My girls came home last night.

They were both a little wanky.  In the equine world, we call it "off."  In small animal vet med, we have two terms, "ADR" and "NDR", depending on how ghetto/southern your clinic is.  It stands for "ain't doing right" and "not doing right", respectively.

The emergency clinic where they spent two nights is the only e-clinic in the city.  And they've got a pretty horrible reputation.  The 24-hr clinic I worked at had an okay reputation, but money was always an issue.  Money, money, money.  This e-clinic didn't take a deposit because I was in the field and actually ended up discounting a considerable chunk, due to professional courtesy.  The thing that's setting off little red flags, though, is the blood work.

The girls had blood glucose tests (BGs) done every two hours or so.  This is called a blood glucose curve, as your BG shifts in accordance to you eating (simplified, of course).  The normal BG for a healthy, non-diabetic dog ranges from 70 to 150, all depending on where they are in the curve.  My girls were fed multiple small meals to keep the BG up and were also on and off dextrose, also to keep the BG up.  The dropping of the BG is called hypoglycemia and was a result of the xylitol toxicity.  With me so far?

Here's the fishy part:  for the 36ish hours that they were at the e-clinic, their BGs were never, never in the normal range.  In my brief, stilted conversations with the technicians, I was told that they weren't stabilizing, that if they went off the dextrose, they dropped.  When I initially spoke with the vet (the one and only time), she said that it would be 18-24 hrs of fluids, dextrose weaning and observation and then they could go home.  The technician made the estimate for two days, though.  Like she knew.  Okay, I get it.  I was on the other side for so long, I understand that I'm a bitter dog mom and I just wanted my girls to come home, so of course they were doing something wrong.

Here's the fishier part:  they went off fluids yesterday morning at about 6-7 am (I think, who knows?).  They pulled a BG at about 6 am and both girls were in the 60s.  I picked them up at 7:30 am and I transferred them immediately to my rDVM (where I work weekends occasionally).  They pulled BGs at about 8 am to see how they were and if they needed to go back on fluids.  Scarlette was 150 and Savannah was 89.  Perfect, normal range.  I explained to my husband that sometime excitement can do that - raise the BG.  "Mom has come to save us!  OH MY GOD, it's a car ride!"  That effect, you know?

But the girls never went back on dextrose, never left the normal range, and all it took was crossing the doorway of my rDVM.

Fishy.

And the e-clinic ran two chem panels on both girls - an initial to get a baseline and a 24 hr to see if there were any liver changes.  My rDVM ran a third at the 48 hr mark, again to look for changes.  There are a multitude of panels that can be run - in house, it depends on your equipment and what you're looking for (diagnostic, complete blood count, etc.); for the lab, it essentially depends on what deal you've got with what company.  All of this blood work was in house, for both clinics, because we needed results ASAP.  ...But only my rDVM held a certain liver value.  A liver value that was inflated for Scarlette.  So, we have no idea if this value was inflated when she checked in (it would have taken 8-24 hrs to show liver changes) or as a result of the toxicity.  So, she goes back tonight to have that tested again.  I'm sure she's excited.

New toy!

Wiped out.

Photos, because I love my little furry bastard daughters:

Scarlette

Playing.

Jealous.

Savannah loves me.

Savannah