UT-VMC emergency room tails: Jingle

UTVMC ER TAILSBy Dr. Amanda Rainey

Sundays are usually one of the busiest days for our ER service, which makes complete sense.  Most general practices are closed on Sunday, and although the veterinarians may take calls they often don’t have the staff or capability to hospitalize patients.  It came as no surprise when we received notice during one of my recent weekend shifts that a very sick puppy was on its way in.  The puppy was around 8 weeks old, and had been purchased from a breeder as an early Christmas gift for the small children in her new home.  She began vomiting and having diarrhea the day after she joined her family, and was now not able to eat or drink.  I was very concerned, because my first thought after hearing her clinical signs was that this puppy could have Parvo.

When she arrived we immediately placed little Jingle and her owners in an exam room to prevent possible spread of such an infectious agent, and tested her right away.  Jingle lay quietly on the table, completely lacking the exuberance and curiosity of a normal pup, and her fluffy white fur rose and fell with the effort of her breathing.  She was a Great Pyrenees, and I hoped that being a bigger breed puppy would help her overcome the illness, if she truly had contracted Parvovirus.  Unfortunately Jingle’s test came back a very strong positive, and we began discussing our recommendations for the care she needed.

The owners felt very guilty for purchasing a puppy as a Christmas gift, as they realized that often this time of year is not the best for introducing a new pet.  Finances were tight for them already, but with the expense of obtaining Jingle and their other bills, they had very limited funds available to treat her condition.  Jingle could barely raise her head she was so weak from dehydration, and had a high fever due to the compromised intestinal barrier that the virus creates.  It attacks all fast dividing cells, and often what kills the puppy is a septicemia resulting from the destruction of intestinal cells which then allows the bacteria that normally reside in the GI tract to enter the bloodstream.  We can’t treat the virus, but we can address the bacterial component with antibiotics and also provide fluid therapy for the dehydration and ongoing losses, as well as administer medications that prevent nausea and vomiting.  These puppies are monitored very closely, as their blood glucose often drops and we need to supplement with intravenous dextrose, and they need feeding tubes to provide their GI tract with nutrition, as this has been proven to benefit the health of the GI cells.  It is an expensive condition to treat, and sometimes even with our best efforts they don’t survive.

After much deliberation, it was decided that we would begin aggressive treatment for Jingle in our hospital, and then her family would find a local veterinarian to continue her care on Monday, as it might be more affordable for their budget.  Jingle didn’t seem to be improving until sometime early the next morning, when she suddenly sat up and began whining.  By the time she was discharged for transfer to a general practice facility, her fever had resolved and she was giving puppy kisses.  We hoped she would be one of the survivors, but it was still too soon to know.  I consider finding out a few days later that she was indeed improving and possibly going home to her family that day to be the best Christmas surprise I could ever ask for.

(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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