There are emergencies, and then there are Emergencies...

I've been telling it on the mountain to anyone who would listen for weeks now. Many veterinary emergencies are best handled at a tertiary care veterinary hospital. In our neck of the woods, that means an after hours emergency and referral center.

Love 'em or hate 'em -- I've heard both sides of the story. Yes, it's expensive. Emergencies are expensive. When is the last time you walked out of a human ER with less than $1,000 invoice for treatment of a trauma or unrelenting pain? What amazes me is that for every client who swears she won't go to the after hours emergency veterinary hospital because of the cost, there is another client who hustles in at midnight to have her dog's itchy ears treated.

Now most ear infections can wait until morning for treatment by the regular veterinarian (there are exceptions to every rule). And many so-called emergencies are chronic problems that have been ignored or avoided for so long they just magically turn into urgent issues at five minutes past 5 o'clock on Friday evening. Procrastination may be human nature, but it unfortunately makes medical problems more difficult and expensive to address.

Merriam-Webster dictionary defines emergency as "an unforeseen combination of circumstances ... that calls for immediate action." True veterinary emergencies are unexpected and do require immediate attention: hit-by-car accidents, heat stroke, unrelenting seizures and sudden collapse are just a few examples (more scenarios are listed on my clinic website).

Most of the emergencies that befall pet animals are readily handled by your regular veterinarian, especially during regular business hours when the clinic is appropriately staffed and the "machinery of medicine" is up and running. At the very least, the pet's injuries or condition can be assessed, he or she can be stabilized, and specialized care at a referral hospital can be arranged if necessary.

The terrible events of March 20, 2011, in Fond du Lac, Wisconsin, reinforced in me the belief that there are times when nothing other than a veterinary facility dedicated to emergency veterinary care will suffice. I believe Fond du Lac Police K9 Officer Grendel would not have survived gun shot wounds received in the line of duty on that day if it were not for the local after hours emergency facility.

I have heard complaints that our local after hours emergency center is too far away, especially in an emergency. To this I have two responses. First, having driven through North Dakota where for some rural residents the nearest tiny human hospital is over an hour or two away I'm thrilled to have so many choices for pets within an hour's driving distance! Second, due to the circumstances, Grendel's medically-disastrous gun shot wounds were several hours old by the time he reached the veterinary hospital (and believe me, his trip north on Highway 41 was considerably shorter than most with squad car lights and sirens blazing!)

Had his emergency happened on a Tuesday morning instead of a Sunday, Grendel could have received an excellent diagnostic workup, immediate stabilization and compassionate care from any number of general practitioners in the area. Fortunately for Grendel, he was transported to a hospital that also could provide advanced imaging, expert abdominal and thoracic exploratory surgery, around-the-clock critical care, and numerous treatments to support blood pressure, clotting and more. The medicines used for Grendel are so specialized and costly no general practitioner I know could justify keeping them on the shelf in case of a rare emergency of this magnitude.

News clip on Grendel's recovery

After just eight days of intensive surgical and medical care at the veterinary emergency hospital, Grendel joined his human police partner at home in a joint recovery. Both returned to the line of duty on May 9th. From a veterinary medical standpoint, Grendel's full recovery is stunning.

In cases of life threatening injury, a patient's best chance for survival rests in the hands of exceptional doctors and staff, available life support technologies, inner strength and good fortune. Grendel had all of these on March 20th and the days that followed. For that, as a veterinarian and as a citizen of Fond du Lac County, I am grateful.

A Doggie Myers-Briggs?

Cheeks, Jimi Happy and Karate Kitten

I spent last evening blissfully entwined in the tiny tender arms of Cheeks, my highly affectionate female farm cat. She sneaked into the house somehow and did not have the good sense to stay hidden like her colleagues, the twin orange boys, would have. Or probably she didn't care about the possible repercussions of being caught inside. The first time I met Cheeks she wrapped her little white paws around my neck and began to nuzzle and purr. She is so loving she even allows my toddler to cuddle her (and you can imagine how pleasant that is). While I love the orange brothers and enjoy their antics, they are far more aloof than Cheeks. But even between them there are noticeable differences in personality with Karate Kitten being more tolerant of being held and snuggled.

It's no surprise to modern animal lovers that pets have personality. The topic of animal personality may seem like mere cocktail party chit chat, but it is actually a legitimately debated, scientifically studied issue--at least for dogs.* Jennifer Arnold, founder of Canine Assistants, discusses research on dog personality and how understanding a dog's personality relates to successful training in her book, Through a Dog's Eyes.

Currently, the kids and I are listening to a library copy of Through a Dog's Eyes in the car. It is such an inspiring true story of canine devotion and assistance that my son has developed a sudden interest in dog training. Luckily for our yellow lab EdGrrr that involves simple tasks like sitting and lots and lots of Pupcorn treats.

In one chapter of her book, Arnold explains how the personality types of assistance dogs and their human recipients are assessed with standardized measures. Her organization has found that dogs and humans which score similarly in certain areas are more likely to form strong bonds and work better together. In essence, people adore dogs most like themselves. Amazingly, the same is true of dogs! Intrigued about personality typing canines, I visited a website for a dog personality test mentioned in the book: www.petconnectgame.com.

First, I tested EdGrrr. Fiercely protective, attentive, trainable and enthusiastic, EdGrrr's behavior type index is "Deputy." That means he is high activity, organized (an organized dog!?), submissive and moldable, happily does the leader's bidding, and is everyone's friend. I have to agree with the assessment --  once he gets over his instinctive "law enforcement" duties he is truly a loyal friend to everyone.

If this isn't personality, I don't know what it is...
GrrrD (right) with foster brother Rudy

Next I tested GrrrD, our 13-year-old English Springer Spaniel. If you know GrrrD you won't be surprised she is classified as "Aristocrat." Prim and proper yet horribly bossy with other dogs, GrrrD sports facial expressions Jim Carrey would admire. Apparently an aristocratic dog "causes people to feel privileged to be its company" and has an "air of greatness." Oh, boy. Don't tell GrrrD, or she'll be even more impossible to live with!

Knowing your dog's personality type is fun.But it can also be a useful tool in behavior management. Understanding your dog's unique temperament and motivations allows you to solve training problems, increase your enjoyment of your dog and help improve your dog's lifestyle.

* Cats get the raw end of the stick in many scientific endeavors, with most medication being developed for pooches and then being used cautiously in felines until we know they work safely! Also, when commercial pet foods were developed decades ago, dogs and cats were fed the same formula until it was recognized--sadly after many cats became afflicted with strange diseases resulting from dietary deficiencies--that cats had entirely different dietary needs from dogs.

In Case of Armageddon Pull Here

Maybe it's a lingering obsession with pioneering days, a romanticized notion of self-sufficiency epitomized by Little House on the Prairie. Maybe it's survival stories like Gary Paulson's Hatchet that my kids and I can't get enough of. Or maybe it's a healthy dose of survival instinct. It's probably a combination of all these things that keeps my family's eye trained on catastrophe, and keeps us constantly considering ways to weather "the end of the world as we know it."

Admittedly, my family's preparations are more academic than hands-on at this point. While we haven't yet planted a Victory garden or worked out the kinks of preserving food, we recognize the good fortune of having wild plum trees growing in our tree lines. We stop cursing the burdock and other weeds invading our yard (for a little while) after reading a survival tale where the heroine dines on their roots and leaves. We admire the genius of a composting toilet and solar water heaters.

An example of home-made e-collars

Therefore, as someone who admires creative problem solving in a pinch, I thrill to hear tales of MacGuyver-like veterinarians creating e-collars out of ice cream buckets and--yes, of course--duct tape. Just yesterday a neighbor shared the contents of his hunting dogs' first-aid kit complete with antiseptic wipes, bandages and dental floss. The dental floss caught my eye. "Ahhh, for in-the-field suturing of wounds!" Amazing!

Maybe your dog doesn't chase bears through the North Woods of Wisconsin (and certainly may not tolerate major wound repair without sedation), but it is a good idea to have first-aid supplies on hand for house pets and hunting dogs alike. After all, if it's not a zombie attack or tornado, it could be a bee sting or deep scrape.

So what should you keep in your pet first-aid kit? Here are some suggestions:

• Sterile gauze pads (3" x 3") and gauze bandage rolls (1" and 2")
• First-aid adhesive tape, 1" roll
• Cotton swabs (Q-tips®)
• Tweezers
• Scissors
• Small bottle of 3% hydrogen peroxide
• Styptic pencil or cornstarch (stems blood flow from minor cuts)
• Antibacterial ointment
• Antiseptic cleansing wipes
• A current pet first-aid book
• Eyewash or sterile saline solution
• Eyedropper
• Digital rectal thermometer in a plastic case
• Leather work gloves (to protect you from being bitten)
• Latex gloves
• Leash
• Thin rope
• Splint materials (tongue depressor, 12-inch wooden ruler or thick magazine)
• Benadryl® or generic diphenhydramine (for allergic reactions -- get a dose from your vet!)
• Telephone number for and directions to the nearest emergency veterinary facility

Place the contents in a plastic storage box, tackle box or coffee can with lid. Ready-made first-aid kits are available for purchase at pet supply stores pharmacies, retail and discount stores and on-line.    Naturally, you should contact your veterinarian before administering any medications and for assistance following emergency treatment at the scene of injury.

Thankfully the world did not end on May 21, 2011, as forecasted, giving my family some extra time to build a root cellar, install solar panels and learn how to can vegatables. But there's no reason to wait to put together some simple first-aid items for you and your pets.

It's Not the Heat, It's the Humidity

With no air conditioning in our house, EdGrrr spent the day stretched out on the garage floor while GrrrD staked out a spot under the steps in the clinic. For now, it is a cool haven on a hot day but as soon as I open the veterinary clinic in a few weeks, I bet the spaniel will have to be dragged kicking and screaming into the place!

I know heat exhaustion is a topic I've addressed here before, but it apparently bears repeating. Check out the scene my friend Jennifer H. captured on film last Thursday:

"How about I put you in a snowsuit inside of a sauna...."

Leaving a dog in a car for any period of time in this kind of weather is not a good idea, regardless of the breed. Here are some other tips for keeping your pet safe in this hot, humid weather:

• Limit exercise to the coolest part of the day, no matter how happy your dog is to participate when it is warm. 
• Older, obese or short-nosed dogs (e.g., pugs, pekingese, bulldogs) are less heat tolerant and should be kept in cool areas as much as possible.
• All dogs need constant access to shade and an endless supply of cool, clean water.
• Heat exhaustion can kill your pet!  Never leave a pet alone in a car, even with the windows down.  On a sunny day your car can reach 120 degrees in minutes, even if the temperature feels reasonable on the outside.
• Remember, even if you park in the shade, it won’t stay that way. What was shady an hour ago will soon be sun-beaten.
• Dogs perspire through their paw pads, so the longer he is on the hot pavement or sandy beach, the less able he is to cool down. Don’t tie your dog up in the sun or make him stand on the street in hot weather.
• Pets can get sunburned too!!  Areas of the skin that have less hair, such as the lips, ears and nose are common areas for sunburn, especially in light-colored pets.  Keep pets in the shade during peak sun hours (10 am – 4 pm).
• Inside the house, you should provide adequate ventilation with screened, open windows, air conditioning or fans.

While playing outside, watch for signs of heat stroke. An overheated animal may pant heavily, slobber from the mouth, vomit or have diarrhea. Glassy eyes, frantic panting, or collapse indicate a dog needs immediate veterinary help. You must quickly reduce the body temperature by soaking the animal in lukewarm (not icy) water and gently massaging the legs and body. Assessment and additional treatment by your veterinarian is recommended.

As uncomfortable as this humidity is for us people and pets, I'd still choose today's weather over windchill and snow drifts any day!

Brats: Good for People, Bad for Dogs

Happy 4th of July! Campfires, cookouts and fireworks. Heat, humidity and biting bugs. Each is an icon of Wisconsin summer. Some we dream of on a frigid January day. Others we put up with as necessary evil. Each would make a great blog topic for The Practical Pet Vet as patriots and their pets celebrate this holiday weekend.

Hard as it is to pass over a discussion on firework phobias--there will be time later since fireworks season lasts all summer long nowadays giving phobic dogs no peace--I figured to talk about a threat less well known. Brats. Yes, you heard right. Brats. Not just a formidable adversary to trim waistlines everywhere, brats can be a deadly foe to our canine comrades.

Sipping a wine cooler, watermelon slice in hand, the off-duty veterinarian (never truly off duty as we shall see) stretches out in the lawn chair beside a crackling fire. Mosquito repellent perfumes the air. A group of children play flashlight tag under a stand of pine trees. The party's host mans the grill, loading a plate high with steaming succulent brats. Oops! A tasty pork delight slides off the plate onto the ground. "Here, Freddy*!" the host calls out graciously to his dog wriggling nearby in anticipation. "Noooooooo!" shouts the veterinarian lunging to grab the poor pooch's collar as he makes for the brat.

Huh? The host and other party guests (those not married to the crazed veterinarian) are dumbfounded. It happens time and again that some seemingly innocent trifle sets off the DVM in the crowd. Why can't the dog have a brat? Apologetically, I explain (yes, the veterinarian is yours truly) that fatty foods, notoriously pork products, are known to trigger pancreatitis in dogs.

One of the jobs of the pancreas is to secrete enzymes into the intestines to help break down food. When the pancreas becomes inflamed, the enzymes leak into and start digesting surrounding abdominal tissue! This condition is not only painful, but also in the worst cases it can be deadly. Dogs with pancreatitis usually stop eating and drinking, repeatedly vomit, develop diarrhea and have severe abdominal discomfort. Treatment often includes intensive supportive care, pain medications, and a special low-fat diet when the dog leaves the veterinary hospital.

A dog begging for food.

Certainly not every dog who eats a brat or a slice of bacon develops pancreatitis. For instance, my two dogs ingested an astounding amount of unadulterated pig fat, the trimmings from a spanferkel (a.k.a. pig roast) last fall with no lasting ill effects. They barfed up most of the fat in a putrid pile on the garage floor and merely suffered from a bit of a belly ache for the rest of the day. We dodged a bullet that time.

There are no hard and fast rules about which dog will get pancreatits. There are many factors that contribute to the disease. Breed, genetics, obesity, fatty meals and certain medications have all been linked to pancreatitis. Some dogs develop low-grade pancreatitis and recover without so much as a trip to the vet. Others develop complications from the disease and die despite heroic efforts in the veterinary hospital. It's a terrible game of Russian roulette.

So, let's not take any unnecessary chances. Just pick up that fallen brat and give Freddy his evening scoop of kibble instead. And let's get back to celebrating our Independence Day.

* Name changed to protect privacy.