Visiting Veterinarian : On Martha's Vineyard and everywhere else, vets covet certainty
I was sitting down to write Dr. Jasny's More-Or-Less Annual All Creatures Great And Small Labor Day Awards, but wasn't feeling particularly clever. I had come up with a few good chuckles. The Wikileaks Award for incontinence. The Congressional Partisanism It's Enough To Make You Barf Prize for dogs who ingested bad things requiring us to induce vomiting.
But as I flipped through my appointment book, refreshing my memory about cases for the column, I kept getting interrupted. As many of you know, there is no 24-hour emergency animal hospital on the Vineyard, so most Island veterinarians participate in a cooperative that rotates providing urgent care. It was my turn on call, on top of a full day of appointments. Somewhere between puppy boosters for Larz, the English springer spaniel, and evaluating Gus, the King Charles cavalier for luxating patellas, I got a call about a Labrador retriever that had swallowed a screw.
I questioned the owner. How old was the dog? How big? How long ago did he swallow it? What size screw? Was the end pointed or flat? What was it made of? If the screw were very big or the dog very small, it could cause an obstruction. If it were made of zinc, it could actually be toxic. If it were sharp, it could perforate the gastrointestinal tract leading to life-threatening peritonitis. On the other hand, if we induced vomiting, a sharp screw might tear the esophagus as the pup heaved it up.
Learning that this was a small, sharp, steel screw in a big dog, I advised feeding bread to envelop the screw in doughy material, then follow with an oral lubricant to grease it through. "Watch him closely until the screw passes in his poop," I told the owner. "Call if he has abdominal pain, loss of appetite, or vomiting."
That wasn't so hard. Or was it? As I hung up the phone, I thought of all the dogs I knew who had passed things uneventfully in their stools...and those that hadn't. The poodle with Addison's disease with a severe intestinal blockage from eating a stuffed animal, who had ultimately defecated the material and survived. The shepherd that was euthanized due to repeated obstructions from eating knee socks. The Corgi who lived unaffected for years with a hunk of glass lodged in his stomach. The cat that died when a toothpick caused intestinal perforation, and another cat that vomited a large metal buckle without complication. The dog with the metal nut in her stomach that caused terrible bouts of pain until we removed it surgically. Today's case seemed unlikely to have dire consequences, but I couldn't be 100 percent sure. We finished the day's appointments and locked the door.
Soon after, the next call came. A bulldog puppy had swallowed a six-inch chunk of bully stick in one gulp. The pup was only 12 pounds. That's pretty small to have a six-inch foreign body in your tummy. But bully sticks are just dried muscle from bull penises and totally digestible. Still, that's big for a small dog.
"Bully sticks soften in stomach acid," I told the caller after scanning cases on my veterinary service online. I gave the same advice as for the Labrador. Bread, lubricants, observation. And stifled my qualms about the size of the puppy. Would it pass? I thought so, but I couldn't be 100 percent sure. Time would tell. My family sat down to dinner.
As I picked up my fork, the phone rang again. A dog had chewed on an ant trap. Another had been stung by a bee. For the first, I advised that they call Animal Poison Control directly. I was pretty sure there was no cause for concern but couldn't find precise information about the specific ingredient in this trap. "Let's make sure there's no danger," I suggested, offering to call them back in 15 minutes as smells wafting from the dinner table beckoned me. "If Poison Control advises treatment, then I'll have you come in."
I grabbed a mouthful of food, called the people with the bee-sting dog, told them to give benadryl, ate another bite of dinner, then called back the ant-trap folks. Animal Poison Control had said the dog might get an upset stomach but no immediate intervention was indicated. Did I detect a note of annoyance from the owner? Did they think I should have known off the cuff that this particular ant trap wasn't a problem and spared them the fee for Poison Control? Probably not, but I couldn't be 100 percent sure. I finished my supper, said good night to my children, and went to bed.
At midnight I was awakened by a call from a woman who had purchased an over-the-counter spray and earlier that evening had spritzed her cat all over. Kitty was now foaming profusely at the mouth. I suspected the cat had merely licked itself and that the stuff tasted terrible, provoking salivation, but I couldn't be 100 percent sure. I had the owner read me the active ingredients. They were unfamiliar to me. There was nothing on my online veterinary service. Maybe I should have her call Animal Poison Control, I thought sleepily, then remembered that hint of annoyance I had imagined in the ant trap caller's voice.
"Hang on, " I said. "Let me google it." The owner murmured that she guessed she could have googled it herself, but I was already on it. Finding the product's website, I went to FAQ, and read the owner the part that says the stuff indeed tastes bad and cats who lick it will drool. I advised wiping off the product and getting something else for fleas the next day. That was easy.
Except now it was 1 am and I was wide awake. Since I was already at my computer, I gave another stab at writing that Labor Day Awards column. But I wasn't feeling particularly clever.