Posts Tagged ‘foxtail’

Murphy and Ruska

September 5, 2011

I refer to my last week at work as the “Murphy and Ruska Show” in honor of two delightful patients who arrived at my doorstep one day apart, each with a life-threatening disorder called pneumothorax. “Pneumo” means air and “thorax” refers to the chest cavity, so “pneumothorax” is air within the chest cavity.  If you’re scratching your head wondering, “Isn’t there supposed to be air in the chest cavity?” here’s what you need to know.  While the lungs are air-filled, the space surrounding the lungs, known as the pleural space, is normally devoid of air.  Pneumothorax refers to the accumulation of air with the pleural space. In order to understand how a pneumothorax causes difficulty breathing, it helps to think of the chest cavity as an empty barrel into which the lung lobes expand as they inflate (like balloons filling with air).  The lungs readily inflate with minimal effort because negative pressure (a vacuum effect) normally exists within the pleural space.  Fill the pleural space with air and the negative pressure is disrupted resulting in more effort required for lung expansion.  Make sense?

Murphy and Ruska were both observed by their families to experience an abrupt onset of labored breathing. Murphy also became subdued, a marked deviation from his normal wiggly-waggly Labrador self and he was unwilling to lie down.  Clever Murphy figured out that lying down makes labored breathing even more of a struggle.  In addition to working extra hard to breathe the normally ravenous Ruska refused her breakfast, a sure sign that this sweet Shepherd was off her game.

Normal Chest

The two most common causes of pneumothorax are penetrating chest cavity wounds that allow external air to enter the pleural space and leakage of air from the surface of a diseased or injured lung lobe.  Pneumothorax is readily diagnosed with a chest x-ray.  Have a look at the accompanying normal and abnormal x-ray images. In both views, the dogs are lying on their sides with their head end to the left and their tail end to the right.  You can see the spines at the top of the images.  Note the heart, the whitish round structure in the middle of the chest cavity. Air shows up black on an x-ray. Now notice how much more black (air) there is surrounding the heart in the pneumothorax image compared to the normal chest. Makes you want to become a radiologist, eh!

Pneumothorax

Murphy and Ruska were referred to me to figure out why they had leaky lung lobes.  The most common cause of pneumothorax is a blunt blow to the chest cavity (hit-by-car trauma is classic) forceful enough to tear a lung lobe and allow leakage of air into the pleural space. Ruska and Murphy were both closely supervised with no known trauma history.  Computed tomography (CT scanning) is my test of choice for solving the mystery of the leaky lung lobe. Murphy’s scan revealed multiple small blisters (aka, blebs or bullae) on his lung lobe surfaces.  Just as in people with this abnormality the blisters are thin-walled and capable of spontaneous rupture allowing air to leak into the pleural space. Fortunately, as was the case with Murphy, most lung blisters are self-sealing within a few days. Worse case scenario, a stubborn leaker can be surgically sealed. Murphy’s family has been forewarned that his multiple blebs will likely mean multiple penumothorax episodes.  They know what to be watching for and will return with Murphy any time, day or night, should his labored breathing recur. Murphy is now home, happy as can be with instructions to be a couch potato for the next two weeks with hopes of avoiding disruption of the body’s “bandaid” on his leaky lung blister.

Ruska’s CT scan documented a small walled off abscess on the surface of one lung lobe.  Given the time of year and where Ruska lives and plays, I’d be willing to bet my first born child that a foxtail plant awn is living within that abscess.  Fortunately, Ruska’s lung lobe leak resolved itself, and the pros and cons of surgically exploring the site versus long-term antibiotic therapy (foxtails shuttle bacteria wherever they migrate) were discussed and are still being considered.  I should be hearing back from Ruska’s mom sometime this week.  For now, this big girl is back home and, like her friend Murphy, she is doing her best to be a cooperative couch potato (easier for a Shepherd than a Lab!).

Our emergency room vets are used to seeing pneumothorax patients because hit-by-car trauma is so prevalent.  As a small animal internist I rarely see them, yet here were two within one week! (I suspect the third is on its way.)  Have you or a loved one (human or canine) experienced a pneumothorax?  Please do tell.

Best wishes for good health,

Nancy Kay, DVM
Diplomate, American College of Veterinary Internal Medicine
Author of  Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot is available at Amazon.com, local bookstores, and your favorite online book seller.

Advertisements

It’s foxtail season, again!

May 31, 2011

Photo © Margaret Birkhaeuser

 The emergency room docs I work with are  busy pulling foxtails out of eyes, ears, noses, and throats as well as from in between toes.  Such activity reminds me that it is once again time to blog about these pesky bristly plant awns that grow in abundance where I live in California.  In fact they are reported in most every state west of the Mississippi.  For more information about foxtails and the ways they wreak havoc, please read the blog I wrote right about this time last year.  

This year I’d like to tell you about a new way to prevent foxtails from finding their way into their favorite canine orifices (eyes, ears, nose, and mouth). Check out the OutFox Field Guard™ (www.outfoxfieldguard.com), the brainchild of a clever woman named Margaret Birkhaeuser. I suspect her invention was born as a result of multiple foxtail related trips to the veterinary hospital.  Have a look at Margaret’s site and you will see dogs modeling their mesh bonnets along with a video demonstrating the ease of attaching and detaching the device from a dog’s collar.  Believe it or not, dogs can drink and even carry toys in their mouths while wearing them!  A few of my clients who have purchased the product are completely sold on their investment.  

Photo © Margaret Birkhaeuser

If your dog has been a foxtail repeat offender I strongly encourage you to consider the OutFox Field Guard™.  Not only is it a great insurance policy to protect your dog’s health, think about the money you’ll save by eliminating trips to the vet clinic during foxtail season.  

Photo © Margaret Birkhaeuser

Has your dog been a repeat offender?  Please share your story.  

Best wishes for good health,   

Nancy Kay, DVM
Diplomate, American College of Veterinary Internal Medicine
Author of  Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook   

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot is available at Amazon.com, local bookstores, and your favorite online book seller.

Those Frustrating Foxtails

May 18, 2010

My littlest dog Nellie came in the house tonight sneezing.  Any other time of year and I would be unconcerned, but in late spring and early summer an abrupt onset of sneezing after being outdoors is a “foxtail in the nose alarm bell”.  I’ll be watching Nellie like a hawk for the rest of the evening. Any crinkling of her nose, ongoing sneezing, or bloody nose and she’ll be my first patient tomorrow morning. 

If you are unfamiliar with foxtails, count your blessings! These pesky, bristly plant awns grow in abundance throughout California and are reported in most every state west of the Mississippi.  Once the plant heads dry, they become hell bent on finding their way into dogs’ noses, ears, eyes, mouths, and just about every other orifice.  They can dive deep into a dog’s nostril or ear canal (beyond sight) in the blink of an eye. And a foxtail camouflaged under a layer of hair can readily burrow through the skin (a favorite hiding place is between toes).  Foxtails can wind up virtually anywhere in the body and associated symptoms vary based on location.  For example, a foxtail within the ear canal causes head shaking, under the skin a draining tract, or within the lung labored breathing and coughing.  Not only is the dog’s body incapable of degrading or decomposing foxtails, these plant awns are barbed in such a way that they can only move in a “forward” direction.  Unless caught early, they and the bacteria they carry either become walled off to form an abscess or migrate through the body causing infection and tissue damage.  Once foxtails have moved internally, they become the proverbial needle in a haystack- notoriously difficult to find and remove. 

Take the example of Emma Louise, an undeniably adorable Brittany Spaniel mix whose family told me that her favorite pastime is running through fields with her nose to the ground. They described her as a “foxtail magnet” having accumulated several in her ears and nose over the years.  I was asked  to  help figure out the cause of Emma Louise’s hunched back and straining to urinate. With abdominal ultrasound I discovered a gigantic abscess tucked up under Emma Louise’s spine, extending into her pelvic canal.  Given this girl’s history, I just knew there had to be a foxtail in there somewhere.  The question was, would we be able to find it?  

As is my medical tradition before launching a foxtail search, I recited a prayer to the “god of foxtails.” I then turned Emma Louise over to one of my surgical colleagues for exploratory surgery. After two hours of nail biting and a barrage of expletives originating from the O.R., I heard a shout of,   “Got it!”   The foxtail had been located and removed, and sweet little Emma Louise made a rapid and complete recovery.  Not finding the foxtail would have meant a lifetime of antibiotics to treat her foxtail induced infection. 

If you suspect your dog has a foxtail related issue, contact your veterinarian right away to find out what steps can be taken (at home or in the veterinary hospital) to rid your dog of this unwanted plant material.  Whenever possible, avoidance of foxtail exposure is the best and only foolproof prevention. If your dog does have access to foxtails, carefully comb through his or her haircoat a couple of times daily- checking ears and toes, too- to remove any that are embedded and poised to wreak havoc!  Have you and your dog experienced any foxtail nightmares?  If so, please share your story.

Best wishes to you and your four-legged family members for abundant good health, 

Nancy Kay, DVM
Diplomate, American College of Veterinary Internal Medicine
Recipient, American Animal Hospital Association 2009 Animal Welfare and Humane Ethics Award
Recipient, 2009 Dog Writers Association of America Award for Best Blog
Recipient, 2009 Eukanuba Canine Health Award
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life

Website: http://www.speakingforspot.com
Become a Fan of Speaking for Spot on Facebook 

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot is available at Amazon.com, local bookstores, or your favorite online book seller.

Tipper’s Trials and Tribulations

October 21, 2009
Tipper and Jacob

Tipper and Jacob

Tipper came to live with us just over a month ago.  We don’t know what he was called during his former life in Louisiana.  Like so many other dogs, Hurricane Katrina forced Tipper to adapt to a new name, unfamiliar humans, and an unknown environment (while undergoing treatment for heartworm disease).  Tipper is the definition of adaptable, and he came through all this change with flying colors and a big ‘ole smile on his face.  He’s a big beefy mutt- likely the result of a Doberman and Shepherd rendezvous.  His tail is jet-black with a white tip (thus the name Tipper) and never quits wagging.  My son Jacob, then an undergrad at Colorado State University, signed up to adopt a Katrina rescue dog.  He was paired with Tipper (a match made in heaven) and the two have been inseparable, up until now that is.

Jacob graduated in May with a Bachelor of Science degree in wildlife biology and minors in Spanish and conservation (can you sense a mama bragging here).  He is now off in Guatemala studying jaguars.  He figured he could trust his two parents, both veterinarians, to take care of his dog.  So now Tipper has become part of our canine trio enjoying the life of a country dog. In addition to goats, and horses (and horse manure), and deer, and cats, and foxes, and wild turkeys, Tip’s experienced some unexpected mishaps during his short stay with “grandma” and “grandpa”.  

Week one:  It’s foxtail season here in California, and one of these annoying plant awns landed deep in Tipper’s ear canal resulting in furious head shaking. Using an otoscope and a special type of instrument called an “alligator forceps” I fished the foxtail out of his ear canal. Tipper and his eardrum were immediately relieved. Problem solved. 

Week two:  Over the course of a few hours, Tipper vomited six times and his face swelled to the point of his eyes being closed.  Poor boy must have ingested or been stung or bitten by an insect or spider resulting in a severe allergic reaction.  Some antihistamine and TLC were administered and, within 24 hours, Tip was good as new.  Problem solved. 

Week three (at dusk):  Tipper came scampering into the house with his eyes at half-mast and reeking of “Eau de Skunk.”  Clearly, the little black and white critter took good aim and hit poor Tipper right between the eyes.  Fortunately, Nellie and Quinn, his two partners in crime managed to avoid the skunk- they’ve learned from past mistakes.  Tipper received eye ointment and his first California baths.  Problem solved (although he still smells a bit skunky). 

Week four:  One minute the dogs were ripping around the horse pasture, the next minute Tipper was three-legged lame.  Manipulation of his affected leg revealed a torn ligament in his knee. Tip’s going to need to have surgery followed by a couple of months of rehabilitation therapy.  Problem will be solved. 

I hate to think what week five holds in store……………

Wishing you and your four-legged family members good health,

Dr. Nancy Kay
Specialist, American College of Veterinary Internal Medicine 

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot is available at Amazon.com, local bookstores, or your favorite online book seller. 

Join our email list – http://speakingforspot.com/joinemaillist.html

Look for us on Twitter – http://twitter.com/speakingforspot

Become a Fan of Speaking for Spot on Facebook

Listen to Dr. Kay’s interview – A Veterinarian Advises “How to Speak for Spot” on NPR’s Fresh Air with Terry Gross –