Why Is My Pet Vomiting?

why is my dog vomiting

We see pets that are vomiting present through the ER for all sorts of reasons. In young animals, the most common cause is due to foreign body ingestion such as socks, underwear, sticks and other items found around the home.  These items are usually not visualized with x-rays unless they are made of rock or metal. In middle-aged and older animals, pancreatitis (inflammation of the pancreas) and cancer tend to be more common.

Blood work is often normal if the vomiting has not been present for long but tends to become abnormal with more serious causes of vomiting (prolonged presence of a foreign object in the intestine, pancreatitis and sometimes cancer).

Ultrasound is widely used in determining the cause of the vomiting. While many facilities do not have ready access to ultrasound, AVC is fortunate to have this valuable diagnostic in both locations. Patients can receive ultrasound within 24 hours which helps determine the course of treatment.

Food allergy is also a common cause for vomiting in any age pet, but especially the young dog. Dogs with food allergy tend to have a long history of intermittent vomiting, weight loss or decreased ability to maintain weight. Some will have soft stool  and itchy skin as well. The ultrasound exam often will demonstrate mild lymph node enlargement and changes in the intestine compatible with inflammation. Cats with inflammation of the intestine tend to be middle-aged and older. Their condition is likely more immune mediated rather that dietary. Cats with a true food allergy generally present for intensive scratching at the head and face rather than vomiting.

In my opinion, no pet with serious vomiting should go without ultrasound. It is affordable and highly diagnostic. If foreign material is present within the intestine it should be removed as soon as possible to prevent life-threatening damage to blood supply and intestinal wall integrity.

If your pets needs an ultrasound, I will do my best to help you as quickly as possible.

Ultrasound exams generally do no require sedation. The atmosphere is with low-lighting and most pets seem relatively relaxed during the scan. If you have blood work or radiographs, it is helpful to bring them to the appointment. It is also best to have your pet scanned on any empty stomach (no food within about 6 hours) but this is not necessary.

An ultrasound scan at AVC costs $290. In general there are no other fees. I have 20+ years with ultrasound and recognize this to be a tool that needs to be affordable and accessible if we are going to be able to help pet owners help their pets.

Nasal Bleeding and Chronic Sneezing

dog nose bleed

One of the more common reasons for performing CT on a patient at AVC is for chronic sneezing and/or bloody nasal discharge. In most cases, the patient is a dog, but sometimes cats are seen for this condition as well. CT is a highly sensitive tool in determining the cause of the bleeding or discharge from the nose. The information gained helps determine  prognosis and the best course of treatment.

Unfortunately, many patients are referred too late when the underlying problem is cancer. If many months have passed and a dog has undiagnosed nasal cancer (usually adenocarcinoma), bony destruction and extent of disease is usually so advanced that treatment is no longer an option. For dogs where adenocarcinoma is detected early and is localized to a small area, prognosis can be very good when radiation therapy is pursued. Survival rates at 2 years for patients receiving radiation therapy ranges from 10-48%. The smaller the tumor and the earlier the detection, the more likely that a dog will have an almost 50% chance of survival at 2 years. For more information on nasal tumors, please visit vsso.org.

There are certainly other causes for nasal bleeding, discharge and sneezing. The most common cause tends to be rhinitis, which is inflammation of the nares. These patients tend to be of large breed with long noses. Biopsies are taken with a small instrument at the time that the CT  is performed to confirm a diagnosis of rhinitis.

Unlike people, nasal polyps are very uncommon in dogs but are sometimes seen in cats. Fungal infections are also uncommon but sometimes diagnosed. Approximately 10% of patients with disease of the nares will have an underlying fungal infection. In our experience, these patients are young and tend to have originated from southern states.

X-rays are often not sensitive enough in evaluating the nasal cavity. Anesthesia is required and multiple views need to be taken. CT on the other hand is very sensitive in evaluating the small bones in the nose, the thin bone that separates the nasal cavity from the brain, and the bulla of the middle ear. Although anesthesia is required for CT evaluation, the procedure is fast and the anesthetic agents used are short acting.  Patients are discharged soon after the scan. CT images are uploaded to the internet and sent off to a boarded radiologist for review. In most cases results are available within just a few hours after submitting the scan.

Please don’t hesitate to contact us if you have questions about CT and whether or not it may help with a particular nasal problem in a pet.

Urinary Obstruction in Cats

 

Blocked cat

Urinary obstruction is one of the more common problems seen in the ER. It is a life-threatening situation not only from a medical aspect, but a financial one as well. Cats with this condition present for straining to urinate and are unable to pass urine due to either ‘grit’ or ‘sand’ within the urethra. This is more common in males than females due to the very small opening of the male urethra. These cats require general anesthesia and the passing of a small catheter into the tip of the urethra/penis to flush back any blockage. The catheter is left in place for a few days and then removed. Most cats will then be able to urinate on their own. However, some cats have underlying stones which are causing the blockage and require surgery.

There have been many discoveries during the past 10-15 years with respect to feline nutrition. Although we have always known that cats are carnivores, we have not been feeding them as such. Dry cat food is carbohydrate loaded and not the appropriate diet for a cat. Many cats, however, will not eat canned. For the ‘dry cat food junkies’ it is possible to eventually wean them onto canned food. Dr. Lisa Pierson has a very thorough article outlining the process (warning:it’s a long article!): Rehab for the Dry Cat Food Addict

Cats that are maintained on an appropriate diet do exceptionally well and in my experience, there have been very few failures with respect to urinary obstruction (none that I can actually remember). Feeding canned food is important for a few reasons. One being to increase the moisture content in the diet. The other being to decrease the carbohydrate content.

A question I am often asked is: “do you think my cat got the ‘sand’ from the litterbox”? The answer is no. The ‘sand’ is actually created by your cat. If the environment within your cat’s body is just right (PH, ash content of the food, water content, maybe genetics), sand, or grit is formed and causes the blockage. Stones are simply a more exaggerated form of sand (when you think about rocks and their relationship to sand for instance). Interesting, the ‘sand’ often looks like silica. It is usually white in appearance, almost glass-like and very tiny. It feels ‘gritty’ on your fingers.

Although I love helping people with their pets, it always puts an ache in my heart when I see something I may have been able to help the pet owner prevent. I hope this information will help keep your pet healthy. Pass it on to a fellow cat-lover!

 

CPR and First Aid for Your Pet-Applying a Bandage

How To Apply A Bandage and Control Bleeding

Allergic Reactions-When to be concerned

Allergic reactions to food, insect bites, pollen are relatively common in pets. Itching and swelling (ears, skin, feet) are the most common symptoms. Clinical signs can last anywhere from a few hours to the whole season. Certain breeds seem to be more prone to allergic reactions than others. For instance, Chihuahuas, Bulldogs and Boxers commonly present to emergency room soon after being bit by an insect. These guys seem to be ‘frequent flyers’ for these events. Some respond to a few doses of benadryl at home while others require a trip to the veterinarian for steroids. Although pets initially respond to treatment, the allergic component remains in the body for a few days and despite medication the pet may experience return of hives and facial swelling, although less severe, over the following 48-72 hours.

chihuahua allergic reaction

While dogs tend to have hives and facial swelling, cats seem more apt to develop red ulcers, called ‘rodent ulcers’ on the lips, red itchy lesions above the eyes or on the temple region of the head. Food allergies frequently result in intense itching of the head and face.

cat with ulcer

These types of common reactions are irritating, inconvenient but generally not life-threatening. They can be managed with a few medications and in a pinch, a cool ice-pack.

Anaphylaxis

The more serious condition, called anaphylaxis, is a rare event where a pet goes into shock immediately (within minutes) after being bit by an insect or receiving a vaccine. These pets often will collapse and experience vomiting and diarrhea. Breathing may become difficult as well. It is not unusual for a pet owner to not even realize that their pet has been stung by an insect and these guys can stump even experienced veterinarians when they initially present to the emergency room. As they present for shock, however, they are generally treated for shock, and measures to increase blood pressure are taken. This often includes giving a dose of steroids if blood pressure does not respond to common measures taken with shock. If a pet owner has a dog or cat known to have anaphylaxis, an EpiPen or syringe of epinephrine should be kept at home and taken with the pet when away from home. Dogs weighing over 45 lbs can use the standard 0.3 mg epinephrine EpiPen. Dogs weighing between 20-45 lbs can use the EpiPen Jr. For dogs weighing less than 20 lbs and cats, it may be more appropriate to have a syringe at home containing the proper dose as even the EpiPen Jr. may be too much. Your veterinarian can show you how to administer an injection to prepare you for an emergency situation.

IV fluid puppy

If you have given your pet an injection of epinephrine due to a severe allergic event, he or she may look great, but keep in mind the epinephrine is very short acting and you need to take your pet to the emergency room immediately so that longer acting medications and supportive measures can be given.

In Summary signs of anaphylaxis:

*vomiting/diarrhea soon after being stung
*collapse/weakness after being stung
*signs of shock without any known sting is possible (but rare)

Dogs Will Eat Anything!

Izzy is a middle-aged Clumber Spaniel. She likes to eat things, but REALLY loves eating rocks. In the past 3 years she has had surgery twice for the very same thing … eating as many rocks as will fit into her stomach! Take a look at the x-ray below

I don't feel so good ...

I don’t feel so good …

Although no one really understands why little Izzy loves to eat rocks, we think that there must be a genetic predisposition. For example, Izzy’s mom ate rocks, her mom’s mom even ate rocks!

Although Izzy eats these rocks on a regular basis (will need to wear a muzzle when outside to prevent) it’s only when she eats the wrong one, one that is larger than a ping-pong ball. And oooops! Everything comes to a screeching halt … except for poor Izzy’s adopted mom that gets her into the car for a ride to the ER!

*look closely and you can see the larger rock that crashed the party …

Are pennies poisonous to pets?

Zinc toxicity can be a life-threatening emergency. The most common source of zinc for pets is found in pennies. When the pennies are swallowed the stomach acid causes the dangerous zinc to dissolve and quickly enter the blood stream. 

Ingested pennies need to be removed ASAP! This is done either by causing the pet to vomit or taking the pet to surgery. Once the pennies are removed it will take about 48 hours for the zinc to be eliminated from the blood stream.

We had the worst zinc toxicity case that I have ever seen in my 20+ years of practice. A young dog requiring a lengthy surgery then developed severe anemia requiring an emergency transfusion. After a few days of worry and intensive care we were able to send our little patient home. Her full recovery will still take many more days as the organs begin to repair.

Interesting fact: pennies minted in 1983 and later are composed of 97.3% zinc. Also, ever wonder where money travels before making it to you? Actually, it’s probably better not to think about it :o)

Please be safe!

Dr. Deborah Kelloway
Pennies

 

Veterinary Ultrasound: A look inside to see what ails your pet

We can all see how beautiful your pet is on the outside :o) but when he or she is not feeling well, what do things look like on the inside? X-rays are great for bone and gas structures (like lung), but when it comes to soft tissue, nothing can beat the diagnostic superiority of ultrasound. Echo (sound) waves are used to penetrate water (which is what soft tissue mostly contains). These sound waves bounce off of the tissue and return to the operator’s probe. Depending on the type of tissue will determine how fast the sound waves return to the probe. The varying speed of echo wave return is what creates the various levels of gray and ultimately the image on the screen. Fascinating! And really useful.

We have been open in Concord for just a little over 1 week and each serious case that came through our doors experienced life-saving, valuable information based on ultrasound. Each required immediate surgery and are doing well.

Below are a few cases with photos:

A middle-aged hound dog was referred by his veterinarian for ultrasound out of concern for an abdominal mass. The pet had been vomiting for a few days and there was concern that cancer was the cause for the vomiting. However, after a thorough exam of the abdomen, the ultrasound demonstrated foreign material (likely a sock) within the upper part of the intestine. The pet was taken to surgery and a long section of very smelly fabric was removed!

The patient is being prepped for surgery.

The patient is being prepped for surgery.

A little dog presented for vomiting multiple times within a 12 hour period. Although looking pretty good in the exam room, 8-9 events of vomiting is a lot and the owner was very concerned. Ultrasound was pursued and it was immediately apparent that the gallbladder was leaking. The patient was taken to surgery and the leaking gallbladder was found to be barely attached at its base! Removal of the gallbladder proved to be life-saving.

This patient's gallbladder was causing pain and vomiting.

This patient’s gallbladder was causing pain and vomiting.

This morning, we were presented with a lovely middle-aged dog that had been vomiting and not feeling well for about 3 days. Although she did not have a fever (surprising) and no discharge from under her tail (even more surprising!), the abdominal ultrasound demonstrated an enormous uterus full of infection and ready to rupture. No time was wasted. She was treated for shock and whisked into the surgery suite. Take a look at this amazing structure — which weighed 7 pounds 14 ounces! (Cover your eyes if you are squeamish.)

This is pyometra, a very infected uterus. Ready to break open!

This is pyometra, a very infected uterus. Ready to break open!

 

Stay tuned if you find ultrasound interesting. We will post more interesting cases soon!

Porcupine Quills in Dogs

This is the season where we see dogs coming into the ER with porcupine quills. Some dogs will get a few quills in their muzzle and quickly retreat. However, many larger breed dogs will not be deterred by a few quills and continue to attack the porcupine. The end result … often hundreds of quills in the muzzle, mouth, front limbs, chest. If your dog has only a few quills, they can often be removed with pliers and a quick pull. However, anything more that 2-3 quills, will result in a very stressed pooch if the quills are pulled without sedation. If only a handful of quills are present, light sedation is all that is required. If there are many quills (>50) then most dogs will need to be anesthetized to allow a team of technicians and veterinarian to work diligently in locating and removing the quills.

It is not uncommon for 1-2 quills to remain. Either it is not noticed or it is simply too deep to be safely removed. These quills eventually migrate, usually to the surface where their owners may notice a sharp protrusion (generally days to weeks after the event) from the skin. If the pet allows and the quill is sufficiently exposed, then a quick, firm pull to remove the quill is often possible.

Quills are not easy to see by any other means other than the naked eye. Sophisticated diagnostics such as CT and MRI often do no allow visualization of quills. Occasionally dogs may have a quill protruding into the heart sac causing blood to build up around the heart. These quills can sometimes be seen with ultrasound.

Pet insurance is recommended for any pet, but accidental pet insurance is definitely a very good idea for any porcupine offender! Dogs do not learn their lesson after the event but rather seem to get even more worked up about porcupines with any future encounters.

AVC Concord

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