Rhabdo Scare After Routine Procedure At Vet

[Guest JAV]

Hi all,

 

I've seen several posts on how scary Rhabdo can be, but I always thought it was something that only happened after too much vigorous exercise or some sort of trauma. Following our scare a few days ago, I did a search on GT and saw that a couple of others have also had experiences with this condition in circumstances that were apparently just stressful, but no trauma, etc.

 

Given that this is apparently pretty rare, but DOES happen with Greys, I was encouraged to post about our experience so others have it for reference.

 

On Friday, our 6-year old grey, Sonny, needed to have his tail amputated. (Had been damaged weeks ago, and after it appeared to be doing well, started to get necroses and needed to go). The procedure seemed to go fine, but he was obviously stressed out and shaking because of it. As soon as we left the vet's office, he peed and it looked like motor oil - I believe the literature says "tea-colored". Brown. We ran back inside and everyone was puzzled - this would normally look like Rhabdo, but how could it be given he wasn't running a race??

 

Apparently some other GT members have also gotten Rhabdo after, among other things, a stressful trip to the groomer and the stress of having a dental cleaning under anesthesia. Here, the trigger was being at the vet all day and having a tail amputation.

 

We didn't know at the time what was going on, so it was a stressful Friday night. Saturday morning things became more clear, and we got him on an IV drip, and my husband and I sat with him all day at the vet's office for that so he would be calm. They also gave us a good supply of Trazadone, which did WONDERS to relax him. By the end of the day, his urine was approaching a much more normal color. Ideally, we'd have liked to continue fluids, but didn't want to induce more stress by taking him to the ER overnight. So, we took him home and monitored all night to be sure nothing got worse. (Basically, watching behavior and comparing urine sample colors).

 

We went back to the vet for another all-day fluid IV session Saturday, after which they re-ran his blood work. When we went in for a check on Monday morning, they said that the numbers that had been totally haywire was normal or approaching normal, with the exception of his AST liver value. That number had come down from the stratosphere, however, and was still "really high." So we got some Denamarin pills to give him for the next week and re-check in a week.

 

We've also been making sure to add a lot of water to his food and make sure he doesn't do too much exercising, just some short walks, until this is fully cleared up.

 

If anyone else has any advice or experiences to share, we would be greytful. We are hoping he continues to make steady progress. As of this morning, his behavior seems back to normal (with the exception of walking slower outside, etc.)

 

Going forward, we are thinking that if he needs any procedures, we want to follow what another member posted - have him calm beforehand (maybe with meds), have him anesthetized immediately upon arrival at the vet, and make sure they know that he should go home earlier than normal if he starts to stress out when waking up.

 

Welcome any thoughts! Thank you!

 

 

 

 

[MaryJane]

Is there a chance that your dog could have over-heated (temp > 103). This happened to one of my dogs after a dental and as he was waking up from the anesthesia. When they brought him out to me - I noticed that he was really panting and I had them take a temperature - it was 102 but within a few minutes went up to about 105. Over the next 30 minutes we cooled him down. This happened again with another vet visit. I started to have the staff check for over-temperature if he started breathing too hard and we were eventually able to control it better by giving gabapentin (calms them down) before his visits.

 

When a dog overheats, there is dectruction of blood cells and I suppose it could possibly resemble rhabdo (I'd have to do much more reading to determine how accurate this is).

[Neighsayer]

Is there a chance that your dog could have over-heated (temp > 103). This happened to one of my dogs after a dental and as he was waking up from the anesthesia. When they brought him out to me - I noticed that he was really panting and I had them take a temperature - it was 102 but within a few minutes went up to about 105. Over the next 30 minutes we cooled him down. This happened again with another vet visit. I started to have the staff check for over-temperature if he started breathing too hard and we were eventually able to control it better by giving gabapentin (calms them down) before his visits.

 

When a dog overheats, there is dectruction of blood cells and I suppose it could possibly resemble rhabdo (I'd have to do much more reading to determine how accurate this is).

 

I had that happen, too. Dog was in the hospital for a procedure. They called to tell me it went well, and he was waking up. Got another call a short time later. His temp was over 106, and they needed to cool him down. They wanted permission to do what they needed to do to get him stable. They didn’t want to have to take the time to call several times if the first step wasn’t working. They said it was something to be aware of in case he ever had to be put under in the future.

[NeylasMom]

Highly doubt it was anything but rhabdo with urine that color. It's the myoglobin that's produced as the muscle breaks down that causes that port wine color. Blood in urine doesn't look the same. Certainly possible he overheated and that caused the rhabdo though. But you can get rhabdo from stress alone. According to Care of the Retired Racing Greyhound excessive panting causes chemical changes in the body that can cause it and certainly the excessive trembling/shaking can.

 

I'm guessing I might be the other member you're referring to. Violet had a stress/heat induced episode of rhabdo back in 2013 and then some sort of stress incident after her first dental that wasn't definitely rhabdo, we just weren't sure. Regardless we take a lot of precautions and use specialists for anything more involved. The veterinary dentist was fabulous and consulted with an internal medicine specialist to come up with our plan, which is essentially anti-anxiety and anti-bleeding meds and supplements days to a night before and morning of, absolutely no pre-meds, just straight to catheterization and sedation and them someone sits with her and keeps her calm as she wakes up. Went really well last time, but she didn't have extractions that time so she was also under less time so hard to know what did it. Anyway, feel free to PM me if you want more details, but probably best to consult with your own vets to come up with an individual plan. I do think for us that skipping the pre-meds is huge. I also do bring a frozen stuffed kong for her to work on for the short time we have to wait. You want them to have an empty stomach, but we decided that risk was less of a concern, especially since I didn't put a ton of food in it. I just wanted her to be able to work on something that would calm her.

 

Hope your boy recovers well. Do you know if he had a lot of casts in his urine at any point during this? If so, one thing to consider is that his kidneys may be somewhat compromised. You won't see kidney damage on bloodwork until they're about 75% damaged so possible he will end up with some and you won't see it. I just keep it in mind for Violet and choose medications, etc. that are gentler on kidneys when there are options. You might also think about a kidney supplement (Standard Process makes a good one, as does Vetri-Science) and milk thistle for at least a few weeks.

Edited July 10, 2018 by NeylasMom

[MaryJane]

Highly doubt it was anything but rhabdo with urine that color. It's the myoglobin that's produced as the muscle breaks down that causes that port wine color. Blood in urine doesn't look the same. Certainly possible he overheated and that caused the rhabdo though. But you can get rhabdo from stress alone. According to Care of the Retired Racing Greyhound excessive panting causes chemical changes in the body that can cause it and certainly the excessive trembling/shaking can.

 

It is not intact blood cells in the scenario I mentioned. I said that high temperatures can cause blood cells to be destroyed and thus releasing the hemoglobin which is then released by the kidneys into the urine. It would look the same and is differentiated by tests.

[Guest JAV]

Thanks all!

 

Greyaholic - Yes, I did read your posts in detail! I don't know about the casts in urine - I'll ask the vet, and will also keep the kidney point in mind. Great points.

 

Also, though it's a good point to consider, he definitely was not overheated. His temp was normal or a tad low throughout the entire process.

 

Will keep you posted.

[JohnF]

It's probably 'Malignant Hyperthermia' you're dealing with.

[NeylasMom]

It's probably 'Malignant Hyperthermia' you're dealing with.

Unlikely since his body temp wasn't elevated. You'd also expect that he would have had an issue during his neutering or other previous anesthesia, and you would expect that he wouldn't have recovered without treatment with Dantrolene.