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Crazy Case # 5- Keep Your Nose Out of Other People’s Business……and Weeds: Harley’s Story.

19 Jan 2012 Leave a Comment

by Frey Pet Hospital in Crazy Cases

“So, how much did that cost ya?”, “You saw him with WHO?”, “How old are you really (asking a woman… yikes!)?”. No no, not that kind of nosey. Although, you know what they say: if dogs could talk…. This is a tale about one happy, spotted guy named Harley who was trying to follow his nose to greener pastures, but it lead him here instead.

As humans, we try to keep our heads held high and eyes forward to the tasks that lie ahead. For dogs, keeping your eye on the prize often means keeping your nose to the ground (this also applies to people steering clear of an angry boss). And for Harley, keeping his nose to the ground resulted in weeks of sneezing fits and numerous trips to his veterinarian. When Harley’s antibiotics weren’t helping, his doctor suggested that he come and see us for some x-rays and to scope his nose. Sneezing can be caused by many different things. Dogs often sneeze for the same reasons that we do such as allergies, irritating smells, and infections. They can even do something called a reverse sneeze which actually sounds more like a snort than a sneeze. Heck, we’ve even seen pets sneeze out of excitement! It is easy to forget that sometimes animals can have the same symptoms as humans. So when our pets show obvious symptoms such as Harley’s sneezing attacks, we often jump to the conclusion that there must be something stuck in their nose. And in most cases, there isn’t. But Harley was an exception.

When Harley came in to see Dr. Steen, it was obvious that he had something going on. He was sneezing violently and his left eye appeared to be winking (even though Dr. Steen is a looker, we were sure this was probably related to his sneezing issue). After Dr. Steen examined Harley and spoke with his family, he was brought back to our treatment area to get the ball rolling on finding out what was causing Harley’s sneezing. After an IV catheter was placed, Harley was placed under anesthesia and taken to radiology for a digital X-ray of his nose. An X-ray would help us see and rule out something like a foreign body, nasal cavity mass, or a tumor. After reviewing his X-rays, they appeared normal and Dr. Steen did not see anything that could be causing Harley’s sneezing. This was good news for Harley, but we still had yet to get to the bottom of his issue.

Next, we took Harley to our special procedures suite so we could scope his nose with our vetscope. A vetscope is a camera at the end of a speculum that allows us to view its images on a monitor. It can be used to look inside of an ear canal or the inside of a dog’s nose in this case (we assured Harley that even though the camera adds 10 pounds, this wouldn’t make his nose look big). First, Dr. Steen used the vetscope and viewed the inside of Harley’s right nostril. Other than some slight irritation from his sneezing, it appeared normal. Then, he viewed his left nostril with the vetscope.  We could tell immediately what the problem was: a weed. Because in most cases there usually isn’t a foreign object found, you can imagine our excitement and relief that we actually found what was bothering Harley and causing his left eye to wink (clearly not Dr. Steen). Dr. Steen then proceeded with a long, flexible alligator forceps to retrieve the weed. An alligator forceps is a small forceps designed to grab or grip things in small/or delicate areas. Once he retrieved the weed, we realized it was a foxtail weed. After double checking with the vetscope to make sure that his nasal passages were clear and there were no remnants left, Harley could be taken off of anesthesia to recover. Nobody is sure how Harley got such a big weed in his nasal passage!

Harley’s family was thrilled that we found the issue and were able to resolve his sneezing. Harley was sent home with some preventative antibiotics and would be just fine. When Dr. Steen called Harley’s family to see how he was doing, they informed us that the sneezing has stopped and that he was back to normal and doing great! We hope Harley continues to do great, and can enjoy sniffing around the outdoors with maybe a little less enthusiasm. It just goes to show you that being nosey, even for a dog, can lead to trouble- and leave people tired of saying “Gesundheit”!

This was the Foxtail weed being extracted from Harley's nose.

The image of Harley's nasal cavity via the Vetscope.

Crazy Case #4- “Dixie’s Triple Trauma”

12 Jul 2011 Leave a Comment

by Frey Pet Hospital in Crazy Cases

It is hard to put into words how courageous, strong, affectionate, and sweet Dixie is. And after enduring what Dixie did while still maintaining this wonderful personality, she was one of a kind. Many stories seem to start out by saying “that particular day was just like any other day”. Dixie’s story also started out this way. And when Dixie’s family saw her lying under a tree, they didn’t think anything was wrong until she tried to walk. Her family was shocked when they had realized that their sweet chocolate lab had been hit by a car and appeared to have multiple injuries. They immediately took her to their regular veterinarian who then referred her here.

When Dixie’s family arrived here, they had brought along Dixie’s X-rays that were taken at her referring vet clinic. Dr. Steen ordered additional X-rays to view her injuries from another angle to get an accurate diagnosis. After Dr. Steen had reviewed them, they confirmed his suspicions. She had a fractured radius and ulna (front leg) on her right side and a fractured (shattered) right femur (the biggest bone in the body-hind leg). Dixie needed surgery to repair these injuries, and she needed them A.S.A.P before her bones started to heal incorrectly. Dixie’s family agreed with Dr. Steen that Dixie’s best chance at a full recovery was to go ahead with the surgeries. Even though Dixie had suffered severe trauma to 2 separate areas, it didn’t phase her sweet personality and her tail never stopped wagging.

The first plan of action was to get Dixie placed on IV fluids and administer pain medication to help keep her comfortable and to keep her condition stable. Because of the extensive surgery that Dixie’s injuries required, Dr. Steen decided it would be best if she were hospitalized overnight to receive IV fluids prior to her surgery. For Dixie and many pets having more than routine surgery, IV fluids are crucial to keep the body’s organs hydrated and working properly. And in Dixie’s case, the fluids would help to prevent her from going into shock. She was also able receive any medications she might need faster and more efficiently through her IV. Once her IV was placed and she was given morphine for pain, she was closely monitored to ensure she was comfortable and not in any distress. When a pet has been hit by a car, chest X-rays are always a good idea to determine if there is any internal damage. Dr. Steen ordered chest and abdominal X-rays as well. Unfortunately her X-ray revealed that not only she also had a diaphragmatic hernia. A diaphragmatic hernia is a tear in the membrane that separates the chest from the abdomen. Because of this injury, Dixie’s abdominal organs such as her spleen, liver, and intestines had moved into her chest making it very difficult for her to breathe. Dr. Steen then contacted Dixie’s family to update them on her situation. A diaphragmatic hernia can be life threatening in some situations. After consulting with Dixie’s family, it was decided to proceed with her orthopedic repair along with repair of her hernia. Once the pain medication began taking effect, Dixie was able to relax and get some much needed rest. She was going to have a long day ahead of her.

The next morning came, and Dixie seemed in good spirits and like always, was still wagging her tail and delighted to see us. By this point, we had all gotten very attached to her. We knew today was a big day for her. She would be undergoing 3 major surgeries and would be under anesthesia for several hours. Dixie needed lots of love, luck, and the wonderful team of Frey PetHospital to help her through this. Dr. Steen had also called upon a colleague, Dr. Reimer (a board certified surgeon), to participate in Dixie’s surgeries. After many, many hugs and kisses, Dixie was placed under anesthesia and was prepped for surgery. Because Dixie now had 3 different areas that required surgery, shaving and prepping those areas would not be a quick task.

Once in surgery, the first plan of action was to fix Dixie’s hernia. This surgery required a different anesthetic protocol than a routine surgery. Normally when a pet is placed under anesthesia, they are intubated and the tube in their trachea delivers a mix of oxygen and anesthetic that the pet will breathe in on their own. Because of Dixie’s condition, she needed someone to provide manual ventilation and essentially breathe for her. Jen, one of our technicians, made sure that she received regular breaths throughout the surgery while making sure that her heart rate and blood pressure were holding steady. Dr. Reimer and Dr. Steen focused on getting Dixie’s organs back to their proper place in her abdomen while repairing the tear in her diaphragm. Shortly before the procedure was finished, a chest tube was placed to remove excess air. Once the doctors were certain that the air had been removed, the chest tube was taken out as the incision was being preventing any air from rushing back in. Once the incision was closed, Dixiewas able to regulate her breathing on her own without Jen’s assistance. Now that her abdominal organs were no longer in her chest, Dixie  was able to breathe normally. So far, Dixiewas doing great. And since she was able to breathe easier, it made it easier for her body to handle being under anesthesia to repair her fractured legs.

Next on the agenda was to repair her radius/ulna fracture (her front leg). This would require a bone plate. A bone plate is a “strip” of surgical grade stainless steal that is attached to the bone by using screws of the same material. Once the incision was made and her bone was exposed, the doctors were then able to start repairing the fracture. Her bones were lined up the way they would need to be in order to heal properly. While being held in place, the bone plate was then used to hold the bones in this place permanently. In most cases, the plate is applied to the radius. However, in Dixie’s case, the fracture type dictated that the plate be applied to the ulna. Because the stronger bone (the radius) could not be plated, a splint would need to be placed on her leg to give extra support and to allow her bones to heal properly. It was important that Dixie not put all of her weight on this leg without support as to not add stress to the fracture. Without the splint, Dixie could re-injure the leg with the bone plate being the only thing holding her bones in place before it had time to heal. After this was completed, it was time for her last surgery.

The last surgery was to repair Dixie’s fractured/shattered femur. The femur is the largest bone in the body. In addition to using a bone plate like in her front leg, she would also need an intra-medullary rod/pin. An IM rod/pin is a surgical grade stainless steel rod that is driven into the bone marrow cavity or center of the bone to serve as framework for the bone. With this rod inserted in her femur, it would keep it in place and give her the support she needed to be able to use it while it healed. Once this was inserted, her incision was closed. Surgery was now completed, and Dixie was doing great! However, she still needed a splint placed on her front leg, and she needed post-operative X-rays to confirm that her bones were set properly and that her chest and lungs were normal. Because Dixie would have difficulties walking over the next few days, a urinary catheter was also placed to eliminate Dixie from having to walk outside to urinate so she could continue to rest. It was all over with, and Dixie could now recover from anesthesia.

After everything had been completed, Dixie had been under anesthesia for about 5 ½ hours. Dr. Steen and Dr. Reimer were pleased with the outcome of all 3 surgeries, and expected her to make a full recovery! We were so happy and relieved that Dixie was doing great. She would have to stay for a few more days so we could monitor her, but we didn’t mind at all. Dixie was a wonderful patient! Even though we loved having her there, we were excited for her to go home with her family and continue her road to recovery.

Over the next few days, Dixie did outstandingly well. She spent most of her daytime lounging on a big comfy blanket in our treatment area, lapping up our affection until her and her comfy blanket were transferred to her kennel at night for her to rest. She was becoming more and more mobile and was even trying to follow us around. We knew she loved us as much as we loved her. Dixie knew that we were there to help her and we knew she appreciated us. The day came when she could finally go home. Dixie was so excited to see her family, and even had a new family member to go home to. During Dixie’s stay with us, her “mom” had a baby! It was a joyous day for Dixie’s family to have both of their “babies” home with them.

Dixie is back to normal and doing awesome! Her legs have fully healed, and she is back to being her typical lab self and swimming in the family pond. Dixie has since come in for multiple visits, and everyone is so happy to see her and how great she is doing. We are so happy that we could be a part of Dixie’s life.  Having transferred her care back to her regular veterinarian, we hope Dixie continues to thrive and are grateful to have had the opportunity to help play a part in her road to recovery.

 

Dixie's chest before with diaphragmatic hernia

A normal dog chest

Dixie’s femur before surgery

Dixie's femur after surgery

Dixie's radius/ulna before surgery

Dixie's radius/ulna after surgery

Crazy Case # 3- “Wait… You mean that wasn’t cat nip?”

17 May 2011 Leave a Comment

by Frey Pet Hospital in Crazy Cases

Oh, how we love the holidays. They are a time for family, friends, food, and celebrations. The holidays also come with special knick-knacks and decor. It wouldn’t be a party without decorations. Halloween is usually decked out with fake bugs or spiders of sorts, pumpkins and gourds, and candy (oh my, LOTS of candy). During Christmas there are the twinkle lights, ornaments for the tree, and tinsel just to name a few.  And we can’t forget about Easter. You’ve got more candy, plastic eggs, and the notorious colored Easter grass that spruce up the baskets and make the candy look much more appetizing. It’s the same Easter grass that you swear you aren’t going to buy the next year because you are tired of finding remnants of it around your house for months after Easter has come and gone. But every year you buy it, because it’s not Easter without that grass.

It is very common around the holidays for veterinary hospitals to be swarmed with pets that have gotten into Halloween candy or have eaten a box of Valentine’s Day chocolates. For a little black cat named Harlie, it wasn’t the candy that intrigued her.

It was a few days after the “Easter Bunny” had visited Harlie’s house that she wasn’t feeling well. Harlie had a bellyache, and was not interested in eating much of anything. Then, she began vomiting. After a few days of not really wanting to eat and continued vomiting, her family knew that something was wrong. And when Harlie vomited up a few strands of Easter grass, her owner knew exactly what was going on. She had decided to graze on the fake grass for a little snack, and now it was stuck. After discovering what Harlie had done, her family was certain that Harlie needed to come see us.

It was a Friday that Dr. Kingus first examined Harlie.  Dr. Kingus and Harlie’s family both agreed after the exam that blood work and an X-ray were the first steps in assessing how sick Harlie was, and how much Easter grass she had ingested. Harlie’s blood work was normal but did indicate that she was dehydrated (most likely from vomiting). Because her blood work was normal, it was a good indication that even if Harlie was obstructed, her body was at least able to function somewhat normally for now. Harlie’s X-ray indicated that there was indeed something in Harlie’s stomach. Dr. Kingus discussed some treatment options with Harlie’s family. She explained that in most cases, doing a barium series can help determine the severity of the obstruction, if any. Barium is a liquid that will show up on an X-ray. A barium series is when barium is administered to a pet by mouth. Then, through a series of X-rays taken periodically over a few hours or more, we are able to see the progress the barium is making through the pet’s stomach and intestinal tract. Since the X-rays are taken at specific intervals to track the barium’s progression, we are able to see when the barium cannot continue due to an obstruction. Because of what Harlie was suspected to have eaten, Dr. Kingus didn’t think a barium series would be the best route for her since liquid barium would probably be able pass around and through the Easter grass and continue normally through her intestines.  After explaining this to Harlie’s owner, Dr. Kingus suggested that an immediate exploratory surgery followed by hospitalization would be the best option. Harlie’s family also agreed, and after many hugs and kisses. Harlie was then admitted into our hospital.

Harlie was prepped for surgery by having an IV catheter placed in her leg so she could receive fluids and medications during and after surgery. After being placed under anesthesia and having her surgery site prepped, she was ready to have Dr. Kingus perform the exploratory surgery. Our goal was to be able to find and remove the rest of the Easter grass, or anything else she may have eaten. Once in surgery, Dr. Kingus made an incision in Harlie’s abdomen and began by carefully examining her intestines inch by inch. She also examined the intestinal color of the intestines to make sure they were healthy. When Dr. Kingus was finished and had seen that her intestines were healthy and in working order, she moved on to Harlie’s stomach. She made a small incision in her stomach, and then used a hemostat to gently probe the inside. When doing this, Dr. Kingus could tell that there was something in there that didn’t belong. When she pulled the hemostat back out, clasped inside was a ball of still brightly colored yellow and green Easter grass!! Dr. Kingus was very pleased that she was able to find and retrieve the Easter grass that was causing Harlie to be sick. After making sure she had retrieved all of the Easter grass remnants, Dr. Kingus examined her intestines one more time and took a look around her abdomen just to be sure that everything appeared normal and healthy. Once she was satisfied that she had removed all the Easter grass and made sure there was nothing else abnormal, she sutured the incision in multiple layers, and Harlie was moved out of surgery to recovery with Ashley.  While in recovery, Ashley made sure that Harlie’s core body temperature was normal, her fluids continued to run well, and that she was waking up from anesthesia comfortably. Harlie’s surgery was a success and she appeared to be doing great!

Harlie continued her stay with us for a few more days to receive special care and continue IV fluids. Because she had an abdominal surgery, it was also very important to keep Harlie from being active. It was also imperative to get Harlie eating again by feeding her very small but frequent meals of a highly digestible canned food made for pets with special digestive needs. Since Harlie’s stomach had an incision, it was important that she only receive a small amount of food to eat at one time. Over the course of 4 days, Harlie continued to receive IV fluids, antibiotics and pain medications, and was fed her special feeding regimen. She was feeling and looking great and was ready to go home.

On Monday, Harlie’s IV fluid therapy was stopped. After Dr. Kingus examined her, she gave Harlie the OK to go home. At home, Harlie’s family would have to continue her frequent meals for a while and keep her activity limited. With special TLC at home, she is expected to make a full recovery and be just fine! It appeared as though her family brought her in just in time, making Harlie’s surgery and recovery a lot less invasive. We hope that next time Harlie thinks twice before munching on something other than what’s in her food bowl. On second thought, maybe the “Easter Bunny” should just skip over her house next year!

Crazy case #2-Little Lazarus

24 Feb 2011 1 Comment

by Frey Pet Hospital in Crazy Cases

This is a case that was indeed crazy…and scary…..and miraculous….all with a happy ending. We would love to tell you about Gracee. Gracee is a bouncy, tiny, adorable 18-week-old Yorkshire Terrier. When we met her, we loved all 1.5 lbs of her!

  Being so small, it is advised that small breed puppies are fed multiple meals throughout the day to avoid low blood sugar, especially those as small as Gracee. So when her owners brought her in one Saturday morning because she was non-responsive, our first instinct was that her blood sugar had dropped dangerously low. Her owners were aware of this possibility, so they had tried to give her a NutraCal supplement and some sugar water. Dr. Kingus and Tara (one of our certified veterinary technicians) were on the case immediately and checked her blood sugar, which was normal. Dr. Kingus advised to give Gracee a dextrose solution as a precaution. At this time, Gracee’s temperature was too low to register on our thermometers. Tara and Dr. Kingus quickly got her to a heating pad, and also placed a warm IV bag next to her and kept her bundled up to help raise her body temperature. When a dog’s temperature reaches below 92 degrees, their body starts to go into a “reserve mode” and will slow other parts of the body to help and save vital organs. Our first goal was to get Gracee stable! While keeping her warm, Tara attempted numerous IV catheters in Gracee’s legs. However, Gracee’s veins were very delicate given her small size and her current condition. Tara was quick to assess the situation and successfully placed an IV catheter in Gracee’s jugular vein. Once the fluids were going, more bloodwork was drawn to further assess her condition.

  The day before, Gracee’s owners had brought in their other dog Selah, for routine care and had brought Gracee along for the ride. They had mentioned that Gracee’s nose had been runny but was otherwise doing great. Dr. Kingus examined Gracee and prescribed antibiotics for an upper respiratory infection. Now back in the next day with normal blood sugar, Dr. Kingus quickly suspected complications from her infection and administered an IV antibiotic. At this time, Gracee was vocal and breathing. A few moments later, she had a white foamy liquid coming from her nose and mouth, her heartbeat was very irregular and faint, and Gracee was agonal breathing. Agonal breathing is a breathing reflex of the body in last effort to try and get more oxygen into the body, and will appear that the pet is ‘gasping’ for air.  At this time, Gracee was immediately placed on oxygen while Dr. Kingus gave her a dose of Epinephrine. Epinephrine is a drug that basically stimulates and “jumpstarts” the heart, similar to an adrenaline rush. While Tara administered CPR to Gracee in effort to save her life, Dr. Kingus notified Gracee’s owners of her poor condition and prognosis. At this point, Gracee’s heart was very faint and barely beating.

 When Dr. Kingus returned to the treatment area to check on Gracee, Tara gave her some surprising news! Gracee was starting to breathe regularly, and her heartbeat was stronger and more regular! It appeared that the Epinephrine had finally kicked in and gave Gracee the tiny boost she needed to continue fighting for her life. It was nothing short of amazing! Gracee was finally stable, so Dr. Kingus ordered an X-Ray of her chest so she could assess the condition of her lungs. The radiograph confirmed Dr. Kingus’ theory that Gracee did indeed have a severe infection in her lungs and chest that was just too much for her little body, thus causing her health to decline so rapidly. Dr. Kingus updated Gracee’s owners on her findings and on her current condition. They were so thankful to hear that Gracee was improving! We invited them back to the treatment area to hold her and stay with her while she was still receiving supplemental heat and fluid therapy. Gracee’s temperature was also increasing; another promising sign that Gracee would be okay! She started to have more discharge from her nose, which seemed to be causing her to have a little trouble breathing. Dr. Kingus decided it would be best if she was placed in our enclosed oxygen kennel while she received her fluids and heat therapy. Since her breathing was compromised, we wanted each of Gracee’s breaths to be more concentrated with oxygen to help her along.

  Exactly 2 hours after Gracee arrived to our hospital, non-responsive and barely hanging on for her life, she was standing in our oxygen kennel and wagging her little tail! Like a little Lazarus, she had come back to life. Her temp had also returned to normal. She was so active that she even managed to dislodge her jugular catheter, so we removed it and recommended her owners take her out to the Eastern Iowa Veterinary Specialty Center for overnight observation. Gracee has since come in several times for rechecks and is doing wonderful and is as spunky as ever thanks to the quick actions of Dr. Kingus and Tara!! Gracee is a dog that we here at Frey will never forget, and was one of the most astounding “comebacks” we have seen. It just goes to show that it’s not the size of the dog in the fight; it’s the size of the fight in the dog!