Author: Dr. Ryan Llera (page 2 of 27)

Cats, Strings, & Intestinal Things

cats and string

from kittenwhiskers.com

The country song goes “Mamas don’t let your babies grow up to be cowboys…” and the same thing applies to cats playing with string.  Media is chock full of images of kittens playing with balls or yarn whether it be cartoons, advertisements, or the endless supply of cute videos on YouTube.  But behind all this cuteness lies a deadly risk if a cat eats string, thread, yarn, or dental floss.  These kitties can be fixed but it’s not easy.  This is Mira’s story…

Mira cats and string

Mira

Sometimes you see your cat eat the string and sometimes you don’t.  Often times the first thing you may notice is vomiting.  This was the case with Mira.  At just 2 years old, she’s still an intensely curious cat.  All cats may vomit from time to time – hairballs, catching a mouse, chewing on plants, but never just vomiting out of spite.  When Mira started vomiting multiple times over several hours, her family knew something wasn’t right and brought her in to see us at the Kingston Veterinary Clinic.  The diagnosis was easily found as soon as Dr. Vander Wilp, a colleague of mine, saw the string wrapped over and under her tongue.

When a string gets trapped at this spot, the other end of it starts moving through the stomach and intestines.  Essentially what happens is the string begins to act like a saw cutting through the intestines as it pleats them like an accordion.  Palpating a cat’s abdomen like Mira’s you can feel the intestines bunched up and thickened.  At this point, we weren’t sure how long the string had been present.  What we were all sure of was that Mira needed help in the form of surgery.

Yet, surgery isn’t just a simple snap of the fingers.  Many factors need to be considered.  Due to her vomiting, Mira was dehydrated.  With the risk of the string cutting into the intestines, blood and protein gets lost through these injuries which can complicate healing as well as leaking intestinal contents contributing to infection.  And the biggest mystery, what will you do once you’re there actually seeing the abdominal contents.  Mira’s family elected to go ahead and get her fixed up.

cats and string

Mira’s plicated intestines

Once we had her on some IV fluids and got her a bit better stabilized, I took her into surgery and investigated the damage.  In total, 7 perforations were noted and I discovered the other end of the string was in the colon.  Effectively, it was acting like a drawstring on pair of sweatpants pulling on her intestines at both ends.  Due to the number of perforations and their locations, the best option was to remove a large section of intestine and reattach the good ends.  After releasing the ends of the string through separate incisions in the stomach and end of the small intestine, I removed 32cm of the small intestine and reattached the ends before rinsing her abdomen and closing her up to recover her.

Over the next couple of days, we monitored Mira in the hospital.  Things weren’t going as we had hoped.  She wasn’t eating, kept spiking fevers, and seemed generally quieter than expected.  She only would eat tiny amounts when her family visited.  On the third day post-op, we checked some blood as she still wasn’t doing as we expected and noted several changes in the blood cell count and protein levels that concerned us and raised the suspicion that something had broken down inside.  The results were worse than before the initial surgery.  Despite all the precautions and steps we had taken to help Mira, something was leaking.

After some discussion, her family elected to have us attempt a second surgery as a means of fully discovering the extent of the problems and to fix what we could.  As soon as I got back into her abdomen, I had all the explanation we needed.  Her anastomosis site (the reattached portion) had broken down and a small leak was seen near it.  Given the amount of damage that was found and the previously removed section of intestine, I felt it best to call her family immediately and give them an update.  Assessing the extent of everything internally, I let them know her prognosis was very guarded to poor even with attempting a second repair and advised them that euthanasia was not an unreasonable option.  Her family conferred for a moment and told me to do my best to save her.  Back in surgery, I removed as little intestine as possible that was no longer viable and reattached the new ends.  After a very thorough rinsing of the abdomen and closing her back up, we all hoped for the best.

blood donor cat

Pioneer, the blood donor

Great news the next morning!  Her temperature was normal and she greeted us with alertness and purring unlike any other morning before.  A recheck of her blood now showed dangerously low levels of red blood cells and protein.  Mira needed a transfusion to give her the best chances for survival.  Luckily, one of our staff members volunteered to have her cat donate.  Mira received the much needed blood and was on the complete road to recovery.  By the next day, she was feeling spunky, her blood values had improved, and she was eating everything we gave her.  Mira was going home.

cats and string

Mira getting her transfusion

I like to think of Mira as a little “Mira-cle in May.”  Not all cats get this outcome.  It took the right combination of family commitment, veterinary team care, and a bit of luck.  The important message here is that when your pet seems sick, it’s best to not wait to see if it will pass — at a minimum, please talk with your veterinarian.  Waiting too long could make things worse.

Disclaimer: Blog posts may contain some opinions which are my own and may not reflect those of any current or former employers. Mira’s story is published with permission from her owners and some non-essential details have been omitted for brevity.

Don’t forget to follow along on Instagram @drryanllera , Facebook , or  Twitter for more pet info and interesting daily happenings!

Why Wounds Shouldn’t Wait

The warmer weather has finally arrived.  Dogs and cats are out playing.  Outdoor cats are once again patrolling their territory.  Sometimes that playtime or territorial behavior can end up in somebody getting  a cat or dog bite wound or other type of injury caused by their exploration.  You know what else is back?  Bugs….specifically flies, mosquitoes, fleas, and ticks – but more on this later.

Superficial wounds would classify as scrapes, scratches, abrasions, and bruising.  In many of these cases, they can be addressed at home by basic first aid cleaning.  Yet, if it doesn’t seem to be going well, you should get your pet in to be checked by their veterinarian.  It’s the nasty bite wounds and lacerations that I’m mostly worried about.

dog bite wound

A wound that waited too long

In medicine, we have what is called the “golden period” when discussing wounds.  This is the optimal time period in which we have to clean and repair a wound.  Over the course of history, the length of time has varied between 6-24 hours.  Generally, after this time, wound repair becomes more complicated as the edges have generally dried up or become necrotic.  This is the real reason it’s a bad idea to wait or try to treat these larger or deeper wounds at home.  The longer it takes for a wound to be addressed leads to increased pain, risk of infection, time to heal, and increased costs.

dog bite wound

Drain placement for a pocketed wound

Some wounds might be simple punctures.  Yet, some of those puncture wounds also include pulling away of the skin from the underneath subcutaneous layers.  This creates a pocketing effect where inflammatory fluid can accumulate.  If the hole closes up too quickly and the wound hasn’t been adequately flushed, this is how abscesses are created and drain will need to be placed during a surgical procedure.  The time it may not go exactly this way is bite wounds on the legs which causes a diffuse, painful inflammation around the muscles and nerves – this is one of the most common reasons I see outdoor cats limping.

From Univ. of Florida Entomology Dept

Remember those bugs?  Flies are the worst ones when it comes to wounds as they have no decency!  Some flies may lay eggs in a pet’s wound and when that happens what amounts to an alien horde is going to beam down next.  Once the eggs hatch, you get maggots.  Ick!  While they prevent the wound from healing, they can also lead to further infection and pain.  Maggots need to be cleaned out, in one piece, and the dead tissue needs to be removed followed by additional treatments.  Breaking or crushing maggots could lead to the release of substances that can cause shock, an anaphylactic reaction, or even death.

As you can see, wounds can be a serious matter and in some cases just “waiting to see how they turn out” could lead to further problems.  At a minimum, get it checked out and don’t delay.  Early intervention can prevent bigger problems in the long run!

Disclaimer: All blog posts are my own opinion and do not reflect those of any current or former employers.

You can also find me on Instagram @drryanllera and as always on Facebook & Twitter!

Keep Calm and Socialize Your Pet

Animal behavior is one of the hardest areas of veterinary medicine.  I’ll admit it…it’s not my favorite area and we got virtually no education in the subject during my time in vet school in the early 2000s.  While myself and many other veterinarians have gotten continuing education in the field, behavior problems are still the top reason for animals to be surrendered or euthanized.  It’s a complicated and gray area but I want to give you one of my top tips to help your pet.

Socialize, socialize, socialize!!!

Cat buddies

For dogs & cat, the prime development period where they truly learn to form relationships is between 3-16 weeks of age.  Most of the time, puppies & kittens are still with their mothers until at least 7-8 weeks of age and they can learn to develop a hierarchy.  They will also start to bond with the people who are caring for them.  It’s the time they come home that they can truly start to develop a personality and meet different people.  Use this time to start puppy classes or for your kitten encourage friendly play. Invite your friends over and use the bribery of treats or playtime to let your pet get used to different people.  For cats though, it can likely take a longer time and with people who have a quiet demeanor.

Rudy the couch potato

Additionally, you want to get your pets to meet other animals.  Maybe you have other pets or friends with pets.  You want the interactions to be fun and friendly.  My own dog Rudy has his own issues.  We adopted him when he was 14 months old.  He was given up supposedly for his non-stop energy and activity.  I’m going to call that out as a lie.  He can be a regular couch potato.  Yes, he’s got allergies but he’s also a jerk a lot of the time.  His problem is he doesn’t know how to greet other dogs.  Most of the time he wants to play but to the casual observer he looks like he wants to fight.  We have made our best efforts to help him, and he’s improving, but a lot of this could have been avoided through some proper socialization and behavior training.

socialize your pet

Grateful kisses from Max

The last thing that particularly is troublesome is animals who are afraid of somebody giving them a possibly endless supply of cookies.  Yeah, I’m talking about pets visiting the veterinarian…and most dogs don’t leave without spoiling their dinner with liver treats.  I’m happy when pets are healthy, but I think it’s a disadvantage to them in terms of stress in visiting an unfamiliar place.  I want to encourage everyone to start with your young cat or dog, bring them in regularly for visits just to say hi, get a few treats, or hop up on the scale.  A visit without any poking or prodding can go a long way to reducing stress during those medical visits.  But it doesn’t stop after they become adults.  Your pet should visit the vet at least once a year, even if they seem healthy, it’s good to get that confirmation from your veterinarian but also to maintain a friendly relationship between your pet & their vet.

I encourage you to help your cat or dog adjust to their new life with you and to be a role model for other pets.  Ask your veterinarian or friends and get references for trainers in your area if you need help.  Some of them will use properly updated methods that are more positive for your pet while others use what may be considered archaic or negative reinforcement.  Trust me, your veterinarian and their staff will also thank you for having a well behaved pet.  By encouraging good social skills, our pets can live happier and healthier lives.

Disclaimer: All blog posts are my own opinion and do not reflect those of any current or former employers.

You can also find me on Instagram @drryanllera and as always on Facebook & Twitter!

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