A Blood Draw for Sal
Sal was brought to us to establish why he had been having chronic vomiting and diarrhea. When I approached him in the lobby, he immediately pinned his ears and retreated under the couch. We brought him into an exam room, and he warmed up a bit but was still wary. Mom and Dad mentioned that in the past at other clinics he was taken to “the back” for vaccines and they could hear him vocalizing from the exam room.
We needed to sedate him to further work up his history of vomiting and diarrhea. Since this would take a while, Mom and Dad went out for lunch and we kept Sal in our treatment area, where he became noticeably more anxious with the absence of his family. We used desensitization and counterconditioning techniques with small pieces of Braunschweiger and he eventually did not even notice when he was being touched along his epaxial muscles. He did not vocalize or notice whatsoever when we gave him his IM sedation. His abdominal ultrasound was normal, which was great for him but meant that we needed to further work up his symptoms. The veterinarian on the case recommended that he come in for an ACTH stimulation test.
The technician working with him mentioned that we needed to provide Sal with some pre-visit medications so it would be less stressful for him. This specific test measures cortisol and if Sal was stressed it could affect the test results. The veterinarian consulted our behavior department about what medications he could come in on that would not affect the test results.
Because Sal vomited during a trial of Trazodone at home, he came in on gabapentin alone. Because this didn’t go well, we called it a day and decided to attempt a different medication combination. The next time Sal received gabapentin, Trazodone, and Cerenia 30 minutes prior to the appointment time. This time when we entered the room, Sal was significantly sleepier and more relaxed. We offered him chicken baby food and he loved it. We placed him on the table, Mom and Dad talked to him and fed him while one technician occluded his vein, and the other technician performed the blood draw and administered the medication. Sal ate chicken baby food throughout the entire process. Then Mom and Dad waited patiently in the exam room with Sal until it was time to draw the 1-hour post sample. We repeated the same process. Sal was a rock star and ate throughout the blood draw. Now we have a set protocol for when he comes in for workups or annual visits, and he stays with mom and dad for any procedure possible.
Maria Marano, RVT, Fear Free Certified, Community Practice, The Ohio State University Veterinary Medical Center, Columbus, Ohio