Daisy is a gorgeous, lively wire-haired Jack Russell terrier who is a much-loved family member. Daisy presented on the morning of Friday 29th April to one of our Morrinsville Companion Animal Vets, Georgie, with a large swelling on her neck that was causing her to have a great difficulty breathing. The swelling came up rapidly and looked like an allergic reaction to an insect sting and the owner said there were wasps around. There was also a bad smell coming from her mouth and her temperature was elevated too, so an abscess or infection was on the list of many possible causes.
Regardless of the cause, Daisy needed to be stabilised immediately before diagnostics could begin. Georgie and the dedicated nurses Kim and Sam acted quickly to provide oxygen, calming drugs, antihistamines and antibiotics but Daisy did not improve. Her ability to breathe on her own was deteriorating and we needed to Xray Daisy’s neck to look for a possible cause of the swelling and to provide her oxygen more directly. The owners consented to us placing Daisy under an anaesthetic so we could take x rays safely without Daisy becoming stressed and potentially causing her airway to close up.
Placing a tube down Daisy’s airway was incredibly difficult due to a large amount of swelling. The tube placed was half the size of the usual tube we would use in a dog her size. Daisy’s oxygenation improved once she had a tube placed and she was very stable under her anaesthetic. Xrays were taken and there was no object such as a ball or bone detected. The xrays were sent to an expert radiologist for emergency interpretation.
We next took samples with a needle from Daisy’s swelling to look under the microscope to check for signs of pus or allergic cells, as well as blood samples to check her blood cells and organ function.
After looking under the microscope at the fluid sampled from under Daisy’s swelling, it raised suspicion of a bleeding disorder or trauma to the neck. The fluid was just blood and there was no sign of infection or allergic reaction. The in-clinic blood tests showed that Daisy was dangerously anaemic (low red blood cells) and a clotting test-driven urgently to the IDEXX lab in Hamilton by our dedicated receptionist Julie, confirmed the diagnosis- rat bait poisoning. Daisy was bleeding into the neck area and this swelling was causing her to struggle to breathe.
Daisy unknowingly ate a rat that had eaten rat bait. After eating bait or a rat that has eaten the bait, the poison takes 2-3 days to cause an inability for the blood to clot. This can lead to uncontrolled bleeding anywhere in the body so can present in many different ways. It can show as visible bleeding from the nose, the whites of the eyes, bruising in the groin area or blood in the poo, urine or vomit. Sometimes, if the bleed is internal, the signs can be vague such as being low in energy or off food. If the bleed is into the lungs, you can see coughing and sometimes blood will be coughed up. In Daisy’s unusual case, she bled into the neck area, with no signs of bruising or fresh blood anywhere.
Daisy immediately received an injection of the antidote for rat bait poisoning- vitamin K. Vitamin K, however, takes up to 12 hours to start having an effect and Daisy was continuing to bleed into her neck. If the tube down her airway became obstructed with mucus or blood, it would need to be removed and a new one placed. Placing a new tube may prove impossible as the swelling was ever-worsening, and without an airway, poor Daisy would not survive.
There is a procedure called a tracheostomy, which involves cutting into the neck to access the airway further down the neck. Doing this procedure in a dog that cannot clot its blood would be very dangerous and cause even more uncontrolled bleeding. It was essential that we get Daisy a blood transfusion to replenish her red blood cells and provide her with another dog’s clotting abilities until the vitamin K could do its job.
A lovely owner with a gorgeous labrador called Winnie came to Daisy’s rescue and donated her blood to save Daisy’s life. The blood transfusion went well but Daisy was not out of the woods yet. Removing the airway tube too soon could cause her airway to close so we needed to wait until the swelling came down before we could safely remove it. We want to avoid a tracheostomy if we can, as this procedure isn’t without its own risks.
As this was now a Friday evening, in order for Daisy to have 24/7 one to one monitoring over the weekend, Georgie, Sam and Kim transported Daisy under anaesthetic to our excellent Waikato After Hours Veterinary (WAHV) service, which has nurses and vets working on-site through the night to care for critical patients. This service is second to none for after hours veterinary care in the Waikato and has vets and nurses performing a non-sleeping night shift where the pets get the complete attention they need and deserve. We find that having this service available means that our Anexa clients get the best care for their pets from night staff that are fresh and awake, rather than day staff who need to rest in order to give top-notch care during waking hours.
As much as we would have loved to keep caring for Daisy, by this point our team was exhausted and needed to rest and it was in Daisy’s best interest to have a fresh team. The caring team at WAHV continued our plan for Daisy. Her swelling came down slowly over the weekend under their close attention. The tube became clogged with mucus toward the end of the weekend so it had to be removed. The team was ready to do an emergency tracheostomy if needed, but thankfully, Daisy had enough airway open to finally breathe on her own. Daisy woke up and gave the nurses a big lick to say thanks!!!
When the after-hours vet called Georgie on Sunday to say Daisy was awake and okay, she could not have been happier. She promptly let the Anexa nurses Kim and Sam know and they too were beyond ecstatic.
As Anexa Veterinary staff, this is why we do this job – to get the best outcome we can for you and your companion. Daisy’s owners were dedicated, kind and appreciative and we enjoyed working with them to get Daisy better.
Daisy is now feeling much better – here a few photos post-recovery.