Duke Nearly Died Last Night
This is a story of how Duke nearly died but was saved by the ER/ICU service at the UC Davis VMTH. I wrote this on 5/07/2002, a few days after the event to send to our Bouvier e-mail list. I publish it here as I wrote it.
The moral of the story is always be ready to make a middle of the night visit to veterinary Emergency services.
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Sunday before last, while I was still siting shiva for my Sweetie, good kind old Duke damn near died from something kinda off the wall.
Those of you who have been on the list a long time should remember Duke. He is the dog whose life was saved by q deluge of mail and phone calls from list members about 4 years ago. He'd shown up in the night box at the Sacramento City Pound with a note that the Pound thought mad ehim sound aggressive, so they were absolutely determined to kill him, but our wonderful list members browbeat them into releasing him to me. That night he got out and hit by a car, shattered foreleg and tricky orthopedic repair. His first adopter died suddenly a year after adopting him. his second adopter had family members who werent very dog-smart and Duke took advantage of them. so he came back to me shortly after Bonsey died, and I looked into his eyes and promised him that he could stay here for the rest of his life. that was two years ago.
So now Sunday afternoon , I had a few hours and chose to take the dogs for a walk rather than sit at the computer. normally a very good choice. It was a beautiful spring day (something unusual in Davis where we normally have only two seaons : Hot & Dry vs Cold & Wet-or-Windy. Towards the end of the walk, when Duke often is lagging a bit, I looked back to see him really stuffing down weeds. Since too much grass eating tends to cause an irreitated throat, I put him on leahs and hauled him along out of rach of grazing. put him in my bedroom and shut the stretch gate so he couldn't go into my yard and graze. I've had a number of incidents with a number of dogs of a dog doing obsessive grass eating : first they eat something rough that irritates the throat , then they eat more grass trying to relieve the itch and it becomes a viscious circle. The usual cure is to confine them a few hours or over night and maybe also give some yoghurt to sooth the throat.
That evening I watched my favorite Sunday SciFi shows and 60 Minutes (= redeeming social importance). Late during 60 Minutes, having previously seemed OK, Duke started occasionally retching gagging and trying to cough up something. He'd be OK for 10 or 15 minutes and then have a spell of trying to cough up something. He started bringing up white foam and some of it seemed tinged with red, ie fresh blood. I started worrying at that point. I felt his belly -- NOT tense or painful or even faintly distended, thus NOT bloat.
So I phoned the VMTH -- knowing that the primary emergency vet on weekends is the vet who used to own the private practice we go to, Dr Joan who is absolutely marvelous. Had to talk to the 4th year student who was on emergency intake and she relayed to Dr Joan. Now I really should have insisted on talking to Joan herself directly because she would have heard the concern in my voice as being more significant than the symptoms I described.
At that point I thought we almost certainly had an especially bad case of the Grass Eating Obsession syndrome. But I was a bit worried that , since we'd walked by the creek, maybe maybe longshot he could have swallowed a fish-hook or perhaps , less of a long shot, some tinfoil trash from someone's lunch. Message relayed back was to give him 25 mg of Benadryl to sooth the irritation and either take him in bathroom and turn shower on hot (hot moist air treatment) for a while or else use a cool mister or vaporizer in the room. I did so, but over the next hour or so he got worse.
So I called again and this time said that I was bringing him in because I was genuinely worried. At the very least knowing that x-ray could rule out fish-hook or tinfoil. And knowing Joan would damn well figure it out if anyone could. And that if I spent our $130 walk-thru-the-door fee to find out that he was actually perfectly all right, it would be well worth it.
Well at this point his breathing was starting to get rapid. when Joan took his temp , it was up 2 degrees. I don't think she liked his mucous membrand color either. She got him into x ray -- no waiting line at midnight , and emergency x ray service is a bargain ($100 for as many as you like). Then she checked him into the ICU (Intensive Care Unit), put him on IV fluids and antibiotics and put him into an oxygen cage so he could have higher oxygen content and moist air. He definately had disturbed breathing. Somewhere along the line of course she drew blood for a chem panel -- always one of the first moves when you don't know what's wrong, as it often gives you a good shove in the right direction. The x-rays showed a small pebble in his tummy but also showed definataely NOT bloat -- a relief to me as I was starting to fear maybe I'd missed it andf if so that extra hour or more would be very serious. Then she used valuim and ketamine to put him under enough that she could really see into his throat, including to see if he might have larngeal paralysis. She saw nothing visibly abnormal in his throat, ie upper part that can be seen.
Next day , after a night of disturbed breathing and continued efforts to retch up something, with his blood oxygen and his temp being continually monitored. temp down, but still needs oxygen support. A number of vets conferred. At this point they are pretty well convinced that he ate grass with or without some added undesirable ingrediants and that in trying to vomit it back out, he probably aspirated plant material and stomach fluid into his lungs. Some debate about whether to do the bronchoscopy now or later . Decided to do sooner rather than later. And that object in his tummy hasnt moved, sitting right at the exit from tummy into intestine. seem to be two much smaller bits next to it. So they plan to do bronchoscopy first and then put the endoscope down his esophagus and into his stomach to see and clear out whatever is in there. The scope is a fiberoptic that lets you see quite a bit of what is at the far end and there is a little grabber that can let you take a biopsy sample of tiseue or let you grab hold of foreign objects and bring them out.
They had him on the table from mid aftenoon into evening. Found his trachia damn near obstructed by vegetation -- grass, foxtails, a whole wheat head. The obstruction was just above where the trachea splits into two big bronchi. Then they did the best they could to examine as much as possible in both lungs. Now I used to think of the lungs as big empty sacks filled with air; not so, acttally they are much like sponges , with the air-channels branching branching branching smaller and smaller. so there is no way you could ever explore all the possible channels. but they did bring quite a lot out. Finally they had removed everything they could see except out of reach were one wheat seed and one blade of grass. Later on after recovery he brought up a blade of grass, presumably that blade of grass. It could be he also brought up the seed but swallowed it into esophagus, which would be ok. NO way to be sure that other stuff didnt remain unseen in the lungs. They brought up a huge mass of vegetation out of his stomach. they couldn't see the pebble and assumed it had passed on down the line. The next day's x ray showed it was still there in stomach but was moving around freely. It is small enough that it will sooner or later pass out and eventually make its way to the rear exit. We will continut to check x rays weekly -- or untill I find it in his poop.
He spent another day in IC and then another in the wards. He was not needing oxygen by the time he went to the wards. By this time they had culture and sensitivity tests on his tracheal wash, so they adjust the antibiotics to be those most suited to combat his pneumonia.
Sent him home Thurs morning. He's on two antibiotics and I nembulize (= moist air treatments) him several times a day , followed by coupage ( = thumping on his ribs with cupped hand fairly vigoursly to help loosen any guck inside his lungs so he can cough it out).
Two ways you can nebulize at home. well acutally three if you have a shower in your bathroom ( ie run hot water and steam the room up thoroughly). I can take my cool mist vaporizer (buy for aobut $20 at any drug store) and connect it to a big tube (eg wrapper from newpaper ) leading into a "space helmet" or "nembulzation hat" which is an elizabethan collar with the front covered over with plastic wrap -- leaving a small exit hole of course. so moist air from the vaporizer flows into the covered e-collar. The third way, and what Duke likes best, is to take an X-pen (or a crate) and cover most of sides and top with plastic drapes of some kind ; put vaporizer inside so outflow goes into the cage. leave it running half an hour or more. For a crate, I'd put the vapourizer in front of the door and hang the drapes to enclose it. For an x-pen , you can criss cross the outer two panels so the vapourizer is in a little triangle cage of its own. That's so the dog can't tip it or chew the electric cord.
Duke likes going tint his moist air tent -- this probably feels good -- and he wags his tail and looks happy while I coupage him afterwards. His temp has stayed down , normal, and his respiration rate and overall quqlity of respiration is pretty much normal. He coughs a bit when I coupage him -- which is supposed to happen. A bit of coughing other times. He's on restricted excercise. He gets freedom of house (about 1200 sq ft available to dogs , as they dont get to go into office of back porch) and yard (50 x 70 or so) is OK as he isn't the kind of dog to be very active.
Gotta watch him carefully for abnormal temp, respiration, vomit, diarehha , blood in stool, etc etc. Thre are some very nasty things that might still happen but most likely wont.
IF I HAD NOT TAKEN HIM IN AT MIDNIGHT SUNDAY, HE WOULD HAVE DIED BEFORE MORNING. He would have died of suffocation before morning. or even if he survived till then , he'd have been in much much worse shape for the 'scopy proceedures and might not have lived thru the anesthsia. and he would almost surely have been badly brain damaged from insufficiaent oxygen.
ANY TIME YOU ARE WORRIED THAT YOUR DOG IS IN BIG TOURBLE AND NEEDS TO SEE A VET VERY SOON NOW, YOU ARE PROBABLY RIGHT. TAKE HIM INTO EMERGENCY CLINIC OR VET SCHOOL NOW. DONT WAIT TILL MORNING. HE MAY WELL DIE.
DUKE WOULD HAVE DIED OR BEEN BRAIN DAMAGED.
Duke got to live several more years of very good quality life.return to top of page