Christine McFadden: Solving the mystery of little SugarCube’s illness

08/15/2014 5:00 PM

08/16/2014 9:59 PM

She was all white, an itty-bitty poodle and absolutely miserable.

Trouble was, her gums were white, too. And when you look in a dog’s mouth, the gums should be bubble gum pink (exception: dogs with Chinese heritage may have black-pigmented gums and tongue – called a flowered tongue – like Chow Chows).

A dog that pale is anemic, meaning it doesn’t have the normal number of blood cells circulating, and no blood means no oxygen and no nutrients are being carried throughout the body. Anemic pets are very weak. Little SugarCube was also vomiting and had bloody diarrhea.

As a veterinarian I see a fair bit of diarrhea (ask me, please!), but it is uncommon to have one so severe that the dog looks like it’s bleeding out.

Nothing in SugarCube’s history gave me a clue as to cause: She was a house dog, with no exposure to rat or mouse bait (rodenticides); she didn’t travel, so exotic parasites were unlikely; she was older and vaccinated, so forget parvo; and her diet was neither varied nor was she given bones that might upset her stomach.

When faced with a problem like this, we start at the beginning: basic blood work and X-rays. These two simple tools are the building blocks upon which so many further diagnostic tests depend. They rule in – or out – many possible disease causes.

Because we can run these simpler tests in-hospital, we knew within the hour that SugarCube had a life-threatening form of anemia, a hemolytic anemia, where the body is bursting its own cells. But, more oddly, she had a metallic foreign object in her stomach. It was shaped like a hoop earring, which the owner identified but couldn’t place when the dog might have gotten it.

This was one of the few times when my work with birds came in handy for another species. Birds frequently chew and bite on odd objects and frequently present for “heavy metal toxicity” (nope, not a music overload). Both lead poisoning and zinc toxicity are treated the same in birds, but symptomatically there’s one huge difference: Both can kill, but only zinc causes a hemolytic anemia.

So as we stared at the X-rays, I hypothesized that the foreign object in SugarCube’s stomach was poisoning her and we had to get it out. But how on earth was she going to live through surgery?

There wasn’t time for the antidote to work, even if we had enough on hand for a dog (we didn’t and the stuff, calcium versenate, isn’t stocked by regular or human hospital pharmacies). We began treatment to shore up her immune system, started IVs to stabilize her, and began a blood transfusion. Within hours of her arrival at our hospital, we took SugarCube to surgery.

We entered her abdomen, going right through the belly button, and quickly examined her intestine, spleen and other abdominal organs. Gently palpating (feeling) her stomach, we could feel the metal ring. Fixing it in place with a finger, we sliced into her stomach and removed ... a penny.

A copper Lincoln head penny! It had been in her stomach for so long that the natural gastric juices (weak hydrochloric acid) had worn away the face and created a hole in the middle of the coin, faking us out that it was an earring when seen by X-ray!

(Trivia break : Copper pennies minted after 1981 are filled with zinc! Thank you, birds – all the ducks, geese and an occasional chicken that swallow pennies).

Our diagnosis was confirmed and with the source of her poisoning removed, we quickly sewed everything back up and awakened SugarCube. She went on to make a full recovery.

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