By Dr. Perry Stanfield, DVM
One thing I have always loved about my profession is the variety I encounter each day. That isn’t to say that we don’t experience difficulties: transitioning patients through end of life happens more than any of us would prefer; we deal with the occasional unhappy patient or client; some types of cases get a little mundane. On the other hand, I get to know clients and their families, at least a little bit; and I become a family’s doctor who is trusted to provide the best care I can for their furry family member. And, every once in a while, a very gratifying case comes along that helps keep me going.
Enter, Maggie….. a very sweet middle aged Boston Terrier, who very early Saturday morning was admitted to our local emergency clinic with signs of difficulty breathing and swallowing . The owner feared that something was stuck in her throat. The ER doctor on duty couldn’t rule that out, and recommended that they have an endoscopic examination done. On a Saturday with full appointments doing something like this is a stretch, but true to KVH form we told them to come in.
An endoscope is a very expensive instrument which you don’t find in many veterinary clinics. For a case like Maggie’s, who might have something embedded in her throat, it can be a critical tool that is less invasive then general surgery. It’s great for removing bones, salmon hooks, and the like. Once she had an IV catheter placed and was anesthetized with an IV, the next step was to place a trachea tube to allow gas anesthesia. Here is a picture of what you should see before placing a trachea tube:
When we place trachea tubes, this is the part of the “Adams apple” that marks the beginning of the airway. Before using an endoscope, an airway has to be established to use gas anesthesia. Here is what we found as we prepared to intubate Maggie:
No need to use an endoscope here, problem partially solved…….. Her epiglottis (see arrows) is terribly inflamed and swollen. Amazing she could breathe at all! Taking some samples to our laboratory showed tons of white blood cells, indicating infection. Why? Wrong question. Don’t know, probably will never know. What should we do? A better question. We managed to intubate her, which allowed her to breathe much more easily. We gave her high doses of intravenous steroids, antibiotics, and antihistamines.
Patient over about an hour woke up well, breathing better than before we started, and by that night was doing extremely well. The next day Maggie was her normal self.
Why am I sharing this case? It indeed was a unique, and I hope interesting case. I told you these cases help keep me going in this profession. The other reason for sharing: I am proud of KVH. We have equipment that allows us to take on many challenging cases. We agreed to take this case on a very busy day. We have awesome technicians that prepared Maggie and got her under anesthesia and a fantastic laboratory which gave me the information I needed to provide effective treatment. Every day we devote ourselves to doing our best to care for your four legged family members.
Have a fantastic spring everyone!