Lake Ray Hubbard
Emergency Pet Care Center

was established in Rowlett in 1997 by a local group of veterinarians to provide high quality emergency and critical care on nights, weekends, and holidays... more

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DeetsSignalment: 4YR, intact male, Belgian Sheepdog

History: Acute onset of abdominal discomfort noticed by owner several hours prior to presentation. “Deets” had been seen crouching in a “praying” posture and also was acting unusual. No retching, vomiting or diarrhea had been observed and there had been no history of dietary indiscretion.

Exam: Mucous membrane color was slightly muddy, femoral pulses reduced, and very mild stomach distension was observed on abdominal palpation. Hydration status was normal and “Deets” was very alert and active in the examination room.

Diagnostics: CBC, chemistry analysis, and electrocardiogram were normal. Radiographs revealed abnormal gas accumulation with compartmentalization in the stomach suggesting gastric distension and volvulus.

Diagnosis: Gastric distension and volvulus (GDV)

“Deets” owner, Lisa, immediately approved the necessary resuscitation and surgery to correct this life threatening condition. An intravenous catheter was placed for rapid administration of iv-fluids, antibiotics, steroids and pain medications. “Deets” visit to the emergency clinic had quickly become a fight for his life. Within hours after arrival to the emergency clinic, “Deets” was being prepped for surgery. Pulse oximetry, apnea monitors, and electrocardiogram continuously monitored his cardiovascular status intra-operatively. Upon entering the abdomen, the stomach was “de-rotated” to its normal anatomical position. The spleen also had torsed with the stomach and also had to be untwisted and placed to its normal position. To prevent recurrence, the stomach is “tacked” or sutured (incisional gastropexy) to the right side of the abdominal wall. This procedure is performed to hold the stomach in place and does not interfere with normal digestive processes.
Due to Lisa’s rapid recognition of a problem and awareness of the severity of a GDV condition, no complications were encountered perioperatively. “Deets” was discharged and is expected to live a normal and healthy life.

Discussion:
Etiology: The cause of GDV is not entirely understood but it has been found that large breed dogs that are fed once daily, fast eaters and those that are underweight or lean are more prone to develop the condition Intact males seem to be overly represented and those dogs with a history of inflammatory bowel disease may also be at a higher risk. Any condition that prevents normal gastric motility resulting in distension of the stomach and swallowing of air may progress to a torsion. Although uncommon, obstruction of the pylorus (outflow tract) of the stomach can lead to the condition.

Signs: Owners often report retching (non-productive vomiting), abdominal distension, pain, rapid breathing, dark mucous membranes (gums) and rapid progression of weakness.

Effects: The severely distended and rotated stomach results in reduced blood circulation to the stomach wall and also causes “sludgeing” of blood in the rear half of the body. The poor circulation results in loss of the integrity of the stomach wall, eventual absorption of bacteria and toxins into the bloodstream from the gastrointestinal tract, build up of toxic metabolic by-products, and loss of blood pressure. The progression of shock occurs quite rapidly if left untreated.

Following the decompression and de-rotation of the stomach, the release of toxins into the general circulation may lead to fatal heart arrythmias or massive “stroke-like” syndromes.

Treatment: GDV is a condition requiring immediate medical stabilization and surgical correction.

Prognosis: If rapid diagnosis is made, ~85% of dogs usually recover. Dogs with severe necrosis (devitalized areas) of the stomach wall usually encounter severe and sometimes fatal complications.

What's New

Dr. Lynn Britton - VRCEDVRCED welcomes Dr. Lynn Britton to our staff.  Dr. Lynn Britton’s areas of surgical expertise include wound management and reconstruction, fracture repairs, cranial cruciate ligament disease, and intervertebral disc disease while utilizing the latest in medical technology ...

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Dr. Carmen WooleyWe are pleased to announce that Dr. Carmenn Woolley has joined our practice as a Staff Internist and is currently accepting small animal internal medicine referrals from your veterinarian. Dr. Woolley graduated from Oklahoma State, completed her residency requirements at Cornell University, and is board certified by the American College of Veterinary Internal Medicine. She has received advanced training in the diagnosis and treatment of serious medical problems including those which affect major organ systems such as the heart ...

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From a Technician's Perspective

Emergency practice is completely different from the day practice. The animals in the hospital are usually very sick or severely injured. You become so close to the animals because your primary job is to care for them. You know that each animal is part of a family and it is up to you to get them back home.

At the beginning of each day I review cases, make sure that every animal in the hospital is as comfortable as possible and has everything it needs. I get the hospital ready for any emergency that could arrive. When the doorbell rings the day begins...

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The following article appeared in The Dallas Morning News.

ROWLETT - Bud had crawled home bleeding from what looked like buckshot wounds.

Coco had stopped eating and was barely generating enough body heat to stay alive.

Whiskers had parvo so severe that he couldn't stand, and Ozzy was starting to show parvo symptoms.

Just a typical weekend at the Lake Ray Hubbard Emergency Pet Care Center, the only 24-hour, seven-day-a-week "animal ER" in the Rockwall-Rowlett area and one of only a handful in North Texas.

By Monday, the furry patients would have stolen staffers' hearts and taxed their skills. As in human hospitals, there would be long, uncertain waits, some ending in relief, others in sorrow.

At first glance, Coco appeared to be an old piece of fleece someone had left in the corner of the incubator. But a tap on the glass brought up the 15-week-old toy poodle's head to see what had disturbed his nap.

Owner Lupe Zepeda of Rowlett said his older poodle had been scaring the puppy away from food and water at home. Eventually, the pup had stopped eating altogether. When he arrived at the clinic Saturday morning, Coco was near death...

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More Interesting Stories

Interesting Case

LaylaSignalment: 4 YR FS DSH

History: “Layla” was an adult stray cat, wandering the neighborhood when she was taken in by her good hearted owner. For the first two years in her new home “Layla” was healthy and received regular veterinary care. Layla’s owner began to notice weight loss and then blood tinged urine outside the litter box. At that time, “Layla” also began hiding and avoiding all attention. “Layla” was taken to her regular veterinarian where her blood work revealed anemia. It was suspected that she had a blood borne parasite or an autoimmune disorder, immune mediated hemolytic anemia (IMHA). She was prescribed the antibiotic Doxycycline and a vitamin supplement. Her owner observed labored breathing and increasing lethargy the following morning, “Layla” was referred to the ER.

Exam: She presented depressed with fair pulses, pale mucus membranes and increased bronchovesicular sounds in dorsal lung fields.

Diagnostics: The CBC revealed anemia (Hct 14%) and thrombocytopenia (62 K/uL). Hyperbilirubinemia (0.8 mg/dL) and hyperglycemia (266 mg/dL) were noted on the chemistry analysis.

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DieselHistory:  Diesel presented with facial swelling redness and hives on his chest and abdomen.  His owner stated that he was outside for approximately 1 hour, and noted the swelling after 30 minutes. Owner gave him a bath the he began rubbing his face.  Diesel began developing hives on the car ride to the clinic. The family’s yard is small and in a residential area, and they are not aware of any toxins or abnormal items that he could have ingested.  Diesel had had no recent changes in his diet, no flea products applied, and no vomiting.  He has no history of allergies or any other medical issues. He is also current on vaccinations and takes a monthly heartworm preventative.

Exam:  All of the abnormalities found were associated with Diesel’s skin.  He had generalized red skin (erythema) which was most pronounced on his head/neck, and swelling (angiodema) which was primarily affecting his face.  He was itchy (pruritic) and also had hives (urticaria).  Otherwise Diesel appeared to be a normal Boston Terrier.

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DeetsSignalment: 4YR, intact male, Belgian Sheepdog

History: Acute onset of abdominal discomfort noticed by owner several hours prior to presentation. “Deets” had been seen crouching in a “praying” posture and also was acting unusual. No retching, vomiting or diarrhea had been observed and there had been no history of dietary indiscretion.

Exam: Mucous membrane color was slightly muddy, femoral pulses reduced, and very mild stomach distension was observed on abdominal palpation. Hydration status was normal and “Deets” was very alert and active in the examination room.

Diagnostics: CBC, chemistry analysis, and electrocardiogram were normal. Radiographs revealed abnormal gas accumulation with compartmentalization in the stomach suggesting gastric distension and volvulus...

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SateviaSignalment: 3 month old, Chihuahua

History: Acute onset of weakness and lethargy. Owners also observed difficulty breathing (dyspnea).
Exam: Tachypnea (rapid breathing), pale mucous membranes, weak, lethargic, muffled heart sounds bilaterally.

Upon further discussion with the owners, it was found that the puppy had eaten rat bait poison approximately 3 days prior to presentation.The owners believed that the poison was an anticoagulant.

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Signalment: 6 1/2 YR NM DSH

JackHistory: ~2wk history of lethargy; owners now reporting loss of appetite, vomiting and vocalizing when picked up. Hx of feline asthma. Becomes stressed while owners are out of town. Current meds include prednisolone and amoxicillin.

Exam: Presented lethargic, ~8-10% dehydrated, unkempt hair coat, occasional vocalizations, mild gingivitis, tender on abdominal palpation, wt loss.

Diagnostics: Normal WBC on CBC (later elevated to 23k), elevated liver values (ALT 473 U/L), hypokalemia (3.2 mMOL/L), hypophosphatemia (3.0 mg/dl), mild hyperbilirubinemia (1.0 mg/dl) and severe hyperglycemia (425 mg/dl) observed on chemistry analysis. UA revealed concentrated urine (sg 1.044) with severe glucosuria (500 mg/dl) and severe ketonuria. Bilirubin initially normal but elevated to 4.2mg/dl 3 days after admission.

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