What Would You Do? Part II

A week ago I challenged you by asking, “What would you do?” pertaining to a series of pet-related symptoms. Thanks to the more than 100 of you who submitted your responses. All of your names were entered into the book drawing. And the lucky winner is…… drum roll…… Brenda Bass with Middle Tennessee Boxer Rescue. Congratulations Brenda!

Below, you will find my preferred responses to the scenarios I presented. Know that there is always room for differing opinions, particularly given your personal experience and what you know to be true for your own pets.

If ever you have doubt about how best to proceed in response to your pet’s symptoms, I strongly encourage you to solicit advice from a staff member at your family vet clinic or local emergency pet hospital. It is perfectly okay to have your pet examined on an emergency basis for something that ends up not being a true emergency. This happens all the time. Better to be safe than sorry, and your peace of mind will be well served.

Recommended courses of action

For all of the symptoms described below, the options were:

  1. Do some “watchful waiting”.
  2. Call a staff member at your family veterinary clinic or local emergency hospital for advice.
  3. Schedule an appointment to have your pet examined by your family veterinarian.
  4. Take your pet immediately to your family vet clinic if they are open. Otherwise head to your local pet emergency hospital.

Now, here are the my preferred responses.

1. It’s 8:00 at night and your pet just vomited some fluid mixed with food. He seems perfectly normal otherwise, and you know of nothing unusual that he might have eaten.

For this scenario, I feel comfortable advising you to do some “watchful waiting”. This is based primarily on the other information provided (nothing toxic or unusual ingested, perfectly normal otherwise, vomited one time only). Should there be more vomiting or progression to other symptoms, veterinary attention is recommended. During the “waiting and watching” period following an episode of vomiting, it is typically a good idea to withhold food for six to eight hours while offering frequent access to small amounts of water. Left to their own devices, dogs who are feeling nauseated often “gorge” on water, prompting ongoing vomiting. When food is reintroduced, it is wise to offer small, frequent meals of bland diet (a mixture of nonfat cottage cheese and plain boiled white rice for dogs, and jarred turkey or chicken baby food for cats) for 12-24 hours. After this time period, if all is well, the normal diet can be reintroduced. Calling a staff member at your family veterinary clinic or local emergency hospital for advice is an option I would fully support here as well.

2. For the past few weeks you’ve been needing to fill your pet’s water bowl more frequently than normal. Your pet seems completely normal otherwise.

While this observation does not represent an emergency situation, it definitely warrants scheduling an appointment to have your pet examined by your family veterinarian. Increased thirst can be an early symptom of many disorders, some of which include: kidney disease, liver disease, urinary tract infection, and hormonal imbalances (diabetes mellitus, Cushing’s disease, Addison’s disease, diabetes insipidus). Your vet will be pleased if, before your appointment, you’ve measured your pet’s 24 hour water intake (ideally 2-3 day’s worth). Normal water intake is less than one ounce per pound of body weight per day.

3. Your pet just had what looked like a seizure. The episode lasted approximately 30 seconds. He appeared completely normal both before and immediately following the seizure. He’s never done anything like this before, and you know of nothing unusual (toxic) he could have been exposed to.

My preferred course of action is that you take your pet immediately to your family vet clinic if they are open. Otherwise head to your local pet emergency hospital. It can sometimes be difficult to know if what was observed was truly a seizure or a fainting episode (usually caused by heart disease). In either case, early intervention has the greatest potential to arrive at a diagnosis and favorably influence the outcome.

4. Your normally very well house-trained dog or litterbox-trained cat has urinated two times on your bathroom rug. He seems completely normal otherwise.

Whenever an undesirable behavior such as inappropriate urination develops, I always encourage giving your pet the “medical benefit of the doubt”. By this I mean ruling out an underlying medical problem rather than just assuming this is “bad behavior”. In this case, it is very possible that the urination on the bathroom rug is a symptom of a urinary tract infection, bladder stones, a sterile inflammatory process within the bladder (cats), a structural problem within the lower urinary tract, or a disease causing increased thirst, therefore increased urine production. Based on the symptoms described, my recommendation is to schedule an appointment to have your pet examined by your family veterinarian.

5. Your pet suddenly appears more tired than usual, and his tongue seems pale. He seems completely normal otherwise.

The pale tongue is the key here. It creates concern about heart failure, respiratory tract disease, a shocky condition, and severe anemia caused by internal bleeding or an autoimmune disorder. All of these possibilities represent true emergencies and I recommend taking your pet immediately to your family vet clinic if they are open. Otherwise head to your local pet emergency hospital.

6. For the past week your pet has been eating his normal amount of food, but is nibbling throughout the day rather than consuming the entire meal in one sitting as he normally would. He seems completely normal otherwise.

While it may be tempting to dismiss this change given that the total amount of food your pet is eating has not changed, my advice is that this symptom warrants scheduling an appointment to have your pet examined by your family veterinarian. Dogs and cats tend to be creatures of habit, and a break from their normal routine is a heads up that something is amiss. The change in food interest described here could be caused by something as simple as a painful tooth to something as serious as kidney failure.

7. For the past two days your pet has has had a mild limp. Your thorough inspection of the leg did not identify anything abnormal. He seems completely normal otherwise.

In this situation (note that I described the limp as mild) I feel very comfortable with “watchful waiting”. Just like us, our pets can experience bruises and sprains that will improve over the course of two to three days, particularly if exercise restriction is enforced. If, after a few days, the lameness is not improving or is worsening, it is time for a veterinary visit. Even if the cause of the lameness is something more sinister (a torn ligament, a bony tumor, etc.) the overall outcome will not have been negatively impacted by having delayed veterinary care by a few days. A word of warning- please do not give your pet any over-the-counter human antiinflammatory medications (aspirin, ibuprofen, acetaminophen, etc.) during this waiting and watching period. Such products can cause far more harm than good.

8.  Your pet growled at you when you attempted to move him from the couch to the floor. This is something he’s never done before. He seems completely normal otherwise.

In this situation I strongly encourage scheduling an appointment to have your pet examined by your family veterinarian. This will help rule out an underlying medical issue, such as a painful body part, as the cause of the growling. As described in number 4 above, your four-legged family member is deserving of your “medical benefit of the doubt”.

9.  Your normally ravenous pet showed no interest in his breakfast this morning. He seems completely normal otherwise.

Our pets tend to be such creatures of habit, particularly around mealtime. When there is a sudden change in food bowl behavior, I am always concerned. While this situation does not raise any “emergency alarm bells” for me (based on the fact that everything else appears normal), I do think scheduling an appointment to have your pet examined by your family veterinarian makes good sense, with the caveat that the appointment be scheduled for sooner rather than later. Calling a staff member at your family veterinary clinic or local emergency hospital might be a reasonable option, but I am concerned that you may be advised to wait and watch. A sudden change in appetite has the potential to be associated with a serious underlying medical issue. Simply waiting and watching could sabotage a window of opportunity to create a good outcome.

10.  It’s bedtime and your pet is breathing heavily and doesn’t want to lie down. He seemed completely normal throughout the day.

This is a worrisome scenario particularly if such behavior is truly out of character for your pet. While fear or anxiety can produce an abrupt onset of these symptoms, they can also be caused by a number of serious medical maladies some of which include: internal bleeding, heart failure, severe respiratory tract disease, or any underlying problem causing severe pain. This is definitely a “better to be safe than sorry” situation and I recommend taking your pet immediately to your family vet clinic if they are open. Otherwise head to your local pet emergency hospital..

How did you do? Do you agree with my recommendations? Are there other symptoms you would have liked me to include?

Best wishes,

Nancy Kay, DVM

Diplomate, American College of Veterinary Internal Medicine
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Author of Your Dog’s Best Health: A Dozen Reasonable Things to Expect From Your Vet
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot and Your Dog’s Best Health.   There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot and Your Dog’s Best Health are available at www.speakingforspot.com, Amazon.com, local bookstores, and your favorite online book seller.


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7 Comments on “What Would You Do? Part II

  1. You asked if there was a topic that we would like to have had included in this quiz… I’d be interested in hearing your thoughts on balancing concerns about various lumps and bumps of old age.

  2. I’d like to add just one thing. There is a danger, for some clients and some veterinary surgeons, that someone who brings their dog in frequently – and quickly – for things that turn out to be nothing much.

    I had what I thought was a good vet practice. As I said in my earlier comment, I take my dogs in for consultation sooner rather than later, and it turns out that this practice may have begun to take me a bit less seriously than they should. To my eternal shame, it took misdiagnosis and subsequent death of three of my dogs before I left them.

    These days, I request a referral if my vets don’t seem to have the answer and the vets I’m with now are very happy to agree. This worked well for us recently when my ten year old tripod greyhound was referred to a vet school hospital because he was having increasingly severe mobility problems with no obvious cause. This lasted nearly a year, with many, many vet visits, x-rays, etc. As time went on, I strongly suspected the hind foot, but the vets could find nothing.

    It turned out that he had a large corn which was not visible on the surface unless his foot was soaked for twenty minutes when you could see a small, faint circle. The vet school had three specialists look at him within the space of an hour, my theory was proved correct and the corn has now been removed with great results. They also have some before and after video which they will be using for teaching purposes!

  3. I agree with the first commenter: know your pet. There were a couple of questions to which I would not have answered ‘schedule an appointment/rush to the emergency clinic’ because I DO know my dogs. And, I hasten to add, my vets and I know each other rather too well – I take my dogs sooner rather than later, by choice!

    The other point raised was that it does depend how experienced you are with animal illnesses and disease. Having trained and worked as a veterinary nurse, I can look at the pacing, panting dog with a pale tongue and make an informed decision as to whether it’s fear or pain, or something serious like bloat, internal bleeding, or shock.

    I’ve had dogs which pace and pant (with mild variations on mucous membrane colour) through fear, through pain, through over-exertion etc, and I’ve had them pant and pace and have congested or pallid mucous membranes through congestive heart failure or chronic airway disease. I’ve never had a hound with bloat, but I’ve seen many dogs in serious pain and internal trouble (bleeding, intestinal blockage, poisoning etc) during my period of working for vets and I’m pretty sure I wouldn’t miss it.

    Thanks for creating the quiz – and for updating with the answers. It is a very useful rough guide for owners with no particular experience or knowledge with medical matters!

  4. The major point in all of this is ‘know your pet’. I would not have much concern if my dog Annie was off her food for a day because at 11 yrs of age she has always done this from time to time. A checkup never turned up any medical issues; she is just a picky eater. Over the years I’ve been through all types of dry and canned foods, home cooking and raw freeze-dried & still we get a day where she needs coaxing or just takes a break.

    If my cat refused a meal I’d take him to the vet in record time. He never misses a meal. In fact his goal in life is to snag an additional meal or treat during the day.

    Experience with certain illnesses helps – I’ve had a cat with kidney failure & dogs with Lymphoma, Diabetes, UTI, Uvitis/Cataract/lens subluxation & soft tissue sarcoma. I have some good dog/cat books I refer to when there is a health concern so I can make a more informed decision.

  5. My choices matched yours until the last three. I said wait (with a maybe call for an appt) on #8. I also would wait on #9, mostly to see if it continued. And, I blew it on 10. I would have waited until morning, then called / made an appointment if not better.

  6. I think I did “too” good. While this is great for my dogs, it’s kind of sad for me, as I feel I have way too much experience with such things. But hey, it is good for my dogs, right?

  7. For a young-to-middle aged dog with no health issues, I’m more relaxed. With my elderly dogs and my diabetic, things are often more urgent than they would be for a younger dog. My diabetic’s first instance of vomiting was actually due to spinal inflammation (that was fatal). My dog that had supposedly been cured from melanoma developed a sudden cough. It was pericardial effusion, also fatal. My dog with lymphoma vomited her whole meal for the first time ever. It turned out her tumor had grown to occupy almost her whole abdomen. I have no idea how she got along to that day, but it was her last day. My vet’s receptionist wanted to make an appointment for several days later, but I took my dog to the E.R. where I learned the bad news. I’d rather have known than to come home from work to find her dead (that happened to me once too)