Keeping your pets safe and healthy is our #1 priority!  We hope these articles help do just that.
Is It an Emergency or Not?

On a typical day, owning a pet is nothing more than unconditional love, playing, petting and feeding. But what happens when your furry friend is just not acting right? Do you wait to see your veterinarian the next day? Call and make an appointment for next week? Or should you be rushing to the closest emergency hospital?

Well, unfortunately, the answer is not always that clear cut.  While some emergency scenarios are obvious: your pet experiences some form of trauma such as being hit by a vehicle, dog bite wounds, jumping from places they should not, choking, then the animal should be evaluated by a veterinarian immediately.

But what if your pet is vomiting or having diarrhea, ingested something it should not have, coughing or breathing abnormally?

Well the good news is you can always call either your veterinarian or your local emergency hospital to discuss what is happening with your pet. They can then guide you on whether you should come in immediately or if the problem can wait for a day or two when an appointment can be made.

Here is a list of problems to look for in your pet to evaluate if it might be an emergency:

  • Abnormal breathing
  • Increased rate or effort in breathing
  • Abnormal noises when breathing or coughing
  • Vomiting, diarrhea or inappetence
  • Lethargy or abnormal behavior
  • Inappropriate urination or defecation or no urination or defecation
  • Pale color to the gums
  • Pain or restlessness
  • Open wounds or bleeding
  • Lameness

This list is not all-inclusive and the bottom line is that if you are concerned about your pet’s problem you can always take him or her to an emergency hospital for evaluation. There are no problems considered too small or insignificant and your piece of mind and your animal’s well being are exceptionally important.

Kerri Wiedmeyer, DVM
ER Veterinarian

Vestibular Disease

Every so often, a client will bring their dog or cat to the veterinarian for an urgent evaluation because of a sudden onset of difficulty walking (almost as if drunk, perhaps complete inability to get up) and a head tilt.  Vomiting is sometimes reported.  Upon closer examination, nystagmus (eyes going back and forth rapidly) is seen.  Clients will comment that they believe that their pet has had a ‘stroke’.  Understandably, these pet parents worry that there may be some type of permanent injury and are distressed in watching their companion endure what can be very dramatic symptoms.

We understand a ‘stroke’ from human medicine as a sudden hemorrhage or blood clot to an area of the brain that can lead to weakness, paralysis, potential loss of speech and cognitive functions and potentially, death.   While it is not impossible for dogs and cats to develop bleeding problems in the brain, the most common explanation for what is commonly called a ‘stroke’ in small animal medicine is actually vestibular disease.

Vestibular disease (or syndrome) is a general term describing clinical signs consistent with abnormal functioning a part of the nervous system that controls the body's balance and equilibrium. The vestibular apparatus is the neurological equipment responsible for perceiving your body's orientation relative to the earth (determining if you are upside-down, standing up straight, falling etc.) and informing your eyes and extremities how they should move.  The vestibular apparatus allows us to walk and run on uneven ground without falling, helps us know when we need to right ourselves, and allows our eyes to follow moving objects without becoming dizzy.

In animals and people, balance is controlled by the ears (vestibular receptors of the inner ear) working together with specific areas of the brain. Together they represent the vestibular system.  If the vestibular apparatus is not working properly, then you may not accurately perceive your orientation. To put it more simply, you won't know which way is up, whether or not you are standing up straight or slanted, and you will feel dizzy.  The following are signs of vestibular disease:

  • Ataxia (lack of coordination without weakness, or involuntary spasms - in other words, stumbling and staggering around)
  • Nausea, vomiting (motion sickness)
  • Nystagmus (back and forth or rotational eye movements)
  • Circling
  • Head tilt
  • Falling to one side (you may notice that your pet will only lie on one side and will roll on the floor when attempting to move or when you try to turn him on to the other side)
  • Trouble with other nerves controlling the head and face
  • Cats may also vocalize due to the imbalance

Many diseases can cause loss of balance – an ear infection, ruptured ear drum,  a tumor in the brain or the inner ear, a vascular problem, toxicity to chronic drug administration (e.g., metronidazole), and idiopathic vestibular disease – so it is important that a veterinarian examine the animal to begin to determine the most likely cause.  An initial diagnosis is made by the history, general physical exam, ear exam with an otoscope, and by the neurologic examination.  If there is a suspicion that something else is going on, your veterinarian might recommend further tests.  Additional tests could include blood work, imaging of the middle ear and/or brain (via x-rays and/or CT scan), maybe chest x-rays (to help rule out heart disease or tumors that could contribute to ‘wobbliness’. 

A middle ear infection is a likely possibility for vestibular disease especially if there is a history of ear infections. Debris in the external ear, could imply infection in the middle ear as well. However, the absence of debris in the external ear does not mean that a middle ear infection is unlikely. Imaging of the middle ear bones may be in order.  One way to evaluate the middle ear is with radiographs called a bulla series, so named because it focuses on an ear bone called the tympanic bulla. If the bulla appears abnormal, the ear may require surgical drainage. The problem is that x-rays are often not sensitive enough to pick up damage in the middle ear and a normal set of films does not rule out disease. In these cases, special imaging such as a CAT scan or MRI is better. These techniques also allow imaging of the brain tissue itself (which radiology does not) thus allowing brain abnormalities to be evaluated as well.

Brain tumors can be a cause of vestibular disease if the signs fit with a lesion of the central nervous system. In these cases, CT or MRI scans are needed to make the diagnosis. Such tumors may be treatable depending on their location.

Idiopathic vestibular disease is the most common form of vestibular disease in dogs (also called ‘old dog vestibular disease’) and cats. The clinical signs happen extremely rapidly, sometimes over a few minutes, and can cause severe incapacitation.

Treatment depends upon the severity of the symptoms and the likely cause.   An ear infection would require antibiotic therapy.  In some cases in which a cause is not determined, or if it is presumed to be idiopathic disease, symptomatic treatment and supportive care is given.  It is not unusual for a dog or cat to be unable to get up and walk because the loss of balance is so severe. It is assumed that your pet feels dizzy and nauseous.  With the more severe presentations, hospitalization, fluid support and medications for nausea are advised.  If the patient is able to eat and drink, and came move about without needing significant assistance, home care can be appropriate.

Most cases of idiopathic vestibular syndrome improve within several hours to a few days but could take days to weeks to completely resolve.  This syndrome can occur again at some point in your pet's life, however it cannot be predicted.  If the patient is not improving, or is worsening, more aggressive diagnostics and treatment would be advised.  Despite the severity of the clinical signs and the anxiety of your pet (and you), the chance of recovery is excellent. All your dog or cat needs is some time and your help. 

Keeping Pets Safe in Summer

During warm weather, our veterinary clinics start to see cases of heat stroke again. Heat stroke is an emergency condition where the body becomes overheated. If severe enough, this can affect essentially every organ system including the brain, kidneys, liver, and even the animal's ability to clot blood appropriately. Heat stroke can sometimes be fatal if severe enough. 

The most well known cause for heat stroke is leaving an animal in a poorly ventilated car on a hot day. However, unventilated cars can become dangerously warm even on cooler days (think temperatures in the 70s). Besides this, there are many other causes of heat stroke, including exercising in warm weather. Our brachycephalic breeds (pugs and others with squished faces), as well as pets with a darker coat are also more prone to heat stroke than others. 

Signs of heat stroke include weakness, collapse, respiratory distress, and of course, an elevated body temperature (typically > 104.5 degrees Fahrenheit). 

If you think your pet is experiencing heat stroke, he or she should be taken immediately to a veterinary hospital for evaluation. Prior to transport, you can wet your pet with tepid (lukewarm) water. Using cold water actually causes blood vessels to constrict (shrink), resulting in retention of heat internally. When you are on your way, it is always a good idea to call the clinic ahead of time. However, getting your pet there safely is more important.

Once at the clinic, your pet will be rapidly assessed and treatments initiated. Typically, IV fluids are started to help with internal cooling, and the pet's temperature is closely monitored. Internal damage can still occur even if your pet's temperature returns to normal quickly. Bloodwork, hospitalization, and monitoring are usually recommended. 

To prevent heat stroke, never leave animals in a car on a warm day, make sure to provide adequate shade and water if outside, and avoid strenuous exercise during warm weather. If your pet is a brachycephalic breed or dark in color, be especially cautious since prevention of heat stroke is far easier than treatment.


Winter Safety Tips

It’s a common belief that dogs and cats are more resistant than people to cold weather because of their fur. This is untrue. Similar to people, dogs and cats are susceptible to hypothermia and frostbite.  Know your pet’s limits, their activity level, their hair coat or body fat stores, and adjust outdoor activities accordingly. Old, young, or wet dogs are at a greater risk of hypothermia and/or frostbite. Short-legged pets may become cold faster because their bellies and bodies are more likely to come into contact with snow-covered ground. Pets with underlying illnesses (diabetes, heart disease, kidney disease, or hormonal imbalances such as Cushing’s disease) may have a harder time regulating their body temperature.

Frostbite occurs when exposed tissue becomes so cold ice crystals form within the tissue, causing irreversible damage. In our pets, this most often occurs on ears, paws, and the tail. Monitor for signs of frostbite such as redness in the early stages, or cold, pale/white areas in the late stages. Please bring your pet in to a veterinary clinic if you notice any of this signs. Salt and other chemicals used to melt the snow and ice can irritate paw pads, and track the chemicals into your house. Clean the paw pads (and belly if short-legged) when you come inside, and monitor for injuries such as cracked paw pads or bleeding. 

Many people know the dangers of leaving their pets in parked cars during the summer months, but leaving your pet in a car during the winter months can be just as dangerous. A car amplifies the effects of extreme weather, and in the winter a car can easily reach temperatures below freezing, causing your pet harm. Additionally, do not leave your pet in the car if it is warming up in the garage.  The garage can trap carbon monoxide, and it can take only minutes for a pet to die from this exposure.

With the cold temperatures, pets left outside and wild animals may seek shelter in places we do not think about. Animals sometimes choose to sleep under the hoods of cars where it is warmer. When the motor is started, the animal can be injured or killed in the fan belt. To prevent this, bang loudly on the hood of the car or honk the horn, and wait a few seconds before starting the car to allow any animal the chance to escape.

Antifreeze is a sweet tasting chemical that animals may frequently come into contact with during the winter months. The ethylene glycol in antifreeze is deadly, and causes acute kidney failure in our pets and wild animals. Please keep it away from children and pets, and wipe up any spills that you notice. You may also use an anti-freeze coolant that is made with propylene glycol rather than ethylene glycol.

Ideally, all pets would be brought inside during winter months.  If your pet must stay outside, make sure they have a warm, dry, stable shelter against the wind and elements. Ensure they have fresh, non-frozen drinking water. Outdoor pets may require more food since keeping warm requires a large amount of energy. Sweaters and booties will help keep your pet warm, and protect them from not only the cold, but chemicals and toxins they may come into contact with during these winter months. 

The holidays bring lots of guests, decorations, and activity around the house. Make sure house guests close all appropriate doors so your pets do not escape. Animals may lose their sense of smell and direction after a large snowfall, and become lost. Make sure your pets have collars with up to date information on their tags.

Keep electrical cords out of the pet’s reach; electrocution can occur if a pet chews on the cord. Clinical signs of electrocution include electrical burns in the mouth, difficulty breathing, seizures, cardiac arrest, and require immediate veterinary care. Ribbons, tinsel, and pine needles from trees may cause gastrointestinal problems if your pet ingests them, including obstruction of the intestines that requires emergency surgery. Pets may think glass ornaments are toys and break them or ingest them. If your pet develops gastrointestinal signs (vomiting and/or diarrhea), please have them evaluated by a veterinarian.

Rebecca Brockman, DVM


Four-Legged First Aid Know How

Many can cope with emergencies that arise with people but are uncertain how to approach similar situations with their pets.  The details of treating specific emergency situations are beyond the scope of this article but are summarized in a Pet Emergency Care booklet available online or at WVRC. 

Since animals cannot use 911 service, the numbers of your primary care veterinarian and animal emergency center should be readily available.  Pet sitters should know where to find these numbers in your absence.  When travelling with your pet, identify a local veterinarian or emergency care facility to use if necessary.  For questions about ingestion of a toxic substance, the Animal Poison Control Center 1-888-426-4435, is available 24/7.  They provide valuable information to help your veterinarian in treating specific types of chemical, plant, and medication exposures.

Know how to recognize when your pet needs emergency care.  Be familiar with ‘normal’ for your animal.  The heart rate is felt near the point where the left elbow touches the rib cage.  The pulse is found on the middle of the inner thigh a few inches below the groin. The oral membranes (inside of lip and gums) should be medium pink and moist.

Some symptoms are easy to identify – visible bleeding or swelling, labored breathing, tremors, collapse, difficulty walking, vomiting, diarrhea, straining to urinate.  Other signs can be more subtle: anxiety or pacing, lethargy or confusion, significant variations from normal body temperature, heart rates and breathing patterns, oral membranes that appear pale, gray or blue 

Know how to stabilize your pet until veterinary care is obtained.  Anyone familiar with first aid as taught by the American Red Cross will recognize the ABCs – maintaining an airway, breathing and circulation.  Core principles of first aid that are given to a human are the same as those for a small animal.  Apply direct pressure onto bleeding wounds.  If your pet is not breathing, look in the mouth for any foreign object that may be blocking the airway. Remove it if it is completely stopping breathing.  If there is no object and the animal is not breathing, hold the muzzle closed and forcefully blow air (4-5 breaths) into the animal’s nose.  Repeat until he/she is breathing normally.  Begin chest compressions ONLY if there is no heartbeat.  There should be 3-5 chest compressions for each artificial breath. 

A key difference in providing care to an animal is to avoid being injured by the patient.  The most docile animals can react aggressively when painful or afraid.  Keeping yourself and your pet calm could be the most difficult task in an emergency situation.  If necessary, place a muzzle over the mouth before attempting to move a patient or examine a wound.  A towel or blanket can be used as a sling to assist in walking, as a stretcher to help move an animal or to loosely swaddle cats to prevent biting and scratching.

Normal Ranges:

Temperature:  dogs and cats 100-102.5 degrees Fahrenheit 

Heart Ratesmall dogs (under 30 pounds) 100-160 bpm; medium to large dogs (over 30 pounds) 60-100 bpm; puppies (until 1 year old) 120-160 bpm; cats 130-220 bpm

Respiratory rate: dogs 10-30 breaths/min; cats 20-30 breaths/min (panting or open mouth breathing in a cat needs immediate attention) 

These are basic tenets to follow in any scenario.  The best way to handle an emergency is to be prepared. 

Chocolate Toxicity in Pets

Chocolate can be very toxic to dogs and cats.  Chocolate is toxic to our pet friends because it contains a substance called theobromine. There are many factors that we have to take into consideration when finding out just how toxic the chocolate is that your animals ate. What type of chocolate was it? How big is your animal? When did your pet eat the chocolate? Do they have any other medical problems?

The type of chocolate makes a substantial difference in the toxicity that may occur. White chocolate contains very little theobromine, while baking chocolate is highly concentrated. The milk chocolate that we mostly commonly have around contains 1/3 the amount of theobromine that semi-sweet chocolate contains and 1/10 the amount that baking chocolate contains.

One can easily see how a dog eating a bar of milk chocolate will cause significantly different clinical signs than if it ate the same amount of baking chocolate. 

Pets that ingest chocolate can start with clinical signs of vomiting and diarrhea. They can then proceed to be restless or hyperactive. In severe ingestions, they can develop tremors, seizures and abnormal heart rhythms (arrhythmias) and even possibly death.

It is very important to contact your veterinarian or an emergency facility if your pet ingests chocolate. They will assist you in determining if your pet needs to be seen immediately and even possibly hospitalized.

Even though chocolate is a nice treat for us; it can cause severe sickness in our furry friends. Remember to keep that in mind as the holidays approach!

Kerri Wiedmeyer, DVM

The Facts About Leptospirosis

Leptospirosis is a bacterial organism that affects dogs and people, with peak incidences occurring July through November, which coincides with some hunting seasons in Wisconsin.  

There are many different strains, also known as serovars, of leptospirosis.  Reservoir hosts of the bacteria include rats, raccoons, cows, pigs and even mice.  The bacteria are shed from the kidneys of affected animals, and in most cases dogs are exposed by way of urine-contaminated water, soil or food.  Leptospires are hardy and can remain infectious in the environment and soil for weeks to months, although freezing temperature can kill the bacteria.

Leptospirosis causes a variety of illness in dogs, ranging from mild signs to severe illness or even death associated with kidney or liver failure.   Some of the earlier signs often start with increased thirst and urination, decreased appetite or fever.   A veterinarian's exam with blood work and urinalysis often yield a high index of suspicion for the disease, but a diagnosis is made following leptospirosis-specific tests. 

People can become infected and sick with leptospirosis as well as dogs.  Infection in some people is very mild and can present as flu-like symptoms whereas in severe cases, the kidneys, liver and even lungs can be affected.  People can become infected with leptospirosis from infected dogs.  Therefore, if there is any concern for human exposure or illness, a physician should be notified immediately.  

The good news about leptospirosis is that dogs can respond well to treatment and in many cases, make a full recovery with hospitalization, supportive care and antibiotic therapy.  Dogs with a higher risk of infection can be vaccinated annually.  These dogs include herding, working or hunting dogs and dogs that are those exposed routinely to wildlife or livestock.   Current vaccines appear to reduce shedding and may even be able to prevent disease.  Interestingly, cats do not appear to become sick from leptospirosis.

Uncommonly Known Food Toxins

Does your pet counter surf and look for any type of food scrap?  Many of our favorites foods are toxic to cats and dogs.  Most people are aware about chocolate, grapes, raisins and many chemicals such as anti-freeze, rat poison, and acetaminophen, etc.  A few others that are not a well known are macadamia nuts, xylitol, bread dough, onions and garlic.  

In dogs, macadamia nut ingestion symptoms included weakness in the legs, they appear to be in pain, have tremors and may develop a low grade fever.  

Xylitol is a low-caloric sweetener found in many baked goods, chewing gum and other items. It causes a severe drop in blood sugar levels in dogs and causes disorientation and seizures anywhere from 30 minutes to several hours after ingestion.  Large amounts of xylitol can cause liver failure and can be fatal.  

The live cultures in bread dough is what makes it dangerous.  When combined with the warm, moist environment of the stomach, it begins to expand and can cause restricted blood flow to the stomach and breathing issues.  As the yeast multiplies, it produces alcohol that can result in alcohol intoxication.  Symptoms include distended abdomen, disorientation and vomiting.

All types of onions and garlic can cause damage to both cat and dog red blood cells.  It may be unlikely for your pet to ingest a raw onion but you need to watch for exposure to concentrated forms such as onion soup powder, garlic powder or dehydrated onions. Symptoms in cats and dogs do not appear until 3-5 days after.  Watch for weakness and reluctancy to move or tiring easily after mild exercise.  The urine may be orange to dark red in color.  

If your pets are showing any of these symptoms please notify your veterinarian or call WVRC. For more information on toxicities or any other pet related issues, visit our Education Library.       

Rodenticide Poisioning

Rodenticide poisoning is one of the most common poisonings that we see on an emergency basis.  There are 3 main types of poisons that can be used: anticoagulants, neurotoxins or Vitamin D containing compounds. One of the most prevalent anticoagulant rodenticides that has been used is d-CON, but there are numerous other manufacturers. Rodents have become more resistant to some of these drugs and recently the EPA has placed a ban on many of these anticoagulant products. As a result, other rodenticides, such as the neurotoxin, bromethalin, are being used more commonly to replace the anticoagulants. 

Bromethalin's primary effect causes changes that result in cerebral edema or fluid accumulation in the brain. Bromethalin poisoning is dose dependent and cats are even more sensitive to the toxic effects, meaning a smaller ingested amount is even more harmful than in dogs. At high doses, signs can develop within 4-36 hours after ingestion. Dogs often exhibit a convulsant syndrome consisting of tremors, hyperexcitability, and seizures. Dogs that ingest a lower toxic dose more often develop a paralytic syndrome 1-5 days later, beginning with weakness of the hind limbs and incoordination that progresses to paralysis of the hind limbs and depression that may ultimately result in a coma. Cats appear to more commonly develop the paralytic syndrome and they may also get a distended abdomen. 

Unfortunately there is no test for bromethalin poisoning, making a diagnosis without a history of bait ingestion more difficult. Diagnosis is dependent upon a history of ingestion of poison coupled with development of the above progressive neurological signs in an appropriate time framework. 

Unlike the anticoagulants, there is no antidote for this poison. Because the poison is rapidly absorbed (peak levels in 4 hours) and slowly excreted, prompt treatment in the first few hours is very important to success. The first step is inducing vomiting to remove as much of the poison as possible if the pet has recently ingested the poison. Second, to reduce further absorption of the toxin, repeated doses of activated charcoal are administered. Finally, if the pet is exhibiting signs of toxicity, treatment is directed towards supportive symptomatic treatment, which may include medications to control seizures and providing nutritional support and basic nursing care. Pets that are paralyzed or having seizures have a poor to grave prognosis even with aggressive treatment. 

Since the active ingredient cannot be determined from the bait's color or physical appearance, identifying the type of rodenticide from the package label is important in distinguishing which type of rodenticide has been ingested to treat successfully. If your pet has ingested a rodenticide, keep the container/box listing the ingredients to bring in and contact a veterinarian as soon as possible for further recommendations. The ASPCA also has an animal poison control hotline 888-426-4435; there is a $65 consultation fee.