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.
"My parents bought the puppy," said Mr. Zepeda. "We fell in love with it right away. There's no way we were going to let it die."
The clinic administered glucose intravenously, and by Sunday afternoon Coco was eating a little at Dr. Stephane Farmer's coaxing.
Dr. Farmer has her own veterinary practice in Carrollton but has worked part time at the Rowlett clinic almost since it opened in November 1997. The clinic also has three full-time vets, another part- timer and a support staff of 10.
"Here, you have to think fast and you have to act fast," Dr. Farmer said. "This is a cool job."
Round the clock
A quick glance at the Yellow Pages shows hundreds of veterinary clinics scattered around the Dallas area but few offering round-the- clock critical care. The east side was especially bare when the clinic opened, said its chief of staff, Dr. Travis Dennett.
"We needed something for the residents here," he said.
The clinic shares a building just across the State Highway 66 bridge from Rockwall with the Animal Hospital of Rowlett. The hospital's staff handles cases weekdays and Saturday mornings; the emergency center's staff covers the other hours.
In July, the emergency center became the first in the country to receive accreditation in emergency and critical care from the American Animal Hospital Association. To gain the specialty accreditation, the clinic had to meet 300 standards and offer 24- hour care.
Debbie Gadamoski, practice accreditation manager for the association, said the only other hospital to win the certification is in Virginia, though other clinics are going through the process to receive accreditation.
'Like a family member'
Shortly before 5 p.m. Sunday, Henry Lewis brought in Bud. The 13- year-old chow/German shepherd mix was shaking and bleeding from several wounds, the worst of which gaped open on his chest, back and right rear leg.
The vet recommended antibiotics, X-rays and surgery to close the larger wounds. Mr. Lewis, who has had Bud since the dog was 2 weeks old, didn't flinch at the $850 estimate.
"He's like a family member," said the resident of Poetry, in Kaufman County. "He's been with us longer than the kids have."
The next patient, a Chihuahua/rat terrier cross, couldn't stand and was almost too weak to shake. With advanced parvo, Whiskers didn't stand much of a chance. The virus destroys the inner lining of an animal's intestine, causing it to lose protein and fluid and allowing bacteria into the bloodstream.
Owner Angie McClure of Sachse tearfully decided to have Whiskers euthanized.
"This is one of the hardest things we have to do here," Dr. Dennett said, petting the small black dog.
In addition to life-threatening illnesses, the Rowlett emergency clinic sees injuries caused by cars, fights and shootings. Around the holidays, poison cases crop up as pets get into candy. Chocolate, especially baking chocolate, is toxic to animals.
Antifreeze poisoning and snakebites are fairly common, as well. And the clinic is starting to see more geriatric patients with heart problems, kidney failure and cancer.
"People are taking better care of their animals these days, so these guys are living longer," Dr. Dennett said.
X-rays to ultrasound
By Sunday evening, Bud was resting quietly in a kennel, though some bleeding persisted. A few X-rays were ordered to make sure none of the lead pellets had damaged his lungs or fractured bones. If not, the doctors said, the pellets would probably remain in the dog.
"You can cause more damage trying to retrieve them," Dr. Farmer explained.
Bud's X-rays came back about half an hour later, showing so many white circles that it looked almost as if someone had emptied a paper punch onto the film. Shotgun pellets, apparently.
"Unbelievable," Dr. Farmer said.
X-rays are among the clinic's more ordinary tools. It also has miniature cameras that can be inserted into an animal's windpipe or esophagus to find and remove swallowed or inhaled balls, foil or candy wrappers. Ultrasound is used to detect problems such as fluid accumulation around organs and tumors in the abdomen or chest. And blood tests can be performed to show red and white blood cell counts, blood oxygen and gas levels and kidney and liver function.
The clinic keeps plasma, red blood cells and hemoglobin on hand for use by its own staff or other area veterinarians.
Dr. Dennett said the clinic can provide the level of care one would expect from an emergency room for humans. It is also like human hospitals in another way:
"You wait," said Yvette Walters of Garland.
Ms. Walters had arrived about 8:30 p.m. Sunday with Ozzy, her daughter Courtney's 6-week-old Lhasa apso.
The puppy was showing symptoms similar to Whiskers', and Ms. Walters feared he had the same virus. Dr. Dennett at first suspected the dog's illness was caused by a change in diet, but a parvo test came back positive.
"This puppy's severity just went up," Dr. Dennett said. "We need to treat him very aggressively."
Like human critical care, emergency care for pets is not cheap.
The estimate for Ozzy's first overnight stay was about $450. Each day he had to be held for observation was likely to add $150 to $230, and Dr. Dennett said it could take a week.
The exam fee alone is $70 for dogs and cats, $80 for exotics. Routine blood work averages $100. Dr. Dennett said people rarely walk out the door without spending at least $175.
The first 12 hours are the most expensive, he said, because of immediate procedures such as plasma transfusions, catheters, blood tests and medication.
Dr. Dennett thought Ozzy had a good chance because he had received a vaccine a few weeks earlier and the parvo infection was in its early stages.
Ms. Walters cried as the vet explained the effects of the virus.
"Courtney's waiting for you," she whispered as she kissed Ozzy good night. "You get better."
The emotion inherent in such situations concerns Dr. Curtis Jung of the Rowlett Veterinary Clinic. He said he is glad the pet emergency center is there but feels "kind of sorry" for people who may hastily agree to costly care at an emotional time.
"Just like in a human ER, it's real expensive," Dr. Jung said.
Other vets' views
But some local vets have come to rely on the clinic. Dr. Mike Sealock in Rockwall said that by directing after-hours emergencies to the clinic, he has gotten his family life back.
"I can be there for my kids at the end of the day," he said.
Dr. Danny Gentry said the Lakeside Veterinary Clinic in Rockwall transfers most of its critical cases to the clinic.
"Our hours are 7 to 6," he said. "Trying to run emergencies with as many clients as we have would be rather difficult."
Dr. Keith Taylor of the Rockwall County Veterinary Clinic said his office occasionally sends patients to the Rowlett clinic for overnight critical care but handles most of its own emergencies, regardless of the hour.
"I just believe in taking care of my own people," he said.
Dr. Dennett sees the center as an extension of area vets' practices.
His staff may not know the clients as well, "but we try to assure them their pet will receive the best medical care possible as soon as possible," he said.
'Back from the dead'
Ozzy whined and barked for hours after being moved to isolation about 10:30 p.m. Sunday, but Dr. Dennett took it as a good sign. The dog was slightly dehydrated, but the blood work looked good.
After reviewing new X-rays of Bud, Dr. Dennett decided the buckshot was probably from an old shooting and the fresh injuries were probably from a fight.
In more than an hour of surgery that started at 1:05 a.m., Dr. Dennett examined and cleansed the wounds and inserted tubes to drain two of them. Bud left the ER Monday afternoon and was expected to make a full recovery.
Coco finally developed an appetite Monday and went home Tuesday night.
"We're very pleased," Mr. Zepeda said. "They were able to bring the dog basically back from the dead."
Ozzy was not so lucky. By Tuesday afternoon, he had developed a high fever, a sign that bacteria were being absorbed into his bloodstream. He died that night.
"With all of the advanced medical procedures and treatments that we are now able to perform," Dr. Dennett said, "sometimes we cannot beat the inevitable."
Reprinted with permission of The Dallas Morning News.