I REALLY could have used some hip waders this weekend as I was literally up to my knee caps in projectile watery, bloody, diarrhea. Case #1: Rimadyl ingestion toxicity (a whole bottle). A 6-year-old 75-lb FS Labrador Retriever mixed breed.

I REALLY could have used some hip waders this weekend as I was literally up to my knee caps in projectile watery, bloody, diarrhea. Case #1: Rimadyl ingestion toxicity (a whole bottle). A 6-year-old 75-lb FS Labrador Retriever mixed breed.

• The patient was presented for vomiting after ingesting a bottle of Rimadyl.
• Treated with Norm-R fluids, gastroprotectants, anti-emetics, and Metronidazole.
• By day three of supportive care the flood gates of hematochezia were apparently opened…onto my shoes.
• Hematochezia improved greatly after that, but was still having some bloody-tinged puddles as my shift was ending.

Case #2: HGE (classic presentation).  A 5-year-old 10-lb FS Yorkshire Terrier.

• The patient was presented for vomiting, lethargy, and gelatinous, bloody diarrhea.
• PCV was 61 and the blood chemistry would not run due to the “sludginess” of the blood.
• Treated with LRS fluids, gastroprotectants, Metronidazole, Centrine, anti-emetics, and Ampicillin.
• Hematochezia resolved within 12 hours on supportive care.

Case #3:  R/O Pancreatitis vs. HGE.  An 8-year-old 15-lb FS Rat Terrier.

• The patient was presented for non-resolving vomiting, lethargy, shaking, and discomfort.
• Treated with LRS fluids, gastroprotectants, antibiotics, anti-emetics, Metronidazole, and Buprenex.

*Note to self: Never put a dog with G.I. issues in a top cage!* Thank goodness her roommate in the cage below was out for a walk when the giant SPLAAASH occurred.  Otherwise two baths would have been in order, possibly three if I was in the vicinity.     (I already had to hose off Case#1 more than once).

• Blood chemistry and CBC were not too exciting as of yet, mild ALP increase, and CBC unremarkable.  Nothing that would scream out pancreatitis and definitely not HGE.
• 24-hours later the patient is still looking fairly depressed, not vomiting, drinking small amounts of offered water, and drizzling many  puddles of hematochezia frequently.

Being that it was the weekend and we do not have a solid in-house ultrasound crew at our disposal my patient will have to wait until tomorrow to see if is a true pancreatitis, severe gastroenteritis, or other.  My patient is feeling “poopy” literally and figuratively speaking.  Does anyone have any tips or alternative treatments, new or different meds that can provide some more comfort for this girl? I was thinking Fentanyl patch at first if it is panc but what about an MLK drip? I don’t know why I always think of CRI’s last.