In this engaging encore episode, we welcome back Dr. Karl Jandrey, a renowned emergency veterinarian and professor of clinical small animal emergency and critical care at the UC Davis School of Veterinary Medicine. Dr. Jandrey explores common pet emergencies that every owner should know about, from the dangers of foreign objects to gastrointestinal issues. Dr. Jandrey shares invaluable insights on what symptoms to watch for and when to seek veterinary care. Listeners will learn about the importance of understanding their pet’s normal behavior and how to react in various scenarios, including what to do if your pet has been injured or ingested something harmful. The conversation also covers unique cases Dr. Jandrey has encountered, highlighting the unpredictable nature of pet care.
Now there’s soothing relief for your pet’s irritated skin from allergic response, contact allergens and insect bites. AtopiCream HC by Vetrimax is a unique anti-inflammatory, rehydrating, leave on lotion/conditioner for animals that is quickly absorbed, providing sustained benefits while leaving no residue. Fortified with ceramides, these lipids help restore the skin’s natural protective barrier and aid in healthy skin regeneration for your pet. AtopiCream HC is made in the USA, and not only provides quick relief for irritated skin, but it’s also an aid in detangling your animals coat. Ask your distributor about Vetrimax products – Vetrimax makes it better!Today, our podcast listeners can try all VetriMax products for 15% off at Chewy.com by entering promo code VETRIMAX15 at checkout.
◇ ─ ◇ ─ ◇
All footage is owned by SLA Video Productions.
—
Listen to the Podcast here
The Essential Guide To Pet Emergencies With Dr. Karl Jandrey
Welcome to the show. I’m Dr. Alice Novotny Jeromin, a board-certified veterinary dermatologist.
I’m Janet Novotny King, the doctor’s sister. I am not certified or board whatever in anything. I’m a pet lover and owner. We’re here to bring you some good science-based information so you can be pet owners. Pretty much, it’s all the stupid questions I call my sister at 2:00 AM to ask her about my pets. We’re bringing it all to you. If you have questions, email them to us. We always have some phenomenal guests. Who do we have here? It’s a two-timer.
Introduction To Dr. Karl Jandrey
Encore visit with Dr. Karl Jandrey. He’s the Professor of Clinical Small Animal Emergency Medicine and Critical Care at UC Davis. Dr. Jandrey is a Buckeye. He graduated from Ohio State University College of Veterinary Medicine, did an emergency internship in LA, and his residency in Northern California. He went East to Philly, where he was Director of Emergency Services at a specialty hospital.
He came back to UC Davis in 1999, where he is the Associate Dean of Admissions and Student Programs. Dr. Jandrey is the person to talk to, at least at UC Davis. He currently teaches patient side in the emergency room and intensive care unit at the Pritchard Veterinary Medical Teaching Hospital at UC Davis.
He shares his life with another veterinarian-clinician scientist. A perfect yellow lab, which we always have questions about, numerous saltwater tanks and two recently adopted cats. We have Dr. Jandrey on because I don’t want you all to feel helpless when you come upon an injured animal, an emergency situation. We’re going to ask Dr. Jandrey, what are some tips that we need to follow. God forbid we see an animal hit by a car or want to rescue an animal.
It happens when you’re least expecting it, when you’re visiting your sister in Ohio. She says, “Come on.” She threw a trap in the back of the car and a couple of shovels and said, “I was out of my walk. There’s some baby raccoons stuck in a thing.”
Hugging each other in the street.
I’m like, “This will be easy. They’re going to be little kittens.” Those darn things, when you go to shovel them, they shriek. I jumped on a high feet.
They do like to make a lot of noise. Having said that, how horrible would you feel by not helping them? I’m talking about helping things like turtles because spring will come to Ohio, Janet, where I live and in Connecticut, where you live. We got those turtles crossing the road. You’ve got to help them.
You taught me to move it to the direction it’s going. Don’t go near the mouth.
Don’t pick it up by the tail.
They tend to retract, but then they’ll come back out. You teach me a lot.
Except snapping turtles. Snapping turtles aren’t big on retracting. They can reach that head around. We’ve got to be careful of that.
Hence, the name snapping.
Since Dr. Jandrey is all things emergency, we’ve got a lot of questions for him. Sometimes, what’s deemed an emergency to a vet isn’t that much of an emergency. Things that the pet should have been seen for as an emergency aren’t recognized by the owner. We need to weed through that with Dr. Jandrey.
This might help avoid those 2:00 AM phone calls from the sister.
Welcome, for his encore visit, Dr. Karl Jandrey. Janet, why don’t you start. We have a ton of questions, Dr. Jandrey.
I’m going to start with, what is the number one dog emergency or cat emergency that you see in your practice? I’m sure it’s a collective, but that owners should be aware of.
There’s a huge array of veterinary emergency practices. Some people have access to a general practice that’s open late into the evening. Whereas, some might be more in an urban center where it’s a 24-hour specialty hospital. If they’re lucky enough to be near a 24-hour academic teaching institution, there’s about 34 of them in the country. They all have different accessible points. The types of patients that are seen at those local places are very different.
If I’m going to answer your question very clearly, it’s a tough question. Everyone that I see might not be representing the normal local practice because we see the sickest of the sick from almost the western half of the states. We see so many things because of the advanced types of care we can give. We see a huge number of very severe, very complicated patient referrals.
Don’t get me wrong. We see plenty of first-opinion cases as well. We see just over 10,000 patients a year through our emergency room. When you talk about what’s common, what’s common in private practice are things like cat bite abscesses, urinary obstructions in cats. Dogs who eat things they’re not supposed to whether they’re foreign material or their meds from the owners in their household or strange products out in their garden or on their farm.
Some of the other types of things that we might see because we have specialty services. We see a lot of advanced care for things like hemodialysis and hemoperfusion for toxins or for renal replacement therapy. We see a lot of animals with acute spinal injuries that are mostly due to discs that are weak. They break and impinge the cord to cause paresis or paralysis in these dogs.
We see a mixed bag. I think your question is probably leading towards what people should do or what they should be ready for or what they should have in their back pocket as they get to the veterinarian. Let’s just say the common things are common across the world. Let’s just talk about vomiting and diarrhea for a second.
I love those two.
It’s always an emergency because it affects the household.
You certainly don’t want diarrhea all over your nice white carpets.
Alice sent me a yellow sign like they use that says “Wet Floor.” It says “Caution: Cat Vomit.” On one side, it says “Vomito de Gato.” It has a cat. You said that to me years ago. We have an incidence of it. We pull it out.
We need to send them to Karl.
Understanding Veterinary Emergency Thresholds
I would love it. Not every animal that vomits needs to see the veterinarian or doesn’t need to come to the emergency room. Let’s talk about the thresholds over which you should seek veterinary care. How’s that? If I’m a healthy middle-aged dog or cat and I never vomit and I never have diarrhea. I’m eating. I’m happy. I do all the things, whether I’m indoor or outdoor. Whether I have an active hunting lifestyle or I’m a couch potato. Let’s just set the stage.
I’m not a vomiter. One-time vomiting, you look at it and you’re like, “That’s weird because that’s not what my dog or my cat typically do.” If they’re still wagging their tail, they’re still interactive, they’re still eating and drinking. You might just watch and wait. However, if this is an animal who never vomits or never has diarrhea, you’re basically like, “At what point do I go to the veterinarian?” One is too much.
If it’s a healthy, otherwise young animal, they stop eating. They look more lethargic. They aren’t doing their normal interactive behavioral patterns like they normally do. You say, “Something’s off.” Your brain is like, “I don’t know what’s wrong, but something is just off.” Perfect. Maybe then you should seek the attention. That’s for the healthy middle-agers who never vomit.
Let’s talk about the extremes of age, the youngsters and the oldsters. I don’t wait as long on those guys because there could be something more insidious. Age is not a disease. More things happen more commonly as we age. There are more things that are more likely in youngsters, too, especially things like infectious diseases. Whether they’re parasites or viruses.
Age is not a disease. More things occur more commonly as we age. Share on XI would say my threshold for seeing veterinary care is shorter than if I was a healthy young middle-aged adult cat or dog. If I’m going to wait three days, for instance, on a dog or cat who’s middle-aged. I might wait a day or day and a half on a small youngster or an oldster. Those are the healthy ones that never do all the weird things.
Let’s talk about the ones who are always vomiting. You have them. There’s a cat. There’s a dog. I vomit once a week. I vomit every other day. I vomit a hairball. I go on my happy way. That’s a normal pattern. If your pattern is once-a-week vomiting, once-a-week regurgitation, or once-a-week little soft stool. I’m probably not so excited until it’s every day that week instead of the normal pattern.
Again, I’m resetting the focus as to what is the normal for this critter? How does it get thrown off balance? It’s a gray scale. You’re not going to have a black and white on here. You’re going to have to say, “I’m just going to pull the trigger today because it’s been three days in a row of once-a-day vomiting.” They’re still wagging their tail. They’re still eating, but it’s off the pattern. It’s often better to get on top of it a little earlier than later.
Do you need to see your emergency veterinarian? If you can get an appointment with your generalist the next day, you could probably wait until the next day or the next day after that. If there’s a real striking change, one-time vomiting a day, a once a week. All of a sudden, it’s once a day, three days in a row. The last one, he vomits two or three times on that last day. That’s completely different. This is now amped up to increasing frequency. It could be increasing severity. You’re going to say, “I just got to get this checked out.” Sometimes, being safe is better than being sorry. That’s a lot of talking for our first question.
What I get from that is it sounds like anything that’s outside the norm for that animal needs to be addressed. Like Karl said, “They vomit once a week? If it’s going to be two times a week, three times a week, that’s abnormal now for that pet.” They are creatures of habit, sort of. Aren’t we all?
Does content matter? For instance, Libby, we have a lot of geese and a lot of ducks. We have a pond and all that stuff. She doesn’t throw up. All of a sudden, she throws up. It is like a load of goose poop. I’m like, “You dummy, you ate all of it.” She’s fine. She’s wagging her tail, barfing her guts out. She’s fine. In contents, probably, if you see blood, that to me would scare the crap out of me. I’d be at the vet in about five seconds.
It’s a good point, Janet. When I’m talking about this vomit, I’m just talking about undigested food, that foamy stuff. If it’s blood, yes. If it’s a foreign material, yes. If it’s a strange creature that they ate, sure. Blood is never something you want to see, whether it’s vomit or diarrhea.
It should stay in the inside.
I like it on the inside. I don’t like it on the outside on the white carpet. I’m just going to tell you. Wine Away doesn’t take that out.
Use hydrogen peroxide if it’s bloody.
That’s right. My neighbor, Karl, wanted me to ask you. Their family is visiting because everybody in Florida has family visiting. He ate eight boxes of raisins. At 6:00 AM, he came running down for the hydrogen peroxide. When he was sitting at the emergency clinic with his dog to be seen, he started talking to the person next to them. Their dog ate gunpowder. I know. That’s why I said, “I’m going to ask my friend Dr. Jandrey how often he sees that.”
What’s gunpowder made out of? If it’s not lit, it’s not going to hurt?
You can’t make your own bullets or do something like that.
I’m just saying. I wonder if that would hurt them.
I have never dealt with gunpowder ingestion.
I will tell him.
I would have to do some looking. I wouldn’t plead ignorance. I would suggest that, “This is interesting.” I deal with animals eating weird stuff all the time. This one’s new to me. I’m going to go look.
Give us the weird. What’s the weirdest?
Besides underwear and stuff like that. We know that.
Dangers Of Foreign Object Ingestion
There’s so many great things that animals see. I love them to death, but I know that they’re going to do it again. One of my favorites was on Thanksgiving, when I’m the only vet working a 24-hour shift. This is very early in my career and happy-go-lucky. It’s a golden retriever. The family comes in. They’re like, “He just ate the Butterball turkey mesh.” You know how you buy the turkey that’s got this plastic mesh thing?
That thing’s hard as a rock. It’s hard to get off the turkey.
The dog ate the entire mesh over this 20-pound butterball turkey. It had turkey juice before it was cooked. It was turkey skin and whatever. It probably tasted great to the dog. It ate the whole thing. I tried to make it vomit with my chemicals and didn’t vomit. I had to do a surgery to cut it out of its stomach.
Was it all in the stomach or starting to pass into the intestine?
It was starting to pass. That’s why I had to get it out. I had to get it out because it was partly in the stomach, partly in the small intestine. For those who don’t know, you don’t want anything spanning that muscle valve that contracts and opens. That’s a bad sign because it gets stuck in the stomach. The rest of intestines do this accordion of that linear foreign body.
The mesh and/or string starts sawing away inside the intestine. Sooner or later, it saws through the intestine. The intestinal contents leak into the abdomen cavity. We call that a septic peritonitis because it’s a huge infection in the belly. They go from sick to critically ill, nearly dead, pretty quick. Sometimes, dealing with these repeat offenders that love to eat things is a problem.
What about cats, Karl? What about cats with the string around the tongue? Do you still see that?
On occasion. Whenever we get a cat that’s vomiting, it’s essential that we have to look under their tongue.
Janet, did you ever hear about that? Karl, tell her what happens because I know Janet needs to know about this.
There’s no way I could get into these cats’ house to look for a string. Why do they? Is it because they play with it and they eat it?
String off of packages, ribbons, tinsel from Christmas trees, thread. They’re long. They’re longer than a cat. They go down. Sometimes, they get looped around the base of their tongue. It’s stuck. It goes all the way down through the esophagus, the stomach, and into the intestine. Again, it starts this accordioning where it’s going to start sawing through the inside lining of their gastrointestinal tract. It’s super bad.
Every cat, despite them being mean or not, we have to look under their tongue. Sometimes, we have to just sedate them to make sure that our exam is full and complete. While they’re sedated, we’ll probably take an X-ray. Sometimes, these can come out with endoscopy. It’s a fiber optic camera on the end of a scope that’s flexible and could go down the intestinal tract, like people have endoscopies or colonoscopies. We use the same kind of video cameras on big, long, flexible tubing that allows us, under anesthesia, to find these foreign materials. Sometimes, we can pull them out without surgery.
I bet those cats don’t have to do the colonoscopy like humans do.
Karl, do you cut if it’s wrapped around the base of the tongue? Do you trim that and then let the string go all the way through or pull it out? You see what I’m saying?
Usually, we don’t pull it out.
You let it go through.
If we can cut it and pull it gently, we’re in luck. If it all comes out smoothly without any tension or resistance, I’ll pull it. If it has any resistance or tension, it’s stuck on something else down below. That’s going to have to be a surgery or a sculpt. Janet, you should come to the emergency room. You should come work with me for a day and just see what is going on.
I could do all the sound effects, Dr. Karl. I’d be like, “Oh, my God.” I’m good at that.
Cats eat a threaded needle.
With the needle in there?
Also, fish hooks.
I looked up gunpowder. Sulfur, charcoal, and potassium nitrate, which is called saltpeter. Is that deadly?
I still have no idea.
Not if it doesn’t go boom.
Honestly, I have to look it up.
Our next question. I’m driving in a car. The car in front of me hits a dog and they keep going. I’m the caring person and stop.
They didn’t notice they hit the dog.
They were on their phone.
What do we do?
Protocol For Hitting An Animal While Driving
First and foremost, don’t drive while texting. That’s my public service announcement. I’m not a veterinarian now. If you happen to do the unfortunate thing and hit an animal while driving. We’re in Davis, California. We’re the biking capital of the States. People hit animals up on their bikes. We get hit by bikes. We get hit by cars. When I worked in Philadelphia, we got hit by SEPTA, the light rail train system. We’ve had all sorts of hit-bys. Sometimes, the animals fall out of the back of a truck, too, because they’re not cross-tied. There’s lots of trauma.
Don’t drive while texting. If you unfortunately hit an animal while driving, stop safely and handle the situation responsibly. Share on XBack to your question, Alice, I would suggest that first and foremost, you have to realize that this animal is anywhere from normal and unscathed to dead. Anywhere in between. If they’re unscathed, they’re going to walk around. They’re going to run from you. They might come up and find you to be a soul that’s going to comfort them. They can also be aggressive. They might want to kill you because they think you just did that.
They’re scared.
First and foremost, don’t get bitten. If you’re in your car, hopefully, you have some supplies that you might be able to pull that might help you to restrain. I would have a blanket to cover an animal, a leash, just in case, to put a slip lead around the dog’s neck. A blanket would help to cover a cat that’s freaking out or halfway up a tree.
You can decide to corral it. I doubt you’re going to carry muzzles and things along those lines, but another slip lead, another leash. You can put it around their muzzle, cross it under their neck, and tie it behind their back. That could be a way to prevent them from biting you. You want to do good things, but you shouldn’t put yourself at risk.
You’re then going to have to get a rabies shot at some point.
Alice and I are already vaccinated as veterinarians because this is our line of work and our titers are good. If you’re never been vaccinated, I don’t want you getting bitten because next thing you know, you’re going to the hospital. Who’s taking the animal to the nearest hospital? A thing about being prepared also is to know where your emergency clinics are, if you’re a member of this community.
Especially if you’re a traveler.
If you’re traveling, say, you took a car ride. You’re halfway between Ohio and Florida. This happens in North Carolina on I-95. You’re going to have to start googling the nearest vet hospital that’s open. Knowing where to go is certainly helpful because you’re going to try to restrain the animal, corral the animal, and get that animal safer than on the road.
There’s not a lot you’re going to be able to do, potentially for the most critically ill. You just need to scoop and run as fast as possible. If the animal is not so bad and you can have an ID tag on it, then you might be able to find a phone number to call the owner. You can just confine the animal. Keep them as calm as possible. Assess the situation.
If they’re moving, if they are walking on three legs instead of four, you make phone calls to the people. Say, “It looks like he’s injured X leg or he’s walking around fine. He’s just scared out of his wits. I don’t know where you live. I’m here at the corner of X and Y. Come and get your critter.” That’s the simple stuff. It requires to have, as I said, maybe a couple blankets or towels, a couple slip leads, leashes and muzzle, maybe. That’s all if you had to stock your car.
Alice told me once, because I always have a couple of beach towels because of the dog. You said, Alice, once I have a beach towel, cover up their face. The other thing I can tie a muzzle with is a sock. For some reason, that’s stuck in my head. You could use that.
The other thing I want to add to the emergency first aid kit that you carry in the car. I carry a small cardboard box, just in case. I found those baby possums, Janet, that were crawling out of the hit possum mommy. Birds also because people immediately find an injured bird. They want to feed it. You need to put it in the box. Keep it somewhere warm and dark. Leave it alone for a while because sometimes they’re just shocky. Anything to add to that, Karl?
I agree with that, Alice. A box is not a bad idea because there are a lot of little creatures that people stumble upon. You go to a gas station. There’ll be little kittens hanging out over the curb. You go on a hike and next thing you know, a bird fell out of a tree. Sometimes, nature needs to be nature. Their parents might be looking. They fell out of a tree, but they’ve done this before.
Sometimes, if you scoop and run with the fledgling, you may have just disrupted their abilities to be a parent and that fledgling to have learned. Sometimes, you have to use your thought process. Not everyone knows every species’ behavior patterns. We have to be thoughtful about, “Do I grab this critter and take it to a vet or a wildlife rehab center? Do I just let it be?”
I assume that most people have access to their county animal shelters or animal services. If you don’t know, it’s probably worth calling them. Sometimes they would say, “In this case, thank you for calling us. We recommend it because we understand the behavior. It’s the breeding season or it’s the flyaway season. Let’s just let that one sit there. That’s the best thing for it.”
If it’s a domesticated species and you have more knowledge. We’re more commonly understanding behavior patterns of dogs, cats, maybe rabbits or hamsters, or guinea pigs. If you see a fancy guinea pig running around on I-90, that’s not normal. You probably want to scoop it up and put it in your box. It’s a good idea. The other thing about the muzzle, use your belt.
We live with woods around us in Connecticut. It must be deer make out season or something because they’re all traipsing through. Some of the bucks have one of these, some have two. These two, the one’s big, so I think he’s the hot guy. They all look different coming through the yard.
Rutting season’s more like November, Janet.
I don’t know. Something’s going on because they’re strutting their stuff. There’s something to do with the size of those antler things.
There is.
I’ve got a question for Karl. I’ve had some friends of mine. This happened to two of their older dogs, where they woke up one morning and couldn’t stand up. It’s like their balance is off. Would you address that, Karl? It’s usually old dogs.
I also want to address seizures. We haven’t talked about seizures either. We’re going into neurologic emergencies. We talked about the gastrointestinal ones. We’re done with vomiting and diarrhea. Hit-by, car traumas, we went through that. Neurologic emergencies are pretty clear. If your animal is walking along completely normal, and has a head tilt, its eyes are jiggling back and forth fast without thinking about it. It’s just looking at you and its eyes are going like this. Twisting its body, maybe alligator rolling, and they can’t stand up. Maybe they’re even vomiting.
What’s alligator rolling?
People in Florida know what that is. It’s like you try to confine an alligator. It tries to get away. It gets away by rolling and turning around.
You’ve seen it, Janet.
It rolls. You mean dogs do that?
Not normally. If they’re doing it, I worry about their balance. They could have this wicked thing called vestibular disease. It’s like vertigo in people. It would be a problem with either their inner ear, the brain that receives the signals, or a combination of the both of them. These animals, as Alice said, tend to be a little older. These could come out like a ton of bricks, 100% normal. All of a sudden, the animal’s twisty head, twisty body vomiting, and flops all over the ground.
It’s frightening.
It’s very scary because you’ve never seen anything like that before. Five seconds ago, your dog was perfectly normal. This is typically a dog thing more than a cat thing. Cats can get it, but I would say it’s a little more rare. It’s something you should probably check out with a veterinarian. Get your dog comfortable, scoop them up, console them, and stop them.
It might take a bit of time because they have no horizon. Their horizon is flipping everywhere. They don’t know what’s going on. You might have to just wrestle them a little bit, hold them tight. Hold them close to you. Hopefully, they’re not going to bite you because they’re okay with this. That one probably should see a veterinarian.
It’s like a seizure. If your animal has been normal, never has had a problem, and then, in front of you falls over and starts having very severe muscle spasms. It’s almost like they’re unconscious to the world. If you call their name, they’re not going to respond. They could be chattering their teeth and drooling. They might vomit. They might have defecated. They’re running in place, shivering. Their entire body is convulsing. This is a very short thing. It usually lasts 30 to 60 seconds and it stops. This would be a classic grand mal seizure.
What should you do when they’re doing that? Leave them alone? You shouldn’t try to go up to them, right?
Recognizing And Managing Seizures
I would stay away from their mouth. One, they could bite you. It’s not because they are doing it out of malice. They are just unconscious. They have no idea what they’re doing. I would just stay away from the face to tell you the truth. I’m a big fan of blankets. I’d cover them with a blanket and try to hold them down if you can.
Again, they’re so much stronger than you can imagine when they’re doing this. Every muscle is tight and working and pumped up. They are often much stronger than us. Confining them is difficult. Staying away from injury is important and trying to maintain their safety. There’s been some animals that seizure, they seizure into the pool.
They’re going to drown because they’re unaware of what’s going on. Thirty seconds in a pool. Falling down the stairs, that kind of stuff. If they’re on the couch and they do this, protect them from falling off the couch because the injury could be worsened when they hit the ground. Those are the kinds of things with seizures. If it’s never happened before, you might want to see a veterinarian.
If your animal has had a consistent history of seizures, again, what’s the normal pattern of my dog or my cat? If it’s been diagnosed as an epileptic when it was two or three years old and it has one seizure every three months. You’ll be like, “I’ve seen this before. This one looks like every other seizure. I’m just going to watch it. I’m going to record it in my calendar. I’m going to be done with it because I hope it’s just like every other seizure.” You wait. You go on your merry way and act as if nothing’s happened. You record it.
If your animal has an increasing seizure frequency, so more than once every three months in this case. If each seizure is more severe, instead of 30 to 60 seconds, they’re now lasting three to five minutes. If they come in clusters, normally that animal, for this instance, was once every three months. If it has four seizures in one single day, that would be a cluster. Increasing severity, increasing frequency or clustering, definitely need to be seen. That’s different from the normal pattern for this dog. Every animal’s seizure disorder is going to have a different pattern.
At what point does the dog need to go on anti-seizure meds?
Some neurologists, after doing a full workup and determining that it’s epilepsy. If the animal has seizure frequency maybe once every three months or more frequently, they might start medicating it. The goals typically are to increase this distance between the seizure by two. If we’re seizuring once every three months and we want to slow that down, our goal is to give a medication to go no more frequently than once every six months. I would say that’s probably a successful long-term therapy.
If we have an animal that seizures once a year, it’s probably not worth putting them on drugs for an entire year to prevent a seizure every year to go to one seizure every two years. Everyone’s having a little different threshold, again, for what they can tolerate in a seizuring animal. I’m talking about an epileptic-type animal. This is one that has no known cause for the seizures. It’s probably just a little glitch in the talking of their nerves. Not a structural problem, an infection or a cancerous process or an inflammatory condition.
It depends on how frequent. If you want to see your dog seizure once a month and it doesn’t do him any problems, you might not want to medicate him. The dog doesn’t care and you don’t care. Some people are like, “I just don’t want to see that that often.” Have a discussion with your veterinarian, whether they’re a general practitioner, an emergency practitioner, or a neurology specialist. They can all give you guidance.
This is going to sound strange. I want to talk about the rectal area. Nobody looks at that area. No pet owners look at the butt. Yet, I’m sure. I know when I manned the phones as a senior vet student, we got a lot of questions about scooting. “What’s that smell back there? My dog’s having blood from his rectum.”
Believe it or not, in dermatology, we would see a lot of problems back there. Sometimes, it was nothing. To me, if it’s something to the owner, it’s something. Even though Carl and Mia’s vets would say, “The anal glands were full. We just emptied them.” Sometimes, you get a ruptured anal gland. That has to be painful for the dog and blood is coming out. Karl, would you address why pet owners should look back there occasionally?
Blood coming out of anything is not good.
Importance Of Rectal And Anal Health
Alice, it’s funny that you bring up butts because let’s just say I agree with you, as a veterinarian. Not only do animal owners not pay enough attention to the south end. Veterinarians don’t often do a rectal exam as part of their complete physical. I would suggest that if we have not done a rectal exam on a dog. There’s a rare cat that’s going to allow you to do that. I’m giving cats a pass here. If I’m to do a rectal exam, they’re going to be sedated. There’s a lot of fun stuff that goes on in cats’ south parts. I love our clients. They’re so cute. They’re like, “Something’s going on down there.” They have different euphemisms for it.
Animal owners often don’t pay enough attention to the “south end,” and veterinarians don’t always include a rectal exam as part of a complete physical. Share on XThey’re private.
We’re looking at the bottom of the feet down there. “No, the other down there.”
I have to be that guy that’s like, “Are you meaning the anus? Are you meaning the vulva? Are you meaning the prepuce? Is it the scrotum?” I have to be that guy.
Many words, right?
I have to do what’s best for the animal. I need to know these things. I can’t sugarcoat anything because I want the best for their animal. I hope that people are not offended by us using words. I understand their worries when they talk about down there. Maybe it’s not culturally appropriate, so I have to dial it back to science. Yes, there are a lot of bad things that go on down there, anal sac problems, scooting.
Cancer back there.
We see perirectal tumors. We see perineal hernias and perianal hernias. Those old German shepherd guys that have just an immune disease where their tissues around their butt just start disintegrating unless we get on top of it with severely immunosuppressant drugs. Perirectal abscesses from an anal gland. Cats are often looking down there when they have signs of penile disease, preputial disease, urethral disease, or cystic disease, meaning their urinary bladder.
They could have urinary obstruction. They can have urethritis. They can have preputial disease. They could have vaginitis when they’re young puppies. There’s a lot of attention that the dog is going to be drawing to and the owner is going to have to pay attention. Be like, “Why are you looking at your butt so much?” When you look under the tail, God love them, cattle dogs, Australian shepherds, they’re so hairy back there. Sometimes, you don’t see anything.
Golden retrievers.
It’s months and months of development where all of a sudden, we shave off the hair. The next thing you know, we’re like, “Whoa, this horse is way out of the barn on that one.” It’s been going on for weeks or months because the animal’s just too trucking along. “I just lick it every so often to make it feel better. I’m just going to tolerate it.” Until we do some stuff where we’re like, “This is hot. We need to help this little critter out.” There’s a lot of stuff that goes on back there.
In the little furry dogs, like a Lhasa or Shih Tzu, sometimes the hair is so caked back there that they can’t poop. The poop doesn’t come out. Like Karl said, you shave and shave. There’s a little surprise of maggots back there. In collies, long-haired dogs, especially in summer, in August. When Karl and I were examining our animals, we always looked back there because there can be surprises. I know it’s a private area, but it’s your pet.
It’s not private to the pet, right? Do you know what I’m saying? It’s more of a human thing.
They don’t care. They’d appreciate it if you paid attention. Thanks to all our wonderful groomers who are reading. Thanks for the hard work that you do because they do amazing things with these animals who don’t want them to do things to them like shaving their butt ends. Because it’s important. Shaving between their toes so they don’t get plants and foxtails stuck in there, which can cause infections in between their toes.
For doing the ear trims and plucking the hair in there because that’s another source of ear infections. We see so many fox tails in California. They just get on the hair, right on the tip. With a hairy ear, it just finds its way inside the drum. Next thing you know, Dr. Jeromin has to go in there with a video scope and clean everything out. It’s a mess. Thanks to the groomers for doing all these upkeeps. They do a lot of prevention, so kudos to that.
They’re thorough.
Karl, do you have porcupines in California like they do here in Eastern Ohio and Pennsylvania?
We have some porcupines. They’re not super common. They’re not common right by us in Davis, but they’re around. I’ve dealt with porcupines in Sedona County.
We would get a few of every year, too.
He’s got rattlesnakes out there. We had tarantulas when I lived there. I used to see them on my walks. It’s creepy.
Love the rattlesnakes.
Do you?
I think they’re super cool.
I used to go out to my hose box. I’d be like bam, bam, bam with my foot because you never know. It was coming out of there.
You have to rattle whatever you’re going for in the summer. You’re going to get a tool out of the tool shed. You’ve got to rattle the door and scare all the black widows away and all the rattlesnakes out. You never put your boots on.
What’s that bad spider? The brown recluse.
Those aren’t such a big deal. They’re overrated.
You get bit, and you swell up. I do have a prop. See, it goes like this. Whenever we have a little cat vomit, we put it out.
In my house, I clean it up.
We do, too. It’s so funny because after you’ve had cats for a long time, you’re just like, “There’s cat vomit in the family room. I’ll get it.”
Are those two cats you adopted, Karl, vomiting?
No. My cats don’t vomit, luckily.
Mine too.
However, they did decide to eat chunks of the plastic Christmas tree. We had two episodes of vomiting, classic green plastic Christmas tree shrew.
The bristles? This was the first year we had a fake tree. They didn’t go near it. Usually, they’d go under it. Sleep under it like they were in the wilderness. The fake one, they didn’t go near it.
I don’t put tinsel on my trees. I try to make sure there’s no ribbons or strings or anything like that around the holidays. My cats are just a little over a year with me. I got them as adults. I can’t trust them for anything. I don’t want to have to do the things that I have to do, like X-rays and surgery. They’re insured. Don’t get me wrong. I can afford all the things they need. I just don’t want to go there.
Not trustworthy cats.
Prevention that’s the most important. I’m an emergency critical care specialist, but it’d be so much better if I was a preventionist. Maybe I should form a business. I can go into people’s houses and coach them on how to animal-proof things.
Prevention is the most important thing. We need to animal-proof our spaces. Share on XIt’s like baby-proofing.
Are there baby-proofers?
Yes. It was a huge business down in where I lived in Menlo Park. They’d come in and put those things on your drawers and the knob covers and all this. How hard is that to do?
Anyway, I’m going to make that animal preventionist service when I retire. I’d love to do that. I can do that.
What are the cats’ names?
Mango and Chutney.
Janet, you don’t know this. Karl surprised me by going into emergency medicine because I thought he was going to go into ophthalmology, which is my next question for him.
You almost went into ophthalmology, too. That’s when she was doing her internship, where she goes, “Go look in the refrigerator.” I opened it up. There’re cow eyeballs in there. It’s just not my world, Karl.
I want to ask Karl what owners need to look for because eyes can, as we say, go south in 24 hours. What are some things? If the cat’s rubbing its eye or my golden that just came here. If I notice one of her eyes is red and she’s doing this. Take it from there.
Assessing And Treating Eye Emergencies
Luckily, we have two eyes because there’s always one to compare with. We hope if one is off, then the other one, hopefully, is the normal one. You can be like, “That one doesn’t look like that one.” Extra fluid tearing coming out of the eye onto the face. Blinking, squinting, we call blepharospasm, if the eye is shut. If it’s swollen in appearance, the eye or the eyelids.
Again, asymmetry, one side looks normal and one side looks bizarre. You don’t want to wait at all. Sometimes, you might see the cornea here. It’s a nice, crystal-clear cornea. You can see my iris. This one, what if it’s all white and milky? You don’t see. It looks like there’s a cloud on the surface. That would be a problem because, again, it doesn’t look like the other one.
Discoloration, pain, fluid, and swelling. Those are probably the big four. One other thing I was going to say is sometimes, painful eating. Sometimes, they might have this swollen eye. It would be hard to chew because the back of the eye hits the back of the mouth. As they crunch down, it causes pressure here. Sometimes, this is manifested as oral pain. That’s a harder one to see. Usually, that’s the big swollen eye. Sorry, Alice. I missed your question.
I was going to say, what if the white of the eye is red?
It could be just a little irritation, which is still something you should get on top of. It could indicate a scratch. It could indicate that it was poked. If it’s a dog who is like a pug or a French bulldog whose eyeballs are basically out in front of their face like a bumper instead of their nose. Sometimes, the eye hits something first before their nose does. They might have gotten a puncture. A cat ran by and slashed them with their claw onto their cornea. Those all need to be seen fast.
If you’re going to have something at home for those kinds of things, the only thing I would have for people to have in their little veterinary toolkit is to have artificial tears. Either artificial tear drops or artificial tear ointments. No drugs. All protection. You might just want to slather that on an eye and get to a veterinarian. Take your product with you and say, “I saw this weird swelling. I saw this weird redness. I saw this weird cloudiness. I put this on it to protect the eye.” You bring your little bottle in with you or the tube of ointment. Just say, “This is what I put on it.” They’ll be happy. They’ll know what you did.
I would not use your own eyeball medicines. If you have special meds for yourself. Don’t do that because you could use the wrong medicine for the wrong problem. You could be way behind a ball. You may have done more damage. Just a non-drug protecting eye ointment or a non-drug artificial tear drop. That would be something to help the eye just be comforted while you seek veterinary attention.
What if they get sprayed in the face by a skunk? What do I do for the eyes then?
If they’re irritated, that might just be to flush them out with a contact saline-type solution. There are saline solutions that have preservatives in them. Those ones might be somewhat irritating. Some animals are a little irritated by the benzalkonium chloride preservative. If it’s a simple eye wash solution, just a saline solution, that might be the best thing to do.
Often, when they’re sprayed in the face, they tear up a lot. The tearing is naturally bathing the gunk out of their eye. If you can get over the smell of a skunked animal, you can flush their eyes out with saline. Again, you might just want to seek veterinary attention. Everything’s so deep. It sounds like everything I say is to go seek a veterinarian’s advice. We’re talking about a lot of stuff. I’m not just trying to drum up business. Many things need a knowledgeable person. I don’t know if Dr. Google is good enough to fine-tune the recommendations.
I’m all about seeking consultations by beautiful shows like this to learn things. Looking on another show or some one-pagers that might be on the internet about what to do in case my animal has whatever or licking their butt or scooting or has bloody tears, or something like that. Still, the veterinarian is going to be your best source of information. Don’t hesitate to go when you don’t know.
What about this thing that people get very nervous about, this reverse sneeze that we call?
What is that?
Understanding Reverse Sneezing
The honest answer is no one knows. The last stuff I read said there might be a source of allergens. This might be an allergenic response to something that’s floating around their environments. One paper was eons ago. Alice, you can remind me. It was a trial of a diphenhydramine or Benadryl may have reduced the symptoms of patients that may have had allergenic-induced reverse sneezing. This reverse sneezing is just an irritant response. It’s something you don’t need to seek veterinary attention for. First thing of the day, we don’t need to see a vet for.
Is it in dogs or cats?
Dogs.
Karl, I remember when I was laying in bed, studying. I was just about to go to sleep. It was a chapter in a book. I looked to see how many pages were left. I saw the last page had a paragraph about four sentences about reverse sneeze. I thought, “I’m finally going to find out what this reverse sneeze is all about.” The very last sentence is, “We don’t know what causes it.” It was such a letdown.
Veterinarians know things, but we still do not know everything. Same with physicians and same with all sorts of medical professionals. We’re learning all the time. The explosion of information is huge. Reverse sneezing hasn’t made it to the level of “Let’s study this.”
Veterinarians know a lot, but we still don’t know everything. The same is true for physicians and other medical professionals—we’re all learning continuously. Share on XThat’s sad. It’s in the company of sebaceous adenomas or “warts.” It’s the thing that’s always out there. Nobody’s ever studied it.
It’s not killing anyone.
It’s a concern. That’s the thing. It’s a concern for people. It keeps happening, like in poodles and cocker spaniels. They get all these, people call them warts, but they’re overgrowth of these oil glands, sebaceous glands. We don’t know how to prevent them. The only way to get rid of them is surgical. They’re fourteen-year-old dogs. You don’t want to put them under for a benign skin problem. I just wish sometimes we would focus on more common things. Getting to the root, like the common cold. We still don’t know about that either.
We still don’t know, or the flu.
I think that sometimes we should just live with our warty little critters. Be thankful that they don’t have bloody diarrhea all over our house.
Vomit on the white carpet. Karl, what are you most passionate about in your profession and the work that you do?
Janet, you are so cute. That’s a great question. I’m just a guy who loves what I do. I’m so glad to be able to do something I love, to be able to help people and their animals, to be able to help my scholars to advance to their level that they want to get to. I am so lucky, even to get to do clinical research. Sorry, Alice, not on sebaceous adenomas, not on reverse sneezing.
I like blood. If you want to have a whole episode about blood, bleeding, and clotting, I’m your guy. What am I passionate about? I’m passionate about the fact that I get to do amazing things with amazing people. I never ever have been bored. I never have ever felt fatigued. I get tired, but it’s more energizing than debilitating. I graduated in the ‘90s.
It’s not work.
Thirty-two years of being a vet and I still feel like I just graduated. It’s fascinating. It’s all cool. The more people I know, the more amazing I got. I saw a faculty seminar on orthopedics. When’s the last time I touched a bone to do an orthopedic surgery? It was vet school. I have no interest in surgery of bones. I know how to do orthopedic exams. I know how to fix and stabilize fractures, radiographs, all this stuff. I sent them to the surgeon.
I was captivated by this presentation. It was so interesting. Much detail and so many advances that they were reporting over this ten-year career of this veterinarian who’s applying for a job. I hope we get to hire him because he’s amazing. I was floored by how good it was. I don’t care at all about orthopedics, but this is so cool. I’m just passionate about being curious. I’m still curious.
I think you love learning. That’s the secret. The moment you don’t want to learn, you might as well. Learning is so cool because there’s so much to learn. Especially, well, not just in veterinary medicine, but I agree with you, Karl. I was listening to a neurology podcast the other day and I listened to it twice. It was so good.
Karl, do you know Catie Morgan? She’s a student.
I do. She’s from Connecticut.
I know because her aunt and uncle live two doors down from me. I’m friends with them and her mom, and her dad. We love Katie. I just saw her at Christmas. I said, “We had somebody on from Davis. He’ll be back on.” It was so funny. She’s adorable.
Katie was on emergency with me. I wrote her a letter for her internship. She’s a winner. I can’t believe you live on the same street. It’s Darien. Katie’s going to be graduating in May 2025. I’m very excited for her next step.
Such a small world.
For sure.
I love graduation. It’s like your children are leaving.
It’s amazing to be able to see them. As the Associate Dean of Admissions and Student Programs, I can see them through the pathway programs as they’re making their application. I can welcome them into our school. I can watch them grow for four years. It’s powerful to see someone come in. Average age of entry is about 23 for our scholars. They finish about 27.
That growth in that four-year timeframe, they go from young men and women with passion and curiosity to being professionals. I am super proud of them. How cool is that? In four years, I can help mold with the other faculty members here, with our staff members of technicians and all the other clerical folks. You turn these people into people you’re so proud of.
It makes me feel great about the veterinary profession. When I say, “Go see a veterinarian for all your stuff.” I don’t say, “Go see only this veterinarian.” You see any of these veterinarians because they all got the chops. They’re going to be the ones that are going to help you out. Whether it’s a cow, a dog, an ostrich, a herd of otters floating in the sea. Veterinarians do it all. It’s pretty cool. Janet, as you asked, what are you passionate about? I’m passionate about what I do. I’m proud of the people I do it with.
Karl, I’ll never forget at our graduation. Not the big one in the stadium, but our vet school graduation. It was in Mershan Hall at that time. Dr. Bednarski, the anesthesiologist, was the one that announced our names. We picked up the diploma. At the very end, after we were all seated and everyone got their diploma.
He stood there and said, “Ladies and gentlemen, our pride and joy.” Everyone stood up. All the parents, all the spouses, all the partners that supported us stood up and just applauded. I looked because we’re sitting next to each other, our classmates. We just didn’t know what to say or do. It was such a moment that I’ll never forget.
I’m the guy who gets to do that here in Davis.
Every year. You lucky devil.
Do you get to do the tassel?
I do. I read everybody’s name. I have them move the tassel. I introduce them to the world. It’s powerful. Sometimes, I choke up.
It’s like a birthing, almost.
Katie’s brother is a PhD candidate at the Harvard History Department. He does a BA in Archaeological Studies from Yale. He studied for two years in archeological research in Anglo-Saxon, Norse, and Celtic. You see why I was like, “Okay, right.” What kind of questions do you ask about that? “See any hieroglyphics lately?”
You ask the same question. You dial it back and say, “What are you most passionate about now?” Come on, Janet, you’re probably good at a cocktail party. You probably got good questions to ask people.
She is good at a cocktail party, I’ll give you that. She could work a room at a cocktail party and have.
The funny thing is, we’ll come home from a cocktail party. My husband and I will be like, “Did you meet John? He’s this and that, and then Susie.” He’s like, “Jesus Christ, how did you get all this crap out of these people?” They’re over there eating the sausage ringies. I’m over there talking to people.
I have to suggest that you’re probably the extrovert in the family then.
Both of us.
We all are, though. Penny, too, our older sister. She’s a little more quiet.
When they meet Penny, she just wants to know everything about them. People love to talk about themselves. She zeroes in. She’s a good listener. She asks good questions. “Where did your daughter go to school?” It’s all that stuff.
She’s the introvert who wants to talk to one person in detail and in depth. Extroverts, in general, yours truly included, are okay with superficial meeting everybody. Superficial is not necessarily meaning we’re not caring. It means knowing about three or five facts. We don’t need to know six years of history.
Many people, so little time.
I need to work the whole room.
You should see Alice and I. We’ve done these appearances at these dog events. It says, “Ask the vet” and they start asking me. I’m like, “No, hold on. Got to get the doctor.”
We’ve heard from a prosecutor talking about the police that he prosecuted. We hear stories that have nothing to do with pets. It starts out about pets and then it just morphs into something else. It’s very interesting.
I have learned a lot.
Me, too. Even though this is my profession. This episode that launched was on American Heartworm Society. Karl, you and I know about heartworm. It’s a nice refresher.
Look what I learned. I wasn’t putting the tick medicine on the cats because they’ve run for me. I learned that it has the heartworm preventer in it. I’ve had these cats for two years. I got it on them twice. The 20th of every month, we’re tracking them down, putting it on whether they like it or not. Otherwise, I wasn’t doing it because they gave you trouble.
We’d better wind it up. Karl’s got to go back and do CPR on somebody.
That’s a good question for our readers. Do you do it the same as humans?
I don’t think we should attempt that. Karl, what do you think?
Performing CPR On Pets
Let’s just say that my veterinary specialty college is very big in training CPR and the veterinary professionals, for sure. Our next level is first responders. Have our clients saved their animals at home with CPR? Yes. I can tell you one, particularly. He was a paramedic. He just adopted a dog. He did it for his own Yorkshire Terrier. The dog lived. It was fabulous.
On an everyday basis, we would need to have some training because it’s not a three-minute or five-minute thing. It’s going to be theory and practice. It’s probably going to be a four-to six-hour thing for you to get clear about how to do it right and well without doing damage. This is just a fact. Some people would say, “If the alternative is death, does it matter? Should I just do something?” In that short answer, yes. Pretend it’s a small person. Do what you were trained by the American Heart Association as best as you can.
That’s what I would say in a short answer for CPR on dogs and cats. It’s adapted differently to other species like fish. There is a very special way to do CPR on a fish. Different things are different. For dogs and cats, do what you do on a human. Be careful not to break ribs. If the alternative is death, I’m not going to say no. The potential win is a win. Maybe we would need to create a nice big coast-to-coast campaign to train animal owners how to do CPR.
CPR for dogs and cats is adapted differently across species—fish even have a very specific method. For dogs and cats, it’s similar to human CPR, but care must be taken not to break ribs. Still, if the alternative is death, you act—the chance of… Share on XCan we back up? How do you CPR on a fish?
They’re underwater. You push them back and forth. You have to have them move water through their gills, and hopefully, it’s oxygenated water. You have to push them through water so that you get the flow through their gills. That’s what you do for their ventilation, basically. You can’t stick a tube in there. It breathes oxygen for them. You have to do that. It’s hard to do that while you’re squeezing their little chest at the same time. Let’s just say I never had to do it. I’m a dog and cat veterinarian. I rarely have had to be called in. I’ve done other species, but I’m not good.
On that note, Janet, we need to wrap it up.
From vomiting and diarrhea to fish CPR. You heard it all here, folks. There was a little tangent on the south side of the northbound critter. We started with vomiting and diarrhea. We ended with fish CPR. We covered a lot of ground. I’m proud of you two for continuing to learn and to continue to spearhead good animal ownership. That’s excellent. I appreciate you both. I look forward to our next time. What is our next topic?
We got a million of them. We’ll come up with something.
Have your people call my people.
This is Dr. Alice Novotny Jeromin, one of the Novotny sisters from Cleveland, Ohio.
I am Janet Novotny King. Thanks for joining us. Dr. Jandrey, thank you for being on with us from the great state of California. We’ll hear you all next time.
You’re very welcome.
Important Links
About Dr. Karl Jandrey
Karl Jandrey is a Professor of Clinical Small Animal Emergency and Critical Care at the UC Davis School of Veterinary Medicine. He attended The Ohio State University and earned both his undergraduate and veterinary degree in 1992. After graduation, Jandrey accepted an internship at a small animal private specialty practice in Los Angeles. He continued his veterinary career as an associate in private general practice, followed by a residency in Northern California before becoming director of emergency services for a specialty hospital in suburban Philadelphia. Jandrey began his academic career as a lecturer at the Veterinary Hospital of the University of Pennsylvania and returned to Davis in 1999. Jandrey was board-certified by the American College of Veterinary Emergency and Critical Care (ACVECC) in 2001.
Jandrey’s publications focus on topics in hemostasis and coagulation as well as scholar well-being and belonging. The later topic evolves from his work as the Associate Dean of Admissions and Student Programs, where he is tasked to strategize and manage the team that provides all extracurricular support for all veterinary scholars at UC Davis. He has earned various honors and awards and especially honored by the UC Davis School of Veterinary Medicine (SVM) Class of 2004 & Class of 2006 as the Favorite Small Animal Faculty Clinician.
Jandrey is involved in many activities and organizations outside of the SVM including the ACVECC, American Association of Veterinary Medical Colleges, and the UC Health Working Group for Diversity in the Health Professions. His clinical research of bleeding and clotting disorders in dogs and cats has been awarded grants from San Francisco Miller Foundation, Center for Companion Animal Health, American Kennel Club Canine Health Foundation, and ACVECC.
Jandrey teaches patient-side in the emergency room and intensive care unit of the Pritchard Veterinary Medical Teaching Hospital, provides lecture and laboratory teaching in several pre-clinical courses, and has lectured worldwide on topics including transfusion therapy, pain control, feline aortic thromboembolism, extracurricular scholar support. He shares his life with another veterinary clinician-scientist, a perfect Yellow Lab, many gallons of saltwater tanks, including vertebrates and invertebrates, and 2 recently adopted cats.