guest veterinarian archive
print story
email storyTop 5 life-threatening surgical emergencies
*The following information has been provided by Dr. Phil Zeltzman, a board-certified veterinary surgeon from Whitehall, Pennsylvania as a courtesy to goodnewsforpets readers. The following article is only for the sharing of knowledge and information; it is not intended to replace consultation of a veterinarian or other qualified pet care professional. To subscribe to his newsletter,here.
There are so many surgical emergencies that it is tough to limit this newsletter to the top 5. So to sort through them, I've asked myself which ones are common, and which ones requires surgery TODAY, or even within the next few hours, to avoid death or serious long-term complications. So although this list is definitely subjective and debatable, here are the results...
1. Bloat
Aka twisted stomach or GDV (Gastric Dilatation Volvulus).
We just dedicated 2 newsletters to this complicated disease, so what follows is just a quick reminder.
Bloat is the ultimate dog killer. The stomach becomes hugely distended with air and can possibly twist on itself.
From there, the enlarged stomach puts pressure on all organs & wrecks havoc in the entire body.
The main sign is that the dog, typically a large breed (Great Dane, German shepherd, Mastiff, Lab, Golden...) retches, ie tries to vomit but cannot. The belly becomes large and tense. This is the ultimate emergency, so you need to take your dog to a vet or an emergency clinic or a surgeon ASAP for "stabilization" and surgery.
Bloat is very rare but has been described in kitties...
2. Spleen masses
Masses often grow in the spleen. Worse, they can rupture, ie break open, and cause internal bleeding. It is a common emergency, day or night.
Of course, you don't wake up one morning and say: "Hm, my dog has a spleen mass." It is typically diagnosed by palpation (ie feeling the belly) and/or X-rays and/or ultrasound.
We don't know what causes them. They can be benign, such as a pocket of blood (hematoma) or malignant (ie cancerous) and very aggressive. The most common type of cancer in the spleen is hemangiosarcoma. There is a 50-50 chance that any given spleen mass is benign vs. malignant.
In some cases, the dog needs a blood transfusion. Surgery requires removing the spleen. The horrible dilemma pet owners face is deciding to do surgery on a typically older dog, who has a 50-50 chance or having cancer...
A ruptured mass always requires emergency surgery, because it is the only way to stop the internal bleeding.
A non-ruptured mass is not a true emergency, since we don't know when it will "pop."
3. Foreign bodies
Not all foreign bodies are true emergencies. For example, an obviously rounded, not-too-big rock in the stomach is usually not a life-threatening emergency... until it decides to go down into the intestine, where it can cause a blockage. And nobody can predict when this is going to happen. Plus, there is a chance it could be removed with an endoscope.
That said, it seems that most of the time, a foreign body in the intestine is an emergency because pet owners will notice vomiting once the foreign body is in a precarious location. So the blockage should be relieved ASAP. The risk of not rushing to surgery is that the intestine can start to die off from the pressure (this is called necrosis), and intestinal contents (a polite way to say poop) can leak into the belly and cause an infection (septic peritonitis).
Cats are attracted to "linear foreign bodies" which include anything that looks like a ribbon or a string. I think that it is fine for a cat to play with such "toys" as long as they don't swallow them, and as long as they are supervised at all time while playing. All potential linear foreign bodies should be removed promptly from their reach. The entire family should be informed about this!
And if anybody complains about that rule, ask them how they will feel if their cat's intestine is cut open, or if they will pay $2,000 for surgery.
Recent foreign bodies we have removed (and mentioned in this newsletter) include a mango pit in a Mastiff, a TON of grass in the stomach in various dogs, a rubber band in a kitty etc. We recently had 2 dogs who went through the trash and ate tampons. Another one ate several rolls of toilet paper.
What is wrong with the world???
4. Slipped disc in the back
At worst, this can cause enough pressure on the spinal cord to cause paralysis of the back legs. Again, time is of the essence. The spinal cord has very little tolerance for pressure, and beyond a certain point, paralysis could be permanent.
Granted, if paralysis is not present, surgery is not necessarily urgent. The problem is that nobody can predict if and when the disc will slip further and cause paralysis. In the past month, I have probably spoken with half a dozen people (pet owners or vets) who didn't believe this. I'm certainly don't have a crystal ball, but all of these poor dogs ended up paralyzed... because people waited too long.
So again, if the patient is paralyzed, time is of the essence.
Now, why should we consider a disc hernia was a life-threatening emergency?
Sure, it's debatable. Let's just say that few people are willing to keep a dog that is permanently paralyzed and/or incontinent... It may be doable with a Doxie, but it becomes more challenging (although not impossible) with an 80 or 150 pound dog...
The most common breed we treat is the Doxie, although it can happen to virtually any breed of dog. Cats are rarely affected. Actually, we think of tumors whenever a cat has spinal issues. But that's an assumption. Cats can indeed have a slipped disc, so please don't euthanize a cat based on the assumption that they have a tumor in their spine!
Diagnosis includes a fancy X-ray study (called a myelogram), a CAT scan or an MRI to confirm the exact location of the problem and what the problem is (slipped disc, infection, tumor etc).
Surgery involves removing the disc to relieve the pressure on the spinal cord.
5. Slipped disc in the neck
A severe disc can cause paralysis in all 4 legs, but most of the time is causes severe pain and varying degrees of wobbliness.
Diagnosis and surgery are somewhat similar to the above description for slipped discs in the back.
The most common breed is the Doxie, although it can happen to virtually any breed of dog. Beagles often display the most severe pain. More than other breeds, it seems that when a Beagle has a slipped disc, it is heart breaking... Cats are rarely affected.
Hopefully, none of these situations will happen to your pet. If they do, at least you'll be informed and you'll know what to do: stay calm, call your vet or your local emergency clinic, and take your pet there ASAP. A consultation is always the first step. Then you and your vet need to decide whether or not your pet needs life-saving surgery.
Think your dog is well trained?
It will take 4:30 minutes of your time to find out the answer.
youtube.com/watch?v=rJlV7CT86aU
