Pet of the month: Duke
Duke, a 7 ½ year old male neutered Golder Retriever was presented to Hickory Emergency Service on December 5, 2018, for a few days of progressive lethargy, anorexia and vomiting. Duke had a history of intermittent forelimb lameness from suspected arthritis, but was otherwise healthy prior to this incident.
On initial physical exam, Duke was very lethargic and mildly painful on abdominal palpation. Bloodwork was performed that showed moderate anemia with a large number of immature red blood cells and decreased platelets. The pattern of labwork suggested internal hemorrhage, but could also be due to destruction of red blood cells by infection or an immune mediated disease. Since Golden Retrievers are predisposed to a type of cancer called hemangiosarcoma resulting in abdominal bleeding bleeding, there was great concern for that possibility. Duke also had an elevated number of white blood cells which is a non-specific finding.
An abdominal ultrasound confirmed that Duke had fluid in his abdomen. A sample of fluid from his abdomen revealed a large number of neutrophils but no blood. Based on these findings, Duke was diagnosed with septic peritonitis secondary to a suspected gastrointestinal perforation. Duke’s prognosis was guarded since the survival rate for a septic abdomen is about 50%. Despite these odds, Duke’s dedicated owners decided to move forward with potentially life-saving treatment.
Broad spectrum antibiotics were started immediately, and Duke had an emergency abdominal exploratory surgery performed by Heather Swann, VMD, DACVS. Dr Swann discovered a large (3 cm) perforation in the wall of the stomach and severe inflammation of other organs such as the pancreas, small intestines and bladder. The gastric perforation was resected and submitted for biopsy, the gastric wall was then reconstructed. The abdomen was lavaged with a large amount of sterile saline to remove the infectious material. A temporary Jackson-Pratt drain was placed in his abdomen to promote further drainage and allow for analysis of this fluid.
Duke spent a few days in the hospital recovering from his surgery. Small amounts of a bland diet were introduced slowly to make sure that Duke could tolerate them without vomiting. His appetite and energy level improved continuously, and he was discharged from the hospital six days later to continue his recovery at home.
Duke returned for suture removal 14 days later and was doing well at home. The gastric biopsy ruled out cancer as a cause for the perforation. Duke’s owners had been giving Duke the human pain reliever ibuprofen on an intermittent basis in an effort to treat his forelimb lameness. This likely lead to a gastric ulcer and later perforation.
Many pet owners are unaware of the dangers of over-the -counter pain relievers such as ibuprofen and acetaminophen for pets. Duke’s owners were happy to share his story in the hope of preventing this scenario in another dog. If you dog has pain, please visit a veterinarian to obtain appropriate pain relieving medications.
It is approximately two months after Duke’s ordeal, and he is thriving at home. He is eating well, and his energy level is back to normal. In his free time Duke enjoys performing tricks such as roll over and high five but his favorite things are spending time with his family on long walks or just handing out at home.
Duke is a very special dog and was a wonderful patient. He quickly became a staff favorite at Hickory Veterinary Hospital. We are so happy that Duke is doing well at home and thank his family for allowing us to share his story.