NORI’S STORY:

Nori was being looked after by a pet sitter while her family were away in Europe. Her eagle-eyed caretaker spotted Nori eating what they thought was 1-2 handfuls of grapes. Prudently, they brought her to the emergency veterinarian right away.

The toxicity of grapes can be unpredictable, so the emergency veterinarian induced vomiting immediately. What was suspected to be a couple of handfuls turned out to be more than 60 grapes!

ABOUT THE CONDITION: GRAPE AND RAISIN TOXICITY

Grapes, raisins, and some currents have been known to cause toxic effects in dogs. The exact compound in grapes that causes illness is unknown, but recently, tartaric acid has been suspected. The dose of grapes that triggers illness has not been determined; some dogs that eat a lot of grapes never get sick, while others that eat just one or two have become severely ill. Ingestion of a large number of grapes is more likely to cause severe illness…but not every case follows this rule. It is known that the concentration of tartaric acid varies with the grape’s variety, growing conditions, and ripeness. Dried raisins and currents have a higher concentration of tartaric acid than fresh grapes.

The clinical signs of grape toxicity include vomiting and diarrhea, which can progress to acute kidney failure and neurological signs. Abdominal pain, appetite loss, changes in urination volume, lethargy, weakness, and staggering may be observed. 1-2 days after grape ingestion, an increase in blood nitrogen signals the kidney injury. Grape toxicity can be fatal if not treated promptly and aggressively.

TREATMENT

Because the toxic dose of grapes cannot be pinpointed, all dogs must be treated for the “worst case scenario” when ingestion is known or even suspected.

Upon admission, Nori was given an injection of apomorphine to induce vomiting, therefore removing as much grape material from the stomach as possible. She was then given activated charcoal, which binds certain toxins and prevents absorption into the blood stream.

Blood was collected immediately to establish Nori’s baseline (healthy) kidney function. This allowed the veterinary team to monitor for any changes periodically over the next 3 days…keeping an eye out for signs of kidney injury.

Nori was then placed on IV fluids for the next 48 hours. Aggressive fluid therapy is performed to dilute any absorbed toxins, and speed the clearance of toxic compounds from the blood in an attempt to protect the kidneys.

Fortunately, and because of the quick actions of Nori’s caregivers and veterinary team, Nori never developed any signs of toxicity or kidney injury. Decontamination measures were successful, and Nori was discharged in excellent condition after 48 hours of hospital care and monitoring.

CLAIM OUTCOME

Pets Plus Us pack member Nori needed $2,285.32 in veterinary care following her culinary adventure with grapes. Her family was reimbursed $2,056.79 through their Pets Plus Us Accident and Illness More plan.

Stick to the milk bones from now on, Nori!

View Previous Claims Stories

• Jojo - Chronic Otitis
  

  Condition: Grape Toxicity
  Pet: Jojo* a 5-year-old male English Bulldog

  ACTUAL CLAIM PAID: $4,945.00**

  JOJO’S STORY:

  Jojo was adopted as a puppy in 2018. During his first puppy vaccines, the veterinarian informed Jojo’s family that while Jojo was in great health, unfortunately, his breed was prone to numerous health conditions. Prudently, the family enrolled in pet insurance immediately, and made sure to include hereditary conditions in their coverage.

  At around three years of age, Jojo began to have ear infections in his right ear. The infections would improve with treatment, but always seemed to come back. The infections reoccurred so many times, that the tissue within his ear canal began to swell and proliferate. Bacterial cultures started to show the appearance of antibiotic resistant bacteria. The infections became increasingly painful, smelly, and difficult to treat. To improve Jojo’s health and comfort, his veterinarian recommended a surgical procedure called a TECA-BO, or Total Ear Canal Ablation with Bulla Osteotomy.

  ABOUT THE CONDITION: CHRONIC OTITIS

  Otitis externa is the inflammation of the ear canal. Inflammation of the skin inside the ear is often caused by allergies/atopy. The surface of inflamed skin is warmer and more moist than healthy skin…and this is especially true inside the ears where heat and moisture are trapped. Unfortunately, this creates a perfect environment for bacteria and yeast to flourish. It is normal for some microbes to live in the ears, but under the influence of inflammation, the types and numbers of microbes present become harmful, contributing to tissue damage, and increased immune response. Inside the ear canal, secondary changes occur as a result of the tissue damage, including proliferation and mineralization of the ear canal.

  Repeated treatments with ear drops can lead to antibiotic resistance. Additionally, dogs with recurrent otitis are often in a lot of pain. They often start to resist cleaning and medication of their ears.

  TREATMENT

  Otitis externa is treated with ear cleaning, antibiotic/antifungal ear drops, and pain medications. Additionally, if the infections are recurrent, the root cause, such as food allergies, will be investigated and treated.

  Bacterial and fungal cultures may be performed to identify the microbes present, and select the ideal antibiotic treatment.

  When ear infections reoccur frequently, lead to chronic changes in the ear canal, and become resistant to treatment, a surgical procedure called TECA-BO may be reccommended. This procedure removes all of the tissue of the ear canal. It also allows flushing and removal of infected tissue from the tympanic bulla, a middle-ear structure which may harbor bacteria and yeast.

  The TECA-BO procedure is considered a salvage procedure because it results in loss of hearing in the treated ear. However, patients are often much more comfortable afterwards, and maintain the normal appearance of their pinna (ear flap).

  The goal of the procedure is to eliminate pain and future incidents of otitis.

  CLAIM OUTCOME

  Jojo required two years of treatment for recurrent cases of otitis. On top of that, his TECA-BO procedure cost his family $6,458.00 in veterinary fees. His Pet Partners Companion Plus policy reimbursed them $4,945.00 of those fees. We are happy to report that Jojo has many comfortable years ahead of him!

• Tucker - Gastrointestinal Foreign Body
  

  Condition: Gastrointestinal Foreign Body
  Pet: Tucker* a 4-month-old male Goldendoodle

  ACTUAL CLAIM PAID: $2,945.24**

  TUCKER’S STORY:

  Tucker is a bouncy, mischievous and adorable four-month-old goldendoodle puppy. Like many goldendoodles, he explores his world with his mouth and often eats things he shouldn’t.

  One morning, Tucker started the day by vomiting yellow fluid, paper towels and some other unidentified materials. His appetite was good, but soon after he ate his breakfast, he vomited all of the food back up again. Over the next 24 hours, his energy level dipped and he continued to vomit, especially whenever he ate or drank water.

  Tucker’s family brought him to their family veterinarian. They told the health team about his naughty eating habits and mentioned he had been playing with a sock, which was now missing.

  On physical examination, the veterinarian could feel a suspicious lump within the abdomen. A radiograph confirmed a complete obstruction of Tucker’s small intestine. Some bloodwork was completed, showing he had some minor dehydration and electrolyte abnormalities. IV fluids and pain control started and surgery was planned to explore his abdomen.

  ABOUT THE CONDITION: GASTROINTESTINAL FOREIGN BODIES

  Both dogs and cats occasionally ingest materials that are not digestible and can lead to obstructions or trauma to the gastrointestinal tract. Young, curious puppies and kittens and certain food-motivated breeds are notorious for inappropriate ingestions.

  Common foreign bodies include things like toys, hair ties, corn cobs, socks and underwear, rocks and plastic. Linear foreign bodies like thread, yarn and ribbon can be particularly dangerous because they can lacerate the inside of the gastrointestinal tract.

  Undigestible materials can become lodged anywhere in the digestive system, including the esophagus, stomach and small and large intestines. They may cause pain and partial or complete obstructions, interfering with food digestion and water intake. This results in appetite loss, vomiting and diarrhea. The resulting dehydration and electrolyte abnormalities can make patients extremely sick in a short period of time. Trauma to the stomach or intestines can even allow bacteria to enter the abdominal cavity, causing peritonitis, sepsis and in some cases, even death. For this reason, foreign body ingestion is a medical and surgical emergency.

  TREATMENT

  Treatment for gastrointestinal foreign bodies involves stabilizing the patient first. That means correcting dehydration and electrolyte abnormalities, treating pain and nausea and instituting antibiotic therapy as necessary.

  When the patient is stable, either endoscopy (“scope”) or surgery is performed to locate and remove the foreign body. The affected parts of the gastrointestinal tract must be examined closely for trauma, and sometimes damaged sections need to be removed and healthy portions sutured together.

  After surgery, most pets experience a great deal of relief. Ongoing pain and nausea management and antibiotic therapy is required for a week. Some pets need additional nutritional support, appetite stimulation and assistance with gastrointestinal motility. Potential complications include poor healing, infection and strictures.

  Tucker was taken to surgery where a sock was removed from his small intestine without complications. He recovered very well and was eating the following day.

  CLAIM OUTCOME

  Tucker required $3,931.55** in veterinary care for the initial treatment of his intestinal foreign body. For their first claim on the policy, Tucker’s relieved family was reimbursed $2,945.24 of those fees by their Pets Plus Us Accident and Illness More plan.

  Now that’s one way to demonstrate the value of pet insurance! We hope you stick to the kibble from now on, Tucker!

• Jack - Corneal Ulcer and Entropion
  

  Condition: Corneal Ulcer and Entropion
  Pet: Jack*, 7-month-old male Pug

  ACTUAL CLAIM PAID: $2,266.49**

  JACK’S STORY:

  Jack the pug started to have discharge from his eyes late one week. By the weekend, he was squinting and his eyes looked painful and swollen.

  When he was examined, the vet found that the left eye was red and watering. The surface of the eye appeared wounded: it was cloudy and absorbed a special stain used to detect eye injuries. His vet diagnosed a superficial corneal ulcer – the traumatic loss of part of the surface layer of the eye. He was prescribed antibiotic eye drops to treat and prevent infection and additional eye drops to provide lubrication and treat pain.

  At first, Jack’s eye seemed to improve, but after two days of treatment, things got worse. Jack started rubbing and scratching his eye, and there was more redness, squinting and swelling. The vet prescribed additional pain medications and a cone collar.

  Unfortunately, the ulcer didn’t respond to treatment. The infection worsened and caused the defect to become deeper, threatening the eye. A decision was made to refer Jack to a veterinary ophthalmologist.

  The ophthalmologist determined that the eye was at risk for rupturing. He discovered the ulcer was likely caused by entropion – a condition where the lower eyelids roll inwards, causing the hair on the lid to repeatedly brush against the surface of the eye.

  ABOUT THE CONDITION: CORNEAL ULCERATION

  The cornea is the crystal-clear tissue that we see at the front of the eye. It is made of a waterproof layer of cells on the surface and several transparent layers of cells underneath. A membrane is found at the deepest layer, separating the cornea from the liquid anterior chamber of the eye.

  Physical injuries, chemical exposure and biological agents like bacteria and viruses can disrupt the superficial layers of the cornea. This is very painful, often causing the pet to rub and scratch at their eyes and worsen the trauma. Injury to the cornea also allows secondary infection to occur. Bacterial activity and the resulting inflammatory response can sometimes lead to a “melting ulcer.” Without treatment, melting ulcers become progressively deeper until the inner membrane is at risk of rupturing. Rupture and infection of the interior of the eye can be difficult to treat. It may even lead to the need for surgical removal of the eye.

  TREATMENT

  Along with antibiotic eye drops, lubrication and pain relief, Jack also needed three surgical procedures. The first two were left and right blepharoplasty – surgical treatment to correct the inward rolling of the eye lids and prevent ongoing damage. The third surgery was a conjunctival graft. In this procedure, the soft tissue surrounding the eye was sutured across the corneal ulcer to provide protection and additional blood supply while the cornea took it’s time healing.

  CLAIM OUTCOME

  Pets Plus Us pack member Jack needed $3, 083.11** in specialized veterinary care for his entropion and corneal ulcer. His human was reimbursed $2,266.49 through their Pets Plus Us Accident and Illness More plan.

  We wish you a speedy recovery, Jack!

• Simon - Crystalluria
  

  Condition: Crystalluria
  Pet: Simon* a 5-year-old male Ragdoll cat

  ACTUAL CLAIM PAID: $4,214.60**

  SIMON’S STORY:

  Simon was normally a laid-back, no-fuss cat. When he started going in and out of the litter box one morning, straining and crying, his family knew something was wrong. At first, his family members suspected that Simon was constipated but they soon realized he was only passing small dribbles of urine.

  Simon was taken to a local emergency veterinarian, where urethral obstruction was diagnosed. His bladder was full, firm and painful and his bloodwork showed signs of stress and mild electrolyte abnormalities. While an abdominal ultrasound showed a large amount of dense, sand-like sediment in the bladder and possible bladder stones.

  ABOUT THE CONDITION: URINARY CRYSTALS AND STONES

  Under ideal chemical conditions, all of the salts, minerals, and metabolites that are excreted in the urine remain dissolved in liquid, so they can be easily and painlessly eliminated from the body. Unfortunately, when metabolic, inflammatory, or dietary illnesses occur, the chemistry of the urine can change. Under these conditions, minerals and other compounds can precipitate (come out of solution) forming crystals and even stones within the bladder.

  The lower urinary tract includes the bladder and urethra. In cats, inflammation in this region combined with dietary excesses of certain minerals can lead to the formation of crystals and stones. Additionally, liver conditions, some drugs and even some cancers can change the urine chemistry and lead to crystal formation. Crystals and stones are abrasive: they slosh around within the urine, causing spasms, damage, pain and inflammation on the internal surfaces of the lower urinary tract. Stones and inflammatory secretions can even form plugs that obstruct urinary flow out of the body – a potentially deadly surgical condition known as urethral obstruction.

  Microscopic and chemical analysis of urinary stones and crystals can help to identify the type of crystals present. This information helps veterinarians to develop a plan to treat and even prevent future urinary crystals.

  TREATMENT

  Simon was given a sedative, pain control and IV fluid therapy to address his hydration and electrolyte abnormalities. Once he was stable, he was anesthetized and his urethral obstruction was relieved using a urinary catheter and some hydropulsion (moderate-pressure flushing). Urine was collected for analysis, revealing abundant struvite crystals and inflammatory cells. Simon’s bladder was fully emptied and flushed several times with sterile saline to try to remove all of the crystals.

  Since ultrasound imaging revealed persistent heavy sediment in the bladder, a concern for bladder stones was still present. As a caution, a cystotomy procedure was performed. In this procedure, the bladder is entered surgically so any remaining grit and stones can be visualized and removed.

  Simon recovered well from his surgery. He remained on IV fluids for a further 24 hours to help his kidneys catch up after the period of urethral obstruction. His urinary catheter was also maintained in place so any remaining grit could pass easily while urinary inflammation and spasms had a chance to subside.

  When Simon was ready, he was discharged to his relieved family with pain medication, muscle relaxants, antibiotics, and strict instructions to stay on a urinary diet long-term. Urinary prescription diets promote an acidic urine pH and have low levels of crystal-forming minerals. They can dissolve some crystals and stones (including struvite) and prevent the formation of new ones.

  Urinary crystals and urethral obstruction have a high risk of re-occurring without proper management and close monitoring. Simon’s owners will have to keep a watchful eye on his urination habits and urinary comfort from now on.

  CLAIM OUTCOME

  Pets Plus Us pack member Simon is doing well after his painful urethral obstruction. He is expected to remain crystal-free with ongoing dietary management. He needed more than $5,176.47 in veterinary care at the emergency hospital. His family was reimbursed, $4,214.60** through their Pets Plus Us Accident and Illness More plan.

• Ace - Fall-Related Trauma
  

  Condition: Ace* a 1-year-old male cat

  ACTUAL CLAIM PAID: $1,826.14**

  ACE’S STORY:

  Ace escaped out the patio door of his family’s apartment and followed the Autumn sun rays to the sixth-floor balcony. Unfortunately, disaster struck! With all the stimulation that the outdoors had to offer, Ace lost his footing and fell to the ground below. When his worried family reached him, he seemed stunned and fearful, and he didn’t want to move or eat.

  He was brought to the emergency veterinary hospital where the veterinary team looked him over thoroughly. They watched him closely for limping or abnormal movements, took note of his mental status, listened to his chest, observed his breathing closely and they felt his limbs, spine and abdomen, looking for painful areas. Throughout this examination, it was clear Ace’s breathing was shallow and rapid and he had cuts and abrasions on his back legs. Pain medication was given as soon as possible while x-rays and ultrasound imaging were used to evaluate Ace’s chest, abdomen and skeleton for injuries.

  ABOUT THE CONDITION: FALLS AND “HIGH-RISE SYNDROME”

  Cats, especially young ones are prone to injuries from falling. When an animal falls from a height greater than two meters, veterinarians refer to the expected collection of injuries as “high-rise syndrome.” They must consider all of the possible injuries that can occur from such a fall. Broken bones are common, but vets will also look for head injuries, dental or jaw fractures, internal bleeding and bruising, organ damage and even spinal injuries.

  Damage to the lungs can be especially dangerous after falls. Lung abnormalities like pulmonary contusions (bruising), and pneumothorax (development of air pockets) can impair the lungs’ ability to expand and exchange gasses, leading to oxygen deprivation and even death. The presence of these injuries can be revealed two to three days after a fall.

  When an animal first arrives at the hospital, veterinarians will observe them for signs of neurological changes that might indicate a head injury. From there, any potential fear or pain is addressed with medication. Finally, oxygen support can be given if needed while the team performs a more thorough examination. The goal is to evaluate for fractures, bruising, pneumothorax, internal bleeding and neurological injuries.

  The veterinary team will often want to observe a fall victim for at least 48 hours and sometimes longer depending on the injuries the patient has sustained. Even “normal” looking animals can develop clinical signs related to head trauma, lung trauma and blood loss in the hours after the incident. Serial tests and imaging are prudent.

  TREATMENT

  Fortunately, Ace’s mouth and jaw appeared normal, his x-rays didn’t reveal any bone fractures and an ultrasound of his abdomen did not reveal any free fluid that could indicate internal bleeding. However, Ace’s chest wasn’t so lucky. X-ray and ultrasound imaging showed some bruising on both sides of his lungs as well as a small area of pneumothorax, which explained his fast and shallow breathing. It was determined that Ace would need hospitalization over the next day or so, to deliver supplemental oxygen and make breathing easier. This also allowed doctors to provide comprehensive pain control and perform re-check imaging to make sure his lung injuries were not worsening. The wounds on Ace’s back legs were also cleaned and stitched and antibiotics were given to prevent infection.

  After 24 hours, Ace was able to breathe easily without the additional oxygen and his test results showed that none of his lung injuries were progressing. He was discharged to his grateful owners with pain medication, antibiotics and strict instructions to rest.

  CLAIM OUTCOME

  Pets Plus Us pack member, Ace, is expected to recover well following expert care after his dramatic fall. He needed more than $2,251.27 in veterinary care and monitoring after the accident. His family was reimbursed, $1,826.14** through their Pets Plus Us Accident and Illness Max plan.

  We wish you a speedy recovery, Ace!

*Name changed for privacy
**Source: 2022 PTZ Insurance claims data. Value of claims in $ CAD.