Meet Charlie....

There have been a series of post regarding holiday emergencies over the past few weeks.  Many times these stories do not have a happy ending.  I thought that I would share one that happened to me over the holiday weekend.

My family lives in Stevens Point and I knew that we had many different stops planned and that there would be a variety of foods consumed over the weekend.  My dog is just the perfect height to counter surf and he is allergic to many, many things.  Did I mention that he is a red bone coonhound? This means that when his nose is on, his ears are off.  Although I knew that he would miss seeing and playing with his dog and human cousins, I decided to board him so I would have one less thing to worry about, plus I know he is spoiled and loved when he is boarding.

Well, let’s just say my stress free animal weekend was anything but.  Enter into the picture, Charlie.  Charlie is the newest addition to my sister’s family.  He is an adorable poodle mix and 99% of the time, a perfect puppy.   The other 1%, not so much.  He is all puppy! 

When we returned to my sister’s, I could tell something was not right.  They were all on edge.  Then the news came, “we think Charlie ate a sock”.  They too just arrived home from her in-laws and when the kids were taking off their shoes, Charlie stole a sock off of her son’s foot and ran under the tree.  He older son tried to get it but it was too late, Charlie ate the sock.

How lucky is my sister to have a sibling who happens to be a Certified Veterinary Technician with many years of emergency experience. 

Charlie was promptly given some hydrogen peroxide via a sports water bottle and seconds later up came the sock…. Along with his supper and a few treats.  Although my nephews were very worried and scared for their pup Charlie, they learned a valuable lesson and I was glad I could be there to help out. 

For a free Animal Emergency Guide please visit our website at www.gbaec.com

(This article was submitted by L. Schuh of the FVARC)

Holiday Emergencies

Working at a 24 hour emergency animal hospital, we see cases around the 24/7/365.  Many times the types of injuries we see can be prevented.  Attached is an article that ran in the Post Crescent a few years ago but is still relevant because it covers how to be prepared.  You may also visit our website for a copy of our Animal Emergency Book:

http://www.fvarc.com/images/pages/FVARC_AECBooklet.pdf



Jan Zablocki was away at her daughter's college the first time her beloved dog, Kitty, experienced an emergency.

When she received the phone call, Kitty was lethargic, whimpering and vomiting. "She was practically dead," Zablocki said.

Fortunately for the Shih tzu, who was 4 years old at the time, there was someone available to respond to an emergency while Zablocki was away. Zablocki's ex-husband rushed Kitty after-hours to its primary veterinarian. But the news was not good. The vet couldn't diagnose the problem so he drove three hours in the middle of the night to Appleton's Fox Valley Animal Referral Center, where an emergency services veterinarian diagnosed Kitty with hepatitis. Hospital staff treated, cared for and later released her. It would be the first of many emergencies to come over the next 11 years.

That first experience reinforced the importance of having an emergency plan should a pet become ill, a plan that should include having a trusted and committed backup person assigned to handle animal emergencies. It's especially important when you have children, Zablocki said, particularly during the summer months when older kids may be home alone during a time when animals can experience everything from heat stroke to poisoning to car accidents.  "You really need to have that person who can go that extra mile for you," Zablocki said. "You might need them to stay home with children while you handle the emergency or they may need to handle it for you if you're not there."

When it comes to making sure your family is prepared for an animal emergency, having backup help ranks right up there with recognizing signs of a potential emergency, discussing the dos and don'ts of handling an emergency, having veterinarian phone numbers visible and maintaining a pet first aid kit, said Lyn Schuh, outreach coordinator for the Fox Valley Animal Referral Center , Central Wisconsin Animal Emergency Center, and the Green Bay Animal Emergency Center.

The Appleton hospital is fully staffed at all times with emergency veterinarians and trained staff.   The Animal Referral Center is the place most primary vets refer patients if they are unable to respond to an emergency situation during regular hours.

The Green Bay and Central Wisconsin hospitals are open after hours, holidays, and weekends.

"Every time I'm there, I grab a stack of cards and go home and tell everyone I can about it," said Zablocki, who lives three hours away in Upper Michigan.

In Zablocki's case, not only does she have back-up help in emergencies, but she is the emergency backup for two dogs owned by the family who employs her as their nanny. Their miniature Doberman Pinscher and laborador mix also have kept her — and the kids — on their toes throughout the years. Some of their emergency situations, including a particularly nasty run-in with a porcupine, have served as a reminder of how important it is to practice safety first when it comes to mixing injured animals and children.

The best thing, she said, is for the children to keep a safe distance from the animal, Zablocki said.
"You don't want anyone to get hurt, and an injured dog can get nippy," said Zablocki, who said the porcupine incident was an especially difficult one because the dog was in tremendous pain. Although all of the children drove with her to the vet office, she did make sure she was the only one handling the dog.

Just as is the case with a human emergency, staying calm is important because it allows a doctor — in this case, the veterinarian — to most easily assess the situation, Schuh said. Although the veterinarians and technicians at the Animal Referral Center don't tell family members they can't come back to the treatment areas when an animal is experiencing an emergency, they do sometimes gently offer to separate the animal if people appear too distraught.  "It's easier said than to do, but all you can do is remain calm yourself so the animal doesn't pick up on the stress and then calmly tell the children what is happening, explain that everything will be OK and that it's important to remain calm for the animal's sake," Zablocki said.

An accident or injury generally presents an obvious emergency situation, but other types of emergencies can be harder to identify. It's helpful for families to be aware of symptoms of distress in cases where an animal is sick or ate something it shouldn't have. Heat stroke, poisoning, car accidents, lawn mower accidents, run-ins with wild animals and allergic reactions to bee stings, spiders and other insect bites are some of the most common warm weather emergencies, Schuh said. Not all of these will result in symptoms that are immediately recognizable.

"The bottom line is know what's normal so you know what's not normal," Schuh said.  An animal's eyes should be clear and the pupils each the same size. The gum color should be a healthy pink — not blue, purple, dark red or pale. When pressure is applied to the gums, the area should go white, but the pink should reappear in just a few seconds. There should be no swelling of the tongue or around the eyes. Watch for abnormal behaviors. Excessive panting, nervousness, hiding and other out-of-character behaviors might be signs the dog is sick, Schuh said.  "Nice dogs might suddenly become nippy, while standoffish dogs might get cuddly," she said.

In case of an emergency, telephone numbers should be posted where children and baby sitters easily can find them. They should include contacts for the emergency back-up contact; the primary veterinarian; the Animal Referral Center, 920-993-9193; the Green Bay Animal Emergency Center, 920-494-9400, Central Wisconsin, 715 693-6934, and the Animal Poison Control Center, 888-426-4435. 

A first aid kit containing adhesive tape, gauze, elastic bandages, scissors, a pen knife, gloves, a rectal thermometer, tweezers, iodine scrub, hydrogen peroxide, styptic powder, a bottle of saline or distilled water for wound irrigation and gloves is another must have in a pet household. Make sure to leave out the heating pad, though. Anything but a warm towel or blanket can burn an animal, Schuh said.

Zablocki said her first aid kit continues to grow after 15 years with Kitty, nine of which have been spent in one emergency after another.  "Do I have a first aid kit?" she laughed. "I have an entire first aid cupboard for the dogs. I'm prepared for pretty much anything and everything."

CT comes to the Fox Valley

Computed Tomography at FVARC

Computed tomography (CT) has been available at the Fox Valley Animal Referral Center since December 2008. CT is useful for diagnosing disorders of the nasal cavity, middle and inner ear, brain, abdomen, lung, mediastinum, and the musculoskeletal system. There are several major advantages of CT over conventional radiography. First, cross-sectional CT images eliminate superimposition. Second, because of the high-contrast resolution of CT, various soft tissues can be distinguished. Third, data from a CT scan can be viewed as images in multiple planes, greatly enhancing diagnostic capabilities and aiding in therapeutic planning.

Unlike conventional radiography in which a broad x-ray beam is emitted from a stationary tube, CT images are made using a narrow x-ray beam that is emitted from a tube as it revolves 360 degrees around the patient. As the x-ray tube rotates, the patient is moved through the aperture of the scanner on a table in small increments (axial scan) or continuously (helical scan). Opposite to the x-ray tube are electronic detectors that record the intensity of x-rays exiting the patient. A computer reconstructs the data obtained from the multidirectional x-ray beam into cross-sectional images of the patient. Scan time is typically 30 to 60 seconds. Accurate patient positioning is vital to obtain optimal CT images. For this reason, animals are sedated or anesthetized.

CT images represent thin sections or “slices” of the patient, thus multiple images are required to view one structure. Thin slices are used to obtain high resolution images of small, high-contrast structures. Thicker slices are used to distinguish between tissues of lower contrast.

CT images are digital (comprised of pixels). Each pixel in a CT image is assigned a number (Hounsfield Unit [HU] or CT number) which represents the amount of x-ray attenuation by the tissue. HU is a unitless number representing the degree of x-ray attenuation in tissue relative to water. The scale of HU ranges includes -1000 HU for air, 0 HU for water, and +3,000 HU for compact cortical bone. Once a CT scan has been acquired, the range of HU displayed can be adjusted according to the tissue of interest.

CT can distinguish between various soft tissues and fluid types, such as blood versus transudate.

Images are usually acquired in the transverse plane, but data can be reprocessed to produce images in the sagittal, dorsal, coronal, or oblique planes as well as three-dimensional reconstructions. Intravenous contrast medium can be combined with CT to more clearly identify structures. Contrast CT studies include urography, myelography, portography, and angiography.

Head CT

CT provides superior high resolution imaging of fine structures including tooth roots, orbits, nasal turbinates, the nasopharynx, and cribriform plates. CT is particularly well-suited for examination of the nasal cavity because of the high contrast provided by bone and air-containing structures. It is the best imaging modality for diagnosing nasal Aspergillosis, showing turbinate destruction in exceptional detail. CT is ideal prior to rhinoscopy to aid in planning biopsies and treatment.

Brain CT is performed in cases of seizures, neurologic disease localized to the brain or cranial nerves, and head trauma. While MRI provides better soft tissue definition, CT is generally less expensive than MRI and has a shorter scan time, which may enable scanning without anesthesia in critically ill patients.

Thoracic CT

Of major importance, CT has significantly higher sensitivity for detecting pulmonary nodules than radiology. One study reported that nodules as small as1 mm can be detected on CT, while nodules must be 7-9 mm to be reliably detected on radiographs. While there are many indications for thoracic CT, a primary use is to rule out metastasis prior to a surgical procedure. Additionally, by manipulating image display, CT enables detailed assessment of the location and extent of a lesion, aiding in tumor staging, radiation therapy, and surgical planning.

Abdominal CT

Uses in veterinary medicine include but are not limited to the diagnosis of portosystemic shunts, splenic and hepatic neoplasia, adrenal disease, and ectopic ureters.

Musculoskeletal CT

CT is more sensitive than radiography in detecting small fractures because the cross-sectional images eliminate superimposition. It is also useful in the diagnosis of intervertebral disc disease and other orthopedic conditions that are sometimes difficult to appreciate with conventional radiography.

For more information on CT at FVARC, please call (920) 993-9193.

CT for pets arrives in the Fox Valley

Computed Tomography at FVARC

Computed tomography (CT) has been available at the Fox Valley Animal Referral Center since December 2008. CT is useful for diagnosing disorders of the nasal cavity, middle and inner ear, brain, abdomen, lung, mediastinum, and the musculoskeletal system. There are several major advantages of CT over conventional radiography. First, cross-sectional CT images eliminate superimposition. Second, because of the high-contrast resolution of CT, various soft tissues can be distinguished. Third, data from a CT scan can be viewed as images in multiple planes, greatly enhancing diagnostic capabilities and aiding in therapeutic planning.

Unlike conventional radiography in which a broad x-ray beam is emitted from a stationary tube, CT images are made using a narrow x-ray beam that is emitted from a tube as it revolves 360 degrees around the patient. As the x-ray tube rotates, the patient is moved through the aperture of the scanner on a table in small increments (axial scan) or continuously (helical scan). Opposite to the x-ray tube are electronic detectors that record the intensity of x-rays exiting the patient. A computer reconstructs the data obtained from the multidirectional x-ray beam into cross-sectional images of the patient. Scan time is typically 30 to 60 seconds. Accurate patient positioning is vital to obtain optimal CT images. For this reason, animals are sedated or anesthetized.

CT images represent thin sections or “slices” of the patient, thus multiple images are required to view one structure. Thin slices are used to obtain high resolution images of small, high-contrast structures. Thicker slices are used to distinguish between tissues of lower contrast.

CT images are digital (comprised of pixels). Each pixel in a CT image is assigned a number (Hounsfield Unit [HU] or CT number) which represents the amount of x-ray attenuation by the tissue. HU is a unitless number representing the degree of x-ray attenuation in tissue relative to water. The scale of HU ranges includes -1000 HU for air, 0 HU for water, and +3,000 HU for compact cortical bone. Once a CT scan has been acquired, the range of HU displayed can be adjusted according to the tissue of interest.

CT can distinguish between various soft tissues and fluid types, such as blood versus transudate.

Images are usually acquired in the transverse plane, but data can be reprocessed to produce images in the sagittal, dorsal, coronal, or oblique planes as well as three-dimensional reconstructions. Intravenous contrast medium can be combined with CT to more clearly identify structures. Contrast CT studies include urography, myelography, portography, and angiography.

Head CT

CT provides superior high resolution imaging of fine structures including tooth roots, orbits, nasal turbinates, the nasopharynx, and cribriform plates. CT is particularly well-suited for examination of the nasal cavity because of the high contrast provided by bone and air-containing structures. It is the best imaging modality for diagnosing nasal Aspergillosis, showing turbinate destruction in exceptional detail. CT is ideal prior to rhinoscopy to aid in planning biopsies and treatment.

Brain CT is performed in cases of seizures, neurologic disease localized to the brain or cranial nerves, and head trauma. While MRI provides better soft tissue definition, CT is generally less expensive than MRI and has a shorter scan time, which may enable scanning without anesthesia in critically ill patients.

Thoracic CT

Of major importance, CT has significantly higher sensitivity for detecting pulmonary nodules than radiology. One study reported that nodules as small as1 mm can be detected on CT, while nodules must be 7-9 mm to be reliably detected on radiographs. While there are many indications for thoracic CT, a primary use is to rule out metastasis prior to a surgical procedure. Additionally, by manipulating image display, CT enables detailed assessment of the location and extent of a lesion, aiding in tumor staging, radiation therapy, and surgical planning.

Abdominal CT

Uses in veterinary medicine include but are not limited to the diagnosis of portosystemic shunts, splenic and hepatic neoplasia, adrenal disease, and ectopic ureters.

Musculoskeletal CT

CT is more sensitive than radiography in detecting small fractures because the cross-sectional images eliminate superimposition. It is also useful in the diagnosis of intervertebral disc disease and other orthopedic conditions that are sometimes difficult to appreciate with conventional radiography.

For more information on CT at FVARC, please call (920) 993-9193.

Grapes good for people, bad for pets...

Toxicology Grape and Raisin Toxicosis in Dogs

The American Society for the Prevention of Cruelty to Animals’ Animal Poison Control Center (APCC) reports a trend in dogs that have ingested grapes or raisins. Almost all of them develop acute renal failure (ARF). 

The source of the fruits did not seem to matter (whether store-bought or home-grown), and the suspected grapes and raisins tested negative for pesticides, fertilizers or antifungals. Ingested amounts ranged from over 1 pound of grapes to a single human serving size of raisins. 

Clinical signs include vomiting a few hours after ingestion, anorexia, diarrhea, lethargy and abdominal pain that can last from days to weeks. Blood panels frequently show hypercalcemia, elevated blood urea nitrogen, creatinine and phosphorous, which increase from 24 hours to days after ingestion. Oliguria and anuria (leading to death) are possible sequelae.

Treatment protocol: the exact mechanism of renal failure is unknown. Prevention of ARF can be achieved if treated early enough. APCC recommends inducing vomiting and administering activated charcoal in recent ingestions. Give intravenous fluids for 48 hours minimum and monitor blood chemistries daily. If blood work is normal after 72 hours, it is unlikely that renal failure will occur. If renal failure has occurred, fluids must be continued and other medications should be used to stimulate urine production. Some dogs may require peritoneal dialysis.

If you suspect your pet has ingested grapes or raisin, please contact your veterinarian.

Source:  Means, C: The Wrath of Grapes (from VIN) per:  22(2); 2002.