Visiting Vet: Worries

Sometimes it’s best to just keep an eye on things.

My mom celebrated her 93rd birthday this week, so I have been in Connecticut visiting with her. A quintessential Jewish mother, she has taught me well how to worry. Is it dangerous to drink that milk that expired yesterday? Is that freckle on my leg cancerous? Will the ferry I’m on break down, leaving us adrift on an ocean made tempestuous by global warming? Will Trump be elected president? Oh, wait … too late. Deep breathing. Where was I? Oh, yes. Worrying. My penchant for anxiety helps me empathize with all the folks who call me after hours with concerns about their pets. Like the owner whose young boxer-Labrador cross ate a couple of raw chicken breasts off the kitchen counter. Should she be worried?

The major risk with consumption of raw chicken is possible exposure to salmonella, a kind of bacteria that can lead to serious illness. In people, Salmonella infection can cause nausea, vomiting, bloody diarrhea, abdominal cramps, fever, and, occasionally, even life-threatening problems such as endocarditis. Symptoms in pets with salmonella infection are similar, and may include decreased appetite, fever, abdominal pain, lethargy, bloody diarrhea, and vomiting. Some infected pets can appear healthy, but carry and shed the bacteria, posing a risk to other animals or humans. What should I tell this dog’s owner?

The first question when an animal ingests something with potential negative consequences is whether to advise an owner to try to make the pet throw up. In certain situations, vomiting can actually make things worse. Corrosive substances and sharp things like jagged bones can do more damage coming back up, causing dangerous esophageal trauma, even perforation. I thought a minute about raw chicken breasts. “Boneless?” I asked. “Yes, boneless.” If vomiting would be beneficial, there are several ways to make that happen. For dogs, an appropriate dose of oral hydrogen peroxide usually makes them upchuck, but it also irritates the stomach. Always talk to your veterinarian before doing this at home, and never give more than the prescribed amount. (Cats should never be given hydrogen peroxide, as kitties are far more susceptible to peroxide-related severe gastritis, which may rarely lead to stomach perforation and death.)

In some situations, it’s better to let your veterinarian induce vomiting using drugs that don’t irritate the stomach but instead “tell” the brain to make the animal purge. These drugs are more effective at fully emptying the gut, thus better for removing sticky things like chocolate that don’t always come up easily, or for highly toxic things without antidotes, like certain types of rat poison, where you really want to get every last bit out.

For the chicken-stealing dog, even though the meat was boneless, I decided vomiting was not worthwhile. If there was salmonella contamination, puking at this point wouldn’t eliminate the bacteria from the dog’s gut anyway. Should I advise preventive antibiotics? I decided not. The reality is, some people routinely, albeit ill-advisedly, feed raw chicken to dogs. The resulting incidence of illness is relatively low. Statistically, the risk from this one-time ingestion was very small. “Don’t worry,” I said. “Just keep an eye on her and call if she doesn’t feel well.”

Later that week, while pouring the second ritual glass of grape juice at the synagogue’s Passover Seder, my phone buzzed in my pocket. Slipping discreetly out of the sanctuary, I exited the building to return a call from clients worried about their recently acquired Labrador puppy. “She’s just sleeping excessively tonight,” her mother reported. “She even urinated right where she lay in her bed.” Flashbacks to parenting small children who slept so soundly they wet the bed. Remember those middle-of-the-night linen changes, moms and dads? Young puppies play hard, but then often sleep like, well, babies. Still, I worried. So I asked questions. Had she been eating normally? Any coughing, vomiting, diarrhea? Did she feel feverish? Was she limping? Her owner confirmed everything else seemed normal. I asked them to rouse the puppy, get her to move around, offer treats, while I waited on the phone. Puppy walked and took the proffered treats. “I think you just have a tired baby,” I concluded. “Don’t worry. Keep an eye on her and call me in the morning if she doesn’t seem right.”

The next call happened at midnight. A middle-aged German shorthaired pointer had been having diarrhea for several days, but now suddenly collapsed after going outside to do her business. Her dad had already put her in the truck, ready to bring her over immediately. Throwing on my clothes, I gave full rein to worrying. Could she have something requiring emergency surgery like gastric torsion, or a ruptured splenic tumor? Something less lethal like hemorrhagic gastroenteritis or Rocky Mountain spotted fever? I tried to think through all the possibilities as I hurriedly pulled out supplies I might need. When the dog arrived, she was already rallying — walking around, eating the liver treats I offered. She did have diarrhea, and was exhibiting some abdominal discomfort that looked like intestinal cramps. “I think she just has the runs,” I concluded, “… and gas pains.” I gave an injection to calm the cramps and sent her home on antidiarrheal medication and a bland diet. “Don’t worry,” I said. “Keep an eye on her and call me in the morning if she’s not continuing to improve.”

It’s often difficult for people to know when they should or shouldn’t worry. That’s true for veterinarians as well as pet owners. Not every after-hours phone call warrants an emergency visit to the veterinarian. On the other hand, we can’t really diagnose things over the telephone. The best we can do is combine our training and experience with your observations and knowledge of your individual pet, then make a decision. The chicken eater and the sleepy puppy were both fine the next day, and the pointer with the runs is on the mend. Now I have to go call my husband. I’m worried I may have left the stove on.