01x04: Trude Mostue | First Aid

Do you know what to do if your dog gets a paw cut, suffers from diarrhea and vomiting, or eats a plate of chocolate? Veterinarian Trude Mostue shares her best first aid tips.

JEANETTE: I remember rushing home from riding lessons every Wednesday to catch the latest episodes of Vet School and Vets in Practice, where today’s guest was one of the stars. The student from Bristol School of Veterinary Science became well-known in England as well as other countries. Later, she started her own veterinary clinic in Norway, and now she’s leading the vets in FirstVet. Trude Mostue, welcome.

TRUDE: Thank you very much. That was very impressive, actually. All the things you mentioned, I’d almost forgotten all of it because it’s a long time ago. But I have very nice memories from that time. I spent so much of my career on camera. It was very unusual, but at least I can say that I’ve been working as a veterinarian all these years. Now it’s actually 20 years.

JEANETTE: Now you are the boss of I think 15 vets in FirstVet. What is FirstVet?

TRUDE: This is really exciting, actually, because for so many years I’ve been working in the ordinary veterinary practices – which is very exciting and very nice. You meet people and you see the patients and you do diagnostics and you operate. And I still do that one day a week, but times are changing. I’ve been so lucky to take part in the newest of developments when it comes to what we call telemedicine, which is actually that you can have your veterinarian on your mobile.

So if you have a question or if you’re worried about your pet, let’s say, you’re out in the woods or if you’re in the mountains, on a boat or wherever – I actually did have a patient that called me from a sailboat the other day, and they were worried about their dog. It was vomiting. Maybe it was seasick. They were far away from the vet and they called me on video cam.

This service is actually based on consultations via video cam on your mobile, so I consult my patients by talking to them through a camera. Of course, I can’t check the pet physically, but I can tell a lot by just watching a pet and asking the owners to check different things. Also, they have a lot of questions, and I answer all the questions. Instead of googling, they will very often call us and they will feel reassured afterwards whether they should go to the vet or not.

JEANETTE: What are the most common questions you get and the most common injuries you see?

TRUDE: It’s a lot of first aid situations. For instance, one of the most common things people call me about – and the rest of the team, of course – is injuries to paws, like cuts. They’ve been cutting their paws on glass or different things when they’ve been for a walk. Then I have to talk to them and help guide them through how to clean the wound, how to make sure there’s no glass in the wound, and how to bandage the foot. Then I assess the wounds, whether they need to be stitched or not.

This is a quite cool thing to do because when you’re out there, maybe in the middle of the woods – or maybe you’re just home from a walk – it’s great to have someone to talk to and someone to guide you. So I think that’s the most common thing I see.

JEANETTE: Do you have any general guidelines? I know every injury is different, but what should I do if my dog gets a wound in the paw when I’m out hiking, for instance?

TRUDE: I think on a general basis, I always advise my clients maybe after they talk to me, because they always are missing a lot of equipment, I always think you should carry, wherever you are, a little first aid kit, which could include some bandaging, some antibacterial wash, maybe some scissors and some cotton and so on. I think the most important thing to do if you have a clean cut in the paw, and particularly under the paws, is to flush the wound, maybe just with some sterile saline water to make sure there’s no glass or dirt in the wound.

Once you’ve flushed and cleaned it, I think you need to dry it and then you bandage with cotton between the toes. People very often say they know how to bandage their hand, but the difference between a human hand and a dog paw is of course that they sweat a lot on their paws. So you have to make sure you put a lot of cotton in between the toes, for instance, before you put on the bandage.

So I think the most important thing when it comes to these kind of injuries is for people to think ahead, make sure they have what they need if it should happen. Saline, for instance, or chlorhexidine is excellent. A little bottle of chlorhexidine.

JEANETTE: But if you don’t have this, is it okay to use water?

TRUDE: Of course you can use water and whatever you have. I think the most important thing is to flush it so you don’t get the dirt staying in the wound. Then if you don’t have any bandaging material – which maybe that’s the realistic situation – if you are out in the woods, then maybe just put a sock on. Take your sock off and put the sock on.

What very often happens if you get cuts in those types of areas, you get a lot of bleeding. Some people panic when they see all this blood, but always remember that very little blood looks very, very dramatic, particularly when you have a white dog. [laughs] I have a lot of clients that call and they’re in full panic, full of blood, and saying “oh, there’s blood everywhere!” But actually, it just looks dramatic.

But it’s important to know how to stop the bleeding as well, because they can bleed an awful lot, and then you need to put a pressure bandage on. This is actually quite a simple thing to do, even if you don’t have bandaging material. You can be creative. You put something firm on the top of the wound and put pressure on it, and then you just put a long strip of something. It could still be your poor sock. [laughs] I think everyone should have some spare socks in their rucksack when they’re out for a walk.

And then just tie it really hard, and of course then it will stop bleeding after a little while. So I think that’s the most important thing when it comes to stopping bleeding in the wounds.

JEANETTE: When do you know if the dog is bleeding too much or if this is just normal bleeding, so to speak?

TRUDE: It’s really hard to know whether it’s a normal bleed or not because it really depends where the cut is. Sometimes if you’re unlucky, it’s been cut in a place where you have big blood vessels, and then you will have very dramatic blood loss. But you will know that because the blood is really pumping out.

Regardless of how much or how little, you should try to put a pressure bandage on. A normal dog that doesn’t have any blood diseases that stops the blood from clotting, it should stop bleeding very quickly, within minutes.

JEANETTE: We started talking about legs. When you are active with your dog, accidents can happen, and sometimes dramatic accidents like breaking a leg.

TRUDE: Oh my gosh, yes. That’s a very dramatic accident, and yes, that is a very acute emergency. You obviously have to go and see a veterinary clinic as soon as possible. But the things you can do, and the most important thing to do, is to stabilize the fracture. You probably will have to carry your dog, so I hope you have a Chihuahua and not a Rottweiler. But to stabilize the fracture is really important.

JEANETTE: What do you mean by stabilizing the fracture?

TRUDE: Again, if you’re out and about, you have to take whatever you have – and maybe you have to take two sticks on each side of the leg, and then you wrap a sock again, maybe. [laughs] Again we have to use socks. Maybe you should always wear two pairs of socks in case something happens. And long socks. So use something that you find to tie the sticks around the leg.

But of course, if it’s an open fracture, which is very dramatic, you have to make sure you rinse with some water or whatever you have accessible first, and then try to – I’m saying bandaging, but if you don’t have any bandage, then use whatever you have. A t-shirt, rip the t-shirt apart, and okay, you have to walk home in your bra, but never mind. [laughs]

JEANETTE: Most important is the dog.

TRUDE: Most important is the dog. So the most important point is to stabilize the fracture so it’s not getting worse by the time you reach the veterinarian.

JEANETTE: Other dramatic accidents could be choking, if your dog gets something in their throat.

TRUDE: Choking is actually not such a common acute emergency as you would think it is, but I have come across it a couple of times in my career. Personally, it was a quite dramatic experience because I was quite new in the profession. It was a dog that swallowed a little rubber ball. Those kind of things are quite dangerous when you’re playing with your dog and you let it play with small rubber balls because they get stuck in the back of the throat.

At this particular incident, the dog showed the typical symptoms of going a little bit blue. The tongue went blue. The dog was really stressed. It was not able to breathe, and it was just standing there looking really desperate.

The way you should handle a situation like this – and remember, differentiate between if it’s coughing and the airways are open – but you have to aim for open airways. You can actually practice the Heimlich maneuver on dogs.

JEANETTE: How do you do that on a dog?

TRUDE: The challenge we have in the veterinary world and in the dog world is obviously that we have very small dogs and we have very big dogs, like the Great Dane and the Chihuahua. They’re two quite different approaches.

With the very small dogs, you just have to lift them up, put them halfway upside down, and push their chest from the side.

JEANETTE: How rough can you be when you do this? Because I know with myself, I would be a bit scared to injure the dog.

TRUDE: It’s really hard to say because, again, it really depends. On a Chihuahua, of course you have to be a little bit more careful than you have to be with a German shepherd. You need to see some form of effect. You have to see that their chest is actually moving. The chest actually can take quite a lot of pressure. I can show you, but it’s difficult to explain in this type of format.

JEANETTE: I’m not quite done with the paws yet, because something that happens quite often is also that the dog may lose a claw or injure a claw.

TRUDE: Very common problem, you’re absolutely right. Of course, dogs walk around everywhere and they run around and they twist around, and one of the other most common problems we have is ruptured claws, fractured claws, or they actually manage to pull off the cover of the claw, so the nerve and the blood vessels are bare, which is quite dramatic. It doesn’t bleed so much, but it’s actually very, very painful.

What you always should do if you have an acute lame dog is to go through the claws. If he has just a partial fracture of the claw, it’s very painful. Sometimes you can see the claw is in a different angle. It’s not like a massive emergency, but it’s really painful, and the dog will be lame.

What I would say to that is that if the claw has broken, if it has a really big fracture in it, or if the capsule is off, then you have to come and see us. But you can put a bandage on so it doesn’t hurt so much in the meantime. To learn how to put a proper bandage on your dog’s leg is very important.

JEANETTE: It’s not always easy to see that something is wrong with your dog, but one thing that’s quite easy to see is if it’s vomiting or having diarrhea. What can you do if that happens?

TRUDE: Two of my favorite symptoms. [laughs] It’s the most common symptoms you will see in your dog in all of its life, really, because dogs do vomit and they do have diarrhea because of their feeding habits. They will eat anything. Well, my dog does, anyway, and it does induce vomit.

The most important thing is really to understand when your dog is vomiting and when it has diarrhea because it has eaten or stolen a piece of pizza – because that does happen – or when it is caused by something you should worry about.

I would say two things. The most important thing to look for is how is your dog in itself? Is there blood in the vomit and the diarrhea, and particularly the diarrhea? If we just talk about the diarrhea in itself, I have a lot of people sending me photographs of diarrhea, which is very nice.

JEANETTE: Lovely. [laughs]

TRUDE: It’s lovely, particularly if I’ve just had my dinner. [laughs] So I’m very used to assessing photographs of diarrhea. We can laugh, but there’s actually quite a lot of information to read from a photograph of diarrhea, or just to ask questions around the diarrhea, because that tells me quite a lot.

Let’s say you have a dog that is well in itself, it’s jumping around, it vomits a couple of times, and then he runs out again, and then he goes out to have liquid diarrhea. Then he comes running back in again and he wants to play. Then I would probably say it’s okay. He’s probably eaten something that doesn’t agree with his gastrointestinal tract. If it continues to be well in itself and it doesn’t seem affected and he still has diarrhea, I would still say that’s probably just something he has eaten.

But if he should start to be a little more sleepy, more fatigued, not interested in food, and maybe the diarrhea goes from just being soft to watery and maybe bloody diarrhea, and then he starts to vomit more and more, and maybe there’s blood in the vomit as well, then there’s reason to be worried.

Let’s go back to what you can actually do yourself. The situation you don’t need to be worried about, when the dog is bright and happy in itself, playing around, and he vomits and he has a little bit of diarrhea, but it’s still very happy and eating and everything – the way to handle that is actually to starve it for 24 hours and then swap the normal food with something easily digestible, like white fish and rice or chicken and rice. Dogs love that, normally. This is just to restart their stomach lining and the intestines. It’s to give it a break from whatever the dog has eaten.

JEANETTE: Should the chicken or the fish be raw or cooked?

TRUDE