Seizures, syncope, collapse, oh, my!
Friday started out normal enough. Angie needed flea and tick medicine, Belle graduated from the puppy plan, Molly got booster vaccinations, Leo needed a nail trim, Baby needed bird food, and then Liset, the cat, was in for a swollen eye that really was severe mouth inflamation and problems.
Early in the morning Maddi showed up. The little white fluffy dog had been in the day before for pain and collapsing. We had done blood work and a good physical exam the day before, but something different was happening at home. I could find no pain when all of Maddi’s joints were flexed and extended and her back was palpated. We admitted her for observation her for the day and planned on radiographs and thermal imaging.
We had a light surgery day. Bosco and BowBow were brother chihuahuas that were in for neuters. Fiona needed her teeth cleaned (the bacteria causes heart and kidney problems) and she had a fatty tumor the owners wanted removed. While Steph and I were working on surgeries, Michelle and Lindsay got some work done on new white boards for better communications on grooming/physical therapy dogs.
Lindsay and I used some of the time to catch up on some new boarders that needed vaccines and tests. Ginger, Penelope, and Chompa all had internal parasites that needed to be treated so they wouldn’t infect others. Tessa just needed vaccines and tests. Before afternoon appointments, Cassie came in with her bleeding rectal area. This time, I could palpate the rectal mass and confidently recommend surgery at a specialist.
I’m not sure the order of what happened after that. Lulu was in for a puppy plan visit while Kip, Onyx, Snickers, Finn and Henry went home from boarding. Ozzie got a nail trim and meds, Hershey got special food and Paris got flea medicine. Chloe and Buster got their “andog” or annual exam, tests and vaccines.
But in the midst of a full day of appointments, there were a fair number of emergencies. Bella, a tiny Chihuahua, collapsed and couldn’t breathe. Ollie, an overweight lab, collapsed and couldn’t get up to walk. Sophie, a cute yorkie, vomited and then collapsed and didn’t seem like she could breath. That meant that Bella, Sophie, Ollie and Maddi all got some variation of what we consider a cardiac work up.
A cardiac work up at Guardian Animal Medical Center consists of a CBC (Complete Blood Count: red blood cells, white blood cells, and plateletts); chemistry (liver, kidney, diabetic, and electrolytes); chest radiographs (evaluate heart and lungs) and an ECG (rate, rhythm and conduction).
Bella was the housemate to the boys getting neutered. The owners thought that she had a seizure, but when I did my exam, her heart murmur was palpable. When we drew blood, she started to turn blue (cyanotic) from lack of oxygen. I recommended adding an ECG and chest rads to her seizure work up. The owners quickly agreed. Coming in for a seizure, Bella was diagnosed with an enlarged heart, cardiac murmur and probably had a syncope event. Medicine will help her.
(From the American Heart Association: Syncope is a temporary loss of consciousness usually related to insufficient blood flow to the brain. It's also called fainting or "passing out." It most often occurs when blood pressure is too low (hypotension) and the heart doesn't pump enough oxygen to the brain.)
Sophie was quite normal by the time I saw her, but her owner was still stressed. Sophie had vomited and then collapsed. Her breathing was audible and somewhat difficult. Anyone who wouldn’t have been stressed by seeing their dog like this probably does not need one. We did blood work which was normal, but from the owner’s description of the breathing, I suspect that Sophie fainted (a form of syncope) from the vomiting and then had laryngeal spasm or where the epiglottis gets trapped over the soft palate. We can do a similar thing when we drink an ice cold coke. Scary, but not life threatening.
Ollie collapsed and could not get up. His owner was a physician, so he knew what work up Ollie needed. Ollie’s blood work was abnormal. He has a bacterial infection as evidenced by the increase in white blood cells. Ollie also has a small mass in the forward part of his chest. That mass is unlikely to be causing Ollie’s problem, but we will continue evaluating it. I do think part of Ollie’s problem is that he is 126# yellow lab. The yellow lab is not the problem, but the obesity contributes to the pain and not wanting to walk. We are working with him on that.
So, of all the dogs that came in for a “seizure,” Maddi was the only one that probably had one. I still didn’t think so, but when the owners showed me a video of the events, I could see things that they had missed. What they thought was pain, was a petite mal seizure. We did send home some medication to help her anxiety which can potentiate her seizures.
Any emergency event can add to the excitement of our day. We want all of our patients to do well and live forever. We understand it is not possible, but seizures, syncope, collapse, oh, my!
Dr. MJ Wixsom owns and practices at Guardian Animal Medical Center on Bellefonte Road in Flatwoods, KY. 606.928.6566 and online at www.GuardianAnimal.com
