1. By: Michelle West DVM

2. It was a busy day at Shoreline Animal Hospital when Dr. West met Phoebe, a 5 year old pug. She was not feeling well.

3. Presenting Complaints Weakness Vomiting

4. History How long ago did it start?30 minutes Vomiting how many times? Once What was in the vomit?Dog food, paper and sticky white globs Could she have gotten into anything? Garbage?no Chemicals?no Plants?no Food?Possibly sugar free gum Objects?Mother’s purse was disturbed Does she go outside unsupervised?no Is she having diarrhea?No

5. Physical Exam Very quiet- weak Gums moist and pink Heart Rate 80 normal Temperature 101 normal Respirations normal Abdomen not painful Lymph nodes normal

6. Diagnostic Tests Blood work Blood Glucose (sugar level) 60 below normal Liver Values slightly high Radiographs= x-rays- not done Blood Pressure= not done

7. XYLITOL TOXICITY

8. Dextrose Fluids Intravenously to raise blood sugar level and prevent liver damage

9. Fluid Therapy

10. Max 1 year old Golden Retriever While Phoebe was getting IV fluids, Max arrived at the hospital with the same presenting complaints Weakness Vomiting

11. History When did it start? Yesterday How many times did he vomit? 9 What was in the vomit? Yellow liquid Any diarrhea? No Does he go out unsupervised? Yes Could he have gotten into anything? Chemicals No PlantsYes GarbageYes ObjectsYes FoodYes

12. Physical Exam Mucous membranes pale and dry Heart Rate 160 Very quiet Painful abdomen Lymph Nodes OK Eyes, Ears OK Temp= 102.8

13. Diagnostic Tests Blood Work Shows dehydration X-rays gas filled loops of intestine large foreign object in intestine

14. Barium Series

15. Treatment Antibiotics IV Fluids Pain Medication

16. SURGERY

17. Socks Should I try another one?