8.16.2016 Emergency, South Bay, CA

Birthday puppy

Late night birthday surprise

Case Count: 4

15yo female spayed Chocolate Lab
UTI, may have eaten a chicken bone, history of low thyroid, paralyzed larynx, arthritis, and ACl tear
     This spunky little girl limped in after supposedly having eaten a whole chicken bone. Luckily, no bone seen on xrays. Those are tough because they can break and slice things open whether we them puke or we let the bones slide on through. Confirmed UTI, which probably explains the accidents in the house, though she also poops with difficulty. I think she has pain when posturing to toilet and puts it off until she can't anymore. Started antibiotics. Paralyzed larynx, common in Labs and Retrievers, is when the nerve stops telling one or both cartilages in the back of the throat to open when the dog breaths. They get a ragged-sounding pant because of the partially-blocked airway. They can also aspirate (solids going down the windpipe) easily. ACL (called cranial cruciate ligament, or CCL) tears in dogs are most common in large breeds, possibly related to age of spay, though that part is new science. Repair of CCL tear is the most common orthopedic surgery in dogs. 

11yo male neutered Cock-A-Poo
Acute front leg paresis (not quite paralysis)
     Pet found unable to stand on his front legs after being at home alone for 10 hours. No known trauma or other causes, but he does jump off things often. I performed a Neurologic Exam, which is a specialized physical exam that tests a standard set of neurologic functions. Everything other than slight neck pain and both his front legs being weak was normal, and both front legs were equally affected, which tells me that the problem is in his spinal cord in the region where his neck meets his thoracic spine. The most common cause in dogs is intervertebral disc protrusion (a "slipped disk"), but this is a strange spot for it. Other possible causes include direct trauma, a blockage of a blood vessel in the spinal cord, cancer, infection, auto-immune disease, and others. My best guess is he landed poorly and had abnormal discs to begin with. Xrays were unremarkable and we are trying cage rest and pain meds/anti-inflammatories. 

6yo male neutered Domestic Shorthair (DSH) Cat
UTI and vomiting
     Urinary blockage is common in male cats, especially overweight ones. This patient had a series of urethral obstructions (the narrowest part of the urinary tract) and had a surgery performed called a perineal urethrostomy, where his penis was removed and the urethra was sewn to the skin to create a urethral opening larger than what the penis provided. Larger opening also means easier access for bacteria, so UTI's are common in these kitties. I suspect the vomiting is from discomfort, but could indicate kidney damage (from infection or re-blockage) or a completely unrelated problem. Owner elected to focus on the UTI with fluids, antibiotics, and pain meds. Gave an antacid to cover our bases and will recheck if things go sideways. There was blood in the vomit, but coagulation tests were normal.  

5yo male neutered Cock-A-Poo
Painful left knee after falling off a bicycle
     Patient jumped into his owner's arms while the owner was slowly riding a bicycle. Both fell over and the dog would not use his left rear leg. I performed an Orthopedic Exam, a specialized physical exam focusing on the musculoskeletal system, and found that the dog's left knee was painful. I could not detect a CCL tear in this patient, but he really hated to be handled and his owner did not want to sedate to be sure. We gave hydromorphone and sent home anti-inflammatories (NSAID). Strict cage rest, recheck as needed.