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Finally Freedom from Pain
 Denali , a five year old Mastiff was referred to AMC because of a chronic left ear infection that had been unresponsive to medical management for several years. Denali was continuing to scratch and shake her head, whining at night due to the discomfort. Since treatment was becoming more difficult, Denali’s referring veterinarian determined that a surgical consultation was warranted.
Upon evaluation at AMCNE our surgeon found that the ear canal was severely inflamed and painful, and agreed with the decision of the referring veterinarian that surgery should be performed. Previous cultures of the ear canal had revealed a mixture of bacteria and a previous biopsy of a mass within the ear had revealed inflammatory tissue. Radiographs of Denali’s skull demonstrated that the inflammation was severe enough to cause calcification of the horizontal canal.
 There were three primary surgeries that could be performed to treat Denali’s condition:
- Lateral resection
- Vertical ablation
- Total ear canal ablation
The purpose of lateral resection and vertical ablation would be to preserve the horizontal canal allowing access to medication and airflow when doctors have determined that medical management can cure the disease. The decision to perform these procedures is based on finding only moderate disease of the ear canal. In Denali’s case the vertical ear canal was calcified and the bulla was severely thickened.
A decision to use the third option of total ear canal ablation was made for Denali, since successful medical treatment of the horizontal ear canal was unlikely due to the severity of inflammation and scarring. Total ear canal ablation can be a technically challenging procedure with the possibility of complications including damage to the facial nerve or branches of the sympathetic nerve. However, the cosmetic outcome is excellent and the procedure provides outstanding relief from pain and disease.
In Denali’s case, Dr. Kurt Schulz, our board-certified surgeon, performed total ear canal ablation with an extremely successful outcome. Denali is recovered without complication and is now pain free - and free of the need for ongoing medical treatment of his ear.
Detox in the ICU
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 “Bigsley”, a 9.9 pound, 8-year-old, male castrated miniature pinscher was brought to the hospital at 2:00am one morning for convulsions and collapse following ingestion of an alcoholic beverage.
The owners had made a “White Russian” (vodka, kahlua, and milk) and accidentally left it on a coffee table when they went to bed. Around 1:00 am, the owners were awakened by Bigsley, who was convulsing in their bed. The owners quickly noted that Bigsley had ingested an estimated ¼ to ½ cup of the mixed drink and immediately brought him to AMCNE for treatment.
 When he arrived Bigsley was limp and severely disoriented, exhibiting head twitching, urinary incontinence, and compulsive licking of his lips and swallowing. He was markedly hypothermic at 95.9°F and he emanated an extremely strong odor of alcohol. An intravenous catheter was placed immediately to stabilize him and a “Bair hugger” was utilized to bring up his temperature.
Because he appeared unable to swallow normally, a nasogastric tube was placed to allow administration of activated charcoal. A large amount of air was aspirated from the stomach (easily identified by the odor), and medication was administered intravenously. Over the next few hours, Bigsley’s body temperature gradually returned to normal and he became slightly more animated. Ten hours after his initial admittance to the hospital he was able to stand on his own (although still very wobbly), and eat a small amount of food. After another four hours he was able to walk normally on his own and was ready for discharge.
Ethanol toxicity, while not a common small animal emergency, can cause severe neurologic and gastrointestinal disturbances. Dr. Christina Barnett, who treated Bigsley, discovered that literature on the subject of ethanol toxicity is scarce. Emergency and toxicology texts revealed few suggestions on treatment of this condition, but Dr. Barnett was able to find instances of similar cases on VIN (Veterinary Information Network). There appeared to be no specific recommended treatment for ethanol toxicity, other than symptomatic and supportive care with IV fluids and medication to control nausea. One interesting fact that Dr. Barnett noticed on her VIN search… it seems that White Russians are the drink of choice among discriminating canines!
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