It has taken me almost two whole weeks but I have finally recovered from my horrifying Sunday on emergency call. Not only did I have to attend to 3 seizuring dogs, 2 pony colics, a dog stitch up and two strays.. but also had to drag my poor husband in ON HIS BIRTHDAY to monitor two patients while I was out treating one of the ponies.
After that horrible Sunday, I had a great weekend at Sydney as we got to properly celebrate my belated husband’s birthday.
One of the emergency calls I received on that black Sunday was ‘Nellie’, an 8 year old Border Collie cross, that the owner thought was walking a ‘bit funny’ in her back legs. The owner thought that she was lame on one or both her hind legs. Given the dog’s age, I recommended she bring her in.
As soon as Nellie walked in around 11ish a.m., I knew she was suffering from some type of poisoning.
All her muscles were twitching, she was walking like a drunk and any noise would make her jump out of her skin. I immediately put in an IV catheter in her leg and gave her a dose of muscle relaxant to prevent her twitching from escalating into a seizure.
During that time, I was also busy interrogating her owner about any poisons the dog could have had access to like snail pellets or insecticide spray or an overdose with flea control treatment. When I uttered the words snail pellets, the owner’s face went pale and I had my answer. She immediately called her husband to make sure the other dog they had in custody (one they were looking after) was not clinical.
Unfortunately, ‘Nellie’s twitching started to get worse and she was almost starting to convulse.
I had topped her up with several doses of muscle relaxant and they weren’t doing anything. I explained to the owner that if I can’t get the twitching under control, I will need to put ‘Nellie’ under full anaesthetic and perform a gastric lavage (stomache pump) and enema to get rid of any undigested snail pellets in her gastrointestinal tract. I offered to call a vet nurse in so the owner can go home but she refused as she knew every minute mattered and we had to act fast. She was more than happy to assist me in whatever had to be done.
I proceeded with giving ‘Nellie’ alfaxalone, an induction agent intravenously and passed an endotracheal tube down her throat and hooked her up to an anaesthetic machine. Even under full anaesthetic, ‘Nellie’ continued to twitch and was about to start seizuring. I gave her another dose of muscle relaxant while she was under anaesthetic and her twitching finally hit a halt! I then passed a stomach tube down her throat and we started to perform a gastric lavage. We got a small amount of green snail pellets out but after a while, we weren’t getting anything so I filled up her stomach with activated charcoal. Activated charcoal is meant to neutralise snail pellet poisoning.
We then performed an enema and we didn’t yield much there. After ‘Nellie’ experienced a full gastric lavage and enema while under full anaesthetic for over 2 hours, it was time to wake her up. I warned the owner that this was the moment of truth; Nellie may still wake up and start to twitch and if we can’t control those symptoms with muscle relaxants, she will need to be put back under full anaesthetic for a much longer period and her prognosis for recovery would become fairly guarded.
The prolonged anaesthetic had lead ‘Nellie’ to develop hypothermia.
To help her recover from her anaesthetic, we had to offer her excessive supportive therapy to warm her up. This included placing her on a heat matt, covering her with heaps of blankets and surrounding her with hot water bottles. Expectedly, her owner was quite anxious during this period. Every time ‘Nellie’ made a move, her owner would look at me and ask if that was normal.
As ‘Nellie’ started to warm up, she was starting to wake up and shiver a little bit. Many pets shiver when they recover from an anaesthetic and it can be due to a combination of things: hypothermia, confusion or even pain. However, in this particular case, I was watching her like a hawk and trying to make sure that her shaking wasn’t progressing to any form of seizure activity.
It was actually quite hard identifying if ‘Nellie’ was deteriorating into a hyper excitable state. We had to hold our guns and be patient and allow her to fully recover from the anaesthetic. After 1.5 hours, ‘Nellie’ progressed to howling and she appeared quite confused and distressed. She couldn’t get comfortable even in the owner’s presence. While the owner was distressed with ‘Nellie’s vocalisation, I was actually happy to see her conscious and free of any seizure activity.
Just as I thought things were looking really bright for her, ‘Nellie’ started to vomit.
Nellie’ brought up a lot of activated charcoal. We also discovered her vomitus contained snail pellets wedged in grass. We had to fish all that material out of her mouth and prevent her from swallowing or inhaling them. I was informed that ‘Nellie’ was big on eating lots of grass.
That information suddenly dawned on me as it explained why the stomach tube kept getting clogged up and didn’t facilitate much lavage. This also meant that ‘Nellie’ may still have a stomach full of snail pellets which will only lead her to develop symptoms of poisoning. A horrible possibility suddenly popped in my head: ‘
The snail pellets were wedged in a web of fibrous plant material and the only way to get them out would be surgically!
During that perplexing revelation, I decided to hold onto my seat and not make any rash decisions. I had to monitor the patient closely and my next treatment step would be tailored to what develops. ‘Nellie’ continued to vomit and brought up heaps of snail pellets that we kept clearing from her mouth, throat and bedding. She was starting to get sick of us opening her mouth and shifting her around.
Fortunately, she didn’t develop any recurrent symptoms of snail pellet poisoning. However, she did manage to inhale some charcoal into her lungs in spite of all our efforts at averting that situation. At that stage, ‘Nellie’ developed sporadic coughing episodes and she actually coughed up charcoal on a few occasions. I immediately started her on antibiotics to prevent her from contracting an aspiration pneumonia.
By 6 p.m., ‘Nellie’ was bright and alert and had stopped vomiting but she still had a persistent cough.
I was simply inundated with so many emergency calls that night and so I felt that ‘Nellie’ would be monitored best at home by her owners. I thoroughly discussed home care instructions with ‘Nellie’s owner and sent her home with her IV catheter still in place. The owner was aware that if any twitching episodes returned, she was to call me and bring ‘Nellie’ straight back into my care.
At 11 p.m., I was called out to my second pony with colic. I finally got home at around 1ish a.m. and still hadn’t heard back from ‘Nellie’s owners. The saying ‘No news is good news’ kept echoing in my head.
Just before I went to bed, I started to reflect on the course of my day and was quite astounded with ‘Nellie’s owner. She really stepped up to the plate when it came to the crunch time. She did not bail on her dog during her time of need. Not only was she playing an excellent vet assistant and witnessing many gory parts of my job but also maintained her cool while her own dog was under full anaesthetic. She remained quite focused on all the tasks I had given her throughout the ordeal from monitoring ‘Nellie’s breathing to filling up the syringe with activated charcoal and so forth. Personally, I don’t think I could have even managed to maintain my cool if my own dog was in ‘Nellie’s shoes. During the whole process, ‘Nellie’s owner kept confessing her absolute remorse for her poor judgement in not cleaning up the snail pellets that were spilled in the shed.
‘Nellie’s owner and I forged an excellent team in treating a critical patient and this illustrated that a veterinarian and client working together can make a world of difference for the patient involved!
I booked ‘Nellie’ in for a revisit the next morning. She arrived full of beans and happy as ever. I took her IV catheter out, loaded her with yummy liver treats and sent her on her merry way. She went home with a 14 day course of antibiotics to treat her aspiration pneumonia and she made a full recovery.
This is ‘Nellie’ the day after her poisoning. Looking at her, would you be able to tell what she had been through 12 hours ago?
Related articles
- Poison is poison (rayyathevet.com)
Dr Rayya's Online Veterinary Journal 
May 27, 2012 at 11:36 pm
Raya! OMG! I am exhausted just reading all of this. I could have never been a vet as much as I love animals – could not have been a poeple dr either obviously! ha! You are amazing and you keep yur cool – Wish you were here by me. You remind me f my very first and favroite vet in Chicago, where i am originally from, Dr Marla. You even look similar! She was an amazing vet – she has retired from her practice after getting sick with lung cancer – which is so not fair fr a woman who was simly fabulous. I met her when she had first come out of vet school when she was young like you. She later went on t create a big practice with a friend of hers which today is still very popular and growing. You are wonderful!!!!!!!!!!!!!! Congrats and give yourself a pat on the back! xo
May 28, 2012 at 9:37 pm
Hey Sherri.
You are absolutly right, composure is a very important characteristic to possess during an emergency. I don’t think it would help my clients if I am freaking out, hehehe…However, I sometimes have to internalize my emotional turmoils!
Thank you so much for your very supportive comment. I love hearing about great vets that have made an impact on their clients. Dr. Maria obviously was an amazing vet. I feel priveleged to be compared with her :-). Take care.
May 28, 2012 at 12:38 am
What heroics. I can’t believe you brought the dog through. A real success story. What a cute dog face. They are just like kids. I sometimes wonder how kids and dogs make it to old age.
May 28, 2012 at 9:39 pm
Hey Gretchen.
I honestly didn’t think ‘Nellie’ would pull through initially especially when she was still having muscle tremors after I had put her under full anaesthetic.
So true about dogs being like kids. 🙂
May 28, 2012 at 2:16 am
There are so many poisons out there that animals can get into. Bad enough that some plants are poisonous but all these pesticides add to the problem. Ideally we would all have organic gardens. Snail bait comes with a warning right on the package, but I think most of us don’t take it too seriously until something like this happens. I’m glad to hear you saved poor Nellie. I’m not passing judgment on the owner. It could happen to anyone.
May 28, 2012 at 9:49 pm
You are absolutely right…there are so many poisons out there and owners must be extra careful these days. Having dogs is worse than children because they never grow up. They will always be curious to get into something you least expect like chewing the freezer bricks which can contain anti-freeze which is toxic!
Believe it or not, some snail baits advertise themselves as safe around cat and dogs and that they won’t be interested in eating them…
May 28, 2012 at 3:13 am
Poor Nellie! Those chemicals are a killer and should be banned. Along with all the other organophophates out there. Thank God (and you!) she survived. Bless you!
May 28, 2012 at 9:50 pm
Hey Mollie. I am all for a total ban of organophosphates. I think your blog is amazing and so informative, keep up the great work! Nellie is as tough as boots and that’s what helped her pull through 🙂
May 28, 2012 at 5:46 am
Hey Dr. Rayya, Jet here.
Omdog. What a horrible experience for Nellie. You and Nellies Mom were so smart and brave. Goes to show you what teamwork, expertise and love can do. Thanks for what you do Dr. Rayya. Sending belated birthday wishes to your husband. Lots of Jetty kisses and JJ hugs for you. Xoxoxo
May 28, 2012 at 9:52 pm
Hey Jet. Yes Nellie sure endured an ordeal. A vet and client working together is essential and allows for a great outcome. Thanks for your very supportive comment and my husband really appreciated our birthday wishes :-).
May 28, 2012 at 9:56 pm
Hey Dr. Rayya, Jet here.
Indeed… Nellie’s Mom went above and beyond…
Hope Mr. Dr. Rayya got lots of lovies from your K9s… I’ll send extra Jetty kisses and JJ hugs too!
May 28, 2012 at 9:53 pm
Big Big hugs back at you Jetty 🙂
May 28, 2012 at 9:57 pm
Hey Dr. Rayya, Jet here…
Awww shucks… I’m blushing… I love when humans call me Jetty and send me lovies!!!
May 28, 2012 at 8:49 am
Wow that was a scary moment, and a busy Sunday for you. When I worked at the clinic we had something similar. A Boston terrier at a bag full of Dove chocolate with the wrappers. In this case no seizure, but an upset tummy as everything came out, wrappers and all. You and Nellie’s mom did great under stress, BRAVO!!!!
May 28, 2012 at 9:56 pm
I have to admit I think cleaning chocolate flavoured vomit isn’t so bad. I bet it was still not enjoyable and I am glad you took care of your cheeky boston terrier patient. Thanks for the supportive comment :-). Keep up the great work at your end too.
May 28, 2012 at 10:49 am
I’m so glad this story has a happy ending! I had to look up “snail pellets” because I had never heard of them before.
May 28, 2012 at 9:59 pm
Hey Pam. I apologise for assuming everyone would know what ‘snail pellets’ were. They are just so commonly used in Australia to get rid of snails. People often spread them on their gardens. There are two prevalent types of snail pellets: green or blue in colour and both are quite lethal to dogs. More recently, they have created a new snail pellet that they say is safe around pets because it doesn’t contain organophosphate but instead pets can iron toxicity.
May 28, 2012 at 12:37 pm
Whew! I was on pins and needles worried that Nellie wasn’t going to make it.
I had to google snail pellets because I had no idea what they were. I’ve been told that crushed egg shells will keep snails away from vegetables and know that those will not make your dog ill.
I’m glad you had the opportunity to celebrate your husband’s birthday.
May 28, 2012 at 10:01 pm
Hey Jodi.
Best to stick to the crushed egg shells to keep snails away. Again I apologise for assuming everyone would know what ‘snail pellets’ were. They are just so commonly used in Australia to get rid of snails. People often spread them on their garden beds.
Yes it was great to finally have time off to enjoy pampering my hubby! 🙂
May 28, 2012 at 3:11 pm
What a terrible ordeal for both Nellie and her owner – and how brave was the owner to assist you when treating Nellie. She did good, didn’t she? I was relieved Nellie made a full recovery – what a gorgeous face – just look at those eyes!
Glad to finally got to celebrate your husband’s birthday!
May 28, 2012 at 10:04 pm
Hey Barb.
I was absolutely blown away with Nellie’s owner. She really did so well. I even pitched her a vet nurse/vet assistant job the next day. :-).
‘Nellie’ sure is a cutie. It was quite awesome to enjoy celebrating wally’s bday a week later 🙂
May 28, 2012 at 9:01 pm
I just couldn’t have coped – when my little Ming needed holding to take her stitches out, I just kept bursting into tears and in the end the vet nurse had to come and hold her. Nellie’s owner was so brave.
May 28, 2012 at 10:07 pm
Hey Rosie
I am very thankful Nellie’s owner managed to own up to the challenge. It can really be a very difficult thing to do. I am quite the wimp when it comes to my own dogs and I can totally connect with what you are saying.
Always great to hear from you!
May 28, 2012 at 10:35 pm
Few people think twice about slug pellets but for some reason dogs love the taste of them. Poor Nellie must have eaten a lot though. Well done you, Nellie and N’s owner – for her to look so good less than 24 hours later is testament to her treatment.
May 29, 2012 at 11:34 pm
Unfortunately with snail pellets, dogs don’t need to eat much to get significant poisoning. The blue pellets are the worse ones as you need a tiny amount to cause serious damage as compared to the green ones.
Nellie is a trooper and I couldn’t have saved her without her mom’s help and dedication. 🙂
May 29, 2012 at 4:21 am
Hi
Whee just wanted to let you know you are our sunshine – http://hutchagoodlife.wordpress.com/2012/05/28/amazing-awards/
xxxx
May 29, 2012 at 11:35 pm
Thank youuuuuuu for the amazing nomination…
You always put a smile on my face when I read your blog :-).
May 29, 2012 at 5:15 am
Well done! An amazing story. I’m really glad that Nellie is back to her bouncing self.
May 29, 2012 at 11:36 pm
Thanks Jo. ‘Nellie’s fighting spirit sure shined through. It is truly a great outcome for everyone involved.
May 29, 2012 at 6:14 am
How very scary for Nellie. Glad she is OK.
May 29, 2012 at 11:37 pm
It sure was. Nellie is back to her full hyperactive self 🙂
May 29, 2012 at 3:02 pm
Another poison I always warn everyone about is antifreeze for cars. Dogs for some reason feel it is appealing to ingest. I am always surprised at the amount of people that didn’t know that antifreeze is a poison for animals. I am so happy Nellie made it threw . She is a cutie and I am happy that her owner was smart enough to bring her to you when she had no idea it was poison.
May 29, 2012 at 11:39 pm
Thanks for bringing up a very important poison. I can’t agree more with you about the fact that so many dogs love to gulp antifreeze for cars. It’s insane! There are so many poisons that pets can get into these days and so we must really keep everything out of their reach.
Nellie’s owner reacted fast and that’s what saved her dog. Had she just left it for a few hours before calling me, we would have definitely had a very different outcome!
May 30, 2012 at 12:06 am
You know exactly how I feel about your saving Nellie! But what I want to know is, how did you celebrate in Sydney? Happy belated to your hubs. 🙂 xo nicole and gwendolyn
June 4, 2012 at 8:56 pm
Hey Nicole. My hubby’s best mate organised a house party & close friends showed up. 😉
June 2, 2012 at 8:12 am
Rayya ,I have picked you for the Sunshine Award I really like your blog. There are a few rules and after my short story I list them. I understand you are busy and might not have the time to complete but I picked you anyways Because you have a great Blog and gives so much sound advice.
http://sassybrat1904.wordpress.com/2012/05/31/did-you-hear-about/
June 4, 2012 at 9:01 pm
Thank you do much for your wonderful comment. I am so touched that you nominated my blog an award. I hope you keep enjoying it. 🙂
June 5, 2012 at 12:10 pm
Nellie is lucky to have such a wonderful vet to care for her
June 5, 2012 at 10:48 pm
Thanks heaps Fiona. I appreciate your ongoing support. Howz Lucy?
June 5, 2012 at 6:30 pm
Unbelievable what snail poison can do! Let this story also be an eyeopener for people who are still using this kind of stuff. I feel also sorry for the snails by reading this story (I have planted a Hosta, especially for the snails to eat, though they don’t bother my other plants). I’m so happy Nellie survived in the hands of two great people: you and the owner 🙂
June 5, 2012 at 10:50 pm
I really value your opinion. I think we myet focus on humane means to coinhabition with the other inhabitants on this planet. I hope all these horrible poisons will be exterminated soon.
Nellie is one tough cookie, that’s for sure.
August 27, 2012 at 7:31 pm
What a nightmare. Hats off to you, the owner and Nellie.