LUCY & CANINE BLOAT

If you've already visited my "CANINE BLOAT" Page then you know that I'm already all too familiar with canine bloat, having almost lost my Irish Setter, Gracie, to this life-threatening medical condition. (If you haven't visited this page, please do as it explains in some detail the symptoms of and treatment for canine bloat and preventive measures.) A description of what bloat is bears repeating so I've included it below. After that you'll find Lucy's story.

WHAT IS "BLOAT"?

Bloat/Torsion is the common term for Gastric Dilatation-Volvulus, a term that exactly describes the course of events. (Almost every breed of dog has been affected by GDV but it's more commonly seen in large, deep-chested breeds - Akitas, Great Danes, St. Bernards, German Shepherds, Irish Wolfhounds and Irish Setters.) It's universally agreed that bloat is one of the true surgical emergencies that occurs in dogs.

Different levels of "bloat" exist. Simple bloat is where the stomach quite literally fills with air. Sometimes, however, because of the way the stomach swings in the body cavity, the ligaments stretch, and the stomach begins to rotate, closing off the openings to the stomach. At that point any air in the stomach is trapped, the pressure cuts off blood circulation, the stomach tissues begin to die and toxins begin to be released. This rotation also compresses one of the major veins carrying blood to the heart, severely depressing normal blood circulation. Rotation of the stomach also obstructs blood flow in the vein that delivers nutrients from the small intestine to the liver which produces congestion of the blood vessels, lack of oxygen supply to the tissues and eventual death of these and other abdominal organs (liver, pancreas, small intestines and spleen). ALL OF THIS CAN QUICKLY LEAD TO SHOCK AND DEATH unless immediate veterinary intervention occurs!!

On Thursday, April 12th, Lucy and Gracie and I set out for Buffalo for an Easter visit with my mom. The weather forecast for Buffalo was for a high temperature of about 70 degrees. (This was important to me because the air conditioning in my van had croaked last September and rather than spend $1000 to have it repaired I'd made up my mind to trade my van in before this year's hot weather set in.) Unfortunately, weather forecast notwithstanding, Erie and Buffalo decided to break all records with a high temperature of 80 degrees, making our trip a very warm one even with the van windows open. (Had I known it was going to be that warm I would have set out much earlier than when we did set out at 10:45 a.m.) Since puppyhood Lucy has never been a happy traveler. Although she eventually outgrew carsickness, Lucy NEVER sleeps when we travel - trips are spent with Lucy alternating between laying down in her crate and sitting up, always panting regardless of the temperature. We arrived at my mom's on Thursday at about 2:15 p.m. and, as usual, Lucy and Gracie couldn't wait to get to their water bowl for a good long drink of water.

At about 4:30 p.m., just 2 short hours after we'd arrived, I noticed that Lucy had become very restless. Instead of staying in the living room with my mom and I, she started pacing around, lying down in one place after another and then getting up to do some more pacing. I wasted no time heading for Lucy and Gracie's "travel bag" where, among other things, was a brand new box of UltraPhazyme. (Because Irish Setters are at risk for bloat, I never travel without an ample supply of simethicone, UltraPhazyme's only active ingredient.) By 5:30 p.m. Lucy had 1200 mg of simethicone in her system but she clearly was still in distress and had twice tried to vomit with no success. I called a veterinary clinic 4 miles from my mom's house and told them that I had an emergency - an 8 year-old Irish Setter who was exhibiting symptoms of bloat. They told me to bring her in immediately. We were there in less than 10 minutes. 30 minutes later a vet was finally examining Lucy. When she asked me how Lucy was doing I indicated that she seemed to be in extreme discomfort and that I thought she should be "tubed" ASAP. (A tube is passed through the dog's mouth into the stomach to relieve the pressure of the gas building up in the abdomen.) The vet agreed and I was sent off to the waiting room. 30 minutes later the vet told me that she had been able to get a tube into Lucy's stomach (always a good sign) and had been able to remove some gas and fluid. She recommended that Lucy be x-rayed to see if there was any gas remaining in Lucy's stomach. I agreed. Another 35 minutes later we were finally looking at Lucy's x-rays. The vet pointed to an area on the x-ray that looked like two bubbles - one large and one small. She explained that these were 2 bubbles of gas, one on top of another, and quoted an old veterinary school adage - "double bubble, you're in trouble". Since it was now "after hours" at this clinic, she recommended that I take Lucy to an after-hours emergency clinic where they could flush out Lucy's stomach to eliminate those gas bubbles and the remaining fluid in her stomach. She called ahead to tell them I was on my way, and I set out with Lucy and her x-rays. (At this point it seemed to me that Lucy was in even more distress than ever.)

I arrived at the emergency clinic 20 minutes later and had to fill out all sorts of paperwork and sign a "Canine Bloat Red Alert Authorization Form" indicating that "Occasionally the use of extra-ordinary emergency treatment is necessary to try to save your pet. When these extreme measures are indicated, the costs of this type of care can add up significantly ($700-$1200) in a very short period of time. THESE EXTRA-ORDINARY EMERGENCY CARE MEASURES ARE INDICATED NOW TO TRY TO SAVE YOUR PET!". I also had to provide a credit card which they used to "preauthorize" a charge of up to $900 before a vet would even look at Lucy. (I realize this is most probably standard operating procedure at most, if not all, emergency clinics but be aware that concern for your pet may very well be secondary to revenue at an emergency clinic even in life-threatening situations!) At long last a vet came and took Lucy and her x-rays. A few minutes later I was told that they were going to do a "decompress and lavage" and that I could call in an hour or so to see how things were going. By now it was after 9:00 p.m. and, much as I wanted to stay rather than call, I was sure that by now Lucy's sister Gracie was in dire need of a potty trip and I wasn't about to call my 89-year old mom and tell her to take Gracie out on her flex-lead (and have Gracie yank mom's arm right out of its socket :-) At 10:15 p.m. I called the emergency clinic and was told that they were just starting the lavage procedure and to call back again at 11:00. At 11:00 I was told that Lucy was doing fine and that I should pick her up between 7:00 and 7:30 a.m. the next morning.

Needless to say, I was at the emergency clinic at about 7:00 a.m. Friday morning. While I was waiting for them to bring Lucy out, I glanced at the "Medical History Report" that accompanied my bill and saw the word "torsed". At about the same time the receptionist was telling me that the first clinic that had seen Lucy was on the phone wanting to know when I'd be bringing Lucy in for surgery to have her stomach "tacked" (sewn in place so that it couldn't rotate). In disbelief, having seen the word "torsed" on Lucy's medical history report, I asked the receptionist if Lucy's stomach had, in fact, actually flipped. I was told that that's what the word "torsed" meant (as if I didn't already know that!!) I demanded to see the emergency clinic vet that had treated Lucy and she confirmed that Lucy's stomach had, in fact turned upside down but that the "decompress and lavage" procedure had caused it to rotate back to where it should be. She assumed that I would be taking Lucy right back to the first clinic for the surgery that would insure that it couldn't rotate again ("tacking" or gastropexy). I reminded her that I was from out of town (she had apparently forgotten this) and that my preference was to have this surgery done by the same vet, Dr. Patrick Manubay, who had treated Lucy's sister Gracie for bloat. Given the statistics for a recurrence of bloat especially once the stomach has already rotated, the emergency clinic vet made it clear that she thought the preventive gastropexy procedure should be performed immediately. I told her that I was fully prepared to head back to Ohio within the hour, sure in my mind that Pat Manubay would be there for Lucy just as he had been for Gracie, and that I'd be calling him as soon as his office opened at 8:00 a.m. to confirm this. She reluctantly gave me the 2 powerful tranquilizers that I requested to ease Lucy's trip home; I also asked for and got the x-rays that she'd taken and the x-rays that had been taken at the first clinic.

By 8:30 a.m. I was back at my mom's and on the phone with Dr.Manubay. I explained what had transpired and he understood how reluctant I was to have Lucy's gastropexy done there in Buffalo. He gave his reluctant approval for us to head back to Ohio ... if it appeared as though Lucy was going back into a bloat situation I was to go directly to his clinic for Lucy's surgery ... if she didn't go into another bloat episode he would do the gastropexy Saturday morning. Willful snot that she is, Lucy fought those tranquilizers I'd given her for the entire 3-1/4 hour trip home. Rather than crate her, I decided she'd be more comfortable uncrated but she spent the entire ride back doing just what she'd have done if she'd been in her crate - standing or sitting up, lying down, standing up, lying down, etc. etc. Mercifully, the temperature on Friday was only 50 degrees, a far cry from the previous day's 80 degrees, and although the tranquilizers did nothing to make her sleep, at least she wasn't doing any of the panting that she had always done before when we travelled. Once we got home Lucy headed for her water bowl. I let her drink a very small amount of water and then took it away from her. In a huff, Lucy laid down to take a nap and was out like a light for hours. Clearly she had survived the trip home without going into another bloat episode.

Yesterday, April 14th, Pat Manubay did the surgery that will prevent Lucy's stomach from rotating again. While Lucy was being prepped for her surgery, I asked Pat to review all of the x-rays that I had brought with me. I asked him to do this because once I'd gotten back home I finally had had a chance to review the entire Medical History Report on Lucy that I'd been given by the emergency clinic. To my utter disbelief and amazement, the report indicated that the x-rays taken at the FIRST clinic showed torsion had already occurred!!! Dr. Manubay confirmed this - those two "bubbles of gas" that the first vet had pointed out to me surely did look just like two bubbles but they were nothing of the sort. What she had pointed out to me was, in reality, a large area of EMPTY SPACE (separated by Lucy's esophagus) that had previously been occupied by Lucy's stomach before it had rotated 180 degrees!!! "Double bubble, you're in trouble" indeed.

In my first bloat web page I stressed that you contact your vet right now to be sure he or she knows how to treat bloat. I also strongly recommended that you check out any and all emergency clinics in your area, ones that treat animals during "off hours" when your regular vet isn't available, to be sure that THEY know how to treat bloat. Given all the trips to Buffalo that I've made with Lucy and Gracie, I should have followed my own advice and done some research on veterinary clinics in the Buffalo area but somehow I'm not sure it would have done any good ... another lesson I learned is that you're clearly at the mercy of whatever vet or vets happen to be on duty at the time you're having your emergency.

If you think your Irish Setter isn't at risk for bloat, please do think again. I'd said for almost 4 years that if any dog was going to bloat, it would be Gracie, and sure enough, at age 4-1/2, she did. I've also been saying for years that Lucy would be the LEAST likely Irish Setter to bloat -- not the deep chest that Gracie has and much more laid-back than her half-sister. As unexpected as Lucy's bloat was, and despite all of the circumstances surrounding it, Lucy survived. Final lesson learned? As Pat Manubay said after he'd looked at all of Lucy's x-rays ... sometimes it's better to be lucky than good!!!!

Lucy, 4 days after her bloat episode and 2 days after the surgery that will prevent her stomach from rotating again. April 16, 2001

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