Watch out for these holiday threats to your pets


NorthStar VETS’ Chief of Staff, Dr. Daniel Stobie, has these reminders for pet owners, which are always important to remember at this time of year.

Decorations

Some pets like to chew on decorations, which can be harmful to their health.Cats love to play with tinsel and ribbon. Try to keep pets from playing with these decorations as they can quickly and easily become what’s called a linear foreign body, which means something stuck in the esophagus or intestines.

Some pets, especially puppies, will chew on Christmas lights and wires. In addition to the obvious electric shock risk posed by this, pets can also be burned in their mouth, and experience pulmonary edema, which is fluid accumulation in the lungs.

Plants

Poinsettias (Euphorbia pulcherrima) are mildly toxic to animals and pets should be discouraged from eating them. Additionally, the water at the base of Christmas trees can cause gastrointestinal upset to pets, and pet owners should do all they can to keep pets from drinking it.

Food

Limit table foods that pets eat, and always avoid bones.Chocolate and certain nuts can be toxic to pets, especially dogs. The main chemical in chocolate that creates toxicity is called theobromine. Dogs who eat too much chocolate, especially if it is dark chocolate or baker’s chocolate, may experience tremors and heart abnormalities. This can be life threatening to your pet.

Also, while many people enjoy sharing table food with pets at a holiday meal, limit it to just a couple of tablespoons. Pets are more sensitive to sudden dietary changes and fatty foods, and can experience pancreatitis, which is an inflammation of the pancreas. Pancreatitis can be life threatening.

And never give bones to your pets! They can splinter and do damage to the intestines as they pass through your pet, or get stuck and become a foreign body, which may require surgery to remove.

Other threats

Anti-freeze is always an issue for pets when the weather gets cold. The active component of anti-freeze, a chemical called ethylene glycol, causes kidney failure. The good news is that there is an antidote, so get your pet to the veterinary emergency hospital as soon as you can as the situation becomes more life-threatening after several hours. Because ethylene glycol is an alcohol-based chemical, pets who have consumed anti-freeze appear “drunk.”

Call the animal poison control or pet poison hotlines if you think your pet has eaten something poisonous.

By knowing what the biggest holiday threats are and taking some time to create a safer environment for your pet, you can avoid a potentially life-threatening situation for your pet. As always, be prepared and know where your nearest veterinary emergency hospital is and how to get there, and have their phone number programmed into your phone or posted on your refrigerator. You might even want to create an account for them to speed up the check-in process.

If NorthStar VETS is your nearest veterinary emergency hospital, know that we are always open, day and night, even through the holidays. Our phone number is 609.259.8300.

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Local Veterinarian Runs Animal Shelter in the Wake of Hurricane Sandy


Dr. Boncheck looks out over the clothing and pet check-in areas at the shelterThe scene is a little bit chaotic. All around this post-Hurricane Sandy animal shelter, set up in a gymnasium at a church in Burlington Township, people come by to visit with their pets, while others come through the gym to use the shower room or to select clothing they’ll need while they’re in the shelter.

Since last Monday, this place has been where you’d be most likely to find Rebecca Boncheck, VMD, a veterinarian and owner of the Chesterfield Veterinary Clinic in Bordentown, NJ. Dr. Boncheck is also in charge of the Burlington County Animal Response Team (CART), a county organization that works with similar groups state-wide to help animals in the event of a disaster such as Hurricane Sandy. Ann, a volunteer at the shelter, handles check-in for the pet shelterFor the past week, she has done everything from setting up the dog, cat and isolation wards, to examining and treating animals, managing an inventory of donated items, and building all of the protocols, processes and volunteer staff needed to make this animal relief effort a well-oiled machine. A few days in, she feels like the operation is working well, although there are still needs to be met. Because of what she’s built, many similar organizations will be looking to Dr. Boncheck in the coming months as a thought-leader on the best way to set up and run a shelter like this in the face of a disaster.

A technician puts ear medication on a beagle staying at the shelterThe outpouring of support at this shelter in Burlington Township has been tremendous, and so has been the need. As people displaced by the storm, some left only with their closest family members and the clothes on their back, try to cope and figure out their next move, the veterinary and local volunteers do everything they can to make the experience as comfortable as possible for the pets brought in with their owners. Animals here receive exams and necessary treatments, they get walked and played with by volunteers, and see their owners every day.

Dr. Boncheck shows Phil Barnes of NorthStar VETS some of the procedures she's built that enable the shelter to run smoothly.What these shelters and organizations have been doing around the state to help animals get rescued, cared for and reunited with their owners has been amazing. NorthStar VETS has been approved to send its staff down to help, and everyone from the NorthStar VETS Chief of Staff, Dr. Daniel Stobie, to the veterinary technician team, have all had a chance to visit and help these animals in need.

To donate needed items to this shelter, contact the Fountain of Life, located at 2035 Columbus Road, Burlington Township, NJ 08016.
A Pomeranian relaxes in a crate at the Burlington County Animal Rescue Team Shelter A veterinary technician checks on pets in the dog ward at the Burlington CART shelter Many items have been donated to the shelter, and have been instrumental in helping the animals staying there In the distance, a volunteer walks a dog staying at the shelter. The exercise is good for the animals, who may not be used to being crated. A cat looks out of its cage to catch a glimpse of the activity going on around the cat ward. Even birds, ferrets and reptiles were brought to the shelter.

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Burlington County CART names NorthStar VETS as designated veterinary emergency care facility


This just in from the Burlington County Animal Response Team:

“In response to the tropical storm Sandy potentially affecting the NJ area, the Burlington County Animal Response Team (CART) has been notified of an expected pet-friendly emergency evacuation center to open Monday, October 29, 2012 at the location named below. CART is equipped to provide temporary shelter and basic first aid to animals at this location.

If the need arises, the Burlington CART will refer any emergent care cases to NorthStar VETS from its evacuation center. For more information including evacuation preparedness with your pet, please see the CART Facebook page at http://www.facebook.com/BurlingtonCountyAnimalResponseTeamcart

The address is: Fountain of LIFE

2035 Columbus Road

Burlington Township, NJ 08016

Shelter will open at 8am Monday October 29, 2012.”

The above information comes from Dr. Rebecca Boncheck, Deputy Veterinarian for the New Jersey Disaster Response Team. NorthStar VETS has been identified as the closest 24 hour, emergency veterinary facility to this shelter and will be their first line in handling illness and injuries that the shelter is not equipped to handle. Also, NorthStar VETS is the designated location for overflow of this facility in the event that the volume of pets requiring shelter exceeds their capacity. In addition, NorthStar VETS is prepared to board any pets from other veterinary practices or the general public in need of shelter as well.

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Chocolate toxicity in pets


Watch for chocolate toxicity with pets at Halloween

With Halloween approaching, the criticalists at NorthStar VETS thought this would be a good time to pool their collective experiences and offer some suggestions for managing dogs that ingest chocolate. The tips and points provided below are as much based on their experiences in various settings treating many affected dogs, as what may be found in texts and citations. With that, they hope some of the information below will be helpful to you.

Understanding chocolate toxicity in pets

  • In most chocolate compounds, theobromine is the predominant toxic compound, with methylxanthines and caffeine present in much lower concentrations.
  • It is not always clear how much or what kind of chocolate a pet consumed after-the-fact. For animals that ingested chocolate from home-made products or from bakeries, it is especially difficult to identify the exact amount of chocolate used.
  • The Veterinary Information Network (VIN) provides easy-to-use calculators to determine if a pet consumed a toxic amount of chocolate. There are excellent tables and calculators available for smart phones, as well. Regardless, using good clinical judgment, assessing each patient individually and often is more important than trying to forecast what signs to expect and when. As with other intoxications, there is lots of interpatient variability. We become concerned about toxicity and likely need for inpatient observation when dogs eat more than 2 oz/kg of milk chocolate.

Diagnosing chocolate toxicity in pets

  • While not something to share with every client, chocolate ingestion is seldom fatal if pets are treated symptomatically, appropriately and aggressively, even when early decontamination is not possible. When dogs succumb, it is generally due to arrhythmias, respiratory failure, or severe pancreatitis.
  • Typically, chocolate produces marked emesis such that the actual exposure is less than what the dog actually ate.
    • EXCEPTION: YOUNG LAB RETRIEVERS and the like!
    • If they do vomit, they will often eat it if not careful.
  • Almost all dogs will become mildly symptomatic 2-3 hours after ingestion.
  • Initial clinical signs (observed within 6-8 hours after ingestion): polydipsia, restlessness, vomiting and diarrhea.
  • Polyuria, tremors, tachycardia, tachypnea, hyperthermia, arrhythmias are generally seen after 8-12 hours.
  • If a client suspects chocolate ingestion, and no signs are observed six hours after suspected exposure, it is unlikely this dog will become sick.
  • Some intoxicated dogs will have “paradoxic” signs, e.g.
    miosis, sedation, bradycardia – Absence of classic signs does not rule out exposure.
  • Because of high fat content of many chocolate products, pancreatitis may develop 24-48 hours following ingestion.

Treating chocolate toxicity in pets

  • In general 3% hydrogen peroxide is the only product we occasionally advise for “at home” emesis induction. Salt and ipecac are not recommended. 1 ml/lb, up to a maximum of 45 mls (3 tablespoons) may be given safely.
    • Outdated peroxide (flat, not fizzing) will not work. Peroxide may be mixed with a small amount of peanut butter, yogurt or vanilla ice cream without compromising efficacy.
    • Peroxide is more likely to work if the dog is walked after it is given versus sitting in one place after administration.
  • Apomorphine (dogs only) may be given in-hospital, either IV or conjunctival. In rare cases when marked sedation is observed, naloxone will reverse depression induced by apomorphine, but may actually exaggerate the vomiting. This is not ideal, as repeated vomiting will cause further dehydration in an already compromised pet. Bottom line: try not to reverse unless the pet is obtunded or hypoventilating.
    • Typical apomorphine IV doses are 0.03 to 0.04 mg/kg.
    • Xylazine (0.44mg/kg) IM is the emetic of choice in cats (for which chocolate ingestion is admittedly rare).
    • Consider prescribing maropitant (Cerenia) or dolasetron (Anzemet) after emesis has been successful to help with patient comfort, without the risks associated with naloxone as noted above.
  • Theobromine has a long half-life and undergoes entero-hepatic recirculation. Thus, repeated doses of activated charcoal (AC) are given. Recommendations vary, but we give 1-2 g/kg (~5 ml/lb of Toxiban) every 4-6 hours (while symptomatic), almost never needing to be given after 24 hours following ingestion. Most activated charcoal suspensions are available with and without cathartic.
    • A generally safe rule of thumb (that may be applied to most, though not all intoxications) is to give AC with a cathartic (e.g. sorbitol or MgSO4) for the first dose, then AC WITHOUT a cathartic for subsequent doses.
  • While acepromazine is not an anxiolytic in the dog, it appears to be very effective for managing the marked agitation observed with this toxicity. We do not give acepromazine in rare cases when seizures occur. We prefer to manage seizures in this setting with a constant rate infusion of benzodiazepine, such as diazepam. Propofol is also reasonable, but its use requires uninterrupted patient observation (for apnea).
  • Barbiturates are likely effective but currently not available.
  • Muscle tremors often respond to methocarbamol. If the injectable form is not available or IV access is not possible, tablets can be crushed and given per rectum.
  • Try to avoid aggressive cooling measures in hyperthermic dogs, such as cold water baths.
  • We do not treat modest tachycardia; however a heart rate > 160 beats/min in a dog with associated symptoms should probably be treated. Some sources advise using metoprolol, or other seldom prescribed anti-arrhythmics not stocked in most practices. Propranolol, to effect, is acceptable, and can be given rectally if other access not available.
  • Theobromine accumulates in urine and can be re-absorbed through the bladder wall. Thus, dogs should be walked hourly. If recumbent, place a urinary catheter and evacuate the bladder hourly or continuously (closed collection system).

NorthStar VETS criticalists and emergency veterinarians are always happy to speak with you if you have concerns about any of your patients – please call us – we don’t bite – not even at Halloween!

Reid Groman, DVM, DACVIM, DACVECC
Joshua Portner, DVMDiplomate, American College of Veterinary Emergency and Critical Care
Originally from Long Island, NY, Dr. Groman received his veterinary degree from Colorado State University in 1994. After completing an internship at Texas A&M University, he worked in general practice for two years only to return to the university to complete a residency in internal medicine in 2000. Because of his love of learning, Dr. Groman then went on to pursue and complete his residency in emergency medicine at the University of Pennsylvania in 2003. His passion for kidney disease led him to a fellowship in renal medicine and hemodialysis at the University of California-Davis in 2003.

Prior to joining NorthStar in October 2010, Dr. Groman spent eight years on clinical faculty at the University of Pennsylvania, where he remains an adjunct clinical assistant professor helping to mold future veterinarians. Dr. Groman is active on several committees within ACVIM and ACVECC. His professional interests include acute kidney disease, extracorporeal therapies, and general emergency medicine. Outside of work, Dr Groman likes golfing, hiking, and traveling with friends and family.

Joshua Portner, DVM, DACVECC
Joshua Portner, DVMDiplomate, American College of Veterinary Emergency and Critical Care
Dr. Portner grew up in Southern New Hampshire. He obtained his bachelor’s degree in Biology/All-College Honors from Canisius College in Buffalo, New York, and his veterinary degree from Tufts University School of Veterinary Medicine in Massachusetts in 2004. After graduation from Tufts University, Dr. Portner completed a rotating internship in small animal medicine and surgery at Alameda East Veterinary Hospital in Denver, Colorado, and went on to complete his residency in Emergency and Critical Care at Ocean State Veterinary Specialists in Rhode Island in July of 2008. In 2009, Dr. Portner passed the specialist certification examination and became board certified in Emergency and Critical Care Medicine.

Dr. Portner has special interests in mechanical ventilation, nutrition for critical patients, and transfusion medicine. Along with membership in the Veterinary Emergency and Critical Care Society (VECCS), American Veterinary Medical Association (AVMA), and the New Jersey Veterinary Medical Association (NJVMA), he has also been a member of the International Veterinary Academy of Pain Management (IVAPM) and the International Sled Dog Veterinary Medical Association (ISDVMA), as well as several state associations. During his residency, he was a member of the Rhode Island Disaster Response Team, which is an organization responsible for providing medical care to sick and injured animals during a state of emergency.

Dr. Portner joined the NorthStar VETS team in November of 2008. He is currently an active member of the Policy and Procedure Comittee and runs the Blood Donor Program for the hospital. Dr. Portner has led several lectures for technicians and doctors in the hospital, as well as for members of our referral community. Most recently, he has become a member of the hospital’s Infection Control Comittee and was the lead team member during the control of a canine influenza outbreak in the central NJ region. Dr. Portner is currently working on a few publications for veterinary journals, one of which is expected to be published in 2010. In his spare time, he keeps busy by building furniture, playing indoor soccer, shooting archery, and going to the movies.

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Paying it Forward


Yesterday Dr. Jennifer Kim experienced one of the most altruistic acts among her clients.  A past client, who had a dog that succumbed to cancer, came in to say hello, but also to do what he called ‘pay it forward.’  During his dog’s treatments, an anonymous acquaintance had gifted a couple of treatments.  He was so touched by this act, that he came back to do the same thing for someone else.  He requested to pay for a treatment for another patient he had met while his dog was alive anonymously, and chance would have it, that dog was coming in later in the day.  You can only imagine the smile and warm hearts we all had when the owner went to check out to find her bill was paid already.

So how can you pay it forward?  Give to Vet-I-Care, it is a foundation that allows people with financial hardship to have their beloved companions treated.  Donations can be given to the foundation as a whole, or to Erin’s Hope Fund for cancer patients.  The owner who ‘payed it forward’, also made a donation to Vet-I-Care and will have a star on our wall in the lobby to honor his amazing dog.

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Holiday Threats for your Pets


Hi Everyone!

The other day Dr. Stobie and I were having a conversation about how information is being shared in the way we live today. How do you like to receive your information? Do you get your news from Facebook status updates, Tweets, watch the morning news or still have time to pick up the paper?

We do our very best to get information to you quickly and take advantage of multiple channels. But, this past week we thought you would be even busier with the holidays and so…we decided to make you the first NorthStar VETS Minute video so that you get the information you need to make sure your pets are safe and so that we can wish you Happy Holidays in person…(even though it’s virtual 😉

We wish you Happy Holidays and in case of emergency we are here for you and your companion 24/7. Just call us! 609.259.8300

Watch holiday threats for your pets on YouTube!

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Santa Paws is coming to NorthStar VETS


Join us for our 2nd Annual Santa Paws Pictures at our NEW! location!

315 Robbinsville-Allentown Road, Robbinsville, NJ 08691

Your chance to stop by NorthStar VETS for a photo with your companion on Santas’s sleigh.  No pets?  That’s ok, all are welcome!  And in the spirit of giving we’re donating all of the proceeds to the hospitals foundation, Vet-i-Care dedicated to helping keep families and their companions together.

View our Santa Paws 2011 Photos Here!

To learn more about Vet-i-Care, please visit www.vet-i-care.org

Some of last years photos:

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2nd Annual NorthStar VETS Stashmasters are back for Movember


That’s right! The NorthStar VETS Stash Masters are back to raise “mo” money to help raise raise vital funds and awareness for men’s health, specifically prostate cancer and other cancers that affect men.

They have made yet another appearance here at NorthStar VETS! So if you’re wondering why our veterinary care technicians, Stephen, Dan V., Dan B., Jim, Josh had a little more facial hair than usual, why our staff surgeons Dr. Garrett Levin, and Dr. Ben Staiger were less clean shaven, turned your head sideways while trying not to stare at our Emergency Supervisor, Dr. George Motley, and Emergency Veterinarian, Dr. Joshua Sprague, or saw some guy sporting a NorthStar VETS polo walking around fixing things with some extra scruff, (Facility Manager, Gavin) it’s all because these fellows sacrficed their handsome looks to raise money and awareness for the month formerly known as November. In our generous efforts toward the community, and other national causes November is now considered Movember at NorthStar VETS!

Before the “Mo”

Check out some of these “Mo’s” that our team has sprouted here in the hospital!

Eileen and Gavin

(from left to right) Dr. Garrett Levin, Dan Vinai, Dr. George Motley

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Interventional Radiology Provides Good Quality of Life for Dog


Hi Everyone!  Interventional Radiology is no longer just for humans, we are bringing it to veterinary medicine! It is with great enthusiasm I am pleased to introduce one of our two newest stars (stay tuned to learn about the 2nd):

Interventional Radiology.

Interventional Radiology (IR) refers to a subspecialty of radiology in which advanced imaging techniques are utilized to guide the delivery of materials for diagnostic and therapeutic purposes.  Veterinary IR procedures and case management are typically team efforts and are part of an initiative at NorthStar VETS directed toward providing advanced therapies for companion animals in a minimally invasive fashion. This approach to treatment facilitates shorter hospital stays, decreased pain, and a more rapid return to function. This new service will be helpful in providing patients with more options and is currently only available at our hospital.

On November 8, 2011 we performed our very first Interventional Radiology Case:

Meet Jake!

Jake is a 12-year old MC Australian Shepherd who presented to the internal medicine service with a history of straining to urinate and bloody urine.  His signs were progressive to the point where he was only dribbling urine and his bladder was very large and uncomfortable.

On ultrasound his prostate was found to be asymmetrically enlarged and mineralized (often a sign of neoplasia).  It was suspected that Jake had a urethral obstruction secondary to prostatic neoplasia.

Ultimately, prostatic cancer is fatal but many dogs can enjoy a good quality of life for 6-12 months.  Jake’s inability to urinate made his condition immediately life threatening.  In order for Jake to live, he needed a way to have his urethra opened to allow him to urinate normally.  More traditional methods might have included surgery to make an opening from his bladder through to his side.  However, this procedure requires surgery and has the potential for many complications.

The interventional radiology team comprised of two surgeons, Drs. Levin and Staiger, and an internal medicine specialist, Dr. Hammer, placed a stent in Jake’s urethra that opened up his urethra and allowed him to urinate normally.  The procedure was done non-invasively (no surgical incisions) and Jake went home the next day urinating with a normal stream.

Below is a radiograph of Jake’s abdomen after the procedure.  The stent can be seen in the back of his abdomen behind his bladder.

After speaking with Jake’s mom today, we were excited to hear how well he is doing and how his quality of life has dramatically improved.

The interventional radiology and endoscopy team is now able to provide many procedures including urethral stenting, ureteral stenting, tracheal stenting, and anything else you can think of.

NorthStar VETS is very excited to be the 1st referral and specialty hospital to offer this service. Learn more here:

Please contact NorthStar VETS at 609.259.8300 if you have a patient  that you think you would benefit from our new cutting edge service!

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Dog Makes Miraculous Recovery


Sometimes, our stories, do have happy endings!  Today, I am sharing a guest written blog from our clients perspective on a case that was seen by our Internal Medicine department, more specifically Dr. Justin Guinan, and our technician Ann.  Please read on to see how the NorthStar VETS Team helped create a happy ending.

Case: “Phoebe” Thwaite is a 2-yr old female English Bulldog. She presented in March 2011 at 1.5 yrs of age for a one-month history of regurgitation (not holding down food or water), lethargy and dramatic weight loss. She had a megaesophagus (when the esophagus, the tube from the mouth to the stomach, becomes dilated, looses tone, and cannot transport food to the stomach, resulting in regurgitation) on x-rays.

Here is her story from the words of her mother:

My husband and I have been rescuing animals since we got engaged and moved in together about 10 years ago.  At one point, we had 4 dogs, 3 of them rescues, in the house.    We rescued all 3 as healthy animals, but they all eventually ended up with life-long illnesses that needed to be monitored.

Our Min Pin, Ricky, developed diabetes and would eventually go blind.  Jaq, our German Shepherd, had severe allergy issues and Exocrine Pancreatic Insufficiency (EPI).  And Nugget, our Chihuahua, who is still with us, has Addison’s disease.

When it came time for a new dog, I wanted a Bulldog puppy.  Although we are still very committed to rescue, we were just looking to have a puppy that didn’t come with baggage and medical issues for a change.  I met Phoebe and that was it.  For the first year or so of our lives together, she was a typical puppy, but she also has a tremendous amount of personality.  I can be mad at her for eating our sofa one minute and laughing hysterically the next as she jumps in my lap and smothers me with kisses.  Everyone that meets her just loves her (ask your staff).

She turned one on October 1, 2010.  The following February, she started throwing up and I couldn’t get any food into her.  My Chihuahua had been sick with a little cough just a few weeks earlier, so I thought she just had a virus like he did.  I took her to our local vet, Blackwood Animal Hospital, to get checked out and hopefully get some meds to settle her tummy.

That was the first time I heard the words, myasthenia gravis.  I was completely blind-sided with this possibility.  X-rays were done showing her enlarged esophagus.  There are very few reasons a dog would get an enlarged esophagus, and of course, the most likely reason, myasthenia gravis, is very expensive to test to draw that conclusion.  We were advised to try different things in order to get food into her stomach to see if this just went away on its own, which it could also do.  We took her home and tried everything – we fed her at an elevated level to have gravity help us; we danced with her around the kitchen after each meal; we had her sit like a person and hand-fed her.  Sometimes food would make it down, but most of the time it didn’t.

Exactly one month to the day later, I took her back to our vet; we knew it was bad – she was skin and bones and just couldn’t eat anymore.  They immediately told me she needed a specialist and Northstar VETS was one of three in the tri-state area that they recommend with an internal medicine vet on staff.  I made the appointment and took her up there the next day.

This was my first meeting with Dr. Guinan and Ann.  They were so nice.  I was very upset and my husband was traveling so I was alone.  Dr. Guinan took his time and explained everything to me about what he was going to do.  Of course, the first priority was to save her life.  She had lost over 20 lbs. in a month!

Dr. Justin Guinan did a special blood test called an acetylcholine receptor antibody test. This test diagnosed her with Myasthenia Gravis (an autoimmune disease that interrupts the way nerves communicate with muscles and causes muscles to become weak and not function correctly). Phoebe’s muscles around her esophagus were affected and she could no longer transport food and water to her stomach. She was hungry, and would eat, but could not utilize the food, causing her to loose weight rapidly.  Essentially, she was starving.

They had to keep her for a few days as they scoped down her esophagus into her stomach and inserted a feeding tube.  They were also going to run blood work to rule out some other illnesses and of course run the test for myasthenia gravis.  When I left Phoebe that day, I really wasn’t sure if I’d see my puppy again.

Feeding tube.

Dr. Guinan put Phoebe under anesthesia and placed a PEG tube (percutaneous endoscopically placed gastric feeding tube). The tube went into her stomach through her body wall and allowed us to put food, water and medication directly into her stomach. She was started on a medication called Mestinon to treat the Myasthenia Gravis and tube feedings for nutrition and weight gain. She did not receive anything by mouth to avoid regurgitation.

She stayed at NorthStar for a couple of days and then we went to pick her up.  My first look at her with the feeding tube was overwhelming.  I’m not sure what I thought it would look like, but the way it protruded from her body definitely caught me off-guard.  We had very detailed instructions on what we had to do as far as feeding her and keeping her hydrated.  We also had three different medicines to give her.  She was to get nothing by mouth for a while.

We were very stressed when we first brought her home.  She was to be fed 4x a day via the feeding tube, and she was to be given her medicine and water via feeding tube as well.  She had to be separated from the other dogs at feeding times and I had to keep her from the water dish they all use.  Her food had to be special ordered and mixed with water and inserted into the feeding tubes ahead of time.  We got her t-shirts that we cut to fit her properly.  The t-shirts helped hide the tube and keep it from getting caught on stuff and also to keep the other dogs from sniffing around.

Feeling under the weather.

A week or so after she came home, we did get the results of her blood work – it was confirmed for myasthenia gravis.  Since that was the assumption that Dr. Guinan was working with given her symptoms, we were basically confirmed that we were treating her correctly.

The stress of dealing with her disease affected Phoebe’s personality as well.  My once happy puppy who just wanted to play with everyone, was very snappy with the other dogs, and her closest buddy, Bing, our new Min Pin, was actually scared of her for awhile.  In addition to knowing she was “different” with the feeding tube, she was also on prednisone, which I will swear contributed to her aggression.

Support from a friend.

Dr. Guinan and I had bi-weekly calls to discuss her progression.  After a few weeks, she was drinking water and then we started giving her snacks here and there.  Jim said she was crabby because she lacked “flavor” in her life.  But she was keeping the treats down too.

Phoebe eventually started putting weight on and we were eventually able to start stepping her down on the tube feedings as we re-introduced food to her by mouth.  We had to have the test for myasthenia gravis run again and the results were positive.  I was very anxious to get her off the tube all together, but Dr. Guinan wanted to proceed with caution.  He didn’t want to be pre-mature in its removal only to have to put the feeding tube in again.  We started weekly visits to our local vet for a weekly weigh-in.  Amazing how quickly it can come off but it was slow to put back on.

As we made positive strides in getting her healthy again, she slowly got that special personality of hers back and became more social again.

Dr. Guinan with Phoebe

On July 31st, we brought her up to NorthStar and the feeding tube was removed.  It was a very happy day.  She’s still taking some of her meds but all her hair has grown back and she’s making up for lost time with playing and causing trouble.  You would never know that just a few short months earlier we thought we were going to lose her!

We just celebrated 3 months of the tube being removed and while my Chihuahua isn’t a big fan of hers, we’re all very happy to have her back with us and healthy.  It was a very scary few months, but the staff at NorthStar was very patient with us and helped to keep me calm and on track.

Dr. Guinan told me (after she was getting better) that it’s very rare that he gets to remove a feeding tube from a recovered, healthy dog.  So that day was pretty important for him as well, I assume.

Phoebe happy and healthy!

Over several months she began gaining weight, regaining her energy and eventually was allowed to eat on her own again. After proving she could eat and taker her medication by mouth without regurgitating, her PEG tube was pulled. She is now a happy, healthy, playful 2 yr old and her owners are thrilled to have their puppy back!

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