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Pet Health Medical Emergencies

Common Pet Health Medical Emergencies when you must bring your pet for examination and treatment as soon as possible:

Acute Paralysis

Loss of function of one or more limbs can indicate damage to nerves, spinal cord or blood vessels.

Dachshunds, other long backed dogs, Dobermans and other breeds are prone to degenerative disc disease; discs can rupture and put pressure on the spinal cord leading to pain, then loss of function, usually affecting the back legs. 

Any dog, or cat, dragging their rear quarters or any limb warrants early treatment to improve chances of full recovery. 

Animals that have sustained trauma may rupture discs, dislocate vertebrae or fracture the spinal bones...causing damage to, or even severing, the spinal cord. 

Some of these patients can be repaired and rehabilitated to full recovery.  Trauma of any kind can damage nerves to a portion of leg or a part of the body.

Dogs can sometimes sustain sudden pain and loss of function secondary to clots to the spinal cord, called fibrocartilaginous infarcts.

 Cats, and rarely dogs, can throw blood clots (called thromboembolisms) related to heart disease or other factors.  These blood clots often end up obstructing blood flow to the rear legs, leading to pain, then loss of function and stiffness of the rear limb muscles. 

Treatment is complicated and successful recovery is uncommon, but possible.  Treatment has to include investigation and treatment of the inciting cause, and measures to reduce risk of repeat clots. 

Cats that throw blood clots are usually affected with various forms of heart dysfunction, called cardiomyopathy. 

Allergic Reactions

Dogs are more affected than cats but either can react to vaccinations, other prescription medications, or, most commonly, the bite/sting of an arthropod (insect or spider).  Reactions can include vomiting, red skin, itchiness, hives, and swelling of face (especially around eyes and muzzle) and ears. 

Of greatest concern is compromise to the breathing due to similar internal swelling.  These patients can be miserably uncomfortable, or just happy and very swollen.  Straight forward therapy can rapidly reverse their symptoms and is always recommended to reduce risk of breathing difficultites. 

If the reaction appears to be caused by recent vaccination or a medication he/she is on, alternative vaccination strategy or different medications would likely be part of the recommended plan.

 Anemia

Dogs or cats can suffer weakness and oral mucous membrane pallor due to anemia.  In a small number of cases, this is due to recent blood loss.  In most cases, it is due to lack of red cell production or rapid destruction of the red cells.

Anemia can be caused by infectious disease, certain parasites, cancer, kidney failure, bone marrow disease and in situations where the immune system destroys the red blood cells. 

The latter condition, often called "Autoimmune Hemolytic Anemia" is a variable and usually very serious condition, often secondary to other problems, that requires intervention.  In many of these patients, therapy may include transfusions with whole blood, packed red blood cells, or hemoglobin based oxygen carriers. 

In all cases, therapy is directed by results of diagnostic tests and may include locating and removing bleeding tumors, treating kidney failure, eliminating parasistes, suppressing the immune system, etc. 

Cats often show few signs of anemia, though you may notice decreased activity or increased rate of breathing, along with pale gums. Dogs often are more noticeably quiet, have reduced tolerance for activity or become profoundly weak.

Birthing Difficulties (Dystocia)

Dogs and cats occasionally have difficulty having babies.  This can be related to disproportionate size (small litters often produce large kittens or puppies), uterine inertia (a lazy uterus), low blood sugar or calcium levels, twisting of the uterine horns or other problems. 

It is an emergency if the mother is actively pushing for more than an hour, of if a puppy/kitten is visible in the birth canal for more than 10-15 minutes. 

Signs that you should take welping dog to a veterinarian as an emergency.   

  • Strong abdominal contractions for greater than 30 minutes with no production of a fetus
  • Weak straining for greater than two hours
  • Greater than four hours between puppies
  • Prolonged gestation greater than 68 days
  • Retained pup at the vulva for more than 10-15 minutes
  • Lochia (green/black discharge from vulva) present for 3 hours with no delivery of pup
  • Copious clear discharge
  • Bloody discharge
  •  

    Cats, and sometimes dogs, can take long breaks between babies; if they are not distressed and are not pushing, it is less of a worry. Treatment can involve medications to induce labor, obstetrical manipulations or surgery (C-section).  

    Bloat (GDV, or gastric dilatation and volvulus)

    Dogs of certain conformations (deep chested) can acutely twist their stomachs.  In some cases, it is a matter of being too active too soon after eating, it can be related to eating too fast or eating something out of the ordinary, and it can be related to chronic problems (gastritis, inflammatory bowel syndrome, cancer). 

    In all cases, gas and/or air accumulate in the stomach faster than the dog can eliminate it, the stomach becomes bouyant and rises up along the body wall, then flips. 

    Once it twists (called volvulus), the blood supply to stomach and spleen is compromised, tissues begin to die and many complications may ensue...including rapid progression to death. 

    Affected patients are often (not always) visibly distended and retching loudly, sometimes expectorateing frothy fluid.  The potential complications include pain, heart rhythm disturbances, shock (lack of effective circulation), reperfusion injury, systemic inflammation, and death.

    Treatment is needed right away, and includes IV fluids, pain medications, medications to support the GI tract and surgical intervention to reposition the stomach, attach it to the belly wall so it can not twist ever again (called gastropexy) and to inspect and repair any damage to the stomach and spleen. 

    Surgery also includes measures, such as biopsy, to identify any underlying cause.  In young patients that are treated early, recovery is usually fast and uncomplicated.

    In patients who were bloated for a longer period of time before treatment and in older patients or those with pre-existing conditions, recovery can be prolonged and associated with any number of complications. 

    Still, these days, this is mostly a fixable problem when identified and treated early

    Blunt Force Trauma

    Blunt trauma (as opposed to penetrating trauma) can occur with vehicular impacts, falling from a height or being stepped on.  Very serious internal injuries can occur without any visible wound or mark on the outside. 

    This can include internal bleeding, bruising or bleeding into the lungs, ruptured urinary bladders and damage to other internal organs, including heart and brain. 

    Early intervention usually results in better outcome

    Breathing Difficulties

    Cats and dogs suffer a variety of problems than can lead to increased rate or increased effort of breathing.  When breathing is ineffective, tongue and gums can turn purple or blue (called cyanosis) and patients are usually anxious. 

     Breathing difficulties can arise from irritation to oropharynx, nose, upper airways or lower airways and lungs, partial obstructions, lung disease, chest wall disease, allergic airway disease (asthma) and a variety of problems in the chest. 

    Infections (pyothorax, pneumonia), aspiration of material into the lungs and airways, cancer, electric shock, heart failure, rib fractures, head trauma, seizures and certain metabolic diseases can cause altered breathing. 

    Abnormal and noisy breathing in warm weather can reflect upper airway problems, including laryngeal edema or paralysis.  Old labradors are often affected with gradual paralysis of the vocal cords that leads to acute upper airway obstruction during exertion in hot humid weather. These dogs need immediate help, and ultimately may benefit from surgery to pull the vocal folds out of the way.  

    Short faced dogs often have elongated soft palates, which can become entrapped in the epiglottis and present in acute distress;  over time much damage can occur and, sooner better than later, surgery to shorten the elongated soft palate is in their best interest. 

    Many small dogs have weak and collapsing tracheas, exacerbated by exertion or excitement and resulting in cough, noisy breathing and sometime fainting. 

    Cats can be subtle about impending crisis.  Fluid accumulating in chest or lungs may not affect them until it is very advanced, and they can then decompensate very rapidly.  Cats with rapid breathing, open mouth breathing, noisy breathing, etc, should be evaluated right away.

    Upper respiratory infection can manifest, especially in cats, with nasal discharge and sneezing or snorting.  This is less urgent, but they are uncomfortable and would benefit from care as soon as possible.

    In general, a patient with open mouth breathng, turning blue, having noisy breathing, struggling to breath or becoming exhausted by the work of breathing need immediate care, which often involves oxygen, mediation to reduce anxiety and specific therapy based on their actual problem.

    Choking

    Acute gagging and distress can indicate obstruction or irritation of the oropharynx and/or upper airways, which is true choke.  Esophageal foreign bodies can cause great distress, but these patients are able to breath and are not turning blue. 

    Choke is often associated with objects, such as the dog who catches a slippery racquet ball in his mouth and can't dislodge it. 

    If the circumstance is such that you know the crisis is related to such an object, a modified Heimlich maneuver is appropriate;  suspend with head down and give a sharp blunt press to the abdomen.  Object may come flying out.  This procedure is not appropriate for most other situations. 

    Whatever else you do, you should be working your way to the nearest veterinarian with appropriate experience.

    Dental Problems

    Problems related to teeth are very common, but uncommonly an urgent issue.  Fractured teeth are very painful and pain medication is needed if a dog or cat acutely breaks a tooth. 

    Untreated, infection of the root and jaw can occur.  If the goal is to preserve the tooth, early treatment yields a better result, but root canal and crown restoratoin may be needed. 

    With certain traumas, usually vehicular accidents or major falls, there can be simple or complicated fractures of upper or lower jaws, which will require repair and which may damage the teeth.

    Chronic dental problems are associated with gum disease, bad breath, loose and lost teeth, difficulties eating and other problems. 

    Good dental health prevents problems.  An older, sick or traumatized patient with chornic orodental disease is at risk of infection spreading to bloodstream, lungs, kidneys, heart valves and other vital organs, complicating the treatment and recovery.

    Diabetic Complications

    Your pet will not die immediately from a blood sugar that is too high;  a blood sugar that gets too low can kill.  When in doubt (diabetic pet is not eating, is vomiting, or is not acting quite right) do not give next dose of insulin. 

    If you give insulin and your pet seems groggy or dazed, assume their blood sugar is getting too low and given honey, Karo syrup or sugar water....and call for advice.  Many times, much more care will be needed to get them out of danger and one needs to figure out why their sugar levels got low.

    Diabetes may be secondary to pancreas problems (such as pancreatitis) and can be associated with complications such as infection, liver disease and other endocrine problems (such as Cushing's disease). 

    Uncontrolled diabetes can escalate to ketoacidosis, which can rapidly escalate to life threatening proportion and requires hospitalized care. 

    Management of diabetes in harder in cats than dogs, is never as 'tightly controlled' as it is in people and involves diet, insulin (in most cases) and certain medications. 

    Monitoring involves doing insulin response curves and checking fructosamine levels;  these things are most often done with your primary care veterinarian.

    It is important to realize that every patient metabolizes insulin differently and that there are many types of insulin.  Getting just the right long term treatment plan can involve time and some trial and error.

    Diabetes mellitus ("sugar diabetes") is not the same as diabetes insipidus ("water diabetes").

    Difficulty Urinating:

    Difficulty Urinating can be a much more serious problem. In male cats, the penis can be blocked completely by a "plug" of crystals that have formed in the bladder. If your cat is straining and passing small amounts of urine then this can probably wait until normal consulting hours, even if the urine is bloody. But if he's unable to pass urine at all for a period of 8-12 hours or more, then he needs immediate treatment. This urgent problem is unlikely in dogs or female cats.

    Dog and Cat Bite Injuries

    Dog and cat bite wounds are often very serious, with a significant risk of infection if not cleaned early.  Dog bites often cause significant crushing and tearing injuries, especially if there is a large dog attacking a smaller one, if multiple bites occur, and/or if there is grabbing and shaking involved. 

    What is visible after the altercation may be 'tip of the iceberg' with substantial tissue damage below the surface that needs to be irrigated and drained.  Very serious internal injuries, including ruptured organs, perforated intestines, and internal bleeding, can occur even in the absence of visible external wounds.

    Naturally, these wounds are often painful.  Cat versus cat fight wounds often become infected very quickly and can lead to extensive tissue loss, requiring reconstructive surgery;  this is partly because of the nature of microbes in cat mouths, the fact cat teeth penetrate deeply when afflicting a wound, and because their skin tends to seal over the wound quickly. 

    Dog and cat bite wounds should be treated as soon after the fact as possible;  treatment usually involves pain managemnt, irrigation and closure of the wounds where appropriate, placement of drains and antibiotics.

    Ear Problems

    Dogs and cats can develop very uncomfortable ear problems related to infection (bacteria or yeast), foreign bodies or parasites (ear mites). 

    Itching can be intense and affected animals may shake and paw at the ear or ears.  A bad odor or unusual discharge may become obvious.  Some will develop massive swelling of the ear flaps (pinnas) that will require drainage.  After a point, they are pretty miserable and inflict increasing damage to themselves and there is often rather little that can be done for them at home.

    Treatment involves identifying and eliminating the underlying problem, pain relief, protective measures (such as an E collar or bandage), drainage, and medications to control infection and/or inflammation. 

    Over time, chronic infections can lead to permanent damage to the pinna and/or the ear canals and surgical treatment may become necessary.

    Eye Problems

    In general, eye problems require immediate attention to prevent damage from self trauma and permanent damage that can affect vision.  Eye injuries are often very painful, including superficial scratches to the cornea.

    If a dog or cat is squinting, rubbing at the eye, rubbing the eye along things or producing much discharge, patient needs help ASAP. 

    A very 'bloodshot' or red eye, one that seems to be cloudy or one that seems to be bulging requires equally urgent attention.  These symptoms can be due to foreign objects, superficial trauma, allergy, infection, glaucoma, etc.

    In certain dogs and certain types of trauma, the eye can be displaced from the socket;  this is called a prolapse.  If treated early and there is no penetrating wound to the globe, early repair can allow full and normal function. 

    In some cases, nerve or muscle damage will occur that may or may not affect the function (whether he or she can see, make tears, or close the lid properly) and which may, or may not, affect the cosmetic appearance of the eye.

    Fractures

    Limbs that are held at awkward angles or are dangling, especially if it happens acutely and is associated with a fall or similar trauma, may be broken and/or dislocated. 

    Pain management is obviously needed and stabilization of the injury with splint or sling is most often necessary, to prevent damage to nerves, muscles and blood vessels related to the fracture fragments moving around. 

    Some fractures are best treated with surgical repairs, including bone plates and screws, bone pins and wire, external fixators and other techniques.  This is especially true in very large and active animals, or in the very old animal. 

    Tiny toy breed dogs, because of the paucity of muscle and blood supply, often require bone plate fixation as early as possible to assure suitable outcome.

     Heatstroke

    Overheating is most common in dogs and often associated with hot humid weather, excessive activity and/or ineffective cooling.  In some cases it is secondary to accidental exposure (e.g. being locked in a car) or seizure activity.  In can be cause or effect of upper airway obstruction, such as larygneal paralysis or swelling. 

    Overheated animals can suffer systemic complications, including multiple organ dysfunction, inabilty to clot blood, brain injury and death.  Rapid cooling is an appropriate first aid measure, but should not delay professional treatment. 

    Cooling the dog with cold water from a hose or immersion, ice packs, etc, should occur rapidly and affected animal then immediately transported for emergency treatment. 

    This is a classic situation where early and aggressive intervention notably increases survival rate.

    Hit by Car
    Injuries from animals that are hit by cars vary greatly and can include lacerations,
    abrasions, fractures, internal hemorrhage, and organ damage. Initially signs may be
    mild but can progress over several days. Therefore, veterinary attention for all
    animals hit by motor vehicles is strongly recommended.
    Prevention.
    Do not allow animals to run loose. Keep dogs on a leash.
    Neuter male dogs and cats-neutered animals tend to roam less. Check underneath parked
    vehicles for animals.

    Treatment.
    Diagnostic tests to determine the extent of injury may include
    x-rays and bloodwork. Treatment will depend on the nature and severity of injury and
    may include IV fluids and medications for shock, blood loss, and pain, surgery for
    lacerations and fractured bones, etc. 

    Ingested Poisonous Plants

      Lilies
    Members of the Lilium spp. are considered to be highly toxic to cats. While the poisonous component has not yet been identified, it is clear that with even ingestions of very small amounts of the plant, severe kidney damage could result. 

    Marijuana
    Ingestion of Cannabis sativa by companion animals can result in depression of the central nervous system and incoordination, as well as vomiting, diarrhea, drooling, increased heart rate, and even seizures and coma. 

    Sago Palm
    All parts of Cycas Revoluta are poisonous, but the seeds or “nuts” contain the largest amount of toxin. The ingestion of just one or two seeds can result in very serious effects, which include vomiting, diarrhea, depression, seizures and liver failure. 

    Tulip/Narcissus bulbs
    The bulb portions of Tulipa/Narcissus spp. contain toxins that can cause intense gastrointestinal irritation, drooling, loss of appetite, depression of the central nervous system, convulsions and cardiac abnormalities. 

    Azalea/Rhododendron
    Members of the Rhododenron spp. contain substances known as grayantoxins, which can produce vomiting, drooling, diarrhea, weakness and depression of the central nervous system in animals. Severe azalea poisoning could ultimately lead to coma and death from cardiovascular collapse.

     Oleander
    All parts of Nerium oleander are considered to be toxic, as they contain cardiac glycosides that have the potential to cause serious effects—including gastrointestinal tract irritation, abnormal heart function, hypothermia and even death. 

    Castor Bean
    The poisonous principle in Ricinus communis is ricin, a highly toxic protein that can produce severe abdominal pain, drooling, vomiting, diarrhea, excessive thirst, weakness and loss of appetite. Severe cases of poisoning can result in dehydration, muscle twitching, tremors, seizures, coma and death. 

    Cyclamen
    Cylamen species contain cyclamine, but the highest concentration of this toxic component is typically located in the root portion of the plant. If consumed, Cylamen can produce significant gastrointestinal irritation, including intense vomiting. Fatalities have also been reported in some cases. 

    Kalanchoe
    This plant contains components that can produce gastrointestinal irritation, as well as those that are toxic to the heart, and can seriously affect cardiac rhythm and rate. 

    Yew
    Taxus spp. contains a toxic component known as taxine, which causes central nervous system effects such as trembling, incoordination, and difficulty breathing. It can also cause significant gastrointestinal irritation and cardiac failure, which can result in death. 

    Amaryllis
    Common garden plants popular around Easter, Amaryllis species contain toxins that can cause vomiting, depression, diarrhea, abdominal pain, hypersalivation, anorexia and tremors.

     Autumn Crocus
    Ingestion of Colchicum autumnale by pets can result in oral irritation, bloody vomiting, diarrhea, shock, multi-organ damage and bone marrow suppression. 

    Chrysanthemum
    These popular blooms are part of the Compositae family, which contain pyrethrins that may produce gastrointestinal upset, including drooling, vomiting and diarrhea, if eaten. In certain cases depression and loss of coordination may also develop if enough of any part of the plant is consumed. 

    English Ivy
    Also called branching ivy, glacier ivy, needlepoint ivy, sweetheart ivy and California ivy, Hedera helix contains triterpenoid saponins that, should pets ingest, can result in vomiting, abdominal pain, hypersalivation and diarrhea. 

    Peace Lily (AKA Mauna Loa Peace Lily)
    Spathiphyllum contains calcium oxalate crystals that can cause oral irritation, excessive drooling, vomiting, difficulty in swallowing and intense burning and irritation of the mouth, lips and tongue in pets who ingest.

    Pothos
    Pothos (both Scindapsus and Epipremnum) belongs to the Araceae family. If chewed or ingested, this popular household plant can cause significant mechanical irritation and swelling of the oral tissues and other parts of the gastrointestinal tract. 

    Schefflera
    Schefflera and Brassaia actinophylla contain calcium oxalate crystals that can cause oral irritation, excessive drooling, vomiting, difficulty in swallowing and intense burning and irritation of the mouth, lips and tongue in pets who ingest.

    Ingested Batteries

    When dogs ingest alkaline batteries, there is both risk of obstruction and serious tissue damage.  Tissue damage can occur in mouth, esophagus or stomach related to leaking alkaline fluid from batteries that have been bitten. 

    Swallowed intact, batteries can lodge in such a way as to generate current causing burns or perforations. 

    Measures to remove the battery are indicated to protect against obstruction and electric burns;  other measures are taken to prevent or treat caustic injury from the fluid.

    Ingested Foreign Objects

    Dogs and cats frequently eat strange and dangerous things. 

    Strings, ribbons and dental floss are particularly common and dangerous to cats.  Bone fragments, clothing, expansive glues and practically any object known to humans has ended up inside a dog. 

    Some dogs are fortunate and pass or vomit up the foreign object.  In others, the object lodges in esophagus, stomach, intestines or rectum, causing tissue damage and pain.

    Early intervention sometimes allows successful non surgical recovery of some foreign objects.  In many cases, surgery is needed to remove the objects and inspect/repair any damage. 

    Perforation of the gastrointestinal tract and resulting septic infection of the abdomen or chest (in the case of esophagus damage) is a dangerous but treatable outcome if the object is sharp or has lodged for a long enough time in one spot. 

    Certain objects (sharp bones, fishhooks, etc) are inherently more dangerous and some objects can lead to complications related to metal intoxication (lead, copper, zinc).

    Electric Shock

    Electric shock is most often related to puppies or kittens biting electric cords.  Damage is entirely dependent on the course the electricity takes and may be limited to localized burns of the mouth, or damage to internal structures. 

    After electric shock, some patients develop severe fluid congestion of the lungs (called non cardiogenic pulmonary edema) which can be life threatening and which requires treatment for best chance to have a good outcome

    Lacerations

    Cuts and scrapes are probably one of the most common veterinary emergencies.
    While small, superficial abrasions will likely heal on their own, larger and deeper
    lacerations will likely need medical attention. Lacerations in the mouth, on the face,
    on the feet, and on the tail will often bleed more profusely than lacerations in other
    areas. Lacerations that do not stop bleeding on their own or with simple direct pressure
    need medical attention. In addition, the skin is the first line of defense against
    infection. Therefore, any laceration has the potential to become infected.
    Prevention.
    While some lacerations are unavoidable, there are some simple steps you can take to
    help minimize the risk. Scout areas of play before allowing pets to run. Remove
    sharp objects such as glass and metal from areas in which pets have access. Keep
    branches on trees and shrubs trimmed. Remove dead/fallen limbs and branches from the
    ground. Check metal fences (pens or yard fences) for loosened fasteners or links--
    especially at the bottom.
    Treatment.
    For superficial lacerations, the area can be cleaned of debris and hair and observed
    carefully for signs of infection. For deeper lacerations, direct pressure should be
    applied to stop any bleeding, the area should be cleaned of hair and debris, and
    suturing should be considered. Prompt treatment by a veterinarian will allow for more
    rapid healing with fewer complications.

    Lameness-Limping

    Limping can be due to acute soft tissue injury (sprain, strain, bruising), flare up of chronic disease (arthritis) and various bone or joint diseases, including rheumatoid arthritis and Lyme disease.

    Pain management, measures to reduce inflammation, and appropriate diagnostics (which may include x-rays, Lyme testing, joint taps, etc) are needed.

    In many cases, rest and simple medications may be appropriate but always call a veterinarian for advice. Many medications suitable for people are unsafe for dogs or cats. Many medications safe for dogs are dangerous for cats.

    Loss of Balance

    Loss of balance (ataxia) can indicate ear infections, inner ear infections, trauma, brain injury and a variety of other things (brain tumor, cerebrovascular accidents, etc). 

    Old animals often are afflicted with acute idiopathic (cause not known) vestibular syndrome, often associated with head tilt and the rapid twitching of the eyes.  This condition, often misconstrued as a "stroke" is usually benign and temporary but can look the same as more serious problems. 

    Treatment can keep these patients comfortable until the worst part of their problem is over. 

    In some animals, migrating parasites (cuterebra, other) are suspected for acute and severe neurologic signs.  Old animals can have sudden onset signs related to true stroke, brain tumors and bleeding.

    Pain

    It is sometimes very obvious that a dog or cat is in pain, and sometime hard to detect.  Animals that can not sit still, assume unusual postures, whimper or meow excessively, yip or screech, become reclusive or are reluctant to be touched might reasonably be assumed to be in pain.  Rabbits may grind their teeth.  Some animals drool or pant because of pain, or simply stop eating. 

    Sometimes the only way to know a patient is in pain is to treat with an effective pain relieving medication and observing their response.  In situations such as chronic osteoarthritic disease of the hips, spine or other joints, the pain may wax and wane and some dogs are tremendously stoic;  when they get relief with appropriate recognition and treatment, it is often rewarding to see how active and playful they become.

    Pain can be from unobserved trauma, internal organs that are diseased or swollen, damaged or infected teeth, stones that develop in kidneys or bladder, arthritis, intervertebral disc protrusion, bite wounds, fractures, oral wounds, eye injuries, glaucoma and myriad other conditions.  When pain is suspected, therapy is warranted. 

    Sometimes, managing the pain is just the first step and investigation can occur later on a less urgent need.  Sometimes a thorough investigation is needed to identify the problem to allow effective treatment. 

    Managing pain allows better healing, for many reasons. Effective pain management can involve a multimodal approach, including one or several different types of medication, physical therapy and measures such as ice packing. 

    Good pain management can allow a healing patient to try to be too active too soon, putting them at risk of reinjury;  sedation and exercise restriction may be necessary in such cases.

    Seizures

    Seizures, which are uncontrolled contractions of the musculature, can be caused by epilepsy, toxins, brain disease and certain metabolic derangements (low blood sugar, altered liver function, etc.) 

    Epilepsy usually becomes apparent in young animals and is diagnosed when all other possibilties are ruled out, including inflammation of the brain, viral disease, and the various organ dysfunctions. 

    In old animals, the chances are much greater that the seizures are caused by brain disease or organ dysfunctions.  Along with the usual bloodwork, old dogs with seizure disorders need evaluation of blood pressure and spinal fluid, and possibly advanced imaging such as MRI. 

    Control of seizures is necessary if they overheat from protracted seizure activity or the seizures are too frequent or too violent.  When an underlying cause is identified, treatment is aimed at resolving that problem.  In other cases, treatment may involve anti-convulsants and/or anti-inflammatory medications.

    Urinary Tract Problems in Cats

    One of the most common and truly life threatening emergencies that cats experience is urinary tract blockage.  It is also one of the few times cats are demonstrably distressed.  There are other, less dangerous but also painful problems of the urinary tract in both male and female cats.  Because some cats are less vocal and because advanced life threatening problems do not necessarily look worse than less life threatening problems, any cats exhibiting urinary tract signs should be evaluated immediately.

    Signs of significance include frequent trips to the litter box, a sudden development of urinating outside the box, unproductive straining in or outside of the box, yowling, licking at genital region and/or blood in the urine.

    In male cats, because the urinary tract is long and narrow, obstruction is common.  This can be due to physical debris (blood clots, grit, stones), tissue swelling or tissue spasm.  Male cats will commonly respond to this by licking at their genitals, which can cause much damage.  They act like all urinary tract cats initially (frequent trips, small amounts) but are not always observed demonstrating this behavior.  Once they have been obstructed for any length of time, they become increasingly depressed, may vomit and often become very lethargic.  In many cases, they collapse in or near their litter boxes.

    Male cats that are obstructed may need a little or a great deal of help.  Removing the obstruction is the first step.  IV fluids, pain relief, antispasmodics and glycosaminoglycans are commonly administered.  Radiographic imaging can detect stones or grit that would mandate a dietary change.  Depending on the state of the urinary tract and the patient, the urinary catheter may need to stay in place for several or more days.  A very sick kitty may require IV fluids for a day or more. 

    Female cats only rarely obstruct and are more apt to have a bacterial infection, both due to the fact that they have wider, shorter urinary tracts.  They can have sudden onset of pain and straining due to inflammation, though this abrupt onset of signs does not mean the problem has just started.  In some cases, there is a smoldering chronic inflammation that then has acute onset of symptoms.  In any event, they squat frequently, pass small amounts or no urine, may pass blood, and are often restless and vocal as they go in and out of the litter box and/or void in inappropriate places.

    Collecting and analyzing their urine is an important first diagnostic step.  Initial therapy includes medications for comfort, medications to promote healing of the urinary tract, medications to relive tissue spasm and fluids to promote flushing of the urinary tract.  Additional diagnostics that may be appropriate include imaging (x-rays or ultrasound) to look for stones, urine culture and bloodwork.  In older cats, an opportunistic bladder infection may be due to inadequate kidney function and, conversely, bacterial infections that start in the lower urinary tract (bladder and urethra) can ascend into the upper urinary tract (kidneys).  If infection is believed or proven to be a significant part of the problem, antibiotics become part of the therapy.  Some cats have true ‘kidney stones’ as a contributing factor (stones located in the kidneys, not the bladder).

    Surgery may become necessary in any of these cats.  In males with severe or recurrent obstruction, removal of the narrowest portion of the urinary tract (procedure called perineal urethrostomy) often gets them feeling well and happy quickly.  Surgery to remove bladder stones is often advised;  analyzing these stones helps guide recommendations for diet and medications.  Sometimes structural changes to the bladder, such as polyps or an out pouching diverticulum, will need to be corrected surgically.  In some cases, biopsy and culture of the bladder wall will be needed to direct therapy.  With new technologies now available, some of these surgeries can be done with minimally invasive laparoscopic procedures, especially useful for removal of bladder stones.

    Cats, male or female, with intermittent and/or recurrent urinary problems may have interstitial cystitis. (This is also common in human women.)  Over time, the mucosal inner barrier of the bladder, comprised of glycosaminoglycans erodes away and urine can seep into the bladder wall causing chronic inflammation.  The bladder walls of such kitties is much thicker and harder than regular healthy bladders.  Restoration of the bladder lining is part and parcel of healing, though it is not entirely clear how to do this.  Providing oral supplemental glycosaminoglycans is a safe, cheap and reasonable approach.   (In women, the bladder is sometimes treated with direct infusions of these substances.)

    Long term management may require serial re-analysis of urine samples to adjust medical and dietary recommendations.  The goal is to minimize inflammation and maintain a urine pH that does not promote formation of irritating crystals or stones.  Maintaining the proper urine pH (acidity) is most easily accomplished with a special diet.

    There are myriad behavioral problems that rarely manifest acutely but which may have started with a painful litter box experience.  Offering these kitties a choice of litter, choice of litter boxes, and choice of litter box locations may help lure them back to normal litter box habits.  If these simple approaches fail to work, a number of anti-anxiety, anti-inflammatory and other behavioral modification medications might be recommended.

    Urinary Obstruction-Cat

    Male and female cats are often affected with inflammation of the lower urinary tract, sometimes associated with things like infection or bladder stones.  In male cats, who have very narrow outflow tracts, obstruction can occur from debris, grit, stones, blood clots, tissue swelling, tissue spasm and self trauma (licking at the genitals).  Male cats who are straining and passing little or no urine are uncomfortable and, if obstructed, are in a life threatened state.  When in doubt, have them checked out!!

    Female cats can be very uncomfortable and exhibit frequent straining, but only occasionally will become obstructed.  This is due to the fact that the urinary outflow tract is much wider in females.

    Treatment involves pain relief, eliminating the obstruction, fluid therapy, etc.  Early detection and early treatment yields best outcome.

    Urinary Obstruction-Dog

    Dogs are less often affected and, again, it is most often males that get in trouble.  Small breed dogs and Dalmatians are especially at risk.  Any dog exhibiting straining, passing only small amounts of urine, dribbling urine or passing bloody urine are in need of attention right away.

    Treatment involves pain relief, eliminating the obstruction, fluid therapy, etc.  Early detection and early treatment yields best outcome.

    Vaccine Reactions

    Dogs (mostly) and cats can have reactions to ordinary vaccinations.  These reactions can be very soon after, or develop hours later.  In most cases, patients become itchy and red, and/or have facial swelling or hives. 

    Treatment involves antihistamines and sometimes anti-inflamamatory medications to provide rapid return to comfort and, mostly, protect them from escalation of symptoms to the point of compromised breathing. 

    Less commonly, dogs or cats can have serious organ disease caused, it is assumed and rarely proven, by some portion of the vaccination.  In the worst case scenarios, this can include things like liver failure or immune mediated disease attacking red blood cells.  Any illness relatively soon after vaccinations might be related.

    In any such case, future vaccination strategies might need to change.  It may be appropriate to pre-treat with antihistamines, try a different type of vaccination or vaccinate with fewer vaccines at any one time. 

    For most of the serious diseases, annual vaccinations give more than one year of protection, sometimes many.  Checking a blood level (called a titer) to check their status may find that they are sufficiently protected and do not need to be vaccinated that particular year.

    Vaginal Discharge

    Dogs that have not been spayed may exhibit discharge from the vulva that is red, brown, yellow, green or white and this can be a clue to a very serious uterine infection, called pyometra.  A female dog who has a uterus and has a vaginal discharge should be seen as soon as possible.  Surgery to remove the uterus is almost always the best treatmetn and sooner is better (otherwise, uterus can rupture and/or patient can get toxic.

    Dogs who do not have a uterus but have a discharge from the vulva may have less urgent problems such as vaginitis, vaginal tumors and the like.  In some cases, they are very uncomfortable (restless, unable to settle down, constantly licking at the area) and these patients would appreciate evaluation and treatment as is possible.

    Vomiting

    Vomiting can be a simple and effective way for the body to react to motion sickness or eating something that is inappropriate.  

    It can signal any of many serious organ diseases, including urinary or intestinal obstructions, problems with pancreas, liver or kidneys, diabetes or adrenal diseases, gastritis, etc. 

    Very many dogs, especially puppies, eat inapproporiate things but require help settling their systems down.  Many cats vomit routinely but are well in between. 

    Vomiting is always more of a concern when it involves small, old or frail animals, is relentless, if the animal is acting poorly before or between episodes, if abdomen seems distended or if blood is seen. 

    In the simplest situations, withholding food and water for a prescribed time and then feeding small meals of easy to digest food may be all that it takes. 

    It is always worth a phone call to discuss your particular situation.

    Vomiting-Diarrhea
    Vomiting and diarrhea can be the result of many different problems including dietary
    indiscretion, internal parasites, viral or bacterial infection, pancreatitis,
    inflammatory disease, allergy, cancer, gastrointestinal obstruction, etc. Prolonged
    vomiting or diarrhea can lead to dehydration, electrolyte imbalance, and weight loss
    and should be treated promptly.
    Prevention.
    Keep your pets properly vaccinated and dewormed. Do not allow your pets to eat human
    foods/table scraps. When changing to a different type of food, switch gradually over
    a week. Keep small toys or other non-edible objects out of the reach of pets. Monitor
    your pet's bowel movements for blood and mucus since these abnormalities may be an early
    sign of gastrointestinal problems.
    Treatment.
    Due to the multitude of causes of vomiting and diarrhea diagnostic tests such as
    bloodwork, fecal floats, and abdominal x-rays may be performed to determine the cause
    and institute effective treatment. Treatment, again depending on cause and severity,
    may include IV fluids for rehydration, antibiotics, drugs to decrease frequency of
    vomiting and diarrhea, therapeutic foods, etc.

    Wounds

    Wounds of unknown origin are not uncommon and may be due to encountering other animals, running into sharp objects (barbed wire, sticks, thorns, etc).  Bleeding wounds on feet, ears and tails often require stitches to get the bleeding under control. 

    All wounds require cleaning. 

    When there are large wounds or subcutaneous pockets, thorough irrigation of the wounds in necessary and this may require local or general anesthesia.  Drains may need to be placed in certain types of wounds. 

    Very fresh wounds can often be fully closed and may not require antibiotics; older or obviously infected wounds may not be so easily managed and performing a culture to guide antibiotic therapy will often be recommended.  Some wounds invite self mutilation or are in difficult areas.  Bandaging may be required with various dressings (including honey or sugar in some cases);dressings may need to be changed frequently in early phases of wound treatment. 


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