shiny new lead soldiers.  Of course, sometimes we weren't as careful as we should have been.  Once some hot lead landed on my toe.  We were in our pajamas and barefoot while doing this.  I skipped briskly to the bathroom and dunked my toe in what commercials used to refer to as "the bathroom bowl".  This was screamingly funny to my little brothers, and little children often find it amusing even today.

So, you shouldn't eat lead paint, and the Chinese are bums for putting it on toys, but your dog is probably not going to get enough to hurt him... unless he helps us make lead soldiers.

Pet Food Recall Rises from the Grave

Two different issues this time.  A couple of different foods recalled due to possible Salmonella (the germ that causes "food poisoning") contamination: Krasdale Gravy dry, and Red Flannel large breed dry foods.  Check out the Mars Pet Care site.

For more  Salmonella opportunities, try "Eight in One" chicken jerky.  Here's the FDA listing on those products and how to get them.

On the melamine front (our regular, reliable, Chinese poisonous contamination), Wal-Mart has removed some fabulous Chinese chicken jerky from their shelves.  Their official statement is more about what responsible merchants they are than anything else, but it does list the product. 

It's always good to know that people are learning from their mistakes.  By people, I mean US, not Wal-Mart.