D. E. Larsen, DVM
The pup tried to lift his head as he laid on the exam table, but he just didn’t have the strength to accomplish the feat. He let it settle back to the towel on the stainless steel tabletop, resigned to his fate, whatever that may be.
“I don’t know anything about him, Doc,” Paul said. “I was working on the house I am building in Liberty, he walked out of the brush and collapsed at my feet. I guessed that meant it was up to me to try and save him. I am just happy that you can look at him on a Sunday afternoon.”
Cachexia was one of those words I was forced to learn in vet school. Dr. Kainer, the freshman nemesis, seldom remarked about the words he heaped upon us. Still, he had indicated that we would rarely need to use cachexia in our records. If anything described the condition of this pup, it was cachexia. He was literally skin and bones, and completely out of strength. He was looking for a place to die, or maybe hoping for a miracle.
“Just off the cuff, my guess is his chances are slim to none,” I said. “We will spend a little money to figure out what is wrong with him unless we get lucky. And then treatment is going to be more expense.”
“I have an extra hundred dollars in my pocket today, Doc,” Paul said. “If that will buy him a new start, that would be great. If not, at least we tried.”
This was something I learned early when I came to Sweet Home in the middle 1970s. If you can save them for a hundred dollars, they will do it. If it was going to much over that, there would be careful consideration of the options.
I opened the pup’s mouth, it was almost dry, the saliva was white and mucus-like. This was from extreme dehydration. His tonsils stood out like bright red grapes hanging in the back of his throat.
As I ran my hands over his body, I could feel every bone. He was like a skeleton covered with skin. He weighed 12 pounds, and as a young mixed pup, he should be over 40 pounds. Every lymph node was enlarged, noticeable enough that I didn’t have to palpate them. His abdomen was empty but gurgled with my palpation. The mercury in the rectal thermometer was just a little over 95, quite low for a July afternoon. A drop of liquid stool hung on the thermometer when it was removed from his rectum. I carefully transferred that drop to a microscope slide.
“I will take a second to look at this under the microscope,” I said to Paul. “If you would, make sure he doesn’t jump off the table.”
“Surely you jest,” Paul said.
I mixed the small sample with a couple drops of floatation solution and put a coverslip on the slide. Under the microscope, a diagnosis was confirmed with just one glance. Nanophyetus salmincola eggs covered the field. This pup had Salmon Poisoning.
“Paul, this pup has a very advanced case of salmon poisoning,” I said. “Actually, I have never seen a case this advanced. Most dogs are dead before they get this bad. I don’t know if we can help him, my guess is we will be throwing your money down the drain.”
“I said a short time ago, I have a hundred dollars to put into him,” Paul said. “You haven’t had to do any fancy blood testing to find out his problem, lets put the rest of it into some medication and see how he does.”
“Okay, we can wing it from here,” I said. “Ideally, we should check to see how his liver and kidney function is doing, but I will put him on an IV, run some fluids, and give him a couple of miracle drugs. We will see what morning brings.”
Working on this unnamed pup by myself was no problem. He did not move a muscle, not even a flinch when I inserted a catheter in his vein. I started a bottle of fluids at a slow drip. Then I gave a dose of Oxytetracycline as a slow IV injection.
I drew on the experience of a couple of the men whose shoulders I stood upon. Doctor Annes at Colorado State always said that no patient should die without the benefits of steroids. And Doctor Haug from Myrtle Point always treated his salmon poisoning patients with Oxytetracycline and an equal volume of Dexamethasone. I usually gave a small dose of Dexamethasone on the initial treatment for salmon disease. Still, looking at this guy, he could probably benefit from Doctor Haug’s larger dose. I gave the larger dose of Dexamethasone as a slow IV injection.
Scratching his head, I wished him luck and turned to fill out the records. “Name of Pet” jumped out at me from the top of the paper.
“So, guy, what are we going to call you,” I asked the pup. He sort of raised one eyelid, the first real response I had seen from him. I pondered the name.
“I think you might make a pretty good Ellwood, At least for the next few hours,” I said. “But, I am telling you, Ellwood, you had better get well quick. The ticket is for a short ride. I will be back and check on you after dinner.”
Anyone who has been around salmon poisoning knows that the odor of the diarrhea is most offensive. I have had clients tell of waking at 3:00 in the morning after their dog has had an explosive event in the hallway. Everyone in the house wakes up with a headache from the odor. The same thing can happen in the veterinary clinic, especially in a patient who is so dehydrated that their diarrhea has stopped. When they get some fluids, an explosive event often follows.
After dinner, I was a little apprehensive about opening the clinic door. I hoped I would not be greeted with a clinic filled with a salmon poisoning dog’s pungent odor. No odor, that was good. Now all I needed was for Ellwood to still be alive.
Much to my surprise, Ellwood was up, resting on his sternum with his head up and watching for me as I came through the kennel room door. He was a completely different pup.
“Will, I’ll be, Ellwood, you might just live after all,” I said as I looked him over. “You are so thin, I wonder if you would eat a bite.”
Because salmon poisoning dogs lose their appetite early in the course of the disease. Many will not eat for several days after treatment is started. And there is often some residual vomiting if food is given too soon. But I opened a can of mild intestinal diet food and placed a spoonful between Ellwood’s paws. It disappeared so fast that I almost questioned myself about if I really put it there.
“Wow, one more spoonful tonight, then we will give you more in the morning it this stays down,” I said. I thought I saw a slight wag of the end of Ellwood’s tail as I placed the second spoonful between his paws. Again it was gone in an instant.
In the morning, the bottle of fluids was empty, and Ellwood was standing up, and wagging is tail. I could almost say he was bright and alert.
“You are a sight, Ellwood,” I said. “How can you stand with those muscles of yours?”
I placed several spoonfuls of the canned food in a small bowl. Ellwood wolfed it down and wagged his tail. I put a small pan of water in the kennel, Ellwood lapped it up in short order.
“I think you’re well, Ellwood,” I said. “Never in my wildest dreams would I expect it today, especially on your budget.”
When Paul arrived at the clinic later in the morning, I think he was worried if he was going to have to dispose of the body or if we would do that for him. He was pleasantly surprised to see Ellwood up and wagging his tail.
“I think he had survived the disease,” I said. “He just needed some fluid replacement and drugs. I think you have a new pup.”
“I didn’t expect him to be alive. I was thinking I was going to have to dig a hole for him,” Paul said. “Do you think he is going to be okay.”
“I am not sure my opinion means much concerning Ellwood,” I said. “I didn’t expect him to live through the afternoon yesterday.”
“Where did you find his name?” Paul asked. “I looked for a tag, and I couldn’t find one.”
“That is just a name that I thought would fit him,” I said. “He is sort of a fighter, a little like an Ellwood I know.”
We fixed Paul up with a special diet, medication, and instructions for the next week. He stood at the counter, with Ellwood on a leash, while I finished calculating the bill.
Paul noticed my diploma on the wall behind the counter and held his hand out to shake. “Good job, thanks, Ellwood.”
Salmon Poisoning Link: https://en.wikipedia.org/wiki/Nanophyetus_salmincola