8.23.2016 Emergency, South Bay, CA

Case Count: 9

Favorite Quotes

  • "It's still my birthday month, so you still have to treat me like a princess."
  • "The veterinary student in me can always smell free food."
  • "The new pizza place brought us free pizza! FINALLY our prayers have been answered for once!"

5yo male intact Shih Tzu
Hit by car (HBC), crushed pelvis
     Very sweet little guy that WILL BITE if you touch him wrong, but I can't blame him. There are three types of pelvic fractures you don't want to have, and he has all three, plus others. Only a small portion of the pelvis actually transmits the weight  from the leg to the spine, so breaking this "weight-bearing axis" means the corresponding leg can't do its job. This dog has a break, or fracture, through the bone of the weight-bearing axis (ilium) AND the joint between the pelvis and the spine (sacro-iliac joint) is dislocated (luxated) on one side. The other SI joint is also dislocated. The ball and socket of the hip joint meet so smoothly that a grain of sand would shred it painfully. This dog has a fractured socket. Perfect repair is needed and arthritis is still a high risk. There's also a break in the pubic bone and the right half of the pelvis is shoved over to the left. Tiny dogs can do surprisingly well with these injuries as long as there's enough space through the pelvis for stool to exit. The owner is likely going to surrender the pet to a humane society that has said they'd pay for treatment and adopt the dog out. Estimate is $5,000-10,000. 

Oxygen chamber touch screen

9yo female spayed Pomeranian
Suspected bronchitis (or pneumonia, or heart failure, or something else)
     Overall healthy little fat dog that started coughing two days ago. Progressed to difficulty breathing. Turns blue if not in an oxygen chamber. Xrays kinda don't show much. This one's a bit of a puzzler. Owner is in Bulgaria, very worried, pooch will have to stay in the hospital until able to breathe on room air just for diagnostics. Treating with a little bit of everything to cover all the bases - steroids, antibiotics, bronchodilators, oxygen chamber. Oxygen chambers are no trifle, it's important to manage not only oxygen, but temperature (I had one patient overheat and die once), CO2 (add soda-lyme), humidity (can't dry out or over-moisten the lungs). These atypical cases sometimes need to be on oxygen for several days before big diagnostics can be done. 

5yo male neutered Mastiff mix
Snake bite to the face
     This poor pooch;s face is about twice the normal size, eyes swollen shut. He's gotten several doses of anti-venin, which is only partially helpful. Mostly it's about supportive care - pain meds, fluids, antibiotics if open wounds are present. The big worry is clotting. this patient required two transfusions of clotting factors (part of blood) and was still not doing well after 48 hours. Fingers crossed, very nice owners are cutting into their 401K to pay for treatment, both have come and lay on the floor with him to visit today. 

6yo male neutered Chocolate Lab
Xylitol toxicity
     Bad news toxin, kids. Xylitol is a sweetener in sugar-free gum and other sugar-free foods. It mimics sugar, but without actually feeding cells in the body. When the body detects xylitol, it thinks sugar is available (from a meal or something), so it pumps out insulin. Insulin drives that sugar into cells as fuel, but the xylitol stays in the blood. Once the small amount of circulating blood sugar is used up, the brain fails because it can ONLY use sugar for energy (cells in other organs can use other energy sources in a pinch). The brain shutting down is tremor, then seizures, then death. It can also destroy the liver for up to three days after exposure. We gave extra sugar until the dog started regulating it on its own, and tracked liver values. Did great, discharged with instructions to recheck liver values over the rest of the week. As an aside, this dog also chews kennel doors obsessively, so he had all of his worn, broken front teeth removed a couple of months ago. Very nice elderly sisters with funny senses of humor. Sweet dog too.  

6yo male neutered Domestic Longhair (DLH) cat
Urinary obstruction, twice in 48 hours
     First time offender did ok with urinary catheter, pain meds, fluids, and muscle relaxers, but re-obstructed after taking the urinary catheter out. If he re-obstructs, surgery to remove the penis and create a larger opening is recommended. Common problem in male cats, especially overweight ones (which is all of them these days). 

8.5yo female Guinea Pig
Seizure
     This is an OLD Guinea Pig, most only live a few years even with good care. This owner was very upset to find hers seizuring at breakfast time. Due to age and severity of signs, owner decided to euthanize. Seizures that last more than 5 minutes raise body temperature and intracranial pressure, and are less likely to respond to therapy. Sad case. 

14yo female spayed Black Lab
Seizure
     Second seizure in 3 months. Most common cause for first time seizure after 5 years old is brain tumor, usually arising from the surface of the brain (meningioma) and responsive to surgery. I've met very few people who go that far. This dog barely moves due to arthritis, but does better with pain medication. Owner wanted a little more time before euthanizing, so we sent home two pain meds, one with antiseizure effects (gabapentin). Very sweet owner, very sweet dog.  

7yo male neutered  Shih Tzu
Spinal pain, suspect IVDD
     Yelped and started acting painful after being out of sight momentarily. Limped on right rear leg, but that resolved. Seemed painful in the mid-back. Most common cause is intervertebral disc disease (IVDD). Sent home pain meds and owner will restrict his activity. Fingers crossed.

11yo female intact Welsh Terrier
Chronic lethargy, ongoing hypoparathyroidism
     Lethargic for about a month (rush right in!). Also itchy ears. Owners declined all tests due to price. Hypoparathyroidism is a malfunction of the parathyroid gland, which regulates calcium levels. Specifically, the calcium floating in the blood rather than packed in the bones. Low ionized calcium affects muscle and other calcium-related functions. Weakness, lethargy, etc are common. Often just supplementing calcium is effective treatment. Dirty ears, owners will clean them.