Posts Tagged ‘Interesting Cases’

Dog ate chocolate – how much chocolate is dangerous?

March 28th, 2013

dog ate chocolate cake

Below is an example question and answer from a concerned pet parent whose dog ate chocolate. If your dog ate chocolate, you can ask a vet if you need to worry or if the amount should be okay by typing your question into the box at the right.

Pet parent question:

My 90 lb dog ate 4.5 oz of baking cocoa powder chocolate …he ate 3/4 of a chocolate cake. It’s been 1.5 hours, he seems fine. He’s a actually sleeping, heart rate is 80. Should I be worried?

VetLIVE Veterinarian:
I have received your question and am doing the calculation right now for you. I will be right back with you.
Dr. Laci

Hi again,
For a 90 lb dog to eat 4.5 oz of baking cocoa powder absolutely warrants an emergency vet visit. Though he seems fine now, the absorption of the chocolate’s toxic components is delayed if he had food in his GI tract. When it does get absorbed, it will be enough of the toxic chemicals to put him in serious danger, including seizures and tremors that may or may not become life-threatening. I know it is not what you want to hear but if he ate that amount and type of chocolate, he needs to go in. Without veterinary intervention, death is possible.
Best wishes,
Dr. Laci

You may be wondering why chocolate is so bad for dogs. The toxic ingredients in chocolate include caffeine and a chemical called theobromine. Baker’s cocoa is one of the most toxic types of chocolate but no chocolate is safe for pets, so you need a dog chocolate calculator like a VetLive veterinarian to help you out.

In general, the amount of theobromine found in chocolate is small enough such that chocolate can be safely consumed by us as humans. Dogs however metabolize theobromine much more slowly than we do, and can easily consume enough chocolate to cause chocolate poisoning. Caffeine and theobromine are both stimulants of the brain and heart. The clinical signs reflect this and can include hyperactivity, increased heart rate, muscle tremors,  seizures and eventually death within 24 hours.

Reviewing EPI in Cats

May 20th, 2011

diarrhea in cats, EPI in cats

Yes, it can happen
The following is an excerpts from a real answer from the pet parent of a 12-13 yr DSH cat that was been diagnosed as a diabetic 3 years ago. Her diabetes is well-regulated, but she has loose and very pungent stools. Hyperthyroidism was ruled out, and the below is a portion of the discussion about Exocine Pancreatic Insufficiency (EPI), which her vet suspected but had yet to be diagnosed.

Exocrine pancreatic insufficiency (EPI) is a disorder in which the pancreas does not produce an adequate amount of digestive enzymes. This deficiency results in maldigestion (poor digestion) and malabsorption (poor absorption). EPI is rare in cats, but it does exist.

Clinical signs include weight loss, ravenous appetite, poor haircoat, and very thin body condition.

The most common cause of EPI in a cat is chronic pancreatitis. Many cats with EPI also have concurrent IBD.

Testing is by running a serum TLI. This is the only accurate test, and there isn’t a point in spending your money on the others. The TLI test is a simple and reliable way of confirming the diagnosis of EPI; however; it is essential to use an assay specific for feline TLI since there is no cross reactivity between canine and feline TLI. Performing the test to rule it in or out of course is best. You may want to ask your vet how much it costs, as it may not be more expensive than the enzymes your vet is using, depending on the brand.

Most cats with EPI can be successfully treated by dietary supplementation with pancreatic enzymes. Dried extracts of bovine or porcine pancreas are available (e.g. Viokase or Pancrezyme). The powder is more effective than tablets or capsules. Read the rest of this entry »

Household Substances Can Be Dangerous Not Only to Your Pet, But Also to Your Relationship

March 23rd, 2011
The entertaining chronicles of life as a veterinarian

It was several years ago but I remember that night well.  It was 3 AM on a Saturday morning when I was handed a chart for a three-year-old snorting Bulldog name Bennie that was having problems eating and holding down his chow. The confident rascal was known to eat garbage and the owners, a young bickering couple, reported that he had been left unattended the night before and had made a mess of the apartment.Cute dog chewing slipper

The x-ray showed something large in his stomach displacing food that in all probability was not going to pass. I showed the couple the x-rays and recommended removal through the use of an endoscopic camera. They couldn’t afford that so I told them that there was a small chance that if I made him vomit, I mean, really vomit, that the object may come out the way it came in. They agreed, so I administered the drug and waited.

Read the rest of this entry »

Dog Diabetes: Ask the Veterinarian

March 2nd, 2011

I thought we would do something different today.  We receive a lot of questions about canine diabetes mellitus, and it seems to be a commonly confused topic in veterinary medicine for pet owners.  Today I wanted to share with you a portion of a Q&A from our ask a vet service.  Additional topics were discussed, but for the purpose of this post, I have only included relevant information on diabetes.

Ask a vet a Question:

ask a vet a question, ask the vet, dog diabetesI have a seven-year old female miniature schnauzer Daisy. Over the past month, I have noticed her drinking more, asking to go out more–just to pee it seems, and she seems to be losing weight. She still has a strong appetite, and seems otherwise normal. I already went to the vet, and they thought it was probably a urinary tract infection and gave her antibiotics. We didn’t do the test because the vet thought it was pretty sure and money is tight, and the antibiotics were expensive enough. We finished the antibiotics but they didn’t seem to help any. What do you think could be wrong?

Vet Answers:

I am very suspicious that your dog may have a condition called diabetes mellitus. Diabetes mellitus (DM) is a endocrine disease often called “sugar diabetes” because of the dog has an abnormally high blood and urine sugar levels. Diabetes arises when the pancreas does not produce enough insulin, the hormone that allow the body to use glucose, and in turn, when not enough insulin is produced, there is excessive glucose in the blood, and negative consequences happen.

The most common reason is that the cells of the pancreas that are responsible for insulin production, called beta cells, get destroyed. They usually get destroyed from chronic inflammation of the pancreas, such as flare ups with pancreatitis or chronic GI issues of many kinds. This is Type 1 DM, and is the most common type of DM in dogs, while Type II which arises from insulin resistance is very rare in the dog.

The common clinical signs are why I am suspicious this is what your pooch is suffering from. Increased thirst and urination are the most common signs. The miniature schnauzer is one of the most common breads that we see DM in, and females are more likely to suffer from it than males. The average age of onset is 7-9 years. Other signs are increased appetite and weight loss. This is because even though they are eating more, the body can’t effectively use the glucose because of low insulin levels, so they are in essence starving.

The diagnosis is fairly straight-forward. A significantly elevated fasting blood glucose Read the rest of this entry »

Palliative Treatment, II

January 27th, 2011

Madison’s Story

Continued from Part 1.

There was really no time for the shock of diagnosing Madison with terminal bone cancer to wear off. It was time to act as her veterinarian and guardian.

sick dog, how to tell if my dog is sick, ask a vet, online vet

First things first.

Amputation is currently a strong option for bone cancer, that is if the patient is a candidate for this major surgery. Most dogs function well as tripods, but there is a small group that are ill-suited for this category. Among those are pets whose joint problems are severe enough that dividing up the animal’s weight from four limbs to three puts too much added pressure on the remaining limbs. Some examples are dogs with hip dysplasia, or other causes of bone pain. Luckily, there is a mock test that gives you a rough idea of how your pet will fare sans one limb.

It was test time.

The hospital staff helped me wrap Madi’s cancerous leg up with gauze and vet wrap and gently secure it to her trunk. This is something best done by your vet, as the affected leg is very painful and wrapping in general can carry some risks, such as decreasing circulation if applied too tightly.

Osteosarcoma is the most common type of canine bone cancer.  It affects an estimated 8,000 dogs a year, but is rare in cats.  In 90% of the cases, cancer is already in the lungs by the time of diagnosis.

She managed to hobble around the hospital for a couple laps but then she was flat out. I unwrapped her, and allowed her to walk as normal, but now she was so painful she was limping now on her other front limb. Dr. Jed and I looked at each other, not wanting to be the first person to say it. This meant her elbow dysplasia was too painful.

Amputation was not an option.

Read the rest of this entry »

When a cat can’t urinate

January 19th, 2011

How well read are you?ask a vet, cat can't urinate, sick cat, online vet
Today I want to share a special story that happened this week to a colleague and best friend of mine. Sadly, it happens all too often in veterinary medicine.

This past Saturday, an elderly couple took their cat to the vet with the complaint of having trouble urinating. The vet did an analysis of the urine and saw a plethora of crystals and white blood cells. I don’t know if the owners were wearing ear plugs, had their hearing aids turned off, denied all treatment, or if the vet was really that lousy, but the people went home with nothing but antibiotics–which is insane treatment to another vet.

Come Tuesday morning, the concerned couple again called the vet. Their beloved cat was doing worse, had vomiting and diarrhea, still had trouble urinating, and just seemed like a very sick cat.  They were told to bring him back in–for more fees of course. They declined, as they were on a fixed budget.

At 4:30 pm, they showed up at the vet’s office. Granted, they did not have an appointment, so I understand this can be difficult to squeeze them in as a vet, BUT, ethically, you are the active and current doctor overseeing this case which does put an legally arguable responsibility on you to see the pet.

This vet should have been thinking, “oh my goodness, this cat is probably blocked and could be about to die. I need to make this cat my #1 priority!”

Read the rest of this entry »


January 13th, 2011

ask a vet, online vet, ask the vet, dog health adviceBy Judy Nelson

Today we are very happy to have a post from Judy Nelson of the popular Facebook group PetPeople share with us a cute story through the mind of her dogs.

Everybody’s story counts!

Mom had received an invitation to begin blogging again, promising to think about it, with the intention of taking action—which is really all it takes! Having ‘put it to bed’, she could feel the ideas begin growing from that little seed…

Then on January 9, Mom finally brought herself to put ‘our’ Christmas tree away as she was watching the CBS Sunday News program. All of us are so pleased that she ‘listened to us’ and decorated her home with mementos of us to comfort her through the holiday season, “especially since I just left 5 months ago and she isn’t ready for another pet just yet,” Black Jack pipes in.

She was still pondering what she could blog about when she heard author David Sadaris say on the TV that people don’t want to hear about themselves, but rather prefer feeling they are being entertained through stories about animals!

Read the rest of this entry »

Diet Pills for Dogs?

December 27th, 2010

ask a vet, dog obesity, is my dog overweight, dog nutritionMost of us now consider pets part of the family and have accepted pets in dresses, winter booties, and many pet owners even home cook our pets’ diets, but has the latest drug from Pfizer crossed the line?

Slentrol is a diet pill for dogs that is now available for the bargain price of a couple bucks a day. It works by a couple ways: 1) reducing the amount of fat that the body can digest, and 2) affecting the cells in the dog’s small intestines to make the dog feel full before they normally would.

As a vet, I fully understand that the pet obesity epidemic is real and on the rise, and that there are sometimes medical causes of obesity that require intervention with a pill of some form, but in those instances, there are actual medical problems that result in obesity, not a too large dog measuring cup or days of endless inactivity spend curled up in front of the fire.

As humans, it takes self-restraint and will-power to lose weight.  Perhaps this pill’s entrance to the veterinary market is proof that it takes self-restraint to make your dog or cat lose weight as well.

I try to be very open-minded regarding new medications and new forms of therapy, of both western and eastern origin, but this “Slentrol” is really rubbing me the wrong way. I’ve yet to prescribe it for a patient, and none of my veterinarian friends have either.

I understand at least  on some level, human diet pills. When I was a freshman in college and eating cookie dough for breakfast and midnight snacks caught up with me, I purchased some Chinese herbal dieter’s tea. Wow, what a mistake! But the point? I was susceptible to wanting an easy solution.

Easy fix?  Yes, please! Read the rest of this entry »

Dogs on Airplanes: A Hazard for the Airline Passengers or the Dog?

December 7th, 2010

ask a vet a question, pet health problems, dog skin issuesPart One

As you may have seen on the news, a 12 pound Manchester terrier recently bit two people on an airplane en route from Newark to Phoenix. Though the bites were not serious, the pilot landed the plane in Pittsburgh as a precaution.

Granted, I have no idea how extensive the wounds were, but in my opinion, this pilot likely landed the plane to calm the passengers, not because the dog was posing an actual threat.

Fear-biting is believed to be the number one cause of dog bites sustained by people. People that are unfamiliar or uneducated in dog behaviour language will continue to be bitten everywhere they act on ignorance—the dog park, doggie day care, dog shows, or yes, even a plane.

Why, you say? I have been on planes where passengers became severly ill, more so than a dog bite—such as when Dr. Jed herniated a disc in his spine on our
L-O-O-O-O-O-O-O-N-G flight to SE Asia sitting in tiny seats engineered for the shorter Asian flying population (no joke).

Want further reason that the airline was not actually concerned about the safety of their passengers and was merely looking to diffuse the situation? The woman and her dog were indeed asked to not board the plane again when it re-embarked for it’s original destination.

The catch?  The woman and her viscious dog were allowed to board another plane shortly after.

ask veterinarian, ask a veterinarian, sick dog, online vet

Is this the future of air travel? I think not.

Read the rest of this entry »

Palliative Treatments: Is it Ethical to Treat if there is no Cure in Sight?

November 30th, 2010

ask a vet, ask a vet online, talk with a vetOur Plight Down a Dismal Road

Palliative treatments are those treatments that are aimed at not curing the disease, but increasing the patient’s comfort. It is an area of some controversy, as some people don’t believe it is right to put an animal through procedures–be they surgery, chemotherapy, radiation therapy, the list goes on–if there is no way the animal will be cured of the disease in the end.

Whether the reasons be financial, ethical, compassion, or personal, many people feel passionately about their stance. People say that veterinary medicine is rapidly evolving, and that the “younger generation vets” are more pro-treatment and active to find a diagnosis; I would have to agree, and say that I typically fall into that stereotype. I for the most part believe this is a positive step for veterinary medicine. Mostly.

Even how you & your vet reach a diagnosis should customized.  We went against the text-book medicine route, as we felt it was pointless, and would only cause her pain.

It was a personal experience, the loss of our first pet as adults, that truly opened my eyes and made me realize it truly is a personal decision, one that must be customized by every pet owner, pet, and vet. I wish Dr. Jed and I had not gone through the story that follows in a multi-part post, but am grateful for the lessons it taught us.

It was the evening of October 27, 2008. Dr. Jed and I were newlyweds, and he was back in school full-time studying for his MBA and working as a business consultant, while part-time still “vetting;” I had taken over the hospital. He had just returned home from night school when Madison, our beloved Great Pyr limped. Just a little bit, but with two vets as parents watching over our four-legged children like hawks, not much gets past us medically.

We immediately did a lameness exam on the kitchen floor, and Dr. Jed found a slight swelling towards the end of her radius, one of the bones in her front leg. Read the rest of this entry »