PVH equine ambulatory veterinarian Dr. Travis McKinzie recently wrote an article about equine first aid for the Washington State Quarter Horse Association newsletter. We've shared his article below and hope you find this informative!

Here are a few pointers on when to call a veterinarian and what to do until he or she gets there. Colic, lacerations and choke are just a few hot topics. We will cover more in another issue.


Colic simply means abdominal pain, but for horses, this is an emergency because of their very long intestinal tract. Signs include pawing, kicking or biting at side, going down, rolling (without shaking off), not eating, etc. Call your vet and try to keep your horse from rolling until your horse can be seen. You may have to walk your horse or trailer him or her to keep the horse from rolling. Banamine is a useful drug, but your vet should be consulted before giving it because it can mask some of the signs for the exam and the IV form is better if your vet can see your horse quickly. If the vet visit will be delayed, then he or she will often have you give it. A general rule of thumb is that if a colic requires banamine, it should also be seen and stomach tubed.


Lacerations are inevitable with horses. If the cut is suturable, it is generally best if this occurs within four hours. Do not put powders, creams, etc. into a wound that you want sutured. Cleaning the wound with saline and applying K-Y Jelly to keep the wound from getting recontaminated is good as the K-Y is water-soluble and will allow for any dirt or hair to be more easily flushed out. Also remember that “proud flesh” is nothing more than a good healing mechanism (granulation tissue) gone to excess. Anything that kills proud flesh stops healing tissue that is needed in the early stages of wound healing. These products should be used only after granulation has filled in the wound defects. Granulation can be handled by trimming if need be. Tetanus needs to be up to date and antibiotics will likely be needed. If you see white in the wound (bone, tendon or ligament), this wound is more urgent.


Choke sometimes resembles colic as your horse may become very distressed. This is a plug of feedstuff in the esophagus that the horse cannot swallow. The difficulty breathing is that saliva (or water the horse drinks) will build up and the horse cannot swallow it. Pronounced coughing and nasal discharge with feed mixed in are the major signs. It is OK to delay veterinary treatment a couple of hours for choke. You will need to walk the horse some to relieve the distress and massage the lower neck and throat area to help your horse resolve this on its own. However, if not clearing within two hours, it is important to get treatment. Injury to the esophagus and aspiration pneumonia are complications that are possible if you wait too long. Also, treating these is a messy process, so be prepared to get coughed on.

In any case, having a good relationship with your veterinarian ahead of emergencies is very important. Have contact/emergency numbers accessible.


Dr. McKinzie's Equine First Aid Presentation (PDF)
From a Recent Horse Owner Education Seminar

By Travis McKinzie, DVM, Equine Ambulatory Department

Located in Snohomish, Pilchuck Veterinary Hospital offers ambulatory, referral and 24/7 emergency care. Call 360.568.3111 or visit pilchuckvet.com for more information.  


Following is an update re: Serum Amyloid Testing for our veterinary colleagues:

Pilchuck Veterinary Hospital (PVH) is pleased to announce the availability of a test for Serum Amyloid A (SAA). SAA is an acute phase reactant that is present in mammalian species. It is present in serum at a low (often undetectable) level in healthy animals. But the levels increase rapidly (within 4 hours) of the onset of an inflammatory reaction, and will continue to rise as long as the inflammation is present with peak levels 36-48 hours after the inflammatory insult. The half-life of this protein is short (30 minutes to 2 hours) so that values will fall rapidly after the inflammation subsides. SAA has been studied most extensively in horses but can also be used in dogs and cats to identify acute inflammation.  The SAA increases are apparent prior to increases in fibrinogen (by 36-48 hrs) and may also be apparent 2-4 hours before iron levels decline. This test can be run on serum/heparinized plasma/or body fluids. This test is run daily as the results decline by as much as 20% over 48 hours of storage. The reference interval is 0 -18ug/ml in horses.  


  1. Jacobsen S; Kjelgaard-Hansen M, Peterson H et al; Evaluation of a commercially available human serum amyloid A (SAA) turbidometric immunoassay for determination of equine SAA concentrations. Vet Journal 2006; 172, 315-319.
  2. Christensen M, Jacobsen S, Ichiyanagi et al; Evaluation of an automated assay basedon monoclonal anti-huma serum amyloid A (SAA) antibodies for measurement of canine, feline and equine SAA. Vet Journal 2012; 194: 332-337.


PVH runs plasma ACTH levels on a daily basis and can guarantee results Monday to Friday within 4 hours of receipt of the sample as long as the samples (EDTA plasma) are in the laboratory by 3pm. Plasma ACTH levels run along with Insulin levels (serum or heparinized plasma) and a panel of chemistries that include triglyceride (metabolic panel) can be helpful in identifying various forms of the metabolic syndromes that exist in horses.

Please call us at 360.568.3111 for details and pricing information.


Donor Hero Profile: Tito


We’re looking for a few good dogs and cats to join our blood bank donor program.

Pilchuck donor heroes donate blood to help other pets in need of transfusions. Pet donors and their people help us save lives!

For more than 10 years, Pilchuck Veterinary Hospital has offered a blood bank for dogs and cats. Advances in veterinary transfusion technology have fueled the need for blood products, which can save the lives of many companion animals.

Valentino, aka Tito, has been in the donor program for the past few years.

“Hello! My name is Valentino, aka Tito. I was adopted six years ago from a humane society by one of Pilchuck’s technicians. I’m nothing but a ham in the clinic, and I love all the attention I can get from anyone willing to spare me the time. I have been in the blood donor program for the past few years helping sick animals get well.”

To meet more donors and learn about donor benefits and requirements, please visit: pilchuckvet.com/bloodbank

Want to Help?

Call 360.568.3113 or email smallanimalinfo@pilchuckvet.net.

Ella, Orion and Bromethalin Toxicity

Being hospitalized isn’t ALL that bad ... because sometimes we get to play in the sunshine!

Recently two pups from different families – Ella (4-month-old Labradoodle) and Orion (1-year-old Akita) – thought it would be a good idea to get into some tasty rat bait.

Although it may be yummy, rat bait can contain a neurotoxin called bromethalin, which can be very dangerous for any animal that ingests it.

All types of rodenticides are potentially toxic to any mammal, not just the species targeted by the rodenticide use.

Luckily both of these fur kids were treated right away; prompt and appropriate treatment is critical. Ella and Orion spent a few days with us in the hospital – having some fun as you can see! – and fortunately were able to go home happy and healthy.


via the AVMA

Kudos to PVH veterinary team member Kay St. Aubin for the post and for capturing the pawsome photos of Orion & Ella!

At Pilchuck Veterinary Hospital, we have veterinarians and staff available 24 hours a day to help with your animal companion's emergencies. We also consult with and refer to specialty hospitals for advanced care when necessary. If you have any questions as to whether your pet’s issue requires immediate attention, our doctors and highly skilled technicians are always just a phone call away: 360.568.9111 for 24/7 veterinary ER in Snohomish.

Pet First Aid: A Primer for Pet Parents

April Is Pet First Aid Awareness Month

For those of us with pets, pet first aid may not be a subject that often crosses our minds. But when it does, it is usually due to an all-too-interesting situation, because our animal friends love to get themselves into some of those.

Boiled down to the basics, pet first aid is not that different from human first aid. But there are some big differences to be aware of:

#1: Dogs and cats (most of them, anyway!) have fur.
This makes wound care a bit more difficult. Generally, please don't try to use scissors on your pet's fur; even experienced groomers and vet staff can occasionally have accidents and cut the skin. It is usually fine to do an initial cleaning with warm water and/or hydrogen peroxide (alcohol stings, but is safe to use if tolerated) but leave further clipping and cleaning of a wound to your veterinarian, as soon as you can get to one.

Protecting the wound until it can be further treated makes sense to keep out bugs in the environment and to prevent self-trauma. Especially if there is some bleeding, covering with a temporary bandage or applying firm and steady pressure for at least 1 to 2 minutes, or longer for severe hemorrhage, will help speed clotting. Basic supplies for a bandage can be as simple as paper towels and scotch tape, in a pinch, or sterile gauze held in place by medical adhesive or elastic tape from your (hopefully well-stocked) first aid kit. The major thing to know about home or field-placed bandages is not to overly constrict what you are bandaging, as this can cause far worse complications than the initial injury (constriction leads to loss of blood flow and oxygen, and amputation in the most severe cases). And realize that what you put on will need to be taken off at the vet, so try to avoid the duct tape (but actually, if it is all you have, it gets the job done).

#2: Dogs and cats walk around barefoot, all the time ...
... so foot injuries, penetrating wounds, foreign bodies, infections and torn toenails are much more common for them than in people. Some of these are extremely painful, and your pet may not tolerate your touching anything close to the foot. Small animals instinctively guard their feet unless trained to allow handling for the most part, more so when they are painful. This would indicate you need to get your pet to a vet quickly to have him or her examined under proper physical or chemical restrain (i.e., sedation or anesthesia). This is sometimes not only more comfortable and less stressful for your pet, but may help prevent a lifelong fear of the vet clinic or of having their feet handled in general. (We all know a few dogs who have to have the groomer or veterinary staff trim their toenails because it takes a group effort of professional restrainers or sedation every time.)

#3: Dogs (and some cats) are indiscriminate eaters.
This means that anything, and I mean anything, is game for mouthing. We pull everything from sticks and other plant parts, underwear, knives from the birthday cake, fish hooks, tennis balls, porcupine quills, you name it, from their mouths and further down the GI tract (stomach and intestines).

Drooling, dropping food, or holding the head or neck positioned abnormally can be signs of something lodged in an odd corner of the mouth or throat. Items can migrate to some very interesting locations, which are not always straightforward to find. If the pet has swallowed something that passes into the stomach or somewhere along the intestinal tract, vomiting or pain and general malaise can follow. Inappetance (a decrease in appetite) to full-blown anorexia (refusal to eat anything) is common, as well as eating or drinking and throwing it up, whether after every meal or only some meals, sometimes right afterwards, sometimes hours later, and whether food appears digested or less so. Some will drink water but often not enough to meet hydration requirements, especially if they lose fluids through vomiting or diarrhea.

Edible foods also can make them quite ill (ever have a rough time following an outing to a spicy Indian or Mexican restaurant?). And don't forget food "poisoning" or ingestion of a large enough quantity of disease-causing bacteria that thrive in the environment of the intestines to overwhelm the immune system. Many of these produce toxins, the most severe and luckily not as common ones even causing toxic shutdown of multiple organs and death within 48 hours.

Inedible foods can be life-threatening, depending on the specific item’s potential to cause obstruction or other complications. And just because your pet has not done it before does not mean he or she will not do it for the first time, at any age.

#4: Last but most importantly, dogs and cats can’t tell us when something’s wrong.  
It seems too obvious to need stating, but sometimes owners don’t understand why, as vets, we will focus in on a tiny detail of history that the owners give us. Sometimes we are extremely lucky to catch an early sign that something is wrong. If you notice any physical abnormality or sense something unusual in any aspect of your pet's behavior, it's best to trust your intuition and pay attention.

Stocking a Pet First Aid Kit

The American Veterinary Medical Association has a very helpful list for stocking your pet first aid kit. I personally also like to assess what activities your pet typically does, and if you include your pet in travel plans or do specific things like agility, hunting, hiking and camping, you may want to have a smaller or activity-specific version of your first aid kit packed separately. Keeping a car first aid kit for yourself and the family can also include any additional pet first aid kit supplies you might need for on-the-go mishaps. The good news is that stocking a pet first aid kit is very similar to stocking your own, so by preparing for your pet’s medical benefit, you are also helping to be aware of things you might need for you and your family.

Here is the list from the AVMA (further details and lots of other great resources are available here: https://www.avma.org/public/EmergencyCare/Pages/First-Aid-Tips-for-Pet-Owners.aspx):

  • Phone numbers for your regular family vet, the local emergency vet (if you are traveling, it is good to research this ahead of time), and the animal poison control hotline phone numbers (animal poison control: 888-4ANI-HELP or 888-426-4435)
  • Gauze squares and roll gauze in a variety of sizes
  • Nonstick bandages, towels or strips of clean cloth for covering wounds 
  • Adhesive tape for securing bandages (white medical tape found at any pharmacy, because band-aids don’t work well for dogs or cats ... remember that whole not having hair thing?)
  • Hydrogen peroxide (a great first-time cleaning for a wound and helps remove blood really well, but don’t use during the healing process). You may also use this to induce vomiting in dogs (not cats), if you cannot get to the vet, although it is very irritating to your pet’s stomach. Give about 1-2 tablespoons per 10#, but not over 3 tablespoons total in larger dogs. Never induce vomiting if they have ingested something sharp, or a caustic chemical-type toxin (like bleach or acid). Always contact your veterinarian or local poison control center before inducing vomiting or treating an animal for poison.
  • Digital thermometer. The most accurate temperature is a rectal temperature, and some pets will allow their owners to take one, although it may take a second person to help gently restrain. You can also take one in the axilla (armpit) but it is 1-2 degrees cooler than the rectal temperature and is less accurate. Normal temperatures vary and are slightly higher in cats, but over 103F is usually suspicious for a fever. My favorite is the Vicks Speed Read with the flexible tip.
  • Eye dropper or syringes for administering/measuring medications (smaller sizes). Larger sizes are also good to have around for certain medications and for flushing wounds. Sterile saline is my favorite solution for flushing wounds, but an improvement over tap water is a very dilute iodine or chlorhexidine/Nolvasan solution in water, which are easily found at the pharmacy.
  • Muzzle. If a pet has suffered a painful injury, placing a muzzle may be the safest option for all involved, especially if the nature of the injury requires you to physically handle the painful part of the body before you can get to the vet. If your pet is vomiting, please don’t place a muzzle as that could cause him or her to choke or aspirate.
  • Leash. You also never know when you might get caught without a leash, so even just a compact braided nylon slip lead can come in handy.
  • Stretcher. For a small dog or cat, the bottom of a plastic kennel/crate is adequate (so have a removable top, ideally). For a medium to large dog, a large blanket or dog mattress could be used with a person on each end (or a person on each corner if you need extra heft), but realize this won’t give as much stability as an actual stretcher or a large board, a door, etc.
  • Medications. There are a few over-the-counter medications that are safe to use in a variety of emergency situations and unlikely to cause harm even if used unnecessarily. Talk with your veterinarian about which medications would be appropriate for your pet's first aid kit. Please do not give over-the-counter medications in place of taking your pet to a veterinarian promptly for evaluation. Important note: Don’t ever give your pets human pain medications like Tylenol or ibuprofen because they are toxic. Cats and dogs are unable to process these drugs the same way humans do. An example of a safe use of human OTC medication would be to give Benadryl at a dose of 1mg per pound of body weight by mouth up to every 8 hours in the event of a suspected allergic reaction (sudden appearance of hives, facial swelling, sudden severe itchiness and or skin redness, or also following a bee or wasp sting to prevent an allergic reaction from occurring). The Benadryl alone may not control the reaction, however, so it is given to reduce signs as much as possible while coming ASAP to the animal ER.

By Holly Droske, DVM, PVH Small-Animal Emergency Department

At Pilchuck Veterinary Hospital, we have veterinarians and staff available 24 hours a day to help with your animal companion's emergencies. We also consult with and refer to specialty hospitals for advanced care when necessary. If you have any questions as to whether your pet’s issue requires immediate attention, our doctors and highly skilled technicians are always just a phone call away: 360.568.9111 for 24/7 veterinary ER in Snohomish.

We’re Seeking Participants for a “Fitbit for Dogs” Study

Our own Dr. Hanlin Song is heading a very interesting case study using the latest in wearable technology – for dogs! – and we currently are recruiting participants.

If your dog is a bit older, is not currently taking RIMADYL ® (an anti-inflammatory) OR has been taking it on an as-needed basis, has some degree of arthritis/pain and, because of this, may have some mobility issues ... then please keep reading!

Most of you probably have a Fitbit or have heard of one. (If not, it’s a “tracker” that monitors activity levels such as steps and other wellness data.) This study basically uses a Fitbit for your dog! The device is called the Voyce Pro Health Monitor

The 12-week case study focuses on individual dosing for Rimadyl ® (an anti-inflammatory) in dogs to see how Rimadyl ® can improve overall quality of life. The study's goal is to answer the question: “Does utilizing the Voyce Health Monitor assist with individual dosing for Rimadyl in dogs?”

With the assistance of Voyce Pro collar, we will monitor our canine participants’ activity levels and accordingly adjust the Rimadyl ® dosing over time.

If I sign up, what am I responsible for?

The owner participant is simply required to make sure the Voyce Pro device is charged. Reminders will be sent if the device is not collecting any data, and we will help troubleshoot (determine if it’s a battery issue, out-of-network problem, etc.). Your dog? He or she just has to wear Voyce like a regular collar.

What are the pros for participating in the study?

  • Finding out your dog's daily heart rate and activity level for the duration of the study (12 weeks)
  • Helping fellow canine patients!

The cons?

  • Some expenses, including medication and lab work to ensure organ functions are maintained
  • During the course of this study, Rimadyl must be purchased through PVH and not an online pharmacy. Dr. Song’s initial exam will be at no charge.


If this sounds like something you’d be interested in, please reach out to Dr. Song via Becky Peterson at bpeterson@pilchuckvet.net as soon as possible. We can assist you with getting more information and setting up an appointment.

Thank you!
Dr. Hanlin Song & Becky Peterson

Spring Ahead With These Seasonal Safety Tips for Your Pet

This Sunday, March 20, we can officially welcome spring! While almost everyone loves the onset of springtime, the season arrives with its own hazards for pets. With that in mind AND National Poison Prevention Week also beginning on the 20th, we've compiled a listing of spring pet safety tips so you and your animal friends can enjoy the season to its fullest:

Gardening Poisons

In our part of the country, we emergency veterinarians see many pets hospitalized for ingesting slug and snail baits that contain metaldehyde. This particular substance causes seizures if ingested. Prompt treatment is needed to save your pet’s life. Compost also contains mold compounds that lead to seizures. If you do compost, keep the pets away!

Easter Lilies

Those beautiful white trumpets that many people buy this time of year – along with some of their cousins that aren’t necessarily white – can lead to severe kidney failure and death in cats. This is one of those poisons where you don’t want to wait to see how your cat does. Prompt and aggressive treatment is necessary. If you live with cats, keep lilies out of your home!

Via the AAFP


Not all those chocolate Easter eggs and chocolate bunnies will be found by the children! Some will be found by your dog, either in the yard, in the house, and, in some instances, in your car on the way home from the grocery store! Chocolate – especially baker’s chocolate and dark chocolate – is toxic to pets no matter what the season.

Daffodils, Jonquils, Narcissus

Most of us are excited to see these bloom this time of the year. Most animals will not readily eat these leaves, which can look like thick blades of grass. However, some dogs and cats will attempt to play with them, and we know that cats and dogs sometimes chew on things they play with. These plants contain calcium oxalate crystals, which can cause severe internal swelling of the throat and, if severe enough, will stop your pet from breathing if the throat swells shut.

The Easter Ham, Turkey, Roast

No matter what you are feasting on, keep it out of reach of your pet! Things can sometimes get a little hectic with family and friends over. If you leave a tempting dish unattended on the counter or table ... or even in an easily accessed garbage can, chances are it will be devoured by your furry friend. Dramatic changes in diet such as gorging on the Easter ham can cause gastrointestinal upset and pancreatitis. Also: Watch out for any bones!

By Joe Musielak, DVM, PVH Small-Animal Emergency Department

Related Resources

When MRI May Be Helpful in Equine Lameness: Three Case Examples

This is the second part of Dr. Greg Haines' article on MRI for horses. Read part one of the article.

Magnetic resonance imaging (MRI) may be indicated when a lameness has been localized to a specific region, generally through diagnostic nerve or joint blocks. Through limitations, other imaging modalities (X-rays, ultrasound, bone scan) may have failed to determine a specific diagnosis.

MRI has greatly advanced our diagnostic capabilities particularly within the equine foot. Common injuries within the foot that have been diagnosed with MRI include deep digital flexor tendon (DDFT) injuries and navicular bone degeneration. Below are specific examples when MRI was helpful diagnostically. The first two deal with the foot, the third with the proximal metatarsus (Mt3) – cannon bone/hock.

Case #1

A mare presented with a seven-week history of forelimb lameness that failed to improve. There were no obvious clinical findings and no response to solar hoof tester placement. The lameness was worsened when the mare trotted in a circle. She showed minimal improvement to a palmar digital nerve block (blocks the heel area and sole of the foot) and was essentially sound after an abaxial sesamoid nerve block (blocks from the fetlock to the foot). X-rays failed to identify any specific abnormalities. Given the chronicity and lack of improvement, an MRI was undertaken. A marked DDFT lesion was diagnosed by MRI.

Case #2

This horse had only a two-week history of forelimb lameness that was also worsened by trotting in a circle. Again, specific abnormalities on initial examination were not noted. The lameness essentially resolved after a palmar digital nerve block and radiographs failed to provide a specific diagnosis. MRI evaluation revealed marked navicular degeneration characterized by a flexor cortex erosion.

Case #3

This horse had a two-month history of right rear lameness that was localized to the area of the proximal metatarsus (Mt3) – cannon bone/hock. The horse displayed a mild improvement to a lateral plantar nerve block (blocked the area of the proximal cannon bone – suspensory ligament), but a significant improvement was noted after a tibial peroneal nerve block (blocked the area of the hock). Radiographs failed to identify any significant abnormalities. An ultrasound evaluation of proximal Mt3 demonstrated proximal suspensory ligament enlargement. A bone scan of the rear limbs was considered normal. The horse was rested and had extracorporeal shock wave therapy performed to the area of the proximal suspensory ligament without any clinical improvement. An MRI evaluation revealed enlargement of the origin of the suspensory ligament with disruption of the medial bundle. The area of the hock was ruled out as a potential source of lameness.

In each instance, a specific treatment plan was initiated and a more accurate long-term prognosis for soundness was provided. It is important to remember that MRI is not a survey technique or a substitute for a thorough clinical investigation, including conventional imaging modalities. The interpretation of MRI findings is greatly enhanced by the information obtained from these evaluations. It is clearly not indicated in all situations, but may be considered in selected cases through consultation with your veterinarian.


Article written by Greg Haines, DVM, DACVS

Pilchuck Veterinary Hospital offers comprehensive diagnostic imaging options, including MRI, video endoscopy, high-resolution ultrasound and more. Please call 360.568.3111 for more information.

Dr. April Tolle Joins Our Small-Animal Department!

We're very happy to announce that Dr. April Tolle has joined our small-animal team! Her professional interests include veterinary dentistry, internal medicine and radiology, and we are thrilled to welcome her to PVH. Read a little more about Dr. Tolle below:

April Tolle, DVM
Dr. April Tolle knew at an early age she wanted to be a veterinarian. She grew up near Houston, Texas, and relocated to Dayton, Ohio, her senior year of high school. In Dayton, she shadowed local veterinarians and worked in the kennel of a local clinic.

She attended The Ohio State University in Columbus and graduated with her DVM in 2007. After veterinary school, she worked at small-animal practices in Cleveland before relocating to the Seattle area in 2012. Dr. Tolle’s professional interests include dentistry, internal medicine and radiology.

During her downtime, she enjoys drawing, climbing, and getting outside to hike and camp with her dog, Cooper. She also has a cat, Mr. Stigglesworth.

Update on the Dog Flu and Vaccine Options

You may have heard about the recent outbreak of a new type of “dog flu” affecting pets across the country. This highly contagious and, for some dogs, potentially serious respiratory infection is caused by canine influenza virus H3N2, or CIV H3N2 for short.

Chances are, if your dog is exposed to CIV H3N2, he or she may become infected.

Dogs that are frequently in contact with other dogs may be at high risk of infection with CIV H3N2.

This includes dogs that: 

  • are boarded
  • are enrolled in day care, or 
  • often visit the local dog park. 

If you have a puppy, elderly or pregnant dog or a dog that is immunocompromised, you should take extra precautions.

The good news is that PVH now has a vaccine available to help control disease associated with CIV H3N2.

We also have a vaccine, Vanguard® CIV, that has been available for several years for another type of canine influenza, CIV H3N8, which is capable of causing severe respiratory disease in dogs as well. 

Vaccination against both types of CIV (H3N2 and H3N8) helps to ensure maximum protection.

Please call us at 360.568.3113 to discuss your dog’s risk for CIV (H3N2 and H3N8).

This is particularly important if you plan to board your dog in the near future or regularly send him or her to a grooming or day care facility. 

We’ll answer your questions about dog flu and help you to decide whether vaccination is right for your pet. You can also visit dogflufacts.com for more information.