Sunday, June 10, 2012

Day 14: Hookworm, Bladder Stones, Corneal Ulcer, Paralysis, and Leptospirosis

                Today when I first came in, there was a dog that had hookworms.  A dog can get hookworms by two ways, either from ingesting his/her mother’s milk as a puppy, or from ingesting dirt.  Hookworms live in the small intestines, where they attach to the lining and suck blood and tissue.  This can cause severe blood loss as well as malnutrition, and puppies can die within a few weeks of obtaining the parasite.  In addition to blood loss and malnutrition, dogs will have will have bloody and dark diarrhea.  Adult dogs will start passing hookworm eggs with their fecal matter after having the parasite for a couple of weeks, which is how other dogs can obtain it (it they eat dirt/grass, or if they get the dirt on them and then ingest it while cleaning themselves).  Blood loss (resulting in paleness), malnutrition, and bloody/dark diarrhea are really the only signs besides finding eggs in the fecal matter, so sometimes it can be difficult to detect if the owner isn’t keeping a watch out for these symptoms.   Dr. Todd gave her some dewormer medication, and told her owner to come in for a recheck in about a week/week and a half to make sure all the worms are gone.
A diagram of the life cycle of hookworm.

A hookworm as seen under a microscope.

An enlarged view of a hookworm's mouth, with the teeth it uses to hook onto the lining of the small intestine.

A hookworm egg as seen under a microscope.  These are typically found in the fecal matter of animals.  A fecal sample is how a Veterinarian can definitely tell if the animal has hookworm or not.

                Some of the smaller appointments we had today were a ferret with blood sugar problems, a Dalmatian with bladder problems, and a Yorkshire Terrier named Meme with a corneal ulcer.  The ferret was being checked to see if he had Insulinoma, which is a tumor of beta cells (insulin-producing cells) in the pancreas that causes the body to make excess insulin, therefore causing glucose deficiency.  Dr. Todd checked his blood sugar with a blood glucose monitor, and the blood sugar reading was low (65 mg/dL) in comparison to a normal reading (90-125 mg/dL), but Dr. Todd said it wasn’t low enough to be diagnostic for Insulinoma.  After checking the glucose reading, Nancy gave the ferret 25 cc’s (cubic centimeters, same as 25 mL) of lactated Ringer's solution, which is the same thing as the sub-q (subcutaneous) fluids that go under the skin into the subcutaneous tissue layer to hydrate the animal (the fluids will form a fluid bubble under the animal’s skin, and the fluid inside will slowly disperse throughout the body over a given time period.  This is a very effective way of hydrating an animal).  After the ferret, we had the Dalmatian who was having bladder problems.  Dr. Amanda took a urine sample and tested it to see what was wrong.  While she was looking at the urine and analyzing it, I helped Dr. Todd with Meme.  After Meme was taken care of, I asked Jen what happened with the Dalmatian and she said that he had bladder stones and a possible bladder infection, and he needed antibiotics and a surgery in order to get rid of the stones and infection.  However, the owner couldn’t afford surgery, so we will have to see what happens with the Dalmatian.
The ferret getting his blood glucose checked.

The Dalmatian with the bladder stones and possible bladder infection.

                Meme was very tiny, and I held her for Dr. Todd as he looked at her eye.  He placed some staining drops in her eye (which stained her eye green momentarily and allowed him to see the ulcer), and then inserted some numbing drops in her eye so she wouldn’t feel anything touching her eye.  In order to have the corneal ulcer heal, he took a clean needle and gently began to lightly scrape the ulcer part of the eye.  He explained to me that this scraping would cause blood vessels (hence more blood) to the ulcer, which would cause the ulcer to heal.  He also gave the owner some antibiotic drops when he was finished scraping the cornea, so hopefully Meme’s ulcer will be healed within a few days.   Dr. Todd also then continued working on Faith (the constipated cat from yesterday).  The saline solution he injected into her colon didn’t help soften up the stool, so he spent a while trying to break it up again.  However, he was able to get the majority of the rest of the stool out, so that was good and Faith seemed to feel better when she woke up from the anesthesia.
Meme, the Terrier with the corneal ulcer. 

Dr. Todd using a needle to gently and lightly scrape the ulcer in order to draw blood to it so it would heal.

There weren’t any appointments for a couple of minutes after Meme, so I walked around the recovery room to see the new patients we had.  There was a Domestic Short-Haired cat named Pogo with renal failure, a Long-Haired Chihuahua named Precious with chronic heart failure, a lab named Nickson who had Calcinosis Cutis, and Jack, the boxer from yesterday who had gotten attacked by another dog.  Pogo is an 18-pound cat who had eaten a lily, which are poisonous to cats.  The exact reason as to why they are poisonous is unknown, but ingesting even a little part of the plant can cause renal failure and death if not treated quickly enough.  When he came in he was vomiting and being very lethargic, and he was receiving plenty of fluids and antibiotics.  Precious, as I stated before, had chronic heart failure and he was receiving oxygen while also being on the antibiotics Furosemide (used to treat edema, which is where watery fluid collects in the cavities and tissues of the body, and causes increased passing of urine), Vetmedin (used to manage congestive heart failure in dogs by helping the heart pump more efficiently), and Benazepril (helps treat high blood pressure and congestive heart failure by dilating the blood vessels to allow better blood flow).  Nickson has had a case of the skin disease Calcinosis Cutis, which is where calcium deposits form in the skin.  This disease is caused by local skin damage, and the cause can be either dystrophic or metastatic.  Dystrophic means that local factors cause the damage leading to calcification, and metastatic means that there is too high of a calcium concentration in the blood, which leads calcium deposits in the locally damaged tissues.  Nickson has had this disease for a little while, and he was coming in to get checked.  His skin condition has improved a bit, which is good.  After Nickson, Jack came back in today to have his bandaging changed, so Dr. Amanda changed the bandaging for him and he was all set to go back home.
Pogo, the cat that ate a lily.

Precious, the chihuahua with chronic heart failure.

Nickson, the lab-mix with Calcinosis Cutis. 


The two last patients I assisted with today before I left was a beagle named Buddy, and a beagle mix named Boomer.  Buddy came right before I left.  His owner brought Buddy to the hospital with the decision to euthanize him.  Buddy’s back legs were paralyzed, and he couldn’t control his bowel movements anymore.  He was also ill (with specifically what, I don’t know), so his owner decided it was time to put him out of his misery and put him to sleep.  Boomer had been here all day because he was a lepto (Leptospirosis) suspect, and he was vomiting.   Lepto is an extremely contagious bacterial disease (to other dogs, animals, and humans) that is spread through urine (so if a dog who has lepto goes to the bathroom in a park and another animal or person touches it somehow, they can get the disease).  Lepto causes massive aches, inflammation, and fevers, and lots of rest and antibiotics are needed to get rid of the disease.  Like I said, we didn’t know for a fact if Boomer had the disease or not, he was just a suspect.  He threw up a couple of times as the day went on, and he was resting in his cage a lot as well as receiving plenty of fluids with Ampicillin, Baytril, and Cerenia.  The Ampicillin and Baytril were both fighting the bacterial infection (the Ampicillin specifically fighting the infection in the urinary tract), and the Cerenia was helping to calm the vomiting.  Unfortunately, Boomer became really bad in the afternoon, to the point where he wasn’t moving anymore and the doctors couldn’t think of anything else they could do for him.  Dr. Amanda called the owners and told them what was going on, and she suggested euthanasia so he wouldn’t be suffering anymore.  It was either that, or hope that he would recover over the next couple of days; though of course, there was no guarantee of that happening, and Boomer would be in a lot of pain if they chose to not euthanize.  When the family came to see him, they decided to euthanize him and were really torn up about it.  I helped Nancy take them into a private room with Boomer, where they stayed until they were ready for a doctor to come and euthanize him.   After he passed away, Lauren made a clay paw print for the family, and Nancy wrapped him and placed him in the freezer in the back.
Buddy, the paralyzed beagle.

Boomer, the beagle-mix who was the possible lepto suspect, and who became very ill as the day went on.

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