*SIGH* Just read and you'll understand.
Week 5: February 9-15, 2014
My animals are falling apart.
I pulled up to my house after work Thursday night, and in the headlights I saw my dog in the backyard. When I saw the way he was holding his leg, I yelled, “Noooooo!” in very dramatic fashion. After many months of working at Bayshore and seeing dogs in a similar condition, I knew immediately what was wrong. But of course, I chose to be in denial until one of the vets could look at him. I took him to work with me the next day and explained that he was let outside to potty, and ten minutes later when I pulled up, he was limping on his left hind leg. No one saw what happened, but he does like to run back and forth across the fence barking at the trees. The veterinarian examined each joint starting at the digits, working up to the stifle. He did the “drawer test” by holding the femur and moving the tibia to see if it protruded forward.
You just had to open the drawer!
He gave me a look, and I knew: my dog had ruptured his CCL. The overall theme lately is the care for aging pets. My dog and two of my cats are approaching 9, and though I still consider that fairly young, I have to remember that their bodies are aging rapidly, and that I must prepare myself for age related illness. My dog has never had blood work run, so I decided to prepare a Senior send-out to an outside lab for 25 chemistries, T4, UA, and CBC to make sure he’s healthy enough for the next step: surgery. I also have a lateral ear resection for my cat’s left ear to schedule. It’s been a week.
My patient of the week was Olive, a 6yr old Pug that came in for hacking. She displayed the typical pug snort and raspy breathing, and her owner mentioned that she occasionally had respiratory attacks that she had a prescription of Valium for to use as needed. Olive was adorable, with a brachycephalic face that was so smashed in that she resembled a Persian. She was calm, unlike other pugs I’ve seen that are constantly panting and snorting. The veterinarian recommended an x-ray to see if there was anything in her throat. We took lateral and VD thoracic radiographs that included the trachea, and the doctor felt that she should be sedated for a closer look. Once Olive was asleep with doggy magic, a throat exam was performed, and it was discovered that not only did Olive have an elongated soft palate, but that she also had larygneal paralysis. She was reversed with Antisedan and given Dexamethasone for inflammation. As she began to wake up, I noticed she was acting strange and making an odd gurgling noise. I alerted the doctor and she took her heart rate and felt that she was reacting to the Ketamine. She had me hold her in sternal recumbancy while she recovered. I became concerned as the strange sounds continued, so I checked to see what color her mucous membranes were, and saw her tongue was turning blue. I grabbed my technician and we masked Olive with oxygen, feeling that the procedure and her panic had resulted in her throat swelling and cyanotic state. Thankfully, her color began to return to pink, and I was instructed to keep the oxygen on her for a while.
Fifteen minutes later, she had a seizure. I was alone in treatment, so I had to yell for help, and staff came running. It was amazing how they jumped right into action. One technician shaved a forearm while another started gathering catheter supplies and an ET tube and another veterinarian drew up Valium while I held off the cephalic vein. When Olive was settled enough, my technician intubated her so she would have an open airway and we continued the oxygen. The hustle and teamwork was very impressive! A catheter was placed and Olive was hooked up to EKG with me monitoring her for the next 2 hours until her owner was able to take her to an emergency 24 hour hospital for monitoring. Happily, Olive was starting to become more alert and was breathing comfortably without the ET tube when she left, and her doctor felt that she would be okay.
Dogs with smashed in faces are super cute, but unfortunately, the abnormal shape of their skull leads to many health issues related to respiration, skin, and eyes.
Experiencing how well my team worked when a crisis happened made me very proud to be a part of this hospital. Because everyone was on their A-game, Olive was well on her way to recovery even though surgery is likely in her future to correct her anatomical abnormalities. What made the situation more stressful was that the owner was a new client, Olive was a new patient, and this was the first time we’d seen both. The impression we made must have been favorable because the owner said she would definitely be coming back!