Instead of one of the myriad "want to make me yank my hair out and simultaneously beat my head against a wall until blood sprays from ears" stories from this week, I'll tell one with a happy ending.
Monday night, my technician handed me a chart. The patient was a larger breed dog (around 60#) with a history of lethargy beginning that morning. She was seen at her veterinarian. He did not notice anything out of the ordinary. Bloodwork was submitted to an outside laboratory, and he discharged the dog (Izzy). Throughout the day, her lethargy progressively worsened, and then she began to breathe hard. It wasn't respiratory distress, just very heavy breathing. She also developed a huge swelling on her neck.
When I examined her, I found a depressed dog with muddy gum color, harsh respiratory sounds at the top of her chest, decreased sounds at the bottom, and a large, soft, fluid-y swelling under her neck. Izzy was a free roamer in the country - running wherever she wanted, no fence. Many things popped into my head, but I couldn't figure out what the swelling under her neck was.
So I went to talk to the owner. It was then that I noticed the name on the chart. It was my realtor! The very one that found us our house. We chatted about Izzy's history, and I recommended repeat bloodwork, then stepped back into the ICU. Then my technician (thank God for great techs!) slapped her hand on the table and said, "I bet I know what that swelling is! I bet it's a hematoma (blood clot) from where they took blood from her jugular this morning." At that moment, the pieces started to fall into place - labored breathing, pale gums, hematoma, and free-roaming.
That equals RAT POISON!
Sure enough, the clotting times were off the chart high. Izzy was bleeding (very mildly at that point) into her chest space and also a little into her lungs. After her fresh frozen plasma transfusion and vitamin K, Izzy was a new dog. She went home with her very grateful mom to hopefully live many, many more days. Her owner told me the next morning that they had scattered rat bait around the barn, and they'd noticed Izzy was pooping green - but they hadn't put two and two together.
Needless to say, they cleaned up all the rat bait, and Izzy will live to fight another day.
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