Gucci is a six month old Lhasa Apso that lives with her mother and several siblings (amongst others!). Gucci, like all puppies, has a tendency to put everything in her mouth and eat things she perhaps shouldn’t so her owners were not too worried when she was a little bit sick but by a Sunday night in April she was refusing food, had stopped playing with her siblings, started vomiting and passing haemorrhagic (bloody) diarrhoea. Her owners were very worried and contacted the emergency service who advised that Gucci should be brought to the surgery immediately. When Gucci was examined by the vet she was very lethargic, uncomfortable and had a fever (high temperature). The vet was concerned about an infection and gave Gucci an antibiotic and painkiller by injection. Gucci’s owners are very experienced pet owners and breeders and were able to provide good nursing care so it was decided that Gucci would be allowed home overnight. She needed oral electrolytes (to replenish losses through the vomiting and diarrhoea) to be syringed into her mouth every few hours and some paste to provide probiotics (good bacteria) and natural binding agents to coat the lining of the bowel. An appointment was made for first thing the following morning to recheck Gucci.
Unfortunately despite her owner’s excellent nursing care, the vomiting had continued and Gucci was now dehydrated. Her abdomen (tummy) was painful. She was very weak and wouldn’t even lift her head. Gucci needed to be admitted for intensive care and further tests to identify the cause of her illness.
At this stage the cause of Gucci’s clinical signs was unknown but there was a possibility that the disease could be contagious and even a zoonosis (possibly infects people) so she had to be hospitalised in isolation with barrier nursing. This meant Gucci had her own private room away from other patients and her own private nurse and vet to attend her. Strict disinfection procedures were put in place (wearing disposable gloves and aprons and dipping our shoes when we exited the area).
Gucci was fading fast, showing signs of shock- collapse, pale gums, high heart rate and respiratory rate and a low body temperature. Time was of the essence.
Shock is when the fluid losses cause the body to change its circulation to preserve blood flow to the heart, brain and kidneys and this can spiral out of control causing death if not treated promptly.
Gucci was put onto intravenous fluids (a drip) to rehydrate and support her. Essential nutrients (glucose, proteins, vitamins and minerals) were added to the drip bag as Gucci would not be able to eat or drink whilst she was vomiting. The vet took a blood sample and as we have a laboratory on site, the results were available within twenty minutes. It revealed that Gucci had a very low white blood cell count. White blood cells are very important in fighting infection and a low level indicated an overwhelming infection, a life threatening situation.
Gucci was started on anti-ulcer medication and high dose antibiotics and pain relief intravenously (directly into the vein in her leg) to ensure they acted quickly. At this stage one possible cause of Gucci’s illness was a severe infection, (the most worrying being parvoviral enteritis) with or without a bowel obstruction.
Parvo is a highly contagious serious viral infection that attacks infects the intestines. It destroys the cells that line the intestine causing severe vomiting and bloody diarrhoea. Secondary bacterial infections are common. The damaged bowel can allow toxins produced by the bacteria to enter the body and cause organ failure. All dogs are potentially at risk of infection although disease is usually most severe in young, old and immunocompromised individuals. The virus can survive for long periods in the environment. Infected dogs contaminate the environment and disease is usually from ingesting this infected material (e.g. faeces, urine, saliva). Currently there is no direct treatment against the virus. Fortunately there is a vaccine available to prevent the disease.
A sample of the bloody diarrhoea was sent by courier to a specialised laboratory for analysis to look for the infectious cause. The sample had to be cultured so the result took a few days.
Radiography (x-ray) of her abdomen was performed to look for evidence of an obstruction of the gastrointestinal tract (stomach and bowel). Although there was no obvious foreign body there was some gas collecting within the stomach and small intestine which can be seen in cases of obstruction. This would need careful monitoring to ensure the gas was moving along the tract.
Despite round the clock intensive care and therapy, Gucci was not responding. She was still vomiting and not passing any motions. Her abdomen was re-radiographed. The gas within the bowel had not moved and even more had developed. Concerned that there could be an obstruction the Fromus team had no option but to perform surgery to open up the abdomen (exploratory laparotomy) and investigate.
A general anaesthetic carries several risks especially for Gucci, including heart and respiratory failure, hypothermia (low body temperature) and coma. Abdominal surgery carries an additional risk of infection and bleeding.
Gucci was anaesthetised and transferred to the theatre for surgery. She was on a heat pad and monitored closely. Under sterile conditions, her abdomen was opened up and her organs examined. The stomach and entire small intestine were severely inflamed. The bowel was swollen and bleeding. There was no obstruction to be removed but the bowel was so severely damaged it was not working properly and gas was building up. The rest of the abdominal organs were checked before the surgical wound was closed with several layers of stitches.
Now that absence of an obstruction had been confirmed, anti sickness injections that would help stimulate motility of the bowel were added to her list of medications.
The specialised laboratory dealt with the faecal sample urgently and faxed the results as soon as they had them. Fortunately parvovirus was not found, however, a serious bacteria was. A test was performed to find out which antibiotic could kill this bacteria. It was good news that Gucci was on the correct one.
We could do no more than continue intensive care, medical therapy and wait. It was touch and go. Gucci was very weak and the odds were against her. It was a very anxious time for Gucci’s owners and the Fromus team.
After five days, Gucci started to show signs of improvement. She was able to sit up and even wagged her tail. We all breathed a sigh of relief. We were turning a corner. Soon after, the diarrhoea and vomiting stopped and she was able to have some special intestinal sensitivity diet and cooked chicken. From this point on she went from strength to strength and was able to tolerate oral medication and maintain her hydration so she could come off the drip.
After eight days in the hospital, Gucci was well enough to go home and be pampered again by her owners. She was soon bounding around with her siblings and back to her mischievious self. Gucci has been back to see us since she went home and is still wagging her tail and doing really well.
Gucci had made it but her survival was due to the perseverance of her committed, caring owners allowing the Fromus team to give everything they had.
Throughout her ordeal Gucci remained a good natured, brave, compliant patient. She fought hard. This is why she deserves the pet of the month award.