Visiting Vet: Sally and the sock

What do you do when your Lab is a ‘Hoover’?

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It was almost lunchtime when Sally, a 2-year-old Labrador retriever, arrived. The owners were concerned Sally might have swallowed a sock the night before.Today she just wasn’t acting herself. “What makes you think she ate a sock?“ I asked, escorting them into the exam room. Sally looked quite energetic, bouncing around the room. “Did you see a sock in her mouth? Is one missing?”

It seems Sally just gets into everything — a common behavior for young dogs in general, and Labradors in particular. “Ah,” I nodded. “A Hoover.” That’s what I call dogs who vacuum up anything they can find. “Vomiting?” I asked. “Refusing food? Diarrhea?” Sally had eschewed breakfast, which was unusual. She was not vomiting, but seemed “uncomfortable” — restless and distressed, tail tucked between her legs. “We didn’t actually see her eat anything,” her mom said. “But two years ago, she did eat a sock and was acting kind of like this.” Back then, they took her to a veterinarian who “gave a shot to make her vomit.”

We contacted that veterinary office for medical records from that episode. I wanted to see what Sally’s symptoms had been, what treatments had been needed. According to those notes, Sally had received an injection to induce vomiting in case the sock was still in the stomach. This was a good idea. Once a foreign body like a sock moves out of the stomach into the intestines, which are much narrower in diameter, it has the potential to get stuck — an obstruction that often requires surgical intervention. Unfortunately, it turned out that the sock was no longer in her stomach. Fortunately, it turned out the sock had traveled almost all the way through her intestines without getting stuck. The gastrointestinal contractions elicited by the injection resulted in Sally pooping out one small ankle sock.

But a second sock was still missing. So was a small stuffed animal. In case Sally had also eaten those, and because she had bloody diarrhea, she was referred to a specialty practice where she was treated for dehydration and prescribed antibiotics and antacids. Sally recovered uneventfully. The second sock and teddy bear never showed up, so probably had not been ingested after all.

Two years later, here was Sally in my exam room. I offered her a liver treat. She refused. Odd for a Hoover Labrador, but not unheard-of, especially with such an anxious dog. She had a low-grade fever, but that could be a result of her nervousness. Her belly was, well, a big belly. I couldn’t palpate much, but at least her abdomen didn’t seem tense or painful. I checked rectally, and found perfectly normal stool. Normal color. Normal consistency. No socks. But Sally definitely looked worried — pacing, panting, tail between her legs. Unlike the first sock episode, this time Sally had no vomiting or drooling. “This doesn’t really look like a foreign body case to me,” I concluded. What else could be making her act this way? I pressed her mother for more details.

Sally was not spayed. Her last heat was in November. She might have been drinking more water than usual last night. Sally was not vaccinated for Lyme disease. These facts suggested many possibilities. The one that worried me most was pyometra — a serious bacterial uterine infection that can happen to intact female dogs. Usually occurring one to three months following a heat cycle, the uterus fills with pus, rapidly leading to a life-threatening situation. There may be visible vaginal discharge, but in most cases nothing is apparent externally. Signs can include depression, lethargy, loss of appetite, increased drinking and urination, fever, vomiting, and abdominal distension. Symptoms can be very subtle until, suddenly, things turn critical. Diagnosis is made via history, radiographs, and/or ultrasound. Blood tests may help support the diagnosis, but cannot definitively rule it in or out. Pyometra is more common in middle-aged females, but younger dogs can occasionally be affected. Treatment usually requires an immediate hysterectomy.

Could Sally have a pyometra? She was on the young side, had no vaginal discharge, and her heat had ended quite a while ago, but she also had enough other symptoms to raise a little red flag. Her owners wanted to hold off on x-rays, but OKed some initial blood tests. Complete blood count — completely normal. That meant serious bacterial infection like pyometra was less likely. Lyme test — faint positive. But this could be a red herring. She’d never been tested before, and many Island dogs test Lyme positive without any signs of illness. And we still couldn’t rule out her having eaten that sock.

By the time we discussed the differential diagnosis and options for next steps, Sally was settling down. I offered another liver treat. This one she ate. She ate the next one. And the next one. “I don’t think this is pyometra or gastrointestinal,” I said. Watching Sally move as we walked toward the door, I noticed something odd. Usually once a pup is off my table and headed home, they wag their tail, or at least hold it up. Not Sally. Her owners confirmed that, even at home, she was not lifting her tail or wagging. I palpated Sally’s spine and tail. Nothing seemed painful … but she always returned her tail to its downward direction. We went outside. She trotted around eagerly. No lameness. But tail still tucked.

I began to suspect Sally might simply have hurt her tail. Active dogs sometimes fall while running around, and jam their tails, like a person slipping on a banana peel and landing on their coccyx. A bruised tailbone can really put you off your game, especially if you’re a sensitive, anxious soul like Sally. Perhaps it was nothing serious. No swallowed sock or pyometra. Perhaps just a sore tail? I prescribed pain medication, and advised consulting their regular veterinarian if no improvement, but Sally’s tail started wagging again within hours of the first dose of her prescription. How’s that for a happy ending?