UT-VMC emergency room tails: Tuffy, the dog who lived up to his name

UTVMC COLUMN HEADER  2By Dr. Amanda Rainey

I remember the first time I truly felt like a veterinarian. It involved a little Yorkshire terrier, Tuffy. I met him during my internship at the UT-VMC. His owner was the supervising secretary in the small animal department office and had been very helpful to me as a new employee and newcomer to Knoxville. I was in the waning hours of my overnight shift when I received a call from the after-hours answering service; someone was at our front door and needed assistance. When I made the trek from the ICU up to the receiving area, I immediately saw our secretary holding what appeared to be a very limp little dog.

“I found him in the hallway at home. He’s not moving and won’t respond to anything I say or do,” she said frantically with tears running down her face. I was a new doctor, but instinct told me that the Yorkie was in serious trouble. I scooped him from her arms and began running back to the ICU after quickly explaining that I wanted to examine him and begin stabilization procedures.

“His name is Tuffy. I know you haven’t met him yet, but he’s my baby,” she choked out as I turned the corner down the hallway. Once in the ICU, my technician expertly placed an intravenous catheter while I assessed my patient. He appeared very dehydrated and was almost comatose, requiring oxygen therapy and warming blankets. A quick check of his red blood cell count revealed that it was severely elevated, which is associated with a condition called hemorrhagic gastroenteritis (HGE). The hallmark of HGE is a markedly increased red cell count with normal or low protein levels. It usually causes GI signs, such as vomiting and bloody stool, but rarely do symptoms appear right away. The mainstay of therapy is fluid administration along with monitoring of parameters such as blood glucose, hydration and possibly giving intravenous antibiotics. In some instances it can be a life-threatening illness. Tuffy certainly fell into this category.

We immediately gave Tuffy intravenous fluids with other measures of supportive care. Thankfully, within about half an hour, he suddenly started moving and seemed more aware. When his owner came to check on him, he was trying to run to her and even whined in recognition of her presence.

Tuffy required hospitalization to address the GI problems that developed, but ultimately went home completely recovered. He lived to survive several minor scuffles with his fellow Yorkie housemates along with the usual abnormalities that result from the normal aging process.

Unfortunately, over a year ago he was diagnosed with a brain tumor. It ultimately took his life last month. I went to see his owner after he had passed to pay my respects and thank her for allowing me to care for him. She pointed out that he definitely lived up to his name. I wholeheartedly agreed. I also shared with her that treating him that early morning so long ago was really a defining moment for me as a doctor and served as a building block for my career. Some of what I have become, I owe to Tuffy.

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