Category: Medical & Chronic Health (page 1 of 5)

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!

Dear Gord

Guest Author – Mandy Jackson, RVT

Gord megaesophagus fosterI put a dog to sleep yesterday.  He was my foster dog.  He came to me quite ill, and with a disease I knew I couldn’t cure.  Gord had megaesophagus.  What that meant for him was that his esophagus, the “tube” that carries food from your mouth to your stomach, was stretched out like a balloon that has been blown up and deflated dozens of times.  The muscular contractions, called peristalsis, that help move your and waste through your body did not occur in his esophagus.  I described it as though he had something like a pelican pouch in his throat.  When he ate, much of his food and water would collect in this “pouch”, rather than being digested in his stomach and intestines.  He regurgitated a lot of what he was fed.  He came to me emaciated, needing to gain about 35% of his body weight, a daunting task for both of us.  How do you get a dog who can’t maintain his weight to gain 20 pounds?

megaesophagus foster walkMegaesophagus is an awful disease.  To have a beautiful, kind and gentle soul in your home, starving despite your best attempts to feed him is heartbreaking for you, but unquestionably worse for him.  We tried several different textures and consistencies and with the help of a friend who also cared for Gord in her home while I was unavailable, we learned that “meatballs” worked best for him.  I’d roll his food into golf ball sized nuggets and toss them to him one by one, hold him sitting in the begging position and then go for a short walk.  Water was more difficult, but I taught him to drink from a huge rabbit bottle mounted so he had to hold his head up to drink.  After 3 weeks of trial and error I finally felt like we were on the right path.  That maybe, just maybe, he could be managed.  That he could potentially live a “normal” life.  For almost 5 days he gained weight and strength.  He was producing more urine, and it was becoming paler in colour, showing that he was better hydrated than before.  He walked faster on our short travels, not rude enough to pull me, but enthusiastic enough that I could feel a difference in him.  I was so very proud of him.

And then, on Thursday, I went to check on him in his run at work.  To give him his dinner and spend my lunch break walking him.  He had vomited 3 puddles of blood in his kennel.  My heart sank into my feet.  I will not go into more detail here, but it’s most likely that 2 years of poorly managed megaesophagus left his mind and spirit willing to recover, but his body just too damaged, the last 18 hours of his life caused a shocking transformation in his body and spirit.

Deciding to end the life of a foster is a uniquely horrible experience.  He wasn’t really “my” dog, but I had taken responsibility for his life and his care.  He was mine in trust, on loan, my temporary dog. I was only supposed to be a resting place, a bump in his road.  But there he was, getting sicker in front of me and waiting for me to make it better.  Not able to tell me how he felt, what he wanted.  I sat on my couch with his big, blocky, black velvet head in my lap and promised him that I would make it stop.  My beautiful Gord was not Gord anymore.  For the first time since I met him, he was in pain and that was not part of the deal I made with him.  I took him to work, one last sad car ride.  Carried him into the treatment room and gave his care over to 2 of the loveliest people I’ve ever met.  At the end of his life I wasn’t his nurse or his foster mom anymore.  I was just his person, finally.  Gord of No Fixed Address (the horrible nickname I gave him, a joke that started when a friend suggested I adopt him) was at home in my heart.  I climbed up on the table and wrapped myself around him, buried my face in that perfect spot behind every retriever’s ears and held him close.  He went quietly, left this world in the arms of someone who loved him enough to make that call. Gord with bear

Dear Gord,

I’m sorry.

=======================================

Mandy Jackson RVT

Mandy Jackson is a registered veterinary technician at the Kingston Veterinary Clinic.  Mandy shares her home with her 2 dogs, Auden and Olivia, and her cat, Floyd Pepper.  When she’s not at work, she co-runs Friends of Willow Rescue (an all-breed rescue), is a busy foster-mom, avid reader and a recent convert to the joys of crocheting.

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.

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