Case of the Month June 2014

June’s case of the month is the amazing Derby Morden – a 14 and a half year old female Staffie who was determined to survive despite her near drowning! Poor Derby is your typical Staffie, loves life and refuses to appreciate that she is getting old now!  At 14 years and 5 months in human years she is roughly 78 years old.  Despite this she is a determined old lady who still loves her walks and swimming….. Unfortunately for Derby she was enjoying her walk as usual and playing in and out of the river.  However she managed to get out of her depth and in deeper water was too weak to get back again and started to struggle.  Her owners realised this and jumped into the river but by the time they reached her she had lost conciousness and was under the water.  Heroic efforts on the side of the river bank (much like resuscitating a person) resulted in her regaining conciousness but she was bringing up alot of water and coughing and spluttering. She was immediately rushed to the emergency vets at Vets Now, by this point able to walk and seeming much brighter.  You can see from her x-ray taken at Vets Now, that she had not only swallowed alot of water but had also aspirated water into her lung tissue.  You can see the fluffy white shadows over the heart region below however the rest of the lung tissue is black indicating nice air flow. Derby day of drowning vets now Derby was immediately started on antibiotics, supportive treatment for shock and oxygen therapy – however we all knew we were in for a rough ride and that all the odds were against her.  You would think you could just go into the chest and suck the water and debris out but unfortunately the damage has already been done. She was transfered to Oak Barn the next morning and unfortunately things were already taking a major turn for the worse.  Many of you will not realise that the initial drowning is actually the least of your worries if you survive that point.  Lung tissue is incredibly delicate and does not like water coming into contact with it – the delicate alveolar cells will explode and copious amounts of mucous are produced blocking vital air flow.  Worst still river water contains millions of bacteria, plant material and algae that all lead to life threatening aspiration pneumonia.  As you can see in the picture taken below (concious radiographs) 24 hours later Derby’s airway was severely comprimised. Derby day 1 Already her lungs were congested and the heart was becomming obscured by the odema within her lungs.  Only a small amount of black lung tissue at the top of the chest can be seen, the black area is the only area where air can circulate and provide the body with the vital oxygen it needs.  Three types of intravenous antibiotics were given and oxygen treatment was given continuously along with pain relief, bronchodilators and mucolytics – almost every type of drug on the shelf was used! Day two was the worst with almost her entire lung field blocked.   Despite this Derby fought on and we continued the fight with her.Derby Close up day 2 concious By day three we knew she was turning the corner as she started to get grumpy when we were treating her!  Never a fan of vets her entire life, we didn’t mind as it was a sign she was getting better.  This day we managed to stop the oxygen and she managed to maintain her breathing without assistance.  Her blood test counts were returning to normal and she was finally on the slow road to recovery. Throughout this you can imagine that she had been far too ill to eat and although had been receiving intravenous fluids with electrolytes and glucose it is never a replacement for food.  With her throat still so sore from the damage and infection by day four she was fit enough to undergo an anaesthetic and have a feeding tube placed.  Have a look at the picture below to see what an improvement had been made. Derby day 4 With a feeding tube in place medication could be swapped from intravenous to oral and the owners were thrilled to be able to take Derby home on strict rest and syringe feeding by day five. It took another week before she was strong enough to eat well on her own and remove the feeding tube.  Roast dinner with all the trimmings is her favourite and moving back onto normal dog food now seems impossible! We are all thrilled that Derby has made a full recovery, she has the odd cough and will have some scar tissue within her lungs but she is off all medication now.  It was a real team effort with round the clock nursing.  As a determined old lady she is enjoying walks again thanks a real team effort but swimming is banned for ever more!  Here you can see her fully recovered coming second in the Golden Oldies Class at Shalford Show three weeks later! photo 22photo 20