It was a Sunday morning in early September and the fall air was cool and crisp. A gentleman hurried into the ER entrance carrying a box that he frantically explained to the front desk he had found behind a carwash. Inside the box was a small, motionless tan dog curled in a tight ball. The dog didn’t appear to be alive as the triage technician quickly moved toward the man. He placed his stethoscope on the dog and found a slow, faint heartbeat. He assured the gentleman that the dog was alive and rushed her to the treatment area to be evaluated by a doctor. Chihuahua #38752 was so malnourished you could easily count her bones without touching her. The skin around her neck and chest was discolored from bruising. She did not respond to being touched. It was hard to tell if she was breathing and the room became silent as everyone watched her chest for movement. Finally, she took a slow shallow breath and everyone in the room let out the breath they had been holding. Her heart rate, which should have been around 150 beats per minute, was only about 30 and was barely audible with a stethoscope. Her body temperature was too low to read by the thermometer, meaning it couldn’t have been more than 90 degrees. She remained tightly curled into herself as she was carefully lifted from the box, wrapped in blankets and placed on a heating device. She was hooked up to equipment to monitor her heart rate and breathing while the staff discussed the next steps in her care. Humane euthanasia would not have been a wrong decision; she was barely alive and had clearly suffered some kind of trauma. At this point it was impossible to say what her prognosis was, and no one wanted to cause her any further suffering. Everyone gathered around, looking from her to the monitor displaying her vitals, trying to make the best decision for this sweet tiny dog. Her heart rate was still in the 30s but she was maintaining it and her ECG rhythm was normal otherwise. She appeared to be young, maybe around two to three years old. She looked like a miniature deer with her fawn-colored fur, spindly legs and perfectly oversized ears. She took another slow, shallow breath as everyone watched her and it was unanimously decided to give her a chance.
Hope
As soon as the decision was made, an IV catheter was placed, and she was given dextrose and warmed IV fluids. Her blood was drawn and tested to evaluate organ function and metabolic stability. As her body temperature returned to normal and she adjusted to the nutrients being pumped into her body, she began having tremors and seizure-like activity. She was still not responding to voices or touch. She tested positive for methamphetamines, which explained many of her symptoms, but it was still unclear if there was head trauma in addition to drug toxicity. The odds were stacking up against her and the doctors and staff once again discussed euthanasia, not wanting her to suffer any more than she already had. It was decided to give her 24 hours and reevaluate. She was given medications to help stabilize her neurologic function, heavily sedated to stop the seizure activity and transferred to the ICU for supportive care overnight, hoping that time would allow her little brain to heal.
Recovery
Despite the odds, Chihuahua #38752 survived the night. She had maintained her body temperature and blood glucose on her own all night. Her blood pressure was normal, she was maintaining a heart rate around 100 beats per minute and the staff were hopeful. Doctors decided to begin reducing her sedatives and pain medications to allow reevaluation of her neurologic status. As her consciousness returned, there were substantial improvements in her reflexes, but she was dysphoric and would scream and thrash if she wasn’t swaddled tightly and being held. She was sedated again while her continued care was discussed. Although she has made substantial improvement overnight, it was unknown if she would recover further. Even if she did survive, she had a long recovery ahead of her. The situation was further complicated since she did not have an owner and was not adoptable with such an unknown future. As an ER facility, supporting a long-term rehabilitation plan was not realistic, and again, humane euthanasia was discussed. Fortunately for her, one of the technicians that had been caring for her since the beginning had fallen in love with her and wanted to adopt her. Just like that Chihuahua #38752 became Mary, a dog with a home and a family who loved her.
Triumph 
It was touch and go for a few days, but with the loving care of her new family Mary made consistent progress. She was holding her head up and responding to voices after three days. By day five, she was eating and drinking on her own and responding when her name was called. With the continued dedication of her new family and her doctors, Mary has made incredible progress. On day 10, Mary is walking around, exploring her new surroundings and being sassy with her canine siblings, as any chihuahua should be. Mary continues to take medication to prevent seizures but has otherwise made a full recovery and is adjusting well to her loving home. Your contribution to MyBalto helps give dogs like Mary a second chance. For more information on how to help pets in your community follow this link.
~AERC Technician, Amy Necessary