Gastric Dilatation-Volvulus in a 9 week old puppy – and 1 year later update (2/20/20)

By definition from the American College of Veterinary Surgeons .Gastric Dilatation-Volvulus (GDV) is a rapidly progressive life-threatening condition of dogs. The condition is commonly associated with large meals and causes the stomach to dilate, because of food and gas, and may get to a point where neither may be expelled. As the stomach begins to dilate and expand, the pressure in the stomach begins to increase. The increased pressure and size of the stomach may have several severe consequences, including:
  • prevention of adequate blood return to the heart from the abdomen
  • loss of blood flow to the lining of the stomach
  • rupture of the stomach wall
  • pressure on the diaphragm preventing the lungs from adequately expanding leading to decreased ability to maintain normal breathing
The stomach can become dilated enough to rotate in the abdomen, a condition called volvulus. The rotation can lead to blockage in the blood supply to the spleen and the stomach. Most pets are in shock due to the effects on their entire body. The treatment of this condition involves stabilization of your pet, decompression of the stomach, and surgery to return the stomach to the normal position permanently (gastropexy). This is a fast-moving, immediately life threatening emergency.  It has been called “the mother of all emergencies”. This is just one GDV story, but unlike most, this has one very unusual twist… the victim is a 9 week old puppy, and the puppy survived!   Katie Bell ate her dinner. Went outside and was found eating food left by one of our older dogs who, unknown to us, had not finished her food. She then tried to drink a lot of water.  We stopped her, because she looked extremely full.  We put her up to rest with her sister, and within 30 minutes, heard a sound that can only be described as a very loud exaggerated belch.  It was a sound that made four adults jump.  I went to check on the puppies.  Katie Bell was trying to vomit, trying to get comfortable and crying. She could not vomit. She was in notable distress, and her greatly expanding abdomen was alarming.  We were visiting our daughter, so she called her Vet for an emergency-vet referral and I videotaped Katie Bell, so that the Vet could see the onset symptoms.  We initially thought it might be just “food bloat”, but I strongly sensed she was in a life-threatening situation, and after several attempts we tried to contact any close Emergency Vet (E-Vet).   One was closed because of snow (the vet could not get in).  The second was a known to give sub-par care.  The last was called “Pets R Us“, which terrified me (they REALLY need to consider a name change), but was about 5 minutes away, and this girl needed immediate attention. We left, praying Katie Bell would survive.  This is the video I took as she called her Vet: We arrived at the clinic in less than five minutes of leaving the house, and were brought straight back.  He took x-rays and sent them to the radiologist for an “official” reading, and at the same time, prepped Katie Bell for surgery.  I credit Dr. Habeeb for his quick decisions.  He had to wait for the Radiologist report because of clinic policy, but he wasn’t fooling around while he waited. He started a IV catheter and begin shock management which included rapid administration of intravenous fluids, and pain medications. Blood work was done to assess internal status, placed on a cardiac monitor, and antibiotics given.   She was completely prepped and hydrated by the time the result came back.  Note how her stomach is not in the proper position and is very bloated: This is the radiologist’s review: The Dr. told us to go home, and that he would call us the moment he finished the surgery.  Reluctantly, we left our precious baby in his care, and prayed.  We knew all the risks of this condition, and being a retired ER Nurse, I knew too much, which led me to believe I would never see Katie Bell alive again.  When the stomach twists, it immediately cuts off all circulation to the stomach and the bowels.  The spleen is often involved in the torsion as well.  Hemorrhage is a real risk when the spleen is damaged, and because the torsion has effects on the whole body, including the heart, the surgery and post-op period are gravely complicated.  The risk of death is absolute in an adult dog (about 50% depending on the amount of time from torsion to surgery), and we were dealing with a baby.  No veterinarian I have spoken to since, has ever seen GDV in a puppy, although literature states it can happen, and none would expect a puppy to survive.   Katie Bell was in the skilled hands of Dr. Habeeb, and absolutely was in the hands of God.    The Dr. rotated her stomach back into position (yes, it was in full torsion), and her spleen and stomach were checked for damage. Her stomach was intact (no rupture), and as it re-profused, it looked like the tissue was going to be okay.  Her spleen had a small amount of discoloration at the tip, but showed signs of re-profusion immediately.  A tube was passed down the esophagus and into her stomach, to decompress the stomach, which was full of gas, fluid, and food.  He did not surgically enter the stomach.  A gastropexy was performed whereby the stomach is tacked to the body wall behind the rib cage down low, so that it could not twist again out of position, however, due to the delicate nature of her tissues, he was not confident that the gastropexy would hold.  She did suffer some cardiac dysrhythmia related to decreased coronary perfusion and re-perfusion injury during the surgery.   A few hours later we got the call that she wasn’t just doing well, she was wagging her tail.  He stated she was fully awake within 15 minutes of the surgery.  Sedated, she would now sleep, and so could we.  The next few days could bring heartache, as complications often happen within days of this surgery.  Sometimes, the necrosis (death of tissue) is not fully realized when the surgery is complete, and death of stomach, bowel, heart, lung and spleen tissues could advance well after the surgery is complete.  Three days later, Katie Bell was released from the hospital.  A good Veterinarian friend suggested human baby onesies, rather than make this baby wear a cone, as long as she did not fuss with the outfit.  This was a precious tip!  Not only was it effective, it was clean, and we bought several, so that they could be changed frequently, and darn it… they were darling.   We stayed with our daughter (in California) for a few more days, to be sure she would not suffer any complications, and because Katie Bell was on so many medications (about six), we wanted to make sure our trip home to Idaho was as risk-free as possible. I am very fortunate to have a number of friends who are Veterinarians, and breeder friends who have trusted vets, that we had the names of several who would see her at a moment’s notice, night or day, on our two day trip home. At least we thought it would be a two day trip home. We were wrong. A snow storm hit us when we reached Klamath Falls Oregon, and by the time we got to Bend Oregon, we knew we had to stay put. None of the Veterinarians we had lined up were in Bend. We took her to Central Oregon Animal Hospital and had her rechecked for safety by Dr. Douglas, wanting him to see her stable in the event she suffered any change in condition. What a kind and thoughtful Dr.!! She was in great condition (for a puppy who should have died), and we were much more comfortable knowing she had been rechecked. This was the second Veterinarian we had seen with her that was not familiar to us, which is scary when you have come to trust your pet to the care of well-vetted doctors. We were snowed in for three days. We had her rechecked by her own vet the day after we got home. Needless to say, like the others, he just shook his head that this puppy was alive, and acting perfectly normal. Katie is a *very* rapid eater, and immediately after surgery we realized the need for special bowls to slow her down.
It had been our intention to keep Katie Bell for showing purposes, but we decided that she’d had enough in her short life. She needed a family of her own, to just be a pet. However, the risk of GDV recurrence is great without a gastropexy, and we weren’t sure if hers would hold. Then our daughter and her family came forward, asking for her. Our daughter is a P.A. in the Army, and fully understood the dangers, risks, and necessary precautions that need to be done, up to and including checking and possibly re-doing the gastropexy at a later date. Dogs who have had GDV and do not have a functioning gastropexy have a 85% chance of re-torsion at a later date. A functioning gastropexy reduces the risk to 4%. Katie Bell has since had two occurrences that indicate that her gastropexy may have held afterall. She became mildly distressed and bloated, then belched and was fine in a very short period of time. We believe she suffered from mild gastric dilation, and belched up the gas.  Today, Katie Bell is growing up and is a very well-behaved puppy.  She is quite the little rock-star, gaining attention everywhere she goes.  She’s a little walking miracle.  We owe such a debt of gratitude to Dr. Habeeb and his staff, to Dr. Douglas, and of course our own Dr. Mihlfried, but mostly, we are grateful to God for this precious little life.   How much did her care cost us?  That was the least of our concern, but about $5,000.00 when all was said and done (surgery, meds, rechecks, etc.).  She’s worth every penny! This is Katie Bell during her recovery, and meeting her new family – our daughter, her husband, and our grandchildren – (click on thumbnails for larger images:):

1 YEAR LATER – UPDATE!

One year later, Katie Bell is living a normal life with her family.  We did have some dicey moments when she was spayed.  There was no way to know that her abdomen had developed a massive amount of adhesions (bands of scar-like tissue). Normally, internal tissues and organs have slippery surfaces so they can shift easily as the body moves. Adhesions cause tissues and organs to stick together. They can connect the loops of the intestines to each other, to nearby organs, or to the wall of the abdomen. They can pull sections of the intestines out of place. This may block food from passing through the intestine.  Katie’s adhesions have done most of the above.  Her bowel was firmly adhered to her abdominal wall, her organs and intestines are glued together.  Her family is aware this could cause loops of intestine to twist in the future.  When the veterinarian made his first incision, the adhesions gluing the intestine to the abdominal wall put the intestine right under his scalpel.  A small amount of bowel was nicked.  This resulted in her losing four inches of bowel.  It turned a “normal” spay (there will never be a normal surgery where Katie Bell is involved) into a three day stay in the hospital.   In usual Katie Bell style, she bounded out of the hospital as if nothing had happened.   This is Katie Bell today, on her “I’m alive” re-birthday: katie_bell

Cabbage Leaves and Mastitis

I have had several new canine mothers with mastitis.  For many years, the only thing I could do was apply ice packs or heat packs to give her relief, waiting for antibiotics to work.  One day, I found another source of help…

Seven years ago my youngest daughter had her first baby.  A few days later she had so much breast engorged that she was in agony.   We’re talking skin splitting hard and swollen.  She had a reasonable amount if redness.  I was worried she was quickly progressing to mastitis.  She was pale and crying.  We had tried warm compresses and cool.  Nothing helped.  Her daughter could hardly latch, let alone nurse well, because of the intense engorgement.  I couldn’t convince her to seek medical help, her husband felt helpless too.  She was in so much pain, we *all* felt helpless.   She wanted to wait until the next day to seek medical attention.

I had read that cabbage leaves help with engorgement and early mastitis.  Now, I am an old ER Nurse, and I am mighty fond of traditional medicine, and skeptical of various home remedies, and respectfully cautious of others.  Some is pure bunk, and some work, even to a dangerous degree if a patient doesn’t disclose that they’re using them.  So, I was skeptical at best.  BUT, I suggested her husband go buy a cabbage.  I challenged her (as a Physician’s Assistant, she was more than skeptical too), saying it surely couldn’t hurt anything, and figured it would give us a good laugh later for having tried.  She dutifully packed some in her bra and went upstairs in tears of agony (literally) to lie down.  One hour later, she nearly skipped into the room!  “I’m SO much better!!”.  Her previously pale complexion was pink, and that look of agony gone from her face!  Her tissue was far more relaxed, no longer red, and the baby was finally able to nurse.  I was astounded, as was everyone else.  No placebo affect here, as nobody thought it would help at all.

So, medical opinion is mixed, as to it’s anti-inflammatory properties.   Some Dr’s advise it.  Some say it is bunk.  An extract of cabbage in ointment form was tested, and had no positive effects.  It seems to only work in leaf form.  Cold, room temp or cooked doesn’t seem to make a difference (but I am sure cool feels good on that painful area).  Some sources caution that it should only be applied 20 min/3 times per day, or milk production is affected.

So, when I had a litter following the episode with my daughter, and my girl got an early mastitis, I quickly turned to cabbage, and kept puppies working at keeping the milk flowing (thinking the next morning I would have her at the vet for antibiotics).  She had a slight temp, was swollen, red, restless (pain) and very engorged.  The next morning, she was resolved.  Now, maybe she would have been regardless, but I can only report what happened.   I will say, that no home treatment should ever replace proper medical treatment  As I said, my bitch was scheduled to go the the vet the next morning, however, she completely resolved.

My daughter (a PA in the Army) Responds:
“Trust me… this is something you should absolutely believe without hesitance.  I had frozen a wet towel and stuffed that in my bra… it did nothing but wet my shirt and bra and heat up VERY quickly.  The leaves had an IMMEDIATE effect.  The first thing I noticed was the intense cool and an almost immediate decrease in the pulling of my skin.  I was so uncomfortable, I’d been pulling my shoulders up to my ears and I was finally able to relax them (along with the rest of me).  It didn’t take long to warm up the chilled cabbage leaves, but they still felt amazing. 

Just try it when you have a bitch (or woman) who needs it. Some women say it doesn’t work for them, but I’m telling you, NOTHING else worked for me and it was more miserable than the birth itself. At least I thought so at the time. This was the ONLY thing that gave me any relief.”

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Preventing and recognizing mastitis in dogs

Check her mammary glands twice daily:

Prevention:

  • Trim puppy nails frequently.  Sharp nails cause breaks in the skin. Clean scratches with a mild soap and water, and be sure to rinse well and dry the area.
  • Observe that your bitch does not have a preferred side to lay on.  This causes inconsistent use of each teat.  Rotate her in the box to be sure she’s swapping sides she lies on.
  • Close observation of her mammary glands.
  • Keep fur around mammary glands trimmed in long-hair breeds.
  • Take a rectal temperature morning and evening.
  • Seek veterinary care for any signs of mastitis.  These infections get worse very rapidly.

Observe for the following (remember, mastitis is a bacterial infection):

  • Mammary glands lumpy
  • Mammary glands painful to touch
  • Mammary glands that are unusually warm or hot to the touch
  • Mammary glands with red, bruised, or purplish-blue areas
  • Reluctant to nurse puppies
  • Discolored milk or blood in the milk
  • Restlessness
  • Fever
  • Lethargy

Someone is going to be very happy!

One of my favorite stories goes back to Winnie Limbourne of Wingmaster Labradors.  I was reminded of that today,   Her granddaughter noticed Winnie looking in a microscope.  Now this young girl had been witness to many canine breedings and collections, so she had a reasonable understanding of how reproduction occurred.  She had never, however, actually seen a shipment being prepared for a bitch owner.

A shipment is carefully readied with test tubes, syringes, medical straws, and of course the precious cargo that actually makes the magic, all placed in special thermal packaging.  It’s important to verify life and activity before packing everything up.   Winnie told her to come on over and see for herself.  Young Tasha focused her eyes on the viewer of the microscope, and her grandmother turned the dials until Tasha indicated that she could see clearly.

Winnnie:  “see those swimming things that look like polliwogs?”
Tasha:  Yes.
Winnie:  “Well, each one of those represents a puppy.”.
Tasha’s eyes got large and happy, as she looked up and said…

GRANDMA!  Someone is going to be VERY happy!!

this sample is in 10 day extender, and the focus is bad.  Sorry about that  It was the best I could do with my phone.

Click here for Video

 

 

Mid-Winter Spa Day

Snow is on the ground, and our increasing temperatures have turned walkways into ice. Every day, one or two of the dogs come in and get undivided attention. Today was Miley’s turn. Last week I noticed she was getting pretty dirty, as the snow starts to melt and mud season is starting, Miley, being yellow,  is the first to show the effects of a wet winter thaw (her yellow daughter will likely be next).  Miley also takes great pleasure in rubbing her body on the chain link in her kennel, transferring black carbon onto her coat.  It’s nearly impossible to wash out, but seems quite easy to rub into the coat.  I couldn’t take it one more moment. Today we’ll be having a winter spa day!

Filthy Miley!

Miley, we’re off to the bathtub!

Yes, it’s warm water from the kennel water heater.

Our booster bath tubs are a Godsend.  Yay for not having to bend to ground level to wash a dog!  We can move it close to the large kennel door, and put the drain hose under the closed door, allowing it to drain outside, while keeping the kennel fairly dry and warm (except for the obligatory wet dog shaking, which manages to wet a six-foot circumference). She was so dirty, we couldn’t even work up suds with a ton of shampoo.

No doubt someone is going to ask what doggie shampoo we use, so this is where I tell you to listen to your Vet if you want to be sure, but in truth, we use human shampoos. I use baby shampoo on the face (no tears), and whatever shampoo I happen to have laying around on the rest of them.  I DO NOT ever use a conditioning shampoo or a conditioner on a Lab. Their coat is supposed to be hard to the touch to properly shed water. When I am shampooing for a dog show, I do it a week or so before the show if they need a bath at all, and I usually use T-Gel shampoo on the blacks, to get rid of dandruff. If a Lab isn’t visibly dirty, the best bath for a show is just a good swim or hosing down. Yay for a wash-and-wear breed!

Bath time is an important time for us. You would be surprised how even while petting and playing with a dog,  you can miss a suspicious lump or a cut. We’ve made it a practice to use bath time to do a critical hands-on exam, to physically go over each dog, feeling every inch of their bodies for any physical anomaly that may have come up. Once wet, and underneath that thick coat, we have found things our hands never detected before. It’s a good practice. All Miley had was that healing scratch under her left eye (she scratched her eye a couple of weeks ago and lost the hair around the scratch), and the scars on her chin that she has had for a long time (that’s another story for another day).

Our industrial blow dryer makes fast work of drying a dog, and quickly gets rid of shedding hair.  It’s far better than a brush!  I’ve had this dryer for better than 15 years.  It is one of our most valuable possessions.  Her groaning in response to being dried, spoke to how good that forceful/warm air stream feels.

As I type this, Dan is still out in the kennel trying to clean up the fur it blew off Miley, onto every surface of the kennel building.  That’s one downside to winter baths – you can’t blow dry the dog out in the snow.

After a lot of soap, rinsing and drying, a nicely clean Miley ran to the back door and thought briefly about rolling in the mud next to the steps. I caught her just as she was headed for it and a firm “NO” stopped her (thank heavens).  What is it about being clean that a dog can’t stand?   It never fails that a sparkling clean dog will quickly roll across the lawn, in the bushes, in mud, or in a puddle.

Miley, you are a very bad girl sometimes!

Attention to the feet comes after the bath.  Hair on the bottom of their feet probably keeps their feet warm in the snow, but when the paths turn to ice, their hairy feet have little traction ability.  Skipping in the ice or wood floors is an invitation to injury.   It has become habit, that after a bath,  we check feet and nails.  As you can tell, Miley was WAY overdue!

Miley, look at those hairy feet!! They’re naturally grown slippers.

One down. Look at the difference!!

Her back feet have graduated from slipper status to snowshoes.

After a trim, comes toenail clipping. Much better!!

Now she can show off.  There is nothing like the feeling of having a shower and pedicure!

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The dog bath is found at:  https://www.boosterbath.com/

The blow dryer may be found here:  https://k9dryer.com/product/k-9-ii-dog-dryer/ – shop around for better pricing  on similar items.

Mom always said…

DON’T RUN WITH STICKS IN YOUR MOUTH!!!

Luna demonstrated this month, how a dog can impale themselves on a stick. For now, that’s what we think happened. She showed up in the morning with facial swelling, and the Vet found a puncture wound in the back of her mouth where the muzzle meets the upper jaw, behind the last pre-molar. It’s still possible that this is really a tooth root abscess, but the wound he found was bloody (not pus filled), and pretty large. It seems that she punctured it with a stick (that we never found). Antibiotics have taken care of it… thankfully!  Picture three is two days after antibiotics. This shows you how fast it can happen, and, with treatment, how fast it can heal.

Sudden swelling on the left side of her face.
A few hours on antibiotics
Much better after 24 hours on antibiotics.
Feeling much better!
A few days on antibiotics, and she was feeling great!

Rose’s TPLO 16 weeks

The snow has melted, and we’re well into spring activities.  Rose is healing well.  She has had it with months of rest.  As a puppy, all she wants to do is play and run.  But, her exercise is quite limited and always monitored for another few weeks.  As you can see, she puts good weight on the knee.  We’re still dealing with a bit of tendonitis in that hock, but it should work out with time and more movement with exercise.

Rose’s TPLO Recovery Week 6

Today is the big day!  Rose had her 6 week checkup.  She had an x-ray, which her surgeon states looks good.  Her healing is normal.  I discussed with him the lateral wobble of her knee, and he believes it may be a little tendonitis.  She may now have three 15 minute walks/day.  As stated previously, she is increasingly difficult to entertain.  She is inventing ways to chew up anything that is stationary in her box.   She wants to play with her sister so very badly.  It will be a very long time until she is allowed to do that.

This is Rose waiting to see her vet.

Rose’s TPLO Recovery week 5

Rose continues to improve.  I am noticing a lateral rotation to her knee when she walks.  I suspect it has to do with muscle atrophy.  She is so tired of the inactivity.   It’s becoming increasingly difficult to entertain her.   Every so often I cheat and put her on the flexi leash to let her move out a bit without running or jumping (which she is not permitted to do).

Rose’s TPLO Recovery Week 4

We’re at the beginning of week four.  This has been the week that marks Rose’s breaking point.  She is so done with inactivity.  We’ve bought chew toys, chew bones, real bones, distraction toys… you name it.  Her attention span is almost nil.  She has decided to take her frustration out on the carpet she is on, chewing the corner nicely.  We take Rose everywhere we go, so as to give her new things to look at, people to see, and so that we can monitor her activities.  She has been increased to one 10 minute slow walk each day, which she loves.  She continues to put more weight on the affected leg.   This was taken on  a trip to set up 6000 Easter eggs stuffed with candy for local children.

Happy Easter, everyone!