Friday, May 16, 2008

Overnights and weird S---

So, if you don't know, I work as and ICU nurse in a busy emergency veterinary hospital. This past week was my dreaded overnight week. I worked Fri/Sat/Sun day, then Tue/Wed/Thurs night. My shifts are 7-7, but never leave on time, so basically I work 13 hour shifts on my feet. Yikes...So, I am typing here after coming of my last overnight of the month. I can only sleep 3 hours on the last morning, because I have to go back to bed tonight to have a normal schedule again. It sucks, but I guess I am used to it at this point, not that I like it...
It was a busy week, and we were understaffed, which is a chronic problem in veterinary emergency hospitals. People just aren't signing up for OT anymore, we are all just too tired to work anymore hours then required.
So, anyway...Strange case of the year occured Wednesday night. We had a dog come in (before I got to work) who was just referred over from their regular vet. He had been acting a bit drunk (which is the first sign of antifreeze toxicity) so they sent him right over. He was walking at 4pm, within the course of an hour he was non-responsive. His antifreeze test was negative. We gave him Naloxone, (which is basically what they give people that OD on drugs), to reverse any possible narcotics, and pumped his stomach. We have him activated charcoal to absorb any other possible toxins. By the time I got to work he was no longer blinking and had lost his gag reflex, which is one of the last things to go. He was in a coma.
This was a first for me, I have seen many dogs with many neurologic problems, brain injuries, but never actually seen a dog in a coma.
A few hours later we had another dog come in with strange neurologic signs. She was acting as if she was having mild seizures, and appeared blind. (this happens with seizures, so we weren't all that suprised) There was something strange about the case though, she didn't seem the typical seizure dog. That was when the receptionist noticed that they lived on the same street as the dog in the coma. As we found out, they actually shared a driveway with the other dog. Yikes!! We bolted into action to hopefully stop the horrible cascade of events that had unfolded on the other dog. We immediatly lavaged her stomach to get any contents out and gave her the activated charcoal. She acted completely drunk for several hours, not really able to move much except to swim around her cage, which was better then the other dog. We gave her several doses of charcoal and gave her a high dose of fluids. Over the course of the night she improved somewhat. I fed her at 3am and she was ravenous, in a strange way. Dogs that are given anti seizure medications (barbituates) are extremely hungry and thirsty much of the time. This dog was acting just like that! (they have a very classic way of eating/looking for food)]
By morning the second dog was vastly improved and ended up going home later that day. Sadly, the first dog stopped breathing at 5am and was euthanized.

It was a sad night, it is one thing to lose a patient, it is part of my job to deal with that, it is another to lose a patient and not know why.

On another strange note...For any of you who may have Gorilla Glue (graphic link) in your house...If you have dogs, please throw it out, or at least keep it under lock and key. For some reason, dogs love the stuff. As soon as it is ingested it begins to foam inside the stomach. It almost instantly becomes a large, hard foam ball. If a dog eats this glue you cannot make your dog vomit! Once ingested it is too late! They need immediate surgery! No ifs ands or buts! We have seen a few cases of this type of thing. The dog ends up having a 10# foam ball removed from their stomach!

Check out this link for other strange things dogs eat!

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