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Nursing Marvin Back to Health

By: Ashley Berke Date: Oct 5, 2015

Marvin, Ryan Hospital patientParticularly in tune with animals’ needs, veterinary technicians at Penn Vet’s Ryan Hospital consistently go above and beyond to provide the best in nursing care. Marvin’s case was no exception.

The two-month-old hound mix puppy had regurgitated several times, so his caretakers from Mostly Muttz Rescue brought him to the hospital in mid-July. The tiny pup underwent surgery for repair of a persistent right aortic arch, an abnormal development of the major blood vessels in the chest, which had caused an enlarged esophagus.

Following the successful surgery, Marvin recovered in Ryan Hospital’s Intensive Care Unit, where he received around-the-clock care from a team of Penn Vet experts, including Registered Veterinary Technician Tracy Darling. Tracy Darling, Penn Vet ICU Vet Tech

“Marvin did well after surgery,” Darling said. “We assessed him for pain and determined the best approach for pain management.”

Marvin received a constant infusion of Fentanyl to alleviate pain from the chest tube that had been placed during surgery.

“The biggest challenge from a nursing perspective was that Marvin was only eight weeks old,” Darling said, “so he was still developing physiologically.”

Because of his young age and heightened sensitivities, Marvin metabolized drugs differently than an older dog. Additionally, his small size made him prone to hypothermia and low blood sugar. But thanks to the attentive care he received from Darling and others, he was able to return home a few days after surgery.

But the young pup’s days at Ryan Hospital were not over.

Intensive Care

Less than a week later, Marvin returned with swelling around his groin as well as limb edema, a condition characterized by excess fluid in the body’s tissues. Radiographs also revealed fluid around Marvin’s lungs and aspiration pneumonia.

According to Darling, “His blood sugar was low. His proteins were low. His temperature was low.”

Marvin, patient at Penn Vet Ryan Hospital

Marvin ended up back in the ICU, where the team led by Dr. Erin McGowan, Critical Care Resident, could frequently monitor his blood glucose and help manage his edema.

“We massaged his limbs and did physical therapy every four hours,” Darling said.

“We had to weigh him every two hours and check his blood sugar every two to four hours to make sure he was getting the fluids and nutrition he required without giving him too much.” 

Another challenge was keeping Marvin stimulated.

“As he started to feel better, he became a spunky little puppy, wanting to play and chew on things, including his catheters,” Darling said. “We had to find ways to keep him emotionally and mentally happy.”

At one point, Darling put a bit of liquid diet on a toy so Marvin had something to lick and chew on for a while.

Marvin remained in the ICU for nearly two weeks until his blood glucose levels returned to normal. In early August, he was finally able to return home.

Rigorous Training

While at Ryan Hospital, Marvin benefited from the expertise Darling gained through her rigorous training. As a member of Penn Vet’s elite team of Certified Veterinary Technicians, Darling went to an accredited college and obtained state certification to practice, which she maintains through continuing education courses.

In addition to receiving her Registered Veterinary Technician license in California, Darling also received her Veterinary Technician Specialist credentials in small animal internal medicine.

Prerequisites for obtaining VTS status vary by specialty, but most require at least four to five years of experience in the field, completion of advanced skills, case logs, case reports, documentation of continuing education, good-standing credentials, and an exam. Once VTS status is granted, credentialed technicians must complete advanced continuing education, including mentoring, lecturing, and publishing relevant articles.

When she’s not busy working in the ICU and maintaining her credentials, Darling volunteers at the Penn Vet Working Dog Center, where she focuses on K9 first aid, husbandry, and rehabilitation. Darling and her husband, Eric, also whelped and cared for the Center’s two litters of puppies at their home. They are now proud owners of Quackenbush, a black Labrador Retriever puppy from the most recent litter, who will join their other dogs, Ben and Wyatt, in Urban Search and Rescue work.

“Tracy is a tremendous asset to our team,” said Rosemary Lombardi, CVT, VTS, Director of Veterinary Technicians at Ryan Hospital. “Our technicians have truly unmatched depth and breadth of experience. In fact, many of our technicians served as inaugural members of their specialties, and wrote the qualifications and exam questions and now serve on committees to approve applicants.”

Technicians at Penn Vet support all clinical services at Ryan Hospital. Darling chose the ICU, in particular, where she could help the most critically ill patients.

Tracy Darling and Marvin, Ryan ICU

“I like being closely involved in the care of my patients and I enjoy the nuances of monitoring critically ill pets,” Darling explained. “In the ICU, vet techs take on a lot of responsibility and are able to make recommendations and be part of the decision-making process to help heal patients.”

Dr. Lesley King, Professor of Critical Care and Director of Penn Vet’s Intensive Care Unit, echoed these thoughts about the role of veterinary technicians in the ICU.

“Our ICU technicians demonstrate a high level of responsibility for our patients,” King said. “They play an integral role in collaborating with clinicians to develop treatment goals and plans, and they are the first to notify clinicians of pertinent changes in patient status, behavior, or other abnormalities. They are a vital part of our team.”

“Our 10 certified ICU technicians collectively bring more than 100 years of experience to the table,” King added. “This highly skilled and experienced group focuses on patient welfare and provides exceptional monitoring and treatment to pets in need.”

According to Darling, the collaborative nature of the ICU is essential for success.

“There is a lot to take into consideration when caring for a critically ill patient. How are we going to feed them? How are going to take blood samples? How are we going to manage multiple drugs at once?” Darling said. “We take a team approach to deciding how everything will happen most efficiently without sacrificing animal comfort.”

Nursing Care in the Hospital and at Home

In addition to receiving first-class care from Darling at Penn Vet, Marvin was well cared for at home with foster mom Fatima Sattar, a Neonatal Intensive Care Unit nurse at a human hospital in the Lehigh Valley.

“I agreed to take Marvin because I had the experience caring for sick human babies,” Sattar said. “I commend the ICU nurses at Penn Vet who are attuned to really subtle changes in animals of all kinds.”

Sattar’s dedication to Marvin was evident from the amount of special assistance she provided at home. Because it could take weeks following surgery for Marvin’s esophagus to return to normal, a feeding tube was placed to ensure he would be provided with the nutrients needed to grow.

Sattar tube-fed Marvin every eight hours following surgery. After his second visit to the hospital, feedings increased to six times daily, every four hours, over the course of a month.

She also administered an anti-nausea medication, an antacid, a medication to promote gastric motility, a steroid, a medication to decrease gastric acid production, and a GI protectant. 

“Marvin didn’t know how small or how sick he was,” Sattar said. “When he came home after his long stay in the ICU, he was a completely different dog. He finally behaved like a normal puppy.” Marvin at home after Penn Vet treatment

Marvin’s feeding tube was removed in early September and Sattar reports that he is doing very well at home, gaining weight and showing lots of energy. Thankfully, his condition was discovered early enough that he should not suffer from ongoing complications. He is currently available for adoption through Mostly Muttz. To view his adoption page, click here.

“I’m hoping that he finds a really great home,” Sattar said. “Thanks to Penn Vet, we now have hope for his future.”