Monday, May 28, 2012

Day 6: Description of Parvovirus, Diabetes, Anemia, Description of Gastric Dilatation Volvulus, Liver Tumor, Drain Rinsings, Description of Heat Shock


Today was strictly emergency hours because of the holiday, but it was still fairly busy; we had at least one patient at a time throughout most of the day.  When I first came in today, Lauren was moving a dog named Monstarr, who has parvovirus, into the isolated room (which is the room there we house any stray cats we receive).  Lauren was placing Monstarr into the stray cat room because parvovirus is extremely contagious to other dogs, but it doesn’t affect cats; so that was really the only safe room for Monstarr to be in.  Parvovirus is passed through the feces, so direct or indirect contact with an infected dog’s feces will cause other dogs to pick up the virus.  Symptoms of this virus are lethargy, vomiting, and diarrhea.  Also, the feces of an infected dog have a very distinct smell, which is an automatic, easy-to-recognize alarm if a dog has the virus.  Unfortunately, Monstarr had the virus, so she has to stay isolated from other dogs and her family for a few days while we observe her, give her antibiotics, and allow her to rest.
           Monstarr resting right after being moved to her cage in the stray cat ward.
A second patient I was able to see today was Jetta, a tabby cat who had been at the hospital since yesterday.   Jetta has diabetes, and unfortunately for her, her owners never really seemed to take that fact into consideration when it came to what they fed her, the amount they fed her, and when they fed her.  Nancy told me that a normal, healthy range for a cat’s glucose is 110-220, but Jetta’s glucose was at a mere 41 today.   Yesterday, however, her glucose had been extremely high; so it’s strange that her glucose levels took such a dive, and really strange that her levels were so drastically above or below the healthy range.  Dr. Christy told me that since her owners never really paid attention to her diabetes, her body was all out of whack and not metabolizing sugar properly.  Since she had so little insulin being produced, the body was breaking down fat instead of glucose, which created acid groups called ketones.  These are extremely harmful to the body, and if they build up they can lead to diabetic ketoacidosis, which in turn can cause death.  This poor cat was so weak she wouldn’t move, eat, or drink.  She was being given fluids, antibiotics, and some insulin, but she still seemed to be in a really bad state.  Lauren tried to get her to eat and drink, but she wouldn’t.  The Vets and technicians kept checking blood and urine, but she didn’t seem much better when I left for the evening.  I’ll have to check on her tomorrow and see how she’s doing.
Jetta after we triedn to feed her. She didn't chew or swallow and doesn't move or change positions unless we do it for her.

A new patient we had today was a cocker spaniel named Mr. Knightley.  He had anemia and liver problems, so he was receiving a blood transfusion and receiving the antibiotics of Flagyl (aka Metronidazole, helps with intestinal infections), Ampicillin (helps clean the urinary tract), and Cerenia (helps with nausea). Anemia is the deficiency of red blood cells and/or hemoglobin, which is why he was receiving the blood transfusion.  He was quite pale and weak this morning when he came in, even his gums were nearly white; but thankfully he got better and better and perked up as the day went on.
                                                                       Mr. Knightly
Mr. Knightley's gums.  As the picture shows, his gums are pretty pale.  This is improved color from what they were when he first came in; his gums were pretty much white at that time.

We had two cases within the past two day which either involved CPR, or almost involved CPR.  The first case was with a bulldog named Reagan.  He came in yesterday (when I wasn’t there), so I didn’t actually see what had happened but the Veterinarians and technicians told me what had happened: his stomach had bloated and twisted 180-degrees sometime while he was at home; since the stomachs of dogs hang down, this can happen quite easily, especially with medium-sized and larger dogs.  It is really harmful to the dog because it releases toxins and doesn’t allow anything to enter or leave the stomach, which prevents the dog from getting nutrition and from releasing digested food, and causes the stomach to bloat even further.  Because the blood supply is being cut off to and from the stomach, the stomach tissue begins to die.  This can result in death, so the dog needs to be taken to the hospital right away when this happens so that he/she can receive the surgical procedure that will fix his/her stomach.  Reagan’s family rushed him into the vet hospital as soon as they discovered his stomach had twisted, but right after he had gotten to the hospital his body had arrested (stopped breathing) and he passed away.  Dr. Amanda and Dr. Karen performed CPR on him, and thankfully they were able to bring him back to life.  They rushed him into surgery and they untwisted his stomach, and he has been in recovery since that time yesterday.  From what I saw of him today, he seemed pretty healthy!  He was energetic and eating, which of course were very good signs, and he was able to go home during the afternoon today.
Reagan
Side view of Reagan.  His stomach is still a little bloated, though it isn't nearly as bloated as it was yesterday.

The second case that almost involved CPR was with a cat.  A family brought in an orange tabby cat named Pumpkin whom had hyperthyroid issues.  He had been having trouble breathing and was very lethargic over the course of the past few days, but the family didn’t bring him in to get him checked out (which I don’t understand) until today.  However, he had died on the way over to the hospital, and by the time we had him in our hands it was too late to try and save him; Dr. Christy was going to attempt CPR but then realized from quickly checking the cat that it was too late.  It was really unfortunate.   While we were trying to find out what exact cause of Pumpkin’s death was, Dr. Christy found a huge tumor in his liver.  She let me feel it through his skin, and it was huge and as hard as a rock.  If that had anything to do with his death, I’m not sure; we didn’t really find what the exact cause of his death was, but I‘m sure the tumor and hyperthyroid all contributed to it.  We made a remembrance paw print for his family, bagged him with a tag including his name and information, and placed him in the freezer outside for All Paws.
Pumpkin after he was taken out of his carrying crate; Dr. Christy had just felt his pulse and breathing and discovered he was dead (and had been for a little bit), and she is feeling the liver tumor right now.

Some miscellaneous and/or smaller cases we had today were a pug with cornea issues, a stray snake, a checkup for Buddy, and a Pomeranian-Keeshond mix that had a fractured pelvis.  Pugs are a breed of dog that genetically don’t produce a lot of tears, and because of this they can have cornea issues.  Dr. Christy checked his eyes and gave him some eye drops to keep his eyes moist, and he was placed in the dog ward for some observation.  The snake had been found by someone along a road near where he lived, so the snake was caught and brought in.  Buddy was a dog that had gotten into a car accident around Tuesday night of last week (he came in after I had left for the evening that day), and he was just getting a checkup to make sure he was healing properly and that his drains had been working properly.  He was healing up fine and his drains were working wonderfully, so Dr. Christy cleaned off dried blood (his family never wiped the blood or dried blood off of him), took the drains out, and he was able to go home again for the time being.  The Pomeranian-Keeshond mix was named Lou, and he had a fracture pelvis.  He was given a morphine shot to lessen the pain, and was given painkillers to take home.  He too was able to go home after he was checked out.  The remaining Chihuahuas who had eaten the castor beans, Ninja and Oreo, were able to leave and go home over the weekend as well.
The pug and his dry eyes
Dr. Christy testing and flushing the drains in Buddy.
Buddy after being all cleaned up and having his drains removed.
The stray snake.  I'm not sure what is going to happen with him.
Lou.  He didn't seem to be in much pain when I saw and held him, so hopefully his pelvis wasn't completely broken and/or the morphine was starting to work.

The last major case of the day before I left was a beagle named JoJo whose body was going into shock, and he was having bloody diarrhea.  His family had been playing and exercising with him outside in the sunny, hot, 95-degree weather for over an hour, and JoJo had heat stroke.  To cool him off, his family hosed him down with cold water, which sent his body into shock and he started throwing up and having explosive and bloody diarrhea.  The poor guy looked so sad in like he was in such pain when he arrived.  He was cooled off too quickly with water that was too cold, which was causing his hypothalamus (a gland in the forebrain that coordinates autonomic nerve and the pituitary gland) to act up and think he was still warm because he had been cooled off so quickly.  His body temperature was low (around 98-degrees) so we gave him fluids, and worked on warming him up.  We wrapped him in about five thick blankets, placed him on a heating pad, placed another heating pad on top of him because his temperature continued to drop, and a bunch of us were half hugging, half laying across him so he could absorb our body heat.  His body heat dropped from 98.9oF to 98 oF, then 96.7 oF, then97.6 oF, then 97.3 oF, then to 96.5 oF,  and after about a half hour of warming him his body temperature finally started going back up towards 97 oF.  We were really worried for a while because if his body temperature continued to drop, it could have gotten to the point where the odds of us being able to save him would have been pretty slim; but luckily, we didn’t reach that point because he began to slowly warm up. Throughout this warming period, the only real obstacle we faced was that he tried to get up and off the heating pad a few times, and the bloody diarrhea kept coming and getting all over his blankets and towels. We continuously had to change the cloths and clean up the messes so he wouldn’t be covered in his own blood and fecal matter.  As I had said before all we wanted to do was make him better because we could tell he was upset about it and didn’t feel good, so the fact that we were able to get his temperature to start rising was a really good sign.  We moved him to the dog ward, and when I left he was still warming up but also still having the bloody diarrhea, so I will check on him again tomorrow to see how he is recovering and feeling.
Poor JoJo.. This was his facial expression throughout the majority of the time that we were treating him.


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