A very concerned owner came into our hospital with a 12-year-old FS mixed breed dog weighing approximately 8 lbs. She was convinced her dog was having G.I. issues, either from a virus, dietary indiscretion, or some sort of organ failure due to age. The owner described the dog as having been lethargic, anorexic, and vomiting more than once in a 24 hour time period. The patient had a history of elevated liver enzymes and slight azotemia one year prior.
A very concerned owner came into our hospital with a 12-year-old FS mixed breed dog weighing approximately 8 lbs. She was convinced her dog was having G.I. issues, either from a virus, dietary indiscretion, or some sort of organ failure due to age. The owner described the dog as having been lethargic, anorexic, and vomiting more than once in a 24 hour time period. The patient had a history of elevated liver enzymes and slight azotemia one year prior.
- Upon presentation the patient was moderately ataxic and visibly nauseous, with a hunched back.
- The results of an in-house CBC/Chem Stat were within normal limits.
- Lateral abdominal radiographs showed a severe compression along the middle of the spine in the area of the thoracic and lumbar vertebrae causing a tremendous amount of pain.
- The patient was given a dose of Oxymorphone, had a Fentanyl patch placed, and was discharged with Tramadol and a high-end dose of Deramaxx.
- 8 hours later the patient appeared to be 80% better, but was no longer ambulatory yet not sedate from the pain meds that were given.
- Within 24 hours the patient showed marked improvement. The patient was now very comfortable , eating again, and was ambulatory x 4.
- The “G.I.” issue that the patient was experiencing was directly related to the amount of pain she was in as her symptoms resolved as soon as the pain was under control.
This is why I love veterinary medicine. A patient presents in one way with symptoms that could be attributed to so many problems and you get to play a type of veterinary “CSI” to figure out a diagnosis. So very often what you think it is isn’t and what you are almost 99% sure it is not, it is. In this case of course the symptoms of G.I. were due to primary back pain that we so commonly see in our Beagle friends, so not very “CSI’, but always a learning experience none the less. I am happy to report that little gal is now 100% better and happy once again. 🙂
Comments
Nice example sonogirl about
Nice example sonogirl about how pain is so important in vet med and causes clinical signs in other organs and delays healing. Pain is the hidden truth that our patients cant tell us about unless we are aware of it. Take the pain away and they get better more often than not and better faster. Doug Casey has great info re pain management in his folder. I can’t tell you how many sonograms i do for “abdominal pain” when its just referred back pain and nothing abdominally to cause the changes. Fentanyl and IV lidocaine CRI for everyone:) makes them easier to manage clinically as well and less wrestling.
Nice example sonogirl about
Nice example sonogirl about how pain is so important in vet med and causes clinical signs in other organs and delays healing. Pain is the hidden truth that our patients cant tell us about unless we are aware of it. Take the pain away and they get better more often than not and better faster. Doug Casey has great info re pain management in his folder. I can’t tell you how many sonograms i do for “abdominal pain” when its just referred back pain and nothing abdominally to cause the changes. Fentanyl and IV lidocaine CRI for everyone:) makes them easier to manage clinically as well and less wrestling.
Thank you Dr. Lindquist, had
Thank you Dr. Lindquist, had we admitted this patient a lidocaine drip would have been our next course of action. And I second the notion of less wrestling. It causes more trauma and stress to the body and ultimately leads to an unhappy patient.
Thank you Dr. Lindquist, had
Thank you Dr. Lindquist, had we admitted this patient a lidocaine drip would have been our next course of action. And I second the notion of less wrestling. It causes more trauma and stress to the body and ultimately leads to an unhappy patient.
Quick comment: with that
Quick comment: with that degree of compression I would have thought that cortisone would have been indicated, yet she resolved with only opioids and NSAIDs. Case also shows the importance of a full physical examination!
Quick comment: with that
Quick comment: with that degree of compression I would have thought that cortisone would have been indicated, yet she resolved with only opioids and NSAIDs. Case also shows the importance of a full physical examination!
Very true Dr. Lobetti, thank
Very true Dr. Lobetti, thank you.
Very true Dr. Lobetti, thank
Very true Dr. Lobetti, thank you.