Progression of Signs. Lethargy. Coughing

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1 1 Emergency Pet Care Info for Hannah Members Dear Hannah Member, Below is information 1 on how to respond to several common after-hours pet symptoms. If this information is not sufficient, then call our main phone number Additional information is available at the end of this document and at home page in the footer. If the problem progresses or if you cannot reach us, then proceed to our emergency facility listed on page 5. Note: If the member uses the emergency facility unnecessarily, (e.g. for non-emergencies, or as a personal convenience) then the member will be responsible for paying the related fees. Progression of Signs The overriding principle when determining if a visit to the emergency hospital is warranted is related to a measurable progression of any clinical sign. The rule of thumb is f Lethargy This is a common general sign of illness, and by itself is rarely a cause for an emergency visit. he lethargy trigger for an emergency visit is if the Pet does not respond to his or her name, or is unable to walk. Coughing All animals cough periodically from a variety of causes. Some dogs periodically seem to have trouble technically is not a cough. In a reverse sneeze the 1 These instructions/recommendations are the advice of Hannah veterinarians and may differ from advice given directly by the emergency facility.

2 key finding is that the dog is normal before the episode starts, it lasts 1-2 minutes at the max, and then the dog is normal again. Sometimes this process is repeated, but is not an emergency. If the coughing persists steadily without interruption for 10 minutes, or if the P or blue instead of pink, then please transport the pet to the Emergency Hospital. 2 Red Skin, Itching, or Fleas Intact skin is rarely cause for a trip to the Emergency Hospital. However, some dogs begin to bite and scratch red skin gradually causing weepy sores on their skin. occurs simply prevent the dog from accessing the area using an, head in a bucket attached to collar), a neck brace (to prevent bending the neck to reach the area), or a T-Shirt taped so it gently wash the skin, dry, and apply a triple antibiotic cream. This problem can usually wait until the next day. If fleas are observed, please call our medical line for advice Red or Swollen Eye The first possibility is trauma causing the eye to become red, and this is usually not an emergency. - clearly that is an emergency visit. Most people call it a swollen eye when it is really the tissue around the eye that is swollen. Sometimes one half of the face including the area around the eye swells up after a bee sting or other insect bite. If the swelling does not go down in a day, then bring it in for a routine visit. The exception is that if the swelling is followed by difficult breathing, then this suggests the larynx or lungs are affected internally, and this is cause for an immediate trip to the ER. Seizures A seizure is a symptom of abnormal brain el convulsions where the entire body is tense and moving uncontrollably in a rhythmic back and forth, or running in place still uncontrollable by the pet. Seizures are very concerning, but are not painful. The most common cause is epilepsy which has an average age of onset between 2 and 5 years of age. A single seizure lasting less than 5 minutes by the clock is not an indication for an emergency visit. If a seizure occurs do the following: 1. Write down the date, time, and duration of the seizure to report to the Hannah medical team. 2. Determine if the pet might have consumed any insecticides or toxic materials. If consumed, then an emergency visit is warranted. 3. Look for chewed electrical wires. If chewed, then an emergency visit is warranted.

3 3 4. If the seizure lasts more than 5 minutes by the clock, take the pet to an emergency hospital. 5. OR if there are more than 3+ seizures within an hour that last under 5 minutes each Unable to Walk If the Pet is suddenly unable to stand or walk, this is always an indication to go to the emergency hospital. In some cases, the pet seems fully alert and not in pain, but still unable to walk. A Pet in this condition needs to get to the emergency hospital as soon as possible. Vomiting and or Diarrhea Gastrointestinal (GI) signs are common in pets and rarely require a visit to the emergency hospital. Here is what to do: 1. Prevent any new food from entering the stomach in order to give it a chance to rest and recover. 2. If vomiting after drinking water, then provide a bowl of ice cubes. This will slow fluid intake to the rate of ice melting, and the cold temperature has a calming effect on the stomach. 3. It is common to withhold food for up to 24 hours when a pet has a digestive upset. Call the Hannah Medical Team the next business day. Consider it an emergency if GI signs that might include any of the following: 1. Fresh blood in the vomit or stool coupled with lethargy 2. Gradual loss of consciousness over minutes or hours 3. Inability to stand 4. Unexplained panic that does not resolve within an hour Worms Seen in the Stool Dogs get worms much more commonly than people, and puppies get worms the most. One estimate is that nearly half of all puppies are born with worms from the mother into the puppy. These puppy stool and look a little like spaghetti. This is why the current recommendations are that puppies be routinely wormed every 2-4 weeks until they are about 4 months old. The other common worm seen in dogs is tapeworm segments. These start out near the anus or on the feces and are about one inch long and mobile. Once outside the body they dry and shrink to about the size of a grain of rice. These worms are obtained by the dog eating fleas who are carrying the tapeworm eggs. Neither of these worms are cause for an emergency visit, but call our Medical Team at Phone: and bring a sample worm if possible, and certainly a fresh sample of the stool in so we can identify the worm and provide treatment to clear the infestation.

4 4 Anorexia (Complete refusal of all food) Pets stop eating for several reasons, and none of these reasons is cause for a visit to the emergency hospital. If the pet is refusing its normal food and there are no other signs, it is likely that you are offering too much food. If the pet is refusing food AND other symptoms, then use those guidelines to determine if an ER visit is indicated. Pawing at the Ear Pawing at the ear may or may not be considered an emergency condition. If the onset is gradual, it is most likely inflammation or infection. This condition should be addressed the next business day before it has a chance to become a chronic recurring problem. If the onset is sudden and the pawing is intense, it might be a small object in the ear. The home remedy is to put mineral oil into the ear to soften the object. If this does not provide comfort then an emergency visit is indicated. Bleeding from a Nail All animals who have nails have the ability to break one off. Depending on the situation, this can include some tissue which causes bleeding. Though painful, this is not normally a cause for an emergency visit. If the nail is solidly in place, apply pressure to stop the bleeding, then come in the next day. If the broken nail is hanging by a tag of tissue: 1. Make one quick pull to remove the broken nail. If this is successful it causes a short burst of pain, but avoids ongoing movement and persistent pain. 2. Hold pressure on the bleeding, and it should stop within 5 minutes. 3. If it does not stop with intense pressure for 5 minutes, then an emergency visit is indicated. Hit by a Car Some pets experience a glancing blow that is painful, but they recover quickly. If there is a solid blow, or if the tire runs over the pet and it survives but is clearly hurt, then an immediate trip to the emergency hospital is indicated. Dog Fight A dog fight can result in a wrestling match, a fatality, or anything in between. 1. Scrapes or partial puncture holes alone can be cleaned and if available, triple antibiotic cream applied, but does not usually require a visit to the ER. 2. If there are full thickness multiple skin punctures, skin tears or other significant injury then an emergency visit is indicated.

5 5 Other Medical Symptoms For all other medical symptoms when unclear if an emergency visit is indicated, the first step is note the time of day, and record the symptom. A rule of thumb is that if you are not SURE there is an ab. Once you are certain that something is abnormal, then begin to list the specific signs noted and watch for a progression of signs, then refer to e. If you are traveling out of town, go to the nearest veterinary hospital. Hannah will reimburse the cost of necessary emergency care. Keep the receipt. Contact us the next business day to get authorization for a second day or longer. fe threatening emergency then please contact us the next business day and we will be happy to address any medical concern. Hannah Authorized Emergency Hospital: St. Francis 24 Hr Animal Hospital Northeast 65th Street Vancouver, WA Phn (360) Fax (360) Contact Person: Michael Baker, DVM NOTE: This information is also available to you from the footer (bottom) of the home page at Instructions to the Emergency DVM are at