But Doc, It's his leg that's broken.....

Most of the time when I have to see a dog or cat that has undergone major trauma the owners are concerned about the broken bones. They remind me of the first video they show you in Human First Aid. If you took the course you know the one. The little girl is in the pool and she drowning. The instructor then asks how many of you would jump into the pool. Of course, everybody in the class raises their hands. The camera then pans out and you see the electric pole that fell into the pool. You just jumped in to a pool filled with electricity. I missed the obvious by not assessing the situation first.

Before we get too far in, of course the pain needs to be dealt with. But we need to make sure the important functions are working. So I thought I would give everyone a short list of the way we assess a patient that has been presented after a major trauma. This should help you too in the unfortunate circumstance that you have to deal with a pet that has been in an accident.

In the field the first thing you should do is avoid getting yourself injured. Make sure the area is safe for you to approach.

Just like in the human field, the ABC's are the first area to assess (Airway, Breathing Circulation). However, in animals, we proceed very carefully with assessing the airway. Many of these animals are in pain and I'm not all that interested in putting my hands in a painful cats mouth.

Next, we assess the patients breathing. In the hospital, we have the aid of a stethoscope. But you can get a good read on a patient's respiratory status by just looking. First, look for obvious trauma to the chest wall. Next, you want to observe the rate, pattern and sounds.

Circulation can be the hardest part of the evaluation. The gums of a healthy dog should be pink. However, the shock of pain can make a dog's gums white. I usually use the tongue as my gauge. Painful dogs generally still have a pinkish tongue. Estimating blood loss can be difficult even for someone with training. A little blood on the ground always looks like a lot.

The next thing to look for is the animal's mental status. Does the dog know what's going on? Does she respond to you when you talk to her? Are her pupils even?

Finally, I'm looking at broken bones. Unlike people, dogs and cats don't die from complications of broken bones in the short-term. They need to be addressed for pain and future repair, but they are not usually life threatening.

For tips on how to move a dog or cat that has been traumatized the American Red Cross has a great website:

http://www.redcross.org/news/hs/firstaid/010801petfirstaid.html

For the Birds

I am not an exotic animal specialist, but I do see a fair amount of birds, reptiles, hamsters and guinea pigs. I have to. The other emergency clinics in Middle Tennessee won't touch a dieing exotic pet with a ten foot pole. I feel that I have some obligation to at least try to stabilize the patient until someone who knows what they are doing can fix the problem. That's not to say that I don't know what I'm doing. I pull blood feathers on birds, I've taken foreign bodies out of ferrets and I've treated hamsters with mites. But I do understand the other emergency clinics concern about treating these pets.

For starters, people who have never taken these pets to a veterinarian before demand a specialist at 3am. And in the age of litigation, I understand the that veterinarians are afraid they are going to do more harm than good and end up in a legal battle for their license just for trying to help. At my place we tell people when they call that I don't do exotics regularly, but I'm willing to try. If they want an expert they should keep calling around, I'm not their man.

With birds, most of the time there isn't much I can do. I know that people always say that "this just started today", but most of the time it didn't. Birds are very good at hiding illness so by the time you notice something is wrong, it's very late in the process. that's not to say that they can't be saved, but they need a bird doctor, not your dog and horse vet who took a weekend continuing education seminar on "Basic Bird Care". So, here is a list of things that I see on emergency that should have been addressed long before I got my hands on the case:

1) Lethargy for any more than 1 day. A bird that is not moving is food for some other animal. If they already are lethargic, they are in trouble.

2) Burns. Birds fly into frying pans, or try to perch on hair irons and they need their feet to live. Plus, all the Neosporin in the world isn't going to pain that bird is in.

3) Loss of appetite for more than 1 day. They have a very high metabolic rate and eat all the time.

4) Sitting on to bottom of the cage. There a reason he's there and watching him for a day or two isn't going to alter that reason.

5) Blood anywhere. They don't have much of a blood volume and small amounts of blood loss can be lethal.

Which leads me to my last piece of advice: find a veterinarian that deals with birds as soon as you get a bird. Most veterinarians who deal with exotics have an emergency plan for established clients. (and I don't blame them for turning away non-established clients. Who wants to get up at 3 am to hear, "I only paid $5 for this bird, why should I pay you $70 for an exam!" and then get stiffed?)

Like with the rest of life, a little bit of preparation may prevent a whole lot of heartache.

Why you should wash your hands after playing with turtles.

When I was a kid, my mother was constantly telling me to wash my hands before eating. Most of the time, I tried to get around it. Now that I'm older I wonder how I got this far. It turns out that many kids get Salmonella from playing with turtles. So many, in fact, that the CDC put out a report on it:

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5703a3.htm

Who knew?

Your Kid Can Be A Veterinarian Too!

It's estimated that by 2050 we will need more than 26,000 more veterinarians than we have right now. Here are some tools to help teach kids about what veterinarians do: http://www.avma.org/educators/ I don't know if your kid wants to inspect meat or watch pigs grow, but this would be a great place to find out!

Cat Fights

Sometimes my job can be a real pain in the butt. I work for a humane society that provides free spay/neuter to certain groups of people and my hospital performs low cost spay/neuter to anyone who has $40. Yet, some people just can't seem to get there. I mean they make appointments and just don't show up. It's not just that they don't care about their animals, they take up a spot from someone who might actually show up. At the humane society we get about 50% of the appointments to show up. I love the people we call only to wake them up. It's free and they can't even be bothered to get out of bed!
Alright, that rant was brought on by an article in JAVMA Vol. 232. No. 8 page 1152 on Feline Leukemia (FELV), Feline Immunodeficiency Virus (FIV) and cats presented for being in a cat fight. So let's discuss the viruses first.
FELV and FIV are common retroviruses found in cats. The viruses are acquired by direct contact with infected body fluids, and are not contagious to humans. However, like the most widely known retrovirus HIV, there is no cure in cats, it can be difficult to detect in the cat and some cats may be carriers with no apparent clinical signs. Unlike HIV, there are vaccines for both FELV and FIV.
The study involved almost 1000 cats that were presented to a veterinary hospital for treatment of an abscess or bite wound. At presentation, about 20% of the cats were positive for FELV, FIV or both. Cats that were negative for both were told that retesting in 6 months was necessary to make sure that the cats didn't acquire a virus during the current episode. Only 5% of the owners returned to have the cats retested. Here's the kicker: the clients were paid to get the tests run on their pets! Didn't get that? Let me quote the article, "Financial incentives were provided to veterinarians and clients to promote compliance."

So let's summarize this article:
FELV and FIV and deadly diseases that are completely avoidable by keeping you cat inside, or current on his vaccinations.

People and their cats were enrolled in a study to see how many cats that got into a fight had contracted either FELV or FIV.

Even though the clients were being paid to do what was right for their cat, 95% couldn't bother.

Like I said some days my job is a pain in the butt.


It's not all bad news: Here are the AVMA's current recommendations on vaccinating your cat against this common killer.

http://www.avma.org/vafstf/rbbroch.asp

Cat Vitamin Recall

Hartz recently recalled two batches of cat vitamins for potential Salmonella contamination. There have been no reported cases of sickness, in cats or in humans. The lot numbers affected are: SZ-16371 and SZ-22771. If you have any questions about the products you should call Hartz at 800-275-1414.

Lyme Disease

We have a lot of people who come into my clinic and find a tick on their dog, only to pull it off and ask me for some place to throw it out. I always have to fight the urge to cringe. I know it's pretty rare for a human to catch a disease this way, but ticks transmit a bunch of diseases you never want to catch. Which brings us to today's topic: Lyme Disease. It's a nasty little bug that can cause arthritis, kidney disease and even death, in both you and your pet. There is a vaccine available for dogs, and the maker of the vaccine has chosen April, the start of tick season in most areas, as Lyme Disease Prevention month. The website is www.LymePrevention. com.
Yeah, it's a website commercial, but it's got some good information.