I was reading Trauma Queen blog and his comment about fitting in a patient (although it was more complex than that and fitting was only a part of it) reminded me of some of the cases l have been involved with.
One of the ones that sticks in my mind was the 2 Labradors (not the real breed) that came in both fitting. You do not get that unless they have access to toxins but the owners swore blind they did not.
We pinned the dogs and got iv catheters in and a hopeful bolus of diazemuls/weight to stop the fitting.
They bolus did nothing so a second then a third followed. This stopped them for about one minute and they started again, going by that the dogs were in deep trouble and would need stronger drugs.
The first test on a simple glucometer with the blood from the catheter stylet drew paydirt part one, they had almost no blood sugar in them. We drew up a “hit” of glucose and put it into them.
The fitting continued and we tried another cocktail of anticonvulsants this slowed them for a couple of minutes but they still twitched. A quick ear prick to check glucose and it was 1. That was crazy it should have been climbing upwards. I called the results over to vet who was gazing at the drugs wondering which he should do and his cussing matched mine.
The vet got me to double the glucose bolus and went to speak to the owners. Coming back with the info the owner was a diabetic on insulin tablet control but swore blind he had all his tablets. The most likely case was he had miscounted in a panic at the dogs fitting, there was no blame as there shouldn’t be in accidental cases, they are that accidents. Ultimately reasons didn’t matter. The 2 dogs were in deep trouble and uncharted waters.
The vet went for the big guns. He set up 2 Propofol infusions using a high dose glucose drip (extra glucose added to a glucose saline drip). Propofol is a drug that looks like milk and used in humans and animals to induce anaesthesia. If you have had a general anaesthetic and the Dr looked like he was about to inject milk, he was probably using Propofol.
Being mixed into a drip and going into the patient at a set rate sends patients into a deep anaesthetic and stops the fitting. The time the patient is under varies on the condition the main criteria being “the shortest possible time” for the problem to resolve.
The patient is allowed to wake up slowly over a period and is observed to see that the fitting has stopped. If it hasn’t or starts again and is not controllable with other drugs they are once again seen into a deep sleep.
The 2 dogs continued to fit so we pumped more and more glucose into them. The magic barrier was 2.5 on the glucose scale. Not for any reason other than it was higher than we seemed able to get and hold them. They would get to 2 and within minutes they would slide back again towards 0.7.
With each glucose bolus “hit” the fitting would slow down to a twitch then within 5 minutes would start to fit. Without the Propofol control they were totally out of control. The longer (and harder) they fitted the more chance their brains would overheat burn out and their organs would be permanently damaged. Not counting what was being done to them with the lack of glucose.
I cooled them as best as l could with wet towels, fan’s and ice packs. The night was luckily quiet on patients and callers so it allowed us to concentrate on these two.
By about 4am we were becoming desperate for glucose. We woke the practice manager and made his night by getting him to go and raid the other surgeries for all their glucose products. We were throwing everything at these dogs, glucose syrup on the gums, Glucagon, injectable iv glucose and glucose No18 drips. The highest we got their glucose was 2 for a short time mostly it was around 0.7 to 1.5.
Around 4:45am we were loosing the patients. The dogs had come in at about 24:00 and had been uncontrollable since then. If we could control the fitting the glucose may have a chance to work, depending on what else had gone wrong that was not showing yet.
We used to have a drug called Sagital which is basically Pentobarb, the drug used to put animals down with but at a much lower concentration. This was discontinued in around 2004 and much lamented, it was ideal for fitting animals. It was then we switched to Propoflo drips.
I remember when the word came out about it going to be withdrawn and the vet l was on with checked out the % difference between Sagital and Pentobarb (for putting animals down).. just in case. I also wrote the dilution down as l worked with different vets.
Taking a breath l asked the duty vet what about diluting down Pentobarb to the Sagital dose and using that as a last ditch. He is very experienced and was a certificate holder in anaesthesia, even he baulked at the idea but we had run out of ideas. He rang the owners for permission as there was a good chance even diluted we would kill them in their state, permission was given.
He diluted the drug down and took a deep breath. Slowly he trickled it into the first dog and the fitting slowed and stopped. Then number 2 dog and the same result. We stood and stared at them and the clock.
2minutes... no fit…
3minutes... no fit…
5minutes... no fit…An ear prick at 5mins showed the last glucose bolus had taken the glucose from 0.6 to around 1.7 things had to be looking up the dogs were due a lucky break.
By 10 minutes there was no fitting but the glucose was dipping to 1 so more glucose bolus.
20 minutes and they still hadn’t fitted; they had more glucose boluses as their blood glucose fluctuated like a fluttering butterfly wing.
25minutes and they hit the magic 2.5 were we to early to think the prayed for miracle was coming that the 2 dogs may just make it against all odds.
30 minutes and 2.8 on the glucometer..
Suddenly then the dreaded twitches on dog two followed almost at the same time by dog one, more of the dilute pentobarb and it stopped again, but the glucose continued to fall back to 0.7 we managed to stop it there.
The glucose wouldn’t climb any more but the fitting had stopped, ok one out of two we could work on those odds just so long as we had glucose we hoped to hold the tide until it turned back in our favour.
By 6am the first dog had started to deteriorate and show other signs to the fitting. The vet rang the owners for permission to put the dog out of his misery they agreed, and were warned that dog two would probably end up the same as the first dog within a short time, probably minutes as they had mirrored each other step for step. In fact as the vet spoke on the phone dog two was showing similar signs.
The owner requested euthanasia for both dogs. As brothers in life they were inseparable, in death they would still be together.
I confirmed the request with him for the vet as it was over the phone and not in writing, a job l hate as you have to get the owner to repeat the request, not nod or just sign a piece of paper.
Wherever the insulin had come from, and it could only be that, it had done its job and pulled the glucose from the bloodstream.
By 06:10 both dogs were dead, the war was lost.
Showing posts with label Toxicity. Show all posts
Showing posts with label Toxicity. Show all posts
Sunday, 3 January 2010
Saturday, 12 December 2009
Shootings, Chocolate and Work
Sorry it has been so long since l wrote or replied. I have been on the good old work treadmill but covering 2 different practices, several days going from the day shift to the emergency job to cover part of the late evening shifts. That means that l have only really glanced at the computer to tired to bother.
Then this week l got hammered with this bug that is going around and have had about enough energy to get me from shift start to shift end with nothing left over.
High temperatures and hacking cough is not my idea of fun. I may as well have lived in a sauna l have been so sweated out.
All l want is to get fit, l have just got over my last problem of 3 weeks cold and laryngitis but it seems health must wait.
Food has been on my list of l can’t face much and l have had so much chicken broth l am about to start to crow.
On the work front the feeling of good will seems to as usual be lacking to many animals. There has been a lot of older abandoned dogs appearing needing veterinary care, mainly for cold and arthritis. Stray puppies are doing the odd guest appearance but they won’t really start to hit till Xmas day and beyond.
Last week we had a cat in that was owned. It looked to have been attacked by a dog and was full of holes. We gave a quick x-ray to check for ruptured diaphragm (from being shaken) or any other x-ray obvious injuries and lo some scum had shotgun’ed the cat.
I lost count at 35+ pellets, it is not easy to count them your eyes tend to get confused.
He was quite bright considering the holes in him. His tail will probably have to come off as that has been fractured in what’s called a high tail base fracture, thankfully his urination isn’t affected.
He had a pellet removed from his stomach and a couple from his intestine. Some may need removal from his legs but the majority will be left as it is better than going aimless hunting and if they are not causing a problem then they are left.
The same night we had a small terrier in. His owners had gone out and come back to find their house broken into and the dog stabbed once into the chest.
Air had leaked under the skin and he was very blown up. His skin felt like bubble wrap as the air rippled under it in the fat, not a nice feeling. He was stabilised overnight and a thoracotomy sorted him out.
Parvo dogs have been pouring in. One night we had 4 in isolation and one stray with kennel cough. The small day practice l have been at has also had several parvo dogs in.
Good old Xmas poisonings are starting to make their way in as well, raisins, grapes and chocolates top the charts at the moment.
I am not a fan of American Bulldogs. The ones l know have all been darn right nasty. That has changed and l have fallen for a big lump of one.
He came in because he had eaten a tea-towel, socks and a few other items, apparently the breed is as bad as Labradors for scavenging. All l have known the AB to scavenge though is human body parts, whichever its teeth can close on. The socks and other items reappeared, tea towel hadn’t.
What a sweet dog, stood there while dripped just trying to give sloppy licky kisses. Post op he was in a walk in on a duvet and then l wrapped him like a big sausage roll in a flower duvet. All you could see all night was his nose, even awake he snuggled in.
A couple of days later he came into the small day practice l am at for an op check. He was a bit subdued still but gave me a nice welcome. I chatted to the owner while Bruno (not his name) sat on my lap trying to give more sloppy kisses while l sat on the floor in reception. Apparently his sister had a pair of pyjamas removed from her not long ago.
2 days after that Bruno came back in for another check and he bounded in. He heard my voice as l came round the door to greet him and almost knocked me over.
His long suffering wallet….sorry owner, said he had removed some newspapers from Bruno that day so he was on the mend.
They do try and keep him separated from items but with kids on hand l don’t think it is too easy.
The American Bulldog is a very powerful breed and needs to be line checked carefully for temperament especially and health. I had a history lesson on the breed in the UK and it was the usual. Bad lines brought over from USA and bred with garden breeders for money.
Then a few dogs carefully chosen and brought over from USA by a breeder and bred but a higher price and carefully checked potential owners. Bruno comes from the careful lines and it shows, too many do not.
The emergency hospital is part of a corporate setup and they have upset the whole night shift. There was an Xmas party H/O said they would pay £25 they were quids in. It was to difficult for the majority of us to get to and day shift were going enmasse, and quite frankly was not really anyone’s on nights cup of tea, a drunken night out with non work friends. Not that we do not like them just they are a different world and most day and night shifters do not really meet.
We wanted a nice get together, chat laugh and just unwind so we organised our own, although l am a locum l am included as l spend so much of my life there and doing stupid shifts and getting them out of the brown stuff.
This split party had been done other years. There is a whole setup of night shift starting at 13:00 in the afternoon and ending at 8am, collection drivers, vets, veterinary nurses, receptionists, auxiliaries. Some staff were not going to go to bed, others missing a couple of hours of shift and going it at about 15:00 not 13:00 (day shift were fine about that) Some of us due to work that night and forgoing a full days sleep. It meant we could all get together and have a lunch time gathering. The place chosen was an all you can eat pub. £5.99/head.
The practice manager rang up H/O on Tuesday to get final clearance and was told tough they should have gone to the night meal. The fact it meant that out of 20 who put their name down for the day meal about 5 could have gone to nights was not their problem.
A letter signed by a lot of us has been sent in not that we expect it to do any good. Night shift is a set group of people who only do nights and unsociable hours. There is bank holidays and weekends and all those family gatherings they miss. If their normal work pattern falls on a weekend they do not get extra. They get less holiday than days and less for covering bank holidays. Yet again night shift has been shafted.
Then this week l got hammered with this bug that is going around and have had about enough energy to get me from shift start to shift end with nothing left over.
High temperatures and hacking cough is not my idea of fun. I may as well have lived in a sauna l have been so sweated out.
All l want is to get fit, l have just got over my last problem of 3 weeks cold and laryngitis but it seems health must wait.
Food has been on my list of l can’t face much and l have had so much chicken broth l am about to start to crow.
On the work front the feeling of good will seems to as usual be lacking to many animals. There has been a lot of older abandoned dogs appearing needing veterinary care, mainly for cold and arthritis. Stray puppies are doing the odd guest appearance but they won’t really start to hit till Xmas day and beyond.
Last week we had a cat in that was owned. It looked to have been attacked by a dog and was full of holes. We gave a quick x-ray to check for ruptured diaphragm (from being shaken) or any other x-ray obvious injuries and lo some scum had shotgun’ed the cat.
I lost count at 35+ pellets, it is not easy to count them your eyes tend to get confused.
He was quite bright considering the holes in him. His tail will probably have to come off as that has been fractured in what’s called a high tail base fracture, thankfully his urination isn’t affected.
He had a pellet removed from his stomach and a couple from his intestine. Some may need removal from his legs but the majority will be left as it is better than going aimless hunting and if they are not causing a problem then they are left.
The same night we had a small terrier in. His owners had gone out and come back to find their house broken into and the dog stabbed once into the chest.
Air had leaked under the skin and he was very blown up. His skin felt like bubble wrap as the air rippled under it in the fat, not a nice feeling. He was stabilised overnight and a thoracotomy sorted him out.
Parvo dogs have been pouring in. One night we had 4 in isolation and one stray with kennel cough. The small day practice l have been at has also had several parvo dogs in.
Good old Xmas poisonings are starting to make their way in as well, raisins, grapes and chocolates top the charts at the moment.
I am not a fan of American Bulldogs. The ones l know have all been darn right nasty. That has changed and l have fallen for a big lump of one.
He came in because he had eaten a tea-towel, socks and a few other items, apparently the breed is as bad as Labradors for scavenging. All l have known the AB to scavenge though is human body parts, whichever its teeth can close on. The socks and other items reappeared, tea towel hadn’t.
What a sweet dog, stood there while dripped just trying to give sloppy licky kisses. Post op he was in a walk in on a duvet and then l wrapped him like a big sausage roll in a flower duvet. All you could see all night was his nose, even awake he snuggled in.
A couple of days later he came into the small day practice l am at for an op check. He was a bit subdued still but gave me a nice welcome. I chatted to the owner while Bruno (not his name) sat on my lap trying to give more sloppy kisses while l sat on the floor in reception. Apparently his sister had a pair of pyjamas removed from her not long ago.
2 days after that Bruno came back in for another check and he bounded in. He heard my voice as l came round the door to greet him and almost knocked me over.
His long suffering wallet….sorry owner, said he had removed some newspapers from Bruno that day so he was on the mend.
They do try and keep him separated from items but with kids on hand l don’t think it is too easy.
The American Bulldog is a very powerful breed and needs to be line checked carefully for temperament especially and health. I had a history lesson on the breed in the UK and it was the usual. Bad lines brought over from USA and bred with garden breeders for money.
Then a few dogs carefully chosen and brought over from USA by a breeder and bred but a higher price and carefully checked potential owners. Bruno comes from the careful lines and it shows, too many do not.
The emergency hospital is part of a corporate setup and they have upset the whole night shift. There was an Xmas party H/O said they would pay £25 they were quids in. It was to difficult for the majority of us to get to and day shift were going enmasse, and quite frankly was not really anyone’s on nights cup of tea, a drunken night out with non work friends. Not that we do not like them just they are a different world and most day and night shifters do not really meet.
We wanted a nice get together, chat laugh and just unwind so we organised our own, although l am a locum l am included as l spend so much of my life there and doing stupid shifts and getting them out of the brown stuff.
This split party had been done other years. There is a whole setup of night shift starting at 13:00 in the afternoon and ending at 8am, collection drivers, vets, veterinary nurses, receptionists, auxiliaries. Some staff were not going to go to bed, others missing a couple of hours of shift and going it at about 15:00 not 13:00 (day shift were fine about that) Some of us due to work that night and forgoing a full days sleep. It meant we could all get together and have a lunch time gathering. The place chosen was an all you can eat pub. £5.99/head.
The practice manager rang up H/O on Tuesday to get final clearance and was told tough they should have gone to the night meal. The fact it meant that out of 20 who put their name down for the day meal about 5 could have gone to nights was not their problem.
A letter signed by a lot of us has been sent in not that we expect it to do any good. Night shift is a set group of people who only do nights and unsociable hours. There is bank holidays and weekends and all those family gatherings they miss. If their normal work pattern falls on a weekend they do not get extra. They get less holiday than days and less for covering bank holidays. Yet again night shift has been shafted.
Friday, 23 October 2009
Toadstools for Tea
It has been a poisonous time on shift this week not counting the usual cases that we have in.
Had a cat in whose renal parameters were all over the place but the worst was the way the calcium was heading to ground zero on subsequent checks. Given how his bloods stacked the vet was certain it was antifreeze tox. It is so depressing to see a lovely cat folding in and dying his bloods going worse and worse and nothing we could do would help. The vet rang the owner about 2am and had a chat.
A dog we had in had decided on a walk that those yummy orange toadstools growing out that nice smelly pile of cow dung were put there as a meal just for him. Being as he was a Labrador by the time the owner got to him and got him off the “meal” there was not much left.
He had a bad night of hallucinating (we think) as his eyes were like saucers and he was falling all over the place. With the aid of lots of iv fluids and some other treatment at the end of 24hrs he was able to go home with just checks for a couple of weeks.
We were all relieved to see him go because he was farting with a vengeance. To quote the vet “something horrible crawled up the dog’s arse and died” Critical care was so aromatic even with my bad cold l could smell it.
Another Labrador had been pulled off different toadstools [not orange ones] to late and he was very bad. His pcv (thickness of red blood cells) was 76. It should normally be max 55. He was so dehydrated that he did not have blood but syrup in his veins.
He needed fluid flung down his iv in vast quantities. He was shaking and collapsed, he had stinking blood leaking out of his rectum and saliva running like a bath out of his mouth. In fact saliva flowed out of the kennel like a tide onto the floor.
His owners were rung in the middle of the night and warned that it was unlikely he would see the morning and to be prepared for the worst.
Never say never though, at about 4am he was more alert, moved to a comfier position on his own and slowed down salivation. I went to do his stats and he raised his read and checked me out. By change over at 7am his rectal blood had stopped leaking.
He whizzed through 3 litres of fluid in 10hours on my shift, not counting what he had before l got in and more during the day, when l got in l the next night was over the moon to find out he had gone home. Again checks over the next couple of weeks but looking good.
Mind you l recon it was the noisy cat in the kennel above him must have helped keep him awake. He was claustrophobic. He had been in an RTA his back leg was past salvation. They had put a support dressing called a Robert Jones on and he had been going mad the dressing had slipped and it needed changing. The vet decided that if he was in so much pain the leg would come off in the night but in the mean time the 2nd dressing slipped.
He held the cat while l cut it [dressing] off, after first unscrewing the leg a couple of times so it faced the correct way.
We put him back in the kennel to see if he would settle down often animals just can not handle the dressing.
No it was obvious the leg was not bothering him but he loathed the kennel. He would pin himself to the door shaking it and yowling in anger leg whirring in the air. When not pinned to the door he did not even look at his leg but gazed angrily out. Stats were impossible, as soon as l tried to slide open the door l was being attacked by angry cat.
We got too busy for the leg so the vet gave him a very deep sedative and he took several hours to wake up to the agitated state he had been in.
His leg was removed the next day and he was sent home, a bit woozy but he was so stressed, first act on awakening was to attack the door. By now he had made his feelings clear that it was better he was sent home with less strength analgesia treatment instead of keeping him in overnight for stronger as we would normally do.
Yet 2 more dangerous dogs in that were grabbed on behalf of the police with instructions to slide water under the door lob food over the top and don’t go near them. One bit the collection driver the other tried.
Actually it was 3 dangerous dogs but number 3 was a boisterous staffie cross with no manners. We had him out having a game and a hunt the treat time and he was fine with us, what he needed was discipline. The most dangerous thing about him was his snapping for treats so we dropped them on the floor.
Had a cat in whose renal parameters were all over the place but the worst was the way the calcium was heading to ground zero on subsequent checks. Given how his bloods stacked the vet was certain it was antifreeze tox. It is so depressing to see a lovely cat folding in and dying his bloods going worse and worse and nothing we could do would help. The vet rang the owner about 2am and had a chat.
A dog we had in had decided on a walk that those yummy orange toadstools growing out that nice smelly pile of cow dung were put there as a meal just for him. Being as he was a Labrador by the time the owner got to him and got him off the “meal” there was not much left.
He had a bad night of hallucinating (we think) as his eyes were like saucers and he was falling all over the place. With the aid of lots of iv fluids and some other treatment at the end of 24hrs he was able to go home with just checks for a couple of weeks.
We were all relieved to see him go because he was farting with a vengeance. To quote the vet “something horrible crawled up the dog’s arse and died” Critical care was so aromatic even with my bad cold l could smell it.
Another Labrador had been pulled off different toadstools [not orange ones] to late and he was very bad. His pcv (thickness of red blood cells) was 76. It should normally be max 55. He was so dehydrated that he did not have blood but syrup in his veins.
He needed fluid flung down his iv in vast quantities. He was shaking and collapsed, he had stinking blood leaking out of his rectum and saliva running like a bath out of his mouth. In fact saliva flowed out of the kennel like a tide onto the floor.
His owners were rung in the middle of the night and warned that it was unlikely he would see the morning and to be prepared for the worst.
Never say never though, at about 4am he was more alert, moved to a comfier position on his own and slowed down salivation. I went to do his stats and he raised his read and checked me out. By change over at 7am his rectal blood had stopped leaking.
He whizzed through 3 litres of fluid in 10hours on my shift, not counting what he had before l got in and more during the day, when l got in l the next night was over the moon to find out he had gone home. Again checks over the next couple of weeks but looking good.
Mind you l recon it was the noisy cat in the kennel above him must have helped keep him awake. He was claustrophobic. He had been in an RTA his back leg was past salvation. They had put a support dressing called a Robert Jones on and he had been going mad the dressing had slipped and it needed changing. The vet decided that if he was in so much pain the leg would come off in the night but in the mean time the 2nd dressing slipped.
He held the cat while l cut it [dressing] off, after first unscrewing the leg a couple of times so it faced the correct way.
We put him back in the kennel to see if he would settle down often animals just can not handle the dressing.
No it was obvious the leg was not bothering him but he loathed the kennel. He would pin himself to the door shaking it and yowling in anger leg whirring in the air. When not pinned to the door he did not even look at his leg but gazed angrily out. Stats were impossible, as soon as l tried to slide open the door l was being attacked by angry cat.
We got too busy for the leg so the vet gave him a very deep sedative and he took several hours to wake up to the agitated state he had been in.
His leg was removed the next day and he was sent home, a bit woozy but he was so stressed, first act on awakening was to attack the door. By now he had made his feelings clear that it was better he was sent home with less strength analgesia treatment instead of keeping him in overnight for stronger as we would normally do.
Yet 2 more dangerous dogs in that were grabbed on behalf of the police with instructions to slide water under the door lob food over the top and don’t go near them. One bit the collection driver the other tried.
Actually it was 3 dangerous dogs but number 3 was a boisterous staffie cross with no manners. We had him out having a game and a hunt the treat time and he was fine with us, what he needed was discipline. The most dangerous thing about him was his snapping for treats so we dropped them on the floor.
Tuesday, 3 February 2009
Poison Warning
The vetnurse site l go on has posted a warning for us to pass on, have not heard of this before but it is available all over the world:
A popular sweetener found in chewing gum and used in cooking has been blamed for the agonising death of two pet dogs. The case in Australia, being investigated by the RSPCA, has prompted an urgent warning that the artificial sweetener xylitol is highly toxic to dogs and cats. It is not harmful to humans but the amount in one stick of chewing gum could kill a family pet.
The dogs' owners are angry that they had no warning about the sweetener's potential dangers. The family's dogs ate most of a batch of 60 homemade petit fours sweetened with xylitol.
Both dogs vomited late that night and were lethargic and not hungry the next day. They assumed the dogs had bellyache from overeating. It was not until two days later that they realised how sick they were. The dogs were rushed to the vet, but died from internal bleeding.
Australian Veterinary spokesman Dr David Mason said if owners suspected a dog or cat had consumed xylitol, they should rush the animal to a vet within an hour or two to have a chance of a full recovery.
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Apparently Xylitol causes dogs and cats to secrete insulin so the animals blood sugar levels drop very quickly. Liver failure follows and regardless of Intensive treatment the outcome is usually fatal.
A popular sweetener found in chewing gum and used in cooking has been blamed for the agonising death of two pet dogs. The case in Australia, being investigated by the RSPCA, has prompted an urgent warning that the artificial sweetener xylitol is highly toxic to dogs and cats. It is not harmful to humans but the amount in one stick of chewing gum could kill a family pet.
The dogs' owners are angry that they had no warning about the sweetener's potential dangers. The family's dogs ate most of a batch of 60 homemade petit fours sweetened with xylitol.
Both dogs vomited late that night and were lethargic and not hungry the next day. They assumed the dogs had bellyache from overeating. It was not until two days later that they realised how sick they were. The dogs were rushed to the vet, but died from internal bleeding.
Australian Veterinary spokesman Dr David Mason said if owners suspected a dog or cat had consumed xylitol, they should rush the animal to a vet within an hour or two to have a chance of a full recovery.
====*====*====*====*====*====*====*====*====*====*====*====*====*
Apparently Xylitol causes dogs and cats to secrete insulin so the animals blood sugar levels drop very quickly. Liver failure follows and regardless of Intensive treatment the outcome is usually fatal.
Saturday, 20 December 2008
Chocolate Feast
This has been for some reason one of the worst seasons l have known for pets and chocolate. Possibly word is finally getting out or maybe people are just being more careless.
Last night we had 2 “chocolate” dogs in and kept both overnight on drips and treatment as a precaution. One ate chocolate several hours before, the other was more impressive.
He was 15kg in weight (about the size of a cocker spaniel) and the owner rung us up. The dog had eaten an 8pack of mars bars and a pack of breakaway biscuits.
I gave him a little injection in the neck with a rather nasty drug. Nasty because after you have eaten all that yummy chocolate, you are not going to keep it, no matter how hard you try, ahh the bliss of apamorphine.
I sat the owner and partner in a consult room with a load of incontinence sheets and said shove that under when he throws up.
I have to say l haven’t seen so much chocolate come out of a small dog before. The owner was muttering l don’t believe it he got the dairy milk as well, OMG he got the crème caramels, and look he got some quality street.
The vet decided that for safety sake we would keep it in. We did not know how much had been absorbed and the sheer volume had us all shocked as he was just a smallish dog. He had climbed on the counter top into the cupboard while the owners were out. Never done anything like this before, now they had to figure out how to stop future problems.
The photo shows most of the chocolate thrown up but a couple of the sheets of chocolate had been thrown away before l got the photo.
Last night we had 2 “chocolate” dogs in and kept both overnight on drips and treatment as a precaution. One ate chocolate several hours before, the other was more impressive.
He was 15kg in weight (about the size of a cocker spaniel) and the owner rung us up. The dog had eaten an 8pack of mars bars and a pack of breakaway biscuits.
I gave him a little injection in the neck with a rather nasty drug. Nasty because after you have eaten all that yummy chocolate, you are not going to keep it, no matter how hard you try, ahh the bliss of apamorphine.
I sat the owner and partner in a consult room with a load of incontinence sheets and said shove that under when he throws up.
I have to say l haven’t seen so much chocolate come out of a small dog before. The owner was muttering l don’t believe it he got the dairy milk as well, OMG he got the crème caramels, and look he got some quality street.
The vet decided that for safety sake we would keep it in. We did not know how much had been absorbed and the sheer volume had us all shocked as he was just a smallish dog. He had climbed on the counter top into the cupboard while the owners were out. Never done anything like this before, now they had to figure out how to stop future problems.
The photo shows most of the chocolate thrown up but a couple of the sheets of chocolate had been thrown away before l got the photo.
Monday, 3 November 2008
Toxic Flea Treatment
They buzzed down the back. “You have a Bob Martins on the way” These inspiring words mean that yet another person:
1) Has not read the warning on the dog flea treatment box.
2) Tried to treat their cat on the cheap with supermarket/pet shop products
3) This will now cost them either several hundred pounds and/or the cats life or both.
Bob Martins produce 2 types of flea treatment one for cats for use on cats, the other for use on dogs. The dog’s one contains Permethrin. There is a warning on the packet but for some reason people do not “see” it.
I should say that it is not just BM that use it but the name has become the byword for the problem.
Premethrin is a neurotoxin that works by damaging the nervous system. When used on cats it causes anything from tremors, staggering to severe seizures and for many death is the outcome. It is very slow to be metabolized from a cats body so it is a case of supportive treatment.
The cat when it came down was having seizures, his pupils were dilated (large) and black orbs. He was lashing out with blindly then going into violent spasms; actually it was hard to separate the two actions.
He was very scared about what was happening to him and his temperature was up from the seizures.
The auxiliary managed to pin the cat and hold the front leg out for me to place the iv catheter without us both getting badly scratched. A good auxiliary is worth their weight in gold and all too often they are overlooked.
The vet sorted out initial treatment and the cat was given a bolus of Diazemuls to sedate it, this stopped the seizures.
Finally we clipped the oily patch on its back where the owner had applied the spot on, and gave it a quick wash, to help remove residue.
During washing round 2 began and he started to spasm again, l gave him his next bolus to sedate him again, then placed the patient into a kennel in ICU.
The vet had gone off to speak to the owner and l stood by for round 3. Sure enough after a couple of minutes the twitches began again and l gave the next bolus, this stopped the twitching for a couple of minutes but not long enough by any stretch.
By now the vet was back and had a different drug. The owner was filling in consent for treatment and then going home. He decided that he did not want to see his cat, it was to upsetting for him to know what he had caused.
The new treatment lasted for about 10min, then it was overwhelmed by the toxin, and back to “bouncy cat”, it was going to be a stinker of a BM to treat this one.
The vet decided that as the owner had used a large dog spot on, and the cat was so ill he would have to call in the big guns. A 100ml bag of saline was hooked up to the infusion pump and a measured dose of Propofol (used to induce anaesthesia for operations) was placed in the bag. The cat was given a bolus of Propofol directly into the iv catheter to cause an anaesthetic effect. The saline/propofol drip was started to keep the cat sedated for several days. To put it bluntly the cat was placed into a coma to control the seizures.
Oxygen was placed to help his breathing, and he was turned every 2 hours, to prevent lung congestion from being in one position for too long.
24hours later the vets decided to try and lighten the patient and see what would happen. As the patient came lighter, the twitching re-started, a bit longer to see if it would settle, it got worse. The drip was turned up and the patient was deepened down again.
This lightening and deepening was repeated over 3 days.
Eventually the twitches stayed steady and did not progress. It took a further 48 hours for the cat to be allowed totally awake and sedation to wear off.
The effects of the Premethrin took a couple of days more for the body to overcome.
The patient was in for 8 days in total and the cost was over £600 for treatment.
*====*====*====*====*====*====*====*====*====*====*====*====*
The story above is a typical BM tox. case. It vary's from mild twitching and ataxia (wobbly/falling over) and the cat home in a couple of days, to extreme enough to die. Very often they are like the story above.
1) Has not read the warning on the dog flea treatment box.
2) Tried to treat their cat on the cheap with supermarket/pet shop products
3) This will now cost them either several hundred pounds and/or the cats life or both.
Bob Martins produce 2 types of flea treatment one for cats for use on cats, the other for use on dogs. The dog’s one contains Permethrin. There is a warning on the packet but for some reason people do not “see” it.
I should say that it is not just BM that use it but the name has become the byword for the problem.
Premethrin is a neurotoxin that works by damaging the nervous system. When used on cats it causes anything from tremors, staggering to severe seizures and for many death is the outcome. It is very slow to be metabolized from a cats body so it is a case of supportive treatment.
The cat when it came down was having seizures, his pupils were dilated (large) and black orbs. He was lashing out with blindly then going into violent spasms; actually it was hard to separate the two actions.
He was very scared about what was happening to him and his temperature was up from the seizures.
The auxiliary managed to pin the cat and hold the front leg out for me to place the iv catheter without us both getting badly scratched. A good auxiliary is worth their weight in gold and all too often they are overlooked.
The vet sorted out initial treatment and the cat was given a bolus of Diazemuls to sedate it, this stopped the seizures.
Finally we clipped the oily patch on its back where the owner had applied the spot on, and gave it a quick wash, to help remove residue.
During washing round 2 began and he started to spasm again, l gave him his next bolus to sedate him again, then placed the patient into a kennel in ICU.
The vet had gone off to speak to the owner and l stood by for round 3. Sure enough after a couple of minutes the twitches began again and l gave the next bolus, this stopped the twitching for a couple of minutes but not long enough by any stretch.
By now the vet was back and had a different drug. The owner was filling in consent for treatment and then going home. He decided that he did not want to see his cat, it was to upsetting for him to know what he had caused.
The new treatment lasted for about 10min, then it was overwhelmed by the toxin, and back to “bouncy cat”, it was going to be a stinker of a BM to treat this one.
The vet decided that as the owner had used a large dog spot on, and the cat was so ill he would have to call in the big guns. A 100ml bag of saline was hooked up to the infusion pump and a measured dose of Propofol (used to induce anaesthesia for operations) was placed in the bag. The cat was given a bolus of Propofol directly into the iv catheter to cause an anaesthetic effect. The saline/propofol drip was started to keep the cat sedated for several days. To put it bluntly the cat was placed into a coma to control the seizures.
Oxygen was placed to help his breathing, and he was turned every 2 hours, to prevent lung congestion from being in one position for too long.
24hours later the vets decided to try and lighten the patient and see what would happen. As the patient came lighter, the twitching re-started, a bit longer to see if it would settle, it got worse. The drip was turned up and the patient was deepened down again.
This lightening and deepening was repeated over 3 days.
Eventually the twitches stayed steady and did not progress. It took a further 48 hours for the cat to be allowed totally awake and sedation to wear off.
The effects of the Premethrin took a couple of days more for the body to overcome.
The patient was in for 8 days in total and the cost was over £600 for treatment.
*====*====*====*====*====*====*====*====*====*====*====*====*
The story above is a typical BM tox. case. It vary's from mild twitching and ataxia (wobbly/falling over) and the cat home in a couple of days, to extreme enough to die. Very often they are like the story above.
Saturday, 18 October 2008
Anti Freeze
Yayyyy a day off, I have not had a day off for 2 weeks. I can chill, sleep in and be lazy, catch up on emails and do all those jobs l have not had a chance to do. Well l can think about doing them, does not mean l will them.
Back working tomorrow and then off down the middle of the country to the referral centre about 4am Monday morning. This is so l can avoid the M6 traffic snarl up and be bright eyed and bushy tailed as the old saying goes to start the days work.
*====*====*====*====*====*====*====*====*====*====*====*====*
It was a Sunday night and l was at home getting ready for work on the 22:00 – 8am shift when reception rang, they were busy and asked me to buy some pots of yogurt on the way in for a patient, then they rang off.
I could not think of any animals that needed such a food. l stopped at the corner shop and bought several strawberry and cherry flavours, as no one had mentioned flavours or amount.
At work l found out the lucky or unlucky drinker of this buyout. Max a young Alsatian pup, about 4 months old. He had been in the garden and found he could nose the garage side door open. In there he had discovered the yummy sugar taste of anti freeze (ethylene glycol). His owner noticed the door open to the garage an hour or so later, saw the patch of anti freeze gone from where he dripped it when he had been adding it to the car, and rushed him straight in.
Anti freeze has an ingredient called ethylene glycol which is one of those evil poisons that need not be. With modern chemicals it is not needed. Those that do use it in anti freeze could add a nasty tasting and smelling chemical of some kind, to mask the sweet sugar flavour. The manufactures won’t do this though for some reason.
Anti Freeze poisoning causes many thousands of animals to die a nasty, needless death. The kidneys fail then the central nervous system. Once symptoms show it is too late.
If you are in time, time being the main word in all toxicity cases, very often you do not realise poison has been taken till to late, and then it can be a guessing game.
There are couple of antidotes to anti freeze/ethylene glycol poisoning. One is not usually on the shelf.
The second antidote is easy to get, alcohol. In Max’s case a bottle of vodka had been bought in.
The alcohol mixes with the ethylene glycol and helps remove it from the body.
You do need other medications but they are usually in stock at the average vets.
Max was on a drip and wearing a buster collar. The infamous “head bucket” to stop him getting to the iv and pulling out again.
A set amount of vodka/kg had to be fed to him every hour but he did not like the taste. Someone had tried some yogurt mixed into the vodka and he loved it.
The 10hours of my shift was marked for hourly Max medication breaks, giving him his vodka/yogurt cocktail. He rather liked the cherry yogurt, was not so keen on the strawberry flavour, but it all went down. Being a puppy he was not to fussy if it tasted almost nice then that would do.
He had been on the mix about 5 hours before l got in and had to be on it for 24hrs +.
About 6am l tried to take him out his kennel, give him a quick walk and a new bed. He sort of fell out of the kennel, the buster collar pinned to the floor making him look like he was playing ostriches and hiding his head in the ground, and he staggered in a circle, the collar keeping him almost upright.
Poor lad was paralytic l took off the buster collar no chance he would see straight enough to remove his iv, the walk was also cancelled.
One of the symptoms of anti freeze poisoning is staggering as if drunk, but the vet was happy enough in Max’s case it was alcohol not ethylene related.
Max was in for some time. He had a lot of blood tests to check his liver and kidney etc functions on a twice daily then daily, weekly and finally a monthly basis, although by now he was home.
He recovered, he was lucky, he survived anti freeze toxicity, most dogs and cats don’t.
His owner reported he had developed a love of yogurt, they were warned not to give any alcohol to him. They only use yogurt for a small treat for special occasions, apparently it has proved to be a useful bribe.
*====*====*====*====*====*====*====*====*====*====*====*====*
If you suspect that your pet might have had something toxic. Contact the vet and let them know. Have all details to hand when you ring if there is any paperwork, containers read out the ingredients, inform them of the species, breed, age and when it may have had the poison.
If need be the vet practice can ring Poisons Information Unit for advice. Very often calls must be made to PIU to find out how to treat the problem.
Ringing up first allows the vet to decide if you need to come in, was an item toxic or not and if you have to go in, to get things set up for when you arrive.
Take all paper work, containers in to the vet's as well, they can double check that nothing else was in the ingredients you may have missed when you were worrying.
Back working tomorrow and then off down the middle of the country to the referral centre about 4am Monday morning. This is so l can avoid the M6 traffic snarl up and be bright eyed and bushy tailed as the old saying goes to start the days work.
*====*====*====*====*====*====*====*====*====*====*====*====*
It was a Sunday night and l was at home getting ready for work on the 22:00 – 8am shift when reception rang, they were busy and asked me to buy some pots of yogurt on the way in for a patient, then they rang off.
I could not think of any animals that needed such a food. l stopped at the corner shop and bought several strawberry and cherry flavours, as no one had mentioned flavours or amount.
At work l found out the lucky or unlucky drinker of this buyout. Max a young Alsatian pup, about 4 months old. He had been in the garden and found he could nose the garage side door open. In there he had discovered the yummy sugar taste of anti freeze (ethylene glycol). His owner noticed the door open to the garage an hour or so later, saw the patch of anti freeze gone from where he dripped it when he had been adding it to the car, and rushed him straight in.
Anti freeze has an ingredient called ethylene glycol which is one of those evil poisons that need not be. With modern chemicals it is not needed. Those that do use it in anti freeze could add a nasty tasting and smelling chemical of some kind, to mask the sweet sugar flavour. The manufactures won’t do this though for some reason.
Anti Freeze poisoning causes many thousands of animals to die a nasty, needless death. The kidneys fail then the central nervous system. Once symptoms show it is too late.
If you are in time, time being the main word in all toxicity cases, very often you do not realise poison has been taken till to late, and then it can be a guessing game.
There are couple of antidotes to anti freeze/ethylene glycol poisoning. One is not usually on the shelf.
The second antidote is easy to get, alcohol. In Max’s case a bottle of vodka had been bought in.
The alcohol mixes with the ethylene glycol and helps remove it from the body.
You do need other medications but they are usually in stock at the average vets.
Max was on a drip and wearing a buster collar. The infamous “head bucket” to stop him getting to the iv and pulling out again.
A set amount of vodka/kg had to be fed to him every hour but he did not like the taste. Someone had tried some yogurt mixed into the vodka and he loved it.
The 10hours of my shift was marked for hourly Max medication breaks, giving him his vodka/yogurt cocktail. He rather liked the cherry yogurt, was not so keen on the strawberry flavour, but it all went down. Being a puppy he was not to fussy if it tasted almost nice then that would do.
He had been on the mix about 5 hours before l got in and had to be on it for 24hrs +.
About 6am l tried to take him out his kennel, give him a quick walk and a new bed. He sort of fell out of the kennel, the buster collar pinned to the floor making him look like he was playing ostriches and hiding his head in the ground, and he staggered in a circle, the collar keeping him almost upright.
Poor lad was paralytic l took off the buster collar no chance he would see straight enough to remove his iv, the walk was also cancelled.
One of the symptoms of anti freeze poisoning is staggering as if drunk, but the vet was happy enough in Max’s case it was alcohol not ethylene related.
Max was in for some time. He had a lot of blood tests to check his liver and kidney etc functions on a twice daily then daily, weekly and finally a monthly basis, although by now he was home.
He recovered, he was lucky, he survived anti freeze toxicity, most dogs and cats don’t.
His owner reported he had developed a love of yogurt, they were warned not to give any alcohol to him. They only use yogurt for a small treat for special occasions, apparently it has proved to be a useful bribe.
*====*====*====*====*====*====*====*====*====*====*====*====*
If you suspect that your pet might have had something toxic. Contact the vet and let them know. Have all details to hand when you ring if there is any paperwork, containers read out the ingredients, inform them of the species, breed, age and when it may have had the poison.
If need be the vet practice can ring Poisons Information Unit for advice. Very often calls must be made to PIU to find out how to treat the problem.
Ringing up first allows the vet to decide if you need to come in, was an item toxic or not and if you have to go in, to get things set up for when you arrive.
Take all paper work, containers in to the vet's as well, they can double check that nothing else was in the ingredients you may have missed when you were worrying.
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