Cool Case Rosey

Rosey is a happy and playful 10-month-old Bichon mix that was recently adopted by her family as an emotional support dog. She was a healthy puppy with no previous medical history.

Rosey was brought in to see Dr. Nancy Vail-Archer, Emergency clinician and Medical Director of the NorthStar VETS hospital in Maple Shade, for a sudden onset of vomiting followed by collapse. Her family reported that she was perfectly normal earlier that morning. They were very concerned and unable to think of what could have happened to make Rosey so ill.

RoseyOn presentation, she was stuporous (poorly responsive) with miotic pupils (constricted pupils). Rosey was hypersalivating (drooling excessively), tetraparetic (unable to use all four of her limbs), she was vocalizing and highly sensitive to any stimulation. Further examination revealed that Rosey was unable to swallow due to an impaired gag reflex. Given her young age, rapid onset of signs and clinical presentation, a toxin exposure was high on the list of differential diagnoses.

Many of her clinical signs were consistent with a baclofen toxicosis. Baclofen is a common medication that acts on the central nervous system to provide muscle relaxation. The drug rapidly crosses the blood-brain barrier (travels from the blood stream into the brain) resulting in suppression of the central nervous system. Further discussions with her family revealed that baclofen was in the home and could not be ruled out as a potential cause. The treatment for a baclofen toxicosis can be intensive, but with aggressive supportive care, the prognosis is often good for recovery. Severe muscle relaxation can result in an inability to breathe, and may necessitate intubation and mechanical ventilation.

Rosey was treated with IV fluids, antinausea medications and medications to help reduce the toxic effects of the baclofen. Cotton balls were placed in her ears to help reduce stimulation. A particularly important treatment was the use of Intralipid emulsion (ILE). ILE will help to capture the toxicant and carry it to organs that can detoxify and/or excrete the toxicant. Additional nursing staff was called in to provide one-on-one supportive care for Rosey. Over the next 24 hours Rosey gradually became more responsive and fully recovered by her 3rd day in the hospital. We are happy to know that Rosey is at home and is back to being a playful puppy!

Learn more about the Emergency and Critical Care service at NorthStar VETS.

Nancy Vail-Archer, DVM – Medical Director, Maple Shade
Nancy Vail-Archer, DVM - Medical Director, Maple ShadeDr. Vail-Archer returned to her hometown of Bordentown, New Jersey along with her two dogs, Ricky and Saba, when she joined NorthStar VETS in 2007. She completed her undergraduate studies at Rutgers University where she earned a degree in biological sciences, and her interest in research and medicine led her to Princeton University where she worked as a research assistant. She completed her veterinary studies at Ross University School of Veterinary Medicine, with a year of clinical training at the University of Missouri College of Veterinary Medicine. She completed a 13-month rotating internship at Fifth Avenue Veterinary Specialists in New York City and has a special interest in emergency and critical care medicine. Outside of veterinary medicine, Dr. Vail-Archer enjoys running, skiing and scuba diving.

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