Raisin Toxicity - Guess the number of raisins in a single cookie!

Grapes and Raisins are Toxic?
Actually, yes. The idea has floated around the internet as an urban legend, but it really is true. The exact mechanism that causes the toxicity is still unknown, but consumption of grapes or raisins by your dog can cause renal (kidney) failure which can lead to death.

How much is considered a toxic dose?
There are numerous variables that seem to play in to determining a toxic dose. The lowest known amount that caused a toxic response was about 1 oz, or 1/2 Tablespoon, of raisins. However, the animal's metabolism, other foods it may have eaten, size of the animal, and other factors combined determine whether an animal will be affected.

If you are a visual learner perhaps the following pictures will help you understand the potential danger. Some of our Veterinarians wanted to know just how many raisins are in a single oatmeal raisin cookie. So in the middle of a slow ER shift they found out! This dissection was of a standard 3" diameter cookie from a local supermarket bakery - the kind you might pick-up to bring to your next holiday party.

Cookie Dissection

One Cookie = 1 TBS Raisins

Drs. Fields & Germundson

Turns out this brand contains a whole tablespoon of raisins in a single cookie.  Who knew?  But really, in all seriousness, that means that if a 10 lb dog ate one cookie it could be a potentially deadly dose of raisins.

What should I do if my dog eats raisins or an Oatmeal Raisin Cookie?
The best thing to do is bring your pet to your veterinarian right away.  If the consumption of the raisins or cookies was recent the veterinarian will try to induce vomiting followed by administering activated charcoal to absorb any remaining toxins in the stomach.  A blood test will be used to check the blood chemistry values related to kidney function.  Your pet will be started on IV fluids to help flush the kidneys of the toxin and should be hospitalized to monitor blood chemistry levels as well as fluid input and output, another indication of renal condition.  If your pet is already exhibiting signs of renal failure medications such as furosemide, dopamine, or mannitol will be used to support the kidneys.

Caught soon enough, and provided with good supportive care,  your dog should make a full recovery.

If you perform any of your own at home dissection of oatmeal raisin cookies in the name of science be sure to let us know your results.  But, keep the raisins and grapes out of reach of your dog!

Thanksgiving Thankfulness

Thanksgiving is truly a wonderful holiday.  Time set aside for family, friends and remembering all there is to be thankful for.  Because really, no matter the circumstances, we can choose to find things for which we can be thankful.

Our pets usually rank on the "thankful for" list.  The funny noises, kisses, friendly swats, companionship and warmth make them wonderful additions to the family. 

As you prepare for your family dinner, no matter the size of your gathering, remember to keep your "Lucky" dog or cat safe with the food choices offered.  Cats and dogs don't usually do well with a lot of diet changes, especially if the food contains a lot of grease, fat, bones or skin.  So while your turkey tastes delectable you should only share a small portion of cooked meat and vegetables with your furry family members.

Another caution is to keep your pets out of the kitchen during prep time.  It is easy for pets to get under foot when they smell all the deliciousness being created in your kitchen, but that can be dangerous for you and/or your pet.  A recent patient found that out firsthand when the hot drippings from a roasted turkey got spilled on his back.  The 3rd degree burns healed and he is doing great, but Mom and dog learned to do things different the next time.

All the activity can be the way an otherwise indoor animal manages to escape outside when the door is open and closed to welcome visitors.  It's best to contain your pets to a room with a closed door or place them in a kennel until the activity level has died down a bit to keep them safe.

Warm wishes for a wonderful Thanksgiving from Central Veterinary Emergency Services at VRCC Veterinary Specialty & Emergency Hospital.

Picture from http://dynamitedogtraining.blogspot.com/

The Unforgettable Moment - The Loss of a Pet

So many of the Facebook posts and blog articles we post for VRCC are happy and carefree, sharing the excitement over the great outcome for a family and their beloved pet.  We love those stories - and rightfully so.  But what if you didn't get the happy outcome?  What if you, directly or indirectly, had to make a really hard decision and your pet isn't coming home?  What then?

“Zeke” Adopted February 4, 2000

Over the rainbow bridge and 

forever in their hearts –

September 24, 2009

Part of the everyday life of working with sick animals is walking through the process of letting go for pets and their humans.  It is a difficult process, whether it's a sudden accident or a long battle, and we don't take it lightly.  Sometimes it is easier than others, but they all have an impact.  We recognize that these animals are precious parts of other lives and each has a different story. 

As professionals in animal health we do our best to listen and empathize with clients during the pain of those moments. But we can't walk out the door with the clients and help them through the healing process.  What we can offer are some great resources that can help you or a friend on that journey.

The Pet Loss Support Page website has Ten Tips on Coping with Pet Loss on the home page.  They also have a directory of resources by state.  Just click on your states initials in the upper left hand corner of the home page.

Are you a parent wondering how to talk with your kids?  Gail Weinhold wrote an article in the Richfield Post talking about that very topic.  She has some great tips about memorializing the special place their pet had in their family and helping her children to grieve.  She also recommends the book Dog Heaven that can be found on Amazon.com. She ends the article with this thought.  "Think of their soft eyes, purring tummies or wagging tails and the answer is clear, they love seeing their loved ones happy.  In our house, we are still struggling day-by-day and sometimes hour by hour, but we recognize that our lives are better off because of the time we spent with our furry family member.  Life is precious and in the end every paw printed moment counts."  

Denver has The Human Animal Bond Trust (HABT) "which exists to serve those who are anticipating, or have lost, an animal companion".  The HABT provides the Denver Pet Loss Support Group which meets every Thursday evening at the Denver Area Veterinary Medical Society office at 191 Yuma Street in Denver.  Anyone is welcome to attend.  No reservation is needed.

CSU Veterinary Teaching Hospital has the privilege of having the Argus Institute on their campus that offers a client support program.  Counselors are available to help advocate for you and your pet's needs and to support individuals and families during and after the process of losing a pet. See their website for contact information and hours.  Argus Institute Website

The ASPCA offers a Pet Loss Hotline by calling (877) GRIEF-10.  This hotline can be utilized for assistance with the decision to euthanize as well as support after the loss.  The ASPCA website has additional articles and insights that might answer questions you still have.

Admittedly it is a sad subject, and yet one that is better acknowledged than ignored.  Loss is hard and I hope some of these resources, plus relationships to which you can turn, will help you on the journey to healing.

Will You Please Fill My Prescription?

More than a request.

As a Veterinary Emergency practice we often receive phone calls from clients who have run out of a prescription requesting that we either refill the medication ourselves or call the request into a Pharmacy.  The request seems innocent and simple enough, but there is more to the story.  Unless a veterinarian has examined the patient and prescribed the medication for the current condition we would not be able to say "yes" to the client's request.  Why?  It has to do with federal and state laws surrounding the Veterinarian-Client-Patient Relationship or VCPR.

The Creation of the VCPR.

The American Veterinary Medical Association, or AVMA, is made up of medically educated and licensed veterinarians who care deeply about the current practice and future well being of veterinary medicine as a profession.  Formed in 1863 and renamed to the AVMA in 1889 the association has helped form much of the foundation on which the profession operates.  Part of that foundation includes the Principles of Veterinary Medical Ethics of the AVMA originally approved by the House of Delegates in 1867 as the AVMA Code of Ethics.  The code of ethics includes the definition of the relationship between a veterinarian, their clients, and patients.  The state of Colorado has also defined the VCPR in the Veterinary Practice Act that governs the ability of veterinarians to dispense medications.

Establishing and Maintaining a VCPR

The VCPR is defined by the AVMA as a "relationship that exists when your veterinarian knows your pet well enough to be able to diagnose and treat any medical conditions your animal develops."  A VCPR is established when your veterinarian has the opportunity to examine your animal in person and continues only as long as regular visits with your veterinarian are maintained.  Once the VCPR expires, your pet would need to be reexamined by the veterinarian before any diagnoses or dispensing of medication could take place.  As stated by the AVMA "a valid VCPR cannot be established online, via email, or over the phone."

Ethical, Legal and Medical Basis

For those reasons the veterinarians at Central Veterinary Emergency Services have to deny the request to fill medication prescriptions for any animals they have not examined on an ethical, legal, and medical basis.  We truly want the best for your pet.  Our veterinarians have on average 8+ years of training and internships that give them the basis of knowledge by which they can examine, diagnose and treat your pets condition.  To be certain the best care is provided to your pet a personal examination is necessary in order to establish the relationship with you and your pet.  It couldn't be said better than as stated by the AVMA "a hands-on physical examination is incredibly valuable to your pet and can't be replaced by a phone conversation, web-based conversation, or e-mail description".

For more information about the VCPR visit the AVMA and Colorado's Practice Act websites

Marijuana Is NOT Safe for Pets

Dispensaries have popped up everywhere in Colorado since the legalization of medical marijuana.  As a result, our veterinary emergency service has also seen a marked increase in marijuana toxicity cases.  We see 2-3 cases of marijuana ingestion/toxicity per week compared to the 2-3 per month that used to be the norm for our hospital.

There is lots of information on the web that makes light of animals getting exposed to marijuana either accidentally or on purpose.  Unfortunately, some of the information would actually put your animal at risk if you followed the advice.

Marijuana is toxic to cats, and dogs.  The most common type of exposure is ingestion of the plant, or a baked good that contains various forms of the plant, like "marijuana brownies", "canabutter", or "hash cookies".  The main ingredient in marijuana is Tetrahydrocannabinol or THC.  THC can vary in strength from 0 - 70% depending on how it was prepared - the "canabutter" tends to be the most potent.  Dogs are far more likely to ingest marijuana than cats - 97% to 3%. 

Clinical signs of marijuana exposure (usually ingestion) include prolonged depression, vomiting, in-coordination (ataxia), sleepiness or excitation, increased heartbeat (tachycardia) or decreased heart beat (bradycardia),excessive drooling, dilated pupils, low blood pressure, low body temperature, uncontrolled urination, seizure, coma,  or even death - though it is very rare.

Should your animal display any of these symptoms it is important to bring  him/her to the vet right away.  It is also important to let the Veterinarian know about the possible exposure to marijuana.  The other most common toxicity that has the same clinical signs as marijuana is Ethylene Glycol.  The testing and treatment for Ethylene Glycol is much more involved and requires longer hospitalization to ensure the patient doesn't go into kidney failure.  The Veterinarian is not under obligation to report the owner/client to the police and it is better for all involved to treat the animal appropriately.


Treatment may include causing the animal to vomit if the ingestion happened within the last 2-4 hours. They are then given activated charcoal to decrease the absorption of THC or other psychoactive substances found in marijuana.  

Animals that ingest the marijuana in brownies or the hashish butter are at risk for chocolate toxicity or pancreatitis as well as the marijuana toxicity.  Additional treatment may be necessary to combat the effects of the other toxins.

Your pet may be hospitalized for observation of temperature, heart rate, and breathing, and for treatment with intravenous fluids, repeat administration of activated charcoal, and intensive nursing care if critical.  Some animals require sedation with Valium.  Most animals recover fully following treatment.

The moral of the story...Fluffy and Fido should not get into the stash.

Garden Design with Your Pets In Mind

Today is the official first day of spring and I'm itching to get into my garden.  Of course, your dog or cat usually follows you into the garden and there is always that one favorite spot where they like to dig or curl up for a nap, usually right on top of your favorite flower.  So how can we garden, with our pets in mind, to make it enjoyable for them and us?

I found lots of websites with ideas for designing your garden or landscaping with your pets in mind. The Gardening Know How website has a great post on Creating a Dog Friendly Garden and Sunset Magazine included an article titled How to Landscape a Dog-Friendly Garden.  Both are great articles and include some ideas to get your creative juices flowing.  Maybe your dog will even help with the digging. (just kidding)

In an emergency practice, of course, we see cases where animals have gotten themselves in trouble in the great outdoors, including the backyard garden.  So whether you are planning your spring planting, or your next major landscaping project, here are some additional things to keep in mind to keep your pets safe.

Thorns
First, consider the roses.  I love roses, but as I was pruning some this weekend I was reminded of my love/hate relationship with all those thorns.  If you plan to have roses, or other bushes with thorns, consider putting them behind a fence or up against the house where there is less likelihood of "Lucky" getting some nasty scrapes on the snout or in the eye.  The thorns can scratch the cornea causing permanent injury, infection and potentially loss of sight; thorns can also get embedded in the skin and form an abscess.

Mulch
In dry Colorado many plants do better with mulch to retain some moisture. Be aware that "Cocoa Mulch", which consists mainly of cocoa bean shells, is potentially dangerous to your pets.  The cocoa bean shells contain theobromine, a substance similar to caffeine that is not easily metabolized by animals.  Theobromine can cause vomiting, diarrhea, seizures,  ataxia (unsteady on their feet), and in serious cases, even death.

Lawn Edging
The metal demarcation between lawn and garden is supposed to keep the grass where it belongs.  Unfortunately,  it is a dangerous knife in the grass waiting for a soft paw to step just right and cause a serious injury.  Choose a plastic edging material, treated wood, or other natural material for your yard to eliminate this danger.  In a study done by Colorado State University Veterinary Teaching Hospital of the 60 dogs injured by lawn edging in the study, 85 percent of them needed surgery, and 18 percent required extensive surgical repair of skin, subcutaneous tissue, and muscle, tendon, or fascia.  We see multiple lawn edging injuries every year.

Wood Chips or Rock
Creating a rock walkway or zero scape area is pretty common and usually a great option in landscaping design.  But, if you have a dog that likes to eat wood chips or rocks it could become a daily hassle.  Some dogs, more so the large breed dogs like labs or golden retrievers, have a fetish for eating rocks or wood chips.  If it's just one or two rocks or a couple wood chips, no problem, it all comes out the other end.  But, if for some reason the dog gets stressed out or is overly bored and decides to eat lots of rocks or wood chips, you could be looking at a foreign body obstruction that requires surgery.  So consider your pet's habits when you choose a landscaping material or you may be saying "no, don't eat the rocks" many more times than you'd like.

Poisonous Plants
It's always good to review the lists of poisonous plants.  Unless they smell especially tasty it is unusual for the common plants found in most landscapes to be consumed by pets, but it's always better to be safe than sorry.  The fact that we had Peony's for years and our cats and dogs never touched them would be little consolation if yours decided to take a sample.

In the end, there is more likelihood of lots of enjoyable hours with your pet in the garden and your troubles could be as small as an occasional hole, stolen vegetables, or a squashed flower.  Just keep these few tips in mind and we wish you lots of happy gardening.

After the Vet Visit: The At Home Care Instructions

Imagine with me...it's 2 am and you  just got home from an emergency visit to the veterinary hospital.  "Lucky", your 2 year old black lab, was running in the yard and cut a tendon in his leg on the lawn edging.  You make it back home with his fresh bandage, e-collar, and a bag with pills in it and all you want to do is fall into bed.  When you wake in the morning your late night saga comes rushing back and you vaguely remember that "Lucky" needs a dose of medicine.  But you can't quite remember what to do.

Does that sound familiar?  Perhaps a different scenario, but the part about being confused about medicine or bandage changes, follow-up visits or food restrictions might resonate with you.  It can be confusing, and maybe even overwhelming, to get a sick or injured pet back home and be responsible for his/her care.  The important thing is to make sure before leaving the hospital that the instructions are written down and you ask questions.  Then never hesitate to call your Veterinarian's office if you don't understand the instructions.

Here are some typical home care instructions and why it is important to follow them:

1.  Medication instructions:  Most medications have a very specific amount and administration frequency to ensure the best outcomes for your pet.  It is important that you follow those instructions.  For instance, check if it needs to be refrigerated, whether the medicine should be given with food or on an empty stomach.  Read all instructions on the bottle and/or in the written instructions from your veterinarian.  If you are unsure, please call for clarification.  Also, if it appears your pets condition is not improving or you think the medicine isn't working consult with your veterinarian before increasing the amount or frequency of dose.  Increased doses could be harmful to your pet.

2.  Restrict Activity:  This is a tough one, but can be vitally important.  Fractured bones, deep or large cuts, stitches, neurological problems, etc are all conditions that may require one or more days of confinement for your pet so that healing can take place.  If your pet gets too active too quickly there is a greater possibility of added injury or longer healing time.  A crate, small room with a door, or quiet companion can all help to keep your pet from getting too rowdy.

3.  Bandage Instructions:  If your pet is sent home with a bandage the instructions will most likely include something like:

- Keep the bandage clean and dry.

- Check the toes twice a day for swelling. 

- Check the bandage for slippage, loosening, pain, limping, bleeding, heat, foul odor, etc.

- Check for rubbing or pressure sores at the top or bottom of the bandage/cast.

- Keep your pet from chewing at the bandage.

- The bandage should be checked by a Veterinarian in 3-5 days to reassess the wound and decide if the bandage needs to be replaced.

All these instructions are important to decrease the risk of infection and to increase the chances for healing.  If you are unsure call your vet and say "I don't know if this is a big deal or not, but".... and describe what is happening with the bandage and the area where the bandage is applied.  It's always better to ask.

4.  Elizabethan Collar or E-Collar:  We like to call them their "party hat"!  Not many pets like their party hat, but it is important to keep it on.  Pets have a propensity for chewing on bandages or ripping out sutures if left with access to the wound.  They may also try to lick a painful area excessively which can aggravate and cause additional problems.  So the longer they can wear the party hat the better.

5.  Diet Restrictions or Changes:  Often, if an animal comes in for vomiting and diarrhea the veterinarian will recommend restricting access to food or water for a short period.  This can help the pet feel better and can also be an indication of underlying causes should the conditions continue.  Other types of diet changes may include feeding a bland diet of rice or boiled chicken or perhaps adding some sort of fiber to the diet.  These instructions are important and should be followed as close as possible.  

6.  Re-check:  If you take your pet to an animal ER it is always good to call your family veterinarian to let them know about the visit and make sure they got a copy of the medical record.  You might also need to follow-up with bandage changes, staple or suture removals, or additional diagnostics.  Your family veterinarian can help with the follow-up care.  Re-checks and bandage changes are important to ensure a safe and full recovery or to find out sooner than later that maybe additional or different medications are needed or that the wound needs additional care.  Be sure to get back to a veterinarian if a re-check is recommended.

Albuterol Toxicity : Why Inhalers Help You, but Harm Lucky

Written by:  Sara Shypkoski

For many of the 22 million people in the United States with asthma a simple device known as an inhaler can offer almost immediate relief during an attack.

Inhalers are composed of a small pressurized canister that contains a solution of asthma medicine fitted into a plastic actuator that releases a fixed dose of the solution in an aerosol or inhalant form.  An Inhaler can either be used in emergencies to manage acute symptoms or on a daily basis to control chronic symptoms.  The majority of rescue inhalers contain albuterol, a drug used to stimulate the bronchial muscles in the lungs to relax and allow the air passages to open.  When used properly, an   inhaler is the safest, quickest, and most effective way to manage an asthma attack.

Unfortunately, to dogs the colorful plastic, small size and odd smell is something they won’t just pass by if they find it lying around. When his sharp teeth puncture the pressurized canister, the entire contents are released instantly. In a 60-lb dog, a full inhaler contains approximately 10 times the therapeutic dose of albuterol. In an overdose, these drugs affect both the bronchial muscles as well as the cardiac muscles. The results are immediate, severe, and include the following:

•    Increased heart rate (up to 200 beats a minute!)
•    Abnormal heart rhythms (arrhythmias)
•    Increased respiratory rate or panting
•    Abnormal behavior (Tremors, shaking, restlessness, hiding, agitation, lethargy, weakness)
•    Low or high blood pressure
•    Electrolyte abnormalities, most commonly low potassium
•    Nausea and/or vomiting

If you see your pet bite into or ingest an inhaler, or if your pet is experiencing symptoms of albuterol toxicity, take him to your nearest emergency clinic for immediate care. Bring the inhaler, and if available, the original packaging as well as any medications that your pet is currently taking. Do NOT induce vomiting at home or give your pet any over-the-counter medication.

Lucky will typically need to be hospitalized on IV fluids for 12 to 48 hours while his body metabolizes or gets rid of the albuterol.   An electrocardiogram or ECG machine will provide continuous visualization of his heart rate and rhythm, and his blood pressure will be regularly monitored. Blood tests will be used to check his electrolytes and regular doses of a beta antagonist (aka beta blocker) may be used to counteract the effects of the albuterol, an agonist. Other drugs may be given for muscle tremors, seizures, arrhythmias, vomiting, or diarrhea.

If treated promptly albuterol toxicity is rarely fatal, though pre-existing heart conditions or pets on other medications are at greater risk for complications. The best thing you can do for your pet is to keep those inhalers out of their reach. Avoid disposing of used canisters in trash cans that are accessible to pets as even used inhalers can be dangerous. Central Veterinary Emergency Services is available night, weekends, and holidays so that, if Lucky does take a bite out of your inhaler, you can breathe easier knowing that he’s in the best of hands and hearts.

Hit By A Car

It's scary when it happens.  Your pet darts into the road at the wrong time and gets tangled with an oncoming car.  But what do you do next?  How should the pet be handled? Should you take him directly to the vet?  What if he has an open wound? Or, what if he doesn't look hurt at all?

These are all great questions, but the main one I want to answer is the last one, what if he doesn't look hurt?  Maybe your pet came out of the incident with a small cut or a slight limp and you are debating whether a trip to the veterinarian's office is required.  On the one hand "Lucky" has lived up to his name and it's great that the external injuries are minimal.  However, the potential internal injuries that can't be seen are actually still life threatening.

When a client brings an animal to the vet that has been hit by a car obviously the external injuries are easier to see and treat.  Any lacerations, penetrating injuries, or fractures need to be assessed and treated appropriately.  But the Veterinarian is also observing and evaluating the animal for appropriate gum color, breathing difficulties, bleeding from the mouth, nose, or rectum, blood in the urine, indication of pain when touched, uneven pupil dilation, staggering, or inability to stand.  All of these are indications of potential head injury or internal organ damage that, if left untreated, can be critical or even fatal.

The Veterinarian will likely recommend x-rays to view the size and shape of internal organs, silhouette of the lungs, and whether there looks like free fluid in the abdomen.  Additional diagnostics may include a blood test that might indicate internal bleeding, and an ultrasound to get a better view at the internal organs if there is suspicion of injury.

Your pet may also need treatment for shock which would include intravenous fluids and hospitalization to stabilize before heading home.

Of course, we hope for the best possible outcome; that the pet truly has sustained no more than a couple scrapes and all is well.  We also believe that it is in your pet's best interest to get checked out at the Veterinarian's office should such an unfortunate event occur.

Gorilla Glue: Apparently To Pets It's Rather Tasty

Video Courtesy of KSL.com

Resting comfortably in his cage is a one year old boxer named Wiley who had an up close and personal experience with Gorilla Glue. Fortunately he didn't eat much, but what remained in his stomach had to be surgically removed.  He'll be feeling much better in a couple days.

CVES sees about 3 to 4 cases a year of Gorilla glue ingestion and so far most of those cases have had a positive outcome.  The problem with gorilla glue is that it can actually adhere to the stomach lining and, depending on the amount of time it remains in the stomach, may require removal of some of the stomach with the gorilla glue to get it out.

This is an example of the type of mass the glue can grow into.  This was not the actual glue removed from Wiley.  You can see that about three quarters of the bottle was consumed and it grew into a size significantly larger.

On the Gorilla Glue website you'll find this statement:  Gorilla Glue is a polyurethane glue. All polyurethane glues foam when they come in contact with moisture and may cause gastro-intestinal blockage if swallowed. This is not unique to Gorilla Glue, but true of all polyurethane glues. If you think there has been a case of ingesting the glue, seek medical or veterinary advice immediately.

The primary signs of a problem after gorilla glue ingestion are vomiting, diarrhea, and poor appetite.  If you suspect your pet has ingested gorilla glue get him or her to a veterinary hospital right away.  Gorilla Glue has its place, but do your best to make sure that place in not in your pet's stomach.

Hypothermia in Pets

Winter finally hit in Colorado.  With temperatures in the teens and 20s and overnight lows dropping below zero it is important to take some extra precautions to keep you pets warm.  Some dogs are more sensitive to the cold than others. Small breeds, short haired dogs, puppies and geriatric dogs, dogs that are normally "indoor" pets, and those with heart or other medical conditions are all more sensitive to colder temperatures. A dog's normal body temperature is between 99.5 and 102.5. When a dog fitting one of the above descriptions is exposed to colder temperatures he or she often has a difficult time keeping his/her core body temperature within the normal range. When the temperature dips below the normal range hypothermia sets in. Hypothermia means that your dog is loosing body heat faster than it can be replaced.

Signs of hypothermia:
- shivering
- lethargy
- stiff muscles
- pale or gray gums
- stumbling or lack of coordination
- fixed and dilated pupils
- low heart and breathing rates
- collapse
- or even coma

With mild hypothermia your dog is likely to be shivering and appear lethargic. As the hypothermia increases in severity the other symptoms become evident.  Your dog becomes increasingly unresponsive as his body goes into heat conservation mode. At this time your dog's focus will be on keeping his vital organs working by restricting the blood flow from all other parts of the body. If it's not treated, hypothermia can be fatal.

Prevention is Key
Dogs sensitive to cold should be kept inside with quick potty breaks outside. The small dogs and short haired breeds benefit from a doggy jacket that helps to keep their core warm. Booties may also be a good idea as lots of heat escapes through a dogs foot pads.

Treatment
Mild hypothermia can be reversed by getting back in a warm environment and wrapping your dog with a blanket until the shivering stops. Hypothermia that has dropped the dogs temperature to the 90-94 degree range will require rewarming methods. Water bottles filled with warm water placed around your dog deliver a safe warm heat source. Stay away from heating pads as it is easy to burn your dog's skin. It is recommended that you take your animal to your family veterinarian or veterinary emergency service for observation and/or treatment if you need to treat for hypothermia. Severe hypothermia requires immediate veterinary intervention. Unfortunately, it may be difficult to reverse the damage at this level of hypothermia, but we can hope for the best.

Cuddle up with your four-legged friends and stay warm!

Skiing and Your Dog

Winter in Colorado is a funny thing.  Storms can dump feet of snow in the mountains and not a flake will reach the valley and plains.  Such is the case this winter.  The great part is that the feet of snow in the mountains makes for great skiing, on the slopes or back-country, whichever you choose. But if you choose to bring your dog into the woods with you, consider his safety.

A very energentic 11 month old Visla was having fun in the woods with his owners, who were on snowshoes, when a back country skier collided with their dog.  Unfortunately, the dog sustained a severe laceration to his right front leg that needed immediate medical care.  The edge of the ski sliced through the muscle and a nerve, cutting down to the bone.  The owners were able to get him to Central Veterinary Emergency Services where the ER Veterinarian sutured the wound.  This sweet dog lost a lot of blood, but he recovered well and was sent home that evening.  It will be 2 - 3 months before the Veterinarian and his owners will be able to determine the full extent of his injuries and whether he suffered any long term effects from the accident.

Fortunately there is a positive ending to this story, but had his owners been in the back country when this happened he might not have faired so well.

Outside magazine has a great article that describes the steps to train your four footed friend to behave safely around you as you're skiing, but it really depends on the dog. Cross-country skiing is less dangerous, but, as some commentors pointed out at the end of the article, is still best done with a well trained dog.

The moral of the story... enjoy the great outdoors, but consider how well your dog can obey commands before bringing him along.

Toxic Compost Pile

Composting has become a rather common practice as  more people look for ways to "go green" or to simply decrease their food bill.  The booth at the farmers market was busy all summer long describing the various systems of composting and how to get started.  If you are considering starting your own compost pile and have a dog, consider the method that is best for keeping your four legged scavenger out of the pile.

Unfortunately, a largely unknown danger may be lurking in your compost pile.  A substance identified as a tremorgenic mycotoxin could be growing in your pile and if ingested by your dog, could cause a serious or even deadly reaction.  Tremorgenic = shaking, tremors, seizures and mycotoxin = poisonous fungus.  Penitrem A is a type of tremorgenic mycotoxin associated with the Penecillium fungi that can be found in compost piles and spoiled food.

If you see your animal get into the spoiled garbage or catch him eating from the compost pile it is best to get him to a Veterinarian who can induce vomiting, especially if symptoms of poisoning are present.  Symptoms of toxicity include increased heart rate, panting, tremors, very excited or anxious, vomiting, hyperthermia or fever, and if enough has been ingested, or if left untreated, can develop into seizures or even death.

Treatment will include making the dog vomit followed by a dose of activated charcoal (also known as Toxiban) that helps to absorb any remaining mycotoxin left in the stomach.  Then medication will be administered to stop the tremors which will help decrease the body temperature.  Additionally IV fluids and other supportive measures will help flush the poison from the body and make the dog more comfortable. 

Tremorgenic Mycotoxin is not a common household name, but if your dog is caught munching in the compost pile it's one that you know warrants immediate action with a trip to the Veterinarian.  Tell "Lucky" to leave the compost for the garden - he has plenty of delicious food in his dog dish!

My Pet Is Having A Seizure - What Do I Do?

It's been a busy holiday weekend for Central Veterinary Emergency Services.  When I asked one of the Technicians the most common condition among the cases her response was that we had seen all kinds of conditions without any common theme.  Then just an hour later we had three dogs come in for seizures all in a row. 

This sweet Rottweiler may look like she's ready or Christmas, but the bells are actually to alert us if she starts having more seizures. 

Seizures are an indication of something else going on in the body.  The cause can originate from a toxic exposure, epilepsy, too much calcium after having puppies, a tumor, a head injury, or multiple other disease conditions.  Your veterinarian can take a full history and do some diagnostic testing to rule out possible causes and narrow down the reason for the seizures.

Watching your cat or dog have a seizure can be frightening.  His body may tense up. He may have a far away look on his face along with body twitching or feet paddling. His whole body may shake and convulse. He may start drooling and seem unaware of your presence.  He may even stop breathing or urinate or defecate on himself.

The best thing you can do for your pet during a seizure is to keep both of you safe. Protect him from rolling off a bed or couch, or falling down stairs. Keep your hands and face away from his mouth so he doesn't unknowingly bite you. Place pillows or blankets under his head and between his body and sharp corners or furniture.  Remove other pets from the area.  Dim the lights and turn off load noises like TVs or radios to provide a quiet environment. Time and record the length and intensity of each seizure.  Call your veterinarian right away to determine if an immediate visit is advisable. Be sure to inform your veterinarian of any possible exposure to a poisonous substance.

Give your pet some time to recover.  He may be groggy or "out of it" for a while.  Once he has returned to normal (within about 10 to 20 minutes) he can resume regular activities.  Allow him to go outside for a potty break if he is stable on his feet and seems aware of his surroundings.  It may be advisable to keep him in close proximity for a while to see if another seizure develops.

A seizure can be an isolated incident or they can become recurrent.  Medications can be prescribed by your veterinarian to control seizure activity.  As always you know your pet the best ,so be an advocate for him to be sure he gets care if you are concerned or feel like something isn't right.

Thanksgiving Safety for Your Pets

Just a couple days left to finish your meal planning and decorating for the start of the holidays. What is your favorite part of the Thanksgiving dinner? The turkey, or maybe ham, mashed potatoes with gravy, or let's not forget the stuffing and pumpkin pie. Are you drooling yet? Guess who else is drooling? Or maybe a four legged feline is walking between your legs, purring loudly, letting you know he wants some too.

Pets add a special part to any holiday celebration, whether you are entertaining one or 20. You may be tempted to include your pet in the festivities by handing him some table scraps or letting him lick your plate clean. For the sake of your pet, and your stress level, you may want to rethink that "treat".

Pancreatitis
Dogs that are fed very fatty food can develop a sudden onset of pancreatitis. Symptoms of acute pancreatitis may range from mild to very severe. The symptoms are similar to those of other diseases and may include a very painful abdomen, lack of appetite, depression, dehydration, a 'hunched up' posture, vomiting, and perhaps diarrhea. Fever often accompanies these symptoms. Cats can get pancreatitis also, but they don't usually have the acute symptoms and it is usually associate with other causes.

Turkey Bones
The other common food indiscretion at Thanksgiving are the turkey bones. Even if you try your best to keep your pets out of the turkey carcass they have a way of being sneaky just when you turn your back. Cooked turkey bones can be brittle and will shatter easily when chewed. The sharp slivers of bone are dangerous if swallowed. They can get caught in the throat causing him to choke, or pierce the stomach or intestine requiring surgery. Sometimes the bones will pass uneventfully. To increase the likelihood you may feed your dog some pieces of bread. The thought is that the bones will get encased in the bread and decrease the danger of passing through the intestinal tract.

For either of these instances, if your pet is vomiting, has diarrhea, seems very week or lethargic, has pale gums, or seems painful it is best to bring him to see a Veterinarian right away.

Hopefully these tips will decrease your chances of needing a Veterinary Emergency Room on Thanksgiving, but if you do, we'll be open all day and would be happy to see your pet. If you are in the Denver area just call 303-874-7387.

From our Veterinary ER to you, we wish you a very Happy Thanksgiving!

Coughing Kitty

Have you noticed a persistent cough from your favorite feline?  There are a few possible reasons for a cough.  They range from a respiratory infection or asthma to parasites or even a heart condition.

If you've recently adopted your kitty from a shelter it's possible that he/she picked up an URI or Upper Respiratory Infection.  URIs can be be either bacterial or viral.  Either way you should separate her from other cats in the house and have her seen by a Veterinarian for diagnosis and treatment.

There are simple things you can do in your home to help decrease respiratory problems.  Keep the air clean and smoke fee, use a litter with little to no dust, be careful about cleaning products - if you have a hard time breathing when you use them your cat probably does to.  It is also important to decrease stress for your kitty.  Give her a safe place to get away from young children, other pets, or loud noises.

See my early post titled "Cat Air" for  more information on a heart condition known as cardiomyopathy that can be indicated by a persistent cough.

If the cough is combined with decreased activity, decreased appetite and less drinking it is important to get her in to see a Veterinarian right away.  These signs could indicate pneumonia or other infection that could be life threatening.  Cats tend to hide illness much longer than dogs and often by the time the signs are evident they are already very sick.

The AAHA PetsMatter November/December edition has a great article on coughs in cats as well.  Be sure to jump over to their website for additional information.

Herbal Remedies for Animals

CAVM aka Complementary and/or Alternative Veterinary Medicine is a growing segment of the veterinary market.  CAVM can include chiropractic, acupuncture, homeopathic, naturopathic practices along with use of herbal remedies, Bach flower essences,  massage, traditional Chinese medicine, nutraceuticals, and many other modalities. This blog post is not intended to make a recommendation for or against CAVM treatment options.  Rather, as I have done in many other posts, in order to keep you informed and your animal safe I will point out some products or practices that without proper application could be potentially harmful to your pet.

I will mention that there are strong opinions on both sides concerning the use of CAVM modalities in Veterinary Medicine. As with any type of medicine, it is important to research the education and practice background of the person providing treatment. Treatment of your dog or cat by someone unfamiliar with small animal anatomy, physiology, and body systems may prescribe a treatment that while non-toxic for humans, could be potentially life threatening to your pet.

For instance, there are herbal remedies that affect animals differently than people.

Garlic:  Garlic is used in herbal remedies in whole plant form or infused oil for its antiviral, bactericidal and fungicidal properties.  Like onions, garlic ingestion can cause anemia in pets.  Anemia is a decrease in the number of red blood cells or hemoglobin in blood.  Since hemoglobin caries oxygen from the lungs to tissue, severe anemia can have negative effects on multiple organs and systems in the body.  Symptoms of anemia often show up three to five days after an animal has ingested the vegetable oil.  Exposure to garlic oil on the skin can cause a dog or cat to have allergic reactions of the skin or asthmatic attacks as well.

Chamomile:  This herb is often used in tinctures or teas as a digestive aid, stress reducer, poultice for cuts or burns or for the treatment of abscesses.  It can also be found in oil form.  For animals chamomile causes vomiting and lack of muscle coordination.

Oil of Wintergreen:  Are you familiar with Bengay ointment?  Bengay and other natural pain relieving ointments use Oil of Wintergreen as a main ingredient.  It comes in ointment or oil form and is applied to the skin to relieve muscle pain.  The scientific name for this type of medicine is a Salicylate.  Salicylates are toxic to cats and dogs.  Signs of salicylate toxicity include nausea, vomiting, restlessness that progresses to seizures and coma.

Tea Tree Oil:  Ridding your animals and house of fleas can be a tough job. One of the suggested methods is the use of Tea Tree oil as a topical application for your pet as well as a spray for bedding.  Tea tree oil can be toxic to pets if applied in large quantities or groomed off the skin by the pet.  According to the ASPCA "clinical effects that may occur following dermal (skin) exposure to significant amounts of tea tree oil include loss of coordination, muscle weakness, depression, and possibly even a severe drop in body temperature, collapse and liver damage."

Moral of the story...what's good for the goose may not be good for the gander.  In other words, talk to your veterinarian about herbal remedies before using them for your pet.  Your pets may be thought of as human, but their body systems are very different and some medicines don't cross over well.

Much of this data can be found in Kirk's Current Veterinary Therapy volume XII

Counterfeit Pet Drugs - FDA Warning

US - COUNTERFEIT PET DRUGS The FDA has issued a consumer alert to pet owners, warning them about the dangers of buying discounted pet drugs online. The FDA warns that its own investigations have found online companies that sell unapproved drugs or other counterfeit products and some will sell them without a veterinarian prescription. The FDA advises pet owners who want to buy online drugs to place orders at sites that are a Vet-VIPPS (Veterinary-Verified Internet Pharmacy Practice Sites) accredited pharmacy. (Veterinary Advantage)

I know it is sometimes tempting to try to find a "deal" on medication for your animal, but the FDA has issued a very valid warning with good reasoning behind their concerns.  Website pharmacies who dispense drugs without a veterinary exam or try to evaluate your pet through a questionnaire on their website are potentially putting your animal in danger.  It is very difficult to assess and diagnose an animal without an actual hands on examination.  Often, results of blood tests must be reviewed before dispensing certain medications to ensure that your pet will not be harmed by taking the drug.

There are two types of medications sold online through disreputable websites that are especially concerning.

NSAIDS - Non steroidal anti-inflammatory drugs
Heart Worm Medication

I've written about NSAIDS before  under the title Is She In Pain? as well as the post titled Top 10 Human Medications that Poison Pets.  In addition to that information there is really only one NSAID that can be given to cats and it is only approved for one injection after surgery.  Otherwise, any NSAID given to a cat can cause life threatening kidney damage.

 Secondly, heart worm medication can be harmful or even fatal to your dog if already infected with heartworm.  Before starting a preventive program, all dogs should be tested for heartworms.

Adult heartworms produce millions of microscopic "baby" heartworms (called microfilaria) into the bloodstream. When you give a monthly heartworm preventive to a dog with circulating microfilaria, this can cause the sudden death of microfilaria, triggering a shock-type reaction. Even if your dog does not have this type of reaction, heartworm preventives do not kill the adult heartworms (although they may shorten the worms' life expectancy). This means an infected dog will remain infected with adult heartworms.

Unfortunately, as long as a pet remains infected, heartworm disease will progress and damage the heart and lungs, which can lead to life threatening problems. Giving heartworm preventives to heartworm-positive dogs can mislead an owner into thinking everything is all right, while within a pet, heartworm disease is worsening.

The moral of the story...look for the Vet-VIPPS certification before buying online.

Halloween From Your Pet's Perspective

Halloween is a fun time of year, especially for kids and many pet owners who consider their pets to be their kids. While it's great to go all out for the holiday and have fun with dressing up and decorating, there are some aspects about the event that need a little oversight.

Dr. Pointer with the ASPCA gives some great tips to keep your pets safe this Halloween. Dr. Pointer covers things like pet costumes, candy, and proper identification. You may have heard these before, but perhaps you have recently adopted, or purchased, a new pet and this is your first Halloween. Watch the video for ways to keep your "Lucky" safe.

Remember, how you view Halloween and how your pet perceives the holiday are very different. The costumes, constant doorbell ringing, candy smells and burning candles can be very unsettling to even the most friendly dog or cat. Keep that in mind as you look for your favorite costume for this Halloween.

Trick-or treat!

Pennies Cause Zinc Poisoning in Dogs

I saw a headline recently that caught my attention from the sheer craziness of the animal involved in the story.  The headline was Puppy Survives Swallowing 113 Pennies.  Why would any animal swallow that many pennies? Then I got to wondering, how many dog owners  know that swallowing even one penny can be cause for concern for their four-legged friend? 

Penny starting to corrode in stomach

It's true that this story is not the norm, most dogs will only swallow one or two pennies, not 113!!  In our ER we see a case about every 4 months where a dog has found a penny and decided to find out how it tasted.  The problem is the contents of the penny.

All pennies minted after 1983 have a zinc core covered by copper.   Pennies are just heavy enough that they tend to stay in the stomach even when the animal has been given medication to make him or her vomit.  The acidic environment, depending on the amount of food in the stomach, can cause the penny to break down rapidly.  Once the penny starts to corrode the zinc is released into the bloodstream and causes anemia and liver damage.  It could take a few hours to a couple days before signs of toxicity start to show up.

Corroded penny removed from Dachshund

Signs of zinc toxicity and anemia can include extreme tiredness, vomiting, bloody urine, decreased appetite, and seeming depressed.  These signs signify the need to get your dog to the vet very quickly.

Radiographs and blood tests will be used to determine the cause of the symptoms.  Once penny ingestion and zinc toxicity is determined the immediate treatment goals will include decreasing zinc absorption, correcting anemia, minimizing liver damage, and removing the penny.  Most likely the penny will be surgically removed although endoscopy may by possible if the penny is still sitting in the stomach.  The time it could take to allow the penny to pass, if it even will, could cause irreparable damage to the liver or even death.

Once the penny is removed the patient may need a blood transfusion to correct the anemia and will be given IV fluids to flush the liver to help the body get rid of the zinc. Additionally, the dog may receive Pepcid for stomach upset and/or an anti-nausea medication to prevent vomiting.  Supportive care may be needed for additional days or weeks depending on the amount of toxicity and how the animal responds to treatment.

Other common objects or products that contain zinc include zinc supplements, diaper rash ointment, sunscreen containing zinc oxide, automobile fuses, wire, and some nails. But the one most often overlooked is still the penny.

The moral of the story...you can't count your pennies with your hound dog by your side!