CASE OF THE MONTH
OCTOBER - FLYNN
Flynn presented to us at the end of September after his owner suspected he had been bitten by a snake. He would not come when called, was acting strangely and vomited - all signs that are typically seen shortly after envenomation.
He was rushed to the clinic and by the time he got to us he could not walk at all.
Flynn was in shock which was corrected with IV Fluid therapy.
Blood tests confirmed our suspicions, as Flynn had increased enzymes indicating muscle breakdown, an effect of myotoxins in snake venom. He also had obviously red urine, a result of haemolysin toxins that were breaking down his red blood cells. Without haste, Flynn began to receive antivenom. He was becoming progressively paralysed by the snake's neurotoxins and he could not swallow or even blink. Flynn was monitored constantly while his reflexes began to return, and within only hours of receiving antivenom, he was able to stand again. The facial swelling he had (as seen in the pictures) was at the site of the snake bite.
Over the following 5 days Flynn received treatment and monitoring in hospital. While his reflexes returned quite speedily, Flynn's haemoglobulinuria (blood pgiment in the uring) persisted, meaning that his kidneys were under stress from these large particles being filtered through them. this meant that he needed to be on IV fluids at all times to support his renal function. A few days into treatment Flynn was mooving around, eating and drinking well. His urine began to return to normal slowly however, when it turned red AGAIN - we were worried.
A microscopic blood smear examination and measurement of Flynn's totaly red blood cells ("packed cell volume" or "PCV") confirmed that Flynn's own immune system was attacking his red blood cells and therefore he was becoming anaemic.
Treatment with steroids commenced, and Flynn has not taken a step backwards since!
Flynn will need to continue treatment for his IMHA (Immune Mediated Haemolytic Anaemia) for the next 5 months and is receiving regular checck-ups to ensure that his anaemia is improving. Throughout his treatment Flynn has been such a resiliant patient, with a friendly and loving nature and patience with all his treatments and tests. We are so glad to see him up and about again and enjoying life, and hope he leaves those pesky snakes alone from now on!
Case of the montH
may - mater
Here’s one of the reasons we advocate castration of male dogs early (prior to 6 months of age) or if not then, as soon as they are finished breeding (and hurry up to finish breeding).
Like all males, testicles produce testosterone which is the hormone for male characteristics both physical and behavioural. However, male dogs and cats do not need testes for anything apart from the production of semen. There are many scientific reasons to desex male and female pets and this case highlights this.
Mater is a 5year old male bull arab that presented a bit off one day. Then about 2 wks later started to drip blood from his penis. He was urinating well and defaecating well but not eating quite normally. Mater was admitted for tests.
It was discovered Mater had a prostatic mass and he needed surgery to explore this further. Poor Mater – it was quite painful to palpate it and he was not his usual self either.
Mater was scheduled for surgery and when we opened him up, we discovered he had a huge fluid filled cystic structure that incorporated his prostate and was around his bladder. It was about 20cm x 15cm and extended to both sides of his abdomen. We had to open and drain the fluid from this cyst and were thankful it was not an abscess. We then sutured omentum (cobweb like membrane in the abdomen) into the hole left behind to continually drain the cyst until it regressed. We also had to castrate Mater to stop the testosterone effect on the prostate.
With any male dogs having prostate or urinary problems, castration is the most important thing we can do to prevent incomplete healing of infections or further exacerbation of problems due to the testosterone influence on the prostate.
Mater made an amazing recovery and luckily went home the next day. He was feeling heaps better.
We sent a piece of the wall of the cystic structure to the lab and it was discovered to be a ‘Paraprostatic Cyst’ and it would not improve unless he was castrated so this was already done! These do not form in castrated male dogs so could have been avoided for him.
We are so glad Mater is back to his normal self without blood from his penis and his prostate is now closer to the normal size.
case of the month
march - reggie
Reggie Thorne is one tough girl!
Chasing pigs is not something on Reggie's usual daily agenda, but in a fleeting moment of fun and a decision she likely regrets, Reggie found herself being rushed into the clinic as an after hours emergency from serious pig attack wounds that had put her in a very unstable condition.
Reggie had vital organs outside her body, a complete tear as well as other damage to her intestines and a considerable level of contamination to her abdominal cavity that was all very concerning. Thankfully her owner had done an excellent job at first aid and had wrapped her abdomen to reduce the risk of further damage and to keep her organs from drying out.
Reggie underwent over 5hrs of surgery to repair damage to her intestines (with portions having to be removed), bits of dying tissue removed, her abdominal cavity flushed out and an abdominal drain placed.
It was early morning by the time Reggie had woken up from surgery and started intensive care on multiple intravenous drip lines and medications, to give her the best chance of survival. The next few days following surgery would be the toughest in Reggie’s recovery, uncertain the extent of damage to the liver and pancreas and the risk of breakdown where the intestines had been repaired always a possibility. Reggie also had to be monitored closely to ensure she didn’t go into DIC (disseminated intravascular coagulation), a very hard to control whole body inflammatory response.
Reggie spent 3 days in intensive care at the clinic before heading home. Every day of Reggie’s recovery has truly amazed us; from being well enough to want to eat again herself, to being able to walk again unassisted and there were of course the big smiles as the whole family came to collect her from hospital to take her home. Reggie’s family have been fantastic with her home care and treatment and Reggie’s recovery has been a testament to her owner’s ongoing support.
Reggie is a very special dog, with a very special family who have two young boys who couldn’t wait to have her home.
We wish Reggie all the best in the rest of her recovery and hope she’s learnt her lesson about playing dodge-boar with the 2-tusked kind.
Case of the month
February - Jessie
Ever had a dog that was fine but when they returned from a run they were lame? That’s how it all started with Jessie. She has always had a funny walk due to a prior accident so the owners were not surprised she returned with an even more ‘funny’ walk but they quickly realised she had done something to hurt herself as she had a limp now too. When she came in for an exam, we diagnosed Jessie with a torn cruciate ligament, something footballers and netballers do quite a lot.
Because Jessie is a large breed, there was really only two options to help repair the damage. Either a TTA (tibial tuberosity advancement) procedure done here, as she was a candidate for this particular procedure, or referral to a surgeon. The only other alternatives were to do another procedure D’Angelis suture, which is not indicated for a dog her size, or nothing – which would leave her painful and limping and dependant on pain relief for more comfort (not ideal) and she would get knee arthritis very quickly.
Soon afterwards, Jessie came in for the TTA procedure. The procedure takes quite a while as there is cutting of bone, implants to place and screws to hold it all together. Jessie had to stay for the night but as she really prefers to be at home, we felt it was better to send her home the following afternoon.
Since then, Jessie has improved to much better than she had been prior to the surgery. She has had her 8 week post op radiographs and we are happy with how it has healed. Jessie can now get on with rehabilitation for her knee and start to get back to her normal activity levels, as she was restricted for 8 long weeks.
case of the month
January - cash
Cash presented to us in early January after being run over whilst his family were out camping. On physical examination Cash was non-weight-bearing on his left hind leg and it was suspected that his hip was dislocated. Cash was then sedated to have radiographs taken of his injured leg where it was confirmed that he had a cranial dislocation of his hip, meaning that the top of his femur was sitting out of his hip joint and upwards. Cash was then anaesthetised to try and reduce his hip dislocation. Unfortunately, his hip could be put back where it belonged but it would not stay in at all, popping in and out far too easily. It was then discovered that Cash had a luxating patella on the same leg, a condition that can be from birth however, as Cash has never had issues using his leg, it was likely that he had sustained this injury in his accident also. This changed the surgery plans for Cash, who was initially to have his femoral head removed to manage his untreatable hip dislocation. He now had a knee issue as well, meaning that he would have to have two major surgical procedures to fix his leg, and would then have to endure a long recovery time. All the options were presented and Cash’s owners decided to amputate his leg, to save him the hassles of future complications with his injured joints and to cut his recovery time down to 10 days instead of six weeks.
Cash underwent an extensive surgery to amputate his leg through his hip joint. Usually, a hind leg is amputated halfway up the femur, making it a shorter and less demanding surgery. However, as Cash’s hip was affected, his whole hind leg had to be taken. Cash stayed in overnight on constant rate infusions of pain relief and recovered from his anaesthetic very nicely. The next day he was being taken on walks outside and adapting well to his new configuration very well. In less than 24 hours after his surgery Cash was walking out the door with his owner – and pulling on the lead!
Throughout his say with us Cash was dealing with a painful condition and underwent a very big surgery. He remained friendly, tolerant and brave throughout all his procedures and is back to being his usual cheeky self at home. We all thoroughly enjoyed treating Cash and are excited that he has a long, active and happy life ahead of him.
Case of the Month
October - Rusty
Rusty presented to the clinic one Saturday after his owner discovered he was unable to use his back legs. His owner suspected that he may have had a paralysis tick. Sure enough, during physical examination a large tick crater (distinctive red mark left behind where the paralysis tick was attached) was found on Rusty’s neck and a diagnosis of tick paralysis was made. Rusty’s owner is usually very conscientious with tick prevention for all his dogs, however this year Spring caught them a little by surprise.
Rusty was a grade 4B tick paralysis case, meaning that he could not walk at all and that his respiratory muscles were starting to be affected by the tick toxin also. He had an increased respiratory rate and his heart rate was increased in compensation. Rusty had almost no gag reflex as the muscles of his upper respiratory tract were quite severely affected.
Paralysis tick saliva contains a neurotoxin that disrupts the signal being transmitted from the nerves to the skeletal muscles (especially muscles of the limbs, between the ribs, diaphragm and upper respiratory tract). Affected animals therefore suffer a ‘flaccid’ paralysis and present with differing degrees of ataxia or ‘wobbliness of the legs’ as well as degrees of respiratory system compromise.
Rusty was placed in hospital for two days to receive the paralysis tick antiserum and fluid therapy as he was not allowed to eat or drink. This was due to the high risk that he might aspirate food or water down into his lungs (causing aspiration pneumonia) as he could not gag or swallow properly. As Rusty could not get up to go to the toilet or adjust his positioning he required constant nursing care and soft bedding. Rusty progressed well in hospital and at the end of his two-day hospital stay he was walking normally again. Even though Rusty’s improvement was rapid he tired out very easily, as the junctions between his nerves and muscles were still recovering from being affected by the tick toxin. His gag reflex was still not normal when he returned home so Rusty’s owner had to hand feed and water him from a height until he could swallow normally again.
Rusty has since been back to see all the girls at the clinic and is doing fantastically. He is still on strict rest as it will take three to four weeks for his body to be ready to be out chasing cows again.
As the weather begins to warm up the risk of our pets picking up paralysis ticks is increasing. There are many paralysis tick preventatives available and one to suit each pet’s current parasite control plan. Please chat to us about tick prevention for your pets as prevention is always better than a cure!
CASE OF THE MONTH
SEPTEMBER - RED
It was going to be a fairly quiet afternoon here at Stanthorpe Vet Care however, Red had other ideas...
Red was presented with tremors. She had been ok in the morning and had gone to work with her Dad. However, a couple of hours later and she started to have muscle tremors. Her dad was a bit worried so decided to bring her in to work out what was wrong and fix her as she is a great work dog and is well loved by everyone. Her dad was adamant she had no access to any toxins or plants that may have caused an issue. Close questioning and there was nothing.
She was given Valium to help with the tremors however, it did not make much difference. On close examination of her mouth however, there was the tiniest amount of green between her teeth and it was immediately evident she had access to snail bait (rat bait was also a possibility but is a slightly different green colour and ratbait does not show these symptoms and snail bait does).
So we immediately started treatment which consists of a general anaesthetic and then a continual infusion of anaesthetic to keep her from waking or tremoring as well as supplementing her with oxygen. We put a tube into her wind pipe to prevent her breathing in any bait or fluid. We then had to pump her stomach, which was very full of green snail bait. As the owner was still adamant there was none around, we were concerned for where she may have gotten it as she had been let out for a run earlier in the morning. There was no doubt however, that it was snail bait as there was white granules through it and it smelt like chemical. It took us a long time to completely empty her stomach of green bait as it kept blocking the tube also. Once we had emptied all the green from her stomach, we put charcoal down her tube to her stomach which helps to adsorb the toxin that may have been remaining in her intestine. We then had to do an enema to clear her bowel and rectum from the snail bait also. Poor Red had the works!!! Later that evening, she did a small green faeces while still asleep and we had to repeat the enema but by this stage the snail bait and charcoal were coming out so we knew the rest of her intestines were empty. We then had to wait for Red to wake up and manage any symptoms from there.
By early evening Red had started to wake. By late evening, Red was standing and walking wobbly. Then by the next morning, Red was happy to eat and drink and was good enough to go home. A miraculous recovery and quick too given all she went through. Her dad was very happy she did so well and she was very happy to see him. We eventually discovered there was in fact some snail bait that was at home unknown to Red’s dad and this is where she got it from.
Snail bait is usually a carbamate. Carbamates cause symptoms similar to organophosphates. From salivation and twitching to tremors, seizures and death as they cause muscle fasciculation and spasm and then inability to breathe. They can also cause vomiting and diarrhoea. Fortunately symptoms are short lived (which accounted for Red’s speedy recovery) and last about 4 hours however, in poor Red’s case, she must have had about a bucket in her gut and would have died if left untreated. In this case her owner’s prompt recognition of a problem and arrival here surely enabled her survival.
Today Red is just another ordinary kelpie working to keep her cattle under control, with an extraordinary life story to tell.
Case of the month
August - thor
Well, another case that is lucky to be alive thanks to a quick response from the owner. Much longer and we would not have been so lucky!! We were presented with ‘Thor’ a 6 year old mastiff dog who was unable to get up or stand. He had been ok the night before – just a bit off his food and not quite his usual self for a couple of days but still active and able to move around. That morning the owner had seen Thor, he had lifted his head and wagged his tail and seemed bright. Fortunately his Dad actually went over to him to check how he was and discovered he was unable to get up. He was then rushed in to see us.
On arrival his gums were red, heart rate was 52 (should be over 120-140), temperature was 35.5 (hypothermic) and he was in shock. We took bloods and started a drip at a really rapid rate immediately. However, because his shock was so bad we were unable to get any of the veins apart from his jugular which was concerning as this demonstrated his blood pressure was extremely low. He also had black tarry faeces. When we got the bloods back we discovered his potassium was extraordinarily high. This causes his heart rate to slow down then stop. We have never seen a potassium level so high and Thor was very close to death just from that. We also discovered his platelets were low (which help clot blood) then his clotting was tested and it was taking him too long to clot. This meant he had a condition from the shock that may cause him to die called DIC. This means he starts clotting his blood inside his vessels and has no clotting mechanism left for normal clotting and starts to bleed and also the clots inside his vessels can lodge in organs and cause major problems. We had to do plasma transfusions and fast!!
Poor Thor had a lot of tests and medications done over the next couple of days but we found out he has a condition called ADDISONS or hypoadrenocorticism when the adrenal glands do not make enough compounds/hormones that are required for normal day to day function of the body. This leads to electrolyte imbalances which lead to a ‘crash’ (severe shock) and death. Fortunately Thor (like his namesake), is an amazingly tough dog and survived the odds against him and we now treat him with 2 types of tablets every day and he will need life-long medication and monitoring to ensure he does not have an ‘addisonian crash’ ever again.
Addisons is not extremely common but is common enough in dogs. They usually have waxing and waning symptoms which usually include off food, not eating properly, weakness, black tarry faeces then they collapse. Diagnosis can be difficult because they are often put on fluids and this can correct symptoms and dogs are sent home. Bloods are needed to check electrolytes as electrolyte imbalances raise the suspicion for the disease then a further test is needed to be sure (ACTH stimulation test) which is testing the adrenal gland function. Thor was unlucky because he had complications from the severe shock which were life threatening in itself. This is one of the reasons we have in house lab machines so our results were very quick and lead to correct identification of the problems and appropriate treatment.
CASE OF THE MONTH
JULY - MISSY MOO
Well, we’ve recently had a prime example of one reason we advocate desexing all pets unless they are to be used for breeding (and then to desex when finished breeding). We had 2 cats from the same family come in for desexing on the same day. However, one of them was noticed to have pus from the vulva and a suspected pyometra.
Both the cats' uterus are seen in the photo above, the smaller one is regular size and the other large one is infected and what is called a pyometra.
A pyometra is a uterus that is infected and full of pus. All female entire (i.e. not desexed) dogs and cats are at risk of getting a pyometra. It is more of a hormone imbalance that renders the uterus prone to an overgrowth of bacteria and hence the pyometra. Once a pet has a pyometra, the cervix can be either open – like this cat (and pus can drain out) or closed (the pus can’t drain out). When the cervix is closed there is no way out for the pus and your pet is at a much higher risk of illness and therefore dying, and quickly. When the cervix is open, your pet won’t get as sick as quickly however, is still at risk of dying if left untreated. With this much pus, the only treatment is desexing your pet however, we are then performing surgery on a sick animal so the risk of complications and death increases substantially.
So in this case, this cat was a little sick however, her illness was not realised by the owner as is was not severe yet. Fortunately she was desexed and there were no complications and she is now doing well and a lot better than she was. So, it goes to show, this can happen at any age (8mths old for this cat) and the older they get the more risk there is.
CASE OF THE MONTH
JUNE - SPROCKET
You know what it’s like to breathe……to cough…..Well, try doing it through a straw for a minute or so. Now you know what this cute little fella had to go through only days after arriving here in Stanthorpe. Sproket was a mere 10 weeks old when his owner noticed him coughing and he seemed to get worse through the night. By morning he was heaps worse. So it was an emergency trip here. After an exam and xrays, the diagnosis was aspiration pneumonia due to a hypoplastic trachea. This meant Sprocket had accidentally breathed down food/vomit/saliva to his lungs to cause pneumonia and it was due to a congenital (born with it) underdeveloped trachea or airway. His trachea was more narrow than a straw and it should have been at least 3-4 times the diameter it was.
Poor Sprocket had nowhere near enough oxygen circulating in his blood and was in danger of dying. So he had to have nasal oxygen in both of his nostrils, a drip, heaps of medications to help him get rid of the infection and 3-4 times a day we had to nebulise him to help break up the mucous. The only way up for all the mucous was through his narrow trachea by coughing which was such a difficult thing for him and when he was coughing a lot his oxygen was very low. Sprocket’s life hung in the balance. It took so much more effort for him to breathe, cough and get rid of his pneumonia. Sprocket was not eating very much at all as the effort would reduce his oxygen levels also. He had to
After 3 long days, Sprocket finally turned the corner and started to improve. It was slow improvement to start with - his oxygen levels were creeping up and he was eating so much better. Then he started to get cheeky and we really saw his personality which was a cheeky, fun, active and lovable puppy. After a couple of more days, Sprocket’s parents and family were finally able to take him home. They were so happy especially as he had spent more of his time here than he had at his new home.
Sprocket’s airway is a little larger than it first was after all his medication and he continues to improve at home. We miss him now as he was here for so long and such an intensive patient. We all hope his airway grows much faster than he does so that in the future there is much less risk of this happening again.