Hour 11: ER Dos and Don’ts, Part Deux

In Part 2 of the ER guest post, Dr. Baebler divides some of the most common emergency complaints into three categories based on degree of urgency.

PART 2: DO I NEED TO GO INTO THE EMERGENCY ROOM OR NOT?

Onto the meat of this post. Below are a list of signs/disease conditions and the urgency with which they should be attended:

Get thee to the ER doctor ASAP (remember to call us to let us know you’re on your way!):

– Trouble breathing or choking

– Trauma – obvious broken bones, open bleeding wounds, hit by a car, etc

– Eye problems – squinting, yellow/green eye discharge. Often eye problems can escalate quickly, so we will always advise an eye problem to be seen sooner rather than later.

– Your pet is unresponsive or minimally responsive when you attempt to rouse it

– Seizure lasting longer than 1 minute, or more than 1-2  seizures in a 12 hour period. Most vets say that more than 1 seizure per month warrants medication, but if your pet has had seizure #2 for the month at 9pm, is acting normally afterwards and doesn’t have any more problems, you can usually wait to see your regular vet in the morning.

– Your pet has eaten something it shouldn’t have – If your lab wolfed down your underwear or snacked on a sock, we can induce vomiting to get it out before it gets further down the digestive tract and requires surgery. If it’s sharp and pointy, we usually have to remove it surgically, and the sooner we do that, the better the prognosis is. The same goes for ingestions of toxic substances (see below).

– Your pet has been vomiting or having diarrhea on a regular basis for more than 2-3 hours, or there is a large amount of frank (red) or digested (black and tarry looking) blood in their stool or vomit.

– For large breed, deep-chested dogs (usually shepherds, danes, labs, boxers, etc) – Acutely bloated abdomen, especially if it happens right after they wolfed down dinner, then ran around like a maniac in the back yard.

– Your pet is straining to urinate and/or defecate (this is especially critical in male cats).-Your regular veterinarian has advised you to take your pet to the ER clinic based on signs for a specific disease condition (ie excessive coughing/increased respiratory rate in heart disease patients, diabetic patients that don’t want to eat, etc.)

– Vaccine/allergic reaction: Swollen face, hives on body, vomiting. diarrhea, often after having vaccines given or a bite/sting from an insect.

– For those of you with small herbivores (bunnies, guinea pigs, chinchillas): No eating or stool production in 8-12 hours is a medical emergency. So is diarrhea. Animals with decreased appetite or small, irregularly shaped stools should be seen as soon as possible as well.

Call for further clarification. Probably should be seen:

– Intermittent mild vomiting or diarrhea

– lameness with no open wounds

– prolonged painfulness

– bleeding toenail (or blood feather in birds) that you cannot stop  yourself

– Pet slightly lethargic, appetite decreased

– Mild upper respiratory problems – mild nasal discharge, occasional coughing (a dry honking cough is usually kennel cough, and unless it is keeping you and your pet up at night, it is usually self-limiting and rarely needs antibiotics. That being said, always follow the advice of your vet)

OK to wait until tomorrow morning:

– most skin conditions, unless the pet is very uncomfortable or they are scratching to the point of drawing blood

– external or internal parasites with no other signs of illness (worms in the poop of a puppy without vomiting or diarrhea, fleas, ticks on a pet that is otherwise acting normally, etc)

– most ear infections (unless the pet is very uncomfortable or shaking head a lot)

– vaccinations and regular exams. ER vets are not here to do routine care. Most do not carry routine vaccines, heartworm preventative, or flea control in their clinics. We will be happy to refer you to a local day practice for these types of services.

– My clinic will not see skunked animals. Most ER clinics are not set up to be able to groom a skunked animal. There are many recipes out there on the internet for getting the skunk smell out. Those with things like hydrogen peroxide, dish soap, and baking soda in them usually work best. We will only see skunked animals if they have been bitten or have other obvious injuries that need immediate attention.

Here is a list of common toxins I see in my practice:

– Chocolate. Baking chocolate is the worst, followed by dark chocolate, then milk chocolate.

– Caffeine. This includes chocolate covered espresso beans. Usually spent coffee grounds have less caffeine in them, but they could still be problematic.

– Over-the-counter topical spot-in flea/tick preventatives (pyrethrin based). Especially problematic in cats.

– Marijuana and other illegal substances. Side note – if your dog gets into your ‘stash’ of any substance, your vet needs to know. We just want to fix your animal. The guilt and veterinary bill you incur are usually punishment enough  😉

– Tremorgens. These are toxins created by moldy food (attention: dumpster divers/trash can surfers!). They can cause disorientation, tremors, and seizures.

– Grapes and raisins. Toxic in dogs.

– Onions. Raw are more toxic than cooked.

– Avocados.

– Tylenol, ibuprofen, and other over-the-counter human pain relievers – Most human pain relievers can cause big, big problems in dogs and cats. Don’t try to self-medicate your pet at home with human medications of any kind unless directed to do so by a vet.

– A note about toxins in dogs and cats: Veterinarians aren’t all knowing when it comes to toxic substances. Often, we will ask you to contact an animal poison control center or will do so ourselves when you come in to make sure we are treating your pet appropriately. There are too many things out there for us to be versed in everything your pet could potentially eat!

Poison control centers: ASPCA Poison Control: 1-888-426-4435.

Pet Poison Helpline: 1-800-213-6680.

Pet poison control centers charge a fee for consultation so they can keep the phones on and veterinary toxicologists on staff to answer questions at 3am.

I hope this helps. Don’t ever hesitate to call your regular veterinarian or local ER veterinary clinic if you have concerns about your pet. This list isn’t all-inclusive, and it’s always better to be safe than sorry.

Dr. Baebler is an ER/exotic pet veterinarian in the Chicago area. She been practicing medicine for 2 1/2 years now, and completed a specialized internship in exotic pet medicine. In her emergency practice she sees dogs, cats, and most small exotic pets, including birds, rabbits, ferrets, and non-venomous reptiles.