February 2021

Practical Emergency: Does your pet need immediate care, or can it wait?

Author: Dr. Kirk Dixon, DVM

Having practiced veterinary medicine for over 38 years, I have seen thousands of emergencies and dealt with way more phone calls. The reality is that 95 percent of the emergencies I have seen over the years could have waited until the next business day. This is meant to be a practical guide for preventing or dealing with the most common real or perceived crisis situations. I will also debunk some myths and highlight common mistakes.

The biggest and most common myth is that the candy bar, chocolate chip cookies or the assorted chocolate candies he/she ate is going to kill your dog. What is toxic is unsweetened baking chocolate. If your dog ate a bar of that, there could be problems. However, that has never happened in my career. Milk chocolate and its assorted derivatives will only cause vomiting and diarrhea at worst. In addition, I have never seen a problem from the foil wrappers in which they are enclosed. Over the years, I have been amazed by the things dogs have passed without complication. Onions, grapes, raisins and acorns are also items from which I have never seen a pet have problems from ingesting. While in theory many items can be toxic, the amount that has to be consumed is often more than they would ever eat.

If your dog does eat something potentially toxic or dangerous, like rat poison or human drugs and medications, and it has been less than two hours post-ingestion, make them throw it up with hydrogen peroxide. Lift their head upward, pull out the corner of their mouth, and start pouring the peroxide slowly. Keep making them drink it until the foaming action in the stomach makes them vomit. Once they vomit the peroxide, they will stop vomiting. If it has been more than two hours, most likely it is out of the stomach and the only realistic option is to treat any symptoms if they arise.

Speaking of swallowing things, in cats, the most dangerous items are strings, tinsel, thread and occasionally abandoned fishhooks with bait on them. In dogs, socks, nylons, corn cobs, bones and toys are the most dangerous. The string-like things, including socks/nylons that can fray, are especially dangerous because they can ball up on each end and get stuck with strands in between. The vomiting action will cause the threads to act like a wire saw and cut open the intestines in several locations, often producing a massive infection and a fatal result. They will rarely show up on an x-ray, which makes diagnosis very difficult. I once had clients who owned an Old English Sheepdog, and they would laugh while telling me how many pairs of underwear their dog would throw up in a week. Unfortunately, one time it was a pair of nylons that frayed, and the result was fatal. If your pet likes to swallow things, try to be very careful as it eventually catches up to them.

Vomiting and/or diarrhea is a frequent after-hours call. The pet has been vomiting all day or for days but suddenly at 10 p.m., it is an emergency. If your pet has either of these, the very best thing you can do for them is to fast them for 24 hours—no food of any kind. If vomiting, no water for three or four hours, then start with a quarter cup of water followed by another quarter cup in 30 minutes, slowly increasing the amount over many hours; then call your vet the next day.

Bleeding (including bloody urine, vomit, or feces) is another symptom that freaks people out. Most of the time, blood looks worse than it is. If bleeding on the outside, the best thing is pressure on the area. Usually within 15 minutes the bleeding will stop. Many times, someone would insist on coming in after hours, only to have the bleeding stop on the way to the clinic. A little patience can often be very helpful.

Acute lameness is another overreaction. Something happens, the dog is screaming, and the owner wants to rush them in immediately. Very often, by the time they get to the clinic the dog is walking and not vocalizing. Medically speaking, even a broken bone does not have to be dealt with immediately. The point is that most lameness and injuries can wait until the next day.

With old, big dogs, the call is that they had a very active day, laid down and now can’t get up. Once again, rarely a need to panic. Put a towel under their abdomen, pull them up and force them to take a few steps. Usually after moving, their arthritic joints loosen a little and they can walk again.

When my kids were teenagers I used to lecture them that nothing good happens after midnight. Regarding pets, I have a variation of that point. If you remember nothing else, remember this: Nothing good happens in the bushes, especially at night during warm weather. Ticks, snakes, poisonous spiders, bugs and rat poison baits are all in the bushes. Almost all of the snake bites I have seen over the years happen after dark. If your pet is bitten by a poisonous bug, the sting/bite site will swell 10 to 30 percent, usually over an hour or so. With a poisonous snake, the bite location will swell twice as big within 30 minutes. If there is no swelling, there is no venom.

Antivenin has become very popular in emergency clinics. The only antivenin available is for rattlesnakes, and it is very expensive (expect a $1,500-$2,000 bill). Most of our snake bites are copperheads, and there is debate how well antivenin works. I have never used antivenin and have never had a death or a treatment failure using a hefty dose of corticosteroids and antibiotics.

I haven’t covered every possibility, but I have tried to touch on the most common reasons to call a veterinarian after hours. Most of the time, an emergency visit is not necessary, and the veterinary visit can wait until the next day. 

Dr. Kirk Dixon, DVM practices veterinary medicine at Hilton Head Veterinary Clinics, with locations on Hilton Head Island and Okatie. For more information, visit hiltonheadpet.com.

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