Max is a five-year-old Shih Tzu who was fine when the owners went to work one morning last month. When they came home for lunch, Max had vomited several times. This continued several more times during the day until Max saw us that evening. On presentation Max was severely dehydrated and felt awful. His eyes were dull, and he was very lethargic. A full blood screen showed all values within normal range including tests for pancreatitis. While we were unsure what the primary cause of the issued were with Max, our tentative diagnosis was either dietary indiscretion or hemorrhagic gastroenteritis (HGE).
Max was started on IV fluids and given a medication to help calm his stomach. After several hours we had Max’s dehydration and vomiting under control, but he continued to feel poorly. While we felt he was more stable, we also felt he needed additional treatment. Since we do not have someone available overnight monitoring the pets, Max was discharged for his owners to monitor and take directly to the emergency clinic if his condition worsened.
Max was back the first thing the next morning with no vomiting but still felt bad. He was placed in the ICU ward again and fluids were continued. He now had developed bloody diarrhea, so medications were instituted to help resolve this. With the advent of the new symptom, we determined that Max likely had HGE and IV antibiotics were started. We also continued the nausea medication.
HGE is a poorly understood syndrome that revolves around severe vomiting and foul, bloody diarrhea. While the cause is largely suspected to be viral, no virus has ever been isolated from the sick pets. Treatment revolves around keeping the pet hydrated and covering them with antibiotics to help present sepsis from translocation of the intestinal bacteria in an unhealthy intestine.
Max continued the treatments in the ICU ward during the day, followed by observation by his owner at night. Over the course of several days and much TLC, he slowly began to drink some water and regain his appetite until he eventually became the active and energetic dog he was before.
Because of Max’s recovery from HGE, he is AHS’s canine Pet of the Month.
Scaredy Cat is a senior cat that presented with some weight loss and advanced dental disease. Scaredy Cat also had a heart murmur. Scaredy Cat’s owners were interested in having his dental disease addressed with anesthesia and dental radiographs for assessment and subsequently having any needed extractions performed. The weight loss was concerning, as it was potentially related to the dental disease. Due to Scaredy Cat’s age and weight trend, we did some blood work to assess surgical risk. Scaredy had a heart murmur but a normal heart blood test which assesses heart stress. Scaredy cat also has a high thyroid level. Hyperthyroidism is a disease common in aging cats in which they develop tiny benign tumors on their thyroid gland which in turn produce too much thyroid hormone. This in turn leads to increased thyroid levels, which increase the body’s metabolism. This leads to weight loss and a cat that cannot eat enough to maintain its weight. The organs, such as the heart and kidneys, get overtaxed as well. Due to the increased surgical risk with the hyperthyroidism, we decided to correct the thyroid levels first. Scaredy was started on methimazole. This is a medication which blocks thyroid hormone production in the thyroid gland. Scaredy came back two weeks later with a normal thyroid hormone level and improved heart murmur. Scaredy Cat was anesthetized, as we deemed his anesthetic risk was acceptable. We cleaned his teeth and extracted several painful teeth. Scaredy Cat’s owners were very please afterwards. Scaredy cat was playing again and very social. These were behaviors the owners had not seen in a long time. Scaredy cat is a sweet, amazing cat and has a new lease on life. That is why he is our AHS feline Pet of the Month.