I smell a rat (and not just because the dog ate its dinner)
Whenever I get cases with two or more seemingly unrelated problems I automatically start looking for the possible connection. It dogs me (no pun intended) until I figure it out (or the specialist does it for me).
First thing Saturday morning I saw a ten-year-old Lab named Luby. She looked like a bar fight survivor. And her nineteen-year-old owner was convinced she’d been bitten by a rat in her lush, tropical backyard.
Hmmm…a rat...I don’t think so. A rat with a baseball bat, maybe…
No puncture wounds—just a ginormously swollen head and face over her right eye…oh, and a massive fever of almost 105.
Luby’s eye was so swollen it was hard to tell whether it was the eye itself, the tissues over the eye or the tissues beneath the eye that were most involved. In other words, where was the problem centered? With all that swelling (and pain) I honestly couldn’t tell. I couldn’t even get a good look inside the eye but what I did see made me feel better about its integrity—and her vision.
There was no history of trauma (and I know this owner’s family—no reason to assume overt abuse, in other words). But her dental disease was something we had discussed and had been intent on tackling in the near future. Perhaps this is one nasty dental abscess. That would also explain the fever. Worst case scenario? A tumor behind the eye.
…or so I thought…until I saw the blood.
Is she in heat?
I knew of Luby’s history as one of those unspayed older dogs who’d recently gotten knocked up “by accident.” Spaying was on her menu but somehow had not yet come to pass. Until I saw the blood on her backside I had honestly forgotten about it, though.
Suddenly I had a lot of other options to consider. Is she truly in heat or does she have a pyometra (a uterine infection common in older, unspayed bitches)? If so, that might explain the fever as well.
Time to get to work. X-rays were unrevealing. Skull, dental and abdominal films were boring (which is good). Bloodwork was similarly unexciting (the teeniest bit of anemia but otherwise everything was peachy). Evaluation of the vaginal discharge showed normal blood (no infection) and normal cells. She might just be entering a normal heat (her owners thought she might have been starting her heat last month, as well) I’d have to recheck in a couple of days to know for sure.
Knowing I’d not get any specialist help on the weekend I set her up on fluids, pain meds and antibiotics for the next couple of days. She looked so much better by that afternoon, however, that I sent her home to hang out with her family until Monday morning.
Monday’s re-evaluation was interesting. Now that all the swelling was down I could see how much bruising had taken place. Her vaginal discharge was no longer a scant, muddy brown flow. It was a heavier-flowing bright red.
To the average person it might look as if we’d fixed her up well (in fact, her owners almost didn’t come back in). No fever. No pain. Swelling almost 100% resolved. Normal heat. But I knew better. Things were much worse. I thought I smelled a rat.
About that rat…
After questioning the entire family we determined that rodenticide pellets had been laid down to help eliminate the yard’s recent invasion. The entire perimeter had been peppered with green land mines to kill the nasty buggers. Luby’s taste for the stuff had not been a consideration…until now. Significantly, neither had her brother’s. And he’s a rat terrier.
Let me explain: Certain types of rodenticides (rodent killing poisons) are really broad-spectrum mammal poisons. They interfere with any mammal’s ability to form blood clots. That’s why Luby is bleeding. Blood tests on Monday confirmed it. Luby might have eaten the pellets themselves…or a rat that had recently consumed them. Either way—it’s probably been a couple of weeks since her exposure. Too late to pump her stomach. But maybe just in time to save her life—if we’re lucky.
Luby’s rodenticide (a coumadin-like drug) is among the most powerful types of rodenticides. And while there is an antidote (Vitamin K1), she’ll still bleed for a while before it’ll start working. I’ve had patients die of this kind of poisoning but they were much further along in the process. Then again, they didn’t have a bleeding uterus.
I think we’ll be able to save Luby. But I’m worried. I’m still convinced she may have a bad case of pyometra. This kind of complication is especially frustrating. It’s sad to think that she may lose her life because of something her family should have taken care of years ago.
Now I’m sure I smell a rat.