Pet medical emergencies often happen outside of regular office hours, which is why most veterinarian practices provide an after-hours contact. Some seemingly urgent issues can, however, wait until the next day. But how can you be sure?

Veterinarian Lloyd Kenda, of Valley Veterinary Centre (www.valleyvetcentre.com.hk) shares his thoughts on the topic.

"Many of the after-hours calls can be resolved on the phone, with some advice and reassurance. Only a small percentage of pet illnesses are true emergency situations. As vets, we understand that a pet owner may not be able to determine what needs immediate treatment and what does not. Hence a few minutes on the phone may avoid an unnecessary midnight trip to the vet, or may indicate that such a trip is critical to save your pet's life."

Top of his urgent list for dogs is gastric dilatation volvulus. "This is a situation where the dog's stomach actually rotates and twists on itself. Despite a lot of research we do not know what actually causes this to happen," Kenda says.

He adds that anecdotally, there have been reports that it is more likely to occur when a dog is fed a meal and then is active afterwards. This is why it is often seen as an after-hours problem when the dog is fed in the evening, then taken for a walk or play and then a couple of hours later the problem begins.

"These dogs appear to try to vomit, but nothing comes out. This is because the stomach is twisted and nothing can get out of the stomach in either direction." As the condition develops, food ferments and gas builds up in the stomach, but the gas, too, cannot escape. The abdomen takes on a bloated appearance and quite quickly becomes as tight as a drum. "The tightness of the overstretched stomach, the compromised blood flow to the stomach and often the spleen, which is attached to the stomach and sometimes twists with it, and the pressure on the surrounding blood vessels results in a cascade of very bad physiological events."

Within minutes the dog looks very ill and weak and if not treated within the next few hours, it will invariably die. "Even with the best treatment [which involves emergency surgery] and substantial intensive post-operative recuperation, a significant proportion of these cases will die within the following seven days."

Next are heatstroke and poisonings, both of which, sadly, are often seen in Hong Kong. Some of the most common poisonings are from chocolate, grapes, raisins, human medications, lilies, rat poison and slug poison.

"In both of these cases the dog usually experiences seizures and convulsions, and may vomit. Both need to be seen to urgently as prompt treatment makes the difference between life and death."

Swallowing a foreign object - the possibilities can be anything from a small toy to parts of a shoe - is another frequent after-hours issue. In many cases the object will pass through but sometimes it can cause a life-threatening blockage. Signs to watch for include poor appetite, vomiting and constipation.

Accidents such as falling from high-rise buildings, being hit by a motor vehicle and attacks by other animals are key issues for contacting a vet after hours.

"The urgency of treating these depends on if the animal is conscious, the amount of blood loss and the pain the animal is in," Kenda says. "The vet will discuss over the phone the at-home first aid to give and advise on the required steps from there." While some of these cases can wait until the morning, most do need to be seen as soon as possible, the vet adds.

Chronic vomiting and diarrhoea, which result in dehydration, also need attention, Kenda says. "Vomiting once or twice is not critical, but if it persists, treatment and fluid replacement therapy [are necessary]. In some cases, this requires an emergency procedure."

He says the best rule of thumb is to be better safe than sorry. "If you are not sure, then speak to the vet after hours. We can advise owners if the pet should be seen urgently or not." 

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