Case 2: Mystery toxin

In the midst of a busy afternoon the receptionist stopped me to say that animal control was on the phone and urgently needed to speak with the vet.  That is never a good thing.  As it turned out they were busy trying to catch a dog that had been running loose for 3 days.  The dog was previously friendly but now would not even approach the owner, was drooling, growling, and tremoring.  As they taught us in school...think rabies first.  I thought great, now I have to stay late and cut off a head today.  But as it turned out it was a well vaccinated adult dog and unlikely to be rabies.

But, when the dog did finally he arrive, he was definitely having a problem.  The poor dude was shaking uncontrollably, and very nervous.  And the more worked up he got, the worse the shaking got.  Unfortunately because of his mental status I didn't get to do more than a visual assessment at a distance.  Toxin of some sort was at the top of my list but primary brain disease like meningitis was also there.  We drew blood, which was all normal, so we started fluids, valium and antibiotics.

The next day he was quite a bit better and in 48 hours he was normal.  This case is the one where I'm not 100% sure if I made the difference or not.  But, he was in bad shape when he came to me and got better after we treated him, so, I count it as a win.  Could have been stopping the tremors and breaking the cycle helped, or fluids to flush whatever it was out of his system, or maybe even the antibiotics   If nothing else he finally got a good (chemically induced) night's sleep! Based on his full and rapid recovery toxin is still my primary differential but the list of possibilities is quite long-ivermectin, chocolate, caffeine  moldy food, amphetamines (legal and illegal) or other drugs just to name a few.