UT-VMC emergency room tails: a gentle giant

UTVMC COLUMN HEADER  2By Dr. Amanda Rainey

It had been unusually quiet for the days leading up to a holiday weekend. The Fourth of July was fast approaching and as I rounded with the daytime clinicians when I arrived for my evening shift it seemed that things had remained eerily calm. We had just gathered our students to discuss the topic of fluid therapy, when the familiar ring of my work cellphone interrupted our academic activities. Excusing myself to take the call, I found the closest unoccupied room and grabbed a piece of paper to record notes on. I scribbled down the information about the dog as provided by the primary veterinarian and after hanging up relayed a few brief details to the front desk about the impending arrival.

Captain had not been feeling well for about a week, but had no symptoms other than mild lethargy. His owner took him to his regular veterinarian for a checkup where a serious cardiac arrhythmia had been detected on his physical exam. This prompted Captain’s referral to the UT-VMC with the goal of having him evaluated by our cardiology staff to determine the origin of his heart issues. Upon arrival, we were all stopped in our tracks by Captain’s imposing physique. He weighed close to 140 pounds with a giant blocky head and thick limbs. He was a little overweight but mostly muscular with a smooth coat of shiny black fur. When he noticed us staring at him, he began to slowly wag his tail and immediately approached the nearest person he could find, nuzzling the fourth year student’s hand with his enormous head to demand attention. Despite his size, he was the perfect patient and a complete gentleman, even going so far as to help us lift him onto the echocardiogram table by placing his upper body on the surface as we lifted him from behind.

It turns out that Captain had a condition called dilated cardiomyopathy, which had led to the development of atrial fibrillation. His heart was literally too big and not able to contract very well since the muscle was weakened by the dilation and chest X-rays demonstrated that he was also in early heart failure. Unfortunately, his heart disease was quite advanced and our cardiologist was only able to predict that he might make it another year on medication to address the issue. When we broke the news to Captain’s owner, we were all saddened to tell him about the sweet dog’s serious illness. We heard how Captain’s housemate, a tiny Yorkshire terrier, bosses him around and how great Captain was with the family’s small children.

We prescribed multiple medications to both treat his heart failure as well as to help his heart contract more efficiently. We also gave him an intravenous injection of a diuretic to remove the fluid from his lungs along with another drug to address the increased heart rate caused by the atrial fibrillation. Thankfully Captain seemed to feel much better before he was discharged and he happily walked back up front to meet his owner with more swagger in his step.

It’s always hard when one encounters such a wonderful patient and knows that they have too little time left due to situations beyond our control. We were thankful to be able to make this time more enjoyable for Captain and his family, and to have met such a gentle giant.

(Dr. Amanda Rainey, DVM, is a clinical assistant professor in the small animal clinical sciences department at the University of Tennessee Veterinary Medical Center in Knoxville.)

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