IT’S ALWAYS A SHOCK WHEN A PET suddenly begins to exhibit signs of serious illness. Without warning, you are confronted with an emergency. Usually at two in the morning. On a holiday weekend when your vet is closed.
Sometimes it is obvious that an animal needs immediate medical attention—in a case of acute pain, for example. But more often, pet owners are confused about whether their pet’s condition warrants a trip to the emergency room. That indecisiveness can be dangerous—even potentially fatal to their pet.
If you phone the ER before going in, you may be able to obtain information. But there are many problems that can’t be assessed without an exam. Emergencies depend on both the animal’s condition and the owner’s ability to deal with the problem. Although a bleeding toenail may not be life threatening, if an owner can’t stop the bleeding it could be something that requires immediate attention at an ER.
Keep the phone numbers for your vet, the closest animal emergency center, and the ASPCA’s Animal Poison Control Center (888-426-4435) in a place that’s easy to find. Also, take a drive by the nearest animal ER during daylight hours to be sure you can find it in an emergency, when you may be fighting panic.
Allopathic medicine (conventional medicine that uses pharmacologically active agents or physical interventions to treat or suppress symptoms or diseases) shines in a real emergency. After the emergency is over, however, consider alternative methods, dietary changes, and supplements to avert future issues and support the overall health of your pet.
THE ER—TO GO OR NOT TO GO
Bloat is a life-threatening condition most commonly exhibited by dogs when the stomach is overfilled with air or gas and is possibly twisting.
Signs of Bloat
Obvious discomfort
Pacing
Hypersalivating (drooling)
Extreme nausea accompanied by retching
Abdomen may appear distended
Gums may be pale
Collapse
Action
Go to the ER as soon as possible.
Bloat is a real emergency where minutes count. It can become life-threatening very quickly.
In mild cases, you can try to get the dog to burp by standing them on their rear legs, as if you were dancing. Don’t waste time if it doesn’t work immediately.
Urinary blockage in cats is a serious condition where male cats strain to urinate indicating an obstruction from stones, crystals, swelling, or infection in the urinary tract that blocks the flow of urine.
Signs of Urinary Blockage
Frequent visits to the litter box with no urine production
Pacing and crying, sometimes near the litter box
Small amounts of urine, sometimes bloody, in inappropriate places
Loss of appetite
Listlessness
Vomiting
Action
Go to the ER.
Urinary blockage is a real emergency where time is of the essence.
Difficulty breathing can be caused by a number of illnesses, including lung disease, pneumonia, asthma, tumors, pulmonary fluid, heart disease, pain, airway obstruction, laryngeal paralysis, fungal infection, parasites, and trauma.
The X-ray machine is a much more effective tool than the stethoscope for diagnosing lung disease.
Signs of Trouble Breathing
Increased respiratory rate
Increased abdominal effort to breathe—belly moving dramatically with each breath
Shallow breathing
Pale gums or any shade of blue, rather than pink
May be combined with an inability to lie down or lying in a prone (sphinxlike) position.
Action
Trouble breathing is always considered an emergency. Go straight to the ER.
Bleeding
Any kind of bleeding could be an emergency or just a temporary response to trauma—just as in humans.
Pay attention to how much and how quickly the blood is coming.
Ears, tongues, feet, and tails bleed profusely and often justify an ER visit.
Blood in the urine may look terrifyingly dramatic because it is diluted in the urine. This needs to be treated, but may not be an emergency if there is no straining. Consult with a vet.
Although it is alarming and can indicate a severe problem, many dogs develop diarrhea with blood as a reaction to gastrointestinal irritants A trip to the ER may be necessary.
Action
Use common sense.
Cuts will bleed but usually can be stopped with pressure or a bandage where possible.
Try to elevate the bleeding body part above the heart and apply pressure to the bleeding area for several minutes.
Excessive bleeding that doesn’t stop is an emergency.
Bleeding toenails stop bleeding when you apply a quick-stop powder, styptic pencil, bar-soap shavings, cornstarch, or tea leaves from a used tea bag, with firm pressure to the bleeding nail. It should stop after a minute or two.
Whether to go straight to the ER because of bleeding is a judgment call. You might ignore a mild cut and go back to sleep, but if blood can’t be stopped you may need to race to the ER in your pajamas.
Trauma from Being Hit by a Car
Go to the ER. Have the pet checked by a vet as soon as possible.
Even if animals appear fine after being hit by a car, they need to be assessed by a vet.
Internal injuries—bruising to the heart muscle, contusions on the lungs, and small hairline fractures—can be missed by the untrained eye.
Prolonged Vomiting (for More Than a Day)
Animals that have not been able to keep food or water down for more than a day will probably need a visit to the ER.
Note what is being vomited up.
If it is early-morning vomiting on an empty stomach, with yellowish fluid (bile), and the pet still has a good appetite, it is likely to be less of an emergency and more a chronic diet/acidity issue.
If it includes pieces of fabric or a toy and you’re concerned there might be more, that is more of an emergency.
Some dogs seem to be thinking, “I’ll eat this and if it isn’t good for me, I’ll vomit it up.” If they act normal after vomiting and their appetite returns, this is probably not an emergency, unless a toxin is involved.
Note: Don’t keep giving food to a vomiting animal. If they are also vomiting water, withhold that too, and call a vet or your ER.
Lethargic Puppies or Kittens
There can be many causes, but often this indicates hypoglycemia and the pet needs ER care.
Put honey or syrup on the gums, but then get to the vet or ER.
Heatstroke can occur if the animal is exposed to high temperatures over 85 degrees without water or shade, or even less, depending on their health and age. Ambient temperature may be as low as 70 degrees but the temperature in a car—even with windows open—can climb to over 100 very quickly. Within minutes! Be careful about leaving animals in cars! A greyhound arrived for a routine rehab with a temperature of 104.5 just because her owner’s car air-conditioning wasn’t working for the ten-minute drive to my clinic.
Signs of Heatstroke
Panting
Restlessness
Vomiting/diarrhea
Excessive salivation (thick, ropey saliva)
Stumbling gait
Seizures
Collapse
If you take a rectal temperature in a heat-stressed animal and it’s over 104, go to the ER.
Cool animal down by using coolish (not ice-cold) water all over, especially in groin area, on the feet and head, and go to the vet.
Do not use alcohol. It can be absorbed through the skin and may be toxic to the animal.
A veterinarian may need to give IV fluids and other treatments to stabilize the pet.
Heatstroke can become life-threatening very quickly, especially for greyhounds, brachycephalic breeds, and cats.
Choking is a known or unknown obstruction or foreign body blocking the airway.
Signs of Choking
Sudden collapse from no oxygen, depending on the cause and severity of the obstruction
If airways are partially obstructed, the pet may paw at his face or mouth, trying to vomit.
Lying down in odd positions
Running around with the neck stretched out
Salivating excessively
Action
Choking can be a real emergency.
Try clearing the airway before going to the ER. This is an emergency where seconds, not minutes, count.
If an animal has an object stuck in its mouth or throat, try to remove it if it is visible but avoid getting bitten. Put something in the mouth to hold it open for you, such as a cloth or a roll of thick tape.
Administer the Heimlich maneuver—apply quick pressure just under the ribs. Use a two-handed fist, one hand covering the other, and aim up and in toward the head. Attempt this several times. At times, the obstruction may be dislodged, but the dog won’t start breathing unless artificial respiration or CPR is performed. That type of action is beyond the scope of this chapter, but animal CPR courses are available.
Usually from chewing on electric cords, electric shock can result in anything from no injury to a mild oral trauma at the base of the teeth, to severe life-threatening injuries, which can include fluid in lungs. Signs can be difficult to assess without the help of an exam and radiograph.
Signs of Electrical Shock
panting
high-pitched screaming
trouble breathing
dizziness
walking oddly
visible burns on mouth/skin
lesions in the mouth
chewed electrical cord
Action
After an electrical shock, you need a veterinarian to assess the damage and pain issues with an exam and possibly a radiograph.
Go to your vet or an ER.
Lameness is when an animal is not using a leg properly.
Signs of Lameness
A lame animal that can bear some weight on the leg and is otherwise acting normally does not usually need a visit to the ER and may wait for a regular vet appointment.
When an animal is not using a leg (or legs) at all, or can’t get up on its own power, or if there is bleeding or any significant swelling or pain in a limb, it’s time to get to the ER, especially in breeds prone to disc disease (long-backed animals).
Signs of Eye Issues
Squinting/shying away from light, significant eye swelling, bleeding from the eye, or animal showing significant pain is an emergency.
In most cases, tearing, moderate discharge, and mild reddening can wait for a regular vet visit.
Action
Go to the ER for severe signs. For milder eye issues, see your regular vet.
Seizures are involuntary twitching/convulsing, sometimes accompanied by involuntary urination or defecation.
Twitching can be local, like snapping motions with just the muzzle or jaw, or it can involve the whole body—paddling and shaking.
The animal usually is not in pain during a seizure and is most likely not aware of the seizure.
If the episode lasts more than one or two minutes or returns immediately, or they come in clusters, it is an emergency.
First-time seizures are in the emergency category because the cause may be determined to be something treatable—for example, toxin or illness—if caught early enough.
Action
Generally, it is best to see a vet or go to the ER immediately if your animal has a seizure for the first time and it’s undiagnosed.
Don’t worry about them “swallowing their tongue.” They won’t—you’ll only get bitten if you put your hand in the pet’s mouth.
Try to keep them from falling or injuring themselves, and keep them cool—prolonged seizures can dramatically increase body temperatures.
Go to a vet if the seizures are prolonged or are in clusters, or the animal’s temperature starts to rise due to the seizure.
If it is possible, apply gentle pressure on closed eyelids to help decrease the heart rate and calm a seizure. If there is a lot of shaking, uncontrolled poking at the eyes can cause damage, so just get to the ER.
Any cat that has not eaten anything in over twenty-four hours should be seen by a vet.
Not eating is a life-threatening situation for a cat, especially for an overweight cat. They can quickly develop fatty liver from mobilizing too much body fat for energy because food was not available. Fatty liver is a serious condition.
Try offering foods that are warm, that have extra warm water added, or that have a new flavor to tempt them.
Sometimes assist-feeding with a dropper in the side of the mouth can jump-start cats to eat again.
High Fevers
Normal temperatures in dogs and cats are about 101–102.5 degrees.
Anything above 103.5 degrees should be assessed. Over 104 degrees, go to ER.
Dog or Animal Bites
If your dog tussles with another dog, try to detect any areas that seem unusually hot. Bite punctures may not bleed much or be immediately apparent. If you don’t feel heat, wait an hour and then check again. Any painful areas may need medical attention, and bite wounds usually require oral or topical antibiotics.
Assist Feeding
See page 116 for assist feeding instructions.
Dark chocolate and baking chocolate are the worst.
One ounce per pound of body weight of milk chocolate is a toxic dose. For a 30-pound dog, eating about 2 pounds of milk chocolate could be toxic. Smaller amounts cause diarrhea and possible vomiting.
One ounce per three pounds of body weight of semisweet chocolate is a toxic dose.
For the same 30-pound dog, eating a little over half a pound of semisweet chocolate may be toxic.
1 ounce per 9 pounds of body weight of baker’s chocolate is a toxic dose.
If a chocoholic 30-pound dog ate just three ounces of baker’s chocolate—a typical candy-bar-size amount—it would be toxic.
Other Common Toxic Substances to Avoid
alcohol
antifreeze (1 tsp can be toxic to a 7-pound dog or cat)
cleaning agents (some are more toxic than others)
grapes
lily plants (very toxic to cats)
marijuana (paper/remains of burnt marijuana are all toxic to dogs and cats)
onions
raisins
rodenticides, insecticides
toads (eating or licking toads or frogs can be toxic depending on the species, and, I suppose, the amount of licking...)
wild mushrooms (especially amanita)
xylitol sugar-free sweetener (can be very toxic even in small doses)
There are many other toxins that, because of space, we can’t list here.
Action
Call your veterinarian or the ASPCA Animal Poison Control Center immediately.
Provide information about the type of animal you have: its weight and as much information about what the pet has ingested as possible: the label, the packaging type, when it was eaten and exactly how much.
Do not induce vomiting without consulting a veterinarian first. Some toxins or other substances can do more damage on the way back up than they do on the way down.
When advised to induce vomiting, you can do so by giving fresh hydrogen peroxide orally—about one ml per pound of dog—which is about 1/8 cup for a 30-pound dog and 1/4 cup for a 60-pound dog. If there is no vomiting in 10 minutes, repeat dose. Hydrogen peroxide works best if it’s fresh—less than six months old.
Over the holidays pets are exposed to many toxic or dangerous seasonal items. Even one or two mistletoe berries can be extremely toxic for a pet. On the other hand, poinsettias are only irritating to the mouth and, although they may cause vomiting, are not as toxic as people believe. Decorations, electrical cords, tree ornaments, and tinsel are all possible dangers to pets. Holiday candy that is toxic for pets includes chocolates, and sugar-free candies with xylitol. Easter lilies are toxic to cats. Don’t leave wrapped gifts that are food/candy under the Christmas tree or in an accessible area. Animals may try to drink the water for a Christmas tree, so don’t put in chemicals. An abundance of leftovers can be too rich for a pet’s GI tract. Your holidays will be less stressful for you and your pets without a trip to the ER. However, if something does go wrong with your pet, don’t hesitate to seek emergency care.
AN ITCHY PET MAY not be a medical emergency, but it is often a mental emergency.
Allergies are a big issue in veterinary medicine. Although a sneeze can be an initial sign of allergy, a more common sign of allergy is itching. Itchy dogs and cats chew at their skin and feet, scratching, licking, irritating, and even ulcerating skin. Itching is distressing for both pets and owners. It’s hard to live or sleep with a pet that can’t stop scratching. The irritated pet can really weigh on the mind. Not to mention the extreme discomfort the pet is going through.
Not only are people allergic to animals, but animals are allergic to our world, too. I use the analogy of a cup overfilling when I explain allergies to my clients. As long as the cup isn’t brimming over with allergens and immune problems, the animal won’t show any signs of irritation. However, when the cup runneth over, the itchy signs maketh themselves known.
Note: Some of my clients have been told that their pet is allergic to meat. I believe it is highly unlikely that a carnivore is allergic to a meat. Although I know it can be true, it should be the exception, not the rule. More commonly, the culprit is the chemicals in processed meats or poor-quality meats, or the grains and chemicals in the processed food irritate an animal’s GI tract, making the intestines a poor border protector. An unhealthy GI tract may allow more antigens into the bloodstream. When a food change alleviates allergies, it is more likely because the food improves the health of the GI tract by providing a good protein content, and fewer grains or chemicals. A healthy GI tract makes all the difference in resolving allergies.
Relieve Allergies
The most important change: feed the pet an anti-inflammatory diet, which is one that excludes corn, wheat, soy, white potato, and peanut butter
alleviate the effects of itching and inflammation (meds, herbs, baths, topicals)
uncover possible allergens
discover ways to empty the cup of those allergens
strengthen the immune system
support the overall health of the pet
sustain the pet’s comfort level by monitoring allergens and keeping them at a minimum
Moisturize and safely clean hair coat and skin with a mild, natural shampoo and rinse or Murphy’s Oil Soap.
Herbal remedies
The main concept behind herbal remedies is to support overall health, circulation, and lymphatic drainage, while also regulating the immune system, which is overreacting to the allergen.
Western herbs and supplements for allergies include:
ashwaganda—adaptogen and immune regulation
nettles—blood cleanser, relieves itching and hives, and can be used in gout.
quercitin—supports and regulates histamine levels
bromelain—anti-inflammatory effect
aloe vera—cooling for the skin
coconut oil—soothing and nutritive for skin
Chinese herbal formulas can also be very effective for an allergic animal, and can be prescribed based on the animal’s particular condition. The herb Si Miao San is particularly versatile. I advise using Chinese herbs only when prescribed by a practitioner. I also use laser therapy on skin lesions caused by allergies. It can help calm down the inflammation.
Medical Conditions/Tests to Consider in an Allergic Pet
Thyroid status
Cortisol (adrenal function)
Anal glands (full or impacted anals can cause generalized itching)
Mites
Resistant bacterial infections
Skin cancers
Overbathing or not rinsing well enough
Overperfuming
Allergens to Avoid
Plastic feeding bowls
Wool blankets/carpets/toys
Dust mites (check ductwork and keep floors extra clean)
Cat litter with wheat or corn
Secondhand smoke
Plastic chew toys
Skin Growths and Cancer
If actively bleeding and not manageable at home, skin growths can be an emergency.
Cauliflower-like growths that suddenly appear on lips, tongue, gums, or feet are generally benign viral papillomas and are not an emergency. They can indicate a compromised immune system and are usually seen in puppies. Based on physical exam, homeopathic and herbal supplements can be recommended.
Masses on the toes or in and around the mouth may be infections, abscesses, melanomas, squamous cell carcinomas, or other malignant or benign tumors. On the toes and around the mouth, cancers can be aggressive. It may not require an ER visit, but make a vet appointment soon.
Pigment changes on the nose can be hormonal or thyroid related—not an emergency.
Animals that have unrelenting itching may be suffering from mange, allergies, fungal infections, or other conditions. Though not life-threatening, this is debilitating and needs serious, prompt attention.
Eyelid growths are not an emergency unless the mass is actively bleeding or the cornea is affected. Signs of cornea involvement include squinting, pawing at the eye, redness, and discharge.
Ear infections are usually not an emergency unless the animal is in extreme pain.
Ticks can look like growths and vice versa. Look carefully and remove the tick promptly. They are more likely to transmit disease the longer they are embedded in the pet.
PET FIRST AID KIT
HERE IS A LIST of things that come in handy when you’re dealing with a pet problem at home or getting veterinary advice over the phone.
Use a portable container with compartments for easy storage. I found a tackle box works well.
1. Digital thermometer and lubricating jelly for thermometer
2. Quick-stop powder to stop bleeding—nails and other areas
3. Vet wrap or Ace bandages
4. Tweezers or hemostats
5. Emergency blanket
7. Eyewash/saline/artificial tears
8. Activated charcoal (buy the veterinary formula)
9. Arnica gel—bruises/trauma
10. Calming herbal formula like Serenity by Gaia—about 1/4 of the capsule orally for a cat, and 1–2 capsules for a 50-pound dog up to every 8 hours
11. Calendula cream or tincture (disinfects/cleans)
12. Silver Shield gel (disinfects, supports immune system, great for burns)
13. Arsenicum—for allergies
14. Traumeel tablets (homeopathic, safe anti-inflammatory for pain/trauma/arthritis)
15. Aloe gel—cooling and supportive for the skin for burns/rashes
16. Peppermint—oral oil very diluted or even some of those little red and white pinwheel candies can work to calm the stomach (carminative)
17. Betadine—antiseptic cleaner, can be diluted with cool water for skin lesions
18. Triple antibiotic ointment and cortisone cream for topical use when directed
19. Benadryl liquid (small pets) or tablets (over 25 lbs)—works for allergic reactions, hives, muzzle-swelling reactions. The dose is 1 mg per pound or 25 mg for a 25-pound dog; 75-pound dog would take 75 mg (that seems like a lot but is okay).
20. Hydrogen peroxide (fresh bottle every 6–12 months)—antiseptic and can be used to make an animal vomit (1 teaspoon per every 5–10 pounds) but only if directed. Some things are worse coming back up than continuing through.
21. Cotton balls—for everything, but don’t let your dog eat them, especially after cleaning the ears (they love to eat them then)
22. Animal ear cleaner for after swimming/irritation/infection
23. Pet shampoo (not human shampoo) or something soothing such as Murphy’s Oil Soap
24. Latex exam gloves (for gross things)
25. Bulb syringe (to help clean out wounds)
26. Feeding syringe
27. Muzzle (animals in pain may try to bite)
28. Doggy life preserver—for boating, and to help lift injured dog or help them up the stairs
29. Carrier if appropriate
EQUALLY IMPORTANT WHEN DEALING WITH GASTROINTESTINAL PROBLEMS
1. White rice
2. Chicken broth or jars of meat baby food (chicken, lamb, without onion powder) to help give pills, use as bland diet, assist feed or rehydrate
3. Unsweetened canned pumpkin (one tablespoon per 30-pound pet)
4. Slippery Elm powder—stomach soother and fiber source
5. Probiotic—Bacillus coagulans, lactobacillus, acidophilus can provide proper bacteria for any out-of-whack GI tract
6. Green Tripe (canned or frozen, provides bacteria and fat and easily digestible protein for a healthy gastrointestinal tract)
7. Powdered medicinal clay—aids absorption of toxins in the GI tract due to diarrhea
MYTHCONCEPTION
It is safe for dogs to eat cooked bones.
Not true.
Cooked bones can splinter into razor-sharp pieces and harm the GI tract.