Due to this, the WCVM treatment team consisted of small animal internal medicine specialists, a clinical nutritionist, canine rehabilitation therapists, small animal surgeons and the intensive care unit (ICU). They drew on the expertise of clinical nutritionist Tammy Owens, DVM, from UC Davis, to assist with carefully increasing the amount of food that Bruno could receive and properly supplementing his intake of essential electrolytes: phosphorous, magnesium and potassium.
Bruno’s electrolyte levels were constantly monitored and supplemented intravenously until they stabilized—a process that took two and a half weeks. His digestive system was also extremely sensitive to the new food being introduced.
“There is a multitude of reasons why, in those patients, you can’t just feed them normally and expect a good outcome. They’re not physiologically capable of absorbing and utilizing the food normally,” Owens said.
Taylor commends the close care provided by the ICU for monitoring Bruno 24 hours a day, providing three different continuous intravenous infusions, and for feeding him a precise amount of food several times per day.
“We could do this because we have 24-hour technical support,” Taylor said.
Bruno also had suffered injuries when he had tried to climb out of the well. He had also developed sores on his paws, after being in the water for so long. The veterinarians used cold-laser therapy, which proved effective in treating the wounds on his paws and his hindquarters. This technique stimulates the cells, speeds healing and reduces pain.
This treatment helped Bruno heal without having to undergo surgery, which would have been difficult due to his already delicate condition.
“The fact that we are able to pull from so many different resources—and everyone has been so willing to be involved in this case—obviously contributed to how quickly he recovered,” Khoo said.
Khoo, Taylor and Owens plan to collaborate on a scientific case report documenting Bruno’s remarkable recovery, and their work could help other veterinarians who need help dealing with refeeding syndrome in dogs.
“Because these cases are rare, it was exciting to make a good contribution to a case that’s going to have a good outcome,” Owens said. “I think the best cases are those that have a collaborative approach, because the patients get the best care.”
Right now, they’re happy to see Bruno going home.
“When he first came in, he still looked like he was in trouble,” Khoo said. “I don’t think many dogs would have survived this. To continue to see him improve has been so rewarding.”
