Izzy was referred to the Veterinary Medical Center of Central New York by her family veterinarian. Izzy, a 3 year old otherwise healthy Yorkshire Terrier, had collapsed and was non-responsive by the time she arrived at her family veterinarian. She was not breathing well, and her veterinarian quickly responded by placing a breathing tube and beginning assisted breathing with an ambu-bag. Izzy’s heart rate was abnormally fast, and so IV fluids were also administered. Because her family veterinarian knew Izzy needed specialty care, she was transferred to the Critical Care Service at the Veterinary Medical Center of CNY. Izzy’s owners drove her here (an approximately 45 minute drive) with a tube in her airway. Izzy was comatose and they were not sure that she would even survive the drive.
On arrival to the Veterinary Medical Center’s Critical Care Service, Izzy was immediately rushed to the ICU for evaluation and treatment. She remained in a coma, with a fast heart rate and low blood pressure. Her oxygen level was low, so she was given supplemental oxygen while a technician gave her breaths through an ambu-bag. Tests were performed immediately while additional treatments were provided in order to improve Izzy’s condition. An EKG showed a fast heart rate. Blood pressure and oxygen levels were low. Emergency blood work showed a low red blood cell level as well as a low protein level. Izzy continued to receive IV fluids while her parameters were continuously monitored. During this time a large swelling was noted on Izzy’s neck. Further inspection of this swelling showed it was due to bleeding under the skin. Izzy had also bled heavily from her IV catheter sites. An ultrasound showed she was bleeding around her lungs, causing her lungs and airways to collapse. This was deemed the cause of her difficulty breathing.
Based on these findings she was immediately screened for anticoagulant rat poison toxicity, a toxin which causes life-threatening internal and external bleeding. Her test results were highly suggestive of rat poison toxicity. Izzy’s owners were informed of this and realized that there had been the potential for exposure to rat poison a few days prior to this incident. Izzy immediately received treatment for this condition, which included a red blood cell transfusion, a plasma transfusion and Vitamin K injection. She continued to be continuously monitored while a Critical Care specialist and a team of licensed veterinary technicians stood constantly by her side. Over the next hour Izzy became responsive and able to breathe well on her own. The breathing tube was removed, and her heart rate and blood pressure normalized. Within 2 hours of treatment Izzy was up and going outside for walks!
Izzy remained hospitalized in the ICU for 48 hours to be closely monitored and receive supportive care. During this time she made a steady recovery. For the first 24 hours she remained in an oxygen cage to help support her breathing. Her heart rate, breathing rate, temperature, blood pressure and EKG were closely monitored. Recheck blood work was performed to monitor her for internal bleeding. She was eating and drinking well, and she was bright and alert (especially when her family came by for visits!). Izzy was discharged 48 hours after presenting to the Veterinary Medical Center. She was sent home with a 4 week course of treatment with Vitamin K. A recheck evaluation performed 1 month later showed that Izzy made a complete recover and no further treatment was necessary.
Recently the Veterinary Medical Center received these pictures of Izzy running through her yard, happy and healthy. We are so grateful that Izzy has made a full recovery, and we wish her all the best! Izzy is a very special patient of the CriticalCare Service, and she will never be forgotten!
So what made Izzy’s case so successful? Not only did Izzy receive immediate care and treatment by her primary care veterinarian, but Izzy’s transfer to the Veterinary Medical Center (VMC) was an important step in her treatment. At the VMC Izzy was directly cared for by board-certified specialists in Emergency and Critical Care. The VMC is the only private hospital in central New York to have not only one, but two full-time Emergency and Critical Care Specialists, Dr. Maureen Luschini and Dr. Elise Craft. Please refer to "What is Veterinary Critical Care" or our website for more information.
Thanks to our Medical Director, Dr. Maureen Luschini, for summarizing Izzy's case for this post and some very special thanks to Izzy's family for allowing us to share her story!