Category: Case Reports

Real life reports of patients that I’ve seen and have something to teach us.

Pets and Ibuprofen Don’t Mix

Otis ibuprofen toxicityThe following is a true story (used with permission) of how easily accessible medications, like ibuprofen, can be harmful to your pet.

Meet Otis.  His story is one that challenges the old adage about curiosity and cats, but he is a curious dog.  Don’t worry, he’s fine now; but he almost wasn’t.  While his person was sleeping one day, Otis took the opportunity to sample some medications that were accidentally within his reach.  Nobody knows his motivation but it’s a good thing his family noticed.  The culprit in this case was ibuprofen.  Yes, many people’s favorite, useful, pain relieving medication really is bad for your pets.

The first sign of trouble was the medication actually being found.  The liquid filled capsules were strewn about on the floor and with no one home other than Otis and his person, it was easy to figure out who the chew marks belonged to.  At this point, many people might be thinking “okay, no big deal.”  And then the vomiting started, which is the first sign of a toxicity issue.  Otis couldn’t hold anything down and the more he threw up, the worse his dehydration got.

otis-blood-resultsBecause ibuprofen toxicity can actually cause kidney failure along with the intestinal upset, his owner brought him to me to check some blood tests and what we found was consistent with ibuprofen ingestion as his kidney values were mildly elevated above normal.  Otis was admitted to the hospital and we started him on intravenous fluids to essentially help dilute the drug in his blood stream and preserve blood flow and pressure supplying the kidneys.  Without this treatment, Otis would surely become more ill.  In addition to the IV fluids, I started him on some medications to help gastrointestinal tract due to the ulcerations that can develop.

During his first couple of days, Otis started to show improvement.  He was happy, eating well, and most importantly – not vomiting!  But when we checked his kidney values, they had gotten slightly worse.  After talking with his family and agreeing that he was clinically stable, we felt it was best that he stay on his IV fluids for a couple more days.  Checking Otis’ kidney values daily for the next few days we noted that they returned to normal with the additional treatment.  After five days in hospital, Otis finally got to go home!

Otis taught us all a valuable lesson; one that he was fortunate to recover from.  While he got into ibuprofen accidentally, many people will try to self medicate their pets with over the counter medications that may not be safe.  This can inadvertently lead to permanent damage, or worse.  Please, for the safety of your pets, don’t rely on Dr. Google or your neighbor to prescribe something for your pets if they become ill; talk to your veterinarian.  Has your pet ever gotten into over the counter medications??

Otis ibuprofen going home

Otis got to go home!

Disclaimer: All blog posts may contain opinions which are my own and may not reflect those of any current or former employers.

Thanks for reading and don’t forget you can subscribe on the right side to get new posts directly to your email!  And I’m now on Instagram @drryanllera and as always on Facebook, Twitter, and Pinterest!

Diabetic Cats – Yes They Can Change!

Sal in hospital

Sal in hospital

The following is a true story (used with permission) of how diabetic cats can change their insulin requirements.

Sal is a 13 year old domestic shorthair cat who was diagnosed with diabetes in 2010.  He had been showing the initial signs of increased urination and having accidents outside the litterbox.  These signs, along with weight loss and increased drinking, are some of the most commonly noted first symptoms of diabetes or an alert to a pet owner that something is wrong.  Some cats may vomit, have a decrease in their appetite, or start to walk in a flat-footed position.  In later stages of not being diagnosed or treated, diabetic cats can have labored breathing and lethargy.

Insulin varieties

Insulin varieties

Back to Sal…  At the time of his diagnosis, he was started on insulin and his diet was changed to a higher protein, lower carbohydrate diet.  He had been doing well for a number of years and was considered to be a well controlled diabetic.  As part of our continuing care of these patients, we recommend doing a glucose curve every 6-12 months as part of their annual examination.  For some cats, we realize that the stress of the clinic setting might be too much for them and encourage home testing (which can be quite easy and most veterinarians will show you how!).  For cats that home testing is difficult either for the patient or the family (not everyone can stand the sight of blood), we do this testing in hospital.  Sal was one of these cats who fit into the latter category.

Hypoglycemia in diabetic cats

Hypoglycemia

Life happens and things don’t always get to go as planned; work or family obligations change, moving might happen, or the budget might be a little tight at times.  That’s okay and can be understandable…it even happens to us as vets too with our own pets and families.  Sal had been delayed in coming in for his annual check up.  His owner brought him in because he was seeming weak and hadn’t been eating well.  I examined him and checked his blood glucose level which was 1.2 (or 21.7 depending on your units)!  The average normal range for a cat is 4.0 – 9.7 (72.6 – 176).

So why did Sal present like this?  His signs were easily attributed to his low blood sugar (hypoglycemia) but his insulin dose had not been increased.  Well, it’s been known for some cats to convert to not needing insulin and their diabetes may be controlled by diet.  This is exactly what happened to Sal.  As he converted, his previously needed insulin dose essentially became that of an overdose.

Normal blood glucose

Normal blood glucose

Rest easy everyone.  Sal is doing fine.  We admitted him to the hospital and put him on intravenous fluids that contained dextrose to help bring his glucose levels up and remove the risk of seizures.  We checked his glucose levels without him getting insulin as well and he never went above the high end of normal so 2 days later he got to go home and now doesn’t need insulin injections!  For now he is doing well, but his family is still going to keep a close eye on him because there may come a time when he might need to start the injections again so he’ll be getting regular checkups from now on.

Disclaimer: All blog posts may contain opinions which are my own and may not reflect those of any current or former employers.

Thanks for reading and don’t forget you can subscribe on the right side to get new posts directly to your email!  And I’m now on Instagram @drryanllera and as always on Facebook, Twitter, and Pinterest!