Fun Cases!

[battie]

I go over to the human med side of SDN and recently found a good thread about fun/cool cases in the ER subforum. I think it would be fun to share cases we liked, found interesting, etc.

This week I had an adult Husky come in for xylitol toxicity of 2.0-2.4g/kg (4x the hepatotoxicity level). Hospitalized thinking he'd die despite my best efforts. Nope! Kiddos BG maintained normal levels the whole time. Liver values never changed. And the psychopath howled and hollered the whole time on ace, gaba, and trazodone.

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[DVMDream]

I go over to the human med side of SDN and recently found a good thread about fun/cool cases in the ER subforum. I think it would be fun to share cases we liked, found interesting, etc.

This week I had an adult Husky come in for xylitol toxicity of 2.0-2.4g/kg (4x the hepatotoxicity level). Hospitalized thinking he'd die despite my best efforts. Nope! Kiddos BG maintained normal levels the whole time. Liver values never changed. And the psychopath howled and hollered the whole time on ace, gaba, and trazodone.

RIP to your ear drums.

 

[battie]

RIP to your ear drums.

I have never regretted a hospitalized patient more if I'm being honest. He chewed through 4 fluid lines.

 

[TheGirlWithTheFernTattoo]

I go over to the human med side of SDN and recently found a good thread about fun/cool cases in the ER subforum. I think it would be fun to share cases we liked, found interesting, etc.

This week I had an adult Husky come in for xylitol toxicity of 2.0-2.4g/kg (4x the hepatotoxicity level). Hospitalized thinking he'd die despite my best efforts. Nope! Kiddos BG maintained normal levels the whole time. Liver values never changed. And the psychopath howled and hollered the whole time on ace, gaba, and trazodone.

When I was a student we had one at 8mg/kg who came in lateral and hypoglycemic. She had wicked high liver enzymes (I think like ALT 8-10k but this was many years ago) but never progressed to fulminant failure and left hospital doing well a week later.

 

[eleanor713]

We saw a cat that survived after getting 3mL of insulin instead of 3 units by the pet sitter

 

[DVMDream]

When I was a student we had one at 8mg/kg who came in lateral and hypoglycemic. She had wicked high liver enzymes (I think like ALT 8-10k but this was many years ago) but never progressed to fulminant failure and left hospital doing well a week later.

Do you mean 8g/kg? 8mg/kg of xylitol won't even stimulate insulin release at all.

 

[TheGirlWithTheFernTattoo]

Do you mean 8g/kg? 8mg/kg of xylitol won't even stimulate insulin release at all.

Yeah, the massive overdose one haha.

 

[Trilt]

My last husky toxicity earned himself a dexdomitor CRI after the second destroyed cath and e-collar, lol.

 

[Alicat9152]

I have never regretted a hospitalized patient more if I'm being honest. He chewed through 4 fluid lines.

That checks out 😂

 

[MixedAnimals77]

Had an older spayed dog come in for lethargy and adr. Clearly anemic. Kidney failure. P rapidly declined and passed in hospital. Necropsy showed diffuse cancer and cause of death was cardiac tamponade. Was very sad but thankful the o let us necropsy. Took chest rads post mortem and didn't show Mets but those lungs were full of tiny spots.

 

[pxton]

Younger cane corso puppy counter surfed and took the fork with the food! Ended up vomiting it up himself.

 

[katiemcat]

Younger cane corso puppy counter surfed and took the fork with the food! Ended up vomiting it up himself.

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Ok OUCH! But also awesome! Thanks for sharing.

 

[battie]

Younger cane corso puppy counter surfed and took the fork with the food! Ended up vomiting it up himself.

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I audibly gasped

 

[VeggieTrex]

Younger cane corso puppy counter surfed and took the fork with the food! Ended up vomiting it up himself.

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Zero lessons learned according to that face.

 

[that redhead]

I’ll take “FBs you should never induce vomiting for” for 1000, Alex (or should I say Ken…)

 

[battie]

Okay. So funnily enough I was over at the human ER sub forum again, reread that entire thread about ER wild cases again, and then was like, "I wonder if we have a thread on cool cases 🤔"

So here I am, resurrecting a thread I made after rereading a thread I read 6 months ago 🤣

I incidentally found a splenic mass on rads in a kiddo where I was looking for rocks a few weeks ago. They ended up doing initial work-up with me, then transferring to specialty for surgery and potentially chemo!

 

[MixedAnimals77]

P had anemic episode ~1mo ago. Hadnt been to a vet-found 6/6 murmur with thrill and DM. Threw the kitchen sink at it got better. Came back Tuesday with ascites. Got ascites drained and finally went to heaven today.

P with ~1 month lethargy since I first saw her. Had like a 0.2 hyperglobulinemia 1 month ago. Came back 2 weeks later and o thought just issues getting up so Got carprofen. Came back Wednesday ~2 weeks later for continued decline. Azotemia and hyperglobulinemia. Suspect lymphoma. Hospitalized on fluids and azotemia got worse. I'm guessing we will euthanize this next week unless her acth comes back positive or her steroids are magical.

9yr great Dane hx of not eating enlarged submamdibular ln ended up erlichia positive. Really hoping that's what it is for this patient.

Duckling accidently stepped on by child broken tib fib went to heaven but I was ready to try.

 

[SkiOtter]

Okay. So funnily enough I was over at the human ER sub forum again, reread that entire thread about ER wild cases again, and then was like, "I wonder if we have a thread on cool cases 🤔"

So here I am, resurrecting a thread I made after rereading a thread I read 6 months ago 🤣

Laugh react for this portion 😂

 

[battie]

Laugh react for this portion 😂

#momlife and #pregnancybrain 🤣

 

[Trilt]

I have a dog hospitalized for bad cluster seizures. He's a young golden, and he has escalated through zonisamide, keppra and phenobarbital treatment and is still routinely having seizures. He's been seen by neuro and had the MRI/CSF, so suspect "just" a bad epileptic.

He had a home cluster and got started on clorazepate and higher keppra, had another and was hospitalized. Had two more seizures back to back and earned himself a midazolam CRI.

He's been annoyingly whiny and dysphoric on it per normal, but no more seizures. Was about to go outside for a walk last night and suddenly starts the preamble to throw up.

Me: dude, c'mon, you have a really big problem already don't add to it.

He throws up, walks a couple more steps, vomited again....

Throws up Minnie Mouse, beanbag version:

No more vomiting since. Why you'd want to swallow a fist sized beanbag whole like a freaking boa constrictor, unknown, but at least he got rid of it for us!

 

[finnickthedog]

Well now, let me try to post this without accidentally hitting post on an unfinished comment...

Part of me was going to wait until I have more results to share this one, but I don't know if or when the owner is going to pursue the additional testing so that, what the heck.

I had a patient last week in for lactating. Not pregnant. Normally this is false pregnancy but the timeline is a little off for that. I found out that apparently hypothyroidism can cause lactation and I think that might be what is going on here.

But not confirmed yet because we haven't run a thyroid panel. T4 is really low though and remainder of bloodwork is unremarkable.

 

[battie]

I found out that apparently hypothyroidism can cause lactation and I think that might be what is going on here.

I learned something new today

 

[WhtsThFrequency]

Well now, let me try to post this without accidentally hitting post on an unfinished comment...

Part of me was going to wait until I have more results to share this one, but I don't know if or when the owner is going to pursue the additional testing so that, what the heck.

I had a patient last week in for lactating. Not pregnant. Normally this is false pregnancy but the timeline is a little off for that. I found out that apparently hypothyroidism can cause lactation and I think that might be what is going on here.

But not confirmed yet because we haven't run a thyroid panel. T4 is really low though and remainder of bloodwork is unremarkable.

Any chance of a pituitary lesion? A lactotroph adenoma/prolactinoma pumping out prolactin and messing up the other cells in that area (e.g suppressing the thyrotrophs, corticotrophs, etc)

I always try to find cancer though, so take me with a grain of salt hah. It could be just the whole pituitary gland getting hyped up due to feedback from the thyroids. Any signs of cortisol imbalance?

 

[finnickthedog]

Any chance of a pituitary lesion? A lactotroph adenoma/prolactinoma pumping out prolactin and messing up the other cells in that area (e.g suppressing the thyrotrophs, corticotrophs, etc)

I always try to find cancer though, so take me with a grain of salt hah. It could be just the whole pituitary gland getting hyped up due to feedback from the thyroids. Any signs of cortisol imbalance?

I hope not! I don't need any more surprise cancer. I'm having a run of it.

She has no other symptoms though. I mean she's a little overweight but like, "pet weight" and everything else is normal. She's just lactating when she shouldn't be.

 

[battie]

I incidentally found a splenic mass on rads in a kiddo where I was looking for rocks a few weeks ago. They ended up doing initial work-up with me, then transferring to specialty for surgery and potentially chemo!

This kiddo got through his surgery well and has started chemotherapy for hemangiosarcoma. I know the odds weren't exactly in his favor, but I was really hoping this family would be lucky with a hematoma or something. Should have known better; there was no normal spleen left. It was all tumor.

 

[Angelo84]

Fun case last week

360 degree GDV. Had intermittent signs for prior 18 hours. Looked like a bit funky GD on films but tachycardic unable to pass tube. Took to surgery and confirmed 360 torsion. Did great and went home next day. Now I probably won’t see another one.

 

[Trilt]

Fun case last week

360 degree GDV. Had intermittent signs for prior 18 hours. Looked like a bit funky GD on films but tachycardic unable to pass tube. Took to surgery and confirmed 360 torsion. Did great and went home next day. Now I probably won’t see another one.

I had one in a previously pexied dog last year! (a normal 180 GDV, not 360 - just a neat GDV case).

On explore the pexy was still intact, just very small and stretttchhhhed and almost identical to the diagram from a published similar situation.

Cool case, dog did well.