Do you feed your dog ham bones?

I had an interesting case this weekend. Sandy presented with a ham bone caught on her lower jaw . In the first two pictures you will see the bone is completely around the lower jaw and caught behind both canines. Even with sedation, I had a very difficult time removing the bone and was considering cutting it with a bone saw when it finally managed to pop back over the canines. The last picture is Sandy (sedated) with the bone next to her.

I'm sure there are a large number of people that give bones to their dog without ever having a problem. When problems do occur, however, they can be serious. Take a look at the following warning from FDA’s website. Item number three specifically discusses Sandy’s condition as well as more serious problems that can occur with bones.

http://www.fda.gov/AnimalVeterinary/ResourcesforYou/AnimalHealthLiteracy/ucm204796.htm

I do not recommend feeding any type of bone to dogs, especially since there are safer alternatives out there.

Jeffrey A. Nunez, DVM

A Letter of Thanks

Below is a letter we received this past week - we wanted to share it with you because we appreciate the kind words. Working in this field can be very stressful and depressing at times - letters such as these remind us why we are here.




9/7/10

Mike Grafinger, DVM, DAVCS
Triangle Veterinary Emergency Clinic
3319 Durham-Chapel Hill Blvd
Durham, NC 27707

Dear Dr. Grafinger,

Last tuesday as I got ready to go to work our 15 year old beagle, Sheba, fell off our deck 15 feet onto a flagstone path below. At 6 am in the morning our regular vet referred us to your clinic.

Like many of the animals you probably see, Sheba is a dear member of our family, growing up with our children, so gentle with our daughter Rae, who was 7, and in particular "raising" her boy Max from the time he was 10 and we got her as a puppy.

I heard the sickening thud as she hit the ground and the pitiful sounds that followed. As a physician myself, the images of broken bones, cord or neurologic injuries or internal bleeding that filled my mind as I tried to stabilize her spine and drive to your facility were distress beyond words. While she was breathing and even awake in my arms riding into Durham, with a fifteen year old dog the likelihood of choosing between suffering or euthanasia seemed almost inevitable.

I think you know the "miracle" or "ninja dog" story from there. Not a break or a bleed, hardly a bruise, home that same day with some IV hydration and off sedation in 48 hours. For the labor day weekend the kids were all home, and Sheba was her "old" self--I am attaching 2 pics of her on her favorite couch and with her boy.

It was my understanding that you are the owner of TVEC, and I am writing this email to you not only as the doctor who took over her care on day shift, but also on behalf of your facility. While I am sure you know in detail the comfort and support that your team provided to Sheba during her stay with you, I am writing to share with you how much the TVEC team meant to me and to our family during the 11 fearsome hours from arrival to discharge.

I particularly want to single out Dawn Lanza and the receptionist/technician who worked with her, a woman whose name I am sorry to say I did not get in the chaos of events. Quite literally from the moment I walked through the door of TVEC I was awash in a sense of compassion and competence. Sheba was briskly but lovingly taken into the back, and I was seated in the waiting area, filling out the basic forms. It seemed like Dr. Lanza came out every few minutes with an update, as well as with a brief and clear explanation of the next steps, from vital signs to x-rays, blood tests, IVs, and what each was intended to explore or reveal over the range of concerns for an elderly animal after this kind of fall. As she looked me straight in the eye with each of these encounters, I simply felt Blessed to have urgently plunged into the presence of a true health care partner, who seemed as able to do what had to be done first for Sheba, and yet remain so aware of her "family" in the waiting room.

As an interventional cardiologist for the past 3 decades, I have participated in a large number of acute care scenarios, from shock/trauma to acute cardiogenic shock and heart attacks. I know well that to be able to move briskly without giving the family or patient a sense of panic or a 'fire drill" in motion reflects a unique balance of experience, expertise and compassion. I can only say that if our emergency group at Duke Medical Center performed on a par with your team last tuesday am, I would be very proud of them.

I expect you get a lot of letters like this, judging from the kind of service you provide in the setting of veterinary emergencies. But all I can say, both as one doctor to another and as a family member from our entire family, is thank you all so very much for being there, for doing the kind of work that you do, and for taking care of our beloved Sheba when she, and we all, needed it most.



BELOW: Sheba “after the fall” on her favorite couch and with her “boy”, Max.



With very best regards,

M. W. Krucoff MD FACC, FAHA
Professor Medicine/Cardiology
Duke University Medical Center
Director, CV Devices Unit
Director, eECG Core Lab
Duke Clinical Research Institute

While Mommy's away, cats will play!

Sophie, a 3 year old kitty, had some fun with her favorite toy recently and had to come see the TVEC emergency service. She started playing with her favorite toy which her mom had tied to a few feet of fishing line. When Mom got home, Sophie had the toy and a few inches of line hanging from her mouth. Her mom acted quickly and brought her right in where an x-ray showed her intestines all bunched up together.

Sophie went to surgery and the length of the string had traveled from her mouth all the way down her esophagus into her stomach. It pleated her small intestines like an accordian and continued on into her colon! The line was removed and Sophie is doing great - but will have to find a new toy!

On another note - if you ever see a string hanging from your pet's mouth or rectum, you should never pull on it! If it is snagged then it can cause serious damage!

Congratulations Bethany!

Triangle Veterinary Emergency clinic is proud to have one of our own starting veterinary school at North Carolina State University. Dr Jeffrey Nunez presented Bethany with her “white coat” during the 2010 White Coat Ceremony in August. Each year, NC state host the ceremony to honor the incoming veterinary class. Each incoming freshman chooses a sponsor that has been influential in their career to present them with the coat. Receiving the white coat is the first of many milestones the veterinary students will pass in their goal of obtain their doctorate.

Good luck Bethany! We know you will be a great veterinarian.