A Dog in Distress: Ernie’s Story

Ernie is a calm, quiet 8-year-old French Bulldog with two loving owners. He has a great relationship with his primary care vet. In fact, the vet’s office is near Ernie’s home, so he can pop his snout into the vet’s office during his daily walks just to woof, “Hello!”

This Frenchie normally has a great disposition, so it’s easy to spot when something’s wrong. And so our story starts…

Ernie was showing no interest in food and was very lethargic. He had a 4-day bout with vomiting. His pet parents took him to the vet, where he was x-rayed and had blood drawn. Two days later, their sweet bulldog’s illness was still a mystery, so Ernie was taken back to his vet for repeat x-rays with a barium contrast. The vet was concerned that Ernie had an intestinal foreign body, that’s when an object is stuck somewhere in the digestive tract. Ernie was in danger of dehydration and it looked like Ernie needed an emergency surgery, so his owners agreed to transfer him to one of Veterinary Emergency Group’s Chicago vet hospitals, VEG South Loop.

A VEG VET ALWAYS TAKES THE CALL

When you call any VEG emergency animal hospital, you get to speak with a veterinarian right away. So, when the referring vet called VEG South Loop, Medical Director Dr. Shawn Wharrey took the call.

VEG’s staff welcomed Ernie and quickly got to work. They performed a complementary smaller blood panel and repeat x-rays to ensure Ernie still needed surgery. Barium makes a foreign object really stand out—and the x-ray showed what the vets suspected. “Things looked pretty horrific,” says Dr. Wharrey.

An object was in the stomach, but it was what Dr. Wharrey didn’t see that was most alarming. He explains, “The problem was that this dog had barium two days earlier and none of it was even in the colon.” Nothing was passing through Ernie’s system. That meant immediate surgery.

FOREIGN BODY GONE WONKY

Ernie’s pet parents agreed to his surgery. When the team started abdominal exploratory surgery, it wasn’t good news. Dr. Wharrey said, “We had to have a hard conversation with the owner. We realized that not only was it a foreign body, but it was plicating (pleated) from the stomach to the intestinal tract.”

On top of that, the intestinal tract was perforated in three places and Ernie was leaking intestinal contents. Dr. Wharrey continues, “Not only do you have to worry about sepsis, but you have to worry about all that bacterial leakage from the intestinal tract.” Ernie had a double whammy, he had bacteria leaking and barium leakage, which causes severe abdominal inflammation.

The poor pooch required almost 12 inches of bowel to be resected. He would be hospitalized for observation, so the staff could check for signs of dehiscence, which is a partial or total separation of a wound after surgery. Dr. Wharrey alerted Ernie’s parents. He says, “They had to be in it to win it. And they were.”

A CRITICAL AND COMPLEX VETERINARY CASE

A vet assistant monitoring Ernie noticed that there was bruising in the location of the ECG clamps shortly after surgery. His blood work was reperformed and it revealed hypoglycemia/low glucose and “pretty much no white blood cells” due to the major infection in his body. Sepsis was a strong possibility.

Here’s where the bulldog’s crisis gets even more complicated. The bruising progressed to his entire abdomen due to disseminated intravascular coagulation aka DIC. Basically, this means tiny clots formed through the blood vessels, which uses up the dog’s clotting factors. With that, there’s a risk of significant bleeding elsewhere in the body.

Vet Nurse and Shift Lead Nikki Lewis, CVT, VTS (ECC) was on duty for Ernie’s case. She looks back on the situation, “This is either every nurse’s dream or nightmare. All the tubes in all the holes.” It took a heroic effort to work on saving Ernie’s life. The VEG team did the following:

• Placed a central line and a nasogastric tube. This, says Lewis, “starts feeding the guts to help healing and promote more protein retention”
• Inserted a drain to remove additional fluid from the peritoneum. Lewis explains, “We did perform cytology on that drain every 24 hours to make sure that the number of bacteria were decreasing and to make sure our sepsis protocol was effective”
• Administered suction to ensure stomach fluid didn’t accumulate
• Gave Ernie a plasma transfusion to replace coag factors
• Provided him with dextrose supplementation, as bacteria eats up sugar

POST-OP PROTOCOL FOR THIS TOUGH PUP

Ernie’s pain was controlled. His antibiotics were ramped up every 6 hours. Says Lewis, “Because of the severity of his infection, we wanted to make sure we had constant antimicrobial coverage.”

In cases of sepsis, you need to prevent septic shock. Post operative, there’s a risk of organ dysfunction during the first 48 hours, so monitoring is key. The team maintained good blood flow (perfusion) to the kidneys, and monitored blood pressure and hydration status.

PET PARENTS CAN STAY WITH THEIR PET

Ernie had one of his parents stay with him during the entire six days of hospitalization at VEG South Loop. The VEG staff (aka VEGgies) set them up in a room, complete with toiletries and a Murphy bed. This became Ernie’s parents’ home away from home, and they participated in his care, keeping his head elevated to prevent aspiration (he’s a Frenchie after all!).

The caring owners walked Ernie around with all of his tubes and attachments. Showering this tough bulldog with love and care contributed to his successful recovery.

DAY 6: ERNIE’S DISCHARGE DAY

VEGgies lined up to cheer Ernie on, as he was heading home! They gave him a round of applause and a VEG goodie bag, and we’ll admit it, there were lots of happy tears.

Fun fact: You can see Ernie and his owner Sam and members of the South Loop Team on NBC TV Chicago! They’re featured in a news spot covering his survival and the owners’ ability to stay with Ernie in the VEG hospital the entire time!

If your pet needs emergency care, call VEG or come right in. We’re open 24/7 and ready to handle animal and avian emergencies. And like Ernie’s parents, you can stay with your pet the entire time!