Summer Emergencies:

Heat Stroke:

Dogs most often present with heat stroke after being confined in a vehicle, after activity or exercise in extreme heat. Cats can present with heat stroke after being closed in an operating clothes dryer. The owners might report excessive panting or respiratory distress, drooling, brick red mucous membranes, collapse or seizures. This is a life threatening condition and these pets need immediate medical attention. Treatment for these pets involves cooling their core body temperature, aggressive IV fluid therapy, and other interventions to support or protect organ function and potential coagulation disorders.

Near Drowning:

Near drowning often occurs in pets who have fallen into a swimming pool and cannot find a way out. It can also occur in the spring or fall when the cover is still on the pool and the pets get stuck just under the edge of the cover. Near drowning can of course occur in any body of water including ponds, lakes or the ocean.

The most obvious clinical sign associated with a near drowning event is respiratory distress or difficulty breathing. Aspiration of the water into the lungs causes fluid and swelling in and around the lung tissue as well as potential collapse of one or more lung lobes. Hypoxemia (low oxygen levels in the blood) can lead to an irregular heart rhythm, heart or other end-organ (kidney, liver, brain) failure.

Other factors that influence the prognosis for the near-drowning victim include the temperature and particulate nature (bacteria or protozoa content, salt, sand, algae, etc) of the water. Victims who fall into water that is less that 5C have a better prognosis because they experience shunting of blood  to the heart and brain which protect both organs from the effects of low oxygen levels. Pets who aspirate water with a high particulate content are more likely to develop severe lung infections even if they survive the initial submersion.

Treatment of these patients initially includes oxygen therapy and help with ventilation. Many patients will require both diuretics (to help get rid of fluid within the lungs) and IV fluid therapy to support circulation and oxygenation of tissues and to correct electrolyte imbalances.

Rodenticide Toxicity:

Many of the most common rodenticides (rodent poisons) are vitamin K antagonists so they inhibit the formation of vitamin K in the body. Vitamin K is necessary for the formation of essential clotting factors in the liver. Without available vitamin K, the clotting factors cannot be produced and the pet is predisposed to spontaneous and uncontrolled bleeding. Usually the bleeding is "deep bleeding" into the chest, abdomen or joints and less likely bleeding from mucous membranes such as nose bleeds (epistaxis) or gastrointestinal bleeding.

This is an example of a toxin that has a delayed reaction. It may not be until several days after exposure to the rodenticide that a pet will begin to experience uncontrolled bleeding. If an owner witnesses the ingestion of the rodenticide, early intervention can prevent the bleeding disorder from occurring altogether. Your veterinarian may induce vomiting, administer activated charcoal to prevent absorption of the poison and begin vitamin K therapy while monitoring bloodwork for early signs of a coagulation disorder.

If a coagulation disorder develops after unknown exposure to a rodenticide, it often causes internal bleeding into the chest or abdomen and may not be obvious to the owners. The pet may show signs of lethargy, depression, weakness, bruising, pale mucous membranes or difficulty breathing. Treatment at this point would include transfusions of whole blood or plasma to replace red blood cells or clotting factors and well as vitamin K therapy. If the pet survives the first 48 hours after spontaneous bleeding begins, their prognosis improves.

Insect Stings:

Bee or wasp stings can cause a localized allergic reaction or may progress to anaphylactic shock. Localized reactions typically include hives, itching, redness and facial swelling.

Anaphylactic shock occurs after the release of histamine and other mediators from cells within the body that ultimately cause circulatory and respiratory collapse. A pet who experiences anaphylactic shock may have difficulty breathing, salivate excessively, have vomiting or diarrhea, have pale mucous membranes and may collapse. An anaphylactic reaction usually occurs after the pet has been sensitized to the particular allergen (venom, vaccine, medication, etc) once or twice.

A pet who presents in anaphylactic shock has a guarded to poor prognosis. Treatment may involve IV fluid therapy, antihistamines, steroids and oxygen or respiratory support.

It is important to avoid future exposure to the allergen if it can be identified to avoid a more severe reaction.