Interesting Cases
Previous interesting cases:
Dog hit by car
Animal Exhibits and Human Diseases
Other archived interesting cases.
Fleas and Anemia
Mitzie was a strictly indoor cat. Her owner had no idea that the stray cat she had been feeding could be carrying a disease that would threaten her cat's life. The stray seemed nice enough. He would allow people to pet him and pick him up and his endearing ways made him a welcome visitor. Unfortunately he brought some friends with him. This stray had a severe flea infestation.
Mitzie's owner never imagined that the eggs from the fleas would be brought in on her clothes leading eventually to a horrific flea infestation of her home and her cat. Fleas reproduce at an alarming rate. Each female can lay up to 50 eggs per day. The eggs can hatch and mature into adult fleas in as little as 3 weeks causing an exponential explosion in the flea population. To support this high reproductive rate, the female fleas eat several times their body weight per day in blood. If there is a dog or cat nearby, the fleas will prefer to live in their dense fur rather than on humans. This allows the flea infestation to progress unnoticed by people until it becomes very severe.
Mitzie was brought in for a bath and flea treatment as well as her physical exam. Her gums were pale and she seemed weak. Blood tests showed a severe anemia. Mitzie's blood was thin and watery.
Her packed cell volume was only 8%. Normal is between 30% and 45%. Mitzie was in big trouble. How could fleas cause such a severe anemia in an adult cat? An added problem for Mitzie came from a blood parasite that was carried by her fleas. Mycoplasma hemofelis is a red blood cell parasite that is transmitted as fleas feed on cats. The cat’s immune system destroys the red blood cells that contain the parasite. This drastically compounds the anemia.
Fortunately for Mitzie, we were able to kill all the fleas quickly, and treat her with antibiotics to eliminate the Mycoplasma hemofelis organism.
Her owner was able to alert the family that adopted the stray cat so that he could be treated effectively. Unfortunately some cats succumb to the anemia brought on by fleas. October is the worst flea month in the Northern Virginia area. November and September are very bad as well. Beware of fleas even if your cats are strictly indoors. Advantage® and Frontline Top Spot® are the best products for eliminating fleas. If used regularly, there is no need to treat the house and yard, but when a severe infestation occurs, treating the house will speed up the elimination of the fleas.
Dog Hit By Car
The frantic call came in on a Thursday evening. "A dog has been hit by a car and needs attention immediately!! She's bleeding and can't walk!" Chris, a Good Samaritan who had been a long standing client of Burke Veterinary Clinic knew the dog was in critical condition. "Bring her right in!" the receptionist instructed. Chris was at our door in a matter of minutes. A sweet young German Shepherd had been struck by a car during rush hour traffic and sustained multiple fractures of both front legs. She was in pain and in shock and like too many pets, had no identification on her. We named her Koko and immediately began life saving measures. We had to place an I.V. line in the rear leg because both front legs had open fractures. Koko responded quickly to the treatment for shock, and she was started on a continuous drip of pain medication to keep her comfortable and relaxed. X-rays of her front limbs told a sobering story. Both bones of both front legs were shattered.
Koko was doing surprisingly well despite her serious injuries.
Koko's bones were not only severely broken, but the bone fragments had penetrated her skin. These "open" or "compound" fractures are at significant risk of infection. We continued with supportive care for Koko and immediately began intravenous antibiotics. We contacted Fairfax Animal Control to alert them that Koko had been brought in in hopes that they might be able to locate her owner. She was in remarkably good spirits, and quickly improved to the point of showing us what a wonderful dog she was.
Koko's worried owners contacted Animal Control and discovered her fate. They were so relieved that she was alive and stable, but now the bad news. Koko's fractures would be a challenge to repair because both legs were broken, and the risk of infection was great. It was recommended that Koko be transferred to an orthopedic surgeon to have both legs repaired with surgical plates. Unfortunately the $5,000 estimate was more than her owners could afford. They were heartbroken that Koko would have to be euthanized because of the severity of the injuries. The staff had grown so attached to this sweet girl that no one wanted to face the decision of saying good bye to Koko. The owners sadly agreed to relinquish Koko to us to try and help her. If we could repair her legs, Koko would be adopted out to a new home.
Koko's fractures might heal with an External Fixation Device. This is the same approach that was used to repair "Chipper" the squirrel's fracture, but with both legs broken, many challenges lie ahead. The pins would have to be placed at different angles so the devices on each leg would not hit each other when she walked. Koko would have to be supported on the front end until she could bear weight on her front legs, and the ever present risk of infection would impact healing. She would need to wear a collar to keep her from chewing her fixation device. The task ahead was daunting, but this precious dog deserved a chance. We donated our services to save her life. Koko was made ready for the surgery.
Orthopedic surgery is often like carpentry. Cross pins are drilled into and through the bone, and metal side bars are secured to the cross pins to keep the fracture site stable.
Just as we began to place the first cross pin, the call came in: "Dr. Deutsch! Great news! Koko's owner agreed to our payment plan and have decided they will be able to keep her after all." We were all so delighted that Koko's owner would be able to keep her. Now with a little luck, a bit of creative surgery, and a lot of prayers Koko might heal and be able to romp and play like a normal dog. Only time would tell. Koko's post op films showed good alignment and an excellent chance for a normal life.
The challenging surgery occupied most of Friday morning, and miraculously Koko was walking without support by Sunday morning. It took several months for Koko's bones to mend, but persistence and excellent home care paid off. This is what the healing fractures looked like 12 weeks after her surgery:
Koko's bones will continue to heal and remodel over the next year or so. The bones of our bodies are continuously broken down and rebuilt cell by cell such that every bit of our skeleton is replaced every 7 years. This remodeling is influenced by gravity and muscle movement such that Koko's fracture sites will look completely normal in 1-2 years.
The efforts of the whole staff were rewarded with Koko's ability to walk again after such a severe injury. Special thanks to Chris for bringing her in that fateful day. 4 months after the accident, Koko was just about back to normal.
Koko's case brings up several concerns. Up to half of all dogs and 90% of all cats that are found by Animal Control have no identification on them. You should consider having a microchip implanted in your pet to ensure that if someone leaves your gate open and your pet escapes (which was the case with Koko), veterinarians and Animal Control can locate you right away. Second, accidents are unpredictable. Pet insurance is available but only about 2% of pets in the United States are covered. INSURANCE WILL NOT COVER PRE-EXISTING CONDITIONS!! It costs about $25 per month for a young healthy dog or cat. The problem with pet insurance is that the people that really need it never get it. Most of our clients with pet insurance are intelligent and affluent. They could easily pull out a credit card and pay for any emergency without having to think about it. It is the less affluent that need it the most, but they never get it because they think it is a waste of money. $300 per year could save your pet's life. You can make that much in 2 weeks of delivering pizzas. Check out these sources, or do your own search for pet insurance companies:
- http://www.petinsurance.com/
- http://www.petcareinsurance.com
- http://www.petshealthplan.com
- http://www.sheltercare.com/
- http://www.petsbest.com/
Animal Exhibits and Human Diseases
This month we feature a case that does not involve illness in animals, but rather illness in humans.
Timmy and Sarah were so looking forward to their upcoming trip to the state fair. They got out their books every evening and read about all the farm animals they were going to see. 5 year old Timmy's favorite farm animal was the goat featured in one of his bedtime stories. He had seen drawings and photos of goats, but soon he would get to see a real live one.
His 7 year old sister told him all about her school field trip last year to the petting zoo. She described in detail how you got to put a coin in the candy machine and it gave you pellets of animal food instead of candy. The animals would eat the food right out of your hand! Sarah's favorite was the pony because she loved the pony rides she had been on at the pumpkin patch last fall.
Timmy and Sarah were on their best behavior during the days leading up to the fair. They were going to eat lots of junk food, and ride the thrill rides, but most of all it was the contact with the animals they dreamed about. At the fair, they first went to see the sheep to see if she had any baby lambs with her.
They fed the pony and the cow and they were able to pet the goat, the sheep and even the pig!
They worked up such a big appetite, they almost inhaled their hot dogs and popcorn. The rides were a blast, and after a long tiring day, Timmy and Sarah rode home with their parents, falling fast asleep in the car.
The next morning both kids were feverish and developed vomiting and diarrhea. The pediatrician knew right away what to suspect because his brother was a veterinarian, and had told him to be on the look out for children with signs of dysentery after visiting petting zoos or other animal exhibits. The main pathogens isolated in these events include Cryptosporidium, E.coli, and Salmonella. It is worthwhile for us city folk to learn about farm animals, and these animal exhibits offer children an opportunity to learn a great deal about the world around them. The most important factor in preventing disease transmission at these events is THOROUGH HAND WASHING. For more information about this particular topic, visit the Center for Disease Control’s website.