While attending the Pet Expo last weekend, Dr. Henri Bianucci and I (Dr. Perry Jameson) held a question-and-answer session and met a lot of you and your pets.

One of the questions that came up frequently was “when should I get worried and call your emergency clinic.”

This is a great question, and I have compiled some guidelines to help you.

Many of these are obvious, but others are more subtle but can indicate severe underlying problems. By being proactive, we can often prevent complications from developing.

1. Bleeding.

OK, this one is obvious. If your pet is bleeding, take the time to assess the severity of the bleeding. Is it a significant volume? Did it stop on its own after 1-2 minutes?

Small lacerations can be monitored at home as long as the bleeding stops within several minutes.

Bleeding from the nose, mouth, vomiting with blood, skin lacerations and blood in the stool (fresh or dark tarry stools) are all emergencies. If the bleeding persists, it should be evaluated.

2. Broken/trauma.

Another obvious one if you actually see the traumatic event (hit by car, etc.) or if you can tell that something is broken, but sometimes all we see is lameness.

If your pet is in pain and holding up a limb and not placing any weight on it, you should have them evaluated.

3. Blue/respiratory distress.

Sometimes it can be difficult to tell the difference from panting and respiratory distress. Here are a couple of clues to help you.

Look at their gums: If they are grey, pale, or blue, this is an emergency. If you pet is extending its head/neck or open mouth breathing, this is an emergency.

Watch the pattern of breathing: If there is abdominal effort to the breathing or the respiratory rate/effort does not improve with rest, you should call the emergency clinic.

4. Collapse/weakness/ seizures.

Collapse can be due to many causes and several can be life threatening such as bleeding into the abdomen or an arrhythmia. Sometimes, acute weakness is the only sign we see.

Seizures also can be due to many causes such as low blood sugar, liver disease, toxins, and primary neurologic diseases to name a few.

A physical examination and basic blood work can help determine how to treat the signs and what other diagnostic tests need to be performed.

5. Foreign body ingestion.

The sooner these pets are brought into the emergency clinic, the more treatment options are available. For some objects, we can induce vomiting or perform endoscopy to remove the object. Once the object is in the small intestine, surgery is required and this equates to a more invasive procedure and greater expense. If you see your pet eat something it shouldn’t, don’t wait to see if it will pass. Call the emergency clinic.

6. Toxin exposure/snake bite.

Again an obvious one. Toxins (plants such as sago palm and lilies, anti-freeze, rat bait) all have the potential to be deadly. If you know of ingestion or even suspect possible ingestion, do not delay. Seek emergency help as soon as possible. Snake bites are common in this area and can also be deadly. Anti-venin can be administered within the first four (and possibly up to 72) hours in an effort to decrease the severity of the effects of the venom.

7. Inability to urinate/ defecate.

This is probably one of the most difficult signs to notice if your pets are allowed out a dog door or are indoor/outdoor cats. Signs you might notice in the house are lethargy and hiding. Sometimes if you feel your pet’s belly, they might seem uncomfortable and “full” back toward the rear of their belly.

These signs should trigger you to monitor the urination/defecation habits and call the emergency clinic. Unproductive straining or frequent attempts to posture to urinate/defecate should be evaluated by a veterinarian.

Cats in particular can develop stones, crystals, inflammatory debris, or mucous plugs that if go unnoticed, can be life threatening ... not to mention uncomfortable.

8. Unproductive vomiting.

With 6 pets in our house, vomiting is a weekly occurrence. We typically don’t worry about it unless it is frequent (daily or several times within a day), contains blood or if it is unproductive. Unproductive heaving can be an indicator of bloat. This is a life-threatening condition in which the stomach distends and twists. Surgery is often needed to correct the twisted stomach.

9. Swollen abdomen.

Some causes of a distended abdomen are due to loving our pets with food (obesity), but others can indicate a more sinister underlying problem. Acute changes in the distension of the belly (especially in combination with weakness or lethargy) can be due to a bleeding mass or heart failure and should be evaluated.

10. Ocular changes.

Squinting, tearing, trauma to the eye, an enlarged eye, cloudiness to the eye and ocular pain are all considered emergencies. While some of these changes can be simple to treat such as a superficial ulcer, others can indicate more severe disease such as glaucoma, a corneal perforation or an underlying systemic disease process (cancer, autoimmune disease, etc.).

11. Reproductive issues.

If your pet is pregnant and having strong abdominal contractions for 45-60 minutes without producing a puppy/kitten or weak and infrequent contractions for 4-6 hours without producing a puppy or kitten, this is considered dystocia and is an emergency. If your pet has a puppy or kitten stuck in the birth canal or is in pain, you should call the emergency clinic.

Hopefully, these tips will help you decide when you need to contact the ER, but the bottom line is that if you are worried in any way, please contact your veterinarian or the closest emergency clinic. The veterinary technicians and doctors will be able to give you advice and let you know if you need to come in.

Dr. Henri Bianucci and Dr. Perry Jameson are with Veterinary Specialty Care LLC. Send questions to petdocs@postandcourier.com.